Pain Domains Research Articles

The association of permanent versus absorbable fixation on developing chronic post-herniorrhaphy groin pain in patients undergoing laparoscopic inguinal hernia repair

IntroductionFixation of mesh during minimally invasive inguinal hernia repair is thought to contribute to chronic post-herniorrhaphy groin pain (CGP). In contrast to permanent tacks, absorbable tacks are hypothesized to minimize the likelihood of CGP. This study aimed to compare the rates of CGP after laparoscopic inguinal hernia repair between absorbable versus permanent fixation at maximum follow-up.MethodsThis is a post hoc analysis of a randomized controlled trial in patients undergoing laparoscopic inguinal hernia repair (NCT03835351). All patients were contacted at maximum follow-up after surgery to administer EuraHS quality of life (QoL) surveys. The pain and restriction of activity subdomains of the survey were utilized. The primary outcome was rate of CGP, as defined by a EuraHS QoL pain domain score ≥ 4 measured at ≥ 1 year postoperatively. The secondary outcomes were pain and restriction of activity domain scores and hernia recurrence at maximum follow-up.ResultsA total of 338 patients were contacted at a mean follow-up of 28 ± 11 months. 181 patients received permanent tacks and 157 patients received absorbable tacks during their repair. At maximum follow-up, the rates of CGP (27 [15%] vs 28 [18%], P = 0.47), average pain scores (1.78 ± 4.38 vs 2.32 ± 5.40, P = 0.22), restriction of activity scores (1.39 ± 4.32 vs 2.48 ± 7.45, P = 0.18), and the number of patients who reported an inguinal bulge (18 [9.9%] vs 15 [9.5%], P = 0.9) were similar between patients with permanent versus absorbable tacks. On multivariable analysis, there was no significant difference in the odds of CGP between the two groups (OR 1.23, 95% CI [0.60, 2.50]).ConclusionMesh fixation with permanent tacks does not appear to increase the risk of CGP after laparoscopic inguinal hernia repair when compared to fixation with absorbable tacks. Prospective trials are needed to further evaluate this relationship.

Which lumbar vertebra should be the lowest level of fusion in adolescent idiopathic scoliosis of Lenke types 5 and 6?

It is important to protect the mobile segment in the lumbar region in scoliosis surgery. The aim of this study was to compare the clinical and radiological results of patients who underwent surgery for a diagnosis of adolescent idiopathic scoliosis (AIS) with the lowest instrumented vertebra (LIV) at L3 or L4 level. The study included 36 patients who underwent surgical treatment in our institution for a diagnosis of Lenke type 5 and 6 AIS with a follow-up period of at least 24 months. The patients were separated into 2 groups according to the LIV level of L3 (n=21) and L4 (n=15). These 2 groups were compared preoperatively (PO), early postoperative (EPO), and at the final follow-up examination (last control (LC)) with respect to radiological parameters in the coronal and sagittal planes, and the Scoliosis Research Society - 22 (SRS-22) questionnaire values. In both groups the mean age (L3: 16 ± 7.3; L4: 17 ± 6.1 years) and follow-up periods (L3: 44 ± 20; L4: 47 ± 18 months) were similar. Radiologically, the L4 group had a greater Cobb angle in the scoliosis main curves measured PO (P=.001). The Cobb angles measured at EPO (P=.767) and at LC (P=.674) were similar in both groups. No significant difference was observed between the 2 groups in respect of the LIV tilt values at PO (P=.469), EPO (P=.297), and LC (P=.065). When the groups were evaluated separately, the LIV tilt values at EPO and LC were similar in the L4 group (EPO: 6.93 ± 3.058; LC: 7.26 ± 2.313; P=.618). In the L3 patients, although there seemed to be a significant increase in LIV tilt values when EPO values were compared with LC values (EPO: 8.47 ± 3.970; LC: 9.57 ± 3.76; P=.030), this was within the error range of Cobb angle measurement. The results of the SRS-22 questionnaire showed significantly better results in the L3 group in the domains of pain, function/activity, mental health, and satisfaction with treatment (P=.011, P=.002, P=.019, P=.046, respectively). There was no radiological superiority between L3 and L4 LIV groups in the thoracolumbar/lumbar curve patients. However, according to the SRS-22 questionnaire, the results of patients with L3 level LIV were better in the areas of pain, function/activity, mental health, and satisfaction with treatment. Cite this article as:Baymurat AC, Tokgoz MA, Abdulaliyev F, Tosun MF, Can MM, Senkoylu A. Which lumbar vertebra should be the lowest level of fusion in adolescent idiopathic scoliosis of Lenke types 5 and 6? Acta Orthop Traumatol Turc., 2024;58(2):116-123.

