Quality Of Life In Group Research Articles

1126. Effect of Remdesivir on Recovery, Quality of Life, and Long-COVID Symptoms One Year after Hospitalization for COVID-19 Infection: A Randomized Controlled SOLIDARITY Finland Trial

Abstract Background Coronavirus disease 2019 (COVID-19) patients frequently suffer from long-term sequelae, often called “long COVID” or “post COVID-19 condition”. Remdesivir, given in early disease, decreases the risk of hospitalization and potentially mortality. No randomized trials have thus far published long-term follow-up data on any COVID-19 drug treatment. We investigated the effects of remdesivir on a range of patient-important outcomes at one year. Methods Between July 2020 and January 2021, an open-label randomized multicenter trial in Finland recruited 208 adult patients from 11 Finnish hospitals. Patients were randomly assigned (1:1 ratio) to standard of care (SoC)with remdesivir (median duration of remdesivir treatment 5 days) or SoC alone. Primary outcomes were self-reported recovery, exertional dyspnea, fatigue, and quality of life at one year. Secondary outcomes were overall mortality and several potential long-COVID symptoms. Results At one year, 5 (4.4%) of 114 patients in the remdesivir and 5 (5.3%) of 94 in the SoC group had died (RR 0.82, 95% CI 0.25-2.76; absolute difference: -0.9%, 95% CI -7.9-5.3); 181 (92% of survivors) completed the follow-up. Self-reported recovery (fully or largely) occurred in 85% in remdesivir and in 86% in SoC (RR 0.94, 0.47-1.90; absolute difference: -0.9%, 95% CI -11%-10%). Exertional dyspnea occurred in 5% in remdesivir and 8% in SoC (OR 0.61, 95% CI 0.20-1.85; absolute difference -3.3%, 95% CI -12%-4.4%). We found no convincing difference between remdesivir and SoC groups in quality of life or symptom outcomes (p > 0.05 for all). Of the 21 potential long-COVID symptoms, patients often reported moderate or major bother from fatigue (26%), joint pain (22%), persistent respiratory mucus (21%), and problems with memory (19%) and attention/concentration (18%) (Figure). Bother from potential long-COVID symptoms at one year from COVID-19 hospitalization between the standard of care and standard of care plus remdesivir groups. Conclusion After a one-year follow-up of hospitalized patients (with a very high participation rate), approximately one in four reported substantial bother from fatigue, and one in six reported that they had not recovered well from COVID-19. We found no convincing evidence of a remdesivir effect, but confidence intervals were wide and included possible substantial benefit and substantial harm. Disclosures Hanna-Riikka Kreivi, MD, PhD, Pfizer: Advisor/Consultant|Roche: Advisor/Consultant Tuomas Rosberg, MD, PhD, AstraZeneca: Honoraria|Boehringer-Ingelheim: Honoraria|GSK: Honoraria.

Antipsychotic dose reduction compared to dose continuation for people with schizophrenia.

Antipsychotic dose reduction compared to dose continuation for people with schizophrenia.

The effect of oral zinc sulfate on prevention of chemotherapy-induced oral mucositis in breast cancer patients treated with adriamycin and cyclophosphamide; a double-blind randomized clinical trial

Introduction: One of the most important complications faced by cancer patients is chemotherapy-induced oral mucositis (CIOM). In addition, the role of orally used zinc sulfate in its prevention and treatment is still a controversial issue and the results in this regard have not been conclusive. Objectives: Evaluation the effect of zinc sulfate supplement on prevention of CIOM in breast cancer patients treated with adriamycin and cyclophosphamide was the aim of this study. Patients and Methods: The current double-blind randomized clinical trial was conducted on 87 patients with breast cancer. Consumption of two oral zinc sulfate tablets and two placebo tablets with food was prescribed in the case (44 patients) and control (43 patients) groups, respectively. During the 4 cycles of chemotherapy, the incidence and severity of CIOM, the onset time of mucositis from the start of chemotherapy, the severity of pain, and the severity of dry mouth were recorded. In addition, the patients’ quality of life was recorded using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Results: Findings revealed that the severity of CIOM in the first, second, and third sessions with the values of 1.22±1.01, 1.18±0.97 and 1.02±0.79, respectively, was significantly lower in the case group than the control group with the values of 1.91±0.89, 1.80±0.92, and 1.67±0.85, respectively (P<0.05). In addition, the severity of pain and dry mouth in the first and second sessions of chemotherapy was significantly lower in the case group (P<0.05). However, no significant difference was observed between the two groups in quality of life (P>0.05). Conclusion: Oral zinc sulfate had a significant role in reduction of the incidence and severity of CIOM, the severity of dry mouth, and the severity of pain in the initial sessions of chemotherapy. However, no significant difference was in postponing the incidence of CIOM and the quality of life of patients in the case group. Trial Registration: This trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20150304021338N2; https://irct.ir/trial/51105, ethical code# IR.MUI.MED. REC.1399.277).

