Life Quality Index Research Articles

Neuroprotective component of outpatient rehabilitation of patients with lumbosciatica and depression

The aim of the study was to investigate the effectiveness of including cytoflavin in complex outpatient rehabilitation therapy for patients suffering from lumboschialgia and depression .Material and methods. 86 patients (38 men and 48 women, average age — 53.2 ± 5.9 years) with lumboschialgia and depression were examined. All patients underwent dynamic somatic and neurological status examination (before and after therapy), laboratory and instrumental studies were performed. To assess the neurological profile, the following were used: digital rating scale (DRS) of pain, Oswestry questionnaire (version 2.1a), hospital anxiety and depression scale (HADS), CGI-S scale, DN4 and SF-36 questionnaires. All patients underwent dynamic diagnostics of spinal mobility using the following parameters: Thomayer test (spinal flexion, distance floor – fingers (FF)), distance fingers legs (FL), backward bend while standing and lying on the stomach. In addition to standard treatment, patients in the main group (n = 44) were prescribed cytoflavin: 2 tablets 2 times a day regardless of food intake, 30-day course. The subjects from the control group (n = 42) received only standard treatment.Results. Inclusion of cytoflavin in the regimens contributed to a more pronounced reduction in pain syndrome compared to the control group: by 5 times according to the Oswestry questionnaire (version 2.1a), by 1.7 times versus 1.3 times according to the DN4 questionnaire, respectively (p < 0.05). The disappearance or significant reduction of pain syndrome contributed to the expansion of motor activity due to the increase in mobility in the spine — a more pronounced positive dynamics in terms of extension: 34.2 % and 22.9% in the main group versus 15.9% and 17.7% in the control group (p < 0.05). The inclusion of the drug contributed to a more significant reduction in neurological symptomatology disorders than in patients in the control group: anxiety indicators (according to the HADS scale) in the control group decreased by 5.3 times, while in the control group they decreased only by 1.75 times (p < 0.05); signs of depression — by 2 and 1.5 times, respectively (p < 0.05). At the same time, the subjects to a greater extent noted a decrease in fatigue, an improvement in night sleep, an increase in activity and performance. The effectiveness of the presented outpatient rehabilitation scheme was confirmed by the positive dynamics of the patients’ quality of life indicators on all SF-36 scales: the most significant increase on the scales of “role functioning due to physical condition” and “pain intensity” — on average by 25.9 points in the control and 26.3 points in the main, respectively (p ≥ 0.05).Conclusion. The inclusion of cytoflavin in the complex treatment of patients with this pathology helps to reduce the intensity of pain, increase spinal mobility and eliminate the neuropathic component, which improves the quality of life of patients. The results obtained can serve as a basis for further research in this area.

THE CARE SCENARIO IN PRIMARY HEALTH CARE FOR THE BLACK POPULATION

This research aims to analyze inequalities in access to health care for the black population in Primary Health Care (PHC) in Brazil, highlighting the impact of structural and institutional racism on care practices. The overall objective is to analyze the current scenario of care and health promotion in primary care for the black population. The research methodology was a qualitative and descriptive literature review. The research shows that PHC, although it is the gateway to the Unified Health System (SUS), often fails to equitably meet the needs of the black population, resulting in worse health and quality of life indicators. The conclusion points out that it is urgent to implement inclusive public policies and anti-racist practices, in addition to promoting the continued training of health professionals with a focus on the specificities of the health of the black population. The active participation of this population in the formulation of policies and the encouragement of research on their health conditions are essential to promote comprehensive and equitable health.

Housing Australian Children: A Snapshot of Health Inequities in the First 2000 Days.

