Mental Component Research Articles

Effects of Adalimumab-adbm Versus Adalimumab Reference Product on Patient-Reported Outcomes in Rheumatoid Arthritis: Results from VOLTAIRE-RA.

This post hoc analysis of VOLTAIRE-RA compared patient-reported outcomes, including health-related quality of life (HRQoL), in patients with rheumatoid arthritis (RA) before and after treatment with biosimilar adalimumab-adbm or adalimumab reference product. HRQoL was assessed by 36-Item Short Form Survey (SF-36) Physical and Mental Component Summary (PCS and MCS, respectively) and domain scores at baseline and weeks12/24. Results were considered clinically meaningful if improvements were greater than or equal to minimum clinically important differences (MCIDs) of 2.5 for PCS and MCS and 5.0 for domain scores. Comparisons with age- and sex-matched norms and treatment-associated changes in domain scores from baseline were quantified using spydergrams and the health utility SF-6D measure. All comparisons between treatment groups were descriptive in nature. No differences in PCS scores were reported between treatment groups at baseline or weeks12/24. MCS scores slightly favored the reference product group at baseline, and differences in scores at weeks12/24 generally reflected those differences. Improvements in PCS scores greater than or equal to MCID at weeks12/24 were reported by over 65% of patients in both treatment groups, while over 56% experienced improvements in MCS scores greater than or equal to MCID at weeks12/24. Similar proportions receiving reference product and adalimumab-adbm reported scores greater than or equal to US age- and sex-matched normative values at week24: 14-39% versus 15-36%, respectively, compared with baseline (1-17%). In patients with moderate to severely active RA, adalimumab-adbm and adalimumab reference product were both associated with clinically meaningful improvements in SF-36 PCS, MCS, and domain scores that were highly similar at weeks12/24. The high proportion of patients reporting scores greater than or equal to normative values in both treatment groups is notable, as this represents a treatment goal that was difficult to achieve in earlier RA trials. Video abstract available for this article. VOLTAIRE-RA (ClinicalTrials.gov number, NCT02137226; EudraCT number, 2012-002945-40). Video abstract (MP4 29755 KB).

Association Between Health Behaviors and Mental Health Among Airline Pilots

ABSTRACTBackgroundLifestyle behaviors including physical activity, sleep, nutrition, smoking, and alcohol consumption are independently associated with health, yet the relationship between these behaviors and mental health has not been explored among airline pilots. The aim of this study was to measure the association between health behaviors and mental health.MethodsA cross‐sectional study was conducted among 502 airline pilots. The primary outcome measure was the mental component score (MCS), derived from the Short Form Health Survey 12v2. We collected information regarding age, sex, ethnicity, height, body mass, alcohol consumption, tobacco smoking status, moderate‐to‐vigorous physical activity (MVPA), fruit and vegetable intake, and sleep duration.ResultsAfter controlling for demographic and anthropometric parameters, MVPA, fruit and vegetable intake, and sleep duration were positively correlated with MCS (p ≤ 0.001), and alcohol consumption and tobacco smoking were negatively correlated with MCS (p ≤ 0.001). Multiple linear regression analyses revealed alcohol consumption was the strongest predictor of MCS (β = −0.308, p ≤ 0.001), followed by smoking (β = −0.236, p ≤ 0.001), MVPA (β = 0.233, p ≤ 0.001), sleep (β = 0.148, p ≤ 0.001), and fruit and vegetable intake (β = 0.097, p = 0.003).ConclusionThe results suggest that greater physical activity, sleep duration, and fruit and vegetable intake are associated with better mental health. Meanwhile, excessive alcohol consumption and tobacco smoking undermine mental health status.

Effectiveness of an exercise therapy program based on sports in adults with acquired brain injury: a randomized controlled trial

