Quality Of Life In Patients Research Articles

Real-World Effectiveness of Mepolizumab in Severe Asthma: Results from the Multi-country, Self-controlled Nucala Effectiveness Study (NEST).

The Nucala Effectiveness Study (NEST) assessed the effectiveness of mepolizumab in patients with severe asthma (SA) in countries previously underrepresented in real-world studies. A multi-country, bi-directional, self-controlled, observational cohort study conducted in Colombia, Chile, India, Türkiye, Saudi Arabia, United Arab Emirates, Kuwait, Oman, and Qatar. Historical and/or prospective data from patients with SA were assessed 12months pre- and post-mepolizumab initiation. incident rate ratio (IRR) of clinically significant exacerbations (CSEs). Key secondary endpoints: healthcare resource utilisation (HCRU), oral corticosteroid (OCS) use, lung function and symptom control (Asthma Control Test [ACT] scores). Overall, 525 patients with SA burden pre-initiation (geometric mean blood eosinophil count [BEC] 490.7 cells/µl; 31.4% prior biologic use; 37.3% obese) received at least one dose of mepolizumab 100mg subcutaneously. Post-initiation, a significant reduction in CSEs was observed (76% [p < 0.001]; IRR [95% confidence interval] 0.24 [0.19-0.30]); 72.0% of patients had no CSEs. Mepolizumab treatment led to a reduction in OCS use (52.8% pre-initiation vs. 16.6% post-initiation) and a mean (standard deviation [SD]) change in OCS dose of -18.1 (20.7) mg post-initiation; 36.1% of patients became OCS-free. Fewer patients were hospitalised post-initiation (22.5% pre-initiation vs. 6.9% post-initiation). Improvements in mean (SD) forced expiratory volume in 1s (62.8 [20.2]% pre-initiation vs. 73.0 [22.7]% post-initiation) and ACT scores (15.0% pre-initiation vs. 64.5% of patients post-initiation with well-controlled asthma) were observed. Proportion of patients with BEC ≥ 500 cells/µl decreased from 84.4% pre-initiation to 18.1% post-initiation. Mepolizumab was effective in reducing the burden of SA by significantly reducing CSEs, reducing OCS use and HCRU, and improving lung function and asthma control, which could translate to improvements in health-related quality of life in patients with SA and high OCS dependency in the countries studied. A graphical abstract is available with this article.

Effect of Dry Needling Plus Static Stretching on Plantar Flexors Spasticity in Chronic Stroke Patients.

Stroke is a leading cause of disability worldwide and is often accompanied by complications such as spasticity. Static stretching (SS) is a common physiotherapy intervention for reducing spasticity, whereas dry needling (DN) is a novel approach. However, the combined effects of DN and SS on spasticity have not been thoroughly investigated. Given the pivotal effect of spasticity on daily activities, mitigating spasticity can significantly contribute to restoring patient independence. This study will explore the impact of DN plus SS on spasticity, alpha motor neuron excitability, overall function, and quality of life in patients with chronic stroke. A double-blind, randomized, sham-controlled trial will be conducted in patients with post-stroke spasticity in the plantar flexor muscles. Twentyeight participants will be randomly assigned to either an intervention or control group. The intervention group will receive DN (60s × 3 days/week; 1 week) plus SS (20 min × 5 days/ week; 1 week). The control group will undergo sham DN (60s × 3 days/week; 1 week) and SS (20 min × 5 days/week; 1 week). DN plus SS or sham DN plus SS. Both groups will be assessed at baseline, immediately post-treatment, and after 1 week of follow-up. Outcome measures will include the Modified Modified Ashworth Scale, H-reflex latency, Hmax/Mmax ratio, active and passive ankle dorsiflexion range of motion, timed up and go test, and the EuroQol questionnaire. Results from this randomized, sham-controlled study will provide evidence for the effectiveness of DN in combination with SS for spasticity. The additional impact of DN in conjunction with SS, a widely used method for reducing muscle tone, remains unclear and warrants investigation. This study, with a high level of evidence, aims to address this knowledge gap.