Housing is a critical social determinant of children's health. While individual pathways between housing and health are well evidenced, there has been less attention on the co-occurrence of housing disadvantages. We aim to identify typologies of children's housing disadvantage and describe the health inequities they generate. A cross-sectional latent class analysis (LCA) was conducted on 4355 Australian children aged 4 to 5years who participated in the Longitudinal Study of Australian Children. Nine binary indicators-dwelling tenure, external condition, affordability, stability, crowding, cleanliness, fuel poverty, and noise exposure-were used to generate latent housing typologies. Generalized linear models with robust standard errors described disparities in quality of life, injury, disability, and health service use across these housing typologies. Four distinct housing typologies were identified in this cohort: "good condition, affordable, and secure" (60%); "insecure" (11%); "crowded" (24%); and "unsuitable" (5%). Unsuitable housing, characterized by crowding, poor external conditions, and noise exposure, was more likely to be occupied by single-parent families, low-income households, and be headed by parents with low levels of education. Children in unsuitable housing lagged on quality of life indicators at preschool age (e.g., by 8.0 points on emotional functioning, 95% CI - 10.6, - 5.5), and underutilized primary healthcare services (e.g., prevalence ratio 0.76 for GP services, 95% CI 0.67, 0.87), compared to children in good quality housing. This finding supports the case for early intervention strategies that account for children's housing circumstances.

Assessing the evidence for health benefits of low-level weight loss: a systematic review.

Individuals with excess weight are at a higher risk for various physical and mental health conditions. Interventions targeting weight loss can improve health, with modest weight loss of five to ten percent of body weight often considered clinically meaningful for enhancing health outcomes. However, the benefits of achieving low-level weight loss ( < 5% body weight) are poorly understood. We aimed to systematically review relevant literature and synthesise the evidence that assessed the potential health benefits of losing less than five percent body weight. We searched seven academic databases and included studies in any language, from any country, with no time constraints. We included any intervention studies that assessed the impact of less than five percent weight loss on any measured physical or mental health markers or indices. 70 studies from 68 articles were included, with study participants ranging from 14 to 10,742. In total, 137 health markers were assessed, categorised into metabolic markers (n = 42), cardiovascular markers (n = 32), anthropometric measures (n = 19), quality of life indices (n = 10), inflammatory biomarkers (n = 10), renal and hepatic markers (n = 9), psychosocial and behavioural measures (n = 8), pulmonary function (n = 3), total mortality (n = 2), ovulatory function (n = 1), and muscle strength (n = 1). Overall, 60% of studies reported improvements, 37% found no change or mixed results, and 3% observed a worsening of health markers or indices. Based on the available data, 87% of participants (n = 15,839) in the studies reported improvements in health markers or indices as a result of low-level weight loss. Our findings suggest that low-level weight loss can lead to various health benefits and challenges the conventional threshold for effective weight loss.Preregistration The review protocol was pre-registered with PROSPERO (CRD42023406342).

Pressurized Intraperitoneal Aerosol Chemotherapy for Peritoneal Carcinomatosis in Colorectal Cancer Patients: A Systematic Review of the Evidence

Introduction: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) consists of the administration of aerosolized chemotherapy into the abdominal cavity of patients suffering from peritoneal carcinomatosis. Our aim was to review the evidence supporting PIPAC in patients with peritoneal carcinomatosis from colorectal cancer. Methods: A systematic review was performed in accordance with the 2020 PRISMA guideline. MEDLINE and CENTRAL were searched using combinations of terms including “Peritoneal carcinomatosis”, “Peritoneal metastasis”, “PIPAC”, “Pressurized intraperitoneal aerosol chemotherapy” and “Colorectal cancer”. Original studies, in English, including patients treated with PIPAC for colorectal peritoneal carcinomatosis, were considered eligible. Case reports, non-English or French language articles and secondary analyses were excluded. Results: A total of 385 articles were screened and 374 articles were excluded, leaving 11 publications for inclusion in the qualitative analysis. The included studies totalized 949 patients who received PIPAC for peritoneal carcinomatosis due to colorectal cancer. The median peritoneal carcinomatosis index (PCI) ranged from 10 to 31. In all studies, the complete PIPAC protocol was achieved with an average of two to three 3 PIPAC sessions per patient. Oxaliplatin (OX) was used as a chemotherapeutic agent in all studies and could be associated with intravenous 5-FU and leucovorin. Most post-operative adverse events were recorded as mild to moderate with no intraoperative complications. Only four studies reported a decrease in the average PCI score for 50% of the patients. Median overall survival ranged from 8 to 37.8 months. Quality of life indicators were stable between PIPAC-OX cycles with a small but not statistically significant trend of improvement of most functional scales. Conclusions: PIPAC for peritoneal carcinomatosis from colorectal origin is feasible, safe and tolerable. Its impact on survival outcomes or quality of life remains to be demonstrated by randomized trials.