To examine the effects of a sport-based exercise therapy program combined with usual care (sET+UC) compared with usual care alone (UC) on health-related quality of life, upper limb motor control, functional capacity, mobility, balance, and physical activity participation in ambulant adults with acquired brain injury (ABI). Single-blind, parallel-group, randomized controlled trial. Rehabilitation center. Twenty-three adults with ABI (82.6% stroke; 17 males; mean age of 59.6±10.3 yr) INTERVENTION: Participants received either sET+UC (n=11) or UC (n=12). The sET+UC group received sixteen 60-minute sessions of a sport-based ET program in addition to sixteen 60-minute sessions of usual care, whereas the UC group attended usual care only. Primary outcome measures were health-related quality of life (Short Form-36, SF-36) and upper limb motor control (Fugl Meyer-Upper Extremity; FM-UE), while the secondary included functional capacity (6-Minute Walk Test, 10-Meter Walk Test), mobility (Timed Up and Go Test), balance (Berg Balance Scale) and physical activity participation (Global Physical Activity Questionnaire). Significant differences were found in all outcome analyses at post-intervention when comparing between groups. The sET+UC group showed significant improvements in both the physical (p=.027, r=.46) and mental component summary (p=.001, r=.71) of the SF-36 as well as FM-UE (p=.004, r=.60), with large effect sizes. In turn, all secondary outcomes were also significantly improved in this group (all p<.05 r>.05). In contrast, the UC group showed slight improvements in post-intervention scores but did not reach significance in any of these measures. This study shows that a sport-based exercise therapy program combined with usual care can effectively improve all the aforementioned outcomes measures in ABI population. Further research with larger sample sizes and follow-up assessments is crucial to gain a more comprehensive understanding of the long-term effects of the intervention in this specific population.

Formation of a health culture among adolescents as a key factor in development of society

Objective: to assess the dynamics of the formation of a culture of health and the perception of their own health by schoolchildren on the example of students at the stage of pre-professional medical education. Material and methods. The study was conducted on the basis of the Pre-University of Sechenov University. A questionnaire was used to assess the physical, mental, social and spiritual components of health culture. A questionnaire was used to assess the key components of the culture of health: physical, mental, social and spiritual. In 2018, 260 teenagers (171 girls and 89 boys, average age — 16.6±0.74 years) were interviewed, in 2024-702 (519 girls and 183 boys, average age 16.3±0.91 years). The data were analyzed using the Pearson x2 test with Yeats correction, and Spearman's rank correlation coefficient was calculated to study the relationship between qualitative features. Results. During the period understudy, the share of students with high values of the level of health culture increased by an average of 12.9±5.5% (p&lt;0.01); attaching importance to lifestyle, ecology, rejection of bad habits, receiving information about health from reliable sources by more than 10%(p&lt;0.01), a relationship was found between adolescents' perception of their own health and the professional status of their mothers (2024 —p=0.733; 2018 — p=0.730, t=0.11). Conclusions. An increase in the proportion of adolescents with a high level of health culture has been shown, there is no significant difference in health self-esteem and there is a strong and direct link between the perception of adolescents of their own health and the professional status of their mothers.

The Effect of Discharge Education and Post-Discharge Telephone Counseling on Quality of Life in Patients Undergoing Radical Prostatectomy: A Randomized Controlled Study

Aim: This study aims to determine the effect of model-based discharge education, and post-discharge telephone counseling on patients who have undergone radical prostatectomy on their quality of life. Methods: This randomized controlled study consisted of patients who underwent radical prostatectomy surgery and completed with a total of 42 patients, 20 of whom were in the experimental and 22 in the control group. The experimental group patients and their relatives were given discharge education and patients were called every two weeks after the operation. The control group received standard care. The patients’ quality of life was evaluated the day before the operation, and at the 6th and 12th weeks after surgery. The data were collected with the “Personal Information Form”, and “Short Form-12 Health Survey (SF-12)”. Results: 55.0% of the patients in the experimental group and 54.5% of the patients in the control group experienced urinary incontinence; 45.0% of the experimental group patients and 50.0% of the control group patients experienced erectile dysfunction three months after surgery. The experimental group had statistically significantly higher SF-12 mental component scores in the 12th week than the control group (p &lt; 0.05). Conclusion: Model-based discharge education and post-discharge telephone counseling for patients who had radical prostatectomy surgery were effective in the mental dimension of the patient's quality of life, but not in the physical dimension. Providing patients with different information channels will support the psychological dimension of their quality of life.

Transcutaneous Electrical Acupoint Stimulation for Elders with Amnestic Mild Cognitive Impairment: A Randomized Controlled Pilot and Feasibility Trial

