Validated Health Questionnaire Research Articles

Naso-mucociliary Clearance Time among Patients with Chronic Rhinosinusitis in Ilorin, North-central Nigeria.

The mucociliary clearance system is an important component in the prevention of chronic inflammation of the nasal and paranasal sinus. The study aims to establish the normal values of mucociliary clearance in our region and to study the variation in mucociliary activity in patients with chronic rhinosinusitis in Ilorin, North-central Nigeria. This was a prospective, cross-sectional study using consecutive consenting participants in both the control and study groups carried out at both family medicine and otorhinolaryngology clinics among patients attending the clinics. After ethical approval was sought, informed consent was obtained from patients, a modified version of the validated health questionnaire was filled, semi-structured questionnaires were also filled after which patient undergo anterior rhinoscopy, nasal patency test and spirometry was done. The saccharine test has been used to measure nasal-mucociliary clearance time in the past. All information were entered into SPSS version 20 and analysed descriptively, and results were presented in tables and figures. Consecutive consenting 125 patients with rhinosinusitis (study group) and those without rhinosinusitis (control group) underwent naso-mucociliary clearance test. There were 34 males and 91 females with a male:female ratio of 1:2.6 among the study group and 55 males and 70 females with a male:female ratio of 1:1.3 for the control group. The age range was from 18 to 68 years with 18-40 years constituting the modal age group. The mean age for the studied group was 35.7 years while that of the control group was 33.1 years. The mean naso-mucociliary clearance time among the study group was 35.1 min standard deviation (SD = 12.32 ± 1.63), while among the control group, it was 14.8 min (SD = 5.59 ± 0.43). Compared to the control group, there was a roughly 200% prolonged increase in the duration of naso-mucociliary clearance time among patients with rhinosinusitis. There was also a positive correlation with increasing age. Future studies comparing the pre-operative and post-operative treatment of rhinosinusitis will contribute to knowledge.

The influence of lifestyle and biological factors on semen variability

PurposeSemen parameters are subjected to within-individual variability over time. The driving factors for this variability are likely multi-factorial, with healthier lifestyle associated with better semen quality. The extent in which variations in individual’s lifestyle contributes to within-individual semen variability is unknown.MethodsA total of 116 repeat semen samples from 29 men aged 19–37 over 6 months were collected. Basic semen analysis as per 5th WHO manual and extended semen parameters (sperm DNA fragmentation, redox potential and lipid peroxidation, sperm binding to hyaluronan and hyperactive motility) were assessed. An additional 39 lifestyle/biological factors (weight, blood pressure, etc.) were collected at each sample including validated health questionnaires SF36 Health Status, Australian Recommend Food Score, and International Physical Activity Questionnaire.ResultsOnly 10 out of the 39 lifestyle factors varied within men across samples including age (P = 0.0024), systolic blood pressure (P = 0.0080), social functioning (P = 0.0340), energy (P = 0.0069), non-alcoholic caffeinated beverages (P = 0.0010), and nutrition (P < 0.0001). The only semen parameter that varied between collections was sperm morphology (coefficient of variation 23.8 (6.1–72.0), P < 0.05). We only observed weak (r < 0.3) to moderate (r > 0.3– < 0.6) correlations between lifestyle factors, including body mass index, waist circumference, nutrition, exercise, blood pressure and semen parameters including sperm count, progressive motility, and sperm DNA fragmentation (P < 0.05).ConclusionIn healthy men from the general population, semen quality and associated lifestyle factors do not significantly vary over 6 months, indicating that one semen sample is likely sufficient for determining male fertility in this population.

Peer support impact on therapeutic adherence in patients with multiple sclerosis: a mixed-methods pilot trial protocol

IntroductionPatient partnership is a key component of patient-centred care. One form of partnership is individual peer support, which can improve patients’ quality of life and adherence to treatment. Patient with...

