Study 36-Item Short-Form Health Survey Research Articles

Comparative Study to Assess the Effectiveness and Safety of Etoricoxib & Aceclofenac in Osteoarthritis Patients

Osteoarthritis (OA) is defined as a disorder that involves the movement of limbs characterized by cellular stress and a deterioration of the outer matrix that trigger malignant remodelling responses that include inflammatory mechanisms of natural immunity. Non-steroidal anti-inflammatory (NSAID) drugs are the first choice of treatment, since they reduce pain, improve functional ability. So, by comparing the effectiveness and safety of NSAID used in the treatment of OA can enhance the quality of life of patients. The goal of the study was to compare the effectiveness and safety of Aceclofenac and Etoricoxib in OA patients as well as to assess the quality of life (QOL) and medication adherence among subjects. It is an observational study conducted in the selected Orthopaedics clinics in T. Dasarahalli, Bengaluru District for a period of 6 months, based on various inclusion and exclusion criteria. Standardized questionnaire used in the study were Western Ontario and McMaster Universities Arthritis Index, Medical Outcomes Study 36-Item Short-Form Health Survey and Morisky Medication-Taking Adherence Scale. The collected data were entered in Microsoft Excel and appropriate descriptive and inferential statistical analysis was performed. On comparing Aceclofenac and Etoricoxib in terms of WOMAC score Etoricoxib (28.42) was found to be more effective than Aceclofenac (31.61) while comparing Etoricoxib 60 mg and 90mg, 90 mg (26.22) was found to be more effective. Regarding the safety of these drugs, Etoricoxib was found to be safer than Aceclofenac in terms of side effects. On associating the QOL scores in both the groups, it was found that the subjects belonging to the Aceclofenac group had the highest overall mean score 57.68. Investigation of medication adherence in the study population revealed that out of 68 subject’s majority of them had shown low adherence (n=38). Because of its enhanced safety profile, Etoricoxib is a better option than Aceclofenac for treating .....

Baduanjin exercise intervention trial: research protocol of a randomised controlled trial for frail kidney transplant recipients

IntroductionFrailty is one of the most common comorbidities in kidney transplant recipients (KTRs). Physical, psychological and social frailty could be improved by exercise intervention. Baduanjin, also known as Eight-section Brocades,...

Evaluation of ALBA device for upper extremity motor function in adults with subacute and chronic acquired brain injury: a randomised controlled trial protocol in a tertiary clinic of the metropolitan region of Chile

IntroductionStroke is a significant worldwide cause of death and a prevalent contributor to long-term disability among adults. Survivors commonly encounter a wide array of motor, sensory and cognitive impairments. Rehabilitation...

A Prospective Observational Study of Factors Affecting the Change in Quality of Life in Patients With Primary Aldosteronism After Treatment

ObjectiveTo explore the changes in the health-related quality of life (HRQoL) in patients with primary aldosteronism (PA) after standardized treatment and determine the effects of different variables on the change in the HRQoL of patients. MethodsA total of 116 patients with PA were prospectively included from November 2020 to March 2022. Data were collected at their initial diagnosis and the follow-up after 12 months of treatment, including demographic and clinical data and the scores of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The scores of each dimension of SF-36 of patients before and after treatment were compared, and the factors affecting their change in the quality of life were analyzed using multiple linear regression. ResultsAfter standardized treatment, the aldosterone-to-renin ratio (Z = −4.967, P < .001), systolic blood pressure (t = 8.985, P < .001), and diastolic blood pressure (t = 7.233, P < .001) of patients with PA decreased compared with baseline, and hypokalemia was effectively corrected (χ2 = 69.014, P < .001). In terms of quality of life, 6 of 8 dimensions of SF-36 and the total score of SF-36 significantly improved at 1-year follow-up compared with baseline (all P < .05). The results of multiple linear regression showed that the improvement in the HRQoL in patients with PA after standardized treatment was correlated with the change in the blood potassium level (P = .007) and systolic blood pressure (P = .003). ConclusionCorrection of hypokalemia and control of diastolic blood pressure are essential factors contributing to the improvement in the HRQoL in patients with PA regardless of the standardized treatment received.