TAXA DE FALHA DE PROTOCOLO UTILIZANDO A TÉCNICA ALL-ON-4: UMA REVISÃO NARRATIVA

Oral rehabilitation through dental implants is a fundamental solution for restoring the quality of life in edentulous patients and has been widely used due to its high success rates. The all-on-four concept combines two anterior axial implants and two posterior angled implants, making it a viable rehabilitation option for patients with severe bone loss, minimizing the complexity of the surgical procedure, and enabling immediate rehabilitation. Although it presents excellent success rates, it is important to understand the risk factors for implant survival failure. The aim of this work is to conduct a narrative review of the literature and, from it, analyze the failure rates of rehabilitations using the all-on-four protocol. The possible factors identified were gender, maxillary bone, smoking, presence of bruxism, systemic diseases, and previous periodontitis. The implant survival rate confirmed the high success rates of the technique, varying between 94% and 99%. Smoking was shown to be the main risk factor for failure, a variable present in all reviewed articles. The presence of bruxism also presented relevance, albeit more discreetly. The other factors did not show significant impact. It is concluded that there is a need for a greater number of randomized clinical trials with larger samples and long-term follow-up, as the current evidence is limited by the quality of available studies and the scarcity of data on longer clinical outcomes.

Effects of the teach-back method on the health status of patients with chronic obstructive pulmonary disease: a real-world community-based cluster-randomized controlled trial.

The teach-back method (TBM), also known as the "show-me" method, is a technique for verifying patients' understanding of health-related information that has been recommended for improving health literacy. However, the research on TBM effect on the outcomes of chronic obstructive pulmonary disease (COPD) patients is limited. Therefore, the aim of this study was to examine the effect of a TBM intervention on the health status of COPD patients. This real-world community-based cluster-randomized controlled trial enrolled 1,688 patients with COPD from 18 communities in China. Participants received either TBM plus usual care (UC) or UC only. General practitioners were trained in TBM before the intervention. The primary outcomes were depression and anxiety symptoms, as measured by the Hospital Anxiety and Depression Scale (HADS). The secondary outcomes were health-related quality of life and dyspnea, as measured by the COPD Assessment Test (CAT). Dyspnea was assessed using the modified Medical Research Council (mMRC) dyspnea scale. Data on acute exacerbations and deaths were extracted from medical records. Lung function was expressed as the forced expiratory volume in 1 second as a percentage of the predicted value [FEV1 (% pred)]. In total, 336 of the 853 COPD patients in the intervention group (TBM plus UC) had comorbid depression, compared with 329 of the 835 in the control group (UC only). The TBM group showed a significantly greater improvement in HADS depression and anxiety subscale scores (HADS-D and HADS-A, respectively) than the UC group at12 months (t =8.34, P<0.001; t=12.18, P<0.001). The CAT and mMRC scores were significantly lower in the TBM than UC group at 12 months (t=8.43, P<0.001; t=7.23, P<0.001). The numbers of acute exacerbations and deaths were significantly lower in the TBM than UC group at 12 months (mean MCF values were 0.35 and 0.56, respectively [difference of 0.22; 95% confidence interval (CI): -0.41, -0.02; χ2=9.63, P<0.001]. The FEV1 (% pred) was significantly higher in the TBM than UC group at 12 months (t=7.45, P<0.001). General practitioners can use TBM interventions to effectively reduce anxiety, depression, and dyspnea symptoms, decrease the frequency of exacerbations and likelihood of death, and improve health-related quality of life and pulmonary function in patients with COPD. The trial was registered on the Chinese Clinical Trials Registry (reference: ChiCTR-TRC-12001958).

Impact of chronic pain and depressive symptoms on the quality of life of adults with Chiari Malformation type I: A comparative study.

Chiari Malformation type I (CM-I) is a neurological disorder characterized by cerebellar tonsillar herniation. Chronic pain, particularly headaches, is a prevalent symptom in CM-I patients, significantly impacting their quality of life. The objective of this study was to evaluate the perceived quality of life in adults with CM-I and examine the influence of chronic pain and comorbid symptoms on their well-being. 26 CM-I patients (8 with decompressive surgery) and 26 matched healthy controls were recruited. Participants completed the following questionnaires: WHOQOL-BREF, HDI, NDI, OLBPDQ and HADS. CM-I patients exhibited significantly lower scores across all domains of quality of life when compared to healthy controls. Chronic pain, including headache, neck pain, and low back pain, was more pronounced among CM-I patients and demonstrated a significant correlation with depressive symptoms. Notably, after controlling for chronic pain, the differences in quality of life between CM-I patients and controls diminished. The results suggest that chronic pain, especially headaches, and comorbid depressive symptoms exert a substantial impact on the quality of life of CM-I patients. Surgical intervention alone may not fully address these issues, highlighting the importance of considering psychological interventions as part of the comprehensive treatment. Further research with larger samples and pre-post-surgery assessments is needed to validate these findings and explore the potential benefits of psychological therapies in enhancing the quality of life for CM-I patients.

