scholarly journals Prospective comparison of sinonasal outcomes after microscopic sublabial or endoscopic endonasal transsphenoidal surgery for nonfunctioning pituitary adenomas

2016 ◽  
Vol 125 (2) ◽  
pp. 323-333 ◽  
Author(s):  
Carrie L. Pledger ◽  
Mohamed A. Elzoghby ◽  
Edward H. Oldfield ◽  
Spencer C. Payne ◽  
John A. Jane

OBJECT Both endoscopic and microscopic transsphenoidal approaches are accepted techniques for the resection of pituitary adenomas. Although studies have explored patient outcomes for each technique individually, none have prospectively compared sinonasal and quality of life outcomes in a concurrent series of patients at the same institution, as has been done in the present study. METHODS Patients with nonfunctioning adenomas undergoing transsphenoidal surgery were assessed for sinonasal function, quality of life, and pain using the Sino-Nasal Outcome Test-20 (SNOT-20), the short form of the Nasal Obstruction Symptom Evaluation (NOSE) instrument, the SF-36, and a headache scale. Eighty-two patients undergoing either endoscopic (47 patients) or microscopic (35 patients) surgery were surveyed preoperatively and at 24–48 hours, 2 weeks, 4 weeks, 8 weeks, and 1 year after surgery. RESULTS Patients who underwent endoscopic and microscopic transsphenoidal surgery experienced a similar recovery pattern, showing an initial increase in symptoms during the first 2 weeks, followed by a return to baseline by 4 weeks and improvement beyond baseline functioning by 8 weeks. Patients who underwent endoscopic surgery experienced better sinonasal outcomes at 24–48 hours (SNOT total p = 0.015, SNOT rhinologic subscale [ssRhino] p < 0.001), 2 weeks (NOSE p = 0.013), and 8 weeks (SNOT total p = 0.032 and SNOT ssRhino p = 0.035). By 1 year after surgery, no significant differences in sinonasal outcomes were observed between the 2 groups. Headache scales at 1 year improved in all dimensions except duration for both groups (total result 73%, p = 0.004; severity 46%, p < 0.001; frequency 53%, p < 0.001), with 80% of either microscopic or endoscopic patients experiencing improvement or resolution of headache symptoms. Endoscopic and microscopic patients experienced reduced vitality preoperatively compared with US population norms and remained low postoperatively. By 8 weeks after surgery, both groups experienced significant improvements in mental health (13%, p = 0.005) and vitality (15%, p = 0.037). By 1 year after surgery, patients improved significantly in mental health (14%, p = 0.03), role physical (14%, p = 0.036), social functioning (16%, p = 0.009), vitality (22%, p = 0.002), and SF-36 total (10%, p = 0.024) as compared with preoperative measures. There were no significant differences at any time point between the 2 groups for the total SF-36 or for any of the 8 subscales. CONCLUSIONS Patients who underwent either an endoscopic or a microscopic approach experienced the greatest nasal symptoms at 2 weeks postoperatively and exhibited similar time courses of recovery in nasal, headache, and quality of life assessments. Although patients who underwent endoscopic surgery experienced significantly fewer nasal symptoms during the first 8 weeks, by 1 year after surgery, there were no significant differences between the 2 groups.

2009 ◽  
Vol 35 (5) ◽  
pp. 436-441 ◽  
Author(s):  
Maria Penha Uchoa Sales ◽  
Maria Irenilza Oliveira ◽  
Isabela Melo Mattos ◽  
Cyntia Maria Sampaio Viana ◽  
Eanes Delgado Barros Pereira

