Patient-reported Questionnaires Research Articles

Alberta Childhood Cancer Survivorship Research Program.

Adverse outcomes after childhood cancer have been assessed in a range of settings, but most existing studies are historical and ascertain outcomes only after 5-year survival. Here, we describe the Alberta Childhood Cancer Survivorship Research Program and its foundational retrospective, population-based cohort of Albertan residents diagnosed with a first primary neoplasm between the ages of 0 and 17 years from 1 January 2001 to 31 December 2018. The cohort was established in collaboration with the Alberta Cancer Registry and Cancer in Young People in Canada program and has been linked to existing administrative health databases and patient-reported outcome questionnaires. The cohort comprised 2580 survivors of childhood cancer, 1379 (53.4%) of whom were 5-year survivors. Approximately 48% of the cohort was female, 47% of the cohort was diagnosed between 0 and 4 years of age, and the most frequent diagnoses were leukemias (25.4%), central nervous system tumors (24.0%), and lymphomas (14.9%). Detailed treatment information was available for 1741 survivors (67.5%), with manual abstraction ongoing for those with missing data. By the study exit date, the median time since diagnosis was 5.5 years overall and 10.4 years for 5-year survivors. During the follow-up time, 82 subsequent primary cancers were diagnosed, 20,355 inpatient and 555,425 ambulatory/outpatient events occurred, 606,773 claims were reported, and 437 survivors died. The results from this research program seek to inform and improve clinical care and reduce cancer-related sequelae via tertiary prevention strategies.

Assessing a nurse-assisted eHealth intervention posthospital discharge in adult patients with non-communicable diseases: a protocol for a feasibility study

IntroductionA growing number of patients with non-communicable diseases (NCDs), such as heart failure (HF) and colorectal cancer (CRC), are prone to comorbidity, a high rate of readmissions and complex healthcare...

Digital tool to identify and monitor regorafenib-associated hand-foot skin reactions: A proof-of-concept study protocol.

The FACET study is a prospective, open-label, low risk interventional clinical trial aiming at exploring the fitness-for-purpose and usability of an electronic device suite for the detection of hand-foot skin reaction symptoms in patients with metastatic colorectal cancer treated with regorafenib. 38 patients with metastatic colorectal cancer are being selected in 6 centers in France, and will be followed for 2 regorafenib treatment cycles, or for approximately 56 days. The electronic device suite includes connected insoles and a mobile device equipped with a camera and a companion application with electronic patient-reported outcomes questionnaires and educational material. The FACET study is intended to provide information useful for the improvement of the electronic device suite and its usability before the testing of its robustness in a larger follow-up study. This paper describes the protocol of the FACET study and discusses the limitations to consider for the implementation of digital devices in real-life practice.

Rapid home therapy infusion of velaglucerase alfa in naïve patients with Gaucher disease.

Enzyme replacement therapy (ERT) has revolutionised the management of patients with Gaucher disease (GD). In 2018, we published the safety and efficacy of rapid 10-min infusion of velaglucerase alfa in previously treated patients, mostly on low-dose therapy. To improve quality of life (QoL) for patients needing lifelong bi-weekly infusions by introducing a 10-min infusion instead of 1 h per label in patients naive to ERT and on high-dose therapy. Fifteen naive patients were enrolled; all received bi-weekly infusions of 60 units/kgBW velaglucerase alfa; the infusion rate was gradually reduced in the hospital, followed by home infusions. Each infusion was followed for safety. Efficacy parameters were assessed every 3 months. Patient-reported outcome questionnaires were collected at baseline and follow-up. Ten-minute rapid infusions were well tolerated without related severe adverse events (SAEs). Two patients experienced a non-related SAE and another a possibly related AE. In three patients, the infusion rate was increased to 30 or 60 min (two because of suboptimal response and one because of AE). Two patients dropped out because of an unwillingness to attend follow-up visits during the COVID-19 pandemic. All 13 remaining patients reached the 24-month end-point. The platelet counts increased by a median (range) of 68.38% (12.5-300%) and the lyso-Gb1 levels decreased by 62.6% (32.9-89.9%). Home therapy with rapid infusion of high-dose velaglucerase alfa was a safe, effective and preferable alternative for patients with GD naïve to treatment. We believe that shortening the infusion time improves the QoL of patients with GD who have a lifelong commitment to intravenous therapy.