Effect of Carrying out Continuous Nursing Based on Mobile Platform on the Life of Children with Leukemia after Discharge from Hospital.

Objective To analyze the effect of carrying out continuous nursing based on mobile platform on the life of children with leukemia after discharge. Methods A total of 104 children diagnosed with leukemia admitted in Pediatric Internal Medicine, Hainan Provincial People's Hospital, from September 2019 to August 2020 were randomly divided into two groups, observation group and control group, with 52 cases in each group. For the control group, routine follow-up was used for continuous nursing after discharge from hospital, and the observation group was treated with continuous nursing based on mobile platform on the basis of routine follow-up nursing after discharge from hospital. Results When discharged from hospital, there was no significant difference in SDS and SAS scores between the two groups (P > 0.05). After 8 weeks of discharge, SDS and SAS scores in both groups were significantly decreased, and SDS and SAS scores in the observation group were significantly lower than those in the control group, with statistical significance (P < 0.05). After 8 weeks of discharge, the cancer-related fatigue score of the observation group was significantly lower than that of the control group, and the difference was statistically significant (P < 0.05). When discharged from hospital, there was no significant difference in quality of life between two groups (P > 0.05). Eight weeks after discharge, the quality of life in both groups was significantly improved, and the quality of life in the observation group was significantly better than that in the control group; the difference was statistically significant (P < 0.05). The occurrence of adverse reactions in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion After children with leukemia were discharged from hospital, medical staff used mobile platform to carry out continuous nursing for them, which could relieve the negative emotions of children, reduce the incidence of adverse reactions, and improve the quality of life. This kind of intervention had promotion value.

The Effect of Long-Acting Beta-2 Agonist Monotherapy and Long-Acting Anticholinergic Monotherapy to Quality-of-Life in Group B Stable COPD Patients

Background: Based on the 2019 Global Initiative for Chronic Obstructive Lung Disease (GOLD), treatment for group B stable COPD patients is a long-acting beta-2 agonist (LABA) or long-acting anticholinergic (LAMA). Some studies experienced that LAMA was better than LABA but the opposite was also found in several studies. COPD patients often experience a decline in physical activity which causes a decrease in quality of life. We aimed to compare the effect of LABA or LAMA on quality of life in group B stable COPD patients.Methods: This was a study with case series design conducted on 50 COPD patients divided into two groups. The first group consisted of patients who used LABA for at least 3 months. The second group used LAMA for at least 3 months. All subjects filled in the SGRQ. The calculation of SGRQ was carried out using Microsoft Excel Calculator SGRQ.Results: A total 41 men and 9 women were enrolled in this study. There was no significant difference between the use of indacaterol monotherapy and tiotropium monotherapy on the quality of life although tiotropium showed a better quality of life (76%) than indacaterol monotherapy (64%).Conclusion: There was no significant difference in the use of indacaterol and tiotropium on the quality of life although in this case tiotropium showed better results (P=0.538).

IN-HOME-PD: The effects of longitudinal telehealth-enhanced interdisciplinary home visits on care and quality of life for homebound individuals with Parkinson's disease

