scholarly journals Vasomotor Dysfunction in Patients with Ischemia and Non-Obstructive Coronary Artery Disease: Current Diagnostic and Therapeutic Strategies

Biomedicines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1774
Author(s):  
Amr Abouelnour ◽  
Tommaso Gori
Keyword(s):  
Quality Of Life ◽  
Invasive Coronary Angiography ◽  
Obstructive Coronary Artery Disease ◽  
Correct Diagnosis ◽  
Significant Proportion ◽  
Chronic Stable Angina ◽  
Coronary Microvascular Dysfunction ◽  
Repeated Testing ◽  
Objective Evidence

Many patients who present with symptoms or objective evidence of ischemia have no or non-physiologically-significant disease on invasive coronary angiography. The diagnosis of ischemic heart disease is thus often dismissed, and patients receive false reassurance or other diagnoses are pursued. We now know that a significant proportion of these patients have coronary microvascular dysfunction and/or vasospastic disease as the underlying pathophysiology of their clinical presentation. Making the correct diagnosis of such abnormalities is important not only because they impact the quality of life, with recurring symptoms and unnecessary repeated testing, but also because they increase the risk for adverse cardiovascular events. The mainstay of diagnosis remains an invasive comprehensive physiologic assessment, which further allows stratifying these patients into appropriate “endotypes”. It has been shown that tailoring treatment to the patient’s assigned endotype improves symptoms and quality of life. In addition to the conventional drugs used in chronic stable angina, multiple newer agents are being investigated. Moreover, innovative non-pharmacologic and interventional therapies are emerging to provide a bail-out in refractory cases. Many of these novel therapies fail to show consistent benefits, but others show quite promising results.

scholarly journals Intestinal barrier dysfunction in irritable bowel syndrome: a systematic review

2021 ◽  
Vol 14 ◽  
pp. 175628482199358
Author(s):  
Nikita Hanning ◽  
Adam L. Edwinson ◽  
Hannah Ceuleers ◽  
Stephanie A. Peters ◽  
Joris G. De Man ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Barrier Function ◽  
Significant Proportion ◽  
Healthy Controls ◽  
Barrier Dysfunction ◽  
Irritable Bowel

Background and Aim: Irritable bowel syndrome (IBS) is a complex and heterogeneous disorder. Sensory, motor and barrier dysfunctions are the key physiological endophenotypes of IBS. Our aim is to review studies evaluating barrier dysfunction in adults and children with IBS, as well as to link those changes with IBS symptomatology and quality of life. Methods: A comprehensive and systematic review of multiple databases was performed up to March 2020 to identify studies comparing intestinal permeability in IBS patients with healthy controls. Both in vivo and in vitro studies were considered. Results: We identified 66 studies, of which 27 used intestinal probes to quantify barrier function. The prevalence of barrier dysfunction differed between PI-IBS (17–50%), IBS-D (37–62%) and IBS-C (4–25%). At a group level, permeability was increased compared with healthy controls in IBS-D (9/13 studies) and PI-IBS (4/4 studies), but only a minority of IBS-C (2/7 studies) and not in the only IBS-M study. All four studies in children with IBS demonstrated loss of barrier function. A heterogeneous set of tight junction genes were found to be altered in small and large intestines of adults with IBS, but these have not been evaluated in children. Positive associations were identified between barrier dysfunction and bowel disturbances (6/9 studies), abdominal pain (9/13 studies), overall symptom severity (1/6 studies), depression and anxiety (1/1 study) and quality of life (1/4 studies). Fecal slurry or supernatants of IBS patients were found to induce barrier disruption in animal models (5/6 studies). Conclusions: Barrier dysfunction is present in a significant proportion of adult and all pediatric IBS studies, especially in the IBS-D and PI-IBS subtype. The majority of studies indicated a positive association between loss of barrier function and symptoms such as abdominal pain and changes in the bowel function.

scholarly journals Dietary fruits and arthritis

2018 ◽  
Vol 9 (1) ◽  
pp. 70-77 ◽  
Author(s):  
Arpita Basu ◽  
Jace Schell ◽  
R. Hal Scofield
Keyword(s):  
Quality Of Life ◽  
Global Health ◽  
Significant Proportion ◽  
Health Concern

Arthritis is a global health concern affecting a significant proportion of the population and associated with reduced quality of life.