OBJECTIVE: To evaluate changes in health-related quality of life (HRQoL) after twelve months of smoking cessation. METHODS: This was a prospective study to evaluate the effectiveness of a smoking cessation program on the quality of life of 60 self-referred subjects, at a public hospital, during the period of August 2006 to December 2007. The program consisted of 2-h group sessions once a week during the first month and then every 15 days over six months, followed by monthly phone contacts for another six months. The treatment was based on behavior modification and the use of bupropion in combination with nicotinic replacement therapy. Abstinence was verified by exhaled CO measurements. Patient HRQoL was quantified using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) questionnaire. Differences in quality of life scores between quitters and non-quitters at twelve months after the initial intervention were evaluated using analysis of covariance with baseline characteristics as covariates. RESULTS: Self-reported quality of life scores were significantly higher among the 40 quitters than among the 20 non-quitters. The following SF-36 domains were most affected: role-emotional (p = 0.008); general health (p = 0.006); vitality (p < 0.001); and mental health (p = 0.002). At twelve months after the smoking cessation intervention, the SF-36 mental component and physical component summary scores were higher among quitters than among non-quitters (p = 0.004 and p = 0.001, respectively). CONCLUSIONS: Our findings illustrate that smoking abstinence is related to better HRQoL, especially in aspects of mental health.


2016 ◽  
Vol 124 (6) ◽  
pp. 1627-1633 ◽  
Author(s):  
Amparo Wolf ◽  
Sandy Goncalves ◽  
Fateme Salehi ◽  
Jeff Bird ◽  
Paul Cooper ◽  
...  

OBJECT The relationship between headaches, pituitary adenomas, and surgical treatment of pituitary adenomas remains unclear. The authors assessed the severity and predictors of self-reported headaches in patients referred for surgery of pituitary adenomas and evaluated the impact of endoscopic transsphenoidal surgery on headache severity and quality of life (QOL). METHODS In this prospective study, 79 patients with pituitary adenomas underwent endoscopic transsphenoidal resection and completed the Headache Impact Test (HIT-6) and the 36-Item Short Form Health Survey (SF-36) QOL questionnaire preoperatively and at 6 weeks and 6 months postoperatively. RESULTS Preoperatively, 49.4% of patients had mild headache severity, 13.9% had moderate severity, 13.9% had substantial severity, and 22.8% had intense severity. Younger age and hormone-producing tumors predisposed greater headache severity, while tumor volume, suprasellar extension, chiasmal compression, and cavernous sinus invasion of the pituitary tumors did not. Preoperative headache severity was found to be significantly associated with reduced scores across all SF-36 QOL dimensions and most significantly associated with mental health. By 6 months postoperatively, headache severity was reduced in a significant proportion of patients. Of the 40 patients with headaches causing an impact on daily living (moderate, substantial, or intense headache), 70% had improvement of at least 1 category on HIT-6 by 6 months postoperatively, while headache worsened in 7.6% of patients. The best predictors of headache response to surgery included younger age, poor preoperative SF-36 mental health score, and hormone-producing microadenoma. CONCLUSIONS The results of this study confirm that surgery can significantly improve headaches in patients with pituitary adenomas by 6 months postoperatively, particularly in younger patients whose preoperative QOL is impacted. A larger multicenter study is underway to evaluate the long-term effect of surgery on headaches in this patient group.


2012 ◽  
Vol 20 (2) ◽  
pp. 346-353 ◽  
Author(s):  
Lígia da Silva Leroy ◽  
Maria Helena Baena de Moraes Lopes

This case-control study evaluated whether UI in the puerperium compromises the health-related quality of life (HRQoL) and if so, in which aspects. The study included 344 women (77 case group and 267 control group) up to 90 days postpartum, who were attended the Obstetrics Outpatient Clinic of a public teaching hospital, for the postpartum follow up consultation. A socio-demographic and clinical data questionnaire formulated and validated for the study, the International Consultation on Incontinence Questionnaire - Short-Form (ICIQ-SF), the King's Health Questionnaire (KHQ) and the Medical Outcomes Study 36 - Item Short Form Health Survey (SF-36), were applied. The mean score of the ICIQ-SF was 13.9 (SD: 3.7). The case group presented high mean scores in the domains Impact of the Incontinence, Emotions, Daily Activity Limitations and Physical Limitations, of the KHQ. The groups differed significantly in the domains Physical Aspects, Pain, General Health Status, Vitality, Social Aspects and Mental Health of the SF-36. It is concluded that UI significantly affects the physical and mental health of puerperae.