Toward a Skin Dose-Area Metric Predictive of Moist Desquamation Using In Vivo Skin Dosimetry and Skin Assessments

Moist desquamation (MD) is a concerning acute side effect of radiation therapy for breast cancer, often seen in skin folds for patients having large or pendulous breasts. In vivo skin dosimetry, clinical assessments, and patient-reported skin reactions were used to determine a relationship between dose-area metrics and the development of MD, to lend insight into skin tolerances and possibly guide future treatment planning dose constraints. Skin dose was measured using GafChromic film on the inner surface of an early prototype carbon-fiber accessory for breast support to remove the inframammary fold in 20 patients at high risk of developing MD undergoing adjuvant whole breast radiation therapy. Prescribed doses were 42.5 Gray (Gy) in 16 fractions or 50 Gy in 25 fractions using 6 to 15 MV x-rays. To account for fraction size differences, analysis was performed using the equivalent dose in 2 Gy fractions using α/β=11 (EQD211). MD was assessed out to 2 weeks post radiation therapy by trained therapists and by a patient-reported outcome questionnaire. Statistically significant differences in areas receiving 30 to 48 Gy (EQD211) were observed between patients who did and did not develop MD in the inframammary area. Patients receiving EQD211 maximum dose ≤ 46 Gy and ≥ 38 Gy to ≤ 50 cm2 of their breast skin did not develop MD. The findings of this study offer insight into the relationship between skin toxicity and areas of skin irradiated to doses up to 50 Gy. Potential skin dose constraints to test in future studies to prevent MD are suggested.

Internal consistency and construct validity of the Short Musculoskeletal Function Assessment (SMFA) in older adults

Objective The primary objectives of this study were to 1) investigate the internal consistency 2) and construct validity of the Short Musculoskeletal Function Assessment Questionnaire (SMFA) in older adults commencing physical rehabilitation in an outpatient setting. Methods This cross-sectional study recruited older adults who had commenced physical rehabilitation in an outpatient setting. The SMFA consists of two indices: 1) dysfunction capturing the impact of musculoskeletal disorders on physical limitations, and 2) bothering capturing how the individual is emotionally affected by their disorder. SMFA holds four categories: ‘mobility’, ‘daily activities’, ‘emotional status’, and ‘function of the arm and hand’. Participants answered the SMFA alongside other patient-reported questionnaires (such as the 36-Item Short Form Survey, SF-36) and similar) and objectively measured muscle strength for the upper and lower body and functional capacity. Results We included 115 older adults with a median age of 74 years (IQR 9). Adequate internal consistency was seen with Cronbach’s alpha values of 0.90–0.94 for the SMFA indices and 0.77–0.91 for the SMFA categories. The strongest correlations between the SMFA indices were observed with the SF-36 physical component summary (SMFA-Dysfunction r = 0.74, p < 0.05, SMFA-Bother r = 0.72, p < 0.05). Only fair correlations were found between SMFA index scores and clinical outcome measures. Discussion This study demonstrated that the SMFA has adequate internal consistency and construct validity for self-reported health status in older adults, especially when considering components covering physical health status. However, we only observed fair correlations between SMFA and clinical outcome measures, indicating that SMFA does not adequately capture muscle strength and functional capacity.

Responsiveness and the Minimal Important Change of Knee Injury and Osteoarthritis Outcome Score Following Physiotherapy Intervention in Iraqi People with Knee Osteoarthritis