IntroductionHomebound individuals with advanced Parkinson's disease (PD) are underrepresented in research and care. We tested the impact of interdisciplinary, telehealth-enhanced home visits (IN-HOME-PD) on patient quality of life (QoL) compared with usual care. MethodsNonrandomized controlled trial of quarterly, structured, telehealth-enhanced interdisciplinary home visits focused on symptom management, home safety, medication reconciliation, and psychosocial needs (ClinicalTrials.gov NCT03189459). We enrolled homebound participants with advanced PD (Hoehn & Yahr (HY) stage ≥3). Usual care participants had ≥2 visits in the Parkinson's Outcomes Project (POP) registry. We compared within- and between-group one-year change in QoL using the Parkinson's Disease Questionnaire. ResultsSixty-five individuals enrolled in IN-HOME-PD (32.3% women; mean age 78.9 (SD 7.6) years; 74.6% white; 78.5% HY ≥ 4) compared with 319 POP controls, with differences in age, race, and PD severity (37.9% women; mean age 70.1 (7.8) years; 96.2% white; 15.1% HY ≥ 4). Longitudinally, the intervention group's QoL remained unchanged (within-group p = 0.74, Cohen's d = 0.05) while QoL decreased over time in POP controls (p < 0.001, Cohen's d = 0.27). The difference favored the intervention (between-group p = 0.04). POP participants declined in 7/8 dimensions while IN-HOME-PD participants' bodily discomfort improved and hospice use and death at home—markers of goal-concordant care—far exceeded national data. ConclusionsTelehealth-enhanced home visits can stabilize and may improve the predicted QoL decline in advanced PD via continuity of care and facilitating goal-concordant care, particularly among diverse populations. Extrapolating features of this model may improve continuity of care and outcomes in advanced PD.

Treating peripheral neuropathy in individuals with type 2 diabetes mellitus with intraneural facilitation: a single blind randomized control trial.

ObjectiveTo evaluate the effectiveness of intraneural facilitation (INF) for the treatment of diabetic peripheral neuropathy (DPN).MethodsThis single-blind, randomized clinical trial enrolled patients with type 2 diabetes mellitus and moderate-to-severe DPN symptoms below the ankle. Patients were randomly assigned to receive INF or sham treatment. In the INF group, trained INF physical therapists provided therapy for 50–60 min, three times a week for 3 weeks. Sham treatment consisted of patients believing they received anodyne therapy for 3 weeks. Pre- and post-treatment data were compared between the two groups for quality of life, balance, gait, protective sensory function and pain outcome measures.ResultsA total of 28 patients (17 males) were enrolled in the study (INF group n = 17; sham group n = 11). There was a significant decrease in the overall pain score in both the INF and sham groups over time, but the decrease was greater in the INF group (1.11 versus 0.82). Between-group comparisons demonstrated significant differences in unpleasant pain and protective sensory function. The INF group showed post-treatment improvements in protective sensory function and composite static balance score.ConclusionsINF treatment improved pain perception, the composite static balance score and protective sensations in patients with DPN.Research Registry number: CNCT04025320

Efficacy and Safety of Temozolomide Combined with Radiotherapy in the Treatment of Malignant Glioma.

MG is a clinical common intracranial tumor, with the characteristics of strong invasion. In our study, we aim to explore the efficacy and safety of temozolomide combined with radiotherapy in the treatment of malignant glioma (MG) and its influence on postoperative complications and survival rate of patients. 120 MG patients admitted to our hospital (January 2019–January 2020) were chosen as the research objects and were randomly divided into group A (n = 60) and group B (n = 60). All patients were treated with radiotherapy, and patients in group A were additionally treated with temozolomide. The clinical efficacy, quality of life, incidence of adverse reactions, incidence of postoperative complications, survival rates, and average survival time of the two groups were compared. The objective remission rate (ORR), disease control rate (DCR), survival rates after one year and two years of follow-up, and the number of patients with improved quality of life in group A were markedly higher compared with group B (P < 0.05). The incidence of postoperative complications in group A was remarkably lower compared with group B (P < 0.05). The average survival time of group A was dramatically longer compared with group B (P < 0.001). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05), and no new adverse reactions occurred in the patients. Temozolomide combined with radiotherapy can effectively improve the quality of life, treatment effect, and survival rate of MG patients, with a lower incidence of postoperative complications and better tolerance. Our finding indicates that temozolomide combined with radiotherapy has a high clinical application value. In addition, it indicates that this treatment method should be promoted in practice.

Effect of the Application of Health Management in Nursing on Osteoarthropathy

Objective: To explore the effect of the application of health management in nursing on osteoarthropathy. Methods: Fifty patients with osteoarthropathy in our hospital were randomly selected and recruited for the current study from January 2018 to January 2020. They were divided into group A and group B according to the random number table method. group A (25 cases) received routine nursing, while group B (25 cases) received health management in nursing on the basis of the treatment given to group A. Joint function index, quality of life and nursing satisfaction were compared between the two groups. Results: The index of joint function in group B was higher than that in group A, the quality of life in group B was higher than that in group A, and the nursing satisfaction in group B was higher than that in group A (P &lt; 0.05). Conclusion: For patients with osteoarthropathy, the application of health management can effectively improve joint function and improve the quality of life. The effect is ideal and the method is worthy of wide application.