Factors Predicting the Quality of Life of Persons with Spinal Cord Injuries

Purpose: This study investigated the impact of depression, fear of falling, and activities of daily living (ADL) on the quality of life (QoL) among patients with spinal cord injuries (SCIs) in South Korea.Methods: This study adopted a prospective cross-sectional design. Data were collected using self-reported questionnaires from 70 SCI patients who visited the outpatient department of rehabilitation medicine. The data collection period was from October 16, 2017 to February 2, 2018. Participants’ American Spinal Injury Association Impairment Scale classifications were C and D.Results: The study found that QoL correlated with self-rated health (Spearman rho=.41, &lt;i&gt;p&lt;/i&gt;&lt;.001), SCI duration (Spearman rho=-.26, &lt;i&gt;p&lt;/i&gt;=.030), depressive symptoms (Spearman rho=-.43, &lt;i&gt;p&lt;/i&gt;&lt;001), and fear of falling (Spearman rho=-.75, &lt;i&gt;p&lt;/i&gt;&lt;.001). Additionally, QoL was associated with fear of falling (β=-.68, &lt;i&gt;p&lt;/i&gt;&lt;.001) and SCI duration (β=-.18, &lt;i&gt;p&lt;/i&gt;=.025) in the regression analyses. These results were significant and accounted for 59.5% of the variance in QoL.Conclusion: Interventions targeting the QoL of patients with SCI can help reduce the fear of falling.

Body image perception and social support are important predictors of quality of life in bladder cancer patients after cystectomy with urinary diversion.

Systematic evaluations focusing on the perception of body image and social support in relation to quality of life (QoL) outcomes in patients RC with UD are currently lacking. This study investigated the relationship between body image perception, social support, and QoL in bladder cancer patients who underwent radical cystectomy (RC) with urinary diversion (UD). A cross-sectional survey was conducted using validated general oncology tools to assess QoL in relation to newly implemented tools assessing body image perception and social support. Body image perception was assessed with the Self-Image Scale, and social support was assessed using the Illness-Specific Social Support Scale. Logistic regression models were used to analyze factors associated with QoL and body image respectively. The survey revealed a significant association of body image perception with QoL, as well as social support with body image perception. This is the first study to systematically evaluate these psychosocial factors in the context of QoL for RC patients, highlighting their critical role in patient-reported outcomes. Body image perception and social support are important psychosociological factors that affect QoL of bladder cancer patients post-RC. Targeted psychosocial interventions could be promising for improving QoL patients post-RC.

A Prospective and Observational Study on the Impact of Patient Counselling on Medication Adherence and Quality of Life in Stroke Patients