Association between pregnancy status and COVID-19 clinical manifestations, morbidity, and mortality among unvaccinated women in Metro Manila, Philippines: A multi-center prospective cohort study

BackgroundThe presenting clinical manifestations and the influence of pregnancy on the progression and symptomatology of COVID-19 among Filipina women are still understudied. This study assessed the association between pregnancy status and COVID-19 clinical manifestations, morbidity, and mortality among unvaccinated women in Manila, Philippines. MethodsThis multi-center prospective cohort study ascertained the pregnancy status and presence of SARS-CoV-2 with a validated health questionnaire. Generalized linear models with a Poisson distribution were fitted to estimate the association between pregnancy status and the clinical manifestations, morbidity, and cause-specific mortality from COVID-19, adjusting for confounding factors. ResultsNon-pregnant women were observed to report thermoregulatory, respiratory, musculoskeletal, and digestive symptoms more frequently than pregnant women. Being pregnant vs. not pregnant was associated with clinical manifestations of sore throat and being feverish. In addition, pregnancy is less likely to result in hospitalization and mortality among unvaccinated Filipinas. ConclusionPregnancy status indicates influence on hospitalization prevalence and mortality among unvaccinated Filipino women. Research on the longitudinal nature and post-recovery persistence of the symptoms of COVID-19 among women is recommended.

Minor changes in the incidence of primary and secondary involuntary childlessness across birth cohorts 1916 to 1975, but major differences in treatment success.

There have been tremendous advances in assisted reproductive technologies (ARTs) over the past 50 years. The present study assessed infertility outcomes among women of reproductive age during this period. The seventh survey of the Tromsø Study (Tromsø7, 2015-16) recruited Tromsø residents aged 40-98 years. The questionnaire collected information on sociodemographics and infertility, as well as data from a wide range of validated health questionnaires. Primary involuntary childlessness was defined as reporting one or more of the following: the clinical definition of infertility (i.e., infertility period of >1 year), infertility examination, use of ART, and/or the birth of a child conceived during ART. Women with secondary involuntary childlessness were those who reported infertility experience and had least one naturally conceived child. Parous women without infertility experience were classified as fertile, and nulliparous women without infertility experience as voluntarily childless. The main exposure was birth cohort (1916-35, aged 80-98 years; 1936-45, aged 70-79 years; 1946-55, aged 60-69 years; 1956-65, aged 50-59 years; 1966-75, aged 40-49 years). The incidence of primary involuntary childlessness was significantly higher in the 1956-75 cohort (6.0%; 95% CI: 5.4-6.6) than the 1916-55 cohort (3.7%; 95% CI: 3.2-4.3). The incidence of secondary involuntary childlessness was higher than that of primary involuntary childlessness across all birth cohorts and was highest for the 1966-75 cohort (10%), with no differences observed across the other birth cohorts (6-7%). An increasing proportion of women from the oldest to the youngest birth cohorts reported infertility examination and ART. ART success increased substantially with time, reaching 58% for primary and 46% for secondary infertility in the 1966-75 cohort. Voluntarily childless women comprised 5-6% of the 1916-55 cohort and 9-10% of the 1956-75 cohort. There were minor differences in the incidence of primary and secondary involuntary childlessness across the 1916-75 cohorts. Advances in ART over the past 50 years comprised 2.0% and 3.3% of population growth in the 1956-65 and 1966-75 cohorts, respectively: a remarkable achievement.

Post-9/11 veterans perceptions of the pandemic: Areas of greatest impact on health and well-being.

Assess potential impacts of the COVID-19 pandemic on a subset of Post-9/11 U.S. Veterans included in a study of post-traumatic epilepsy (PTE). Two measures were added to a structured health interview for Veterans during temporary pandemic research shutdown: a validated health questionnaire [1] previously completed by survey, and a semi-structured instrument developed to assess whether pandemic conditions affected responses to the health questionnaire and identify unique impacts. Interviews were conducted between August 2020 - February 2021. Scaled items were calculated and t-tests used to compare results. Open-ended items were coded using thematic analyses. Veterans identified eight major areas of impact with negative and positive impacts: mental health, family, social, work/employment, access to resources, physical health, finances, and education. The temporary shut-down of a large health study for Post-9/11 Veterans provided an opportunity to devise an instrument to assess COVID-19's impact on health and well-being. The instrument was accepted as of the first Veteran instrument in a pandemic SDOH research repository [2], and is being used in other studies. This study highlights the need to assess and understand interrelated relationships of factors impacting health and well-being, especially as COVID-19 moves from pandemic to endemic with reverberating effects across multiple social determinants of health (SDOH).

