Spino‐Pelvic Alignment and Surgical Outcomes in Chinese Elderly With Lumbar Stenosis Syndrome: A Prospective Study

General Practitioner are important and should be involved in decision making and Advanced Care Planning for patients with advanced kidney disease Advanced kidney disease has a biphasic nature of life trajectory No treatment does not mean no dialysis for the patient with CKD - CKD care and terminal phase care.

The Impact of Age on Quality of Life in Breast Cancer Patients Receiving Adjuvant Chemotherapy: A Comparative Analysis From the Prospective Multicenter Randomized ADEBAR trial

Background This paper describes the global trend of population ageing in the modern world and draws demographic parallels between analogical processes taking place in the countries of European Community and in the Russian Federation. The authors disclose a probable etiology and characteristics of the course of oral diseases in elderly and senile patients and describe clinical manifestations of diseases of the oral cavity. Psychologica.complications that can arise in building constructive relationships between elderly patients and health workers are described. Measures relating to the oral health related quality of life in elderly and senile patients are described in detail, and an analysis of the probable causes of deterioration in quality of life in patients of the mentioned group is carried out. The authors give a description of the generally accepted methodology of quality of life research in gerontology and dentistry. Specific international questionnaires to attain these goals are carried out. Objectives To present .comprehensive authorial study related to the research characteristics of quality of life in elderly and senile patients. Methods The methods of logical and statistical analysis were used to research the question of measuring quality of life in elderly and senile patients. Results The trend of population ageing in the Russian Federation is a part of the global phenomenon. The causes of population ageing lie in the economic and social processes occurring in the country. Human health should be considered as a many-sided concept relating to the physiological and psychological well-being and social adaptation of an individual. Manifestations of many oral-dental diseases in elderly and senile patients are caused both by natural processes of ageing and the presence of visceral diseases. There is no question that all the present somatic and dental diseases lead to deterioration in the quality of life of elderly and senile patients and result in their social isolation. Conclusion It is concluded that the assessment of oral health-related quality of life can facilitate a solution to a number of problems of organising dental care for an ageing population. The use of instruments for measuring quality of life can not only conduce to oral health but also improve health care quality and increase levels of well-being of elderly persons.

Single center, retrospective cohort study. Little is known about the surgical outcomes and quality of life in patients with C2-sacrum posterior spinal fusion (PSF). Though it is thought to be a "final" construct, it remains unknown how patients fare postoperatively. We sought to evaluate the surgical outcomes and quality of life of patients after C2-sacrum PSF. Consecutive patients undergoing C2-Sacrum PSF from 2015-2020 by 4 surgeons at a single institution were included. The study time period for each patient began after their index operation that led to the C2-sacrum fusion. Dates of surgery, complications, reoperations, patient reported outcomes (PROs) including EuroQol 5 Dimensions (EQ-5D), Oswestry Disability Index (ODI), Scoliosis Research Society (SRS) questionnaires, and activities of daily living (ADL) questions were collected and analyzed. Descriptive statistics, paired t-tests, student t-tests, and linear regression were used. Of the 23 patients who underwent C2-sacrum PSF, 6 patients (26%) required a total of 10 reoperations after a mean of 1.5years (range 0-4years) after C2-sacrum PSF. Five reoperations were for mechanical failure; 3 for wound complications/infection; and 2 for instrumentation and spinous process prominence. PROs were collected on 18 patients with mean follow-up of 2.4 years (range .5-4.5) after their C2-sacrum PSF. At 6-months, both SRS-22 and ODI scores improved significantly after C2-sacrum PSF (SRS: 57.5 to 76.3, P = .0014; ODI: 47.0 to 31.7, P = .013). Similarly, at a mean 2.4years postoperatively, mean ODI improved significantly (47.0 to 30.4, P = .0032). Six patients (33%) had minimal symptoms (ODI <20). The median postoperative EQ-5D score was .74 (range .19 to 1.0), which compares favorably to patients with hip/knee osteoarthritis (EQ-5D .63) and diabetes mellitus (DM) (EQ-5D .69) and hypertension (HTN). In terms of activities of daily living (ADL), 10 patients (56%) exercised regularly-a mean 4.5 days/week. 11 (61%) could do light aerobic activity (e.g. stationary bike). 10 (55%) were able to play with children/grandchildren as desired. Eight patients (44%) hiked, and 2 (11%) drove independently. 11 (61%) could tolerate short air-travel comfortably. Of the 17 patients who could toilet and perform basic hygiene preoperatively, 16 (94%) were able to do so postoperatively. Though C2-sacrum PSF is thought to be a "final" construct, approximately 1 in 4 patients require subsequent operations. However, C2-sacrum PSF patients had a significant improvement in SRS and ODI scores by 6 months postop. Over 60% of patients were regularly performing light aerobic activity 2years after their C2-sacrum PSF. EQ-5D suggests that this population fares better than those with degenerative hip/knee arthritis and similarly to those with common chronic conditions like DM and HTN.