Delayed Fixation of Acetabular Fractures Affects Functional Outcomes and Health-Related Quality of Life, Not Just Quality of Reduction.

Delayed operative fixation of acetabular fractures remains a major problem in many parts of the world. No previous studies have reported the effect of fixation delay on health-related quality of life (HRQOL). We aimed to investigate the effect of delayed operative fixation of acetabular fractures on health-related quality of life, EuroQol-5 Dimension questionnaire (EQ-5D), and other related outcomes. We retrospectively analysed 117 patients who underwent open reduction internal fixation for displaced acetabular fractures between 2014 and 2021. Patients were divided into groups based on the admission-to-surgery time (interval between injury and definitive surgery): 1-14, 15-21, and >21days. Patients were analysed for associations between admission-to-surgery time and postoperative outcomes, including operative time, estimated blood loss, blood transfusion, postoperative complication, and quality of reduction. Eighty-five patients with a mean follow-up time of 3.94 ± 1.84years were analysed for the association between admission-to-surgery time and conversion to total hip arthroplasty, the Modified Merle d'Aubigné and Postel score, EQ-5D score, ability to sit cross-legged, and ability to sit squat. Multivariable linear regression was used for continuous outcomes and logistic regression for categorical outcomes associated with delayed operative fixation. An admission-to-surgery time > 14days was associated with significantly higher blood loss [785mL (236-1335), p = 0.006]. For associated fractures, an admission-to-surgery time > 21days increased the risk of poor reduction [odds ratio (OR), 5.21 (1.42-19.11), p = 0.013]. Further, admission-to-surgery time > 21days was associated with poor Modified Merle d'Aubigné and Postel scores [OR, 8.46 (1.48-48.29), p = 0.016], EQ-5D pain domain [OR, 3.55 (1.15-11), p = 0.028], and EQ-5D usual activity domain [OR, 4.24 (1.28-14), p = 0.018]. Delayed operative fixation of acetabular fractures after 21days affected the functional outcomes and HRQOL, independent of the reduction status. Surgical interventions and patient referrals should occur at the earliest and within 21days from the time of injury. The online version contains supplementary material available at 10.1007/s43465-024-01163-x.

Patient-reported outcomes after oral cancer reconstructions with radial and ulnar forearm-free flaps.

This study aimed to evaluate patient-reported quality of life and incidence of decision regret in patients undergoing radial (RFFF) and ulnar forearm-free flaps (UFFF) reconstruction. Patients undergoing either RFFF or UFFF were assessed with the University of Washington Quality of Life (UW-QOL) and Oral Health Impact Profile (OHIP-14) questionnaires, and the Decision Regret Scale (DRS), both before and at least 12 months post-reconstruction. In total, 40 RFFF and 40 UFFF were included. Harvesting time was longer in RFFF (p = 0.043), and the donor-site defect was significantly larger in RFFF than in UFFF (p = 0.044). Patients with UFFF scored better UW-QOL in the appearance, pain, activity, mood, and social functioning domains (p < 0.05). However, the RFFF group excelled in swallowing and chewing domains. The DRS score revealed a significant difference between RFFF and UFFF, with scores of 36.26 versus 27.36, respectively. Moreover, the mean DRS score reduced at 12 months compared with 6 months, significantly superior for UFFF. Oral cancer patients reconstructed with UFFF exhibited a better appearance, social domain, and mild decision regret compared with RFFF, indicating that the UFFF may contribute to improving postoperative quality of life in oral cancer patients.

The Relationship between Anxiety Symptoms and Perceived Quality of Life among Caregivers of Children with Autism Spectrum Disorder in the Amazon.

The relationship between anxiety symptoms and perceived quality of life among caregivers of children with autism was verified. To assess perceived quality of life, the Short Form Healthy Survey Item was used; perception of anxiety symptoms was assessed using the Beck Anxiety Inventory. Eighty caregivers of children with autism participated, with 68.7% of caregivers being mothers. Of the total number of caregivers, 68.8% had a severe level of anxiety. Regarding perceived quality of life, they demonstrated greater impairment in limitation due to physical aspects, limitation due to emotional aspects, vitality, and pain. Caregivers with severe anxiety levels had a worse quality of life in the domains of pain (p = 0.012), social aspects (p < 0.001), limitation due to emotional aspects (p = 0.001), and mental health (p < 0.001). However, in the functional capacity domain, caregivers with a moderate level of anxiety had a better physical capacity score (p = 0.001). There was a negative correlation between the general anxiety score and the general physical (p = 0.029) and general emotional components of perceived quality of life (p < 0.001). It was found that caregivers of children with ASD have a high level of anxiety, which is a predictor of the perception of a worse quality of life.

