Patient Subjective Assessment Research Articles

Patient-reported outcomes in human papillomavirus-related oropharyngeal cancer.

This review explores how human papillomavirus-related oropharyngeal cancer affects health-related quality of life (HR-QoL) and the role patient-reported outcomes (PROs) can play in optimizing treatment. PRO measures (PROMs) are comprehensive, subjective assessments of patients' day-to-day HR-QoL. Developed through a scientifically robust, multistage process, PROMs offer insight into patients' symptoms, function, and satisfaction with care. The use of PROMs can increase symptom awareness, stimulate discussion, and enhance shared decision-making between patients and healthcare providers.

Safety and Efficacy of BroadBand Intense Pulsed Light Therapy for Dry Eye Disease with Meibomian Gland Dysfunction.

BackgroundBroadBand light intense pulsed light (BBL-IPL) therapy has shown to reduce hordeolum and blepharitis frequency. This study aims to evaluate the efficacy and safety of BBL-IPL therapy in patients with dry eye disease (DED) from meibomian gland dysfunction (MGD).MethodsThis is a retrospective, consecutive case series of 48 patients with DED from MGD who underwent BBL-IPL therapy from October 2016 to January 2019 at a single, outpatient clinic in Ontario, Canada. Clinical outcomes included first and average non-invasive keratograph tear break-up times (NIKBUT), bulbar redness (BR) scores, tear meniscus heights (TMH), visual acuity (VA) and meibograph grades. Patient-reported outcomes included the Canadian dry eye assessment (CDEA) questionnaire and patient subjective assessment (PSA) scores. Outcomes were measured at baseline and after completion of 4 monthly BBL-IPL sessions.ResultsThe mean severity of dry eye symptoms as measured by the CDEA and PSA decreased significantly from 19.78 ± 9.62 to 12.08 ± 7.40 (p<0.001) and from 7.65 ± 1.74 to 4.77 ± 2.03 (p<0.001), respectively. Twenty-five percent of patients reported no dry eye symptoms after treatment. The meibograph grade improved significantly in both eyes (p<0.001). Approximately 71.0% and 80.1% of patients had an improved meibograph grade in the right and left eye, respectively. Near-significant improvements were observed for BR scores and VA. There was also a trend towards improved first/average NIKBUT and TMH scores. No adverse events were noted.ConclusionBBL-IPL appears to be an effective and safe treatment modality in improving dry eye symptoms and meibomian gland function in patients with DED from MGD.

Non-psychotic depression and the social burden of illness

The burden of depression is increasing worldwide, caregivers are seen as a psychologically vulnerable group, and the social burden of non-psychotic depression remains unexplored.&#x0D; The aim of the study was to examine the clinical and functional characteristics of non-psychotic depression and the burden of family members of patients most involved in the interaction with patients. The study objectives included analysis of quality of life and co-occurring behavior of patients relatives as characteristics of their psychosocial adaptation.&#x0D; Methods. We used clinical and scales assessment of depression level, quality of life, subjective distress level, and coping behavior features.&#x0D; Results. Nonpsychotic depression was detected approximately half a year after the onset of symptoms, and in more than 40% of cases not by psychiatrists, self-treatment was typical. Impairments in social functioning in non-psychotic depression patients affected more in the areas of socially useful activities and social relationships, predominantly in non-working patients. 62.96% of patients rated relationships with loved ones as good, and 82.6% rated support from relatives in connection with the illness as adequate. In 60.87% of cases, there were psycho-traumatic microsocial factors. Spouses (45.5%) prevailed among supportive relatives, of whom 60% were employed, and limitation of labor activity due to the relatives illness was not characteristic, and material losses were insignificant. Supportive relatives more often than their sick relatives assessed the relationship with the sick as good (81.8%). In about 91% of cases, the attitude toward the mental illness of the relative was adequate, which exceeds the subjective assessment of patients with non-psychotic depression. The close relatives of the patients had decreased quality of life, which was mediated by severity of depression, higher than average level of distress related to mental disorder of the loved one (64,59,34 VAS scores). The structure of coping in supportive relatives is characterized on the whole by prevalence of constructive and relatively constructive coping-strategies, the most problematic being the emotional sphere of coping behavior.&#x0D; Conclusion. Even mild to moderate non-psychotic depression is associated with the presence of social burden of illness, covering not only the patients themselves, but also their family members, which necessitates psychologically corrective work with supportive relatives.