Intra, short and long-term results of mitral VIV for the degenerated surgical mitral prosthesis from italian VIV registry (MIVIV registry)

Abstract Background/Introduction Reoperation of failed bioprosthetic mitral valves is associated with significant morbidity and mortality. Transcatheter mitral valve-in-valve (MViV) replacement was explored early in the development of THVs with transseptal/transfemoral (TS/TF) and transapical (TA) approaches. Purpose This is the first Italian Registry on mitral VIV and it was designed to explore contemporary MViV outcomes with all types of balloon expandable valves. The present study out of the registry aims to asses the &amp;gt;10 years follow-up outcomes in terms of mortality, gender diversity, and perioperative result. Methods Participating centers used standardized definitions to collect clinical information, including patient demographic characteristics, comorbidities, functional status, quality of life indexes, procedural details, and patient outcomes from consecutive MViV cases. Cohort of 265 patients was available for the primary analysis and follow-up too.The patients were grouped by 11 hospitals in Italy performing VIV for degenerated biological mitral prostheses. Results A total of 265 pts underwent mitral VIV due to bioprosthesis degeneration between January 2010 and January 2023. They have been subdivided by transfemoral (TF) with 117 (44%) pts and transapical (TA) with 148 (55,8%) pts. Most of the patients were of female sex (59,2%) and EuroScore II for surgical re-operation was 16.1%. Mixed disease (48%) was more common than mitral regurgitation (29%) and stenosis (22%). 69,8% of the total cohort was in class NYHA III and the mean LVEF was 54%.Otherwise, there were no significant demographic differences between patients undergoing TS and TA. In TF there was more severe PVL (5%)(p-value: 0,001) and much more cases of severe grade of stenosis (54,7%) and regurgitation (57%)(p-value&amp;lt; 0,0001). Considering intraoperative outcomes, technical success has been established in around 97,7% of the total cohort without difference btw groups. Only 3,3% died during hospitalization without difference between groups (P-value=0,735). LVOT obstruction has been seen in 3,4% in the case of TA and 0 for TF. Only 1,5% of the total cohort underwent surgical conversion as well as embolization in only 1,1%. Overall survival from the total cohort was 91,3% at &amp;gt;10 years, Figure 1. Concerning the freedom from cardiac death (CV death) was 96,6% in the total cohort at 13 years. Concerning the difference between access, the general survival is established at 97,4% in TF while 86,3% in TA (p-value =0,050)(Figure 2). Freedom from CV death was 99,1% in TF and 94,5 in TA (p-value=0,209). In gender analysis differentiation, the general survival in females was 98,5% in TF and 85,6% in TA at 13 years (p-value=0,056). Conclusion(s) Transcatheter MViV using a balloon-expandable valve is associated with high technical success, a low complication rate, and a solid long-term benefit in terms of survival. Transseptal access was associated with lower mortality compared with TA access.Figure 1Figure 2

Comparison Between Anterior-Apical Mesh (Surelift) and Anterior Mesh (Surelift-A) in Transvaginal Pelvic Organ Prolapse Surgery: Surgical and Functional Outcomes at 1-Year Follow-Up.

Surelift is a transvaginal synthetic mesh (TVM) kit that is intended to treat anterior and apical pelvic organ prolapse (POP). The kit can be configured to use an anterior-apical (Surelift) or anterior (Surelift A) approach. The aims of this study were to evaluate the short-term objective and subjective outcomes of the different approaches at the 1-year follow-up. From June 2018 to April 2021, a total of 280 patients with symptomatic advanced POP (stages III and IV) had surgery with the Surelift or Surelift A. The primary outcome was postoperative de novo stress urinary incontinence (SUI), as well as subjective evaluation based on the Urinary Distress Inventory 6 (question 3 score > 1) and Incontinence Impact Questionnaire 7, during the 1-year follow-up period. Secondary outcomes measured quality of life, the presence of lower urinary tract symptoms, and complications. In total, 265 patients were assessed. Among these, 137 had Surelift, whereas 128 underwentSurelift A with SSF. At 1-year postoperative follow-up, de novo urodynamic stress incontinence occurred more frequently in the Surelift group than in the Surelift-A group (28.8% vs 9.1% respectively, p = 0.012). Additionally, Surelift patients had a higher rate of de novo SUI than Surelift A (33.2 vs 11.4 respectively, p = 0.013). Both study groups experienced improvements in their quality of life indicators. The Surelift device is a safe and effective technique of treating advanced-stage POP. De novo urine incontinence appears to be more common in the Surelift group than in the Surelift-A group. We found good anatomical outcomes and subjective relief in both study groups, with a low complication rate.