Background: The Knee Injury Osteoarthritis Outcome Score (KOOS) is a widely used patient-reported questionnaire to evaluate individuals with knee osteoarthritis or a history of knee injuries. Objectives: The aim of this study was to evaluate the responsiveness and establish the minimal important change (MIC) for the Arabic version of KOOS in Iraqi individuals with knee osteoarthritis following physiotherapy intervention. Methods: Fifty volunteers (13 male and 37 female, mean age: 59.3±9.6 years old) with an orthopedic diagnosis of knee osteoarthritis participated in this study. The Arabic KOOS was completed by the participants once before the intervention and once after completing a 4-week physiotherapy treatment program. A seven-item global rating of change scale was used as an external anchor to assess the participants' opinion about the treatment and its possible changes. Responsiveness was evaluated by calculating the receiver operating characteristic (ROC) curve, and the MIC was established by identifying an optimal cut-off on the ROC curve. Results: All subscales of the Arabic KOOS showed an area under the curve &gt; 0.70. The MICs reflecting the values required by the participants to feel the improvement were 15.5, 14.5, 11, 11.5, and 12.5 for the pain, symptoms, activities of daily living, sports and recreation, and quality of life subscales, respectively. Conclusions: All subscales of the Arabic KOOS are responsive to physiotherapy treatment. Therapists and researchers can use the MIC values to evaluate whether their prescribed treatment was satisfactory and effective from their patients' point of view.

Patient Satisfaction and Scar Quality Following Upper Blepharoplasty Using a Simplified Preoperative Marking Technique.

One of the most popular plastic surgical interventions both abroad and in Kazakhstan is blepharoplasty. Plastic surgeons continue to debate various methods for performing this operation; however, some of the methods used by plastic surgeons for preoperative marking of the upper eyelid skin may not be suited to the type of incision that should be used on the eyelids of individuals from Kazakhstan. For this reason, the surgery may not achieve the desired results. We conducted a study of patients from Kazakhstan who underwent upper blepharoplasty using a simplified technique for eyelid marking that we developed at our plastic surgery center. We used the Patient-Reported Outcome Measure Questionnaire (PROM-Q) to measure patient satisfaction and the Patient and Observer Scar Assessment Scale (POSAS) to measure scar quality. The results of our study showed that the majority of patients who underwent upper blepharoplasty performed by surgeons using our method of preoperative marking were extremely satisfied with the effect. The patients noted rapid tissue repair and minimal scarring. We concluded that the use of a simplified marking technique can significantly help aesthetic surgeons performing upper blepharoplasty by reducing the risk for negative postoperative effects.

Symptoms associated with headache in youth.

To determine the underlying relationships between a broad range of headache-associated symptoms and how they relate to headache burden. Symptoms associated with head pain inform classification of headache disorders. However, many headache-associated symptoms are not included in the diagnostic criteria, which is largely based on expert opinion. Large symptom databases can assess headache-associated symptoms irrespective of pre-existing diagnostic categories. We conducted a large single-center cross-sectional study on youth (6-17 years old) assessing patient-reported outpatient headache questionnaires between June 2017 and February 2022. Multiple correspondence analysis, an exploratory factor analysis, was applied to 13 headache-associated symptoms. 6662 participants (64% female; median age 13.6 years) were included. Multiple correspondence analysis dimension 1 (25.4% of the variance) captured the absence or abundance of headache-associated symptoms. A greater number of headache-associated symptoms correlated with greater headache burden. Dimension 2 (11.0% of the variance) revealed three symptom clusters: (1) cardinal features of migraine (light, sound, and smell sensitivity, nausea, and vomiting), (2) nonspecific global neurologic dysfunction symptoms (lightheadedness, trouble thinking, blurry vision), (3) vestibular and brainstem dysfunction symptoms (vertigo, balance problems, ear ringing, double vision). Assessing a broader range of headache-associated symptoms reveals clustering of symptomatology and a strong relationship with headache burden.

Patient's Scar Satisfaction after Conventional Thyroidectomy for Differentiated Thyroid Cancer.

Differentiated thyroid carcinoma (DTC) is the most frequent endocrine neoplasm. Its treatment is based on surgery with consequent impact on patients' quality of life (QoL) and aesthetic implication. The aim of the present study is to assess scar satisfaction in patients affected by DTC who underwent total or partial thyroidectomy. A comparison was also made between scar satisfaction with different subcuticular suture. Validated questionnaires have been employed during a 3-month follow-up: Patient and Observer Scar Assessment Scale (POSAS) and the Patient Scar Assessment Questionnaire (PSAQ). Eventually, the impact of thyroid cancer on QoL of patients was performed in the studied population employing the Thyroid-related patient-reported outcome questionnaire (ThyPRO) and European Organisation for Research Additionally, Treatment of Cancer-Quality of Life questionnaire-C30 (EORTC QLQ-C30). It was conducted in a single center observational study considering 74 patients respecting inclusion criteria. Overall scar satisfaction was found to improve during follow-up, reaching the best scores at 3 months from surgery. Subcuticular suture does not seem to influence the scar satisfaction. In our study male patients seem to be more satisfied, on the other hand age does not seem to influence satisfaction. Overall, the ThyPRO questionnaire and EORTC QLQ-C30 scores did not statistically differ between preoperative and postoperative suggesting a small impact of DTC in QoL.

