Quality Of Life Scores Research Articles

Improved Gynecomastia Surgery: Power-Assisted Liposuction With Stab-Flatten Technique Without Resection.

Gynecomastia, the enlargement of male breast tissue, significantly impacts both physical and psychological health. Surgical intervention is often necessary, utilizing various techniques to reduce glandular and fatty tissue. This paper introduces an innovative surgical method combining power-assisted liposuction with the stab-flatten technique to enhance precision and cosmetic results. We present our clinical experience and evaluate its effectiveness in gynecomastia treatment. From June 2021 to January 2023, 128 gynecomastia patients underwent power-assisted liposuction and the stab-flatten method via a single axillary incision. We collected demographic and clinical data, including surgery duration, complications, and patient satisfaction regarding physical appearance, mental state, and social interactions. The BODY-Q questionnaire was used preoperatively and 3 months postoperatively for assessment. The study included 128 male patients, treating 252 breasts, with an average age of 35 years and a mean BMI of 27.7kg/m2. Most procedures were bilateral (96.9%), with an average fat removal of 224.5mL and a surgery duration of 147 minutes. The complication rate was low at 2.0%, with bruises in 5 breasts. The average hospital stay was 2 days. Significant improvements were noted in BODY-Q scores for appearance satisfaction and health-related quality of life, with increased appearance satisfaction and reduced appearance-related distress. Since June 2021, the combined use of power-assisted liposuction and the stab-flatten technique has been effective in managing gynecomastia. This synergistic approach not only achieves aesthetically pleasing outcomes but also minimizes the surgical risks associated with traditional methods.

Quality of Life of Men Who Have Sex with Men: A Cross-sectional Study from Sagar, Madhya Pradesh

Background: Men who have sex with men (MSM), a high-risk group for HIV/AIDS, face various health issues. However, research is scarce on MSM in India, and available studies generally focus on the mental health of HIV-infected MSM rather than their overall health. Therefore, this study aimed to assess the quality of life (QOL) among MSM. Materials and Methods: This observational cross-sectional study was done in Sagar, Madhya Pradesh, involving 100 MSM individuals. Participants were recruited from a non-governmental organization that works toward the welfare of MSM individuals. Socio-demographic data were collected using a semi-structured questionnaire, while QOL was measured using the Hindi version of the WHOQOL-BREF questionnaire. Quantitative variables were summarized using mean and standard deviation, and qualitative variables were summarized using frequency and percentage. The differences between mean QOL scores were analyzed using t-test/analysis of variance, and Pearson’s correlation coefficient was used to assess the correlation between domains. Results: Most participants were 21-40 years of age, with a mean age of 34.8 (±8.1) years. Most participants resided in urban areas and identified as Hindu (92%). The scores of WHOQOL-BREF ranged from 0 to 100, with higher scores indicating better QOL. The mean scores for general QOL and general health among participants were 42 ± 20.4 and 67.5 ± 24.7, respectively. Among the four domains of WHOQOL-BREF, social relationship domain had the highest mean QOL score (72.7 ± 11.5), while the psychological domain exhibited the lowest score (57.2 ± 11.7). The mean scores for the physical and environmental domains were 70.9 ± 8.7 and 59.6 ± 10.7, respectively. Conclusions: The findings underscore the importance of addressing various health aspects beyond HIV/AIDS in this population to improve their overall well-being and life satisfaction.

Efficacy of Ultrasound-Guided Transverse Abdominal Plane Block for Residual Pain After Pulsed Radiofrequency in Abdominal Acute/Subacute Herpes Zoster-Related Pain.