2017 ◽  
Vol 36 (4) ◽  
pp. 332-340 ◽  
Author(s):  
Luciano Magalhães Vitorino ◽  
Renata de Castro e Santos Soares ◽  
Ana Eliza Oliveira Santos ◽  
Alessandra Lamas Granero Lucchetti ◽  
Jonas Preposi Cruz ◽  
...  

Background: Studies have shown that spiritual/religious beliefs are associated with mental health and health-related quality of life (HRQoL). However, few studies evaluated how spiritual/religious coping (SRC) could affect hemodialysis patients. Objectives: The present study investigated the role of SRC behaviors on HRQoL and depressive symptoms in hemodialysis patients. Design and Participants: This was cross-sectional study with 184 patients. Patients completed the Beck Depression Inventory, Brief SRC Scale, Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and a Sociodemographic and Health Characterization Questionnaire. Results: From 218 patients, 184 (84.4%) were included (53.8% male with a median age of 55.9 years). Negative SRC, but not positive SRC, was associated with depressive symptoms. Positive SRC presented significant effects in SF-36 pain and physical and social functioning. On the other hand, negative SRC exhibited significant effects in SF-36 role emotional, energy/fatigue, pain, and physical functioning. Conclusion: SRC influences the mental health and HRQoL in Brazilian hemodialysis patients in two distinct ways. If used positively, it may have positive outcomes. However, if used negatively, it may lead to dysfunctional consequences such as greater depressive symptomatology and affect HRQoL. Health professionals must be aware of these “two sides of the same coin.”


Author(s):  
DeJesus BM ◽  

Aim: To evaluate how incorporating dance practice into the lifestyle can impact the Quality of Life (QOL) of People with Disabilities (PWD) over four years. Method: This is a prospective study with dance protocol classes specific for PWD, once a week, 60 min per class, over four years. In addition, the participants performed public presentations each year. Participants were assessed twice per year (at the beginning and at the end of each year of dance practice), totalizing 8 assessments, using the Medical Outcomes Study Survey Short Form 36 (SF- 36) questionnaire. Results: Forty-one PWD with different clinical conditions, both sexes, ranging in age from 3 to 39 years, participated in the study over four years (Y1 to Y4). With regard to QOL domains in the SF-36, significant changes were found when comparing the years (two-way ANOVA (F=19.87; p <0.0001)). Values increased in the following QOL domains: Year I: functional capacity, physical aspects, emotional aspects, vitality, pain and mental health. Year II: physical and emotional aspects, pain and mental health. Year III: functional capacity, physical and emotional aspects, vitality, general health, pain and mental health. In Year IV the values increased in all domains. Interpretation: Over the course of four years, dance practice contributed to the QOL of participants; this suggests that it is an activity that promotes inclusion for PWD in the sociocultural arena.


2009 ◽  
Vol 37 (2) ◽  
pp. 296-304 ◽  
Author(s):  
FREDERICK WOLFE ◽  
KALEB MICHAUD ◽  
TRACY LI ◽  
ROBERT S. KATZ

Objective. The Medical Outcomes Study Short-form 36 (SF-36) provides numerical measurement of patient health, but does not include preferences for health states and cannot be used directly in cost-effectiveness analyses. By contrast the Euroqol EQ-5D can be used for cost-effectiveness analyses. The EQ-5D has rarely been used in systemic lupus erythematosus (SLE). We compared SF-36 and EQ-5D values across rheumatic diseases.Methods. We studied 1316 patients with SLE, 13,722 with rheumatoid arthritis (RA), 3623 with non-inflammatory rheumatic disorders (NIRD), and 2733 with fibromyalgia (FM).Results. The mean EQ-5D, physical (PCS) and mental (MCS) component summary scores were 0.72, 36.3, and 44.3, respectively, in SLE. There was essentially no difference among EQ-5D and PCS scores for patients with SLE, RA, or NIRD. MCS was lower in SLE compared with RA and NIRD (44.3, 49.1, 50.8, respectively). All scores were more abnormal in FM (0.61, 31.9, 41.9). Within SF-36 domains, physical function was better, but general health, vitality, social function, role-emotional, and mental health were more impaired in SLE compared with RA and NIRD. In SLE, quality of life (QOL) was predicted by damage, comorbidity, income, education, and age. Fifteen percent of patients with SLE were very satisfied with their health, and their QOL scores (0.84, 45.4, 50.1) were similar to those found in the US population for EQ-5D and MCS, but were slightly reduced for PCS.Conclusion. EQ-5D and PCS are at the same levels in SLE as in RA and NIRD, but are more abnormal in SLE in the MCS and mental health domains. EQ-5D values allow preference-based comparisons with other chronic conditions.


