FIS Scores Research Articles

Mood Disorders After COVID-19

Introduction. The COVID-19 pandemic has led to a high prevalence of post-COVID-19 syndrome (PCS), with mood disorders being the most common manifestations.
 Objective: To study the prevalence of PCS-associated mood disorders and their features.
 Materials and methods. We examined patients after COVID-19 (n = 91; age: 24-84 years; median time to recovery: 7 months) using the following tools: the BDI and HADS (screening for anxiety and depression); the Starkstein Apathy Scale; FIS and FSS (fatigue assessment); the MoCA, MMSE, and FAB (cognitive assessment); the FIRST, ESS, PSQI, and ISI (sleep disorders evaluation); the EQ5D (quality of life measurement). We designed a special questionnaire to collect data related to a history of COVID-19 and patients' condition after discharge. In addition, we analyzed electronic medical records and discharge summaries and performed neurological examination.
 Results. Of all the examined patients, 65 (71.4%) participants had signs and symptoms of PCS. Mood disorders were observed in 33 (50.8%) cases, with apathy (78.7%), anxiety (66.7%), and fatigue (60.6%) being the most common. Depressive disorders were found in 12 (36.3%) patients. Cognitive functions were impaired in 7 (21.2%) patients; sleep disorders were observed in 16 (48.5%) cases. We found a positive correlation between depressive disorders and fatigue based on the BDI, FIS, and FSS scores (rS = 0.711; rS = 0.453), depressive disorders and anxiety (rS = 0.366), fatigue and apathy (rS = 0.350). Anxiety increased the risk of sleep disorders (rS = 0.683). Quality of life has been shown to decrease in patients with mood disorders due to the negative effect of long-term fatigue and depressive disorders.
 Conclusions. There is a close connection between different types of mood disorders that develop after COVID-19 and exacerbate symptoms of each other. Early diagnosis and treatment of these disorders can improve patients' quality of life and preserve their ability to work.

Fuzzy Inference System in Assessing the Improved Wastewater Quality for Irrigation through Sedimentation, Dilution, and Biochar Filtration in Sulaymaniyah City, Iraq

The study aims to improve the quality of wastewater in Sulaymaniyah city, Iraq, which has been facing drought problems, by using sedimentation, dilution (1:1), and biochar filtration. It provides an alternative source of water for agriculture, addressing the water shortage problem in the region. The irrigation water quality is evaluated based on the Water Quality Index (WQI) using a fuzzy inference system, a mathematical tool that converts complex statements into mathematical terms and simplifies them into outputs. The centroid defuzzification technique is applied to convert the fuzzy results into crisp numbers. The output of the FIS score is used to determine the suitability of water for irrigation. The study utilized six different samples: groundwater (GW), wastewater (WW), sedimented wastewater (SW), filtered sedimented wastewater (FSW), diluted sedimented wastewater (DSW), and filtered diluted sedimented wastewater (FDSW). The samples were analyzed for their physical and chemical properties, including pH, electrical conductivity (EC), total suspended solids (TSS), turbidity (TUR), total nitrogen (TN), total phosphate (TP), cations (Ca, Na), anions (Cl and SO4), and heavy metals (Mn, Fe, Co, Ni, Zn, Cu). The study found that the WQI FIS-I values for wastewater increased with each treatment step, with the final step of passing the DSW through a biochar filter resulting in an FIS WQI-I value of 61.59, indicating good water quality. The deterministic method also showed improved levels for TP, TN, TSS, and turbidity. Mean TN and TP values decreased to 8.9 mg L-1 and 3.62 mg L-1, respectively, in the FDSW, with turbidity and TSS also decreasing to 0.37 NTU and 21 mg L-1. The resulting FDSW was of the best quality among the treated waters, making it suitable for drip irrigation.

Real-World Evidence for Favourable Quality-of-Life Outcomes in Hungarian Patients with Relapsing-Remitting Multiple Sclerosis Treated for Two Years with Oral Teriflunomide: Results of the Teri-REAL Study.