Effects of Hypopressive Abdominal Training on Ventilatory Capacity and Quality of Life: A Randomized Controlled Trial.

Pelvic floor dysfunctions, associated with alterations in respiratory mechanics and, consequently, quality of life, are the cause of the most frequent gynecological problems. Pelvic floor muscle training emerges as a first-line treatment, with new approaches such as hypopressive exercises. The aim of this study was to analyze the efficacy of an 8-week supervised training program of hypopressive exercises on the pelvic floor and its impact on improving the ventilatory mechanics and quality of life in women. Analysis of the spirometric parameters showed a significant main Group × Time effect for three parameters: the ratio of FEV1/FVC (p = 0.030), the forced expiratory flow at 75% of the expired vital capacity (p < 0.001), and the forced expiratory flow over the middle half of the forced vital capacity (p = 0.005). No statistical significance was found regarding the SF-12 questionnaire components; only differences were found over time in the physical role (p = 0.023), bodily pain (p = 0.001), and vitality (p < 0.010) domains and in the physical component summary score (p = 0.010). After an 8-week intervention of hypopressive exercises, an improvement in the ventilatory and pulmonary capacities can be observed.

Physical Activity and Pain During Pregnancy

Low back and pelvic girdle pain are prevalent during pregnancy, impacting about 50% of pregnant women. Previous studies conducted on the general population have suggested that physical activity has been associated with reductions in pain levels. Purpose: To determine if women with higher levels of physical activity experience less low back and pelvic girdle pain and lower disability scores than women who are less physically active. Methods: Pregnant women (n=24, 32.2 ± 4.1 years) were recruited between 28- and 32-weeks gestation. Participants reported their weekly physical activity, responded to subjective pain surveys, and underwent a battery of objective pain testing. Spearman’s-rho was used to assess correlations between physical activity scores and each subjective pain measure. Results: Tests for correlation between pregnancy physical activity scores and pain domain measures were not significant (ps&gt;0.05), so no relationship could be determined between physical activity levels and low back/pelvic girdle pain based on this study. Conclusion: This study was not able to identify a significant correlation between physical activity levels and low back/pelvic girdle pain during pregnancy.

Comparison of promestriene with vaginal fractional CO2 laser and radiofrequency treatments of genitourinary syndrome of menopause

ObjectiveTo compare the effects of fractional CO2 laser and microablative fractional radiofrequency treatment with promestriene topical estrogen on sexual function and genitourinary syndrome of menopause symptoms. MethodsThis was a prospective randomized open-label clinical trial conducted with 62 postmenopausal women assigned to three intervention groups: a) topical promestriene for 90 days (n = 17); b) fractional CO2 laser treatment (n = 24); and c) microablative fractional radiofrequency treatment (n = 21). Each of the latter two groups underwent three treatment sessions at 4-week intervals. At baseline and at the end of the study, all participants had a gynecological examination that included vaginal pH measurement, and the completion of the Vaginal Symptom Score, the Vaginal Health Index, and the Female Sexual Function Index. For the energy treatment groups, adverse effects were evaluated after each session. Group homogeneity was assessed at baseline, and results were evaluated over time (from baseline to the end of treatment) and between groups over time. ResultsAll baseline parameters were similar among studied groups. At the end of the study, all 3 treatments had produced similar effects: a reduction of vaginal pH, and an improvement of vulvovaginal symptoms (Vaginal Symptom Score and Vaginal Health Index scores) as well as sexual function (higher total Female Sexual Function Index scores, and in the desire, arousal, lubrication and pain domain scores), with no differences observed between groups. Side-effects were slight for both energy treatment groups, mainly represented by vaginal discharge. ConclusionThe present study suggests that the two energy treatments were efficient along with promestriene at improving postmenopausal genitourinary and sexuality symptoms.Clinical trial identification numberNCT04717245.

Concurrent Validity of PROMIS and LD-SRS Scores in Pediatric Patients With Lower Limb Differences.