Surgery of congenital breast asymmetry\u2014which objective parameter influences the subjective satisfaction with long-term results

PurposeCongenital breast asymmetry is a serious gynecological malformation for affected patients. The condition hits young women in puberty and is associated with socio-esthetic handicap, depression, and psychosexual problems. Surgical treatment is usually early in the patient's lifetime, so a long-term sustainable solution is important. Although postoperative outcome has been evaluated in several studies before, this study is the first to analyze which objective parameters have the greatest influence on subjective satisfaction with long-term results.MethodsThirty-four patients diagnosed with congenital breast asymmetry that underwent either lipofilling or implant therapy between the years of 2008 to 2019 were examined. On average, our collective comprised patients seven years after surgery. Data were mainly gathered through manual measurements, patient-reported outcome measures (Breast Q™), and breast volumetry based on 3D scans (Vectra® H2, Canfield Scientific).ResultsAmong all analyzed parameters, only areolar diameter correlated significantly negatively with the subjective outcome satisfaction of the patient. Regarding the subjective assessment of postoperative satisfaction with similarity of the breasts, again the mean areolar diameter, but also the difference in areolar diameter and breast volume between the right and left breasts correlated significantly negatively.ConclusionAreolar diameter was revealed as being a significant factor influencing subjective long-term satisfaction in breast asymmetry patients. Moreover, 3D volumetry proves to be an effective tool to substantiate subjective patient assessments. Our findings may lead to further improvements to surgical planning and will be expanded in further studies.

A Comparative Study of Isolated Osteotomies Versus Osteotomies with Spreader Graft Placement to Correct Primary Deviated Nose.

It is a complete objective and subjective comparative study between two techniques of septorhinoplasty in patients undergoing primary rhinoplasty for crooked nose deformity. Forty patients having crooked nose deformity were randomly divided into 2 groups exhibiting two different techniques of correction. Patients were randomly divided into 2 group: Group 1: 20 patients underwent correction of crooked nose by performing bilateral triple osteotomies + Septoplasty Group 2: 20 patients underwent correction of crooked nose by performing bilateral triple osteotomies as well as placement of spreader grafts + Septoplasty Objective and subjective assessment of patients in preoperative and postoperative period was done by various scales and scores. Both the groups showed improvement in facial angles, ROE score, nasal airflow, and NOSE score. But, group 2 patients were more satisfied than group 1 patients in terms of both aesthetic appearance of nose and breathing function. It is very well known to the authors that aesthetic result of rhinoplasty is not just dependant on one technique. Keeping this in mind, we conclude that as group 2 patients were more satisfied with their overall results, the additional step of spreader graft placement helped these patients with the complaints associated with crooked nose deformity. However, we also emphasize that additional studies on larger numbers of patients should be performed to compare and know other intricacies of each technique that may play minor or major roles in deciding the success of each technique. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Evaluation of Therapy Effectiveness in Men with Different Erectile Dysfunction Severity