2018 ◽  
Vol 17 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Junho Ahn ◽  
Michael A. Del Core ◽  
Dane K. Wukich ◽  
George T. Liu ◽  
Trapper Lalli ◽  
...  

The aim of this study was to examine if using orthogonal and oblique factor analysis detect changes in health-related quality of life differently in diabetic patients on the Short Form-36 (SF-36) survey. A total of 155 patients had diabetic foot complications (DFC), and 145 patients had no DFCs. The SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were calculated using scoring coefficients determined by orthogonal and oblique rotation principle component analyses of the subscales. The DFC group had lower orthogonal ( P < .00001) and oblique PCS scores ( P < .00001). However, despite lower Mental Health subscale scores in the patients with DFCs, orthogonal MCS scores ( P = .156) did not differ. In contrast, the oblique MCS scores reflected the difference in the Mental Health subscale ( P = .0005). Orthogonal and oblique PCS scores did not differ significantly. However, orthogonal MCS scores were significantly higher than oblique MCS scores in those with DFCs ( P = .0004) and without DFCs ( P = .005). The shorter, 12-item SF-12 survey demonstrated similar results. Poorer physical function leads to higher orthogonal MCS scores than if determined by oblique scoring coefficients since Physical Function, Bodily Pain, and General Health are weighted more negatively in orthogonal coefficients when calculating the MCS score. Oblique scoring coefficients may address this issue, but further study is necessary to confirm whether oblique MCS scores accurately represent the mental health of patients with diabetic foot disease.


2018 ◽  
pp. 130-134
Author(s):  
V. S. Petrov

The article presents the results of a study of the quality of life in 102 non-surgically treated patients with chronic rheumatic heart disease (CRHD) over 5 years. The authors used questionnaires to assess the quality of life: the Short Form Medical Outcomes Study (SF-36), the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Minnesota Living with Heart Failure Questionnaire (MHFLQ). During 5-year follow-up, a statistically significant decrease in the total index of SF-36 physical health component from 36.39 ± 0.54 to 34.04 ± 0.74 and the functional status KCCQ from 23.14 ± 0.56 to 21.2 ± 0.58 was recorded against a 18.6 meters decrease in 6 minute walk distance, an increase in dyspnoea according to a visual analogue scale, a 0.1 cm2 decrease in the mitral orifice area and an increase in the atrium size. According to the summary of the SF-36 mental health component, the total clinical KCCQ indicator, and according to MHFLQ data, no statistically significant changes were observed. Two summary indicators of the KCCQ questionnaire had a significant correlation with SF-36: the functional KCCQ status correlated with the physical (correlation coefficient 0.689) and SF-36 mental (correlation coefficient 0.365) health components. The overall clinical KCCQ indicator also correlated with the SF-36 physical (correlation coefficient 0.305) and mental health – 38.65 ± 0.73 (correlation coefficient 0.588) components. Thus, SF-36 and KCCQ proved to be the most appropriate questionnaires to assess the quality of life of patients with CRDS.