The coronavirus disease 2019 (COVID-19) pandemic has significantly worsened the health and quality of life of vulnerable populations, particularly elderly patients with heart failure. This study aimed to assess the effect of COVID-19 infection on the quality of life in elderly patients with heart failure during the pandemic. This retrospective case-control study included elderly heart failure patients admitted to the Second People's Hospital of Lanzhou between December 2022 and December 2023, all of whom were diagnosed during the ongoing COVID-19 pandemic. All patients underwent COVID-19 nucleic acid testing upon admission. Among the 96 heart failure patients who tested positive for COVID-19 and the 68 who tested negative, multiple validated instruments were used to assess both physical and mental health quality of life. These instruments included the Minnesota Living with Heart Failure Questionnaire (MLHFQ), 36-Item Short Form Health Survey physical component summary score (SF-36 PCS), 6-Minute Walking Test (6MWT), Geriatric Depression Scale-15 (GDS-15), Self-Rating Anxiety Scale (SAS) Total, Pittsburgh Sleep Quality Index (PSQI), Mini Nutritional Assessment-Short Form (MNA-SF), and the Fatigue, Resistance, Ambulation, Illness, and Loss of weight (FRAIL) Scale. Heart failure patients who tested positive for COVID-19 exhibited significantly lower blood pressure, SF-36 scores, and 6MWT distances compared to those who tested negative (P<0.05). Additionally, the COVID-19-positive group had higher MLHFQ scores, older average age, a greater proportion of patients in NYHA class III-IV, more frequent electrolyte imbalances, elevated D-dimer, C-reactive protein (CRP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, and longer hospital stays (P<0.05). These patients also exhibited higher levels of anxiety (SAS total), poorer sleep quality (PSQI), and greater frailty (FRAIL Scale) compared to their COVID-19-negative counterparts (P<0.05). In addition, heart failure patients with COVID-19 infection reported more severe symptoms of dyspnea and fatigue (P<0.05). Both age and COVID-19 infection were identified as significant factors negatively affecting the quality of life in this patient population. COVID-19 infection significantly exacerbates the decline in quality of life in elderly patients with heart failure. This highlights the urgent need for strengthened, comprehensive treatment and targeted mental health support for this vulnerable group.