Pulse radiofrequency (PRF) can reduce the persistent pain of herpes zoster (HZ), but some patients still have residual pain and do not achieve satisfactory results. This study aimed to assess the efficacy of PRF combined with transverse abdominal plane (TAP) block for abdominal acute/subacute HZ-related pain. A total of 137 acute/sub-acute HZ patients with successful PRF treatment were recruited from the Pain Department of Wuhan No. 1 Hospital between January 2018 and January 2020. There were two groups: the transversus abdominis plane group (TAP group, n = 64) and the normal saline group (NS group, n = 60). Pain intensity, sleep quality, and quality of life were quantified using the visual analogue scale (VAS), the five-item questionnaire and scoring system, and the 36-item Short Form Health Survey (SF-36) questionnaire, respectively. Follow-up assessments were conducted at baseline, 1 day, 3 months, 6 months, and 12 months after the block therapy. Compared to the NS group, the TAP group showed significantly decreased pain scores 1 day, 3 months, 6 months, and 12 months after block therapy (P < .05). The sleep quality scores were lower in the TAP group than that in the NS group at 6 months (5.0 ± 2.4 vs 6.3 ± 3.7, p = .042), and 12 months after therapy (3.1 ± 1.8 vs 4.1 ± 2.4, p = .031). For quality of life, in comparison to NS group participants, those in the TAP group exhibited significantly higher scores (p < .05) for quality of life at 3 months, 6 months, and 12 months follow-up. There was a significant decrease in the proportion of pregabalin and analgesic medications in the TAP group and NS group at 6 and 12 months after treatment compared to Baseline (p < .001). Furthermore, the results showed that there was a significant difference in VAS, sleep quality scores (SQS), and quality of life between the PRF + TAP group and pharmacological therapies group before and 12 months after treatment (p < .05). The TAP block is a promising complementary treatment for acute/subacute HZ patients who have undergone PRF treatment. Combining PRF with the TAP block has the potential to alleviate HZ-related pain, enhance the patients' quality of life, and improve their sleep quality.

A Pharmacoeconomic Study of Post-Exposure Prophylaxis Strategies for Influenza Virus Infections in Japan.

Vaccines can prevent influenza (flu) infections and are cost-effective for society and healthcare. However, the cost-effectiveness of post-exposure prophylaxis as a follow-up strategy is unclear. This study aims to evaluate the cost utility of post-exposure prophylaxis and treatment strategies with neuraminidase inhibitors and a cap-dependent endonuclease inhibitor for flu infections from the perspective of healthcare costs in Japan. A base-case analysis was used to compare oseltamivir, zanamivir, and laninamivir for neuraminidase inhibitors and baloxavir marboxil for the endonuclease inhibitor. The costs of the first visit to a physician and pharmacy were excluded because of the policy on out-of-pocket expenses for post-exposure prophylaxis in Japan. Direct medical costs include the second physician visit, pharmacy and hospital admission expenses, and drug prices, based on the 2020 Japanese Medical Fee Index. The EuroQol-5Dimention-5Level was utilized to measure healthy participants' quality of life scores, with a time horizon of 14days. Deterministic and probabilistic sensitivity analyses were conducted. We have found baloxavir marboxil as the post-exposure prophylaxis agent and laninamivir as the treatment agent to be the most cost-effective strategy in Japan, followed by oseltamivir as the post-exposure prophylaxis agent and zanamivir as the treatment agent. Baloxavir marboxil and oseltamivir are cost-effective prophylactic agents for flu from the perspective of healthcare costs in Japan. This strategy to select baloxavir marboxil or oseltamivir would be helpful to manage a formulary for post-exposure prophylaxis in Japan.

Sustained Clinical Benefit of Adaptive Deep Brain Stimulation in Parkinson's Disease Using Gamma Oscillations: A Case Report.

Adaptive deep brain stimulation (aDBS) dynamically adjusts stimulation parameters according to patient needs. We recently showed that chronic aDBS utilizing invasive neural signals for feedback control is superior to conventional DBS (cDBS) during normal daily life in a 2-month trial. The stability of aDBS over longer periods remains unclear. To assess the effects of aDBS on motor symptoms and quality of life (QoL) in one individual with Parkinson's disease over 8 months. We used stimulation-entrained cortical gamma oscillations as a control signal for aDBS in the subthalamic nucleus and quantified benefits using motor diary ratings, QoL scales, and wearable metrics. We found that aDBS delivered superior and consistent benefits compared with baseline cDBS in measures of bradykinesia and QoL. aDBS can achieve prolonged, stable improvement over clinically optimized cDBS. The neural signal remains stable, and aDBS parameters remain appropriate over extended periods. © 2024 International Parkinson and Movement Disorder Society.