Application of Predictive Dietary Guidance in Radiotherapy Nursing of Esophageal Cancer

Objective: To explore the effect of predictive diet guidance in radiotherapy nursing of esophageal cancer. Methods: 96 patients with esophageal cancer in our hospital (from January 2019 to January 2021) were randomly divided into group A and group B. Group A (48 cases) received routine nursing, and group B (48 cases) received predictive dietary guidance on the basis of group A. The incidence of adverse reactions, clinical indicators and quality of life were compared between the two groups. Results: After nursing, the incidence of adverse reactions of radiotherapy in group B was lower than that in group A, the clinical indexes in group B were higher than those in group A, and the quality of life in group B was higher than that in group A (P &lt; 0.05). Conclusion: For esophageal cancer patients undergoing radiotherapy, the implementation of predictive diet guidance can effectively reduce complications, improve the quality of life of patients, and improve nursing satisfaction. The effect is ideal, which is worthy of widespread application.

EFFECTS OF HEALTH EDUCATION BASED ON OMAHA SYSTEM ON ANXIETY, DEPRESSION AND SELF-MANAGEMENT ABILITY OF PRIMIPARA

Primiparas are prone to tension, anxiety, depression and other emotions due to their lack of experience related to delivery and fear of the unknown during pregnancy. Meanwhile, their self-management ability decreases because of their failure to immediately adapt to the transformation of their roles in a short time. A nursing model was constructed in this study based on the combination of the Omaha System with PBL health education to examine the effect of this model on the anxiety, depression, quality of life and self-management ability of primiparas. From January to December 2020, 170 primiparas were recruited as volunteers in this study by means of voluntary registration. They were randomly divided into the observation group and the control group, with 85 members in each group. The intervention lasted 6 weeks. SDS, SAS, WHOQOL-BREF scale and ESCA scale were used to compare the scores of the two groups before and after the intervention. (1) After the intervention, the changes of the observation group in self-management ability and its four dimensions are higher than those of the control group, with the differences being statistically significant (P<0.05). (2) After the intervention, the changes of the observation group in quality of life and its four dimensions are higher than those of the control group, with the differences being statistically significant (P<0.05). (3) The changes of the observation group in anxiety and depression are higher than those of the control group. Specifically, the change of the observation group in anxiety before and after the intervention is 6.40±5.61, in comparison with 2.67±3.71 in the control group; the change of the observation group in depression before and after the intervention is 9.07±8.42, in comparison with 3.19±7.06 in the control group. the new nursing method proposed in this study effectively improves the self-management ability and quality of life of primiparas, significantly reduces their anxiety and depression, has a high application value in obstetric nursing and also provides a new idea for the implementation of scientific and efficient nursing for primiparas.

The Cannabis Extraction Product as an Adjuvant Treatment in Tourette’s Syndrome: A Case Report

Tourette’s syndrome (TS) is a pediatric onset of neuropsychiatric disorder characterized by motor and vocal tics. First line medication is dopaminergic blocking agents. Yet, these drugs are not effective in all patients and sometimes the side effects are intolerance. Cannabis and its derivatives are to use as an adjuvant treatment. They are used to improve tics in TS patients who failed from the first line treatment. The aim of the present report was to describe the clinical course after using the Government Pharmaceutical Organization (GPO) medical cannabis extraction product as an adjuvant treatment in TS patient. Here, the researchers reported a case of a 26-year-old female patient who had TS. She had received sublingual medical cannabis product. The clinical course and disease severity were recorded before and during the administration of the medical cannabis extraction product using several standards severity score: The Yale Global Tic Severity Scale (YGTSS), Tourette’s Syndrome Severity Scale (TSSS), Turette’s Disorder Scale (TODS), and quality of life using a standardized measure of health-related quality of life developed by the Euro Quality of life group (EQ-5D-5L). The researchers’ observation showed that sublingual administration of medical cannabis extraction product [tetrahydrocannabinol (THC):cannabidiol (CBD) 1:1 and THC enriched] improved both motor and vocal tics without significant adverse effect that came out to be improving the patient’s quality of life as a whole. Keywords: Tourette’s Syndrome (TS); The Government Pharmaceutical Organization (GPO); Medical cannabis extraction product; Cannabidiol; Tetrahydrocannabinol

