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Sample records for alendronate improves qol

  1. Alendronate

    Science.gov (United States)

    ... have undergone menopause (''change of life,'' end of menstrual periods) and to treat osteoporosis in men. Alendronate ... alendronate.Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

  2. Whole body vibration exercise improves body balance and walking velocity in postmenopausal osteoporotic women treated with alendronate: Galileo and Alendronate Intervention Trail (GAIT).

    Science.gov (United States)

    Iwamoto, J; Sato, Y; Takeda, T; Matsumoto, H

    2012-09-01

    A randomized controlled trial was conducted to determine the effect of 6 months of whole body vibration (WBV) exercise on physical function in postmenopausal osteoporotic women treated with alendronate. Fifty-two ambulatory postmenopausal women with osteoporosis (mean age: 74.2 years, range: 51-91 years) were randomly divided into two groups: an exercise group and a control group. A four-minute WBV exercise was performed two days per week only in the exercise group. No exercise was performed in the control group. All the women were treated with alendronate. After 6 months of the WBV exercise, the indices for flexibility, body balance, and walking velocity were significantly improved in the exercise group compared with the control group. The exercise was safe and well tolerated. The reductions in serum alkaline phosphatase and urinary cross-linked N-terminal telopeptides of type I collagen during the 6-month period were comparable between the two groups. The present study showed the benefit and safety of WBV exercise for improving physical function in postmenopausal osteoporotic women treated with alendronate.

  3. Systemic alendronate treatment improves fixation of press-fit implants: a canine study using nonloaded implants

    DEFF Research Database (Denmark)

    Jensen, Thomas B; Bechtold, Joan E; Chen, Xinqian

    2007-01-01

    of alendronate treatment. Bone ongrowth (bone in contact with implant surface) was estimated using the linear intercept technique and shear strength was calculated as the slope on a load-displacement curve. For the press fit implants, alendronate treatment significantly increased bone ongrowth from 24% to 29...... early implant stability is an important predictor of longevity, systemic alendronate treatment could be an important clinical tool to positively influence the early stages of implant incorporation. Udgivelsesdato: 2007-Jun...

  4. Alendronate Can Improve Bone Alterations in Experimental Diabetes by Preventing Antiosteogenic, Antichondrogenic, and Proadipocytic Effects of AGEs on Bone Marrow Progenitor Cells

    Directory of Open Access Journals (Sweden)

    Sara Rocío Chuguransky

    2016-01-01

    Full Text Available Bisphosphonates such as alendronate are antiosteoporotic drugs that inhibit the activity of bone-resorbing osteoclasts and secondarily promote osteoblastic function. Diabetes increases bone-matrix-associated advanced glycation end products (AGEs that impair bone marrow progenitor cell (BMPC osteogenic potential and decrease bone quality. Here we investigated the in vitro effect of alendronate and/or AGEs on the osteoblastogenic, adipogenic, and chondrogenic potential of BMPC isolated from nondiabetic untreated rats. We also evaluated the in vivo effect of alendronate (administered orally to rats with insulin-deficient Diabetes on long-bone microarchitecture and BMPC multilineage potential. In vitro, the osteogenesis (Runx2, alkaline phosphatase, type 1 collagen, and mineralization and chondrogenesis (glycosaminoglycan production of BMPC were both decreased by AGEs, while coincubation with alendronate prevented these effects. The adipogenesis of BMPC (PPARγ, intracellular triglycerides, and lipase was increased by AGEs, and this was prevented by coincubation with alendronate. In vivo, experimental Diabetes (a decreased femoral trabecular bone area, osteocyte density, and osteoclastic TRAP activity; (b increased bone marrow adiposity; and (c deregulated BMPC phenotypic potential (increasing adipogenesis and decreasing osteogenesis and chondrogenesis. Orally administered alendronate prevented all these Diabetes-induced effects on bone. Thus, alendronate could improve bone alterations in diabetic rats by preventing the antiosteogenic, antichondrogenic, and proadipocytic effects of AGEs on BMPC.

  5. Improvement of Quality of Life (QOL in Osteoporotic Patients by Elcatonin Treatment: A Trial Taking the Participants’ Preference into Account

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    K. Yoh

    2012-01-01

    Full Text Available Osteoporosis is associated with compromised quality of life (QOL, to which pain has the most important contribution. Elcatonin, a derivative of calcitonin, is widely used in the treatment of osteoporosis in two ways. One is as the inhibitor of osteoclastic bone resorption. The other is for osteoporosis-related pain based on the unique analgesic effects of elcatonin. Since pain is subjective in nature, and QOL is the only clinical outcome representing the patients’ subjective perception of health status, pain associated with osteoporosis would be best evaluated based on QOL assessment. Evidence based medicine gives the highest remarks to the double-blinded, randomized controlled trial, which, however, cannot be free from methodological problems on some occasions. For example, it is practically impossible to remain blinded in the trial of a potent analgesia, which in turn causes biases. Thus, the significance of taking the patients’ preference into account is increasingly acknowledged. In this study, 45 osteoporotic patients were given brochures describing the pros and cons on the three treatment choices; calcium and alfacalcidol, additional use of elcatonin, and additional use of bisphosphonate. Those who favored elcatonin were older, had more vertebral fractures, and lower QOL scores. QOL was evaluated before and three months after the treatment using SF-8; the most widely used generic questionnaire, and RDQ; a lumbago-specific measure. Elcatonin treatment improved physical function, general health, and vitality of SF-8, and RDQ score. Although this is a preliminary study, our results suggest that patients with vertebral fracture(s have impaired QOL and more likely to favor elcatonin treatment expecting analgesia.

  6. Alendronate-Loaded Modified Drug Delivery Lipid Particles Intended for Improved Oral and Topical Administration

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    Lacramioara Ochiuz

    2016-06-01

    Full Text Available The present paper focuses on solid lipid particles (SLPs, described in the literature as the most effective lipid drug delivery systems that have been introduced in the last decades, as they actually combine the advantages of polymeric particles, hydrophilic/lipophilic emulsions and liposomes. In the current study, we present our most recent advances in the preparation of alendronate (AL-loaded SLPs prepared by hot homogenization and ultrasonication using various ratios of a self-emulsifying lipidic mixture of Compritol 888, Gelucire 44/14, and Cremophor A 25. The prepared AL-loaded SLPs were investigated for their physicochemical, morphological and structural characteristics by dynamic light scattering, differential scanning calorimetry, thermogravimetric and powder X-ray diffraction analysis, infrared spectroscopy, optical and scanning electron microscopy. Entrapment efficacy and actual drug content were assessed by a validated HPLC method. In vitro dissolution tests performed in simulated gastro-intestinal fluids and phosphate buffer solution pH 7.4 revealed a prolonged release of AL of 70 h. Additionally, release kinetics analysis showed that both in simulated gastrointestinal fluids and in phosphate buffer solution, AL is released from SLPs based on equal ratios of lipid excipients following zero-order kinetics, which characterizes prolonged-release drug systems.

  7. Effects of Aqua Exercises Towards Improving The Quality of Life (QoL) of Obese Women in Malaysia

    Science.gov (United States)

    Karim, Noor Liyana Binti; Jalil, Asma Diyana binti Abd; Hasri, Noor Haninah Binti; Rahman, Hezlin Aryani Binti Abd; Shari, Maisarah Binti; Idris, Nur Izzati Binti

    2018-05-01

    Aqua exercise is a form of water exercise, done in the water which is beneficial for weight loss as well as improving the quality of life. It is suitable for all age group and fitness levels whereby due to the water buoyancy makes it easier to perform exercises especially for obese and knee-injured people. However, there was not much study done to measure the effectiveness of the aqua exercises in improving the quality life. Thus, this study aims to investigate and compare the effectiveness of aqua exercises towards obese women within eight domains of the Quality of Life (QoL). This study uses the 36-Items Short Form Health Survey (SF-36) questionnaire and a purposive sample of 61 participants to measure the effectiveness of the aqua exercise before and after 36 days of aqua workout. As the nature of the data collected was not normally distributed, hence the Wilcoxon signed rank test was used as the statistical method of analysis. The findings of this study showed that there was a significant difference between the overall QoL pre and post since the p-value physical functioning, general health, social functioning, mental health, and health transition were the domains showing significant difference between the pre and post-test (p-value < 0.05), and where majority of the participants showed a significant improvement after the aqua workouts. Thus, it can be concluded that aqua exercises is effective in improving the general QoL of obese women.

  8. Home-based walking improves cardiopulmonary function and health-related QOL in community-dwelling adults.

    Science.gov (United States)

    Okamoto, N; Nakatani, T; Morita, N; Saeki, K; Kurumatani, N

    2007-12-01

    The objective of our study was to investigate the effects of a home-based walking program on physical fitness and QOL among community residents. Subjects (n = 200, mean age: 64.2 years, range: 42 - 75 years) who participated in the 32-week trial were randomly allocated to one of two groups: an exercise (E) group and a control (C) group. The E group was instructed to increase the number of steps a day that they walked and to perform aerobic walking at a target heart rate for 20 minutes or more daily, 2 or more days a week. The C group was told to continue their normal level of activity. Outcome measures were the 3-minute shuttle stamina walk test (SSWT), 30-second chair-stand test (CS-30), and SF-36. Increases in SSWT values were significantly greater in the E group than in the C group (men 24.1 m vs. 6.3 m; women 8.8 m vs. 2.4 m), as were increases in CS-30 values (men 5.9 vs. 2.6; women 4.5 vs. - 0.1). On the SF-36, the scores in the E group for vitality and mental health increased significantly. Home-based walking is considered to be an effective and feasible method to improve physical fitness and QOL among community residents.

  9. Nodular scleritis following alendronate therapy.

    Science.gov (United States)

    Tabbara, Khalid F

    2008-01-01

    To report a case of nodular scleritis following alendronate sodium. A 54 year-old male was treated with alendronate sodium 70 mg orally once per week. Eight weeks later, he experienced pain and redness of the right eye. Biomicroscopy was performed. Patient was found to have inferonasal nodular scleritis. Laboratory work-up was unrevealing. Patient was given 4 mg of subtenon's triamcinolone acetate in the area of the nodular scleritis and had complete resolution. Two weeks following rechallenge with alendronate sodium resulted in recurrence of his scleritis. Alendronate led to nodular scleritis and rechallenge caused recurrence of scleritis.

  10. Alendronate in early postmenopausal women

    DEFF Research Database (Denmark)

    Ravn, Pernille; Weiss, S R; Rodriguez-Portales, J A

    2000-01-01

    We studied the effect on bone mass of alendronate treatment for 5 yr and its withdrawal. Four hundred and forty-seven postmenopausal women with normal bone mass entered a 3-yr randomized trial followed by a 2-yr open label extension. Three hundred and eleven women completed the first 3 yr, and 263...... consented to continue and completed the extension. We are reporting data from groups using the dose of alendronate currently approved for osteoporosis prevention (5 mg) or from the group in which alendronate treatment was withdrawn: 52 women received alendronate (5 mg) for 5 yr (group I), 56 received 3 yr...

  11. Diagnostic PET Imaging of Mammary Microcalcifications Using 64Cu-DOTA-Alendronate in a Rat Model of Breast Cancer.

    Science.gov (United States)

    Ahrens, Bradley J; Li, Lin; Ciminera, Alexandra K; Chea, Junie; Poku, Erasmus; Bading, James R; Weist, Michael R; Miller, Marcia M; Colcher, David M; Shively, John E

    2017-09-01

    The development of improved breast cancer screening methods is hindered by a lack of cancer-specific imaging agents and effective small-animal models to test them. The purpose of this study was to evaluate 64 Cu-DOTA-alendronate as a mammary microcalcification-targeting PET imaging agent, using an ideal rat model. Our long-term goal is to develop 64 Cu-DOTA-alendronate for the detection and noninvasive differentiation of malignant versus benign breast tumors with PET. Methods: DOTA-alendronate was synthesized, radiolabeled with 64 Cu, and administered to normal or tumor-bearing aged, female, retired breeder Sprague-Dawley rats for PET imaging. Mammary tissues were subsequently labeled and imaged with light, confocal, and electron microscopy to verify microcalcification targeting specificity of DOTA-alendronate and elucidate the histologic and ultrastructural characteristics of the microcalcifications in different mammary tumor types. Tumor uptake, biodistribution, and dosimetry studies were performed to evaluate the efficacy and safety of 64 Cu-DOTA-alendronate. Results: 64 Cu-DOTA-alendronate was radiolabeled with a 98% yield. PET imaging using aged, female, retired breeder rats showed specific binding of 64 Cu-DOTA-alendronate in mammary glands and mammary tumors. The highest uptake of 64 Cu-DOTA-alendronate was in malignant tumors and the lowest uptake in benign tumors and normal mammary tissue. Confocal analysis with carboxyfluorescein-alendronate confirmed the microcalcification binding specificity of alendronate derivatives. Biodistribution studies revealed tissue alendronate concentrations peaking within the first hour, then decreasing over the next 48 h. Our dosimetric analysis demonstrated a 64 Cu effective dose within the acceptable range for clinical PET imaging agents and the potential for translation into human patients. Conclusion: 64 Cu-DOTA-alendronate is a promising PET imaging agent for the sensitive and specific detection of mammary tumors as

  12. EFFICACY AND SAFETY OF ALENDRONIC ACID IN PATIENTS WITH JUVENILE RHEUMATOID ARTHRITIS AND OSTEOPOROSIS

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    A.O. Lisitsin

    2010-01-01

    Full Text Available Search for and practical application of new medications to treat of osteoporosis is one of the critical issues in pediatric rheumatology. The article reviews the efficacy and safety of alendronic acid in 64 subjects with juvenile rheumatoid arthritis and systemic osteoporosis. It is demonstrated that alendronate-based therapy in weekly 1 mg/kg doses over 12 months facilitated reliably increased bonedensity, decreased intensity of pain syndrome, and lowered C-terminal telopeptide serum concentration, which indicates improved bone metabolism processes.Key words: juvenile rheumatoid arthritis, osteoporosis, children, treatment, bisphosphonates, alendronic acid. (Pediatric Pharmacology. – 2010; 7(1:48-54

  13. Neuro-QOL

    Science.gov (United States)

    Lai, J.-S.; Nowinski, C.J.; Victorson, D.; Peterman, A.; Miller, D.; Bethoux, F.; Heinemann, A.; Rubin, S.; Cavazos, J.E.; Reder, A.T.; Sufit, R.; Simuni, T.; Holmes, G.L.; Siderowf, A.; Wojna, V.; Bode, R.; McKinney, N.; Podrabsky, T.; Wortman, K.; Choi, S.; Gershon, R.; Rothrock, N.; Moy, C.

    2012-01-01

    Objective: To address the need for brief, reliable, valid, and standardized quality of life (QOL) assessment applicable across neurologic conditions. Methods: Drawing from larger calibrated item banks, we developed short measures (8–9 items each) of 13 different QOL domains across physical, mental, and social health and evaluated their validity and reliability. Three samples were utilized during short form development: general population (Internet-based, n = 2,113); clinical panel (Internet-based, n = 553); and clinical outpatient (clinic-based, n = 581). All short forms are expressed as T scores with a mean of 50 and SD of 10. Results: Internal consistency (Cronbach α) of the 13 short forms ranged from 0.85 to 0.97. Correlations between short form and full-length item bank scores ranged from 0.88 to 0.99 (0.82–0.96 after removing common items from banks). Online respondents were asked whether they had any of 19 different chronic health conditions, and whether or not those reported conditions interfered with ability to function normally. All short forms, across physical, mental, and social health, were able to separate people who reported no health condition from those who reported 1–2 or 3 or more. In addition, scores on all 13 domains were worse for people who acknowledged being limited by the health conditions they reported, compared to those who reported conditions but were not limited by them. Conclusion: These 13 brief measures of self-reported QOL are reliable and show preliminary evidence of concurrent validity inasmuch as they differentiate people based upon number of reported health conditions and whether those reported conditions impede normal function. PMID:22573626

  14. Evaluation of QOL in cancer patients treated with radiation therapy

    International Nuclear Information System (INIS)

    Takahashi, Takeo; Machida, Kikuo; Honda, Norinari; Hosono, Makoto; Murata, Osamu; Osada, Hisato; Omichi, Masahide

    2002-01-01

    Evaluation of quality of life (QOL) in cancer patients is an important theme. However, we do not have an established method to assess QOL in cancer patients during radiotherapy in Japan. We evaluated both the changes of QOL and the factors affecting QOL in radiotherapy patients. Three hundred fifty-five cancer patients, who filled in a questionnaire at the beginning, middle, and end of radiotherapy between 1998 and 2001, were studied. We used The QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL-ACD)'' devised by Kurihara et al, the Ministry of Health and Welfare. The QOL Questionnaire had five categories: physical activity, physical condition, mental state, social interaction, and face scale. The total score, sum of the score of five categories, were established synthetically (maximum score is 110). The mean of total QOL scores were 75.8, 77.6, and 78.2 at the beginning, middle, and end of radiotherapy respectively. Patients with symptoms related to cancer had apparent improvement of QOL score. Patients receiving chemotherapy had a decreased QOL score at the end of radiotherapy. The score of physical condition was reduced improvement. It was suggested that radiotherapy could be performed without losing QOL of cancer patients, including older patients. However, patients receiving chemotherapy and those with head and neck cancer may lose their QOL, therefore, we should treat such patients carefully. (author)

  15. Possible alendronate-induced polyarticular synovitis

    Directory of Open Access Journals (Sweden)

    K Gökkus

    2016-01-01

    The patient had no evidence of rheumatoid arthritis, pyrophosphate arthropathy, or seronegative/seropositive arthritis. Our main aim in this study is to highlight the potential adverse effects of alendronate and to warn orthopedic surgeons about the possibility of such a side effect that might lead orthopedic surgeons to administer wrong and unnecessary treatments like arthrocentesis. The withdrawal of alendronate is found to be the treatment of choice. Alendronate should be considered as a possible cause of synovitis or polyarthritis in patients treated with this agent in the absence of any other pathology. An association between alendronate and synovitis has rarely been described in the literature. We present a patient who developed polyarticular synovitis after treatment with alendronate and responded to its withdrawal.

  16. Effect of heparin and alendronate coating on titanium surfaces on inhibition of osteoclast and enhancement of osteoblast function

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Ho-Jin; Yun, Young-Pil [Department of Maxillofacial Biomedical Engineering, School of Dentistry, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Han, Choong-Wan; Kim, Min Sung [Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Institute of Oral Biology, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Kim, Sung Eun; Bae, Min Soo [Department of Maxillofacial Biomedical Engineering, School of Dentistry, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Kim, Gyu-Tae; Choi, Yong-Suk; Hwang, Eui-Hwan [Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Institute of Oral Biology, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Lee, Joon Woo [Department of Technology Commercialization Information, Korea Institute of Science and Technology Information (KISTI), 66, Hoegi-ro, Dongdaemun-gu, Seoul 130-741 (Korea, Republic of); Lee, Jin-Moo; Lee, Chang-Hoon [Department of Oriental Gynecology, College of Oriental Medicine, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Kim, Duck-Su [Department of Conservative Dentistry, School of Dentistry, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Kwon, Il Keun, E-mail: kwoni@khu.ac.kr [Department of Maxillofacial Biomedical Engineering, School of Dentistry, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Institute of Oral Biology, Kyung Hee University, Seoul 130-701 (Korea, Republic of)

    2011-09-23

    Highlights: {yields} We examine bone metabolism of engineered alendronate attached to Ti surfaces. {yields} Alendronate-immobilized Ti enhances activation of osteoblast differentiation. {yields} Alendronate-immobilized Ti inhibits osteoclast differentiation. {yields} Alendronate-immobilized Ti may be a bioactive implant with dual functions. -- Abstract: The failure of orthopedic and dental implants has been attributed mainly to loosening of the implant from host bone, which may be due to weak bonding of the implant material to bone tissue. Titanium (Ti) is used in the field of orthopedic and dental implants because of its excellent biocompatibility and outstanding mechanical properties. Therefore, in the field of materials science and tissue engineering, there has been extensive research to immobilize bioactive molecules on the surface of implant materials in order to provide the implants with improved adhesion to the host bone tissue. In this study, chemically active functional groups were introduced on the surface of Ti by a grafting reaction with heparin and then the Ti was functionalized by immobilizing alendronate onto the heparin-grafted surface. In the MC3T3-E1 cell osteogenic differentiation study, the alendronate-immobilized Ti substrates significantly enhanced alkaline phosphatase activity (ALP) and calcium content. Additionally, nuclear factor kappa B ligand (RANKL)-induced osteoclast differentiation of RAW264.7 cells was inhibited with the alendronate-immobilized Ti as confirmed by TRAP analysis. Real time PCR analysis showed that mRNA expressions of osteocalcin and osteopontin, which are markers for osteogenesis, were upregulated in MC3T3-E1 cells cultured on alendronate-immobilized Ti. The mRNA expressions of TRAP and Cathepsin K, markers for osteoclastogenesis, in RAW264.7 cells cultured on alendronate-immobilized Ti were down-regulated. Our study suggests that alendronate-immobilized Ti may be a bioactive implant with dual functions to enhance

  17. Evidence for Using Alendronate to Treat Adult Avascular Necrosis of the Femoral Head: A Systematic Review

    Science.gov (United States)

    Luo, Ru-Bin; Lin, Tiao; Zhong, Hui-Ming; Yan, Shi-Gui; Wang, Jian-An

    2014-01-01

    Osteonecrosis or avascular osteonecrosis (AVN) of the femoral head is a devastating multifactorial disease that affects 20 000 persons each year in the United States. The purpose of this systematic review was to determine the efficacy and safety of alendronate for adult AVN during short- and long-term follow-up. Electronic databases were searched for randomized or nonrandomized clinical trials, cohort, case-control studies, and series of cases in which alendronate was used for treatment of adult AVN of the femoral head. Relevant articles with adequate data on reduction of pain, improvement of articular function, slowing of bone collapse progression, or need for total hip arthroplasty (THA) were included after applying inclusion and exclusion criteria. Eight articles involving 788 hips with evidence level 1b to 3b were included in this systematic review. Most studies suggested a positive short-term efficacy of alendronate treatment in reducing pain, improving articular function, slowing of bone collapse progression, and delaying the need for THA for adult AVN patients. The favorable long-term results were also presented in those treated patients after 10-year follow-up. In addition, there were no severe adverse effects associated with alendronate treatment observed during short- and long-term follow-up, and most of the included studies suggested use of alendronate in early AVN with small necrotic lesion to achieve better outcomes. The findings support consideration of alendronate use for adult AVN, particularly with early stage and small necrotic size. The lack of large-scale, randomized, and double-blind studies justifies new studies to demonstrate the detailed indication and the optimized strategy of alendronate treatment. Level of evidence: Level 3a. PMID:25424061

  18. Improving Symptom Control, QOL, and Quality of Care for Women with Breast Cancer: Developing a Research Program on Neurological Effects via Doctoral Education

    Science.gov (United States)

    2006-06-01

    orQOL "I CAN’T tell where my feet are" <is> Root Footwear Issues <is> Root Emotional Rx:: Mood effects <is> Root Sx Description <is...time, holding a pen and “scrawling” handwriting , “loss of fine motor skills”, “loss of strength”, “dropping things • LEISURE: turning book pages...interventions on pain in adults with cancer. Oncology Nursing Forum, 31(2), 313-319. Devine, E., & Westlake, S. (1995). The effects of psychoeducational care

  19. Would Be Prophylactic Administrations of Low Concentration of Alendronate an Alternative for Improving the Craniofacial Bone Repair? A Preliminary Study Focused in the Period of Cellular Differentiation and Tissue Organization.

    Science.gov (United States)

    Göhringer, Isabella; Muller, Carmem L Storrer; Cunha, Emanuelle Juliana; Passoni, Giuliene Nunes De Souza; Vieira, Juliana Souza; Zielak, João Cesar; Scariot, Rafaela; Deliberador, Tatiana Miranda; Giovanini, Allan Fernando

    2017-10-01

    Alendronate (ALN) is a nitrogen-bisphosphonate that may induce an anabolic effect on craniofacial bone repair when administrated in low doses. Based on this premise, this study analyzed the influence of prophylactic low doses of ALN on bone healing in defects created in rabbit mandible. A 5 × 2-mm diameter deep defect was created in the calvaria of 28 rabbits. Fourteen of these rabbits received previously 50 μg/kg of 1% sodium ALN for 4 weeks, while the other rabbits received only 0.9% physiological saline solution (control). Animals were euthanized at 15 and 60 days postsurgery (n = 7), and the data were analyzed using histomorphometry and immunohistochemistry using the anti-CD34, bone morphogenetic protein -2 (BMP-2), and transforming growth factor (TGF)-β1 antibodies. On the 15th day postsurgery, the specimens that received previous treatment with ALN demonstrated large vascular lumen and intense positivity to CD34 either concentrated in endothelium or cells spread among the reparative tissue. These results coincided with intense positivity for BMP-2+ cells and TGF-β1 that was concentrated in both cells and perivascular area. In contrast, the control group revealed scarce cells that exhibited CD34, BMP-2+, and the TGF-β1 was restricted for perivascular area on well-formed granulation tissue. These patterns of immunohistochemical result, especially found on the 15th day of analysis, seem to be responsible for the development of larger quantities of bone matrix in the specimens that receive ALN on the 60th day postsurgery. These preliminary results showed that the prophylactic administration of low doses of ALN might be an alternative to craniofacial bone craniofacial bone repair because it increases the immunopositivity for TGF-β1 and consequently improves the CD34+ and BMP-2+ cells on reparative sites.

  20. The Effect of Alendronate on Various Graft Materials Used in Maxillary Sinus Augmentation: A Rabbit Study.

    Science.gov (United States)

    Ayranci, Ferhat; Gungormus, Metin; Omezli, Mehmet Melih; Gundogdu, Betul

    2015-12-01

    Increasing sinus pneumatization and the accompanying alveolar bone resorption complicate dental implant placement. This problem can be overcome today by raising the maxillary sinus floor with graft materials. Bisphosphonates are commonly used to accelerate the recovery of the graft materials and to prevent resorption. The purpose of this study is to investigate whether systemic administration of a bisphosphonate (alendronate) would improve new bone formation and reduce fibrous tissue formation over a 6-week follow-up in rabbits treated with two different grafting materials for maxillary sinus floor augmentation. This experimental animal study was conducted at the Experimental Medical Application and Research Center at Erzurum/ Turkey. Twelve New Zealand rabbits, each weighing between 2.7 and 3.3 kg, were used. Twenty-four maxillary sinus floor elevation operations were performed, two on each animal (n = 24). Each elevation was repaired with either deproteinized bovine bone (xenograft) or autogenous bone graft obtained from the iliac crest. Both groups were divided into 2 subgroups: saline-treated and alendronate-treated. All groups underwent the same surgical procedures and evaluation, and were sacrificed at the 6th postoperative week. Sinuses augmented with deproteinized bovine bone (xenograft) and autogenous bone graft were examined histopathologically and histomorphometrically. At 6 weeks, the bone area was significantly larger in the Xenograft-Alendronate group (33.0% ± 5.0%) than in the Xenograft-Saline group (20.8% ± 4.9%) and the bone area was significantly larger in the Autogenous-Alendronate group (43.3% ± 3.8%) than in the Autogenous-Saline group (37.5% ± 6.6%) (P = 0.001). The histomorphometric and histopathological results consistently showed that alendronate stimulated bone formation and reduced fibrous tissue formation in maxillary sinus augmentation grafts, especially in the deproteinized bovine bone group (xenograft). Alendronate may be

  1. Prevention of aromatase inhibitor-induced bone loss with alendronate in postmenopausal women: The BATMAN Trial.

    Science.gov (United States)

    Lomax, Anna J; Yee Yap, Saw; White, Karen; Beith, Jane; Abdi, Ehtesham; Broad, Adam; Sewak, Sanjeev; Lee, Chooi; Sambrook, Philip; Pocock, Nicholas; Henry, Margaret J; Yeow, Elaine G; Bell, Richard

    2013-12-01

    Postmenopausal women on aromatase inhibitors (AI) are at risk of aromatase inhibitor-associated bone loss (AIBL) and fractures. In 2005 Osteoporosis Australia proposed an algorithm for bisphosphonate intervention. Three hundred and three postmenopausal women with early breast cancer (EBC) were enrolled (osteoporotic, n=25; osteopaenic, n=146; normal bone mineral density (BMD), n=126). Weekly alendronate (70 mg) treatment efficacy as triggered by the algorithm in preventing bone loss was evaluated. All patients received anastrozole (1 mg daily), calcium and vitamin D. All osteoporotic patients received alendronate at baseline. Eleven out of the 146 (7.5%) osteopaenic patients commenced alendronate within 18 months of participation and eleven commenced after. One hundred and twenty four out of the 146 (84.9%) osteopaenic patients and all 126 with normal baseline BMD did not trigger the algorithm. At three years, lumbar spine mean BMD increased (15.6%, p<0.01) in the osteoporotic group. BMD in the osteopaenic group with early intervention significantly increased at three years (6.3%, p=0.02). No significant change was seen in the late intervention group. No change was observed in those with osteopaenia without alendronate. There was a significant drop in lumbar spine (-5.4%) and hip (-4.5%) mean BMD, in the normal BMD group, none of whom received alendronate. Fracture data will be presented. In postmenopausal women with endocrine-responsive EBC, BMD improved over time when a bisphosphonate is administered with anastrozole in osteoporotic patients using an osteoporosis schedule. Subjects with normal baseline BMD experienced the greatest BMD loss, although none became osteoporotic.

  2. Effect of topical alendronate on root resorption of dried replanted dog teeth.

    Science.gov (United States)

    Levin, L; Bryson, E C; Caplan, D; Trope, M

    2001-06-01

    Alendronate (ALN) is a third generation bisphosphonate with demonstrated osteoclast inhibitory activity that may slow down the resorptive process after severe traumatic injuries. Eighty-two premolar roots of five mongrel dogs were endodontically treated and restored, extracted and treated as follows: 70 roots were bench dried for either 40 or 60 min. Thirty-eight of these roots were then soaked for 5 min in a 1 mM solution of ALN in Hanks' Balanced Salt Solution (HBSS) and replanted. Thirty-two roots were soaked for 5 min in HBSS and replanted. In the remaining 12 roots which were not exposed to the bench drying procedure, a 0.5 mM deep lingual mid-root cemental defect was made. Six of these roots were soaked in a 1 mM solution of ALN in HBSS for 5 min and replanted. The other six roots were soaked for 5 min in HBSS and replanted. Historical negative and positive controls were used from similarly treated teeth in our previous studies. After 4 months the dogs were killed and the roots prepared for histological evaluation. Five-microm-thick cross-sections of the root and surrounding tissue taken every 70 microm were evaluated for healing according to the criteria of Andreasen. In the 12 roots with cemental defects, healing with cementum of the damaged root surface was evaluated. In addition, residual root mass was also measured to determine the extent of root structure loss for each soaking method. Cemental healing took place in all 12 artificially damaged roots, indicating that these soaking media did not inhibit cementogenesis. The alendronate-soaked roots had statistically significantly more healing than the roots soaked in HBSS without alendronate. This improvement in healing was seen in all dogs except one and in all teeth except the first premolar. Soaking in alendronate also resulted in significantly less loss in root mass due to resorption compared to those teeth soaked in HBSS without alendronate.

  3. Alendronate functionalized mesoporous hydroxyapatite nanoparticles for drug delivery

    International Nuclear Information System (INIS)

    Li, Dongdong; Zhu, Yuntao; Liang, Zhiqiang

    2013-01-01

    Highlights: ► The synthesized mesoporous hydroxyapatite has nanostructure and bioactivity. ► The materials have high surface area and amino group. ► The materials show higher drug loading and slower release rate than pure HAP. - Abstract: Mesoporous nanosized hydroxyapatite (HAP) functionalized by alendronate (ALN) was synthesized using cationic surfactant CTAB as template. The structural, morphological and textural properties were fully characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FT-IR) and N 2 adsorption/desorption. Then the obtained materials were performed as drug delivery carriers using ibuprofen (IBU) as a model drug to investigate their drug storage/release properties in simulated body fluid (SBF). The materials showed relatively slower release rate compared with HAP due to the ionic interaction between -NH 3 + on the matrix and -COO − belongs to IBU. The system provides a new concept for improving the drug loading or slowing down the release rate

  4. Treatment of osteoporosis after alendronate or risedronate

    DEFF Research Database (Denmark)

    Eiken, P; Vestergaard, P

    2016-01-01

    Alendronate (ALN) and risedronate (RIS) are ideal as first-choice therapy options in the treatment of postmenopausal osteoporosis. What to do for patients who do not respond adequately to bisphosphonates has not been conclusively determined, but transitioning to other therapies should be considered....... The aim of this article is to describe potential alternatives for patients switching from ALN or RIS to other therapies for osteoporosis. A systematic search of PubMed was conducted to find papers that evaluate the effects of switching therapies on fractures, bone mineral density (BMD), or bone turnover...... markers. Results from 11 studies that prospectively assessed treatment after ALN or RIS in women with postmenopausal osteoporosis were reviewed. All studies are of short duration (all 24 months or less) and assess the topic of transitioning therapy from ALN or RIS. None of the studies had the statistical...

  5. Glucocorticoid Steroid and Alendronate Treatment Alleviates Dystrophic Phenotype with Enhanced Functional Glycosylation of α-Dystroglycan in Mouse Model of Limb-Girdle Muscular Dystrophy with FKRPP448L Mutation.

    Science.gov (United States)

    Wu, Bo; Shah, Sapana N; Lu, Peijuan; Richardson, Stephanie M; Bollinger, Lauren E; Blaeser, Anthony; Madden, Kyle L; Sun, Yubo; Luckie, Taylor M; Cox, Michael D; Sparks, Susan; Harper, Amy D; Lu, Qi Long

    2016-06-01

    Fukutin-related protein-muscular dystrophy is characterized by defects in glycosylation of α-dystroglycan with variable clinical phenotypes, most commonly as limb-girdle muscular dystrophy 2I. There is no effective therapy available. Glucocorticoid steroids have become the standard treatment for Duchenne and other muscular dystrophies with serious adverse effects, including excessive weight gain, immune suppression, and bone loss. Bisphosphonates have been used to treat Duchenne muscular dystrophy for prevention of osteoporosis. Herein, we evaluated prednisolone and alendronate for their therapeutic potential in the FKRPP448L-mutant mouse representing moderate limb-girdle muscular dystrophy 2I. Mice were treated with prednisolone, alendronate, and both in combination for up to 6 months. Prednisolone improved muscle pathology with significant reduction in muscle degeneration, but had no effect on serum creatine kinase levels and muscle strength. Alendronate treatment did not ameliorate muscle degeneration, but demonstrated a limited enhancement on muscle function test. Combined treatment of prednisolone and alendronate provided best improvement in muscle pathology with normalized fiber size distribution and significantly reduced serum creatine kinase levels, but had limited effect on muscle force generation. The use of alendronate significantly mitigated the bone loss. Prednisolone alone and in combination with alendronate enhance functionally glycosylated α-dystroglycan. These results, for the first time, demonstrate the efficacy and feasibility of this alliance treatment of the two drugs for fukutin-related protein-muscular dystrophy. Copyright © 2016 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  6. Alendronate for fracture prevention in postmenopause.

    Science.gov (United States)

    Holder, Kathryn K; Kerley, Sara Shelton

    2008-09-01

    Osteoporosis is an abnormal reduction in bone mass and bone deterioration leading to increased fracture risk. Alendronate (Fosamax) belongs to the bisphosphonate class of drugs, which act to inhibit bone resorption by interfering with the activity of osteoclasts. To assess the effectiveness of alendronate in the primary and secondary prevention of osteoporotic fractures in postmenopausal women. The authors searched Central, Medline, and EMBASE for relevant randomized controlled trials published from 1966 to 2007. The authors undertook study selection and data abstraction in duplicate. The authors performed meta-analysis of fracture outcomes using relative risks, and a relative change greater than 15 percent was considered clinically important. The authors assessed study quality through reporting of allocation concealment, blinding, and withdrawals. Eleven trials representing 12,068 women were included in the review. Relative and absolute risk reductions for the 10-mg dose were as follows. For vertebral fractures, a 45 percent relative risk reduction was found (relative risk [RR] = 0.55; 95% confidence interval [CI], 0.45 to 0.67). This was significant for primary prevention, with a 45 percent relative risk reduction (RR = 0.55; 95% CI, 0.38 to 0.80) and 2 percent absolute risk reduction; and for secondary prevention, with 45 percent relative risk reduction (RR = 0.55; 95% CI, 0.43 to 0.69) and 6 percent absolute risk reduction. For nonvertebral fractures, a 16 percent relative risk reduction was found (RR = 0.84; 95% CI, 0.74 to 0.94). This was significant for secondary prevention, with a 23 percent relative risk reduction (RR = 0.77; 95% CI, 0.64 to 0.92) and a 2 percent absolute risk reduction, but not for primary prevention (RR = 0.89; 95% CI, 0.76 to 1.04). There was a 40 percent relative risk reduction in hip fractures (RR = 0.60; 95% CI, 0.40 to 0.92), but only secondary prevention was significant, with a 53 percent relative risk reduction (RR = 0.47; 95% CI

  7. Alendronate functionalized mesoporous hydroxyapatite nanoparticles for drug delivery

    Energy Technology Data Exchange (ETDEWEB)

    Li, Dongdong, E-mail: lidongchem@sina.cn [State Key Laboratory of Inorganic Synthesis and Preparative Chemistry, College of Chemistry, Jilin University, Changchun 130012 (China); Zhu, Yuntao; Liang, Zhiqiang [State Key Laboratory of Inorganic Synthesis and Preparative Chemistry, College of Chemistry, Jilin University, Changchun 130012 (China)

    2013-06-01

    Highlights: ► The synthesized mesoporous hydroxyapatite has nanostructure and bioactivity. ► The materials have high surface area and amino group. ► The materials show higher drug loading and slower release rate than pure HAP. - Abstract: Mesoporous nanosized hydroxyapatite (HAP) functionalized by alendronate (ALN) was synthesized using cationic surfactant CTAB as template. The structural, morphological and textural properties were fully characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FT-IR) and N{sub 2} adsorption/desorption. Then the obtained materials were performed as drug delivery carriers using ibuprofen (IBU) as a model drug to investigate their drug storage/release properties in simulated body fluid (SBF). The materials showed relatively slower release rate compared with HAP due to the ionic interaction between -NH{sub 3}{sup +} on the matrix and -COO{sup −}belongs to IBU. The system provides a new concept for improving the drug loading or slowing down the release rate.

  8. Effect of combined treatment with alendronate and calcitriol on femoral neck strength in osteopenic rats

    Directory of Open Access Journals (Sweden)

    Fotovati Abbas

    2008-12-01

    Full Text Available Abstract Background Hip fracture is associated with pronounced morbidity and excess mortality in elderly women with postmenopausal osteoporosis. Many drugs have been developed to treat osteoporosis and to reduce the risk of osteoporotic fractures. We investigated the effects of combined alendronate and vitamin D3 treatment on bone mass and fracture load at the femoral neck in ovariectomized (OVX rats, and evaluated the relationship between bone mass parameters and femoral neck strength. Methods Thirty 12-week-old female rats underwent either a sham-operation (n = 6 or OVX (n = 24. Twenty weeks later, OVX rats were further divided into four groups and received daily doses of either saline alone, 0.1 mg/kg alendronate, 0.1 μg/kg calcitriol, or a combination of both two drugs by continuous infusion via Alzet mini-osmotic pumps. The sham-control group received saline alone. After 12 weeks of treatment, femoral necks were examined using peripheral quantitative computed tomography (pQCT densitometry and mechanical testing. Results Saline-treated OVX rats showed significant decreases in total bone mineral content (BMC (by 28.1%, total bone mineral density (BMD (by 9.5%, cortical BMC (by 26.3%, cancellous BMC (by 66.3%, cancellous BMD (by 29.0% and total cross-sectional bone area (by 30.4% compared with the sham-control group. The combined alendronate and calcitriol treatments improved bone loss owing to estrogen deficiency. On mechanical testing, although OVX significantly reduced bone strength of the femoral neck (by 29.3% compared with the sham-control group, only the combined treatment significantly improved the fracture load at the femoral neck in OVX rats to the level of the sham-controls. The correlation of total BMC to fracture load was significant, but that of total BMD was not. Conclusion Our results showed that the combined treatment with alendronate and calcitriol significantly improved bone fragility of the femoral neck in OVX osteopenic

  9. Development of docetaxel and alendronate-loaded chitosan ...

    African Journals Online (AJOL)

    Development of docetaxel and alendronate-loaded chitosan-conjugated polylactide-co-glycolide nanoparticles: In vitro characterization in osteosarcoma cells. ... typical time-dependent cellular uptake and also displayed superior cytotoxicity in MG-63 cells compared with blank NPs, which were safe and biocompatible.

  10. Effects of local alendronate sodium gel as an adjunct to scaling and root planing on smokers with chronic periodontitis: a pilot study

    Directory of Open Access Journals (Sweden)

    Farin Kiany

    2017-04-01

    Full Text Available Background: Chemical treatments for the modulation of host response are applied along with mechanical modalities as adjunctive to periodontal treatment. The objective of this pilot study was to investigate the effects of locally-delivered alendronate sodium gel in adjunction to scaling and root planning on periodontal indices and bone formation within vertical defects of smokers with chronic periodontitis. Methods and Materials: In this study vertical defects (n=8 with depth>5 mm have been investigated. After performing the phase I of periodontal treatment, alendronate sodium gel (1% was applied into the periodontal pockets. The whole procedure was repeated after 4 weeks. Periodontal indices (plaque and bleeding, probing depth, gingival recession, and radiographic parameter (depth of bony defect were measured at the beginning and following 6 months. Results: Compared to pre-treatment, the probing depth, radiographic depth of bony defect and bleeding and plaque indices were significantly reduced by local application of alendronate sodium gel (P=0.026; P=0.012 and P=0.007 respectively. Gingival recession showed significant increase (P=0.011. Conclusion: Local alendronate sodium gel (1% plays an important role in the improvement process of periodontal indices and bone formation within vertical bony defects of smoker patients with chronic periodontitis.

  11. A new questionnaire for measuring quality of life - the Stark QoL.

    Science.gov (United States)

    Hardt, Jochen

    2015-10-26

    The Stark questionnaire measures health-related quality of life (QoL) using pictures almost exclusively. It is supplemented by a minimum of words. It comprises a mental and a physical health component. A German sample of n = 500 subjects, age and gender stratified, filled out the Stark Qol questionnaire along with various other questionnaires via internet. The physical component shows good reliability (Cronbach's alpha = McDonalds Omega = greatest lower bound = .93), the mental component can be improved (Cronbach's alpha = .63, McDonalds Omega = .72, greatest lower bound = .77). Confirmatory factor analysis shows a good fit (Bentlers CFI = .97). Construct validity was proven. The Stark QoL is a promising new development in measuring QoL, it is a short and easy to apply questionnaire. Additionally, it is particularly promising for international research.

  12. Esophageal and gastric cancer incidence and mortality in alendronate users

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Pazianas, Michael; Eiken, Pia Agnete

    2011-01-01

    their esophageal or gastric location could be accurately distinguished. We conducted a register-based, open cohort study using national healthcare data for Denmark. Upper endoscopy frequency, cancer incidence and mortality was examined in 30,606 alendronate users (female, age 50 + ) and 122,424 matched controls......Recent studies have reached conflicting conclusions regarding the risk of esophageal cancer with oral bisphosphonates. Prior studies did not record the number of cancer deaths or endoscopy rates, which could be higher in bisphosphonate users and lead to more cancers being diagnosed at a stage when....... Primary outcomes were esophageal cancer incidence and death due to esophageal cancer. The analysis showed that alendronate users were more likely to have undergone recent upper endoscopy (4.1 vs 1.7%, p ...

  13. Impact of generic alendronate cost on the cost-effectiveness of osteoporosis screening and treatment.

    Directory of Open Access Journals (Sweden)

    Smita Nayak

    Full Text Available Since alendronate became available in generic form in the Unites States in 2008, its price has been decreasing. The objective of this study was to investigate the impact of alendronate cost on the cost-effectiveness of osteoporosis screening and treatment in postmenopausal women.Microsimulation cost-effectiveness model of osteoporosis screening and treatment for U.S. women age 65 and older. We assumed screening initiation at age 65 with central dual-energy x-ray absorptiometry (DXA, and alendronate treatment for individuals with osteoporosis; with a comparator of "no screening" and treatment only after fracture occurrence. We evaluated annual alendronate costs of $20 through $800; outcome measures included fractures; nursing home admission; medication adverse events; death; costs; quality-adjusted life-years (QALYs; and incremental cost-effectiveness ratios (ICERs in 2010 U.S. dollars per QALY gained. A lifetime time horizon was used, and direct costs were included. Base-case and sensitivity analyses were performed.Base-case analysis results showed that at annual alendronate costs of $200 or less, osteoporosis screening followed by treatment was cost-saving, resulting in lower total costs than no screening as well as more QALYs (10.6 additional quality-adjusted life-days. When assuming alendronate costs of $400 through $800, screening and treatment resulted in greater lifetime costs than no screening but was highly cost-effective, with ICERs ranging from $714 per QALY gained through $13,902 per QALY gained. Probabilistic sensitivity analyses revealed that the cost-effectiveness of osteoporosis screening followed by alendronate treatment was robust to joint input parameter estimate variation at a willingness-to-pay threshold of $50,000/QALY at all alendronate costs evaluated.Osteoporosis screening followed by alendronate treatment is effective and highly cost-effective for postmenopausal women across a range of alendronate costs, and may be cost

  14. The measurement of health-related quality of life (QOL in paediatric clinical trials: a systematic review

    Directory of Open Access Journals (Sweden)

    Eiser Christine

    2004-11-01

    Full Text Available Abstract Background The goal of much care in chronic childhood illness is to improve quality of life (QOL. However, surveys suggest QOL measures are not routinely included. In addition, there is little consensus about the quality of many QOL measures. Objectives To determine the extent to which quality of life (QOL measures are used in paediatric clinical trials and evaluate the quality of measures used. Design Systematic literature review. Review Methods Included paediatric trials published in English between 1994 and 2003 involving children and adolescents up to the age of 20 years, and use of a standardised QOL measure. Data Sources included MEDLINE, CINAHL, EMB Reviews, AMED, BNI, PSYCHINFO, the Cochrane library, Internet, and reference lists from review articles. Results We identified 18 trials including assessment of QOL (4 Asthma, 4 Rhinitis, 2 Dermatitis, and single studies of Eczema, Cystic fibrosis, Otis media, Amblyopia, Diabetes, Obesity associated with a brain tumour, Idiopathic short stature, and Congenital agranulocytosis. In three trials, parents rated their own QOL but not their child's. Fourteen different QOL measures were used but only two fulfilled our minimal defined criteria for quality. Conclusions This review confirms previous reports of limited use of QOL measures in paediatric clinical trials. Our review provides information about availability and quality of measures which will be of especial value to trial developers.

  15. Alendronate treatment in the revision setting, with and without controlled implant motion

    DEFF Research Database (Denmark)

    Søballe, Kjeld; Chen, Xinqian; Jensen, Thomas B

    2007-01-01

    Introduction Bisphosphonates have been proposed to delay or prevent loosening of joint replacement implants by reducing bone resorption. It is known, however, that implant motion prevents the bone anchorage necessary to maintain secure implant fixation. Methods We used our experimental implant...... conditions, even with alendronate. With alendronate and stabilized implants, increased bone was observed near the sclerotic shell of the revision cavity, but it was reduced with alendronate when the implant was unstable. Interpretation Our findings suggest that it may be difficult for alendronate...... administration alone to rescue implants that are already loose. In implants that have not progressed to loosening, alendronate may increase bone density at the border with the sclerotic shell, but the effect of this bone in delaying eventual loosening is not known. Udgivelsesdato: 2007-Dec...

  16. The Effect of Alendronate and Calcitonin Treatments on Bone Mineral Density and Quality of Life in Women With Postmenopausal Osteoporosis

    Directory of Open Access Journals (Sweden)

    F. Taşçıoğlu

    2002-06-01

    Full Text Available The aim of this study was to compare the effect of alendronate and calcitonin treatments on bone mineral density (BMD and quality of life of women with postmenopausal osteoporosis. One hundred ninety-three patients were randomly assigned to two groups: 93 patients received daily doses of 10 mg alendronate and calcium 1000 mg, and 98 patients used intranasal salmon calcitonin (sCt at a dosage of 200 IU/day and they also received daily doses of 1000 mg calcium supplements. DXA was used for the measurement of BMD of the lumbar spine and proximal femur before and after the study period. SF-36 was used as a measure of health-related quality of life. At the end of the treatment, ALN produced significant increases in BMD at the lumbar spine (p< 0.001, femur neck (p<0.05, trochanteric region (p<0.001 and at the Ward triangle (p<0.05. In contrast, intranasal sCt treatment resulted in a significant bone loss in the femur neck (p<0.01 and Ward triangle (p<0.05, and only a significant increase in BMD of the lumbar spine was observed with calcitonin treatment(p< 0.05. Quality of life as assessed by SF-36 improved significantly in both groups(p<0.05. In conclusion, alendronate seemed to be more effective than calcitonin, increasing both spinal and femoral BMD, for the treatment of postmenopausal osteoporosis. Both treatments were found to be effective for the improvement of quality of life.

  17. Relationship Between Student QoL With Irritable Bowel Syndrome and Related Factors at Ahvaz Jundishapur University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Asadi

    2015-01-01

    Full Text Available Background Irritable bowel syndrome (IBS is one of the most common functional disorders of the lower gastrointestinal tract characterized by abdominal pain and changes in bowel habits. This disorder changes the QoL (QoL for patients. Objectives This study examines the relationship between QoL for nursing students with other associated factors. Patients and Methods These descriptive-analytic studies indicate a census for 57 senior nursing students of the School of Nursing-Midwifery, Ahvaz in 2013–2014. The data from the demographic questionnaire and QoL questionnaire (QOL-34 was collected. Data using ANOVA and t-tests with significance level of P 0.05.While for QoL and academic Grade Point Average (P = 0.048, ethnicity (P = 0.006, disease duration (P = 0.049, and disease severity (P = 0.030 were significantly related . Conclusions It seems important to pay attention to health problems and to apply interventions that will influence QoL. Lifestyle changes and staying away from activities that are associated with tension stress can help to eliminate the symptoms and disease severity and improve the QoL for student.

  18. Utility analysis and calibration of QOL assessment in disease management.

    Science.gov (United States)

    Liu, Mo

    2018-05-02

    In clinical trials, the assessment of health-related quality of life (QOL) (or patient-reported outcome [PRO] measure) has become very popular especially for clinical studies conducted for evaluating clinical benefits of patients with chronic, severe, and/or life threatening diseases. Health-related QOL information and PRO measures are useful for disease management for achieving best clinical practice. In this article, we will focus on health-related QOL assessment. The concept, design, and analysis of health-related QOL in clinical trials are reviewed. Validation of the use of health-related QOL instrument in terms of some key performance characteristics such as accuracy, reliability, sensitivity, and responsibility for assuring quality, integrity, and validity of collected QOL data are discussed. The concept of utility analysis and calibration (e.g., with respect to life events) for achieving the optimization of disease management are proposed. The change of the QOL could be translated into different life events for effective disease management. These translations could evaluate the treatment effect by more directly displaying the change of the QOL.

  19. The Quality of Life Scale (QOLS: Reliability, Validity, and Utilization

    Directory of Open Access Journals (Sweden)

    Anderson Kathryn L

    2003-10-01

    Full Text Available Abstract The Quality of Life Scale (QOLS, created originally by American psychologist John Flanagan in the 1970's, has been adapted for use in chronic illness groups. This paper reviews the development and psychometric testing of the QOLS. A descriptive review of the published literature was undertaken and findings summarized in the frequently asked questions format. Reliability, content and construct validity testing has been performed on the QOLS and a number of translations have been made. The QOLS has low to moderate correlations with physical health status and disease measures. However, content validity analysis indicates that the instrument measures domains that diverse patient groups with chronic illness define as quality of life. The QOLS is a valid instrument for measuring quality of life across patient groups and cultures and is conceptually distinct from health status or other causal indicators of quality of life.

  20. Magnetic resonance imaging of osteosarcoma using a bis(alendronate)-based bone-targeted contrast agent.

    Science.gov (United States)

    Ge, Pingju; Sheng, Fugeng; Jin, Yiguang; Tong, Li; Du, Lina; Zhang, Lei; Tian, Ning; Li, Gongjie

    2016-12-01

    Magnetic resonance (MR) is currently used for diagnosis of osteosarcoma but not well even though contrast agents are administered. Here, we report a novel bone-targeted MR imaging contrast agent, Gd 2 -diethylenetriaminepentaacetate-bis(alendronate) (Gd 2 -DTPA-BA) for the diagnosis of osteosarcoma. It is the conjugate of a bone cell-seeking molecule (i.e., alendronate) and an MR imaging contrast agent (i.e., Gd-DTPA). Its physicochemical parameters were measured, including pK a , complex constant, and T 1 relaxivity. Its bone cell-seeking ability was evaluated by measuring its adsorption on hydroxyapatite. Hemolysis was investigated. MR imaging and biodistribution of Gd 2 -DTPA-BA and Gd-DTPA were studied on healthy and osteosarcoma-bearing nude mice. Gd 2 -DTPA-BA showed high adsorption on hydroxyapatite, the high MR relaxivity (r 1 ) of 7.613mM -1 s -1 (2.6 folds of Gd-DTPA), and no hemolysis. The MR contrast effect of Gd 2 -DTPA-BA was much higher than that of Gd-DTPA after intravenous injection to the mice. More importantly, the MR imaging of osteosarcoma was significantly improved by Gd 2 -DTPA-BA. The signal intensity of Gd 2 -DTPA-BA reached 120.3% at 50min, equal to three folds of Gd-DTPA. The bone targeting index (bone/blood) of Gd 2 -DTPA-BA in the osteosarcoma-bearing mice was very high to 130 at 180min. Furthermore, the contrast enhancement could also be found in the lung due to metastasis of osteosarcoma. Gd 2 -DTPA-BA plays a promising role in the diagnoses of osteosacomas, including the primary bone tumors and metastases. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. Efficacy of alendronate, a bisphosphonate, in the treatment of AVN of the hip. A prospective open-label study.

    Science.gov (United States)

    Agarwala, S; Jain, D; Joshi, V R; Sule, A

    2005-03-01

    To study the efficacy of alendronate, in the treatment of avascular necrosis (AVN) of the hip. Sixty patients with AVN of the hip (100 hips with AVN) were studied. The follow-up period ranged from 3 months to 5 yr. The most common cause of AVN was steroids. Parameters studied were walking time, standing time, pain and disability on a visual analogue scale (VAS), range of motion of the hip, X-ray and MRI of the hip. All patients were treated with alendronate 10 mg/day (or 70 mg/week) along with 500-1000 mg of daily calcium and vitamin D supplements, and were advised to avoid weight-bearing. NSAIDs and analgesics were permitted as needed and were recorded. Forty-one patients (71 AVN hips) with AVN have been followed up for a minimum of 1 yr, 24 patients (42 AVN hips) for 2 yr and 21 patients (37 AVN hips) for more than 2 yr (average 37 month). Fourteen patients have been followed up for less than 1 yr (3-9 months). Significant reduction in pain and disability scores (P 0.001). Radiologically, the hips either stabilized in the same grade or progressed by one grade. MRI showed a decrease in marrow oedema in most cases at the 1-yr follow-up. Six patients (10 hips) required surgery and there were two (three hips) dropouts. The drug was well tolerated and there was a reduction in NSAID requirement. Alendronate reduces pain, improves function and retards AVN progression. Early surgical intervention can be avoided in most patients.

  2. Kampo medicines improved blood test and QOL in two vasculitis cases of Churg–Strauss syndrome and Henoch–Shönlein purpura after inadequate treatment with conventional therapies

    Directory of Open Access Journals (Sweden)

    Yasuyo Hijikata

    2010-02-01

    Full Text Available Yasuyo Hijikata1, Yumiko Ikemoto2, Urara Kohdera31Toyodo Hijikata Clinic, Osaka, Japan; 2St Mary’s Hospital, Himeji, Japan; 3Nakano Children’s Hospital, Osaka, JapanObjective: Based on the tenets of traditional Chinese medicine (TCM theory, Kampo medicines were selected and applied to two cases of Churg–Strauss syndrome and Henoch–Shönlein purpura. Two vasculitis syndrome patients exhibited persistent symptoms and abnormal blood tests after treatment with conventional therapies.Methods: As the two cases had “blood stagnation” and “damps and heat” and one had a “yang deficiency” in terms of TCM theory, we applied certain selected Kampo medicines.Results: In case 1, the patient presented with hypereosinophilia, venous thrombosis, pulmonary infarction, decreased platelet count, ulner nerve palsy and Raynaud’s phenomena, which led to a diminished quality of life. After starting the Kampo medicines, the patient improved quickly and recovered within 11 months. In case 2, persistent purpura, abdominal pain, and bloody feces quickly improved and disappeared after Kampo treatment. After starting the Kampo medicines, prednisolone was stopped at 21 days without any sign of relapse to date.Conclusion: Kampo medicines helped clear the persistent abnormal symptoms and laboratory findings of vasculitis syndromes, Churg–Strauss syndrome and Henoch–Shönlein purpura, which had responded inadequately to the conventional therapies administered.Keywords: Kampo medicine, vasculitis, Churg–Strauss syndrome, Henoch–Shönlein purpura

  3. [A Case of HPN, In Which QOL Improvement Was Achieved by Combining Continuous Infusion with Once-Weekly Intermittent Infusion - Contribution of Pharmacists to Health Promotion among Home Patients Receiving Infusion Therapy].

    Science.gov (United States)

    Takeda, Namihiro; Hamana, Tomoko; Oka, Toyoka; Hirohara, Masayoshi; Kushida, Kazuki

    2016-12-01

    Patients receiving parenteral nutrition at home have the following two options: 24-h continuous or intermittent infusion. To date, for patients with impaired glucose tolerance and/or other metabolic disorders or for those with decreased cardiac/ pulmonary/renal function, it is desirable to opt for continuous infusion to minimize the variance in the body's metabolic rate as much as possible. Furthermore, it should be noted that continuous infusion evokes a stronger feeling among patients of being constrained because it restricts their everyday activities. This case witnesses collaborations among the patient's doctor, dispensary's pharmacy, and patient's family. Because ofthe use ofintermittent infusion more or less once per week in addition to continuous infusion, significant improvement in quality of life was achieved, and the patient was able to enjoy taking a short trip. To assist a home patient receiving infusion therapy, it is essential that the pharmacist be equipped with skills to manage risks associated with infusion therapy and have knowledge about insurance to cover incidents concerning infusion fluids or medical materials. It will certainly depend on the degree ofindependence ofpatients and the level ofcare their families can provide; however, should we manage to use a similar medical procedure in at least a few cases in the future, we may be able to contribute to "joie de vivre" in home patients receiving infusion therapy.

  4. Pharmacokinetic characteristics of formulated alendronate transdermal delivery systems in rats and humans.

    Science.gov (United States)

    Choi, Ahyoung; Gang, Hyesil; Whang, Jiae; Gwak, Hyesun

    2010-05-01

    The objective of this study was to examine the absorption of alendronate from formulated transdermal delivery systems in rats and humans. When alendronate was applied to rats by transdermal delivery systems (7.2 mg) and oral administration (30 mg/kg), a statistically significant difference was found in the amount remaining to be excreted at time t (Ae(t)) and the amount remaining to be excreted at time 0 (Ae(infinity)) (p transdermal delivery systems. There was a linear relationship (r(2) = 0.9854) between the drug loading dose and Ae(infinity). The Ae(infinity) values from the transdermal delivery system containing 6% caprylic acid (53.8 mg as alendronate) and an oral product (Fosamax), 70 mg as alendronate) in humans were 127.0 +/- 34.2 microg and 237.2 +/- 56.3 microg, respectively. The dose-adjusted relative Ae(infinity) ratio of the transdermal delivery system to oral product was calculated to be 69.7%. The long half-life of alendronate in the transdermal delivery system (50.6 +/- 6.4 h), compared to that of the oral product (3.5 +/- 1.1 h) could allow less-frequent dosing. In conclusion, this study showed that a transdermal delivery system containing 6% caprylic acid in PG could be a favorable alternative for alendronate administration.

  5. Radiodensitometric and DXA analyses for the measurement of bone mineral density after systemic alendronate therapy

    International Nuclear Information System (INIS)

    Lucisano, Marilia Pacifico; Nelson-Filho, Paulo; Silva, Raquel Assed Bezerra da; Silva, Lea Assed Bezerra da; Battaglino, Ricardo; Watanabe, Plauto Christopher Aranha

    2013-01-01

    Precise techniques for the measurement of maxillary bone mineral density (BMD) are useful for the early diagnosis of systemic diseases. The aim of this study was to compare in vivo the efficacy of dual energy x-ray absorptiometry (DXA) and radiographic densitometry for the measurement of BMD after systemic administration of sodium alendronate. Wistar rats were randomly allocated to a control group (n = 5), which received distilled water, and a sodium alendronate group (n = 8), which received two doses of chemically pure sodium alendronate (1 mg/kg) per week. After 8 weeks, the animals were euthanized, the tibias were removed, and the BMD of the proximal tibial metaphysis was analyzed radiographically and by DXA. The data were subjected to statistical analysis by the Kruskal-Wallis test at a significance level of 5%. Both of the techniques revealed that the alendronate-treated group had a significantly higher BMD (p < 0.05) than the control group after 8 weeks of treatment. Comparing the groups with and without alendronate therapy revealed increases of 14.9% and 29.6% in BMD, as detected radiographically and by DXA, respectively. In conclusion, both of the methods were able to detect an increase in BMD of the proximal tibial metaphysis after alendronate therapy. (author)

  6. Radiodensitometric and DXA analyses for the measurement of bone mineral density after systemic alendronate therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lucisano, Marilia Pacifico; Nelson-Filho, Paulo; Silva, Raquel Assed Bezerra da; Silva, Lea Assed Bezerra da, E-mail: nelson@forp.usp.br [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Fac. de Odontologia. Dept. de Clinica Pediatrica, Preventiva e Odontologia Comunitaria; Morse, Leslie [Department of Physical Medicine and Rehabilitation, School of Medicine, Harvard Univ., Boston, MA (United States); Battaglino, Ricardo [Department of Skeletal Biology, Forsyth Institute, Cambridge, MA (United States); Watanabe, Plauto Christopher Aranha [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Fac. de Odontologia. Dept. de Morfologia, Estomacologia e Fisiologia

    2013-05-15

    Precise techniques for the measurement of maxillary bone mineral density (BMD) are useful for the early diagnosis of systemic diseases. The aim of this study was to compare in vivo the efficacy of dual energy x-ray absorptiometry (DXA) and radiographic densitometry for the measurement of BMD after systemic administration of sodium alendronate. Wistar rats were randomly allocated to a control group (n = 5), which received distilled water, and a sodium alendronate group (n = 8), which received two doses of chemically pure sodium alendronate (1 mg/kg) per week. After 8 weeks, the animals were euthanized, the tibias were removed, and the BMD of the proximal tibial metaphysis was analyzed radiographically and by DXA. The data were subjected to statistical analysis by the Kruskal-Wallis test at a significance level of 5%. Both of the techniques revealed that the alendronate-treated group had a significantly higher BMD (p < 0.05) than the control group after 8 weeks of treatment. Comparing the groups with and without alendronate therapy revealed increases of 14.9% and 29.6% in BMD, as detected radiographically and by DXA, respectively. In conclusion, both of the methods were able to detect an increase in BMD of the proximal tibial metaphysis after alendronate therapy. (author)

  7. Acute bilateral uveitis and right macular edema induced by a single infusion of zoledronic acid for the treatment of postmenopausal osteoporosis as a substitution for oral alendronate: a case report.

    Science.gov (United States)

    Tian, Yiming; Wang, Rui; Liu, Lianyuan; Ma, Chunming; Lu, Qiang; Yin, Fuzai

    2016-02-11

    Zoledronic acid-induced uveitis (ZAIU) is rare but severe, and has been recently considered part of an acute phase reaction. Only 15 cases have been reported since 2005. Here we describe a case with macular edema, which is the first reported case observed after long-term alendronate tolerance. A 63-year-old Asian woman received her first intravenous zoledronic acid treatment for the management of postmenopausal osteoporosis as a more convenient substitute for oral alendronate. Twenty-four hours later, bilateral eye irritations, periorbital swelling, blurred vision, and diplopia presented. The complete blood count and transaminase levels were normal, but the erythrocytic sedimentation, C-reactive protein, and serum C4 levels were elevated. On detailed ophthalmological examination, a diagnosis of bilateral acute uveitis and macular edema in the right eye was made. The ocular symptoms were not improved until administration of topical and oral steroids. Complete resolution was achieved. There was no rechallenge of bisphosphonates, and no recurrence at 6 months follow-up. Based on an extensive review, abnormal fundus is rarely reported, especially in cases of macular edema. Rechallenge with zoledronic acid in five cases induced no additional uveitis, and changing the medication to pamidronate in another patient was also tolerated. Interestingly, our patient suffered from uveitis soon after intravenous zoledronate exposure after a two-year tolerance to oral alendronate. This is the first report of zoledronic acid induced uveitis with macular edema after long-term alendronate tolerance. Prior oral alendronate may not entirely prevent ZAIU. Steroids are usually necessary in the treatment of ZAIU. Bisphosphonate rechallenge is not fully contraindicated, and prior steroid administration may be a more reasonable treatment choice according to the available evidence.

  8. Exercise prevented the lansoprazole-induced reduction of anti-osteoporotic efficacy of alendronate in androgen deficiency rats.

    Science.gov (United States)

    Cegieła, Urszula; Pytlik, Maria; Folwarczna, Joanna; Miozga, Rafał; Piskorz, Szymon; Nowak, Dorota

    2014-01-01

    Clinical studies indicate that proton pump inhibitors (PPIs), used long-term in elderly patients, increase the risk of osteoporotic fractures, and decrease the anti-fracture efficacy of alendronate. The aim of the present study was to examine the effect of physical exercise on the anti-osteoporotic efficacy of alendronate administered concurrently with lansoprazole, a PPI, in male rats with androgen deficiency induced by orchidectomy. Male Wistar rats at 3 months of age were divided into: sham-operated control rats, orchidectomized (ORX) control rats, ORX rats receiving alendronate, ORX rats receiving alendronate and lansoprazole, ORX rats receiving alendronate and subjected to exercise, and ORX rats receiving alendronate and lansoprazole and subjected to exercise. The orchidectomy or sham-operation was performed 7-8 days before the start of drug administration. The rats were subjected to the exercise on the treadmill 1 hour/day for 7 weeks (6 days a week). Alendronate sodium (3 mg/kg p.o.) and lansoprazole (4 mg/kg p.o.) were administered once daily for 7 weeks (6 days a week). Mechanical properties of the tibial metaphysis and femoral neck were assessed. Bone turnover markers, histomorphometric parameters, bone mass and mass of bone mineral were also studied. Lansoprazole weakened the anti-osteoporotic efficacy of alendronate. The exercise increased the alendronate effect. Similar changes were observed in the rats treated with lansoprazole and alendronate, subjected to exercise; no deleterious effects of lansoprazole were observed. In conclusion, the exercise prevented the lansoprazole-induced reduction the anti-osteoporotic efficacy of alendronate in orchidectomized rats.

  9. Differences in otosclerotic and normal human stapedial osteoblast properties are normalized by alendronate in vitro.

    Science.gov (United States)

    Gronowicz, Gloria; Richardson, Yvonne L; Flynn, John; Kveton, John; Eisen, Marc; Leonard, Gerald; Aronow, Michael; Rodner, Craig; Parham, Kourosh

    2014-10-01

    Identify and compare phenotypic properties of osteoblasts from patients with otosclerosis (OSO), normal bones (HOB), and normal stapes (NSO) to determine a possible cause for OSO hypermineralization and assess any effects of the bisphosphonate, alendronate. OSO (n = 11), NSO (n = 4), and HOB (n = 13) cultures were assayed for proliferation, adhesion, mineralization, and gene expression with and without 10(-10)M-10(-8)M alendronate. Academic hospital. Cultures were matched for age, sex, and passage number. Cell attachment and proliferation + alendronate were determined by Coulter counting cells and assaying tritiated thymidine uptake, respectively. At 7, 14, and 21 days of culture + alendronate, calcium content and gene expression by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) were determined. OSO had significantly more cells adhere but less proliferation than NSO or HOB. Calcification was significantly increased in OSO compared to HOB and NSO. NSO and HOB had similar cell adhesion and proliferation rates. A dose-dependent effect of alendronate on OSO adhesion, proliferation, and mineralization was found, resulting in levels equal to NSO and HOB. All cultures expressed osteoblast-specific genes such as RUNX2, alkaline phosphatase, type I collagen, and osteocalcin. However, osteopontin was dramatically reduced, 9.4-fold at 14 days, in OSO compared to NSO. Receptor activator of nuclear factor κB ligand/osteoprotegerin (RANKL/OPG), important in bone resorption, was elevated in OSO with decreased levels of OPG levels. Alendronate had little effect on gene expression in HOB but in OSO increased osteopontin levels and decreased RANKL/OPG. OSO cultures displayed properties of hypermineralization due to decreased osteopontin (OPN) and also had increased RANKL/OPG, which were normalized by alendronate. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  10. Self-initiated coping with Tourette's syndrome: Effect of tic suppression on QOL.

    Science.gov (United States)

    Matsuda, Natsumi; Kono, Toshiaki; Nonaka, Maiko; Fujio, Miyuki; Kano, Yukiko

    2016-02-01

    Because of the semi-voluntary nature of tics, patients with Tourette' syndrome (TS) often report self-initiated coping with tics. Our goals were to understand the experiences of self-initiated coping with tics by individuals with TS (e.g., suppression frequency, suppression ability, and side effects of tic suppression), and investigate the effects of tic control on quality of life (QOL). One hundred participants with TS (38 children and 62 adults) answered a questionnaire concerning tic control, QOL, and other clinical characteristics. Fifty-eight percent of the participants always or frequently tried to suppress tics daily. In contrast, over 90% felt uncomfortable or incomplete when they suppressed tics and needed concentration or extra effort to suppress them. Thirty-four percent could suppress tics for less than one minute and 65% could suppress tics for less than 10min. Higher subjective satisfaction with tic control was positively correlated with life satisfaction and QOL. Individuals with TS often attempt self-initiated coping in their daily lives, especially through tic suppression, despite experiencing subjective discomfort and being aware that the duration of tic suppression is often limited. Moreover, it was found that their subjective satisfaction with tic control and effective tic suppression might have a positive influence on their life satisfaction and QOL. Thus, self-initiated coping with tics is vital for improving the QOL of individuals with TS and intervention aimed at enhancing subjective satisfaction with tic control could help manage TS. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  11. In vitro disintegration studies of weekly generic alendronate sodium tablets (70 mg) available in the US.

    Science.gov (United States)

    Dansereau, Richard J; Crail, Debbie J; Perkins, Alan C

    2009-02-01

    Bisphosphonates as a class have the potential to cause upper gastrointestinal irritation. Although the generic alendronate sodium tablets are bioequivalent to the branded product, a potential concern is that the pharmaceutical attributes of the various generic formulations my affect the potential for local irritation and tolerability. The in vitro disintegration times were determined using the method described in the US Pharmacopeia 30 (USP 30). The disintegration of three generic alendronate sodium tablets 70 mg available in the United States was compared to that of the branded product. The mean disintegration times of the generic alendronate sodium tablets ranged from 9 to 10 s for the Barr lots to 108 s for the Watson lot. The disintegration time of the branded product (Fosamax) was 53 s. The three Barr lots and one Teva lot had rapid disintegration times which were similar to the disintegration standards (disintegrating tablets. Since there is no established disintegration time for alendronate sodium tablets there can be no assurance that the generic tablets are equivalent to the branded product in terms of esophageal exposure. However, the in vitro disintegration times have not been correlated with in vivo disintegration performance. Copies of generic alendronate sodium tablets are approved based on the results of single-dose bioavailability studies in healthy subjects and this is not considered adequate to establish similar disintegration characteristics.

  12. Cytotoxicity evaluation of sodium alendronate on cultured human periodontal ligament fibroblasts.

    Science.gov (United States)

    Correia, Vera de Fátima Padrão; Caldeira, Celso L; Marques, Márcia Martins

    2006-12-01

    External root resorption processes are usually associated with dental trauma, mainly avulsion and intrusion. In such cases endodontic therapy aims to prevent this process by using medications that can inhibit osteoclastic activity, such as bisphosphonates. However, these drugs must be biocompatible to the periapical tissues. The aim of this study was to analyze the cytotoxicity of a bisphosphonate (sodium alendronate) on human periodontal ligament fibroblasts (PDL cells). Cells were plated in a density of 1 x 10(3) cells per dish. The experimental groups were GI (control) no sodium alendronate, and GII, GIII, and GIV with sodium alendronate at the concentrations of 10(-5), 10(-6), and 10(-7) M, respectively. The experimental times were 1, 6, 12, and 24 h (short-term) for viability and 2, 4, 6, and 8 days (long-term) for cell survival. Data in triplicate were statistically analyzed. Cultures treated with the highest alendronate concentration (GII) showed cell viability percentages significantly lower (P < 0.01) than those of the other groups (GI, GIII, and GIV), at 12 and 24 h. Cell growth on GII and GIII groups was similar. GII presented smaller growth than the other groups (P < 0.05). We concluded that sodium alendronate, on direct contact with human periodontal ligament fibroblasts, is cytotoxic in concentrations higher than of 10(-6) M.

  13. Preparation and biological studies of 68Ga-DOTA-alendronate

    Directory of Open Access Journals (Sweden)

    Ashraf Fakhari

    2016-07-01

    Full Text Available Objective(s: In line with previous research on the development of conjugated bisphosphonate ligands as new bone-avid agents, in this study, DOTA conjugated alendronate (DOTA-ALN was synthesized and evaluated after labeling with gallium-68 (68Ga.Methods: DOTA-ALN was synthesized and characterized, followed by 68Ga-DOTA-ALN preparation, using DOTA-ALN and 68GaCl3 (pH: 4-5 at 92-95°C for 10 min. Stability tests, hydroxyapatite assay, partition coefficient calculation,biodistribution studies, and imaging were performed on the developed agent in normal rats.Results: The complex was prepared with high radiochemical purity (>99% as depicted by radio thin-layer chromatography; specific activity: 310-320GBq/mmol after solid phase purification and was stabilized for up to 90 min with a logP value of -2.91. Maximum ligand binding (65% was observed in the presence of 50 mg of hydroxyapatite; a major portion of the activity was excreted through the kidneys. With the exception of excretory organs, gastrointestinal tract organs, including the liver, intestine, and colon, showed significant uptake; however, the bone uptake was low (

  14. Preparation and Biological Study of (68)Ga-DOTA-alendronate.

    Science.gov (United States)

    Fakhari, Ashraf; Jalilian, Amir R; Johari-Daha, Fariba; Shafiee-Ardestani, Mehdi; Khalaj, Ali

    2016-01-01

    In line with previous research on the development of conjugated bisphosphonate ligands as new bone-avid agents, in this study, DOTA-conjugated alendronate (DOTA-ALN) was synthesized and evaluated after labeling with gallium-68 ((68)Ga). DOTA-ALN was synthesized and characterized, followed by (68)Ga-DOTA-ALN preparation, using DOTA-ALN and (68)GaCl3 (pH: 4-5) at 92-95° C for 10 min. Stability tests, hydroxyapatite assay, partition coefficient calculation, biodistribution studies, and imaging were performed on the developed agent in normal rats. The complex was prepared with high radiochemical purity (>99% as depicted by radio thin-layer chromatography; specific activity: 310-320 GBq/mmol) after solid phase purification and was stabilized for up to 90 min with a log P value of -2.91. Maximum ligand binding (65%) was observed in the presence of 50 mg of hydroxyapatite; a major portion of the activity was excreted through the kidneys. With the exception of excretory organs, gastrointestinal tract organs, including the liver, intestine, and colon, showed significant uptake; however, the bone uptake was low (<1%) at 30 min after the injection. The data were also confirmed by sequential imaging at 30-90 min following the intravenous injection. The high solubility and anionic properties of the complex led to major renal excretion and low hydroxyapatite uptake; therefore, the complex failed to demonstrate bone imaging behaviors.

  15. Changes in bone density and turnover after alendronate or estrogen withdrawal

    DEFF Research Database (Denmark)

    Wasnich, Richard D; Bagger, Yu Z; Hosking, David J

    2004-01-01

    OBJECTIVE: To compare bone mineral density (BMD) and bone turnover changes after therapy withdrawal in postmenopausal women treated with alendronate or estrogen-progestin. DESIGN: In this randomized, blinded, multinational, placebo-controlled trial, 1,609 healthy postmenopausal women ages 45 to 59...... years were assigned to receive alendronate, placebo, or open-label estrogen-progestin (conjugated equine estrogens plus medroxyprogesterone acetate or a cyclic regimen of 17 beta-estradiol, norethisterone acetate and estradiol). Of the original women, one third after year 2 and one third after year 4...... were switched from alendronate to placebo, while remaining blinded to treatment assignment. The women taking estrogen-progestin in years 1 to 4 were followed off therapy in years 5 and 6. BMD at the lumbar spine and hip and biochemical markers of bone turnover were measured. RESULTS: The treatment...

  16. Effect of insulin combined alendronate sodium on bone mineral density and levels of serum BAP, TRAP-5b and BGP in aged patients with type 2 diabetes mellitus with osteoporosis

    Directory of Open Access Journals (Sweden)

    Fang Wang

    2016-06-01

    Full Text Available Objective: To explore the effect of insulin combined alendronate sodium on bone mineral density and levels of serum BAP, TRAP-5b and BGP in aged patients with type 2 diabetes mellitus with osteoporosis. Methods: A total of 136 patients with type 2 diabetes mellitus with osteoporosis in January 2014 to January 2016 in our hospital for the treatment were selected, and randomly divided into 4 groups, each of 40 cases. Caltrate D was given as a basic treatment to all the patients, and the control group was given the treatment of insulin, and the metformin group was given the treatment of metformin, and the combination group was given the treatment of metformin combined alendronate, and the experiment group was given the treatment of insulin combined alendronate. BMD of the femoral neck and the serum levels of BAP, TRAP-5b and BGP were detected and recorded before the treatment and after one year’s treatment. Results: On index of bone mineral density, the control group and the metformin group showed no significant differences; the combination group was slightly improved, but showed no statistical significance; After the treatment, the bone mineral density of the experiment was significantly improved. On index of bone turnover, the levels of serum BAP and BGP all had been improved and the level of TRAP-5b all was reduced then before the treatment in the control group, the combination group and the experiment group, but only the experiment group showed significant differences; On index of bone turnover, the experiment group were better than other groups, the differences were statistical significant. Conclusions: It has greater clinical curative effect that insulin combined alendronate sodium in the treatment of aged patients with type 2 diabetes mellitus with osteoporosis, it can effectively balance the metabolism of bone, safe and reliable, and it is worthy of application.

  17. Effect of Low-Magnitude Whole-Body Vibration Combined with Alendronate in Ovariectomized Rats: A Random Controlled Osteoporosis Prevention Study

    Science.gov (United States)

    Zhong, Zhao-Ming; Wu, Xiu-Hua; Huang, Zhi-Ping; Li, Wei; Ding, Ruo-Ting; Yu, Hui; Chen, Jian-Ting

    2014-01-01

    Background Alendronate (ALE) is a conventional drug used to treat osteoporosis. Low-magnitude whole-body vibration (WBV) exercise has been developed as a potential treatment for osteoporosis. The aim of this study was to investigate whether low-magnitude WBV could enhance the protective effect of ALE on bone properties in ovariectomized rats. Methods A total of 128 Sprague-Dawley rats were randomly divided into five groups (SHAM, OVX+VEH, OVX+WBV, OVX + ALE, OVX+WBV+ALE). The level of WBV applied was 0.3 g at 45–55 Hz for 20 min/day, 5 day/week and for 3 months. ALE was administered in dose of 1 mg/Kg once a week. Every four weeks eight rats from each group were sacrificed and their blood and both tibiae were harvested. The expression of osteocalcin and CTX in serum was measured by enzyme-linked immunosorbent assay (ELISA) and the tibiae were subjected to metaphyseal three-point bending and μCT analysis. Results Osteocalcin rose after ovariectomy and was not appreciably changed by either alendronate or WBV alone or in combination. Alendronate treatment significantly prevented an increase in CTX. WBV alone treatment did not alter this effect. Compared with the OVX+WBV group, nearly all tested indices such as the BV/TV, TV apparent, Tb.N, Tb.Th, and Conn.D were higher in the OVX+ALE group at week 12.Compared with the OVX+WBV group, certain tested indices such as BV/TV, TV apparent, Tb.N, and Con.D, were higher in the OVX+WBV+ALE group at week 12. At week 12, tibiae treated with WBV+ALE exhibited a significantly higher Fmax compared to the OVX+VEH group, and a significant difference was also found in energy absorption between the OVX+WBV+ALE and OVX+VEH groups. Conclusions Compared with the WBV, ALE was more effective at preventing bone loss and improved the trabecular architecture. However, WBV enhanced the effect of alendronate in ovariectomized rats by inducing further improvements in trabecular architecture. PMID:24796785

  18. rTMS in fibromyalgia: a randomized trial evaluating QoL and its brain metabolic substrate.

    Science.gov (United States)

    Boyer, Laurent; Dousset, Alix; Roussel, Philippe; Dossetto, Nathalie; Cammilleri, Serge; Piano, Virginie; Khalfa, Stéphanie; Mundler, Olivier; Donnet, Anne; Guedj, Eric

    2014-04-08

    This double-blind, randomized, placebo-controlled study investigated the impact of repetitive transcranial magnetic stimulation (rTMS) on quality of life (QoL) of patients with fibromyalgia, and its possible brain metabolic substrate. Thirty-eight patients were randomly assigned to receive high-frequency rTMS (n = 19) or sham stimulation (n = 19), applied to left primary motor cortex in 14 sessions over 10 weeks. Primary clinical outcomes were QoL changes at the end of week 11, measured using the Fibromyalgia Impact Questionnaire (FIQ). Secondary clinical outcomes were mental and physical QoL component measured using the 36-Item Short Form Health Survey (SF-36), but also pain, mood, and anxiety. Resting-state [(18)F]-fluorodeoxyglucose-PET metabolism was assessed at baseline, week 2, and week 11. Whole-brain voxel-based analysis was performed to study between-group metabolic changes over time. At week 11, patients of the active rTMS group had greater QoL improvement in the FIQ (p = 0.032) and in the mental component of the SF-36 (p = 0.019) than the sham stimulation group. No significant impact was found for other clinical outcomes. Compared with the sham stimulation group, patients of the active rTMS group presented an increase in right medial temporal metabolism between baseline and week 11 (p FIQ and mental component SF-36 concomitant changes (r = -0.38, p = 0.043; r = 0.51, p = 0.009, respectively). QoL improvement involved mainly affective, emotional, and social dimensions. Our study shows that rTMS improves QoL of patients with fibromyalgia. This improvement is associated with a concomitant increase in right limbic metabolism, arguing for a neural substrate to the impact of rTMS on emotional dimensions involved in QoL. This study provides Class II evidence that rTMS compared with sham rTMS improves QoL in patients with fibromyalgia.

  19. Dysphagia-related quality of life in oculopharyngeal muscular dystrophy: Psychometric properties of the SWAL-QOL instrument.

    Science.gov (United States)

    Youssof, Sarah; Romero-Clark, Carol; Warner, Teddy; Plowman, Emily

    2017-07-01

    The Swallowing Quality of Life instrument (SWAL-QOL) is a patient-reported outcome measure of swallowing-related quality of life (SR-QoL). Its psychometric properties in oculopharyngeal muscular dystrophy (OPMD) are not known. We administered the SWAL-QOL to U.S. OPMD Registry participants. We described SR-QoL profiles and assessed reliability and validity. The mean composite score in 113 individuals with OPMD was 54.4 ± 20.7, indicating moderate impairment. Severe impairments were observed in eating duration, burden, and fatigue scales. Internal consistency reliability of all scales was found to be satisfactory, and 9 of 10 scales demonstrated adequate test-retest reliability. Data confirmed 86% of hypotheses, supporting construct validity. The SWAL-QOL limitations in OPMD include: floor/ceiling effects in 7 of 10 scales and low specificity of sleep, fatigue, and communication scales for dysphagia. SR-QoL is reduced in OPMD. Given several limitations of the SWAL-QOL, development of an improved dysphagia-specific QoL instrument for OPMD is warranted. Muscle Nerve 56: 28-35, 2017. © 2016 Wiley Periodicals, Inc.

  20. Alendronate has a residual effect on bone mass in postmenopausal Danish women up to 7 years after treatment withdrawal

    DEFF Research Database (Denmark)

    Bagger, Yu Z; Tankó, László B; Alexandersen, Peter

    2003-01-01

    for 7, 5, or 3 yr, respectively. Bone mineral density of the lumbar spine, hip, and forearm was measured by dual-energy x-ray absorptiometry. Biochemical markers of bone turnover were induced serum C-terminal telopeptides of type I collagen (CTX) and osteocalcin. Women who received alendronate (2...... was found in women treated with alendronate 20 mg per day for 2 yr (9.7%, P=0.01 vs. placebo). The rate of bone loss after alendronate withdrawal was comparable to the bone loss observed in the placebo group. Bone markers tended to reverse back to normal levels, but were still affected even several years...

  1. Efficacy and safety of alendronic acid in the treatment of osteoporosis in children

    Directory of Open Access Journals (Sweden)

    Alberto Martín Siguero

    2015-11-01

    Full Text Available Objectives: to describe the efficacy and safety of the off-label use of alendronate in the treatment of osteoporosis in children and adolescents. Method: a retrospective study (2008-2014 of all patients under 18 years who were dispensed alendronate for this indication. The criteria for initiating treatment were: bone mineral density with a Z-score ≤ -2.5 SD, a past history of bone fractures without a previous traumatism, and persistent pain. The variables collected were: demographic, treatment-related, clinical. and safety data. The treatment was considered to be effective when there was an increase in bone mineral density up to a Z-score > -2.5 SD. Results: a total of 12 patients, 8 of them male, with a mean age of 11 years (} 3 SD, were treated with alendronate. After a mean time of treatment of 2.15 years (} 1.2 SD, there was an increase in bone mineral density in all patients, 9 of which achieved a Z-score > -2.5 SD, so the drug was considered effective in 75% of cases. No patient had bone fractures or expressed adverse effects during treatment. Conclusions: alendronate increased bone mineral density and was well tolerated in all patients, therefore it could be considered as a therapeutic option in the treatment of osteoporosis in children.

  2. Risk of hip, subtrochanteric, and femoral shaft fractures among mid and long term users of alendronate

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Eiken, Pia; Prieto-Alhambra, Daniel

    2016-01-01

    OBJECTIVES: To determine the skeletal safety and efficacy of long term (≥10 years) alendronate use in patients with osteoporosis. DESIGN: Open register based cohort study containing two nested case control studies. SETTING: Nationwide study of population of Denmark. PARTICIPANTS: 61 990 men...... ratio (MPR, a proxy for compliance) >80%) compared with poor adherence (MPR

  3. Injectable nanoparticle-loaded hydrogel system for local delivery of sodium alendronate

    Czech Academy of Sciences Publication Activity Database

    Posadowska, U.; Pařízek, Martin; Filová, Elena; Wlodarczyk-Biegun, M.; Kamperman, M.; Bačáková, Lucie; Pamula, E.

    2015-01-01

    Roč. 485, 1-2 (2015), s. 31-40 ISSN 0378-5173 R&D Projects: GA MZd(CZ) NT13297 Institutional support: RVO:67985823 Keywords : sodium alendronate * PLGA * nanoparticles Subject RIV: EI - Biotechnology ; Bionics Impact factor: 3.994, year: 2015

  4. Effect of alendronate on early bone loss of renal transplant recipients.

    Science.gov (United States)

    Abediazar, S; Nakhjavani, M R

    2011-03-01

    Renal transplant recipients (RTRs) are at risk of developing osteoporosis and osteopenia due to underlying renal osteodystrophy, hypophosphatemia, and immunosuppression. This process occurs more frequently in the first year after renal transplantation (RTX), resulting in eventual bone loss and fractures. The purpose of this study was to evaluate the effect of low-dose alendronate to prevent early bone loss after RTX. We prospectively studied 43 successful RTR including 22 men and 21-women with a mean overall age of 39.16±11.73 years, mean body mass index of 23.6±3.73, and mean dialysis duration of 25.73±17.67 months. We matched them based on age and sex: the alendronate-treated group received vitamin D (Vit D) during the study plus 30 mg alendronate weekly from 1 month after RTX. The control group only received Vit D. We measured serum calcium, phosphate, alkaline phosphatase, blood urea, creatinine, and intact parathyroid hormone (iPTH) at the pretransplant baseline and monthly thereafter as well as BMD of the lumbar spine, femur, and radius pretransplant baseline versus 3 and 6 months after RTX. At 6 month after RTX, the lumbar BMD in the alendronate group increased significantly from 0.819±0.11 to 0.863±0.14 (Pbone loss and increase BMD immediately after RTX. Copyright © 2011. Published by Elsevier Inc.

  5. Tc-99m Radiolabeled Alendronate Sodium Microemulsion: Characterization and Permeability Studies Across Caco-2 Cells.

    Science.gov (United States)

    Elitez, Yetkin; Ekinci, Meliha; Ilem-Ozdemir, Derya; Gundogdu, Evren; Asikoglu, Makbule

    2018-01-01

    Alendronate sodium (ALD) is used orally but it is poorly absorbed from the gastrointestinal (GI) tract. For this reason, microemulsion system was chosen to evaluate ALD from the GI tract after oral delivery. This study was aimed to prepare water-in-oil (w/o) microemulsion formulation of ALD and evaluate the permeability of ALD microemulsion from Caco-2 cell lines with radioactive and nonradioactive studies. The ALD microemulsion was developed by using pseudo-ternary phase diagram and composed of Soybean oil, Colliphor EL, Tween 80, Transcutol and distilled water. The prepared ALD microemulsion was characterized by physical appearance, droplet size, viscosity, pH, electrical conductivity and refractive index. The stability of the formulation was investigated for 6 months at 25±2°C/60±5% of relative humidity (RH) as well as at 40±2°C/75±5% RH. After that 1 mg of ALD was radiolabeled with 99mTc and added to microemulsion. The permeability studies were performed with both 99mTc-ALD microemulsion and ALD microemulsion. The experimental results suggested that ALD microemulsion presented adequate stability with droplet size varying from 37.8±0.9 to 39.9±1.2 nm during incubation time. In addition, ALD microemulsion was radiolabeled with high labeling efficiency (>95%). In a non-radioactive study, ALD permeability was found to be 45 µg.mL-1 and microemulsion has high permeability percentage when compared to another study. The novel w/o microemulsion formulation has been developed for oral delivery of ALD. Based on the results, permeability of ALD could be significantly improved by the microemulsion formulation. In addition, 99mTc-ALD microemulsion in capsule can be used for bone disease treatment and diagnosis. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  6. Time trends for alendronate prescription practices in women with chronic obstructive pulmonary disease and women exposed to systemic glucocorticoids

    DEFF Research Database (Denmark)

    Brask-Lindemann, Dorthe; Eiken, P; Eskildsen, P

    2013-01-01

    Summary Chronic obstructive pulmonary disease (COPD) and systemic glucocorticoid exposure are well-known risk factors of osteoporosis. We evaluated alendronate prescription practices related to COPD and exposure to systemic corticosteroids from 1996 to 2008 and showed an increasing targeting...... of alendronate treatment in patients with COPD and patients with systemic corticosteroid exposure. Introduction COPD and systemic glucocorticoid exposure are well-known risk factors of osteoporosis and fragility fracture, but osteoporosis is often underdiagnosed and undertreated in these patients. This study...... aims to evaluate alendronate prescription practices related to COPD and/or to exposure to systemic glucocorticoids among Danish women. Methods A total of 388,314 female subjects >50 years old, 64,719 of whom initiated treatment with alendronate, and 323,595 age- and gender-matched controls were...

  7. Edentulism and dental prostheses in the elderly: impact on quality of life measured with EuroQol--visual analog scale (EQ-VAS).

    Science.gov (United States)

    Cano-Gutiérrez, Carlos; Borda, Miguel G; Arciniegas, Antonio J; Borda, Claudia X

    2015-01-01

    The objective of this study was to measure the impact of edentulism and dental prostheses on quality of life (QOL) in older adults in Bogota, Colombia. Edentulism is a frequent condition in older adults and has great impact on their QOL. No epidemiological data are currently available on edentulism among older adults in Colombia. Data were obtained from the SABE-Bogota study, a cross-sectional study conducted in 2012, and used to analyze the EQ-VAS (Visual Analog Scale) from the EuroQol instrument to measure the perception of quality of life (QOL) in relation to edentulism. The study included 2,000 individuals over 60 years old. The Spearman-Rho correlation was used to analyze the correlation between EQ-VAS and edentulism. Chi-Square, ANOVA and t-test were used to study the differences in EQ-VAS scores between edentulous and healthy subjects. Statistical significance was set at peducation were related to edentulism. Individuals with fewer teeth and dental prostheses had lower EQ-VAS scores (pmeasuring the perception of QOL in dental health scenarios. Edentulism significantly affects QOL in older adults and the use of dental prosthesis does not improve the perception of QOL.

  8. Validity, reliability, and factor analysis of Persian version of quality of life questionnaire for irritable bowel syndrome (IBS-QOL-34

    Directory of Open Access Journals (Sweden)

    Nasrine Masaeli

    2013-01-01

    Full Text Available Background: Quality of life (QOL improvement is the main objective of treating patients with irritable bowel syndrome (IBS. This study aimed to assess the validity, reliability, and factor analysis of IBS-QOL-34 questionnaire as a common transcultural instrument for Iranian IBS patients. Materials and Methods: Two hundred and forty patients with IBS (based on gastroenterologists′ diagnosis according to ROM III criteria were referred to Digestive Health Clinic in Psychosomatic Research Center have been selected in this study. Aside with IBS-QOL-34, MOS 36-item short-form health survey (SF-36 and IBS severity index (IBSSI questionnaires were completed by the cases for determination of correlation coefficients; the data were analyzed using descriptive statistics, factor analysis, Cronbach′s alpha, Pearson correlation coefficient by Statistical Package for Social Sciences (SPSS software, version 18. Results: Total reliability of the questionnaire was reported by using Cronbach′s alpha as 0.95, ranging from 0.65 to 0.90. Correlation coefficients of concurrent implementation of IBS-QOL with SF-36 and IBSSI resulted in −0.61 and 0.64, respectively. Exploratory factor analysis using varimax rotation identified eight principle components, which will determine QOL at 67% variance. Conclusion: According to the results, IBS-QOL-34 questionnaire has good psychometric properties in the research community and can be safely used as a valid tool to assess QOL of patients with IBS for healthcare and therapeutic purposes.

  9. Use of Calcium and Alendronic Acid Preparations in Correction of Structural and Functional Disorders of Bone Tissue in Thyrotoxicosis

    Directory of Open Access Journals (Sweden)

    O.B. Oliynyk

    2012-02-01

    Full Text Available Impact of calcium and alendronic acid preparations on disorders of structural and functional state of bone tissue in experimental animals at exogenic thyrotoxicosis was studied. It was defined that introduction of calcium preparations reduces bone mineral density loss in female rats with drug thyrotoxicosis, and combined use of calcium and alendronic acid prevents bone tissue loss regardless of thyrotoxicosis duration and presence of ovariectomy.

  10. Alendronate Sodium as Enteric Coated Solid Lipid Nanoparticles; Preparation, Optimization, and In Vivo Evaluation to Enhance Its Oral Bioavailability.

    Directory of Open Access Journals (Sweden)

    Khaled Mohamed Hosny

    Full Text Available Treatment of osteoporosis with alendronate sodium has several challenges. The first challenge is the low bioavailability. The second main challenge is side effects, which include oesophageal ulceration. The aim of this research was to reformulate alendronate sodium as enteric coated solid lipid nanoparticles in order to enhance its bioavailability, and preventing the free alendronate sodium from coming into direct contact with the gastrointestinal mucosa, and thereby reducing the possibility of side effects. Enteric coated solid lipid nanoparticles were prepared according to the Box-Behnken design employing Design expert® software, and characterized for size, morphology, and entrapment efficiency. The optimized formula was coated with an Eudragit S100 and evaluated for drug release in acidic and basic media, stability studies and pharmacokinetic evaluations on rabbits. The results indicated that, using Derringer's desirability functional tool for optimization, the highest entrapment efficiency value of 74.3% and the smallest size value of 98 nm were predicted under optimum conditions with a desirability value of 0.917. The optimized nanoparticles released alendronate sodium only at an alkaline pH. The pharmacokinetic evaluation revealed that alendronate sodium bioavailability was enhanced by more than 7.4-fold in rabbits. In conclusion, enteric coated solid lipid nanoparticles is a promising formula for the delivery of alendronate sodium, eliminating its oesophageal side effects and enhancing its bioavailability.

  11. Validation of the prolapse quality-of-life questionnaire (P-QOL): An ...

    African Journals Online (AJOL)

    Background. The prolapse quality-of-life questionnaire (P-QOL) has been validated and translated into eight languages. The lack of an Afrikaans version of the P-QOL limits studies in Afrikaans-speaking patients with pelvic organ prolapse (POP). Objective. To validate an Afrikaans version of the P-QOL in a South African ...

  12. [Relationship between Quality of Life (QOL) and cognitive function among community-dwelling elderly].

    Science.gov (United States)

    Konagaya, Yoko; Watanabe, Tomoyuki; Ohta, Toshiki; Takata, Kazuko

    2009-03-01

    It has become important for elderly to live better rather than to live longer. There have been many reports about quality of life (QOL) of the elderly, but we have no knowledge about the relation between the QOL and the cognitive function. We investigated the relationship between the QOL and the cognitive function among community-dwelling elderly. A total of 12,059 community-dwelling elderly were invited to join a cognitive screening study by telephone (TICS-J) combined with a mailed QOL questionnaire. Among them, 1,920 subjects (age 71.87+/-5.50 (mean+/-SD) years old, duration of education 11.08+/-2.61 years) who completed both TICS-J and QOL questionnaire were actually measured. TICS-J was administered by the previously reported method, and the QOL questionnaire was developed based on the component of QOL proposed by Lawton, and consisted of 6 subscales (daily activity, satisfaction with health, satisfaction with human support, satisfaction with economic state, symptoms of depression, and positive mental attitude). Correlations were analyzed among the scores of TICS-J, age, duration of education, and scores on each QOL subscale. Multiple linear regression analysis was conducted after QOL subscale scores, adjusting for gender, age, and duration of education, were entered as dependent variables. Four out of 6 subscales scores of QOL showed significant differences between men and women. All QOL subscale scores showed significant differences between the two groups in the TICS-J scores. Partial correlations were seen among TICS-J scores and each QOL subscale score. Multiple linear regression analysis revealed significant influence of cognitive function by TICS-J on QOL subscales scores. Cognitive function was considered to have more influence on QOL scores than gender or age. TICS-J and the QOL questionnaire in this study were useful to evaluate the outcome of welfare in community-dwelling elderly.

  13. Neuro-QOL and the NIH Toolbox: implications for epilepsy

    Science.gov (United States)

    Nowinski, Cindy J; Victorson, David; Cavazos, Jose E; Gershon, Richard; Cella, David

    2011-01-01

    The impact of neurological disorders on the lives of patients is often far more complex than what is measured in routine examination. Measurement of this impact can be challenging owing to a lack of brief, psychometrically sound and generally accepted instruments. Two NIH-funded initiatives are developing assessment tools, in English and Spanish, which address these issues, and should prove useful to the study and treatment of epilepsy and other neurological conditions. The first, Neuro-QOL, has created a set of health-related quality of life measures that are applicable for people with common neurological disorders. The second, the NIH Toolbox for the Assessment of Neurological and Behavioral Function, is assembling measures of cognitive, emotional, motor and sensory health and function that can be used across all ages, from 3 to 85 years. This article describes both the projects and their potential value to epilepsy treatment and research. PMID:21552344

  14. Modulation of adhesion-dependent cAMP signaling by echistatin and alendronate

    Science.gov (United States)

    Fong, J. H.; Ingber, D. E.

    1996-01-01

    We measured intracellular cAMP levels in cells during attachment and spreading on different extracellular matrix (ECM) proteins. Increases in cAMP were observed within minutes when cells attached to fibronectin, vitronectin, and a synthetic RGD-containing fibronectin peptide (Petite 2000), but not when they adhered to another integrin alpha nu beta 3 ligand, echistatin. Because echistatin also inhibits bone resorption, we measured the effects of adding another osteoporosis inhibitor, alendronate, in this system. Alendronate inhibited the cAMP increase induced by ligands that primarily utilize integrin alpha nu beta 3 (vitronectin, Peptite 2000), but not by fibronectin which can also use integrin alpha 5 beta 1. These results show that cell adhesion to ECM can increase intracellular cAPM levels and raise the possibility that inhibitors of osteoporosis may act, in part, by preventing activation of this pathway by integrins.

  15. Development and characterization of a gastroretentive dosage form composed of chitosan and hydroxyethyl cellulose for alendronate

    OpenAIRE

    Chen YC; Ho HO; Chiu CC; Sheu MT

    2013-01-01

    Ying-Chen Chen,1,* Hsiu-O Ho,1,* Chiao-Chi Chiu,1 Ming-Thau Sheu1,2 1School of Pharmacy, College of Pharmacy, Taipei Medical University, 2Clinical Research Center and Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei, Taiwan*These authors contributed equally to this workAbstract: In this study, alendronate, the most commonly used biphosphonate for treating osteoporosis, was formulated as gastroretentive dosage form (GRDF) tablets to enhance its oral bioav...

  16. Theoretical analysis of alendronate and risedronate effects on canine vertebral remodeling and microdamage

    OpenAIRE

    Wang, Xiang; Erickson, Antonia M.; Allen, Matthew R.; Burr, David B.; Martin, R. Bruce; Hazelwood, Scott J.

    2009-01-01

    Bisphosphonates suppress bone remodeling activity, increase bone volume, and significantly reduce fracture risk in individuals with osteoporosis and other metabolic bone diseases. The objectives of the current study were to develop a mathematical model that simulates control and 1 year experimental results following bisphosphonate treatment (alendronate or risedronate) in the canine fourth lumbar vertebral body, validate the model by comparing simulation predictions to 3 year experimental res...

  17. [Clinical application of alendronate for osteoporosis/osteopenia secondary to hyperthyroidism].

    Science.gov (United States)

    Yang, Li-Juan; Shen, Fei-Xia; Zheng, Jing-Chen; Zhang, Hai-Ling

    2012-02-01

    To evaluate the efficacy and safety of alendronate for the treatment of osteoporosis/osteopenia secondary to hyperthyroidism. From April 2008 to November 2009, 27 patients with hyperthyroidism with osteoporosis/ osteopenia measured by dual energy X-ray absorptiometry (DXA) were included in this study, and then they were randomly divided into two groups (group A and group B) by simple random sampling. Group A consisted of 14 patients treated with antithyroid drug and caltrate D, the antithyroid drug change with thyroid function, and caltrate D 600 mg per day. Group B consisted of 13 patients treated with antithyroid drug, caltrate D and alendronate, antithyroid drug and caltrate D the same as group A, and alendronate 70 mg weekly. Meanwhile, 21 healthy voluntary adults were chosen as control group. And compared with the control group which was treated with nothing. Followed-up for one year, the bone mineral density (including T-score, Z-score, BMD) in lumbar spine (LS), femoral neck (FN) and distal radius (DR) and general information, were compared before and after treatment. BMD at FN and DR were significantly higher at 12 months after treatment than at the baseline in group A (P = 0.000); T-score, Z-score, and BMD at the LS, FN and DR were all significantly higher at 12 months after treatment than at the baseline in group B (P hyperthyroidism and osteoporosis/osteopenia. Compared with anti-thyroid drugs alone, treatment with alendronate can obtain more clinical effect and also very safety.

  18. Process analytical technology to understand the disintegration behavior of alendronate sodium tablets.

    Science.gov (United States)

    Xu, Xiaoming; Gupta, Abhay; Sayeed, Vilayat A; Khan, Mansoor A

    2013-05-01

    Various adverse events including esophagus irritations have been reported with the use of alendronate tablets, likely attributed to the rapid tablet disintegration in the mouth or esophagus. Accordingly, the disintegration of six alendronate tablet drug products was studied using a newly developed testing device equipped with in-line sensors, in addition to the official compendial procedure for measuring the disintegration time. The in-line sensors were used to monitor the particle count and solution pH change to assess the onset and duration of disintegration. A relatively large variation was observed in the disintegration time of the tested drug products using the compendial method. The data collected using the in-line sensors suggested that all tested drug products exhibited almost instantaneous onset of disintegration, under 2 s, and a sharp drop in solution pH. The drop in pH was slower for tablets with slower disintegration. The in-house prepared alendronate test tablets also showed similar trends suggesting rapid solubilization of the drug contributed to the fast tablet disintegration. This research highlights the usefulness of the newly developed in-line analytical method in combination with the compendial method in providing a better understanding of the disintegration and the accompanying drug solubilization processes for fast disintegrating tablet drug products. Copyright © 2013 Wiley Periodicals, Inc.

  19. Hydroxyapatite nanocrystals functionalized with alendronate as bioactive components for bone implant coatings to decrease osteoclastic activity

    Science.gov (United States)

    Bosco, Ruggero; Iafisco, Michele; Tampieri, Anna; Jansen, John A.; Leeuwenburgh, Sander C. G.; van den Beucken, Jeroen J. J. P.

    2015-02-01

    The integration of bone implants within native bone tissue depends on periprosthetic bone quality, which is severely decreased in osteoporotic patients. In this work, we have synthesized bone-like hydroxyapatite nanocrystals (nHA) using an acid-base neutralization reaction and analysed their physicochemical properties. Subsequently, we have functionalized the nHA with alendronate (nHAALE), a well-known bisphosphonate drug used for the treatment of osteoporosis. An in vitro osteoclastogenesis test was carried out to evaluate the effect of nHAALE on the formation of osteoclast-like cells from monocytic precursor cells (i.e. RAW264.7 cell line) showing that nHAALE significantly promoted apoptosis of osteoclast-like cells. Subsequently, nHA and nHAALE were deposited on titanium disks using electrospray deposition (ESD), for which characterisation of the deposited coatings confirmed the presence of alendronate in nHAALE coatings with nanoscale thickness of about 700 nm. These results indicate that alendronate linked to hydroxyapatite nanocrystals has therapeutic potential and nHAALE can be considered as an appealing coating constituent material for orthopaedic and oral implants for application in osteoporotic patients.

  20. Inhibited osteoclastic bone resorption through alendronate treatment in rats reduces severe osteoarthritis progression.

    Science.gov (United States)

    Siebelt, M; Waarsing, J H; Groen, H C; Müller, C; Koelewijn, S J; de Blois, E; Verhaar, J A N; de Jong, M; Weinans, H

    2014-09-01

    Osteoarthritis (OA) is a non-rheumatoid joint disease characterized by progressive degeneration of extra-cellular cartilage matrix (ECM), enhanced subchondral bone remodeling, osteophyte formation and synovial thickening. Alendronate (ALN) is a potent inhibitor of osteoclastic bone resorption and results in reduced bone remodeling. This study investigated the effects of pre-emptive use of ALN on OA related osteoclastic subchondral bone resorption in an in vivo rat model for severe OA. Using multi-modality imaging we measured effects of ALN treatment within cartilage and synovium. Severe osteoarthritis was induced in left rat knees using papain injections in combination with a moderate running protocol. Twenty rats were treated with subcutaneous ALN injections and compared to twenty untreated controls. Animals were longitudinally monitored for 12weeks with in vivo μCT to measure subchondral bone changes and SPECT/CT to determine synovial macrophage activation using a folate-based radiotracer. Articular cartilage was analyzed at 6 and 12weeks with ex vivo contrast enhanced μCT and histology to measure sulfated-glycosaminoglycan (sGAG) content and cartilage thickness. ALN treatment successfully inhibited subchondral bone remodeling. As a result we found less subchondral plate porosity and reduced osteophytosis. ALN treatment did not reduce subchondral sclerosis. However, after the OA induction phase, ALN treatment protected cartilage ECM from degradation and reduced synovial macrophage activation. Surprisingly, ALN treatment also improved sGAG content of tibia cartilage in healthy joints. Our data was consistent with the hypothesis that osteoclastic bone resorption might play an important role in OA and may be a driving force for progression of the disease. However, our study suggest that this effect might not solely be effects on osteoclastic activity, since ALN treatment also influenced macrophage functioning. Additionally, ALN treatment and physical activity

  1. Evaluation of thyroid eye disease: quality-of-life questionnaire (TED-QOL) in Korean patients.

    Science.gov (United States)

    Son, Byeong Jae; Lee, Sang Yeul; Yoon, Jin Sook

    2014-04-01

    To assess impaired quality of life (QOL) of Korean patients with thyroid eye disease (TED) using the TED-QOL questionnaire, to evaluate the adaptability of the questionnaire, and to assess the correlation between TED-QOL and scales of disease severity. Prospective, cross-sectional study. Total of 90 consecutive adult patients with TED and Graves' disease were included in this study. TED-QOL was translated into Korean and administered to the patients. The results were compared with clinical severity scores (clinical activity score, VISA (vision loss (optic neuropathy); inflammation; strabismus/motility; appearance/exposure) classification, modified NOSPECS (no signs or symptoms; only signs; soft tissue; proptosis; extraocular muscle; cornea; sight loss) score, Gorman diplopia scale, and European Group of Graves' Orbitopathy Classification). Clinical scores indicating inflammation and strabismus in patients with TED were positively correlated with overall and visual function-related QOL (Spearman coefficient 0.21-0.38, p < 0.05). Clinical scores associated with appearance were positively correlated with appearance-related QOL (Spearman coefficient 0.26-0.27, p < 0.05). In multivariate analysis, age, soft-tissue inflammation, motility disorder of modified NOSPECS, and motility disorder of VISA classification had positive correlation with overall and function-related QOL. Sex, soft-tissue inflammation, proptosis of modified NOSPECS, and appearance of VISA classification had correlation with appearance-related QOL. In addition, validity of TED-QOL was proved sufficient based on the outcomes of patient interviews and correlation between the subscales of TED-QOL. TED-QOL showed significant correlations with various objective clinical parameters of TED. TED-QOL was a simple and useful tool for rapid evaluation of QOL in daily outpatient clinics, which could be readily translated into different languages to be widely applicable to various populations. Copyright © 2014

  2. Implication for QOL after I-125 brachytherapy for prostate cancer

    International Nuclear Information System (INIS)

    Teishima, Jun; Yasumoto, Hiroaki; Inoue, Syogo; Masumoto, Hiroshi; Hasegawa, Yasuhisa; Matsubara, Akio

    2009-01-01

    The aim of this study is to evaluate the quality of life (QOL) of patients following prostate brachytherapy. Between July 2004 and May 2008, 139 patients underwent I-125 permanent brachytherapy. Among those patients, 69 who were followed up for more than one year using the Expanded Prostate Index Composite (EPIC), Japanese version v1 TM , were enrolled in this study. Urinary summary scores became worse temporarily at 1 month after the end of treatment, but then recovered gradually to the level before treatment. Sexual summary scores before treatment were 42.2±16.3. They became worse temporarily at 1 month after treatment but then recovered gradually in patients whose sexual summary scores were more than 40. Urinary morbidity scores after prostate brachytherapy were not so severe and recovered within a short period. Further long-term observation is thought to be required in the future. Sexual function scores of patients before treatment in the present study were lower compared with those recorded in previous studies. (author)

  3. Determination of pKa values of alendronate sodium in aqueous solution by piecewise linear regression based on acid-base potentiometric titration.

    Science.gov (United States)

    Ke, Jing; Dou, Hanfei; Zhang, Ximin; Uhagaze, Dushimabararezi Serge; Ding, Xiali; Dong, Yuming

    2016-12-01

    As a mono-sodium salt form of alendronic acid, alendronate sodium presents multi-level ionization for the dissociation of its four hydroxyl groups. The dissociation constants of alendronate sodium were determined in this work by studying the piecewise linear relationship between volume of titrant and pH value based on acid-base potentiometric titration reaction. The distribution curves of alendronate sodium were drawn according to the determined pKa values. There were 4 dissociation constants (pKa 1 =2.43, pKa 2 =7.55, pKa 3 =10.80, pKa 4 =11.99, respectively) of alendronate sodium, and 12 existing forms, of which 4 could be ignored, existing in different pH environments.

  4. Role of 1% alendronate gel as adjunct to mechanical therapy in the treatment of chronic periodontitis among smokers.

    Science.gov (United States)

    Sharma, Anuj; Raman, Achala; Pradeep, Avani Raju

    2017-01-01

    Alendronate (ALN) inhibits osteoclastic bone resorption and triggers osteostimulative properties both in vivo and in vitro, as shown by increase in matrix formation. This study aimed to explore the efficacy of 1% ALN gel as local drug delivery (LDD) in adjunct to scaling and root planing (SRP) for the treatment of chronic periodontitis among smokers. 75 intrabony defects were treated in 46 male smokers either with 1% ALN gel or placebo gel. ALN gel was prepared by adding ALN into carbopol-distilled water mixture. Clinical parameters [modified sulcus bleeding index, plaque index, probing depth (PD), and periodontal attachment level (PAL)] were recorded at baseline, at 2 months, and at 6 months, while radiographic parameters were recorded at baseline and at 6 months. Defect fill at baseline and at 6 months was calculated on standardized radiographs by using the image analysis software. Mean PD reduction and mean PAL gain were found to be greater in the ALN group than in the placebo group, both at 2 and 6 months. Furthermore, a significantly greater mean percentage of bone fill was found in the ALN group (41.05±11.40%) compared to the placebo group (2.5±0.93%). The results of this study showed 1% ALN stimulated a significant increase in PD reduction, PAL gain, and an improved bone fill compared to placebo gel in chronic periodontitis among smokers. Thus, 1% ALN, along with SRP, is effective in the treatment of chronic periodontitis in smokers.

  5. Factors that influence the QOL of cancer patients who have undergone radiotherapy as outpatients

    International Nuclear Information System (INIS)

    Senuma, Maiko; Shinoda, Shizuyo; Kitada, Yoko; Takei, Akemi; Kanda, Kiyoko; Seyama, Ruka; Igarashi, Reiko

    2011-01-01

    The purpose of this study was to elucidate the factors that influence the QOL of cancer patients who have undergone radiotherapy in the outpatient setting. The patient's quality of life (QOL) was investigated by using the QOL evaluation standard functional assessment of cancer therapy-general (FACT-G) in 73 cancer patients (mean age 64.2±12.2 yrs standard deviation (SD)) who had undergone radiotherapy as outpatients. The mean QOL score was 74.8±17.1 pointy, and a significant difference was seen in about 25 items as a result of examining the factors that influenced the patient's QOL. In addition, a stepwise multiple regression analysis revealed that the factors which influenced the QOL were the operation due to the original disease, social support (excluding the family), tiredness, relapse and the metastasis, performance status (PS), uneasiness of presence in descending order of influence. The results revealed the strong influence of psychological, mental and social factors on the QOL score. From the patient of view of nursing support for cancer patients, screening for these factors may allow earlier detection of any decrease in the QOL, or identify when the QOL has already decreased. Furthermore, support should be initiated at as early a stage as possible. (author)

  6. Effects of radiotherapy for brain metastases on quality of life (QoL). Prospective pilot study of the DEGRO QoL working party

    Energy Technology Data Exchange (ETDEWEB)

    Steinmann, Diana; Bruns, Frank [Medical School, Hannover (Germany). Radiation Oncology; Schaefer, Christof; Hipp, Matthias [Regensburg Univ. (Germany). Radiation Oncology; Oorschot, Birgitt van [Wuerzburg Univ. (Germany). Radiation Oncology; Wypior, Hans-Joachim [Hospital Landshut (Germany). Radiation Oncology; Boelling, Tobias [Muenster Univ. (Germany). Radiation Oncology; Sehlen, Susanne [Ludwig Maximilians Univ., Muenchen (Germany). Radiation Oncology; Hagg, Juliane [Ulm Univ. (Germany). Radiation Oncology; Bayerl, Anja [Hospital Krems (Austria). Radiation Oncology; Geinitz, Hans [Technical Univ. Muenchen (Germany). Radiation Oncology; Vordermark, Dirk [Halle-Wittenberg Univ., Halle (Germany). Radiation Oncology

    2009-03-15

    Background: Prospective data on quality-of-life (QoL) effects of radiotherapy for brain metastases are currently lacking, but would be of great interest to guide therapeutic decisions. Patients and Methods: From 01/2007 to 08/2007, 46 patients with previously untreated brain metastases were recruited at eight centers. QoL was measured at start of treatment (T{sub 0}) and at 3 months ({sub T3mo}). In the pilot study, two combinations of QoL instruments could be used at the discretion of the centers (A: EORTC QLQ-C30 and B: EORTC QLQ-C15-PAL both with brain module BN20, assessment by proxies with A: Palliative Care Outcome Scale, B: self-constructed brain-specific instrument). Results: All patients received whole-brain radiotherapy, four with an additional boost irradiation. At T{sub 3mo}, 26/46 patients (56.5%) had died. 17/20 survivors (85%) completed the questionnaires. In 3-month survivors, QoL deteriorated in most domains, significant in drowsiness, hair loss and weakness of legs. The scores for headaches and seizures were slightly better after 3 months. Assessment by proxies also suggested worsening of QoL. Initial QoL at T{sub 0} was better in those alive than in those deceased at T{sub 3mo}, significant for physical function and for the symptom scales of fatigue and pain, motor dysfunction, communication deficit and weakness of legs. Conclusion: Practicability and compliance appeared better with the (shorter) version B. This version is now used in the ongoing main phase of the study with additional centers. First results indicate a moderate worsening of QoL during the first 3 months after start of palliative radiotherapy for brain metastases. QoL at initiation of radiotherapy may be prognostic for survival. (orig.)

  7. Effects of long-term alendronate treatment on bone mineralisation, resorption parameters and biomechanics of single human vertebral trabeculae

    Directory of Open Access Journals (Sweden)

    M Krause

    2014-09-01

    Full Text Available Due to their well-established fracture risk reduction, bisphosphonates are the most frequently used therapeutic agent to treat osteoporosis. Bisphosphonates reduce fracture risk by suppressing bone resorption, but the lower bone turnover could have a negative impact on bone quality at the tissue level. Here, we directly assess the structural and mechanical characteristics of cancellous bone from the lumbar vertebrae (L5 in non-treated osteoporotic controls (n = 21, mid-term alendronate-treated osteoporotic patients (n = 6, and long-term alendronate-treated osteoporotic patients (n = 7. The strength and toughness of single trabeculae were evaluated, while the structure was characterised through measurements of microdamage accumulation, mineralisation distribution, and histological indices. The alendronate-treated cases had a reduced eroded surface (ES/BS, p < 0.001 and a higher bone mineralisation in comparison to non-treated controls (p = 0.037, which is indicative of low turnover associated with treatment. However, the amount of microdamage and the mechanical properties were similar among the control and treatment groups. As the tissue mineral density (TMD increased significantly with alendronate treatment compared to non-treated osteoporotic controls, the reduction in resorption cavities could counterbalance the higher TMD allowing the alendronate-treated bone to maintain its mechanical properties and resist microdamage accumulation. A multivariate analysis of the possible predictors supports the theory that multiple factors (e.g., body mass index, TMD, and ES/BS can impact the mechanical properties. Our results suggest that long-term alendronate treatment shows no adverse impact on mechanical cancellous bone characteristics.

  8. Surgically treated osteonecrosis and osteomyelitis of the jaw and oral cavity in patients highly adherent to alendronate treatment

    DEFF Research Database (Denmark)

    Eiken, P. A.; Prieto-Alhambra, D.; Eastell, R.

    2017-01-01

    register-based cohort study containing one nested case-control study. Patients were treatment-naïve incident users of alendronate 1996–2007 in Denmark, both genders, aged 50–94 at the time of beginning treatment (N = 61,990). Participants were followed to 31 December 2013. Results: Over a mean of 6.8 years...... pump inhibitors were independently associated with surgically treated ONJ. Conclusions: Our data suggest that recent, long-term, and compliant uses of alendronate are associated with an increased risk of surgically treated ONJ. Nevertheless, the rates remain low, even in long-term adherent users. ONJ...

  9. Development and characterization of a gastroretentive dosage form composed of chitosan and hydroxyethyl cellulose for alendronate

    Directory of Open Access Journals (Sweden)

    Chen YC

    2013-12-01

    Full Text Available Ying-Chen Chen,1,* Hsiu-O Ho,1,* Chiao-Chi Chiu,1 Ming-Thau Sheu1,2 1School of Pharmacy, College of Pharmacy, Taipei Medical University, 2Clinical Research Center and Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei, Taiwan*These authors contributed equally to this workAbstract: In this study, alendronate, the most commonly used biphosphonate for treating osteoporosis, was formulated as gastroretentive dosage form (GRDF tablets to enhance its oral bioavailability. GRDF tablets were characterized with the effects of different molecular weights (MWs of chitosan (CS and hydroxyethyl cellulose (HEC at various ratios on swelling, floating, and physical integrity. The CS component was formed using various acids: acetic, lactic, malic, succinic, and citric, and a high viscosity grade of HEC was selected. The results demonstrated that the swelling ratios of the formulations comprising high MW CS were lower than those of low or medium MW CS when salts were formed with any countering acids except for acetic acid. The decreasing ranking of the swelling rates was: CS-citrate > CS-malate > CS-lactate > CS-succinate > CS-acetate. A negative correlation was found between the pKa of the respective countering acid and the swelling rate. The swelling rate was promoted if an acidic salt of CS with a lower water content was incorporated, while it became slower when tablet hardness was higher or the compression force to form tablets was increased. Although HEC did not contribute to swelling or floating, it played a role in maintaining structural integrity. A prolonged dissolution profile of alendronate GRDF tablets developed in this study was observed.Keywords: gastroretentive dosage form, chitosan, hydrogel, hydroxyethyl cellulose, swelling, alendronate

  10. Zoledronic acid and alendronate sodium and the implications in orthodontic movement.

    Science.gov (United States)

    Franzoni, J S; Soares, F M P; Zaniboni, E; Vedovello Filho, M; Santamaria, M P; Dos Santos, G M T; Esquisatto, M A M; Felonato, M; Mendonca, F A S; Franzini, C M; Santamaria, M

    2017-08-01

    To evaluate orthodontic tooth movement (OTM) in rats treated with two types of bisphosphonates (BPs), alendronate sodium (A) and zoledronic acid (Z). In all, 15 male Wistar rats were randomly divided into three groups. Group OTM+A: orthodontic tooth movement and subcutaneous administration of alendronate sodium (2.5 mg/kg); Group OTM+Z: orthodontic tooth movement and subcutaneous administration of zoledronic acid (0.02 mg/kg), and Group OTM: orthodontic tooth movement and subcutaneous injection of saline. The BPs were administered once a day during 25 days before OTM started and during 10 days of OTM. The left upper first molar was moved with a stainless-steel closed coil spring which delivered an initial force of 0.4N. OTM was measured with a digital caliper comparing the moved and the contralateral side. The histomorphometric analysis counted the number of osteoclasts, inflammatory cells, blood vessels and fibroblasts (n/10 4  m 2 ) in periodontal ligament (PDL) of the distobuccal root. A reduction of 58.3% of OTM was found in Group OTM+A and 99.6% in Group OTM+Z, when compared with Group OTM. There was a significant decrease of osteoclasts and inflammatory cells in BP-treated groups. Blood vessels and fibroblastic cells decreased mainly in Group OTM+Z. Alendronate sodium and zoledronic acid have similar effects on the periodontal tissue during orthodontic treatment in rats. Especially, zoledronic acid can affect orthodontic tooth movement. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. The Cerebral Palsy Quality of Life for Children (CP QOL-Child): Evidence of Construct Validity

    Science.gov (United States)

    Chen, Kuan-Lin; Wang, Hui-Yi; Tseng, Mei-Hui; Shieh, Jeng-Yi; Lu, Lu; Yao, Kai-Ping Grace; Huang, Chien-Yu

    2013-01-01

    The Cerebral Palsy Quality of Life for Children (CP QOL-Child) is the first health condition-specific questionnaire designed for measuring QOL in children with cerebral palsy (CP). However, its construct validity has not yet been confirmed by confirmatory factor analysis (CFA). Hence, this study assessed the construct validity of the caregiver…

  12. Quality of life (QoL) and neurotoxicity in germ-cell cancer survivors (GCCS)

    DEFF Research Database (Denmark)

    Lauritsen, J.; Bandak, Mikkel; Mortensen, M. S.

    2016-01-01

    Background: The majority of patients with testicular cancer become long-term survivors. However, treatment is associated with late effects which may hamper QoL. The aims of the present study were to assess the impact of treatment on long-term QoL and evaluate the influence of neurotoxicity on Qo...

  13. Translation and validation of the Uterine Fibroid Symptom and Quality of Life (UFS-QOL questionnaire for the Brazilian Portuguese language

    Directory of Open Access Journals (Sweden)

    Luiz Gustavo Oliveira Brito

    2017-03-01

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: Uterine fibroids (UF, also known as leiomyomas, are the most prevalent gynecological tumors. The Uterine Fibroid Symptoms and Quality of Life (UFS-QOL is the only specific questionnaire that assesses symptom intensity and quality-of-life issues for women with symptomatic UF; however, it only exists in the English language. Thus, we aimed to translate and culturally validate the UFS-QOL questionnaire for the Brazilian Portuguese language. DESIGN AND SETTING: Cross-sectional study, Department of Gynecology and Obstetrics, FMRP-USP. METHODS: 113 patients with UF (case group and 55 patients without UF (control group were interviewed using the UFS-QOL questionnaire after translation and cultural adaptation. The Short Form-36 questionnaire was used as a control. Demographic and psychometric variables were analyzed. RESULTS: Women with UF presented higher mean age, body mass index, weight, parity and comorbidities than the control group (P < 0.05. The most prevalent complaints were abnormal uterine bleeding (93.8%, pelvic pain (36.3% and extrinsic compression (10.6% and these presented adequate construct validity regarding UFS-QOL severity (P < 0.05. The UFS-QOL questionnaire presented good internal consistency regarding symptom severity and quality-of-life-related domains (intraclass correlation coefficient, ICC = 0.82/0.88. Structural validity presented correlation coefficients ranging from 0.59 to 0.91. Test-retest comparison did not show differences among the UFS-QOL subscales. After treatment, women with UF presented improvements on all subscales. CONCLUSION: The UFS-QOL questionnaire presented adequate translation to the Brazilian Portuguese language, with good internal consistency, discriminant validity, construct validity, structural validity and responsiveness, along with adequate test-retest results.

  14. Alendronate inhalation ameliorates elastase-induced pulmonary emphysema in mice by induction of apoptosis of alveolar macrophages.

    Science.gov (United States)

    Ueno, Manabu; Maeno, Toshitaka; Nishimura, Satoshi; Ogata, Fusa; Masubuchi, Hiroaki; Hara, Kenichiro; Yamaguchi, Kouichi; Aoki, Fumiaki; Suga, Tatsuo; Nagai, Ryozo; Kurabayashi, Masahiko

    2015-03-10

    Alveolar macrophages play a crucial role in the pathogenesis of emphysema, for which there is currently no effective treatment. Bisphosphonates are widely used to treat osteoclast-mediated bone diseases. Here we show that delivery of the nitrogen-containing bisphosphonate alendronate via aerosol inhalation ameliorates elastase-induced emphysema in mice. Inhaled, but not orally ingested, alendronate inhibits airspace enlargement after elastase instillation, and induces apoptosis of macrophages in bronchoalveolar fluid via caspase-3- and mevalonate-dependent pathways. Cytometric analysis indicates that the F4/80(+)CD11b(high)CD11c(mild) population characterizing inflammatory macrophages, and the F4/80(+)CD11b(mild)CD11c(high) population defining resident alveolar macrophages take up substantial amounts of the bisphosphonate imaging agent OsteoSense680 after aerosol inhalation. We further show that alendronate inhibits macrophage migratory and phagocytotic activities and blunts the inflammatory response of alveolar macrophages by inhibiting nuclear factor-κB signalling. Given that the alendronate inhalation effectively induces apoptosis in both recruited and resident alveolar macrophages, we suggest this strategy may have therapeutic potential for the treatment of emphysema.

  15. Subtrochanteric and diaphyseal femur fractures in patients treated with alendronate: a register-based national cohort study

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Eiken, Pia; Eastell, Richard

    2009-01-01

    Alendronate (aln) is a potent bisphosphonate with a prolonged duration of action. Recent reports have found long-term aln use to be common in patients with subtrochanteric or proximal diaphyseal femur fracture, raising concerns that these fractures could be a consequence of excessive suppression...

  16. Alendronate augments interleukin-1β release from macrophages infected with periodontal pathogenic bacteria through activation of caspase-1

    International Nuclear Information System (INIS)

    Deng Xue; Tamai, Riyoko; Endo, Yasuo; Kiyoura, Yusuke

    2009-01-01

    Nitrogen-containing bisphosphonates (NBPs) are anti-bone-resorptive drugs with inflammatory side effects that include osteomyelitis and osteonecrosis of the jaw. Oral bacteria have been considered to be a trigger for these NBP-associated jaw bone diseases. The present study examined the effects of alendronate (a typical NBP) and clodronate (a non-NBP) on the production of proinflammatory cytokines by macrophages infected with Porphyromonas gingivalis and Tannerella forsythia, which are important pathogens of periodontal diseases. Pretreatment with alendronate augmented IL-1β, but not TNFα, production by macrophages infected with P. gingivalis or T. forsythia. This augmentation of IL-1β production was inhibited by clodronate. Furthermore, caspase-1, a promoter of IL-1β production, was activated by treatment with alendronate, and caspase-1 inhibitor reduced the production of IL-1β induced by alendronate and P. gingivalis. These results suggest that NBPs augment periodontal pathogenic bacteria-induced IL-1β release via caspase-1 activation, and this phenomenon may contribute to the development of NBP-associated inflammatory side effects including jaw osteomyelitis. Co-treatment with clodronate may prevent and/or reduce these inflammatory effects induced by NBPs

  17. Alendronate augments interleukin-1{beta} release from macrophages infected with periodontal pathogenic bacteria through activation of caspase-1

    Energy Technology Data Exchange (ETDEWEB)

    Xue, Deng; Tamai, Riyoko [Division of Oral Bacteriology, Department of Oral Medical Science, Ohu University School of Dentistry, 31-1 Misumido, Tomitamachi, Koriyama, Fukushima 963-8611 (Japan); Endo, Yasuo [Department of Molecular Regulation, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575 (Japan); Kiyoura, Yusuke [Division of Oral Bacteriology, Department of Oral Medical Science, Ohu University School of Dentistry, 31-1 Misumido, Tomitamachi, Koriyama, Fukushima 963-8611 (Japan)

    2009-02-15

    Nitrogen-containing bisphosphonates (NBPs) are anti-bone-resorptive drugs with inflammatory side effects that include osteomyelitis and osteonecrosis of the jaw. Oral bacteria have been considered to be a trigger for these NBP-associated jaw bone diseases. The present study examined the effects of alendronate (a typical NBP) and clodronate (a non-NBP) on the production of proinflammatory cytokines by macrophages infected with Porphyromonas gingivalis and Tannerella forsythia, which are important pathogens of periodontal diseases. Pretreatment with alendronate augmented IL-1{beta}, but not TNF{alpha}, production by macrophages infected with P. gingivalis or T. forsythia. This augmentation of IL-1{beta} production was inhibited by clodronate. Furthermore, caspase-1, a promoter of IL-1{beta} production, was activated by treatment with alendronate, and caspase-1 inhibitor reduced the production of IL-1{beta} induced by alendronate and P. gingivalis. These results suggest that NBPs augment periodontal pathogenic bacteria-induced IL-1{beta} release via caspase-1 activation, and this phenomenon may contribute to the development of NBP-associated inflammatory side effects including jaw osteomyelitis. Co-treatment with clodronate may prevent and/or reduce these inflammatory effects induced by NBPs.

  18. Development and characterization of a gastroretentive dosage form composed of chitosan and hydroxyethyl cellulose for alendronate.

    Science.gov (United States)

    Chen, Ying-Chen; Ho, Hsiu-O; Chiu, Chiao-Chi; Sheu, Ming-Thau

    2014-01-01

    In this study, alendronate, the most commonly used biphosphonate for treating osteoporosis, was formulated as gastroretentive dosage form (GRDF) tablets to enhance its oral bioavailability. GRDF tablets were characterized with the effects of different molecular weights (MWs) of chitosan (CS) and hydroxyethyl cellulose (HEC) at various ratios on swelling, floating, and physical integrity. The CS component was formed using various acids: acetic, lactic, malic, succinic, and citric, and a high viscosity grade of HEC was selected. The results demonstrated that the swelling ratios of the formulations comprising high MW CS were lower than those of low or medium MW CS when salts were formed with any countering acids except for acetic acid. The decreasing ranking of the swelling rates was: CS-citrate > CS-malate > CS-lactate > CS-succinate > CS-acetate. A negative correlation was found between the pKa of the respective countering acid and the swelling rate. The swelling rate was promoted if an acidic salt of CS with a lower water content was incorporated, while it became slower when tablet hardness was higher or the compression force to form tablets was increased. Although HEC did not contribute to swelling or floating, it played a role in maintaining structural integrity. A prolonged dissolution profile of alendronate GRDF tablets developed in this study was observed.

  19. Metallic stents provide better QOL than plastic stents in patients with stricture of unresectable advanced esophageal cancer

    International Nuclear Information System (INIS)

    Ohta, Kazuki; Nagahara, Akihito; Iijima, Katsuyori

    2006-01-01

    The aim of this study was to elucidate the utility and safety of treatment with esophageal stents (plastic and metallic stents) for unresectable advanced esophageal cancer. Between 1992 and 2002, 14 cases of unresectable advanced esophageal cancer were treated with esophageal stents (the plastic stent group, 7 cases; and the metallic stent group, 7 cases). Of these, 10 cases had a history of chemotherapy and or radiotherapy. An improvement in oral intake and performance status (PS), survival time, periods at home, and adverse events were compared between the two groups. After stenting, oral intake and PS were significantly improved in the metallic stent group. Follow-up at home was possible in 71.4%. There was no significant difference in survival or duration of time at home between the two groups. All adverse events were controllable and there was no difference between the two groups. Stenting not only improved oral intake and PS but also allowed a stay at home, resulting in a marked improvement in patients' quality of life (QOL). Stenting was performed safely even in cases with a history of radiotherapy. There was no difference in survival, ratios of staying at home, and safety between the two groups, but QOL was significantly improved in the metallic stent group. These outcomes indicate that placement of metallic stents should be actively considered to treat stricture due to advanced esophageal cancer. (author)

  20. Validation of the prolapse quality-of-life questionnaire (P-QOL): An ...

    African Journals Online (AJOL)

    Afrikaans version of the P-QOL limits studies in Afrikaans-speaking patients with pelvic organ prolapse (POP). Objective. ... The Cronbach alpha was used to determine internal consistency and ... German,[11] ..... quality of life, and risk factors.

  1. Overview of the Spinal Cord Injury--Quality of Life (SCI-QOL) measurement system.

    Science.gov (United States)

    Tulsky, David S; Kisala, Pamela A; Victorson, David; Tate, Denise G; Heinemann, Allen W; Charlifue, Susan; Kirshblum, Steve C; Fyffe, Denise; Gershon, Richard; Spungen, Ann M; Bombardier, Charles H; Dyson-Hudson, Trevor A; Amtmann, Dagmar; Kalpakjian, Claire Z; Choi, Seung W; Jette, Alan M; Forchheimer, Martin; Cella, David

    2015-05-01

    The Spinal Cord Injury--Quality of Life (SCI-QOL) measurement system was developed to address the shortage of relevant and psychometrically sound patient reported outcome (PRO) measures available for clinical care and research in spinal cord injury (SCI) rehabilitation. Using a computer adaptive testing (CAT) approach, the SCI-QOL builds on the Patient Reported Outcomes Measurement Information System (PROMIS) and the Quality of Life in Neurological Disorders (Neuro-QOL) initiative. This initial manuscript introduces the background and development of the SCI-QOL measurement system. Greater detail is presented in the additional manuscripts of this special issue. Classical and contemporary test development methodologies were employed. Qualitative input was obtained from individuals with SCI and clinicians through interviews, focus groups, and cognitive debriefing. Item pools were field tested in a multi-site sample (n=877) and calibrated using item response theory methods. Initial reliability and validity testing was performed in a new sample of individuals with traumatic SCI (n=245). Five Model SCI System centers and one Department of Veterans Affairs Medical Center across the United States. Adults with traumatic SCI. n/a n/a The SCI-QOL consists of 19 item banks, including the SCI-Functional Index banks, and 3 fixed-length scales measuring physical, emotional, and social aspects of health-related QOL (HRQOL). The SCI-QOL measurement system consists of psychometrically sound measures for individuals with SCI. The manuscripts in this special issue provide evidence of the reliability and initial validity of this measurement system. The SCI-QOL also links to other measures designed for a general medical population.

  2. Overview of the Spinal Cord Injury – Quality of Life (SCI-QOL) measurement system

    Science.gov (United States)

    Tulsky, David S.; Kisala, Pamela A.; Victorson, David; Tate, Denise G.; Heinemann, Allen W.; Charlifue, Susan; Kirshblum, Steve C.; Fyffe, Denise; Gershon, Richard; Spungen, Ann M.; Bombardier, Charles H.; Dyson-Hudson, Trevor A.; Amtmann, Dagmar; Z. Kalpakjian, Claire; W. Choi, Seung; Jette, Alan M.; Forchheimer, Martin; Cella, David

    2015-01-01

    Context/Objective The Spinal Cord Injury – Quality of Life (SCI-QOL) measurement system was developed to address the shortage of relevant and psychometrically sound patient reported outcome (PRO) measures available for clinical care and research in spinal cord injury (SCI) rehabilitation. Using a computer adaptive testing (CAT) approach, the SCI-QOL builds on the Patient Reported Outcomes Measurement Information System (PROMIS) and the Quality of Life in Neurological Disorders (Neuro-QOL) initiative. This initial manuscript introduces the background and development of the SCI-QOL measurement system. Greater detail is presented in the additional manuscripts of this special issue. Design Classical and contemporary test development methodologies were employed. Qualitative input was obtained from individuals with SCI and clinicians through interviews, focus groups, and cognitive debriefing. Item pools were field tested in a multi-site sample (n = 877) and calibrated using item response theory methods. Initial reliability and validity testing was performed in a new sample of individuals with traumatic SCI (n = 245). Setting Five Model SCI System centers and one Department of Veterans Affairs Medical Center across the United States. Participants Adults with traumatic SCI. Interventions n/a Outcome Measures n/a Results The SCI-QOL consists of 19 item banks, including the SCI-Functional Index banks, and 3 fixed-length scales measuring physical, emotional, and social aspects of health-related QOL (HRQOL). Conclusion The SCI-QOL measurement system consists of psychometrically sound measures for individuals with SCI. The manuscripts in this special issue provide evidence of the reliability and initial validity of this measurement system. The SCI-QOL also links to other measures designed for a general medical population. PMID:26010962

  3. Comparison of QOL between patients with different degenerative dementias, focusing especially on positive and negative affect.

    Science.gov (United States)

    Kurisu, Kairi; Terada, Seishi; Oshima, Etsuko; Horiuchi, Makiko; Imai, Nao; Yabe, Mayumi; Yokota, Osamu; Ishihara, Takeshi; Yamada, Norihito

    2016-08-01

    Quality of life (QOL) has become an important outcome measure in the care of dementia patients. However, there have been few studies focusing on the difference in QOL between different dementias. Two-hundred seventy-nine consecutive outpatients with Alzheimer's disease (AD), dementia with Lewy bodies (DLB) or frontotemporal dementia (FTD) were recruited. The QOL was evaluated objectively using the QOL Questionnaire for Dementia (QOL-D).The QOL-D comprises six domains: positive affect, negative affect and actions, communication, restlessness, attachment to others, and spontaneity. General cognition, daily activities, and behavioral and psychological symptoms of dementia were also evaluated. The scores of positive affect of QOL-D of AD patients were significantly higher than those of patients with DLB or FTD (AD 3.1 ± 0.8, DLB 2.6 ± 0.9, FTD 2.6 ± 0.7). The scores of negative affect and action of QOL-D of FTD patients were significantly higher than those of patients with AD or DLB (FTD 2.0 ± 0.8, AD 1.4 ± 0.5, DLB 1.5 ± 0.6). The apathy scores of FTD and DLB patients were significantly higher than those of patients with AD. The disinhibition scores of FTD patients were significantly higher than those of patients with AD or DLB. The apathy of FTD and DLB patients and depression of DLB patients might affect the lower positive affect of FTD and DLB patients compared to AD patients. The disinhibition of FTD patients might affect the abundance of negative affect & actions in FTD patients compared to AD and DLB patients.

  4. Validation of the Stroke Specific Quality of Life Scale (SS-QOL): test of reliability and validity of the Danish version (SS-QOL-DK).

    Science.gov (United States)

    Muus, Ingrid; Williams, Linda S; Ringsberg, Karin C

    2007-07-01

    To test the reliability and validity of the Danish version of the Stroke Specific Quality of Life Scale version 2.0 (SS-QOL-DK), an instrument for evaluation of health-related quality of life. A correlational study. A stroke unit that provides acute care and rehabilitation for stroke patients in Frederiksborg County, Denmark. One hundred and fifty-two stroke survivors participated; 24 of these performed test-retest. Questionnaires were sent out and returned by mail. A subsequent telephone interview assessed functional level and missing items. Test-retest was measured using Spearman's r, internal consistency was estimated using Cronbach's alpha, and evaluation of floor and ceiling values in proportion of minimum and maximum scores. Construct validity was assessed by comparing patients' scores on the SS-QOL-DK with those obtained by other test methods: Beck's Depression Index, the General Health Survey Short Form 36 (SF-36), the Barthel Index and the National Institutes of Health Stroke Scale, evaluating shared variance using coefficient of determination, r2. Comparing groups with known scores assessed known-group validity. Convergent and discriminant validity were assessed. Test-retest of SS-QOL-DK showed excellent stability, Spearman's r = 0.65-0.99. Internal consistency for all domains showed Cronbach's alpha = 0.81-0.94. Missing items rate was 1.0%. Most SS-QOL-DK domains showed moderately shared variance with similar domains of other test methods, r2 = 0.03-0.62. Groups with known differences showed statistically significant difference in scores. Item-to-scale correlation coefficients of 0.37-0.88 supported convergent validity. SS-QOL-DK is a reliable and valid instrument for measuring self-reported health-related quality of life on group level among people with mild to moderate stroke.

  5. Effects of odanacatib on bone matrix mineralization in rhesus monkeys are similar to those of alendronate

    Directory of Open Access Journals (Sweden)

    Barbara M. Misof

    2016-12-01

    Full Text Available Odanacatib (ODN is a selective and reversible inhibitor of cathepsin K which is an important enzyme for the degradation of collagen I. Aim of the present work was the head-to-head comparison between the effects of ODN and alendronate (ALN on bone mineralization density distribution (BMDD, based on quantitative backscattered electron imaging in relation to changes in histomorphometric mineralizing surface per bone surface (MS/BS in 12–22 years old ovariectomized rhesus monkeys. Trabecular and cortical BMDD derived parameters from vertebrae and proximal tibiae were compared among vehicle (VEH, n = 8, odanacatib low dose (ODN-L, n = 8, odanacatib high dose (ODN-H, n = 8, and alendronate (ALN, n = 6 treated animals. Additionally, data from an intact, non-treated group of animals are shown (INT, n = 8. In trabecular bone from the vertebra and metaphyseal tibia, the BMDD of the ODN and ALN treatment groups was shifted toward higher mineralization densities (p < 0.001 consistent with the significant reduction of MS/BS (p < 0.05 in ODN-H and ALN compared to VEH. Vertebral trabecular CaMean (average degree of mineralization was significantly higher in ODN-L (+6.5%, ODN-H (+6.1%, and ALN (+6.7%, all p < 0.001. Tibial osteonal cortical bone revealed also significantly increased CaMean for ODN-L (+1.4%, p < 0.05, ODN-H (+2.2%, p < 0.05, and ALN (+3.4%, p < 0.001 versus VEH, while primary cortical bone (devoid of secondary osteons did not show any significant differences between the study groups. The percentage of primary bone area in the tibial cross-sections (on average 45 ± 12% was also not significantly different between the study groups (p = 0.232. No significant differences in any BMDD parameters of all studied skeletal sites between ODN and ALN treatment were found. Correlation analysis revealed that MS/BS was highly predictive for trabecular BMDD in vertebral bone. The higher MS/BS, the lower was CaMean. Our findings are

  6. Alendronate sodium hydrate (oral jelly for the treatment of osteoporosis: review of a novel, easy to swallow formulation

    Directory of Open Access Journals (Sweden)

    Imai K

    2013-06-01

    Full Text Available Kazuhiro Imai Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan Abstract: Osteoporosis is a skeletal disorder characterized by loss of bone mass, decreased bone strength, and an increased risk of bone fracture. The disease progresses with age, especially in postmenopausal women. Japan is one of the most rapidly aging societies worldwide. Japanese individuals over 65 years of age constituted 23.0% of the population in 2010 and 25.1% to 25.2% as of 2013. The estimated number of people with osteoporosis in Japan is currently 13 million. Bisphosphonates increase bone mineral density by inhibiting osteoclast-mediated bone resorption, thereby reducing the risk of fractures. Alendronate sodium hydrate (alendronate is a bisphosphonate that potently inhibits bone resorption and is used to treat osteoporosis. Sufficient water is required to take an alendronate oral tablet; insufficient water could result in digestive system diseases, such as esophageal ulceration. Elderly patients with swallowing difficulty may choke on the tablet. Taking a tablet with oral jelly is a method to prevent digestive system disease and reduce the choking hazard. Once-weekly alendronate oral jelly was approved in 2012 by the Ministry of Health, Labour, and Welfare of Japan as the world's first drug for osteoporosis in a jelly formulation. It consists of a jelly portion and an air portion. The jelly formulation is smoothly discharged by pushing the air portion. Therefore, elderly patients with physical disabilities are able to easily take all of the jelly formulation from the package. In this review, this new formulation of alendronate sodium hydrate (oral jelly is introduced and discussed in terms of osteoporosis treatment. This new formulation provides an alternative so that patients may select a method of dosing tailored to their preferences. Management of osteoporosis involves assessing fracture risk and preventing

  7. Alendronate-Eluting Biphasic Calcium Phosphate (BCP Scaffolds Stimulate Osteogenic Differentiation

    Directory of Open Access Journals (Sweden)

    Sung Eun Kim

    2015-01-01

    Full Text Available Biphasic calcium phosphate (BCP scaffolds have been widely used in orthopedic and dental fields as osteoconductive bone substitutes. However, BCP scaffolds are not satisfactory for the stimulation of osteogenic differentiation and maturation. To enhance osteogenic differentiation, we prepared alendronate- (ALN- eluting BCP scaffolds. The coating of ALN on BCP scaffolds was confirmed by scanning electron microscopy (FE-SEM, energy-dispersive X-ray spectroscopy (EDS, and attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR. An in vitro release study showed that release of ALN from ALN-eluting BCP scaffolds was sustained for up to 28 days. In vitro results revealed that MG-63 cells grown on ALN-eluting BCP scaffolds exhibited increased ALP activity and calcium deposition and upregulated gene expression of Runx2, ALP, OCN, and OPN compared with the BCP scaffold alone. Therefore, this study suggests that ALN-eluting BCP scaffolds have the potential to effectively stimulate osteogenic differentiation.

  8. Work performance evaluation and QoL of adults with High Functioning Autism Spectrum Disorders (HFASD).

    Science.gov (United States)

    Katz, Noomi; Dejak, Ifat; Gal, Eynat

    2015-01-01

    Studies suggest that adults with High Functioning Autism Spectrum Disorders (HFASD) are reliant on others for support in functioning in everyday life and employment. This study followed a work placement program for people with HFASD over a nine months period. It aimed to measure the trajectory of their work performance and Quality of life on jobs in the open market. Twenty-six participants with HFASD ages 18-40 underwent extensive evaluation and based on it were placed in various jobs on the open market. Participants were followed for nine months at their work place at four different time points. QoL was self-assessed in addition to work performance (WPE) which was assessed both by first-hand and team member's accounts. Team members are health professional who accompany and support the participants in the transition to their jobs. All 26 participants were able to maintain their jobs during the nine months of follow-up. WPE was perceived as high to start with, and its scores slightly improved by both people with HFASD and team members. Self-report suggests a significant change in the quality of life of the participants, specifically in their evaluations of self-competency. This study enhances the importance of providing people with HFASD with work placing programs and following up during actual work performance.

  9. Validated spectrophotometric methods for determination of Alendronate sodium in tablets through nucleophilic aromatic substitution reactions

    Directory of Open Access Journals (Sweden)

    Walash Mohamed I

    2012-04-01

    Full Text Available Abstract Background Alendronate (ALD is a member of the bisphosphonate family which is used for the treatment of osteoporosis, bone metastasis, Paget's disease, hypocalcaemia associated with malignancy and other conditions that feature bone fragility. ALD is a non-chromophoric compound so its determination by conventional spectrophotometric methods is not possible. So two derivatization reactions were proposed for determination of ALD through the reaction with 4-chloro-7-nitrobenzo-2-oxa-1,3-diazole (NBD-Cl and 2,4-dinitrofluorobenzene (DNFB as chromogenic derivatizing reagents. Results Three simple and sensitive spectrophotometric methods are described for the determination of ALD. Method I is based on the reaction of ALD with NBD-Cl. Method II involved heat-catalyzed derivatization of ALD with DNFB, while, Method III is based on micellar-catalyzed reaction of the studied drug with DNFB at room temperature. The reactions products were measured at 472, 378 and 374 nm, for methods I, II and III, respectively. Beer's law was obeyed over the concentration ranges of 1.0-20.0, 4.0-40.0 and 1.5-30.0 μg/mL with lower limits of detection of 0.09, 1.06 and 0.06 μg/mL for Methods I, II and III, respectively. The proposed methods were applied for quantitation of the studied drug in its pure form with mean percentage recoveries of 100.47 ± 1.12, 100.17 ± 1.21 and 99.23 ± 1.26 for Methods I, II and III, respectively. Moreover the proposed methods were successfully applied for determination of ALD in different tablets. Proposals of the reactions pathways have been postulated. Conclusion The proposed spectrophotometric methods provided sensitive, specific and inexpensive analytical procedures for determination of the non-chromophoric drug alendronate either per se or in its tablet dosage forms without interference from common excipients. Graphical abstract

  10. Quality of life assessment in cosmetics: specificity and interest of the international BeautyQol instrument.

    Science.gov (United States)

    Beresniak, Ariel; Auray, Jean-Paul; Duru, Gérard; Aractingi, Selim; Krueger, Gerald G; Talarico, Sergio; Tsutani, Kiichiro; Dupont, Danielle; de Linares, Yolaine

    2015-09-01

    The wide use of cosmetics and their perceived benefits upon well-being imply objective descriptions of their effects upon the different dimensions contributing to the quality of life (QoL). Such a goal pleas for using relevant and validated scientific instruments with robust measurement methods. This paper discusses the interest of the new validated questionnaire BeautyQoL specifically designed to assess the effect of cosmetic products on physical appearance and QoL. After conducting a review of skin appearance and QoL, three phases of the international codevelopment have been carried out in the following sequence: semi-directed interviews (Phase 1), acceptability study (Phase 2), and validation study (Phase 3). Data collection and validation process have been carried out in 16 languages. This review confirms that QoL instruments developed in dermatology are not suitable to assess cosmetic products, mainly because of their lack of sensitivity. General acceptability of BeautyQol was very good. Forty-two questions have been structured in five dimensions that explained 76.7% of the total variance: Social Life, Self-confidence, Mood, Vitality, and Attractiveness. Cronbach's alpha coefficients are between 0.932 and 0.978, confirming the good internal consistency of the results. The BeautyQol questionnaire is the first international instrument specific to cosmetic products and physical appearance that has been validated in 16 languages and could be used in a number of clinical trials and descriptive studies to demonstrate the added value of these products on the QoL. © 2015 Wiley Periodicals, Inc.

  11. Quality of life outcome measures following partial glossectomy: Assessment using the UW-QOL scale

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    Kazi R

    2008-01-01

    Full Text Available Background: The consequences of a diagnosis of head and neck cancer and the impact of treatment have a clear and direct influence on well-being and associated quality of life (QOL in these patients. Aims: To determine the QOL in head and neck cancer patients following a partial glossectomy operation. Design and Setting: Cross-sectional cohort study; Head and Neck Oncology Unit, tertiary referral center. Materials and Methods: 38 patients with partial glossectomy were assessed with the University of Washington head and neck quality of life (UW-QOL scale, version 4. Statistical Analysis: Statistical analysis was performed using the Statistical Package for Social Sciences 10.0 (SPSS Inc, Chicago version III. Information from the scale was correlated using the Mann Whitney test. A P value less than/equal to 0.05 was considered as significant. Results: The mean (sd composite score of the QOL in our series was 73.6 (16.1. The majority (71.8% quoted their QOL as good or very good. Swallowing (n = 16, 47.1%, speech (n = 15, 44.1% and saliva (n = 15, 44.1% were most commonly cited issues over the last 7 days. On the other hand, the groups with reconstruction, neck dissection, complications and radiotherapy demonstrated a significant reduction of quality of life scores (Mann Whitney test, P < 0.05. Conclusion: The composite score and overall QOL as assessed using the UW-QOL scale (version 4 were modestly high in our series of partial glossectomy patients. Swallowing, speech, and saliva are regarded as the most important issues. Stage of the disease, neck dissection, reconstruction, complications, radiotherapy and time since operation were seen to significantly affect domain scores.

  12. Development and evaluation of oral Cancer quality-of-life questionnaire (QOL-OC).

    Science.gov (United States)

    Nie, Min; Liu, Chang; Pan, Yi-Chen; Jiang, Chen-Xi; Li, Bao-Ru; Yu, Xi-Jie; Wu, Xin-Yu; Zheng, Shu-Ning

    2018-05-03

    In this study scales and items for the Oral Cancer Quality-of-life Questionnaire (QOL-OC) were designed and the instrument was evaluated. The QOL-OC was developed and modified using the international definition of quality of life (QOL) promulgated by the European Organization for Research and Treatment of Cancer (EORTC) and analysis of the precedent measuring instruments. The contents of each item were determined in the context of the specific characteristics of oral cancer. Two hundred thirteen oral cancer patients were asked to complete both the EORTC core quality of life questionnaire (EORTC QLC-C30) and the QOL-OC. Data collected was used to conduct factor analysis, test-retest reliability, internal consistency, and construct validity. Questionnaire compliance was relatively high. Fourteen of the 213 subjects accepted the same tests after 24 to 48 h demonstrating a high test-retest reliability for all five scales. Overall internal consistency surpasses 0.8. The outcome of the factor analysis coincides substantially with our theoretical conception. Each item shows a higher correlation coefficient within its own scale than the others which indicates high construct validity. QOL-OC demonstrates fairly good statistical reliability, validity, and feasibility. However, further tests and modification are needed to ensure its applicability to the quality-of-life assessment of Chinese oral cancer patients.

  13. Correlation of physical aptitude; functional capacity, corporal balance and quality of life (QoL) among elderly women submitted to a post-menopausal physical activities program.

    Science.gov (United States)

    de Souza Santos, César Augusto; Dantas, Estélio Enrique Martin; Moreira, Maria Helena Rodrigues

    2011-01-01

    The objective of this study was to evaluate the effect of physical activity from the "Menopause in Form" program on physical aptitude, functional capacity, corporal balance and QoL among elderly women. In addition, correlations among these variables were examined. The present work was a longitudinal study that was quasi-experimental and correlational. A total of 323 elderly women (age: 69.0±5.53 years) participated in this study. Subjects were non-institutionalized, post-menopausal individuals residing at the Elderly Care Center in Belém Municipality (Pará, Brazil) and practiced one activity (i.e., dancing or walking) over a 10-month period. The assessment protocols used were the following: the Fullerton functional fitness test battery (physical aptitude); the activities of daily living (ADL) indices (functional capacity); the Tinetti-scale (corporal balance); and the WHOQOL-OLD questionnaire (QoL). The adopted significance level was p<0.05. Results from the Wilcoxon test demonstrated significant differences for the post-test assessment of functional capacity (Δ%=5.63%; p=0.0001) and general QoL (Δ%=9.19%; p=0.001). These results suggest that the physical activities employed during the "Menopause in Form" program resulted in significant improvements in the functional capacity and QoL of post-menopausal elderly women. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  14. Quality of Life (QoL) Survey in Hong Kong: Understanding the Importance of Housing Environment and Needs of Residents from Different Housing Sectors.

    Science.gov (United States)

    Gou, Zhonghua; Xie, Xiaohuan; Lu, Yi; Khoshbakht, Maryam

    2018-01-27

    This study presents a Quality of Life (QoL) survey to understand the influence of the housing environment and needs of residents from different housing sectors. The research focuses on Hong Kong where living conditions have become the main affect for people's QoL. Through a household survey using a standard instrument "Word Health Organisation (WHO) Quality of Life-BREF", the article found that among the four WHO QoL domains (Physical Health, Psychological Health, Social Relations And Environment), Environment, particularly its constitute aspect housing environment was the most influential factor for overall quality of life for the public rental housing sector where low-income people live. This research also found that different groups of people have differing needs of their housing environments: the low-income group needs better location and privacy while the medium and high-income groups need better architectural quality. Based on differentiating their needs and wants, this research argues for prioritizing the low-income group's needs for effectively improving their QoL.

  15. EFFECTS OF LONG-TERM ALENDRONATE TREATMENT ON A LARGE SAMPLE OF PEDIATRIC PATIENTS WITH OSTEOGENESIS IMPERFECTA.

    Science.gov (United States)

    Lv, Fang; Liu, Yi; Xu, Xiaojie; Wang, Jianyi; Ma, Doudou; Jiang, Yan; Wang, Ou; Xia, Weibo; Xing, Xiaoping; Yu, Wei; Li, Mei

    2016-12-01

    Osteogenesis imperfecta (OI) is a group of inherited diseases characterized by reduced bone mass, recurrent bone fractures, and progressive bone deformities. Here, we evaluate the efficacy and safety of long-term treatment with alendronate in a large sample of Chinese children and adolescents with OI. In this prospective study, a total of 91 children and adolescents with OI were included. The patients received 3 years' treatment with 70 mg alendronate weekly and 500 mg calcium daily. During the treatment, fracture incidence, bone mineral density (BMD), and serum levels of the bone turnover biomarkers (alkaline phosphatase [ALP] and cross-linked C-telopeptide of type I collagen [β-CTX]) were evaluated. Linear growth speed and parameters of safety were also measured. After 3 years of treatment, the mean annual fracture incidence decreased from 1.2 ± 0.8 to 0.2 ± 0.3 (Posteogenesis imperfecta PTH = parathyroid hormone.

  16. Estimating the Time to Benefit for Preventive Drugs with the Statistical Process Control Method: An Example with Alendronate

    OpenAIRE

    van de Glind, Esther M. M.; Willems, Hanna C.; Eslami, Saeid; Abu-Hanna, Ameen; Lems, Willem F.; Hooft, Lotty; de Rooij, Sophia E.; Black, Dennis M.; van Munster, Barbara C.

    2016-01-01

    Background For physicians dealing with patients with a limited life expectancy, knowing the time to benefit (TTB) of preventive medication is essential to support treatment decisions. Objective The aim of this study was to investigate the usefulness of statistical process control (SPC) for determining the TTB in relation to fracture risk with alendronate versus placebo in postmenopausal women. Methods We performed a post?hoc analysis of the Fracture Intervention Trial (FIT), a randomized, con...

  17. Estimating the Time to Benefit for Preventive Drugs with the Statistical Process Control Method: An Example with Alendronate.

    Science.gov (United States)

    van de Glind, Esther M M; Willems, Hanna C; Eslami, Saeid; Abu-Hanna, Ameen; Lems, Willem F; Hooft, Lotty; de Rooij, Sophia E; Black, Dennis M; van Munster, Barbara C

    2016-05-01

    For physicians dealing with patients with a limited life expectancy, knowing the time to benefit (TTB) of preventive medication is essential to support treatment decisions. The aim of this study was to investigate the usefulness of statistical process control (SPC) for determining the TTB in relation to fracture risk with alendronate versus placebo in postmenopausal women. We performed a post hoc analysis of the Fracture Intervention Trial (FIT), a randomized, controlled trial that investigated the effect of alendronate versus placebo on fracture risk in postmenopausal women. We used SPC, a statistical method used for monitoring processes for quality control, to determine if and when the intervention group benefited significantly more than the control group. SPC discriminated between the normal variations over time in the numbers of fractures in both groups and the variations that were attributable to alendronate. The TTB was defined as the time point from which the cumulative difference in the number of clinical fractures remained greater than the upper control limit on the SPC chart. For the total group, the TTB was defined as 11 months. For patients aged ≥70 years, the TTB was 8 months [absolute risk reduction (ARR) = 1.4%]; for patients aged <70 years, it was 19 months (ARR = 0.7%). SPC is a clear and understandable graphical method to determine the TTB. Its main advantage is that there is no need to define a prespecified time point, as is the case in traditional survival analyses. Prescribing alendronate to patients who are aged ≥70 years is useful because the TTB shows that they will benefit after 8 months. Investigators should report the TTB to simplify clinical decision making.

  18. In vitro disintegration and dissolution studies of once-weekly copies of alendronate sodium tablets (70 mg) and in vivo implications.

    Science.gov (United States)

    Dansereau, Richard J; Crail, Debbie J; Perkins, Alan C

    2008-04-01

    The aim of this study was to evaluate the in vitro disintegration and dissolution of 26 alendronic acid tablets (70 mg) on the market in Canada, Germany, the Netherlands, and the United Kingdom compared to the branded product (Fosamax). The disintegration and dissolution times were determined using the methods described in the United States Pharmacopeia 30 (USP 30). The disintegration of four orally disintegrating tablets (non-bisphosphonates) and branded film-coated risedronate sodium tablets were included for comparison. The mean disintegration times of the alendronic acid tablets ranged from 14 s for Pharmachemie (Netherlands) to 342 s (5.7 min) for Betapharm (Germany). The mean disintegration time of the branded product tablets ranged from 43 to 78 s. Six of the 26 companies market alendronic acid tablets with very rapid disintegration times which are similar to those of orally disintegrating tablets (non-bisphosphonates). The alendronic acid tablets with very rapid mean disintegration times are as follows: Pharmachemie (Netherlands), 14 s; Novopharm (Canada), 13-24 s; GRY-Pharma (Germany), 21 s; Juta Pharma (Germany), 30 s; APS/Teva (United Kingdom), 26 and 37 s; and Teva (UK), 14-29 s. Since there is no established disintegration time for alendronic acid tablets there can be no assurance that the copy tablets are equivalent to the branded product in terms of esophageal drug exposure. However, the in vitro disintegration times have not been correlated with in vivo disintegration and performance. The dissolution of all the bisphosphonate tablets was rapid with greater than 80% dissolved in 15 min and all products conformed to the USP 30 specification. The dissolution of all alendronic acid tablets was rapid and complete and conformed to the established USP 30 specifications which should ensure adequate drug absorption from the copy products. However, copies of alendronic acid tablets are approved based on the results of single-dose bioavailability studies in

  19. High-dose radiotherapy or concurrent chemo-radiation in lung cancer patients only induces a temporary, reversible decline in QoL

    International Nuclear Information System (INIS)

    Pijls-Johannesma, Madelon; Houben, Ruud; Boersma, Liesbeth; Grutters, Janneke; Seghers, Katarina; Lambin, Philippe; Wanders, Rinus; De Ruysscher, Dirk

    2009-01-01

    Background and purpose: Aggressive radiotherapy or concurrent chemo-radiation therapy for lung cancer leads to a high incidence of severe, mostly esophageal, toxicity. The purpose of this study was to investigate the evolution of quality of life (QoL) in patients with lung cancer, selected for curative radiotherapy (RT) or chemo-RT. Methods: Seventy-five lung cancer patients completed a longitudinal the EORTC QLQ-C30 and LC13. Linear mixed regression models were fitted to investigate the impact of different factors on overall QoL. Results: Overall QoL decreased shortly after the end of RT (4 points, p = 0.19), but increased back to baseline within 3 months. Mean scores of role functioning (p = 0.018), cognitive functioning (p = 0.002), dyspnoea (EORTC QLQ-LC13; p = 0.043), dysphagia (p = 0.005) and hoarseness (p = 0.029), showed a significant worsening over time. Emotional functioning (p = 0.033) improved significantly over time. Severe esophagitis (≥grade 2) was reported in only 12% of the patients. Next to maximal esophageal toxicity ≥grade 2 (p = .0.010), also tumor stage IIIA (p < 0.001), tumor stage IIIB (p = 0.003), gender (p = 0.042) and fatigue (p < 0.001) appeared to be significant predictors of QoL. Conclusion: High-dose radiotherapy or concurrent chemo-radiation in the treatment of lung cancer seems to be a well-tolerated treatment option with preservation of QoL.

  20. Cultural adaptation and validation of the Neuropathy - and Foot Ulcer - Specific Quality of Life instrument (NeuroQol for Brazilian Portuguese - Phase 1 Adaptación cultural y validación del Neuropathy - and Foot Ulcer - Specific Quality of Life (NeuroQol para el idioma portugués de Brasil - Fase 1 Adaptação cultural e validação do Neuropathy - and Foot Ulcer - Specific Quality of Life (NeuroQol para a língua portuguesa do Brasil - Fase 1

    Directory of Open Access Journals (Sweden)

    Antonia Tayana da Franca Xavier

    2011-12-01

    Full Text Available This methodological study aimed to adapt the Neuropathy - and Foot Ulcer - Specific Quality of Life instrument - NeuroQol to Brazilian Portuguese and to analyze its psychometric properties. Participants were 50 people with peripheral diabetic neuropathy and foot ulcers. The floor and ceiling effects, the convergent and discriminant validity and the reliability were analyzed. The Cronbach’s alpha coefficient was used to test the reliability and the Pearson’s correlation coefficient to estimate the convergent validity, the Student’s t test was used to evaluate the discriminant validity in the comparison of the NeuroQol scores between participants with and without ulcers. Floor and ceiling effects were found in some domains of the NeuroQol. The reliability was satisfactory. The correlations between the domains of the NeuroQol and the SF-36 were negative, significant and of moderate to strong magnitude. The findings show that the Brazilian version of the NeuroQol is reliable and valid and may be employed as a useful tool for improving nursing care for people with DM.Estudio metodológico que tuvo como objetivos adaptar el Neuropathy - and Foot Ulcer - Specific Quality of Life - NeuroQol para el idioma portugués de Brasil y analizar sus propiedades psicométricas. Participaron 50 personas con neuropatía diabética periférica y úlceras en los pies. Fueron analizados los efectos floor y ceiling, la validez convergente, la discriminante y la confiabilidad. Fue utilizado el coeficiente alfa de Cronbach para comprobar la confiabilidad y la correlación de Pearson para estimar la validez convergente; el test t-Student fue empleado para evaluar la validez discriminante en la comparación de los puntajes del NeuroQol entre los participantes con y sin úlceras. Se constataron efectos floor y ceiling en algunos dominios del NeuroQol. La confiabilidad fue satisfactoria. Las correlaciones entre los dominios del NeuroQol y SF-36 fueron negativas

  1. Anxiety, Depression, and Health-Related QOL in Patients Diagnosed with PAH or CTEPH.

    Science.gov (United States)

    Pfeuffer, Elena; Krannich, Holger; Halank, Michael; Wilkens, Heinrike; Kolb, Philipp; Jany, Berthold; Held, Matthias

    2017-12-01

    Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are life-threatening diseases with a high burden of symptoms. Although depression, anxiety, and reduced health related quality of life (HRQOL) have also been reported, a comparative analysis which explores these traits and their underlying factors was lacking. A retrospective analysis of depression, anxiety, and health related QOL was conducted using a Hospital anxiety and depression scale (HADS) as well as the SF-36 HRQOL questionnaire. Results from these tools were compared with haemodynamic and functional parameters in 70 PAH and 23 CTEPH outpatients from a German tertiary care center specializing in pulmonary hypertension. Although HRQOL was reduced in both cohorts of patients, individuals diagnosed with CTEPH scored lower in nearly all SF-36 parameters. Significance was noted in both "mental health" (p = 0.01) and "mental component summary score" (MCS) (p = 0.02). Depression was also more frequent in patients with CTEPH (56%) than in patients with PAH (30%), (p = 0.03). Overall, depression and anxiety correlated with most SF-36 scales in both PAH and CTEPH. In CTEPH, depression also correlated with the Borg Dyspnea Scale (r = 0.44, p = 0.01). These patients also had significantly lower pCO 2 levels than the PAH cohort reflecting more severe ventilation/perfusion mismatch. All other haemodynamic and functional parameters did not differ across the groups. While both cohorts of patients suffer from a reduced HRQOL as well as depression and anxiety, decreases in mental health parameters are more pronounced in the CTEPH cohort. This suggests a strong effort to improve early detection, especially in dyspneic patients with classical risk factors for CTEPH and PAH and argues for mental illness interventions alongside routine clinical care provided to patients diagnosed with PAH or CTEPH.

  2. Combined Treatment of Alendronate and Low-Intensity Pulsed Ultrasound (LIPUS Increases Bone Mineral Density at the Cancellous Bone Osteotomy Site in Aged Rats: A Preliminary Study.

    Directory of Open Access Journals (Sweden)

    H Aonuma

    2011-12-01

    Full Text Available Introduction: During fracture healing, alendronate encourages callus volume by inhibiting bone resorption, whereas low-intensity pulsed ultrasound (LIPUS enhances bone regeneration by promoting an anabolic response. Methods: In the present study, 9-month-old Sprague-Dawley rats, with a unilateral proximal tibial osteotomy, were treated with alendronate (daily, 1 g/kg plus sham-LIPUS (n = 14, saline plus LIPUS (20 min/day (n = 18, alendronate plus LIPUS (n = 16, or saline plus sham- LIPUS as a control (n = 13 for 4 weeks. The rats were then examined for changes in bone mineral density (BMD during metaphyseal bone repair. Results: The combined therapy signi cantly increased BMD at the osteotomy site at 4 weeks (p < 0.001 compared with the control, without affecting the contralateral, non-osteotomized tibia. Both alendronate and LIPUS alone also exerted a positive, albeit less, effect on BMD in the affected limb (p < 0.001 and p = 0.006, respectively. Conclusions: Alendronate and LIPUS cooperate to enhance BMD during metaphyseal bone healing. Keywords: LIPUS, bisphosphonate, bone mineral density.

  3. Romanian Translation and Cross-Cultural Adaptation of the SarQol Questionnaire

    Directory of Open Access Journals (Sweden)

    Ildiko Gasparik Andrea

    2016-09-01

    Full Text Available Sarcopenia, or age-related muscle loss is emerging as a major public health concern. A reduced quality of life (QoL due to impaired physical performance associated with this disease has been evidenced in these individuals. Generic instruments, such as Short Form 36 questionnaire (SF-36, do not accurately assess the impact of sarcopenia on QoL. SarQol (Sarcopenia Quality of Life questionnaire, was the first disease-specific questionnaire addressing quality of life in patients with sarcopenia and has been recently designed for providing a global picture on quality of life in community-dwelling elderly subjects aged 65 years and older. Our aim was the translation and cultural adaptation of the original SarQol, to finally obtain a highly reliable instrument for the assessment of the quality of life of Romanian patients, affected by sarcopenia. We followed the recommended process, the international protocol of translation. The pretest process involved 20 subjects (10 sarcopenic and 10 non sarcopenic with different educational and socioeconomic backgrounds who were asked to complete the questionnaire. Feedbacks were requested from all subjects regarding the clearness of questions, difficulties in completing the test or understanding the meaning of questions. Using the recommended best practice protocol for translation, the pre-final version is comparable with the original instrument in terms of content and accuracy. After the validation of psychometric properties, it should be a useful tool to assess Quality of Life and sarcopenia among elderly romanian patients.

  4. The QOL-DASS Model to Estimate Overall Quality of Life and General Subjective Health.

    Science.gov (United States)

    Mazaheri, Mehrdad

    2011-01-01

    In Order to find how rating the WHOQOL-BREF and DASS scales are combined to produce an overall measure of quality of life and satisfaction with health rating, a QOL-DASS model was designed; and the strength of this hypothesized model was examined using the structural equation modeling. Participants included a sample of 103 voluntary males who were divided into two groups of unhealthy (N=55) and healthy (N=48). To assess satisfaction and negative emotions of depression, anxiety and stress among the participants, they were asked to fill out the WHOQOL-BREF and The Depression Anxiety Stress Scale (DASS-42). Our findings on running the hypothesized model of QOL-DASS indicated that the proposed model of QOL-DASS fitted the data well for the both healthy and unhealthy groups. Our findings with CFA to evaluate the hypothesized model of QOL-DASS indicated that the different satisfaction domain ratings and the negative emotions of depression, anxiety and stress as the observed variables can represent the underlying constructs of general health and quality of life on both healthy and unhealthy groups.

  5. Serum magnesium and not vitamin D is associated with better QoL in COPD

    DEFF Research Database (Denmark)

    Hashim Ali Hussein, Sarah; Nielsen, Lars Peter; Dolberg, Mette K.Bøgebjerg

    2015-01-01

    BACKGROUND: Deficiency of serum levels of vitamin D3 (se vitD), magnesium (se Mg) and calcium (se Ca) may be associated with increased exacerbation risk in chronic obstructive pulmonary disease (COPD). However, associations with other aspects of COPD, e.g. lung function and quality of life (QoL),...

  6. Quality of life (QOL) assessment in patients received carbon ion radiotherapy

    International Nuclear Information System (INIS)

    Imai, Reiko; Kamada, Tadashi; Tsujii, Hirohiko

    2004-01-01

    The purpose of this study was to investigate changes in quality of life (QoL) of medically inoperable bone and soft tissue sarcoma treated carbon ion radiotherapy (CIRT). Fifty-eight patients followed over 1 year were reviewed in this report. The questionnaire, European Organaization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC-QLQ-C30) was assessed before the start of CIRT, and subsequently at the end of CIRT, 3, 6, 12, 24 months after CIRT. During follow-up, it was send to the patients by mail. The compliance was 98% for all follow-up period in this study. The scores about QoL and functioning did not significantly change for 1 year. QoL scores tended to decrease in large clinical target volume (CTV) (>600 cc) group compared to small CTV group. CIRT could keep QoL levels of patients with medically inoperable bone and soft tissue tumors. (author)

  7. The QOL-DASS Model to Estimate Overall Quality of Life and General Health

    Directory of Open Access Journals (Sweden)

    Mehrdad Mazaheri

    2011-01-01

    Full Text Available "n Objective: In order to find how rating the WHOQOL-BREF and DASS scales are combined to produce an overall measure of quality of life and satisfaction with health rating, a QOL-DASS model was designed ; and the strength of this hypothesized model was examined using the structural equation modeling "n "nMethod: Participants included a sample of 103 voluntary males who were divided into two groups of unhealthy (N=55 and healthy (N=48. To assess satisfaction and negative  emotions of depression, anxiety and stress among the participants, they were asked to fill out the WHOQOLBREF and The Depression Anxiety Stress Scale (DASS-42. "nResults: Our findings on running the hypothesized model of QOL-DASS indicated that the proposed model of QOL-DASS fitted the data well for the both healthy and unhealthy groups "nConclusion: Our findings with CFA to evaluate the hypothesized model of QOL-DASS indicated that the different satisfaction domain ratings and the negative emotions of depression, anxiety and stress as the observed variables can represent the underlying constructs of general health and quality of life on both healthy and unhealthy groups.

  8. Exploring the quality of life (QOL) in the Indian software industry: a public health viewpoint.

    Science.gov (United States)

    Jha, Ayan; Sadhukhan, Sanjoy Kumar; Velusamy, Saravanan; Banerjee, Gargi; Banerjee, Arpita; Saha, Amitava; Talukdar, Sumit

    2012-04-01

    Our objectives were to describe the QOL and its determinants among software professionals of Kolkata, and to compare the same according to information technology (IT) and IT-enabled services (ITeS) sub-sectors. An institution-based cross-sectional study was conducted among software professionals of Kolkata applying a two-stage stratified random sampling technique. The WHO QOL BREF questionnaire was administered along with a list of pertinent variables. Overall, the analysis for 338 software professionals (177 IT and 161 ITeS) clearly demonstrated significant differences between mean scores of these two sectors for each of the six outcome domains of WHO QOL BREF. Multilevel multivariate analysis outlined 13 significant predictors of QOL-four positive (age, regular fitness regimes, foreign placements and changing companies frequently) and the rest of the nine, negative (multiple sex partners, multiple addictions, extended working hours, night-shift duties, income, expenditure, carrying office work home, current illness and ITeS company type). Our study helps in obtaining a clear understanding of the multifaceted risk factors prevailing in this sector, the majority of which can be effectively addressed by specific health promotional interventions. A dedicated health policy is mandated at both government and company levels.

  9. Sensitivity and responsiveness of the patient-reported TED-QOL to rehabilitative surgery in thyroid eye disease.

    Science.gov (United States)

    Fayers, Tessa; Fayers, Peter M; Dolman, Peter J

    2016-12-01

    We tested the sensitivity and responsiveness of the TED-QOL to rehabilitative surgery in thyroid eye disease (TED). The 3-item TED-QOL and 16-item GO-QOL, which assess quality of life (QoL) in TED, were administered to consecutive patients undergoing rehabilitative surgery. The questionnaires were completed pre-and post-operatively to assess sensitivity (ability to discriminate between different surgical groups) and responsiveness (ability to detect within patient changes over time).56 patients underwent 69 procedures for TED (29 orbital decompressions, 15 strabismus operations, 25 eyelid procedures). The differences in scores between the three types of surgery (a measure of sensitivity) were statistically significant at the 5% level pre-operatively and post-operatively for all 3 TED-QOL scales and for both GO-QOL scales, but much more so for the TED-QOL scales in each case. The within-patient changes between the pre- and post-operative scores for the same subjects (a measure of responsiveness) were statistically very highly significant for the TED-QOL overall and appearance scales for each of the surgeries. The pre- and post-operative difference for the TED-QOL functioning scale was highly statistically significant for strabismus surgery but not for decompression or lid surgery. The change between the pre- and post-operative scores for the GO-QOL was significant for the functioning scale with strabismus and lid surgery, and was highly significant for the appearance scale with lid surgery but not for strabismus surgery or decompression. The 3-item TED-QOL is sensitive and responsive to rehabilitative surgery in TED and compares favorably with the lengthier GO-QOL for these parameters.

  10. Methodology for the development and calibration of the SCI-QOL item banks.

    Science.gov (United States)

    Tulsky, David S; Kisala, Pamela A; Victorson, David; Choi, Seung W; Gershon, Richard; Heinemann, Allen W; Cella, David

    2015-05-01

    To develop a comprehensive, psychometrically sound, and conceptually grounded patient reported outcomes (PRO) measurement system for individuals with spinal cord injury (SCI). Individual interviews (n=44) and focus groups (n=65 individuals with SCI and n=42 SCI clinicians) were used to select key domains for inclusion and to develop PRO items. Verbatim items from other cutting-edge measurement systems (i.e. PROMIS, Neuro-QOL) were included to facilitate linkage and cross-population comparison. Items were field tested in a large sample of individuals with traumatic SCI (n=877). Dimensionality was assessed with confirmatory factor analysis. Local item dependence and differential item functioning were assessed, and items were calibrated using the item response theory (IRT) graded response model. Finally, computer adaptive tests (CATs) and short forms were administered in a new sample (n=245) to assess test-retest reliability and stability. A calibration sample of 877 individuals with traumatic SCI across five SCI Model Systems sites and one Department of Veterans Affairs medical center completed SCI-QOL items in interview format. We developed 14 unidimensional calibrated item banks and 3 calibrated scales across physical, emotional, and social health domains. When combined with the five Spinal Cord Injury--Functional Index physical function banks, the final SCI-QOL system consists of 22 IRT-calibrated item banks/scales. Item banks may be administered as CATs or short forms. Scales may be administered in a fixed-length format only. The SCI-QOL measurement system provides SCI researchers and clinicians with a comprehensive, relevant and psychometrically robust system for measurement of physical-medical, physical-functional, emotional, and social outcomes. All SCI-QOL instruments are freely available on Assessment CenterSM.

  11. Efficient Transdermal Delivery of Alendronate, a Nitrogen-Containing Bisphosphonate, Using Tip-Loaded Self-Dissolving Microneedle Arrays for the Treatment of Osteoporosis.

    Science.gov (United States)

    Katsumi, Hidemasa; Tanaka, Yutaro; Hitomi, Kaori; Liu, Shu; Quan, Ying-Shu; Kamiyama, Fumio; Sakane, Toshiyasu; Yamamoto, Akira

    2017-08-17

    To improve the transdermal bioavailability and safety of alendronate (ALN), a nitrogen-containing bisphosphonate, we developed self-dissolving microneedle arrays (MNs), in which ALN is loaded only at the tip portion of micron-scale needles by a dip-coating method (ALN(TIP)-MN). We observed micron-scale pores in rat skin just after application of ALN(TIP)-MN, indicating that transdermal pathways for ALN were created by MN. ALN was rapidly released from the tip of MNs as observed in an in vitro release study. The tip portions of MNs completely dissolved in the rat skin within 5 min after application in vivo. After application of ALN(TIP)-MN in mice, the plasma concentration of ALN rapidly increased, and the bioavailability of ALN was approximately 96%. In addition, the decrease in growth plate was effectively suppressed by this efficient delivery of ALN in a rat model of osteoporosis. Furthermore, no skin irritation was observed after application of ALN(TIP)-MN and subcutaneous injection of ALN, while mild skin irritation was induced by whole-ALN-loaded MN (ALN-MN)-in which ALN is contained in the whole of the micron-scale needles fabricated from hyaluronic acid-and intradermal injection of ALN. These findings indicate that ALN(TIP)-MN is a promising transdermal formulation for the treatment of osteoporosis without skin irritation.

  12. Characteristics of patients who suffer major osteoporotic fractures despite adhering to alendronate treatment

    DEFF Research Database (Denmark)

    Abrahamsen, B; Rubin, K H; Eiken, Pia Agnete

    2013-01-01

    .03-1.06, for each drug). Dementia (HR 1.81, 95 % CI 1.18-2.78), prior fracture (one: HR 1.17, 95 % CI 1.02-1.34; multiple: HR 1.34, 95 % CI 1.08-1.67), and ulcer disease (HR 1.45, 95 % CI 1.04-2.03) also increased the risk. Diabetes did not influence fracture risk, nor did rheumatic disorders. The risk was lower...... and associations may not be causal, it may be prudent to include dementia, ulcer disease, and Parkinson's disease to capture the risk of fractures on treatment. Lower risk in patients treated with glucocorticoids and in men probably reflects a lower treatment threshold related to guidelines.......Antiresorptive treatment reduces the risk of fractures, but most patients remain at elevated risk. We used health registers to identify predictors of new major osteoporotic fractures in patients adhering to alendronate. Risk factors showed a different pattern than in the general population...

  13. The resistance of cortical bone tissue to failure under cyclic loading is reduced with alendronate.

    Science.gov (United States)

    Bajaj, Devendra; Geissler, Joseph R; Allen, Matthew R; Burr, David B; Fritton, J C

    2014-07-01

    Bisphosphonates are the most prescribed preventative treatment for osteoporosis. However, their long-term use has recently been associated with atypical fractures of cortical bone in patients who present with low-energy induced breaks of unclear pathophysiology. The effects of bisphosphonates on the mechanical properties of cortical bone have been exclusively studied under simple, monotonic, quasi-static loading. This study examined the cyclic fatigue properties of bisphosphonate-treated cortical bone at a level in which tissue damage initiates and is accumulated prior to frank fracture in low-energy situations. Physiologically relevant, dynamic, 4-point bending applied to beams (1.5 mm × 0.5 mm × 10 mm) machined from dog rib (n=12/group) demonstrated mechanical failure and micro-architectural features that were dependent on drug dose (3 groups: 0, 0.2, 1.0mg/kg/day; alendronate [ALN] for 3 years) with cortical bone tissue elastic modulus (initial cycles of loading) reduced by 21% (pbone remodeling, such as the size of osteons (-14%; ALN1.0: 10.5±1.8, VEH: 12.2±1.6, ×10(3) μm2; pbone tissue are altered by high-dose ALN treatment and contribute to reduced mechanical properties under cyclic loading conditions. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Does Alendronate reduce the risk of fracture in men? A meta-analysis incorporating prior knowledge of anti-fracture efficacy in women

    Directory of Open Access Journals (Sweden)

    Papaioannou Alexandra

    2005-07-01

    Full Text Available Abstract Background Alendronate has been found to reduce the risk of fractures in postmenopausal women as demonstrated in multiple randomized controlled trials enrolling thousands of women. Yet there is a paucity of such randomized controlled trials in osteoporotic men. Our objective was to systematically review the anti-fracture efficacy of alendronate in men with low bone mass or with a history of prevalent fracture(s and incorporate prior knowledge of alendronate efficacy in women in the analysis. Methods We examined randomized controlled trials in men comparing the anti-fracture efficacy of alendronate to placebo or calcium or vitamin D, or any combination of these. Studies of men with secondary causes of osteoporosis other than hypogonadism were excluded. We searched the following electronic databases (without language restrictions for potentially relevant citations: Medline, Medline in Process (1966-May 24/2004, and Embase (1996–2004. We also contacted the manufacturer of the drug in search of other relevant trials. Two reviewers independently identified two trials (including 375 men, which met all inclusion criteria. Data were abstracted by one reviewer and checked by another. Results of the male trials were pooled using Bayesian random effects models, incorporating prior information of anti-fracture efficacy from meta-analyses of women. Results The odds ratios of incident fractures in men (with 95% credibility intervals with alendronate (10 mg daily were: vertebral fractures, 0.44 (0.23, 0.83 and non-vertebral fractures, 0.60 (0.29, 1.44. Conclusion In conclusion, alendronate decreases the risk of vertebral fractures in men at risk. There is currently insufficient evidence of a statistically significant reduction of non-vertebral fractures, but the paucity of trials in men limit the statistical power to detect such an effect.

  15. Production, quality control, biodistribution assessment and preliminary dose evaluation of {sup 166}Ho-alendronate as a bone marrow ablative agent

    Energy Technology Data Exchange (ETDEWEB)

    Fakhari, Ashraf [Tehran University of Medical Sciences (Iran, Islamic Republic of). Dept. of Radiopharmacy; Jalilian, Amir Reza; Yousefnia, Hassan; Zolghadri, Samaneh; Samani, Ali Bahrami; Akbari, Mahmoud Reza; Deha, Fariba Johari [Nuclear Science and Technology Research Institute (NSTRI), Tehran (Iran, Islamic Republic of); Shafiee-Ardestani, Mahdi; Khalaj, Ali [Tehran University of Medical Sciences (Iran, Islamic Republic of). Dept. of Medicinal Chemistry

    2015-07-01

    In this study, production, quality control and biodistribution studies of {sup 166}Ho-alendronate have been presented and followed by dosimetric evaluation for human based on biodistribution data in wild-type rats. {sup 166}Ho chloride was obtained by thermal neutron irradiation of natural {sup 165}Ho(NO{sub 3}){sub 3} samples. {sup 166}Ho-alendronate complex was prepared by adding the desired amount of alkaline alendronate solution (0.2 mL, 150 mg/mL) to 3-5 mCi of the {sup 166}HoCl{sub 3} solution. Radiochemical purity of the complex was monitored by instant thin layer chromatography (ITLC). {sup 166}Ho-alendronate complex was prepared in high radiochemical purity (> 99%, ITLC) and specific activity of 4.4 GBq/mmol. Stability studies of the complex in the final preparation and in the presence of human serum were performed up to 48 h. The major accumulation of the radio-complex was in the bone tissues followed by absorbed dose evaluation of each human organ by RADAR software used for modelling the radiation dose delivered. The final preparation was administered to wild-type rats and biodistribution of the complex was performed 2-48 h post injection showing major accumulation of the complex in the bone tissue. The highest absorbed dose for {sup 166}Ho-alendronate is observed in bone surface and red marrow with 2.670 and 1.880 mSv/MBq; respectively. These findings suggest that {sup 166}Ho-alendronate has considerable characteristics compared to {sup 166}Ho-DOTMP and can be a possible candidate for bone marrow ablation in patients with multiple myeloma.

  16. Effects of short-term alendronate treatment on the three-dimensional microstructural, physical and mechanical properties of dog trabecular bone

    DEFF Research Database (Denmark)

    Hu, J; Ding, Ming; Søballe, K

    2002-01-01

    The bisphosphonate, alendronate, is well known for its potent inhibition of osteoclast-mediated bone resorption. It has been used clinically for the treatment of osteoporosis and has also recently been used to reduce osteolysis around prostheses in a canine revision model of implant loosening...... proximal humeri. These specimens were scanned using a high-resolution microcomputed tomography (micro-CT) system. From accurate data sets, three-dimensional microstructural properties were calculated and physical and mechanical properties were determined. Treatment with alendronate increased bone volume...

  17. Effect of alendronate on bone mineral density in adult patients with Laron syndrome (primary growth hormone insensitivity).

    Science.gov (United States)

    Eshed, Varda; Benbassat, Carlos A; Laron, Zvi

    2006-04-01

    Severe short stature resulting from a deficiency in insulin-like growth factor-I (IGF-I) is a prominent feature of Laron syndrome (LS). Whether patients with LS are osteopenic or not, and whether they need treatment with bisphosphonates, remains uncertain. The aim of this study was to investigate the action of alendronate on the IGF-I-deficient bones of adult patients with LS and osteoporosis, as determined by dual X-ray absorptiometry . Seven patients (5 women and 2 men) of mean age 40.8+/-7.6 years and mean bone mass density (BMD) 0.843+/-0.06 g/cm2 (T score -2.9+/-0.5) at the lumbar spine and 0.734+/-0.11 g/cm2 (T score -2.2+/-0.9) at the femoral neck were treated with alendronate 70 mg once/weekly over a 12-month period. Treatment led to an increase of 5.3% in BMD (p=0.038) at the femoral neck. There was a similar trend at the lumbar spine, but the difference was not statistically significant (2.3%, p=0.34). Mean total alkaline phosphatase decreased by 14% from normal range at baseline (p=0.007). Urinary deoxypyridinoline levels, which were elevated at baseline (10+/-2.3 nM/mMcre), showed a nonsignificant change during treatment. Our study suggests that treatment with alendronate may have positive effects in patients with LS and low BMD on dual X-ray absorptiometry.

  18. Description and Psychometric Properties of the CP QOL-Teen: A Quality of Life Questionnaire for Adolescents with Cerebral Palsy

    Science.gov (United States)

    Davis, Elise; Mackinnon, Andrew; Davern, Melanie; Boyd, Roslyn; Bohanna, India; Waters, Elizabeth; Graham, H. Kerr; Reid, Susan; Reddihough, Dinah

    2013-01-01

    To assess the measurement properties of a new QOL instrument, the Cerebral Palsy Quality of Life Questionnaire-Teen (CP QOL-Teen), in adolescents with cerebral palsy (CP) aged 13-18 years, examining domain structure, reliability, validity and adolescent-caregiver concordance. Based on age, 695 eligible families were invited to participate by mail.…

  19. Validity and QOL of neck dissection preceding radiation therapy for hypopharyngeal cancer

    International Nuclear Information System (INIS)

    Uemura, Hirokazu; Yoshino, Kunitoshi; Fujii, Takashi; Suzuki, Motoyuki

    2009-01-01

    Thirty-one cases of hypopharyngeal cancer with neck dissection preceding radiation and 16 cases of hypopharyngeal cancer with neck dissection for locoregional recurrences after radiation were reviewed in order to make comparative evaluations of difficulty in surgical operation, postoperative complications, laryngeal preservation rate, and cause specific 5-year survival rate retrospectively. And quality of life (QOL) after neck dissection was additionally evaluated through the questionnaire. Since neck dissection preceding radiation for hypopharyngeal cancer may be superior to neck dissection for radiation failure, with easy surgical approach an non-lymphoid tissue preservation, that modality can be a reasonable choice of treatment for patients with nodal lesions, which are probably difficult to treat with radiation alone. Even though further investigation on QOL questionnaire is necessary, this modality can make a contribution to the neck and shoulder condition after neck dissection. (author)

  20. Quality of life (QOL) among community dwelling older people in Taiwan measured by the CASP-19, an index to capture QOL in old age.

    Science.gov (United States)

    Wu, Tai-Yin; Chie, Wei-Chu; Kuo, Kuan-Liang; Wong, Wai-Kuen; Liu, Jen-Pei; Chiu, Shih-Ting; Cheng, Yeung-Hung; Netuveli, Gopal; Blane, David

    2013-01-01

    There was no existing scale in Mandarin Chinese to specifically measure QOL in old age. We aimed to validate a Chinese Taiwan version of the CASP-19 (control, autonomy, self-realization, pleasure), a QOL questionnaire, in Taiwan. The existing CASP-19 Cantonese version was modified into Chinese Taiwan version and pilot tested. Data were then gathered from 699 older people. Score distribution, exploratory and confirmatory factor structure, reliability and clinical validity of the CASP-19 and its shortened version, the CASP-12, were examined. The mean age of the participants was 75.5 (standard deviation (SD) 6.5), and half (49.5%) were female. The mean CASP-19 score was 38.2 (range 11-56; SD 7.1), lower than that of Western countries. Exploratory factor analysis revealed an additional factor, 'participation' (CASPP-19). There was satisfactory internal consistency (Cronbach's α 0.63-0.85) for the subscales, except for the control domain. For the 19-item scale, the first order five-domain model (CASPP-19) yielded the best fit. For the CASP-12, first and second order original CASP-12 models performed equally well. There was an inverse relationship between the CASP total scores and frailty, chronic diseases, depressive disorders, living alone and fall events in the past 12months, supporting good clinical validity for all versions of the CASP scale (CASP-19, CASPP-19, original and new CASP-12). The original CASP-12 may be presently the best choice for use in China, Taiwan or other Mandarin-speaking populations due to its conciseness and model parsimony. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. The QOL-DASS Model to Estimate Overall Quality of Life and General Subjective Health

    OpenAIRE

    Mazaheri, Mehrdad

    2011-01-01

    Objective In Order to find how rating the WHOQOL-BREF and DASS scales are combined to produce an overall measure of quality of life and satisfaction with health rating, a QOL-DASS model was designed; and the strength of this hypothesized model was examined using the structural equation modeling. Method Participants included a sample of 103 voluntary males who were divided into two groups of unhealthy (N=55) and healthy (N=48). To assess satisfaction and negative emotions of depression, anxiet...

  2. A remarkable hematological and molecular response pattern in a patient with polycythemia vera during combination therapy with simvastatin and alendronate

    Directory of Open Access Journals (Sweden)

    Anders Lindholm Sørensen

    2016-01-01

    Full Text Available We report a 57-year old man with polycythemia vera, who had a remarkable hematological and molecular response during treatment with simvastatin and alendronate. The patient was treated with this combination for 56 months, and during this period the patient has been in complete hematological remission. The JAK2-V617F allele burden has dropped from 64% to sustained values below 20%, and follow-up bone marrow biopsies have revealed no change in PV features, without any regular cytoreductive treatment.

  3. The effect of cognitive appraisal for stressors on the oral health-related QOL of dry mouth patients.

    Science.gov (United States)

    Matsuoka, Hirofumi; Chiba, Itsuo; Sakano, Yuji; Saito, Ichiro; Abiko, Yoshihiro

    2014-01-01

    Dry mouth is very common symptom, and psychological factors have an influence on this symptom. Although the influence of emotional factor related to patients with oral dryness has been examined in previous studies, the cognitive factors have not been examined thus far. The purpose of this study was to examine the influence of cognitive factors on patients with oral dryness. The participants were 106 patients complaining of oral dryness. They were required to complete a questionnaire measuring subjective oral dryness, oral-related QOL, cognition for stressors, and mood state. Correlational analyses revealed that OHIP-14 is significantly related to oral dryness, appraisal for effect, appraisal for threat, and commitment. These correlations were maintained even after controlling for the influence of depression and anxiety. Using oral dryness, appraisal for effect, appraisal for threat, and commitment, cluster analysis was done and three clusters (cluster-1, severe oral dryness; cluster-2, positive cognitive style: cluster-3, negative cognitive style) were extracted. The results of ANOVA showed that the group with severe oral dryness (cluster-1) had a significantly higher score on OHIP-14 than the other two groups. There was no significant difference between the groups with positive (cluster-2) and negative (cluster-3) cognitive style. Although the group of patients with positive cognitive style complained of more severe oral dryness than the group with negative cognitive style, no significant difference was observed between these two groups in OHIP-14. These results indicate that cognitive factors would be a useful therapeutic target for the improvement of the oral-related QOL of patients with oral dryness.

  4. Assessment of Quality of Life (QOL) in Obsessive Compulsive Disorder (OCD) and Dysthymic Disorder (DD): A Comparative Study.

    Science.gov (United States)

    Vasudev, Roopesh Gopal Nariyandada; Yallappa, Sudarshan Chikkanayakanahalli; Saya, Ganesh Kumar

    2015-05-01

    There is paucity of data on Quality of Life (QOL) in non-psychotic mental disorders. To assess the Quality of Life (QOL) in Obsessive Compulsive Disorder (OCD) and compare it with Dysthymic Disorder (DD). This hospital based cross-sectional study was conducted in 30 patients each diagnosed to have OCD and DD during October 2009 to September 2011 in a medical institution in Davanagere, Karnataka, India. DSM-IV-TR (Diagnostic statistical manual-IV-Text Revised) criteria was used for diagnosis of OCD and DD. Yale Brown Obsessive Compulsive Scale (Y-BOCS) and WHO QOL BREF (brief form) scales were used. Data was analysed by independent sample t-test. Overall QOL score was 51.07(SD=11.47) and 50.91(SD=7.41) in OCD and DD groups respectively. QOL score was comparatively low in psychological domain with score of 44.12(SD=14.14) and 45.10(12.35) in OCD and DD respectively. There was no significant difference in the QOL score of the two groups with respect to socio demographic variables in OCD group, but it was different with respect to place of residence in DD group (p0.05). Overall QOL score was average and there was no significant difference of QOL score between the OCD and DD groups implying that both these non-psychotic mental disorders may have same influence or effect on QOL of the subjects. Further analytical studies will explore the associated factors of QOL in OCD and DD.

  5. Mutual augmentation of the induction of the histamine-forming enzyme, histidine decarboxylase, between alendronate and immuno-stimulants (IL-1, TNF, and LPS), and its prevention by clodronate

    International Nuclear Information System (INIS)

    Deng Xue; Yu Zhiqian; Funayama, Hiromi; Shoji, Noriaki; Sasano, Takashi; Iwakura, Yoichiro; Sugawara, Shunji; Endo, Yasuo

    2006-01-01

    Nitrogen-containing bisphosphonates (N-BPs), powerful anti-bone-resorptive drugs, have inflammatory side effects, while histamine is not only an inflammatory mediator, but also an immuno-modifier. In murine models, a single intraperitoneal injection of an N-BP induces various inflammatory reactions, including the induction of the histamine-forming enzyme histidine decarboxylase (HDC) in tissues important in immune responses (such as liver, lungs, spleen, and bone marrow). Lipopolysaccharide (LPS) and the proinflammatory cytokines IL-1 and TNF are also capable of inducing HDC. We reported previously that in mice (i) the inflammatory actions of N-BPs depend on IL-1 (ii) N-BP pretreatment augments both LPS-stimulated IL-1 production and HDC induction, and (iii) the co-administration of clodronate (a non-N-BP) with an N-BP inhibits the latter's inflammatory actions (including HDC induction). Here, we add the new findings that (a) pretreatment with alendronate (a typical N-BP) augments both IL-1- and TNF-induced HDC elevations, (b) LPS pretreatment augments the alendronate-induced HDC elevation, (c) co-administration of clodronate with alendronate abolishes these augmentations, (d) alendronate does not induce HDC in IL-1-deficient mice even if they are pretreated with LPS, and (e) alendronate increases IL-1β in all tissues tested, but not in the serum. These results suggest that (1) there are mutual augmentations between alendronate and immuno-stimulants (IL-1, TNF, and LPS) in HDC induction, (2) tissue IL-1β is important in alendronate-stimulated HDC induction, and (3) combination use of clodronate may have the potential to reduce the inflammatory effects of alendronate (we previously found that clodronate, conveniently, does not inhibit the anti-bone-resorptive activity of alendronate)

  6. Alendronate treatment alters bone tissues at multiple structural levels in healthy canine cortical bone.

    Science.gov (United States)

    Acevedo, Claire; Bale, Hrishikesh; Gludovatz, Bernd; Wat, Amy; Tang, Simon Y; Wang, Mingyue; Busse, Björn; Zimmermann, Elizabeth A; Schaible, Eric; Allen, Matthew R; Burr, David B; Ritchie, Robert O

    2015-12-01

    Bisphosphonates are widely used to treat osteoporosis, but have been associated with atypical femoral fractures (AFFs) in the long term, which raises a critical health problem for the aging population. Several clinical studies have suggested that the occurrence of AFFs may be related to the bisphosphonate-induced changes of bone turnover, but large discrepancies in the results of these studies indicate that the salient mechanisms responsible for any loss in fracture resistance are still unclear. Here the role of bisphosphonates is examined in terms of the potential deterioration in fracture resistance resulting from both intrinsic (plasticity) and extrinsic (shielding) toughening mechanisms, which operate over a wide range of length-scales. Specifically, we compare the mechanical properties of two groups of humeri from healthy beagles, one control group comprising eight females (oral doses of saline vehicle, 1 mL/kg/day, 3 years) and one treated group comprising nine females (oral doses of alendronate used to treat osteoporosis, 0.2mg/kg/day, 3 years). Our data demonstrate treatment-specific reorganization of bone tissue identified at multiple length-scales mainly through advanced synchrotron x-ray experiments. We confirm that bisphosphonate treatments can increase non-enzymatic collagen cross-linking at molecular scales, which critically restricts plasticity associated with fibrillar sliding, and hence intrinsic toughening, at nanoscales. We also observe changes in the intracortical architecture of treated bone at microscales, with partial filling of the Haversian canals and reduction of osteon number. We hypothesize that the reduced plasticity associated with BP treatments may induce an increase in microcrack accumulation and growth under cyclic daily loadings, and potentially increase the susceptibility of cortical bone to atypical (fatigue-like) fractures. Published by Elsevier Inc.

  7. In vitro incorporation studies of 99mTc-alendronate sodium at different bone cell lines

    International Nuclear Information System (INIS)

    Evren Gundogdu; Derya Ilem-Ozdemir; Makbule Asikoglu

    2014-01-01

    Bisphosphonates can be labeled with Technetium-99m ( 99m Tc) and are used for bone imaging because of their good localization in the skeleton and rapid clearance from soft tissues. Over the last decades bone scintigraphy has been used extensively in the evaluation of oncological patients to provide information about the sites of bone lesions, their prognosis and the effectiveness of therapy by showing the sequential changes in tracer uptake. Since the lesion visualization and lesion/bone ratio are important utilities for a bone scanning radiopharmaceutic; in this study incorporation of 99m Tc labeled alendronate sodium ( 99m Tc-ALD) was evaluated in U 2 OS (human bone osteosarcoma) and NCI-H209 (human bone carcinoma) cell lines. ALD was directly labeled by 99m Tc, radiochemical purity and stability of the complex were analyzed by radioactive thin layer chromatography and radioactive high performance liquid chromatography studies. For cell incorporation study, NCI-H209 and U 2 OS cell lines were used with standard cell culture methods. The six well plates were used for all experiments and the integrity of each cell monolayer was checked by measuring its transepithelial electrical resistance (TEER) with an epithelial voltammeter. Results confirmed that ALD was successfully radiolabeled with 99m Tc. 99m Tc-ALD incorporated with NCI-H209 and U 2 OS cells. The uptake percentages of 99m Tc-ALD in NCI-H209 and U 2 OS cell lines were found significantly different. Since 99m Tc-ALD highly uptake in cancer cell line, the results demonstrated that radiolabeled ALD may be a promising agent for bone cancer diagnosis. (author)

  8. A cross-sectional study of QOL of diabetic patients at tertiary care hospitals in Delhi

    Directory of Open Access Journals (Sweden)

    Gautam Yogesh

    2009-01-01

    Full Text Available Background: According to WHO estimates India will be the global capital of diabetes by 2025, accounting for 57.2 million diabetics. Worsening the situation is the fact that diabetes affects the economically productive age-group (45-65 years in developing countries. Objective : To measure quality of life (QOL and study the clinical profiles and associated sociodemographic factors affecting diabetic patients aged 20 years and above. Materials and Methods: We conducted a hospital-based cross-sectional study using a generic instrument, Short-Form 36 (SF-36 of the Medical Outcome Study Group to measure QOL of diabetic subjects aged ≥20 years. Two hundred and sixty diabetics, including 91 males and 169 females, were selected from the clinics of SSK Hospital and Dr RML Hospital of New Delhi. Data was analysed using SPSS for Windows, version 12. Results: The mean age of the respondents was 49.7 years, with 80% of respondents being in the age-group of 40-69 years. The majority (52.1% of female respondents were illiterate and 91.1% were economically dependent. Of the male respondents, 65.9% were skilled workers. Substance abuse was present among 41.8% male subjects. Type 2 diabetes was the commonest, with 94.6% of the subjects having this form. The mean duration of diabetes was 6.96 ± 6.08 years. Oral hypoglycemic agents were being taken by 70.77% of the respondents. Among the diabetics the most common comorbidity was hypertension (30.8% and the commonest complication was neuropathy (26.2%. We calculated the body mass index (BMI of all subjects and found that, 46.2% of the male and 59.8% of the female respondents were either overweight or obese. As predicted by the waist/hip ratio (WHR, 53.8% of the male and 66.9% of the female respondents had high risk for CHD. Regular physical activity was undertaken by less than half of the subjects (46.5%. Out of eight domains of QOL in the SF-36, the two most affected were ′General Health′ and

  9. Cumulative Alendronate Dose and the Long-Term Absolute Risk of Subtrochanteric and Diaphyseal Femur Fractures: A Register-Based National Cohort Analysis

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Eiken, Pia Agnete; Eastell, Richard

    2010-01-01

    are currently the subject of a U.S. Food and Drug Administration review. Objective: Our objective was to examine the risk of subtrochanteric/diaphyseal femur fractures in long term users of alendronate. Design: We conducted an age- and gender-matched cohort study using national healthcare data. Patients...

  10. [The relationship of quality of life (QOL) with physical fitness, competence and stress response in elderly in Japan].

    Science.gov (United States)

    Uemura, Shinichi; Machida, Kazuhiki

    2003-09-01

    In order to evaluate the relationship of quality of life (QOL) with physical fitness, competence and stress response in the elderly population in Japan, a cross sectional field survey of elderly subjects was conducted. This survey was taken in Naguri village, Saitama. The data collected included physical fitness, competence, stress response and QOL in addition to demographic variables. As for physical fitness indexes, grip strength (GS), single leg balance with eyes closed (SLB), bar grip ping reaction time (RT), trunk flexion (RF), ten-meter walking time (WT) and vital capacity (VC) were measured. The SF-36 was used for QOL assessment. A total of 120 elderly subjected participated to the survey. There were 42 males (73.5 +/- 5.74 years) and 78 females (74.2 +/- 6.17 years). The associations between physical health parameters in SF-36 and WT were highly significant: physical functioning (beta = -2.96, p fit indexes of the structural equation model describing the relationships among physical fitness, competence, stress response and QOL indicated excellent fit to the data with GFI = 0.95 and AGFI = 0.88. Stress response showed relatively stronger influence on QOL than physical fitness or competence. Although there were slight differences in degree of influence, physical fitness, stress response and competence were found to be clearly related to QOL in elderly subjects. To keep good QOL status, it is important to maintain good physical fitness and level of competence and to reduce stress response.

  11. Effect of an estrogen-deficient state and alendronate therapy on bone loss resulting from experimental periapical lesions in rats.

    Science.gov (United States)

    Xiong, Haofei; Peng, Bin; Wei, Lili; Zhang, Xiaolei; Wang, Li

    2007-11-01

    The aim of the research was to evaluate the impact of an estrogen-deficient state and alendronate (ALD) therapy on bone loss resulting from experimental periapical lesions in rats. Periapical lesions were induced on ovariectomized (OVX) and sham-ovariectomized (Sham) rats. After sample preparation, histologic and radiographic examination for periapical bone loss area and an enzyme histochemical test for tartrate-resistant acid phosphatase (TRAP) were performed. The results showed that OVX significantly increased bone loss resulting from periradicular lesions. After daily subcutaneous injection of ALD, the bone loss area and the number of TRAP-positive cells (osteoclasts) were reduced. These findings suggested that alendronate may protect against increased bone loss from experimental periapical lesions in estrogen-deficient rats. Given recent recognition of adverse effects of bisphosphonates, including an increased risk for osteonecrosis, the findings from this study should not be interpreted as a new indication for ALD treatment. However, they may offer insight into understanding and predicting outcomes in female postmenopausal patients already on ALD therapy for medical indications.

  12. The Use of COVD-QOL Questionnaire in School Vision Screening

    Directory of Open Access Journals (Sweden)

    Nurul Farhana Abu Bakar

    2011-05-01

    Full Text Available Purpose: To evaluate the application of College of Optometrist in Vision Development (COVD Quality of Life (QOL questionnaire in vision screening for normal school children and children with learning disabilities (LD and to determine appropriate referral-score for different target population. Methods: A total of 90 children (Normal: 45, LD: 45 who attended government primary schools aged between 6 to 12 years old were recruited. An interview session with normal children and parents or teachers in children with LD was made to determine visual symptoms using shorter version of COVD-QOL questionnaire. A comprehensive eye examination was performed after completion of the questionnaire. The evaluation was made base on the sensitivity and specificity for detection of refractive error, amblyopia, strabismus, vergence and accommodative disorders. Results: The mean score for normal children and children with LD were 22.47±10.75 and 12.24±8.72 respectively. Rapidity of the test in normal children and children with LD were 177.27±9.52 seconds and 162.16±16.58 seconds respectively. In normal children referral score of =20 showed highest sensitivity (66.7% and specificity (95.8% for detection of amblyopia. Sensitivity and specificity for referral-score of =20, =10 and =4 for detection of overall vision problems in children with LD were (20.4%, 100.0%, (54.5%, 100.0% and (81.8%, 100.0% respectively. Conclusion: COVD-QOL questionnaire was recommended as an easy, rapid and cost-effective tool for school vision screening. Different referral-score was suggested for different target population.

  13. A comparative study of zoledronic acid and once weekly Alendronate in the management of acute Charcot arthropathy of foot in patients with diabetes mellitus

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    R Bharath

    2013-01-01

    Full Text Available Aim: The aim of this study was to assess and compare the response to two forms of treatment-immobilization with zoledronic acid injection and immobilization with oral weekly Alendronate, in patients with diabetes mellitus and acute Charcot arthropathy (CA of foot in terms of clinical and radiological parameters. Material and Methods: Patients attending the endocrinology and podiatry clinic with history of diabetes mellitus and Acute CA were taken for study. The patients were randomized into two treatment groups. Group Z-zoledronic acid injection along with total contact cast (TCC. Group A-Tab. Alendronate 70 mg. once a week till the complete clinical resolution of acute CA along with TCC. Forty-five patients were randomized and 40 of them completed the study. The primary end point was complete clinical resolution of acute CA-defined as temperature difference between normal and affected foot <1oF. Results: Among the 40 patients, 30 (75% had complete clinical resolution. The mean number of days taken for complete clinical resolution since the initiation of treatment (either Zoledronic acid or Alendronate was approximately 122 days. There was no significant difference in a number of days required for complete clinical resolution, between the two forms of therapy. There was more than 50% reduction in the visual score between the baseline and the final scan. The target to non-target ratio in the skeletal phase also showed an average of 40% reduction from the baseline to the final skeletal scintigraphy. Conclusion: Both Intravenous Zoledronic acid and oral alendronate had comparable efficacy with respect to the time taken for attaining complete clinical resolution of acute CA of foot. However, Alendronate therapy was cost effective among the two. 99m Tc MDP bone scan can be used as an adjuvant to the clinical parameters in assessing the response to therapy.

  14. Three-year experience with combined treatment with alendronate and alfacalcidol in Japanese patients with severe bone loss and osteoporotic fracture

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    Iwamoto J

    2011-06-01

    Full Text Available Jun Iwamoto1, Yoshihiro Sato2, Mitsuyoshi Uzawa3, Tsuyoshi Takeda1, Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan; 2Department of Neurology, Mitate Hospital, Fukuoka, Japan; 3Department of Orthopaedic Surgery, Keiyu Orthopaedic Hospital, Gunma, JapanPurpose: Combined treatment with alendronate and alfacalcidol is more useful to increase bone mineral density (BMD than alendronate or alfacalcidol alone. A retrospective study was conducted to investigate the 3-year outcome of combined treatment with alendronate and alfacalcidol in patients with severe bone loss (BMD ≤ 50% of the young adult mean and osteoporotic fracture.Methods: Thirty-four patients (six men and 28 postmenopausal women with primary or secondary osteoporosis who had been treated with alendronate and alfacalcidol for more than 3 years were analyzed. The lumbar spine or total hip BMD and bone turnover markers were monitored, and the incidence of osteoporotic fractures was assessed.Results: The urinary level of cross-linked N-terminal telopeptides of type I collagen and serum level of alkaline phosphatase significantly decreased (-42.5% at 3 months and -18.9% at 3 years, and the lumbar spine BMD, but not the total hip BMD, significantly increased (14.8% at 3 years, compared with the baseline values. However, the incidence of vertebral and nonvertebral fractures was 26.5% and 2.9%, respectively, suggesting a high incidence of vertebral fractures.Conclusion: The results of the present study suggest that combined treatment with alendronate and alfacalcidol may be useful to reduce bone turnover and increase the lumbar spine BMD in patients with severe bone loss and osteoporotic fracture. However, its efficacy against vertebral fractures appears not to be sufficient. Thus, anabolic agents such as teriparatide should be taken into consideration as first-line drugs in patients with severe osteoporosis.Keywords: osteoporosis

  15. The QOL-DASS Model to Estimate Overall Quality of Life and General Health

    OpenAIRE

    Mehrdad Mazaheri

    2011-01-01

    "n Objective: In order to find how rating the WHOQOL-BREF and DASS scales are combined to produce an overall measure of quality of life and satisfaction with health rating, a QOL-DASS model was designed ; and the strength of this hypothesized model was examined using the structural equation modeling "n "nMethod: Participants included a sample of 103 voluntary males who were divided into two groups of unhealthy (N=55) and healthy (N=48). To assess satisfaction and negative  emotions of depress...

  16. Quality of life (QOL) assessment in patients received carbon ion radiotherapy

    International Nuclear Information System (INIS)

    Kamada, Tadashi; Mizoe, Jun-Etsu; Tsuji, Hiroshi; Yanagi, Tsuyoshi; Miyamoto, Tada-aki; Kato, Hirotoshi; Oono, Tatsuya; Yamada, Shigeru; Tsujii, Hirohiko

    2003-01-01

    Until February 2003, a total of 1,463 patients were enrolled in clinical trials of carbon ion radiotherapy. Most of the patients had locally advanced and/or medically inoperable tumors. The clinical trials revealed that carbon ion radiotherapy provided definite local control and offered a survival advantage without unacceptable morbidity in a variety of tumors that were hard to cure by other modalities. In this study, quality of life (QOL) outcomes of patients with unresectable bone and soft tissue sarcoma after carbon ion radiotherapy are investigated. (author)

  17. μCT-based, in vivo dynamic bone histomorphometry allows 3D evaluation of the early responses of bone resorption and formation to PTH and alendronate combination therapy.

    Science.gov (United States)

    de Bakker, Chantal M J; Altman, Allison R; Tseng, Wei-Ju; Tribble, Mary Beth; Li, Connie; Chandra, Abhishek; Qin, Ling; Liu, X Sherry

    2015-04-01

    Current osteoporosis treatments improve bone mass by increasing net bone formation: anti-resorptive drugs such as bisphosphonates block osteoclast activity, while anabolic agents such as parathyroid hormone (PTH) increase bone remodeling, with a greater effect on formation. Although these drugs are widely used, their role in modulating formation and resorption is not fully understood, due in part to technical limitations in the ability to longitudinally assess bone remodeling. Importantly, it is not known whether or not PTH-induced bone formation is independent of resorption, resulting in controversy over the effectiveness of combination therapies that use both PTH and an anti-resorptive. In this study, we developed a μCT-based, in vivo dynamic bone histomorphometry technique for rat tibiae, and applied this method to longitudinally track changes in bone resorption and formation as a result of treatment with alendronate (ALN), PTH, or combination therapy of both PTH and ALN (PTH+ALN). Correlations between our μCT-based measures of bone formation and measures of bone formation based on calcein-labeled histology (r=0.72-0.83) confirm the accuracy of this method. Bone remodeling parameters measured through μCT-based in vivo dynamic bone histomorphometry indicate an increased rate of bone formation in rats treated with PTH and PTH+ALN, together with a decrease in bone resorption measures in rats treated with ALN and PTH+ALN. These results were further supported by traditional histology-based measurements, suggesting that PTH was able to induce bone formation while bone resorption was suppressed. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Effect of alendronate on post-traumatic osteoarthritis induced by anterior cruciate ligament rupture in mice.

    Science.gov (United States)

    Khorasani, Mohammad S; Diko, Sindi; Hsia, Allison W; Anderson, Matthew J; Genetos, Damian C; Haudenschild, Dominik R; Christiansen, Blaine A

    2015-02-16

    Previous studies in animal models of osteoarthritis suggest that alendronate (ALN) has antiresorptive and chondroprotective effects, and can reduce osteophyte formation. However, these studies used non-physiologic injury methods, and did not investigate early time points during which bone is rapidly remodeled prior to cartilage degeneration. The current study utilized a non-invasive model of knee injury in mice to investigate the effect of ALN treatment on subchondral bone changes, articular cartilage degeneration, and osteophyte formation following injury. Non-invasive knee injury via tibial compression overload or sham injury was performed on a total of 90 mice. Mice were treated with twice weekly subcutaneous injections of low-dose ALN (40 μg/kg/dose), high-dose ALN (1,000 μg/kg/dose), or vehicle, starting immediately after injury until sacrifice at 7, 14 or 56 days. Trabecular bone of the femoral epiphysis, subchondral cortical bone, and osteophyte volume were quantified using micro-computed tomography (μCT). Whole-joint histology was performed at all time points to analyze articular cartilage and joint degeneration. Blood was collected at sacrifice, and serum was analyzed for biomarkers of bone formation and resorption. μCT analysis revealed significant loss of trabecular bone from the femoral epiphysis 7 and 14 days post-injury, which was effectively prevented by high-dose ALN treatment. High-dose ALN treatment was also able to reduce subchondral bone thickening 56 days post-injury, and was able to partially preserve articular cartilage 14 days post-injury. However, ALN treatment was not able to reduce osteophyte formation at 56 days post-injury, nor was it able to prevent articular cartilage and joint degeneration at this time point. Analysis of serum biomarkers revealed an increase in bone resorption at 7 and 14 days post-injury, with no change in bone formation at any time points. High-dose ALN treatment was able to prevent early trabecular

  19. Validation of a health-related quality of life instrument for primary ciliary dyskinesia (QOL-PCD).

    Science.gov (United States)

    Behan, Laura; Leigh, Margaret W; Dell, Sharon D; Dunn Galvin, Audrey; Quittner, Alexandra L; Lucas, Jane S

    2017-09-01

    Quality of life (QOL)-primary ciliary dyskinesia (PCD) is the first disease-specific, health-related QOL instrument for PCD. Psychometric validation of QOL-PCD assesses the performance of this measure in adults, including its reliability, validity and responsiveness to change. Seventy-two adults (mean (range) age: 33 years (18-79 years); mean (range) FEV 1 % predicted: 68 (26-115)) with PCD completed the 49-item QOL-PCD and generic QOL measures: Short-Form 36 Health Survey, Sino-Nasal Outcome Test 20 (SNOT-20) and St George Respiratory Questionnaire (SGRQ)-C. Thirty-five participants repeated QOL-PCD 10-14 days later to measure stability or reproducibility of the measure. Multitrait analysis was used to evaluate how the items loaded on 10 hypothesised scales: physical, emotional, role and social functioning, treatment burden, vitality, health perceptions, upper respiratory symptoms, lower respiratory symptoms and ears and hearing symptoms. This analysis of item-to-total correlations led to 9 items being dropped; the validated measure now comprises 40 items. Each scale had excellent internal consistency (Cronbach's α: 0.74 to 0.94). Two-week test-retest demonstrated stability for all scales (intraclass coefficients 0.73 to 0.96). Significant correlations were obtained between QOL-PCD scores and age and FEV 1 . Strong relationships were also found between QOL-PCD scales and similar constructs on generic questionnaires, for example, lower respiratory symptoms and SGRQ-C (r=0.72, pmeasures of different constructs. QOL-PCD has demonstrated good internal consistency, test-retest reliability, convergent and divergent validity. QOL-PCD offers a promising tool for evaluating new therapies and for measuring symptoms, functioning and QOL during routine care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Effects of interactive metronome training on upper extremity function, ADL and QOL in stroke patients.

    Science.gov (United States)

    Yu, Ga-Hui; Lee, Jae-Shin; Kim, Su-Kyoung; Cha, Tae-Hyun

    2017-01-01

    Rhythm and timing training is stimulation that substitutes for a damaged function controls muscular movement or temporal element, which has positive impacts on the neurological aspect and movement of the brain. This study is to assess the changes caused by rhythm and timing training using an interactive metronome (IM) on upper extremity function, ADL and QOL in stroke patients. In order to assess the effects of IM training, a group experiment was conducted on 30 stroke patients. Twelve sessions of IM training were provided for the experimental group three times a week for four weeks, while the control group was trained with a Bilateral arm Self-Exercise (BSE) for the same period. Both groups were evaluated by pre- and post-tests through MFT, MAL, K-MBI and SS-QOL. There were more statistically significant differences (<0.05) in the total score of MFT and the finger control item in the IM Group than in the BSE Group. With respect to ADL, there were more statistically significant differences (<0.05) in the total score of K-MBI and the dressing item in the IM Group than in the BSE Group. The study proposes that IM training can be applied as an occupational therapy program in patients with various diseases who need to adjust the time for performing movements as well as stroke patients.

  1. Surgery for two cases with markedly impaired QOL(Quality of Life) of radiation enterocolitis

    International Nuclear Information System (INIS)

    Shiba, Tadaaki; Tanishima, Satoru; Sato, Masahiko; Yanagisawa, Terumasa; Yoshino, Masaaki; Takatsuka, Jun

    1996-01-01

    Two cases of radiation enterocolitis with markedly impaired QOL for a long period were reported. Case 1: A 61 years old female. She received 60 Gy irradiation post hysterectomy and ovariectomy due to uterine cancer at the age of 39 y. She suffered from fecal incontinence and anal pain at 58 y, was diagnosed to have radiation colitis. She was hospitalized due to neurosis, anal pain and hypertension at 59 y. She received nephrostomy due to hydronephrosis and ureterostenosis at 60 y, and colostomy and ileal conduit formation due to anal pain and dyschezia. Case 2: A 70 years old female who received 60 Gy irradiation post surgery similar to case 1 at the age of 61 y. She suffered from ileus, intestinal retention and hydronephrosis thereafter. She was hospitalized due to metastasis of the cancer to sacred bone, and received further 40 Gy radiation therapy at the age of 65 y. Up to the present, she received several operations such as ileostomy, nephrostomy and hemorrhoids excision. It is important for surgeons to understand the actual QOL of patients with radiation enterocolitis. (K.H.)

  2. Surgery for two cases with markedly impaired QOL(Quality of Life) of radiation enterocolitis

    Energy Technology Data Exchange (ETDEWEB)

    Shiba, Tadaaki; Tanishima, Satoru; Sato, Masahiko; Yanagisawa, Terumasa; Yoshino, Masaaki; Takatsuka, Jun [Toho Univ., Tokyo (Japan). School of Medicine

    1996-10-01

    Two cases of radiation enterocolitis with markedly impaired QOL for a long period were reported. Case 1: A 61 years old female. She received 60 Gy irradiation post hysterectomy and ovariectomy due to uterine cancer at the age of 39 y. She suffered from fecal incontinence and anal pain at 58 y, was diagnosed to have radiation colitis. She was hospitalized due to neurosis, anal pain and hypertension at 59 y. She received nephrostomy due to hydronephrosis and ureterostenosis at 60 y, and colostomy and ileal conduit formation due to anal pain and dyschezia. Case 2: A 70 years old female who received 60 Gy irradiation post surgery similar to case 1 at the age of 61 y. She suffered from ileus, intestinal retention and hydronephrosis thereafter. She was hospitalized due to metastasis of the cancer to sacred bone, and received further 40 Gy radiation therapy at the age of 65 y. Up to the present, she received several operations such as ileostomy, nephrostomy and hemorrhoids excision. It is important for surgeons to understand the actual QOL of patients with radiation enterocolitis. (K.H.)

  3. Female sexual dysfunction (FSD): Prevalence and impact on quality of life (QoL).

    Science.gov (United States)

    Nappi, Rossella E; Cucinella, Laura; Martella, Silvia; Rossi, Margherita; Tiranini, Lara; Martini, Ellis

    2016-12-01

    Female sexual dysfunction (FSD) and quality of life (QOL) are both multidimensional and have a bidirectional relationship across the reproductive life span and beyond. Methodological difficulties exist in estimating the real prevalence of FSD because it is hard to determine the level of distress associated with sexual symptoms in a large-scale survey. Approximately 40-50% of all women report at least one sexual symptom, and some conditions associated with hormonal changes at menopause, such as vulvovaginal atrophy (VVA) and hypoactive sexual desire disorder (HSDD), have a significant impact on sexual function and QOL. Sexual distress peaks at midlife, declines with age and is strongly partner-related. Many postmenopausal women are still sexually active, especially if they are in a stable partnership. Even though sexual functioning is impaired, a variety of psychosocial factors may maintain sexual satisfaction. That being so, health care providers (HCPs) should proactively address sexual symptoms at midlife and in older women, from a balanced perspective. Adequate counselling should be offered. Women with distressing symptoms may benefit from tailored hormonal and non-hormonal therapies, whereas women without distress related to their sexual experiences should not receive any specific treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. The Validity and Reliability Test of the Indonesian Version of Gastroesophageal Reflux Disease Quality of Life (GERD-QOL) Questionnaire.

    Science.gov (United States)

    Siahaan, Laura A; Syam, Ari F; Simadibrata, Marcellus; Setiati, Siti

    2017-01-01

    to obtain a valid and reliable GERD-QOL questionnaire for Indonesian application. at the initial stage, the GERD-QOL questionnaire was first translated into Indonesian language and the translated questionnaire was subsequently translated back into the original language (back-to-back translation). The results were evaluated by the researcher team and therefore, an Indonesian version of GERD-QOL questionnaire was developed. Ninety-one patients who had been clinically diagnosed with GERD based on the Montreal criteria were interviewed using the Indonesian version of GERD-QOL questionnaire and the SF 36 questionnaire. The validity was evaluated using a method of construct validity and external validity, and reliability can be tested by the method of internal consistency and test retest. the Indonesian version of GERD-QOL questionnaire had a good internal consistency reliability with a Cronbach Alpha of 0.687-0.842 and a good test retest reliability with an intra-class correlation coefficient of 0.756-0.936; pGERD-QOL questionnaire has been proven valid and reliable to evaluate the quality of life of GERD patients.

  5. Validation and psychometric properties of the Spanish version of the Quality of Life Scale (QOLS) in patients with fibromyalgia.

    Science.gov (United States)

    Latorre-Román, Pedro A; Martínez-Amat, Antonio; Martínez-López, Emilio; Moral, Angel; Santos, María A; Hita-Contreras, Fidel

    2014-04-01

    Fibromyalgia (FM) is a chronic disease associated with high disability levels, which in turn lead to low quality of life (QOL). The objectives of this study were to translate the Quality of Life Scale (QOLS) into Spanish and to assess its reliability and validity for its use in patients with FM. A total of 140 women are suffering from FM (52.87 ± 9.35 years old). All belonged to an association of FM patients (AFIXA, Jaén, Spain). The Spanish versions of the FM impact questionnaire (FIQ), the SF-36, and Beck's Depression Inventory were used to assess them. The construct's validity was checked by means of exploratory factorial analysis (varimax with Kaiser normalization). Test-retest reliability was assessed through intraclass correlation coefficient (ICC), and convergent validity through Spearman's correlation. Results show that Cronbach's alpha was 0.887, which revealed high internal consistency. The value of ICC for the QOLS total was 0.765 (95 % CI 0.649-0.843, p < 0.001). QOLS presented a significant Spearman's correlation (p < 0.01) with Beck's Inventory, with the physical and mental subtotals of SF-36 and with FIQ. The main component analysis and the varimax rotation revealed the convergence on three factors that account for 54.05 % of variance. Taking into account the severity of the disorder, significant differences (p < 0.05) appeared in QOLS, with moderately afflicted patients getting higher scores than the most severe cases. In conclusion, our study shows that the Spanish version of the QOLS is a reliable instrument, with a good convergent and discriminant construct validity, for measuring the QOL of Spanish FM patients.

  6. QOL in caregivers of Japanese patients with Prader-Willi syndrome with reference to age and genotype.

    Science.gov (United States)

    Ihara, Hiroshi; Ogata, Hiroyuki; Sayama, Masayuki; Kato, Aya; Gito, Masao; Murakami, Nobuyuki; Kido, Yasuhiro; Nagai, Toshiro

    2014-09-01

    This study aimed to measure quality of life (QOL) of the primary family caregivers for patients with Prader-Willi syndrome (PWS). Comparisons were made between caregivers' QOL in regard to their dependents' genotype and age group. The participants with PWS consisted of 22 children (aged from 6 to 12 years) and 23 adolescents (aged from 13 to 19 years), including 6 children and 7 adolescents with maternal uniparental disomy (mUPD) and 16 children and 16 adolescents with deletion (DEL). The QOL of the primary family caregiver for each patient was assessed using the Japanese version of the WHOQOL-BREF. To examine the effect that age (children vs. adolescents) and genotype (DEL vs. mUPD) have on the QOL of caregivers, a two-way ANOVA was conducted, followed by the Bonferroni procedure to test the simple main effects. The two age groups and the two genotypes of PWS were used as independent variables and the total QOL of caregivers as a dependent variable. The two-way ANOVA (F(1, 41) = 6.98, P caregivers of DEL adolescents showed little difference from that with DEL children, but the QOL of caregivers for mUPD adolescents was shown to be lower than that with mUPD children along with that of caregivers with DEL adolescents. There is hence a growing tendency for the deterioration in the QOL of caregivers to manifest itself later in the patients' adolescence, found mainly with mUPD patients. © 2014 The Authors. American Journal of Medical Genetics Part A Published by Wiley Periodicals, Inc.

  7. Effects of local alendronate sodium gel as an adjunct to scaling and root planing on smokers with chronic periodontitis: a pilot study

    OpenAIRE

    Farin Kiany; Hashem Montaseri; Sadaf Adibi; Masoud Golshah; Saba Golshah

    2017-01-01

    Background: Chemical treatments for the modulation of host response are applied along with mechanical modalities as adjunctive to periodontal treatment. The objective of this pilot study was to investigate the effects of locally-delivered alendronate sodium gel in adjunction to scaling and root planning on periodontal indices and bone formation within vertical defects of smokers with chronic periodontitis. Methods and Materials: In this study vertical defects (n=8) with depth>5 mm have be...

  8. The use of alendronate is associated with a decreased incidence of type 2 diabetes mellitus--a population-based cohort study in Taiwan.

    Directory of Open Access Journals (Sweden)

    Ding-Cheng Chan

    Full Text Available Bone remodeling has been linked to glucose metabolism in animal studies, but the results of human trials were inconclusive. Bisphosphonates may play a role in glucose metabolism through their impacts on bone remodeling enzymes. In this study, we aimed to examine the influence of alendronate usage on the incidence of type 2 diabetes mellitus (DM among osteoporotic patients.A retrospective cohort study was designed to include osteoporotic patients without DM from a population-based cohort containing 1,000,000 subjects. Patients treated with alendronate (exposed group, N=1,011 were compared with those who received no treatment (age and gender matched non-exposed group, N=3,033. Newly diagnosed DM was identified from medical records by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9CM code. The incidence of DM in both groups was calculated for comparison.The non-exposed group had a significantly higher incidence of DM (Odds ratio 1.21, 95% confidence interval 1.03~1.41 when compared with the exposed group. In subgroup analysis, the DM risk reduction in exposed group was only significant among those younger than 65 years and those without hypertension or dyslipidemia. Patients who were prescribed alendronate more than or equal to 3 times had demonstrated a significant reduction in DM risk.Our study showed alendronate might yield a protective effect for incident DM. This effect became insignificant in patients with older age, dyslipidemia or hypertension. The underlying mechanism needs further exploration with prospective data for confirmation of the observed findings.

  9. Treated Hypertension has No Influence on the Efficacy of Alendronate in the Therapy of Postmenopausal Osteoporosis: A Non-Randomized, Non-Blind, Controlled Prospective Study

    OpenAIRE

    Matziolis, Doerte; Drewke, Monika; Matziolis, Georg; Perka, Carsten

    2011-01-01

    Changes in hormone metabolism during menopause are involved in the development of osteoporosis and arterial hypertension. A mutual influence of these two clinical pictures is evident on the basis of pathophysiological factors. In this study, we investigated whether a drug therapy of hypertension influences the efficacy of a bisphosphonate (alendronate) in the treatment of postmenopausal osteoporosis. For this purpose, 60 female patients were enrolled in the study, 30 of them on drug treatment...

  10. Localized cortical thickening of the femoral diaphysis captured on an X-ray before alendronate therapy in two cases of atypical femoral fracture

    Energy Technology Data Exchange (ETDEWEB)

    Iizuka, Yoichi [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Shibukawa General Hospital, Department of Orthopedic Surgery, Shibukawa, Gunma (Japan); Takechi, Rumi [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Gunma Cardiovascular Center, Department of Orthopaedic Surgery, Maebashi, Gunma (Japan); Iizuka, Haku; Takagishi, Kenji [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Omodaka, Takuya [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Gunma Central Hospital, Department of Orthopedic Surgery, Maebashi, Gunma (Japan)

    2016-10-15

    We herein report two cases of atypical femoral fracture (AFF). X-ray examinations at the first visit of these two female patients showed a complete fracture of the femoral diaphysis diagnosed as an atypical femoral fracture (AFF). X-rays of these two cases also showed localized cortical thickening of the femoral diaphysis. Both patients had been taking alendronate for more than 3 years because of postmenopausal osteoporosis. We assumed that both of the fractures were associated with the long-term use of alendronate. However, we retrospectively identified localized cortical thickening of the femoral diaphysis on an X-ray taken before the alendronate therapy in both of these cases. Therefore, we suspected a pathogenesis of AFFs in which preexisting stress or an insufficient fracture unrelated to bisphosphonate (BP) therapy and subsequent suppression of bone turnover due to BP administration led to the occurrence of an AFF. The patient underwent surgery using intramedullary nails in both of these cases, followed by the administration of teriparatide, and they were able to walk without any support at the final follow-up examination. (orig.)

  11. Prediction of specific depressive symptom clusters in youth with epilepsy: The NDDI-E-Y versus Neuro-QOL SF.

    Science.gov (United States)

    Kellermann, Tanja S; Mueller, Martina; Carter, Emma G; Brooks, Byron; Smith, Gigi; Kopp, Olivia J; Wagner, Janelle L

    2017-08-01

    Proper assessment and early identification of depressive symptoms are essential to initiate treatment and minimize the risk for poor outcomes in youth with epilepsy (YWE). The current study examined the predictive utility of the Neurological Disorders Depression Inventory-Epilepsy for Youth (NDDI-E-Y) and the Neuro-QOL Depression Short Form (Neuro-QOL SF) in explaining variance in overall depressive symptoms and specific symptom clusters on the gold standard Children's Depression Inventory-2 (CDI-2). Cross-sectional study examining 99 YWE (female 68, mean age 14.7 years) during a routine epilepsy visit, who completed self-report measures of depressive symptoms, including the NDDI-E-Y, CDI-2, and the Neuro-QOL SF. Caregivers completed a measure of seizure severity. All sociodemographic and medical information was evaluated through electronic medical record review. After accounting for seizure and demographic variables, the NDDI-E-Y accounted for 45% of the variance in the CDI-2 Total score and the CDI-2 Ineffectiveness subscale. Furthermore, the NDDI-E-Y predicted CDI-2 Total scores and subscales similarly, with the exception of explaining significantly more variance in the CDI-2 Ineffectiveness subscale compared to the Negative Mood subscale. The NDDI-E-Y explained greater variance compared to Neuro-QOL SF across the Total (48% vs. 37%) and all CDI-2 subscale scores; however, the NDDI-E-Y emerged as a stronger predictor of only CDI-2 Ineffectiveness. Both the NDDI-E-Y and Neuro-QOL SF accounted for the lowest amount of variance in CDI-2 Negative Mood. Sensitivity was poor for the Neuro-QOL SF in predicting high versus low CDI-2 scores. The NDDI-E-Y has strong psychometrics and can be easily integrated into routine epilepsy care for quick, brief screening of depressive symptoms in YWE. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  12. Psychometrics of the Short Form 36 Health Survey version 2 (SF-36v2) and the Quality of Life Scale for Drug Addicts (QOL-DAv2.0) in Chinese mainland patients with methadone maintenance treatment.

    Science.gov (United States)

    Zhou, Kaina; Zhuang, Guihua; Zhang, Hongmei; Liang, Peifeng; Yin, Juan; Kou, Lingling; Hao, Mengmeng; You, Lijuan

    2013-01-01

    To test psychometrics of the Short Form 36 Health Survey version 2 (SF-36v2) and the Quality of Life Scale for Drug Addicts (QOL-DAv2.0) in Chinese mainland patients with methadone maintenance treatment (MMT). A total of 1,212 patients were recruited from two MMT clinics in Xi'an, China. Reliability was estimated with Cronbach's α and intra-class correlation (ICC). Convergent and discriminant validity was assessed using multitrait-multimethod correlation matrix. Sensitivity was measured with ANOVA and relative efficiency. Responsiveness was evaluated by pre-post paired-samples t-test and standardized response mean based on the patients' health status changes following 6-month period. Cronbach's α of the SF-36v2 physical and mental summary components were 0.80 and 0.86 (eight scales range 0.73-0.92) and the QOL-DAv2.0 was 0.96 (four scales range: 0.80-0.93). ICC of the SF-36v2 two components were 0.86 and 0.85 (eight scales range: 0.72-0.87) and the QOL-DAv2.0 was 0.94 (four scales range: 0.88-0.92). Convergent validity was lower between the two instruments (γ <0.70) while discriminant validity was acceptable within each instrument. Sensitivity was satisfied in self-evaluated health status (both instruments) and average daily methadone dose (SF-36v2 physical functioning and vitality scales; QOL-DAv2.0 except psychology scale). Responsiveness was acceptable in the improved health status change (SF-36v2 except vitality scale; QOL-DAv2.0 except psychology and symptoms scales) and deteriorated health status change (SF-36v2 except vitality, social functioning and mental health scales; QOL-DAv2.0 except society scale). The SF-36v2 and the QOL-DAv2.0 are valid tools and can be used independently or complementary according to different emphases of health-related quality of life evaluation in patients with MMT.

  13. Psychometrics of the Short Form 36 Health Survey version 2 (SF-36v2 and the Quality of Life Scale for Drug Addicts (QOL-DAv2.0 in Chinese mainland patients with methadone maintenance treatment.

    Directory of Open Access Journals (Sweden)

    Kaina Zhou

    Full Text Available OBJECTIVE: To test psychometrics of the Short Form 36 Health Survey version 2 (SF-36v2 and the Quality of Life Scale for Drug Addicts (QOL-DAv2.0 in Chinese mainland patients with methadone maintenance treatment (MMT. METHODS: A total of 1,212 patients were recruited from two MMT clinics in Xi'an, China. Reliability was estimated with Cronbach's α and intra-class correlation (ICC. Convergent and discriminant validity was assessed using multitrait-multimethod correlation matrix. Sensitivity was measured with ANOVA and relative efficiency. Responsiveness was evaluated by pre-post paired-samples t-test and standardized response mean based on the patients' health status changes following 6-month period. RESULTS: Cronbach's α of the SF-36v2 physical and mental summary components were 0.80 and 0.86 (eight scales range 0.73-0.92 and the QOL-DAv2.0 was 0.96 (four scales range: 0.80-0.93. ICC of the SF-36v2 two components were 0.86 and 0.85 (eight scales range: 0.72-0.87 and the QOL-DAv2.0 was 0.94 (four scales range: 0.88-0.92. Convergent validity was lower between the two instruments (γ <0.70 while discriminant validity was acceptable within each instrument. Sensitivity was satisfied in self-evaluated health status (both instruments and average daily methadone dose (SF-36v2 physical functioning and vitality scales; QOL-DAv2.0 except psychology scale. Responsiveness was acceptable in the improved health status change (SF-36v2 except vitality scale; QOL-DAv2.0 except psychology and symptoms scales and deteriorated health status change (SF-36v2 except vitality, social functioning and mental health scales; QOL-DAv2.0 except society scale. CONCLUSIONS: The SF-36v2 and the QOL-DAv2.0 are valid tools and can be used independently or complementary according to different emphases of health-related quality of life evaluation in patients with MMT.

  14. Translation and validation of a Japanese version of the irritable bowel syndrome-quality of life measure (IBS-QOL-J

    Directory of Open Access Journals (Sweden)

    Hongo Michio

    2007-03-01

    Full Text Available Abstract Aims To compare quality of life (QOL for patients with irritable bowel syndrome (IBS between the U.S. and Japan, it is indispensable to develop common instruments. The IBS-QOL, which is widely used in Western countries, was translated into Japanese as there has been a lack of Japanese disease-specific QOL measures for IBS. Methods The original 34 items of the IBS-QOL were translated from English into Japanese through two independent forward translations, resolution, back translation, and resolution of differences. Forty nine patients who had GI symptoms but did not have any organic diseases (including 30 IBS patients diagnosed by Rome II criteria were recruited from Tohoku University Hospital in Sendai, Japan and completed a Japanese version of the IBS-QOL (IBS-QOL-J concomitant with a Japanese version of the IBS severity index (IBSSI-J twice within 7–14 days. Results The IBS-QOL-J demonstrated high internal consistency (Cronbach's alpha; 0.96 and high reproducibility (intraclass correlation coefficient; 0.92, p Conclusion The IBS-QOL-J is a reliable instrument to assess the disease-specific QOL for IBS. Considering cross-cultural comparison, this measure is likely to be a valuable tool to investigate the QOL in Japanese patients with IBS.

  15. Caring for a Child with Autism Spectrum Disorder and Parents' Quality of Life: Application of the CarerQol

    NARCIS (Netherlands)

    R.J. Hoefman (Renske); N. Payakachat (Nalin); N.J.A. van Exel (Job); K.A. Kuhlthau (Karen); E.M. Kovacs (Erica); J.M. Pyne (Jeffrey); J.M. Tilford (John Mick)

    2014-01-01

    textabstractThis study describes the impact of caregiving on parents of children with autism spectrum disorders (ASDs). Secondly, we investigate construct validation of the care-related quality of life instrument (CarerQol) measuring impact of caregiving. Primary caregivers of children with ASDs

  16. Factor Structure of the Schalock and Keith Quality of Life Questionnaire (QOL-Q): Validation on Mexican and Spanish Samples

    Science.gov (United States)

    Caballo, C.; Crespo, M.; Jenaro, C.; Verdugo, M. A.; Martinez, J. L.

    2005-01-01

    Background: The Quality of Life Questionnaire (QOL-Q) is used widely to evaluate the quality of life of persons with intellectual disability (ID). Its validity for use with Spanish-speaking cultures has been demonstrated for individuals with visual disabilities, but not for those with physical or intellectual disabilities. Such was the purpose of…

  17. Food allergy QoL questionnaire for children aged 0-12 years : content, construct, and cross-cultural validity

    NARCIS (Netherlands)

    DunnGalvin, A.; de BlokFlokstra, B. M. J.; Burks, A. W.; Dubois, A. E. J.; Hourihane, J. O'B.

    Background To date, there is no food allergy-specific questionnaire that allows parents to report children's health-related QoL (HRQL) from the child's perspective. Objective The aim of this study was to develop a sensitive, multi-dimensional measure to assess parental perception of HRQL in children

  18. Pre-diagnosis quality of life (QoL) in patients with hematuria : Comparison of bladder cancer with other causes

    NARCIS (Netherlands)

    Goossens-Laan, C.A.; Kil, P.J.M.; Bosch, J.L.; de Vries, J.

    2013-01-01

    Purpose To examine quality of life (QoL), health status, sexual function, and anxiety in patients with primary hematuria who later appear to have bladder cancer (BC) and patients with other diagnoses. Methods From July 2007 to July 2010, 598 patients with primary hematuria were enrolled in this

  19. rTMS in fibromyalgia: a randomized trial evaluating QoL and its brain metabolic substrate

    NARCIS (Netherlands)

    Boyer, L.; Dousset, A.; Roussel, P.; Dossetto, N.; Cammilleri, S.; Piano, V.M.M.; Khalfa, S.; Mundler, O.; Donnet, A.; Guedj, E.

    2014-01-01

    OBJECTIVE: This double-blind, randomized, placebo-controlled study investigated the impact of repetitive transcranial magnetic stimulation (rTMS) on quality of life (QoL) of patients with fibromyalgia, and its possible brain metabolic substrate. METHODS: Thirty-eight patients were randomly assigned

  20. Physical and Mental Quality of Life (QOL) in Chronic Pancreatitis(CP): A Case-Control Study from the NAPS2 cohort

    Science.gov (United States)

    Amann, Stephen T.; Yadav, Dhiraj; Barmada, M. Micheal; O’Connell, Michael; Kennard, Elizabeth D.; Anderson, Michelle; Baillie, John; Sherman, Stuart; Romagnuolo, Joseph; Hawes, Robert H.; AlKaade, Samer; Brand, Randall E.; Lewis, Michele D.; Gardner, Timothy B.; Gelrud, Andres; Money, Mary E.; Banks, Peter A.; Slivka, Adam; Whitcomb, David C

    2012-01-01

    Objectives Define the Quality of Life (QOL) in chronic pancreatitis (CP) subjects Methods We studied 443 well phenotyped CP subjects and 611 controls prospectively enrolled from 20 US centers between 2000–2006 in the North American Pancreatitis Study 2 (NAPS2). Responses to the SF-12 questionnaire were used to calculate the Mental (MCS) and Physical component summary scores (PCS) with norm based scoring (normal ≥50). QOL in CP subjects was compared with controls after controlling for demographic factors, drinking history, smoking and medical conditions. QOL in CP was also compared with known scores for several chronic conditions. Results Both PCS (38±11.5 vs. 52±9.4) and MCS (44±11.5 vs. 51±9.2) were significantly lower in CP compared with controls (p<0.001). On multivariable analyses, compared to controls, a profound decrease in physical QOL (PCS 12.02 points lower) and a clinically significant decrease in mental QOL (MCS 4.24 points lower) was seen due to CP. QOL in CP was similar to (heart, kidney, liver, lung disease) or worse than (non-skin cancers, diabetes mellitus, hypertension, rheumatoid arthritis) other chronic conditions. Conclusions The impact of CP on QOL appears substantial. The QOL in CP subjects appears to be worse or similar to the QOL of many other chronic conditions. PMID:23357924

  1. Improving quality of life in patients with hidradenitis suppurativa

    DEFF Research Database (Denmark)

    Dufour, D.N.; Esmann, S.; Jemec, G.B.

    2012-01-01

    Hidradenitis suppurativa is a chronic recurrent inflammatory skin disease with abscess formation and scarring predominantly in the inverse areas. The disease is often difficult to treat and patients experience a decreased quality of life (QoL) and related psychosocial morbidity. Current knowledge...... on improving QoL in patients with hidradenitis suppurativa is therefore reviewed. The literature is limited but indicates that there are two ways of improving patients' QoL: therapy of the somatic disease or psychosocial interventions....

  2. Development of a head and neck companion module for the quality of life-radiation therapy instrument (QOL-RTI)

    International Nuclear Information System (INIS)

    Trotti, Andy; Johnson, Darlene J.; Gwede, Clement; Casey, Linda; Sauder, Bonnie; Cantor, Alan; Pearlman, James

    1998-01-01

    Purpose/Objective: A review of available head and neck quality of life (QOL) instruments reveals them to inadequately address important radiation related side effects, or to be too cumbersome for routine use. The purpose of this study was to develop a head and neck disease specific module as a companion to the previously developed quality of life - radiation therapy instrument (QOL-RTI). The goal was to create a more complete, yet concise, head and neck site-specific module geared toward patients receiving radiation therapy for head and neck cancer. Methods and Materials: This exploratory study included 34 consecutive patients undergoing definitive radiotherapy over a 6-7 week course (60-79.8 Gy). We developed and administered a 14-item questionnaire to all eligible patients treated with radiotherapy for head and neck cancer who were not already registered in another research study assessing quality of life (e.g., RTOG). During the treatment period, the QOL-RTI general tool and the head and neck (H and N) module were administered as follows: at baseline, at week four (for test-retest), and at the end of the treatment period. For validation purposes the QOL-RTI/H and N was compared to the functional assessment cancer tool head and neck (FACT-H and N) questionnaire. The FACT-H and N was administered one time at week 4, on the same day as the QOL-RTI/H and N. This report includes the treatment phase of the study (during the course of radiation). Results: Mean age was 62 years (range 40-75). Internal consistency of the module was satisfactory (Chronbach's α = 0.85). Test-retest yielded a correlation coefficient of 0.90 (p < 0.001). Concurrent validity, established by comparing the module to the FACT/H and N , yielded a correlation coefficient of 0.85. Significant changes in quality of life scores during a course of radiation was noted for both general quality of life tool and the site specific module. For the head and neck module, the difference in the mean baseline

  3. QOL models constructed for the community-dwelling elderly with ikigai (purpose in life) as a composition factor, and the effect of habitual exercise.

    Science.gov (United States)

    Demura, Shinichi; Kobayashi, Hidetsugu; Kitabayashi, Tamotsu

    2005-09-01

    The purpose of this study was to construct QOL models for the elderly that included ikigai as a composition factor and to clarify differences in two kinds of models, one constructed for the elderly with habitual exercise and the other for those without it. The subjects were 1,566 healthy community-dwelling independent people aged 60 years or more (752 males, 814 females). First, the ratio of subjects with ikigai was calculated. The ratios of subjects with different kinds of objects of ikigai were also calculated. Next, structural equation models (SEM) were constructed on the basis of social, physical, and mental QOL and ikigai. Fits of the models were evaluated. To examine whether the presence or absence of habitual exercise caused any difference in the QOL model, subjects were divided into 4 groups according to whether they were male or female and whether they had or did not have an exercise habit. Multi-population group simultaneous analysis was then performed among the four groups. More than 85% of the subjects had objects of ikigai. Ikigai is an important factor for comprehending the QOL of the elderly. It was possible to construct QOL models for the elderly with ikigai as a composition factor. The effect of physical QOL on mental QOL was negligible in females irrespective of whether they had an exercise habit. The effect of social QOL on mental QOL was profound in aged females with an exercise habit. The effect of the living situation on mental QOL was profound in aged females without an exercise habit. The effect of mental QOL on ikigai was more marked in subjects without an exercise habit than in those with an exercise habit.

  4. Validity and reliability of the TED-QOL: a new three-item questionnaire to assess quality of life in thyroid eye disease.

    Science.gov (United States)

    Fayers, Tessa; Dolman, Peter J

    2011-12-01

    To develop and test a user-friendly questionnaire for rapidly assessing quality of life (QOL) in thyroid eye disease (TED). A three-item questionnaire, the TED-QOL, was designed and compared to the 16-item Graves Ophthalmopathy (GO)-QOL and the nine-item GO-Quality of Life Scale (QLS). 100 patients with TED were administered all three questionnaires on two occasions. Results were compared to clinical severity scores (Vision, Inflammation, Strabismus, Appearance (VISA) classification). Main outcomes were construct and criterion validity, test-retest reliability, duration, comprehension and completion rates. TED-QOL correlated strongly with the other questionnaires for corresponding items (Pearson correlation: appearance 0.71, 0.62; functioning 0.69, 0.66; overall QOL 0.53). Test-retest analysis demonstrated good reliability for all three questionnaires (intraclass correlations: TED-QOL 0.81, 0.74, 0.87; GO-QOL 0.81, 0.82; GO-QLS 0.74, 0.86, 0.67). TED-QOL was significantly faster to complete (1.6 min vs GO-QOL 3.1 min, GO-QLS 2.7 min, p<0.0001) and had a higher completion rate (100% vs GO-QOL 78%, GO-QLS 94%). There was only moderate correlation between items on all three questionnaires and VISA scores. The TED-QOL is rapid and easy to complete and analyse and has similar validity and reliability to longer questionnaires. All questionnaires showed only moderate correlation with disease severity, emphasising the discrepancy between objective and subjective assessments and the importance of measuring both.

  5. Treatment, patient and tumor characteristics impact quality of life (QOL) in patients with locally advanced head and neck cancer: Report of the radiation therapy oncology group (RTOG) trial 90-03

    International Nuclear Information System (INIS)

    Fisher, J.; Scott, C.; Fu, K.; Trotti, A.; Spencer, S.; Garden, A.; Phillips, T.; Movsas, B.; Byhardt, R.; Ang, K.

    2001-01-01

    radiotherapy, marital status, tumor site, and nutritional support all effect QOL during the first year post therapy. These data suggest that interventions prior to the start of therapy may improve QOL in long-term survivors

  6. Estimation of EuroQol 5-Dimensions health status utility values in hereditary angioedema.

    Science.gov (United States)

    Aygören-Pürsün, Emel; Bygum, Anette; Beusterien, Kathleen; Hautamaki, Emily; Sisic, Zlatko; Boysen, Henrik B; Caballero, Teresa

    2016-01-01

    To estimate health status utility (preference) weights for hereditary angioedema (HAE) during an attack and between attacks using data from the Hereditary Angioedema Burden of Illness Study in Europe (HAE-BOIS-Europe) survey. Utility measures quantitatively describe the net impact of a condition on a patient's life; a score of 0.0 reflects death and 1.0 reflects full health. The HAE-BOIS-Europe was a cross-sectional survey conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective. Survey items that overlapped conceptually with the EuroQol 5-Dimensions (EQ-5D) domains (pain/discomfort, mobility, self-care, usual activities, and anxiety/depression) were manually crosswalked to the corresponding UK population-based EQ-5D utility weights. EQ-5D utilities were computed for each respondent in the HAE-BOIS-Europe survey for acute attacks and between attacks. Overall, a total of 111 HAE-BOIS-Europe participants completed all selected survey items and thus allowed for computation of EQ-5D-based utilities. The mean utilities for an HAE attack and between attacks were 0.44 and 0.72, respectively. Utilities for an acute attack were dependent on the severity of pain of the last attack (0.61 for no pain or mild pain, 0.47 for moderate pain, and 0.08 for severe pain). There were no significant differences across countries. Mean utilities derived from the study approach compare sensibly with other disease states for both acute attacks and between attacks. The impacts of HAE translate into substantial health status disutilities associated with acute attacks as well as between attacks, documenting that the detrimental effects of HAE are meaningful from the patient perspective. Results were consistent across countries with regard to pain severity and in comparison to similar disease states. The results can be used to raise awareness of HAE as a serious disease with wide-ranging personal and social impacts.

  7. Measuring the quality of life of people with dementia in nursing homes in Germany - the study protocol for the Qol-Dem Project.

    Science.gov (United States)

    Dichter, Martin Nikolaus; Halek, Margareta; Dortmann, Olga; Meyer, Gabriele; Bartholomeyczik, Sabine

    2013-01-01

    QUALIDEM is a standardized dementia-specific quality of life (Qol) measurement, which was developed and validated in the Netherlands. A German version has been available since 2008. This study protocol describes the design and methodology for the quality of life of people with dementia (Qol-Dem) project. This project aims to evaluate the reliability and validity of the German version of the QUALIDEM. Due to the lack of both a universal definition of Qol and of standards to verify the validity of Qol measurements, this study is divided into three phases. The aim of the first theoretical phase is the development of a dementia-specific Qol model as a result of a meta-synthesis of qualitative studies. The second empirical phase consists of the three following steps: (a) an investigation of the scalability and internal consistency of the measure, (b) an evaluation of the interrater and intrarater reliability, and (c) an extensive evaluation of the validity of the QUALIDEM. The resulting Qol model (phase 1) will be used for the selection of appropriate comparators for validity testing. In the third phase, the QUALIDEM will be adapted, if necessary, based on the knowledge generated in the first two phases. The findings of the Qol-Dem project should deliver an accurate assessment of the psychometric properties of the German version of the QUALIDEM. The results will contribute to the further development of the instrument. Furthermore, the results will contribute to the theoretical development of the concept of Qol among people with dementia.

  8. Decreased QOL and muscle strength are persistent 1 year after intramedullary nailing of a tibial shaft fracture

    DEFF Research Database (Denmark)

    Larsen, Peter; Elsoe, Rasmus; Laessoe, Uffe

    2016-01-01

    was measured with the questionnaire Eq5D-5L and compared to norm data from a reference population. Recordings of pain and contralateral muscle strength (isometric maximal voluntary contraction (MVC) for knee flexion and extension were collected at 6 weeks, 3, 6, and 12 months postoperatively. Ipsilateral MVCs......INTRODUCTION:To evaluate the development in patient-reported quality of life (QOL) and muscle strength in the period from surgery to 12 months postoperatively after intramedullary nailing of a tibial shaft fracture. MATERIALS AND METHODS:The design was a prospective, follow-up cohort study. QOL...... compared to the reference population. Six and 12 months after surgery patients demonstrated decreased muscle strength in the injured leg compared to the non-injured leg for knee extension and flexion (P strength during knee...

  9. The influence of alendronate on the healing of extraction sockets of ovariectomized rats assessed by in vivo micro-computed tomography.

    Science.gov (United States)

    Jee, Jeong-Hyun; Lee, Wan; Lee, Byung Do

    2010-08-01

    Many dental patients take bisphosphonates to reduce the risk of hip and vertebral fractures. In vivo micro-computed tomography (micro-CT) was used to examine the longitudinal inhibitory effect of alendronate on the healing of extraction sockets in ovariectomized rats. Twenty 5-week-old Sprague-Dawley rats were assigned randomly to 1 of 3 groups: sham-operated (n = 5), and 2 ovariectomized (OVX) groups: saline treated (0.1 mL/100 g/d, n = 7) and alendronate treated (1 mg/kg/d, n = 8). Before micro-CT scanning, the left maxillary first molars of the rats were extracted. In vivo micro-CT (spatial resolution 50 x 50 mum) of the jaw was performed at baseline and at 2-week intervals for 6 weeks. Alveolar-bone radiographic densities and dimensions were analyzed with repeated measures analysis of variance. The bony healing patterns of the extraction sockets were also evaluated in each group. The radiographic socket densities of the sham-treated and OVX-alendronate groups significantly increased during the first 4 weeks after extraction (P sockets in the OVX-saline group increased, but the increase was significantly lower than for the other groups at 4 weeks (P sockets in all groups 2 to 6 weeks after extraction. There was a significant loss of alveolar ridge height at the second week postextraction compared with baseline, and at the fourth week compared with the second week (P sockets in estrogen-deficient rats and helps resist the loss of alveolar bone adjacent to extraction sockets. Copyright 2010 Mosby, Inc. All rights reserved.

  10. Adherence to alendronic or risedronic acid treatment, combined or not to calcium and vitamin D, and related determinants in Italian patients with osteoporosis

    Directory of Open Access Journals (Sweden)

    Calabria S

    2016-04-01

    Full Text Available S Calabria,1 E Cinconze,2 M Rossini,3 E Rossi,2 AP Maggioni,1,4 A Pedrini,1 M De Rosa2 1CORE, Collaborative Outcome Research, Bologna, Italy; 2Health Care Systems Department, CINECA, Interuniversity Consortium, Bologna, Italy; 3Rheumatology Unit, University of Verona, Verona, Italy; 4ANMCO Research Center, Firenze, ItalyPurpose: Osteoporosis is a chronic disease and an important health and social burden due to its worldwide prevalence. Literature and clinical experience report incomplete adherence to the therapy. This retrospective observational study aimed at assessing the adherence to first-line antiosteoporosis drugs (AODs; reimbursed by the National Health System, according to the Italian Medicine Agency recommendation number 79, alendronate or risedronate, with or without calcium and/or vitamin D supplements, in a real, Italian clinical setting.Patients and methods: Analyses were carried out on data present in the ARNO Observatory, a population-based patient-centric Italian database. From a population of 5,808,832 inhabitants with available data, a cohort of 3.3 million of patients aged ≥40 years was selected. New users of first-line AODs as monotherapy (accrual period, 2007–2009 were followed up over 3 years to assess adherence at 6, 12, and 36 months to AODs and to supplements and related determinants.Results: Approximately 40,000 new users were identified: mostly women, aged on average (standard deviation 71±10 years. Alendronate was the most prescribed (38.2% of patients, followed by risedronate (34.9% and alendronate with colecalciferol as a fixed-dose combination (25.8%. Adherence at the 6-month follow-up was 54%, and this constantly and significantly decreased after 1 year to 46%, and after 3 years to 33% (P<0.01. Adherence to the fixed-dose combination was higher than to plain alendronate throughout the follow-up period. Similarly, adherence to supplements constantly decreased with the duration of treatment. Women and patients

  11. Long-term functional outcomes of PPPD in children--Nutritional status, pancreatic function, GI function and QOL.

    Science.gov (United States)

    Park, Hwon-Ham; Kim, Hyun-Young; Jung, Sung-Eun; Lee, Seong-Cheol; Park, Kwi-Won

    2016-03-01

    The purpose of this study was to analyze the long-term outcomes, such as nutritional status, pancreatic function, gastrointestinal (GI) function, and quality of life (QOL), in children who underwent pylorus-preserving pancreaticoduodenectomy (PPPD). Between 1992 and 2013, there were 15 children who underwent PPPD at Seoul National University Children's Hospital, and 10 of them participated in this study. A retrospective review of the patients' medical records and follow-up was done. Their nutritional statuses were estimated by height, body weight, weight for age Z-score, body mass index (BMI), and serum protein, albumin levels. The endocrine and exocrine functions of the pancreas were estimated by diabetes mellitus (DM), steatorrhea, and Bristol stool chart. The GI function and QOL were evaluated via questionnaires. The follow-up period ranged from 3 to 18years. There were no severe growth disturbances, 6 patients experienced mild steatorrhea and 3 showed above the category 6 in Bristol stool chart. All the patients experienced mild GI symptoms. As for the QOL, there were no significant negative answers, except for one patient with DM. Almost all the study subjects, who underwent PPPD in their childhood, did not present significant problems except for one patient with DM. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Estimation of EuroQol 5-Dimensions health status utility values in hereditary angioedema

    Directory of Open Access Journals (Sweden)

    Aygören-Pürsün E

    2016-09-01

    Full Text Available Emel Aygören-Pürsün,1 Anette Bygum,2 Kathleen Beusterien,3 Emily Hautamaki,4 Zlatko Sisic,5 Henrik B Boysen,6 Teresa Caballero7 1Angioedema Centre, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany; 2Hereditary Angioedema Centre Denmark, Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark; 3Outcomes Research Strategies in Health, Washington, DC, 4Patient Reported Outcomes, Oxford Outcomes Inc., an ICON plc company, Bethesda, MD, USA; 5ViroPharma Incorporated, Chatsworth House, Maidenhead, UK; 6HAEi – Hereditary Angioedema International Patient Organization for C1 Inhibitor Deficiencies, Skanderborg, Denmark; 7Allergy Department, Hospital La Paz Institute for Health Research (IdiPaz, Biomedical Research Network on Rare Diseases U754 (CIBERER, University Hospital La Paz, Madrid, Spain Objective: To estimate health status utility (preference weights for hereditary angioedema (HAE during an attack and between attacks using data from the Hereditary Angioedema Burden of Illness Study in Europe (HAE-BOIS-Europe survey. Utility measures quantitatively describe the net impact of a condition on a patient’s life; a score of 0.0 reflects death and 1.0 reflects full health.Study design and methods: The HAE-BOIS-Europe was a cross-sectional survey conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective. Survey items that overlapped conceptually with the EuroQol 5-Dimensions (EQ-5D domains (pain/discomfort, mobility, self-care, usual activities, and anxiety/depression were manually crosswalked to the corresponding UK population-based EQ-5D utility weights. EQ-5D utilities were computed for each respondent in the HAE-BOIS-Europe survey for acute attacks and between attacks.Results: Overall, a total of 111 HAE-BOIS-Europe participants completed all selected survey items and thus allowed for computation

  13. The cover stent custody case that acknowledged QOL improvement on traffic between trachea and esophagus of esophagus cancer

    International Nuclear Information System (INIS)

    Nagase, Hirotsugu; Okada, Kazuyuki; Murata, Kohei

    2011-01-01

    The case was a 60-year-old man. The patient with a main complaint of husky voice was introduced by a nearby doctor to our otolaryngology department at the end of August 2009. Because of the wall thickening image of the upper part (Ut domain) esophagus, left infraclavicular lymph node and mediastium lymphadenopathy syndrome observed by head and neck CT, the patient was transferred to surgery department. Squamous cell carcinoma was diagnosed based on the upper part gastrointestinal tract endoscopy showing a type-3 advanced cancer of the upper thoracic esophagus sized 25-30 cm from nostril. The patient was in progressive disease (PD), fever and coughing, though we performed 2 FAP therapies. A chest CT revealed that there was a passage between the trachea and esophagus. Then, radiation therapy (a total of 60 Gy, 2 Gy at a time) was enforced. After the radio therapy, a covered type Ultraflex esophagus stent was inserted due to a fistula, though the tumor was reduced to 6 mm in size. The patient was passed away five months after the stent custody; a solid food intake was possible until just before he died. (author)

  14. Development and psychometric characteristics of the SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks and short forms and the SCI-QOL Bladder Complications scale.

    Science.gov (United States)

    Tulsky, David S; Kisala, Pamela A; Tate, Denise G; Spungen, Ann M; Kirshblum, Steven C

    2015-05-01

    To describe the development and psychometric properties of the Spinal Cord Injury--Quality of Life (SCI-QOL) Bladder Management Difficulties and Bowel Management Difficulties item banks and Bladder Complications scale. Using a mixed-methods design, a pool of items assessing bladder and bowel-related concerns were developed using focus groups with individuals with spinal cord injury (SCI) and SCI clinicians, cognitive interviews, and item response theory (IRT) analytic approaches, including tests of model fit and differential item functioning. Thirty-eight bladder items and 52 bowel items were tested at the University of Michigan, Kessler Foundation Research Center, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital, and the James J. Peters VA Medical Center, Bronx, NY. Seven hundred fifty-seven adults with traumatic SCI. The final item banks demonstrated unidimensionality (Bladder Management Difficulties CFI=0.965; RMSEA=0.093; Bowel Management Difficulties CFI=0.955; RMSEA=0.078) and acceptable fit to a graded response IRT model. The final calibrated Bladder Management Difficulties bank includes 15 items, and the final Bowel Management Difficulties item bank consists of 26 items. Additionally, 5 items related to urinary tract infections (UTI) did not fit with the larger Bladder Management Difficulties item bank but performed relatively well independently (CFI=0.992, RMSEA=0.050) and were thus retained as a separate scale. The SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks are psychometrically robust and are available as computer adaptive tests or short forms. The SCI-QOL Bladder Complications scale is a brief, fixed-length outcomes instrument for individuals with a UTI.

  15. Personal goals and factors related to QoL in Dutch homeless people: what is the role of goal-related self-efficacy?

    Science.gov (United States)

    van der Laan, Jorien; Boersma, Sandra N; van Straaten, Barbara; Rodenburg, Gerda; van de Mheen, Dike; Wolf, Judith R L M

    2017-05-01

    Very little is known about the personal goals of homeless people and how these relate to their quality of life (QoL). By using survey data on 407 homeless adults upon entry to the social relief system in 2011, we examined the personal goals of homeless adults and the association between their perceived goal-related self-efficacy and their QoL. A hierarchical regression analysis was used to analyse the association between QoL and goal-related self-efficacy, relative to factors contributing to QoL, such as demographic characteristics, socioeconomic resources, health and service use. Results indicate that the majority of homeless adults had at least one personal goal for the coming 6 months and that most goals concerned housing and daily life (94.3%) and finances (83.6%). The QoL of homeless adults appeared to be lower in comparison with general population samples. General goal-related self-efficacy was positively related to QoL (β = 0.09, P = 0.042), independent of socioeconomic resources (i.e. income and housing), health and service use. The strongest predictors of QoL were psychological distress (β = -0.45, P people as the starting point of integrated service programmes and to promote their goal-related self-efficacy by strength-based interventions. © 2017 John Wiley & Sons Ltd.

  16. Clinical Utility and Psychometric Properties of the Traumatic Brain Injury Quality of Life Scale (TBI-QOL) in US Military Service Members.

    Science.gov (United States)

    Lange, Rael T; Brickell, Tracey A; Bailie, Jason M; Tulsky, David S; French, Louis M

    2016-01-01

    To examine the clinical utility and psychometric properties of the Traumatic Brain Injury Quality of Life (TBI-QOL) scale in a US military population. One hundred fifty-two US military service members (age: M = 34.3, SD = 9.4; 89.5% men) prospectively enrolled from the Walter Reed National Military Medical Center and other nationwide community outreach initiatives. Participants included 99 service members who had sustained a mild traumatic brain injury (TBI) and 53 injured or noninjured controls without TBI (n = 29 and n = 24, respectively). Participants completed the TBI-QOL scale and 5 other behavioral measures, on average, 33.8 months postinjury (SD = 37.9). Fourteen TBI-QOL subscales; Neurobehavioral Symptom Inventory; Posttraumatic Stress Disorder Checklist-Civilian version; Alcohol Use Disorders Identification Test; Combat Exposure Scale. The internal consistency reliability of the TBI-QOL scales ranged from α = .91 to α = .98. The convergent and discriminant validity of the 14 TBI-QOL subscales was high. The mild TBI group had significantly worse scores on 10 of the 14 TBI-QOL subscales than the control group (range, P quality of life in a mild TBI military sample. Additional research is recommended to further evaluate the clinical utility of the TBI-QOL scale in both military and civilian settings.

  17. Development of a head and neck companion module for the quality of life - radiation therapy instrument (QOL-RTI)

    International Nuclear Information System (INIS)

    Trotti, Andy; Johnson, Darlene J.; Gwede, Clement; Casey, Linda; Cantor, Alan

    1997-01-01

    Purpose/Objective: The purpose of this study is to develop a Likert version, disease specific module for the Quality of Life - Radiation Therapy Instrument (QOL-RTI) for head and neck patients. This module combined with the QOL-RTI may help us to determine what changes, if any, occur in the quality of life of patients receiving primary radiation therapy for head and neck cancer. A compelling reason to study head and neck patients is because of the extensive difficulties these patients experience while undergoing radiotherapy. Their psychological and emotional well-being may also have an adverse affect on their quality of life as they strive to cope with both a life-threatening disease and with the prospect of disfigurement or dysfunction that cannot be hidden from view. Many tools have been developed to measure quality of life, however, previously published literature has focused on quantifying functional status and toxicity assessment rather than the alteration of quality of life as perceived by the patient. This study, limited to patients receiving primary radiation, is expected to yield a tool that is applicable to the patient receiving multi-modality treatment for head and neck cancer and will be useful to the physician/nurse in determining interventions for these patients. Materials and Methods: This study is an uncontrolled, non-randomized exploratory study, including fifty (50) consecutive eligible patients undergoing definitive primary radiotherapy. The questionnaires were given to all eligible patients being treated with radiotherapy for head and neck cancer who are not already registered on another research study assessing Quality of Life (i.e. RTOG). During the 5-8 week treatment period, the QOL-RTI/H and N instrument is administered as follows: at baseline evaluation (immediately prior to the beginning of radiotherapy), at week four (4) two days in a row (for test-retest) and at the end of the treatment period. For validation purposes the QOL-RTI/H and

  18. Systematic review and meta-analysis of the efficacy and safety of alendronate and zoledronate for the treatment of postmenopausal osteoporosis.

    Science.gov (United States)

    Serrano, Ana Julissa; Begoña, Leire; Anitua, Eduardo; Cobos, Raquel; Orive, Gorka

    2013-12-01

    The aim of this meta-analysis was to evaluate the efficacy and safety of two bisphosphonates (alendronate and zoledronate) in the treatment of postmenopausal osteoporosis. The incidence of fractures was considered as primary endpoint. Only randomized trials with a follow-up period of 1 year or more were included in this systematic review and meta-analysis. We excluded studies that included patients with secondary osteoporosis especially in relation to therapy with corticosteroids or other drugs or diseases known to affect bone mineral density. Studies published as subgroup analysis, extension studies, economic evaluations, and comparisons with active control were excluded. The methodological quality of controlled clinical trials that met these inclusion criteria was evaluated. No studies were excluded from analysis due to lack of quality. The risk ratio of hip, vertebral and wrist fractures for alendronate were 0.61 [95% confidence interval (CI) 0.40-0.93], 0.54 (95% CI 0.44-0.66) and 0.65 (95% CI 0.33-1.25), respectively. Zoledronate risk ratio was 0.62 (95% CI 0.46-0.82) and 0.38 (95% CI 0.22-0.67) for hip and vertebral fractures, respectively.

  19. Orthognathic surgery improves quality of life and depression, but not anxiety, and patients with higher preoperative depression scores improve less.

    Science.gov (United States)

    Brunault, P; Battini, J; Potard, C; Jonas, C; Zagala-Bouquillon, B; Chabut, A; Mercier, J-M; Bedhet, N; Réveillère, C; Goga, D; Courtois, R

    2016-01-01

    This study assessed quality of life (QoL), depression, and anxiety before and after orthognathic surgery and identified risk factors for poorer postoperative outcome. This multicentre prospective study included 140 patients from five French medical centres. We assessed patients before surgery (T1), 3 months after surgery (T2), and 12 months after surgery (T3). We assessed the severity of the orofacial deformity, physical, psychological, social, and environmental QoL (WHOQOL-BREF), and depression and anxiety (GHQ-28). Risk factors for poorer outcome were identified using linear mixed models. Between baseline and 12 months, there was significant improvement in psychological and social QoL and in depression (although below the norms reported in the general population), but not in anxiety. Physical QoL was poorer in patients who were younger, who had a mild orofacial deformity, and who were depressed. Psychological QoL was poorer in younger patients and in depressed patients. Social QoL was poorer in patients who were single, who had a mild orofacial deformity, and who were depressed. Although orthognathic surgery provides a moderate improvement in psychological and social QoL, the systematic screening and treatment of depression could further improve QoL after surgery because it is a major predictor of poor QoL in this population. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Neuro-QOL: brief measures of health-related quality of life for clinical research in neurology.

    Science.gov (United States)

    Cella, D; Lai, J-S; Nowinski, C J; Victorson, D; Peterman, A; Miller, D; Bethoux, F; Heinemann, A; Rubin, S; Cavazos, J E; Reder, A T; Sufit, R; Simuni, T; Holmes, G L; Siderowf, A; Wojna, V; Bode, R; McKinney, N; Podrabsky, T; Wortman, K; Choi, S; Gershon, R; Rothrock, N; Moy, C

    2012-06-05

    To address the need for brief, reliable, valid, and standardized quality of life (QOL) assessment applicable across neurologic conditions. Drawing from larger calibrated item banks, we developed short measures (8-9 items each) of 13 different QOL domains across physical, mental, and social health and evaluated their validity and reliability. Three samples were utilized during short form development: general population (Internet-based, n = 2,113); clinical panel (Internet-based, n = 553); and clinical outpatient (clinic-based, n = 581). All short forms are expressed as T scores with a mean of 50 and SD of 10. Internal consistency (Cronbach α) of the 13 short forms ranged from 0.85 to 0.97. Correlations between short form and full-length item bank scores ranged from 0.88 to 0.99 (0.82-0.96 after removing common items from banks). Online respondents were asked whether they had any of 19 different chronic health conditions, and whether or not those reported conditions interfered with ability to function normally. All short forms, across physical, mental, and social health, were able to separate people who reported no health condition from those who reported 1-2 or 3 or more. In addition, scores on all 13 domains were worse for people who acknowledged being limited by the health conditions they reported, compared to those who reported conditions but were not limited by them. These 13 brief measures of self-reported QOL are reliable and show preliminary evidence of concurrent validity inasmuch as they differentiate people based upon number of reported health conditions and whether those reported conditions impede normal function.

  1. Quality of life in postmenopausal women: translation and validation of MSkinQOL questionnaire to measure the effect of a skincare product in USA.

    Science.gov (United States)

    Segot-Chicq, Evelyne; Fanchon, Chantal

    2013-12-01

    The 28-item Menopausal Skin Quality Of Life (MSkinQOL), a previously validated French questionnaire, developed to assess psychological features of menopausal women and to measure the benefits of using cosmetic skincare products was translated and validated to assess a skincare product in the USA. Construct validity, reliability, reproducibility, and responsiveness were assessed with two groups of 100 nonmenopausal (NM) and 100 postmenopausal (PM) women. The group of PM women applied a specially developed skincare product twice daily for 1 month and filled in the same questionnaire after 1 month as well as a general self-assessment questionnaire about the efficacy and cosmetic properties of the product. No ceiling or floor effects were identified. Construct and internal validity was assessed using a multitrait analysis: questionnaire items proved closely correlated, and each dimension covers a different aspect of women answers profile. The three dimensions showed good reliability and stability. Baseline values for social effects of skin appearance, health status, and self-esteem were significantly different between PM and NM volunteers. Values of these three dimensions were significantly improved after 2 weeks of product application, and further improved after 4 weeks. This study shows that a careful translation and a rigorous process of validation lead to a reliable tool adapted to each country to explore and measure quality of life in healthy PM women. © 2013 Wiley Periodicals, Inc.

  2. The hydrogen sulfide donor, Lawesson's reagent, prevents alendronate-induced gastric damage in rats

    Energy Technology Data Exchange (ETDEWEB)

    Nicolau, L.A.D. [Núcleo de Pesquisa em Produtos Naturais, Departamento de Farmacologia, Universidade Federal do Piauí, Teresina, PI (Brazil); Silva, R.O.; Damasceno, S.R.B.; Carvalho, N.S.; Costa, N.R.D. [Laboratório de Fisiofarmacologia Experimental, Centro de Pesquisa em Biodiversidade e Biotecnologia, Universidade Federal do Piauí, Parnaíba, PI (Brazil); Aragão, K.S. [Laboratório de Farmacologia da Inflamação e do Câncer, Departamento de Farmacologia, Universidade Federal do Ceará, Fortaleza, CE (Brazil); Barbosa, A.L.R. [Núcleo de Pesquisa em Produtos Naturais, Departamento de Farmacologia, Universidade Federal do Piauí, Teresina, PI (Brazil); Laboratório de Fisiofarmacologia Experimental, Centro de Pesquisa em Biodiversidade e Biotecnologia, Universidade Federal do Piauí, Parnaíba, PI (Brazil); Soares, P.M.G.; Souza, M.H.L.P. [Laboratório de Farmacologia da Inflamação e do Câncer, Departamento de Farmacologia, Universidade Federal do Ceará, Fortaleza, CE (Brazil); Medeiros, J.V.R. [Núcleo de Pesquisa em Produtos Naturais, Departamento de Farmacologia, Universidade Federal do Piauí, Teresina, PI (Brazil); Laboratório de Fisiofarmacologia Experimental, Centro de Pesquisa em Biodiversidade e Biotecnologia, Universidade Federal do Piauí, Parnaíba, PI (Brazil)

    2013-08-16

    Our objective was to investigate the protective effect of Lawesson's reagent, an H{sub 2}S donor, against alendronate (ALD)-induced gastric damage in rats. Rats were pretreated with saline or Lawesson's reagent (3, 9, or 27 µmol/kg, po) once daily for 4 days. After 30 min, gastric damage was induced by ALD (30 mg/kg) administration by gavage. On the last day of treatment, the animals were killed 4 h after ALD administration. Gastric lesions were measured using a computer planimetry program, and gastric corpus pieces were assayed for malondialdehyde (MDA), glutathione (GSH), proinflammatory cytokines [tumor necrosis factor (TNF)-α and interleukin (IL)-1β], and myeloperoxidase (MPO). Other groups were pretreated with glibenclamide (5 mg/kg, ip) or with glibenclamide (5 mg/kg, ip)+diazoxide (3 mg/kg, ip). After 1 h, 27 µmol/kg Lawesson's reagent was administered. After 30 min, 30 mg/kg ALD was administered. ALD caused gastric damage (63.35±9.8 mm{sup 2}); increased levels of TNF-α, IL-1β, and MDA (2311±302.3 pg/mL, 901.9±106.2 pg/mL, 121.1±4.3 nmol/g, respectively); increased MPO activity (26.1±3.8 U/mg); and reduced GSH levels (180.3±21.9 µg/g). ALD also increased cystathionine-γ-lyase immunoreactivity in the gastric mucosa. Pretreatment with Lawesson's reagent (27 µmol/kg) attenuated ALD-mediated gastric damage (15.77±5.3 mm{sup 2}); reduced TNF-α, IL-1β, and MDA formation (1502±150.2 pg/mL, 632.3±43.4 pg/mL, 78.4±7.6 nmol/g, respectively); lowered MPO activity (11.7±2.8 U/mg); and increased the level of GSH in the gastric tissue (397.9±40.2 µg/g). Glibenclamide alone reversed the gastric protective effect of Lawesson's reagent. However, glibenclamide plus diazoxide did not alter the effects of Lawesson's reagent. Our results suggest that Lawesson's reagent plays a protective role against ALD-induced gastric damage through mechanisms that depend at least in part on activation of ATP-sensitive potassium (K

  3. The hydrogen sulfide donor, Lawesson's reagent, prevents alendronate-induced gastric damage in rats

    International Nuclear Information System (INIS)

    Nicolau, L.A.D.; Silva, R.O.; Damasceno, S.R.B.; Carvalho, N.S.; Costa, N.R.D.; Aragão, K.S.; Barbosa, A.L.R.; Soares, P.M.G.; Souza, M.H.L.P.; Medeiros, J.V.R.

    2013-01-01

    Our objective was to investigate the protective effect of Lawesson's reagent, an H 2 S donor, against alendronate (ALD)-induced gastric damage in rats. Rats were pretreated with saline or Lawesson's reagent (3, 9, or 27 µmol/kg, po) once daily for 4 days. After 30 min, gastric damage was induced by ALD (30 mg/kg) administration by gavage. On the last day of treatment, the animals were killed 4 h after ALD administration. Gastric lesions were measured using a computer planimetry program, and gastric corpus pieces were assayed for malondialdehyde (MDA), glutathione (GSH), proinflammatory cytokines [tumor necrosis factor (TNF)-α and interleukin (IL)-1β], and myeloperoxidase (MPO). Other groups were pretreated with glibenclamide (5 mg/kg, ip) or with glibenclamide (5 mg/kg, ip)+diazoxide (3 mg/kg, ip). After 1 h, 27 µmol/kg Lawesson's reagent was administered. After 30 min, 30 mg/kg ALD was administered. ALD caused gastric damage (63.35±9.8 mm 2 ); increased levels of TNF-α, IL-1β, and MDA (2311±302.3 pg/mL, 901.9±106.2 pg/mL, 121.1±4.3 nmol/g, respectively); increased MPO activity (26.1±3.8 U/mg); and reduced GSH levels (180.3±21.9 µg/g). ALD also increased cystathionine-γ-lyase immunoreactivity in the gastric mucosa. Pretreatment with Lawesson's reagent (27 µmol/kg) attenuated ALD-mediated gastric damage (15.77±5.3 mm 2 ); reduced TNF-α, IL-1β, and MDA formation (1502±150.2 pg/mL, 632.3±43.4 pg/mL, 78.4±7.6 nmol/g, respectively); lowered MPO activity (11.7±2.8 U/mg); and increased the level of GSH in the gastric tissue (397.9±40.2 µg/g). Glibenclamide alone reversed the gastric protective effect of Lawesson's reagent. However, glibenclamide plus diazoxide did not alter the effects of Lawesson's reagent. Our results suggest that Lawesson's reagent plays a protective role against ALD-induced gastric damage through mechanisms that depend at least in part on activation of ATP-sensitive potassium (K ATP ) channels

  4. Transcultural adaptation and validation of the Celiac Disease Quality of Life (CD-QOL survey, a specific questionnaire to measure quality of life in patients with celiac disease

    Directory of Open Access Journals (Sweden)

    Francesc Casellas

    2013-12-01

    Full Text Available Introduction: celiac disease is a chronic condition that requires continued treatment, with the resultant impact on health-related quality of life (HRQOL of people who suffer it. Most studies in this field have used generic questionnaires to measure HRQOL in celiac patients. It was therefore decided to conduct a study to translate into Spanish and validate a specific questionnaire for celiac disease, the Celiac Disease Quality Of Life Survey (CD-QOL. Objectives: to translate and validate in Spanish the specific celiac disease questionnaire CD-QOL. Methods: a multicenter, prospective, observational study was designed consisting of two phases: In the first phase, the questionnaire was translated and adapted into Spanish using the translation/back translation procedure and an understandability study. In the second phase, internal consistency of the translated questionnaire was analyzed. For this, results of the CD-QOL were compared to those of EuroQol and the Daily Fatigue Impact Scale (D-FIS. Understandability of the translated and adapted questionnaire was tested in six patients, and the validation study was done in 298 celiac patients (201 treated with a gluten-free diet and 97 at diagnosis. Results: in both celiac groups, Cronbach's alpha coefficient was high (0.90, feasibility was excellent (99.2 % of patients completed all questions, and there were no ceiling and floor effects. Spearman correlation to EuroQol and D-FIS was statistically significant (p < 0.05. CD-QOL score was different depending on whether state of health was good, fair, or poor based on the EuroQol score. Conclusion: the Spanish version of the CD-QOL is a valid tool for measuring HRQOL in celiac patients.

  5. Quality of life in patients with fibromyalgia: validation and psychometric properties of the German Quality of Life Scale (QOLS-G).

    Science.gov (United States)

    Offenbächer, Martin; Sauer, Sebastian; Kohls, Niko; Waltz, Millard; Schoeps, Peter

    2012-10-01

    Our objectives were to translate the Quality of Life Scale (QOLS) into German and to evaluate its reliability and validity for the use in patients with fibromyalgia (FMS). Together with German versions of the Fibromyalgia Impact Questionnaire (FIQ), the SF-36, a tender point count (TPC) and other questionnaires, we administered the QOLS to 146 patients with FMS. Patients were asked about the severity of pain today (VAS) and the duration of symptoms. Test-retest reliability was assessed using Spearman's correlations. Internal consistency was evaluated with Cronbach's alpha. Construct validity of the QOLS was evaluated by correlating the QOLS with the FIQ, the SF-36, the Beck Depression Inventory (BDI), and the Symptom Checklist (SCL-90-R) as well as with the pain variables. An exploratory factor analysis (EFA) was also conducted. Mean age was 53.1 years. Means were for pain today 6.8 and for duration of symptoms 11.8 years. Test-retest reliability for the total QOLS was rho = .91. Internal consistency was α = .90. Low-to-moderate correlations were obtained between the QOLS and the total FIQ (rho = -.42), the SF-36 (e.g. physical functioning rho = .37; mental health rho = .56) as well as the pain variables (VAS rho = -.11 ns; TPC rho = -.20). Psychological variables were moderately to substantially correlated with the QOLS (e.g. BDI rho = -.61). An EFA suggested a three-factor solution. The QOLS-G is a reliable and valid instrument for measuring quality of life in German patients with FMS.

  6. Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease.

    Science.gov (United States)

    van der Valk, Eline S; Smans, Lisanne C C J; Hofstetter, Hedwig; Stubbe, Janine H; de Vries, Marieke; Backx, Frank J G; Hermus, Ad R M M; Zelissen, Pierre M J

    2016-09-01

    Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. The aim of this study was to investigate the quality of life in Dutch patients with Addison's disease particularly regarding the presence of fatigue and the ability to be physically active. In this cross-sectional study, a postal survey was performed among Dutch patients with Addison's disease on stable glucocorticoid replacement therapy with hydrocortisone or cortisone acetate. For quality of life and physical activity assessment, patients completed general and health-related quality of life and physical activity questionnaires, and scores were compared to Dutch controls. A total of 328 patients with Addison's disease were studied. In patients with Addison's disease, only 45·7% met the standard of physical activity (Combinorm) compared to 67·8% of Dutch controls (P < 0·01). Forty-eight per cent of patients showed abnormal fatigue, while 61% had severe fatigue. The CIS fatigue scores were significantly higher compared to controls (P < 0·01). We found reduced general subjective health-related QoL scores in both male and female patients, especially in younger patients <65 years of age. Physical activity is decreased in patients with Addison's disease, combined with a reduced subjective health-related QoL and increased fatigue. © 2016 John Wiley & Sons Ltd.

  7. Multiattribute health utility scoring for the computerized adaptive measure CAT-5D-QOL was developed and validated.

    Science.gov (United States)

    Kopec, Jacek A; Sayre, Eric C; Rogers, Pamela; Davis, Aileen M; Badley, Elizabeth M; Anis, Aslam H; Abrahamowicz, Michal; Russell, Lara; Rahman, Md Mushfiqur; Esdaile, John M

    2015-10-01

    The CAT-5D-QOL is a previously reported item response theory (IRT)-based computerized adaptive tool to measure five domains (attributes) of health-related quality of life. The objective of this study was to develop and validate a multiattribute health utility (MAHU) scoring method for this instrument. The MAHU scoring system was developed in two stages. In phase I, we obtained standard gamble (SG) utilities for 75 hypothetical health states in which only one domain varied (15 states per domain). In phase II, we obtained SG utilities for 256 multiattribute states. We fit a multiplicative regression model to predict SG utilities from the five IRT domain scores. The prediction model was constrained using data from phase I. We validated MAHU scores by comparing them with the Health Utilities Index Mark 3 (HUI3) and directly measured utilities and by assessing between-group discrimination. MAHU scores have a theoretical range from -0.842 to 1. In the validation study, the scores were, on average, higher than HUI3 utilities and lower than directly measured SG utilities. MAHU scores correlated strongly with the HUI3 (Spearman ρ = 0.78) and discriminated well between groups expected to differ in health status. Results reported here provide initial evidence supporting the validity of the MAHU scoring system for the CAT-5D-QOL. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. A randomized assessment of three quality of life (QOL) questionnaires for prostate cancer patients undergoing different radiation treatment modalities

    International Nuclear Information System (INIS)

    Senter, K.K.; Hardy, M.; Flynn, C.; Lewis, L.; Wallace, M.; Boyea, G.; Mitchell, C.; Fluellen, L.; Henry, C.St.; Martinez, A.

    2001-01-01

    Purpose: The goal of this prospective, randomized study was to assess and compare compliance of patients diagnosed with prostate cancer to completing three different validated QOL instruments pre-treatment and six months later. Materials and Methods: Between April 2000 and April 2001, 124 patients were asked to fill out only one of three randomly selected QOL questionnaires (version A, B, C). Each addressed urinary and sexual function. One also addressed patients' physical, social, family, emotional, and functional well being. Study patients received External Beam Radiation Therapy (EBRT) or Brachytherapy (BRACHY), according to departmental policy. Exclusion criteria included current/previous hormone therapy and prostatectomy. Patients were asked to return the questionnaire at their first treatment visit. The three tools were: A The Functional Assessment of Cancer Therapy for Prostate Patients (FACT-P), The Sexual Adjustments Questionnaire (SAQ), and The American Urological Association (AUA) Questionnaire. The Fact-P questionnaire elicits information about physical, social, family, emotional, and functional well being as they relate to prostate cancer. SAQ focuses on sexual function; the AUA on urinary symptoms. B SAQ and AUA only; identical to Version A, but does not address physical, social, family, emotional, and functional well-being. C The International Prostate Symptom Score (I-PSS) Questionnaire, which addresses urinary symptoms and Patient Sexual Function Questionnaire, which focuses on erectile function. Additionally, patients were asked to respond yes/no to four variables designed to evaluate these questionnaires: 1) ease of understanding, 2) too personal, 3)addresses concerns regarding urinary function and sexual potency and 4) willingness to complete questionnaire in six months. These variables were examined for any trends that may exist between the different questionnaires. Results: Fifteen (12%) of the 124 patients returned incomplete questionnaires

  9. Quality of life in patients with Irritable Bowel Syndrome (IBS), assessed using the IBS-Quality of Life (IBS-QOL) measure after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide: results of an international prospective observational cohort study in Poland, Egypt, Mexico and China.

    Science.gov (United States)

    Hou, Xiaohua; Chen, Shengliang; Zhang, Yali; Sha, Weihong; Yu, Xiaofeng; Elsawah, Hesham; Afifi, Afifi Fahmy; El-Khayat, Hisham Raafat; Nouh, Alaa; Hassan, Mohamed Fathalla; Fatah, Ayman Abdel; Rucker Joerg, Isabel; Sánchez Núñez, Juan Manuel; Osthoff Rueda, Rodolfo; Jurkowska, Grazyna; Walczak, Michal; Malecka-Panas, Ewa; Linke, Krzysztof; Hartleb, Marek; Janssen-van Solingen, Gwendolyn

    2014-11-01

    Irritable Bowel Syndrome (IBS) has a substantial impact on health-related quality of life (HR-QoL) but high-quality data pre- and post-treatment using the IBS-Quality of Life (IBS-QOL) measure are limited. The objective of this study was to evaluate the changes from baseline of the IBS-QOL scores, symptom scores and health economic data in IBS patients, after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide. This was a prospective observational cohort study in patients with IBS, diagnosed using the Rome III criteria in four countries (Poland, Egypt, Mexico and China). A total of 607 patients were enrolled. At baseline, the IBS-QOL total scores were 52.0 in Poland, 48.9 in Egypt, 51.9 in Mexico, 76.4 in China and 56.4 overall. Increases in IBS-QOL total score were statistically significant at Weeks 4 and 8 overall and in each country (overall: 11.8 at Week 4, 24.3 at Week 8; p < 0.001). Improvements were shown in all IBS-QOL subscales and scores. Symptoms and health economic outcomes were improved. Furthermore, the favourable safety profile of these treatments was confirmed in this study. This study demonstrated that IBS patients have a substantially reduced HR-QoL and that treatment with mebeverine hydrochloride or pinaverium bromide improved HR-QoL.

  10. Is the content of the Chinese Quality of Life Instrument (ChQOL) really valid in the context of traditional Chinese medicine in Hong Kong?

    Science.gov (United States)

    Wong, Wendy; Lam, Cindy L K; Leung, K F; Zhao, L

    2009-01-01

    Content validity is crucial in quality of life instrument development but there is very little literature on this in Chinese culture. The Chinese Quality of Life Instrument (ChQOL) was developed in Mainland China to capture the health-related quality of life (HRQOL) concepts specific to traditional Chinese medicine (TCM). The aim of this study was to evaluate the content validity of ChQOL in a Chinese population whose spoken dialect and health-care system are different from those of Mainland China to find out whether the instrument is generalizable. 8 TCM practitioners and 10 patients rated the clarity, relevance and appropriateness of each of the 50 items of the ChQOL (HK version), and completed qualitative cognitive debriefing interviews. The content of ChQOL was rated valid by TCM practitioners with CVIs on clarity, relevance and appropriateness ranging from 80 to 100%. 49 out of 50 items were well understood by patients, but 12 items had CVI on relevance and 5 items had CVI on appropriateness lower than 70% among patients. After reviewing the patients and TCM practitioners' opinions, revisions were made for three items (2, 8 and 29) to form the ChQOL (HK version)-2008. In general, the ChQOL was found to be too long which called for shorter version. The content of ChQOL was shown to be really valid in the context of Chinese Medicine for Cantonese speaking Chinese. There was some discrepancy between the judgments of TCM practitioners and patients indicating the importance of evaluation by both experts and lay persons.

  11. The impact of dysphagia on quality of life in ageing and Parkinson's disease as measured by the swallowing quality of life (SWAL-QOL) questionnaire.

    Science.gov (United States)

    Leow, Li Pyn; Huckabee, Maggie-Lee; Anderson, Tim; Beckert, Lutz

    2010-09-01

    This prospective, cross-sectional study evaluated the impact of dysphagia on quality of life in healthy ageing and in subjects with Parkinson's disease (PD) using the Swallowing Quality of Life (SWAL-QOL) questionnaire. Sixteen healthy young adults (8 males, mean age = 25.1 years) and 16 healthy elders (8 males, mean age = 72.8 years) were recruited. Thirty-two subjects with idiopathic PD (mean age = 68.5 years) were recruited from a movement disorders clinic. The severity of PD was staged using the Hoehn and Yahr scale. Results revealed that elders experienced symptoms of dysphagia more frequently than young adults but the overall SWAL-QOL scores were not significantly different. Subjects with PD who experienced dysphagia reported greatly reduced QOL, and significant differences were found in all but one subsection of the SWAL-QOL. Disease progression detrimentally impacts QOL, with subjects in later-stage PD experiencing further reduction in the desire to eat, difficulty with food selection, and prolonged eating duration. These features, which increase with disease severity, are likely to impact negatively upon nutritional status, which is already under threat from PD-related dysphagia.

  12. Measuring anxiety after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Anxiety item bank and linkage with GAD-7.

    Science.gov (United States)

    Kisala, Pamela A; Tulsky, David S; Kalpakjian, Claire Z; Heinemann, Allen W; Pohlig, Ryan T; Carle, Adam; Choi, Seung W

    2015-05-01

    To develop a calibrated item bank and computer adaptive test to assess anxiety symptoms in individuals with spinal cord injury (SCI), transform scores to the Patient Reported Outcomes Measurement Information System (PROMIS) metric, and create a statistical linkage with the Generalized Anxiety Disorder (GAD)-7, a widely used anxiety measure. Grounded-theory based qualitative item development methods; large-scale item calibration field testing; confirmatory factor analysis; graded response model item response theory analyses; statistical linking techniques to transform scores to a PROMIS metric; and linkage with the GAD-7. Setting Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Participants Adults with traumatic SCI. Spinal Cord Injury-Quality of Life (SCI-QOL) Anxiety Item Bank Seven hundred sixteen individuals with traumatic SCI completed 38 items assessing anxiety, 17 of which were PROMIS items. After 13 items (including 2 PROMIS items) were removed, factor analyses confirmed unidimensionality. Item response theory analyses were used to estimate slopes and thresholds for the final 25 items (15 from PROMIS). The observed Pearson correlation between the SCI-QOL Anxiety and GAD-7 scores was 0.67. The SCI-QOL Anxiety item bank demonstrates excellent psychometric properties and is available as a computer adaptive test or short form for research and clinical applications. SCI-QOL Anxiety scores have been transformed to the PROMIS metric and we provide a method to link SCI-QOL Anxiety scores with those of the GAD-7.

  13. 阿仑膦酸钠对绝经后骨质疏松性骨痛的疗效分析%Effect analysis of alendronate on postmenopausal osteoporosis with bone ache

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@ Background: Osteoporosis is a metabolic bone disease characterized by low bone component and regeneration of the microstructure of bone tissues, osteoporosis occurs in postmenopausal women for decreased estrogen level. Those women with osteoporosis often suffer from bone ache, such as pain at low back, back, knees and heels. In severe cases, there may be crookback or non- violent fracture. Objective: To discuss treatment effect of the Alendronate on 56 postmenopausal women with bone ache caused by osteoporosis. Unit: 210 Hospital of PLA.

  14. Determinants of quality of life (QoL) and quality of university life (QuL) in Malaysian public university students

    Science.gov (United States)

    Haron, Halilah; Osman, Balkish Mohd; Maidinsah, Hamidah; Sari, Maznita Maksari @ Md; Zaki, Nurul Qusna Mohd

    2015-02-01

    Quality of life (QoL) refers to the degree of satisfaction, or the sense of well being, people experience in organizations including universities. The quality of life students experience in a university increases when they believe their needs are aligned with the goals of the university because they perceive that the university is responsive to their needs. Quality of University Life (QuL) refers to the students' ability to stabilize their life regarding social activities, academic performance, health and spiritual. A study was undertaken to investigate the accountability of Universiti Teknologi MARA (UiTM), Malaysia, in terms of teaching and learning. The objective of this paper is to identify and evaluate the determinants of QoL and QuL measurement models. Data from 788 students who responded to a set of questionnaire were collected from nine faculties. Factor analysis performed on the data resulted in six determinants for QuL; friendly, skills, satisfaction, interest, learning and feeling. Only two determinants, environment and quality represented QoL. Results indicated that the measures were highly reliable (in terms of internal consistency) based on Cronbach Alpha values ranging from 0.705 to 0.905 for QuL and 0.826 to 0.888 for QoL. Construct validity was supported by Average Variance Extraction values of more than 0.5 for QuL (0.481 - 0.724) and QoL. (0.503 and 0.519). The construct reliability (CR) values ranging between 0.623 to 0.882 for QuL and 0.731 to 0.815 for QoL suggested good reliability construct.

  15. Improving quality of life and physical health in patients with schizophrenia

    DEFF Research Database (Denmark)

    Hjorth, Peter; Medici, Clara Reece; Juel, Anette

    2017-01-01

    BACKGROUND: Patients with schizophrenia experience low quality of life (QoL) and poor physical health, which is explained, in part, by unhealthy lifestyle, tobacco smoking, poor diet and sedentary behavior. AIM: To measure QoL and physical health in patients with schizophrenia and to quantify...... associations between QoL and physical health. METHODS: This was a naturalistic longitudinal 30-month follow-up study including individual guidance, group sessions and treatment as usual. RESULTS: We included 190 patients. QoL was low among newly diagnosed patients. Higher body mass index was significantly...... associated with lower QoL. Newly diagnosed male patients showed lower QoL compared with females. Newly diagnosed patients experienced worsened health during the study period. In contrast, long-term schizophrenic patients started with worse physical health but improved with regard to weight, waist...

  16. An analysis of quality of life (QOL) in patients with epilepsy and comorbid psychogenic nonepileptic seizures (PNES) after vagus nerve stimulation (VNS).

    Science.gov (United States)

    Vivas, Andrew C; Reitano, Christian J; Waseem, Hena; Benbadis, Selim R; Vale, Fernando L

    2017-08-01

    Patients with epilepsy (PWE) may suffer from comorbid psychogenic nonepileptic seizures (PNES). The efficacy of vagus nerve stimulation (VNS) in the treatment of epilepsy and depression is established, however the impact on PNES is unknown. Since many patients with PNES have comorbid depression, we explored the impact on quality of life (QOL) that VNS has on PWE and PNES. The video electroencephalogram (vEEG) of all patients who underwent VNS at our institution was reviewed. Patients diagnosed with both psychogenic seizures and epileptic seizures on their vEEG were included in this study. These patients were contacted, and given a QOLIE-31 survey to assess their quality of life after VNS. Patients also completed a separate survey created by our group to categorize the quartile of their improvement. Pre-operative psychiatric disease was retrospectively reviewed. From a period of 2001 to 2016, 518 patients underwent placement of VNS for drug resistant epilepsy (DRE) at our institution. In total, 16 patients were diagnosed with both epilepsy and PNES. 11/16 patients responded to our questionnaire and survey. 9 out of 11 patients felt that their epileptic seizures had improved after VNS, while 7 of the 11 patients felt that their psychogenic episodes had improved. 2(28.6%), 1 (14.3%), and 4 (57.1%) of participants said their PNES improved by 25-50%, 50-75%, and 75-100%, respectively. 3(27.3%), 3 (27.3%), 1 (9.1%), and 4 (36.4%) of the participants said their epileptic seizures improved by 0-25%, 25-50%, 50-75%, and 75-100%, respectively. The average overall score for quality of life for the study participants was found to be 51 (±8) out of 100. Patients with epilepsy and comorbid PNES may benefit from VNS. It is unclear whether the benefit is conferred strictly from decreased epileptic seizure burden. The possible effect on PNES may be related to the known effect of VNS on depression. Further studies are necessary to elucidate the role of VNS in the treatment of PNES

  17. Quality of Life in Children and Adolescents With Learning Problems: Development and Validation of the LD/QOL15 Scale.

    Science.gov (United States)

    Waber, Deborah P; Boiselle, Ellen C; Forbes, Peter W; Girard, Jonathan M; Sideridis, Georgios D

    2018-05-01

    Learning problems (LP) can have wider implications than the academic deficits per se. The goal of the present series of studies was to develop a reliable and valid quality-of-life measure targeted to children and adolescents with LP. In Study 1, using a 35-item questionnaire, we surveyed 151 parents/guardians of children referred for assessment of learning disorders. Exploratory factor analysis identified a three-factor model: Academic Performance, School Understanding, and Child/Family Psychological. These factors were validated against standardized measures of academic achievement and psychosocial functioning. The questionnaire was then reduced to 15 items-the LD/QOL15 -and administered to a community sample of 325 parents/guardians of children in Grades 1 to 8 (Study 2). The three-factor model was verified with confirmatory factor analysis. Comparison of general education ( n = 232) and LP ( n = 93) groups within the community sample documented substantial group differences ( p measure that is valid to assess quality of life and, potentially, outcomes in children and adolescents with LP.

  18. Caring for a Child with Autism Spectrum Disorder and Parents' Quality of Life: Application of the CarerQol

    Science.gov (United States)

    Hoefman, Renske; Payakachat, Nalin; van Exel, Job; Kuhlthau, Karen; Kovacs, Erica; Pyne, Jeffrey; Tilford, J. Mick

    2014-01-01

    This study describes the impact of caregiving on parents of children with autism spectrum disorders (ASDs). Secondly, we investigate construct validation of the care-related quality of life instrument (CarerQol) measuring impact of caregiving. Primary caregivers of children with ASDs were included. Many parents experienced considerable problems…

  19. Measuring care-related quality of life of caregivers for use in economic evaluations: CarerQol tariffs for Australia, Germany, Sweden, the UK and the US.

    NARCIS (Netherlands)

    Hoefman, R.J.; Exel, N.J.A. van; Brouwer, W.B.F.

    2017-01-01

    Background: Informal care is often not included in economic evaluations in healthcare, while the impact of caregiving can be relevant for cost-effectiveness recommendations from a societal perspective. The impact of informal care can be measured and valued with the CarerQol instrument, which

  20. Quality-of-Life (QOL during Screening for Phase 1 Trial Studies in Patients with Advanced Solid Tumors and Its Impact on Risk for Serious Adverse Events

    Directory of Open Access Journals (Sweden)

    Sidra Anwar

    2017-06-01

    Full Text Available Background: Serious adverse events (SAEs and subject replacements occur frequently in phase 1 oncology clinical trials. Whether baseline quality-of-life (QOL or social support can predict risk for SAEs or subject replacement among these patients is not known. Methods: Between 2011–2013, 92 patients undergoing screening for enrollment into one of 22 phase 1 solid tumor clinical trials at Roswell Park Cancer Institute were included in this study. QOL Questionnaires (EORTC QLQ-C30 and FACT-G, Medical Outcomes Study Social Support Survey (MOSSSS, Charlson comorbidity scores (CCS and Royal Marsden scores (RMS were obtained at baseline. Frequency of dose limiting toxicities (DLTs, subject replacement and SAEs that occurred within the first 4 cycles of treatment were recorded. Fisher’s exact test and Mann-Whitney-Wilcoxon test were used to study the association between categorical and continuous variables, respectively. A linear transformation was used to standardize QOL scores. p-value ≤ 0.05 was considered statistically significant. Results: Baseline QOL, MOSSSS, CCS and RMS were not associated with subject replacement nor DLTs. Baseline EORTC QLQ-C30 scores were significantly lower among patients who encountered SAEs within the first 4 cycles (p = 0.04. Conclusions: Lower (worse EORTC QLQ-C30 score at baseline is associated with SAE occurrence during phase 1 oncology trials.

  1. Summary scores captured changes in subjects' QoL as measured by the multiple scales of the EORTC QLQ-C30.

    Science.gov (United States)

    Phillips, Rachel; Gandhi, Mihir; Cheung, Yin Bun; Findlay, Michael P; Win, Khin Maung; Hai, Hoang Hoa; Yang, Jin Mo; Lobo, Rolley Rey; Soo, Khee Chee; Chow, Pierce K H

    2015-08-01

    To examine the performance of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) global health status/quality of life (QoL) scale and two summary scores to detect changes in the QoL profile over time, according to changes in the individual scales. Data came from 167 clinical trial patients with unresectable (advanced) hepatocellular carcinoma. The global health status/QoL scale of the questionnaire contained two items: overall health and overall QoL. Nordin and Hinz proposed summary scores for the questionnaire. A mixed-effect model was fitted to estimate trends in scores over time. Predominantly the individual scale scores declined over time; however, the global health status/QoL score was stable [rate of change = -0.3 per month; 95% confidence interval (CI): -1.2, 0.6]. Nordin's summary score, which gave equal weight to the 15 questionnaire scales, and Hinz's summary score, which gave equal weight to the 30 questionnaire items, showed a statistically significant decline over time, 3.4 (95% CI: -4.5, -2.4) and 4.2 (95% CI: -5.3, -3.0) points per month, respectively. In contrast to the global health status/QoL scale, the summary scores proposed by Nordin and Hinz detected changes in subjects' QoL profile described by the EORTC QLQ-C30 individual scales. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. A urine midmolecule osteocalcin assay shows higher discriminatory power than a serum midmolecule osteocalcin assay during short-term alendronate treatment of osteoporotic patients.

    Science.gov (United States)

    Srivastava, A K; Mohan, S; Singer, F R; Baylink, D J

    2002-07-01

    We isolated and characterized a peptide fragment corresponding to amino acid sequence 14-28 of human osteocalcin in urine from Paget's disease, and developed a polyclonal antibody reactive to this peptide in urine. We used this antibody to measure urinary fragments of osteocalcin and compared to efficacy of the urinary osteocalcin assay with a serum osteocalcin (sOC) assay (ELISA-Osteo, Cis-Bio International) to monitor the short-term changes in bone turnover in response to alendronate treatment. The synthetic peptide-based urinary osteocalcin (uOC) radioimmunoassay (RIA) showed an analytical sensitivity of 6.25 ng/mL, standard curve range of 3.12-400 ng/mL, and mean intra- (n = 20) and interassay (n = 30) coefficient of variation (CV) of sALP) (Alkphose-B, Metra Biosystems) in serum samples. The percent change data obtained between baseline and 30 days (n = 18) posttreatment suggested a rapid decline in uOC concentration (-27%, p sALP (-3.4%, p = 0.689), two specific markers of bone formation. As expected, due to the coupling of bone formation and bone resorption, the concentration of all markers showed a 30%-45% decline compared with baseline values after 90 days (n = 16) of treatment. Correlation of markers after a 30 day treatment with alendronate revealed a higher correlation (r = 0.61, p sALP (r = -0.14, p = 0.295) with uNTx. Similarly, correlation coefficients with r values between 0.48 and 0.55 (p < 0.05) were observed between uOC, sNTx, and sCTx, whereas no significant correlation was observed between sOC and sNTx or sCTx. These results provide indirect evidence that fragments measured by the urine assay probably originated from bone resorption, and suggest that the uOC assay could be used to assess short-term changes in bone metabolism with regard to osteocalcin.

  3. Measuring depression after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Depression item bank and linkage with PHQ-9.

    Science.gov (United States)

    Tulsky, David S; Kisala, Pamela A; Kalpakjian, Claire Z; Bombardier, Charles H; Pohlig, Ryan T; Heinemann, Allen W; Carle, Adam; Choi, Seung W

    2015-05-01

    To develop a calibrated spinal cord injury-quality of life (SCI-QOL) item bank, computer adaptive test (CAT), and short form to assess depressive symptoms experienced by individuals with SCI, transform scores to the Patient Reported Outcomes Measurement Information System (PROMIS) metric, and create a crosswalk to the Patient Health Questionnaire (PHQ)-9. We used grounded-theory based qualitative item development methods, large-scale item calibration field testing, confirmatory factor analysis, item response theory (IRT) analyses, and statistical linking techniques to transform scores to a PROMIS metric and to provide a crosswalk with the PHQ-9. Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Adults with traumatic SCI. Spinal Cord Injury--Quality of Life (SCI-QOL) Depression Item Bank Individuals with SCI were involved in all phases of SCI-QOL development. A sample of 716 individuals with traumatic SCI completed 35 items assessing depression, 18 of which were PROMIS items. After removing 7 non-PROMIS items, factor analyses confirmed a unidimensional pool of items. We used a graded response IRT model to estimate slopes and thresholds for the 28 retained items. The SCI-QOL Depression measure correlated 0.76 with the PHQ-9. The SCI-QOL Depression item bank provides a reliable and sensitive measure of depressive symptoms with scores reported in terms of general population norms. We provide a crosswalk to the PHQ-9 to facilitate comparisons between measures. The item bank may be administered as a CAT or as a short form and is suitable for research and clinical applications.

  4. Measuring pain phenomena after spinal cord injury: Development and psychometric properties of the SCI-QOL Pain Interference and Pain Behavior assessment tools.

    Science.gov (United States)

    Cohen, Matthew L; Kisala, Pamela A; Dyson-Hudson, Trevor A; Tulsky, David S

    2018-05-01

    To develop modern patient-reported outcome measures that assess pain interference and pain behavior after spinal cord injury (SCI). Grounded-theory based qualitative item development; large-scale item calibration field-testing; confirmatory factor analyses; graded response model item response theory analyses; statistical linking techniques to transform scores to the Patient Reported Outcome Measurement Information System (PROMIS) metric. Five SCI Model Systems centers and one Department of Veterans Affairs medical center in the United States. Adults with traumatic SCI. N/A. Spinal Cord Injury - Quality of Life (SCI-QOL) Pain Interference item bank, SCI-QOL Pain Interference short form, and SCI-QOL Pain Behavior scale. Seven hundred fifty-seven individuals with traumatic SCI completed 58 items addressing various aspects of pain. Items were then separated by whether they assessed pain interference or pain behavior, and poorly functioning items were removed. Confirmatory factor analyses confirmed that each set of items was unidimensional, and item response theory analyses were used to estimate slopes and thresholds for the items. Ultimately, 7 items (4 from PROMIS) comprised the Pain Behavior scale and 25 items (18 from PROMIS) comprised the Pain Interference item bank. Ten of these 25 items were selected to form the Pain Interference short form. The SCI-QOL Pain Interference item bank and the SCI-QOL Pain Behavior scale demonstrated robust psychometric properties. The Pain Interference item bank is available as a computer adaptive test or short form for research and clinical applications, and scores are transformed to the PROMIS metric.

  5. 3D printed alendronate-releasing poly(caprolactone) porous scaffolds enhance osteogenic differentiation and bone formation in rat tibial defects.

    Science.gov (United States)

    Kim, Sung Eun; Yun, Young-Pil; Shim, Kyu-Sik; Kim, Hak-Jun; Park, Kyeongsoon; Song, Hae-Ryong

    2016-09-29

    The aim of this study was to evaluate the in vitro osteogenic effects and in vivo new bone formation of three-dimensional (3D) printed alendronate (Aln)-releasing poly(caprolactone) (PCL) (Aln/PCL) scaffolds in rat tibial defect models. 3D printed Aln/PCL scaffolds were fabricated via layer-by-layer deposition. The fabricated Aln/PCL scaffolds had high porosity and an interconnected pore structure and showed sustained Aln release. In vitro studies showed that MG-63 cells seeded on the Aln/PCL scaffolds displayed increased alkaline phosphatase (ALP) activity and calcium content in a dose-dependent manner when compared with cell cultures in PCL scaffolds. In addition, in vivo animal studies and histologic evaluation showed that Aln/PCL scaffolds implanted in a rat tibial defect model markedly increased new bone formation and mineralized bone tissues in a dose-dependent manner compared to PCL-only scaffolds. Our results show that 3D printed Aln/PCL scaffolds are promising templates for bone tissue engineering applications.

  6. Improved quality of life in hyperthyroidism patients after surgery.

    Science.gov (United States)

    Bukvic, Branka; Zivaljevic, Vladan; Sipetic, Sandra; Diklic, Aleksandar; Tausanovic, Katarina; Stojanovic, Dragos; Stevanovic, Dejan; Paunovic, Ivan

    2015-02-01

    The most common causes of hyperthyroidism are Graves disease (GD) and toxic nodular goiter (TNG). GD and TNG might influence patients' quality of life (QoL). The aim of our study was to analyze and compare the QoL of patients with GD with that of TNG patients and to evaluate the influence of surgical treatment on their QoL. A prospective case-control study was conducted at the Center for Endocrine surgery in Belgrade, Serbia. The ThyPRO questionnaire was used in the QoL assessment of the GD and TNG patients (31 and 28, respectively) pre- and post-operatively. All patients were receiving antithyroid drugs, and none of the patients were overtly hyperthyroid at the time of completing the preoperative questionnaire. The QoL of the GD patients was worse than that of the TNG patients, with significant differences in eye symptoms, anxiety, and sex life domains (P < 0.001, P = 0.005, and P = 0.004, respectively), preoperatively, and in eye symptoms, anxiety, emotional susceptibility, and overall QoL (P = 0.001, P = 0.027, P = 0.005 and P = 0.013, respectively), postoperatively. The improvement in QoL in the GD patients was significant after surgical treatment in all ThyPRO domains. In the TNG patients, the improvement was significant in all but one ThyPRO domain, sex life (P = 0.066). The QoL of GD patients is worse than those of TNG patients. Surgery may improve QoL in patients with GD and TNG even if they have achieved satisfying thyroid status with medication treatment, preoperatively. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Depression, quality of life (QoL) and will to live of community-dwelling postmenopausal women in three Asian countries: Korea, China and Japan.

    Science.gov (United States)

    Ina, Koichiro; Hayashi, Toshio; Nomura, Hideki; Ishitsuka, Asako; Hirai, Hisako; Iguchi, Akihisa

    2011-01-01

    The purpose of this study was to examine the prevalence of screening-detected depression and the association of depression with QoL in community-dwelling postmenopausal women living in three Asian countries. We examined self-reported questionnaires and conducted the study. A total of 698 community-dwelling postmenopausal women living in three Asian countries participated in this study. The mean age was 59.4±6.6 years (±SD) Depressive symptoms were assessed using a 15-item geriatric depression scale (GDS-15). Using the cut-off of 5/6 for the GDS-15, the percentages of subjects with depression were 39.0% of the Korean subjects, 29.2% of the Chinese subjects, and 33.9% of the Japanese subjects. For the assessment of QoL, we used the EQ-5D of the EuroQoL Group. The following five dimensions were assessed: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The proportions of subjects reporting problems for each dimension were examined. Subjects with depression had significantly lower levels of some dimensions of QoL than those without depression in all three countries. In all three countries, 29.2-39.0% of community-dwelling postmenopausal women had screening-detected depression, which was significantly associated with a lower level of some dimensions of QoL. These results suggest that clinicians should pay more attention to depression in community-dwelling postmenopausal women. Copyright © 2010. Published by Elsevier Ireland Ltd.

  8. [QOL questionnaire for pediatric patients with bronchial asthma and their parents or caregivers. Preparation and evaluation of the short form version 2008 (Gifu)].

    Science.gov (United States)

    Kondo, Naomi; Hirayama, Koichiro; Matsui, Eiko; Teramoto, Takahide; Kaneko, Hideo; Fukao, Toshiyuki; Orii, Kenji; Kawamoto, Minako; Funato, Michinori; Ohnishi, Hidenori; Kawamoto, Norio; Morita, Hideyuki; Kimura, Takeshi; Nada, Masatoshi; Tokumi, Tetsuji; Hori, Tomohiro; Watanabe, Rinko

    2008-08-01

    The QOL questionnaire version 2001 for pediatric patients with bronchial asthma and their parents or caregivers includes 15 questions for patients under the age of 4 years and 20 questions for patients over the age of 4 years. We have already reported that the QOL questionnaire version 2001 reflects reliability (including reproducibility), factorial validity, and changes in paroxysmal attacks of asthma. In this study, we revised the questionnaire for use in routine medical practice. In this study, based on the data of a previous report, the number of questions was reduced further and it was revised to the questionnaire the short form by integrated data. The revised version 2008 (Gifu) consisted of emotional burden, asthma attack, instability of symptoms and proper acceptance of asthma as a common factor, moreover 4 or more years old added load of exercise factor which consisted of two questions in each factor. This QOL short form questionnaire version 2008 (Gifu) is a disease specific questionnaire in comparison with health control, bronchial asthma and non-asthmatic patients, such as atopic dermatitis and allergic rhinitis. Although Cronbach's alpha fell with reduction of the number of questions, we conclude that it was acceptable in the clinical practice.

  9. Development and validation of the positive affect and well-being scale for the neurology quality of life (Neuro-QOL) measurement system.

    Science.gov (United States)

    Salsman, John M; Victorson, David; Choi, Seung W; Peterman, Amy H; Heinemann, Allen W; Nowinski, Cindy; Cella, David

    2013-11-01

    To develop and validate an item-response theory-based patient-reported outcomes assessment tool of positive affect and well-being (PAW). This is part of a larger NINDS-funded study to develop a health-related quality of life measurement system across major neurological disorders, called Neuro-QOL. Informed by a literature review and qualitative input from clinicians and patients, item pools were created to assess PAW concepts. Items were administered to a general population sample (N = 513) and a group of individuals with a variety of neurologic conditions (N = 581) for calibration and validation purposes, respectively. A 23-item calibrated bank and a 9-item short form of PAW was developed, reflecting components of positive affect, life satisfaction, or an overall sense of purpose and meaning. The Neuro-QOL PAW measure demonstrated sufficient unidimensionality and displayed good internal consistency, test-retest reliability, model fit, convergent and discriminant validity, and responsiveness. The Neuro-QOL PAW measure was designed to aid clinicians and researchers to better evaluate and understand the potential role of positive health processes for individuals with chronic neurological conditions. Further psychometric testing within and between neurological conditions, as well as testing in non-neurologic chronic diseases, will help evaluate the generalizability of this new tool.

  10. Quality of Life Assessment Using EuroQOL EQ-5D Questionnaire in Patients with Deep Infiltrating Endometriosis: The Relation with Symptoms and Locations

    Science.gov (United States)

    Touboul, C.; Amate, P.; Ballester, M.; Bazot, M.; Fauconnier, A.; Daraï, E.

    2013-01-01

    The objective of this study was to evaluate the quality of life (QOL) of patients with deep infiltrating endometriosis (DIE) using EuroQOL (EQ-5D) and its correlation with symptoms and locations of endometriotic lesions. One hundred and fifty-nine patients referred for DIE from January 2011 to April 2011 were prospectively invited to complete questionnaires evaluating symptoms associated with endometriosis as well as the EQ-5D questionnaire and health state. Patients also had locations of DIE evaluated by clinical examination and magnetic resonance imaging (MRI). All 159 patients completed the questionnaires. Item response rate was 91.1%. The most intense symptoms were dysmenorrhea (7.1/10), painful defecation (6.3/10), and fatigue (6.0/10). Mean (SD) scores were 77 (14) for the EQ-5D questionnaire and 63.4 (21) for the health state. A relation was observed between the EQ-5D questionnaire and the presence of dysmenorrhea, dyspareunia, cyclic pelvic pain, painful defecation, and diarrhea or constipation. Vaginal and rectal infiltrations were significantly associated with altered EQ-5D and health state scores. The EQ-5D questionnaire is easy to complete and well related to symptoms of DIE. Rectal and vaginal infiltrations were found to be determinant factors of altered QOL by the EQ-5D questionnaire and health state. PMID:26464845

  11. The Impact of Hyposalivation on Quality of Life (QoL and Oral Health in the Aging Population of Al Madinah Al Munawarrah

    Directory of Open Access Journals (Sweden)

    Mohammad S. Ahmad

    2017-04-01

    Full Text Available Hyposalivation (HS affects aging individuals by causing pain and discomfort in the oral cavity. The aim here was to determine the impact of hyposalivation and the saliva pH on the quality of life and caries status of geriatrics population. A total of 138 male outpatients attending the Taibah University College of Dentistry (TUCoD dental clinic were included in the study. The saliva flow, pH, Quality of Life (QoL, and caries status were recorded. The QoL was measured using the Arabic version of the Oral Health Impact Profile-14 (OHIP-14, and the caries status was recorded using the Decayed, Missed, Filled Teeth (DMFT index. The mean age was 67.5 years and 64% were classified as having hyposalivation. The older respondents tended to have a lower saliva flow and pH compared to their younger counterparts. There was a significant inverse association (p = 0.02 between the caries status and mean saliva flow rate. There was also a significant (p < 0.001 positive correlation between caries and the OHIP-14 scores (Spearman’s ρ = 0.293. The prevalence of hyposalivation was relatively high and there was an inverse relationship between the age, the saliva flow, and pH. Those with more caries reported significantly poor QoL.

  12. Metastatic breast cancer: do current treatments improve quality of life? A prospective study

    Directory of Open Access Journals (Sweden)

    Fernanda Amado

    Full Text Available CONTEXT AND OBJECTIVE: In metastatic breast cancer cases, the currently available therapeutic approaches provide minimal improvement in survival. As such, quality of life (QOL becomes one of the main objectives of treatment. It is not known whether current treatments derived from trials improve QOL. The aim was to evaluate changes in QOL among metastatic breast cancer patients receiving treatment derived from trials. DESIGN AND SETTING: Prospective observational QOL survey in a tertiary cancer center. METHODS: To evaluate the influence of current treatments on patients' QOL, the Medical Outcomes Study Short Form-36 (SF-36 and the Beck Depression Inventory (BDI were applied on three occasions: before starting treatment and at the 6th and 12th weeks, to consecutive metastatic breast cancer patients over a one-year period. RESULTS: We found an improvement in QOL in the sample evaluated (n = 40, expressed by changes in the overall SF-36 score (p = 0.002 and the BDI (p = 0.004. Taken individually, the SF-36 components Pain, Social Functioning and Mental Health also improved significantly. Patients with worse initial performance status and secondary symptoms displayed greater improvement than those with better initial performance status and asymptomatic disease (p < 0.001. Patients who received more than one type of therapy showed larger gains than those given only one type (p = 0.038. CONCLUSIONS: In our environment, current metastatic breast cancer treatments can improve QOL, especially among symptomatic patients and those with low performance status.

  13. The role of subchondral bone remodeling in osteoarthritis: reduction of cartilage degeneration and prevention of osteophyte formation by alendronate in the rat anterior cruciate ligament transection model.

    Science.gov (United States)

    Hayami, Tadashi; Pickarski, Maureen; Wesolowski, Gregg A; McLane, Julia; Bone, Ashleigh; Destefano, James; Rodan, Gideon A; Duong, Le T

    2004-04-01

    It has been suggested that subchondral bone remodeling plays a role in the progression of osteoarthritis (OA). To test this hypothesis, we characterized the changes in the rat anterior cruciate ligament transection (ACLT) model of OA and evaluated the effects of alendronate (ALN), a potent inhibitor of bone resorption, on cartilage degradation and on osteophyte formation. Male Sprague-Dawley rats underwent ACLT or sham operation of the right knee. Animals were then treated with ALN (0.03 and 0.24 microg/kg/week subcutaneously) and necropsied at 2 or 10 weeks postsurgery. OA changes were evaluated. Subchondral bone volume and osteophyte area were measured by histomorphometric analysis. Coimmunostaining for transforming growth factor beta (TGF beta), matrix metalloproteinase 9 (MMP-9), and MMP-13 was performed to investigate the effect of ALN on local activation of TGF beta. ALN was chondroprotective at both dosages, as determined by histologic criteria and collagen degradation markers. ALN suppressed subchondral bone resorption, which was markedly increased 2 weeks postsurgery, and prevented the subsequent increase in bone formation 10 weeks postsurgery, in the untreated tibial plateau of ACLT joints. Furthermore, ALN reduced the incidence and area of osteophytes in a dose-dependent manner. ALN also inhibited vascular invasion into the calcified cartilage in rats with OA and blocked osteoclast recruitment to subchondral bone and osteophytes. ALN treatment reduced the local release of active TGF beta, possibly via inhibition of MMP-13 expression in articular cartilage and MMP-9 expression in subchondral bone. Subchondral bone remodeling plays an important role in the pathogenesis of OA. ALN or other inhibitors of bone resorption could potentially be used as disease-modifying agents in the treatment of OA.

  14. Effects of music and art education in early life and oral functions on the QOL of the Takarazuka Revue Company OG compared with general elderly females.

    Science.gov (United States)

    Masutani, Takiko; Yamamoto, Yasuji; Konishi, Junya; Maeda, Kiyoshi

    2010-03-01

    Today, Japan is becoming a super-aged society, with senior citizens already constituting over 21% of the population. In this situation, the question of how elderly people can extend their lives and enjoy independent lifestyles is becoming more important. The present study aims to clarify the relationship between the Quality of Life (QOL) of elderly females and their current oral functions and experiences of music and art education in early life. We carried out a survey study focusing on elderly females (Takarazuka Revue Company OG group and general female group) by carrying out a questionnaire survey and comparing cognitive function, oral examinations, cerebral atrophy in magnetic resonance imaging, and other characteristics. It was shown that the Takarazuka Revue Company OG group had greater hippocampal volumes and significantly higher cognitive functions than the general female group. In addition, in the general female group, there was a significant correlation between a decrease in the number of remaining teeth and a decrease in activities in daily living, but in the Takarazuka Revue Company OG group, no such correlation was observed. The results showed that those who have received art education as part of their careers over an extensive period since early life have higher levels of cognitive function, QOL, physical activity, social activity and life satisfaction compared with the general female group; showing that they sense a purpose in life and live with a positive attitude. In contrast, in the general female group, those who have continued to enjoy hobbies have higher levels of cognitive function, QOL, physical activity, social activity and life satisfaction than those who have not, thus showing that they live with a positive attitude.

  15. Do telemedical interventions improve quality of life in patients with COPD?

    DEFF Research Database (Denmark)

    Gregersen, Thorbjorn L.; Green, Allan; Frausing, Ejvind

    2016-01-01

    OBJECTIVE: Telehealth is an approach to disease management, which may hold the potential of improving some of the features associated with COPD, including positive impact on disease progression, and thus possibly limiting further reduction in quality of life (QoL). Our objective was, therefore......, three studies found statistically significant improvements in QoL for patients allocated to telemedical interventions. However, all of the other included studies found no statistically significant differences between control and telemedical intervention groups in terms of QoL. CONCLUSION: Telehealth...

  16. Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs.

    Science.gov (United States)

    Cummings, Steven R; Karpf, David B; Harris, Fran; Genant, Harry K; Ensrud, Kristine; LaCroix, Andrea Z; Black, Dennis M

    2002-03-01

    To estimate how much the improvement in bone mass accounts for the reduction in risk of vertebral fracture that has been observed in randomized trials of antiresorptive treatments for osteoporosis. After a systematic search, we conducted a meta-analysis of 12 trials to describe the relation between improvement in spine bone mineral density and reduction in risk of vertebral fracture in postmenopausal women. We also used logistic models to estimate the proportion of the reduction in risk of vertebral fracture observed with alendronate in the Fracture Intervention Trial that was due to improvement in bone mineral density. Across the 12 trials, a 1% improvement in spine bone mineral density was associated with a 0.03 decrease (95% confidence interval [CI]: 0.02 to 0.05) in the relative risk (RR) of vertebral fracture. The reductions in risk were greater than predicted from improvement in bone mineral density; for example, the model estimated that treatments predicted to reduce fracture risk by 20% (RR = 0.80), based on improvement in bone mineral density, actually reduce the risk of fracture by about 45% (RR = 0.55). In the Fracture Intervention Trial, improvement in spine bone mineral density explained 16% (95% CI: 11% to 27%) of the reduction in the risk of vertebral fracture with alendronate. Improvement in spine bone mineral density during treatment with antiresorptive drugs accounts for a predictable but small part of the observed reduction in the risk of vertebral fracture.

  17. Effects of time and recall of patch test results on quality of life (QoL) after testing. Cross-sectional study analyzing QoL in hand eczema patients 1, 5 and 10 years after patch testing.

    Science.gov (United States)

    Jamil, Wasim N; Lindberg, Magnus

    2017-08-01

    Patch testing can improve health-related quality of life (HRQOL). To study the impact on HRQOL of elapsed time after patch testing (1-10 years), and how the outcome of testing and patients' recall affects HRQOL. The Dermatology Life Quality Index (DLQI) questionnaire was sent to all patients (aged 18-65 years) who were patch tested for suspected contact allergy in 2009, 2005 and 2000 at the Department of Dermatology in Örebro. The response rate was 51% (n = 256). The DLQI score was significantly lower at 10 years after patch testing (mean DLQI = 5.5) than at 1 year (mean DLQI = 7.7). Work was the most impaired aspect. A binary logistic model showed that only time (10 years after testing) was associated with no effect, a light effect or a moderate effect (DLQI negative or positive test results concerning full recall, partial recall or no recall of diagnosed allergens. Although there was an improvement in HRQOL over time, the work aspect remained a major problem. The improvement was not affected by the outcome of testing and patients' recall of test results. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Relief of depression and pain improves daily functioning and quality of life in patients with major depressive disorder.

    Science.gov (United States)

    Lin, Ching-Hua; Yen, Yung-Chieh; Chen, Ming-Chao; Chen, Cheng-Chung

    2013-12-02

    The objective of this study was to investigate the effects of depression relief and pain relief on the improvement in daily functioning and quality of life (QOL) for depressed patients receiving a 6-week treatment of fluoxetine. A total of 131 acutely ill inpatients with major depressive disorder (MDD) were enrolled to receive 20mg of fluoxetine daily for 6 weeks. Depression severity, pain severity, daily functioning, and health-related QOL were assessed at baseline and again at week 6. Depression severity, pain severity, and daily functioning were assessed using the 17-item Hamilton Depression Rating Scale, the Short-Form 36 (SF-36) Body Pain Index, and the Work and Social Adjustment Scale. Health-related QOL was assessed by three primary domains of the SF-36, including social functioning, vitality, and general health perceptions. Pearson's correlation and structural equation modeling were used to examine relationships among the study variables. Five models were proposed. In model 1, depression relief alone improved daily functioning and QOL. In model 2, pain relief alone improved daily functioning and QOL. In model 3, depression relief, mediated by pain relief, improved daily functioning and QOL. In model 4, pain relief, mediated by depression relief, improved daily functioning and QOL. In model 5, both depression relief and pain relief improved daily functioning and QOL. One hundred and six patients completed all the measures at baseline and at week 6. Model 5 was the most fitted structural equation model (χ(2) = 8.62, df = 8, p = 0.376, GFI = 0.975, AGFI = 0.935, TLI = 0.992, CFI = 0.996, RMSEA = 0.027). Interventions which relieve depression and pain improve daily functioning and QOL among patients with MDD. The proposed model can provide quantitative estimates of improvement in treating patients with MDD. © 2013 Elsevier Inc. All rights reserved.

  19. Improving Symptom Control, QOL, and Quality of Care for Women with Breast Cancer: Developing a Research Program on Neurological Effects via Doctoral Education

    National Research Council Canada - National Science Library

    Bakitas, Marie; Ahles, Tim A

    2005-01-01

    The purpose of this traineeship is to develop the academic and research skills of an expert advanced practice nurse towards achieving the career goal of becoming a Clinical Breast Cancer Research Scientist...

  20. Improving Symptom Control, QOL, and Quality of Care for Women with Breast Cancer: Developing a Research Program on Neurological Effects via Doctoral Education

    Science.gov (United States)

    2005-05-01

    not complicated by significant neuro-toxicity. European Journal of Cancer 2002;38(387-391. 285. Van Manen Max: Researching Lived Experience: Human...thoracotomy. Journal of Thoracic & Cardiovascular Surgery 1998; 115(4):841-847. 27. Benner Patricia: Interpretive Phenomenology : Embodiment, Caring, and... Phenomenology . Thousand Oaks, CA: Sage, 1995, pp 129-138. 90. Dixon Jane K: Factor Analysis, in Munro B (ed): Statistical methods for health care

  1. Improving Symptom Control, QOL, and Quality of Care for Women with Breast Cancer: Developing a Research Program on Neurological Effects via Doctoral Education

    National Research Council Canada - National Science Library

    Bakitas, Marie; Ahles, Tim A

    2006-01-01

    ... on the Cognitive Effects of Chemotherapy. The scope of the program was to support the trainee's doctoral education with an ultimate career goal of becoming a Clinical Breast Cancer Research Scientist through a mentored research experience. Ms...

  2. Characterization of alendronic- and undecylenic acid coated magnetic nanoparticles for the targeted delivery of rosiglitazone to subcutaneous adipose tissue.

    Science.gov (United States)

    Saatchi, Katayoun; Tod, Sarah E; Leung, Donna; Nicholson, Kenton E; Andreu, Irene; Buchwalder, Christian; Schmitt, Veronika; Häfeli, Urs O; Gray, Sarah L

    2017-02-01

    Obesity is a state of positive energy balance where excess white adipose tissue accumulates to the detriment of metabolic health. Improving adipocyte function with systemic administration of thiazolidinediones (TZDs) improves metabolic outcomes in obesity, however TZD use is limited clinically due to undesirable side effects. Here we evaluate magnetic nanoparticles (MNPs) as a tool to target rosiglitazone (Rosi) specifically to adipose tissue. Results show Rosi can be adsorbed to MNPs (Rosi-MNPs) with hydrophobic coatings for which we present binding and release kinetics. Rosi adsorbed to MNPs retained the ability to induce PPARγ target gene expression in cells. Biodistribution analysis of radiolabeled Rosi-MNPs revealed a fat-implanted magnet significantly enhanced localization of Rosi to the targeted adipose tissue when administered by subcutaneous injection to obese mice. We propose MNPs for targeted delivery of anti-diabetic agents to superficially located subcutaneous adipose tissue. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Measuring psychological trauma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Psychological Trauma item bank and short form.

    Science.gov (United States)

    Kisala, Pamela A; Victorson, David; Pace, Natalie; Heinemann, Allen W; Choi, Seung W; Tulsky, David S

    2015-05-01

    To describe the development and psychometric properties of the SCI-QOL Psychological Trauma item bank and short form. Using a mixed-methods design, we developed and tested a Psychological Trauma item bank with patient and provider focus groups, cognitive interviews, and item response theory based analytic approaches, including tests of model fit, differential item functioning (DIF) and precision. We tested a 31-item pool at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Veterans Administration hospital. A total of 716 individuals with SCI completed the trauma items The 31 items fit a unidimensional model (CFI=0.952; RMSEA=0.061) and demonstrated good precision (theta range between 0.6 and 2.5). Nine items demonstrated negligible DIF with little impact on score estimates. The final calibrated item bank contains 19 items The SCI-QOL Psychological Trauma item bank is a psychometrically robust measurement tool from which a short form and a computer adaptive test (CAT) version are available.

  4. Measuring stigma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Stigma item bank and short form.

    Science.gov (United States)

    Kisala, Pamela A; Tulsky, David S; Pace, Natalie; Victorson, David; Choi, Seung W; Heinemann, Allen W

    2015-05-01

    To develop a calibrated item bank and computer adaptive test (CAT) to assess the effects of stigma on health-related quality of life in individuals with spinal cord injury (SCI). Grounded-theory based qualitative item development methods, large-scale item calibration field testing, confirmatory factor analysis, and item response theory (IRT)-based psychometric analyses. Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Adults with traumatic SCI. SCI-QOL Stigma Item Bank A sample of 611 individuals with traumatic SCI completed 30 items assessing SCI-related stigma. After 7 items were iteratively removed, factor analyses confirmed a unidimensional pool of items. Graded Response Model IRT analyses were used to estimate slopes and thresholds for the final 23 items. The SCI-QOL Stigma item bank is unique not only in the assessment of SCI-related stigma but also in the inclusion of individuals with SCI in all phases of its development. Use of confirmatory factor analytic and IRT methods provide flexibility and precision of measurement. The item bank may be administered as a CAT or as a 10-item fixed-length short form and can be used for research and clinical applications.

  5. Measuring resilience after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Resilience item bank and short form.

    Science.gov (United States)

    Victorson, David; Tulsky, David S; Kisala, Pamela A; Kalpakjian, Claire Z; Weiland, Brian; Choi, Seung W

    2015-05-01

    To describe the development and psychometric properties of the Spinal Cord Injury--Quality of Life (SCI-QOL) Resilience item bank and short form. Using a mixed-methods design, we developed and tested a resilience item bank through the use of focus groups with individuals with SCI and clinicians with expertise in SCI, cognitive interviews, and item-response theory based analytic approaches, including tests of model fit and differential item functioning (DIF). We tested a 32-item pool at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs medical center. A total of 717 individuals with SCI completed the Resilience items. A unidimensional model was observed (CFI=0.968; RMSEA=0.074) and measurement precision was good (theta range between -3.1 and 0.9). Ten items were flagged for DIF, however, after examination of effect sizes we found this to be negligible with little practical impact on score estimates. The final calibrated item bank resulted in 21 retained items. This study indicates that the SCI-QOL Resilience item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available.

  6. Measuring self-esteem after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Self-esteem item bank and short form.

    Science.gov (United States)

    Kalpakjian, Claire Z; Tate, Denise G; Kisala, Pamela A; Tulsky, David S

    2015-05-01

    To describe the development and psychometric properties of the Spinal Cord Injury-Quality of Life (SCI-QOL) Self-esteem item bank. Using a mixed-methods design, we developed and tested a self-esteem item bank through the use of focus groups with individuals with SCI and clinicians with expertise in SCI, cognitive interviews, and item-response theory-(IRT) based analytic approaches, including tests of model fit, differential item functioning (DIF) and precision. We tested a pool of 30 items at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital, and the James J. Peters/Bronx Department of Veterans Affairs hospital. A total of 717 individuals with SCI completed the self-esteem items. A unidimensional model was observed (CFI=0.946; RMSEA=0.087) and measurement precision was good (theta range between -2.7 and 0.7). Eleven items were flagged for DIF; however, effect sizes were negligible with little practical impact on score estimates. The final calibrated item bank resulted in 23 retained items. This study indicates that the SCI-QOL Self-esteem item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available.

  7. Validation of the quality of life-radiation therapy instrument (QOL-RTI) in patients receiving definitive radiation therapy for locally advanced prostate cancer

    International Nuclear Information System (INIS)

    Gwede, Clement; Friedland, Jay L.; Johnson, Darlene J.; Casey, Linda; Cantor, Alan; Sauder, Bonnie; Beres, Kathleen L.

    1996-01-01

    Purpose/Objective: The incidence of prostate cancer has tripled over the last 10 years, doubled over the last four years and continues to increase. A common method of treating prostate cancer is with external beam radiotherapy with or without hormones. Accurate and comprehensive documentation through prospective studies with long term follow-up is necessary to reduce the negative impact of treatment on a patient's quality of life. While it is increasingly recognized that radiation therapy treatment for prostate cancer may result in permanent alteration of the patient's quality of life, the extent and timing of this change in quality of life has not been adequately investigated in a comprehensive and prospective manner. Furthermore, there are limited instruments developed for use with patients undergoing definitive radiotherapy. The purpose of this paper is to report on the validation of the Quality of Life Radiation Therapy Instrument (QOL-RTI), a 24-item visual analogue general quality of life tool developed for use with patients receiving radiotherapy. Materials and Methods: Health related quality of life was assessed in a prospective study of 62 patients treated with either combined hormonal therapy (HT) plus external beam radiotherapy (EBRT) or EBRT alone for locally advanced prostate cancer. Quality life was measured prospectively before, during, and after radiation therapy. Results: The estimated reliability of the subscales was assessed with coefficient alpha which ranged from 0.57 to 0.68. Internal consistency was calculated using initial questionnaires for the entire sample, yielding a Cronbach's alpha of 0.82. Test-retest produced a correlation coefficient of 0.75 (p<0.0001) [n=60]. Construct validity was assessed by a repeated measures design to look for time effect, group effect, group and time interaction effect. We examined quality of life total scores, subscale total scores and performance status scores for patients who were treated with HT+ EBRT and

  8. An exploratory, large-scale study of pain and quality of life outcomes in cancer patients with moderate or severe pain, and variables predicting improvement.

    Science.gov (United States)

    Maximiano, Constanza; López, Iker; Martín, Cristina; Zugazabeitia, Luis; Martí-Ciriquián, Juan L; Núñez, Miguel A; Contreras, Jorge; Herdman, Michael; Traseira, Susana; Provencio, Mariano

    2018-01-01

    There have been few large-scale, real world studies in Spain to assess change in pain and quality of life (QOL) outcomes in cancer patients with moderate to severe pain. This study aimed to assess changes on both outcomes after 3 months of usual care and to investigate factors associated with change in QoL. Large, multi-centre, observational study in patients with lung, head and neck, colorectal or breast cancer experiencing a first episode of moderate to severe pain while attending one of the participating centres. QoL was assessed using the EuroQol-5D questionnaire and pain using the Brief Pain Inventory (BPI). Instruments were administered at baseline and after 3 months of follow up. Multivariate analyses were used to assess the impact of treatment factors, demographic and clinical variables, pain and other symptoms on QoL scores. 1711 patients were included for analysis. After 3 months of usual care, a significant improvement was observed in pain and QoL in all four cancer groups (pbreast cancer patients showed the largest gains. Poorer baseline performance status (ECOG) and the presence of anxiety/depression were associated with significantly poorer QOL outcomes. Improvements in BPI pain scores were associated with improved QoL. In the four cancer types studied, pain and QoL outcomes improved considerably after 3 months of usual care. Improvements in pain made a substantial contribution to QoL gains whilst the presence of anxiety and depression and poor baseline performance status significantly constrained improvement.

  9. Bioequivalence of generic alendronate sodium tablets (70 mg to Fosamax® tablets (70 mg in fasting, healthy volunteers: a randomized, open-label, three-way, reference-replicated crossover study

    Directory of Open Access Journals (Sweden)

    Zhang Y

    2017-07-01

    Full Text Available Yifan Zhang,1 Xiaoyan Chen,1 Yunbiao Tang,2 Youming Lu,1 Lixia Guo,1 Dafang Zhong1 1State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 2Department of Pharmacy, The General Hospital of Shenyang Military Region, Shenyang, People’s Republic of China Purpose: The aim of this study was to evaluate the bioequivalence of a generic product 70 mg alendronate sodium tablets with the reference product Fosamax® 70 mg tablet. Materials and methods: A single-center, open-label, randomized, three-period, three-sequence, reference-replicated crossover study was performed in 36 healthy Chinese male volunteers under fasting conditions. In each study period, the volunteers received a single oral dose of the generic or reference product (70 mg. Blood samples were collected at pre-dose and up to 8 h after administration. The bioequivalence of the generic product to the reference product was assessed using the US Food and Drug Administration (FDA and European Medicines Agency (EMA reference-scaled average bioequivalence (RSABE methods. Results: The average maximum concentrations (Cmax of alendronic acid were 64.78±43.76, 56.62±31.95, and 60.15±37.12 ng/mL after the single dose of the generic product and the first and second doses of the reference product, respectively. The areas under the plasma concentration–time curves from time 0 to the last timepoint (AUC0–t were 150.36±82.90, 148.15±85.97, and 167.11±110.87 h·ng/mL, respectively. Reference scaling was used because the within-subject standard deviations of the reference product (sWR for Cmax and AUC0–t were all higher than the cutoff value of 0.294. The 95% upper confidence bounds were -0.16 and -0.17 for Cmax and AUC0–t, respectively, and the point estimates for the generic/reference product ratio were 1.08 and 1.00, which satisfied the RSABE acceptance criteria of the FDA. The 90% CIs for Cmax and AUC0–t were 90.35%–129

  10. Development and psychometric characteristics of the SCI-QOL Ability to Participate and Satisfaction with Social Roles and Activities item banks and short forms.

    Science.gov (United States)

    Heinemann, Allen W; Kisala, Pamela A; Hahn, Elizabeth A; Tulsky, David S

    2015-05-01

    To develop a spinal cord injury (SCI)-focused version of PROMIS and Neuro-QOL social domain item banks; evaluate the psychometric properties of items developed for adults with SCI; and report information to facilitate clinical and research use. We used a mixed-methods design to develop and evaluate Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities items. Focus groups helped define the constructs; cognitive interviews helped revise items; and confirmatory factor analysis and item response theory methods helped calibrate item banks and evaluate differential item functioning related to demographic and injury characteristics. Five SCI Model System sites and one Veterans Administration medical center. The calibration sample consisted of 641 individuals; a reliability sample consisted of 245 individuals residing in the community. A subset of 27 Ability to Participate and 35 Satisfaction items demonstrated good measurement properties and negligible differential item functioning related to demographic and injury characteristics. The SCI-specific measures correlate strongly with the PROMIS and Neuro-QOL versions. Ten item short forms correlate >0.96 with the full banks. Variable-length CATs with a minimum of 4 items, variable-length CATs with a minimum of 8 items, fixed-length CATs of 10 items, and the 10-item short forms demonstrate construct coverage and measurement error that is comparable to the full item bank. The Ability to Participate and Satisfaction with Social Roles and Activities CATs and short forms demonstrate excellent psychometric properties and are suitable for clinical and research applications.

  11. Public health dental hygiene: an option for improved quality of care and quality of life.

    Science.gov (United States)

    Olmsted, Jodi L; Rublee, Nancy; Zurkawski, Emily; Kleber, Laura

    2013-10-01

    The purpose of this research was to document quality of life (QoL) and quality of care (QoC) measures for families receiving care from dental hygienists within public health departments, and to consider if oral health for families with economic disparities and cultural differences was improved. A descriptive research study using a retrospective record review was conducted considering QoC. A review of state epid "Do preventive oral health programs based in local health departments provide quality care services, thus impacting QoL for underserved populations?" A dental hygienist working in public health made significant contributions to improving access to care and QoL in a rural, socioeconomically disadvantaged community. A total of 2,364 children received education, 1,745 received oral screenings and 1,511 received dental sealants. Of these, 804 children with caries were referred, with 463 receiving restorations and follow-up care. QoL metrics basis assessed Health Outcomes & Health Determinants. Initial QoL data was ranked in the bottom half of the state, while 70% of original determinant data was also ranked in the bottom half of reported metrics. Dental hygienists in public health settings can positively affect patients offering preventive care outreach services. Education and sealant placement were considered effective as measured by access, delivery and, when required, referral for restorative care. Improvement in QoL for individuals was noted through improved health outcomes and determinant metrics.

  12. Esophageal transit and in vivo disintegration of branded risedronate sodium tablets and two generic formulations of alendronic acid tablets: a single-center, single-blind, six-period crossover study in healthy female subjects.

    Science.gov (United States)

    Perkins, Alan C; Blackshaw, P Elaine; Hay, Peter D; Lawes, Simon C; Atherton, Clare T; Dansereau, Richard J; Wagner, Leigh K; Schnell, Dan J; Spiller, Robin C

    2008-05-01

    Delayed esophageal transit or disintegration of oral bisphosphonate tablets before they enter the stomach may be of concern with respect to iatrogenic complications among patients receiving longterm treatment. Different formulations of generic bisphosphonate tablets meeting regulatory requirements may have substantial differences in pharmaceutical attributes from the branded product that may result in different characteristics during esophageal transit. The primary objective of this study was to evaluate and compare esophageal transit times and in vivo disintegration of 3 bisphosphonate formulations, one branded and the others generic, that are commercially available in Canada and the United Kingdom. This was a single-center, randomized, singleblind, 6-period crossover study in healthy postmenopausal women aged >50 years. Each subject received a single oral dose of a branded risedronate sodium 35-mg tablet and 2 generic formulations of alendronic acid 70-mg tablets (Novopharm Limited, Toronto, Canada, and Teva UK Limited, Morley, United Kingdom) in both the erect and semisupine (45 degrees ) positions. Although the products are labeled to be taken in the erect position, the semisupine position was included to simulate dosing in bedridden patients. Subjects took tablets with 30 mL of water in the morning after an overnight fast. The tablets were radiolabeled with technetium-99m ion-exchange resins to enable visualization and measurement of esophageal transit time and disintegration using a gamma camera. Dynamic scintigraphic images were obtained for a total of 10 minutes: 2 images per second for the first 30 seconds and 1 image every 15 seconds for 9.5 minutes. This was a mechanistic study and tolerability was not assessed. The study was conducted in 20 healthy white female subjects with a mean age of 62 years (range, 51-77 years). The effect of body position was statistically significant (P = 0.043), with the estimated hazard ratio (HR) of 0.74 indicating longer

  13. Quality of life improvement in patients with Hashimoto thyroiditis and other goiters after surgery: A prospective cohort study.

    Science.gov (United States)

    Zivaljevic, Vladan R; Bukvic Bacotic, Branka R; Sipetic, Sandra B; Stanisavljevic, Dejana M; Maksimovic, Jadranka M; Diklic, Aleksandar D; Paunovic, Ivan R

    2015-09-01

    Hashimoto thyroiditis (HT) and other benign goiters (BG) might influence patients' quality of life (QoL). The objective of this study was to analyze influence of surgery on these patients' QoL. A prospective cohort study was conducted. The ThyPRO questionnaire was used in the QoL assessment. The HT patients experienced significantly worse hypothyroid symptoms and sex life than the BG patients. The improvement in QoL in the BG patients was significant after surgery in all ThyPRO domains. In the HT patients, the improvement was significant in all but two domains, eye symptoms and cognitive impairment. The best improvement in both groups was in overall QoL. None of the patients developed permanent consequences. The QoL of HT and BG patients is impaired and improves significantly after surgical treatment. Thyroidectomy should be considered as a treatment option in the HT patients more often as in the BG patients. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  14. Spiritual Therapy to Improve the Spiritual Well-Being of Iranian Women with Breast Cancer: A Randomized Controlled Trial

    OpenAIRE

    Jafari, Najmeh; Farajzadegan, Ziba; Zamani, Ahmadreza; Bahrami, Fatemeh; Emami, Hamid; Loghmani, Amir; Jafari, Nooshin

    2013-01-01

    Purpose. The aim of this study was to investigate the role of spiritual therapy intervention in improving the spiritual well-being and quality of life (QOL) of Iranian women with breast cancer. Methods. This randomized controlled clinical trial (RCT) recruited 65 women with breast cancer, randomly assigned to a 6-week spirituality-based intervention (n = 34) or control group (n = 31). Before and after six-week spiritual therapy intervention, spiritual well-being and quality of life (QOL) were...

  15. Health outcomes in acromegaly: depression and anxiety are promising targets for improving reduced quality of life

    Directory of Open Access Journals (Sweden)

    Victor Jacobus Geraedts

    2015-01-01

    Full Text Available IINTRODUCTION. Remission criteria of acromegaly are based on biochemical variables, i.e. normalization of increased hormone levels. However, the established reduction in Quality of Life (QoL is suggested to be independent of biochemical control. The aim of this study was to test which aspects predict Qol best in acromegaly. METHODS/Design. This is a prospective cohort study in 80 acromegalic patients, with a cross-sectional and longitudinal part. The main outcome measure was health-related quality of life (QoL, measured by a generic and a disease-specific questionnaire (the SF-36 and AcroQol. Main predictors were age, gender, biochemical control, disease characteristics, treatment modalities and psychopathology. RESULTS. Our cohort of 80 acromegalics had a mean age 54.7 ± 12.3 years with an average disease duration of 10.8 ± 10.0 years. Ratio macro-/microadenoma was 54/26. In adjusted mixed method models, we found that psychopathology significantly predicts QoL in acromegaly (in models including the variables age, gender, disease duration, tumor size, basal hormone levels, relevant treatment modalities and relevant comorbidities, with a higher degree of psychopathology indicating a lower QoL (depression vs. AcroQoL: B=-1.175, p<0.001, depression vs. SF36: B=-1.648, p<0.001, anxiety vs. AcroQoL: B=-0.399, p<0.001, anxiety vs. SF36: B=-0.661, p<0.001. The explained variances demonstrate superiority of psychopathology over biochemical control and other variables in predicting QoL in our models. DISCUSSION. Superiority of psychopathology over biochemical control calls for a more extensive approach regarding diagnosing depression and anxiety in pituitary adenomas to improve QoL. Depressive symptoms and anxiety are modifiable factors that might provide valuable targets for possible future treatment interventions.

  16. Antegrade continence enemas improve quality of life in patients with medically-refractory encopresis.

    Science.gov (United States)

    Church, Joseph T; Simha, Sidd; Wild, Laurie C; Teitelbaum, Daniel H; Ehrlich, Peter F

    2017-05-01

    Fecal incontinence is a socially debilitating problem for many children. We hypothesized that in selected patients with medically-refractory encopresis, placement of an appendicostomy or cecostomy tube for administration of antegrade continence enemas (ACE) would improve quality of life (QOL). We reviewed all patients with encopresis who underwent appendicostomy or cecostomy placement from 2003 to 2014 at our institution. We contacted subjects' parents by phone and administered 3 surveys: a survey reflecting current stooling habits, a disease-specific QOL survey, and the PedsQL™ QOL survey. QOL surveys were completed twice by parents, once reflecting pre-operative QOL, then again reflecting current QOL. Pre-procedure and post-procedure scores were compared by paired t-test. Ten patients underwent appendicostomy/cecostomy for encopresis. Eight completed phone surveys. All procedures were performed laparoscopically. All patients experienced fecal soiling pre-operatively, whereas 5/8 surveyed patients (63%) noted complete resolution of soiling post-procedure (pencopresis, likely related to resolution of soiling. 4. Copyright © 2017. Published by Elsevier Inc.

  17. Construct validity of the items on the Stroke Specific Quality of Life (SS-QOL) questionnaire that evaluate the participation component of the International Classification of Functioning, Disability and Health.

    Science.gov (United States)

    Silva, Soraia Micaela; Corrêa, Fernanda Ishida; Pereira, Gabriela Santos; Faria, Christina Danielli Coelho de Morais; Corrêa, João Carlos Ferrari

    2018-01-01

    Analyze the construct validity and internal consistency of the Stroke Specific Quality of Life (SS-QOL) items that address the participation component of the ICF as well as analyze the ceiling and floor effects. One hundred subjects were analyzed: 85 community-dwelling and 15 institutionalized individuals. The analysis of construct validity was performed using classic psychometrics: (1) the comparison of known groups (individuals without restriction to participation vs. those with restriction to participation) using the Mann-Whitney test and (2) convergent validity - correlation between the scores on the SS-QOL items that address participation and the subscale scores of measures used to evaluate the similar constructs and concepts [the Short-Form Health Survey (SF-36), Functional Independence Measure (FIM) and grip strength test]. Spearman's correlation coefficients were calculated for this analysis. Cronbach's α was used for the analysis of internal consistency and both the ceiling and floor effects were analyzed. The level of significance for all analyses was α = 0.05. The a priori hypotheses regarding construct validity were partially demonstrated, as only five of the eight domains exhibited positive moderate to strong correlations (r > 0.40) with measures that address constructs similar to those addressed on the SS-QOL questionnaire. The items demonstrated adequate internal consistency and are capable of differentiating individuals with and without restriction to participation. The ceiling and floor effects were considered adequate for the total SS-QOL score, but beyond acceptable standards for some domains. The 26 items of the SS-QOL questionnaire measure a multidimensional construct and therefore do not only address participation. However, the items demonstrated adequate internal consistency and are capable of differentiating individuals with and without restriction to participation. Implications for rehabilitation The 26 items of the SS-QOL

  18. Short-contact clobetasol propionate shampoo 0.05% improves quality of life in patients with scalp psoriasis.

    Science.gov (United States)

    Tan, Jerry; Thomas, Richard; Wang, Béatrice; Gratton, David; Vender, Ronald; Kerrouche, Nabil; Villemagne, Hervé

    2009-03-01

    Scalp psoriasis has a considerable impact on the quality of life (QOL) of patients, and most patients are dissatisfied with available treatments. Clobetasol propionate shampoo 0.05% has been shown to be effective and safe for moderate to severe scalp psoriasis. We evaluated the effect of clobetasol propionate shampoo on QOL and the degree of participant satisfaction with the product. Participants received once-daily treatment for up to 4 weeks. Their QOL and degree of satisfaction were evaluated by questionnaires. The mean (standard deviation) Dermatology Life Quality Index (DLQI) score decreased significantly from 7.0 (4.9) at baseline to 3.2 (3.2) at week 4 (Pshampoo improved the QOL of participants and resulted in high satisfaction.

  19. Comparison of the EuroQOL-5D with the Oswestry Disability Index, back and leg pain scores in patients with degenerative lumbar spine pathology.

    Science.gov (United States)

    Mueller, Benjamin; Carreon, Leah Y; Glassman, Steven D

    2013-04-20

    Cross-sectional study. To evaluate the response behavior of EuroQOL-5D (EQ-5D) compared with the Oswestry Disability Index (ODI), and back and leg pain scores. Recent changes in policies have highlighted the need for demonstration of both quality and cost effectiveness. In an effort to meet these requirements, surgeons are collecting health-related quality of life and utility data. Unfortunately, the burden of extensive data collection on both physician and patient is considerable. The EQ-5D is a commonly used, easily administered, brief utility measure that can provide both clinical and utility data. The EQ-5D has not yet been validated in spine patients in comparison with established outcome measures. EQ-5D, ODI, back and leg pain (0-10) scores were collected as part of standard clinical practice. Spearman rank correlations between the ODI, back and leg pain scores, and the EQ-5D were determined. A subanalysis to determine dimension-specific effects was done. Data were categorized by level of low back disability and level of back and leg pain. Data from 8385 patients (5046 females, 3339 males), mean age 52 (range, 18-96) were analyzed. There was a strong correlation between EQ-5D and ODI (r = -0.776) and between EQ-5D and back pain (r = -0.648); and moderate correlation between EQ-5D and leg pain scores (r = -0.538). Increasing disability, as measured by ODI, lead to lower EQ-5D scores, with similar response behavior for both back and leg pain scores. All correlations were statistically significant at P < 0.0001. The EQ-5D correlated well with established spine outcome measures, including ODI, and back and leg pain scores. EQ-5D correlated best with ODI scores. Correlation with back pain was stronger than leg pain, but all correlations were relatively strong. The EQ-5D can serve spine surgeons as an effective measure of clinical outcome and health utility for economic analysis.

  20. The effectiveness of wellness coaching for improving quality of life.

    Science.gov (United States)

    Clark, Matthew M; Bradley, Karleah L; Jenkins, Sarah M; Mettler, Emily A; Larson, Brent G; Preston, Heather R; Liesinger, Juliette T; Werneburg, Brooke L; Hagen, Philip T; Harris, Ann M; Riley, Beth A; Olsen, Kerry D; Vickers Douglas, Kristin S

    2014-11-01

    To learn more about the potential psychosocial benefits of wellness coaching. Although wellness coaching is increasing in popularity, there are few published outcome studies. In a single-cohort study design, 100 employees who completed the 12-week wellness coaching program were of a mean age of 42 years, 90% were women, and most were overweight or obese. Three areas of psychosocial functioning were assessed: quality of life (QOL; 5 domains and overall), depressive symptoms (Patient Health Questionnaire-9), and perceived stress level (Perceived Stress Scale-10). Participants were recruited from January 1, 2011, through December 31, 2011; data were collected up to July 31, 2012, and were analyzed from August 1, 2012, through October 31, 2013. These 100 wellness coaching completers exhibited significant improvements in all 5 domains of QOL and overall QOL (Pcoaching, and they maintained these improvements at the 24-week follow-up. In this single-arm cohort study (level 2b evidence), participating in wellness coaching was associated with improvement in 3 key areas of psychosocial functioning: QOL, mood, and perceived stress level. The results from this single prospective cohort study suggest that these areas of functioning improve after participating in wellness coaching; however, randomized clinical trials involving large samples of diverse individuals are needed to establish level 1 evidence for wellness coaching. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  1. Comprehensive yogic breathing program improves quality of life in patients with diabetes

    Directory of Open Access Journals (Sweden)

    Viveka P Jyotsna

    2012-01-01

    Full Text Available Objective: To assess the effect of a comprehensive yogic breathing program on glycemic control and quality of life (QOL in patients with diabetes. Materials and Methods: This is a prospective randomized controlled intervention trial. Patients having HbA1c between 6 and 9% for at least 3 months with lifestyle modification and oral antidiabetic medication were included. They were followed-up and randomized at 6 months into two groups: one group receiving standard treatment of diabetes and the other group receiving standard treatment of diabetes and taught and told to regularly practice the comprehensive yogic breathing program (Sudarshan Kriya Yoga and Pranayam. Change in fasting and post-prandial blood sugars, glycated hemoglobin and QOL as assessed by the World Health Organization QOL WHOQOL BREF questionnaire were assessed. Results: There was a trend toward improvement in glycemic control in the group practicing the comprehensive yogic breathing program compared with the group following standard treatment alone, although this was not significant. There was significant improvement in physical, psychological and social domains and total QOL post-intervention in the group practicing the comprehensive yogic breathing program as compared with the group following standard treatment alone. Conclusion: There was significant improvement in the QOL and a non-significant trend toward improvement in glycemic control in the group practicing the comprehensive yogic breathing program compared with the group that was following standard treatment alone.

  2. Mindfulness Meditation Improves Mood, Quality of Life, and Attention in Adults with Attention Deficit Hyperactivity Disorder.

    Science.gov (United States)

    Bueno, Viviane Freire; Kozasa, Elisa H; da Silva, Maria Aparecida; Alves, Tânia Maria; Louzã, Mario Rodrigues; Pompéia, Sabine

    2015-01-01

    Adults with attention deficit hyperactivity disorder (ADHD) display affective problems and impaired attention. Mood in ADHD can be improved by mindful awareness practices (MAP), but results are mixed regarding the enhancement of attentional performance. Here we evaluated MAP-induced changes in quality of life (QoL), mood, and attention in adult ADHD patients and controls using more measures of attention than prior studies. Twenty-one ADHD patients and 8 healthy controls underwent 8 weekly MAP sessions; 22 similar patients and 9 controls did not undergo the intervention. Mood and QoL were assessed using validated questionnaires, and attention was evaluated using the Attentional Network Test (ANT) and the Conners Continuous Performance Test (CPT II), before and after intervention. MAP enhanced sustained attention (ANT) and detectability (CPT II) and improved mood and QoL of patients and controls. MAP is a complementary intervention that improves affect and attention of adults with ADHD and controls.

  3. Effect of quality of life improvement on type 2 diabetes patients' self-esteem.

    Science.gov (United States)

    Safavi, Mahboubeh; Samadi, Nasrin; Mahmoodi, Mahmood

    2011-09-01

    To study the effects of the quality of life (QoL) improvement on their QoL and self-esteem. This was a random controlled clinical trial study on 123 type 2 diabetes patients admitted to the Diabetes Clinic in Imam Khomeini Hospital at Ardebil, Iran from April 2009 to June 2010. The 30-70 years old participants are afflicted with type 2 diabetes, and randomly divided into 2 groups (experimental group n=61, and control group n=62). The questionnaires were composed of sociodemographic status, Farrel & Grant, and Rosenberg's self-esteem questionnaires and the quality of life (QoL) improvement plan was codified to educate and evaluate them. A plow self-esteem (13%) before QOL training, and they had moderate self-esteem after the intervention (39%), however, the control group had moderate self-esteem (62.5%) in the pre-test, and changed to low self-esteem (12.9%) in the post-test, and there was significant difference in the previous and next intervention (pself-esteem, and QOL as improved may help to reduce the side effects of type 2 diabetes process.

  4. Influence of treatment with alendronate on the speed of sound, an ultrasound parameter, of the calcaneus in postmenopausal Japanese women with osteoporosis: a clinical practice-based observational study

    Directory of Open Access Journals (Sweden)

    Iwamoto J

    2012-06-01

    Full Text Available Jun Iwamoto,1 Tetsuya Takada,2 Yoshihiro Sato,3 Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, 2Department of Internal Medicine, Hiyoshi Medical Clinic, Kanagawa, 3Department of Neurology, Mitate Hospital, Fukuoka, JapanPurpose: The influence of alendronate (ALN treatment on the quantitative ultrasound parameters of the calcaneus remains to be established in Japanese patients. The aim of the present clinical practice-based observational study was to examine the influence of ALN treatment for 1 year on the speed of sound (SOS of the calcaneus and bone turnover markers in postmenopausal Japanese women with osteoporosis.Patients and methods: Forty-five postmenopausal Japanese women with osteoporosis who had received treatment with ALN for more than 1 year were enrolled in the study. The SOS and bone turnover markers were monitored over 1 year of ALN treatment.Results: The urinary levels of cross-linked N-terminal telopeptides of type I collagen and serum levels of alkaline phosphatase decreased significantly from the baseline values (–44.9% at 3 months and –22.2% at 12 months, respectively. The SOS increased modestly, but significantly, from the baseline value (0.6% at both 6 and 12 months. The percentage decrease in the urinary levels of cross-linked N-terminal telopeptides of type I collagen at 3 months was significantly correlated with the percentage increase in the SOS only at 6 months (correlation coefficient, 0.299.Conclusion: The present study confirmed that ALN treatment suppressed bone turnover, producing a clinically significant increase in the SOS of the calcaneus in postmenopausal Japanese women with osteoporosis.Keywords: postmenopausal osteoporosis, quantitative ultrasound (QUS, SOS, bone turnover, biochemical markers

  5. Bosentan therapy in patients with pulmonary arterial hypertension: the relationship between improvements in 6 minute walk distance and quality of life.

    Science.gov (United States)

    Strange, Geoff; Keogh, Anne M; Williams, Trevor J; Wlodarczyk, John; McNeil, Keith D; Gabbay, Eli

    2008-09-01

    Bosentan, an oral, dual endothelin receptor antagonist, significantly improves functional status, haemodynamic measures and survival in patients with pulmonary arterial hypertension (PAH). However, there are limited data on the effect of bosentan on quality of life (QOL) and its relationship to changes in functional status, as measured by the 6 minute walk distance (6MWD). A retrospective analysis was performed of a large, open-label, multicentre trial (VITAL) of bosentan in patients with PAH. Data for 6MWD were collected at baseline, 3 or 6 months and these results were correlated with QOL measurements collected as part of the assessment of patients enrolled in the trial. Sixty-nine patients with PAH (mean age 52 years) who were enrolled in the trial had valid QOL (SF-36) measurements and 6MWD data that could be retrieved from clinical notes. At 3 and 6 months, bosentan therapy improved 6MWD compared with baseline (49.5 m and 47.2 m, respectively, P < 0.001) as well as QOL domains, with a significant correlation between these two markers on cross-sectional analysis. However, there was a poor relationship when comparing changes in 6MWD with changes in QOL, in response to therapy. Bosentan therapy was associated with improvements in QOL and 6MWD for at least 6 months. At all measured time points, there was a close correlation between 6MWD and most QOL domains. QOL is an important parameter and should be considered as part of the standard assessment for any trial investigating therapy in PAH.

  6. Efficacy of Ashwagandha (Withania somnifera [L.] Dunal) in improving cardiorespiratory endurance in healthy athletic adults.

    Science.gov (United States)

    Choudhary, Bakhtiar; Shetty, A; Langade, Deepak G

    2015-01-01

    Ashwagandha (Withania somnifera [L.] Dunal) has been traditionally used for various actions ranging from vitalizer, improve endurance and stamina, promote longevity, improve immunity, and male and female fertility. However, clinical studies are needed to prove the clinical efficacy of this herb, especially in cardiovascular endurance and physical performance. This prospective, double-blind, randomized, and placebo-controlled study evaluated the efficacy of Ashwagandha roots extract in enhancing cardiorespiratory endurance and improving the quality of life (QOL) in 50 healthy male/female athletic adults. Cardiorespiratory endurance was assessed by measuring the oxygen consumption at peak physical exertion (VO2 max) levels during a 20 m shuttle run test. The World Health Organization self-reported QOL questionnaire (physical health, psychological health, social relationships, and environmental factors) was used to assess the QOL. Student's t-test was used to compare the differences in a mean and change from baseline VO2 max levels, whereas Wilcoxon signed-rank test was used to assess changes in QOL scores from baseline in the two groups. There was a greater increase from baseline (P < 0.0001) in the mean VO2 max with KSM-66 Ashwagandha (n = 24) compared to placebo (n = 25) at 8 weeks (4.91 and 1.42, respectively) and at 12 weeks (5.67 and 1.86 respectively). The QOL scores for all subdomains significantly improved to a greater extent in the Ashwagandha group at 12 weeks compared to placebo (P < 0.05). The findings suggest that Ashwagandha root extract enhances the cardiorespiratory endurance and improves QOL in healthy athletic adults.

  7. Quality of life outcome measures using UW-QOL questionnaire v4 in early oral cancer/squamous cell cancer resections of the tongue and floor of mouth with reconstruction solely using local methods.

    Science.gov (United States)

    Boyapati, Raghuram P; Shah, Ketan C; Flood, Valerie; Stassen, Leo F A

    2013-09-01

    Cancer treatment either by surgery alone or in a combination of surgery, radiotherapy±chemotherapy has significant consequences on the physical, mental, emotional and psychosocial wellbeing of the patient. Measurement of quality of life (QOL) is necessary to understand the patient's perception of their own treatment, as clinicians' views can be biased. Reconstruction of a cancerous defect with a free vascular flap is ideal in large, often composite defects, provided it is appropriate to the advanced stage and prognosis of the disease, medical condition of the patient, availability of surgical and financial resources and allows the prosthetic rehabilitation of the anatomic area. Using University of Washington Quality of life 4 questionnaire (UW-QOL4), we assessed the QOL of 38 patients, who underwent local surgical reconstructions after resection of T1/T2 tongue/floor of mouth squamous cell carcinoma defects. Objective assessment of speech and swallow function was also carried out using therapy outcome measure (TOM) scores by the speech and language therapy team (SALT) aiming to see the differences in the scores obtained in patients who underwent post-operative radiotherapy. Our study, conducted 6months after completion of all oncologic treatment for the primary disease, showed satisfactory levels of quality of life parameters with good function showing that local reconstructive methods are successful and may have benefits in the management of early oral cancers involving the tongue and floor of mouth. They are beneficial by providing a good quality in terms of function, by reducing the operating time, the surgical morbidity, simplifying post-operative care and thereby becoming an efficient, effective and a cost effective method. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Prevalence of swallowing and speech problems in daily life after chemoradiation for head and neck cancer based on cut-off scores of the patient-reported outcome measures SWAL-QOL and SHI.

    Science.gov (United States)

    Rinkel, Rico N; Verdonck-de Leeuw, Irma M; Doornaert, Patricia; Buter, Jan; de Bree, Remco; Langendijk, Johannes A; Aaronson, Neil K; Leemans, C René

    2016-07-01

    The objective of this study is to assess swallowing and speech outcome after chemoradiation therapy for head and neck cancer, based on the patient-reported outcome measures Swallowing Quality of Life Questionnaire (SWAL-QOL) and Speech Handicap Index (SHI), both provided with cut-off scores. This is a cross-sectional study. Department of Otolaryngology/Head and Neck Surgery of a University Medical Center. Sixty patients, 6 months to 5 years after chemoradiation for head and neck squamous cell carcinoma. Swallowing Quality of Life Questionnaire (SWAL-QOL) and SHI, both validated in Dutch and provided with cut-off scores. Associations were tested between the outcome measures and independent variables (age, gender, tumor stage and site, and radiotherapy technique, time since treatment, comorbidity and food intake). Fifty-two patients returned the SWAL-QOL and 47 the SHI (response rate 87 and 78 %, respectively). Swallowing and speech problems were present in 79 and 55 %, respectively. Normal food intake was noticed in 45, 35 % had a soft diet and 20 % tube feeding. Patients with soft diet and tube feeding reported more swallowing problems compared to patients with normal oral intake. Tumor subsite was significantly associated with swallowing outcome (less problems in larynx/hypopharynx compared to oral/oropharynx). Radiation technique was significantly associated with psychosocial speech problems (less problems in patients treated with IMRT). Swallowing and (to a lesser extent) speech problems in daily life are frequently present after chemoradiation therapy for head and neck cancer. Future prospective studies will give more insight into the course of speech and swallowing problems after chemoradiation and into efficacy of new radiation techniques and swallowing and speech rehabilitation programs.

  9. Sequential bilateral cochlear implantation improves working performance, quality of life, and quality of hearing.

    Science.gov (United States)

    Härkönen, Kati; Kivekäs, Ilkka; Rautiainen, Markus; Kotti, Voitto; Sivonen, Ville; Vasama, Juha-Pekka

    2015-05-01

    This prospective study shows that working performance, quality of life (QoL), and quality of hearing (QoH) are better with two compared with a single cochlear implant (CI). The impact of the second CI on the patient's QoL is as significant as the impact of the first CI. To evaluate the benefits of sequential bilateral cochlear implantation in working, QoL, and QoH. We studied working performance, work-related stress, QoL, and QoH with specific questionnaires in 15 patients with unilateral CI scheduled for sequential CI of another ear. Sound localization performance and speech perception in noise were measured with specific tests. All questionnaires and tests were performed before the second CI surgery and 6 and 12 months after its activation. Bilateral CIs increased patients' working performance and their work-related stress and fatigue decreased. Communication with co-workers was easier and patients were more active in their working environment. Sequential bilateral cochlear implantation improved QoL, QoH, sound localization, and speech perception in noise statistically significantly.

  10. Differences in cognitive performance, level of dependency and quality of life (QoL), related to age and cognitive status in a sample of Spanish old adults under and over 80 years of age.

    Science.gov (United States)

    Calero, Dolores; Navarro, Elena

    2011-01-01

    The main objective of this study was to analyze the similarities and differences in cognitive performance, level of dependency, cognitive plasticity and QoL in a sample of young-old adults and old-old adults, bearing in mind both the age-group (under or over 80 years) and the cognitive status of the participants. The study population consisted of 220 people living in sheltered accommodation for elderly people in the South of Spain, with an average age of 80.75 years. Participants were evaluated by means of cognitive performance tests, a QoL questionnaire, a depression scale and a dependency assessment scale. The results indicate that the main differences in the variables analyzed are due to the cognitive status of the sample and not to the fact that the participants are under or over 80 years of age. The findings show that major inter-individual differences in this stage of life depend not only on age but also on cognitive status, which is thus an important factor to take into account when working with this sector of the population. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. Among Patients Undergoing Ablative Treatment for Oral Cancer, Does the Provision of Oral Rehabilitation Improve the Quality of Life? A Review of the Current Literature.

    Science.gov (United States)

    Petrosyan, Vahe; Ball, Dimity; Harrison, Rebecca; Ameerally, Phillip

    2016-05-01

    The impact of oral cancer and its treatment is well documented; therefore, oral rehabilitation (OH; eg, with prosthetics, osseointegrated implants, etc) can be indicated to restore some level of form, function, and well-being. The purpose of this study was to review the current literature and evaluate the impact of OH on quality of life (QoL) after ablative surgery. A systematic literature search was conducted using EMBASE, MEDLINE, and PsychINFO. The study population was composed of all articles published from 2000 to 2015. To be included, studies had to use validated, specific head and neck QoL measurements (European Organization for Research and Treatment of Cancer QoL Head and Neck Module or University of Washington QoL Questionnaire). Only 8 articles met these inclusion criteria. In this review, OH was the primary predictor variable and QoL was the primary outcome variable. The 8 articles reviewed used a range of designs, including 1 randomized controlled trial, 3 prospective cohort studies, 3 case series, and 1 single-measurement cross-sectional descriptive study. Sample sizes were small (n = 26 to 102), and there was limited randomization and control of intervention and comparator groups. The overall level of evidence was weak. All studies showed a link between OH and QoL, but the results varied in significance (P < .01 to P = .95). Overall, there appears to be improvement in QoL to varying degrees after OH. However, a more systematic use of QoL measurements is needed before any definitive conclusions can be drawn. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  12. How Do Mobile Information Services Improve Quality of Life? The Case of Japanese Students

    OpenAIRE

    Ghyas, Qazi Mahdia; Kondo, Fumiyo N.

    2016-01-01

    Every technology should be geared to improve the quality of users’ lives. Our study aims to understand how mobile information services (MIS) contribute to quality of life (QoL) for young mobile users. This paper attempts to provide a comprehensive analysis of relationship between two variables: the contribution of MIS in 15 specific life domains and the contribution of MIS to overall quality of life (QoL). We examined bottom-up spillover theory with original and our additional life domains. E...

  13. An individual-based versus group-based exercise and counselling intervention for improving quality of life in breast cancer survivors. A feasibility and efficacy study.

    Science.gov (United States)

    Naumann, Fiona; Munro, Aime; Martin, Eric; Magrani, Paula; Buchan, Jena; Smith, Cathie; Piggott, Ben; Philpott, Martin

    2012-10-01

    Cancer and its treatments produce lingering side-effects that undermine the quality of life (QOL) of survivors. Exercise and psycho-therapies increase QOL among survivors, however, research is needed to identify intervention characteristics most associated with such improvements. This research aimed to assess the feasibility of a 9 week individual or group based exercise and counselling program, and to examine if a group based intervention is as effective at improving the QOL of breast cancer survivors as an individual-based intervention. A three group design was implemented to compare the efficacy of a 9 week individual (IEC n = 12) and group based exercise and counselling (GEC n = 14) intervention to a usual care (UsC n = 10) group on QOL of thirty-six breast cancer survivors. Across all groups, 90% of participants completed the interventions, with no adverse effects documented. At the completion of the intervention, there was a significant difference between groups for change in global QOL across time (p group (1.8 points). The effect size was moderate (0.70). Although the GEC improved QOL by almost 10.0 points, this increase did not reach significance. Both increases were above the minimally important difference of 7-8 points. These preliminary results suggest a combined exercise and psychological counseling program is both a feasible and acceptable intervention for breast cancer survivors. Whilst both the individual and group interventions improved QOL above the clinically important difference, only the individual based intervention was significant when compared to UsC. Copyright © 2011 John Wiley & Sons, Ltd.

  14. EuroQol-5 dimensions utility gain according to British and Swedish preference sets in rheumatoid arthritis treated with abatacept, rituximab, tocilizumab, or tumour necrosis factor inhibitors

    DEFF Research Database (Denmark)

    Gülfe, Anders; Wallman, Johan K; Kristensen, Lars Erik

    2016-01-01

    were plotted over time. RESULTS: Data regarding 2418 treatment courses with abatacept (ABA, n = 100), rituximab (RTX, n = 230), tocilizumab (TOC, n = 121), or TNFi (n = 1967) were included in the analysis. Patients starting TNFi treatment, as expected, had shorter disease duration and less previous...... biologics. Baseline utilities of patients commencing ABA and TOC, but not RTX, were also lower than in the TNFi group. Following treatment initiation, rapid utility improvements were seen with all therapies, reaching plateaus after approximately 1.5 months, and then remaining fairly stable throughout follow......-up in patients adhering to therapy. SE utilities were consistently higher than UK, with baseline values at around 0.7 leaving little room for improvement. CONCLUSIONS: ABA, RTX, TOC, and TNFi treatments were all associated with favourable EQ-5D utility developments in RA patients adhering to therapy...

  15. Twelve-month quality of life improvement and all-cause mortality in elderly patients undergoing transcatheter aortic valve replacement.

    Science.gov (United States)

    Kleczyński, Paweł; Bagieński, Maciej; Dziewierz, Artur; Rzeszutko, Łukasz; Sorysz, Danuta; Trębacz, Jarosław; Sobczyński, Robert; Tomala, Marek; Stąpór, Maciej; Dudek, Dariusz

    2016-10-10

    Restoration of quality of life (QoL) and improvement of clinical outcomes is crucial in elderly patients undergoing transcatheter aortic valve implantation (TAVI). We sought to evaluate changes in QoL and all-cause mortality 12 months after TAVI. A total of 101 patients who underwent TAVI were included. Patients were followed for 12 months. QoL was assessed at baseline and at 1, 6 and 12 months after TAVI using EQ-5D-3L with a visual analog scale (VAS). Patients who reported some problems with mobility at baseline showed better mobility after 12 months (p = 0.001). On the other hand, those who reported issues with self-care, usual activity or pain did not show significant improvement (p = 0.41; p = 0.12; p = 0.27, respectively). Patients reporting anxiety at baseline improved 12 months later (p = 0.003). VAS score showed an incremental increase during follow-up (p<0.001). Transfemoral access was associated with higher VAS score values after 1 month (median (IQR): 65.0 (50.0-75.0) vs. 54.0 (50.0-60.0); p = 0.019) but not after 12 months (70.0 (62.5-80.0) vs. 67.5 (55.0-70.0); p = 0.07) as compared to non-transfemoral access. In multivariable regression analysis, only age and the presence of coronary chronic total occlusion were independently associated with VAS score at 12 months. In-hospital, 1-, 6- and 12-month mortality rates were 6.9%, 10.9%, 15.8 and 17.8%, respectively. TAVI provides improved QoL with relatively good clinical outcomes. However, not all components of QoL may be improved. Patients treated with transfemoral access might have better QoL than those who had non-transfemoral access, especially early after TAVI.

  16. Role of Tamsulosin in Improving Double-J Ureteric Stent-Related ...

    African Journals Online (AJOL)

    Objective: To evaluate the efficacy of tamsulosin in improving stent- related symptoms and quality of life (QoL) in patients with double-J (DJ) ureteric stents. Subjects and Methods: A total of 136 patients were prospectively evaluated and distributed randomly in two groups. Group 1 was 69 patients with mean age 35 years ...

  17. Long-Term Quality of Life Improvement in Subjects with Healed Erosive Esophagitis: Treatment with Lansoprazole

    Science.gov (United States)

    Freston, James W.; Haber, Marian M.; Atkinson, Stuart; Hunt, Barbara; Peura, David A.

    2009-01-01

    Background Gastroesophageal reflux disease (GERD) is a chronic symptomatic condition and may be associated with erosive esophagitis (EE). Considerable data on the long-term maintenance of healing of EE are available, but data on long-term GERD symptom prevention and patient quality of life (QOL) are limited. Aims To investigate QOL in subjects with healed EE who received 12 months of double-blind maintenance treatment with lansoprazole or ranitidine, followed by long-term open-label lansoprazole therapy to prevent recurrence of EE. Methods Subjects with healed EE received 12 months of double-blind maintenance treatment with lansoprazole 15 mg once daily or ranitidine 150 mg twice daily, followed by dose-titrated, open-label lansoprazole therapy for up to 82 months. Results During double-blind treatment (n = 206), lansoprazole-treated patients showed significantly (P ≤ 0.05) greater improvements than ranitidine-treated patients in the frequency, severity, and ‘bothersomeness’ of heartburn, the symptom index, problems of activity limitation, eating and drinking problems, symptom problems, health distress, and social functioning. During dose-titrated, open-label treatment (n = 195), all disease-specific QOL scales except sleep improved significantly (P lansoprazole for 12 months in healed EE subjects produced significantly greater improvements in QOL indicators than ranitidine. These improvements were sustained during dose-titrated, open-label lansoprazole treatment. PMID:19582579

  18. Improved quality of life with immediate versus deferred initiation of antiretroviral therapy in early asymptomatic HIV infection.

    Science.gov (United States)

    Lifson, Alan R; Grund, Birgit; Gardner, Edward M; Kaplan, Richard; Denning, Eileen; Engen, Nicole; Carey, Catherine L; Chen, Fabian; Dao, Sounkalo; Florence, Eric; Sanz, Jesus; Emery, Sean

    2017-04-24

    To determine if immediate compared to deferred initiation of antiretroviral therapy (ART) in healthy persons living with HIV had a more favorable impact on health-related quality of life (QOL), or self-assessed physical, mental, and overall health status. QOL was measured in the Strategic Timing of Antiretroviral Therapy study, which randomized healthy ART-naive persons living with HIV with CD4 cell counts above 500 cells/μl from 35 countries to immediate versus deferred ART. At baseline, months 4 and 12, then annually, participants completed a visual analog scale (VAS) for 'perceived current health' and the Short-Form 12-Item Health Survey version 2 from which the following were computed: general health perception; physical component summary (PCS); and mental component summary (MCS); the VAS and general health were rated from 0 (lowest) to 100 (highest). QOL at study entry was high (mean scores: VAS = 80.9, general health = 72.5, PCS = 53.7, MCS = 48.2). Over a mean follow-up of 3 years, changes in all QOL measures favored the immediate group (P < 0.001); estimated differences were as follows: VAS = 1.9, general health = 3.6, PCS = 0.8, MCS = 0.9. When QOL changes were assessed across various demographic and clinical subgroups, treatment differences continued to favor the immediate group. QOL was poorer in those experiencing primary outcomes; however, when excluding those with primary events, results remained favorable for immediate ART recipients. In an international randomized trial in ART-naive participants with above 500 CD4 cells/μl, there were modest but significant improvements in self-assessed QOL among those initiating ART immediately compared to deferring treatment, supporting patient-perceived health benefits of initiating ART as soon as possible after an HIV diagnosis.

  19. Osteoporosis grave con aplastamientos vertebrales en dermatomiositis juvenil: Efecto del tratamiento con alendronato oral Severe osteoporosis with vertebral crushes in juvenile dermatomyositis: Effect of oral alendronate therapy

    Directory of Open Access Journals (Sweden)

    Cristina Tau

    2007-02-01

    Full Text Available Los glucocorticoides son usados comúnmente para el tratamiento de enfermedades inflamatorias, autoinmunes, enfermedades malignas, y en la prevención de rechazo de órganos trasplantados. Un efecto secundario frecuente del tratamiento prolongado es la pérdida de masa ósea que se produce por varios mecanismos y es causa de osteoporosis y fracturas vertebrales. El tratamiento con disfosfonatos ha sido propuesto para esta situación. Presentamos un caso clínico de osteoporosis grave en una niña con dermatomiositis juvenil, que respondió favorablemente al tratamiento con disfosfonatos orales.Glucocorticoids are used for the treatment of inflammatory and autoimmune diseases, cancer, and in prevention of organ rejects. A frequent secondary effect of longterm treatment with corticoids is the loss of bone mass, caused by several mechanisms: decrease in the intestinal calcium absorption, increase of the renal calcium excretion at the distal renal tubule, suppressive effect on the osteoblast and also in apoptosis of osteoclasts, inhibition in local production of IGF I (Insulin-like growth factor and IGFBPs (binding IGF I proteins necessary for bone metabolism, and decrease on osteocalcin production. Longterm treatment with corticoids is associated with osteoporosis and vertebral fractures. To improve this condition, treatment with bisphosphonates has been proposed. We present here a clinical case of a girl with dermatomyositis and severe osteoporosis with vertebral crushes, who responded well to oral bisphophonate treatment.

  20. The psychological aspects of everyday functioning in a group of patients with varicose veins – an assessment with VEINES Qol/Sym for patients before and after varicose veins surgery

    Directory of Open Access Journals (Sweden)

    Łukasz Migdalski

    2015-10-01

    Full Text Available Psychological functioning of patients in early stages of venous insufficiency has not been a common subject of scientific investigation so far, even though this group of patients experiences many limitations in daily functioning, as well as psychological distress. Varicose veins are the most common type of venous insufficiency, with an epidemiology of up to 50% of the western population. The present study is concerned with the functioning of a group undergoing surgery of varicose veins. The operation was carried out in an ambulatory mode, and such psychological factors as acceptance of illness, anxiety–state, anxiety–trait, and wellbeing (treated as personality construct have been considered. It is the first time that such variables have been used with the new tool for assessing quality of life in venous diseases (VEINES Qol/Sym, and no previous findings about applying VEINES Qol/Sym to assess patients after varicose veins operations exist. The results are promising, especially for combining such psychological variables as anxiety, acceptance of illness, or wellbeing with specific venous measures of quality of life. It has been proved that there is a need for monitoring psychological variables in the group of patients in an early stage of chronic venous illness. Further research on other venous patient groups is necessary to fully understand the specificity of these groups.

  1. Longitudinal trends with improvement in quality of life after TVT, TVT O and Burch colposuspension procedures.

    Science.gov (United States)

    Drahoradova, Petra; Martan, Alois; Svabik, Kamil; Zvara, Karel; Otava, Martin; Masata, Jaromir

    2011-02-01

    Comparison of the quality of life (QoL) trends after TVT, TVT O and Burch colposuspension (BCS) procedures and comparison of long-term subjective and objective outcomes. The study included 215 women who underwent a TVT, TVT O or BCS procedure. We monitored QoL after each procedure and the effect of complications on the QoL as assessed by the IQOL questionnaire over a 3-year period. The study was completed by 74.5% of women after TVT, 74.5% after TVT O, and 65.2% after BCS procedure. In the long-term, the QoL improved from 46.9 to 88.7 and remained stable after BCS; after TVT and TVT O, it declined, but only after TVT O was the decline statistically significant compared to BCS. The IQOL for women with post-operative complications has a clear descending tendency. The effect of the complications is highly significant (pTVT O, but not with TVT or BCS. Anti-incontinence operations significantly improve quality of life for women with MI, but compared to the SI group, the quality of life is worse when measured at a longer time interval after the operation. Anti-incontinence operations significantly improve quality of life, and the difference in preoperative status in the long-term follow-up is demonstrable.

  2. Practice of traditional Chinese medicine for psycho-behavioral intervention improves quality of life in cancer patients: A systematic review and meta-analysis

    Science.gov (United States)

    Liang, Dapeng; Wang, Chunli; Duan, Yangyang; Li, Xiaofen; Zhou, Shiyu; Zhao, Mingjie; Li, Yi; He, Yumin; Wang, Shaowu; Kelley, Keith W.; Jiang, Ping; Liu, Quentin

    2015-01-01

    Background Cancer patients suffer from diverse symptoms, including depression, anxiety, pain, and fatigue and lower quality of life (QoL) during disease progression. This study aimed to evaluate the benefits of Traditional Chinese Medicine psycho-behavioral interventions (TCM PBIs) on improving QoL by meta-analysis. Methods Electronic literature databases (PubMed, CNKI, VIP, and Wanfang) were searched for randomized, controlled trials conducted in China. The primary intervention was TCM PBIs. The main outcome was health-related QoL (HR QoL) post-treatment. We applied standard meta analytic techniques to analyze data from papers that reached acceptable criteria. Results The six TCM PBIs analyzed were acupuncture, Chinese massage, Traditional Chinese Medicine five elements musical intervention (TCM FEMI), Traditional Chinese Medicine dietary supplement (TCM DS), Qigong and Tai Chi. Although both TCM PBIs and non-TCM PBIs reduced functional impairments in cancer patients and led to pain relief, depression remission, reduced time to flatulence following surgery and sleep improvement, TCM PBIs showed more beneficial effects as assessed by reducing both fatigue and gastrointestinal distress. In particular, acupuncture relieved fatigue, reduced diarrhea and decreased time to flatulence after surgery in cancer patients, while therapeutic Chinese massage reduced time to flatulence and time to peristaltic sound. Conclusion These findings demonstrate the efficacy of TCM PBIs in improving QoL in cancer patients and establish that TCM PBIs represent beneficial adjunctive therapies for cancer patients. PMID:26498685

  3. The Design of Local-Authority Rental Housing for the Elderly That Improves Their Quality of Life

    Directory of Open Access Journals (Sweden)

    Yukiko Kuboshima

    2018-05-01

    Full Text Available As the population ages, the demand for suitable rental housing will increase. Suitable housing means housing that can accommodate those impairments that typically correspond with ageing. This paper explores the quality of life (QoL requirements of those elderly with high-care needs who live in rental housing. Using a qualitative case study approach, it examines the living experiences of six elderly people who need assistance and are living in local-authority rental housing in New Zealand. The themes of QoL were identified from the literature and related to the larger themes of; 1. Activities and independence, 2. Sense of control, 3. Privacy, 4. Relationships, 5. Quality of care, and 6. Comfort. The survey consisted of a detailed documentation of the physical environment, followed by interviews with and full-day observations of the residents and their caregivers. The study finds that the design of housing that improves their QoL requires solutions to accommodate the various conflicting needs for their QoL that include those derived from the diversity in the user’s preferences and impairments. In the design of rental housing, there is greater need for additional or reorganized space to accommodate caregivers and visitors, maintain residents’ independence, privacy, and other aspects important for their QoL.

  4. [Study and development of a new automatic suction system (SS) of intratracheal sputum in order to improve QOL of many patients with tracheostomy mechanical ventilation (TMV) and their family members by this new autonomic SS].

    Science.gov (United States)

    Hokezu, Youichi; Yamamoto, Makoto; Tokunaga, Syuichi; Niikura, Makoto; Nagamatsu, Keiji; Kira, Jun-ichi; Fukunaga, Toshihide; Shima, Kouji; Kikuchi, Seiji; Kimura, Itaru; Kondo, Kiyohiko; Mori, Teruhiko; Goto, Katumasa; Takigami, Shigeru; Shioya, Keiichi; Uehara, Minako

    2009-11-01

    In Japan, many patients equipped with TMV are under medical treatment at home after 1990. These patients can't put out sputa in trachea, so that these patient's family members must suck these patient's intratracheal sputa all days. Mr Yamamoto and Mr Tokunaga, main researchers of this study, began the study on the automatic SS of itratracheal sputa from 1999. In first stage, They developed the intermittent SS in detaining the suction tube within tracheal cannula, monitering the intratracheal pressure, but this system takes the ventilation away from the patient. Hypoventilation caused by this SS may cause the serious accident in patient. Therefore, we remodel the SS from intermittent SS to rollerpomp-type SS continuing to suck the itratracheal sputa with low volume from 2004, and thereafter we made up the SS of piston pomp type-SS finally at 2007. We developed the tracheal cannula with double suction holes of inner and lower hole in the lower part of its cannula together with the suction machine. We think that the practical use of this automatic SS will bring these patients with TMV and their family members great benefits. We desire that the practical use of this SS will be realized as soon as possible.

  5. Efeitos do treinamento resistido sobre variáveis relacionadas com a baixa densidade óssea de mulheres menopausadas tratadas com alendronato Effects of resistance training on low bone density-related variables in menopausal women taking alendronate

    Directory of Open Access Journals (Sweden)

    Cláudio Joaquim Borba-Pinheiro

    2010-04-01

    Full Text Available A osteoporose é uma doença crônica que atinge o esqueleto humano. OBJETIVO: Verificar os efeitos do treinamento resistido sobre a densidade mineral óssea (DMO, força muscular, equilíbrio e qualidade de vida em mulheres menopausadas em tratamento com alendronato. MÉTODOS: Participaram do estudo 16 voluntárias. Elas foram separadas em dois grupos: que praticaram o treino resistido (n = 9, 49,7 ± 4,2 idade e que constituíram o grupo controle (n = 7, 53,8 ± 4,4 idade. Os instrumentos de avaliação seguintes foram usados: a absorciometria de dupla energia por raios X -DXA (que mediu a coluna lombar L2-L4, colo do fêmur, triângulo de Wards e trocanter maior, o Osteoporosis Assessment Questionnaire (OPAQ e um teste de equilíbrio. O treinamento foi periodizado em 12 meses, divididos em seis ciclos com intensidade de 70-90% da carga máxima (10RM. Testes paramétricos (t ou Wilcoxon, para análise intragrupo e (Anova para intergrupos, foram usados. RESULTADOS: Foram encontradas diferenças significativas favoráveis ao grupo que treinou nos sítios da lombar L2-L4 (6,8%, p = 0,001, colo do fêmur (4,8%, p = 0,005 e trocanter (0,76%, p = 0,005. Além de diferenças significativas também para o equilíbrio corporal (21,4%, p = 0,001, qualidade de vida (9,1%, p = 0,001 e todas as medidas de força como na pressão de pernas 45° (49,3%, p Osteoporosis is a chronic disease of the human skeleton. OBJECTIVE: To verify the effects of resistance training on bone mineral density (BMD, muscular strength, balance and quality of life in menopausal women taking Alendronate. MATERIALS AND METHODS: Sixteen female volunteers participated in the study. The volunteers were separated into two groups: resistance training participants (n=9; 49.7±4.2 years and control group (n=7; 53.8±4.4 years. The following evaluation instruments were used: absorptiometry-DXA (which measured the lumbar spine L2-L4, neck femur, Wards triangle and major trochanter, the

  6. Sudarshan Kriya yoga improves quality of life in healthy people living with HIV (PLHIV: results from an open label randomized clinical trial

    Directory of Open Access Journals (Sweden)

    N Mawar

    2015-01-01

    Full Text Available Background & objectives: Improving quality of life (QOL of healthy people living with HIV (PLHIV is critical needing home-based, long-term strategy. Sudarshan Kriya yoga (SKY intervention is acknowledged for its positive impact on health. It is hypothesised that SKY would improve PLHIV′s QOL, justifying an evaluation. Methods: In this open label randomized controlled pilot trial, 61 adult PLHIV with CD4 count more than 400 cells/µl and Karnofsky scale score above 70 were enrolled. Those with cardiac disease, jaundice, tuberculosis, or on antiretroviral therapy/yoga intervention were excluded. All were given standard care, randomized to SKY intervention (31: I-SKY and only standard of care in control (30: O-SOC arms. The I-SKY participants were trained for six days to prepare for daily practice of SKY at home for 30 min. A validated 31-item WHOQOL-HIVBREF questionnaire was used to document effect in both arms from baseline to three visits at 4 wk interval. Results: Baseline QOL scores, hypertension and CD4 count were similar in both arms. An overall 6 per cent improvement of QOL scores was observed in I-SKY group as compared to O-SOC group, after controlling for baseline variables like age, gender, education and occupation ( p0 =0.016; 12 per cent for physical ( p0 =0.004, 11 per cent psychological ( p0 =0.023 and 9 per cent level of independence ( p0 =0.001 domains. Improvement in I-SKY observed at post-training and in the SKY adherence group showed increase in these two domains. Conclusions: A significant improvement in QOL scores was observed for the three health related QOL domains in SKY intervention arm. This low cost strategy improved physical and psychological state of PLHIV calling for upscaling with effective monitoring for sustainability of quality of life.

  7. Quality of life improvement in HIV-1 patients treated with raltegravir in a real-life observational study: RACING.

    Science.gov (United States)

    Spire, Bruno; Nait-Ighil, Lella; Pugliese, Pascal; Poizot-Martin, Isabelle; Jullien, Vincent; Marcelin, Anne-Geneviève; Billaud, Eric

    2017-01-01

    Good efficacy and safety of raltegravir in person living with HIV was demonstrated in clinical trials over five years, but real-life data, particularly about quality of life (QoL), are lacking. QoL was evaluated over time in adult patients first treated or switched to regimens containing raltegravir in an observational cohort study. Patient QoL was evaluated using the Fatigue Impact Scale (FIS) and the HIV Symptom Index (HSI). Data were collected at baseline and at 1, 3, 6, 12, 18, and 24 months. Baseline FIS and HSI subscores were compared with the scores at each visit using the paired Wilcoxon test. The impact of time, sociodemographic and medical variables upon patient-perceived fatigue and symptoms was also assessed using mixed multivariate models. From baseline, all FIS and HSI subscores improved significantly after one month of treatment. In addition, psychosocial FIS subscores and both the frequency of bothersome symptoms and HSI subscores improved significantly at each visit. Physical FIS subscores also improved significantly, except at month 18, whereas both cognitive and total FIS subscores improved only after 6 months and 24 months, respectively. In multivariate analysis, employment was independently associated over time with improved improvement in both FIS and HSI subscores. Patient QoL improved significantly over a 24-month period of treatment with a raltegravir-containing regimen. FIS and HSI are sensitive tools to measure the impact of new antiretroviral combinations on a patient's perception of QoL.

  8. Efficacy of a Social Self-Value Empowerment Intervention to Improve Quality of Life of HIV Infected People Receiving Antiretroviral Treatment in Nepal: A Randomized Controlled Trial.

    Science.gov (United States)

    Bhatta, Dharma Nand; Liabsuetrakul, Tippawan

    2017-06-01

    We developed a comprehensive and culturally applicable empowerment intervention social self-value package with an aim to assess its efficacy in order to improve the quality of life (QoL) of HIV infected people receiving antiretroviral treatment. Participants were randomly allocated to receive either six weekly intervention sessions or standard care. Nonlinear mixed-effects models were performed to compare changes in empowerment scores over time. Between September and November 2014, 1447 individuals were screened, of whom 132 were randomly assigned to either the intervention or control group. The mean scores of empowerment, social support and quality of life increased and stigma scores were reduced in the intervention group at 3- and 6-months. An intervention effect on social support, stigma and QoL was significantly increased by time and group with low and high empowerment. No adverse events were reported. The empowerment intervention was efficacious in improving QoL of HIV infected people.

  9. Complex tibial fractures are associated with lower social classes and predict early exit from employment and worse patient-reported QOL: a prospective observational study of 46 complex tibial fractures treated with a ring fixator.

    Science.gov (United States)

    Elsoe, Rasmus; Larsen, Peter; Petruskevicius, Juozas; Kold, Søren

    2018-04-01

    The long-term outcomes following complex fractures of the tibia are reported to carry a risk of knee pain, malalignment, articular injury and post-traumatic osteoarthritis. The main objective of this study was to account for the patient-reported quality of life (QOL) 12 months after ring fixator removal in patients with a complex tibial fracture. Secondary objectives included a review of the socio-economic characteristics of the patient group and the rate of return to work in the study period. A prospective follow-up study was conducted of 60 patients with complex fractures of the tibia treated with ring external fixation. Patient-reported outcomes, radiological outcomes and socio-economic status including employment status of the patients were obtained 12 months after frame removal. Forty-six patients completed the assessment 12 months after frame removal (77%). The mean age of the patient at the time of fracture was 54.6 years (range 31-86). There were 19 males and 27 females. At 12 months after frame removal, the mean EQ5D-5L index was 0.66 (CI 0.60-0.72). The mean EQ5D-5L VAS was 69 (CI 61-76). When this was compared to the established reference population from Denmark, the study population showed a significantly worse EQ5D-5L index. The majority of patients (87%) were in the lower social classes suggesting a higher degree of social deprivation in the study population. Twenty-seven per cent of patients who were employed prior to injury had returned to employment at approximately 19 months following fracture. The onset of post-traumatic osteoarthritis was present in the knee joint in 29% of patients following a proximal intra-articular fracture, whereas osteoarthritis was present at the ankle joint in 35% of patients following a distal intra-articular fracture 12 months after frame removal. This study indicates that at 12 months after frame removal there are poorer patient-reported QOL as when compared to reference populations. Furthermore, this study

  10. Replanning During Intensity Modulated Radiation Therapy Improved Quality of Life in Patients With Nasopharyngeal Carcinoma

    International Nuclear Information System (INIS)

    Yang Haihua; Hu Wei; Wang Wei; Chen Peifang; Ding Weijun; Luo Wei

    2013-01-01

    Purpose: Anatomic and dosimetric changes have been reported during intensity modulated radiation therapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). The purpose of this study was to evaluate the effects of replanning on quality of life (QoL) and clinical outcomes during the course of IMRT for NPC patients. Methods and Materials: Between June 2007 and August 2011, 129 patients with NPC were enrolled. Forty-three patients received IMRT without replanning, while 86 patients received IMRT replanning after computed tomography (CT) images were retaken part way through therapy. Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Head and Neck Quality of Life Questionnaire 35 were completed before treatment began and at the end of treatment and at 1, 3, 6, and 12 months after the completion of treatment. Overall survival (OS) data were compared using the Kaplan-Meier method. Results: IMRT replanning had a profound impact on the QoL of NPC patients, as determined by statistically significant changes in global QoL and other QoL scales. Additionally, the clinical outcome comparison indicates that replanning during IMRT for NPC significantly improved 2-year local regional control (97.2% vs 92.4%, respectively, P=.040) but did not improve 2-year OS (89.8% vs 82.2%, respectively, P=.475). Conclusions: IMRT replanning improves QoL as well as local regional control in patients with NPC. Future research is needed to determine the criteria for replanning for NPC patients undergoing IMRT.

  11. Home parenteral nutrition improves quality of life and nutritional status in patients with cancer: a French observational multicentre study.

    Science.gov (United States)

    Culine, S; Chambrier, C; Tadmouri, A; Senesse, P; Seys, P; Radji, A; Rotarski, M; Balian, A; Dufour, P

    2014-07-01

    Malnutrition is a predictor of poor outcomes in patients with cancer. Little is known about the benefit of nutritional support in these patients. The purpose of this study was to assess the impact of home parenteral nutrition (HPN) on quality of life (Qol) in cancer patients. We performed an observational prospective study to determine the impact of HPN on Qol in a population of patients with heterogeneous cancer. Physicians, patients and family members had to complete a questionnaire before HPN administration and 28 days after the course of HPN. Qol was evaluated using the self-administered questionnaire FACT-G. We included 767 patients with cancer of whom 437 ended the study. Mean patient age was 63±11.4 years and 60.5% were men. Primary gastrointestinal cancer was reported in 50% of patients and 65.3% were presenting metastases. Malnutrition was reported in 98.3%. After 28 days of HPN intake, significant improvement was observed in the Qol (49.95±5.82 vs. 48.35±5.01 at baseline, pnutrition risk index had also improved significantly. Most patients (78%) had perceived a positive impact of the HPN. A significant improvement in patient's well-being was perceived also by family members and physicians. Our data suggest that preventing and correcting malnutrition using HPN in patients with cancer might have a significant benefit on their well-being. Randomized controlled studies are required to confirm this finding.

  12. [Improvement of Stress Resistance and Quality of Life of Adults with Nervous Restlessness after Treatment with a Passion Flower Dry Extract].

    Science.gov (United States)

    Gibbert, Judith; Kreimendahl, Fabian; Lebert, Jennifer; Rychlik, Reinhard; Trompetter, Inga

    The passion flower dried ethanolic extract investigated in this non-interventional study has well-documented calmative effects and good tolerability. We investigated the effects of this extract on the stress resistance (resilience) and quality of life (QoL) of patients suffering from nervous restlessness. The addiction potential of the drug and the course of symptoms were also evaluated. Adult patients aged ≤ 95 years with the diagnosis 'nervous restlessness' were treated for 12 weeks with a dried ethanolic extract of passion flower (Passiflora incarnata L.). Standardized questionnaires were used to evaluate the resilience (RS-13), QoL (EQ-5D including EQ-VAS), and the addiction potential (BDEPQ). After 12 weeks of treatment, significant (p passion flower extract investigated in the present study appears to be effective in improving resilience and QoL in patients suffering from nervous restlessness and is well tolerated. © 2017 S. Karger GmbH, Freiburg.

  13. Improving quality of life in multiple sclerosis: an unmet need.

    Science.gov (United States)

    Zwibel, Howard L; Smrtka, Jennifer

    2011-05-01

    Multiple sclerosis (MS) affects approximately 400,000 people in the United States and 2.1 million people worldwide. It is the most common chronic, non-traumatic neurological disorder afflicting young people during their peak productive ages. MS can diminish quality of life (QOL) by interfering with the ability to work, pursue leisure activities, and carry on usual life roles. Symptoms that affect QOL may include impaired mobility, fatigue, depression, pain, spasticity, cognitive impairment, sexual dysfunction, bowel and bladder dysfunction, vision and hearing problems, seizures, and sDwallowing and breathing difficulties. Direct medical costs of MS in the United States are estimated in excess of $10 billion per year. Indirect costs of MS include costs of reduced employment or unemployment, assistive equipment, disability related home modifications, and paid and unpaid personal care. Although direct medical costs predominate in the earlier stages of MS, indirect costs of productivity loss are responsible for higher costs later. Disease-modifying therapies (DMTs) lessen symptoms, reduce relapses, and delay disability progression. Unfortunately, many DMTs might produce only modest improvements in QOL. Although symptom-specific therapies do not delay disease progression, they may delay unemployment and dependency, thereby reducing indirect costs.

  14. Cardiac rehabilitation: a good measure to improve quality of life in peri- and postmenopausal women with microvascular angina

    Directory of Open Access Journals (Sweden)

    Wojciech Szot

    2015-05-01

    Full Text Available Cardiac Syndrome X (CSX was considered a stable coronary syndrome, yet due to its nature, CSX symptoms often have a great impact on patients’ Quality of Life (QoL. According to ESC 2013 stable coronary artery disease criteria, CSX was replaced by Microvascular Angina (MA.Unfortunately, most CSX or MA patients, after classical angina (involving main coronary vessels has been ruled out, often do not receive proper treatment. Indications for pharmacological treatment of MA patients were introduced only recently. Another problematic issue is that scientists describing the pathophysiology of both CSX and MA stress a lack of a deeper insight into the multifactorial etiology of the source of pain associated with this disease. In the presented article we have attempted to study the influence of cardiac rehabilitation (3 months programme on the QoL of patients recognized as suffering from MA, as well as to check if changes in myocardial perfusion in these patients at baseline and after completion of cardiac rehabilitation match changes in their QoL. Therefore, after screening 436 women for MA, we studied 55 of them who were confirmed as having MA and who agreed to participate in the study. Exercise tests, Myocardial Perfusion Imaging, and QoL questionnaires were studied at baseline and after completing 3 months period of cardiac rehabilitation. Results were subsequently compared, which showed a link between improved perfusion score in SPECT study and improved overall physical capacity, on one hand, and improved QoL score on the other. These results confirm that cardiac rehabilitation is a very useful treatment option for MA patients. It seems that training during cardiac rehabilitation is a very important factor (improved physical efficiency –> increase in self-belief, and that taking into consideration the multifactor pathophysiology of pain, it is connected with a better quality of life for MA patients.

  15. Cardiac rehabilitation: a good measure to improve quality of life in peri- and postmenopausal women with microvascular angina

    Directory of Open Access Journals (Sweden)

    Wojciech Szot

    2015-05-01

    Full Text Available Cardiac Syndrome X (CSX was considered a stable coronary syndrome, yet due to its nature, CSX symptoms often have a great impact on patients’ Quality of Life (QoL. According to ESC 2013 stable coronary artery disease criteria, CSX was replaced by Microvascular Angina (MA.Unfortunately, most CSX or MA patients, after classical angina (involving main coronary vessels has been ruled out, often do not receive proper treatment. Indications for pharmacological treatment of MA patients were introduced only recently. Another problematic issue is that scientists describing the pathophysiology of both CSX and MA stress a lack of a deeper insight into the multifactorial etiology of the source of pain associated with this disease. In the presented article we have attempted to study the influence of cardiac rehabilitation (3 months programme on the QoL of patients recognized as suffering from MA, as well as to check if changes in myocardial perfusion in these patients at baseline and after completion of cardiac rehabilitation match changes in their QoL. Therefore, after screening 436 women for MA, we studied 55 of them who were confirmed as having MA and who agreed to participate in the study. Exercise tests, Myocardial Perfusion Imaging, and QoL questionnaires were studied at baseline and after completing 3 months period of cardiac rehabilitation. Results were subsequently compared, which showed a link between improved perfusion score in SPECT study and improved overall physical capacity, on one hand, and improved QoL score on the other. These results confirm that cardiac rehabilitation is a very useful treatment option for MA patients. It seems that training during cardiac rehabilitation is a very important factor (improved physical efficiency –> increase in self-belief, and that taking into consideration the multifactor pathophysiology of pain, it is connected with a better quality of life for MA patients.

  16. Measuring positive affect and well-being after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Positive Affect and Well-being bank and short form.

    Science.gov (United States)

    Bertisch, Hilary; Kalpakjian, Claire Z; Kisala, Pamela A; Tulsky, David S

    2015-05-01

    To develop an item response theory (IRT)-calibrated spinal cord injury (SCI)-specific Positive Affect and Well-being (PAWB) item bank with flexible options for administration. Qualitative feedback from patient and provider focus groups was used to expand on the Neurological Disorders and Quality of Life (Neuro-QOL) positive affect & well-being item bank for use in SCI. New items were created and revised based on expert review and patient feedback and were then field tested. Analyses included confirmatory factor analysis, graded response IRT modeling and evaluation of differential item functioning (DIF). We tested a 32-item pool at several rehabilitation centers across the United States, including the University of Michigan, Kessler Foundation, Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs hospital. A total of 717 individuals with SCI answered the PAWB questions. A unidimensional model was observed (Confirmatory Fit Index=0.947; Root Mean Square Error of Approximation=0.094) and measurement precision was good (reliability in theta of -2.9 to 1.2 is roughly equivalent to classical reliability of 0.95 or above). Twelve items were flagged for DIF, however, after examination of effect sizes, the DIF was determined to be negligible and would have little practical impact on score estimates. The final calibrated item bank resulted in 28 retained items This study indicates that the Spinal Cord Injury--Quality of Life PAWB bank represents a psychometrically robust measurement tool. Short form items are also suggested and a computer adaptive test is available.

  17. Establishing utility values for the 22-item Sino-Nasal Outcome Test (SNOT-22) using a crosswalk to the EuroQol-five-dimensional questionnaire-three-level version (EQ-5D-3L).

    Science.gov (United States)

    Crump, R Trafford; Lai, Ernest; Liu, Guiping; Janjua, Arif; Sutherland, Jason M

    2017-05-01

    Chronic rhinosinusitis (CRS) is a common condition for which there are numerous medical and surgical treatments. The 22-item Sino-Nasal Outcome Test (SNOT-22) is a patient-reported outcome measure often used with patients diagnosed with CRS. However, there are no utility values associated with the SNOT-22, limiting its use in comparative effectiveness research. The purpose of this study was to establish utilities for the SNOT-22 by mapping responses to utility values associated with the EuroQol-5-dimensional questionnaire-3-level version (EQ-5D-3L). This study used data collected from patients diagnosed with CRS awaiting bilateral endoscopic sinus surgery in Vancouver, Canada. Study participants completed both the SNOT-22 and the EQ-5D-3L. Ordinary least squares was used for 3 models that estimated the EQ-5D-3L utility values as a function of the SNOT-22 items. A total of 232 participants completed both the SNOT-22 and the EQ-5D-3L. As expected, there was a negative relationship between the SNOT-22 global scores and EQ-5D-3L utility values. Adjusted R 2 for the 3 models ranged from 0.28 to 0.33, and root mean squared errors between 0.23 and 0.24. A nonparametric bootstrap analysis demonstrated robustness of the findings. This study successfully developed a mapping model to associate utility values with responses to the SNOT-22. This model could be used to conduct comparative effectiveness research in CRS to evaluate the various interventions available for treating this condition. © 2017 ARS-AAOA, LLC.

  18. Spiritual therapy to improve the spiritual well-being of Iranian women with breast cancer: a randomized controlled trial.

    Science.gov (United States)

    Jafari, Najmeh; Farajzadegan, Ziba; Zamani, Ahmadreza; Bahrami, Fatemeh; Emami, Hamid; Loghmani, Amir; Jafari, Nooshin

    2013-01-01

    Purpose. The aim of this study was to investigate the role of spiritual therapy intervention in improving the spiritual well-being and quality of life (QOL) of Iranian women with breast cancer. Methods. This randomized controlled clinical trial (RCT) recruited 65 women with breast cancer, randomly assigned to a 6-week spirituality-based intervention (n = 34) or control group (n = 31). Before and after six-week spiritual therapy intervention, spiritual well-being and quality of life (QOL) were assessed using Functional Assessment of Chronic Illness Therapy Spiritual Well-being scale (FACIT-Sp12) and cancer quality-of-life questionnaire (QLQ-C30), respectively. t-test, Paired t-test, pearson's correlation, and hierarchical regression analyses were used for analysis using Predictive Analytic software (PASW, version 18) for Windows. Results. After six spiritual therapy sessions, the mean spiritual well-being score from 29.76 (SD = 6.63) to 37.24 (SD = 3.52) in the intervention group (P spiritual well-being and overall QOL. Social functioning was another significant predictor of spiritual well-being. Conclusion. The results of this randomized controlled trial study suggest that participation in spiritual therapy program is associated with improvements in spiritual well-being and QOL. Targeted interventions to acknowledge and incorporate spiritual needs into conventional treatment should be considered in caring of Iranian patients with breast cancer.

  19. Quality of Life in orthognathic surgery patients: post-surgical improvements in aesthetics and self-confidence.

    Science.gov (United States)

    Rustemeyer, Jan; Gregersen, Johanne

    2012-07-01

    The objective of this prospective study was to assess changes of Quality of Life (QoL) in patients undergoing bimaxillary orthognathic surgery. Questionnaires were based on the Oral Health Impact Profile (OHIP, items OH-1-OH-14) and three additional questions (items AD-1-3), and were completed by patients (n=50; mean age 26.9±9.9 years) on average 9.1±2.4 months before surgery, and 12.1±1.4 months after surgery, using a scoring scale. Item scores describing functional limitation, physical pain, physical disability and chewing function did not change significantly, whereas item scores covering psychological discomfort and social disability domains revealed significant decreases following surgery. AD-2 "dissatisfying aesthetics" revealed the greatest difference between pre- and post-surgical scores (paesthetic improvement of facial features post-surgery, the benefit in QoL was generally high. The significant correlation of the pre- to post-surgical changes of item OH-5 "self conscious" to nearly all other item changes suggested that OH-5 was the most sensitive indicator for post-surgical improvement of QoL. Psychological factors and aesthetics exerted a strong influence on the patients' QoL, and determined major changes more than functional aspects did. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  20. Sitting Tai Chi Improves the Balance Control and Muscle Strength of Community-Dwelling Persons with Spinal Cord Injuries: A Pilot Study

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    William W. N. Tsang

    2015-01-01

    Full Text Available Objective. To investigate the effects of sitting Tai Chi on muscle strength, balance control, and quality of life (QOL among survivors with spinal cord injuries (SCI. Methods. Eleven SCI survivors participated in the sitting Tai Chi training (90 minutes/session, 2 times/week for 12 weeks and eight SCI survivors acted as controls. Dynamic sitting balance was evaluated using limits of stability test and a sequential weight shifting test in sitting. Handgrip strength was also tested using a hand-held dynamometer. QOL was measured using the World Health Organization’s Quality of Life Scale. Results. Tai Chi practitioners achieved significant improvements in their reaction time (P=0.042; maximum excursion (P=0.016; and directional control (P=0.025 in the limits of stability test after training. In the sequential weight shifting test, they significantly improved their total time to sequentially hit the 12 targets (P=0.035. Significant improvement in handgrip strength was also found among the Tai Chi practitioners (P=0.049. However, no significant within and between-group differences were found in the QOL outcomes (P>0.05. Conclusions. Twelve weeks of sitting Tai Chi training could improve the dynamic sitting balance and handgrip strength, but not QOL, of the SCI survivors.

  1. Colonoscopic screening for colorectal cancer improves quality of life measures: a population-based screening study

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    Shadbolt Bruce

    2006-10-01

    Full Text Available Abstract Background Screening asymptomatic individuals for neoplasia can have adverse consequences on quality of life. Colon cancer screening is widespread but the quality of life (QOL consequences are unknown. This study determined the impact of screening colonoscopy on QOL measures in asymptomatic average-risk participants. Methods Asymptomatic male and female participants aged 55–74 years were randomly selected from the Australian Electoral Roll or six primary care physicians' databases. Participants completed the Short-Form (SF-36 Quality of Life Assessment at baseline and at a mean of 39 days after colonoscopy. Outcome measures were (i significant changes in raw scores in any of the eight SF-36 domains assessed following colonoscopic screening and (ii improvements or declines in previously validated categories, representing clinically significant changes, within any of the eight SF-36 domains. Results Baseline QOL measures were similar to those of a matched general population sample. Role Limitations due to Emotions, Mental Health and Vitality raw scores significantly improved following colonoscopy (P Conclusion Average-risk persons benefit significantly from colon cancer screening with colonoscopy, improving in Mental Health and Vitality domains of Quality of Life. This improvement is not offset by declines in other domains.

  2. Yoga-based postoperative cardiac rehabilitation program for improving quality of life and stress levels: Fifth-year follow-up through a randomized controlled trial

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    Eraballi Amaravathi

    2018-01-01

    Full Text Available Objectives: This study was aimed to assess the efficacy of yoga-based lifestyle program (YLSP in improving quality of life (QOL and stress levels in patients after 5 years of coronary artery bypass graft (CABG. Methodology: Three hundred patients posted for elective CABG in Narayana Hrudayalaya Super Speciality Hospital, Bengaluru, were randomized into two groups: YLSP and conventional lifestyle program (CLSP, and follow-up was done for 5 years. Intervention: In YLSP group, all practices of integrative approach of yoga therapy such as yama, niyama, asana, pranayama, and meditation were used as an add-on to conventional cardiac rehabilitation. The control group (CLSP continued conventional cardiac rehabilitation only. Outcome Measures: World Health Organization (WHO-QOL BREF Questionnaire, Perceived Stress Scale, Positive and Negative Affect Scale (PANAS, and Hospital Anxiety and Depression Scale (HADS were assessed before surgery and at the end of the 5th year after CABG. As data were not normally distributed, Mann–Whitney U-test was used for between-group comparisons and Wilcoxon's signed-rank test was used for within-group comparisons. Results: At the end of 5 years, mental health (P = 0.05, perceived stress (P = 0.01, and negative affect (NA (P = 0.05 have shown significant improvements. WHO-QOL BREF score has shown improvements in physical health (P = 0.046, environmental health (P = 0.04, perceived stress (P = 0.001, and NA (P = 0.02 in YLSP than CLSP. Positive affect has significantly improved in CLSP than YLSP. Other domains of WHO-QOL-BREF, PANAS, and HADS did not reveal any significant between-group differences. Conclusion: Addition of long-term YLSP to conventional cardiac rehabilitation brings better improvements in QOL and reduction in stress levels at the end of 5 years after CABG.

  3. Housing First improves subjective quality of life among homeless adults with mental illness: 12-month findings from a randomized controlled trial in Vancouver, British Columbia.

    Science.gov (United States)

    Patterson, Michelle; Moniruzzaman, Akm; Palepu, Anita; Zabkiewicz, Denise; Frankish, Charles J; Krausz, Michael; Somers, Julian M

    2013-08-01

    This study used an experimental design to examine longitudinal changes in subjective quality of life (QoL) among homeless adults with mental illness after assignment to different types of supported housing or to treatment as usual (TAU, no housing or supports through the study). We hypothesized that subjective QoL would improve over time among participants assigned to supported housing as compared to TAU, regardless of the type of supported housing received or participants' level of need. Participants (n = 497) were stratified by level of need ("high" or "moderate") and randomly assigned to Housing First (HF) in scattered-site apartments, HF in a congregate setting (high needs only), or TAU. Linear mixed-effects regression was used to model the association between study arm and self-reported QoL at baseline and at 6 and 12 months post-baseline by need level. Based on the adjusted overall score on the QoL measure, participants randomized to HF reported significantly greater overall QoL as compared to TAU, regardless of need level or type of supported housing at both 6 and 12 months post-baseline. Scores on the safety and living situation subscales were significantly greater for both high and moderate need participants assigned to supported housing regardless of type at both 6 and 12 months post-baseline as compared to TAU. Despite multiple health and social challenges faced by homeless individuals with mental illness, HF in both scattered-site and congregate models results in significantly greater perceived QoL as compared to individuals who do not receive HF even after a relatively short period of time.

  4. Exercise improves quality of life in androgen deprivation therapy-treated prostate cancer: systematic review of randomised controlled trials.

    Science.gov (United States)

    Teleni, Laisa; Chan, Raymond J; Chan, Alexandre; Isenring, Elisabeth A; Vela, Ian; Inder, Warrick J; McCarthy, Alexandra L

    2016-02-01

    Men receiving androgen deprivation therapy (ADT) for prostate cancer (PCa) are likely to develop metabolic conditions such as diabetes, cardiovascular disease, abdominal obesity and osteoporosis. Other treatment-related side effects adversely influence quality of life (QoL) including vasomotor distress, depression, anxiety, mood swings, poor sleep quality and compromised sexual function. The objective of this study was to systematically review the nature and effects of dietary and exercise interventions on QoL, androgen deprivation symptoms and metabolic risk factors in men with PCa undergoing ADT. An electronic search of CINAHL, CENTRAL, Medline, PsychINFO and reference lists was performed to identify peer-reviewed articles published between January 2004 and December 2014 in English. Eligible study designs included randomised controlled trials (RCTs) with pre- and post-intervention data. Data extraction and assessment of methodological quality with the Cochrane approach was conducted by two independent reviewers. Seven exercise studies were identified. Exercise significantly improved QoL, but showed no effect on metabolic risk factors (weight, waist circumference, lean or fat mass, blood pressure and lipid profile). Two dietary studies were identified, both of which tested soy supplements. Soy supplementation did not improve any outcomes. No dietary counselling studies were identified. No studies evaluated androgen-deficiency symptoms (libido, erectile function, sleep quality, mood swings, depression, anxiety and bone mineral density). Evidence from RCTs indicates that exercise enhances health- and disease-specific QoL in men with PCa undergoing ADT. Further studies are required to evaluate the effect of exercise and dietary interventions on QoL, androgen deprivation symptoms and metabolic risk factors in this cohort. © 2016 Society for Endocrinology.

  5. Mindfulness Meditation Improves Mood, Quality of Life, and Attention in Adults with Attention Deficit Hyperactivity Disorder

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    Viviane Freire Bueno

    2015-01-01

    Full Text Available Objective. Adults with attention deficit hyperactivity disorder (ADHD display affective problems and impaired attention. Mood in ADHD can be improved by mindful awareness practices (MAP, but results are mixed regarding the enhancement of attentional performance. Here we evaluated MAP-induced changes in quality of life (QoL, mood, and attention in adult ADHD patients and controls using more measures of attention than prior studies. Methods. Twenty-one ADHD patients and 8 healthy controls underwent 8 weekly MAP sessions; 22 similar patients and 9 controls did not undergo the intervention. Mood and QoL were assessed using validated questionnaires, and attention was evaluated using the Attentional Network Test (ANT and the Conners Continuous Performance Test (CPT II, before and after intervention. Results. MAP enhanced sustained attention (ANT and detectability (CPT II and improved mood and QoL of patients and controls. Conclusion. MAP is a complementary intervention that improves affect and attention of adults with ADHD and controls.

  6. Gabapentin can improve postural stability and quality of life in primary orthostatic tremor.

    Science.gov (United States)

    Rodrigues, Julian P; Edwards, Dylan J; Walters, Susan E; Byrnes, Michelle L; Thickbroom, Gary; Stell, Rick; Mastaglia, Frank L

    2005-07-01

    Primary orthostatic tremor (OT) is characterized by leg tremor and instability on standing. High frequency (13-18 Hz) tremor bursting is present in leg muscles during stance, and posturography has shown greater than normal sway. We report on an open-label add-on study of gabapentin in 6 patients with OT. Six patients were studied with surface electromyography, force platform posturography, and a modified Parkinson's disease questionnaire (PDQ-39) quality of life (QOL) scale before and during treatment with gabapentin 300 mg t.d.s. If on other medications for OT, these were continued unchanged. Of the 6 patients, 4 reported a subjective benefit of 50 to 75% with gabapentin, 3 of whom showed reduced tremor amplitude and postural sway of up to 70%. Dynamic balance improved in all 3 patients who completed the protocol. QOL data from 5 patients showed improvement in all cases. No adverse effects were noted. Gabapentin may improve tremor, stability, and QOL in patients with OT, and symptomatic response correlated with a reduction in tremor amplitude and postural sway. The findings confirm previous reports of symptomatic benefit with gabapentin and provide justification for larger controlled clinical trials. Further work is required to establish the optimal dosage and to validate the methods used to quantify the response to treatment. Copyright 2005 Movement Disorder Society.

  7. CONSERVATION OF HISTORIC WATERFRONT TO IMPROVE THE QUALITY OF LIFE IN OLD DHAKA

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    Mohammed Mahbubur Rahman

    2017-07-01

    Full Text Available Liveability of a city is related to the quality of life (QOL assessed by the impact of the quality of physical environment on liveability and the role of recreation in psychological wellbeing of individuals. Like in major Asian cities, the historic waterfront and architectural heritage of Dhaka are important components of the fabric. Despite diminution, it continues to affect the social life of Old Dhaka residents. In recent years, protection of the waterfront from illegal encroachment and pollution has become a major concern, amidst a lack of understanding of the river’s role in improving the QOL of the waterfront residents and the role of community involvement. By comparing waterfronts in similar contexts and through literature review and observations, the authors investigate how the conservation of the historic waterfront can contribute to the improvement of quality of life in Old Dhaka, and suggest ways to protect the riverfront with this objective. Seeing waterfronts as products of human intervention into nature, this paper discusses the socio-political forces that shape this, and investigates how conservation of the historic landscape can improve the QOL of the nearby residents. It uses a case study approach based on documentary research, unstructured and nonparticipant observations, and interviews with community leaders, environmental activists and local bodies.

  8. Measuring health-related quality of life in women with endometriosis: comparing the clinimetric properties of the Endometriosis Health Profile-5 (EHP-5) and the EuroQol-5D (EQ-5D).

    Science.gov (United States)

    Aubry, G; Panel, P; Thiollier, G; Huchon, C; Fauconnier, A

    2017-06-01

    Which of the Endometriosis Health Profile-5 (EHP-5) and the EuroQol-5D (EQ-5D) is the most efficient to assess quality of life in women suffering from endometriosis? Although EHP-5 and EQ-5D instruments had an excellent responsiveness, EHP-5 has a better discriminative ability than EQ-5 to measure health-related quality of life (HrQoL). Proper measurement of HrQoL is important in endometriosis. While many quality of life instruments are available, few have been completely validated in endometriosis. The EHP-5 and the EQ-5D are short and practical scales, which may be useful. Literature is lacking to determine which one is the most suitable in clinical practice or in clinical research. This prospective and observational study conducted between 1 January 2012 and 31 December 2013 included a total of 253 consecutive women with proven endometriosis, undergoing medical or surgical treatment, in 2 French tertiary care centers. Women over 18 years consulting for painful symptoms of at least 3 months' duration or for infertility, with endometriosis proven histologically or radiologically, were requested to fill in the 2 scales before (T0) and 12 months after treatment (T1). Construct validity consisted in testing presupposed relationships between the scales and the characteristics of the patients or the endometriosis. Responsiveness to change was calculated for all patients and in each treatment group. Effect sizes were used according to Cohen's d method. A total of 216 women filled in completely all the questionnaires at T0 and 133 (61.6%) at T1. EHP-5 and EQ-5D had good discriminative abilities regarding the patients' symptoms, with significant superiority of EHP-5 concerning three of the nine hypotheses. The largest difference was that calculated for the 'intensity of dysmenorrhea' using the Visual Analogic Scale, with respectively effect size from Cohen's d (ES) = 0.86 95% CI (0.54-1.17) for EHP-5 versus 0.48 95% CI (0.16-0.79) for EQ-5D. There were no differences in

  9. Home visits as part of a new care pathway (iAID) to improve quality of care and quality of life in ostomy patients: a cluster-randomized stepped-wedge trial

    NARCIS (Netherlands)

    Sier, M. F.; Oostenbroek, R. J.; Dijkgraaf, M. G. W.; Veldink, G. J.; Bemelman, W. A.; Pronk, A.; Spillenaar-Bilgen, E. J.; Kelder, W.; Hoff, C.; Ubbink, D. T.; Havenga, K.; Veltkamp, S. C.; T Dekker, J. W.; Boerma, D.; Eijsbouts, Q. A. J.; Lamme, B.; Vuylsteke, R. J. C. L. M.; Tobon Morales, R. E.; van Tets, W. F.

    2017-01-01

    Aim Morbidity in patients with an ostomy is high. A new care pathway, including perioperative home visits by enterostomal therapists, was studied to assess whether more elaborate education and closer guidance could reduce stoma-related complications and improve quality of life (QoL), at acceptable

  10. Is Telephysiotherapy an Option for Improved Quality of Life in Patients with Osteoarthritis of the Knee?

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    Adesola C. Odole

    2014-01-01

    Full Text Available This study investigated effect of a 6-week telephysiotherapy programme on quality of life (QoL of patients with knee osteoarthritis (OA. Fifty patients with knee OA were randomly and equally assigned into two treatment groups: clinic group (CG and telephysiotherapy group (TG. The CG received physiotherapist-administered osteoarthritis-specific exercises in the clinic thrice weekly for 6 weeks while the TG received structured telephone monitoring with self-administered osteoarthritis-specific exercises for the same duration at home. Participants’ QoL was assessed using WHOQoL-Bref at baseline, second, fourth, and sixth week of intervention. Data were analyzed using ANOVA and independent Student’s t-test. Within-group comparison showed significant improvements in physical health domain (P=0.00* for TG and CG and psychological domain (P=0.02* for TG; P=0.00* for CG of WHOQoL following six-week intervention. However, there were no significant differences (P>0.05 in TG and CG’s social relationship and environment domains. Between-group comparison showed no significant differences (P>0.05 between CG and TG’s physical health, psychological, and social relationships domains of WHOQoL following 6-week intervention. However, there was significant difference in the environment domain (P<0.05. Telephysiotherapy using telephone medium improved QoL in patients with knee OA comparable to clinic based treatment.

  11. Treatment with the first TNF inhibitor in rheumatoid arthritis patients in the Hellenic Registry of Biologic Therapies improves quality of life especially in young patients with better baseline functional status.

    Science.gov (United States)

    Boubouchairopoulou, Nadia; Flouri, Irini; Drosos, Alexandros A; Boki, Kyriaki; Settas, Loukas; Zisopoulos, Dimitrios; Skopouli, Fotini N; Papadopoulos, Ioannis; Iliopoulos, Alexios; Kyriopoulos, John; Boumpas, Dimitrios T; Athanasakis, Konstantinos; Sidiropoulos, Prodromos

    2016-01-01

    To assess in daily practice in patients with rheumatoid arthritis (RA) the effect of treatment with first tumour necrosis factor-α inhibitor (TNFi) in quality of life (Qol), disease activity and depict possible baseline predictors for gains in Qol. Patients followed prospectively by the Hellenic Registry of Biologic Therapies were analysed. Demographics were recorded at baseline, while RA-related characteristics at baseline and every 6 months. Paired t-tests were used to detect divergences between patient-reported (Health Assessment Questionnaire (HAQ), EuroQol (EQ-5D)) and clinical tools (Disease Activity Score-28 joints (DAS28)). Clinical versus self-reported outcomes were examined via cross-tabulation analysis. Multiple regression analysis was performed for identifying baseline predictors of improvements in QALYs. We analysed 255 patients (age (mean±SD) 57.1±13.0, disease duration 9.2±9.1 years, prior non-biologic disease-modifying anti-rheumatic drugs 2.3±1.2). Baseline EQ-5D, HAQ and DAS28 were 0.36 (0.28), 1.01 (0.72) and 5.9 (1.3), respectively, and were all significantly improved after 12 months (0.77 (0.35), 0.50 (0.66), 3.9 (1.5), respectively, p<0.05 for all). 90% of patients who improved from high to a lower DAS28 status (low-remission or moderate) had clinically important improvement in Qol (phi-coefficient=0.531,p<0.05). Independent predictors of gains in Qol were lower baseline HAQ, VAS global and younger age (adjusted R2=0.27). In daily practice TNFi improve both disease activity and Qol for the first 12 months of therapy. 90% of patients who improved from high to a lower DAS28 status had clinically important improvement in Qol. Younger patients starting with lower HAQ and VAS global are more likely to benefit.

  12. Adherence therapy improves medication adherence and quality of life in people with Parkinson's disease: a randomised controlled trial.

    Science.gov (United States)

    Daley, D J; Deane, K H O; Gray, R J; Clark, A B; Pfeil, M; Sabanathan, K; Worth, P F; Myint, P K

    2014-08-01

    Many factors are associated with medication non-adherence in Parkinson's disease (PD), including complex treatment regimens, mood disorders and impaired cognition. However, interventions to improve adherence which acknowledge such factors are lacking. A phase II randomised controlled trial was conducted investigating whether Adherence Therapy (AT) improves medication adherence and quality of life (QoL) compared with routine care (RC) in PD. Eligible PD patients and their spouse/carers were randomised to intervention (RC plus AT) or control (RC alone). Primary outcomes were change in adherence (Morisky Medication Adherence Scale) and QoL (Parkinson's Disease Questionnaire-39) from baseline to week-12 follow up. Secondary outcomes were MDS-UPDRS (part I, II, IV), Beliefs about Medication Questionnaire (BMQ), EuroQol (EQ-5D) and the Caregiving Distress Scale. Blinded data were analysed using logistic and linear regression models based on the intention-to-treat principle. Seventy-six patients and 46 spouse/carers completed the study (intervention: n = 38 patients, n = 24 spouse/carers). At week-12 AT significantly improved adherence compared with RC (OR 8.2; 95% CI: 2.8, 24.3). Numbers needed to treat (NNT) were 2.2 (CI: 1.6, 3.9). Compared with RC, AT significantly improved PDQ-39 (-9.0 CI: -12.2, -5.8), BMQ general harm (-1.0 CI: -1.9, -0.2) and MDS-UPDRS part II (-4.8 CI: -8.1, -1.4). No significant interaction was observed between the presence of a spouse/carer and the effect of AT. Adherence Therapy improved self-reported adherence and QoL in a PD sample. The small NNT suggests AT may be cost-effective. A larger pragmatic trial to test the efficacy and cost-effectiveness of AT by multiple therapists is required. © 2014 John Wiley & Sons Ltd.

  13. Food functionality research as a new national project in special reference to improvement of cognitive and locomotive abilities.

    Science.gov (United States)

    Abe, Keiko; Misaka, Takumi

    2018-04-01

    In Japan, where a super-aging society is realized, we are most concerned about healthy longevity, which would ascertain the wellness of people by improving their quality of life (QOL). In 2014, the Cabinet Office proposed a strategic innovation promotion programme, launching a national project for the development of the agricultural-forestry-fisheries food products with new functionalities for the next generation. In addition to focusing on a conventional prevention of lifestyle-associated metabolic syndromes, the project targets the scientific evidence of the activation of brain cognitive ability and the improvement of bodily locomotive function. The project also involves the analysis of the foods-sports interrelation of chronic importance, and the development of devices for the verification of QOL-associated maintenance of homeostasis. In this review, we provide an overview of these studies, with special reference to cognition as a case of the gut-brain axis which the author is particularly interested in.

  14. Correlation between pain response and improvements in patient-reported outcomes and health-related quality of life in duloxetine-treated patients with diabetic peripheral neuropathic pain

    Directory of Open Access Journals (Sweden)

    Ogawa K

    2015-08-01

    Full Text Available Kei Ogawa,1 Shinji Fujikoshi,2 William Montgomery,3 Levent Alev1 1Medical Science, 2Statistical Science, Eli Lilly Japan K.K., Kobe, Japan; 3Global Patient Outcomes and Real World Evidence, Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia Objective: We assessed whether quality of life (QoL improvement in duloxetine-treated patients with diabetic peripheral neuropathic pain (DPNP correlates with the extent of pain relief.Methods: Pooled data from three multicountry, double-blind, 12-week, placebo-controlled trials of duloxetine-treated (duloxetine 60 mg once daily; total number =335 patients with DPNP were analyzed. Based on improvement in 24-hour average pain scores, patients were stratified into four groups. Improvement in QoL, which was measured as the change from baseline in two patient-reported health outcome measures (Short Form [SF]-36 and five-dimension version of the EuroQol Questionnaire [EQ-5D], was evaluated and compared among the four groups. Pearson’s correlation coefficient was calculated to assess the correlation between improvement in pain scores and improvement in QoL.Results: The group with more pain improvement generally showed greater mean change from baseline in all of the SF-36 scale scores and on the EQ-5D index. Pearson’s correlation coefficients ranged from 0.114 to 0.401 for the SF-36 scale scores (P<0.05, and it was 0.271 for the EQ-5D (P<0.001.Conclusion: Improvement in pain scores was positively correlated with improvement in QoL and patient-reported outcomes in duloxetine-treated patients. Keywords: diabetic peripheral neuropathic pain, duloxetine, efficacy, function, quality of life

  15. What interventions can improve quality of life or psychosocial factors of individuals with knee osteoarthritis? A systematic review with meta-analysis of primary outcomes from randomised controlled trials.

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    Briani, Ronaldo Valdir; Ferreira, Amanda Schenatto; Pazzinatto, Marcella Ferraz; Pappas, Evangelos; De Oliveira Silva, Danilo; Azevedo, Fábio Mícolis de

    2018-03-16

    To systematically review evidence of primary outcomes from randomised controlled trials (RCTs) examining the effect of treatment strategies on quality of life (QoL) or psychosocial factors in individuals with knee osteoarthritis (OA). Systematic review with meta-analysis. Medline, Embase, SPORTDiscus, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science were searched from inception to November 2017. We included RCTs investigating the effect of conservative interventions on QoL or psychosocial factors in individuals with knee OA. Only RCTs considering these outcomes as primary were included. Pooled data supported the use of exercise therapy compared with controls for improving health-related and knee-related QoL. There was limited evidence that a combined treatment of yoga, transcutaneous electrical stimulation and ultrasound may be effective in improving QoL. Limited evidence supported the use of cognitive behavioural therapies (with or without being combined with exercise therapy) for improving psychosocial factors such as self-efficacy, depression and psychological distress. Exercise therapy (with or without being combined with other interventions) seems to be effective in improving health-related and knee-related QoL or psychosocial factors of individuals with knee OA. In addition, evidence supports the use of cognitive behavioural therapies (with or without exercise therapy) for improving psychosocial factors such as self-efficacy, depression and psychological distress in individuals with knee OA. CRD42016047602. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Chronic care model in primary care: can it improve health-related quality of life?

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    Aryani FMY

    2016-01-01

    Full Text Available Faridah Md Yusof Aryani,1 Shaun Wen Huey Lee,2 Siew Siang Chua,3 Li Ching Kok,4 Benny Efendie,2 Thomas Paraidathathu5 1Pharmaceutical Services Division, Ministry of Health Malaysia, Petaling Jaya, 2School of Pharmacy, Monash University Malaysia, Bandar Sunway, 3Department of Pharmacy, Faculty of Medicine, University of Malaya, 4Clinical Research Centre, Kuala Lumpur Hospital, Kuala Lumpur, 5School of Pharmacy, Taylor’s University, Subang Jaya, Selangor, Malaysia Purpose: Chronic diseases such as hypertension, diabetes mellitus, and hyperlipidemia are public health concerns. However, little is known about how these affect patient-level health measures. The aim of the study was to examine the impact of a chronic care model (CCM on the participant’s health-related quality of life (QoL. Patients and methods: Participants received either usual care or CCM by a team of health care professionals including pharmacists, nurses, dietitians, and general practitioners. The participants in the intervention group received medication counseling, adherence, and dietary advice from the health care team. The QoL was measured using the EQ-5D (EuroQoL-five dimension, health-related quality of life questionnaire and comparison was made between usual care and intervention groups at the beginning and end of the study at 6 months. Results: Mean (standard deviation EQ-5D index scores improved significantly in the intervention group (0.92±0.10 vs 0.95±0.08; P≤0.01, but not in the usual care group (0.94±0.09 vs 0.95±0.09; P=0.084. Similarly, more participants in the intervention group reported improvements in their QoL compared with the usual care group, especially in the pain/discomfort and anxiety/depression dimensions. Conclusion: The implementation of the CCM resulted in significant improvement in QoL. An interdisciplinary team CCM approach should be encouraged, to ultimately result in behavior changes and improve the QoL of the patients. Keywords: diabetes

  17. Improvement of quality of life, anxiety and depression after surgery in patients with stress urinary incontinence: Results of a longitudinal short-term follow-up

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    Giesinger Johannes M

    2008-09-01

    Full Text Available Abstract Objective The objective of this study was to compare the effect of incontinence surgery and pelvic floor training on quality of life (QOL, anxiety and depression in patients with stress urinary incontinence (SUI. Methods In a prospective longitudinal study, females with proven SUI were asked to complete a set of standardized questionnaires (sociodemographic data sheet, FACT-G, I-QOL, HADS before and eight weeks after treatment. The comparison groups consisted of a surgical treatment group and a conservative group that underwent supervised pelvic floor training for eight weeks. Results From the 67 female patients included in the study a number of 53 patients completed both assessment time points (mean age 57.4, mean years of SUI 7.6. The surgical treatment group consisted of 32 patients of which 21 patients received a modified Burch colposuspension and 11 patients a tension-free mid-urethral tape suspension. The 21 patients in the conservative group attended eight once-weekly supervised pelvic floor training sessions. After treatment the surgical intervention group showed a significantly higher improvement of QOL (FACT-G and I-QOL and anxiety (HADS than the pelvic floor training group. Conclusion For female patients with SUI surgery yielded a better outcome than pelvic floor training with regard to quality of life and anxiety.

  18. Tai Chi exercise and the improvement of health and well-being in older adults.

    Science.gov (United States)

    Yau, Matthew Kwai-sang

    2008-01-01

    Activity participation has a positive impact on both quantity and quality of life (QOL). Regular participations in physical, social, and cultural activities are associated with successful aging. There is considerable evidence that Tai Chi has positive health benefits; physical, psychosocial and therapeutic. Furthermore, Tai Chi does not only consist of a physical component, but also sociocultural, meditative components that are believed to contribute to overall well-being. This chapter describes the benefits of Tai Chi exercise for the older adults, particularly in terms of the psychosocial aspect. The perceived meanings, associated values and well-being, as well as the impact on QOL, of Tai Chi practice among the older adults in Hong Kong are also discussed. Tai Chi exercise is chosen by the elderly participants for its gentle and soft movements. Besides the physical aspect, the benefits they describe include lifestyle issues, as well as psychological and social benefits. Evidence points out that the improvements in physical and mental health through the practice of Tai Chi among the older adults are related to their perceived level of QOL. Findings from numerous studies support the belief that the practice of Tai Chi has multiple benefits to practitioners that are not only physical in nature. It is recommended as a strategy to promote successful aging.

  19. Can laser treatment improve quality of life of hirsute women?

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    Alizadeh N

    2017-10-01

    Full Text Available Narges Alizadeh,1 Sharad Ayyoubi,2 Mohammadreza Naghipour,3 Rasool Hassanzadeh,2 Zahra Mohtasham-Amiri,3 Shirin Zaresharifi,4 Kaveh Gharaei Nejad1 1Dermatology Department, School of Medicine, Guilan University of Medical Sciences, 2General Practice, School of Medicine, Guilan University of Medical Sciences, 3Community Medicine Department, School of Medicine, Guilan University of Medical Sciences, Rasht, 4General Practitioner, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Background: Hirsutism can have negative impacts on psychosocial aspects of women’s lives and reduce their quality of life (QOL. The aim of this study was to assess the QOL of these women during laser treatment. Patients and methods: Eighty-eight women with unwanted facial hair underwent laser therapy. Each patient completed a questionnaire consisting of a modified Dermatology Life Quality Index (DLQI and visual analog scale (VAS before the first, third, and fifth sessions of laser therapy. Interval between the sessions was 4–6 weeks. Statistical analyses were done using SPSS software version18. Results: The DLQI scores before treatment, and at third and fifth sessions were 7.75±2.36, 5.55±1.88, and 4.14±0.64, respectively (P<0.0001. Also, VAS scores had a decreasing trend between the first and second treatment sessions as the mean patient VAS score fell from 10±0.04 to 5.53±2.41 (P<0.0001. The DLQI scores were significantly different according to areas of hair growth and number of involved areas. There were no significant differences with regard to response to treatment and mean of DLQI score according to the level of education, marital status, and employment status. Conclusion: Hair removal with laser therapy can improve the QOL in hirsute women. Also, socioeconomic status does not affect the satisfaction rate of laser therapy for hair removal. Keywords: hirsutism, laser, quality of life, satisfaction, psychosocial

  20. Home visits as part of a new care pathway (iAID) to improve quality of care and quality of life in ostomy patients: a cluster-randomized stepped-wedge trial.

    Science.gov (United States)

    Sier, M F; Oostenbroek, R J; Dijkgraaf, M G W; Veldink, G J; Bemelman, W A; Pronk, A; Spillenaar-Bilgen, E J; Kelder, W; Hoff, C; Ubbink, D T

    2017-08-01

    Morbidity in patients with an ostomy is high. A new care pathway, including perioperative home visits by enterostomal therapists, was studied to assess whether more elaborate education and closer guidance could reduce stoma-related complications and improve quality of life (QoL), at acceptable cost. Patients requiring an ileostomy or colostomy, for any inflammatory or malignant bowel disease, were included in a 15-centre cluster-randomized 'stepped-wedge' study. Primary outcomes were stoma-related complications and QoL, measured using the Stoma-QOL, 3 months after surgery. Secondary outcomes included costs of care. The standard pathway (SP) was followed by 113 patients and the new pathway (NP) by 105 patients. Although the overall number of stoma-related complications was similar in both groups (SP 156, NP 150), the proportion of patients experiencing one or more stoma-related complications was significantly higher in the NP (72% vs 84%, risk difference 12%; 95% CI: 0.3-23.3%). Although in the NP more patients had stoma-related complications, QoL scores were significantly better (P improved quality of care and life, against similar costs. Based on these results the NP, including perioperative home visits by an enterostomal therapist, can be recommended. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

  1. Exercise training improves selected aspects of daytime functioning in adults with obstructive sleep apnea.

    Science.gov (United States)

    Kline, Christopher E; Ewing, Gary B; Burch, James B; Blair, Steven N; Durstine, J Larry; Davis, J Mark; Youngstedt, Shawn D

    2012-08-15

    To explore the utility of exercise training for improving daytime functioning in adults with obstructive sleep apnea (OSA). Forty-three sedentary and overweight/obese adults aged 18-55 years with at least moderate-severity untreated OSA (apnea-hypopnea index ≥ 15) were randomized to 12 weeks of moderate-intensity aerobic and resistance exercise training (n = 27) or low-intensity stretching control treatment (n = 16). As part of a trial investigating the efficacy of exercise training on OSA severity, daytime functioning was assessed before and following the intervention. Sleepiness, functional impairment due to sleepiness, depressive symptoms, mood, and quality of life (QOL) were evaluated with validated questionnaires, and cognitive function was assessed with a neurobehavioral performance battery. OSA severity was measured with one night of laboratory polysomnography before and following the intervention. Compared with stretching control, exercise training resulted in significant improvements in depressive symptoms, fatigue and vigor, and aspects of QOL (p improved following exercise versus control to a similar degree in terms of effect sizes (d > 0.5), though these changes were not statistically significant. No neurobehavioral performance improvements were found. Reduced fatigue following exercise training was mediated by a reduction in OSA severity, but changes in OSA severity did not significantly mediate improvement in any other measure of daytime functioning. These data provide preliminary evidence that exercise training may be helpful for improving aspects of daytime functioning of adults with OSA. Larger trials are needed to further verify the observed improvements.

  2. [Directions for use of corticosteroids and calcineurin inhibitors against generalized myasthenia gravis: therapeutic strategies that can lead to early improvements and veer away from high-dose oral corticosteroids].

    Science.gov (United States)

    Utsugisawa, Kimiaki; Nagane, Yuriko; Suzuki, Shigeaki; Suzuki, Norihiro

    2012-01-01

    The advent of effective immune treatment has meant that myasthenia gravis (MG) is most often not lethal. However, many MG patients still find it difficult to maintain daily activities due to chronic residual fatigability and long-term side effects of medication, since full remission without immune treatment is not common. Our analysis demonstrated that disease severity, dose of oral corticosteroids, and depressive state are the major independent factors negatively associated with self-reported QOL (MG-QOL15-J score). It is noteworthy that oral corticosteroid, the first-line agent for MG, is negatively associated with patients' QOL. When the analysis took into account MGFA postintervention status and dose of oral prednisolne (PSL), the MG-QOL15-J score of MM status patients taking ≤ 5 mg PSL per day is identically low (i.e., just as good QOL) as that seen in CSR and is a target of treatment. In order to veer away from high-dose oral corticosteroids and to achieve early MM or better status with PSL ≤ 5 mg/day, we advocate the early aggressive treatment strategy that can achieve early improvement by performing an aggressive therapy using combined treatment with plasmapheresis and high-dose intravenous methylprednisolone and then maintain an improved clinical status using low-dose oral corticosteroids and calcineurin inhibitors (cyclosporine microemulsion and tacrolimus). The early stages of MG are susceptible to treatment with calcineurin inhibitors. When using cyclosporine microemulsion for MG, blood concentrations 2 h after administration (C2) correlate with clinical improvement and immediately before administration (C0) with side effects (increased serum creatinine and/or hypertension). Monitoring of C2 and C0 levels is useful to estimate efficacy and safety of the drug.

  3. Improving quality of life in patients with pancreatic neuroendocrine tumor following peptide receptor radionuclide therapy assessed by EORTC QLQ-C30

    International Nuclear Information System (INIS)

    Marinova, Milka; Muecke, Martin; Mahlberg, Lukas; Essler, Markus; Ahmadzadehfar, Hojjat; Cuhls, Henning; Radbruch, Lukas; Conrad, Rupert

    2018-01-01

    Neuroendocrine tumors (NETs) have proven to be appropriate neoplasms for peptide receptor radionuclide therapy (PRRT), as the majority of these slow-growing malignancies overexpress somatostatin receptors. The aim of this study was to evaluate changes in quality of life (QoL) of patients with P-NET following PRRT. Sixty-eight patients with P-NET (31 female, mean age 61.4 y) underwent PRRT: 12 with NET of grade 1, 40 of grade 2, 8 of grade 3 (grade non-available n = 8). Prior to treatment, 39 patients showed ECOG 0, 26 patients ECOG 1, and three patients ECOG 2. Clinical assessment included evaluation of QoL and symptom changes using a standardized questionnaire (EORTC QLQ-C30) and was performed at baseline and every three months following each therapy cycle up to 12 months. Primary analysis compared QoL at baseline and after the fourth treatment cycle (N = 53). Up to four treatment cycles PRRT were performed for each patient. The median cumulative administered activity was 28.2 GBq. Primary analysis revealed that compared to baseline QoL was significantly improved revealing increased global health status (p = 0.008) and social functioning (p = 0.049) at the end of the study. Furthermore, fatigue and appetite loss showed a significant improvement after the last PRRT cycle (fatigue: p = 0.029, appetite loss p = 0.015). Sub-analyses showed that QoL was improved revealing increased global health status (3 months after first, second, and third treatment cycle p = 0.048, p = 0.002, and p < 0.001, respectively), emotional functioning (3 months after first-third cycle p = 0.003, p = 0.049, and p = 0.001, respectively) and social functioning (3 months after the first and second p < 0.001, and after the third cycle p = 0.015, respectively). Furthermore, some symptoms were significantly alleviated compared with baseline: fatigue (after first-third cycle p = 0.026, p = 0.050, and p = 0.008, respectively), nausea and vomiting (after first and second cycle p = 0.006 and p = 0

  4. Improving quality of life in patients with pancreatic neuroendocrine tumor following peptide receptor radionuclide therapy assessed by EORTC QLQ-C30

    Energy Technology Data Exchange (ETDEWEB)

    Marinova, Milka [University Hospital Bonn, Department of Radiology, Bonn (Germany); Muecke, Martin [University Hospital Bonn, Department of Palliative Medicine, Bonn (Germany); University Hospital Bonn, Department of General Practice and Family Medicine, Bonn (Germany); University Hospital of Bonn, Center for Rare Diseases Bonn (ZSEB), Bonn (Germany); Mahlberg, Lukas; Essler, Markus; Ahmadzadehfar, Hojjat [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); Cuhls, Henning; Radbruch, Lukas [University Hospital Bonn, Department of Palliative Medicine, Bonn (Germany); Conrad, Rupert [University Hospital of Bonn, Department of Psychosomatic Medicine and Psychotherapy, Bonn (Germany)

    2018-01-15

    Neuroendocrine tumors (NETs) have proven to be appropriate neoplasms for peptide receptor radionuclide therapy (PRRT), as the majority of these slow-growing malignancies overexpress somatostatin receptors. The aim of this study was to evaluate changes in quality of life (QoL) of patients with P-NET following PRRT. Sixty-eight patients with P-NET (31 female, mean age 61.4 y) underwent PRRT: 12 with NET of grade 1, 40 of grade 2, 8 of grade 3 (grade non-available n = 8). Prior to treatment, 39 patients showed ECOG 0, 26 patients ECOG 1, and three patients ECOG 2. Clinical assessment included evaluation of QoL and symptom changes using a standardized questionnaire (EORTC QLQ-C30) and was performed at baseline and every three months following each therapy cycle up to 12 months. Primary analysis compared QoL at baseline and after the fourth treatment cycle (N = 53). Up to four treatment cycles PRRT were performed for each patient. The median cumulative administered activity was 28.2 GBq. Primary analysis revealed that compared to baseline QoL was significantly improved revealing increased global health status (p = 0.008) and social functioning (p = 0.049) at the end of the study. Furthermore, fatigue and appetite loss showed a significant improvement after the last PRRT cycle (fatigue: p = 0.029, appetite loss p = 0.015). Sub-analyses showed that QoL was improved revealing increased global health status (3 months after first, second, and third treatment cycle p = 0.048, p = 0.002, and p < 0.001, respectively), emotional functioning (3 months after first-third cycle p = 0.003, p = 0.049, and p = 0.001, respectively) and social functioning (3 months after the first and second p < 0.001, and after the third cycle p = 0.015, respectively). Furthermore, some symptoms were significantly alleviated compared with baseline: fatigue (after first-third cycle p = 0.026, p = 0.050, and p = 0.008, respectively), nausea and vomiting (after first and second cycle p = 0.006 and p = 0

  5. Changing core beliefs with trial-based cognitive therapy may improve quality of life in social phobia: a randomized study

    Directory of Open Access Journals (Sweden)

    Vania Bitencourt Powell

    2013-09-01

    Full Text Available Objective: To determine whether there are differences in quality of life (QoL improvement after treatment with the trial-based thought record (TBTR versus conventional cognitive therapy (CCT in patients with social anxiety disorder (SAD. Method: A randomized trial comparing TBTR with a set of CCT techniques, which included the standard 7-column dysfunctional thought record (DTR and the positive data log (PDL in patients with SAD, generalized type. Results: Repeated measures analysis of variance (ANOVA revealed a significant time effect in the general health, vitality, social functioning, and mental health domains of the Short Form 36. It also indicated significant treatment effects on the bodily pain, social functioning, role-emotional, and mental health domains, with higher scores in the TBTR group. One-way analysis of covariance (ANCOVA, using pretreatment values as covariates, showed that TBTR was associated with significantly better QoL post-treatment (bodily pain, social functioning and role-emotional and at follow-up (role-emotional. A significant treatment effect on the role-emotional domain at 12-month follow-up denoted a sustained effect of TBTR relative to CCT. Conclusion: This study provided preliminary evidence that TBTR is at least as effective as CCT in improving several domains of QoL in SAD, specifically when the standard 7-column DTR and the PDL are used.

  6. Changing core beliefs with trial-based cognitive therapy may improve quality of life in social phobia: a randomized study.

    Science.gov (United States)

    Powell, Vania Bitencourt; Oliveira, Olivia Haun de; Seixas, Camila; Almeida, Cláudia; Grangeon, Maria Conceição; Caldas, Milke; Bonfim, Thaís Delavechia; Castro, Martha; Galvão-de Almeida, Amanda; Galvão-de Almeida; Moraes, Roberta de Oliveira; Sudak, Donna; de-Oliveira, Irismar Reis

    2013-01-01

    To determine whether there are differences in quality of life (QoL) improvement after treatment with the trial-based thought record (TBTR) versus conventional cognitive therapy (CCT) in patients with social anxiety disorder (SAD). A randomized trial comparing TBTR with a set of CCT techniques, which included the standard 7-column dysfunctional thought record (DTR) and the positive data log (PDL) in patients with SAD, generalized type. Repeated measures analysis of variance (ANOVA) revealed a significant time effect in the general health, vitality, social functioning, and mental health domains of the Short Form 36. It also indicated significant treatment effects on the bodily pain, social functioning, role-emotional, and mental health domains, with higher scores in the TBTR group. One-way analysis of covariance (ANCOVA), using pretreatment values as covariates, showed that TBTR was associated with significantly better QoL post-treatment (bodily pain, social functioning and role-emotional) and at follow-up (role-emotional). A significant treatment effect on the role-emotional domain at 12-month follow-up denoted a sustained effect of TBTR relative to CCT. This study provided preliminary evidence that TBTR is at least as effective as CCT in improving several domains of QoL in SAD, specifically when the standard 7-column DTR and the PDL are used.

  7. Tertiary individual prevention improves mental health in patients with severe occupational hand eczema.

    Science.gov (United States)

    Breuer, K; John, S M; Finkeldey, F; Boehm, D; Skudlik, C; Wulfhorst, B; Dwinger, C; Werfel, T; Diepgen, T L; Schmid-Ott, G

    2015-09-01

    Occupational hand eczema (OHE) is associated with impaired health-related quality of life (QoL) and mental distress. Interdisciplinary inpatient rehabilitation measures in the framework of tertiary individual prevention (TIP) offered by the German employers' liability insurance associations include dermatological treatment, education and psychological interventions. To investigate the effects of interdisciplinary inpatient rehabilitation in the framework of TIP on mental health in patients with severe OHE and the relationships between recovery of OHE and improvement of mental health and QoL. A total of 122 patients participated in the study. A test battery consisting of the German versions of the Hospital Anxiety and Depression Scale (HADS-D), the Dermatology Life Quality Index (DLQI), the Short Form Health Survey-36 (SF-36) and the Trier Inventory for the Assessment of Chronic Stress (TICS) was applied at the time of admission (T1) and 3 weeks after dismissal (T2). Severity of hand eczema was assessed with the Osnabrueck Hand Eczema Severity Index (OHSI). All parameters improved significantly from T1 to T2. A relationship was established between the improvement of QoL and recovery of OHE, while there was no such relationship between the improvement of mental distress and improvement of OHE. Nonresponders had significantly more cumulative days of sickness at T1. Our data underscore the importance of psychological interventions in addition to dermatological treatment in the framework of prevention measures for OHE. These measures should be applied at an early stage of OHE prior to the occurrence of sick leave. © 2015 European Academy of Dermatology and Venereology.

  8. Spiritual Therapy to Improve the Spiritual Well-Being of Iranian Women with Breast Cancer: A Randomized Controlled Trial

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    Najmeh Jafari

    2013-01-01

    Full Text Available Purpose. The aim of this study was to investigate the role of spiritual therapy intervention in improving the spiritual well-being and quality of life (QOL of Iranian women with breast cancer. Methods. This randomized controlled clinical trial (RCT recruited 65 women with breast cancer, randomly assigned to a 6-week spirituality-based intervention (n=34 or control group (n=31. Before and after six-week spiritual therapy intervention, spiritual well-being and quality of life (QOL were assessed using Functional Assessment of Chronic Illness Therapy Spiritual Well-being scale (FACIT-Sp12 and cancer quality-of-life questionnaire (QLQ-C30, respectively. t-test, Paired t-test, pearson's correlation, and hierarchical regression analyses were used for analysis using Predictive Analytic software (PASW, version 18 for Windows. Results. After six spiritual therapy sessions, the mean spiritual well-being score from 29.76 (SD=6.63 to 37.24 (SD=3.52 in the intervention group (P<0.001. There was a significant difference between arms of study (F=22.91, P<0.001. A significant positive correlation was detected between meaning and peace with all subscales of functional subscales on European Organization for Research and Treatment of Cancer quality of Life (EORTC QLQ-C30 (P<0.05. Hierarchical regression analyses of participants indicated that the study arm, pain, and financial impact were significant predictors of spiritual well-being and overall QOL. Social functioning was another significant predictor of spiritual well-being. Conclusion. The results of this randomized controlled trial study suggest that participation in spiritual therapy program is associated with improvements in spiritual well-being and QOL. Targeted interventions to acknowledge and incorporate spiritual needs into conventional treatment should be considered in caring of Iranian patients with breast cancer.

  9. Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients.

    Science.gov (United States)

    Galway, Karen; Black, Amanda; Cantwell, Marie; Cardwell, Chris R; Mills, Moyra; Donnelly, Michael

    2012-11-14

    A cancer diagnosis may lead to significant psychological distress in up to 75% of cases. There is a lack of clarity about the most effective ways to address this psychological distress. To assess the effects of psychosocial interventions to improve quality of life (QoL) and general psychological distress in the 12-month phase following an initial cancer diagnosis. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 4), MEDLINE, EMBASE, and PsycINFO up to January 2011. We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of included studies. Electronic searches were carried out across all primary sources of peer-reviewed publications using detailed criteria. No language restrictions were imposed. Randomised controlled trials of psychosocial interventions involving interpersonal dialogue between a 'trained helper' and individual newly diagnosed cancer patients were selected. Only trials measuring QoL and general psychological distress were included. Trials involving a combination of pharmacological therapy and interpersonal dialogue were excluded, as were trials involving couples, family members or group formats. Trial data were examined and selected by two authors in pairs with mediation from a third author where required. Where possible, outcome data were extracted for combining in a meta-analyses. Continuous outcomes were compared using standardised mean differences and 95% confidence intervals, using a random-effects model. The primary outcome, QoL, was examined in subgroups by outcome measurement, cancer site, theoretical basis for intervention, mode of delivery and discipline of trained helper. The secondary outcome, general psychological distress (including anxiety and depression), was examined according to specified outcome measures. A total of 3309 records were identified, examined and the trials subjected to selection criteria; 30 trials were included in

  10. Effectiveness of a Combined Dance and Relaxation Intervention on Reducing Anxiety and Depression and Improving Quality of Life among the Cognitively Impaired Elderly

    OpenAIRE

    Dina Adam; Ayiesah Ramli; Suzana Shahar

    2016-01-01

    Objectives: Cognitive impairment is a common problem among the elderly and is believed to be a precursor to dementia. This study aimed to explore the effectiveness of a combined dance and relaxation intervention as compared to relaxation alone in reducing anxiety and depression levels and improving quality of life (QOL) and cognitive function among the cognitively impaired elderly. Methods: This quasi-experimental study was conducted between May and December 2013 in Peninsular Mal...

  11. Herbal Medicine Cordyceps sinensis Improves Health-Related Quality of Life in Moderate-to-Severe Asthma

    Directory of Open Access Journals (Sweden)

    Ningqun Wang

    2016-01-01

    Full Text Available Moderate-to-severe asthma has a substantial impact on the health-related quality of life (HR-QOL of the patients. Cordyceps sinensis is a traditional Chinese medicine that is evaluated clinically for the treatment of many diseases, such as chronic allograft nephropathy, diabetic kidney disease, and lung fibrosis. In order to investigate the effects of Cordyceps sinensis on patients with moderate-to-severe persistent asthma, 120 subjects were randomized to receive Corbin capsule containing Cordyceps sinensis for 3 months (treatment group, n=60, whereas the control group (n=60 did not receive treatment with Corbin capsule. Inhaled corticosteroid and as-needed β-agonists were used in the treatment of both groups. HR-QOL was measured with the Juniper’s Asthma Quality of Life Questionnaire (AQLQ. The incidence of asthma exacerbation, pulmonary function testing, and serum measurements of inflammatory mediators were also evaluated. The results showed that the treatment group indicated a significant increase in AQLQ scores and lung function compared with the control group. The expression levels of the inflammation markers IgE, ICAM-1, IL-4, and MMP-9 in the serum were decreased and IgG increased in the treatment group compared with the control group. Therefore, the conclusion was reached that a formulation of Cordyceps sinensis improved the HR-QOL, asthma symptoms, lung function, and inflammatory profile of the patients with moderate-to-severe asthma. This trial is registered with ChiCTR-IPC-16008730.

  12. Herbal Medicine Cordyceps sinensis Improves Health-Related Quality of Life in Moderate-to-Severe Asthma.

    Science.gov (United States)

    Wang, Ningqun; Li, Jie; Huang, Xiaobo; Chen, Wenqiang; Chen, Yujing

    2016-01-01

    Moderate-to-severe asthma has a substantial impact on the health-related quality of life (HR-QOL) of the patients. Cordyceps sinensis is a traditional Chinese medicine that is evaluated clinically for the treatment of many diseases, such as chronic allograft nephropathy, diabetic kidney disease, and lung fibrosis. In order to investigate the effects of Cordyceps sinensis on patients with moderate-to-severe persistent asthma, 120 subjects were randomized to receive Corbin capsule containing Cordyceps sinensis for 3 months (treatment group, n = 60), whereas the control group ( n = 60) did not receive treatment with Corbin capsule. Inhaled corticosteroid and as-needed β -agonists were used in the treatment of both groups. HR-QOL was measured with the Juniper's Asthma Quality of Life Questionnaire (AQLQ). The incidence of asthma exacerbation, pulmonary function testing, and serum measurements of inflammatory mediators were also evaluated. The results showed that the treatment group indicated a significant increase in AQLQ scores and lung function compared with the control group. The expression levels of the inflammation markers IgE, ICAM-1, IL-4, and MMP-9 in the serum were decreased and IgG increased in the treatment group compared with the control group. Therefore, the conclusion was reached that a formulation of Cordyceps sinensis improved the HR-QOL, asthma symptoms, lung function, and inflammatory profile of the patients with moderate-to-severe asthma. This trial is registered with ChiCTR-IPC-16008730.

  13. Aripiprazole improves associated comorbid Conditions in addition to Tics in adult Patients with Gilles de la Tourette Syndrome

    Directory of Open Access Journals (Sweden)

    Sarah Gerasch

    2016-09-01

    Full Text Available Gilles de la Tourette Syndrome (GTS is characterized by motor and vocal tics, as well as associated comorbid conditions including obsessive-compulsive disorder (OCD, attention deficit/hyperactivity disorder (ADHD, depression, and anxiety which are present in a substantial number of patients. Although randomized controlled trials including a large number of patients are still missing, aripiprazole is currently considered as a first choice drug for the treatment of tics. The aim of this study was to further investigate efficacy and safety of aripiprazole in a group of drug-free, adult patients. Specifically, we investigated the influence of aripiprazole on tic severity, comorbidities, premonitory urge (PU, and quality of life (QoL. Moreover we were interested in the factors that influence a patient’s decision in electing for-or against- pharmacological treatment. In this prospective uncontrolled open-label study, we included 44 patients and used a number of rating scales to assess tic severity, PU, comorbidities, and QoL at baseline and during treatment with aripiprazole. 18 out of 44 patients decided for undergoing treatment for their tics with aripiprazole and completed follow-up assessments after 4-6 weeks. Our major findings were (1 aripiprazole resulted in significant reduction of tics, but did not affect PU; (2 aripiprazole significantly improved OCD and showed a trend towards improvement of other comorbidities including depression, anxiety and ADHD; (3 neither severity of tics, nor PU or QoL influenced patients’ decisions for or against treatment of tics with aripiprazole; instead patients with comorbid OCD tended to decide in favor of, while patients with comorbid ADHD tended to decide against tic treatment; (4 most frequently reported adverse effects were sleeping problems; (5 patients’ QoL was mostly impaired by comorbid depression. Our results suggest that aripiprazole may improve associated comorbid conditions in addition to tics

  14. Improving patient-centeredness of fertility care using a multifaceted approach: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Huppelschoten Aleida G

    2012-09-01

    Full Text Available Abstract Background Beside traditional outcomes of safety and (cost-effectiveness, the Institute of Medicine states patient-centeredness as an independent outcome indicator to evaluate the quality of healthcare. Providing patient-centered care is important because patients want to be heard for their ideas and concerns. Healthcare areas associated with high emotions and intensive treatment periods could especially benefit from patient-centered care. How care can become optimally improved in patient-centeredness is unknown. Therefore, we will conduct a study in the context of Dutch fertility care to determine the effects of a multifaceted approach on patient-centeredness, patients’ quality of life (QoL and levels of distress. Our aims are to investigate the effectiveness of a multifaceted approach and to identify determinants of a change in the level of patient-centeredness, patients’ QoL and distress levels. This paper presents the study protocol. Methods/Design In a cluster-randomized trial in 32 Dutch fertility clinics the effects of a multifaceted approach will be determined on the level of patient-centeredness (Patient-centredness Questionnaire – Infertility, patients’ QoL (FertiQoL and levels of distress (SCREENIVF. The multifaceted approach includes audit and feedback, educational outreach visits and patient-mediated interventions. Potential determinants of a change in patient-centeredness, patients’ QoL and levels of distress will be collected by an addendum to the patients’ questionnaire and a professionals’ questionnaire. The latter includes the Organizational Culture Assessment Instrument about the clinic’s culture as a possible determinant of an increase in patient-centered care. Discussion The study is expected to yield important new evidence about the effects of a multifaceted approach on levels of patient-centeredness, patients’ QoL and distress in fertility care. Furthermore, determinants associated with a change

  15. Reports of "satisfactory relief" by IBS patients receiving usual medical care are confounded by baseline symptom severity and do not accurately reflect symptom improvement.

    Science.gov (United States)

    Whitehead, William E; Palsson, Olafur S; Levy, Rona L; Feld, Andrew D; VonKorff, Michael; Turner, Marsha

    2006-05-01

    Treatment trials for irritable bowel syndrome (IBS) usually define a responder as a patient who reports satisfactory relief or adequate relief of symptoms at the end of the trial. However, these measures have not been adequately validated. (1) Compare a binary satisfactory relief measure to alternative ways of defining a treatment responder. (2) Determine whether baseline IBS symptom severity or psychological distress influence the sensitivity of these outcome measures. A total of 350 patients (81% females, average age 50 yr) who had a medical diagnosis of IBS and satisfied Rome II criteria, were recruited from Group Health Cooperative of Puget Sound. At baseline the Irritable Bowel Severity Scale (IBSS) was used to assess symptom severity and to classify patients as mild, moderate, or severe. Psychological distress and IBS-specific quality of life (IBS-QOL) were also assessed. After 6 months treatment with standard medical care, IBSS and IBS-QOL were reassessed, and patients were asked whether they had experienced satisfactory relief and whether they were somewhat or markedly better. Initial severity of IBS significantly affected the proportion who reported satisfactory relief (mild, 72%; moderate, 53%; severe, 44%) and the proportion who were somewhat or markedly better (mild, 62%; moderate, 44%; severe, 38%), but did not affect the proportion with a 50% reduction in symptoms (mild, 26%; moderate, 25%; severe, 23%). Although mild patients were the most likely to report satisfactory relief, they showed no average decrease in symptom severity or improvement in IBS-QOL. Conversely, severe patients, who were the least likely to report satisfactory relief, had the largest reductions in IBS symptom severity and the largest improvements in IBS-QOL. Psychological distress had no significant effect on the responder rate after adjusting for IBS symptom severity. These data from a descriptive study suggest that satisfactory relief is confounded with initial IBS symptom

  16. Effectiveness of a Combined Dance and Relaxation Intervention on Reducing Anxiety and Depression and Improving Quality of Life among the Cognitively Impaired Elderly

    Directory of Open Access Journals (Sweden)

    Dina Adam

    2016-02-01

    Full Text Available Objectives: Cognitive impairment is a common problem among the elderly and is believed to be a precursor to dementia. This study aimed to explore the effectiveness of a combined dance and relaxation intervention as compared to relaxation alone in reducing anxiety and depression levels and improving quality of life (QOL and cognitive function among the cognitively impaired elderly. Methods: This quasi-experimental study was conducted between May and December 2013 in Peninsular Malaysia. Subjects from four government residential homes for older adults aged ≥60 years with mild to moderate cognitive function as assessed by the Mini-Mental State Examination were included in the study. Subjects were divided into an intervention group and a control group; the former participated in a combined poco-poco dance and relaxation intervention whilst the latter participated in relaxation exercises only. Both groups participated in two sessions per week for six weeks. Anxiety and depression were self-assessed using the Hospital Anxiety and Depression Scale and QOL was self-assessed using the Quality of Life in Alzheimer’s Disease questionnaire. Results: A total of 84 elderly subjects were included in the study; 44 were in the intervention group and 40 were in the control group. When compared to control subjects, those in the intervention group showed significantly decreased anxiety (P <0.001 and depression (P <0.001 levels as well as improved QOL (P <0.001 and cognitive impairment (P <0.001. Conclusion: Dance as a form of participationbased physical exercise was found to reduce anxiety and depression levels and improve QOL and cognitive function among the studied sample of cognitively impaired elderly subjects in Malaysia.

  17. Multiple educational programs improves glycemic control, quality of life with diminishing the impact of diabetes in poorly controlled type 1 diabetics.

    Science.gov (United States)

    Vyas, Chintan; Dalal, Lopa; Talaviya, Praful; Saboo, Banshi

    2017-12-01

    The aim of present study was to assess the outcomes of multiple educational programs on glycemic control, quality of life and impact of diabetes in poorly controlled Type 1 Diabetic patients. A 12 months diabetes education programs were conducted every week for first one month then followed by every 3 months with follow up on improvement of HbA1c and QOL in T1D patients (n=54). Clinical characteristics were recorded at baseline visit. The QOL was evaluated by 15 set DQOL questionnaires in 40 consecutive patients at baseline, 3, 6 and 12 months after education programs. The HbA1c level (%) was evaluated at same time point. Decrease in DQOL score was reported as improvement in QOL. The rate of patients response to educational programs was noted 74.07% (n=40) at end of the study (12 months). The prevalence of T1D was reported higher in men than in women. The overall DQOL score and HbA1c% level was significantly (Peducational programs. Patients exhibited greater satisfaction and diminished impact of diabetes after educational programs was observed after 3 months and it was continue up to end of study. The frequencies of self-monitoring of blood glucose were increased. Numbers of hypoglycemic and DKA events were decreased after educational programs when compared to baseline. Results of study revealed that the appropriate education and counseling diminish impact of diabetes, improve QOL and help to achieve desired glycemic (HbA1c) level in poorly control T1D patients. Copyright © 2017. Published by Elsevier Ltd.

  18. Improvement of cancer cachexia with chemothermotherapy in a patient with advanced pancreatic cancer

    International Nuclear Information System (INIS)

    Takara, Minoru; Akao, Jumpei; Naito, Takeo; Kohno, Tsunefumi; Hirata, Hiroshi

    2007-01-01

    The ultimate goal of cancer treatment is to achieve a complete eradication of the cancer. However, patients with terminal cancer are also treated to obtain an improvement in their quality of life (QOL). In this report, we describe the dramatic response of an end-stage pancreatic cancer patient with cachexia to a combination of hyperthermia (HT) and chemotherapy (CH). The patient was treated with a combination of intermittent 5-fluorouracil (5-FU)/cisplatin (CDDP) therapy and HT. Three months later, the local recurrent cancer had disappeared, the liver metastases were reduced by 80%, the lung metastatic lesion was markedly reduced, tumor markers had returned to normal, and the cachexia had been almost reversed. Performance status (PS) improved from 4 to 1, QOL improved, and the patient survived until his 258th hospital day. In this patient, the combination of CH and HT was useful not only for improvement of cachexia, but also for tumor reduction. A possible mechanism leading to this effect is discussed. (author)

  19. Improvement of cancer cachexia with chemothermotherapy in a patient with advanced pancreatic cancer

    Energy Technology Data Exchange (ETDEWEB)

    Takara, Minoru; Akao, Jumpei; Naito, Takeo; Kohno, Tsunefumi [Matsuyama West Hospital, Matsuyama, Ehime (Japan); Hirata, Hiroshi [Yamaguchi Univ., School of Medicine, Ube, Yamaguchi (Japan)

    2007-12-15

    The ultimate goal of cancer treatment is to achieve a complete eradication of the cancer. However, patients with terminal cancer are also treated to obtain an improvement in their quality of life (QOL). In this report, we describe the dramatic response of an end-stage pancreatic cancer patient with cachexia to a combination of hyperthermia (HT) and chemotherapy (CH). The patient was treated with a combination of intermittent 5-fluorouracil (5-FU)/cisplatin (CDDP) therapy and HT. Three months later, the local recurrent cancer had disappeared, the liver metastases were reduced by 80%, the lung metastatic lesion was markedly reduced, tumor markers had returned to normal, and the cachexia had been almost reversed. Performance status (PS) improved from 4 to 1, QOL improved, and the patient survived until his 258th hospital day. In this patient, the combination of CH and HT was useful not only for improvement of cachexia, but also for tumor reduction. A possible mechanism leading to this effect is discussed. (author)

  20. A mixed exercise training programme is feasible and safe and may improve quality of life and muscle strength in multiple myeloma survivors

    International Nuclear Information System (INIS)

    Groeneveldt, Lara; Mein, Gill; Garrod, Rachel; Jewell, Andrew P; Someren, Ken Van; Stephens, Richard; D’Sa, Shirley P; Yong, Kwee L

    2013-01-01

    Exercise programmes are beneficial for cancer patients however evidence is limited in patients with multiple myeloma (MM), a cancer that is characterised by osteolytic bone disease, giving rise to high levels of bone morbidity including fractures and bone pain. We conducted a single arm phase 2 study of an exercise programme (EP) as rehabilitation for treated MM patients, to evaluate feasibility, effects on QOL and physiological parameters. Patients were given individualised programmes, comprising stretching, aerobic and resistance exercises, carried out under supervision for 3 months then at home for a further 3 months. Study uptake was high, 60 of 75 (80%) patients approached consented to the study. Screen failures (11, due to fracture risk and disease relapse) and patient withdrawals (12) resulted in a final 37 patients enrolling on the programme. These 37 patients demonstrated high attendance rates in the supervised classes (87%), and high levels of adherence in home exercising (73%). Patients reported better QOL following the EP, with improvement in FACT-G and Fatigue scores over time from baseline (p<0.01 for both, one-way repeated measures ANOVA) to 6 months. Upper and lower limb strength also improved on the EP, from baseline to 6 months (p<0.01 for both). There were no adverse reactions. An EP in MM patients is feasible and safe, with high attendance and adherence. Benefits in QOL, fatigue and muscle strength await confirmation in randomized studies, prompting urgent evaluation of the benefits of EP in the rehabilitation of MM patients

  1. Comparison of bioimpedance analysis scan, hemoglobin and urea reduction ratio in hemodialysis patients following and not following monitoring program for improving quality of life

    Science.gov (United States)

    Muzasti, R. A.; Lubis, H. R.

    2018-03-01

    Hemodialysis (HD) is the renal replacement therapy in end-stage renal disease (ESRD), at least 2-3 times a week, impacting substantial changes in daily life. Therefore a monitoring program is needed to improve the quality of life (QoL) of HD patients. Indicators in monitoring QoL include phase angle (PhA), muscle and fat mass, and body fluid composition through Bio Scan impedance analysis (BIA) Scan, hemoglobin level, and urea reduction ratio (URR). An analytic study with the cross-sectional design was performed in 168 patients at Klinik Spesialis Ginjal Hipertensi (KSGH) Rasyida, Medan to compare BIA Scan profiles, hemoglobin levels, and URR in HD patients who follow and do not follow the monitoring program for improving QoL {Program Pemantauan Peningkatan Kualitas Hidup (P3KH)}. Each variable was analyzed by independent T-test, it is significant if p <0.05. This study showed that there were differences in BMI (p = 0.006), fat mass (p = 0.010), extracellular water / intracellular water (ECW / ICW) (p = 0.046), and haemoglobin p = 0.001). Although it was better in the program group, statistically there was no difference of PhA (p = 0.136), muscle mass (p = 0.842), and URR (p = 0.232).

  2. Improvement in Oral Health-related Quality of Life by Periodontal Treatment: A Case Report on Elderly Patient with Chronic Periodontitis.

    Science.gov (United States)

    Suzuki, Eiichi; Aoki, Hideo; Tomita, Sachiyo; Saito, Atsushi

    2016-01-01

    We report a case of an elderly patient with chronic periodontitis requiring periodontal surgery. An 86-year-old man presented to Tokyo Dental College Suidobashi Hospital with the chief complaint of tooth fracture in the anterior region and occlusal pain in the posterior region. Clinical examination revealed 47% of sites with a probing depth (PD) of ≥4 mm and 47% of sites with bleeding on probing. Radiographic examination revealed generalized moderate horizontal bone loss with localized vertical defects. A clinical diagnosis of moderate chronic periodontitis was made. The patient's oral health-related quality of life (QoL) was also assessed at the time of each periodontal assessment. Initial periodontal therapy was provided followed by periodontal surgery. Open flap debridement was performed at sites with a PD of ≥5 mm (teeth #15-17). Surgical crown lengthening with an apically positioned flap was performed on #11 and 13 to gain an adequate biological width for the subsequent crown restoration. After confirming the stability of the periodontal tissue, provisional restorations were replaced with final restorations. No further deterioration was observed in the periodontal condition during the subsequent 1-year period of supportive periodontal therapy. Oral health-related QoL was markedly improved by the periodontal therapy. This suggests that periodontal therapy plays an important role in improving and maintaining oral health-related QoL in elderly people.

  3. Quality of life is modestly improved in older patients with mild primary hyperparathyroidism postoperatively: results of a prospective multicenter study.

    Science.gov (United States)

    Blanchard, Claire; Mathonnet, Muriel; Sebag, Frédéric; Caillard, Cécile; Kubis, Caroline; Drui, Delphine; van Nuvel, Elise; Ansquer, Catherine; Henry, Jean-François; Masson, Damien; Kraeber-Bodéré, Françoise; Hardouin, Jean-Benoît; Zarnegar, Rasa; Hamy, