QOL

QoL
  • 文章类型: Journal Article
    本研究旨在评估经导管胃化疗栓塞(GTC)联合全身化疗(SYS)与单用SYS治疗吞咽困难的有效性。改善晚期胃贲门癌(AGCC)患者的生活质量(QoL)和营养状况。使用2018年1月至2022年12月经历吞咽困难并单独使用SYS或SYS联合GTC的AGCC连续患者的数据进行回顾性审查。进行倾向评分匹配(PSM)分析以解决潜在的混杂因素。Ogilvie吞咽困难评分用于评估吞咽困难,癌症治疗功能评估-一般7(FACT-G7)用于评估QoL,患者主观综合评估(PG-SGA)用于评价营养状况.PSM之后,共有228名患者被纳入分析,每组114人。在初始治疗后4周和8周,GTC+SYS组的Ogilvie评分中位数显著低于SYS单独组(P<0.001).同样,初始治疗后4周,GTC+SYS组的PG-SGA评分中位数为2.0,单独SYS组为6.0.GTC+SYS组的FACT-G7评分中位数为13.0,而单用SYS组为10.5。这些差异在8周时仍然显著(P<0.001)。总之,在SYS中加入GTC可以更有效和及时地缓解吞咽困难,在出现吞咽困难的AGCC患者中,与单独使用SYS相比,改善营养状况并提高QoL。
    The present study aimed to assess the effectiveness of gastric transcatheter chemoembolization (GTC) combined with systemic chemotherapy (SYS) compared with SYS alone in managing dysphagia, and improving the quality of life (QoL) and nutritional status of patients with advanced gastric cardiac cancer (AGCC). A retrospective review was performed using data from consecutive patients with AGCC who experienced dysphagia and underwent either SYS alone or SYS combined with GTC from January 2018 to December 2022. Propensity score matching (PSM) analysis was performed to address potential confounding factors. Ogilvie dysphagia scores were used to assess dysphagia, the Functional Assessment of Cancer Therapy-General 7 (FACT-G7) was used to assess QoL, and the Patient-Generated Subjective Global Assessment (PG-SGA) was used to evaluate nutritional status. After PSM, a total of 228 patients were included in the analysis, with 114 in each group. At 4 and 8 weeks after the initial treatment, the GTC + SYS group demonstrated significantly lower median Ogilvie scores compared with the SYS alone group (P<0.001). Similarly, the median PG-SGA score at 4 weeks after the initial treatment was 2.0 in the GTC + SYS group and 6.0 in the SYS alone group. The median FACT-G7 scores in the GTC + SYS group was 13.0, compared with 10.5 in the SYS alone group. These differences remained significant at 8 weeks (P<0.001). In conclusion, the addition of GTC to SYS may more effectively and promptly relieve dysphagia, improve nutritional status and enhance QoL compared with SYS alone in patients with AGCC presenting with dysphagia.
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  • 文章类型: Case Reports
    AraiN,吉村M,YamamotoS,AbeH,HanayamaK.慢性疼痛的简单身体图像评估和操作的有效性:一例病例报告。JpnJComprRehabilSci2021;12:15-18。
    我们报告了一个案例,其中使用基于评估结果的新的简单身体图像评估和身体图像处理成功缓解了慢性疼痛。
    病人,一个60多岁的男人,在工作中意外遭受左尺骨干骨折和左手脱套伤。大约2年的职业治疗不能完全缓解无名指疼痛(异常性疼痛),导致换衣服和开车困难。使用绷带比较和操纵左无名指的图像以使两个图像相似。异常性疼痛减少(视觉模拟量表10cm→3.6cm),换衣服和驾驶汽车的能力得到了提高。
    绷带大概改变了触觉和视觉信息输入的大小,体重,长度,厚度,和厚度,并重建了感知运动回路。
    Arai N, Yoshimura M, Yamamoto S, Abe H, Hanayama K. Effectiveness of simple body image evaluation and manipulation for chronic pain: A case report. Jpn J Compr Rehabil Sci 2021; 12: 15-18.
    UNASSIGNED: We report a case in which chronic pain was successfully relieved using a new simple body image evaluation and body image manipulation based on the evaluation results.
    UNASSIGNED: The patient, a man in his 60s, accidentally sustained a left ulnar trunk fracture and left hand degloving injury at work. Occupational therapy for approximately 2 years could not completely relieve pain in the ring finger (allodynia), causing difficulty in changing clothes and driving a car. Images of the left and right ring fingers were compared and manipulated using bandages to make the two images similar. Allodynia was reduced (visual analog scale 10 cm → 3.6 cm), and the ability to change clothes and drive a car improved.
    UNASSIGNED: The bandage presumably changed the tactile and visual information inputs of size, weight, length, thickness, and thickness and reconstructed the perceptual-motor loop.
