Lower Quality Of Life Scores Research Articles

P-1450. Impact of Multi-morbidities on Quality of Life Among People Living with HIV at a tertiary care center in India: A cross-sectional study

Abstract Background India is home to an estimated 2.4 million People Living with HIV (PLHIV). The term "multi-morbidity" refers to the simultaneous presence of 2 or more chronic medical conditions in an individual, the prevalence of which is rising. The aim of our study is to assess the impact of multi-morbidities on Quality of Life (QoL) in PLHIV attending the Antiretroviral Therapy (ART) center at a tertiary care hospital in Western Maharashtra, India. Methods This was a cross-sectional study, over 2 months with 285 patients recruited. After ethical clearance was obtained, patients were interviewed to gather comprehensive sociodemographic history, with information on treatment and comorbidities obtained from patient charts. The QoL was measured using the WHOQOL-HIV BREF questionnaire which evaluates QoL across six domains: Physical, Psychological, Independence, Social, Environment, and Spiritual. Results The cohort exhibited an average of 2.2 comorbidities (SD = 1.4), with a notable prevalence of cardiovascular diseases and diabetes. Participants with 3 or more comorbidities demonstrated significantly lower QoL scores in the Physical (mean = 10.4, SD = 1.8, p < 0.01) and Psychological (mean = 11.9, SD = 1.5, p < 0.05) domains compared to those with fewer comorbidities. A longer duration of ART correlated positively with higher scores in the Independence domain (r = 0.26, p < 0.05). Elevated CD4 counts were linked with improvements in the Environmental and Psychological health domains. (p < 0.05) Participants from higher socioeconomic backgrounds reported significantly better scores in the Environmental and Spiritual domains (p < 0.05). Younger patients (< 40 years) reported better Social and Spiritual QoL scores compared to older individuals Gender-specific analysis indicated that females reported higher scores in the Social and Environmental domains. (p < 0.01). Conclusion There is a pressing need for effective management strategies that encompass comprehensive care approaches to address the complex health needs of this population. Enhancing routine screening for comorbidities and educating patients about the implications of multi-morbidities can empower PLHIV to improve QoL. Disclosures All Authors: No reported disclosures

Fatigue in Hemodialysis Patients: A Comparative Analysis with Healthy Controls

This study investigates fatigue and quality of life in hemodialysis patients, examining the influence of demographic and clinical factors on these outcomes. A cohort of 115 hemodialysis patients and 112 healthy controls completed the Modified Fatigue Impact Scale (MFIS), the shorter MFIS-5, and the WHOQOL-BREF quality of life assessment. The findings indicate that hemodialysis patients experience significantly higher levels of fatigue, which correspond with lower quality of life, particularly in the physical and psychological domains, compared to healthy controls. Male patients reported significantly higher levels of fatigue and lower quality of life scores, whereas younger patients demonstrated relatively better outcomes. Extended dialysis sessions exceeding four hours were associated with poorer social well-being, and educational attainment was positively linked with physical and environmental quality of life domains. However, marital status did not show a significant effect. The study validates the consistency between MFIS and MFIS-5 scores, recommending MFIS-5 for time-sensitive clinical use without compromising accuracy. These results underscore the need for individualized, multi-dimensional approaches to fatigue management in hemodialysis patients, emphasizing interventions that address physical, psychological, and social well-being to enhance overall quality of life. The findings highlight specific factors that may guide tailored support strategies to improve patient outcomes in this population.

The relationship between frailty syndrome and quality of life in patients with hypertension: a multidimensional analysis