Результати дослідження чутливості української версії опитувальника Haemo-QoL

Мета: визначити чутливість до змін української версії опитувальника для оцінки якості життя, пов’язаної зі здоров’ям, дітей із гемофілією Haemo-QoL. Матеріали та методи. Оцінка якості життя визначалась кореспондентським методом двічі (первинне та повторне анкетування) шляхом обстеження 48 респондентів — учасників дослідження (24 дитини, хворі на гемофілію А, та 24 їх батька) із використанням пілотної української повної версії опитувальника Haemo-QoL. Тривалість дослідження становила 4 місяці. Модель обстеження: індивідуальне й електронне анкетування. Пацієнтів розподілено на дві групи: група І — погіршення, група ІІ — покращання загального стану. Дані інтерв’ювання проаналізовані і, відповідно, визначено кореляційний зв’язок за шкалами опитувальника та загальним показником якості життя, амплітуду різниці та ефект розміру r Кохена між отриманими показниками оцінки якості життя, пов’язаної зі здоров’ям, при первинному та повторному анкетуванні. Результати. Установлено, що загальний показник вірогідно збільшився в групі І при повторному обстеженні порівняно з первинним, тоді як у групі ІІ вірогідно зменшився, що характеризує, відповідно, погіршення якості життя, пов’язаної зі здоров’ям, у групі І та покращання в групі ІІ. У групі І виявлено вірогідну зміну показників якості життя за усіма шкалами опитувальника, за винятком шкал «Лікування» та «Сім’я». У групі ІІ виявлено вірогідну різницю в балах за усіма шкалами опитувальника. У результаті ефект розміру Кохена становив для версій опитувальника від 0,33 до 0,54, загальний ефект розміру Кохена — 0,50, що є достатнім для характеристики опитувальника як чутливого до змін інструмента. Висновки. Доведено, що українcька версія опитувальника Haemo-QoL є чутливим до змін інструментом для оцінки, пов’язаної зі здоров’ям, якості життя в дітей із гемофілією А та їх батьків.

Cisplatin combined with capecitabine-induced chemotherapy for local nasopharyngeal carcinoma can improve the quality of life and reduce toxic and side effects

BackgroundThis study was designed to probe into the effect of cisplatin combined with capecitabine on nasopharyngeal carcinoma (NPC).MethodsA total of 136 NPC patients treated for the first time in our hospital from January 2016 to March 2017 were collected and divided into two groups: A and B. Among them, 66 in group A were treated with cisplatin intravenous drip, while 70 in group B were treated with capecitabine on the basis of group A. The efficacy, toxic and side effects, and quality of life of the two groups were observed.ResultsThe short-term efficacy of group B was better than that of group A (p<0.05). The toxic and side effects of group B were lower than that of group A (p<0.05). The quality of life in group B was higher than that in group A (p<0.05).ConclusionsCisplatin combined with capecitabine-induced chemotherapy for local NPC can improve the quality of life and reduce the toxic and side effects.

Досвід застосування психокорегуючої терапії в комплексному лікуванні хворих на гастроезофагеальну рефлюксну хворобу, поєднану з дисфункцією жовчовивідної системи