Background: Amnestic mild cognitive impairment (aMCI) is an important window of opportunity for early intervention and rehabilitation in dementia. The aim of this study was to investigate the feasibility and effect of delivering transcutaneous electrical acupuncture stimulation (TEAS) intervention to elders with aMCI. Methods: A total of 61 aMCI patients were randomly allocated into the intervention group (receiving a 12-week TEAS) and control group (receiving health education). The feasibility outcomes included recruitment rate, retention rate, adherence rate, and an exploration of patients’ views and suggestions on the research. The effective outcomes included cognitive function, sleep quality, and life quality, which were measured by the Montreal cognitive assessment scale (MoCA), auditory verbal learning test—Huashan version (AVLT-H), Pittsburgh sleep quality index (PSQI), and quality of life short-term-12 (QoL SF-12). Results: The recruitment rate, retention rate, and adherence rate were 67.35%, 92.42%, and 85.29%, respectively. Most aspects of the research design and administration of the TEAS intervention were acceptable. The quantitative analysis suggests that compared with the control group, the scores of MoCA, AVLT-H, and SF-12 (mental component summary) were significantly better (p &lt; 0.05); however, the differences were not statistically significant in PSQI and SF-12 (physical component summary) (p &gt; 0.05). Conclusions: The findings demonstrated that the study was feasible. TEAS awas possible for enhancing cognitive function and mental health in people with aMCI.

Relationship among Childbirth, Onset of Lower Back Pain, and Health-Related Quality of Life in Female Patients with Lower Back Pain: A Retrospective Study.

This study aimed to investigate the relationship between childbirth and lower back pain and determine the health-related quality of life of female patients with lower back pain. A total of 111 patients were divided into three groups: those who had given birth and developed lower back pain due to pregnancy, childbirth, or child-rearing movements (childbirth group, n=41), those who had given birth and developed lower back pain due to other causes (childbirth and other cause group, n=29), and those who were nulliparous (nulliparous group, n=41). A total of 22 physical therapists evaluated the patients during initial rehabilitation. Basic information and health-related quality of life were compared among the three groups using a one-way analysis of variance for the visual analog scale scores for lower back pain, summary scores (physical health [physical component summary] and mental health [mental component summary]), and subscales (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health) of the Short Form-8 Health Survey. These values were also compared with the national standard values for health-related quality of life. The chi-square test of independence was used to compare distributions, and Fisher's exact probability test was used for cells with an expected value of <5. Most participants had physical component summary scores below the national standard values. The visual analog scale scores for lower back pain were significantly higher in the birth group than in the nonbirth group. The physical component summary, physical functioning, and general health scores were significantly lower in the birth group than in the nonbirth group. Moreover, bodily pain scores were significantly lower in the birth group than in the other groups. For female patients with lower back pain due to pregnancy, childbirth, or childcare activities, physical conditions unique to postpartum women should be considered, and if necessary, instructions for activities of daily living should be provided.

Frailty and pre-frailty associated with long-term diminished physical performance and quality of life in breast cancer and hematopoietic cell transplant survivors.

Physical frailty as a sign of accelerated aging is not well characterized in breast cancer (BC) and hematopoietic cell transplant (HCT) survivors and its correlation with outcomes and quality of life (QOL) is not defined. We conducted a prospective study to determine the prevalence of frailty in adult BC and HCT survivors, examine its impact on QOL, and determine its association with p16INK4a, a molecular biomarker for biological aging. The study included 59 BC and 65 HCT survivors. Median age was 60 years (range 27-81), 68.5% were female and 49.2% were 18-59 vs. 51.8% ≥60 years old. A total of 71 (57.3%) were "fit" (frailty score 0) vs. 53 (42.7%) were pre-frailty/frail (frailty scores ≥1), and of the latter 17 (32.1%) were BC and 36 (67.9%) HCT patients. On multivariate analysis, patients >60 years were twice as likely to be frail (OR 2.04, 95% CI, 0.96-4.33; p=0.07), HCT were more likely to be frail compared to BC patients, and female HCT had 2.43 (95% CI, 0.92-6.40) and male HCT patients had 3.25 (95% CI, 1.37-7.72) times higher risk of frail; p=0.02. Frailty was associated with significant decline in QOL, measured by Medical Outcomes Study (MOS) Short Form 36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS), and FACT (Functional Assessment of Cancer Therapy) scores. p16INK4a expression was higher in those who were frail, older than 60, and with higher expression in frail vs. fit patients who are 18-59 years. Our study highlights the high prevalence of frailty in survivors with detrimental effects on physical and overall wellbeing, and supports an association between frailty and the senescence marker p16INK4a.

The Effects of Laughter Therapy on Perceived Stress and Quality of Life in Women With Breast Cancer Receiving Chemotherapy: A Parallel-Group Randomized Controlled Pilot Trial.