Assessing the sensitivity and acceptability of the Royal Marsden Palliative Care Referral “Triggers” Tool for outpatients with cancer

PurposeTo evaluate the use, acceptability, and experience of a seven-item palliative care referral screening tool in an outpatient oncology setting.MethodsA two-phase convergent parallel mixed-methods study. Patient participants who met any of the “Royal Marsden Triggers Tool” criteria were compared with those who did not in terms of demographic data, palliative care needs (Integrated Palliative Outcome Scale, IPOS) and quality of life indicators (EORTC-QLQ-C30).In-depth interviews were carried out with patients and oncology staff about their views and experience of the “Royal Marsden Triggers Tool”. Qualitative and quantitative data were triangulated at data interpretation.ResultsThree hundred forty-eight patients were recruited to the quantitative phase of the study of whom 53% met at least one of the Triggers tool palliative care referral criteria. When compared with patients who were negative using the Triggers tool, “Royal Marsden Triggers Tool” positive patients had a lower quality of life (EORTC QLQ-C30 Global Health Status scale (p < 0.01)) and a higher proportion had severe or overwhelming physical needs on IPOS (38% versus 20%, p < 0.001). Median survival of “Royal Marsden Triggers Tool” positive patients was 11.7 months.Sixteen staff and 19 patients participated in qualitative interviews. The use of the tool normalised palliative care involvement, supporting individualised care and access to appropriate expertise.ConclusionThe use of a palliative care referral tool streamlines palliative care within oncology outpatient services and supports teams working together to provide an early holistic patient-centred service. Further research is needed to evaluate the effectiveness and feasibility of this approach.

Impact of pain on functional status and quality of life in Jordanian women with breast cancer.

Currently, breast cancer is the most prevalent type of cancer affecting women, and the number of newly diagnosed cases continues to increase both in Jordan and globally. Upon receiving a cancer diagnosis, the suffering experienced by patients intensifies as they grapple with the debilitating side effects that hinder their ability to carry out routine activities. This study aims to assess the impact of cancer pain on functional status and quality of life (QOL) among Jordanian women with breast cancer. A descriptive cross-sectional design and structured interviews were conducted in the Oncology Unit at Al-Bashir Hospital with a sample of 150 eligible Jordanian women with breast cancer who provided data on pain and functional status, and QOL using four Arabic questionnaires (brief pain inventory, functional status SF-12 questionnaire, and quality of life index) to measure pain and functional status and QOL, descriptive statistics, Pearson correlation, and regression statistical test were utilized to analyze the study data. A Significant positive correlation (r = 0.342) was found between cancer pain and functional status interference, a significant negative correlation (r = -0.134) between quality of life and functional status interference, and a significant negative correlation (r = -0.211) between pain and quality of life. Patients with higher intensity of cancer pain are more likely to experience low functional status and poor QOL. Breast cancer patients experience alterations in their quality of life as a result of cancer-related pain, which has a detrimental impact on their ability to carry out daily activities and disrupts their functional abilities. Healthcare providers must take these alterations into account and effectively handle them. Understanding the relationship between cancer pain and breast cancer can aid nurses in managing symptoms and providing holistic care, ultimately improving the quality of life.

"Ups and Downs, Joys and Sorrows" - Assessment and Clinical Relevance of Patient Priorities in an Interdisciplinary Parkinson's Disease Clinic.

