Significant Decrease In Total Score Research Articles

Novel filagrinol-containing emollient

Background. In the last decade, there has been a significant increase in interest in the study of the role of epidermal barrier structural integrity in order to determine the prospects for its pathogenetic correction. It is now known that patients with filaggrin gene mutations have increased risk of developing atopic dermatitis, xerosis, ichthyosis, eczema. Filaggrin participates in the formation of a full-fledged stratum corneum, provides formation of a natural moisturizing factor, stabilizing the water balance of the stratum corneum. In Russia, the innovative filaggrin-containing Admera has been registered, which opens up prospects in the management impaired skin barrier function diseases.
 Aims. Efficacy and safety of "Admera" emollient in patients with primary and secondary xerosis.
 Materials and methods. A single-center prospective interventional study December 2021 March 2022 at the Department of Skin and Venereal Diseases of the Sechenov University. The study included 32 patients (22 main group, 10 control group) aged 18 to 60 years (29 9.78), 14 men and 18 women diagnosed with atopic dermatitis, skin xerosis. Patients applied moisturizers 3 times a day for 21 days. Performance was evaluated using vIGA-AD, POEM, EASI, 5D Elman scale, SKINDEX-29, HADS, on Capricorn AI, ANTERA 3D machines.
 Results. A steady regression of clinical symptoms of xerosis was noted during the study by the dynamics of the study scales. The mean EASI score decreased by 67% from 25.25 18.78 screening to 7.8 4.41 control visit (p 0.001). Assessment of POEM index dynamics showed a significant decrease in total score from 18.65 to 6.6 (p 0.001). There was good tolerability of the product and absence of adverse events.
 Conclusions. The filagrinol-containing emollient Admera (Dr. Reddy's Laboratories Ltd., India) demonstrated high efficacy and safety in all patients. This emollient can be recommended as a basic care product in the treatment schemes and prevention of primary, secondary xerosis, relapses of atopic dermatitis.

Use of the Functional Evaluation of Cardiac Health questionnaire to assess health-related quality of life before and after mitral valve repair in dogs with myxomatous mitral valve disease.

To determine changes in health-related quality of life up to 12 months after surgery in dogs with myxomatous mitral valve disease that undergo mitral valve repair. 54 dogs that underwent mitral valve repair at a United Kingdom referral hospital. Health-related quality of life was assessed with a previously validated, owner-completed questionnaire before and 1, 3, 6, and 12 months after surgery. There was a significant decrease in total score (corresponding to reduced negative impact of cardiac disease on quality of life) between the preoperative timepoint and all postoperative timepoints. A significant decrease in total score was also demonstrated between the 1- and 3-month timepoints, but no additional significant changes in total score between adjacent timepoints were identified beyond 3 months after surgery. Significant improvements in individual question scores were found up to 12 months after surgery. Health-related quality of life was significantly improved following mitral valve repair in dogs with myxomatous mitral valve disease and this improvement persisted for up to a year after surgery. These results may be useful when counseling owners of dogs considered candidates for this procedure.

Abstract No. 150 Development and validation of a health-related quality-of-life measure for vascular malformations: the PROVAM questionnaire

Quality-of-life and patient-reported outcome measures have become a major focus of clinical and outcomes assessments. The purpose of this study was to develop a valid Patient Reported Outcome Measure for Vascular Malformation (“PROVAM”) questionnaire to assess health-related quality of life in patients with vascular malformations (VAMs) before and after treatment. We developed and validated PROVAM using a mixed-methods design during an IRB-approved, prospective clinical trial at a VAM clinic. The pilot instrument consisted of 30 items (26 Likert-type response scale, 4 free-response) across domains including pain, social and emotional well-being, functional impact, and treatment. Functional impact items were specific to VAM anatomic location (head and neck or torso and extremities). Two items were included in the test battery to assess questionnaire relevance and ease of understanding. The questionnaire was implemented in the clinical setting from July 2019 to February 2020 to obtain evidence for reliability and construct validity of items and scales. To evaluate reliability, internal consistency was measured using Cronbach’s alpha. Factor analysis, and convergent and discriminant validity testing were used to assess construct validity. Responsiveness was evaluated using patients with both pre- and post-treatment questionnaires, with the hypothesis that total score would decrease post-treatment. 108 patients with VAM (median age 18 years; 58% female) completed a total of 130 questionnaires. All subscales including pain, emotional and social well-being, and functional impact, had Cronbach’s alpha coefficients > = 0.79. These dimensions were confirmed by factor analysis (P< 0.001). 25 of 26 Likert-type response questions were shown to be valid with good convergent and discriminant construct validity. In a subset of patients who completed PROVAM pre- and post-treatment (median follow up 10-weeks; n = 13), there was a significant decrease in total score (P = 0.036). Participants found survey questions easy to understand (median score 5 [IQR 4-5] on 5-point Likert-type scale) and relevant (median score 4 [IQR 3-5]). Preliminary data support the reliability, validity, and responsiveness of the 30-item PROVAM instrument to measure health-related quality of life in patients with VAMs.