Classification of health needs: a cluster analysis of older adults in urban areas

BackgroundIn this study, a cross-sectional survey was used to understand and analyze the health status and health needs of the elderly in the community. The cluster analysis method was used to explore the relationship between health needs items and investigate the commonness among health demand items, to provide a reference for the development of health management of the elderly with chronic diseases.MethodsWe used convenience sampling to recruit the participants (aged 60 and above) from four urban community centers in Jinzhou City, Liaoning Province, China, in this study. This study uses the Medical Outcomes Study(MOS)36-Item Short-Form Health Survey. The self-designed questionnaire includes sociodemographic characteristics, chronic diseases, physical examination conditions, illness in the past two weeks, and a health needs questionnaire. SPSS 18.0 was used for data entry and analysis. Data analysis methods included descriptive statistical analysis, t-test, one-way analysis, cluster analysis, and linear multiple regression analysis.ResultsThe rate of health needs among the elderly in the community for various health services is 1.3–69.7%, of which the top three are: regular physical examination (69.7%), day Care Center (67.7%), the establishment of a Medical Alert Systems (66.1%). The health needs of the elderly in the community are divided into three categories: basic needs (24 items), health education (13 items), and first aid (2 items). The regression analysis found that the influencing factors of health status were age, revenue and expenditure, medical expenses, health education, basic needs, and first aid.ConclusionsThe community should strengthen the management of chronic diseases of the elderly and the publicity and education of related knowledge, and provide complementary health care services according to the health needs of the elderly, improve the health of the elderly, and improve the quality of life of the elderly.

Quality of life in patients with atrial fibrillation taking into account the phenotype of heart failure

Atrial fibrillation (AF) is a medical problem often associated with several comorbidities and adverse outcomes. In developed countries, chronic heart failure (CHF), which affects 2% to 3% of the population, is also a major cause of morbidity and mortality. The prevalence of both of these diseases is steadily increasing worldwide. CHF with AF is gaining more and more medical and social significance, as it can worsen the prognosis and quality of life (QoL) of a person. The purpose. Assess the quality of life of patients with atrial fibrillation, taking into account the phenotype of heart failure.Material and methods. 300 patients aged 45-65 were examined. Among the examined were 180 (60.0%) women and 120 (40.0%) men. All patients were divided into groups: group I – control, 36 practically healthy persons; group II - patients with CHF with AF and preserved left ventricular ejection fraction (LVHF, n=190); group III - patients with HF with AF and reduced left ventricular ejection fraction (LVHF, n=110). Diagnoses of AF and HF were carried out according to the clinical protocol for providing medical care to patients with atrial fibrillation and heart failure, confirmed by the order of the Ministry of Health of Ukraine №436 of 07.03.2006. The quality of life (QoL) of the patients was assessed using a non-specific questionnaire Medical Outcomes Study 36-Item Short-Form Health Survey (MOS SF-36) and Minnesota living with heart failure questionnaire (MHFLQ).Research results. According to the results of the Minnesota Questionnaire (MLHFQ), patients with HF and AF had higher scores, indicating a worse quality of life (p&lt;0.05). The highest indicators of the quality of life according to the scale of physical and mental health (p&lt;0.05) were established in the control group. In patients with chronic heart failure with atrial fibrillation, significant differences were found, compared to the control group, on the scales of physical (p&lt;0.05), physical-role functioning (p&lt;0.05), pain intensity (p&lt;0.05) and emotional role functioning (p&lt;0.05). It was found that in patients with a reduced left ventricular ejection fraction, compared to patients with a preserved left ventricular ejection fraction, a significant decrease in quality of life indicators on almost all SF-36 scales was set: physical functioning (p&lt;0.05), role functioning (p&lt; 0.05), body pain (p&lt;0.05), general health (p&lt;0.05), vital activity (p&lt;0.05). It has been proven that male gender (p&lt;0.05), age over 65 years (p&lt;0.05), increased body mass index (BMI, p&lt;0.05), impaired glucose tolerance/or diabetes mellitus type 2 (p &lt;0.05) and arterial hypertension (p&lt;0.05) were factors associated with HF and, accordingly, lower quality of life scores according to the SF-36 questionnaire. Probable dependence regarding smoking (p&gt;0.05) and hyperlipidemia (p&gt;0.05) in components of physical and mental health in patients with CHF and AF were not established.Conclusion. According to the results of the Minnesota Questionnaire (MLHFQ), patients with HF and AF had higher scores, indicating a worse quality of life (p&lt;0.05). In the examined patients for chronic heart failure with atrial fibrillation, a decrease in quality of life indicators was found in comparison with the control group on all scales of the SF-36 questionnaire (p&lt;0.05). Significant differences were established, compared to the control group, on the scales of physical (p&lt;0.05), physical-role functioning (p&lt;0.05), pain intensity (p&lt;0.05) and emotional-role functioning (p&lt;0 ,05). It was found that in patients with a reduced left ventricular ejection fraction, compared to patients with a preserved left ventricular ejection fraction, there is a significant decrease in quality of life indicators on almost all SF-36 scales: physical functioning (p&lt;0.05), role functioning ( p&lt;0.05), body pain (p&lt;0.05), general health (p&lt;0.05), vital activity (p&lt;0.05). At the same time, on the scales of social functioning and mental health, there were no significant differences, depending on the left ventricular ejection fraction in atrial fibrillation (p&gt;0.05).

