scholarly journals INSOMNIA CORRECTION WITH SYNTHETIC MELATONIN IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
pp. 8-18
Author(s):  
L.N. Gumenyuk ◽  
E.V. Sarchuk ◽  
N.A. Androshchuk
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Visual Analog Scale ◽  
Severity Index ◽  
Life Assessment ◽  
Analog Scale ◽  
Insomnia Severity Index ◽  
Sf 36 ◽  
Insomnia Severity

One of the features of rheumatoid arthritis, as a multiple-factor disease, is the presence of somnological disorders. The aim of the paper is to study the efficacy of synthetic melatonin in insomnia correction and melatonin effect on clinical parameters and quality of life in patients with rheumatoid arthritis. Materials and Methods. The study involved 89 patients, aged 18–45 years old with verified rheumatoid arthritis. The authors used a questionnaire technique to identify subjective sleep quality, the Insomnia Severity Index; Ritchie index, Visual analog scale; TSQM1.4; MOS SF-36. Results. The use of synthetic melatonin for insomnia correction in patients with rheumatoid arthritis improves the basic sleep characteristics. The most pronounced changes were observed in the following parameters “quality of sleep”, “duration of sleep” and “frequency of nocturnal awakenings”; positive dynamics of the Ritchie index: reduction of morning stiffness, severity of articular and algetic index. High values of treatment persistence can be considered as significant results of the study. In the course of treatment, there was a significant improvement in the indicators of psycho-emotional status, vitality and algia impact on daily activities. There was a tendency towards a decrease in the quality of life assessment due to the reversed insomnia 30 days after the end of therapy. Conclusion. The use of synthetic melatonin in patients with rheumatoid arthritis improves the basic sleeping characteristics, indirectly affects the basic clinical manifestations of the underlying disease and improves the quality of life. At the same time, the therapeutic effect is short-term: the results of dynamic monitoring of the quality of life 30 days after the end of therapy indicated a decrease in both mental and physical components, which was caused by the reversed insomnia and, as a consequence, a general deterioration in the somatic and mental state. Keywords: rheumatoid arthritis, insomnia, synthetic melatonin, treatment. Одной из особенностей ревматоидного артрита как полифакторного с точки зрения характера клинических проявлений заболевания является наличие сомнологических нарушений. Цель – изучение эффективности синтетического мелатонина в коррекции инсомнии и его влияния на клинические показатели и качество жизни больных ревматоидным артритом. Материалы и методы. В исследовании приняли участие 89 больных в возрасте от 18 до 45 лет c верифицированным ревматоидным артритом. В работе использовали анкетную методику выявления субъективных характеристик сна, опросник Insomnia Severity Index; индекс Ричи, Visual analog scale; опросник TSQM1.4; MOS SF-36. Результаты. Применение синтетического мелатонина для коррекции инсомнии у больных ревматоидным артритом позволяет улучшить основные характеристики сна. Наиболее выраженные изменения наблюдались по параметрам «качество сна», «продолжительность сна» и «частота ночных пробуждений»; по показателям индекса Ричи (сокращение продолжительности утренней скованности, выраженности суставного и алгического индекса). Значимым результатом исследования можно считать высокие значения приверженности терапии. На фоне лечения достоверно улучшились показатели психоэмоционального статуса, жизненной активности и влияния алгии на повседневную деятельность. Через 30 дней после завершения терапии регистрировалась тенденция к снижению оценки качества жизни, обусловленному реверсированием инсомнии. Выводы. Применение синтетического мелатонина у больных ревматоидным артритом позволяет улучшить основные характеристики сна, опосредованно влияет на базовые клинические проявления основного заболевания и способствует повышению уровня качества жизни. В то же время терапевтический эффект является краткосрочным: результаты динамического мониторинга качества жизни спустя 30 дней после завершения терапии свидетельствовали о снижении как психического, так и физического компонента, что преимущественно было обусловлено реверсированием инсомнии и, как следствие, общим ухудшением сомато-психического состояния. Ключевые слова: ревматоидный артрит, инсомния, синтетический мелатонин, лечение.

scholarly journals CT-Guided Pulsed Radiofrequency at Different Voltages in the Treatment of Postherpetic Neuralgia

2020 ◽  
Vol 14 ◽  
Author(s):  
Zhenkai Han ◽  
Tao Hong ◽  
Yuanyuan Ding ◽  
Shimeng Wang ◽  
Peng Yao
Keyword(s):  
Quality Of Life ◽  
Visual Analog Scale ◽  
Postherpetic Neuralgia ◽  
Pulsed Radiofrequency ◽  
Analog Scale ◽  
Ct Guided ◽  
Sf 36 ◽  
Group A ◽  
Group B