BackgroundHypertension is a common condition among the elderly and is frequently accompanied by frailty syndrome (FS). The coexistence of hypertension and FS poses significant challenges in patient management and negatively impacts the quality of life (QoL). This study aimed to analyze the relationship between FS and QoL in elderly patients with suspected hypertension.MethodsA cross-sectional study was conducted involving 201 patients aged 65 years or older, referred to a Hypertension Clinic for diagnostic evaluation. Frailty was assessed using the Tilburg Frailty Indicator (TFI), and QoL was evaluated with the World Health Organization Quality of Life Instrument (WHOQOL-BREF). Sociodemographic and clinical data were collected, and statistical analyses were performed to identify correlations between FS and QoL.ResultsThe study found that 79.60% of the patients were identified as frail (TFI ≥ 5). FS was significantly negatively correlated with all domains of QoL, including physical health (r = -0.634, p < 0.001), psychological health (r = -0.675, p < 0.001), social relationships (r = -0.528, p < 0.001), and environmental factors (r = -0.626, p < 0.001). Multivariate analysis revealed that physical (β = -0.091, p < 0.001) and psychological components of FS (β = -0.128, p = 0.016), as well as age (β = -0.022, p = 0.004), were significant predictors of lower QoL scores. Loneliness (β = -0.235, p = 0.049) was also a significant predictor of lower QoL.ConclusionsThe study demonstrated a strong association between FS and reduced QoL in elderly hypertensive patients, emphasizing the need for comprehensive assessments and personalized management strategies. Routine evaluation of frailty and the implementation of targeted interventions aimed at improving physical, psychological, and social well-being could substantially enhance QoL in this vulnerable population.Clinical trial numberNot applicable.

Comparing Quality of Life and Psychological Changes in Benign and Malignant Lung Resections.

Background and Objectives: Pulmonary resections are critical interventions for treating various lung pathologies, both benign and malignant. Understanding the impact of these surgeries on patients' Quality of Life (QoL) is essential for optimizing care. This study aims to compare the Health-Related Quality of Life (HRQoL) and psychological well-being in patients who underwent pulmonary resections for benign versus malignant etiologies. Methods: A cross-sectional study was conducted involving 117 patients who underwent pulmonary resection between January 2022 and June 2023. Participants were divided into two groups: 51 patients with benign lung conditions and 66 with malignant lung tumors. HRQoL was assessed using the SF-36 and WHOQOL-BREF questionnaires. Anxiety and depression levels were evaluated using the Hospital Anxiety and Depression Scale (HADS) and the Perceived Stress Scale (PSS-10). Patients were assessed pre- and post-intervention. Results: Patients with malignant etiologies were older (58.7 vs. 54.2 years) and had lower FEV1% predicted (79.1% vs. 82.5%) compared to the benign group. Malignant patients reported significantly lower scores in physical functioning (68.1 vs. 75.4), role-physical (65.0 vs. 72.3), and general health domains of the SF-36 (62.4 vs. 70.2). WHOQOL-BREF scores indicated a lower overall QoL in the malignant group, particularly in the physical health (65.3 vs. 72.1) and psychological domains (68.0 vs. 74.5). HADS scores revealed higher anxiety (9.1 vs. 7.2) and depression levels (8.5 vs. 6.8) among malignant patients. Correlation analyses showed strong associations between lower QoL scores and higher anxiety and depression levels. Conclusions: Pulmonary resections for malignant conditions are associated with a significant decline in HRQoL compared to benign conditions. Patients with malignant etiologies experience higher levels of anxiety and depression, emphasizing that clinicians should integrate specialized mental health services and tailored physical rehabilitation programs for patients undergoing pulmonary resections for malignant lung conditions to address their significantly reduced quality of life and increased psychological distress.

Quality of Life in Children with Congenital Birth Defects

Background: Congenital birth defects are a leading cause of morbidity and mortality in children, with significant long-term impacts on health and quality of life (QoL). Objective: This study aimed to assess the quality of life (QoL) in children with congenital birth defects in Bangladesh, focusing on the influence of age, type of defect, and surgical interventions. Methods: This prospective cohort study was conducted at the Department of Pediatrics, 250 bedded General Hospital, Nilphamari, Bangladesh from July 2023 to June 2024. A total of 200 children aged 5-18 years with documented congenital anomalies were selected. Data were collected through medical record reviews and structured interviews using the Pediatric Quality of Life Inventory (PedsQL). Statistical analyses, including Chi-square tests and ANOVA, were employed to assess the relationships between QoL scores, age, type of defect, and surgical interventions. Results: The study revealed that the mean PedsQL scores decreased with age, with the lowest scores observed in the 16-18 years age group. Congenital heart defects were the most prevalent, affecting 40% of participants, followed by neural tube defects (20%) and cleft lip/palate (15%). Children with CHDs and neural tube defects had lower QoL scores compared to those with other defects. Additionally, 90% of participants underwent surgical interventions, with multiple surgeries associated with lower QoL. Conclusion: The study highlighted the significant impact of congenital defects on QoL, particularly among older children and those with more severe conditions like CHDs and neural tube defects. These findings underscored the need for targeted interventions to improve the long-term QoL of affected children. J Rang Med Col. September 2024; Vol. 9, No. 2: 21-26

The association of health anxiety with quality of life among medical students in Egypt: Myth or Menace?