Brief Cognitive Behavioral Therapy for Insomnia in Parkinson's Disease: A Case Series Study1

AbstractParkinson's disease (PD) patients frequently suffer from insomnia and insomnia can result in reduction of quality of life in PD. Although pharmacotherapy is most applicable for insomnia, it may cause side‐effects in PD. The purpose of the study was to investigate the efficacy of brief cognitive behavioral therapy for insomnia (CBTI) in PD. A total of 11 PD patients aged 43–84 years with chronic insomnia received two sessions of CBTI. Patients reported a significant decrease in total score for the Insomnia Severity Index (ISI). The total score for the Parkinson's Disease Sleep Scale (PDSS) improved. Although objective sleep measured by actigraph did not improve, subjective sleep measured by sleep diary improved. Functional impairment measured by the Sheehan Disability Scale (SDS) significantly decreased. These results revealed that brief CBTI was effective in improving insomnia in PD, with improvements extending to functional impairments that had been affected by insomnia. Additionally, this non‐pharmacotherapy treatment could be easily applied to PD patients who may have difficulty coming to the clinic frequently due to physical symptoms.

Responsiveness of the Lymphedema Functioning, Disability, and Health Questionnaire for Upper Limb Lymphedema in Patients with Breast Cancer-Related Lymphedema.

Background: The Lymphedema Functioning, Disability, and Health questionnaire for Upper Limb Lymphedema (Lymph-ICF-UL) is a health-related quality-of-life questionnaire for patients with breast cancer-related lymphedema. Previous testing of this questionnaire showed very good psychometric properties; however, responsiveness has not yet been established. The aim of this study was to determine its internal and external responsiveness. Methods and Results: Ninety-five patients treated with decongestive lymphatic therapy in a longitudinal trial were recruited. Patients completed the Lymph-ICF-UL twice within a time interval of 7 weeks ("intensive group" receiving intensive treatment; n = 73) or 3 months ("stable group" receiving maintenance treatment; n = 22), and once the Global Perceived Effect (GPE) questionnaire at the second time point. The significance of change in scores and standardized response mean (SRM) were determined for the total and domain scores. Correlations between Lymph-ICF-UL and GPE were ascertained. In addition, the minimal clinical important difference (MCID) was determined. The Lymph-ICF-UL total score changed significantly in the intensive group (p < 0.001) and nonsignificantly for those in the stable group (p = 0.25). The SRM represented moderate responsiveness (0.65). Patients who reported a clinical improvement ( = responders) after intensive treatment showed a significant decrease in total score (p < 0.001), this was also the case for nonresponders (p < 0.001). Lymph-ICF-UL total and domain scores showed nonsignificant weak correlations with the GPE (p > 0.05). There was a significant difference in mean total score changes between responders and nonresponders (p < 0.001). MCID for the total score was 9%. Conclusion: The Lymph-ICF-UL is responsive to change after decongestive lymphatic therapy. No correlations were found between Lymph-ICF-UL change scores and GPE. Future studies should be conducted in a clinical setting, with more variability between participants and their treatment responses.