Effectiveness of Self-care Support Program on the Quality of Life and Resilience of Family Caregivers of Stroke Patient; A Randomized Controlled Trial

Background: Family caregivers of stroke patients often experience a decline in quality of life (QOL) and resilience due to the challenges posed by the patient's disability, inadequate support systems, and difficulty adapting to the new circumstances. Objectives: This study investigated the impact of a self-care support program (SSP) for stroke patients and their family caregivers on improving their QOL and resilience. Methods: This randomized controlled trial was conducted in Beesat Hospital, Hamadan, Iran, in 2022, involving stroke patients and their family caregivers. A total of 80 patients and 80 family caregivers were randomly assigned to either the intervention group or the control group. The intervention group received the SSP, which included four weeks of continuous face-to-face and telephone follow-up. The control group followed the routine care program provided by the neurology ward. The patients' quality of life was assessed using the stroke specific quality of life (SS-QOL) tool, while family caregivers' QOL and resilience were evaluated using the Short Form-12 and Sixbey 2005 tools, respectively, both before and after the intervention. Data were analyzed using descriptive and inferential statistics, including chi-square, paired t-tests, independent t-tests, and Fisher's exact test. The significance level was set at 0.05. Results: Among patients, the difference in the control group's total QOL score before and after the intervention was not statistically significant (P = 0.065), with scores of 83.77 ± 3.39 and 86.70 ± 8.25, respectively. Conversely, in the intervention group, the total QOL score significantly improved from 83.95 ± 1.43 to 119.72 ± 4.54 (P &lt; 0.0001). For family caregivers, the total QOL score in the control group showed no significant improvement, increasing from 17.30 ± 1.60 to 18.17 ± 2.45 (P = 0.096). However, the intervention group experienced a significant increase in QOL scores, from 17.70 ± 1.11 to 25.37 ± 2.31 (P &lt; 0.0001). Additionally, the resilience score in the control group slightly decreased from 129.15 ± 3.40 to 124.25 ± 5.31 (P = 0.12). In contrast, the resilience score in the intervention group increased significantly, from 130.25 ± 2.81 to 194.20 ± 2.15 (P &lt; 0.0001). Conclusions: The findings of this study demonstrate the effectiveness of the SSP in improving the QOL of stroke patients and their family caregivers while significantly enhancing the resilience of family caregivers. It is recommended that medical and treatment teams prioritize involving family caregivers in care plans for debilitating diseases such as stroke and consider integrating SSPs into standard care protocols.

Quality of life among physicians in Egypy and its influencing factors: a cross-sectional study

Doctors have an essential role in healthcare service, and their quality of life (QoL) is crucial for their professional satisfaction and overall well-being. This study assessed the QoL among physicians and explored the influencing factors that affect it. This cross-sectional study was carried out using a self-administered Internet survey. The survey was focused on physicians employed at various hospitals and clinics in Egypt. Data on participants' demographics, work-related factors, and QoL were collected using WHOQOL-BREF. WHOQOL-BREF questionnaire measures a participant's perception of their life quality across various domains, including general health, physical well-being, psychological health, social relationships, and the environment. The scores for each domain are calculated based on participants' responses to specific items, with higher scores indicating a better QoL. The QoL scores were 3.57±1.02 for the general health domain, 12.93±2.49 for physical domain, 12.29±2.67 for psychological domain, 12.87±3.20 for social domain, and 11.00±2.58 for environmental domain. The overall QoL score was 3.64±0.835. The findings indicate a moderate QoL among the participating physicians. The physicians' QoL domains were affected by age, sex, education level, marital status, chronic disease, smoking, speciality, working hours per week, extra working hours, and work experience.

The Burden of Metastatic Breast Cancer on Caregiver Productivity and Quality of Life: A Survey Study in the United States, United Kingdom, and Germany

BackgroundCaring for a patient with metastatic breast cancer (mBC) can impose a substantial burden and can lead to significant productivity losses. However, the extent to which productivity loss impacts caregiver well-being has not been well-elucidated. This study examined the relationship between productivity and other characteristics with quality of life (QoL) to illuminate the multifaceted challenges faced by caregivers in the context of mBC. MethodsWe conducted a one-time, cross-sectional survey of 345 informal caregivers of people living with mBC in the United States, United Kingdom, and Germany in December 2021. Caregivers were asked about their QoL using the Caregiver Quality of Life Index-Cancer (CQOLC) and pre-/post-caregiving productivity impacts. Heterogeneity in reported burden was assessed across a variety of caregiver characteristics. ResultsOne in three caregivers changed work status after onset of caregiving, either reducing working hours (12%), stopping work altogether (13%), or increasing working hours (8%). Caregivers who reduced hours or stopped working reported better QoL overall with total CQOLC scores of 71.8 and 65.3, compared to those who maintained or increased work hours (CQOLC scores of 61.3 and 54.4, respectively, [p<0.001]). While there were no differences in caregiver QoL by patients’ disease status (p=0.48), longer time spent caregiving was associated with lower burden (p=0.002). ConclusionsCaregiver productivity and QoL scores indicate leaving the workforce may ease the challenges associated with caregiving, suggesting a need for workplace flexibility to better support caregivers. Our study emphasizes the importance of supporting caregivers alongside patients, acknowledging caregiver well-being can significantly influence patient outcomes. Policy SummaryAlthough the burden associated with cancer caregiving has been well documented, policies supporting caregivers, such as flexible employment leave and mental health support resources, are urgently needed to improve QoL and health outcomes for both patients and their informal caregivers.