We sought to assess the concurrent validity of select Patient Reported Outcomes Measurement Information System (PROMIS) domains and Limb Deformity-Scoliosis Research Society (LD-SRS) scores. We prospectively administered PROMIS - 25 (including anxiety, depression, fatigue, pain interference, peer relationships, and physical function) and LD-SRS questionnaires to 46 consecutive pediatric patients with lower limb differences, presenting to a single surgeon for reconstruction. Concurrent validity between various subdomains of the 2 outcome measures was assessed through Pearson's correlation, with significance defined as P <0.05. The strength of correlation was interpreted by Evans criteria: absolute r value <0.20 indicating very weak correlation; 0.20 to 0.39, weak; 0.40 to 0.59, moderate; 0.60 to 0.79, strong; and 0.8 or greater indicating very strong correlation. The LD-SRS Pain, Function, and Mental Health domains most strongly correlated with the PROMIS pain interference ( r =-0.79, P <0.001), physical function ( r =0.74, P <0.001), and anxiety ( r =-0.68, P <0.001) domains, respectively. In addition, LD-SRS pain strongly correlated with PROMIS physical function ( r =0.61, P <0.001) and LD-SRS function with PROMIS pain interference ( r =-0.72, P <0.001). All PROMIS domains significantly correlated with total LD-SRS scores. PROMIS pain interference ( r =-0.79, P <0.001), physical function ( r =0.67, P <0.001), and fatigue ( r =-0.60, P <0.001) domains demonstrated the strongest correlations with the total LD-SRS score. The significant concurrent validity between LD-SRS and multiple PROMIS domains suggests considerable overlap, and perhaps redundancy, between these 2 outcome measures. Given the high degree of concordance and the advantage of computer adaptive testing (CAT) in mitigating administrative burden and survey fatigue, along with the ability to compare outcomes across a wider group of children with a variety of underlying diagnoses, select PROMIS domains may be a viable alternative to LD-SRS score for assessing patient-reported outcomes when treating pediatric patients with lower limb deformities. A larger, multi-center study including pediatric patients with lower limb differences from a diverse background, including age, etiology, native language, and ethnicity, would be helpful to externally validate our findings. Level-I.

Longitudinal assessment of health-related quality of life and clinical outcomes with at home advanced pneumatic compression treatment of lower extremity lymphedema

ObjectiveThis prospective, longitudinal, pragmatic study describes at home treatment with a proprietary advanced pneumatic compression device (APCD) for patients with lower extremity lymphedema (LED). MethodsFollowing institutiona review board approval, four participating Veterans Affairs centers enrolled LED patients from 2016 to 2022. The primary outcome measures were health-related quality of life (HR-QoL) questionnaires (lymphedema quality of life-leg and the generic SF-36v2) obtained at baseline and 12, 24, and 52 weeks. The secondary outcome measures were limb circumference, cellulitis events, skin quality, and compliance with APCD and other compression therapies. ResultsBecause a portion of the trial was conducted during the coronavirus disease 2019 pandemic, 179 patients had 52 weeks of follow-up, and 143 had complete measurements at all time points. The baseline characteristics were a mean age of 66.9 ± 10.8 years, 91% were men, and the mean body mass index was 33.8 ± 6.9 kg/m2. LED was bilateral in 92.2% of the patients. Chronic venous insufficiency or phlebolymphedema was the most common etiology of LED (112 patients; 62.6%), followed by trauma or surgery (20 patients; 11.2%). Cancer treatment as a cause was low (4 patients; 2.3%). Patients were classified as having International Society for Lymphology (ISL) stage I (68.4%), II (27.6%), or III (4.1%). Of the primary outcome measures, significant improvements were observed in all lymphedema quality of life-leg domains of function, appearance, symptoms, and emotion and the overall score after 12 weeks of treatment (P < .0001) and through 52 weeks of follow-up. The SF-36v2 demonstrated significant improvement in three domains at 12 weeks and in the six domains of physical function, bodily pain, physical component (P < .0001), social functioning (P = .0181), role-physical (P < .0005), and mental health (P < .0334) at 52 weeks. An SF-36v2 score <40 indicates a substantial reduction in HR-QoL in LED patients compared with U.S. norms. Regarding the secondary outcome measures at 52 weeks, compared with baseline, the mean limb girth decreased by 1.4 cm (P < .0001). The maximal reduction in mean limb girth was 1.9 cm (6.0%) at 12 weeks in ISL stage II and III limbs. New episodes of cellulitis in patients with previous episodes (21.4% vs 6.1%, P = .001) were reduced. The 75% of patients with skin hyperpigmentation at baseline decreased to 40% (P < .01) at 52 weeks. At 52 weeks, compliance, defined as use for 5 to 7 days per week, was reported for the APCD by 72% and for elastic stockings by 74%. ConclusionsThis longitudinal study of Veterans Affairs patients with LED demonstrated improved generic and disease-specific HR-QoL through 52 weeks with at home use of an APCD. Limb girth, cellulitis episodes, and skin discoloration were reduced, with excellent compliance.

An evaluation of sexual function and health-related quality of life following laparoscopic surgery in individuals living with endometriosis.

