Risk Factors For Poor Quality Research Articles

Clinical impact of lactate on postoperative pancreatic fistula after pancreaticoduodenectomy: A single-center retrospective study of 1,043 patients

Background/objectivesSeveral hemodynamic markers have been studied to predict postoperative complication which is a risk factor for poor quality of life and prognosis. The aim of this study was to determine whether postoperative lactate clearance could affect clinical outcome based on complications in one surgical patient group. MethodsWe retrospectively reviewed data from all patients who underwent pancreaticoduodenectomy (PD) at Samsung Medical Center from January 2015 to December 2019. Differences in baseline characteristics of patients, intraoperative outcome, and postoperative outcome were evaluated according to the presence or absence of clinically relevant postoperative pancreatic fistula (CR-POPF). ResultsAmong a total of 1107 patients, 1043 patients were tested for arterial lactate levels immediately after surgery, and the day after surgery. Immediately postoperative hyperlactatemia (lactate ≥2.0 mmol/L) was not related to CR-POPF (P = 0.269). However, immediately postoperative hyperlactatemia with a negative lactic clearance on postoperative day (POD) 1 was related to CR-POPF (P = 0.003). In multivariate analyses, non-pancreatic cancer (hazard ratio (HR): 2.545, P < 0.001), soft pancreatic texture (HR: 1.884, P < 0.001), and postoperative hyperlactatemia with negative lactate clearance on POD 1 (HR: 1.805, P = 0.008) were independent risk factors for CR-POPF. ConclusionsHyperlactatemia with negative lactate clearance after PD, one of the high-risk surgeries requiring postoperative ICU care, is a risk factor for CR-POPF. In case of immediately postoperative hyperlactatemia after PD, lactate clearance with serial lactate level follow-up can be used for achieving the hemodynamic goal to prevent CR-POPF.

Sleep quality, daytime sleepiness, and insomnia in patient with epilepsy:A single center experience from Saudi Arabia

To measure the burden of insomnia and daytime sleepiness (DTS) and their effects on sleep quality, and the risk factors of poor quality of sleep. We conducted a cross-sectional study of 218 epilepsy patients. We administered well-validated and previously translated questionnaires to assess sleep quality, insomnia, and DTS using the Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Epworth Sleepiness Scale, respectively. Approximately 75% of participants reported poor sleep quality. Moreover, 42.2% did not have insomnia, while 37.6%, 17.9%, and 2.3% had subthreshold insomnia and clinical insomnia of moderate and severe severity, respectively. Roughly 64.2% of participants had normal sleep, 17.8% had an average amount of DTS, and 16.9% and 0.9% may and should seek medical attention, respectively. Compared to normal sleepers, patients with clinical insomnia were 5.45 times likely to experience poor sleep quality, whereas patients with an average amount of DTS and who were recommended to seek medical attention were 6.84 and 44.15 times likely to experience poor sleep quality, respectively. Patients who had seizures every month were 2.51 times likely to experience poor quality sleep, compared to patients who had seizures annually. We found a higher prevalence of poor quality of sleep, insomnia, and excessive DTS in our sample of Saudi epilepsy patients.

Ridge Regression for Functional Form Identification of Continuous Predictors of Clinical Outcomes in Glomerular Disease

Introduction: Penalized regression models can be used to identify and rank risk factors for poor quality of life or other outcomes. They often assume linear covariate associations, but the true associations may be nonlinear. There is no standard, automated method for determining optimal functional forms (shapes of relationships) between predictors and the outcome in high-dimensional data settings. Methods: We propose a novel algorithm, ridge regression for functional form identification of continuous predictors (RIPR) that models each continuous covariate with linear, quadratic, quartile, and cubic spline basis components in a ridge regression model to capture potential nonlinear relationships between continuous predictors and outcomes. We used a simulation study to test the performance of RIPR compared to standard and spline ridge regression models. Then, we applied RIPR to identify top predictors of Patient-Reported Outcomes Measurement Information System (PROMIS) adult global mental and physical health scores using demographic and clinical characteristics among N = 107 glomerular disease patients enrolled in the Nephrotic Syndrome Study Network (NEPTUNE). Results: RIPR resulted in better predictive accuracy than the standard and spline ridge regression methods in 56–80% of simulation repetitions under a variety of data characteristics. When applied to PROMIS scores in NEPTUNE, RIPR resulted in the lowest error for predicting physical scores, and the second-lowest error for mental scores. Further, RIPR identified hemoglobin quartiles as an important predictor of physical health that was missed by the other models. Conclusion: The RIPR algorithm can capture nonlinear functional forms of predictors that are missed by standard ridge regression models. The top predictors of PROMIS scores vary greatly across methods. RIPR should be considered alongside other machine learning models in the prediction of patient-reported outcomes and other continuous outcomes.