Hormonal IUD is the major hormonal contraceptive method used among women aged 40–49 years: Data from the 2015–16 Tromsø Study, Norway

ObjectiveThis study aims to investigate hormonal contraceptive (HC) use and user characteristics in women aged 40–49 years in Norway, as little is known on use of HCs in this age segment. Material and methodsThis prevalence study included 2296 women aged 40–49 years who participated in the 2015–16 Tromsø Study, which collected self-reported sociodemographic information and data from a wide range of validated health questionnaires. The participants had been sexually active the last 12 months prior enrollment, were not pregnant, not trying to conceive, and had no prior fertility problems. We categorized use of HC into three groups; no HC use, hormonal IUD use and other HC use. Explanatory variables included demographic, educational, economic and general health variables. All analyses were performed in SPSS with chi-square test and logistic regression at significance level p < 0.05. ResultsNearly 50 % of the study sample reported HC use with hormonal IUD use as the major method (39.5 %/40–44 years; 43.4 %/45–49 years old women). There were no differences in HC use by partner status, educational level, or BMI. Though statistically significant, we found only minor differences in HC use by occupational status, gross household income, and general health status, with higher proportions of women with no paid work, the lowest income, and poor health status reporting no HC use. ConclusionThe high HC use and the minor differences found across demographic and socioeconomic parameters indicate that HC use, and hormonal IUD use in particular, is widely used among middle-aged women living in the city of Tromsø.

Intraoperative high dose rate brachytherapy during breast-conserving surgery: A prospective pilot study.

To evaluate feasibility, quality of life, toxicity, and cosmetic outcome for intraoperative breast cancer brachytherapy after breast-conserving surgery using high dose rate brachytherapy. Fifty-two consecutive women, ⩾50 years old, diagnosed with a unifocal non-lobular breast cancer ⩽3 cm, N0, underwent breast-conserving surgery and sentinel node biopsy. Twenty-five women received intraoperative brachytherapy pre-pathology at primary surgery and the others post-pathology, during a second procedure. An applicator, connected to a high dose rate afterloader, was used. Two of the women were excluded due to metastases found per-operatively at a frozen section from the sentinel node. Quality of life was evaluated using two validated health questionnaires. Treatment toxicity was documented according to the LENT-SOMA scale by two oncologists. The cosmetic result was evaluated using the validated freely available software BCCT.core 2.0. The clinical procedure worked out well logistically. Seven women received supplementary external radiotherapy due to insufficient margins and, in one case, poor adaptation of the breast parenchyma to the applicator. No serious adverse effects from irradiation were registered. The results from the health questionnaires showed no major differences compared with reference groups from the Swedish population. Only two women were registered as having a "poor" cosmetic result while a majority of the women had a "good" outcome. This pilot study shows that intraoperative brachytherapy is a feasible procedure and encourages further trials evaluating its role in treatment of early breast cancer.

Health questionnaire analysis and development of satisfaction questionnaire for patients treated with extracorporeal shock wave lithotripsy (SATISLIT)