What is the relationship between sexual function, health-related quality of life (HRQoL), and laparoscopic surgery in individuals living with endometriosis? A higher number of laparoscopic surgeries is significantly associated with poorer HRQoL and greater levels of sexual dysfunction in individuals with endometriosis. Prior research indicates that endometriosis is associated with lowered HRQoL and sexual function and that these outcomes are influenced by endometriosis-related symptom profiles, medical, and surgical management. A limited number of studies have examined changes in sexual function in individuals with endometriosis following laparoscopic surgery or following repeated surgeries. A cross-sectional community-based online survey was used to examine the relationships between sexual function, HRQoL, and laparoscopic surgery (n = 210). Individuals with a self-reported diagnosis of endometriosis were recruited via online advertising through social media and gynaecology clinics. Endometriosis-specific data (e.g. diagnostic delay, symptom experience) was collected in addition to engagement with laparoscopic surgery, level of HRQoL (EuroQol-5 Dimension: EQ-5D-5L), and sexual function (Female Sexual Function Index: FSFI). Bivariate correlational analyses and hierarchical multiple regression were used to determine the associations between the variables of interest. Individuals with endometriosis have substantially poorer HRQoL in comparison to Australian normative samples, with greater levels of endometriosis-related symptom burden, distress, and pain significantly associated with lower levels of HRQoL. The mean FSFI score was suggestive of clinically significant female sexual dysfunction, with the lowest level of function noted in the domain of sexual pain and the highest level of function noted in the sexual satisfaction domain. A greater number of laparoscopic surgeries was significantly associated with poorer overall HRQoL and greater levels of sexual dysfunction. The cross-sectional nature of the data precludes direct findings of causality and further longitudinal research is recommended. The information pertaining to engagement in laparoscopic surgery was self-report in nature and was not medically verified. The study's findings highlight the pervasive impact of endometriosis on all domains of living, emphasizing the need to extend treatment planning beyond that of physical pain management alone. Early referral for assessment and management of sexual wellbeing is recommended prior to, and post-surgical intervention, with a focus on maintaining post-surgical changes, potentially reducing the need for multiple surgeries. The study was not associated with research funding. Author CN reports grant funding from the Australian Government and Medical Research Future Fund (MRFF) and was a previous employee of CSL Vifor (formerly Vifor Pharma Pty Ltd). N/A.

Clinical, physical, and psychological outcomes among individuals with post COVID-19 syndrome with different functional status: a cross-sectional study

Introduction: post-COVID-19 syndrome or long COVID is a condition characterized by symptoms that persist after the disease's infection. Objective: to compare clinical, physical, and psychological outcomes among individuals with post COVID-19 syndrome with different levels of functional status after hospitalization for COVID-19. Methods: an observational, analytical, cross-sectional and with a quantitative approach with 75 individuals with post COVID-19 syndrome after hospitalization. Individuals underwent assessment of pulmonary function, six-minute walk test (6MWT), 1-minute sit and stand test (STS1), hand grip strength (HGS) and one repetition maximum test (1RM), Hospital Anxiety and Depression Scale (HADS), Short-Form Healthy Survey (SF-36) and Post-COVID Functional Scale (PCFS). Individuals were separated according to PCFS into two groups: low (LFL) and high (HFL) functional limitation (PCFS 1-2 and PCFS 3-4, respectively). Data regarding anthropometric and clinical characteristics, hospitalization history, and occupational activity were also collected. Results: individuals post COVID-19 syndrome with HFL presented worse score in the SF-36 in the functional capacity (p=0,01); pain (p=0,01), social aspects (p=0,01) and these individuals had a higher need for ICU admission (p=0,03) and prolonged hospitalization stays (p=0,04) compared to those with LFL. Conclusion: individuals with post COVID-19 syndrome that reported HFL exhibit poorer quality of life concerning the domains of functional capacity, pain, and social aspects when compared to those with LFL. Additionally, HFL individuals had a higher need for ICU admission and prolonged hospitalization stays

Is the correlation of the core muscle performance with shoulder pain and function altered by scapular dyskinesis in subjects with shoulder pain?