Women with breast cancer experience various symptoms secondary to chemotherapy that reduce their quality of life and increase their stress levels. To evaluate the effects of laughter therapy on perceived stress levels and quality of life in women with breast cancer receiving chemotherapy using a parallel-group randomized controlled pilot trial. Forty-two women were randomly assigned to intervention and control groups. The intervention group received 40 minutes of laughter therapy twice a week for 8 weeks. The control group received routine treatment. The women in both groups completed the Perceived Stress Scale and SF-12 Health Survey at baseline, week 5, and week 9 after randomization. There was a significant decrease in the mean Perceived Stress Scale scores in the intervention group compared with those in the control group at weeks 5 and 9 compared with baseline, and the difference between groups by measurement week was significant (P < .001). Women in the intervention group had higher Physical Component Summary-12 and Mental Component Summary-12 scores in weeks 5 and 9 compared with those in the control group, and there was a significant difference between groups in terms of change in the Physical Component Summary-12 and Mental Component Summary-12 mean scores over time (P < .001). Laughter therapy is possible to use as a nursing intervention to reduce the perceived stress levels and increase the quality of life of women receiving chemotherapy for breast cancer. Nurses can apply laughter therapy in the symptom management of women receiving chemotherapy.

Health-related quality of life and self-care in heart failure patients under telecare-insights from the randomized, prospective, controlled AMULET trial.

The growing population of heart failure (HF) patients places a burden on the healthcare system. Patient-centered outcomes such as health-related quality of life (HRQoL) and self-care behaviors are key elements of modern HF management programs. Thus, optimized strategies to improve these outcomes are sought. To assess the effects of a new model of medical telecare on HRQoL and self-care in patients with HF (the AMULET study). The study was prospective, randomized, open-label, and controlled with two parallel groups: telecare and standard care. In the telecare group, HF nurses performed patient clinical assessments with telemedical support by a cardiologist and provided education focused on the prevention of HF exacerbation. In the standard care group, patients were followed according to standard practices in the existing healthcare system. At the baseline and at 12 months, HRQoL was assessed using the Short Form 36 (SF-36) questionnaire and the Minnesota Living with Heart Failure Questionnaire (MLwHF). The level of self-care was assessed with the 12-item standardized European Heart Failure Self-care Behavior Scale (EHFScBS-12). In the overall study group, 79% of the subjects were male, the mean age was 67 ± 14 years, and 59% of the subjects were older than 65 years of age. The majority of the subjects (70%) had a left ventricular ejection fraction below 40%. After 12 months, statistically significant increases in physical component of the SF-36 (43.3 vs. 47.4 for telecare vs. 43.4 vs. 46.6 for standard care) and mental component of SF-36 (58.4 vs. 62 for telecare vs. 60.4 vs. 64.2 for standard care) were noted, with no intergroup differences. However, patients receiving telecare showed improvement in specific domains, such as physical functioning, role-physical, bodily pain, vitality, social functioning, role-emotional, and mental health. There was a significant decrease in MLwHF (29 vs. 35.0; lower is better) at follow-up for both groups. Telecare patients had a statistically significant decrease in EHFScBS-12 (lower is better) at 12 months. AMULET outpatient telecare, which is based on nurse-led non-invasive assessments supported by specialist teleconsultations, improved the HRQoL and self-care of HF patients after an episode of acute HF.

Quality of life and psychological distress in end-stage renal disease patients undergoing hemodialysis and transplantation.

Among diverse profound impacts on patients' quality of life (QoL), end-stage renal disease (ESRD) frequently results in increased levels of depression, anxiety, and stress. Renal replacement therapies such as hemodialysis (HD) and transplantation (TX) are intended to enhance QoL, although their ability to alleviate psychological distress remains uncertain. This research posits the existence of a significant correlation between negative emotional states and QoL among ESRD patients, with varying effects observed in HD and TX patients. To examine the relationship between QoL and negative emotional states (depression, anxiety, and stress) and predicted QoL in various end-stage renal replacement therapy patients with ESRD. This cross-sectional study included HD or TX patients in the Eastern Region of Saudi Arabia. The 36-item Short Form Survey and Depression Anxiety Stress Scale (DASS) was used for data collection, and correlation and regression analyses were performed. The HD and TX transplantation groups showed statistically significant inverse relationships between QoL and DASS scores. HD patients with high anxiety levels and less education scored low on the physical component summary (PCS). In addition, the results of the mental component summary (MCS) were associated with reduced depression. Compared with older transplant patients, TX patients' PCS scores were lower, and depression, stress, and negative working conditions were highly correlated with MCS scores. The findings of this study revealed notable connections between well-being and mental turmoil experienced by individuals undergoing HD and TX. The PCS of HD patients is affected by heightened levels of anxiety and lower educational attainment, while the MCS of transplant patients is influenced by advancing age and elevated stress levels. These insights will contribute to a more comprehensive understanding of patient support.