PURPOSE: The study goals are to improve medication adherence and high-quality lifestyles in stroke patients through effective patient counselling. BACKGROUND: Stroke is one of the most common neurological disorders and the second most common purpose of dying worldwide. Stroke is likewise called cerebral infarction or cerebrovascular twist of fate. It occurs when blood flow to the brain is reduced due to permanent or temporary blockage of an artery that carries blood to the brain, or rupture of an artery in the brain because of high blood pressure The primary danger elements of Stroke encountered are high blood pressure, age, diabetes mellitus, obesity, smoking, and alcohol. the burden of stroke is gigantic and recurrence of stroke is a first-rate risk issue for growing the weight of stroke. medications play an crucial position in stopping stroke recurrence. Adherence can be summarized as ‘The extent to which someone’s behaviour taking medicinal drug, following a diet, and/or executing life-style modifications – corresponds with agreed tips from a health care provider”. current estimates are that only one-sixth of all sufferers come close to perfect adherence to their medicine regimen. the issue is gaining importance because of an increase in the prevalence of chronic diseases and an ageing population. common reasons of medicine nonadherence include complicated remedy regimens and patients’ lack of belief within the treatment. Healthcare specialists play an crucial position in remedy adherence amongst stroke survivors. They should deal with the boundaries and facilitate remedy adherence behaviours. METHODOLOGY: It is a prospective observational study conducted in Lalitha Super specialities Hospital, Guntur over 6 months duration study in the neurology department, a total of 200 patients of age groups between 25-85 of both genders with comorbidities like hypertension, diabetes, and affected with stroke were enrolled in the study. RESULTS &amp; DISCUSSIONS: The outcomes were obtained after 6 months duration observe within the neurology branch of tertiary care hospital a total of 200 patients enrolled in the study. The study of the effect of patient counselling on medication adherence and quality of life in stroke patients is a prospective observational take a look at in which facts is amassed in Lalitha super speciality hospital with a random representative sampling method explaining the qualitative &amp; quantitative evaluation. We accrued 200 instances of these tormented by ischemic, hemorrhagic, and transient ischemic stroke, and affected person counselling was given and followed up after discharge. Out of 2 hundred samples, 67% of patients are suffering from ischemic stroke, 22.5% from hemorrhagic &amp; 10.5% from TIA. males (60.5%) are greater stricken by stroke than females (39.5%) and the age group between 46-55 is more affected by stroke (32%). The patients who are with both hypertension and diabetes were extra affected by stroke (45.5%) than the ones having single co-morbidities, high blood pressure (28%) and DM (13.5%). in the collected samples males are more effecting by hypertension (33.88%) and females with diabetes (15.18%) and both high blood pressure &amp; diabetes (49.36%). medication adherence in stroke patients is the primary goal of the observe, figure no 5 indicates that out of 200 sufferers, 129 (sixty four.5%) have highly adhered to medicine, 61 patients (30.5%) are mild, and, 10 patients (5.0%) low adherence to remedy after counselling to the patients. quality of lifestyles is the main objective of this study. figure no 6 suggests the quality of life of 200 stroke patients earlier than and after patient counselling. The exceptional of lifestyles had been measured using a modified ranking SCALE (mRS). After the 6-month observe up the quality of life had improved in patients. A quantitative analysis was done using the chi-square test the end result of x squared value is 35.1 with Df 6 at a significance level of 0.05, and the P value is &lt;0.05. CONCLUSION: The main aim of this study is to provide better patient counselling to improve medication adherence and the quality of life in stroke patients was achieved successfully. In this study 200 stroke patients were enrolled and patient counseling was provided and followed up through face-to-face interviews and phone calls. Among 200 patients, 129 patients (64.5%) were highly adherence to the medication and 61 patients (30.50%) were moderately. 10 patients (5%) were low adherence to medication. The quality of life of stroke patients increased after the counselling compared to before counselling. The medication adherence and quality of life were measured using MMAS-8 QUESTIONS and a modified ranking scale (mRS) respectively. It is also evident from the study that pharmacist intervention is effective in improving medication adherence and its associated effect on the management of patients receiving stroke therapy.

Enhancing the validity and applicability of study for health-related quality of life in patients with conditions affecting the hand: meta-analysis.

Enhancing the validity and applicability of study for health-related quality of life in patients with conditions affecting the hand: meta-analysis.

Beneficial effects of alternative methods, with an emphasis on yoga, for patients affected by pain associated with endometriosis

Aim of the study The aim of this systematic review is to compare studies published since 2017 to evaluate whether yoga and other alternative methods should be recommended to patients with endometriosis and associated pain. As alternative methods, particularly yoga, have gained popularity in recent years, it is crucial for healthcare professionals to ensure that these approaches are scientifically valid. This systematic review examines the effects of practicing different types of yoga and possible advantages of other alternative methods that could be potentially beneficial on pain management for patients suffering form endometriosis. Methods This review synthesizes findings from twenty studies, including randomized controlled trials and observational studies. ConclusionThe results consistently indicate significant improvements in the quality of life for patients with endometriosis. Yoga, as both a physical and mental practice, appears to be beneficial in managing pain. Although there are some limitations related to study design and variability, the evidence strongly supports the benefits of yoga in managing pelvic pain. Future research should focus on identifying which specific types of yoga practices offer the greatest benefits.

Beta-Blocker Interruption or Continuation after Myocardial Infarction.