BackgroundHealth anxiety (HA) is a prevalent concern among medical students, potentially impacting their academic performance and Quality of Life (QoL). This study aims to assess the prevalence of HA and its predictors among medical students in Egypt and its correlation with the Quality of Life.MethodsA descriptive cross-sectional study was conducted during the 2022–2023 academic year across ten Egyptian medical schools. A total of 1,173 students participated by completing an online questionnaire, which included the Short Health Anxiety Inventory (SHAI) and the 12-Item Short Form Survey (SF-12). Data were analyzed using SPSS 25. Chi-square tests, crude odds ratios (COR) with 95% confidence intervals, and Pearson’s correlation coefficients were utilized for statistical analysis. A p-value ≤ 0.05 was considered statistically significant.ResultsThis study found that 15.7% of participants experienced clinically significant HA. Female students (17.5%) and students dissatisfied with their academic performance (18%) exhibited a significantly higher prevalence of HA. A significant negative correlation was observed between HA and QoL (r = -0.393, p ≤ 0.05), with students experiencing HA reporting lower QoL scores. Key predictors of HA included female gender (OR = 1.41, 95% CI: 1.01–1.96) and lack of academic satisfaction (OR = 1.43, 95% CI: 1.04–1.96).ConclusionHealth anxiety (HA) is a notable issue among Egyptian medical students, particularly affecting females and those dissatisfied with their academic performance and is closely linked to reduced quality of life. Effective interventions could enhance the overall educational experience, helping students improve their well-being and manage HA’s impacts on their personal and academic lives.

Disparities in quality of life by race, gender, and sexual orientation: An intersectional analysis of population-representative data in Gauteng, South Africa.

South Africa's history of apartheid has led to persistent inequalities. While progress has been made since 1994, disparities in quality of life (QoL) remain, particularly along racial lines. This study examines how race, gender, and sexual orientation intersect to influence QoL in Gauteng - South Africa's most populous and economically vibrant province. Using data from the Gauteng City-Region Observatory's QoL 6 (2020/2021) Survey, we analyzed a sample of 10,760 respondents. We employed inverse probability weighting with regression adjustment (IPWRA) to estimate the Average Treatment Effect (ATE) of race, gender, and sexual minority status on QoL, while controlling for socioeconomic factors. Significant QoL disparities were observed across intersecting identities. White heterosexual men had the highest QoL scores, while Black sexual minority women had the lowest. After adjusting for covariates, all Black groups exhibited significantly lower QoL scores compared to their White counterparts. The largest gap was between White sexual minority women and Black sexual minority men (ATE: -14.47; 95%CI: -17.18,-11.76). Within the Black population, heterosexual men had significantly higher QoL than heterosexual women (ATE: -0.98; 95%CI: -1.54, -0.42). Despite progress since apartheid, substantial QoL disparities persist in Gauteng, primarily along racial lines, particularly in access to services and socio-economic opportunities. The intersectionality of race, gender, and sexual orientation creates distinct vulnerabilities, particularly for Black sexual minority women. These findings suggest that current policies aimed at improving equity may be insufficient. Addressing these disparities requires a multifaceted approach that considers the complex interplay of race, gender, and sexual orientation in shaping QoL.

Quality of Life Among Kurdish Patients With Knee Osteoarthritis in Duhok Governorate.