Impact of sarcopenia on intertrochanteric femoral fracture in the elderly.

ObjectiveThe aim of this study was to investigate the effect of skeletal sarcopenia on the prognosis of intertrochanteric fracture in the elderly.MethodsWe collected information on 144 patients with femoral intertrochanteric fracture (FIF). The influence of sarcopenia on the chance of death was determined using binary Probit regression analysis. For additional analysis, the Chow test was utilized to select the best distinguishing node in the instrumental activities of daily living (IADL) score. We looked for characteristics that were linked to a higher probability of death and a poor IADL outcome within 1 year. The data collected above were analyzed using logistic regression analysis. The internal calibration degree and model validity were assessed by GiViTI calibration.ResultsSarcopenia, EuroQol-5D 1 month score, age, gender, and hypertension were identified as risk factors for death in older patients with FIF within a year by logistic regression analysis. Sarcopenia, psychotropics, BMI, and length of hospital stay were all found to be risk factors for poor IADL outcomes (P < 0.1). The calibration curves indicated that the anticipated and actual probabilities of these two models were very close. The study’s reliability coefficient was 0.671, showing a satisfactory level of reliability.ConclusionIn elderly patients with FIF, sarcopenia, EuroQol-5D score, age, gender, and hypertension were risk factors for death; sarcopenia, hospital stay length, BMI were risk factors for poor quality of life.

Sarcopenia reduces quality of life in the long-term: longitudinal analyses from the English longitudinal study of ageing

Key summary pointsAimTo examine the association between sarcopenia at baseline and changes in quality of life at 10 years follow-up in a large representative sample of older English adults.FindingsAfter considering numerous confounders, sarcopenia at baseline was associated with a higher incidence of poor quality of life. People having sarcopenia at baseline reported significantly lower values in CASP-19 after ten years of follow-up.MessageSarcopenia is an important and independent risk factor for poor quality of life in older people.

Somatization, Psychological Distress, and Quality of Life in Rural and Urban Russians

The aim of this study was to examine symptoms of anxiety, depression, and somatization as potential risk factors for poor quality of life among rural and urban Russians. The participants were 319 rural (N = 158) and urban (N = 161) residents who completed measures assessing somatization, anxiety, depression, and health-related quality of life. Results showed that urban residents experienced more frequent and intense somatization (53.4% vs. 37.3%), anxiety (38.5% vs. 17.1%), and depressive symptoms (50.3% vs. 19.6%) than did rural residents. Both urban and rural residents complained equally about physical health (68.9% vs. 63.3%), but not mental health (18.1% vs. 17.7%). The relationship between quality of life and psychosomatic status is more complex among rural residents than among urban residents, as it depends on more potential risk factors. In conclusion, these patterns need further empirical testing, after which they can be used to develop medical and psychological assistance programs for the Russian population.

Beyond the physical risk: Psychosocial impact and coping in healthcare professionals during the COVID-19 pandemic.

Aims and objectivesThis study aimed to examine the psychosocial impact and identify risk factors for poor psychosocial outcomes in healthcare professionals during the Coronavirus disease 2019 (COVID‐19) pandemic in Cyprus.BackgroundHealthcare professionals are in the forefront of the COVID‐19 pandemic facing an unprecedented global health crisis, which can have consequences on their psychosocial health. There is a need to identify risk factors for poor psychosocial outcomes to inform the design of tailored psychological interventions.DesignCross‐sectional online study.MethodsA total of 1071 healthcare professionals completed self‐report questionnaires. Measures included sociodemographic information, COVID‐19‐related characteristics, quality of life (Brief World Health Organization Quality of Life; WHOQOL‐Bref), anxiety (Generalized Anxiety Disorder‐7; GAD‐7), depression (Patient Health Questionnaire‐8; PHQ‐8), occupational burnout (Copenhagen Burnout Inventory; CBI), and coping (Brief Coping Orientation to Problems Experienced; Brief COPE). This article follows the STROBE reporting guidelines.ResultsThe prevalence of moderate to severe anxiety and clinically significant depression was 27.6% and 26.8%, respectively. Significant risk factors for poor psychological outcomes included being female, being a nurse or doctor (vs non‐medical professional), working in frontline units (inpatient, intensive care), perceptions of inadequate workplace preparation to deal with the pandemic, and using avoidance coping. Depression and occupational burnout were significant risk factors for poor quality of life.ConclusionThe findings suggest several individual, psychosocial, and organisational risk factors for the adverse psychological outcomes observed in healthcare professionals during the COVID‐19 pandemic.Relevance to clinical practiceThis study highlights the urgent need for screening for anxiety and depression and psychological interventions to combat an imminent mental health crisis in healthcare professionals during the COVID‐19 pandemic. Pandemic response protocols and public health initiatives aiming to improve and prevent mental health problems in healthcare professionals during the current and future health crises, need to account for the various factors at play.