IntroductionDue to the absence of specific instruments to study the psychosocial sphere of patients undergoing extracorporeal shock wave lithotripsy (SWL), the objective of this study is to develop a satisfaction questionnaire regarding the SWL treatment from a health questionnaire which was already designed and had been previously validated. Material and methodsThe design of the satisfaction questionnaire was carried out in 5 phases, based on a previously validated health scale in patients treated with SWL (ESPTL), including a total cohort of 135 patients treated at our center who received a phone interview. Phase 1: descriptive analysis of the series and scores of the 8 items of ESPTL. Phase 2: U-Mann Whitney comparison of ESPTL based on the patients’ sex. Phase 3: study of ESPTL correlation with age using Spearman’s Rho. Phase 4: grouping by factors of ESPTL, comparison by sex and correlation with age, as performed in phases 2 and 3 with the global score. Phase 5: obtaining the satisfaction subscale -SATISLIT-, descriptive analysis, comparison according to sex, correlation with age and linear regression model of SATISLIT with respect to ESPTL. Results135 patients, 85(63%) men, 50(37%) women. Median (minimum-maximum) age 56 (27–79) and ESPTL score 31 (8–39).Differences in global ESPTL score between men and women (p<.001), as well as in items 1 (p=.029), 3 (p=.002), 6 (p=.006), 7 (p=.005) and 8 (p=.025).Non-significant correlation of ESPTL regarding age. Significant correlation in items 2, 4, 5 and 8 but, very weak (<0.2).4 factors, each one with 2 items, with statistically significant differences regarding sex in F2 (p=.001), F3 (p=.007) and F4 (p=.001). Significant correlation with age only in F1 and F3, but very weak (<0.2).Median (minimum-maximum) SATISLIT 18 (4–20). Statistically significant differences regarding patients’ sex (p=.001). Non-significant correlation with age (p=.836). Significant linear regression of SATISLIT with respect to ESPTL (p<.001). ConclusionsBased on validated health questionnaire, the present work has provided a new instrument called SATISLIT for assessing patients’ satisfaction after treatment with SWL. Future studies with external and temporal validation will be necessary to contrast its real clinical usefulness.

Análisis de cuestionario de salud y desarrollo de cuestionario de satisfacción en pacientes tratados con litotricia extracorpórea por ondas de choque (SATISLIT)

IntroductionDue to the absence of specific instruments to study the psychosocial sphere of patients undergoing extracorporeal shock wave lithotripsy (SWL), the objective of this study is to develop a satisfaction questionnaire regarding the SWL treatment from a health questionnaire which was already designed and had been previously validated. Material and methodsThe design of the satisfaction questionnaire was carried out in 5 phases, based on a previously validated health scale in patients treated with SWL (ESPTL), including a total cohort of 135 patients treated at our center who received a phone interview. Phase 1: descriptive analysis of the series and scores of the 8 items of ESPTL. Phase 2: U-Mann Whitney comparison of ESPTL based on the patients’ sex. Phase 3: study of ESPTL correlation with age using Spearman's Rho. Phase 4: grouping by factors of ESPTL, comparison by sex and correlation with age, as performed in phases 2 and 3 with the global score. Phase 5: obtaining the satisfaction subscale -SATISLIT-, descriptive analysis, comparison according to sex, correlation with age and linear regression model of SATISLIT with respect to ESPTL. Results135 patients, 85(63%) men, 50(37%) women. Median (minimum-maximum) age 56 (27-79) and ESPTL score 31 (8-39).Differences in global ESPTL score between men and women (p <.001), as well as in items 1 (p =.029), 3 (p =.002), 6 (p =.006), 7 (p =.005) and 8 (p =.025).Non-significant correlation of ESPTL regarding age. Significant correlation in items 2, 4, 5 and 8 but, very weak (<0.2).4 factors, each one with 2 items, with statistically significant differences regarding sex in F2 (p =.001), F3 (p =.007) and F4 (p =.001). Significant correlation with age only in F1 and F3, but very weak (<0.2).Median (minimum-maximum) SATISLIT 18 (4-20). Statistically significant differences regarding patients’ sex (p =.001). Non- significant correlation with age (p =.836). Significant linear regression of SATISLIT with respect to ESPTL (p <.001). ConclusionsBased on validated health questionnaire, the present work has provided a new instrument called SATISLIT for assessing patients’ satisfaction after treatment with SWL. Future studies with external and temporal validation will be necessary to contrast its real clinical usefulness.

