MOS 36-Item Short-Form Health Survey Research Articles

Relationships Between Self-Reported Pain and Optimism Among Community-Dwelling Older Adults.

Measures of life outlook in older adults have been investigated in connection to pain, as both pain management and outlook are important factors of successful aging. We hypothesized that higher pain is associated with lower optimism among community-dwelling older adults. We utilized data from the UC San Diego Successful Aging Evaluation (SAGE), a prospective longitudinal cohort study initiated in 2010, to evaluate the relationship between pain and optimism in 378 community-dwelling adults aged ≥50 years. We used the revised Life Orientation Test (LOT-R) to measure optimism and three pain subscales-PROMIS Pain Interference, PROMIS Pain Intensity, and MOS 36-Item Short-Form Health Survey (SF-36)-as pain measures. Regression analyses reveal negative relationships between pain and optimism for all three pain scales, with regression coefficients of -0.277 (p < .0001), -0.246 (p < .0001), and 0.269 (p < .0001) respectively. This indicates value in considering physical and psychological elements in future intervention research to promote healthy aging.

The Relationship Between Body Dysmorphic Disorder and Depressive Symptoms with Health-Related Quality of Life in Women with Vitiligo

Background: Vitiligo is a common skin disorder characterized by the loss of skin pigment, which can significantly impact individuals' health-related quality of life (HRQoL), particularly in women. Body dysmorphic disorder (BDD) and depressive symptoms are common psychological comorbidities associated with vitiligo. Objectives: This study aimed to investigate the relationship between BDD, depressive symptoms, and HRQoL in women with vitiligo. Methods: A cross-sectional study was conducted in Ahvaz, Iran, in 2023, involving a sample of 152 women with vitiligo. The study population included all women with vitiligo who presented to dermatology or cosmetic clinics in Ahvaz during that year. Data were collected using the MOS 36-item Short-Form Health Survey (SF-36), the Multidimensional Body-Self Relations Questionnaire (MBSRQ), and the Beck Depression Inventory (BDI). Pearson's correlation and regression analyses were used to assess the relationships between variables. Data analysis was conducted using SPSS-27 software. Results: Women with vitiligo had a mean health-related quality of life score of (58.13 ± 11.50). Their mean score on the body dysmorphic disorder assessment was (99.61 ± 37.33), and the mean depressive symptom score was (20.25 ± 4.47). Significant negative correlations were found between BDD and HRQoL, as well as between depressive symptoms and HRQoL, in women with vitiligo (P &lt; 0.001). Multiple regression analysis showed that BDD and depressive symptoms independently predicted HRQoL (P &lt; 0.001). Conclusions: Body dysmorphic disorder and depressive symptoms are significantly associated with impaired HRQoL in women with vitiligo. Screening for and treating BDD and depressive symptoms may improve HRQoL in this population.

The impact of photobiomodulation on sleep and life quality in hemodialysis patients: A randomized controlled trial.

The quality of life (QoL) and sleep quality are closely linked to the physical and psychological health of end-stage renal disease (ESRD) patients, especially those underwent hemodialysis (HD) therapy. This study aims to investigate the impact of 830nm laser treatment on improving QoL and sleep quality in HD patients. Forty ESRD patients participated in this study. 830nm laser was used to radiate on the palm (at dose of 256.10J/cm2), ST 36 and KI 1 acupoints (at dose of 109.76J/cm2) of HD patients, and QoL and sleep quality questionnaires were utilized to assess changes following the treatment. After 830nm laser radiation, lower global Pittsburgh Sleep Quality Index and Athens Insomnia Scale scores were observed, accompanied by higher physical and mental component summary scores in MOS 36-item short-form health survey version 2 and a global World Health Organization Quality of Life Brief Version score. The laser group also showed significant improvements in QoL and sleep quality indicators. Additionally, pain levels decreased on the third day and after one month according to visual analogue scale. This study revealed the positive effects of 830nm laser on palm, KI 1 and ST 36 acupoints for improving the QoL and sleep quality in ESRD patients underwent HD treatment. The results suggest that 830nm laser applied to specific targets could be used as a complementary and alternative approach to increase the QoL and sleep quality in ESRD patients.

Comparison of proximal femoral nail antirotation internal fixation and artificial hip replacement for elderly patients with intertrochanteric fractures.