Sexual health is an integral part of everyone’s quality of life. Sexual harmony depends on a man’s sexual desire and erectile function. The most common disorder of male sexual health is erectile dysfunction. Improving the treatment of patients with this pathology helps to improve both physical and mental health and thus improve the quality of life. The objective: the aim of the study was to evaluate the efficacy and safety of combination course therapy and monotherapy in patients with erectile dysfunction. Materials and methods. The observation included 89 men with erectile dysfunction of mixed genesis aged 25 to 50 years with mild to moderate severity. All patients were divided into three groups. The I group of 32 patients with moderate ED, received during the month in the morning Bodrex 1 sachet 60 minutes before meals and in the evening Strondex one spray into the oral cavity (12,5 mg sildenafil), regardless of the presence or absence of sexual activity in this day and an additional 30 minutes before sexual intercourse from 12,5 to 25 mg, followed by a comparative assessment of clinical results immediately after treatment in relation to a group of patients (II group – 32), also with moderate ED who received sildenafil in tablet form dose of 25 mg 1 hour before sexual intercourse, but not more often than once a day. The third group (III group – 25) of patients consisted of men with mild ED, who received during the month only Bodrex in the morning 1 sachet 60 minutes before meals, with comparing clinical data before and after treatment. Bodrex and Strondex preparations are presented on the market by the pharmaceutical company Geolik Pharm Marketing Group. Results. The use of course combination therapy (Strondex + Bodrex) in the treatment of patients with moderate ED was found to be significantly more effective than sildenafil monotherapy at a dose of 50 mg on demand before sexual intercourse, as evidenced by subjective assessment of patients and objective data. Namely, the integrative indicator «erectile function» in this group of patients improved almost twice, while in the second group of patients this indicator improved by 62,9% (p&lt;0,05). Accordingly «оverall satisfaction" in group I patients improved 2,3 times, and in group II patients 1,8 times. Dopplerosonography of the penis in patients with moderate ED showed a probable decrease in hemodynamics in the corpora cavernosa, which indicated the presence of vascular factor with impaired vascular endothelial function (p&lt;0,05). After treatment, a more pronounced increase in cavernous blood flow occurred in group I, namely an increase in peak systolic velocity by 69,5%, while in group II by 38,5% (p1&lt;0,05). It was noted that the concentration of ET-1 in the serum of patients with moderate ED was 3 times higher than the average in the group of almost healthy men, which may indicate severe endothelial dysfunction (p&lt;0,05). Accordingly, after treatment, the level of ET-1 in the blood of patients decreased in group I, who received combination therapy, by 44,2%, while in group II by 28,3% (p1&lt;0,05). Before treatment, the majority of patients with moderate ED, namely 78,1%, could not have sexual intercourse due to insufficient erection. After treatment in 53,1% of group I patients receiving combination therapy (Strondex + Bodrex), erection was completely restored, while in group II erection was completely restored in 28,1% of patients. Also, according to the obtained data, it should be noted a significant positive dynamics of all integrative indicators of IIEF on the background of taking Bodrex in patients with mild ED (p&lt;0,05). An increase in the baseline «erectile function» by 1,4 times, contributed to an increase in sexual satisfaction and sexual satisfaction in general by 2,3 times. The mean peak systolic rate of cavernous blood flow before treatment in this group of patients was lower compared with the control group by 21,2% (p&lt;0,05). This indicator improved after treatment by 21,7%, and became not significantly different from this indicator in the control group of almost healthy men (p1&lt;0,05; p2&gt;0,05), which indicated the normalization of hemodynamics in penis. In patients with mild ED, the concentration of ET-1 in the serum was 1,7 times higher than in the control group (p&lt;0,05). After treatment, this index decreased by 1.5 times, approaching the rate in the group of almost healthy men (p2&gt;0,05). Before treatment in this group, no patient had a complete erection, and less than half of the patients (45,5%) had a pratial erection. After a course of treatment with Bodrex, complete erection was restored in 68,2% of patients, and a total of 86,4% of patients were able to have sexual intercourse. Conclusions. The use of combination course therapy (Strondex + Bodrex) in patients with moderate ED and course monotherapy (Bodrex) in patients with mild ED contributes to a more stable clinical effect, as evidenced by the dynamics of the data.

Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) for Tinnitus: A Retrospective Study.

Current studies still find insufficient evidence to support the routine use of repetitive transcranial magnetic stimulation (rTMS) in tinnitus. This study aimed to assess response of tinnitus to treatment with rTMS and identify factors influencing the overall response. Between January 2016 and May 2017, 199 tinnitus patients were identified from a retrospective review of the electronic patient record at the Sun Yat-sen Memorial Hospital. All patients received rTMS treatment. Their clinicodemographic profile and outcomes, including the tinnitus handicap inventory (THI) and visual analog scale (VAS) scores, were extracted for analysis. Regarding the THI results, 62.3% of all patients responded to rTMS. The analysis of the VAS score revealed an overall response rate of 66.3%. Both percentages were close to the patient's subjective assessment result, of 63.8%. Patients with tinnitus of less than 1-week duration had the highest response rate to rTMS in terms of either THI/VAS scores or the patient's subjective assessment of symptoms. Tinnitus duration was recognized as a factor influencing the overall response to the treatment. Repetitive transcranial magnetic stimulation treatment is effective for patients with tinnitus, but its efficacy is affected by tinnitus duration. Tinnitus patients are advised to attend for rTMS as soon as possible since therapy was more effective in those with a shorter duration of disease of less than 1 week.

