Fibroid vascularisation assessed with 3D Power Doppler as predictor for fibroid related symptoms and quality of life; a pilot study

Background: Uterine fibroids present differently, from well vascularised up to calcified, with some causing heavy menstrual bleeding (HMB). Objectives: To investigate the association between fibroid vascularisation and HMB, other fibroid related symptoms and quality of life (QOL). Materials and Methods: A single centre pilot study was carried out in the Netherlands. Women with a maximum of two fibroids who chose expectant management were included. 3D sonography including power doppler was performed at baseline and at 3, 6 and 12 months follow up. Women were asked to complete the Pictorial Blood Assessment Chart (PBAC) and Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaires at every visit. Main outcome measure: The association between fibroid vascularisation and HMB. Results: 53 women were included in the study. Baseline fibroid vascularisation, measured as vascular index (VI) is associated with PBAC score; a 1% higher VI at baseline leads to an 11 point increase in PBAC score over time (RC 10.99, p=0.05, 95% CI -0.15 – 22.12). After correction for the baseline variables ethnicity and fibroid type the association becomes stronger (P<0.05). Fibroid volume at baseline and HMB are also associated: a 1 cm3 larger fibroid leads to 0.6 points increase in PBAC score over time (RC 0.56, p=0.03, 95% CI 0.05 – 1.07). Conclusions: This study highlights that both fibroid vascularisation and fibroid volume may be associated with an increase in menstrual blood loss, other fibroid related symptoms and QOL over time. What is new? We used 3D power doppler to predict symptomatic fibroids.

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The association between health-related quality of life and mortality among hemodialysis patients

Medicina ◽

10.3390/medicina46080076 ◽

2010 ◽

Vol 46 (8) ◽

pp. 531 ◽

Cited By ~ 14

Author(s):

Neda Kušleikaitė ◽

Inga Bumblytė ◽

Vytautas Kuzminskis ◽

Rūta Vaičiūnienė

Keyword(s):

Quality Of Life ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Health Related Quality ◽

Point Increase ◽

Related Quality ◽

Health Related ◽

Over Time

Introduction. Mortality rates for patients undergoing maintenance hemodialysis remain high. Published data regarding association between health-related quality of life (HRQOL) and mortality among hemodialysis patients are inconsistent. Very few data are published on the change in HRQOL over time as a predictor of mortality. The aim of this study was to assess whether HRQOL and change of it over time could be considered an independent predictor of mortality in hemodialysis patients. Material and methods. This prospective observational study enrolled 183 patients undergoing maintenance hemodialysis. HRQOL was measured annually 2004–2008 using a generic Short Form 36 questionnaire. Physical component summary (PSC) and mental component summary (MSC) scores were calculated. The change of the patient’s HRQOL over time was calculated as a difference between SF-36 scores of the first and the last HRQOL measurements. Results. The median follow-up was 48 months (range, 1–72 months). Cutoff values for HRQOL predicting mortality for PSC score was ≥35 and for MSC score was ≥45. In the model adjusted for age, sex, dialysis months, creatinine, albumin and hemoglobin levels, mortality risk decreased by 0.96 (95% CI, 0.95–0.99) for 1-point increase in the baseline PSC score and decreased by 0.97 (95% CI, 0.95–0.98) for 1-point increase in the baseline MSC score. A 1-point decline in the PSC score (relative risk, 1.11; 95% CI, 1.008–1.221) and MSC score (relative risk, 1.07; 95% CI, 1.002–1.149) over the period of follow-up were associated with a significant additional increase in mortality. Conclusions. Both baseline HRQOL and decline of HRQOL are independent predictors of mortality in hemodialysis patients.

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Symptom burden, health-related quality of life, and treatment preference over time as reported by patients with metastatic colorectal cancer (mCRC).