Abstract P322: Health Status of Stable Patients With Obstructive or Non-Obstructive Coronary Artery Disease Compared With Healthy Controls

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Rosanna Tavella ◽  
Natalie Cutri ◽  
John F Beltrame
Keyword(s):  
Quality Of Life ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Obstructive Coronary Artery Disease ◽  
Summary Score ◽  
Healthy Controls ◽  
Sf 36 ◽  
Artery Disease

BACKGROUND. Patients with chest pain and no evidence of obstructive coronary artery disease on angiography (NoCAD) are frequently considered not to have significant pathology and their symptoms trivialized. This study compared the health status of patients with NoCAD, obstructive coronary artery disease (CAD) and healthy subjects. METHOD. Patients undergoing angiography within the preceding 12 months for the investigation of chest pain were categorized as NoCAD or CAD on the basis of the angiographic findings and completed a health-related quality of life instrument, the Short Form-36 (SF-36). These were compared with a ‘healthy control’ group that were randomly selected from the electronic white pages and recruited if they had no self-reported history of cardiovascular disease. Cross sectional comparisons between the three groups were age adjusted and performed using liner regression. RESULTS. As shown in the table below, the healthy controls were significantly younger and therefore comparison of SF36 scores were age adjusted. All SF-36 sub-scales (except for bodily pain) and summary scores (see table ), were significantly lower in the CAD and NoCAD groups compared to the healthy controls. There were no differences in SF-36 scores between NoCAD and CAD. CONCLUSION. Compared with a healthy population, patients with stable CAD and NoCAD have significantly poorer quality of life asF-36. Future management strategies need to address the health outcomes in these patients. Healthy Controls (n = 3168) NoCAD (n = 320) CAD (n = 828) Age 52 ± 15 57 ± 12 * 62 ± 11 # SF-36: Physical Summary Score 49 ± 10 41 ± 11 * 41 ± 11 # SF-36: Mental Summary Score 51 ± 10 46 ± 11 * 46 ± 11 # * p <0.01 for healthy controls vs NoCAD, # p <0.01 for healthy controls vs CAD

Cytomegalovirus Retinitis: Diagnosis and Treatment

1993 ◽  
Vol 4 (6) ◽  
pp. 322-325 ◽  
Author(s):  
Hunter Maclean ◽  
Baljean Dhillon
Keyword(s):  
Quality Of Life ◽  
Correct Diagnosis ◽  
Cytomegalovirus Retinitis ◽  
Morbidity And Mortality ◽  
Diagnosis And Treatment ◽  
Hiv Positive ◽  
Pathogenic Organism

Cytomegalovirus (CMV) is a non-pathogenic organism in the immunocompetent, but is a major cause of morbidity and mortality amongst patients with AIDS, and the retina is the commonest site of infection1. If left untreated, patients with CMVR will develop disease in their second eye and ultimately become blind2. However, with correct diagnosis and treatment useful vision can be maintained in the majority of cases. Fifteen to 20% of patients with AIDS will contract cytomegalovirus retinitis (CMVR)3−7 and this may be the AIDS-defining diagnosis though more commonly it occurs months after the diagnosis of AIDS. Given the increasing number of HIV positive patients and their longer survival, it is likely that CMVR will become an increasingly prevalent condition. In these patients loss of sight from CMVR has devastating consequences in terms of loss of independence and quality of life and therefore ophthalmologists and physicians should be aware of the presenting characteristics of CMVR, be familiar with therapy and its complications, and be able to recognize relapsing infection.

scholarly journals Are the Triptans for Migraine Therapy Worth the Cost?

2000 ◽  
Vol 27 (2) ◽  
pp. 111-115 ◽  
Author(s):  
W.J. Becker
Keyword(s):  
Quality Of Life ◽  
Significant Proportion ◽  
Cost Benefit ◽  
New Drugs ◽  
Major Advance ◽  
Improve Quality ◽  
Migraine Therapy ◽  
The Cost ◽  
Severe Migraine

ABSTRACT:The triptans represent a major advance in migraine therapy but their cost per dose greatly exceeds that of many older treatments. There is evidence that for a significant proportion of migraine patients these new drugs can show a positive cost benefit and also improve quality of life. Cost benefit would be expected to be greatest in patients with more severe migraine attacks.

scholarly journals Hereditary angioedema: an update on causes, manifestations and treatment

2019 ◽  
Vol 80 (7) ◽  
pp. 391-398 ◽  
Author(s):  
Hilary J Longhurst ◽  
Konrad Bork
Keyword(s):  
Quality Of Life ◽  
Hereditary Angioedema ◽  
Genetic Disorder ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Self Administration ◽  
Diagnosis And Management ◽  
Life Threatening ◽  
Short And Long Term

Hereditary angioedema is a rare genetic disorder caused by deficiency of C1 esterase inhibitor (C1-INH) and characterized by recurrent episodes of severe swelling that affect the limbs, face, intestinal tract and airway. Since laryngeal oedema can be life-threatening as a result of asphyxiation, correct diagnosis and management of hereditary angioedema is vital. Hereditary angioedema attacks are mediated by bradykinin, the production of which is regulated by C1-INH. Hereditary angioedema therapy relies on treatment of acute attacks, and short- and long-term prophylaxis. Acute treatment options include C1-INH concentrate, icatibant and ecallantide. Self-administration of treatment is recommended and is associated with increased quality of life of patients with hereditary angioedema. Advances in diagnosis and management have improved the outcomes and quality of life of patients with hereditary angioedema.