Osteoarthritis (OA) is a chronic disease and a leading cause for pain, stiffness, functional dependence, and diminished quality of life (QoL). The assessment of the latter in OA is becoming increasingly common in both research and clinical settings. The study aimed to examine OA among Kurdish patients with unilateral or bilateral OA. A cross-sectional study was conducted at the Duhok Centre of Rheumatology and Medical Rehabilitation in the Kurdistan Region of Iraq, involving 262 patients aged 40-70 who have unilateral or bilateral OA. The study subjects had the lowest mean QoL score in the domain of role limitations due to physical health problems (14.22±34.124). The highest mean QoL score was in the social functioning domain (86.78±20.878). Females had a statistically significant lower QoL mean score across most domains, except for emotional role functioning. Older patients (over 50) had lower scores in several domains, such as physical function, physical role functioning, energy/fatigue, social functioning, and bodily pain. Longer disease duration is correlated with lower QoL scores in most domains, except emotional well-being. Obesity negatively impacted QoL in terms of physical function and pain dimensions. Finally, the severity of osteoarthritis is positively correlated with a lower QoL score in the domains of physical functioning, physical role functioning, energy/fatigue, social functioning, and the pain component. QoL is diminished in Kurdish patients with unilateral or bilateral knee OA and is influenced by age, gender, obesity, disease duration, and OA severity.

OGC SO05 - Prevalence of Malabsorption and Impact on Quality of Life After Oesophago-Gastric Cancer Surgery

Abstract Background Recent Cancer Research UK data highlights a concerning rise in oesophago-gastric cancers, with 9,200 new cases of oesophageal cancer cases and 7,000 new cases of gastric cancer annually, ranking them the 13th and 17th most prevalent cancers, respectively. Surgery offers potential cure, but survival rates remain modest. Procedures include oesophagectomy and gastrectomy with Roux-en-Y reconstruction. Patients frequently experience nutrition-impact symptoms (NIS) associated with malabsorption post-surgery, however limited data exits on how this malabsorption affects their quality of life (QoL). This study aimed to investigate the prevalence of malabsorption and its correlation with QoL following oesophago-gastric cancer surgery. Method A cross-sectional cohort observational study was conducted on 98 cancer-free patients aged 18 or older following oesophagectomy (57%, including 1% with colonic interposition), subtotal gastrectomy (21.4%), or total gastrectomy (20.4%) with curative intent at the Northern Oesophago-Gastric Unit in Newcastle Upon Tyne from January 2013 to December 2023. Data collection utilised a modified Gastrointestinal Symptom Rating Scale (mGSRS) and QoL questionnaire distributed via post or email. Participants assessed their QoL on a self-reported Likert-scale (0-10) for their own subjective QoL perception. SPSS statistical software was employed to explore correlations between post-surgery malabsorption and QoL outcomes within this patient cohort. Results Post-surgery, 44.3% of patients encountered weight management challenges, notably within the first year. Malabsorption was prevalent in 69.9% of patients, with common symptoms such as flatulence and reduced appetite. Steatorrhoea, experienced by 47.3% of patients, also commonly caused flatulence and urgent bowel movements. NIS prevalence varied among surgical procedures, with 64.1% post-oesophagectomy and 78% post-gastrectomy, particularly after total gastrectomy. Pancreatic enzyme replacement therapy remained underused at 9.4%. Malabsorption strongly correlated with reduced QoL scores (r=-0.583, p&amp;lt;0.001), regardless of the time elapsed since surgery. Patients with steatorrhoea reported significantly lower QoL scores compared to those without (MD:-1.874, 95% CI, p&amp;lt;0.001). Conclusion The study highlights a significant prevalence of malabsorption and impaired QoL among patients following oesophago-gastric surgery, particularly notable in those experiencing steatorrhoea. Despite medical advancements, these issues often go unrecognized. The multifaceted nature of NIS and their impact on QoL necessitate a multidisciplinary approach involving gastroenterologists, dietitians, and other healthcare professionals. This collaborative effort aims to identify underlying factors contributing to malabsorption, provide consistent dietetics support, and manage symptoms effectively throughout the patient's recovery. Standardised guidelines are essential for ensuring comprehensive care and addressing both physical and psychosocial aspects, thereby enhancing overall postoperative QoL and long-term health outcomes.