Five-year radiological outcomes between decompression alone and decompression with an interlaminar device for lumbar spinal stenosis.

There is limited literature regarding radiological outcomes in the use of interlaminar devices as an adjunct to decompression compared to decompression alone (DA) for symptomatic lumbar spinal stenosis (LSS). This study aims to assess and compare 5-year radiological outcomes following spinal decompression and decompression with ILD (D + ILD). We conducted a retrospective review of prospectively collected data of 94 patients who underwent spinal decompression with or without ILD insertion between 2007-2015. Patients with symptomatic LSS who met the study criteria were offered spinal decompression with or without ILD insertion. Those patients who accepted ILD insertion were placed in the D + ILD group (n=39); while those opting for DA, were placed in the DA group (n=55). Radiological indices were assessed preoperatively, immediate post-operative, 2 years and 5 years postoperatively. There were a total of 94 patients with 55 in the DA group and 39 in the D + ILD group. In both groups, there was no significant change post-operatively in the sagittal balance parameters namely, the mean pelvic incidence, pelvic tilt, sacral slope and pelvic incidence minus lumbar lordosis (PI - LL) during the 5-year follow-up. Comparing between the groups, there was no significant difference in sagittal balance parameters. Comparing between DA versus D + ILD, there was no significant difference in overall lordosis, but the D + ILD had a significant reduction in sagittal angle (at the index level) of 2.3° compared to the DA group (P=0.01). In the control group, there was no significant difference in the anterior disc, posterior disc and foraminal height post-operatively. In the D + ILD group, there was a significant mean increase of 1.3 mm in anterior disc height, 1.8 mm in posterior disc height and 4.7 mm in foraminal height compared to the control group. In both groups, there was significant improvement in all clinical outcomes namely 36-item short form survey physical component summary (SF36 PCS), 36-item short form survey mental component summary (SF36 MCS) and visual analogue scale (VAS). Comparing the groups, there was significant improvement in the D + ILD group in SF36 MCS (P=0.01) but no difference in SF36 PCS or VAS. Reoperation rates were equivalent. Our study found that in the management of lumbar stenosis, the use of an ILD as an adjunct device compared to DA had significant improvement in anterior disc, posterior disc and foraminal height with expected focal kyphosis at the level of intervention without change in the lumbar lordosis and sagittal balance at 5 years.

Mental health disparities across sexual orientations during the COVID-19 pandemic: Longitudinal analysis of a UK nationally representative cohort

ObjectivesDuring COVID-19, sexual minority groups may have experienced heightened mental health challenges, amplified by unique stressors and the effects of pandemic-related restrictions. This study investigates the differential impact of the pandemic on mental health across sexual orientations, leveraging population-representative data to explore these disparities. Study designProspective cohort design. MethodsData from the United Kingdom Household Longitudinal Study (waves 8–12) was used. Monthly COVID-19 incidence rates at the regional level were used to indicate pandemic severity. Mental health outcomes were evaluated using the Mental Component Score of the Short Form-12 (MCS-12) survey. To examine whether COVID-19 led to differential impacts across sexual orientation, fixed-effect longitudinal models were employed, controlling for individual and time-variant covariates. ResultsLesbian women experienced a significant mental health decline during the COVID-19 pandemic, with a 3.10 MCS-12 score decrease (95 % confidence interval (CI): -5.77 to -0.43) and an 11.0 % higher likelihood of depression (95%CI: -0.3 % to 22.3 %, p = 0.057) compared to heterosexual women. Conversely, the impact on the mental health of heterosexual women was negative but not significant (-0.22; 95%CI: -0.47 to -0.04). Bisexual individuals and other women showed non-significant mental health declines. For men, COVID-19's effect on heterosexuals was similarly non-significant (-0.21; 95%CI: -0.48 to 0.1), with no significant differences observed in gay, bisexual, and other men. ConclusionsSexual minority individuals, especially lesbian women, faced heightened mental health challenges during COVID-19, emphasizing the urgency for targeted interventions.