Comparison of the Effects of Body Mechanics Education Methods on Pain, Disability, and Quality of Life: A Randomized Controlled Study

BackgroundEducating patients undergoing surgery for LDH is important to maintain the proper performance of body mechanics. PurposeThe study compared the effects of standard, brochure-based, and video-based education on postoperative pain, disability, and the quality of life in patients undergoing surgery for lumbar disc herniation. DesignThis was a randomized controlled study. SettingsThe study was conducted in the Department of Neurosurgery of a training and research hospital in Turkey. Participants/SubjectsSixty patients (n = 20 control, n = 20 video, n = 20 brochure) undergoing surgery for LDH who volunteered to participate. MethodsThe study was carried out between 15 January and 30 July 2017. The data were collected preoperatively and postoperatively using the Patients’ Characteristics Form, Oswestry Disability Index (ODI), Short-Form McGill Pain Questionnaire (SF-MPQ), Physical Functioning and Bodily Pain subscales of the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36) and the Survey of Patient Satisfaction with Clinical Education and Materials. ResultsAll three groups were similar in terms of socio-demographic and clinical characteristics. Preoperative scores obtained from the ODI, SF-MPQ, and the two subscales of the SF-36 were not significantly different. However, there was a statistically significant difference between the video group (81.5 ± 24.3) and the control group (67.7 ± 18.6) in terms of the Physical Functioning subscale of the SF-36 in the postoperative period (p< .05). ConclusionsPreoperative education on body mechanics increases the physical functioning of patients with LDH and facilitates the integration of information into their daily activities.

Evaluation of quality of life, sleep, and sleepiness in dental students during active learning and remote emergency learning

Objective: This study aimed to evaluate the quality of life (QoL), quality of sleep, and sleepiness index in undergraduate dentistry students between their active learning (AL) and emergency remote learning (ERL) due to social distancing imposed during the COVID-19 pandemic. Methods: Information was collected using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36-BR), Epworth Sleepiness Scale (ESS-BR), and Pittsburgh Sleep Quality Index (PSQI-BR) questionnaires administered before and during the COVID-19 pandemic. A comparison regarding the type of education, demographic factors, academic performance, PSQI-BR, ESS-BR, and SF-36-BR between the groups was performed, considering a significance level of 0.05. Results: A total of 55 students were from AL, while 45 students were from ERL. The sample consisted of 74 women and 26 men aged 21–30 years. The academic coefficient of these students ranged from 7 to 8 points (AL= 38.2% and ERL= 57.8%). In addition, a large proportion of the students reported having no failures (AL=60% and ERL= 66.7%). Regarding QoL, the students presented a greater impairment in functional capacity (p = 0.01), followed by limitations in social aspects, general health perception, body pain, and vitality. According to the ESS-BR scores (p = 0.04), the students presented a lower quality of sleep. Conclusion: Dentistry students had the worst QoL panoramas and poor relative sleep quality before and during the COVID-19 pandemic. Furthermore, QoL instruments were reliable for quantifying health-related QoL in AL and ERL.