Comparison of economic burden of disease and quality of life in patients with premature ejaculation and erectile dysfunction

To compare the economic burden of disease and quality of life in patients with premature ejaculation (PE) and erectile dysfunction (ED). A convenience sampling method was used, and self-designed general information questionnaire, disease economic burden questionnaire, and SF-12 quality of life questionnaire were used to investigate 494 patients with ED and 285 patients with PE who attended a tertiary hospital in Taiyuan City from October 2021 to May 2023, and the relevant data were analysed using SPSS26.0 statistical software. The direct, indirect, intangible, and total economic burdens of the two groups were compared, and the differences were statistically significant (P < 0.05), and the direct, indirect, intangible, and total economic burdens of ED patients were higher than those of PE patients; the scores of the two groups in the dimensions of PF (physical function), RP (role physical), RE (role emotion), and MH (mental health) as well as in the MCS (mental component score), and overall quality of life scores, the differences were statistically significant (P < 0.05), with ED patients having lower quality of life scores than PE patients. Compared with PE patients, ED patients have a heavier economic burden of disease and lower quality of life, suggesting that the government and relevant departments of society should pay attention to the economic burden of disease and quality of life of ED patients and take appropriate measures to improve them.

Musculoskeletal disorders and quality of life of artisanal fishermen from riverside localities in the Brazilian Amazon.

Artisanal fishing is widely practiced in the Amazon region. However, the exhaustive labor demand impacts on the health of fishermen. Thus, this study aimed to evaluate the prevalence of musculoskeletal disorders (MSDs) and the relationship with the quality of life (QoL) of artisanal fishermen. A cross-sectional study was carried out, evaluating male fishermen from two rural communities bordering Janauacá lake, Amazonas. Data were collected through interviews, using REDCap installed on smartphones. The Nordic Musculoskeletal Questionnaire was utilized to identify the body regions with the greatest pain complaints, and QoL was assessed using the mental and physical components of the SF-12. After the descriptive analysis, linear regression analysis was performed to evaluate the association between the occurrence of MSDs and the components of QoL. The analyses were performed using Stata SE software, version 17. In total, 115 fishermen were evaluated. MSDs were reported in all of the body regions assessed, with a higher prevalence in the lower (80.0%) and upper (43.5%) back, and knee (40.9%). Lower QoL scores were observed in emotional performance (20.7 ± 4.0), physical performance (25.1 ± 4.3), and mental health (29.0 ± 13.6). It was observed that individuals with any MSD presented worse QoL in the physical component (βadj=-5.0; 95%CI=-9.7; -0.3). The findings showed a high prevalence of MSDs in the study population, as well as its impact on the QoL of artisanal fishermen. This highlights the need to reorganize health services to prevent the occurrence of MSDs, as well as for their treatment and rehabilitation.

Health Related Quality of Life Among Private School Teachers in Chengalpattu District, Tamil Nadu, India-A Cross Sectional Study

Background: Teachers are the foundation of any civilized society, as they preserve information, wisdom, and ideals. The study was conducted to analyze the Health-Related Quality Of Life among private school teachers and associate the findings with various demographic and occupational parameters. Methodology: This cross-sectional study was conducted among 300 private school teachers in Chengalpattu district from March-to May 2024.Sample size was determined by multistage random sampling technique. A semi-structured questionnaire consisting of background, occupation related details, and SF-36 to assess the HRQOL were used to collect data. Data was entered in excel and analysed using SPSS version 26. Results: Out of 300 teachers,233 were female and 152 were above the age of 40. Most affected domains were Bodily Pain and General Health Perception. In both these domains, very low mean levels of quality of life were significantly associated with teachers age more than 40 years old, those who got monthly income of more than 40k, married, teaching experience more than 20 years, those who travelled more than 60 minutes to reach school and those who had comorbidities. Conclusions: At least one variable across all domains analysed was associated with lower quality of life scores. Administrators and policymakers must provide appropriate health education or health promotion programs and comprehensive prevention strategies for improving their HRQOL.

Assessment of Depression, Anxiety, Stress, Quality of Life, and Fatigue in Patients After a Cerebrovascular Accident.