Abstract C053: Racial differences in adverse sexual symptoms and implications for quality of life and adjuvant endocrine therapy adherence among women with early-stage breast cancer

Abstract Background Adjuvant endocrine therapy (AET) is effective at reducing breast cancer recurrence risk. It is associated with adverse symptoms, including sexual symptoms (e.g., vaginal dryness, reduced libido, dyspareunia), that can contribute to medication nonadherence and poor quality of life (QoL). Black women are least likely to start and maintain AET. We conducted post hoc analysis of a randomized clinical trial (RCT) to examine racial differences in how sexual symptoms affect sexual satisfaction and how these contribute to differences in AET adherence for Black and White women with early-stage breast cancer. Methods We used data from a nonblinded RCT of women diagnosed with early-stage (Stage I-III), hormone receptor-positive breast cancer and prescribed AET at a regional cancer center in the U.S. Mid-South. We restricted to Black and White participants who completed surveys at enrollment, 6-, and 12-months (N=275). The Functional Assessment of Cancer Therapy-Endocrine Subscale (FACT-ES) captured sexual symptoms (e.g., vaginal itchiness, bleeding, dryness, discharge, change in interest in sex, and pain with intercourse) and PROMIS Sexual Function and Satisfaction captured changes in sexual satisfaction with 5-item options ranging from “not at all” to “very much.” The 12-item Short Form Health Survey measured QoL with physical and mental health component summaries (higher scores indicated better QoL). AET adherence, captured by an electronically monitored pillbox, was measured as the proportion of days participants took their medication as prescribed over the 1-year follow-up. We conducted race-stratified linear regressions to examine associations of sexual symptoms with QoL and adherence. Results Among 275 participants, 102 (37%) were Black. Black women reported greater severity of vaginal discharge and that loss of sexual satisfaction was due to sexual symptoms at 6- and 12-months (p&amp;lt;0.05). Vaginal itchiness, vaginal discharge, painful intercourse, and loss of interest in sex were associated with lower mental QoL for Black and White women at all three time points. However, loss of interest in sex was associated with lower physical QoL at all three time points for Black women only. Worsening vaginal dryness was associated with lower 6-month AET adherence for Black (p=0.018) but not for White women (p=0.90). Similarly, lower sexual interest and lower sexual satisfaction was associated with lower 12-month AET adherence for Black women (p&amp;lt;0.05) but not for White (p=0.21 and p=0.13, respectively). Conclusion Women with early-stage breast cancer on AET reported adverse sexual symptoms with associated reductions in their sexual satisfaction and physical and mental QoL. Vaginal dryness, reduced libido, and lowered sexual satisfaction are associated with AET nonadherence among Black women, a group with known adherence barriers and recurrence risks. Our findings suggest that adverse sexual symptoms and sexual health challenges contribute to racial disparities in AET adherence and QoL. Oncosexuality care interventions for Black women are needed. Citation Format: Janeane N. Anderson, Freddie Yang, Xin Hu, Gregory A. Vidal, Ilana Graetz. Racial differences in adverse sexual symptoms and implications for quality of life and adjuvant endocrine therapy adherence among women with early-stage breast cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C053.

Physical and Mental Components of Quality of Life after a Cardiac Rehabilitation Intervention: A Systematic Review and Meta-Analysis.

Background: This study aimed to analyze the effect of cardiac rehabilitation programs on the health-related quality of life of patients after a coronary cardiac event using patient-reported outcome measures (PROMs) for up to 6 months of evaluation. Methods: A comprehensive search was carried out in the MEDLINE, CINAHL, CENTRAL, and Web of Science databases for randomized controlled trials comparing the cardiac rehabilitation program with usual care. Two independent reviewers assessed the studies for inclusion, risk of bias using the Cochrane tool, and quality of evidence through the GRADE system. A meta-analysis was performed on studies assessing health-related quality of life with the SF-12 (Physical Component Summary and Mental Component Summary) up to 6 months after the program. Results: Twelve studies encompassed 2260 patients who participated in a cardiac rehabilitation program after a coronary event, with a mean age of 60.06 years. The generic PROMs used to assess quality of life were the SF-12, SF-36, EQ-5D-3L, EQ-5D-5L, and GHQ, and the specific coronary heart disease PROMs were MacNew and HeartQoL. There was a positive effect of participation in cardiac rehabilitation on the physical component of health-related quality of life at 6 months (MD [7.02]; p = 0.04] and on the mental component (MD [1.06]; p = 0.82) after applying the SF-12. Conclusions: This study highlights the significant benefits of cardiac rehabilitation programs on health-related quality of life, particularly in the physical domain at 6 months. Assessing outcomes over time through PROMs after coronary heart events is essential, thus making it possible to personalize patients' care and improve their health status.