Quality of Life among Patients with Retinal Vein Occlusion: A Case-Control Study

ABSTRACT Purpose: The purpose of this study was to evaluate health-related quality of life in patients with retinal vein occlusion (RVO) and investigate the possible risk factors for poor quality of life in patients with RVO. Methods: Participants in the study were 67 patients with RVO, 42 male and 25 female, mean-aged 73.1 ± 10.9 years, and 70 sex- and age-matched controls. Demographic data, lifestyle factors and medical history were recorded. All patients underwent best-corrected visual acuity measurement, dilated fundoscopy and optical coherence tomography. All participants completed two questionnaires assessing quality of life (EQ-5D, NEI VFQ-25). Risk factors for health-related quality of life in RVO patients were investigated. Results: Patients with RVO exhibited significantly lower composite score for VFQ-25 compared to controls (74.1 ± 3.8 vs. 91.7 ± 3.9 for patients and controls, respectively, p < .001). In addition, RVO patients had significantly lower EQ-5D Index score compared to controls (0.88 ± 0.15 vs. 0.92 ± 0.12 for patients and controls, respectively, p = .043). Risk factors associated with quality of life in patients with RVO were found the alcohol consumption, the presence of thyroidopathy, coagulation disorders, visual acuity in the eye with RVO, central retinal thickness, the type of edema, the presence of ischemia and the condition of external limiting membrane. In multivariate analysis, only alcohol consumption and visual acuity in the eye with RVO were found to be independent risk factors, affecting quality of life in RVO patients. Conclusions: Patients with RVO presented lower quality of life in comparison with controls. Potential risk factors should be taken into account and their early detection may improve quality of life in such patients and lead to targeted health policies.

Social Media Use and Loneliness Among Older Adults: The Mediating Role of Social Contact and Perceived Social Support

Loneliness is a risk factor for poor quality of life among older adults. Social media use provides a new dimension of communication for older adults to connect with people and to maintain social relationships. However, research has been inconclusive about whether social media use reduces loneliness among older adults, which is due in part to a lack of appropriate measures for capturing different types of social media use. Furthermore, little is known about the underlying mechanisms through which social media use is associated with loneliness. This study investigates the association between social media communication with close social ties and loneliness among community-dwelling older adults (65+), and further examines the mediating role of social contact and social support in the association. Data from the 2014 wave of the Health and Retirement Study (HRS) are analyzed to address our research questions (N = 4,184). Path analyses are employed to examine the relationships among social media communication with close social ties (i.e., children, family, and friends), frequency of contact with social ties (i.e., phone, in-person contact, write/email), perceived social support from social ties, and loneliness (R-UCLA loneliness scale). The results show that a higher level of social media communication is associated with lower levels of loneliness through social contact and perceived social support. Moreover, the relationship between social media communication and perceived social support is partially mediated by social contact. These findings suggest that social media communication may be considered an intervention that may reduce loneliness among older people.