Memory During the Presumed Vegetative State: Implications for Patient Quality of Life

2020 ◽  
Vol 29 (4) ◽  
pp. 501-510
Author(s):  
NICOLA TAYLOR ◽  
MACKENZIE GRAHAM ◽  
MARK DELARGY ◽  
LORINA NACI
Keyword(s):  
Quality Of Life ◽  
Clinical Diagnosis ◽  
Life Experiences ◽  
Vegetative State ◽  
Significant Proportion ◽  
Standard Of Care ◽  
Mental Life ◽  
Successful Performance ◽  
Clinical Criteria

AbstractA growing number of studies show that a significant proportion of patients, who meet the clinical criteria for the diagnosis of the vegetative state (VS), demonstrate evidence of covert awareness through successful performance of neuroimaging tasks. Despite these important advances, the day-to-day life experiences of any such patient remain unknown. This presents a major challenge for optimizing the patient’s standard of care and quality of life (QoL). We describe a patient who, following emergence from a state of complete behavioral unresponsiveness and a clinical diagnosis of VS, reported rich memories of his experience during this time. This case demonstrates the potential for a sophisticated mental life enabled by preserved memory in a proportion of patients who, similarly, are thought to be unconscious. Therefore, it presents an important opportunity to examine the implications for patient QoL and standard of care, both during the period of presumed unconsciousness and after recovery.

Bone-anchored hearing aids in children and young adults: the Freeman Hospital experience

2010 ◽  
Vol 125 (2) ◽  
pp. 153-157 ◽  
Author(s):  
Y Ramakrishnan ◽  
S Marley ◽  
D Leese ◽  
T Davison ◽  
I J M Johnson
Keyword(s):  
Quality Of Life ◽  
Young Adults ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Adult Population ◽  
Significant Proportion ◽  
Glasgow Benefit Inventory ◽  
Bone Anchored Hearing Aid ◽  
Children And Young Adults

AbstractObjective:To investigate the utilisation of bone-anchored hearing aids and Softband, as well as the effects on quality of life, amongst the paediatric and young adult population of Freeman Hospital, Newcastle Upon Tyne, UK.Method:Retrospective, anonymised, cross-sectional survey using the Glasgow Benefit Inventory and Listening Situation Questionnaire (parent version), administered at least three months following the start of bone-anchored hearing aid or Softband use.Results:One hundred and nine patients were included, of whom syndromic children made up a significant proportion (22 of 109). Patients using bone-anchored hearing aids obtained significant educational and social benefit from their aids. The mean Listening Situation Questionnaire difficulty score was 17 (15 patients), which is below the trigger score of 22+ at which further reassessment and rehabilitation is required. 87% (of 15 patients) did not require further intervention. The overall mean GBI score for the 22 patients (syndromic and non-syndromic) was +29.Conclusion:The use of bone-anchored hearing aids and Softband results in significant improvements in quality of life for children and young adults with hearing impairment. There is significant under-utilisation of bone-anchored hearing aids in children with skull and congenital abnormalities, and we would advocate bone-anchored hearing aid implantation for these patients.

Differences in quality of life between pediatric sickle cell patients who used hydroxyurea and those who did not

2014 ◽  
Vol 27 (6) ◽  
pp. 468-481 ◽  
Author(s):  
Emmanuel Nwenyi ◽  
Joan Leafman ◽  
Kathleen Mathieson ◽  
Nkonye Ezeobah
Keyword(s):  
Quality Of Life ◽  
Regression Analysis ◽  
Sickle Cell ◽  
Significant Proportion ◽  
Cell Disease ◽  
Content Type ◽  
Quality Of Life Inventory ◽  
Parental Marital Status ◽  
Life Inventory

Purpose – The purpose of this paper is to examine the differences in quality of life (QoL) between two groups of pediatric sickle cell patients: those who used hydroxyurea and those who chose not to use the medication to treat sickle cell disease. Design/methodology/approach – The study was a quantitative, non-randomized, cross-sectional, comparative study. In total, 100 children ages seven to 17 participated in the study. Parents of the patients completed a demographic questionnaire while the participants completed the Pediatric Quality of Life Inventory (Peds QoL) and Sickle Cell Disease Quality of Life Inventory (SCD QoL). Findings – The Ped QoL regression analysis revealed that hydroxyurea use and parental marital status accounted for a significant proportion of the variance in Ped QoL. The SCD QoL regression analysis also revealed that hydroxyurea and age accounted for a significant proportion of the variance in SCD QoL. Finally, the regression analysis revealed that SCD, parental marital status, parental income, sex, age, race and number of siblings did not account for a significant proportion of the variance in SCD crises per year. Originality/value – This paper proved a need to study the differences in QoL between those pediatric patients who used hydroxyurea and those who did not use the medication.

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