Serum syndecan1 has the potential to reflect activity at diagnosis and predict death during follow-up in patients with ANCA-associated vasculitis

ObjectivesThis study investigated whether serum syndecan1 at diagnosis reflects activity at diagnosis and predicts poor outcomes during follow-up in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).MethodsThe study included 79 patients with AAV from the cohort of Korean patients diagnosed with AAV. AAV-specific indices, including the Birmingham vasculitis activity score (BVAS), five-factor score (FFS), 36-item short-form survey (SF-36) physical and mental component summary (PCS and MCS), and vasculitis damage index (VDI), were assessed. Laboratory data including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were also collected. The highest tertile and upper half of the BVAS were tentatively defined as having high AAV activity. Serum syndecan1 levels were measured in sera stored at diagnosis.ResultsSerum syndecan1 at diagnosis was significantly correlated with AAV activity and functional status, as assessed by BVAS, FFS, SF-36 PCS, MCS, and acute-phase reactants, including ESR and CRP. Patients with serum syndecan1 ≥ 76.1 ng/mL at diagnosis, and those with serum syndecan1 ≥ 60.0 ng/mL at diagnosis showed significantly higher risks for the highest tertile and the upper half of BVAS at diagnosis than those without, respectively. Patients with serum syndecan1 ≥ 120.1 ng/mL at diagnosis had a significantly higher risk for all-cause mortality during follow-up than those without, and further, exhibited a significantly lower cumulative patients’ survival rate than those without.ConclusionSerum syndecan1 at diagnosis may not only reflect AAV activity at diagnosis but may also be associated with all-cause mortality during follow-up.

Mid- to long-term outcome of reverse total shoulder arthroplasty as revision procedure for failed hemiarthroplasty after proximal humerus fracture

BackgroundInsufficient tuberosity healing is the most common reason for poor outcome after treatment of proximal humerus fractures (PHFs) using hemiarthroplasty (HA). In these cases, revision to reverse total shoulder arthroplasty (RTSA) can improve function and reduce pain in the short term, however, long-term results remain scarce. Aim of this study was to evaluate the clinical and radiological mid- to long-term results in patients with a revision RTSA after failed HA for PHF.MethodsIn this retrospective study all patients that received a revision to RTSA after failed fracture HA between 2006 and 2018 were included. A total of 49 shoulders in 48 patients (38 female, 10 male; mean age 82 ± 9 years) were identified in our database. A total of 20 patients (17 female, 3 male; mean age was 79 ± 9 years) were available for follow-up examination after a mean time period of approximately eight years (3–14 years) after revision surgery. At final follow-up, patients were assessed using a subjective shoulder value (SSV), range of motion (ROM), visual analogue score (VAS), the Constant Score (CS) and the 12-Item Short Form Survey (SF-12).ResultsAt final follow-up, mean CS was 55 ± 19 (19–91), VAS averaged 3 ± 3 (0–8) and mean SSV was 61 ± 18% (18–90%). Mean SF-12 was 44 (28–57) with a mean physical component summary (PCS) of 38 (21–56) and a mean mental component summary (MCS) of 51 (29–67). On average active forward flexion (FF) was 104° (10–170°), active abduction (ABD) was 101° (50–170°), active external rotation (ER) was 19° (10–30°) and active internal rotation (IR) of the lumbosacral transition was reached. Three patients presented with a periprosthetic humeral fracture after RTSA implantation and underwent a reoperation (15%) during follow-up period.ConclusionsRevision RTSA results in promising clinical results in patients after initial failed HA after PHF. A complication and reoperation rate of 15% is tolerable in consideration of satisfactory functional and psychological outcome.Trial registrationRetrospectively registered.

Impact of chronic illness caused by chikungunya fever on quality of life and functionality.