Therapy of Schizoaffective Disorder and Paranoid Schizophrenia with Episodic Course

Background. The use of atypical antipsychotics in schizophrenia contributes to the reduction of psychotic, affective, negative and cognitive disorders.Aims. To evaluate the effectiveness of ziprasidone therapy in patients with schizoaffective disorder and paranoid schizophrenia with episodic course.Materials and methods. In accordance with ICD-10 there were 14 (63.6 %) people with schizoaffective disorder (F25), 8 (36.4 %) people with paranoid schizophrenia, episodic course (F20.x1). Treatment with ziprasidone lasted 42 days. The dose of ziprasidone in 6 patients (27.3 %) was 80 mg, in 10 patients (45.5 %) – 120 mg, in 6 patients (27.3 %) – 160 mg. Evaluation of the effectiveness of ziprasidone therapy was carried out using psychometric scales (PANSS, General clinical impression scale to assess the effectiveness of therapy – CGI-S, CGI-I), adverse events were registered with the UKU scale.Results. The number of respondents was 19 (86.3 %) (reduction of the total score on the PANSS scale &gt; 20 % of the pre-treatment level). Ziprasidone was effective in patients with schizoaffective disorder with a significant decrease in total score on PANSS subscales to the 14 th day of therapy (p &lt; 0.05), with paranoid schizophrenia with episodic course – by the 21st day (p &lt; 0.01). According to the CGI-S scale at the end of therapy, “borderline condition” was observed in 10 patients (52.6 %), mild severity – in 3 (15.8 %), normal condition – in 6 (31.6 %). CGI-I scale showed a significant improvement in 10 patients (52.6 %), marked improvement – in 9 patients (47.4 %). Among the mild adverse events that do not require discontinuation of the drug, we noted: weakness – in 3 patients (15.8 %), drowsiness – in 3 (15.8 %), impaired concentration – in 2 (10.5 %), orthostatic dizziness – in 2 (10.5 %), galactorrhea – in 1 (5.3 %).Conclusions. Ziprasidone is an effective antipsychotic drug that has a safe tolerability profile. It can be used in patients with schizoaffective disorders and paranoid schizophrenia with episodic course.

The Impact of a Physical Activity Intervention Can be Accurately Assessed By Smart Watches in Patients Completing Autologous Stem Cell Transplantation for Lymphoma or Multiple Myeloma: Results of a Feasibility Study

The Impact of a Physical Activity Intervention Can be Accurately Assessed By Smart Watches in Patients Completing Autologous Stem Cell Transplantation for Lymphoma or Multiple Myeloma: Results of a Feasibility Study

Changes in antiepileptic drug regimen and behaviour in children with epilepsy

Two groups of children with epilepsy, undergoing an increase and decrease in their antiepileptic drug regimens, respectively, were assessed on the Conners Parent Symptom Questionnaire (CPSQ). This was administered prior to and at 6 months following the change in drug regimen. These subjects were further compared with a group of children who experienced no change in their antiepileptic medication over the course of the study, and a normal control group. Intragroup comparisons showed that both the increase and decrease groups demonstrated a significant decrease in Total Score on the CPSQ. The increase group improved on the Psychomatic Factor, whereas the decrease group improved on the Conduct Problem, Anxiety, Impulsive—Hyperactive, and Learning Problem factors. Intergroup comparisons of change scores showed that there were significantly greater improvements over time for the experimental groups than the normal control group. For the increase group, these were seen for the Psychosomatic and Muscular Tension factors and for the decrease group for the Conduct Problem factor. A decrease in drug dose is likely to be beneficial with respect to antisocial and inappropriate behaviours, whereas an increase in dose improves physical wellbeing. The results of this study highlight the multifactorial nature of behaviour.

Two studies of the occurrence of psychophysiological symptoms in chronic headache patients

Two separate, but related, studies are described in which psychophysiological symptoms associated with chronic headache were examined. In the first study, the Psychosomatic Symptom Checklist (PSC) was administered to evaluate the presence of 15 different psychophysiological symptoms in 3 types of chronic headache patients (migraine, tension, and combined migraine and tension). Over 97% of these 438 patients reported at least one other symptom occurring at least monthly and 75% reported another intense symptom occurring at least once a week. The tension and combined headache groups reported significantly higher overall symptomatic distress than the migraine headache patients. The tension patients reported significantly higher scores on the backache and weakness items, while the migraine and combined headache patients reported significantly more nausea. The differences between the diagnostic groups is more a function of the intensity of the symptoms than the presence of the symptoms, since, for many individual symptoms, the percentage of patients reporting is nearly equal. In the second study, 150 patients from the original sample (50 from each diagnostic group) were reassesssed using the PSC after psychological treatment of headache. There were significant decreases in total scores for all 3 groups with no significant differences between groups seen at post treatment. Different treatment effects were seen on the individual symptoms with 7 of the 15 showing significant reduction. Chronic headache does not occur in isolation and headache diagnostic groups do not differentiate well on other individual psychophysiological symptoms.