To compare the effects of proximal femoral nail antirotation (PFNA) internal fixation and artificial hip replacement (AHR) on serum inflammatory factors and hip function recovery in elderly patients with intertrochanteric fractures (IFs). One hundred and thirty patients with IFs who underwent surgery at the People's Hospital of Pingyang between July 2018 and July 2020 were enrolled. Sixty-five patients received PFNA internal fixation (fixation group) and 65 received AHR (replacement group). Surgical indicators and complications were recorded in both groups. The Harris Hip Scale was used to score hip joint function, the Visual Analog Scale (VAS) to assess pain, the MOS 36-Item Short-Form Health Survey (SF-36) to evaluate life quality, and enzyme-linked immunosorbent assay to measure serum tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and IL-1β. The replacement group experienced notably shorter hospitalization times, less complete weight-bearing time, and earlier time to walk compared to the fixation group (all P<0.05). The replacement group also showed a lower incidence of poor fracture healing and complications (both P<0.05). Additionally, on postoperative days 3, 15, and 45, the replacement group had notably lower VAS scores (all P<0.05). Furthermore, the replacement group exhibited higher Harris Hip Scale scores at 1, 2, and 3 months post-surgery (all P<0.05). Higher postoperative SF-36 scores were also observed in the replacement group (P<0.05). On postoperative day 30, both groups presented decreases in TNF-α, IL-6, and IL-1β levels compared to preoperative levels, with even lower levels in the replacement group (all P<0.05). AHR can help elderly patients with IFs ambulate earlier, speed up hip function recovery, reduce inflammation, and improve life quality with fewer postoperative complications, making it worthy of clinical promotion.

Relationship Between Severity of Multiple Sclerosis and Fear of Falling Mediated by Cognitive and Physical Factors

Background &amp; Aims: Multiple sclerosis (MS) patients are exposed to various health threats, including fear of falling (FOF), which restricts their daily life activities and cause isolationism and lower social participation. The present study aimed to investigate the relationship between the severity of MS and FOF through the mediating role of cognitive and physical factors in patients with MS. Materials and Methods: This was a correlational study based on path analysis. The statistical population consisted of all patients with MS who visited the neurology centers of hospitals in Sari, Iran, 200 of whom were selected as the sample using convenience sampling. The research instruments included the Falls Efficacy Scale-International (FES-I), MS Severity Scale, Cognitive Factors Questionnaire, and the MOS 36-item Short-Form Health Survey (SF-36). Results: The results indicated that there was a negative and significant relationship between FOF and cognitive and physical factors and also a positive and significant relationship between FOF and the severity of MS (P&lt;0.01). In addition, the results corroborated the negative and significant relationship between the severity of MS and physical factors (P&lt;0.01). However, the direct relationship between the severity of MS and cognitive factors were excluded from the model because it was not established. The study findings confirmed the relationship between FOF and the severity of MS mediated by cognitive and physical factors (P&lt;0.001). Conclusion: According to the results FOF was found to be much higher among patients with higher MS severity. The severity of MS had a positive relationship with FOF in the patients. Moreover, cognitive and physical factors had a mediating role in the relationship between the severity of MS and FOF.

Efficacy of the PainVision apparatus for assessment of axial neck pain after cervical laminoplasty: a prospective study

BackgroundAxial neck pain is one of the complications of posterior cervical surgeries such as laminoplasty. This study aimed to investigate the efficiency of the PainVision apparatus for axial neck pain assessment by comparing it with other methods.MethodsThis prospective study included 118 patients (90 men and 28 women; average age: 66.9 (32–86) years) with cervical myelopathy who underwent open-door laminoplasty at our medical center between April 2009 and August 2019. Pain degree (PD) measured by PainVision, visual analog scale (VAS), and bodily pain (BP), a subitem of the MOS 36-Item Short-Form Health Survey (SF36), were used to evaluate axial neck pain, which was investigated preoperatively and at 3, 6, 12, 18, and 24 months postoperatively.ResultsComparison of the scores at each evaluation time point found significant improvement between the pre- and post-operative values for all assessment methods. Further, on comparing the amounts of change between pre- and post-operative scores in each pain assessment method, we found significant differences in PD and VAS but not in BP. We also found significant positive correlations between PD and VAS at each time point (all p < 0.001) and significant negative correlations between PD and BP (all p < 0.05) and between VAS and BP (all p < 0.01) at each time point.ConclusionsIn this study, we demonstrated that PD and VAS are more sensitive indicators of changes in axial neck pain than BP and also that PD has an excellent correlation with VAS. These results suggest that the PainVision apparatus may be an effective instrument for quantifying axial neck pain after cervical laminoplasty, though its superiority over VAS needs to be verified in future studies.