Barriers to communication and inaccurate provider assumptions about patient priorities limit the delivery of comprehensive, high-quality, patient-centered care (PCC) to people with Parkinson's (PWP). This study aimed to analyze priorities of PWP using a qualitative, unstructured single-question survey and to test associations with validated quality of life (QOL) measures. During appointments at a subspecialty, interdisciplinary clinic, PWP (n=139) provided written responses to the prompt: "What is important for your care team to know about you?" Patient Health Questionnaire, Montreal Cognitive Assessment, and Hoehn and Yahr scales were obtained through retrospective chart review. Key qualitative themes were identified through grounded theory analysis, and associations with quantitative health measures were tested with correlation analyses. Common themes included participant health (eg, PD-related goals and comorbidities), non-illness identities (eg, family or community role), and the psychosocial impact of PD (eg, losing independence and uncertainty). Positive sentiments (n=73), such as motivation and optimism, were more common than negative sentiments (n=45), such as loss and fear. There was moderate concordance between worsened mental health and uncertainty (rho=0.206, p=0.02) and inverse concordance between worsened mobility and gratitude (rho=-0.174, p=0.04). The range of priorities that PWP want to share with their care team is more diverse than that of common provider assumptions, is correlated with clinical outcomes such as mental health and mobility, and may not be captured by existing QOL assessment tools. An open-ended, qualitative prompt should be incorporated into routine specialist care for PWP as a valuable QOL indicator.

Community attitudes toward tourism and quality of life: a case study of Palangan village, Iran

Community perception is essential for influencing the physical, social, and environmental growth of a region and is key to achieving a high Quality of Life (QOL). Tourism serves as a common means of introducing outsiders to the area where the community lives. Embracing tourism in remote locations like small towns or rural areas can be difficult, and the success of tourism hinges on community attitudes towards it. The community's engagement and approval of tourism are dependent on the benefits such as how tourism improves their QOL in both the short. Therefore, this study aims to explore the local community's perceptions on how tourism influences various aspects of QOL. A survey of 160 households in Palangan Village was conducted to collect primary data, using a conceptual model with 16 indices to evaluate QOL. The findings indicate that the local community generally has a positive perception of the effects of tourism, especially on key QOL components. Civic and generative well-being are considered more significant than other aspects of QOL. Analysis of the data reveals differences in perception across the 16 QOL indices. The highest average ratings were for institutional participation (3.476), quality of employment (3.456), and individual capability (3.203), while the lowest ratings were for standard of living (1.883), social solidarity (2.289), and environmental resource quality (2.725). For instance, the institutional participation index received an average response rating of 3.476. Additionally, the dispersion coefficient index highlighted notable variations in perception, particularly for satisfaction with living conditions (0.488) and standard of living (0.488). Conversely, employment quality (0.360), institutional cooperation (0.385), and freedom of choice had the lowest dispersion coefficients (0.386). Other indices showed moderate levels of dispersion and distribution of perception. In conclusion, these results underscore the significance of community perception in tourism development and its affect on QOL. They also underscore the importance of strategic planning and balanced development to ensure that all aspects of QOL benefit from the expanding tourism sector, leading to a more sustainable and harmonious community.

Impact of daily physical activity level on mental health and quality of life in substance use disorders patients

ABSTRACT Background Substance use disorders patients often exhibit low levels of physical activity. However, the daily level of physical activity appears to significantly impact the patient’s rehabilitation process. Methods This study analyses the daily level of physical activity (International Physical Activity Questionnaire-Short Form) in a group of 125 patients undergoing rehabilitation, and its relationship with levels of mental health (Depression Anxiety Stress Scale) and quality of life (Short Form Health Survey). Additionally, gender differences in all measured variables were analyzed. Results The results show a strong correlation between daily physical activity and levels of mental health (ρ>0.787), as well as a moderate correlation between physical activity levels and quality of life (ρ:0.406–0.586). Furthermore, when analyzing gender differences, women exhibited lower levels compared to men in physical activity (p < 0.001), mental health (p < 0.05), and different quality of life indicators (p < 0.05). Conclusion The results of this study indicate that the level of daily physical activity could influence the quality of life and mental health of patients during the rehabilitation process. Therefore, rehabilitation treatments should include strategies to increase patients’ daily physical activity levels. Furthermore, considering the gender disparities identified, additional studies are warranted in this field.