Identifying Preoperative Factors Associated with Nonresponders in Women Undergoing Comprehensive Surgical Treatment for Endometriosis

Study ObjectiveTo examine whether existing quality of health outcome measures can be used to predict or have an association with nonresponse surgery for endometriosis. DesignRetrospective cohort study. SettingsSingle endometriosis referral center. PatientsWomen (n = 198) undergoing surgery for endometriosis. InterventionsValidated health questionnaires and visual analogue scales. Measurements and Main ResultsPatients were given validated health questionnaires, including Endometriosis Health Profile 30, Gastrointestinal Quality of Life Index, EuroQol-5, Hospital Anxiety and Depression Scale, preoperatively and at 12 months after full surgical excision of endometriosis. Visual analogue scales were also used that measured dyschezia, dysmenorrhea, dyspareunia, and chronic pelvic pain. Surgical management was dependent on severity of disease. Superficial disease was treated by laparoscopic peritoneal excision or laser ablation. Deep infiltrating disease involving the bowel was excised completely together with laparoscopic bowel surgery (shave, disc, or segmental resection) with/without concomitant total hysterectomy and bilateral salpingo-oophorectomy. Nonresponders were defined as women who failed to demonstrate an improvement in pain scores 12 months postoperatively. We examined preoperative and postoperative questionnaires, visual analogue scores, and other variables such as age at onset of symptoms, type of surgery, and the presence of postoperative complications comparing responder and nonresponder women to identify the factors associated with nonresponse. Of 102 women treated for superficial endometriosis, 25 (24.51%) were nonresponders. No factors were associated with nonresponse at 12 months. Of 96 women treated for severe endometriosis involving the bowel, 10 (10.41%) were nonresponders. Nonresponders had significantly less preoperative pain (p = .031) and feeling of control (p = .015) than responders. There was no association between nonresponders and women who underwent a hysterectomy with bilateral salpingo-oophorectomy or those with complications. Radical bowel surgery (resection) was associated with nonresponders. ConclusionMinimal preoperative factors are associated with nonresponse for women having surgery for endometriosis. The severity of pain experienced by women with endometriosis may be used to predict their response to surgery.

The clinical presentation, diagnosis and pathogenesis of symptomatic sports-related femoroacetabular impingement (SRFAI) in a consecutive series of 1021 athletic hips.

Aim:To examine the pathogenesis and clinical presentation of sports-related femoroacetabular impingement (SRFAI) in a large consecutive series of symptomatic athletes.Methods:Between January 2009 and February 2017 prospectively collected data from competitive athletes within the Gaelic Athletic Association (GAA), and who subsequently underwent arthroscopic treatment for symptomatic FAI, were analysed. Data was collected using internationally validated health questionnaires (Harris Hip Score, UCLA, SF-36, WOMAC) and recognised clinical (ROM, symptom presentation, provocation tests) and radiological (AP pelvis, Dunn, False profile) indicators/measures of FAI.Results:A total of 1021 consecutive cases (mean 26.6 ± 6.2 years) were included. In every case, conservative treatment failed to resolve symptoms with athletes attending an average of 2.4 ± 1.1 health care professionals prior to referral. Symptoms developed gradually (78%) and consisted primarily of groin pain (76.1%) and hip stiffness (76.5%) following activity.An acetabular rim deformity (pincer) was present in all cases; a cam deformity in 72.1%. The prevalence and degree of cam deformity increased with progressing age groups (p < 0.001); mean lateral centre-edge angle remained static (p = 0.456). Increasing CEA, alpha angle and presence of rim fracture was associated with a reduction in all ranges of hip movement (p < 0.001).Conclusion:Symptomatic SRFAI presented in this large series of GAA athletes failed to resolve with non-operative treatment. Increasing hip deformity resulted in poorer ROM. Abnormal acetabular morphology remains static with increasing athletic age while cam deformity is progressive and most likely a secondary pathology.

Working Health Services Scotland: a 4-year evaluation.