Effects of egg yolk choline intake on cognitive functions and plasma choline levels in healthy middle-aged and older Japanese: a randomized double-blinded placebo-controlled parallel-group study

BackgroundCholine, as a neurotransmitter acetylcholine precursor, is reportedly associated with cognitive function. Although there are several cohort and animal studies on choline-containing foods and cognitive function, only a few interventional studies were reported. Egg yolk is a rich source of different choline-containing chemical forms, such as phosphatidylcholine (PC), lysophosphatidylcholine (LPC), and α-glycerophosphocholine (α-GPC). This study aimed to investigate the effect of consuming 300 mg of egg yolk choline per day on cognitive function of Japanese adults.MethodsA 12-week, randomized, double-blind, placebo-controlled, parallel-group study was conducted in 41 middle-aged and elderly males and females (43.9% female) aged ≥ 60 years and ≤ 80 years without dementia. Participants were randomly assigned to placebo and choline groups. The choline group received a supplement containing egg yolk choline (300 mg/day), and the placebo group received an egg yolk supplement free from choline for 12 weeks. Assessments of Cognitrax, Trail Making Tests (TMT) part A and B, the MOS 36-Item Short-Form Health Survey (SF-36), the Simplified Japanese Version of the WHO-Five Well-Being Index (WHO-5), and plasma choline levels were performed before and 6 and 12 weeks after supplement intake. In the present study, 19 subjects (9 in the placebo group and 10 in the choline group) were excluded due to the violation of the discontinuation criteria or participant compliance, and 41 subjects were analyzed.ResultsThe change amount of verbal memory scores and verbal memory test-correct hit (delay) was significantly higher in the choline group than in the placebo group at baseline-6 and baseline-12 weeks. The plasma free choline level was significantly higher in the choline group compared with the placebo group at 6 weeks. Conversely, the choline group showed significantly lower Cognitrax processing speed scores, symbol digit coding testing correct responses, and SF-36 physical quality of life summary scores compared to the placebo group at 6 weeks.ConclusionsThe results suggested that continued 300 mg/day intake of egg yolk choline improved verbal memory, which is a part of cognitive functions. To confirm the observed effects of egg yolk choline, more well-designed and large-scale studies are warranted.Trial registrationStudy protocols were pre-registered in the Clinical Trials Registration System (UMIN-CTR) (UMIN 000045050).

Cervical collar use following anterior cervical hybrid surgery: protocol for a prospective randomized, time-controlled trial

IntroductionCervical hybrid surgery (HS) combines anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) to establish an individualized surgical plan for patients with multiple cervical disc degenerative diseases. In order to maintain the stability of the spine after HS, an external cervical collar is often used. However, there is still controversy regarding the importance of a cervical collar following surgery. This study aims to determine whether the cervical collar is effective and how long it should be worn after surgery.MethodsThis is a randomized, single-center, prospective, parallel-controlled trial. Eligible participants will be selected according to the inclusion and exclusion criteria. The primary outcome is the neck disability index, which will be evaluated before surgery and at one week, 3 weeks, 6 weeks, 3 months, 6 months, and 12 months following surgery. The secondary outcomes consist of the Japanese Orthopedic Association Scores, MOS 36-item short-form health survey (SF-36), visual analog scale, Pittsburgh Sleep Quality Index (PSQI), Bazaz dysphagia scoring system, Falls Efficacy Scale, cervical collar satisfaction score, neck soft tissue assessment, and Braden Scale, as well as radiologic assessments for cervical lordosis, disc height of the operative levels, fusion rate, range of motion (ROM), and complications including anterior bone loss, prosthesis migration, and heterotopic ossification. The clinical and radiologic examinations were performed by investigators with no therapeutic relationship with the individual patient. All radiographs were examined by one independent radiologist.Ethics and disseminationThe results of this study will be published in peer-reviewed journals and presented at conferences. Upon completion of this trial, our findings could provide an appropriate cervical collar-wearing guideline for patients receiving HS.Trial registrationChiCTR.org.cn ChiCTR2000033002. Registered on 2020–05-17.