Unveiling Post-COVID-19 syndrome: incidence, biomarkers, and clinical phenotypes in a Thai population

BackgroundPost-COVID- 19 syndrome (PCS) significantly impacts the quality of life of survivors. There is, however, a lack of a standardized approach to PCS diagnosis and management. Our bidirectional cohort study aimed to estimate PCS incidence, identify risk factors and biomarkers, and classify clinical phenotypes for enhanced management to improve patient outcomes.MethodsA bidirectional prospective cohort study was conducted at five medical sites in Hatyai district in Songkhla Province, Thailand. Participants were randomly selected from among the survivors of COVID-19 aged≥18 years between May 15, 2022, and January 31, 2023. The selected participants underwent a scheduled outpatient visit for symptom and health assessments 12 to 16 weeks after the acute onset of infection, during which PCS was diagnosed and blood samples were collected for hematological, inflammatory, and serological tests. PCS was defined according to the World Health Organization criteria. Univariate and multiple logistic regression analyses were used to identify biomarkers associated with PCS. Moreover, three clustering methods (agglomerative hierarchical, divisive hierarchical, and K-means clustering) were applied, and internal validation metrics were used to determine clustering and similarities in phenotypes.FindingsA total of 300 survivors were enrolled in the study, 47% of whom developed PCS according to the World Health Organization (WHO) definition. In the sampled cohort, 66.3% were females, and 79.4% of them developed PCS (as compared to 54.7% of males, p-value <0.001). Comorbidities were present in 19% (57/300) of all patients, with 11% (18/159) in the group without PCS and 27.7% (39/141) in the group with PCS. The incidence of PCS varied depending on the criteria used and reached 13% when a quality of life indicator was added to the WHO definition. Common PCS symptoms were hair loss (22%) and fatigue (21%), while mental health symptoms were less frequent (insomnia 3%, depression 3%, anxiety 2%). According to our univariate analysis, we found significantly lower hematocrit and IgG levels and greater ALP levels in PCS patients than in patients who did not develop PCS (p-value< 0.05). According to our multivariable analysis, adjusted ALP levels remained a significant predictor of PCS (OR 1.02, p-value= 0.005). Clustering analysis revealed four groups characterized by severe clinical symptoms and mental health concerns (Cluster 1, 4%), moderate physical symptoms with predominant mental health issues (Cluster 2, 9%), moderate mental health issues with predominant physical symptoms (Cluster 3, 14%), and mild to no PCS (Cluster 4, 77%). The quality of life and ALP levels varied across the clusters.InterpretationThis study challenges the prevailing diagnostic criteria for PCS, emphasizing the need for a holistic approach that considers quality of life. The identification of ALP as a biomarker associated with PCS suggests that its monitoring could be used for early detection of the onset of PCS. Cluster analysis revealed four distinct clinical phenotypes characterized by different clinical symptoms and mental health concerns that 'exhibited varying impacts on quality of life. This finding suggested that accounting for the reduced quality of life in the definition of PCS could enhance its diagnosis and management and that moving toward personalized interventions could both improve patient outcomes and help reduce medicalization and optimally target the available resources.FundingThe research publication received funding support from Medical Council of Thailand (Police General Dr. Jongjate Aojanepong Foundation), Hatyai Hospital Charity and Wellcome Trust.

The impact of a large airport on residents' quality of life and annoyance

A nearby large airport provides both positive and negative impact on surrounding communities. It can provide economic growth for a region near an airport, but also have a negative environmental and health-related impact with respect to aircraft induced noise exposure and air pollution. To study the impact of aircraft noise together with other aspects of air traffic in an airport region on the quality of life (QoL) and annoyance of residents in surrounding regions, a survey regarding nine QoL indicators was conducted for two Dutch communities. A comparison was made between one higher aircraft noise exposed community situated near Schiphol airport and one in Utrecht without a neighbouring airport and thus less exposed to aircraft noise. Results showed more aircraft noise-annoyed people living near the airport than people living further away. Using a Principle Component Analysis, the nine extracted factors supported previously theorized indicators defining QoL. Noticeable differences were found in neighborhood trouble, social contacts and aerospace perception between these two communities with the airport as main discriminator. Outcomes of this study help to develop a model to measure QoL and improve the understanding of the impact of noise exposure and other characteristics of a nearby airport on people's well-being.