An Indian multicentre real-world study on long-term quality of life outcomes following bariatric surgery.

The purpose of this study was to assess the impact of metabolic and bariatric surgery (MBS) on Quality of Life (QoL) in Indian patients with obesity over 10 years. A retrospective chart review was conducted at 11 centres for individuals with MBS between February 2013 and May 2022. Patient medical records provided the source of de-identified data. Data from 2132 individuals with a mean age of 43.28 ± 11.96 years was analysed. There were 37.43% men and 62.57% females in the study population. The study population had a mean preoperative body mass index (BMI) of 45.71 ± 10.38 kg/m2. The Bariatric Analysis and Reporting Outcome System (BAROS) scoring method showed a higher overall QoL score throughout all follow-up periods, with 'very good' outcomes at one, three and 7 years and 'good' outcomes at 5 and 10 years. Improvements in QoL were associated with a substantial improvement (p < .01) in BMI at every follow-up time point. Following MBS, individuals with obesity exhibited a substantial and long-term improvement in their overall QoL for up to 10 years. This study presents Indian data on QoL, which is considered one of the most important decision-making factors for or against an intervention.

Effect of Narrative Nursing Intervention on Patients with Specific Digestive Tract Malignancies (Esophageal, Gastric, and Intestinal Cancers): A Retrospective Study.

To explore the effect of narrative nursing intervention on patients with esophageal, gastric, and intestinal cancers. A retrospective analysis was conducted on the clinical data of 103 patients with digestive tract malignant tumors admitted to our hospital from January 2022 to January 2024. According to the nursing intervention received by the patients, they were divided into a control group (n=51) and an observation group (n=52). The control group received routine nursing intervention, while the observation group received narrative nursing intervention in addition to the routine nursing intervention. The compliance behavior, negative emotional status, self-perceived burden, quality of life, and adverse reactions of the two groups were compared. After intervention, the observation group showed higher scores in medication, exercise, dietary, and emotional regulation adherence than the control group (P<0.05). Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) for negative emotions decreased in both groups, with a greater reduction in the observation group (P<0.05). Economic, physical, and emotional burden levels also decreased more in the observation group (P<0.05). Quality of life scores in physiological, social/family, emotional, and functional conditions improved more in the observation group (P<0.05). Adverse reactions, including nausea, vomiting, fatigue, pain, gastrointestinal reactions, and insomnia, were less frequent in the observation group than in the control group (P<0.05). Narrative nursing intervention for patients with digestive tract malignant tumors can effectively improve patient compliance behavior, alleviate negative emotions, reduce self-perceived burden, promote the improvement of patient quality of life, and reduce the occurrence of related adverse reactions. However, the study is limited by its small sample size and single-center design, which may affect the generalizability of the findings. Further research with larger and more diverse populations is recommended.

Evaluating the Efficacy of the SENO Decision Framework in Managing Metastatic Spinal Disease: A Comparative Study