BACKGROUND: Daily activities that involve upper limb movements require muscle activation from different body parts by transferring forces and energy along the functional kinetic chain. The scapulae connect and transfer forces between the trunk and the upper limbs, so scapular dyskinesis may compromise the performance of the kinetic chain. OBJECTIVE: To assess the relationship between core muscle performance and shoulder pain and function in individuals with shoulder pain, with and without scapular dyskinesis. METHODS: Data was collected from 77 non-athlete adults aged between 18 and 50 years with shoulder pain, 45 had scapular dyskinesis. Core muscle performance was measured using the prone bridging test (PBT). Shoulder pain and disability were measured by the Shoulder Pain and Disability Index (SPADI), and the upper limbs’ stability was assessed by the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST). The peak torque of shoulder external and internal rotators was measured using an isokinetic dynamometer. Multiple linear regression models evaluated the relationship between the PBT and CKCUEST, SPADI, and shoulder rotator strength. RESULTS: Significant correlations were found between the PBT and the SPADI total score (r = – 0.522), pain domain (r = – 0.513), and disability domain (r = – 0.501); normalized score (r = 0.593), and the power (r = 0.624) of the CKCUEST; and peak torque for external (r = 0.256) and internal (r = 0.292) rotations. Scapular dyskinesis did not influence the magnitude of the correlations and predictive values. CONCLUSION: The PBT was correlated with shoulder pain and function, but scapular dyskinesis did not affect the magnitude of these relationships.

Evaluating the Efficacy of IL-6 as Predictors of Lateral Lumbar Interbody Fusion Success: Insights From Pain Scores and JOABPEQ Assessments.

A prospective study. This study aims to explore the correlation between interleukin (IL)- 6 levels in intervertebral disc (IVD) tissue and clinical outcomes in patients undergoing lumbar surgery for lumbar degenerative disease (LDD). This prospective study analyzed 32 patients (22 men and 10 women, average age 69.6 years) who underwent lateral lumbar interbody fusion (LLIF). IL-6 gene expression in IVD tissues collected during surgery was measured and correlated with pre- and postoperative clinical outcomes, including pain intensity assessed via Numeric Rating Scales (NRS) and quality of life (QOL) evaluated through the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). IL-6 levels showed statistical correlations with postoperative intensity of low back pain (LBP) and several JOABPEQ domains. Patients with higher expression of IL-6 levels experienced more severe postoperative LBP and lower scores in lumbar function, walking ability, social life function, and mental health. The effectiveness rate of JOABPEQ scores was exceptionally high for low back pain (.548), walking ability (.677), and social functioning (.563), demonstrating the effectiveness of LLIF. The average operation time was 105.6 minutes, and the estimated blood loss was 85.6mL. The study underscores IL-6 as a potential biomarker for predicting surgical outcomes in LDD. High IL-6 levels correlate with worse postoperative LBP and lower QOL scores. Integrating molecular markers like IL-6 with patient-reported outcomes could provide a more comprehensive approach to postoperative care in spinal disorders, aiming to improve the overall QOL for LDD patients undergoing LLIF surgery.

The Assessment of SF-36 Survey for Quality-of-Life Measurement after Radical Cystectomy for Muscle-Invasive Bladder Cancer: A Systematic Review.

This study presents a systematic review of the literature on individuals' health-related quality of life (HRQoL) following radical cystectomy for muscle-invasive bladder cancer (MIBC), utilizing the Short Form-36 Health Survey (SF-36) as a primary assessment tool. The review was designed as an exhaustive literature search across three major databases including PubMed, Scopus, and Embase up to December 2023, using the PRISMA guidelines. The selection process refined 2281 identified articles down to 11 studies meeting our inclusion criteria. These studies encompassed a diverse demographic and clinical profile of 774 participants, with follow-up durations ranging from 3 to 130 months, thereby offering insights into both short-term and long-term HRQoL outcomes. The results highlighted significant alterations in individuals' HRQoL across various domains post-radical cystectomy. Notably, the Physical Functioning (PF) and Bodily Pain (BP) domains generally scored higher, indicating a moderate to high perceived physical health status. However, the Role Physical (RP) and Role Emotional (RE) domains showed variability, reflecting the challenges in daily role fulfillment and emotional adjustment post-surgery. A marked variability in physical recovery was observed, with studies reporting significant differences in PF and RP scores between patient groups. The General Health (GH) and Vitality (VT) domains sometimes reflected perceived deteriorations, whereas the Mental Health (MH) scores suggested that many patients maintained or achieved high levels of well-being post-operatively. The conclusions drawn from this systematic review underscore the profound and multi-faceted impact of radical cystectomy on HRQoL, varying widely between studies, being influenced by geographic factors, surgical methods, and the time of evaluation. The findings emphasize the necessity for holistic patient care approaches that address both physical and emotional rehabilitation, aiming to improve HRQoL outcomes.

Do Caregivers and Patients With Early-Onset Scoliosis Share the Same Perspective on Health-Related Quality of Life? A Comparison of 24-item Early-Onset Scoliosis Questionnaire and 22-item Scoliosis Research Society Questionnaire Scores.