Interim report from a 2-year double-blind rct testing fermented papaya preparation on immune enhancement, endothelial health and qol in elderly adults

Background: Agingis associated with alterations in oxi-inflammatory-immune profile, and endothelial cell dysfunction. Indeed, increased generation of free radicals as well as immunosenescence are hallmarks of the aging process and age-related diseases. In the past 12 years or so, data has been accumulated on fermented papaya preparation (FPP®)(Osato Research Institute, Gifu, Japan), a specific functional food with robust redox and immune regulator nutrigenomics effect. The aim of this 2-year ongoing study of which we report the first-year data, was to test FPP® in redox, endothelial, and immune markers.Methods: Study population. From a total of 106 subjects, we report the analyzed data referring to 78 clinically stable, healthy, community-dwelling males and females, aged 60 to 75 years. The study was conducted using a double-blind method with designated groups A and B to fulfill the two different treatments. The two treatments are as follows: Group A, also known as “FPP Group,” was given one sachet two times per day containing 4.5g FPP®, along with one placebo capsule provided in the morning. Group B, also known as “AA Group,” was given one papaya-flavored sachet two times per day, along with one antioxidant mixture capsule in the morning. Morning blood samples were collected and tested for: Ultra-sensitive c-reactive protein (a highly sensitive ELISA), inducible nitric oxide synthase (iNOS) (by Human Nitric Oxide Synthase kit), asymmetric dimethylarginine, or ADMA, (a competitive enzyme-linked immunosorbent assay), apoptosis of PBMCs (by Annexin V staining) and MOS 36-item short-form health survey (SF-36) to assess quality of life. Screening and blood tests were carried out as follows: Visit I: Day 0 - Baseline, Visit II: Day 60, or 2 months, Visit III: 6 months, Visit IV: 11 months.Results: Plasma iNOS levels were comparable among both groups at the beginning of the study. FPP®-treated subjects showed a significant increased level at Visits II and III (P&lt;0.05 vs baseline and vs AA). ADMA values were not affected by AA supplementation whereas FPP® treatment was associated with a significant decrease beginning with observation during Visit III (P&lt;0.05 vs baseline and vs AA administration). The FPP® intervention was associated with improvements among several domains of quality of life such as physical function, general health, and mental components (P &lt; 0.01 vs baseline and vs AA group). There was also at significant and comparable positive effect for time on vitality shown in both AA and FPP® groups.Conclusion: Unlike with the antioxidant treatment, the FPP® intervention yielded a transient decrease of ADMA, a decrease of iNOS and lower percentage in apoptotic PBMC. These results suggest that FPP®, by a more multifaceted, subcellular mechanism, as well as non-redox modulatory properties, was beneficially effective in regulating aging markers. These mechanisms are associated with a better SF-36 profile in support of FPP® as a candidate interventional functional food for health maintenance, and specifically in middle-age/elderly subjects.Keywords: Fermented Papaya Preparation, Nitric oxide, ADMA, apoptosis, antioxidants, SF-36

Physical function, nutritional status, and quality of life before and after chemotherapy in patients with malignant lymphoma.

This study investigates the efficacy of and gender differences in exercise therapy in patients with malignant lymphoma undergoing chemotherapy. Twenty-six patients (13 men, 13 women) received physical therapy (based on the Borg Scale 13) during hospitalization. Physical function was measured using grip and knee extension strength, 6-minute walking distance, and body composition; nutritional status assessed via Mini Nutritional Assessment (MNA®); and serum albumin levels analyzed. Fatigue was evaluated using the Brief Fatigue Inventory, and health-related quality of life was assessed with the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36v2). The analysis of all patients indicated that the right grip strength, skeletal muscle mass, skeletal muscle index, and leg muscle mass significantly decreased, whereas the serum albumin level, MNA® score, and scores of many items of the SF-36v2 significantly increased after chemotherapy. In a gender-specific analysis, only men showed significant declines in the skeletal muscle mass and skeletal muscle index, and improvement in the MNA® score after chemotherapy. In the SF-36v2, there were significant improvements in general health and physical component summary scores among men, and general health and mental component summary scores among women. Exercise therapy at a Borg Scale intensity of 13 may not prevent muscle mass decline in patients with malignant lymphoma, especially male patients. In addition, this study revealed that there is a gender difference in the effect of exercise therapy on quality of life. Thus, gender should be considered in exercise therapy for patients with malignant lymphoma.