Relapsing-remitting multiple sclerosis (RRMS) is a degenerative, inflammatory disease of the central nervous system in which symptoms and disability progression vary significantly among patients. Teri-REAL was a prospective, real-world observational study that examined quality-of-life (QoL) and treatment outcomes in a Hungarian cohort of RRMS patients treated with once-daily oral teriflunomide. QoL was assessed at baseline, 12, and 24 months with the Multiple Sclerosis Quality of Life-54 (MSQoL-54) questionnaire. Other measurements included disease progression (Patient Determined Disease Steps [PDDS]), clinical efficacy (relapses), fatigue (Fatigue Impact Scale [FIS]), depression (Beck Depression Inventory [BDI]), cognition (Brief International Cognitive Assessment in MS [BICAMS]), persistence and safety. 212 patients were enrolled (69.1% female, 50.5% treatment naïve), with 146 (69%) completing the study. Statistically significant improvements in subscales of the MSQoL-54 versus baseline were found at Month 12 and Month 24. Significant improvements were also observed for individual components of the BICAMS score at 24 months, while PDDS, FIS and BDI scores remained stable. The mean annualised relapse rate was 0.08 ± 0.32. There were 93 safety events, most of which were mild to moderate. Improved QoL and cognitive outcomes in teriflunomide-treated patients over 2 years offer a unique perspective to this real-world study.

Family functioning and preschool children's oral health-related quality of life.

Identifying which aspects of how a family functions are relevant to child oral health provides opportunities for interventions targeting the family context. The aim of this study was to investigate the associations of general and domain-specific family functioning with oral health-related quality of life (OHRQoL) of 3-4-year-old children. Cross-sectional data from 740 parent-child dyads from East London were analysed. Family functioning was assessed with the 60-item Family Assessment Device that yields scores for general functioning and six domains (roles, behaviour control, communication, affective involvement, affective responsiveness and problem solving). Children's OHRQoL was measured using the Early Childhood Oral Health Impact Scale (ECOHIS), which measures the lifetime impacts of children's oral conditions on the child (child impact section, CIS) and family (family impact section, FIS). The associations of family functioning with the ECOHIS total, CIS and FIS scores were assessed in negative binomial regression models (rate ratios [RR] and 95% confidence intervals [95% CI] were calculated), adjusting for parental sociodemographic factors and child demographic factors and caries experience. Children in families with unhealthy general functioning had 1.45 (95% CI: 0.87-2.43), 1.24 (95% CI: 0.73-2.13) and 2.19 (95% CI: 1.20-3.99) times greater ECOHIS total, CIS and FIS scores, respectively, than those in families with healthy general functioning after adjustment for confounders. Unhealthy functioning in the roles domain was associated with greater ECOHIS total and FIS scores. Unhealthy functioning in the problem solving, roles and affective involvement domains were also associated with greater FIS scores. Unhealthy family functioning was associated with worse child OHRQoL, especially in terms of disrupting family life. Effective assignment and undertaking of roles should be further explored as a target for intervention.

A comparative evaluation of role of gender, age and socioeconomic status on perceived dental anxiety of 4-8 years old children using two scales

Dental anxiety is a common problem that affects people of all ages and appears to develop mostly in childhood and adolescence. Dental anxiety in children has been recognized as a problem in patient management for many years. It is important that dentists are able to assess dental anxiety in child patients as early as possible so that they may identify patients who are in special need with regards to their fear. Age, gender and socioeconomic status play an important role as determining factors in dental anxiety, hence should be considered while measuring dental anxiety. A randomized control study was conducted in 4 to 8 years old children using two scales. A list of children from 14 schools in Gautam Budh Nagar district (U.P.) was collected and 1025 children were randomly selected. The children were asked about how they feel when they visit a dentist, by VPT and FIS separately their role with gender, age and socioeconomic was evaluated.To do comparative evaluation of role of gender, age and socioeconomic status on perceived dental anxiety of 4 to 8 years old children using two scales. Among 1025 children, 532(51.9%) were males and 493 (48.1%) were females. Age wise comparison of both scales score revealed that mean FIS score was statistically significant and higher than mean VPT scale among 7 and 8 year age groups. Among 4, 5 and 6 year age group, no statistically significant difference was found between two scales. Dental anxiety is found to increase with increasing age. Females had a similar level of anxiety as compared to males and Children from low SES had a high level of dental anxiety than children from high SES.