Background A cerebrovascular accident, or stroke, is a neurological disorder. Those who suffer from a stroke not only face physical disabilities but also a range of psychological issues resulting from concerns about their current situation. The purpose of this study was to assess depression, anxiety, stress, and fatigue after a stroke, along with its effects on quality of life (QoL), degree of disability, and prevalence of various risk factors of stroke. Materials and methods Adult male and female patients who had experienced a stroke and came to the psychiatry or neurology outpatient departments were evaluated. A detailed stroke history was taken for them. The Stroke-Specific Quality of Life Scale (SSQOL) Scale, Depression Anxiety Stress Scale 21, Alcohol Use Disorders Identification Test C (AUDIT C) scale, Suicide Behaviors Questionnaire-Revised (SBQ-R) scale, Fatigue Severity Scale (FSS), and Modified Rankin Scale (mRS) were applied to assess the QoL, depression, anxiety, stress, alcohol use, suicidal behavior, fatigue, and the degree of disability, if any, after stroke. Results The study involved 100 stroke patients aged 18-60 years, with 82 males and 18 females. The mean age was 45.76 ± 8.54 years. 88% experienced an ischemic stroke, and 12% a hemorrhagic stroke. 68% had comorbidities, and alcohol use was present in 48% of patients. The QoL was lowest in the domains of social roles, upper extremity, family roles, and productivity. The study revealed that 67% of patients experienced depression, 63% anxiety, and 62% stress, with 40% having a high risk of suicidal behavior, 57% experiencing fatigue, and 67% disability. There was a significant positive correlation between lower QoL scores, higher depression, anxiety, stress, disability, suicidal ideation, fatigue, and factors such as increased age, female gender, recurrent stroke, psychiatric illness history, multiple comorbidities, and substance use. Conclusion Neuropsychiatric problems following a stroke are common and have serious consequences that significantly influence stroke survivors' QoL and ability to recover.

Stress and Quality of Life of Parents of Children With POLR3-Related Leukodystrophy: A Cross-Sectional Pilot Study.

Background: RNA polymerase III (POLR3)-related leukodystrophy is a rare, neurodegenerative disorder characterized by hypomyelination, hypodontia, and hypogonadotropic hypogonadism. Despite the challenges of caring for a child with POLR3-related leukodystrophy, few studies have examined parents' disease burden. We sought to investigate quality of life and stress levels amongst parents of children with POLR3-related leukodystrophy. Methods: 43 parents of 32 children completed questionnaires on demographics, stress, quality of life, coping mechanisms, and experience of injustice. Detailed clinical data was collected from all patients. Results: Mothers (t[27] = -8.66, P < .001) and fathers (t[16] = -4.47, P < .001) had lower quality of life scores compared to the normative population, yet 80% of parents' stress scores fell within the normal stress range. Parents' experience of injustice scores were high (>60). Correlations were found between and within parents' scores. Years since disease onset and certain life circumstances correlated to mothers' quality of life scores; however, no correlation was found between modifiable factors and fathers' quality of life scores. Helpful coping mechanisms included those that allowed parents to be involved in their child's life. Conclusions: This is the first study to assess stress and quality of life in this population. These results shed light on the importance of implementing services and social support to improve the well-being of parents.

Quality of Life after Open Extremity Trauma (QUINTET) study: An international, multicentric, observational, cohort study of quality of life following lower extremity open fractures

IntroductionOpen lower limb fractures are severe injuries long-lasting consequences. Limited research has been done on the impact of these on quality of life, internationally. MethodsThe Quality of Life after Open Extremity Trauma (QUINTET) study was designed as an international, multi-centre, observational, cohort study of patients admitted with open lower limb fractures. Demographic and clinical information was collected, along with repeated validated quality of life measures. Primary outcomes were SF-12 and EQ-5D-3L and secondary outcomes were soft tissue infection, deep infection, non-union and amputation. ResultsA total 92 patients were enrolled in 8 centres, based in the UK, Spain, Chile and Sudan. Mean age at presentation of 54 years, 47 years for males and 64 years for females. Males presented a higher proportion of road traffic accidents as the underlying mechanism, while for females this was the case for low-energy falls. Participant retention was 71.7% and 73.9% for the 3 and 12-months assessments, respectively. There was a substantial reduction in quality of life after open fracture, which only partially recovered at 12 months. Participants recruited in the UK presented lower quality of life scores compared with patients treated in Spain and Chile. DiscussionFor this study, international patient recruitment proved challenging, leading to most patients being recruited in the UK. Despite this limitation we found significant a statistically significant detriment in self-reported quality of life which did not recover after a year. This study highlights differences in quality-of-life outcomes from a gender and international perspective.