NUTRITIONAL MANAGEMENT OF LIVER CIRRHOSIS AND ITS COMPLICATIONS IN HOSPITALIZED PATIENTS.

Cirrhosis is a chronic and progressive liver disease that occurs from prolonged hepatocellular injury. Malnutrition causes complications in cirrhosis patients that worsen the condition to liver failure. Both are closely linked and increase the chances of morbidity and mortality. Regular nutritional screening and monitoring is prime concern for such patients including comprehensive dietary history, laboratory tests, and evaluation of muscle loss and strength capabilities to determine the degree of frailty. For efficient assessment of liver cirrhosis patients Subjective Global Assessment has been used worldwide. The nutritional objectives for such individuals should be to regain liver functions, to prevent complications associated, and to overcome nutritional deficiencies causing malnutrition. We conducted a literature review using PubMed, Google Scholar and Science Direct for this purpose, a total of 130 articles were reviewed out of which 80 (from the past 5 years) including originally published research, review articles and abstracts were also included. Exclusion criteria of the selected studies was year of publication, irrelevancy and animal studies based on the purpose of current study. The aim of this study was to check nutritional management in patients having complications of liver cirrhosis. According to the guidelines, for the conservation of normal nutritional status of the malnourished patients', energy should be provided 35 kcal/kg/day while to prevent hypoalbuminemia and maintain the protein stores in the body, 1.5 g/kg/day protein has been recommended. Carbohydrates and fats for cirrhosis patients are recommended 50% to 60% and 10% to 20% of the total dietary intake respectively. Initial identification and prevention of malnutrition have the probability to lead to better health outcomes, prevention of complications of the disease, and improving quality of life.

Evaluation of efficacy of intradermal injection therapy vs derma roller application for administration of QR678 Neo® hair regrowth formulation for the treatment of Androgenetic Alopecia-A prospective study.

Non-surgical hair restoration is one of the most exciting and innovative fields in cosmetic surgery today.The addition of latest technique like derma roller seeks to achieve better results for delivering pharmaceutical solution for hair growth in comparison with topical administration. We aim to compare intradermal injection vs. derma roller technique for administration of QR678Neo® hair regrowth therapy for the treatment of androgenetic alopecia (AGA) in male and female patients. A sum of 50 patients in the age range of 20-70years with AGA were included and divided into 2 groups; Group A (intradermal) and Group B (derma roller). Intradermal injection of QR678Neo® formulation and derma roller with superficial application of QR678Neo® was given in each group. Assessment was done using hair pull test, global photographic assessment, video-microscopic assessment, and patient subjective assessment at baseline, 6months, and 1year. Significant diminution in hair fall was seen in both the groups. All the video-microscopic assessment factors were better in intradermal injection group compared to the derma roller group, but not significant. Erythema and pain were high in derma roller group in compare to intradermal. Derma roller technique is more convenient and easy to perform, especially when the availability of a trained person to carry out intradermal injection is not feasible, it gives satisfactory results. It is also beneficial in needle phobic and apprehensive patients. Though the results are more efficacious with intradermal scalp injection technique, this study established satisfactory results with derma roller technique as well.

378 Use of a Clinician’s Global Impression of Severity scale to measure insomnia severity in Alzheimer’s disease-dementia patients