Effects of esaxerenone on blood pressure, urinary albumin excretion, serum levels of NT-proBNP, and quality of life in patients with primary aldosteronism.

Primary aldosteronism (PA) is typically managed with mineralocorticoid receptor antagonists (MRAs) barring adrenalectomy. The efficacy of esaxerenone, a nonsteroidal MRA, were explored in patients with PA. Various parameters such as the urinary albumin to creatinine ratio (UACR) and serum levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) were evaluated in 25 PA patients before and 3 and 6 months after esaxerenone treatment. Systolic and diastolic blood pressure (BP), and the estimated glomerular filtration rate decreased after treatment, while serum levels of potassium and active renin increased. Significant reductions were observed in UACR 3 and 6 months after treatment. A significant decrease in NT-proBNP was evident at 6 months but not 3 months after treatment. Correlation analysis indicated that the reductions in BP and UACR at 3 months were independent of estimated daily salt intake. Furthermore, the effect of esaxerenone treatment on lowering UACR and NT-proBNP levels was independent of BP reduction. Responders whose systolic BP decreased 6 months after esaxerenone treatment by more than 10 mmHg compared to pretreatment had higher pretreatment NT-proBNP and similar UACR before and after treatment when compared with nonresponders. Esaxerenone improved mental, physical, and social quality of life (QOL) 6 months after treatment compared to healthy controls and increased over time. No patients discontinued treatment due to severe hyperkalemia or renal dysfunction. In conclusion, esaxerenone is a safe and effective MRA for PA treatment, offering significant benefits in terms of hypertension, albuminuria, NT-proBNP levels, and QOL improvement. Esaxerenone effectively lowers BP, UACR, and serum levels of NT-proBNP independent of dietary salt intake in mild PA patients. ARC active renin concentration, DBP diastolic blood pressure, MR mineralocorticoid receptor, MRA mineralocorticoid receptor antagonist, NT-proBNP N-terminal pro-brain natriuretic peptide, PA primary aldosteronism, QOL quality of life,SBP systolic blood pressure,SF-36Medical Outcomes Study 36-Item Short-Form Health Survey,UACR urinary albumin to creatinine ratio.

Less, but not gone-gluten-free diet effects on fatigue in celiac disease: a prospective controlled study.

Fatigue is a frequent complaint in patients with celiac disease. A gluten-free diet is the only established treatment for celiac disease, but how this diet influences fatigue is uncertain. We aimed to investigate fatigue prevalence, severity, and associated factors in patients with celiac disease, at diagnosis and at 1 year after commencing a gluten-free diet. 78 patients with serologically and histologically verified celiac disease, 78 age- and sex-matched healthy subjects. Primary endpoints were Fatigue Visual Analog Scale (fVAS), Fatigue Severity Scale (FSS), and inverted Vitality subscale of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36vs). Clinically relevant fatigue was defined as: FSS score ≥ 4, fVAS score ≥ 50 mm, or inverted SF-36vs score ≥ 65. Higher scores represented more fatigue. Fatigue was reduced after a 12-month gluten-free diet. Median scores changed from 3.8 (interquartile range [IQR]: 2.2 to 4.8) to 1.9 (IQR: 1.4 to 3.5) for FSS, from 44.5 (IQR: 18.8 to 66.0) to 15.5 (IQR: 7.8 to 43.3) for fVAS, and from 65 (IQR: 40 to 75) to 35 (IQR: 25 to 55) for inverted SF-36vs (p < 0.001 for all). Fatigue prevalence also declined after treatment. However, scores were significantly higher in patients compared to control subjects. Higher fatigue scores were associated with depression and pain, but not with signs of disease activity or nutritional deficiency. At diagnosis, patients with celiac disease frequently had severe fatigue. Fatigue declined after a gluten-free diet, but it remained higher than that observed in healthy subjects. ClinicalTrials.gov, Identifier NCT01551563.