Clinical Promotion of Comfort Nursing Combined with Comprehensive Nursing in the Treatment of Severe Stroke Patients with Diabetes in ICU.

To investigate the application value of comprehensive nursing combined with comfort nursing for severe stroke patients with diabetes in the intensive care unit (ICU), as well as its effect on the incidence of pressure ulcers and aspiration. Between March 2019 and March 2021, 123 severe stroke patients with diabetes who were treated at our hospital were randomly assigned to one of two groups: the control group (n = 61) or the study group (n = 62). The control group received normal care, but the research group received comprehensive nursing as well as comfort nursing. The two patient groups were compared in terms of the effects of the clinical application. The two groups did not differ significantly in general data (P > 0.05). The shorter ICU monitoring and extubation times, the lower incidence of pressure ulcers, aspiration, and nosocomial infections, and higher self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores and a lower MOS 36-item short-form health survey (SF-36) score were all observed in the research group when compared to the control group (P < 0.05). For severe stroke patients with diabetes in the ICU, comprehensive nursing combined with comfort nursing has a promising effect, significantly, lowering the risk of pressure ulcers, aspiration, and nosocomial infections, accelerating physical recovery, enhancing mental state, and ensuring a better prognosis, deserving general clinical promotion.

The Evaluation of Migraine Patients Living in the Provincial Center of Bingöl in Terms of Quality of Life

Objective: The present study was planned to evaluate the quality of life of migraine patients living in the city center of Bingöl. Method: The population of the study consisted of people over the age of 18 living in the city center of Bingöl and diagnosed with migraine. Data was collected from 102 individuals who were reached between the dates of December 14, 2019 and March 12, 2020, who volunteered to participate in the study. The Personal Information Form and the MOS 36-Item Short-Form Health Survey (SF-36) were used as data collection tools. Results: The participants in our study showed that the SF-36 sub-dimension mean scores were high in PHS (Physical Health Status), PF (Physical Functioning), SF (Social Functioning), MF (Mental Functioning), and the mean scores were low in PR (Physical Role), MR (Mental Role) dimensions, and the mean scores were moderate in P (Pain), GH (General Health), MHS (Mental Health Status), V (Vitality) dimensions. Conclusion:In our study, it was observed that the quality of life of patients diagnosed with migraine decreased, and it was concluded that this situation affects the daily lives of patients.

Long-term survivors demonstrate superior quality of life after haploidentical stem cell transplantation to matched sibling donor transplantation

BackgroundIt has been well-documented that haplo-identical hematopoietic stem cell transplantation (HID-HSCT) can provide outcomes comparable to conventional matched sibling donor (MSD) HSCT, however, little is known about the effects on quality of life (QoL) in long-term survivors. This study is to investigate the differences in longitudinal performance of QoL between HID and MSD HSCT using a comprehensive assessment system.MethodsThis prospective study enrolled consecutive patients who had received allogenic-HSCT (allo-HSCT) between January 2018 and December 2019 in our center. All patients were informed to complete QoL questionnaires including the Mos 36-Item Short-Form Health Survey (SF-36) and the Functional Assessment of Cancer Therapy Bone Marrow Transplant (FACT-BMT, version 4), using an online applet, before transplantation and at scheduled time points after transplantation. The linear mixed-effects model was used to analyze the variation trend of different dimensions of both SF-36 and FACT-BMT with different follow-up times.ResultsOf the 425 participants, recipients of HID and MSD who survived more than 1 year (n = 230) were included in the final analysis of QoL (median age [range]: 36, [15, 66]). The 3 year overall survival (OS) of HID and MSD was 82.42% and 86.46%, respectively. QoL was assessed using both SF-36 and FACT-BMT and there was longitudinal recovery with clinical significance in the cohort. Compared to MSD-HSCT patients, HID-HSCT recipients demonstrated superior QoL performance in some subscales describing physical and mental wellness. Specifically, the difference in physical performance is more remarkable using FACT-BMT whereas that in mental wellness is more significant using SF36. In the subsequent stratified analysis, patients with a history of aGVHD or CMV reactivation demonstrated inferior QoL.ConclusionsLong-term survivors of HID HSCT achieved better QoL in some sub-scales compared to MSD HSCT. In addition, SF-36 and FACT-BMT demonstrated different performance thus combination of both improved capacity of the evaluation system.