Diet and bowel function in children with Hirschsprung’s disease: development and content validation of a patient-reported questionnaire

BackgroundAlthough dietary adjustments are recommended frequently for bowel symptoms, evidence of diet’s impact on bowel function is lacking. The aim was to develop a patient-reported outcome instrument, for children with and without Hirschsprung’s disease (HD), to explore experiences of dietary effects on bowel function.MethodsChildren with and without HD and their parents participated. Questionnaire items regarding the impact of diet on bowel function originated from focus group discussions. Specific food items, reported in the literature or in focus groups to cause bowel functional effects, were listed requesting each item’s effect size and effect type. Content validity was tested within two separate semistructured interviews. A pilot test was performed. Assessing comprehension, relevance and wording clarity structurally, revisions were made accordingly. Children’s bowel function was assessed through the validated Rintala Bowel Function Score.ResultsA total of 13 children with and without HD, median age 7 (range 2–15) years, and 18 parents participated in the validation. Each question’s relevance had been ranked highly early in the validation process but most questions needed refining for improving clarity and comprehension. Wordings regarding bowel symptoms and emotions connected to food in particular were perceived to be sensitive and complex. Specifically wording regarding some bowel symptoms (gases, pain) and parental stress emotions (guilt, ambivalence) were, consistent with participants’ opinions, subjected to multiple step revisions. Following the validation process, which included two semistructure interviews with different participants and then a pilot test with a third cohort, a full track overview of changes and rewording made in all steps of the validation process was presented. The final questionnaire then comprised 13 questions assessing foods’ significance for bowel function, emotions, social impact and 90 specific food items’ possible effects and effect sizes on bowel function.ConclusionsThe Diet and Bowel Function questionnaire, enabling answering by children, was developed and the content validated qualitatively. This report presents insights into the whole validation process, declaring reasons for the selected question- and answering options, and their wordings. The Diet and Bowel Function questionnaire can be used as a survey questionnaire to enhance understanding of dietary effects on bowel function in children, and its results can be supportive in improving dietary-treatment programs.

Nonsurgical Rhinoplasty: Diamond Injection Technique for Nasal Tip Contouring.

Background: A more pleasing nasal tip appearance is becoming the most frequent reason for nonsurgical aesthetic rhinoplasty procedures. Objective: To present the "Diamond Injection Technique," an innovative 4-point hyaluronic acid (HA) filler injection procedure for nasal tip refinement and to assess its aesthetic outcomes and efficacy. Methods: Data were collected from a prospective single-center cohort of patients undergoing nonsurgical rhinoplasty with injectable fillers. Anthropometric measurements, the 5-point Global Aesthetic Improvement Scale (GAIS), and a patient-reported questionnaire were used to evaluate the aesthetic outcomes and treatment efficacy before treatment and 6 months later. Results: The study included 107 patients; 82 were women. The median age was 35 (18-47) years. The mean volume of HA filler injected was 0.12 mL (range: 0.05-0.2). At 6 months, the GAIS-calculated outcome was excellent in 90.65% of patients, with a high degree of patient satisfaction and objectively pleasant changes in anthropometric measurements. Conclusions: The "Diamond Injection Technique" proves to be a safe, comprehensive, and effective procedure for refining the nasal tip to a pleasing diamond shape, satisfying a high percentage of patients.