У сучасну епоху внаслідок бурхливого зростання числа стресорних факторів особливо велике значення мають психотерапія та психофармакотерапія в комплексному лікуванні хворих із захворюваннями шлунково-кишкового тракту. Психогенні нашарування відіграють провідну роль у клінічній картині захворювання та визначають зниження працездатності пацієнтів. Мета. Оцінити ефективність лікування із застосуванням психокорегуючого засобу у хворих на гастроезофагеальну рефлюксну хворобу (ГЕРХ), поєднану з дисфункцією жовчовивідної системи, при наявності у них депресивних і тривожних проявів. Матеріали та методи. Всі хворі були розподілені на дві групи: І групу становили 27 хворих, які отримували тільки комплексне базове лікування, ІІ групу — 25 пацієнтів, яким додатково до базисного лікування призначався тіоридазин, що є піперидиновим похідним фенотіазину та належить до групи нейролептиків. Обидві групи були репрезентативні за віком, тривалістю та перебігом захворювань. У всіх пацієнтів за допомогою шкали HADS були виявлені тривожно-депресивні прояви. Для аналізу якості життя був використаний опитувальник SF‑36. Ефективність терапії оцінювали через 14 діб. Результати. У результаті лікування в обох групах спостерігали покращення загального самопочуття на фоні зменшення больового та диспептичного синдромів. При додаванні психокорегуючого засобу (тіоридазину) до базисної терапії відзначалися більш виражені позитивні зміни за інтенсивністю тривожно-депресивних проявів. Розподіл пацієнтів за рівнем тривоги та депресії після лікування виявив, що відсутність цих показників частіше відзначалась хворими ІІ групи (в 2,6 та 1,5 раза відповідно). Проте в 4,6 та 3,7 раза більше встановлено випадків клінічно вираженої тривоги і депресії в групі пацієнтів, які не отримували тіоридазин. Різниця у балах між рівнем тривоги і депресії до та після лікування була в 4 рази більшою у хворих, які додатково отримували психокорекцію. Також у ІІ групі спостерігалося більш значне покращення показника якості життя при порівнянні балів до та після лікування. Висновок. Включення до основної терапії тіоридазину за наявності депресивних і тривожних порушень у хворих на ГЕРХ, поєднану з дисфункцією жовчовивідної системи, підвищує клінічну ефективність фармакотерапії даної коморбідної патології.

Brazilian Validation of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group (QLG) Computerised Adaptive Tests (CAT) Core.

Background: This study aimed to validate the Brazilian version of EORTC CAT Core and compare the Brazilian results with those from the original European EORTC CAT Core validation study. Methods: After validated translation, 168 cancer patients from Brazil receiving radiation therapy with or without chemotherapy was assessed. Translated EORTC CAT Core and all QLQ-C30 items were administered to patients using CHES (Computer-Based Health Evaluation System) before (T0) and after (T1) treatment initiation. The association between QLQ-C30 and CAT scores and ceiling/floor effects were estimated. Based on estimates of relative validity (cross-sectional, known-group differences and changes over time), relative sample-size requirements for CAT compared to QLQ-C30 were estimated. Results: Correlation coefficients between CAT and QLQ-C30 domains ranged from 0.63 to 0.93; except for dyspnoea, all coefficients were >0.82 (corresponding figures were 0.81–0.93 in the European study). On average across domains, floor/ceiling was reduced by 10% using CAT (9% in the European study) corresponding to a relative reduction of 32% (37% in the European study). Analyses of known-group validity and responsiveness indicated that, on average across domains, the sample-size requirements may be reduced by 17% using CAT rather than QLQ-C30, without loss of power (28% in the European study). The Brazilian sample had less symptom/quality of life impairment than the European sample, which likely explains the lower sample-size reduction using CAT when comparing with the European sample. Conclusions: The results in the Brazilian cohort were generally similar to those from the European sample and confirm the validity and usefulness of the EORTC CAT Core.

Tobacco use in the Myeloproliferative neoplasms: symptom burden, patient opinions, and care

BackgroundPatients with Philadelphia-negative Myeloproliferative Neoplasms (MPN) suffer from numerous symptoms and decreased quality of life. Smoking is associated with an increased symptom burden in several malignancies. The aim of this study was to analyze the association between smoking and MPN-related symptom burden and explore MPN patients’ opinions on smoking.MethodsA total of 435 patients with MPN participated in a cross-sectional internet-based survey developed by the Mayo Clinic and the Myeloproliferative Neoplasm Quality of Life Group. Patients reported their demographics, disease characteristics, tobacco use, and opinions on tobacco use. In addition, MPN-related symptoms were reported via the validated 10-item version of the Myeloproliferative Neoplasms Symptom Assessment Form.ResultsCurrent/former smokers reported worse fatigue (mean severity 5.6 vs. 5.0, p = 0.02) and inactivity (mean severity 4.0 vs. 3.4, p = 0.03) than never smokers. Moreover, current/former smokers more frequently experienced early satiety (68.5% vs. 58.3%, p = 0.03), inactivity (79.9% vs. 71.1%, p = 0.04), and concentration difficulties (82.1% vs. 73.1%, p = 0.04). Although not significant, a higher total symptom burden was observed for current/former smokers (mean 30.4 vs. 27.0, p = 0.07). Accordingly, overall quality of life was significantly better among never smokers than current/former smokers (mean 3.5 vs. 3.9, p = 0.03). Only 43.2% of the current/former smokers reported having discussed tobacco use with their physician, and 17.5% did not believe smoking increased the risk of thrombosis.ConclusionThe current study suggests that smoking may be associated with increased prevalence and severity of MPN symptoms and underscores the need to enhance patient education and address tobacco use in the care of MPN patients.