BACKGROUND CONTEXTThe management of metastatic spinal disease presents a complex challenge, with no universally accepted guidelines currently available. A new treatment approach, termed the “SENO” (Systemic Conditions, Effectiveness of Systemic Treatment, Neurology, and Oncology) decision framework, was developed, incorporating a 12-point grading system for epidural spinal cord compression. PURPOSEThis study aims to assess the clinical efficacy of the SENO decision framework and compare its outcomes with those from traditional treatment frameworks. STUDY DESIGN/SETTINGThis is an observational cohort study that includes the propensity score matching analysis. PATIENT SAMPLEThis multicenter study included 840 patients with metastatic spinal disease, treated across two tertiary hospitals. OUTCOME MEASURESThe study evaluated therapeutic strategies, ambulatory status at hospital discharge, time to initiation of systemic cancer treatments, quality of life at three-, six-, and twelve-month post-discharge, and overall survival. METHODSOf all patients, 523 patients received treatment based on the SENO decision framework (the SENO group), while 307 patients were managed using conventional decision frameworks (the traditional group). Baseline characteristics of patients in both groups were collected and analyzed to ensure comparability. Quality of life was assessed using the Functional Assessment of Cancer Therapy-General Scale questionnaire. RESULTSPatients in the SENO group were less likely to undergo open decompression surgery (16.3% vs. 25.1%) and more likely to receive minimally invasive surgery (64.8% vs. 54.7%) compared to those in the traditional group (P=0.004). Furthermore, the SENO group demonstrated a higher rate of ambulation post-discharge (91.2% vs. 86.0%, P=0.026), a shorter interval before initiating systemic treatments for tumors (6.89 days vs. 10.14 days, P<0.001), and longer survival times (323 days vs. 298 days, P=0.008). Quality of life metrics, including physical, social, emotional, and functional well-being, were significantly better in the SENO group compared to the traditional group (All P<0.015). After the propensity score matching analysis, the baseline characteristics between the SENO and traditional treatment groups were perfectly matched. The SENO group still showed a lower percentage of patients undergoing open decompression surgery (P=0.038), a shorter time to receive systemic treatments (P<0.001), longer median survival times (P=0.016), and markedly better quality of life scores at three, six, and twelve months across various domains, with total scores reaching 92.08 compared to 85.51 in the traditional group at the final follow-up (P<0.001). CONCLUSIONSThe SENO decision framework has the potential to serve as an effective treatment strategy for patients with metastatic spinal disease. By facilitating the use of minimally invasive surgery, this framework leads to better overall functional outcomes, prolonged survival, and an improved quality of life. However, before widespread promotion of the SENO decision framework, it is essential to conduct randomized controlled trials to thoroughly validate its effectiveness.

Association between age or duration of diagnosis in obstructive hypertrophic cardiomyopathy and response to mavacamten treatment: Exploratory analysis of the EXPLORER-HCM trial.

In patients with symptomatic, obstructive hypertrophic cardiomyopathy (HCM), it is unclear if response to cardiac myosin inhibition varies with older age or a longer duration of diagnosis. This study evaluated the response of these subgroups to mavacamten therapy for all primary, secondary, and exploratory endpoints in the EXPLORER-HCM trial (ClinicalTrials.gov: NCT03470545). Patients were stratified by age (≤60 vs. >60 years) and duration of HCM diagnosis (≤5 vs. >5 years). To estimate treatment differences and evaluate age and diagnosis duration by treatment interaction, analysis of covariance was used to model changes in continuous endpoints and a generalized linear model was used for binary endpoints. Older patients were more frequently female (53% vs. 29%), with a lower prevalence of pathogenic/likely pathogenic HCM gene variants (17% vs. 36%), lower mean peak oxygen consumption (pVO2) (17.6 vs. 21.1 ml/kg/min), and a higher mean NT-proBNP level (817 vs. 592 ng/L) but similar NYHA classes and quality of life scores. Patients with a longer vs. shorter diagnosis duration had similar mean ages (59.0±11.6 vs. 57.9±12.3 years) but more family history of HCM (38% vs. 16%) and a higher mean NT-pro BNP level (938±118 vs. 494±145 ng/ml). No differences were observed in improvement in peak oxygen consumption, NYHA class, or patient-reported outcomes among older patients and those with a longer duration of diagnosis. In EXPLORER-HCM, mavacamten treatment had a similar benefit for all primary, secondary, and exploratory endpoints in patients with symptomatic, obstructive HCM regardless of age or duration of diagnosis.

A Study of The Quality of Life in Patients with Schizophrenia: A Cross-Sectional Study in A Tertiary Care Hospital, Mumbai, India

Background: There are limited recent Indian studies assessing the quality of life in patients with schizophrenia. This study evaluated the socio-demographic data, psychopathology, quality of life, and their associations in patients with schizophrenia. Methodology: Fifty outpatients with schizophrenia, meeting ICD-10 DCR criteria, were assessed using Kuppuswamy’s socioeconomic status scale, the Positive and Negative Syndrome Scale (PANSS), and the Quality-of-Life Scale (QLS). Results: The mean patient age was 36.3 years, with a male-to-female ratio of 1.6:1. Most patients were married, unemployed, educated up to middle school, and belonged to the upper-lower socioeconomic class. Clinically, they had mild psychopathology with a mean PANSS total score of 62.36. Quality of life assessment revealed that 12% had severe impairment, 64% had mild to moderate impairment, and 24% had no impairment. Occupational status was significantly associated with QLS scores. PANSS scores negatively correlated with QLS scores, with stronger correlations in the general psychopathology and negative symptom domains. Conclusion: The findings emphasize the need for personalized and holistic approaches to managing schizophrenia, addressing both clinical symptoms and socio-demographic challenges.