Sociodemographic and obstetric factors associated with health-related quality of life of high-risk pregnant women.

To evaluate the association between sociodemographic and obstetric factors and the health-related quality of life of pregnant women in high-risk prenatal care. A cross-sectional study of women in high-risk prenatal care in Ceara, Brazil. The investigated outcomes were health-related quality of life, using the Medical Outcomes Study 36-item short-form health survey; the investigated covariates were sociodemographic and obstetric data. Associative analyses were performed using the Jamovi® software version 0.9. Of the 276 women included in the study, women with the following characteristics presented a better quality of life in some domain of the scale: age equal to or greater than 35 years, higher income per dependent, religious, living with three or fewer persons, with their own home, in primigestation, nulliparous, with no history of previous abortion, and with up to two living children. The regression model showed an association between the total scale score, which means a higher quality of life in women with age equal to or greater than 35 years and a higher income per dependent. The study identified sociodemographic and obstetric factors that may affect the quality of life of high-risk pregnant women, providing subsidies to health providers so that they can promote better prenatal care.

Quality of life in individuals with knee osteoarthritis versus asymptomatic individuals.

Osteoarthritis (OA) is characterised by joint degeneration and represents the leading cause of disability in old age. OA entails a personal burden, with suffering and reduced quality of life (QoL). To compare the QoL of individuals with OA to that of asymptomatic individuals in order to determine the actual impact of OA on the affected population. Cross-sectional study with a sample of 140 patients diagnosed with OA. Another 51 sex- and age-matched asymptomatic individuals with no clinical signs of knee OA or lower limb osteoarticular symptoms for at least the preceding six months were recruited. Knee OA was stratified radiologically according to the Ahlbäck classification (1968). QoL was measured using the SF-36 questionnaire (Medical Outcomes Study 36-Item Short-Form Health Survey). The participants were assigned to "osteoarthritis" (OG) or "asymptomatic" (AG) groups. The OG presented greater body mass and BMI than the AG. Perceived QoL was worse for the OG than the AG across SF-36 domains. In the comparison of the grades of OA degeneration, the group with Ahlbäck grades 4 and 5 (severe) perceived their QoL as poorer than those with grades 1, 2, and 3 (moderate). The grade of OA, older age, and BMI were shown to be strong independent predictors of poor perceived quality of life. Individuals with knee OA showed worse perceived QoL compared with asymptomatic individuals. The domains with the lowest scores were physical functioning and functional limitation. Quality of life was influenced by BMI, age, sex, and grade of osteoarthritis.

A Smartphone Application-Based Remote Rehabilitation System for Post-Total Knee Arthroplasty Rehabilitation: A Randomized Controlled Trial

BackgroundRemote rehabilitation after total knee arthroplasty has gradually gained popularity in recent years. This study aimed to determine whether smartphone application-based remote rehabilitation could outperform home-based rehabilitation and outpatient guidance in terms of 12-week outcomes following primary unilateral total knee arthroplasty. MethodsPatients who underwent primary unilateral total knee arthroplasty were recruited and randomly divided into a telerehabilitation group and a control group. A total of 100 patients were examined, with 50 each assigned to the telerehabilitation and control groups. In the telerehabilitation group, a telerehabilitation application was installed on the smartphones of the participants to allow postdischarge guidance. The primary outcomes were knee range of motion (ROM) at 12 weeks postoperatively. Secondary outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index, Knee Society Score, The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Five Times Sit-to-Stand Test (5xSST), Single-Leg Stance Test (SLST), satisfaction, rehabilitation costs, complication rate, and 90-day readmission rate. All outcomes were collected at 2, 6, and 12 weeks after surgery. ResultsAt 12 weeks postoperatively, the telerehabilitation patients significantly outperformed the controls in terms of knee ROM (124 ± 8.7 versus 119 ± 5.5 P = .01), SF-36 (physiological function) (61.5 ± 20.3 versus 45.5 ± 18.1 P = .000), SF-36 (role-physical) (49.3 ± 41.5 versus 27.7 ± 28.9 P = .012), SLST (13.0 ± 9.1 versus 9.1 ± 5.9 P = .026), and 5xSST (17.7 ± 4.3 versus 19.4 ± 3.5 P = .043). No significant differences were found between groups in the Western Ontario and McMaster Universities Osteoarthritis Index score, Knee Society Score, rehabilitation costs, 90-day readmission rate, or incidence of adverse events. ConclusionOur study showed that smartphone app-based remote rehabilitation worked better than home-based rehabilitation with outpatient guidance in terms of short-term results in ROM, SLST, and 5xSST.