BackgroundPostherpetic neuralgia (PHN) is a form of long-lasting neuropathic pain that can severely affect patients’ quality of life. Pulsed radiofrequency (PRF) has been proven to be effective in treating PHN, but the optimal radiofrequency parameters are still not well defined. This retrospective study aimed to compare the efficacy and safety of CT-guided PRF at three different voltages for the treatment of PHN patients.MethodsThis study included 109 patients with PHN involving the thoracic dermatome who were treated in the Department of Pain Management of Shengjing Hospital, China Medical University, from January 2017 to May 2019. They were divided into three groups based on the PRF voltage used: group A (45 V), group B (55 V), and group C (65 V). The PRF therapy (voltage 45, 55, and 65 V) was performed in all patients by targeting the thoracic dorsal root ganglion. After surgery, patients were followed at 3 days, 1 month, 3 months, 6 months, and 12 months. Observation at each follow-up included basic patient characteristics, visual analog scale (VAS), 36-Item Short Form Health Survey (SF-36) scores, patient satisfaction, complications, and side effects.ResultsVisual analog scale scores decreased and SF-36 scores increased for all patients in the three groups at each post-operative time point (1, 3, 6, and 12 months; all P < 0.01). Pain relief, improvement in quality of life, and overall satisfaction were more significant for patients in group C than for those in groups A and B at the 3-, 6-, and 12-month follow-ups (all P < 0.05). Patients in group B had lower VAS scores and higher overall satisfaction levels than those in group A (both P < 0.01). A small number of patients from each group (n ≤ 3) experienced mild intraoperative and post-operative complications, which bore no relationship with group assignment (all P > 0.05). At post-operative day 3, patients in group C had skin numbness affecting a larger area than patients in the other two groups (both P < 0.05), but the differences were no longer statistically significant at day 30 after the operation. All patients experienced a drop in numbness area of more than 30% after surgery.ConclusionCompared with PFR at 45 and 55 V, PFR at 65 V had superior efficacy in treating PNH, with a favorable safety profile.

scholarly journals AB0881-HPR EVALUATION OF NURSING CARE PLANS FOR RHEUMATOID ARTHRITIS PATIENTS: NURSING 2.0 PROJECT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1464.1-1464
Author(s):  
L. Lopez Pedraza ◽  
M. Rodero ◽  
G. Candelas ◽  
C. Lajas ◽  
T. Mulero López ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Visual Analog Scale ◽  
Analog Scale ◽  
Research Support ◽  
Face To Face ◽  
Care Plans ◽  
Baseline Visit