Low acceptance rate of COVID-19 vaccination and reduced quality of life among heart transplant recipients during the COVID-19 pandemic.

To investigate the impact of the current coronavirus disease 2019 (COVID-19) pandemic on the quality of life (QoL) and status of COVID-19 vaccination in heart transplant recipients (HTRs). Patients who underwent allogeneic heart transplants between June 2006 and December 2019, who survived were selected from a follow-up registration form at our center. Data were collected using questionnaires in 2021, the QoL survey was conducted using the MOS 36-item Short-Form Health Survey (SF-36) and compared to the same time frame in 2019. The patients were divided into two groups: post-epidemic (A) and pre-epidemic (B) groups. We also recorded whether the participants had been vaccinated against COVID-19 (Beijing Sinovac COVID-19 vaccine). All the data obtained were analyzed. There were 88 patients who participated in the study. Only 12 (13.6%) were vaccinated. In terms of SF-36 scale assessments, after the outbreak of the COVID-19 pandemic, Group A scored lower in vitality [52.5(49.0, 58.0) vs.75.0(69.0, 79.0), p < .001], social functioning [54.0(50.5, 58.0)vs. 74.0(67.5, 78.0), p < .001], role emotional [58.5(55.0, 62.0)vs.67.0(63.0, 71.0), p < .001], and mental health [58.5(55.0, 62.0)vs. 76.0(72.0, 79.0), p < .001]. In Group A the mental component summary (MCS) significantly decreased [222.0(214.5, 230.0)vs.289.0(277.5, 299.5), p < .001]. The PCS and MCS of HTRs who had been vaccinated against COVID-19 were significantly higher than those who had not [PCS: 283.5(280.0, 287.0) vs.276.0(271.0, 279.0), p < .001; MCS: 245.0(141.5, 254.0) vs.220.0(213.5, 226.5), p < .001]. Low acceptance levels of COVID-19 vaccination were observed in the HTRs. The QoL of the HTRs decreased after the COVID-19 pandemic.

EFFECTS OF STRESS THEORY ON PSYCHOLOGY AND QUALITY-OF-LIFE IN PATIENTS WITH SPINAL FRACTURE DURING THE PERIOPERATIVE PERIOD

Objective: This study investigates how a psychological and cognitive intervention based on stress theory affected patients with spinal fractures during the perioperative period, with a focus on mental resilience, self-efficacy, and quality-of-life. Methods: The participants included 50 patients who underwent spinal fracture surgery at our hospital (People’s Hospital of Zhongjiang County) between January and June 2022. They were divided into control (25 cases) and observation (25 cases) groups according to a table of random digits. The control group received a routine intervention, while the observation group received a one-week psychological and cognitive intervention based on stress theory. Before and after the intervention, both groups completed the Connor Davidson Resilience Scale (CD-RISC), general self-efficacy scale (GSES), and MOS 36-item short-form health survey (SF-36), with scores compared. Results: Compared with the preintervention results, both groups had significantly higher postintervention scores on the CD-RISC, GSES, and SF-36. Moreover, the observation group showed much higher scores than the control group ([Formula: see text]). Conclusions: Psychological and cognitive intervention based on stress theory can effectively improve psychological resilience, self-efficacy, and quality-of-life in patients with spinal fractures during the perioperative period. This finding is of high clinical reference value.

The Percutaneous Endoscopic Lumbar Debridement and Irrigation Drainage Technique for the First-Stage Treatment of Spontaneous Lumbar Spondylodiscitis: A Clinical Retrospective Study.

