Long-term quality of life and clinical outcomes in patients with resistant hypertension treated with renal denervation

Pseudomonas aeruginosa is responsible for chronic infection in many bronchiectasis patients but it is not known whether it is associated with worse clinical outcomes independent of the underlying severity of disease.This study analysed data from 2596 bronchiectasis patients included from 10 different bronchiectasis clinical centres across Europe and Israel, with a 5-year follow-up period. Prevalence of P. aeruginosa chronic infection and its independent impact on exacerbations, hospitalisations, quality of life and mortality was assessed.The prevalence of P. aeruginosa chronic infection was 15.0% (n=389). P. aeruginosa was associated with a higher mortality in a univariate analysis (hazard ratio (HR) 2.02; 95% (confidence interval) CI 1.53–2.66; p<0.0001) but an independent impact on mortality was not found in a multivariate analysis (HR 0.98; 95% CI 0.70–1.36; p=0.89). P. aeruginosa was independently associated with increased mortality only in patients with frequent exacerbations (two or more per year) (HR 2.03; 95% CI 1.36–3.03; p=0.001). An independent association with worse quality of life of 7.46 points (95% CI 2.93–12.00; p=0.001) was found in a multivariable linear regression. P. aeruginosa was therefore found to be independently associated with exacerbation frequency, hospital admissions and worse quality of life. Mortality was increased in patients with P. aeruginosa particularly in the presence of frequent exacerbations.

Download Full-text

A Longitudinal Study on the Prevalence and Risk Factors for Depression and Anxiety, Quality of Life, and Clinical Outcomes in Incident Peritoneal Dialysis Patients

Peritoneal Dialysis International ◽

10.3747/pdi.2017.00168 ◽

2019 ◽

Vol 39 (1) ◽

pp. 74-82 ◽

Cited By ~ 9

Author(s):

Maggie M.Y. Mok ◽

Carmen K.M. Liu ◽

Man Fai Lam ◽

Lorraine P. Y. Kwan ◽

Gary C.W. Chan ◽

...

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Peritoneal Dialysis ◽

Clinical Outcomes ◽

World Health ◽

First Year ◽

Depression And Anxiety ◽

Younger Age

Background Starting dialysis is an important life event. The prevalence and evolution of psychological symptoms at commencement of long-term dialysis is unclear. We examined the prevalence of and risk factors for depression and anxiety, and the quality of life (QOL) of incident peritoneal dialysis (PD) patients, and also the change of these parameters in the first year of PD in relation to clinical outcomes under the PD-first policy. Methods All patients commencing long-term PD from March 2011 to April 2015 were asked to complete the Hospital Anxiety and Depression Scale (HADS), World Health Organization Quality of Life-BREF and the Kidney Disease Quality of Life Instrument Short Form questionnaire. Patient demographics and the incidence of hospitalization, peritonitis, exit-site infection, and all-cause mortality were studied. The HADS was repeated after 9 – 12 months. Results A high depression score was present in 39.6% of 191 patients at commencement of PD and was more common in diabetes patients (odds ratio [OR] 2.03, 95% confidence interval [CI] 1.09 – 3.81). A high anxiety score was present in 23.6%, and the risk factors included younger age (OR 0.96 per year, 95% CI 0.94 – 0.99) and diabetes (OR 2.59, 95% CI 1.20 – 5.57). Both high depression and anxiety scores were associated with an inferior QOL, overall and across most QOL domains. Depression and anxiety symptoms did not change in the first year of PD and were not associated with short-term clinical outcomes. Conclusions High depression and anxiety scores were prevalent in incident PD patients where PD-first policy is adopted and were associated with inferior QOL. There was no improvement after 1 year of PD. The impact of strategic interventions targeting patient groups at risk such as those with diabetes or of younger age warrants further investigation.

Download Full-text

Abstract TP378: Long Term Follow Up Telephone Evaluation of Post Stroke Quality of Life is Feasible and Effective

Stroke ◽

10.1161/str.48.suppl_1.tp378 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Renata Miranda ◽

Carla Ledo ◽

Daisa Escobosa ◽

Caren Cristina Giannotti Bizutti ◽

Amanda Ruiz ◽

...

Keyword(s):