Background: In Indonesia, low back pain is a common health problem that can interfere with a person's productivity in carrying out activities due to the manifestations of the pain it causes. Acupuncture therapy is one of the complementary treatments that is quite effective in reducing the intensity of low back pain. This study aims to estimate the effectiveness of acupuncture therapy to reduce pain and improve quality of life in patients with low back pain.Subjects and Method: This study is a systematic review and meta-analysis with PICO, Population: Low back pain patients, Intervention: Acupuncture therapy, Comparison: No acupuncture therapy, Outcome: Pain reduction and quality of life improvement. It was measured using the Oswestry Disability Index. The article search process was carried out between 2006-2022 using 3 databases, including Google Scholar, PubMed, and Science Direct. The keywords used in the database search were “acupuncture” AND “oswestry disability index” AND “quality of life” AND “low back pain”. The inclusion criteria for full text articles using a Randomized Controlled Trial (RCT) study design by including the results of the study in the form of the number of respondents, the mean and standard deviation (SD) values, for articles using English and Indonesian. Articles that have met the requirements are analyzed using the RevMan 5.3 application.Results: There are 9 articles that meet quantitative requirements and are divided into 2 categories according to independent variables with a Randomized Controlled Trial (RCT) study design originating from Spain, Australia, South Korea, Brazil, Germany and England, which were carried out in a meta-analysis in this study. Meta-analysis of 7 articles showed estimates that acupuncture therapy was effective in reducing pain in LBP patients. Patients experienced a decrease in pain 0.32 units higher than those who were not given acupuncture therapy (SMD = 0.32; 95% CI= -0.46 to -0.17; p &lt;0.001). Meanwhile, a meta-analysis of 9 articles showed the estimation of the effect of effective acupuncture therapy on improving the quality of life in LBP patients. Patients experienced an improvement in quality of life 0.52 units higher than those who were not given acupuncture therapy (SMD = 0.52; 95% CI= 0.22 to 0.81; p= 0.006).Conclusion: Acupuncture therapy is effective in reducing pain and improving the quality of life of LBP patients. Keywords: acupuncture, low back pain, quality of life, oswestry disability index, meta-analysisCorrespondence: Frannesty Estu Winahyu. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: frannestyestuwinahyu@gmail.com. Mobile: +6285228783882.Indonesian Journal of Medicine (2022), 07(03): 313-325https://doi.org/10.26911/theijmed.2022.07.03.08

Background: In Indonesia, low back pain is a common health problem that can interfere with a person's productivity in carrying out activities due to the manifestations of the pain it causes. Acupuncture therapy is one of the complementary treatments that is quite effective in reducing the intensity of low back pain. This study aims to estimate the effectiveness of acupuncture therapy to reduce pain and improve quality of life in patients with low back pain.Subjects and Method: This study is a systematic review and meta-analysis with PICO, Population: Low back pain patients, Intervention: Acupuncture therapy, Comparison: No acupuncture therapy, Outcome: Pain reduction and quality of life improvement. It was measured using the Oswestry Disability Index. The article search process was carried out between 2006-2022 using 3 databases, including Google Scholar, PubMed, and Science Direct. The keywords used in the database search were “acupuncture” AND “oswestry disability index” AND “quality of life” AND “low back pain”. The inclusion criteria for full text articles using a Randomized Controlled Trial (RCT) study design by including the results of the study in the form of the number of respondents, the mean and standard deviation (SD) values, for articles using English and Indonesian. Articles that have met the requirements are analyzed using the RevMan 5.3 application.Results: There are 9 articles that meet quantitative requirements and are divided into 2 categories according to independent variables with a Randomized Controlled Trial (RCT) study design originating from Spain, Australia, South Korea, Brazil, Germany and England, which were carried out in a meta-analysis in this study. Meta-analysis of 7 articles showed estimates that acupuncture therapy was effective in reducing pain in LBP patients. Patients experienced a decrease in pain 0.32 units higher than those who were not given acupuncture therapy (SMD = 0.32; 95% CI= -0.46 to -0.17; p &lt;0.001). Meanwhile, a meta-analysis of 9 articles showed the estimation of the effect of effective acupuncture therapy on improving the quality of life in LBP patients. Patients experienced an improvement in quality of life 0.52 units higher than those who were not given acupuncture therapy (SMD = 0.52; 95% CI= 0.22 to 0.81; p= 0.006).Conclusion: Acupuncture therapy is effective in reducing pain and improving the quality of life of LBP patients. Keywords: acupuncture, low back pain, quality of life, oswestry disability index, meta-analysisCorrespondence: Frannesty Estu Winahyu. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: frannestyestuwinahyu@gmail.com. Mobile: +6285228783882.Indonesian Journal of Medicine (2022), 07(03): 313-325https://doi.org/10.26911/theijmed.2022.07.03.08