Forskolin-induced swelling of intestinal organoids correlates with disease severity in adults with cystic fibrosis and homozygous F508del mutations

BackgroundCFTR function measurements in intestinal organoids may help to better characterise individual disease expression in F508del homozygous people. Our objective was to study correlations between CFTR function as measured with forskolin-induced swelling in rectal organoids with clinical parameters in adult patients with homozygous F508del mutations. MethodsMulticentre observational study. Thirty-four adults underwent rectal biopsy, pulmonary function tests (FEV1 and FVC), chest X-ray and chest CT. Body-mass index (BMI) was assessed at study visit and exacerbation rate was determined during five years prior to study visit. Organoids were cultured and measured after stimulation with 5 µm forskolin for three hours to quantitate CFTR residual function. FindingsFIS was positively correlated with FEV1 (r = 0.36, 95% CI 0.02–0.62, p = 0.04) and BMI (r = 0.42, 95% CI 0.09–0.66, p = 0.015). FIS was negatively correlated with PRAGMA-CF CT score for% of disease (r = −0.37, 95% CI -0.62- -0.03, p = 0.049). We found no significant correlation between FIS and chest radiography score for CF (r = −0.16, 95% CI -0.48–0.20, p = 0.44). We observed a trend between higher FIS and a lower mean number of exacerbations over the last 5 years of observation, but this was not statistically significant (Poisson regression, p = 0.089). InterpretationFIS of intestinal organoids varied between subjects with homozygous F508del and correlated with pulmonary and nutritional parameters. These findings suggest that differences at low CFTR residual function may contribute to clinical heterogeneity in F508del homozygous patients and small changes in CFTR residual function might impact long-term disease expression.

Therapeutic education program for patients with hypermobile Ehlers-Danlos syndrome: feasibility and satisfaction of the participants

Objectives: To describe a therapeutic education program for patients with hypermobile Ehlers-Danlos syndrome, called PrEduSED and to evaluate its feasibility and efficiency in terms of satisfaction and impact on disease management in daily life. Methods: Prospective observational study. Evaluation before, after and 6 months after PrEduSED, consisted in: CSQ-F, SF-12, HAD, QIC, FIS, Zarit, Quiz and Vignettes (knowledge and skills about the disease), satisfaction questionnaire, Goal Attainment Scales. Results: Nineteen (19) patients (89% women, mean age: 39.2) were included and 9 relatives (78% men, mean age: 44.1). Participants were generally highly satisfied with the content and the organization of PrEduSED. Knowledge about the EDS and skills significantly improved (p < 0.001 for patients, p = 0.016 for relatives). QIC score improved significantly (p = 0.047) and FIS score also for the relationships domain (p = 0.05). At the end of the program, 69% of participants thought they had achieved their goals (mainly about acquiring knowledge and managing their treatment) beyond what they had hoped for; at 6 months, 54% felt they had achieved them beyond what they hoped for. Conclusions: Real success of PrEduSED for patients with hypermobile EDS in terms of recognition, satisfaction, increase of knowledge about the disease and adaptative skills.

Effect of Three Behavior Guidance Techniques on Anxiety Indicators of Children Undergoing Diagnosis and Preventive Dental Care.

Objective(s): To assess the effect of three behavior guidance techniques on anxiety indicators of children undergoing diagnosis and preventive dental care. Study Design: Sixty-three subjects (7-9 years) were divided into three groups as per the behavior guidance technique namely tell-show-do, live and filmed modeling (using Tablet Computer) to receive diagnostic (Oral examination & radiographic assessment using intraoral periapical radiographs) and preventive dental care (Oral prophylaxis and topical fluoride application). Anxiety indicators-Facial Image Scale (FIS) scores and heart rate were recorded before, during and after diagnosis/preventive treatment. Three-way repeated measures ANOVA with post-hoc analysis was performed at significance of p-value < 0.05. Results: There was a statistically significant difference in the anxiety indicators of children under the influence of different behavior guidance approaches undergoing diagnosis/preventive treatments except for mean heart rate of children while oral examination. Multiple comparison results reveal that the mean FIS scores and heart rate of children with modeling techniques were significantly better as compared to tell-show-do technique with no significant difference between the two modeling techniques. Conclusion: This study suggests that the modeling techniques (filmed and live) seem to be an efficient behavioral guidance approach for children aged 7-9 years undergoing routine diagnosis and preventive dental care as compared to tell-show-do technique.