The effect of postintensive care syndrome on the quality of life of intensive care unit survivors: A secondary analysis

BackgroundDespite increasing interest in postintensive care syndrome and the quality of life of intensive care unit survivors, the empirical literature on the relationship between these two variables is limited. ObjectivesThis study aimed to examine whether postintensive care syndrome predicts the quality of life of intensive care unit survivors. MethodsWe analysed secondary data, which were collected as part of a larger cross-sectional study. The participants were recruited from six health institutions in Korea. The data of 496 survivors who had been admitted to an intensive care unit for at least 48 h during the past year were analysed. They responded to measures of postintensive care syndrome and quality of life. ResultsThe participants' mean physical and mental component summary scores (quality of life) were 40.08 ± 8.99 and 40.24 ± 11.19, respectively. Physical impairment (β = −0.48, p < 0.001), unemployment (β = −0.19, p < 0.001), low income (β = −0.11, p = 0.004), older age (β = −0.08, p = 0.039), and cognitive impairment (β = −0.11, p = 0.045) predicted lower physical component summary scores. Mental (β = −0.49, p < 0.001) and cognitive impairment (β = −0.14, p = 0.005) and low income (β = −0.09, p = 0.014) predicted mental component summary scores. ConclusionsThe participants reported poor physical and mental health–related quality of life. Postintensive care syndrome, unemployment, low income, and older age were the main predictors of poor quality of life. In addition, postintensive care syndrome was a stronger risk factor for poor quality of life than demographic characteristics and intensive care unit treatment factors.

Quality of life in patients with resectable rectal cancer during the first 24months following diagnosis.

AimAn increasing number of patients survive rectal cancer, resulting in more patients living with the side‐effects of the treatment. Exploring quality of life before and after treatment enables follow‐up and additional treatment to be adjusted to the patient's needs. The aim of the study was to describe the quality of life during the 24 months following diagnosis and to identify risk factors for poor quality of life.MethodThis is a prospective cohort study of patients with rectal cancer followed up by extensive questionnaires. Patients from 16 surgical departments in Denmark and Sweden from 2012 to 2015 were included. The self‐assessed quality of life was measured with a seven‐point Likert scale.ResultsA total of 1110 patients treated with curative intent were included, and the response rate at the 24‐month follow‐up was 71%. Patients with rectal cancer assessed their quality of life before start of treatment as poorer than that of a reference population. At the 12‐ and 24‐month follow‐up, the quality of life on group level had recovered to the same level as for the reference population. Risk factors for poor quality of life included bother with urinary, bowel and stoma function. A reference population was used for comparison.ConclusionThe quality of life of patients with resectable rectal cancer recovered to levels comparable to a reference population 12 and 24 months after diagnosis. Our results indicate that the urinary, bowel and stoma function has an impact on quality of life.

A comparative study of clinical effect of total knee arthroplasty in the treatment of primary osteoarthritis and osteoarthritis of Kashin-Beck disease.

To evaluate the clinical efficacy of total knee arthroplasty (TKA) in the treatment of primary osteoarthritis (OA) and osteoarthritis of Kashin-Beck disease (KBD). This study enrolled 77 KBD patients (77 knees, KBD-TKA) and 75 OA patients (75 knees, OA-TKA) who underwent TKA from September 2008 to June 2018. Clinical assessments for each patient were performed pre-operatively and last follow-up. The efficacy measures included the visual analogue scale (VAS) pain score, range of motion (ROM), Hospital for Special Surgery (HSS) score, and short form 36 Health Survey (SF-36) as well as related influencing factors between the two groups. All patients were followed up; the follow-up time of KBD-TKA was 14-132months, with an average of 72.68 ± 37.55months; OA-TKA was 15-120months, with an average of 49.2 ± 28.91months. There was no difference in pre-operative VAS score (7.29 vs. 7.24) and SF-36 (PCS) score (4.87 vs. 5.49) between KBD-TKA and OA-TKA (P > 0.05), while compared with OA, KBD-TKA had significantly worse pre-operative ROM (75.48° vs. 82.87°), HSS score (36.40 vs. 41.84), and SF-36 (MCS) score (26.28 vs. 28.73) (P < 0.05). At the final follow-up, there was no significant difference in VAS score (1.13 vs. 1.16), ROM (105.79 vs. 105.79), and HSS score (92.06 vs. 92.25) between KBD-TKA and OA-TKA (P > 0.05), while compared with OA, KBD-TKA had significantly worse SF-36 (PCS) score (36.90 vs. 42.00) and SF-36 (MCS) score (55.16 vs. 59.70) (P < 0.05). In a multivariate regression, controlling for multiple potential confounders, diagnosis of KBD was associated with poor quality of life after surgery, whereas pre-operative pain was specifically associated with post-operative pain. However, preoperative gender, age, BMI, and the angles of knee prosthesis (before and after surgery) were not associated with post-operative outcome. Patients with KBD undergoing primary TKA have excellent outcomes, comparable with OA at the final follow-up, in spite of worse pre-operative ROM, HSS score, and SF-36(MCS) score. However, KBD patients are worse than OA in terms of general health. Pre-operative age, gender, BMI, and the angles of knee prosthesis were not the factors influencing the clinical efficacy of TKA. The diagnosis of KBD was an independent risk factor for poor quality of life after TKA. Pre-operative pain was a clinically important predictor of outcome.