Background: In Indonesia, low back pain is a common health problem that can interfere with a person's productivity in carrying out activities due to the manifestations of the pain it causes. Acupuncture therapy is one of the complementary treatments that is quite effective in reducing the intensity of low back pain. This study aims to estimate the effectiveness of acupuncture therapy to reduce pain and improve quality of life in patients with low back pain. Subjects and Method: This study is a systematic review and meta-analysis with PICO, Population: Low back pain patients, Intervention: Acupuncture therapy, Comparison: No acupuncture therapy, Outcome: Pain reduction and quality of life improvement. It was measured using the Oswestry Disability Index. The article search process was carried out between 2006-2022 using 3 databases, including Google Scholar, PubMed, and Science Direct. The keywords used in the database search were “acupuncture” AND “oswestry disability index” AND “quality of life” AND “low back pain”. The inclusion criteria for full text articles using a Randomized Controlled Trial (RCT) study design by including the results of the study in the form of the number of respondents, the mean and standard deviation (SD) values, for articles using English and Indonesian. Articles that have met the requirements are analyzed using the RevMan 5.3 application. Results: There are 9 articles that meet quantitative requirements and are divided into 2 categories according to independent variables with a Randomized Controlled Trial (RCT) study design originating from Spain, Australia, South Korea, Brazil, Germany and England, which were carried out in a meta-analysis in this study. Meta-analysis of 7 articles showed estimates that acupuncture therapy was effective in reducing pain in LBP patients. Patients experienced a decrease in pain 0.32 units higher than those who were not given acupuncture therapy (SMD = 0.32; 95% CI= -0.46 to -0.17; p &lt;0.001). Meanwhile, a meta-analysis of 9 articles showed the estimation of the effect of effective acupuncture therapy on improving the quality of life in LBP patients. Patients experienced an improvement in quality of life 0.52 units higher than those who were not given acupuncture therapy (SMD = 0.52; 95% CI= 0.22 to 0.81; p= 0.006). Conclusion: Acupuncture therapy is effective in reducing pain and improving the quality of life of LBP patients. Keywords: acupuncture, low back pain, quality of life, oswestry disability index, meta-analysis Correspondence: Frannesty Estu Winahyu. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: frannestyestuwinahyu@gmail.com. Mobile: +6285228783882. Indonesian Journal of Medicine (2022), 07(03): 313-325 https://doi.org/10.26911/theijmed.2022.07.03.08

Objective To explore the effects of the comprehensive geriatric assessment （ CGA） nursing model on the quality of life in elderly patients with coronary heart disease （ CHD ） .Methods A total of 143 cases of hospitalized elderly patients with CHD were randomly divided into two groups , from January 2012 to June 2013 .The control group （ 69 cases ） was given the cardiovascular specialty nursing and the CGA group （74 cases） was given the cardiovascular nursing based on the CGA nursing model .The scores of patients ’ physical strength, illness, medical condition, general life, social psychology, working and interpersonal relationship were surveyed using the questionnaire of quality of life in patients with cardiovascular diseases （ CQQC） when patients first admitted to the hospital and 6 months after discharge .Results In the CGA group , 75.7%patients had two or more kinds of elder problems , within which 67.6% was depression, 66.2% was sleep disorder, 62.2% were hearing disability and 60.8% was visual disability.Before the intervention, the scores of quality of life between groups had no significant differences （P 〉0.05）.After the nursing intervention, the scores of physical strength , illness, medical condition, general life, social psychology, working and interpersonal condition in the CGA group were （10.86 ±5.06）, （8.75 ±4.54）, （5.90 ±0.40）, （5.22 ±1.95）, （8.41 ±3.22）, （0.97 ±0.66） and （40.11 ±9.05）.Those scores in the control group were （7.35 ±4.12）, （4.57 ±0.85）, （4.72 ±0.82）, （3.85 ±1.45）, （3.67 ±1.52）, （0.70 ±0.64） and （24.86 ±4.43）.The differences of scores between groups were significant （ t =4.541, 7.545, 11.137, 4.720, 11.095, 2.470, 12.653, respectively;P 〈0.05 ）.Conclusions Based on the comprehensive evaluation, the CGA nursing model can play a positive role in clinical nursing of elderly CHD patients , and it also can improve the quality of life in elderly patients with CHD . Key words: Coronary heart disease; Quality of life; Comprehensive geriatric assessment