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.29_suppl.82 ◽

2015 ◽

Vol 33 (29_suppl) ◽

pp. 82-82

Author(s):

Amy Little Jones ◽

Nrupen Anjan Bhavsar ◽

Amy Pickar Abernethy ◽

Yousuf Zafar

Keyword(s):

Quality Of Life ◽

Pilot Study ◽

Life Expectancy ◽

Symptom Burden ◽

Treatment Preference ◽

Change Over Time ◽

Limited Life Expectancy ◽

Limited Life ◽

Over Time

82 Background: Clinicians have difficulty predicting longitudinal changes in patient symptom burden and quality of life, and then how those changes might affect treatment preference. The primary aim of this pilot study was to investigate how self-reported symptom burden, quality of life, and treatment preference change over time in mCRC patients with limited life expectancy. Methods: Eligible mCRC patients had incurable disease, received chemotherapy at Duke or Duke Raleigh, were > = 18 years old, and spoke English. Patients were surveyed at each clinic visit and followed for up to 3.8 years on study. Measures included FACT-C (Functional Assessment of Cancer Therapy-Colorectal), PCM (Patient Care Monitor; a validated, 87-item review of systems survey; items measured on a 0-10 scale), and QQQ (Quality-Quantity Questionnaire; a validated, 8-item measure of cancer patient preference for quantity vs. quality of life; items measured on a 1-5 Likert scale). Demographic, disease, and treatment data were abstracted from the medical record. Results: The 56 patients were primarily male (68%) and Caucasian (79%) with a mean age of 55 at diagnosis of metastatic disease. Patients answered surveys a mean of 6.8 times each, with a median 364 days between first and last surveys. Over time, patients reported most symptoms improved or stayed the same (72%, n = 63 symptoms). Mean symptom scores that improved the most from first to last survey were fatigue (3.92 to 3.03) and nausea (2.1 to 1.4), while pain (1.9 to 2.5) and cough (0.4 to 0.7) worsened the most. Decision making about treatment preference also did not change over time, with mean QQQ scores from first survey (22, n = 28) to last survey (22, n = 16) remaining stable. Mean QQQ length and quality scores likewise were unchanged (12.9 to 12.8; 12.4 to 12.2 respectively). Conclusions: In this pilot study of mCRC patients with limited life expectancy, reported symptom burden scores remained stable or modestly improved over time, while preferences for quality vs. quantity of life remained stable. These findings suggest that patients with advanced cancer might perceive symptom burden differently over the course of their treatment.

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The effect of participation in a mobility clinic on self-reported mobility and quality of life in people with lower limb amputation: A pilot study

Prosthetics and Orthotics International ◽

10.1177/0309364620921749 ◽

2020 ◽

Vol 44 (4) ◽

pp. 202-207

Author(s):

Sarah Anderson ◽

Emily Ridgewell ◽

Michael Dillon

Keyword(s):

Quality Of Life ◽

Pilot Study ◽

Lower Limb ◽

Mental Component Summary ◽

Significant Proportion ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Mobility Impairment ◽

Over Time

Background: Many people with lower limb amputation experience mobility impairment and reduced quality of life. Mobility clinics are designed to improve mobility and quality of life for people with lower limb amputation, but their effectiveness is unknown. Objectives: To compare changes in mobility prior to, and 12 weeks following participation in mobility clinic for people with lower limb amputation, and to explain whether changes in mobility explained changes in quality of life. To determine whether the PLUS-M™ was sensitive to the effects of participation in the mobility clinic, and to estimate the sample size required for a definitive study. Study design: Longitudinal observational. Methods: Electronic versions of the PLUS-M and SF-36v2® were completed by people living in the community with lower limb amputation prior to, and 12 weeks following participation in a mobility clinic. Results: There was a significant increase in mobility from baseline to 12 weeks post participation in the clinic ( p = 0.012). Changes in mobility explained a significant proportion of variance in the SF-36v2 mental component summary ( p = 0.024) but not the physical component summary ( p = 0.804). Conclusion: For people with lower limb amputation, mobility increased after participation in the clinic and this explained improvements in SF-36v2 mental component summary. The PLUS-M was sensitive enough to detect a change in mobility over time. Clinical relevance This preliminary data indicated that participation in a mobility clinic improved mobility and the mental components of quality of life for people living with lower limb amputation. The PLUS-M™ seems sensitive to changes in mobility as a result of participation in a mobility clinic.

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Health-related quality of life, motivational regulation and Basic Psychological Need Satisfaction in Education Outside the Classroom: an explorative longitudinal pilot study

BMC Public Health ◽

10.1186/s12889-021-12450-9 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Jan Ellinger ◽

Filip Mess ◽

Simon Blaschke ◽

Christoph Mall

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Pilot Study ◽

Psychological Needs ◽

Health Related Quality ◽

Motivational Regulation ◽

Related Quality ◽

Health Related ◽

Over Time

Abstract Background Given a suboptimal state of mental health among children, an urgent need exists to seek approaches related to health promotion in this population’s settings, such as in schools. Increased health-related quality of life (HRQoL) and improved school motivation could be crucial for children’s mental health. Based on self-determination theory, paths can be identified that could lead to such improvements by strengthening the basic psychological needs (BPN). This study aimed to examine the impact on and the relationships among HRQoL, school motivation and BPN within the promising concept of education outside the classroom (EOtC). Methods In this exploratory study, we employed a between-subjects cohort study design with no blinding or randomisation. We surveyed fifth graders (mean = 10.1 years) attending EOtC (experimental group [EG], n = 25) and normal indoor lessons (control group, [CG], n = 41) at the beginning (T1) and end (T2) of a semester. We used the translations of validated questionnaires and established linear mixed-effects models to evaluate whether the students in EOtC show higher scores of HRQoL and school motivation and, whether the satisfaction of BPN of autonomy (PAut), competence (PCom), social relatedness with classmates (PSRC) and teachers (PSRT) show associations with these outcomes. Results Regarding intrinsic and identified motivational regulation, results showed significant increases over time in the overall sample and significant higher scores in the EG than in the CG. For HRQoL, no group differences were found, but a significant decrease over time in the EG. Regarding possible associations between the outcomes and BPN, such could only be found between HRQoL and PSRC, but not for the other BPN and not for motivational regulation and BPN. Conclusions Without having been able to explain this on the basis of increased BPN values, our results show that EOtC can support improvements in specific regulation types of school motivation. This could contribute to an improvement in the mental health situation in children, as school represents a major stressor for them. Future steps in terms of researching HRQoL in this setting are discussed, as this pilot study does preliminary work for necessary examinations, e.g. in structural equation approaches.

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Treatment of Uterine Myoma with 2.5 or 5 mg Mifepristone Daily during 3 Months with 9 Months Posttreatment Followup: Randomized Clinical Trial

ISRN Obstetrics and Gynecology ◽

10.1155/2013/649030 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Josep Lluis Carbonell ◽

Rita Acosta ◽

Yasmirian Pérez ◽

Roberto Garcés ◽

Carlos Sánchez ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Side Effects ◽

Randomized Clinical Trial ◽

Uterine Fibroids ◽

Uterine Myoma ◽

Similar Improvement ◽

End Of Treatment ◽

Fibroid Volume

Objectives. To evaluate the efficacy, safety, and quality of life by using 2.5 and mifepristone 5 mg daily doses to treat uterine fibroids over 3 months with a 9-month followup period. Design. Randomized clinical trial. Place. “Eusebio Hernández” Hospital, Havana, Cuba. Subjects. 220 women with symptomatic uterine fibroids. Treatment. One-half (2.5 mg) or one-whole 5 mg mifepristone tablet. Variables to Evaluate Efficacy. Changes in fibroid and uterine volumes, in symptomatic prevalence and intensity, and in quality of life. Results. After 3-month treatment, fibroid volume decreased by 27.9% (CI 95% 20–35) and 45.5% (CI 95% 37–62), in the 2.5 and 5 mg groups, respectively, P=0.003. There was no difference in the prevalence of symptoms at the end of treatment, unlike after 6- and 9-month followup when there was a difference. Amenorrhea was significantly higher in the 5 mg group, P=0.001. There were no significant differences in mifepristone side effects between the groups. Both groups displayed a similar improvement in quality of life. Conclusions. The 2.5 mg dosage resulted in a lesser reduction in fibroid size but a similar improvement in quality of life when compared to the 5 mg dose. This trial is registered with ClinicalTrials.gov NCT01786226.

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Mental disorder in children with physical conditions: a pilot study

BMJ Open ◽

10.1136/bmjopen-2017-019011 ◽

2018 ◽

Vol 8 (1) ◽

pp. e019011 ◽

Cited By ~ 18

Author(s):

Alexandra Butler ◽

Ryan J Van Lieshout ◽

Ellen Louise Lipman ◽

Harriet L MacMillan ◽

Andrea Gonzalez ◽

...

Keyword(s):

Quality Of Life ◽

Pilot Study ◽

Mental Disorder ◽

Psychosocial Outcomes ◽

Well Being ◽

Retention Rates ◽

Child Quality ◽

Physical Conditions ◽

Over Time

ObjectivesMethodologically, to assess the feasibility of participant recruitment and retention, as well as missing data in studying mental disorder among children newly diagnosed with chronic physical conditions (ie, multimorbidity). Substantively, to examine the prevalence of multimorbidity, identify sociodemographic correlates and model the influence of multimorbidity on changes in child quality of life and parental psychosocial outcomes over a 6-month follow-up.DesignProspective pilot study.SettingTwo children’s tertiary-care hospitals.ParticipantsChildren aged 6–16 years diagnosed in the past 6 months with one of the following: asthma, diabetes, epilepsy, food allergy or juvenile arthritis, and their parents.Outcome measuresResponse, participation and retention rates. Child mental disorder using the Mini International Neuropsychiatric Interview at baseline and 6 months. Child quality of life, parental symptoms of stress, anxiety and depression, and family functioning. All outcomes were parent reported.ResultsResponse, participation and retention rates were 90%, 83% and 88%, respectively. Of the 50 children enrolled in the study, the prevalence of multimorbidity was 58% at baseline and 42% at 6 months. No sociodemographic characteristics were associated with multimorbidity. Multimorbidity at baseline was associated with declines over 6 months in the following quality of life domains: physical well-being, β=−4.82 (–8.47, –1.17); psychological well-being, β=−4.10 (–7.62, –0.58) and school environment, β=−4.17 (–8.18, –0.16). There was no association with parental psychosocial outcomes over time.ConclusionsPreliminary evidence suggests that mental disorder in children with a physical condition is very common and has a negative impact on quality of life over time. Based on the strong response rate and minimal attrition, our approach to study child multimorbidity appears feasible and suggests that multimorbidity is an important concern for families. Methodological and substantive findings from this pilot study have been used to implement a larger, more definitive study of child multimorbidity, which should lead to important clinical implications.

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Changes over time in the quality of life, prolonged grief and family strain of family caregivers of patients in vegetative state: A pilot study

Journal of Health Psychology ◽

10.1177/1359105314539533 ◽

2014 ◽

Vol 21 (5) ◽

pp. 844-852 ◽

Cited By ~ 18

Author(s):

Alessia Bastianelli ◽

Erminio Gius ◽

Sabrina Cipolletta

Keyword(s):

Quality Of Life ◽

Pilot Study ◽

Family Caregivers ◽

Vegetative State ◽

Prolonged Grief ◽

Family Strain ◽

Changes Over Time ◽

Over Time

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Psychological and Cognitive Aspects of Borderline Intellectual Functioning

European Psychologist ◽

10.1027/1016-9040/a000293 ◽

2017 ◽

Vol 22 (3) ◽

pp. 159-166 ◽

Cited By ~ 2

Author(s):

Bastianina Contena ◽

Stefano Taddei

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Intellectual Functioning ◽

Clinical Impact ◽

Review Of The Literature ◽

Borderline Intellectual Functioning ◽

General Quality ◽

Meta Analyses ◽

Over Time

Abstract. Borderline Intellectual Functioning (BIF) refers to a global IQ ranging from 71 to 84, and it represents a condition of clinical attention for its association with other disorders and its influence on the outcomes of treatments and, in general, quality of life and adaptation. Furthermore, its definition has changed over time causing a relevant clinical impact. For this reason, a systematic review of the literature on this topic can promote an understanding of what has been studied, and can differentiate what is currently attributable to BIF from that which cannot be associated with this kind of intellectual functioning. Using Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) criteria, we have conducted a review of the literature about BIF. The results suggest that this condition is still associated with mental retardation, and only a few studies have focused specifically on this condition.

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