Quality of life and post-traumatic stress disorder among elderly earthquake survivors: a focus on the February earthquake in Turkey.

On 6 February, 2023, Turkey experienced a disaster resulting from two major earthquakes. The elderly population stands out as one of the most vulnerable and least adaptable. This study aims to identify the quality of life (QOL) and post-traumatic stress disorder (PTSD) symptoms among elderly earthquake survivors in Turkey. This research was conducted between 1 October, 2023 and 15 December, 2023 as a cross-sectional design. During the data collection process, survey questions prepared by the researchers (29 questions) and the Elderly Quality of Life Scale (OPQOL-Bref) and the Impact of Events Scale (IES-R) were used. Three hundred and eighty-four elderly people participated in the study. PTSD was more common in those diagnosed with chronic diseases after the earthquake, in those who had a drug-free period after the earthquake, in those who smoked and quit smoking, and in those who started psychiatric medication after the earthquake. Post-traumatic stress was seen more frequently in those with low QOL scores and in those who had a longer period of not using medication after the earthquake. It was observed that QOL was better in married people, high school graduates, those with average income levels, those who did not have chronic diseases before and after the earthquake, those who did not have a drug-free period after the earthquake, those who were physically active, and those who did not use psychiatric medication after the earthquake. Chronic disease diagnosis post-earthquake, drug-free periods, smoking habits, and psychiatric medication usage were identified as influential factors in PTSD occurrence. Additionally, the study shed light on the profound effect of earthquake-related experiences, such as house damage, injuries, deaths in first-degree relatives, displacement, and changes in living conditions, on PTSD prevalence.

Food Avoidance beyond the Gluten-Free Diet and the Association with Quality of Life and Eating Attitudes and Behaviors in Adults with Celiac Disease

Background: The only treatment for Celiac Disease (CeD), which affects about 1% of the population, is a gluten-free diet (GFD). Studies have indicated an association between the GFD, a diminished quality of life (QOL), and maladaptive eating patterns. This study aims to explore food avoidance behaviors in adults with CeD. Methods: This cross-sectional study assessed 50 adults with biopsy-confirmed CeD who completed validated surveys evaluating demographics, psychological factors, QOL, eating pathology, and food avoidance. Results: Overall CDQOL scores were good (mean: 62.7 out of 100). However, 58.0% of the participants self-elected to avoid one or more additional foods without diagnosed allergies or intolerances. Those avoiding one or more other foods had lower QOL scores (57.4 (23.2) vs. 70.2 (15.9)) compared to those only avoiding gluten (p = 0.034). The mean depression score (CESD) for the group avoiding foods beyond gluten was in the depressive range, unlike those avoiding only gluten (16.0 (4.9) vs. 13.6 (4.0), p = 0.078), with 77% of those avoiding more than gluten scoring above the CESD cut-off point of 15, indicating clinical depression. Conclusions: Over half of participants (58%) reported avoiding additional foods beyond the GFD, a behavior associated with decreased QOL and increased depression.

Long-term sequelae and quality of life after childhood-onset craniopharyngioma: Results of a Spanish multicenter study.