IntroductionSurgery is still an effective treatment option for adult degenerative scoliosis (ADS), but how to predict patients’ significant amount of the improvement in quality of life remains unclear. The previous studies included an inhomogeneous population. This study aimed to report the results about concentrating on the amount of immediate changes in spinopelvic radiographic parameters to predict the amount of mid-term improvement in quality of life in ADS patients.Materials and methodsPre-operative and immediately post-operative radiographic parameters included Cobb angle, coronal vertical axis (CVA), sagittal vertical axis (SVA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic tilt (PT), sacral slope (SS), pelvic incidence (PI) and LL/PI matching (PI–LL). Quality of life scores were evaluated pre-operatively and at the final follow-up using Oswestry Disability Index (ODI) and visual analogue scale (VAS). The amount of immediate changes in spinopelvic radiographic parameters (Δ) and the amount of mid-term improvement in quality of life (Δ) were defined, respectively.ResultsPatients showed significant change in radiographic parameters, ODI and VAS pre- and post-surgery, except CVA and PI. Univariate analysis showed a significant correlation between ΔTK, ΔLL, ΔCVA and the amount of mid-term improvement in quality of life, but multivariate analysis did not get a significant result. Univariate and multivariate analyses showed that ΔSVA was still a significant predictor of ΔVAS and ΔODI. The changes in the other radiographic parameters were not significant. The equations were developed by linear regression: ΔODI = 0.162 × ΔSVA − 21.592, ΔVAS = 0.034 × ΔSVA − 2.828. In the ROC curve for ΔSVA in the detection of a strong ΔODI or ΔVAS, the cut-off value of ΔSVA was − 19.855 mm and − 15.405 mm, respectively.ConclusionsThis study shows that ΔSVA can predict the amount of mid-term improvement in quality of life in ADS patients. The changes in the other radiographic parameters were not significant. Two equations were yielded to estimate ΔODI and ΔVAS. ΔSVA has respective cut-off value to predict ΔODI and ΔVAS.

Objective: To investigate the relationship between preoperative vitamin D and albumin levels and postoperative quality of life in patients undergoing spinal surgery. Methods: Patients undergoing thoracic and lumbar spine surgery were evaluated in this prospective study. Their vitamin D and albumin levels were assessed before surgery and quality of life was measured by two questionnaires, Oswestry Disability Index (ODI) and Scoliosis Research Society - 22 (SRS-22), one year after the procedure. Data on infection occurrence and healing time were collected. Preoperative nutritional values and patients’ quality of life were analyzed using the chi-square test and ANOVA for albumin and vitamin D, respectively. The relationship among nutritional status, healing time, and the occurrence of infection was evaluated by the Pearson correlation coefficient. Results: Forty-six patients were included and their mean nutritional values were 19.1 (6.6) ng/mL for vitamin D and 3.9 (0.6) g/dL for albumin [mean (standard deviation)]. No association was found between vitamin D and quality of life of patients measured by ODI (p=0.534) and SRS-22 (p=0.739) questionnaires. There was also no association between albumin levels and quality of life measured by ODI (p=0.259) and SRS-22 (p=0.076) questionnaires. No correlation was found between the healing time or occurrence of infection and nutritional values. Conclusions: There was no association between vitamin D and albumin levels and the surgical result, according to the patient’s perception, besides the occurrence of complications with the surgical wound.

Is Video-Assisted Thoracic Surgery Lobectomy Better? Quality of Life Considerations

Purpose The current study aimed to find any association between various spinopelvic parameters and the quality of life in patients with degenerative lumbar scoliosis (DLS) measured as per the Oswestry disability index (ODI) and visual analog scale (VAS) in the Indian population. Methods We included 20 DLS patients of more than 40 years with a Cobb angle of more than 10° and without any trauma, tumour, infection, or congenital scoliosis presented in our tertiary care centre in the study. The VAS and ODI were calculated for each patient. Radiological parameters were recorded for every patient, including sagittal balance, coronal balance, Cobb angle, pelvic incidence, pelvic tilt, and lumbar lordotic angle. We evaluated the results and sought any association between clinical and radiological variables for DLS. Results Patients with positive sagittal balance had significantly higher disability than those with neutral sagittal balance (p-value 0.007). Furthermore, patients with coronal imbalance had more severe pain (p-value 0.013) and disability (p-value 0.038) than those with neutral coronal balance. We also found that the ODI and VAS were not associated with any other spinopelvic parameters. Conclusion From the present study, we can conclude that in the Indian population, both positive sagittal and coronal imbalances are associated with poor functional status in patients with DLS. Therefore, while planning surgical correction for these patients, both coronal and sagittal balance are important and need to be considered.

BackgroundPreviously, many studies have evaluated quality of life (QoL) in patients with ankylosing spondylitis (AS), however, none of them specifically investigated the correlation between pain-related disability measured by Oswestry Disability Index (ODI) and QoL in AS patients. In addition, the correlation between global kyphosis (GK) in lateral plain radiographs and QoL in AS patients remains unclear up to now. Therefore, this study aimed to evaluate QoL and correlation with clinical and radiographic variables in AS patients, especially to figure out the relationship about the pain-specific disability measured by ODI, GK and QoL.MethodsFrom January 2008 to November 2015, two hundred and forty-five consecutive patients with an average age of 36.2 ± 10.9 years (range, 17–66 years) satisfying the Modified New York Criteria for AS from a single institution were enrolled. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and Bath Ankylosing Spondylitis Global score (BAS-G) were applied to assess the disease activity, functional status, spinal mobility and overall feeling of AS patients, respectively. ODI was recorded to evaluate low back pain-related disability. QoL was evaluated by the Short Form-36 (SF-36). According to global kyphosis (GK) measured on standing lateral full-spine radiographs, the patients were divided into two groups: mild kyphotic group (GK < 70°,n = 176) and severe kyphotic group (GK ≥ 70°,n = 69).ResultsThe scores of BASDAI, BASFI, BASMI and ODI had significant negative correlations with all SF-36 subscale scores (P < 0.01). BASFI and BASMI scores of severe kyphotic group were much higher than those of mild kyphotic group, respectively (P = 0.005 and P = 0.001, respectively) and the score of physical function (PF) subscale in severe kyphotic group was significantly higher than that in mild kyphotic group (P = 0.046) as well. Notably, the scores of ODI, BASFI and BASMI were the major predictors of PF subscale score of SF-36.ConclusionsPoor QoL is significantly correlated with high disease activity, poor functional status and decreased spinal mobility in AS. GK is significantly associated with functional status, spinal mobility and QoL in AS patients. ODI, BASFI and BASMI are the major predictors of PF subscale of SF-36.

The aim of this study was to compare the global sagittal alignment and quality of life in elderly osteoporotic patients with and without vertebral compression fracture (VCF), and to investigate the relationship between global sagittal alignment and severity of VCF. A consecutive series of 72 female patients with osteoporosis aged over 60years and 31 age-matched females without osteoporosis were prospectively enrolled. The patients were divided into VCF and non-VCF group. Patient's clinical demography, nature of VCF, and bone mineral density (BMD) were also recorded. Spinal deformity index was used to evaluate severity of VCF. EOS® biplanar imaging system was then used to evaluate global sagittal parameters: T1 pelvic angle (TPA) and global sagittal angle (GSA). In addition, quality of life was assessed with self-reported questionnaires: the Oswestry Disability Index (ODI) and Short-form 12 (SF-12). Osteoporotic patients and controls were found to be significantly different in terms of TPA, GSA, and BMD. And in patients with VCF, they were found to have significantly higher TPA and GSA. TPA and GSA were significantly correlated with SF-12 and ODI. The number of VCF and SDI significantly correlated with global sagittal alignment. Using regression analysis, parameters significantly associated with abnormal global alignment were the number of VCF (OR = 1.13) and SDI (OR = 1.84). Osteoporotic patients with VCF showed worse global sagittal alignment and decreased quality of life. The number and severity of VCF had a negative influence on global sagittal balance, which indicates that poorer sagittal global alignment may imply worse quality of life and more severe VCF.