The appropriate duration of treatment with beta-blocker drugs after a myocardial infarction is unknown. Data are needed on the safety and efficacy of the interruption of long-term beta-blocker treatment to reduce side effects and improve quality of life in patients with a history of uncomplicated myocardial infarction. In a multicenter, open label, randomized, noninferiority trial conducted at 49 sites in France, we randomly assigned patients with a history of myocardial infarction, in a 1:1 ratio, to interruption or continuation of beta-blocker treatment. All the patients had a left ventricular ejection fraction of at least 40% while receiving long-term beta-blocker treatment and had no history of a cardiovascular event in the previous 6 months. The primary end point was a composite of death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for cardiovascular reasons at the longest follow-up (minimum, 1 year), according to an analysis of noninferiority (defined as a between-group difference of <3 percentage points for the upper boundary of the two-sided 95% confidence interval). The main secondary end point was the change in quality of life as measured by the European Quality of Life-5 Dimensions questionnaire. A total of 3698 patients underwent randomization: 1846 to the interruption group and 1852 to the continuation group. The median time between the last myocardial infarction and randomization was 2.9 years (interquartile range, 1.2 to 6.4), and the median follow-up was 3.0 years (interquartile range, 2.0 to 4.0). A primary-outcome event occurred in 432 of 1812 patients (23.8%) in the interruption group and in 384 of 1821 patients (21.1%) in the continuation group (risk difference, 2.8 percentage points; 95% confidence interval [CI], <0.1 to 5.5), for a hazard ratio of 1.16 (95% CI, 1.01 to 1.33; P = 0.44 for noninferiority). Beta-blocker interruption did not seem to improve the patients' quality of life. In patients with a history of myocardial infarction, interruption of long-term beta-blocker treatment was not found to be noninferior to a strategy of beta-blocker continuation. (Funded by the French Ministry of Health and ACTION Study Group; ABYSS ClinicalTrials.gov number, NCT03498066; EudraCT number, 2017-003903-23.).

Effects of Combined Aerobic and Breathing Exercises on Asthma Control: An RCT

Breathing and aerobic exercises are the most recommended nonpharmacological treatments to improve asthma control and quality of life in patients with asthma. However, the benefits of combining both interventions in these outcomes have never been tested. We aimed to evaluate the effects of the combination of aerobic and breathing exercises on asthma control in individuals with moderate-to-severe asthma. Individuals with moderate-to-severe asthma were randomly assigned to the aerobic + muscle-stretching group (Control group (CG), n=25) or aerobic + breathing exercises group (Experimental group (EG), n=26). The aerobic exercise was performed using constant-load training and breathing exercises using the Buteyko technique. The training program lasted 20 sessions. All individuals were blindly assessed before and after the interventions for asthma control, health-related quality of life, anxiety and depression symptoms, sleep quality, hyperventilation, exercise capacity, lung function, levels of physical activity, and thoracoabdominal kinematics. Group x time interactions were tested using a two-way repeated measures analysis of variance. Pearson's correlation test was used to test the association between outcomes. The groups were similar at baseline (all p>0.05). After the intervention, there were no between-group differences for all outcomes comparing EG and CG. These results suggest that a combination of aerobic and breathing exercises did not improve asthma control, psychosocial symptoms, sleep quality, hyperventilation, exercise capacity, lung function, levels of daily physical or thoracoabdominal kinematics compared with aerobic exercise alone in individuals with moderate-to-severe asthma. ClinicalTrials.gov, NCT04412720.

Primary LYmphedema Multidisciplinary Approach in Patients Affected by Primary Lower Extremity Lymphedema.

Background: Primary lymphedema is a chronic condition caused by a developmental abnormality of the lymphatic system, leading to its malfunction. Various surgical options, including physiologic and excisional procedures, have been proposed. The aim of this study was to present a comprehensive algorithm for the treatment of primary lower extremity lymphedema: the Primary LYmphedema Multidisciplinary Approach (P-LYMA). Methods: Nineteen patients were treated following the P-LYMA protocol. Patients underwent pre- and postoperative complex decongestive therapy (CDT). A variety of physiologic and excisional procedures were performed, either independently or in combination. The primary outcome was to assess the circumferential reduction rate (CRR). The Lymphedema Quality of Life Score (LeQOLiS), reduction in the number of cellulitis episodes, and complications were recorded. Results: The mean CRR was 73 ± 20% at twelve months postoperatively. The frequency of cellulitis episodes per year decreased from a mean of 1.9 ± 0.8 preoperatively to 0.4 ± 0.6 during follow-up. Two patients experienced minor complications. The mean hospitalization time was 5 days. Patients' quality of life, as measured by the LeQOLiS, significantly improved from 70.4 ± 12 preoperatively to 24 ± 14 at twelve months postoperatively. Conclusions: The P-LYMA algorithm maximizes surgical outcomes and improves the quality of life in patients with primary lymphedema. CDT is essential for optimizing results.