Abstract Introduction Full montage polysomnography (PSG) is the gold standard for the objective evaluation of sleep but is time consuming and inaccessible to most clinicians. A Clinician’s Global Impression of Severity (CGI-S) scale can be used in clinical practice to provide a subjective assessment of patients’ insomnia severity. However, the utility of a CGI-S scale for assessing insomnia in patients with Alzheimer’s disease (AD)-dementia is not well understood. In a recent Phase III randomized, placebo-controlled clinical trial (NCT02750306), patients on suvorexant with AD-dementia and insomnia showed improvements in both PSG total sleep time (TST) and CGI-S scores. We conducted additional analyses to examine the association between CGI-S and PSG-TST to inform on the possible use of a CGI-S scale to assess insomnia severity in patients with AD-dementia in real-world settings. Methods Patients (N=285) met clinical diagnostic criteria for both probable mild-to-moderate AD-dementia and insomnia. The primary endpoint was change-from-baseline in overnight PSG-TST at Week-4. A single-item CGI-S rating of insomnia with responses of 1 (normal, not ill at all) to 7 (among the most extremely ill patients) was completed by a trained rater at baseline and after 2 and 4 weeks. CGI-S was an exploratory endpoint. Post-hoc correlational analyses and analyses of distribution of change-from-baseline to Week-4 in CGI-S response categories were performed. Results Pearson correlation indicated a significant association at baseline between PSG-TST and CGI-S (r=-0.18, nominal p=0.004). A correlation of change-from-baseline to Week-4 also indicated an association between PSG-TST and CGI-S (r=-0.24, nominal p&amp;lt;.0001). The distribution of change in CGI-S response category results at Week-4 showed that, compared to placebo, numerically less patients on suvorexant remained stable or worsened by &amp;gt;1 response category (21.8% vs. 29.4%, respectively) and numerically more improved by ≥1 response category (73.3% vs. 67.9%, respectively). Conclusion Our findings suggest that a CGI-S scale may be a useful tool for assessing insomnia severity in mild-to-moderate AD-dementia patients. Future studies with these patients are needed to determine the utility of a CGI-S scale in real-world settings. Support (if any) This study was funded by Merck Sharp &amp; Dohme Corp., a subsidiary of Merck &amp; Co., Inc., Kenilworth, NJ, USA

Psychological status before and after surgery in patients with trigeminal neuralgia

ObjectiveTo analyze the psychological status in patients with trigeminal neuralgia before surgery and in the early postoperative period after microvascular decompression of the trigeminal nerve. MethodsPsychological features of personality were studied in 56 patients aged from 28 to 80 years with trigeminal neuralgia. To study the psychological status, such scales as Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale and Patient's Subjective Assessment of Treatment Effectiveness Scale (PSATES) were used with special attention paid to presence of suicidal thoughts. ResultsThe signs of anxiety were clinically significant in 7%, absent - in 66 % of the patients. There were no signs of depression in 63 % of cases, while 7% of the patients suffered from clinically significant depression. Pain catastrophizing was observed in 76.8 % of patients. None of the patients rated the intervention as "excellent" on PSATES despite the complete pain relief in the majority of patients (78.6 %), and only 16.1 % of the patients rated it as "good". The aggravation factor had a significant influence on this evaluation (p = 0.01). ConclusionsGeneral psychological status assessment can be used to objectify the indicators of the questionnaires and pain scales, as well as to determine the treatment tactics in this group, especially when it is necessary to clarify indications for an intervention and to decide on its proper time. Regardless of the outcome, the patients need time and psychological help for social adaptation due to changes in their social status.

Does exercise therapy improve patient-reported outcomes in rheumatoid arthritis? A systematic review and meta-analysis for the update of the 2020 JCR guidelines for the management of rheumatoid arthritis.

This study aimed to evaluate the impact of exercise therapy on patient-reported outcomes (PROs) in rheumatoid arthritis (RA) as part of the process of updating the 2020 Japanese guidelines for the management of RA according to the Grading of Recommendations, Assessment, Development, and Evaluation system. We searched PubMed, Japana Centra Revuo Medicina Web, and the Cochrane Library (from 2009 to 2018) to identify articles that evaluated PROs of exercise therapy and RA disease activity. A total of 662 articles were identified, including nine RCTs, and meta-analyses were performed on six RCTs on systemic exercise therapy and three RCTs on upper extremity exercise therapy. Analyzed exercise therapies were diverse, differing in target population, intervention method, and duration. Significant improvements were observed in the Health Assessment Questionnaire Disability Index (mean difference -0.35, 95% confidence interval (CI): -0.60 to -0.10), pain (standardized mean difference -2.04, 95% CI: -3.77 to -0.32), and SF-36. For upper extremity exercise therapy, significant improvements in PROs (Disabilities of the Arm, Shoulder, and Hand Questionnaire, Michigan Hand Outcome Questionnaire) were observed. Exercise therapy in RA treatment improves patient subjective assessment of pain, physical function, and quality of life.