The effect of general anesthesia for ambulatory dental treatment on children in Chongqing, Southwest China.

The incidence of early childhood caries shows a significant increasing trend. Often, children younger than 6years need additional help to finish the dental treatment. Therefore, general anesthesia (GA) could help to provide a successful environment for pediatric dental treatment. The aim of this study was to assess the effect of dental treatment under general anesthesia (DGA) on the patients' oral health in Chongqing, Southwest China using the P-CPQ and the FIS questionnaires. We collected the hospital's records of the children who received DGA from 2013 to 2014 and the questionnaires answered by their parents or caregivers before and after the treatment. Then the data were integrated and analyzed to assess the effect of DGA on the children and their family, the incidence of the complications during or after DGA, and the satisfaction of their parents. We collected 659 patients' records including 55.4% boys and 44.6% girls. There were 443 children younger than 4years, and 216 children older than 4years. The main reason why they chose DGA was the patients' fear for the treatment (95.1%). The mean cost of DGA almost reached a half (61.5%) or a third (15.3%) of the family's monthly earning. The mean P-CPQ score and FIS score significantly decreased after DGA. The highest incidence of complications was emergence agitation, headache, and nausea/vomiting. The incidence of emergence agitation and headache was related to the operation time. The majority of families reported a high degree of satisfaction. Children's oral health-related quality of life after DGA improved significantly. Meanwhile DGA showed a positive effect on the whole family and majority of families reported a high degree of satisfaction to it.

Quality of life changes in children following emergency dental extractions under general anaesthesia.

To assess the changes in the oral health-related quality of life (OHRQoL) of 221 preschool children who presented to the emergency department with the consequences of untreated dental caries requiring dental extractions under general anaesthesia (DEGA). Two hundred and twenty-one healthy preschool children, who required emergency DEGA, were recruited over a period of 12 months. The same parent or caregiver completed the Early Childhood Oral Health Impact Scale (ECOHIS) questionnaire; both, prior to the DEGA and at the 2-week post-treatment visit. Data were analysed using repeated anova with adjustments for multiple comparisons using the Bonferroni tests with the significance level set at 5%. One hundred and twenty-six participants, with a mean age of 4.02 and a mean dmft score of 8.27 (SD = 4.13), completed the 2-week post-treatment questionnaires. The overall ECOHIS, CIS, and FIS scores decreased significantly (P < 0.001) after emergency DEGA, demonstrating large effect sizes. The biggest decrease in prevalence after emergency DEGA was observed for the items of pain in teeth, trouble sleeping, being irritated or frustrated, difficulty drinking food, and parents being upset. The OHRQoL of preschool children, who presented to the emergency department with the consequences of untreated dental caries, was significantly improved following emergency DEGA.

Factors Associated with Physical and Cognitive Fatigue in Patients With Crohnʼs Disease

Fatigue commonly impairs quality of life in patients with Crohn's disease (CD). This study aimed to evaluate the prevalence and severity of fatigue in CD (compared with ulcerative colitis [UC] and healthy controls) and to identify potentially modifiable factors associated with global, physical, and cognitive dimensions of fatigue. Clinic attendees with confirmed CD or UC and healthy volunteers were surveyed on fatigue (Fatigue Impact Scale, FIS), psychological comorbidity, sleep quality, medication, and other clinical information. A CD subgroup also completed a similar follow-up survey. In 379 responders (181 CD, 113 UC, and 85 controls), global, physical, and cognitive FIS scores were highest in CD followed by UC and controls (P < 0.01), with a prevalence of global fatigue (total FIS ≥ 40) in 57% of CD patients. On multivariate analysis, concurrently active disease, poor sleep quality, and mental illness were significantly associated with all the 3 fatigue dimensions: regular vitamin B group supplementation was inversely associated with physical fatigue in the CD cohort and those of older age or with previous resection(s) (P = 0.05) were independently associated with cognitive fatigue only. Longitudinally in CD, fatigue scores remained constant between original and follow-up surveys (mean change in total FIS score +0.9; 95% confidence interval, -4.6 to 6.3). Factors independently associated with improved physical fatigue between surveys included avoidance of corticosteroids and establishment of regular exercise and with improved cognitive fatigue included cessation of immunomodulator therapy. Fatigue is highly prevalent and more severe in CD. Anticipated and novel associations with improvement of physical and/or cognitive fatigue were identified, offering clues to potential therapeutic approaches to ameliorating fatigue for clinical evaluation.