Patient-Reported Outcomes Following Revision Total Hip Arthroplasty Demonstrate Less Improvement and Significantly Higher Rates of Worsening Compared to Primaries

BackgroundPatient-reported outcome measures (PROMs) provide the patient’s perspective following total hip arthroplasty (THA), although differences between primary THA (pTHA) and revision THA (rTHA) remain unclear. Thus, we compared the Minimal Clinically Important Difference for Improvement (MCID-I) and Worsening (MCID-W) in pTHA and rTHA patients. MethodsData from 2,159 patients (1,995 pTHAs/164 rTHAs) who had completed Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form (HOOS-PS), Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Short Form 10a (PF10a), PROMIS Global-Mental, or PROMIS Global-Physical questionnaires were analyzed. The PROMs and MCID-I/MCID-W rates were compared using statistical tests and multivariate logistic regressions. ResultsCompared to the pTHA group, the rTHA group had lower rates of improvement and higher rates of worsening for almost all PROMs, including HOOS-PS (MCID-I: 54 versus 84%, P < .001; MCID-W: 24 versus 4.4%, P < .001), PF10a (MCID-I: 44 versus 73%, P < .001; MCID-W: 22 versus 5.9%, P < .001), PROMIS Global-Mental (MCID-W: 42 versus 28%, P < .001), and PROMIS Global-Physical (MCID-I: 41 versus 68%, P < .001; MCID-W: 26 versus 11%, P < .001). Odds ratios supported rates of worsening following revision for the HOOS-PS (Odds Ratio (OR): 8.25, 95% Confidence Interval (CI): 5.62 to 12.4, P < .001), PF10a (OR: 8.34, 95% CI: 5.63 to 12.6, P < .001), PROMIS Global-Mental (OR: 2.16, 95% CI: 1.41 to 3.34, P < .001), and PROMIS Global-Physical (OR: 3.69, 95% CI: 2.46 to 5.62, P < .001). ConclusionPatients reported higher rates of worsening and lower rates of improvement following rTHA than pTHA, with significantly less score improvement and lower postoperative scores for all PROMs after revision. Most patients reported improvements following pTHA, with few worsening postoperatively. Level of EvidenceLevel III, retrospective comparative study.

A prospective, non-interventional study among patients diagnosed with locally advanced or metastatic non–small-cell lung cancer to assess the adherence to oral antineoplastic therapy from data collected through patient-reported questionnaires and tablets count in Spain: LOADH study.

e21101 Background: Oral treatments (OT) available in non-small cell lung cancer (NSCLC) directed at different targets are more effective and have a more favorable safety profile than traditional chemotherapy (CT). However, adherence is a challenge as it could affect the therapeutic outcome of patients (pt). The LOADH study aims to assess adherence from tablets count in pt with NSCLC treated with tyrosine kinase inhibitors (TKIs), as well as to evaluate the influence of pt and treatment characteristics on adherence, evaluate correlation between adherence and progression free survival (PFS) and to detect opportunities for improvement of the pharmaceutical intervention. Methods: Prospective, multicenter, observational study in which 6 Spanish hospitals participated. Adult pt diagnosed with NSCLC receiving or starting treatment with orally administered TKI, prescribed by the oncologist according to standard clinical practice, were included. Pt information was collected at the screening visit and at monthly visits during three consecutive months by virtual or face-to-face pharmaceutical care, during which a count of dispensed and unused tablets was also made. Adherence was calculated as: (N of tablets dispensed – N of unused tablets / N of days in treatment * N of tablets prescribed to be taken per day)*100 The cut-off point for adequate adherence was &gt; 80%. The Chi-square test was used to compare adherence between groups. Results: A total of 99 pt were included, of which 95 were valid for the analysis. Mean age was 66 years (SD 13.1; 46.3% ≤65), 66.3% female, 57.9% non-smokers, 90.5% with metastases; 69.5% received TKI-EGFR, 28.4% ALK inhibitors and 2.1% others. ECOG 0: 51.6%; ECOG 1: 42.1%; ECOG ≥2: 6.3%. Adherence was &gt; 80% in 85.3% of pt. Factors that are related to better adherence are ECOG (0: 91.8%; 1: 82.5%; ≥2: 50%; P = 0.020) previous CT (yes: 61.5%; no: 85.7%; P &lt; 0.001) and Initiation of OT prior to the study (yes: 86.7%; no: 75.0%; P &lt; 0.001). Median PFS from start of treatment was higher in adherent pt: 45.6 vs 18.2 months; P = 0.043; in a sensitivity analysis from start of study, PFS was also higher: 18.9 vs 6.5 months; P = 0.007. Although no statistically significant differences were found, conciliation, review and education are the pharmaceutical interventions that have more influence on adherence (percentage of adherent pt with vs without intervention: 95.7% vs 81.8%, 89.2% vs 82.7% and 87.7% vs 81.3% respectively). Conclusions: The percentage of pt with NSCLC adherent to oral TKIs in Spain is high. Previous CT, ECOG and having started OT before the study are correlated with adherence. Adherence is correlated with a better PFS. The interventions that seem to have the most impact on pt adherence are conciliation, education and review.