Background Minimally invasive or open surgery is contentious in the treatment of spondylodiscitis, therefore finding a balance between the two is urgently needed. In this study, we propose a new treatment paradigm for treating spontaneous lumbar spondylodiscitis by percutaneous endoscopic lumbar debridement and irrigation drainage (PELDID). Then, the Pola classification was used to guide subsequent treatment. Methods From November 2017 to April 2019, this study collected data on 16 patients with lumbar spondylodiscitis who were surgically treated utilizing this treatment paradigm in our department. Clinical effectiveness was determined using the visual analogue scale (VAS), the Oswestry Disability Index (ODI), the MOS 36-item short-form health survey (SF-36), and Kirkaldy-Willis criteria. Results All 16 patients completed the treatment using the above paradigm and were followed up for 28.13 ± 10.15 months. The preoperative Pola classification is as follows: 7 cases of type A, 3 cases of type B, and 6 cases of type C. After the first-stage surgery, the evaluation results of Pola classification were as follows: 8 cases of type A, 8 cases of type B, and 0 cases of type C. Four patients received second-stage surgery with internal fixation through the paravertebral multifidus space approach and intervertebral bone graft fusion through the transforaminal approach, and the reoperation rate was 25% (4/16 cases). The Visual analogue scale (VAS), Oswestry Disability Index (ODI), and SF-36 score all improved significantly from 2.43 ± 0.89 to 0.18 ± 0.40, from 77.31% ± 11.15%to 16.93% ± 5.45%, and from 18.34 ± 7.47 to 80.3 ± 15.36. The CRP and ESR decreased dramatically from 49.61 ± 48.84 to12.50 ± 12.18 and from 65.56 ± 26.89 to 29.68 ± 20.68. There were no recurrences of infection in our study. Conclusions The paradigm of the first-stage PELDID technique combined with the Pola classification system to guide the second-stage treatment for spontaneous spondylodiscitis is a novel and effective strategy for treating spontaneous spondylodiscitis.

Correlation of Presacral Tumour Recurrence with Tumour Metastasis and Long-Term Tumour Recurrence Risk in Patients with Rectal Cancer.

Objective To explore the risk factors that affect long-term presacral tumour recurrence in patients with rectal cancer (RC) after radical rectal cancer resection. Methods In our study, a total of 50 patients with presacral tumour recurrence after radical resection of RC in our hospital between May 2017 and May 2018 were enrolled in the observation group, and the other 50 patients without presacral tumour recurrence after the resection over the same span were enrolled in the control group. The two groups were compared in distant metastatic rate and long-term recurrence, and corresponding K-M curves were drawn. Additionally, the quality of life of the two groups was also compared. Patients in both groups were assigned to a long-term recurrence group or a non-long-term recurrence group based on their long-term recurrence, and a multivariate logistic regression analysis was carried out for analysis of risk factors of long-term recurrence. Results The two groups were not greatly different in clinical data (P > 0.05). The observation group was higher than the control group in terms of distant metastasis and long-term recurrence (P < 0.05). In addition, the MOS 36-Item Short-Form Health Survey (SF-36) scores of the observation group were all lower than those of the control group in the eight dimensions (P < 0.05). Moreover, tumour diameter (OR: 0.315, 95% CI: 0.118–0.835), differentiation (OR: 2.652, 95% CI: 1.086–6.852), and presacral recurrence (OR: 2.370, 95% CI: 1.263–4.447) were all independent risk factors for long-term recurrence of patients undergoing radical resection of RC. Conclusions Patients undergoing radical resection of RC face greatly higher risks of presacral tumour distant metastasis and long-term tumour recurrence, and tumour diameter ≥ 5 cm, low-differentiation degree, and presacral recurrence are independent risk factors for long-term recurrence of patients undergoing radical resection of RC. In the future, when performing radical resection of rectal cancer, it is necessary to pay attention to the changes in the above indicators in patients so as to prevent tumour recurrence.