Genetic effects of habitat fragmentation and population isolation on Etheostoma raneyi (Percidae)

The use of genetic methods to quantify the effects of anthropogenic habitat fragmentation on population structure has become increasingly common. However, in today’s highly fragmented habitats, researchers have sometimes concluded that populations are currently genetically isolated due to habitat fragmentation without testing the possibility that populations were genetically isolated before European settlement. Etheostoma raneyi is a benthic headwater fish restricted to river drainages in northern Mississippi, USA, that has a suite of adaptive traits that correlate with poor dispersal ability. Aquatic habitat within this area has been extensively modified, primarily by flood-control projects, and populations in headwater streams have possibly become genetically isolated from one another. We used microsatellite markers to quantify genetic structure as well as contemporary and historical gene flow across the range of the species. Results indicated that genetically distinct populations exist in each headwater stream analyzed, current gene flow rates are lower than historical rates, most genetic variation is partitioned among populations, and populations in the Yocona River drainage show lower levels of genetic diversity than populations in the Tallahatchie River drainage and other Etheostoma species. All populations have negative FIS scores, of which roughly half are significant relative to Hardy–Weinberg expectations, perhaps due to small population sizes. We conclude that anthropogenic habitat alteration and fragmentation has had a profoundly negative impact on the species by isolating E. raneyi within headwater stream reaches. Further research is needed to inform conservation strategies, but populations in the Yocona River drainage are in dire need of management action. Carefully planned human-mediated dispersal and habitat restoration should be explored as management options across the range of the species.

The effect of enhancing self-efficacy intervention on self-esteem, overall well-being and coping Styles of patients With epilepsy

Objective To explore the effect of enhancing self-efficacy intervention on self-esteem, overall well-being and coping styles of patients with epilepsy. Methods A total of 112 patients with epilepsy were randomly divided into the study group and control group, the control group was given the general health education, and the study groups was given the enhancing self-efficacy intervention, including incentives, social suppor, behavioral approach. Use of The self-esteem scale (SES) and the feelings of inadequacy scale (F1S) , the overall well-being scale (GWB) , and coping style questionnaires was used to evaluate the therapeutic effect before and after training in patients with self-control and two sets of cross-referencing, when the patient was discharged a year impact Results After intervention the SES, FIS, and GWB scores of study group were significantly higher than those of control group , and the immature coping styles scores of study group (self-blame, fantasy, retreat) were significantly lower than those of the control group (P < 0. 01) . Conclusions To enhance self-efficacy intervention, eliminate low self-esteem, enhance their self-confidence and self-esteem and cope with a positive approach to solve the problem can significantly improve the overall well-being in patients with epilepsy. Key words: Epilepsy; Self-efficacy; Overall sense of happiness; Self-esteem; Coping style

Health-related quality of life in relapsing remitting multiple sclerosis patients during treatment with glatiramer acetate: a prospective, observational, international, multi-centre study

BackgroundGlatiramer acetate (GA) and interferon-beta (INFb) are first-line disease modifying drugs for relapsing remitting multiple sclerosis (RRMS). Treatment with INFb is associated with a significant increase in health-related quality of life (HR-QoL) in the first 12 months. It is not known whether HR-QoL increases during treatment with GA.Methods197 RRMS patients, 106 without and 91 with prior immunomodulation/immunosuppression, were studied for HR-QoL (Leeds Multiple Sclerosis-QoL [LMS-QoL] scale, score range 0 - 32), fatigue (Fatigue Impact Scale [FIS]) and depressed mood (Beck Depression Inventory-Short Form [BDI-SF]) at baseline and 6 and 12 months after start of GA treatment.ResultsAt 6 and 12 months mean LMS-QoL scores were significantly increased in the treatment-naive patient group (p < 0.001), not in the pre-treated group. At month 12 43% of treatment-naïve patients had improved HR-QoL (increase LMS-QoL score 3 or more points) (p < 0.001). Likewise, mean FIS scores were decreased at months 6 and 12 in the treatment-naïve group (p < 0.01), not in the pre-treated group. In both groups mean BDI-SF scores did not change. No demographic or clinical baseline factor was predictive of HR-QoL increase. HR-QoL changes were zero to negative for patients who had discontinued GA before month 12 (28.4% of patients).ConclusionsIn RRMS patients without prior immunomodulation/immunosuppression treatment with GA was associated with an increase in HR-QoL in the first 6 months, that was sustained at 12 months. In 4 out of 10 patients HR-QoL improved. Increase in HR-QoL was associated with decrease in fatigue.