Comparison of the effect of dexamethasone, ketoprofen and cold compress on postoperative quality of life following impacted lower third molar surgery: a randomized clinical trial.

To evaluate and compare the effect of dexamethasone, ketoprofen and cold compress on the quality of life (QoL) following surgical removal of impacted lower third molars (ILTMs). Eligible patients requiring ILTM extraction with a modified Pederson difficulty index score of 5-6 were recruited. The patients were randomly allocated into Groups A, B and C. Groups A and C received 100mg of ketoprofen and 8mg of dexamethasone per-oral respectively, preoperatively. Subjects in group B applied a pre-standardized ice pack over the angle of the mandible for 6h postoperatively. The QoL questionnaire was administered on postoperative days 1, 2 and 7. In total, seventy-eight subjects completed the study: 46 (59%) were male and had a mean age of 27.8 ± 4.9 years. The groups were similar sociodemographically. The overall QoL and appearance domain score were significantly better in patients on oral dexamethasone on postoperative day 1 than in the other groups. Oral dexamethasone demonstrates better improvement in postoperative QoL and appearance on day 1 following ILTM surgery compared to ice packs and ketoprofen. Although ice packs are readily available, can be used repeatedly and are a low-cost option, more research is necessary to determine their optimum therapeutic use in outpatient settings. Oral dexamethasone is superior to ice pack compress and ketoprofen in improving the postoperative QoL in ILTM surgery. PACTR202005593102009 at Pan African Clinical Trial Registry.

Analysis of the Efficacy and Safety of Benzbromarone Combined with Sodium Bicarbonate Tablets in the Treatment of Hyperuricemia

Aims/Background Hyperuricemia is a metabolic disorder characterized by elevated levels of uric acid in the blood. If left untreated, hyperuricemia can progress to gout, which manifests as acute arthritic attacks, and may also lead to uric acid nephrolithiasis and other renal conditions. This widespread condition poses significant risks to human health and quality of life. This study retrospectively evaluated the effectiveness and safety of using benzbromarone in combination with sodium bicarbonate tablets for the treatment of gout associated with hyperuricemia. Methods The study reviewed the electronic medical records (EMR) of 150 patients with gout and hyperuricemia who were admitted to our hospital between May 2018 and December 2023. These patients were divided into two groups: a control group and a research group. The control group received oral sodium bicarbonate tablets, while the research group was treated with oral benzbromarone tablets in addition to sodium bicarbonate tablets. The study compared the treatment outcomes and adverse reactions between the two groups, as well as assessed changes in blood-related indicators, the number of tophi, pain levels, and quality of life before and after treatment. Results The research group demonstrated a higher total effective rate compared to the control group (p &lt; 0.05). Post-treatment, the research group exhibited significantly lower levels of serum uric acid (UA), serum creatinine (Scr), and urea (p &lt; 0.05). Additionally, this group had fewer tophi and lower visual analog scale (VAS) scores compared to the control group (p &lt; 0.05). Quality of life scores were also significantly higher in the research group (p &lt; 0.05). No statistically significant difference was found in the incidence of adverse drug reactions between the two groups (p &gt; 0.05). Conclusion The combination of benzbromarone and sodium bicarbonate tablets is highly effective in treating gout associated with hyperuricemia. This treatment not only reduces uric acid levels and the number of tophi but also enhances renal function, alleviates pain, and improves the overall quality of life for patients.