#4699 QUALITY OF LIFE AS REPRESENTED BY PHYSICAL ACTIVITY WAS IMPROVING AFTER FULL CORRECTION OF POST-TRANSPLANT ANEMIA

Abstract Background and Aims Recent studies showed positive impact of correction of post-transplant anemia (PTA) on general health, exercise capacity, and physical scores. So we conducted this prospective randomized controlled trial (RCT) to assess quality of life after full correction of post-transplant anemia in renal recipients receiving erythropoietin stimulating agents. Method We recruited 247 kidney transplant recipients with stable graft function in this RCT with 2 groups according to their target hemoglobin (11-12 g/dl, group 1, n = 183) and (13:15 g/dl (group 2, n = 64) which was achieved using erythropoietin stimulating agents (ESA). Monthly clinical and laboratory evaluation of kidney graft function was carried out. Quality of life (QOL) was assessed –using 25 and 36 questionnaires-at the start and 12 months. Results We observed more females in group 1 and the original kidney disease was chronic glomerulonephritis was significantly higher in group 2 (37.5%) followed by diabetic nephropathy (15.7%) while in group 1 it came as 25.7% and 22.4% respectively (p&amp;lt;0.05).The studied groups were comparable regarding pre-transplant co-morbidities. Most patients received thymoglobulin as induction and most of them were maintained on cyclosporine. We did not find any significant difference between the two groups concerning post-transplant co-morbidities (p &amp;gt;0.05), however better graft function was observed in group 2 at 6 months (p&amp;lt; 0.05). At 12 months, the assessment of QoL using the Medical Outcomes Study 36-Item Short-Form Health Survey, group 1 showed better post-transplant physical features and higher emotional factors related inactivity at 12 month (p&amp;lt;0.05), while group 2 showed significantly higher basal and 12 months activity state (p = 0.05). Basal inactivity was comparable in group 2 with that at 12 months (p&amp;gt;0.05), emotional factors related inactivity was significantly higher at 12 months in group 1. Graft outcome was comparable between both groups (p = 0.125), (p = 0.005). Conclusion Quality of life as represented by physical activity was improving by full correction of PTA in renal transplant recipients receiving ESA.

Impact of Obstructive Sleep Apnea on Health-Related Quality of Life in Patients With Partial Laryngectomy for Laryngeal Cancer.

Objectives: To evaluate the possible risk factors of obstructive sleep apnea (OSA) and its impact on the health-related quality of life (HRQoL) in patients with partial laryngectomy for laryngeal cancer. Methods: A cross-sectional method was used to carry out this study. Patients who underwent partial laryngectomy for laryngeal cancer completed overnight polygraphy (PG) home sleep tests and quality of life questionnaires. The Medical Outcome Study 36-item Short-Form Health Survey (SF-36) questionnaire was used to investigate the factors influencing HRQoL. Results: A total of 59 patients completed the PG tests and quality of life questionnaires, with 74.6% demonstrating evidence of OSA. There were significant differences in tumor area and neck dissection between OSA group and non-OSA groups. Based on sleep-related parameters, patients were divided into cluster 1 (n = 14) and cluster 2 (n = 45) using principal component analysis combined with K-means clustering. Two clusters had significantly different scores of body pain, general health, and health transition in SF-36 domains. Independent factors associated with general health were identified as tobacco use (OR = 4.716), alcohol use (OR = 3.193), and OSA-related condition (OR = 11.336). Conclusions: Larger tumor area and neck dissection might be associated with an increased risk for developing OSA in patients with partial laryngectomy for laryngeal cancer. OSA partially mediated the effect on physical health, including body pain, general health, and health transition. It is important to be aware of the potential impact of OSA on diminished HRQoL of these patients.