Early taxane-induced neurotoxicity and quality of life in patients with breast cancer: A single center, retrospective study.

e12533 Background: Taxane administration in breast cancer patients relates to significant chemotherapy-induced peripheral neuropathy (CIPN). In our four years retrospective observational study, we aimed to evaluate early onset of neuropathy and its influence in patients’ quality of life, assessed through certified questionnaires. Methods: We retrospectively collected data from stage I-III breast cancer patients treated with taxane-based therapy between 2018 and 2022 at the Medical Oncology Unit of the University Hospital of Cagliari. We included 300 patients. The median age was 57 years (range, 32-85). All patients followed a schedule of PCT 80mg/m2 ± 30 weekly; they received up to a maximal cumulative dose of PCT 960 ± 30 mg/m2. Peripheral neuropathy was evaluated by the NCI-CTC scale (national cancer institute, common toxicity criteria for adverse events) at every drug administration. Patient-reported EORTC QLQ-CIPN20 and FACT-TAXANE questionnaires were collected at baseline, at 4 and 12 weeks of treatment. We used the Kruskal-Wallis test for the association between the neurotoxicity grade and quality of life. Difference in the questionnaire score at the different timing was assessed by ANOVA test for repeated measures. To assess the strength of the correlation between the different quality-of-life questionnaires, we used Spearmann's Rho test. Statistical analysis was performed with the MedCalc Statistical Software Version 14.10.2. Results: Our analysis revealed that neurotoxicity influences the quality of life assessed with the QLQ at cycle IV (p = 0.000001) and cycle XII (p = 0.008). With just a cumulative dose of 320 mg/m2 (cycle IV), patients without neurotoxicity achieved a median value of 32 in the QLQ, compared to a median value of 34 in patients with grade 1 toxicity and 43 in the group of patients with grade 2 toxicity. Similarly, at cycle XII and with cumulative dose of 960 mg/m2, patients without neurotoxicity achieved a median value of 27 at the QLQ, compared to a median value of 33 in patients with grade 1 toxicity and 34 in the group of patients with grade 2 toxicity. The ANOVA test showed a significant increase (worsening) in the CIPN20 questionnaire at 4 and 12 weeks versus baseline (p &lt; 0.001 for both). The score remained significantly higher in comparison to baseline also at the evaluation at 3 (p &lt; 0.001), 6 (p &lt; 0.001) and 12 months (p &lt; 0.0001). Similarly, the FACT-TAXANE questionnaire showed a significant worsening at 4 (p &lt; 0.001) and 12 (p &lt; 0.001) weeks in comparison to baseline. Conclusions: The majority of women who received a taxane based chemotherapy regimen for breast cancer reported neurotoxicity. In our study, the use of specific questionnaires (EORTC QLQ-CIPN20 and FACT-TAXANE) allowed to identify early neurotoxicity onset and its correlation to quality of life, yet at an initial phase of treatment (after a cumulative dose of 320 mg/m2 of paclitaxel at IV cycle).

Clinical Outcomes of Osteochondritis Dissecans Lesions of the Capitellum Treated with Arthroscopy with a Mean Follow-Up of 8.3 Years.

While numerous studies exist evaluating the short-term clinical outcomes for patients who have undergone elbow arthroscopy for osteochondritis dissecans (OCD) of the capitellum, the literature on minimum 2-year clinical outcomes for a large cohort of patients is limited. /Hypothesis: We hypothesized that clinical outcomes for patients treated arthroscopically for OCD of the capitellum would be favorable, with improved postoperative subjective functional and pain scores, and with acceptable return to play for these patients. A retrospective analysis from a prospectively collected surgical database was performed to identify all patients treated surgically for OCD of the capitellum at our institution from January 2001 to August 2018. Inclusion criteria for this study included the diagnosis of OCD of the capitellum treated arthroscopically with minimum 2-year follow-up. Exclusion criteria included any prior surgical treatment on the ipsilateral elbow, missing operative reports, and patients with any portions of the surgical procedure performed open. Follow-up was performed by telephone using multiple patient-reported outcome questionnaires: American Shoulder and Elbow Surgeons - Elbow (ASES-e), Andrews/Carson, Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score (KJOC), and our institution-specific return-to-play questionnaire. After the inclusion and exclusion criteria were applied to our surgical database, 107 eligible patients were identified. Of these, 90 were successfully contacted for a follow-up rate of 84%. The mean age was 15.2 years and mean follow-up time was 8.3 years. Eleven patients had a subsequent revision procedure for a 12% failure rate in these patients. ASES-e pain was an average of 4.0 out of a max pain scale of 100, ASES-e function was an average of 34.5 out of a maximum of 36, and surgical satisfaction was an average of 9.1 out of 10. The average Andrews/Carson score was 87.1 out of 100 and the average KJOC score for overhead athletes was 83.5 out of 100. Additionally, out of the 87 patients evaluated who played sports at the time of their arthroscopy, 81 (93%) returned to play. This study demonstrated an excellent return-to-play rate and satisfactory subjective questionnaire scores with a 12% failure rate following arthroscopy for OCD of the capitellum with a minimum 2-year follow-up.

Demographic and clinical determinants of the quality of life in adults with inherited and acquired myopathies.

Measuring health-related quality of life (QOL) is vital for understanding the disease impact, but the complex relationship between clinical parameters and QOL remains unclear. The objective was to determine the demographic and clinical factors that influence the QOL in adults with inherited and acquired myopathies. The study was of cross-sectional design. Detailed demographic and clinical details were collected. Patients answered Neuro-QOL and Patient-Reported Outcomes Measurement Information System short-form questionnaires. Data was collected from 100 consecutive in-person patient visits. Mean age of the cohort was 49.5 ± 20.1 (18-85) years, and the majority were male (53, 53%). Bivariate analysis between the various demographic and clinical features with the QOL scales revealed single simple question (SSQ), handgrip strength, Medical Research Council (MRC) sum score, female gender, and age to be nonuniformly associated with the QOL scales. There was no difference between inherited and acquired myopathies for any of the QOL scores, except for the poorer lower limb function domain in inherited myopathies (36.7 ± 7.3 vs. 40.9 ± 11.2, p = 0.049). Linear regression models revealed lower SSQ, lower handgrip strength, and lower MRC sum score to independently predict poor QOL. Handgrip strength and SSQ serve as novel predictors of QOL in myopathies. Handgrip strength has a significant impact on physical, mental, and social domains and deserves special attention with respect to rehabilitation. SSQ correlates well with QOL and can be employed as a quick and global assessment of a patient's well-being. Differences in QOL scores between patients with inherited and acquired myopathies were minimal.

Mental Health Matters: A Cross-Sectional Survey on Depression and Anxiety Symptoms and the Female and Male Athlete Triad

Objective: To determine the relationship between the female and male athlete triad with depression and anxiety symptoms. Design: Cross-sectional survey. Setting: Survey distributed online through social media to participants. Participants: Male and female high school, collegiate, and postcollegiate athletes. Interventions: Participants completed a survey assessing components of the female athlete triad and the Patient-Reported Outcomes Measurement Information System depression and anxiety short-form questionnaires. Main Outcome Measures: Participants were classified into those with no, mild, moderate, or severe depression symptoms or anxiety symptoms. A female athlete triad (Triad) cumulative risk score was calculated. Multinomial logistic regressions were used to assess the relationship between triad score and depression/anxiety. Results: Two hundred fifty-four men and 780 women completed the survey; 66.6% of women and 41.3% of men reported at least mild anxiety symptoms; 54.2% of women and 38.7% of men reported at least mild depression symptoms. Triad risk score was significantly related to moderate and severe depression symptoms (P &lt; 0 .0001) and moderate (P = 0.003) and severe (P &lt; 0 .0001) anxiety symptoms in women. We found no significant associations between Triad risk score and depression or anxiety symptoms in men. Conclusions: We found a correlation between the female athlete triad and moderate and severe depression and anxiety symptoms in women. Depression and anxiety symptoms were most strongly related to the low energy availability component of the Triad risk score and to the presence of eating disorders/disordered eating. This suggests that mental health illness is most tied to the behavioral aspects of the Triad. Clinical Relevance: This study demonstrates the importance of screening for and treating mental health illness in those diagnosed with low energy availability, disordered eating, and/or the female athlete triad in addition to focusing on a nutrition intervention.

Leukocyte-Poor Platelet-Rich Plasma Injections Improve Cartilage T1ρ and T2 and Patient-Reported Outcomes in Mild-to-Moderate Knee Osteoarthritis

To use T1ρ and T2 magnetic resonance imaging to evaluate the effect of leukocyte-poor platelet-rich plasma (LP-PRP) injections on knee cartilage health and to correlate structural changes with patient-reported outcome measurements. Ten patients with symptomatic unilateral mild-to-moderate knee osteoarthritis (Kellgren-Lawrence Grade 1-2) underwent T1ρ and T2 magnetic resonance imaging of both the symptomatic and contralateral knee before injection and 6 months after injection with LP-PRP. Patient-reported outcome questionnaires (Knee Osteoarthritis Outcome Score and International Knee Documentation Committee) that evaluate the domains of pain, symptoms, activities of daily living, sports function, and quality of life were completed at baseline, 3 months, 6 months, and 12 months after injection. T1ρ and T2 relaxation times, which are correlated with the proteoglycan and collagen concentration of cartilage, were measured in compartments with and without chondral lesions. Ten patients were prospectively enrolled (9 female, 1 male) with a mean age of 52.9 years (range, 42-68) years and mean body mass index of 23.2 ± 1.9. Significant increases in Knee Osteoarthritis Outcome Score for all subscales and International Knee Documentation Committee scores were observed 3 months after injection and the improvements were sustained at 12 months. T1ρ and T2 values of compartments with chondral lesions were observed to significantly decrease by 6.0% (P= .036) and 7.1% (P= .017) 6 months after LP-PRP injection, respectively. No significant associations between T1ρ and T2 relaxation times and improvement in patient-reported outcomes were observed. Patients undergoing LP-PRP injections for the treatment of mild-to-moderate knee osteoarthritis had increased proteoglycan and collagen deposition in the cartilage of affected compartments by 6 months after injection. Patient-reported outcomes scores improved 3 months after injection and were sustained through 1 year after injection, but these improvements were not associated with the changes in proteoglycan and collagen deposition in knee cartilage. Level II, prospective cohort study.

Interaction Between Determinants Governing Urine Volume in Patients With ADPKD on Tolvaptan and its Impact on Quality of Life

Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent genetic cause of kidney failure. Tolvaptan, a vasopressin 2 receptor antagonist, is the first drug with proven disease-modifying activity. Long-term treatment adherence is crucial, but a considerable fraction of patients discontinue treatment, because of aquaretic side effects. Twenty-four-hour urine was collected in 75 patients with ADPKD during up-titration of tolvaptan and, in combination with clinical characteristics, examined to identify factors influencing urine volume. Patient-reported outcomes were analyzed using the Short Form-12 (SF-12) and patient-reported outcomes questionnaires reporting micturition frequency and burden of urine volume. Initiation of therapy led to a large increase in urine volume followed by only minor further increase during up-dosing. Younger patients and patients with better kidney function experienced a larger relative rise. Twenty-four-hour urine osmolality dropped by about 50% after therapy initiation independently of dose, with a considerable proportion of patients achieving adequate suppression. Sodium and potassium intake turned out to be the only significant modifiable factors for urine volume after multivariate linear regression models, whereas age and weight could be identified as non-modifiable factors. No change in quality of life (QoL) was detected in relation to treatment or urine volume using SF-12 questionnaires, a finding that was further supported by the results of the patient-reported outcomes assessment. This study provides an in-detail analysis of factors associated with the degree of polyuria on tolvaptan and puts them into the context of QoL. These findings will contribute to optimized patient counseling regarding this treatment option in ADPKD.