Quality Of Life ◽

Data Collection ◽

Clinical Outcomes ◽

Stroke Recurrence ◽

Post Discharge ◽

Phone Calls ◽

Long Term Follow Up

Background: The long-term follow-up of clinical outcomes in patients admitted with acute stroke can identify relevant clinical data in the prevention of stroke recurrence as well as measure the quality of life of such patients. Follow-up after discharge in hospitals without stroke clinics can be a challenge. Therefore we created in our hospital an outcomes measurement nuclei characterized as a data collection center, with the main objective of periodically measuring clinical outcomes and quality of life of patients after hospital discharge.This sector works together with the different clinical specialties in providing information with a focus on outcome indicators, using questionnaires to estimate the parameters of evaluation of health states.Our objective was to describe data obtained from this data collection center evaluating post-discharge quality of life of patients treated in our stroke center 30, 90, 180 days and 01 years after the diagnosis. Methods: The study was conducted from January 2012 to March 2016, at a tertiary, general, private hospital in São Paulo, Brazil. Phone calls using the EuroQol instrument (EQ-5D) to measure quality of life were performed. The modified Rankin scale and a structured questionnaire to identify stroke recurrence, readmissions and medication failures were also applied. Results: We conducted 2184 telephone calls and obtained 1727 (79%) successful contacts. The mean EQ-5D at 30 days was: 0.732 +/-0.558; at 90 days: 0.722 +/- 0.358; at 180 Days: 0.781 +/- 0.326; and at 12 months 0.766 +/-0.349. During the follow-up, 31 patients (2%) died. The main reasons for censuring patients were unsuccessful contact after 3 attempts (51%); outdated registration data (3%) and refusals (9%). Conclusion: In conclusion, monitoring of standardized clinical outcomes after stroke is possible even in private non academic hospitals, allowing the acquisition of quality of care indicators and patient centered outcomes.

Download Full-text

Results of Treatment of Type 3 Acromioclavicular Joint Dislocation with Three Methods

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0013.2921 ◽

2019 ◽

Vol 21 (3) ◽

pp. 167-176

Author(s):

Adam Łazarski ◽

Sylwia Sarzyńska ◽

Sławomir Struzik ◽

Tomasz Jędral ◽

Paweł Łęgosz ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Outcomes ◽

Acromioclavicular Joint ◽

Hook Plate ◽

Fixation Method ◽

Wire Cerclage ◽

Rockwood Type Iii

Background. Rockwood Type III acromioclavicular joint injuries are treated both conservatively and surgically. There is still no consensus on an optimal fixation method. The aim of this study was to evaluate which of the surgical methods used in our Department produces the best outcomes in long-term follow-up. Material and methods. The study involved 27 patients. Wire cerclage was used in 12 patients, 11 patients were operated on by the Ladermann method, and a hook plate was used in 4 patients. The patients were assessed at a late follow-up visit after a mean of 22 months post-operatively. The Constant Shoulder Scale (CSS), Oxford Shoulder Scale (OSS), and PROMIS v1.2 for the upper limb were used to assess the long-term effects of the treatment. Results. There were no statistically significant differences between the Ladermann method and wire cerclage for the scales applied (p=0.98 at α=0.05). The functional CSS showed a significant advantage of the outcomes of the Ladermann method and wire cerclage in comparison to the hook plate (p=0.014 and p=0.004, respectively, at α=0.05). The quality of life scales OSS and PROMIS showed no significant difference between the methods. Conclusions. 1. The outcomes of treatment with the Ladermann method and wire cerclage are excellent and comparable with regard to both clinical outcomes and the quality of life. 2. The use of a hook plate may substantially contribute to worse clinical outcomes. 3. No considerable difference was found in the quality of life between the different groups, but a study involving a larger number of patients would be necessary for a complete evaluation.

Download Full-text

Health-Related Quality of Life After Renal Denervation in Patients With Treatment-Resistant Hypertension

Hypertension ◽

10.1161/hypertensionaha.112.200865 ◽

2012 ◽

Vol 60 (6) ◽

pp. 1479-1484 ◽

Cited By ~ 52

Author(s):

Gavin W. Lambert ◽

Dagmara Hering ◽

Murray D. Esler ◽

Petra Marusic ◽

Elisabeth A. Lambert ◽

...

Keyword(s):

Quality Of Life ◽

Resistant Hypertension ◽

Renal Denervation ◽

Health Related Quality ◽

Treatment Resistant ◽

Related Quality ◽

Health Related

Download Full-text

Su1243 Long-Term Clinical Outcomes Following Surgery in Crohn's Disease Patients on Combination Immunosuppression: Impact of Anastomotic Reconstruction on Quality of Life and Healthcare Utilization

Gastroenterology ◽

10.1016/s0016-5085(13)61610-8 ◽

2013 ◽

Vol 144 (5) ◽

pp. S-437

Author(s):

Daniel Stein ◽

Yelena Zadvornova ◽

Emery C. Lin ◽

Amar S. Naik ◽

Lilani P. Perera ◽

...

Keyword(s):

Quality Of Life ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Clinical Outcomes ◽

Healthcare Utilization

Download Full-text

Thinking Beyond Language: Intervention for Severe Aphasia

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld19.1.15 ◽

2009 ◽

Vol 19 (1) ◽

pp. 15-22 ◽

Cited By ~ 3

Author(s):

Nina Simmons-Mackie

Keyword(s):

Quality Of Life ◽

Communication Training ◽

Language Intervention ◽

Specific Training ◽

Environmental Support ◽

Total Communication ◽

Communication Partners

Abstract Purpose: This article addresses several intervention approaches that aim to improve life for individuals with severe aphasia. Because severe aphasia significantly compromises language, often for the long term, recommended approaches focus on additional domains that affect quality of life. Treatments are discussed that involve increasing participation in personally relevant life situations, enhancing environmental support for communication and participation, and improving communicative confidence. Methods: Interventions that have been suggested in the aphasia literature as particularly appropriate for people with severe aphasia include training in total communication, training of communication partners, and activity specific training. Conclusion: Several intervention approaches can be implemented to enhance life with severe aphasia.

Download Full-text