Deterioration of health-related quality of life and fatigue in patients with chronic hepatitis C: Association with demographic factors, inflammatory activity, and degree of fibrosis

Health-related quality of life (HRQoL) is impaired in patients with chronic hepatitis C. We investigated HRQoL and fatigue in patients with chronic hepatitis C virus (HCV) infection in relation to the degree of fibrosis and inflammation, and controlled for the influence of relevant demographic and medical variables. We conducted a cross-sectional two-center study including 215 outpatients with chronic hepatitis C applying the Short-Form Health Survey (SF-36) and the Fatigue Impact Scale (FIS-D). The contribution to the variability of these psychometric scores was evaluated for the degree of fibrosis as well as viremia, gender, age, mode of transmission, genotype, and ALT. There was a strong negative association between the degree of liver fibrosis and the physical SF-36 summary score (p=0.016). This was independent of the covariate age, also significantly predicting physical HRQoL (p=0.001). The absolute FIS score was significantly increased in patients with advanced fibrosis (p=0.043). In females, mental SF-36 summary score (p=0.007) and fatigue (p=0.017) were significantly more impaired. Our study suggests a significant association of physical aspects of HRQoL and fatigue with the extent of fibrosis. Fibrosis stage should be considered for the identification and management of HCV patients at risk for reduced physical HRQoL.

Self-Reported Fatigue and Depressive Symptoms as Main Indicators of the Quality of Life (QOL) of Patients Living with HIV and Hepatitis C: Implications for Clinical Management and Future Research

Purpose: To analyze the impact of self-reported fatigue and depressive symptoms on the quality of life (QOL) of patients co-infected with HIV and hepatitis C virus (HCV) not receiving anti-HCV therapy. Method: We used data from a cross-sectional survey conducted among 115 co-infected adults including an assessment of QOL (WHOQOL-HIV bref questionnaire), depressive symptomatology (Center for Epidemiological Studies Depression Scale [CES-D]), and fatigue (Fatigue Impact Scale [FIS]). Results: Eighty-four percent of patients had been infected through injecting drug use (IDU). Half reported a history of depression or other psychiatric co-morbidities, 57% presented depressive symptoms, and 69% reported fatigue. FIS and CES-D scores accounted for 54% and 66% of total variance in psychological QOL and level of independence-related QOL, respectively, in a multivariate analysis adjusted for sociodemographic and clinical characteristics and alcohol or drug use. High FIS scores were independently associated with impaired physical QOL and social relationships, whereas high CES-D scores were independently associated with lower environmental QOL. Conclusion: Self-reported fatigue and depressive symptoms are the best indicators of co-infected patients’ QOL. These two indicators could be more easily used for a better clinical management of co-infected patients and also introduced as patient outcome measures in clinical research.

An assessment of cancer-related fatigue in patients (pts) with chemotherapy-induced anaemia (CIA) treated with darbepoetin alfa (DA): Comparison of two quality of life (QoL) questionnaires