Cognitive function in Parkinson's disease: associations with perivascular space in basal ganglia.

Cognitive impairment is one of the most common symptoms of Parkinson's disease (PD), and may be detectable through changes in neural features visualized by magnetic resonance imaging (MRI). Mild cognitive impairment is a transitional state between normal aging and dementia, and early recognition of Parkinson's disease with mild cognitive impairment (PD-MCI) can help improve the quality of life and treatment for patients. This study investigated the association of enlarged perivascular space (EPVS) and white matter hyperintensity (WMH) with PD-MCI. This study aimed to evaluate whether EPVS and WMH can be used as potential MRI markers for PD-MCI. This retrospective study involved 200 patients with PD who underwent cranial MRI in our hospital from April 2021 to April 2022. Patients were divided into those with no cognitive impairment (PD-NCI) or mild cognitive impairment. Uni- and multivariate logistic regression analyzed associations of EPVS, WMH, and clinicodemographic characteristics with cognitive decline. Univariate regression identified severe EPVS in basal ganglia, severe WMH, older age, late-onset, male sex, low educational level, longer duration of disease, low triglycerides, low uric acid, and low scores on the Mini-mental State Exam as risk factors for PD-MCI. After adjusting for clinicodemographic risk factors in multivariate regression, low education level and EPVS in basal ganglia remained risk factors for cognitive impairment. Severe EPVS in basal ganglia and poor education, but not WMH, are independent risk factors of PD-MCI. Our findings suggest that non-invasive detection of EPVS in basal ganglia by MRI may be a valuable early indicator of cognitive decline in PD patients.

Effect of probiotic administration in adult atopic dermatitis patients

Introduction: Atopic dermatitis (AD) is a chronic skin disease characterized by abnormal skin barrier function and heightened immunologic sensitization. Its incidence has surged recently, with approximately 60% of cases diagnosed within the first year of life. AD can persist or recur, significantly deteriorating the quality of life due to persistent itching and sleep disturbances. Individuals with AD are at increased risk of developing other atopic disorders like asthma and allergic rhinitis. Various dietary approaches, including low carbohydrate, calorie, and fat diets, have been associated with enhanced quality of life by regulating immune responses. Probiotics have been used as adjuvant therapy in allergic conditions, though their effectiveness varies due to the complex nature of allergies. Method: A literature search was conducted using PubMed, Cochrane Library, and Google Scholar. MeSH terms, advanced search strategies, and predefined eligibility criteria were employed to identify relevant studies. Duplicate studies were excluded, and critical assessment tools and levels of evidence were defined per Oxford Center for Evidence-based Medicine standards. Results: One systematic review and meta-analysis of randomized controlled trials (RCTs) met the PICO and eligibility criteria. The meta-analysis demonstrated that probiotics significantly decreased AD severity in adults, enhancing their overall quality of life. Other meta-analyses and systematic reviews supported that probiotics reduce clinical severity and improve life quality in adult AD patients. Conclusion: Probiotic supplementation is a viable option to improve the quality of life for adult AD patients, offering potential therapeutic benefits in managing this condition.

A Prospective Clinical Trial of Radiofrequency Ablation in Patients with Low-Risk Unifocal Papillary Thyroid Microcarcinoma favoring Active Surveillance over Surgery.