Relationship Between Multiple Sclerosis Severity and Fear of Falling With Mediating Roles of Disability, Cognitive Factors, and Physical Factors Among Patients With MS

Background: Fear of falling (FoF) is a permanent concern and may limit daily activities and diminish confidence in balance abilities leading to muscular deterioration, a sedentary lifestyle, and reduced quality of life. The present study aimed to investigate the relationship between multiple sclerosis severity and FoF with mediating roles of disability, cognitive factors, and physical factors among patients with multiple sclerosis (MS). Methods: This research was a correlational study based on path analysis. The statistical population consisted of all patients with MS who visited the neurology centers of hospitals in Sari, Iran. A total of 200 MS patients were selected as the sample using multistage random sampling. Two hospitals were selected from the hospitals of Sari city and the research sample was selected from the neurology centers of these hospitals. The research instruments included the falls efficacy scale-international, the MS severity scale, the expanded disability status scale, the cognitive factors questionnaire, and the MOS 36-item short-form health survey. The data were analyzed by structural equation modeling in AMOS and SPSS software, version 25. Results: The results of structural equation modeling demonstrated that the proposed model fitted the data. FoF had positive significant relationships with MS severity and disability. MS severity and FoF had negative significant relationships with physical factors (P&lt;0.01). The direct relationship between MS severity and cognitive factors was insignificant and excluded from the model. The study findings confirmed the relationship between MS severity and FoF mediated by disability and physical factors in patients with MS (P&lt;0.01). Conclusion: The frequency of FoF was much higher among patients with higher MS severity. Considering the consequences of the FoF among patients with MS, it is recommended that consultation services be provided to patients with MS at healthcare centers to improve their health and activity and reduce their FoF.

"Losing Faith in My Body": Body Image in Individuals Diagnosed with End-Stage Renal Disease as Reflected in Drawings and Narratives.

Chronic kidney disease (CKD) and the dependency on dialysis is an abrupt life-changing event that harms a patient’s life (e.g., social relationships, work, and well-being). This study aimed to examine how individuals who undergo chronic dialysis due to failure end-stage renal disease perceive their bodies, as reflected in drawings and narratives. Following ethical approval and signing a consent form to participate in the study, 29 adults between the ages of 20 and 85 who have undergone dialysis filled out an anonymous questionnaire that consisted of the following measures: The Center for Epidemiological Studies—Depression (CES-D), The Multidimensional Body-Self Relations Questionnaire (MBSRQ), and The MOS 36-Item Short-Form Health Survey (SF-36). After completion, they were asked to draw their self-figure before and after being diagnosed and narrate it. The data were quantitatively and narratively analyzed. The results revealed high levels of depression and concerns regarding body fitness and weight. Few significant differences were noted between self-figured drawings before and after the diagnosis, such as the body line and gender markers. Additionally, Fitness Evaluation and Overweight Preoccupation were significant among the participants.

Results of a study of the quality of life in patients with highly active multiple sclerosis in Russia

Multiple sclerosis (MS) is a chronic autoimmune inflammatory demyelinating and neurodegenerative disease of the central nervous system. Now 2.8 million people in the world suffer from MS, since 2000 every 5 years there has been an increase in the number of MS patients by 10%. At the same time, the number of cases with highly active MS (HAMS) is increasing, i.e. cases of MS with two or more exacerbations without taking specific pathogenetic therapy or one exacerbation during taking MS disease-modifying therapies (DMTsMS), which is accompanied by the corresponding MRI data of the brain and spinal cord (presence of new or active lesions). Previously, there were no studies of quality of life (QoL) in this subgroup of patients in the world.Objective: to compare the QoL indicators of patients with HAMS with those of healthy people and patients with a typical course of relapsingremitting MS (RRMS).Patients and methods. The study included data on 518 patients from 14 regions of the Russian Federation for 2020–2021 years, in whom HAMS was confirmed during a second examination. We used the results of the analysis of clinical data from neurologists and data from questionnaires filled out by patients with HAMS. Two questionnaires were used in the work – the general (non-specific) Questionnaire for assessing the QoL, SF-36 (The MOS 36-item Short-Form Health Survey) and a special questionnaire for MS patients – MusiQoL (Multiple sclerosis Quality of Life).Results and discussion. Almost all indicators of QoL in HAMS were below the control. When compared with the typical course of RRMS, a more pronounced decrease in daily activity indicators, a significant impact of clinical symptoms on QoL, a negative attitude of patients towards the healthcare system, and a low overall health index were noted. Pearson correlation analysis revealed a stronger effect on QoL parameters of the frequency of exacerbations in HAMS than in RRMS.Conclusion. The data obtained in the study indicate the need for more active management of patients with HAMS using second-line DMTsMS.