Review of open libraries for pharmacoeconomic analysis in R environment

Background. To reveal the full complexity of the relationship between medical intervention and disease outcome, new methods of analysis and modeling are actively being developed, and tools are becoming more complex, for the use of which it is important to understand their limitations and advantages.Objective: conducting a critical review of the main open-source packages in R environment for conducting pharmacoeconomic analysis.Material and methods. The selection of libraries used for pharmacoeconomic analysis in the R environment was carried out based on the keywords “health economic”, “DALY”, “QALY” in the CRAN repository. Only libraries that were valid on the date of the review were included in the study. The selected 10 R software libraries for pharmacoeconomic analysis were reviewed from the standpoint of the number of tools they support, the format of the data used, the possibilities of visualizing results and generating reports, the presence of vignettes and the possibilities of parallelizing calculations.Results. The selected libraries can be divided into three classes: packages for calculating various quality of life indices, libraries for calculating indicators and indices of economic effectiveness of medical interventions (DALY, QALY, ICER), libraries for performing sensitivity analysis of the effect of medical interventions based on decision tree algorithms and Markov models. The libraries “heemod”, “hesim”, “rdesign” allow building simple Markov and semi-Markov models, but preference should be given to “heemod” due to the presence of vignettes. To conduct an analysis using cohort Markov models, partitioned survival models, it is recommended to use the “hesim” library, if there are gaps in the results, it is recommended to use “missingHE”. The “rdesigin” library allows building decision trees indicating the risk of developing certain conditions and the cost of therapy. The “survHE” library for survival analysis, used specifically in health economics, allows you to carry out probabilistic sensitivity analysis based on survival models. To calculate the survival models themselves to identify predictors of a patient's transition from one health state to another, you will need to additionally install the “flexsurv” library. To visualize the results of pharmacoeconomic modeling, you should additionally install the “diagram” and “ggplot2” libraries. Conclusion. The conducted critical review of open source libraries in R environment can serve as a navigator for choosing a tool for performing pharmacoeconomic analysis.

Using impedance planimetry (EndoFLIP) to determine ideal distensibility ranges for esophageal motility disorders

ObjectiveUse of impedance planimetry (EndoFLIP) has shown distensibility index ranges associated with improved patient-reported outcomes after antireflux surgery. Questions remain whether the previously described ideal distensibility index range can be used for patients with esophageal motility disorders. We hypothesized that patients with esophageal motility disorders would have a different ideal distensibility range for optimal outcomes. MethodsA retrospective review of a prospectively maintained gastroesophageal database was performed for all patients undergoing Toupet and Nissen fundoplication and impedance planimetry. Demographic data, perioperative outcomes, and quality-of-life indicators (Reflux Symptom Index, Gastroesophageal Reflux Disease-Health Related Quality of Life Questionnaire, and gas/bloat and dysphagia scores) were analyzed and compared between patients by use of the χ2 and Wilcoxon rank-sum tests. ResultsFrom 2015 to 2024, 475 patients underwent laparoscopic fundoplication and impedance planimetry evaluation. Of those, 160 had a final distensibility index score in the ideal range, 165 with a final distensibility index score <2.5, and 150 with a final distensibility index >3.6. In the ideal-range cohort, there were no statistically significant differences between those with normal and abnormal motility in regards to outcomes or quality of life indicators. In the low distensibility index cohort, patients with abnormal motility had worse Gastroesophageal Reflux Disease-Health Related Quality of Life Questionnaire, gas/bloat, and dysphagia scores at 1 year postoperatively compared with those with normal motility. More patients in the low distensibility index cohort required dilations postoperatively, and more patients in the high distensibility index cohort had recurrences compared with those in the ideal range cohort. ConclusionThe previously described ideal distensibility index range of 2.5–3.6 for patients undergoing laparoscopic fundoplication may be used for patients with certain esophageal motility disorders.

Factors affecting the risk of trismus following maxillary ablative surgery comparing free flap reconstruction to prosthetic obturation: a retrospective observational study

The reconstruction of post-ablative maxillary defects is controversial. It is accepted that quality of life indicators are poorer for maxillary reconstruction compared with mandibular reconstruction. One factor highlighted is that of post-treatment trismus. Rates of trismus are reviewed comparing free tissue transfer to that of prosthetic obturation. A retrospective review was undertaken comparing rates of trismus at twelve months post-surgery between free tissue transfer and prosthetic obturation. A total of 85 patients were identified who met the inclusion criteria. Both reconstruction techniques were significant for developing trismus, with a higher rate in the free flap reconstruction cohort than the prosthetic obturation cohort by a factor of 2.51. Modern reconstructive head and neck surgery has moved away from ‘filling a hole’ to a more bespoke, patient-specific reconstruction. The evidence presented here should allow the reconstructive surgeon to better discuss outcomes with patients when considering surgical options for Class II maxillary defects.