Active surveillance (AS) of papillary thyroid microcarcinomas (PTMC) is emerging as an alternative to immediate surgery. While thermal ablation has also shown promise for low-risk PTMC, it has not been prospectively studied in patients appropriate for AS. This study aimed to evaluate the efficacy and safety of ultrasound (US)-guided radiofrequency ablation (RFA) for tumor control and quality of life (QoL) management in patients with PTMC who favored AS over immediate surgery. This prospective clinical trial was conducted at a single tertiary referral hospital from 2018 to 2021. Of 227 adult patients aged ≤60years with low-risk unifocal PTMC favoring AS over immediate surgery, 100 patients underwent RFA for their management. The primary endpoint was the disease progression rate, and secondary endpoints were technical success, volume reduction rate (VRR), complication rates and QoL. The median age of the study population was 42 years (range, 27-59 years), and 83% (83/100, 95 % CI 66.1-100) were female. The median follow-up was 30 months (range, 12-56 months). All 100 patients underwent RFA with technical success. Most of the ablation zones showed continuous volume reduction, and 95.9% (94/98, 95% CI 77.5-100.0) showed complete disappearance at the last follow-up. The median VRR was 100.0 % at 1-year follow-up and persisted throughout the last follow-up. The cumulative disease progression rate among 98 patients who underwent at least 1-year follow-up was 3.1% (3/98, 95% CI 0.6-9.0); one patient had lymph node metastasis (treated with surgery), and two patients had new PTMC (1 treated with RFA, 1 ongoing AS). Major complications were not observed. Psychological (baseline vs. last follow-up, 7.3 vs. 8.0, P=.002) and social (8.0 vs. 8.7, P=.005) QoL scores significantly improved during follow-up without compromising physical QoL (8.6 vs. 8.5, P=0.99). RFA can be a reasonable strategy for effectively and safely controlling tumors and improving QoL in non-elderly patients with low-risk PTMC eligible for AS. This trial is registered with ClinicalTrials.gov: NCT03432299.

Cognitive status, psychological state and needs of caregivers for elderly patients with home-induced pressure injuries: a qualitative study.

Aims/Background Pressure injury stands as a global healthcare concern, primarily affecting elderly individuals. As the ageing of the global population shows no signs of slowing down, both society and the families of the affected individuals continue to bear the brunt of the consequences of pressure injuries. The majority of pressure injury cases are managed at home, and the occurrence and progression of pressure injuries in the elderly are closely associated with informal caregivers. This study aims to qualitatively explore the cognitive status of caregivers for elderly patients with home-induced pressure injuries, as well as their psychological state and needs during the caregiving process. Methods This research is qualitative, descriptive, and phenomenological in nature. A purposive sampling method was used. Eighteen caregivers of elderly patients with pressure injuries were selected from Jiangnan University Medical Centre as interviewees from June 2023 to August 2023. Semi-structured interviews were utilised to collect data regarding the caregivers' cognition, psychological state, and care-related needs while caring for elderly patients with home-induced pressure injuries. The data were then organised and analysed using Colaizzi's phenomenological analysis method and NVivo 11.0. Results Through the analysis of interview data from caregivers of elderly patients with home-induced pressure injuries, three main themes and nine subthemes were identified. The data analysis also revealed that the caregivers surveyed lacked the crucial awareness of preventing pressure injuries and that their caregiving practices were not up to standards. During the caregiving process, they were challenged with substantial stress while also experiencing negative emotions such as anxiety or depression. They had a strong desire for persistent medical support to alleviate the psychological and emotional challenges. Conclusion The findings of this study establish a collaborative relationship network among the hospitals, family, medical staff, and caregivers in the management of pressure injuries, but with a special attention to the caregivers' needs for disease-related knowledge and psychophysical support. Such relationships streamline communication between medical staff, patients, and their caregivers, facilitating the adoption of active and correct methods by caregivers to prevent and care for pressure injuries. This can positively impact the quality of care for pressure injuries, further improving the life quality of patients and their caregivers, controlling the incidence of pressure injuries, and reducing readmission rates.