We aim to describe the characteristics of patients with childhood-onset craniopharyngioma and to analyze factors that impair quality of life (QoL) in this population. Multicenter national study including patients treated between 2008 and 2022, from 2 to 25years of age diagnosed with craniopharyngioma. QoL was assessed once during patient's follow-up by age-adapted versions of Pediatric Quality of Life Inventory (PedsQL) questionnaire. Sixty-six patients were included. Median age at diagnosis was 5years (interquartile range [IQR]: 3-8), while median follow-up was 7.4years (IQR: 2.8-9.7). Most craniopharyngioma were suprasellar (93.9%), and 59.7% had hypothalamic involvement (HI). All patients underwent surgery, 44.4% received radiotherapy, and 23.6% intracystic therapy. Most frequent long-term complications were visual deficit (72.7%) and endocrine impairment (94.5%). Patients exhibited hypothyroidism requiring hormone replacement (92.4%), hypocortisolism (80.3%), diabetes insipidus (86.4%), and/or growth hormone therapy (50%). When parents evaluated QoL, PedsQL median score was 53.8 points out of 100 (IQR: 41-71.6). Higher scores were noted when patients assessed their own QoL (median score 64.8 [IQR: 57.3-81.8]), observing statistically significant differences (p=.019). QoL was impaired by repeated surgeries (r=-.44; p=.014), HI (median score 51.5 [IQR: 39-63.8] vs. 76.4 [59-84.8]; p=.001), radiotherapy (median score 51.9 [IQR: 38.1-61.3] vs. 63.8 [IQR: 49-82.5]; p=.02) and longer follow-up (r=-.3; p=.01). In our study, most patients had significant comorbidities and low overall QoL scores, which was mainly affected by repeated surgery, radiation, and hypothalamic involvement. This reflects the need for further research and intensified studies of systemic therapy/alternate strategies to broaden the standard-of-care options, so that treatment-related sequalae can be avoided.

Expiratory flow limitation development index (ELDI): a novel method of assessing respiratory mechanics in COPD

BackgroundExpiratory flow limitation (EFL) can be detected using oscillometric reactance and is associated with a worse clinical presentation in chronic obstructive pulmonary disease (COPD). Reactance can show negative swings upon exhalation, which may develop at different rates between patients. We propose a new method to quantify the rate of EFL development; the EFL Development Index (ELDI).MethodsA retrospective analysis of data from 124 COPD patients was performed. Data included lung function tests, Impulse Oscillometry (IOS), St Georges Respiratory Questionnaire (SGRQ), modified Medical Research Council (mMRC) scale and COPD Assessment Test (CAT) score. Fifty four patients had repeat data after 6 months. Twenty two patients had data recorded after 5 days of treatment with long acting bronchodilator therapy. EDLI was calculated as the mean expiratory reactance divided by the minimum expiratory reactance.ResultsThe mean ELDI was used to categorise patients with rapid onset of EFL (> 0.63; n = 29) or gradual onset (≤ 0.63; n = 34). Those with rapid development had worse airflow obstruction, lower quality of life scores, and greater resting hyperinflation, compared to those with gradual development. In patients with EFL, ELDI correlated with symptoms scores, airflow obstruction, lung volumes and gas diffusion. Both EFL and ELDI were stable over 6 months. EFL and EDLI improved with bronchodilator treatment.ConclusionsCOPD patients with rapid EFL development (determined by ELDI) had worse clinical characteristics than those with gradual EFL development. The rate of EFL development appears to be associated with clinical and physiological characteristics.

Complicated Pleural Infection is Associated With Prolonged Recovery and Reduced Functional Ability.

Management of complicated pleural infections (CPIs) had historically been surgical; however, following the publication of the second multicenter intrapleural sepsis trial (MIST-2), combination tissue plasminogen (tPA) and dornase (DNase) offers a less invasive and effective treatment. Our aim was to assess the quality of life (QOL) and functional ability of patients' recovery from a CPI managed with either intrapleural fibrinolytic therapy (IPFT) or surgery. We identified 565 patients managed for a CPI between January 1, 2013 and March 31, 2018. There were 460 patients eligible for contact, attempted through 2 phone calls and one mailer. Two questionnaires were administered: the Short Form 36-Item Health Survey (SF-36) and a functional ability questionnaire. Contact was made in 35% (159/460) of patients, and 57% (90/159) completed the survey. Patients had lower QOL scores compared to average US citizens; those managed with surgery had higher scores in physical functioning (surgery: 80, IPFT: 70, P=0.040) but lower pain scores (surgery: 58, IPFT: 68, P=0.045). Of 52 patients who returned to work, 48% (25) reported an impact on their work effectiveness during recovery, similarly between management strategies (IPFT: 50%, 13/26 vs. surgery: 46%, 12/26; P=0.781). Patients with a CPI had a lower QOL compared with average US citizens. Surgically managed patients reported improved physical functioning but worse pain compared with patients managed with IPFT. Patients returned to work within 4 weeks of discharge, and nearly half reported their ability to work effectively was impacted by their recovery. With further research into recovery timelines, patients may be appropriately counselled for expectations.