Recurrent oropharyngeal cancer: Analysis of surgical treatment outcomes

BACKGROUND The main goal of our research is to introduce transoral robotic surgery and laser resection (TLR) as a considerable way of treating patients with recurrent oropharyngeal malignancies. AIM To develop a foundation of minimally invasive transoral surgical technique for patients with oropharyngeal recurrence. METHODS This study prospectively and retrospectively included patients with recurrent tumors from 2003 to 2018. Subjects were allocated into two groups: (1) Group I; underwent TLR; and (2) Group II (control); underwent open surgeries of varying volume. Evaluation was done with intraoperative blood loss, postoperative infection incidence, and quality of life using the scale for patients with head and neck tumors known as the Functional Assessment of Cancer Therapy-Head &amp; Neck Scale. RESULTS One-hundred and forty one patients were included (103 males and 38 females), in 82 cases (85.4%), a recurrent tumor developed earlier than a year after primary tumor therapy; forty-six were in group I and 69 in group II, age ranging from 18 years to 86 years (average: 57.6 years). The first group showed a statistically significant less amount of blood loss and a decreased incidence of infectious complications (P &lt; 0.05). Additionally, there was a significant difference in functional outcomes (quality of life scores) but no significant difference in survival curves. CONCLUSION In properly elected patients, TLR is not just reasonable but tends to be a favorable alternative for recurrent oropharyngeal cancers compared to the outcomes of the open surgery group.

Relationships between emotional state, sleep disturbance and health-related quality of life in patients with axial spondyloarthritis.

Axial spondyloarthritis (ax-SpA) is an autoinflammatory disease affecting multiple organs. While emphasizing the treatment of chronic diseases, it has been found that the prevalence of mental disorders and insomnia in patients is also increasing. We investigated mood status, sleep quality and the health-related quality of life (HRQoL) in these patients. A total of 94 pairs ax-SpA patients and age- and sex-matched healthy controls were included in this cross-sectional study. Demographic and clinical data were collected. We assessed the disease activity by the Ankylosing Spondylitis Disease Activity Score, including C-reactive protein (ASDAS-CRP), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI). The Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI) and the Medical Outcomes Survey Sheet Form-36 (SF-36) were used to evaluate mood status and quality of sleep and life, respectively. We evaluated the factors related to anxiety and depression scores, sleep disturbance scores and quality of life scores, and the predictors of anxiety, depression and sleep disturbance were analyzed. Forty-five active patients and forty-nine relieved patients were enrolled. We found that the median HADS anxiety (HADS-A), depression (HADS-D) subscale scores and PSQI score were significantly higher in active ax-SpA than in inactive patients, and were significantly higher than those in controls (HADS-A 9 vs. 5 vs. 3, p < 0.001; HADS-D 8 vs. 5 vs. 3, p < 0.001; PSQI 10 vs. 6 vs. 3, p < 0.001). Moreover, the HADS-A scores were positively correlated to positive HLA-B27 (p = 0.042), pain (p = 0.002) and the BASFI score (p = 0.012), HADS-D scores were positively correlate to disease course (p < 0.001) and PSQI scores were significantly positively correlated to the BASFI score (p = 0.009). Logistic regression analysis showed that BASFI was a risk factor for anxiety, age was a protective factor for depression and disease course was a risk factor for depression. The optimal cut-off value of BASFI in predicting anxiety was 1.55 with an area under the curve value of 0.8488 (p < 0.001), and the optimal cut-off value of age and the course of the disease in predicting depression was 50.5years old with an area under the curve value of 0.62 (p = 0.0482) and 54months with an area under the curve value of 0.7988 (p < 0.001). In addition, disease activity was negatively correlated with SF-36 dimensions, and anxiety, depression and sleep disturbance in ax-SpA patients also had significant negative effects on HRQoL (p < 0.05). Patients with active ax-SpA tend to be more anxious, depressed and sleep disturbed, and have worse HRQoL than patients in remission. Patients with ax-SpA are more likely to be anxious with worse spinal function, more likely to be depressed with younger age and longer course of disease. Therefore, the assessment of mental health, sleep and HRQoL should also be included in the long-term management of patients with ax-SpA. Key Points • Active ax-SpA patients tend to have more anxiety, depression, sleep disturbances and worse HRQoL compared with patients in remission • The optimal cut-off value of BASFI in predicting anxiety was 1.55, the age and the course of the disease in predicting depression was 50.5years old and 54months.