Determinants of cough-related quality of life in interstitial lung diseases

BackgroundInterstitial lung diseases (ILD) include a wide range of diseases impacting lung parenchyma and leading to fibrosis and architectural distortion. Chronic cough and dyspnea are common symptoms which affect the quality of life (QoL) in ILD patients. The mechanisms of cough in ILD patients are still unknown. The aim of this study was to prospectively investigate histological, radiological, and physiological determinants of cough-related QoL in ILD patients who underwent transbronchial lung cryobiopsy (TBLC).MethodsAll patients (n = 111) filled in The Leicester Cough Questionnaire (LCQ) and The St George’s Respiratory Questionnaire (SGRQ). They underwent lung function tests, forced vital capacity (FVC), forced vital expiratory volume in 1 s (FEV1), diffusion capacity to carbon monoxide (DLCO), high-resolution computed tomography (HRCT), and blood samples before diagnostic TBLC. Two experienced radiologists assessed the extents of following HRCT patterns: ground-glass opacities (GGO), honeycombing, reticulation, traction bronchiectasis, and emphysema. Histology of TBLC were re-analyzed by two experienced pulmonary pathologists and the presence of fibroblast foci, fibrosis, giant cells, granulomas, and honeycombing were recorded.ResultsIn the median multivariate regression analysis, BMI (-0.19; 95% CI -0.37- -0.014; p 0.035), GGO (-0.38; 95% CI -0.61- -0.15; p 0.001), granulomas (-3.21; 95% CI -6.12- -0.30; p 0.031), and current smoking (2.49; 95% CI 0.12–4.86; p 0.040) showed independent associations with LCQ total score. BMI (1.3; 95% CI 0.20–2.42; p 0.021) and DLCO (-0.51; 95% CI -0.85 - -0.16; p 0.004) showed independent association with SGRQ total score.ConclusionDeterminants of cough-related QoL in ILD patients are multifactorial including physiological, radiological and histological parameters.

The Influence of Occlusion Type on Oral Health-Related Quality of Life in Patients with Complete Dentures—Lingualized vs. Bilaterally Balanced Occlusion

Objective: This randomized, single-blind controlled study aimed to investigate the QoL and satisfaction of patients wearing complete dentures with lingualized (LO) and bilaterally balanced occlusion (BBO). Participants were stratified based on their prior experience with complete dentures. Methods: The study involved 131 complete denture wearers who were categorized into four groups: G1—first-time prosthesis wearers treated with LO (n = 33); G2—first-time prosthesis wearers treated with BBO (n = 31); G3—participants with prior prosthesis experience treated with LO (n = 34); G4—participants with prior prosthesis experience treated with BBO (n = 33). After wearing the prosthesis for one month, all participants completed the Oral Health Impact Profile (OHIP-14) questionnaire. A statistical analysis was conducted using the χ2 test, Kruskal–Wallis analysis and Mann–Whitney test, with significance determined at p &lt; 0.05. Results: After dividing the respondents into two groups, a statistically significant difference was observed in the distribution of scores for three questions related to oral pain severity, anxiety, and difficulty relaxing. However, the distribution of scores for all other questions did not show a statistically significant difference between the groups studied (p &lt; 0.05). The total OHIP-14 score was also not statistically different (z = 0.469; p = 0.639). However, when respondents were divided into four groups, the median score for first-time denture wearers was 3.9 points higher in respondents who received dentures with BBO compared to those with LO (p &lt; 0.001). Furthermore, the median score for first-time denture wearers who received BBO was higher than for those in the second group who received BBO (p = 0.013). Conclusion: Patients wearing complete dentures for the first time demonstrated significantly higher satisfaction with the LO scheme compared to the BBO scheme. In contrast, satisfaction levels between occlusal schemes did not significantly differ among patients with prior denture-wearing experience. Novice denture wearers reported heightened sensations of oral discomfort, anxiety, and difficulty relaxing regardless of the occlusal scheme compared to experienced wearers, likely due to the unrealistic expectations that first-time wearers often have about complete dentures.

Advances in migraine treatment - a review

Introduction Migraine is a heavily debilitating disease that ranks second place in Global Burden Disease. It is estimated that around 1 billion of people suffer from it. It also has a significant negative impact on health-related quality of life (HRQoL) of patients and can affect their social, occupational, academic and familial life. Thus, it is crucial that all of the patients receive an effective treatment. Objectives This article aims to review the most recent advances in treatment of migraine. Methods A Literature review of articles published in Pubmed between 2000 and 2024 using the following words ‘migraine’, ‘treatment advances’, ‘CGRP receptor antagonists’, ‘serotonin receptor agonists’, ‘lasmiditan’, ‘zavegepant’, ‘rimegepant’. Results Literature search provides several concepts of advances in migraine treatment. Apart from behavioral treatment, new drugs targeting calcitonin gene related receptors (CGRP) and serotonin receptors agonists are emerging. Conclusion Migraine is a debilitating disease which significantly reduces health related quality of life in patients. New drugs targeting calcitonin gene related receptors (CGRP) and serotonin receptors agonists give a chance for more effective and tailored treatment.