2020 ◽  
Vol 77 (2) ◽  
pp. 158-164
Author(s):  
Branka Gvozdic ◽  
Dragica Milenkovic-Petronic ◽  
Nebojsa Ladjevic ◽  
Aleksandar Vuksanovic ◽  
Otas Durutovic

Background/Aim. Urolithiasis is one of the most common urological illnesses with a continual rise in incidence and prevalence in the population. Its pathogenesis is multifactorial; hence, its consequences are serious problems that can significantly impact the quality of life of patients. In the last years, operational modes of urolithiasis treatment had undergone evolution changes towards minimally invasive treatment techniques aimed at improving its efficacy and patients' life quality. The aim of the study was to examine and evaluate the quality of life of the patients with urolithiasis depending on the applied treatment method. Methods. This research was designed as a panel study ? a combination of a cross-sectional and cohort study. The sample included patients with urolithiasis treated with extracorporeal shock wave lithotripsy (ESWL) or ureteroscopic lithotripsy (Lithoclast). The research was carried during one year period and 100 respondents met the inclusion criteria. They were divided into two equal groups considering the applied method of the stone disintegration: the Lithoclast group (URSL) and the ESWL group. The instrument used for measuring the quality of life was Short Form (SF) 36 questionnaire. It was administrated to the patients immediately before the operation and one month after the operation. Results. The statistical analysis of the scores obtained preoperationally on the SF 36 questionnaire revealed the decrease in the quality of life of patients with urolithiasis in almost all dimensions of life. The statistically relevant difference in preoperative SF scores between the two groups of patients was not established except in the domain of the role of physical health and the domain of mental health. In the domain of the role of physical health, the Lithoclast group had a statistically significant higher score than the ESWL group, but in the domain of mental health, the ESWL group had a statistically significant higher score than the Lithoclast group. The postoperative statistical analysis of SF questionnaire and the examination of the impact of the treatment mode on the quality of life showed that the use of the Lithoclast method resulted in the much higher, statistically significant score at SF36 questionnaires regarding several life dimensions than the ESWL method. The application of the ESWL method even resulted in the decrease in the postoperational score for some life dimensions. Conclusion. The assessment of the quality of life is an adequate tool for the evaluation of treatment modes in the clinical practice. By using the SF 36 questionnaire in this study, we established that the ureteroscopic lithotripsy (the Lithoclast method) is a method that postoperatively results in much higher and statistically significant improvement of the quality of life of patients with urolithiasis in several health domains than the ESWL method.


2021 ◽  
Vol 10 (9) ◽  
pp. 1879
Author(s):  
Karol Piotr Sagan ◽  
Elżbieta Andrysiak-Mamos ◽  
Ernest Tyburski ◽  
Leszek Michał Sagan ◽  
Anhelli Syrenicz

Objective: To determine the effect of transsphenoidal surgery on quality of life and sleep in patients with pituitary adenomas depending on tumor type and compression of the optic chiasm. Methods: In this prospective study, patients with pituitary adenomas who were scheduled for transsphenoidal surgery completed the Short Form 36 Questionnaire, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale preoperatively and 7.5 (±1.5) months after surgery. Patients were analyzed based on tumor type and compression of the optic chiasm. Results: Significant improvements with large effect sizes were seen for patients with Cushing’s disease in general health (Z = −2.37; p = 0.018), vitality (Z = −2.05; p = 0.041), and mental health (Z = −2.06; p = 0.040). A significant deterioration with large effect size occurred in physical functioning (Z = −2.02; p = 0.043) in patients with acromegaly. A significant improvement with medium effect size was seen in subjective sleep quality, (Z = −2.24; p = 0.025), sleep duration (Z = −2.11; p = 0.035), and habitual sleep efficiency (Z = −2.26; p = 0.024) after decompression of the optic chiasm. Multiple significant correlations were observed between sleep parameters and Short Form 36 subscales before and after treatment. Conclusions: Changes in quality of life during the follow-up period depend on tumor type. Circadian rhythm disturbances may resolve promptly after decompression of the optic chiasm. Quality of life in pituitary adenoma patients is associated with quality of sleep in many dimensions, thus implying that developing strategies to improve sleep quality could increase overall well-being and everyday functioning in pituitary adenoma patients.


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