Chikungunya fever compromises the functionality and quality of life in the affected individuals, even one year after the acute phase of the disease. Chronically affected people experience direct impairment in performing daily activities, along with a risk of developing other morbidities. ◼ Even after a year, chikungunya fever-affected people experience damage to their physical and mental health. ◼ Positive screening for depression risk was 13.5 times more likely in chronically affected. ◼ Patients with chronic chikungunya fever had a 76 times higher risk of walking impairments. To evaluate the impact of chronic illness caused by chikungunya fever on the quality of life and functionality of affected individuals. A cross-sectional and comparative study was conducted in which two groups were investigated: a Chikungunya Group comprising 25 patients with chronic fever screened after 1 year of illness via a telephonic survey, and a Healthy Group comprising 25 healthy individuals matched for sex and age by face-to-face interview. The Stanford HAQ 20-Item Disability Scale (HAQ) and the Short Form Health Survey (SF-12) questionnaires were administered to both groups. Generalized Linear Models, Pearson χ2 tests, and odds ratios were used to evaluate the test results. Significant differences in functional capacity and quality of life were observed between the Chikungunya and Healthy Groups. The chance of some impairment in functionality was also much higher in the Chikungunya Group in four of the HAQ categories, especially in the "walking" category (adjusted OR= 109.40). Further, the Chikungunya Group had a higher chance of presenting a below-average score in the mental component summary of the SF-12 (adjusted OR= 16.20) and of being positive in depression risk screening (adjusted OR= 34.57). Even one year after the acute phase, chikungunya fever can compromise the functionality and quality of life in affected individuals, with direct impairment in performing daily activities. Studies and therapeutic plans for chikungunya fever should consider the long-term impacts of this disease.

Functional status and quality of life after ICU discharge in severe COVID-19 patients

PurposeTo assess the health status of individuals affected by COVID-19 after discharge from the ICU. MethodCross-sectional study, with patients discharged from the ICU due to severe COVID-19, in which Quality of Life (QoL) was assessed using the 12-Item SFHF, functionality using the Post-COVID-19 FSS, and the level of physical activity using the IPAQ. ResultsOf the sixty patients, 51.7 % were male, with a mean age of 58 years. The physical component of QoL scored worse than the mental component and older patients had worse QoL in the physical component. These patients were shown to have low functionality scores and an irregularly active level of physical activity B. A lower level of physical activity was associated with individuals who remained in the prone position during hospitalization, while worse functionality was associated with the 70+ age group, although all age groups had functional losses. There was no association between QoL, functionality and level of physical activity and the clinical characteristics of the patients during hospitalization or the time they were discharged. ConclusionThe majority of patients discharged from the ICU after severe COVID-19 have altered functional capacity, QoL and physical activity levels, which is not associated with the clinical characteristics during hospitalization.

Survivorship and Functional Outcomes After Complex Primary Total Knee Arthroplasty With Contemporary Rotating-Hinge Implants

Background: Initial fixed-bearing hinge designs for primary total knee arthroplasty (TKA) had high rates of aseptic loosening. There are limited data on contemporary rotating-hinge implants. Purpose: We sought to determine survivorship and functional outcomes of contemporary rotating-hinge implants used in primary TKA. Methods: Retrospective review identified 54 primary rotating-hinge TKAs implanted in 49 patients from 2014 to 2018 at a single institution. Patients identified were 76% women, the mean body mass index was 29 kg/m2, the mean age was 65 years, and the mean follow-up was 3 years. The primary diagnosis for TKA in all cases was severe instability and ligamentous compromise. Secondary diagnoses included post-traumatic osteoarthritis (11, 20%), neurologic disease (10, 19%), inflammatory arthritis (10, 19%), connective tissue disease (3, 6%), valgus deformity (16, 30%), varus deformity (2, 4%), and recurvatum (2, 4%). Preoperative, postoperative (within 6 weeks), and most recent radiographs were reviewed. In this study, we collected preoperative, 1-year, and 2-year patient-reported outcome measures (PROMs) for patients with primary rotating-hinge TKA. Patient-reported outcome measures were prospectively collected, including the Knee Injury and Osteoarthritis Outcome Survey for Joint Replacement (KOOS JR) scores and the Mental (MCS) and Physical Component Scores (PCS) of the Veterans RAND 12-Item Health Survey (VR-12). Kaplan-Meier analysis was used to determine implant survivorship. Results: Reoperation was required in 6% (3/54); indications included periprosthetic joint infection (1), peripatellar fibrosis (1), and periprosthetic femur fracture (1). At both 2 and 5 years, survivorship free from all-cause reoperation was 95% and from revision for aseptic loosening was 100%. Mean KOOS JR scores increased from 47 preoperatively to 65 at 2 years postoperatively. On radiographic review, there were no progressive radiolucent lines consistent with aseptic loosening at final follow-up. Conclusion: The findings of this single-center, multi-surgeon retrospective case series on the use of rotating-hinge implants for primary TKA suggest excellent 2-year survivorship free from reoperation and no revisions for aseptic loosening. We report modest improvement in a variety of PROMs at 1-year and 2-year follow-up. Despite improvement, clinical outcomes were poor for a primary implant. Longer-term follow-up is required to monitor the durability of primary hinges.