BackgroundWorking Health Service Scotland (WHSS) supports the self-employed and employees of small and medium-sized enterprises (SMEs) in Scotland with a health condition affecting their ability to work, who are either absent or at risk of becoming absent due to it.AimsTo evaluate the impact on health and work outcomes of WHSS clients over a 4-year period.MethodsData were collected at enrolment, entry, discharge and follow-up at 3 and 6 months after discharge. Clients completed up to three validated health questionnaires at entry and discharge—EuroQol five dimensions (EQ-5D) and visual analogue scale (VAS); Hospital Anxiety and Depression Scale (HADS); and Canadian Occupational Performance Measure (COPM).ResultsA total of 13463 referrals occurred in the 4-year period; 11748 (87%) were eligible and completed entry assessment and 60% of the latter completed discharge paperwork. The majority of referrals were due to musculoskeletal conditions (84%) while 12% were referred with mental health conditions. Almost a fifth (18%) of cases were absent at entry and back at work at discharge. Work days lost while in WHSS was associated with age, length of absence prior to entering WHSS, primary health condition and time in programme. All health measures showed significant improvements from entry to discharge. Improvement in general health was sustained at 3- and 6-month follow-up.ConclusionsThe WHSS evaluation findings indicate that participation was associated with positive changes to health and return-to-work. The extent of the positive change in health measures and work ability can be highly important economically for employees and employers.

MP69-13 PATIENT REPORTED HEALTH AND QUALITY OF LIFE AFTER NEOADJUVANT CHEMOTHERAPY AND CYSTECTOMY: RESULTS FROM BLADDER CANCER OUTCOMES AND IMPACT STUDY

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making III1 Apr 2017MP69-13 PATIENT REPORTED HEALTH AND QUALITY OF LIFE AFTER NEOADJUVANT CHEMOTHERAPY AND CYSTECTOMY: RESULTS FROM BLADDER CANCER OUTCOMES AND IMPACT STUDY Dominic Tang, Andrew Leone, Juan Chipollini, Paul Crispen, Carl Henriksen, Michael Poch, Wade Sexton, and Scott Gilbert Dominic TangDominic Tang More articles by this author , Andrew LeoneAndrew Leone More articles by this author , Juan ChipolliniJuan Chipollini More articles by this author , Paul CrispenPaul Crispen More articles by this author , Carl HenriksenCarl Henriksen More articles by this author , Michael PochMichael Poch More articles by this author , Wade SextonWade Sexton More articles by this author , and Scott GilbertScott Gilbert More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2309AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prior quality of life (QOL) research in bladder cancer has predominantly focused on differences between patients treated with radical cystectomy (RC) and different forms of urinary diversion. Other aspects of bladder cancer treatment, such as receipt of neoadjuvant chemotherapy (NAC), have gone unexamined. Using validated health questionnaires, we sought to determine the relationship between receipt of NAC and patient QOL. METHODS 124 patients were enrolled in a prospective complication and QOL assessment study between 2013 and 2015. Patients were surveyed longitudinally with a panel of health questionnaires, including the SF-36, a measure of general quality of life. The SF-36 contains 36 questions that assess several health domains, including physical functioning, physical health problems, pain, general health perception, emotional well-being, emotional health problems, social functioning and energy/fatigue. Patients surveyed in this study completed the SF-36 prior to cystectomy and at 3, 6 and 12-months following RC. Generalized linear models were used to examine differences in SF-36 scores by the primary exposure of interest (receipt of NAC) and adjusted for clinical and demographic factors. RESULTS 87 patients completed the SF-36 at both baseline and 6 months. The mean age was 68 years and 66 (75.8%) were men. More than half (46, 52.9%) received NAC. Patients who were not treated with NAC had lower SF-36 scores 6 months after RC (change in physical composite score (PCS) -1.47 vs. +1.95 and mental composite score (MCS) -1.96 vs. +3.68) compared to those who did. After adjusting for age, gender, diversion type and stage, receipt of NAC was significantly associated with higher general health perceptions (PE 5.29, p=0.012), emotional well-being (PE 5.41, p=0.012), and mental composite score (PE 6.02, p=0.005). There was no difference with NAC in PCS after controlling for confounders (p=0.10). CONCLUSIONS Receipt of NAC is a significant predictor of better quality of life 6 months after cystectomy as measured by SF-36. We found significant differences between patients treated with and without NAC in several domains, including mental composite score, general health perception, and emotional well-being. The exact mediators of this association need to be examined in larger studies. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e931 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Dominic Tang More articles by this author Andrew Leone More articles by this author Juan Chipollini More articles by this author Paul Crispen More articles by this author Carl Henriksen More articles by this author Michael Poch More articles by this author Wade Sexton More articles by this author Scott Gilbert More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Efficiency of laser treatment in patients with hereditary hemorrhagic telangiectasia