The Relationship Between Neuropathic Pain and Spinal Alignment: Independent Risk Factors for Low Quality of Life in Middle-Aged and Elderly People.

Prospective research in middle-aged and elderly people. To investigate low back pain (LBP) and neuropathic pain (NeP); spinal alignment and range of motion (ROM); spinal degenerative changes in plain radiography; osteoporosis; muscle strength; and physical ability as possible risk factors for poor quality of life (QOL). The aging of society has led to an increase in elderly people with chronic pain, including LBP and NeP. However, there has been no analysis of NeP and spinal sagittal alignment as potential risk factors for decreased QOL in the healthy general population. The subjects were 1128 people (male 473, female 655, average age: 64.3 yrs) who attended an annual health checkup in Yakumo study. The prevalence of LBP and sciatica were investigated using a visual analogue scale (VAS), and NeP was defined as more than or equal to 13 points on the painDETECT questionnaire. Sagittal spinal alignment with spinal ROM was also measured. Body mass index, muscle strength, physical ability, osteoporosis, and lumbar degenerative changes were measured, and 36-item short-form health survey (SF-36) was used for QOL analysis. NeP was present in 113 people (10%). The NeP (+) subjects had significantly more severe pain, lower gait speed, higher osteoporosis rate, lumbar kyphosis, and larger spinal inclination (P < 0.01) compared with NeP (-) subjects. On SF-36, physical and mental QOL were significantly lower for NeP (+) subjects (P < 0.0001). In multivariate logistic regression analysis adjusted for age and sex, NeP (+) (odds ratio [OR]: 3.01), positive spinal inclination (OR: 1.14), and high VAS for LBP (OR: 1.04) were identified as risk factors for low physical QOL, and NeP (+) (OR: 5.32) was the only significant risk factor for low mental QOL. These results suggest that interventions for NeP and other identified risk factors may contribute to improvement of low physical and mental QOL in middle-aged and elderly people. 2.

Lifestyle habits associated with nocturnal urination frequency: The Nagahama study.

Nocturia is a risk factor for poor quality of life and increased mortality. This study was aimed to clarifying dietary habits, eating behaviors, and sleep characteristics associated with nocturia to identify modifiable lifestyle factors for nocturia. This cross-sectional study included 5683 community residents (64.5 ± 7.7 years old). The frequency of nocturnal urination was recorded for 1 week using a sleep diary. The frequency of food intake, unfavorable eating behaviors, and sleep characteristics that may have influence on salt intake and wasting were obtained using a structured questionnaire. The frequency of nocturnal urination was increased with age (β = .312, P < .001). Other basic factors associated with the frequency were the male sex (β = .090), hypertension (β = .038), sleep apnea (β = .030), B-type natriuretic peptide level (β = .089), and spot urine sodium excretion (β = -.058). Dietary factors independently associated with nocturnal urination frequency were coffee (≥1 time/day: β = -.059, P < .001) and green vegetable consumption (≥1 time/week: β = -.042, P = .001), whereas habitual intake of dairy products, miso soup, and alcohol were not associated with urination frequency. Later bedtime was inversely associated with nocturnal urination frequency independent of sleep duration (before 23:00: β = -.096; before 24:00: β = -.225; after midnight: β = -.240; all P < .001). Coffee and green vegetable consumption and later bedtime but not sleep duration are lifestyle factors associated with nocturnal urination frequency.