Background:A better quality of care for chronic patients is only obtainable through multidisciplinary teams. In recent years, rheumatology nurses have been involved in the remote monitoring of aged Rheumatoid Arthritis (RA) patients, as their high levels of multi-morbidity and disability make routine contacts too complex for patients and caregivers. Nursing health care should be evidence-based and organized to optimize the professionals’ time.Objectives:To develop a pilot study of two Nursing Care Plans (NCP) in Rheumatology consultations for Rheumatoid arthritis patients, exploring the satisfaction, disease activity, adherence and quality of life of the patients.Methods:This is a non-randomised interventional study. All the stablished RA patients attending our clinics were offered one of the care plans, based on clinic characteristics, functional status, social needs, social support, preferences and health literacy. They are focused on three fundamental axes: adaptation, adherence and safety of the patient. We evaluated the two NCP that were created: (1) Elderly established RA face to face/phone visit, (2) Active young established RA face to face/phone visit. The study included a first baseline visit and a second visit at six months. Outcomes were adherence to treatment: using the Morisky Green questionnaire, disease activity; through the erythrocyte sedimentation rate (ESR), patient satisfaction; using the LOPSS questionnaire and quality of life: using the EUROQOL 5D questionnaire, Visual analog scale of the attention received and Visual analog scale of the care received. Final visit were compared to baseline visit in both groups. The paired Wilcoxon or McNemar test were used.Results:We included 48 patients, 16 from the NCP 1 and 32 from the NCP 2. All patients except one from the NCP 2 were followed-up and ended the study. The mean age of the participants was 56 years. 77.5% were women. 30.6% had an active smoking habit. 46% had universitary studies. 53.1 had an active labor situation. Regarding the main outcomes: a)Disease activity, a slight decrease in activity was observed between baseline and 6 months, but without statistically significant differences. b) Quality of life, we detected some improvement in all care plans in the EQ-index and in the Visual analog scale (VAE) but there were no statistically significant variations. c) Therapeutic adherence, we show the results in the Morinsky Green questionnaire. We obtained statistical significant decrease in the percentage of patients that forgot to take their prescribed medications after 6 months (p=0.04), and we also saw an increase in the percentage of patients taking medications at established times (up to 100% in all groups). d) Patient satisfaction with NCP obtained at the end of study, we used the LOPPS questionnaire. We obtained at six months a punctuation less than 1.5 (ordinal scale that 1 is good 5 is bad). e) Satisfaction of the care received by patients over the phone assessed at the end of study, it was almost 100%, being 75% of the patients scores 9 or over. f) Satisfaction with the care plans assessed at the end of study, the score given by patients was almost 90%, being 75% of the patients scores 8 or over.Conclusion:After applying the NCP in both groups, we found positive results after 6 months and mainly regarding the therapeutic adherence. The program was well evaluated by the patients in terms of satisfaction of the care provided.References:[1]Garner S, Lopatina E, Rankin JA, et al. Nurse-led care for patients with rheumatoid arthritis: A systematic review of the effect on quality of care. J Rheumatol 2017; 44: 757–765.[2]Uthman I, Almoallim H, Buckley CD, et al. Nurse-led care for the management of rheumatoid arthritis: a review of the global literature and proposed strategies for implementation in Africa and the Middle East. Rheumatology International 2020; 1: 3.[3]Bech B, Primdahl J, Van Tubergen A, et al. 2018 update of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis. Ann Rheum Dis 2020; 79: 61–68.Disclosure of Interests:Leticia Lopez Pedraza Grant/research support from: Pfizer, María Rodero Grant/research support from: Pfizer, Gloria Candelas Grant/research support from: Pfizer, Cristina Lajas Grant/research support from: Pfizer, Teresa Mulero López Grant/research support from: Pfizer, Ana María Perez Saez Grant/research support from: Pfizer, Leticia León Grant/research support from: Pfizer, Zulema Rosales Grant/research support from: Pfizer, Benjamin Fernandez Grant/research support from: Pfizer, Lydia Abasolo Grant/research support from: Pfizer, Luis Rodriguez Rodriguez Grant/research support from: Pfizer

scholarly journals Sleep in post-COVID-19 recovery period and its impact on different domains of quality of life

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Samir El Sayed ◽  
Sarah Gomaa ◽  
Doaa Shokry ◽  
Ahmed Kabil ◽  
Ahmed Eissa
Keyword(s):  
Quality Of Life ◽  
Sleep Quality ◽  
Quality Index ◽  
Pittsburgh Sleep Quality Index ◽  
Sleep Problems ◽  
Recovery Period ◽  
Severity Index ◽  
Insomnia Severity Index ◽  
Insomnia Severity

Abstract Background COVID-19 pandemic became a global health problem affecting the life of millions of people all over the world. The effects of this pandemic were not only on the physical and medical aspects but also on the psychological issues including anxiety disorders, depressive manifestations, sleep problems and others. Sleep disorders were very commonly reported during the novel Coronavirus-19 pandemic either in the acute phase of COVID-19 infection or after recovery. These sleep problems might have a drastic burden on the recovered patients’ life. This study aimed to investigate the sleep in the post-Coronavirus-19 period and if has an impact on the different items of patients’ quality of life. This cross-sectional observational study investigated the sleep problems in 500 patients in the post recovery period using Insomnia Severity Index and Pittsburgh sleep quality index (PSQI), their relation to this critical period and their impact on different domains of Quality of Life which was assessed by the SF36 Health Survey. Results Socio-demographic characteristics of 500 post-Coronavirus-19 patients were collected; the insomnia severity index and Pittsburgh sleep quality index evaluated the sleep pattern. The quality of life was investigated using Short Form 36 scale. The study revealed high scores of insomnia severity index (13.01 ± 4.9), Pittsburgh sleep quality index (15.37 ± 4.43), also high scores of different items of scale of quality of life in the studied group. Conclusion Post-COVID-19 sleep disturbances were commonly reported in the recovery period, also these sleep deficits had an impact on the physical and mental aspects of quality of life, so these sleep problems must be managed properly especially in this critical pandemic era.