19654 Background: CIA is often associated with debilitating fatigue and reduced QoL. DA can effectively treat CIA when administered once every 3 weeks (Q3W).This study aims to compare the psychometrics of the Functional Assessment of Cancer Therapy Fatigue Subscale (FACT-F) and The Fatigue Symptom Inventory (FSI) in CIA pts treated with DA Q3W. Methods: Longitudinal single- centre prospective study in adult pts with solid tumours undergoing chemotherapy (CT) and with mild to moderate cancer-related fatigue (CRF) (Visual Analogue Scale (VAS) =30 mm). Pts with haemoglobin (HB) levels &lt;11 g/dL were treated with DA 500 mcg Q3W. Key clinical parameters, FACT-F, and FSI measurements were collected at the beginning and end of the CT treatment period. Psychometric indicators for reliability and validity were calculated. Results: A preliminary analysis was conducted in 58 pts: mean age, 61.3 years (SD 12.3), 51.7% women, 25.9% with breast cancer, 91.4% ECOG 0–1, 69.0% IV stage, 63% had no prior CT. At baseline, the mean CRF score by VAS was 58.8 mm (SD 19.4) and the mean Hb was 10.2 g/dL (SD 0.7). Median CT duration was 15.1 weeks (range, 3.3 - 25.7) and all pts received DA treatment during CT (median duration of CT, 6.6 wks [range, 0 - 19]). The median number of DA doses administered was 3 (range, 1–7). The rate of hematopoietic response (Hb ≥ 12 g/dL or Hb rise from baseline ≥ 2 g/dL) was 69.0%. FACT-F and FIS scores improved by 5.6 and 13.0 points respectively during CT. Consistency (Cronbach alpha coefficient - CA) was high and similar for both questionnaires (FACT-F=0.98; FSI=0.97). Conclusions: Both the FACT-F and FIS QoL questionnaires measured a change in fatigue during the study with high and similar consistency. DA administered at a fixed dose of 500 mcg Q3W seems to be effective in clinical practice. No significant financial relationships to disclose.

Psychometric study of Turkish version of Fatigue Impact Scale in multiple sclerosis patients

Background The aims of this study were to test the validity, test–retest reliability, and internal consistency of Turkish version of FIS; the variables affecting FIS score. Materials and methods 71 MS patients and 68 healthy subjects were included to the study. Results Total FIS score and subscale scores were different statistically between MS patients and healthy volunteers in both first and second FIS applications ( p < 0.001). These results showed that FIS is validated in divergent direction. BDI score was higher in MS patients than healthy volunteers ( p < 0.001). There was no statistically significant difference between two study groups for cognitive subscale scores, after the effect of depression was eliminated ( p > 0.05). To assess the test–retest reliability, the scores of two FIS applications did not differ statistically (cognitive t = 1.948 p > 0.05, physical t = 1.420 p = 0.160, social t = 1.470 p = 0.146, total t = 1.990 p = 0.05). Intraclass correlation coefficients were 0.89 (99% confidence interval: 0.79–0.94) for cognitive, 0.95 (0.91–0.97) for physical, 0.91 (0.83–0.95) for social, and 0.93 (0.86–0.96) for total FIS scores ( p < 0.001). EDSS correlated with physical subscores in both applications of FIS. Conclusion Turkish version of FIS, which is valid and reliable, seems an appropriate tool for the assessment of the effects of fatigue in Turkish MS population.

Application of the POSSUM system in bariatric surgery.

The POSSUM system has been devised for physiologic and operative scoring. The scoring system produced assessment for morbidity and mortality rates, which did not significantly differ from observed rates. The authors have applied this system to bariatric surgery. 20 patients were scored by the POSSUM system. All underwent elective bariatric surgery during 1997. All patients were scored at the time of surgery with the physiologic score (FIS) and at discharge with the operative severity score (IQ). The FIS score included age; cardiac signs; chest radiograph; respiratory history; blood pressure; pulse; Glasgow coma score; determinations of hemoglobin, leukocyte, urea, sodium, and potassium levels; and electrocardiogram. The IQ score included multiple procedures, total blood loss, peritoneal soiling, presence of malignancy, and mode of surgery. The mean POSSUM score was 23.9. The mean FIS was 13.95 (12-22), and the mean IQ was 9.4 (7-16). The distribution of patients was performed for BMI. The group with BMI 35-45 (n = 4 patients) had a mean POSSUM score of 22.75, a mean FIS of 13.75, and a mean IQ of 9.0. The group with BMI >45 (n = 16 patients) had a mean POSSUM score of 24.18, a mean FIS of 14.62, and a mean IQ of 9.5. The morbidities were gastric fistula with peritonitis and deep venous thrombosis. The two complications had similar POSSUM scores with different BMIs. No mortality was observed. According to this experience, the POSSUM scoring system appears to provide an indicator of minor risk of morbidity and mortality in bariatric surgery with vertical banded gastroplasty.