Sleep Electroencephalography Power Spectral Response to Transcutaneous Auricular Vagus Nerve Stimulation on Insomnia Rats

Background: Insomnia is a prevalent sleep disorder and strong risk factor for poor quality of life, depression, and other lifestylerelated diseases. Objectives: To investigate the effect of the transcutaneous vagus nerve stimulation (taVNS) on sleep electroencephalographic (EEG) in the para-chlorophenylalanine (PCPA) insomnia rats. Methods: Rats were divided into control, model, taVNS and sham taVNS (stnVNS) (stimulate the auricular margin, as transcutaneous none VNS, stnVNS) group (n=6 in each group). A week before the experiment, the electrodes were fixed to the skull of all the rats for recording the sleep EEG. PCPA was used to establish insomnia models. The rats of taVNS and stnVNS group were treated via an electroacupuncture apparatus for seven consecutive days, and simultaneously, the sleep EEG were recorded for all groups after the treatment daily. And the power spectrum analysis was used in this experiment. Results: After modeling, the percentage of power spectrum of delta frequency band significantly decreased, while the theta, alpha, and beta frequency bands significantly increased in the model group compared to the control group. After intervention, the percentage of the delta frequency band significantly increased in the taVNS group as compared to the stnVNS group. Conclusion: These results suggest that taVNS can significantly modulate the power spectrum of the delta frequency band and may constitute a potential low-cost alternative for the treatment of insomnia.

Relationship Between Exercise Perception With Physical Activity Level, Body Awareness, and Illness Cognition in Renal Transplant Patients: A Pilot Study

Transplantation offers better quality of life and long-term survival benefits. Further knowledge is needed regarding exercise in daily life of transplant recipients. Here, we investigated the relationship between exercise perception and physical activity level, body awareness, and illness cognition in renal transplant patients. Our study included 53 renal transplant recipients (Standardized Mini-Mental Test score = 26.35 ± 1.36; age = 41.11 ± 13.52 year, body mass index = 25.96 ± 5.26 kg/m², elapsed time after transplant = 3.68 ± 1.53 year). Perceived benefits and barriers to exercise, physical activity level, body awareness, and illness cognition were assessed with the Exercise Benefits/Barriers Scale, International Physical Activity Questionnaire, Body Awareness Questionnaire, and Patient Illness Perception Questionnaire, respectively. Correlations were established with Spearman test for nonparametric data, with regression analysis used to find determinants of physical activity levels. We observed correlations between physical activity level and perceived benefits and barriers to exercise. There was a positive relationship between body awareness and perceived benefits and barriers to exercise and also illness cognition, with significant correlation between perceived benefits and barriers to exercise and illness cognition (P < .05). Perceived benefits and barriers to exercise (P = .006, R = 0.373, R2 = 0.139, beta = 0.373, t = 2.867, F = 8.22) were determining factors for physical activity level. Psychologic and physical factors, including negative emotions and body dissatisfaction, are risk factors for poor quality of life. Although it is important to increase quality of life, tools to enhance body awareness and to develop strategies to alter motor behaviors in daily living activities are needed. Treatment and assessment strategies on body awareness and illness perception should be considered, with emphasis on the importance of physical activity posttransplant.

Sleep disruption as a predictor of quality of life among patients in the subpopulations and intermediate outcome measures in COPD study (SPIROMICS).

Sleep quality is poor among patients with chronic obstructive pulmonary disease (COPD), and studies show that sleep disturbance is associated with low overall quality of life in this population. We evaluated the impact of patient-reported sleep quality and sleep apnea risk on disease-specific and overall quality of life within patients with COPD enrolled in the SPIROMICS study, after accounting for demographics and COPD disease severity. Baseline data from 1341 participants [892 mild/moderate COPD (FEV1 ≥ 50% predicted); 449 severe COPD (FEV1 < 50%)] were used to perform three nested (blocks) regression models to predict quality of life (Short Form-12 mental and physical components and St. George's Respiratory Questionnaire). Dependent measures used for the nested regressions included the following: Block1: demographics and smoking history; Block 2: disease severity (forced expiratory volume 1 s; 6 min walk test); Block 3: risk for obstructive sleep apnea (OSA; Berlin questionnaire); and Block 4: sleep quality (Pittsburgh Sleep Quality Index [PSQI]). Over half of participants with COPD reported poor sleep quality (Mean PSQI 6.4 ± 3.9; 50% with high risk score on the Berlin questionnaire). In all three nested regression models, sleep quality (Block 4) was a significant predictor of poor quality of life, over and above variables included in blocks 1-3. Poor sleep quality represents a potentially modifiable risk factor for poor quality of life in patients with COPD, over and above demographics and smoking history, disease severity, and risk for OSA. Improving sleep quality may be an important target for clinical interventions. SPIROMICS. http://www2.cscc.unc.edu/spiromics/. ClinicalTrials.gov NCT01969344.