Targeting the Affective Component of Chronic Pain

Neurosurgery ◽  
2014 ◽  
Vol 74 (6) ◽  
pp. 628-637 ◽  
Author(s):  
Sandra G.J. Boccard ◽  
James J. Fitzgerald ◽  
Erlick A.C. Pereira ◽  
Liz Moir ◽  
Tim J. Van Hartevelt ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Neuropathic Pain ◽  
Visual Analog Scale ◽  
Analog Scale ◽  
Chronic Neuropathic Pain ◽  
Affective Component ◽  
Sf 36 ◽  
Patient Reported

ABSTRACT BACKGROUND: Deep brain stimulation (DBS) has shown considerable promise for relieving nociceptive and neuropathic symptoms of refractory chronic pain. Nevertheless, for some patients, standard DBS for pain remains poorly efficacious. Pain is a multidimensional experience with an affective component: the unpleasantness. The anterior cingulate cortex (ACC) is a structure involved in this affective component, and targeting it may relieve patients' pain. OBJECTIVE: To describe the first case series of ACC DBS to relieve the affective component of chronic neuropathic pain. METHODS: Sixteen patients (13 male and 3 female patients) with neuropathic pain underwent bilateral ACC DBS. The mean age at surgery was 48.7 years (range, 33-63 years). Patient-reported outcome measures were collected before and after surgery using a Visual Analog Scale, SF-36 quality of life survey, McGill Pain Questionnaire, and EQ-5D (EQ-5D and EQ-5D Health State) questionnaires. RESULTS: Fifteen patients (93.3%) transitioned from externalized to fully internalized systems. Eleven patients had data to be analyzed with a mean follow-up of 13.2 months. Post-surgery, the Visual Analog Scale score dropped below 4 for 5 of the patients, with 1 patient free of pain. Highly significant improvement on the EQ-5D was observed (mean, +20.3%; range, +0%-+83%; P = .008). Moreover, statistically significant improvements were observed for the physical functioning and bodily pain domains of the SF-36 quality-of-life survey: mean, +64.7% (range, −8.9%-+276%; P = .015) and mean +39.0% (range, −33.8%-+159%; P = .050), respectively. CONCLUSION: Affective ACC DBS can relieve chronic neuropathic pain refractory to pharmacotherapy and restore quality of life.

scholarly journals Swedish Translation and Validation of the Pediatric Insomnia Severity Index

2019 ◽  
Author(s):  
Charlotte Angelhoff ◽  
Peter Johansson ◽  
Erland Svensson ◽  
Anna Lena Sundell
Keyword(s):  
Quality Of Life ◽  
Structural Equation ◽  
Sleep Onset ◽  
Well Being ◽  
Severity Index ◽  
Swedish Version ◽  
Insomnia Severity Index ◽  
Pediatric Insomnia ◽  
Insomnia Severity

Abstract Background: To increase health and well-being in young children, it is important to acknowledge and promote the child’s sleep behaviour. However, there is a lack of brief, validated sleep screening instruments for children. The aim of this study was to present a Swedish version of the Pediatric Insomnia Severity Index (PISI), analyse the structure, test the validity and reliability of the instrument. Methods: The English version of the PISI was translated into Swedish, translated back into English, and agreed upon before use. Parents of healthy 3- to 10-year-old children filled out the Swedish version of the PISI and the generic health-related quality of life instrument KIDSCREEN-27 two times. Exploratory and confirmatory factor analyses for baseline and test-retest, structural equation modelling, and correlations between the PISI and KIDSCREEN-27 were performed Results: In total, 160 parents filled out baseline questionnaires (test), whereof 100 parents (63%) filled out the follow-up questionnaires (retest). Confirmative factor analysis of the PISI found two correlated factors: sleep onset problems (SOP) and sleep maintenance problems (SMP). The PISI had substantial construct and test-retest reliability. The PISI factors influenced all KIDSCREEN-27 dimensions. Conclusions: The Swedish version of the PISI is applicable for screening sleep problems and is a useful aid in dialogues with families about sleep. It is also relevant in research and for evaluation of treatment. Keywords: Child; Child, Preschool; Health Promotion; Sleep; Translations; Pediatrics; Validation Studies; Quality of Life

scholarly journals POS1455-HPR RELATIONSHIP BETWEEN PSYCHOLOGICAL FACTORS AND MEASURES OF RHEUMATOID ARTHRITIS ACTIVITY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1011.2-1011
Author(s):  
Y. Olyunin ◽  
V. Rybakova ◽  
E. Likhacheva ◽  
E. Nasonov
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Psychological Factors ◽  
Global Assessment ◽  
Activity Level ◽  
Anxiety And Depression ◽  
Tender Joint Count ◽  
Sf 36 ◽  
Patient Reported