The 24-item Early-Onset Scoliosis Questionnaire (EOSQ-24) is validated in patients with early onset scoliosis (EOS) aged 0 to 18 years and the 22-item Scoliosis Research Society (SRS-22) questionnaire is validated in idiopathic scoliosis patients 10 years and older. EOSQ-24 is completed by the caregiver and SRS-22 is completed by the patient. A prior study comparing patient-reported outcome measures completed by older pediatric patients and their parents showed a low level of agreement. Our purpose was to compare EOSQ-24 and SRS-22 scores completed at the same time point and at subsequent time points, in patients aged 5 to 18 years with idiopathic or congenital EOS without developmental delay. This was a multicenter retrospective study. We identified pairs of EOSQ-24 and SRS-22 completed on the same day or within 6 months. Some patients had multiple pairs of surveys over time. EOSQ-24 and SRS-22 questions were matched and domain scores for Pain, Function, Mental Health, and Satisfaction were compared. Patients with a change in treatment between surveys were excluded. Pearson correlation coefficients ( r ) were used to compare domain scores, with r ≥0.7 indicating a strong relationship. There were 228 patient-caregiver dyads who completed 411 pairs of EOSQ-24 and SRS-22 on the same day. A strong correlation was found only for the Pain domain ( r =0.77). Function, Mental Health, and Satisfaction domains had positive but not strong correlations ( r = 0.58, r = 0.50, r = 0.41, respectively). Subanalysis based on age also showed a strong correlation only for Pain. There were 76 patient-caregiver dyads who completed 134 pairs of surveys with SRS-22 completed within 6 months after an EOSQ-24. All domains demonstrated a positive but not strong correlation, with Pain showing the highest correlation ( r = 0.64). EOSQ-24 and SRS-22 had a strong correlation only for Pain when completed at the same time point. EOSQ-24 and SRS-22 completed within 6 months lacked a strong correlation for all domains. Our findings suggest that parents and children with EOS may not share the same perspective on their health. Self-reported questionnaires should be used when possible to assess health-related quality of life in older children and adolescents with EOS who are developmentally neurotypical. Level III-diagnostic.

Translation, cross-cultural adaptation to Brazilian Portuguese and measurement properties of the WaLIDD score.

Dysmenorrhea is the pain related to menstruation; to screen for the symptoms, a working ability, location, intensity of days of pain, and dysmenorrhea (WaLIDD) score was created. The purpose of this work was to culturally adapt and assess the measurement properties of the WaLIDD score for dysmenorrhea in Brazilian women. In this cross-sectional online study, we evaluated women with and without dysmenorrhea. Criterion validity and construct validity were assessed, respectively, by the Receiver Operator Characteristic (ROC) curve and correlations with the bodily pain and social functioning domains of medical outcomes study 36-item short-form health survey (SF-36), self-report of absenteeism and Stanford Presenteeism Scale for presenteeism. Test-retest reliability and measurement errors were assessed, respectively, by intraclass correlation coefficient (ICC) and Bland and Altman Graph. 430 women completed the test, 238 (55.4%) women had dysmenorrhea, and 199 (46.3%) answered the questionnaire twice for the retest. The cutoff points ≥4, ≥5, and ≥5 could discriminate between women with and without dysmenorrhea, absenteeism, and presenteeism related to dysmenorrhea, respectively. Correlations between SF-36 - pain and social functioning domains and WaLIDD score were weak to strong and negative. For WaLIDD total Score, ICC was 0.95 and the limits of agreement were -1.54 and 1.62. WaLIDD score is a short, valid and reliable instrument to screen and predict dysmenorrhea and could predict absenteeism and presenteeism related to dysmenorrhea in Brazilian women.

Oral Health-Related Quality of Life Among Non-institutionalized Elderly in Malaysia: A Teaching Hospital-Based Survey.