Evaluation of nutritional status in chronic kidney disease patients undergoing hemodialysis

Background: Kidneys perform the important function of excreting nitrogenous waste products and regulating the volume and composition of body fluids. Malnutrition is common phenomenon in maintenance dialysis patients and risk factor for poor quality of life and increased morbidity and mortality. An association of low albumin levels with increased mortality and morbidity in hemodialysis patients has been hypothesized. Present study aims to go through nutritional status of CKD patients in our institute and their relation to disease or dialysis outcome.Methods: Study is conducted on 100 CKD patients on haemodialysis admitted in various medical wards of the Mc Gann hospital attached to Shimoga institute of medical sciences, Shimoga, Karnataka, India. From August 1st, 2016 to April 30th, 2017 detailed history was taken in all the patients and a thorough physical examination was done. Dietary history was taken and blood is collected for analysis of Hb, blood urea, SR electrolyte, serum calcium, phosphorus, serum albumin, cholesterol, creatinine and CRP. BMI is calculated in all patients.Results: There were 60 males and 40 females. Average age is 46±3.6 years. Most of these patients belong to the age group of 41-50 years (37%). According to WHO BMI classification 55% had BMI between 18.5 to 24.9. 17% less than 18.5. 13% more than 30BMI. Blood urea, serum creatinine was elevated as expected. Mean Hb is 8.21±2.57 gm/dl. Serum albumin is lower mean being 2.66±1.86 gm/dl. CRP elevated 16.5±2.36. low calcium is also seen.Conclusions: The malnutrition in CKD is associated with increased morbidity and mortality rates. Despite the better understanding of the pathophysiologic mechanisms of uremic malnutrition and the improvements made in nutritional support, the nutritional condition of CKD and ESRD patients remains a significant cause for concern. Multimodal therapeutic strategies should be considered. Present study showed elevated prevalence of malnutrition in HD subjects. The nutritional status in patients on HD needs more attention. The role of nutrition in the management of CKD is important and needs to be further researched and newer guidelines are need of the hour.

The Relationship between Non-Communicable Diseases History and Health-Related Quality of Life

Disaster-prone population is vulnerable for suffering non-communicable diseases (NCDs) which become risk factors for poor quality of life (QoL). The study aims at investigating the effect of history of NCDs to the QoL. QoL was measured by WHODAS. NCDs with prevalence more than 1% were involved in analysis. Those NCDs included shortness of breath, diabetes, hypertension, joint disease and stroke. Among 1,872 respondents of Riskesdas, 7.7% of them have a poor QoL, suffering hypertension (8.7%), shortness of breath (7.3%) and asthma (6.9%). Risks of poor QoL six times higher among those with a history of PTM (PORadj 5.987; 95% CI 4.210-8.514) after adjusted by age, gender, education, socioeconomic status and region of residence. Stroke gives the greatest impact with POR 25.00 (95% CI 10.406 to 60.063). We recommend that the promotion and prevention of NCDs should be integrated with both mitigation-related and community resilience activities to disasters.

Lived post-stroke of a Senegalese cohort: What risk factor for what quality of life items?

Therefore, the aim of our study was to determine risk factors for poor quality of life by considering disability after stroke in its multidimensional aspects but also to see the impact of each risk factor on the dimensions of quality of life. A prospective study of stroke patients confirmed, followed by neurovascular consultation at Fann Hospital in Dakar has been achieved. Quality of life was evaluated by the 65 Sikness Impact Profile (SIP 65), the depression by the scale of Beck. We included 70 men and 30 women with a mean age of 55.25 years. The education rate was 56.12%. Hypertension (65%); musculoskeletal diseases (26.26%) were the major associated defects. Ischemic stroke was predominant. Depression was observed in 53% of cases. The outputs of the house and in the city were respectively arrested in 50% and 73% of cases. Most of the patients, 61%, were conducting any activity at home. Age was associated with an orientation problem in time significantly ( P = 0.02), musculoskeletal diseases to need help dressing ( P = 0.03); the degree of disability to need help to sit and sleep ( P = 0.00003), a lack of sleep the night ( P = 0.00002) and a home asset; depression suffering of sexual life ( P = 0.002), a shortened working time ( P = 0.005) and reduced leisure time ( P = 0.0004). The sedentary post stroke Senegalese patients can’t be explained solely by altering the physical dimensions of quality of life. All the more that disability assessed by the Barthel showed that locomotion is possible in over 50% of cases.