Background:The patient-reported outcomes are important components of quantitative methods of rheumatoid arthritis (RA) activity assessment which are used to choose the appropriate drug therapy. The value of these parameters can be significantly affected not only by the inflammatory process, but also by the psychological characteristics of the patient and, in particular, by hardiness [1].Objectives:To study the relationship between psychological factors and signs of RA activity.Methods:Patients with RA who met the EULAR/ACR 2010 criteria, and observed at the V. A. Nasonova Research Institute of Rheumatology were included. Clinical examination was performed including patient global assessment (PGA), physician global assessment (PhGA), pain measurement on a visual analog scale, tender joint count (TJC), swollen joint count (SJC). The functional status was determined by HAQ, the quality of life – by SF-36 EQ-5D, the nature of pain – by painDETECT, the presence of anxiety and depression – by HADS. Patients also completed Hardiness Survey questionnaire to assess hardiness (HDS) and 3 components of the HDS – commitment (CMT), control (CT) and challenge (CLN). Disease activity was evaluated with DAS28, CDAI, and RAPID3. All patients signed informed consent to participate in the study. Analysis of the data was performed using Spearman’s rank test, Fisher exact test, qui-square and t-tests.Results:85 patients with RA were included. There were 69 women and 16 men. Mean age was 56.7±13.1 years, disease duration – 7.6±2.7 years. 72 patients were positive for rheumatoid factor, 75 – for anti-cyclic citrullinated peptide antibody. CDAI showed high activity in 15, moderate – in 37, low – in 30, and remission in 3 patients, DAS 28 – in 10, 55, 12, and 8, and RAPID3 – in 24, 25, 15, and 21, respectively. 24 patients had subclinically or clinically expressed anxiety and 15 –subclinically or clinically expressed depression (≥8 according to HADS). In 31 patients, the painDETECT questionnaire revealed possible or probable neuropathic pain. Mean HDS was 84.8±21.7, CMT – 38.9±9.2, CT – 29.4±8.6, CLN – 17.3±7.1. These values were comparable with the corresponding population data for this age group. There was a significant inverse correlation between HDS and RA activity measures, including SJC, TJC, DAS28 (p<0.05), pain, PGA, PhGA, CDAI, RAPID3, and HAQ (p<0.01). In addition, HDS and all its components positively correlated with quality of life, assessed by SF-36 and EQ-5D (p<0.01). In patients with subclinically and clinically expressed anxiety and depression, HDS, CMT, and CT were significantly lower than in patients without anxiety and depression (p<0.01), while the values of CLN in these groups did not differ significantly.Conclusion:The results of the present study suggest that low HDS may be one of the significant factors determining RA activity level because it does not allow patients to adapt adequately to a stressful situation produced by the disease.References:[1]Maddi SR. Am Psychol. 2008 Sep;63(6):563-4.Disclosure of Interests:None declared

scholarly journals Effectiveness of Tocilizumab after switching from intravenous to subcutaneous formulation in patients with rheumatoid arthritis: A single-centre experience

2021 ◽  
Vol 38 (3) ◽  
pp. 247-256
Author(s):  
Sonja Stojanović ◽  
Bojana Stamenković ◽  
Jovan Nedović ◽  
Ivana Aleksić ◽  
Jovana Cvetković
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Drug Administration ◽  
Joint Destruction ◽  
Drug Formulation ◽  
Life Assessment ◽  
Drug Effectiveness ◽  
Therapeutic Modalities ◽  
Number Of Patients

Nowadays, the appropriate control of rheumatoid arthritis (RA) involves the absence of clinical disease activity, delaying joint destruction as long as possible and adequate quality of life of the affected. With currently available therapeutic modalities, this therapeutic goal can be achieved in a large number of patients. The aim of this research was to determine the effectiveness of an IL-6 blocker (Tocilizumab) in patients with RA in everyday clinical practice. We also analyzed whether a change in the mode of drug administration (switching from intravenous to subcutaneous drug formulation) had an impact on drug effectiveness (using the DAS 28 SE and CDAI indexes) and quality of life of patients with RA (HAQ, Beck Depression Inventory, FACIT F score and SF 36 questionnaire). The study included 53 subjects diagnosed with RA, treated with Tocilizumab. After a six-month use of subcutaneous Tocilizumab, we concluded that the method of drug administration did not have an impact on its effectiveness and on all the examined parameters of quality of life assessment.

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