Level of Population’s Satisfaction with Quality of Life Indicators in Krasnoyarsk

Background. The large city of Krasnoyarsk represents a unique urban environment where various indicators, such as ecology, infrastructure, healthcare, and education services, play an important role in shaping the level of residents’ satisfaction and impacting their quality of life. Purpose: To study the level of the population’s satisfaction with the quality of life indicators in Krasnoyarsk. Material and methods. A sociological survey was conducted using a questionnaire. The authors also applied the random sampling technique. The sample size was 687 respondents. Results. The study identified several key problems: low levels of satisfaction with environmental quality, quality of medical services, and accessibility of healthcare organizations; low income of the population; limited opportunities for recreation and entertainment. Overall, the study highlights the importance of further studying and improving quality of life indicators in Krasnoyarsk to increase residents' satisfaction and create a more comfortable urban environment. Conclusion. Based on the level of the population’s satisfaction, it is possible to consider public opinion in management decision-making and developing social programs for urban infrastructure planning.

The impact of group cognitive behavioral psychotherapy on disease severity and psychosocial functioning in patients with inflammatory bowel disease: a randomized controlled study.

Patients with inflammatory bowel disease (IBD) often report symptoms of anxiety and depression as well as impaired quality of life (QoL). To date, there are few studies on the effect of psychotherapy on psychological functioning and clinical outcome in patients with IBD. The aim of this prospective, randomized, controlled study was to investigate the effect of a brief psychotherapeutic intervention on psychological distress, QoL, sexual functioning, and inflammation and disease activity indices in patients with IBD. Participants were randomized to receive either group cognitive behavioral therapy or treatment as usual (controls) and were assessed at baseline and after six months using psychometric instruments to assess psychological distress, QoL, and sexual functioning. In addition, laboratory measurements, including levels of C-reactive protein (CRP), cytokines and calprotectin, and calculations of disease activity indices were performed during the two study periods. 80 participants took part in the study. Patients who received psychotherapy reported a significant decrease in anxiety and depression symptoms, a significant improvement in physical functioning, general health, vitality, social functioning and mental health, a decrease in physical pain and a decrease in role limitations caused by emotional problems. CRP levels and the Crohn's disease activity index (CDAI) also decreased significantly at follow-up compared to controls. Group cognitive behavioral therapy is proving to be an important component of holistic care for IBD patients, as it can significantly improve not only patients' psychosocial functioning but also their clinical course by inhibiting inflammation and reducing disease activity.

Functional outcome and quality of life index after endonasal versus external dacryocystorhinostomy

Abstract Purpose: To compare the functional outcome and quality of life (QOL) index following non-endoscopic endonasal dacryocystorhinostomy (NEN-DCR) and external dacryocystorhinostomy (EXT-DCR). Methods: Patients were prospectively allocated to two groups. All adult patients presenting with primary nasolacrimal duct obstruction (PANDO) undergoing EXT-DCR and NEN-DCR at a tertiary eye care center were included. Patients in one group underwent EXT-DCR and others NEN-DCR. Functional outcomes were measured by Munk Score and fluorescein dye disappearance test (FDDT). A validated quality of life questionnaire (EQ-5D-3L) in the local language (Odiya) was used to measure health status (social impact score) before and 1 day, 2 weeks, 6 weeks, and 3 months after surgery. The primary outcome measure was the functional outcome–Munk Score and secondary outcome measures included the QOL index and the FDDT. Results: A total of 110 patients were recruited and equally distributed (n = 55) in both groups. The mean age of the population was 47.6 years (SD = 14.02; range 20–79 years). The majority (71%, 79/110) were female. When longitudinally followed over time, functional outcome and QOL index showed reasonably rapid and marked improvement in both groups after surgery compared to baseline scores. The Munk score (P = 0.037) and QOL index (P = 0.007) were marginally better on the first postoperative day for the NEN-DCR group compared to EXT-DCR but comparable at all subsequent visits. At a median follow-up of 9 weeks (range: 0.5–24 weeks), the anatomical outcome was comparable between both groups. Conclusion: Our results demonstrate that functional outcome and QOL index show rapid and marked improvement in both NEN-DCR and EXT-DCR after surgery. NEN-DCR outcomes were marginally better on the first postoperative day but comparable to EXT-DCR thereafter.