Background In Malaysia, the Geriatric Oral Health Assessment Index (GOHAI) has been recognized as a vital instrument for evaluating oral health-related quality of life among the elderly population. Its integration into the National Health and Morbidity Survey (NHMS) in 2018 demonstrates the country's dedication to understandingand addressing the unique oral health challenges faced by older individuals. The NHMS, led by the Ministry of Health Malaysia, serves as a crucial platform for identifying and addressing healthcare needs, while also working towards achieving sustainable development goals. This study aimed to provide valuable information for stakeholders and researchers by investigating the relationship between quality of life related to oral health and demographic factors, with the ultimate goal of enhancing oral healthcare for older individuals. Objective The objective of this research was to identify the variables that impact the Oral Health-Related Quality of Life (OHRQoL) of non-institutionalized elderly individuals who visit the Klinik Pergigian Manipal University College Malaysia (MUCM). By utilizing the OHRQoL, dental practitioners can gain insight into the elderly's oral health-related quality of life, which is crucial information for dental healthcare providers to effectively reach out to and cater to the elderly at the institution. Methodology A cross-sectional design was employed, utilizing a non-probability sampling method to select eligible elderly individuals at the clinic. A validated questionnaire comprising 18 items covering sociodemographic details and the Geriatric Oral Health Assessment Index (GOHAI) was distributed to individuals above 60 years via printed forms. One way ANOVA, unpaired t-test and multiple linear regression analysis were performed to analyze the data. Results The overall mean GOHAI score among non-institutionalized elderly attending Klinik Pergigian MUCM was 48.38±9.33, indicating poor OHRQoL. The psychosocial impact domain had a mean score of 19.33±5.21, surpassing the pain and discomfort domain with a score of 10.73±2.82, highlighting the significant impact of psychosocial factors on poor oral health-related quality of life. Multiple linear regression analysis revealed no significantassociations between OHRQoL and factors such asethnicity, living arrangements apart from spouse and family, or tertiary education among older individuals after adjusting for confounding variables. Conclusions This study indicates that sociodemographic aspects have minimal impact on the OHRQoLof seniors. Further examination is needed to understand the economic aspects of tooth replacement options and preventive measures in this age group. To enhance the OHRQoLof older adults, especially those not living infacilities like nursing homes or assisted living centers,tailored oral healthcare plans and strategies arecrucial. Interdisciplinary collaboration among mental health professionals, geriatric experts, and oral healthcare providers is crucial for empowering both healthcare practitioners and seniors to maintain optimal oral health.

Equating and linking Patient-Reported Outcomes Measurement Information System 29-item questionnaire and 36-item Short-Form Health Survey domains using Rasch modeling

ObjectivesTo develop a simple, practical methodology to equate or link equivalent domains of the 36-item Short-Form Health Survey (SF-36) and the Patient-Reported Outcomes Measurement Information System 29-item questionnaire (PROMIS-29) using the Rasch framework. Study Design and SettingIn April 2016, the PROMIS-29 and SF-36 were completed by 1501 individuals selected to be representative of the French population. For each domain common to the two questionnaires, a Partial Credit Model was fitted to the items related to that dimension in the two questionnaires. These items were then calibrated on the same metric, which enabled the scores from one questionnaire to be associated with the scores from the other. ResultsSix of the seven PROMIS-29 scales and five of the six SF-36 subscales (physical, pain, social, vitality, depression and anxiety domains) were equated or linked. Correspondence tables between scores, with a 95% confidence interval, were established for each domain. A freely available Stata macro program was developed to automatize the equating or linking process. ConclusionThese results should facilitate comparisons across studies using the SF-36 and the PROMIS-29 in France. The equating or linking process developed is simple to implement and can be used in other countries and for other instruments.

Musculoskeletal symptoms and their impact on health-related quality of life in chronic nonbacterial osteomyelitis patients

IntroductionChronic non-bacterial osteomyelitis (CNO) is a rare, non-infection- related inflammatory disorder that affects children and teens. Clinical manifestations of CNO range widely from moderate, time-limited, monofocal inflammation of the bone to extreme multifocal or chronically active inflammation of the bone.ObjectivesThe main aim of this study was to explore the correlation between musculoskeletal (MSK) symptoms and health-related quality of life (HRQoL) in patients with CNO.MethodsChildren and adults with CNO and their parents were asked to answer a web-based survey. The survey consisted of multiple questions centered around demographic, clinical and therapeutic data, MSK discomfort form based on the Nordic MSK Questionnaire and HRQoL based on Pediatric Quality of Life Inventory-4 (PedsQL-4) and PedsQL rheumatology module. The inclusion criteria included diagnosis of CNO before the age of 18. Patients who had malignancies or any chronic rheumatic, MSK, neurological disease prior to CNO onset were excluded.ResultsThere was a total of 68 participants, mostly females (66.2%), with median age 14 years and median disease duration 4.75 years. The median number of bones affected by CNO was 5 and ranged from 1 to 24 bones. Among the studied patients, 45 patients (66.2%) had MSK manifestations at the last month. The most commonly affected part was ankle and feet (26.5%). Regarding HRQoL, patients with MSK manifestations had lower scores than did patients without in PedsQL-4 (p < 0.001) including domains of physical functioning (p < 0.001), emotional functioning (p = 0.033), social functioning (p < 0.001) and school functioning (p = 0.007) in addition to lower scores in PedsQL rheumatology module (p < 0.001) including domains of pain and hurt (p < 0.001), daily activities (p < 0.001), treatment (p = 0.035), worry (p = 0.001) and communication (p < 0.001).ConclusionMSK manifestations have a negative impact on HRQoL in CNO patients. So, early identification and treatment are highly recommended.