Caregiver and self perception of quality of life in children with autism spectrum disorder and co-occurring attention-deficit/hyperactivity disorder

Objectives Emotional and social impairments associated with autism spectrum disorder (ASD) negatively impact children’s quality of life (QoL). A co-occurring diagnosis of attention deficit/hyperactivity disorder (ADHD) may worsen perceptions of QoL. This study assessed QoL in children with ASD and ASD/ADHD using self-reports and caregiver proxy-reports. Methods Children and caregivers were invited to complete the Pediatric Quality of Life Inventory (PedsQL) survey during outpatient therapy between 1/1/2015 and 12/31/2016. Results 1094 surveys were included in the analysis. Self-reports represented 18.2% of sample (n = 92 ASD, n = 107 ASD/ADHD) while proxy-reports made up the majority (81.8%) (n = 687 ASD, n = 208 ASD/ADHD). Children with ASD and combined ASD/ADHD reported similar QoL scores, 64.4 vs. 62.8. Caregiver proxy-reported scores were significantly lower by diagnosis, 60.3 in ASD vs. 55.3 in ASD/ADHD. Conclusions This study highlights the influence of combined ASD and ADHD on child and caregiver perceived QoL, emphasizing the importance of considering both perspectives.

Application of Healthcare Failure Mode and Effect Analysis in the Management of Patients With Intrathecal Morphine Pump Implantation

BackgroundIntrathecal morphine pump helps alleviate pain in the advanced stages of cancer, and thus, ensuring safe intrathecal morphine pump infusion is important. In this study, we investigated the effect of healthcare failure mode and effects analysis (HFMEA) in the management of patients with intrathecal morphine pump implantation. MethodsWe included 112 cancer patients with severe pain who met the inclusion criteria for intrathecal morphine pump implantation treatment in the pain department of our hospital from November 2021 to October 2022. We analyzed the severity, likelihood, and crisis of potential failure modes, causes, and results of intrathecal morphine pumps during this period, compiled the records, and formulated the appropriate improvement measures based on the results of the analysis. From November 2022 to October 2023, the HFMEA model was applied to 125 patients in the department, and the effectiveness of the model was evaluated by assessing the patients’ VAS (visual analog scale) score, SAS (self-rating anxiety scale) score, SDS score, PSQI (Pittsburgh Sleep Quality Index) score and quality of life (QOL) (self-rating depression scale) score. ResultsThe occurrence of adverse events (6 cases vs. 2 cases, p < .05), and the total incidence of adverse events (8.9% vs. 1.6%, X2= 6.600, p = .010) was significantly different before and after HFMEA was applied. For patients who received intrathecal morphine pump implantation, the VAS scores and the related pain indices were significantly lower after HFMEA than before. Additionally, the score of SAS (48.91 ± 6.03 vs. 47.02 ± 6.77), PSQI (37.30 ± 5.78 vs. 39.63 ± 5.64), and QOL (9.93 ± 3.04 vs. 8.98 ± 2.31) of patients improved significantly. ConclusionsWith the application of the HFMEA model, a multidisciplinary team assessed the risks associated with the use of intrathecal morphine pumps and prioritized measures to reduce them. By implementing the improvement measures, potential errors decreased significantly during the intrathecal morphine pump process. It allowed nursing managers to change the safety incidents related to drug administration using an intrathecal morphine pump from negative treatment after the event to active prevention before the event, greatly improved the level of drug use safety management, reflected the continuous improvement of nursing quality, and ensured nursing safety.

A comparative study between early and conventional intestinal stoma closure in a tertiary care institute

Background: Little is known about ideal time for stoma closure. Therefore, the aim of this study is to compare early versus conventional stoma closure following bowel surgery in terms of quality of life (QoL), length of hospital stay (LoH), and postoperative complications. Methods: This randomized controlled trial was conducted at a medical college affiliated teaching hospital from May 2023 to June 2024. The 116 patients undergoing bowel surgery with temporary stoma creation were randomized into early closure (3 weeks post-surgery) and conventional closure (8-12 weeks post-surgery) groups. Primary outcome was anastomotic leak rate. Secondary outcomes included other postoperative complications, LoH, and QoL assessed using the EORTC QLQ-C30 questionnaire. Results: There was no significant difference in anastomotic leak rates between early (6.9%) and conventional (12.1%) closure groups. Overall complication rates were similar (56.9% early vs 50% conventional). LoH did not differ significantly between groups. QoL scores were significantly higher in the early closure group, with 100% of patients achieving considerable improvement (EORTC score 26-36) compared to 79.3% in the conventional group (p&lt;0.05). Conclusions: Early stoma closure is safe and feasible in appropriately selected patients, with no increased risk of anastomotic leak or other complications. It significantly improves QoL compared to conventional closure timing, without prolonging hospital stay. These findings suggest that early stoma closure may be a beneficial option for suitable patients following bowel surgery.