A Study for QOL and Surgical Incision Pain in Patients Undergoing Totally Thoracoscopic Combined Aortic and Mitral Valve Replacement Surgery.

In recent years, based on traditional median sternotomy surgery, totally thoracoscopic for aortic and mitral valve replacement surgery is increasingly being performed despite little published evidence. This study investigated postoperative pain and short-term quality of life (QOL) of patients undergoing double valve replacement surgery. From November 2021 to December 2022, 141 patients with double valvular heart disease who underwent thoracoscopic group (N = 62) and median sternotomy group (N = 79) were included. Clinical data were recorded, and a visual analog scale (VAS) was used to measure postoperative pain intensity. The medical outcomes study (MOS) 36-item Short-Form Health Survey assessed short-term QOL after surgery. Sixty-two patients underwent total thoracic double valve replacement, and 79 patients underwent median sternotomy double valve replacement. Both groups were similar in terms of demographics and general clinical data, as well as the incidence of postoperative adverse events. The VAS scores of the thoracoscopic group were lower than those in the median sternotomy group. The hospital stay time was significantly shorter in the thoracoscopic group than in the median sternotomy group (30.2 ± 12 days vs. 36 ± 19 days, p = 0.03). The scores of bodily pains and some of the subscales in SF-36 were significantly different between the two groups (p < 0.05). Thoracoscopic combined aortic and mitral valve replacement surgery can reduce postoperative pain and improve short-term postoperative QOL, which has specific clinical application value.

Association between changes in pulmonary function and in patient reported outcomes during enzyme therapy of adult patients with late-onset Pompe disease".

Pompe disease is a rare, progressive, metabolic myopathy. Reduced pulmonary function is one of the main problems seen in adult patients with late-onset Pompe disease (LOPD). We aimed to explore the association between changes over time in pulmonary function and in patient-reported outcome measures (PROMs), in these patients treated with enzyme replacement therapy (ERT). This is a post-hoc analysis of two cohort studies. Pulmonary function was assessed as Forced Vital Capacity in the upright position (FVCup ). As PROMs, we assessed the physical component summary score (PCS) of the Medical Outcome Study 36-item Short-Form Health Survey (SF-36) and daily life activities (Rasch-Built Pompe-Specific Activity [R-PACT] scale). We fitted Bayesian multivariate mixed-effects models. In the models of PROMs, we assumed a linear association with FVCup , and adjusted for time (non-linear), sex, and age and disease duration at the start of ERT. One hundred and one patients were eligible for analysis. PCS and R-PAct were positively associated with FVCup , while their relation with time was non-linear (initial increase then decrease). A 1%-point increase in FVCup is expected to increase PCS by 0.14 points (95% Credible Interval: [0.09;0.19]) and R-PACT by 0.41 points [0.33;0.49] at the same time point. In the first year of ERT, we expect a change of PCS and R-PAct scores by +0.42 and + 0.80 points, and in the 5th year of +0.16 and + 0.45, respectively. We conclude that the physical domain of quality of life and daily life activities improve when FVCup increases during ERT.

Effect of gait training using rhythmic auditory stimulation on gait speed in older adults admitted to convalescent rehabilitation wards: A study protocol for a pilot randomized controlled clinical trial

BackgroundDecreased walking speed in older patients admitted to convalescent rehabilitation wards (CRWs) is one of the factors that inhibit home discharge. Therefore, interventions to improve gait speed in older patients admitted to CRWs are important, and rhythmic auditory stimulation (RAS) may be an effective intervention strategy. However, the effect of RAS on gait speed in older patients admitted to CRWs is not well known. Therefore, this study protocol aims to determine the feasibility of the RAS-based gait practice for older patients admitted to the CRW. MethodsThe study is designed as a single-center, open-label, pilot, randomized, parallel-group study. Participants will be 30 patients aged ≥65 years admitted to the CRW and randomly assigned to the experimental group (RAS-based gait practice; n = 15) or the control group (normal gait practice; n = 15). In both groups, interventions will be conducted for 30 min per session, 5 times per week for 3 weeks. The primary outcome is the change in the 10-m walk test 3 weeks after the baseline assessment. Secondary outcome is the change in the score of the Medical Outcome Study 8-Item Short-Form Health Survey and the Japanese version of the modified Gait Efficacy Scale from baseline assessment to 3 weeks later. DiscussionThis exploratory RCT was developed using strict scientific standards and is based on defined protocols. Thus, this study will be used to assess the viability of a larger investigation into RAS-based gait practice. If our theory is accurate, this study could serve as a foundation for establishing RAS-based gait practice in CRWs as a common rehabilitation strategy. Trial registrationThis study was registered in the University Hospital Medical Information Network (UMIN) clinical trials registry in Japan (UMIN000049089).