Earlier studies have shown the effect of laser treatment on epistaxis in patients with hereditary hemorrhagic telangiectasia (HHT). At the present time, only very few prospective trials have been performed, and many studies are based on patients' subjective assessment of the severity of epistaxis. This prospective study measures the objective effect of laser treatment in HHT patients with mild to moderate epistaxis. We introduce an objective measure to assess the severity of epistaxis: the bleeding time (BT). Before and after treatment, the quality of life, as measured by the patient, was assessed and compared to normative data. In 30 patients, we measured the BT before laser treatment 1.5 and 6.5months after treatment. The Short form 36 (SF-36), a validated health questionnaire, was completed before and 6.5months after treatment. Compared to preoperative value, BT was significantly reduced 1.5 and 6.5months after laser treatment (p<0.05) in both cases. No significant difference in quality of life, before and after treatment, was found. The quality of life of the HHT patients was reduced in five out of eight dimensions when compared with the Danish background population. Laser treatment reduces epistaxis in HHT patients with mild to moderate epistaxis for at least 6months; this group of patients have reduced quality of life compared to the background population.

Increased Prevalence of Cardiovascular and Autoimmune Diseases in Periodontitis Patients: A Cross‐Sectional Study

Associations between periodontitis and cardiovascular and autoimmune diseases are most often assessed in patients with a particular cardiovascular or autoimmune disease. To prevent selection bias, this study assesses the existence of associations between periodontitis and cardiovascular and autoimmune diseases in patients attending a dental or periodontal clinic. Data were collected from 1,276 randomly selected dental records from patients attending a dental (n = 588) or periodontal (n = 688) clinic. Data on the prevalence of cardiovascular and autoimmune diseases were obtained from a validated health questionnaire. Data on the presence of periodontitis were taken from patients' dental records. In uncontrolled analyses, the prevalence of hypertension, diabetes mellitus (DM), and rheumatoid arthritis (RA) is significantly increased in patients with periodontitis. Controlled for confounding, periodontitis was associated with DM, with an odds ratio of 4 (1.03 to 15.3), in the dental clinic. DM was not associated with periodontitis in periodontal clinics. Hypertension does not seem to be associated with periodontitis when controlling for confounders. Periodontitis may be associated with RA in both clinic types. The increased prevalence of cardiovascular and autoimmune diseases among patients with periodontitis attending dental or periodontal clinics may, at least in part, be influenced by confounding. However, the increased prevalence of DM and RA in patients with periodontitis could not be explained by confounding.

Exposure to environmental pollutants is related to sore throats and increased expression of HLA-DQ in the upper airway mucosa of man

Objectives. To determine the symptomatic and mucosal immune response to environmental pollution in UK population. Methods. We performed a prospective, matched questionnaire and laryngeal biopsy study in normal persons (n = 63). Subjects completed a validated health questionnaire. Levels of exposure to pollutants for the year prior to the study were determined via area-based measurements of environmental particulates and composite air quality indices (CAQI). Quantitative multiple-colour immunofluorescence was used to measure in vivo expression of antigens in laryngeal mucosal pinch biopsies: CD45 (RO, RC: leucocytes), CD4, CD8, CD79, (lymphocytes), MHC I, II (antigen presenting molecules). Multiple linear regression, correcting for age, was used to explore the relationship between dependent variables and pollution measures. Results. Complete data were available for 49 (questionnaire) and 54 (immunohistology) subjects. High levels of particulates and CAQI were associated with self-reported frequent sore throats (P = 0.04 and 0.01, respectively), and with a trend towards increased asthma (P = 0.07 and 0.08). Dual HLA-DQ (MHC II) and CD45 (leucocyte) expression by laryngeal epithelium was significantly correlated with levels of particulates (P = 0.03) and CAQI (P = 0.04). CAQI alone was significantly associated with CD4+ expression (P = 0.002). Conclusions. Pollution is known be associated with an increased prevalence of asthma, but this is the first report of an association with throat symptoms. We hypothesise that environmental pollution may contribute to pharyngeal inflammation by selective up-regulation of the MHC Class II molecule, HLA-DQ in epithelium and subsequent activation of leucocytes.

Outcomes and quality of life assessment in patients undergoing endoscopic surgery for pituitary adenomas

The endoscopic technique is increasingly being used for the resection of pituitary adenomas. Its efficacy and safety have been generally accepted, but its impact on the quality of life of the patients treated has not been previously addressed. Most of the studies assessing the quality of life after long-term cure of pituitary adenomas suggest a significantly impaired quality of life (QoL) in all subgroups of pituitary tumours. In our study we analyse QoL data following endoscopic surgery, and attempt comparisons with normative and data from standard approaches. The validated health questionnaire SF-36 was sent to 80 patients who had undergone pure endoscopic resection of a pituitary adenoma. Fifty-four patients returned the completed questionnaire. Outcomes were compared with normative data for the Short Form-36 (SF-36) Heath survey for the general Canadian population. We also compared the results amongst different types of adenomas. We attempted a comparison to previous studies on quality of life for patients who underwent conventional trans-sphenoidal surgery. Our study suggests only minimal impairment of quality of life in patients after successful treatment of pituitary adenomas using the endoscopic approach. There were only very few differences in the perceived quality of life within the different subgroups of adenomas. There was a trend to improved scores in the endoscopic group compared with previous studies in patients treated by conventional approaches. Whilst our data suggest minimal impact on the quality of life for patients after endoscopic removal of pituitary adenomas, further studies with larger number of patients and longer follow-up are required to encourage this finding.

Patient health record on a smart card

A validated health questionnaire has been used for the documentation of a patient's history (826 items) and of the findings from physical examination (591 items) in our clinical ward for 25 years. This computerized patient record has been completed in EUCLIDES code (CEN TC/251) for laboratory tests and an ATC and EAN code listing for the names of the drugs permanently required by the patient. In addition, emergency data were also included on an EEPROM chipcard with a 24 kb capacity. The program is written in FOX-PRO language. A group of 5000 chronically ill in-patients received these cards which contain their health data. For security reasons the contents of the smart card is only accessible by a doctor’s PIN coded key card. The personalization of each card was carried out in our health center and the depersonalized alphanumeric data were collected for further statistical evaluation. This information served as a basis for a real need assessment of health care and for the calculation of its cost. Code-combined with an optical card, a completely paperless electronic patient record system has been developed containing all three information carriers in medicine: Texts, Curves and Pictures.

Preventive Intervention With the Recently Bereaved

To study the effectiveness of preventive intervention in lowering postbereavement morbidity, 200 widows were assessed in the early weeks following their husbands' deaths. Subjects at risk for postbereavement morbidity were selected and randomly allocated to experimental (N = 31) and control (N = 33) groups. Specific support for grief and encouragement of mourning was carried out with the experimental group during the first three months; no intervention was given to the control group. All were followed up 13 months later with a validated health questionnaire. There was a significant lowering of morbidity in the intervention group as compared to the control group (P less than .02). The most significant impact of intervention occurred with the subgroup of intervention and control subjects who perceived their social networks as very nonsupportive during the bereavement crisis (P less than .001).