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  • 文章类型: Case Reports
    心脏收缩力调节(CCM)已被提议用于患有射血分数降低的心力衰竭(HFrEF)的住院患者。有复发性HF症状.我们介绍了一例在急性冠状动脉综合征的情况下接受经皮冠状动脉介入治疗(PCI)的患者,该患者没有持续的ST段抬高,用最好的药物治疗失代偿性HF。患者拒绝植入心脏复律除颤器(ICD),并减少因HF恶化而住院的人数增加,我们建议使用心脏收缩力调节装置。植入后,通过六分钟步行测试(SMWT),患者的运动努力和生活质量(QOL)显着改善,明尼苏达州心力衰竭生活问卷(MLWHFQ),和超声心动图参数。出院后9个月,没有因HF入院的记录.我们通过斑点追踪成像显示了整体纵向应变(GLS)的改善如何与对心肌细胞的重塑影响相关。
    Cardiac Contractility Modulation (CCM) has been proposed for inpatients affected by heart failure with reduced ejection fraction (HFrEF), with relapsing HF symptoms. We present a case of a patient treated with percutaneous coronary intervention (PCI) in the setting of acute coronary syndrome without persistent ST-segment elevation, with the best medical therapy for decompensated HF. The patient refused the implantable cardioverter-defibrillator (ICD), and to reduce the increasing number of hospitalizations for HF exacerbations, we proposed the use of the cardiac contractility modulation device. After the implant, the patient demonstrated a marked improvement in exercise effort and quality of life (QOL) with a six-minute walk test (SMWT), Minnesota Living with Heart Failure Questionnaire (MLWHFQ), and echocardiographic parameters. At 9 months after discharge, no hospital admissions for HF were recorded. We showed with the speckle tracking imaging how the improvement in global longitudinal strain (GLS) correlates with the remodeling effects on myocardial cells.
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  • 文章类型: Journal Article
    BACKGROUND: There is a general agreement on the importance of health-related quality of life (HRQoL). This type of information is becoming increasingly important for the value assessment of health technology assessment agencies in evaluating the benefits of new health technologies, including medicines. However, HRQoL data are often limited, and additional sources that provide this type of information may be helpful.
    OBJECTIVE: We aim to identify the HRQoL topics important to patients with melanoma based on web-based discussions on public social media forums.
    METHODS: We identified 3 public web-based forums from the United States and the United Kingdom, namely the Melanoma Patient Information Page, the Melanoma International Forum, and MacMillan. Their posts were randomly selected and coded using qualitative methods until saturation was reached.
    RESULTS: Of the posts assessed, 36.7% (150/409) of posts on Melanoma International Forum, 45.1% (198/439) on MacMillan, and 35.4% (128/362) on Melanoma Patient Information Page focused on HRQoL. The 2 themes most frequently mentioned were mental health and (un)certainty. The themes were constructed based on underlying and more detailed codes. Codes related to fear, worry and anxiety, uncertainty, and unfavorable effects were the most-often discussed ones.
    CONCLUSIONS: Web-based forums are a valuable source for identifying relevant HRQoL aspects in patients with a given disease. These aspects could be cross-referenced with existing tools and they might improve the content validity of patient-reported outcome measures, including HRQoL questionnaires. In addition, web-based forums may provide health technology assessment agencies with a more holistic understanding of the external aspects affecting patient HRQoL. These aspects might support the value assessment of new health technologies and could therefore help inform topic prioritization as well as the scoping phase before any value assessment.
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  • 文章类型: Journal Article
    OBJECTIVE: Conventional therapy (calcium and activated vitamin D) does not restore calcium homeostasis in patients with chronic hypoparathyroidism (HypoPT) and is associated with renal complications and reduced quality of life (QoL). The aim of this study was to evaluate in a case-control, cross-sectional study, the rate of renal complications and QoL in two sex- and age-matched cohort of patients with differentiated thyroid cancer with (n = 89) and without (n = 89) chronic post-operative HypoPT (PoHypoPT) and their relationship with the biochemical control of the disease.
    METHODS: Serum and urinary parameters, renal ultrasound and QoL were assessed by SF-36 and WHO-5 questionnaires.
    RESULTS: Forty-three (48.3%) PoHypoPT patients reported symptoms of hypocalcemia. Twenty-six (29.2%) patients were at target for all 6 parameters, 46 (51.6%) for 5. The most frequently unmet targets were gender-specific 24-h urinary calcium (44.9%) and serum calcium (37.1%). Serum phosphate, magnesium and 25(OH)D were in the normal range in > 90% of patients. Renal calcifications were found in 26 (29.2%) patients, with no correlation with 24-h urinary calcium. eGFR did not differ between patients and controls. Conversely, patients had a significant higher rate of renal calcifications and a lower SF-36, but not WHO-5, scores. SF-36 scores did not differ between PoHypoPT patients who were, or not, hypocalcemic.
    CONCLUSIONS: Our study shows that the rate of renal calcifications was higher in patients with PoHypoPT than in those without. This finding, together with the reduced QoL and the presence of hypocalcemic symptoms in about half patients, underscores that the treatment of chronic HypoPT with conventional therapy is suboptimal.
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  • 文章类型: Case Reports
    严重的支气管哮喘是一种具有挑战性的疾病,在常规治疗方式下可能会损害生活质量(QOL)。我们报告了一例52岁女性,患有与嗜酸性粒细胞性慢性鼻-鼻窦炎(ECRS)和嗜酸性粒细胞性中耳炎(EOM)相关的严重哮喘。尽管患者接受了全剂量的吸入性皮质类固醇治疗,白三烯受体拮抗剂(LTRA),茶碱,口服皮质类固醇(OCS)的爆发使用,她的哮喘病加重了,扰乱了她的日常生活.ECRS和EOM症状也变得更糟,尽管治疗与局部应用皮质类固醇的鼻子和耳朵,LTRA,偶尔使用OCS。除了哮喘症状,患者总是患有顽固性鼻塞和听力障碍,导致QOL严重受损。然而,贝那利珠单抗的给药在1个月内不仅对哮喘患者的病情,而且对ECRS和EOM的症状也有了快速和显著的改善.这些结果表明,当患者的生活质量严重恶化时,应考虑使用贝那利珠单抗治疗患有难治性ECRS和EOM的重度哮喘。
    Severe bronchial asthma is a challenging disorder to treat and can impair quality of life (QOL) under conventional therapeutic modalities. We report the case of a 52-year-old woman with severe asthma associated with eosinophilic chronic rhinosinusitis (ECRS) and eosinophilic otitis media (EOM). Although the patient was treated with a full dose of inhaled corticosteroid, leukotriene receptor antagonist (LTRA), theophylline, burst use of oral corticosteroids (OCS), her asthmatic condition aggravated, disrupting her daily life. ECRS and EOM symptoms were also getting worse despite treatment with topical application of corticosteroids to the nose and ears, LTRA, and occasional use of OCS. In addition to asthmatic symptom, the patient always suffered from intractable nasal obstruction and hearing disturbance, which contributed to the heavily impaired QOL. However, the administration of benralizumab showed rapid and remarkable improvement not only in her asthmatic conditions but also in the symptoms of ECRS and EOM within a month. These results suggest that the use of benralizumab for the treatment of severe asthma with intractable ECRS and EOM should be considered when the patient\'s QOL is severely deteriorated.
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  • 文章类型: Journal Article
    Background and objectives: The study assesses quality of life (QoL) in patients who underwent thyroidectomy compared to the general population. Materials and Methods: QoL data from post-thyroidectomy patients and individuals with no subjective health concerns, who had attended a routine health screening visit, were evaluated. QoL was assessed using the modified version of Korean Short Form 12 questionnaire (SF-12). Patients and controls were matched using the propensity score approach and a ratio of 1:4. Results: Data from a total of 105 patients and 420 controls were analyzed. For five SF-12 items, lower QoL was found in patients (p < 0.05). Multivariate analysis revealed that a follow-up duration of <1-year, female sex, and an age of >50 years were independent risk factors. No significant difference was found between controls and patients who were >1-year post-surgery. Conclusions: For specific SF-12 items, QoL was lower in post-thyroidectomy patients than in controls. No intergroup difference in QoL was found >1-year post-surgery.
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  • 文章类型: Journal Article
    Background: Previous studies have indicated that non-motor symptoms are primary problems in focal dystonia, but limited data are available about non-motor problems and their correlation with motor severity in generalized dystonia (GD). Methods: In the present study, we performed a case-control study and enrolled isolated inherited or idiopathic GD patients and age- and sex-matched healthy controls (HC). Clinical characteristics, motor symptoms, non-motor problems, including psychiatric co-morbidity, sleep problems, fatigue, and quality of life (QoL) were assessed in both groups using various rating scales and assessments. Results: Thirty-three patients with GD and 33 controls were enrolled. Significant higher scores on depression and anxiety (p < 0.001) were shown in GD compared with HC, whereas the frequency of obsessive-compulsive disorders approached that of HC (p = 0.238). Patients with GD also had significantly higher Pittsburg Sleep Quality Index (PSQI) and fatigue scores than HC, whereas no difference was observed in excessive daytime somnolence. In GD, QoL was more impaired, with statistically lower scores in both physical and mental components. Psychiatric rating scales did not correlate to motor severity or disease duration but might influence quality of sleep. Subgroup analysis suggests non-motor manifestations differ with different etiologies in GD. Conclusion: This study suggests that non-motor symptoms in GD, such as psychiatric problems, are likely to be primary determinants not correlated to motor severity, which may also affect quality of sleep and fatigue.
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  • 文章类型: Journal Article
    OBJECTIVE: Aripiprazole (ARP) is a popular antipsychotic drug that has demonstrated ameliorative effects on hyperprolactinemia. However, no study to date has studied the utility of ARP in patients with a long history of schizophrenia and antipsychotic treatment. We therefore examined the effect of partial antipsychotic regimen replacement with ARP on hyperprolactinemia induced by chronic antipsychotic use in patients with schizophrenia.
    METHODS: Sixteen patients with a schizophrenia diagnosis (F2) based on the International Classification of Diseases (version 10) were recruited. At months 0, 1, 3, and 6 of the study, serum prolactin, body weight, and blood glucose were measured, and QOL and psychotic symptoms were assessed using Global Assessment of Functioning scores and Clinical Global Impressions of Improvement (CGI-I) scores.
    RESULTS: Nine patients with an average age of 46.7±9.6 years and mean disease duration of 15.9±10.4 years were included in the final analysis. Serum prolactin levels significantly decreased and GAF and CGI-I scores improved significantly over the 6-month period after partial replacement with ARP. Additionally, no changes were observed in body weight or blood glucose over the 6-month period.
    CONCLUSIONS: Partial antipsychotic regimen replacement with ARP improves hyperprolactinemia, and may improve the QOL of patients with a long history of schizophrenia.
    BACKGROUND: Japan Medical Association, Center for clinical trials D: JMA-IIA00245.
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  • 文章类型: Journal Article
    目的:这项研究的目的是调查阅读障碍(RD)儿童的自我和父母评估的生活质量(QoL)以及合并症精神病理学的影响,特别关注年龄和性别差异。方法:使用阅读障碍鉴别诊断马斯特里赫特-匈牙利标准测试,RD组包括127名儿童(<18岁),对照组包括81名儿童。为了测量精神病理学合并症,实施优势和困难问卷(SDQ)。为了评估儿童的QoL,使用了儿童和青少年生活质量测量(ILK)的自我和父母评估版本。使用Mann-WhitneyU检验评估QoL和精神病理学的群体差异。对调节的中介模型进行了测试,其中合并症的精神病理学介导了组成员资格与自我和父母评估的QoL之间的关系,这取决于性别。儿童的年龄和父母的教育水平作为协变量。结果:RD组在几个领域的QoL低于对照组,根据家长报告,虽然两组之间没有发现差异,根据自我报告。在男孩中,结果显示,通过合并症精神病理学(-0.046,BCa95%CI:-0.135至0.043和0.064,BCa95%CI:0.024-0.111,BCa95%CI:0.024-0.111),以及组成员对父母报告的条件直接影响(-0.098,BCa95%CI:0.012-0.184),但不是自我评价的,QoL.没有发现女孩的关系。结论:这项研究强调了从更多来源测量RD儿童的QoL和合并症精神病理学的重要性,并考虑了性别和年龄差异。
    Purpose: The aim of this study is to investigate self- and parent-rated quality of life (QoL) in children with a reading disability (RD) and the impact of comorbid psychopathology, with special focus on age and gender differences. Methods: Using the Dyslexia Differential Diagnosis Maastricht-Hungarian standard test, 127 children (aged < 18) were included in the RD group and 81 in the control group. To measure comorbid psychopathology, the Strengths and Difficulties Questionnaire (SDQ) was administered. To evaluate the children\'s QoL self- and parent-rated versions of the Measure of Quality of Life for Children and Adolescents (ILK) were used. Group differences in QoL and psychopathology were assessed using Mann-Whitney U-tests. Moderated mediational models were tested in which comorbid psychopathology mediated the relationship between group membership and self- and parent-rated QoL, which was dependent on gender. Child\'s age and parents\' level of education were included as covariates. Results: The RD group showed lower QoL than the controls in several domains, according to the parent-report, while no differences between the two groups were found, according to self-report. In boys, results revealed conditional and indirect effects of group membership on self- and parent-rated QoL through comorbid psychopathology (-0.046, BCa 95% CI: -0.135 to 0.043 and 0.064, BCa 95% CI: 0.024-0.111, respectively) as well as a conditional direct effect of group membership on parent-reported (-0.098, BCa 95% CI: 0.012-0.184), but not self-rated, QoL. No relationship was found for girls. Conclusions: This study highlights the importance of measuring QoL and comorbid psychopathology in children with RDs from more sources and accounting for gender and age differences.
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