Long-Term Health-Related Quality of Life and Clinical Outcomes in Patients with β-Thalassemia after Splenectomy

Few data are available on the efficacy and safety of splenectomy in patients with transfusion-dependent Beta-Thalassemia Major (β-TM) and on its impact on a patient's health-related quality of life (HRQoL). We examined the long-term HRQoL of adult patients with β-TM in comparison with those treated with medical therapy by using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). We also evaluated the safety and efficacy of splenectomy. Overall, 114 patients with a median age of 41 years (range 18-62) were enrolled in this cross-sectional study. Twenty-nine patients underwent splenectomy (25.4%) at a median age of 12 years (range 1-32). The median follow-up after splenectomy was 42 years (range 6-55). No statistically significant differences were observed in any of the scales of the SF-36 between splenectomized and not-splenectomized patients. The majority of surgical procedures (96.6%) were approached with open splenectomy. Post-splenectomy complications were reported in eight patients (27.5%): four overwhelming infections, three with pulmonary hypertension, and one with thrombosis. A significantly higher prevalence of cardiovascular comorbidities (58.6 vs. 21.2%, p < 0.001) and diabetes (17.2 vs. 3.5%, p = 0.013) was observed in splenectomized patients. These patients, however, required fewer red blood cell units per month, with only 27.6% of them transfusing more than 1 unit per month, compared with 72.9% of the not-splenectomized group. Overall, our data suggest that physicians should carefully consider splenectomy as a possible treatment option in patients with β-TM.

Comparison of Bleeding Pattern and Quality of Life Before and After the Insertion of a Levonorgestrel Intrauterine System for Heavy Menstrual Bleeding: A Seven-Year Review.

Background This study aimed to examine the role of a levonorgestrel intrauterine system (LNG-IUS) in the treatment of heavy menstrual bleeding (HMB) regarding improvements in bleeding patterns and quality of life (QOL) and determine the reason for its failure or withdrawal from treatment in some patients. Methodology This retrospective study was conducted in a tertiary care center in eastern India. A seven-year assessment, with both qualitative and quantitative assessments, of the effect of LNG-IUS in women with HMB was performed using the Menorrhagia Multiattribute Scale (MMAS) and Medical Outcomes Study 36-Item Short-Form Health Survey (MOS SF-36) score as a tool to assess the QOL, and the pictorial bleeding assessment chart (PBAC) to assess bleeding patterns. The study population was divided into the following four groups based on duration: three months to one year, one to two years, two to three years, and more than years.The continuation, expulsion, and hysterectomy rates were evaluated. Results The mean MMAS and MOS SF-36 scores increased significantly (p < 0.05) from 36.73 ± 20.40 to 93.72 ± 14.62 and 35.33 ± 6.73 to 90.54 ± 15.89, respectively. The mean PBAC score decreased from 176.36 ± 79.85 to 32.19 ± 63.87. In total, 348 women (94.25%) continued the LNG-IUS, and 3.44% had uncontrolled menorrhagia. Furthermore, at the end of seven years, the expulsion rate was 2.28% due to adenomyosis and pelvic inflammatory disease, and the hysterectomy rate was 5.75%. In addition, 45.97% and 48.27% of the participants had amenorrhea and hypomenorrhea, respectively. Conclusions LNG-IUS improves bleeding and QOL in women with HMB. In addition, it requires less skill and is a non-invasive and nonsurgical option, which should be considered first.