Characteristics of patients with chronic hypoparathyroidism not adequately controlled with conventional treatment and management patterns in Spain

Background and objectiveThe current guidelines on hypoparathyroidism offer a model for treating patients but do not cover real-world situations or patient diversity. Given the lack of data regarding hypoparathyroidism, a Delphi panel was convened in Spain to establish consensus in defining the characteristics of patients with chronic hypoparathyroidism not adequately controlled with conventional treatment, as well as to investigate patterns of management. Material and methodsA presentation matrix provided a framework for characterizing inadequately controlled chronic hypoparathyroidism, based on four predefined patient groups: group 1 (normal biochemical levels and the patient feeling well); group 2 (abnormal biochemical levels and the patient feeling well); group 3 (normal biochemical levels and the patient feeling unwell); and group 4 (abnormal biochemical levels and the patient feeling unwell). Based on Likert scales (scored 1–9), the experts were asked to state their agreement/disagreement with the characteristics of patients with chronic hypoparathyroidism, including demographic data, family history, comorbidities, biochemical values, symptoms and quality of life. Consensus was achieved when ≥66% of the respondents were in agreement. ResultsConsensus was achieved on the importance of assessing demographic data and comorbidities (e.g., renal complications) in groups 2, 3 and 4; family medical history in groups 2 and 3; biochemical parameters (e.g., calcemia/urinary calcium excretion) in groups 2 and 4; and clinical symptoms and quality of life in groups 3 and 4. Consensus was also reached regarding the maintenance of several biochemical parameters and the need for personalized treatment and training in symptoms and complications. ConclusionsThe Spanish expert panel reached consensus defining key disease parameters and factors of importance for characterizing and treating patients with inadequately controlled chronic hypoparathyroidism.

Clinical Effect of Transforaminal Endoscopic Surgery in the Treatment of Lumbar Disc Herniation

Objective: Objective to explore the curative effect of transforaminal endoscopic surgery in the treatment of lumbar disc herniation. Methods: From October 2018 to October 2020, 36 patients with lumbar disc herniation were randomly divided into group A and group B. the curative effect, pain, lumbar function and quality of life were analyzed. Results: The curative effect of group A was 94.44%, better than that of group B 61.11%, P&lt; 0.05; The visual analogue scale (VAS) of group A was lower than that of group B on 3D, 5D and 7d after operation (P&lt; 0.05); The KSS of group A was higher than that of group B (P&lt; 0.05); The score of quality of life in group A was better than that in group B (P&lt; 0.05). Conclusion: Lumbar disc herniation patients underwent transforaminal endoscopic surgery, the effect is good, can improve lumbar function, relieve pain, improve the quality of life of patients.

Otosclerosis surgery under local anesthesia with sedation: Assessment of quality of life and stress

ObjectivesThe main study endpoint was tolerance of stapedotomy under local anesthesia with sedation and under general anesthesia using stress and quality of life assessment questionnaires. Secondary endpoints comprised operative time and functional results. Material and methodIn a consecutive series of stapedotomy patients operated on over a 12-month period, quality of life and perioperative stress were analysed by 3 questionnaires: the Glasgow Benefit Inventory, Cohen's perceived stress scale and the Post-traumatic stress disorder checklist scale. Questionnaire responses and audiometric data were compared between groups treated under local anesthesia with sedation and under general anesthesia. ResultsTwenty-two patients were included in the local anesthesia with sedation group and 6 in the general anesthesia group. There was no difference between the groups for quality of life, onset of post-traumatic stress, or perceived pre- and postoperative stress. There was also no difference in operative time. The audiometric data confirmed the reliability of stapedotomy. Stapedotomy under local anesthesia with sedation improved air conduction with≤10dB air-bone gap (ABG), comparable to results under general anesthesia. The rate of ABG≤10dB was 71.4%; no labyrinthisation was observed. ConclusionUnder local anesthesia with sedation, stapedotomy was well tolerated without increasing the stress associated with otosclerosis surgery. By correcting hearing loss, the procedure improves quality of life.