Краткосрочные результаты тотального эндопротезирования тазобедренного сустава у пациентов с анкилозирующим спондилоартритом (первичное сообщение)

Introduction The systemic nature of the disease and the use of modern conservative therapy may cast doubt on the effectiveness and necessity of total hip arthroplasty (THA) in ankylosing spondylitis (AS). A comprehensive assessment of the functional state, quality of life (QOL) and subjective assessment of patients allows the most complete analysis of treatment results. Objective Comprehensive analysis of short-term results of quality of life, clinical and functional status and treatment satisfaction in patients with AS after THA. Materials and methods 17 patients with AS underwent primary THA (5 women, 12 men, average age 43.8 ± 3.1; from 33 to 52 years). Cases of complete bone ankylosis of the hip joint were excluded. An analysis of the functional state using Harris Hip Score and QOL (SF-36v2) was performed before surgery, 2 months, 6 months and 12 months after surgery. Patient treatment satisfaction analysis (VAS) was performed at the same follow-ups. Results A significant improvement in clinical and functional status (HHS) and QOL (SF-36v2) was obtained after 2, 6, 12 months compared with the preoperative level (p &lt; 0.05). High levels of patient satisfaction with treatment outcomes were achieved. Para-articular ossification (3 patients, 18 %), a hematoma in the postoperative wound area (1 patient, 6 %), implant dislocation (1 patient, 6 %) were the main complications. Conclusion THA in patients with AS improves not only the functional state but also the QOL compared with the preoperative level.

Prehospital Needle Decompression Improves Clinical Outcomes in Helicopter Evacuation Patients With Multisystem Trauma: A Multicenter Study.

The utility of prehospital thoracic needle decompression (ND) for tension physiology in the civilian setting continues to be debated. We attempted to provide objective evidence for clinical improvement when ND is performed and determine whether technical success is associated with provider factors. We also attempted to determine whether certain clinical scenarios are more predictive than others of successful improvement in symptoms when ND is performed. Prehospital ND data acquired from one air ambulance service serving 79 trauma centers consisted of 143 patients (n = 143; ND attempts = 172). Demographic and clinical outcome data were retrospectively reviewed. Patients were stratified by prehospital characteristics and indications. Objective outcomes were measured as improvement in vital signs, subjective patient assessment, and physical examination findings. Univariate analysis was performed using chi-square for variable proportions and unpaired Student's t-test for variable means; p < .05 was considered statistically significant. The success rate of ND performed for hypoxia (70.5%) was notably higher than ND performed for hemodynamic instability (20.3%; p < .01) or cardiac arrest (0%; p < .01). Compared to vital sign parameters, clinical examination findings as part of the indication for ND did not reliably predict technical success (p > .52 for all indications). No difference was observed comparing registered nurse versus paramedic (p = .23), diameter of catheter (p > .13 for all), or length of catheter (p = .12). Prehospital ND should be considered in the appropriate clinical setting. Outcomes are less reliable in cases of cardiopulmonary arrest or hypotension with respiratory symptoms; however, this should not deter prehospital providers from attempting ND when clinically indicated. Additionally, the success rate of prehospital ND does not appear to be related to catheter type or the role of the performing provider.

Objective and subjective assessment of the quality and effectiveness of orthodontic treatment

Dentofacial anomalies occupy one of the leading places among dental diseases in people of different age groups. Analysis of epidemiological data on the prevalence of dentoalveolar anomalies indicates that there is no tendency to decrease it in Russia and abroad countries. The demand for orthodontic treatment is increasing with the development of new technologies and materials, the development of modern methods of treatment in the field of dentistry. This trend is accompanied by increased requirements for the quality of orthodontic care. The patient's dissatisfaction with the result of treatment most often arises because of a discrepancy between his subjective assessment of treatment and the objective anatomical, functional and aesthetic state of occlusion. The use of methods for quantitative assessment of dentoalveolar anomalies and the quality of orthodontic treatment makes it possible to objectively substantiate the choice of tactics of orthodontic care and increase its effectiveness. At the same time, the patient's subjective assessment of the quality of orthodontic treatment allows one to see how the proposed (implemented) treatment plan reflects the patient's main complaints and to assess the degree of his satisfaction with the achieved result. That`s why, the issue of using methods of objective and subjective assessment of the quality and effectiveness of orthodontic treatment is relevant today. The purpose of the literature review is to consider the development and implementation of criteria for an objective and subjective assessment of the outcome of orthodontic treatment.

Effect of result retention on patient satisfaction with orthodontic treatment

Background. Nowadays, the number of orthodontic care requests has increased significantly. The technical capabilities of orthodontics have improved exponentially with technological progress. The necessary care can now be provided at almost any age, and the need for aesthetic results has increased, as motivated by the mass media. As a result, patients have high demands to orthodontists. New technologies, such as cortical support, can solve dental abnormalities that previously could only be cured by surgery. However, maintaining high-quality results remains a challenge. Materials and methods. The objective parameters of orthodontic treatment were analyzed and compared with the subjective assessment of patients. Conclusion. The patients motivation, the desire to cooperate with the doctor, and a clear understanding of the treatment goals enable to obtain and retain high-quality results for a sufficiently long period of time.

Assessment of the dynamics of dermatologic index indicators of symptom scale and dermatologic quality of life index under the influence of complex phototherapy in patients with a combination of rosacea subtypes

Background. Taking into account the data of recent studies on the treatment of rosacea, the development of new methods of treating this dermatosis using complex physiotherapeutic approaches and their synergism is of scientific and practical interest. In this work, we took into account the synergism of physiotherapeutic effects exerted by intense pulsed light and submilisecond neodymium 1064 nm laser radiation, as well as an increase in the destruction of pathologically altered vessels observed with the sequential use of both procedures.&#x0D; Aims: to assess the effect of complex phototherapy on changes in the indicators of the dermatological index of the symptom scale and the dermatological index of quality of life, reflecting the effect of the therapy on the clinical manifestations of the disease and the patient's subjective assessment of the skin condition.&#x0D; Material and methods. In the period 20172020 we conducted a randomized controlled study in which 130 patients with a combination of rosacea subtypes took part. All patients were divided into 4 groups. In each separate group, the following types of therapy were used: in group I laser therapy and 1% metronidazole cream; in group II phototherapy and 1% metronidazole cream; in group III complex photo-laser therapy and 1% metronidazole cream; in the comparison group (IV), patients received only 1% metronidazole cream. The treatment included 6 sessions with an interval of 2 weeks, with a total duration of 3 months. The effectiveness of therapy was assessed according to the results of the dermatological index of quality of life (DQL) and the dermatological index of the symptom scale (DYS) before and after treatment.&#x0D; Results. The developed complex method of combination of rosacea subtypes therapy demonstrated maximum efficiency, which was reflected in the maximum (by 55.21%) decrease in DYS in group III compared with the other three groups: in group I, the decrease in DYS was 30.54%, in II 21.51%, in IV 21.56%. The DQL in group III decreased by 67.4%, which was significantly higher than the indicators of the other three groups: in group I, DQL decreased by 31.3%, in group II by 27.4%, in IV by 20.7%.&#x0D; Conclusion. After the course of complex phototherapy in the group of patients with combination of rosacea subtypes, there was a decrease in the severity of clinical manifestations of the disease, as well as an increase in the quality of life of patients according to the data of the DYS and DQL, respectively.

Patient satisfaction as a psychological dimension after rhinoplasty: A randomized study

Introduction: Rhinoplasty is an esthetic and functional nasal reconstruction surgery. The elimination of physical disabilities directly affects mental health and leads to a better psychological balance. Therefore, patient satisfaction is considered a valuable measure of medical service outcomes. The objectives of this study were to evaluate subjective patient satisfaction 1 year after surgery and its influence on the quality of life.Methods: This was a clinical, retrospective, randomized, and single-blinded study in which patients were randomly questioned by the same examiner. All subjects underwent pre-operative preparation and post-operative flow at Eurofarm Centre from 2007 to 2010. The survey was conducted through anonymous questionnaires that were provided to each respondent at least 1 year after discharge from the hospital.Results: Overall, 20 (50%) patients had esthetic and 20 (50%) had functional nasal surgery. Most respondents were born between 1971 and 1980 (52.5%) and between 1981 and 1991 (40%), with the least born between 1951 and 1960 (2.5%). Regarding the education level, 27 had university degrees (67.5%), 1 had postgraduate education (2.5%), and 12 (30.0%) were secondary school graduates. In addition, 25 (62.5%) were unmarried and 15 (37.5%) were married.Conclusion: No statistically significant correlation was found between the subjective assessment of patient’s health based on eight dimensions of health assessment and variables such as type of surgery, age, level of education, and marital status 1 year after undergoing rhinoplasty. A statistically significant difference was found between the type of surgery and physical pain (p = 0.004 &lt; 0.05, Mann–Whitney U test). Based on the research findings, we can conclude that patient satisfaction after undergoing rhinoplasty was moderately correlated positively with the quality of life (r = 0.180-0.345, p &lt; 0.05).

Detection and evaluation of haemophilic arthropathy: Which tools may be considered more reliable.

Progressive arthropathy is the main cause of morbidity in patients with severe haemophilia. Diagnostic imaging can detect even subclinical arthropathy and impact prophylactic treatment. However, in most clinical settings the regular joint evaluation and follow-up are based on clinical evaluation and patient's personal reporting of problems, while diagnostic imaging is not regularly employed. The aim of our prospective study was to assess how ultrasound (US), clinical examination, patient's subjective assessment and certain laboratory biomarkers correlate with magnetic resonance imaging (MRI) for detection and evaluation of haemophilic arthropathy in order to determine which tool is the most reliable. The study included 30 patients with severe haemophilia (age range 16-49years). MRI (IPSG), US (HEAD-US), clinical examination (HJHS 2.1) and patient's subjective assessment of elbows, knees and ankles were performed; additionally, blood samples for laboratory analysis were taken (s-25-OH vitamin D, s-ferritin, s-C-terminal telopeptide of type I collagen, s-N-terminal propeptide of type I procollagen and s-cartilage oligomeric matrix protein). MRI results were used as a reference standard for joint status. Pearson's r was used to assess correlation of other methods with MRI. The correlation with MRI was the highest for US (r=.92), considerably higher than for clinical evaluation (r=.62) and patient's subjective assessment (r=.66). There was no correlation between the presence or degree of haemophilic arthropathy and any of the laboratory biomarkers. The results of our study warrant the inclusion of US into the regular follow-up of patients with severe haemophilia, where the equipment and staffing permit.

Predictors of Improved Early Clinical Outcomes After Elective Implant Removal.

To determine preoperative factors predictive of improvement in pain and function after elective implant removal. We hypothesized that patients undergoing orthopaedic implant removal to relieve pain would have significant improvements in both pain and function. Prospective cohort study. Level I Trauma Center. One hundred eighty-nine patients were enrolled after consenting for orthopaedic implant removal to address residual pain. One hundred sixty-three were available for 3-month follow-up. Preoperative and postoperative outcome measures including Patient Reported Outcomes Measurement Information System (PROMIS) scores were compared. Preoperative scores, surgeon prediction of pain improvement, and palpable implants were analyzed as predictors of outcomes. Median PROMIS physical function and pain interference scores and visual analogue scale significantly improved by 6, 8, and 2 points, respectively (P < 0.001 for all). Worse preinjury scores predicted improvement in respective postoperative outcomes (P < 0.001 for all). Surgeon prediction of improvement was associated with improved PROMIS pain interference (P = 0.005), patient subjective assessment of pain improvement (P = 0.03), and subjective percent of pain remaining at 3 months (P = 0.02). Implant superficial palpability was not predictive for any postoperative outcomes. Although the primary indication for implant removal in this population was pain relief, many patients also had a clinically relevant improvement in physical function. In addition, patients who start with worse global indices of pain and function are more likely to improve after implant removal. This suggests that implant-related pain directly contributes to global dysfunction. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.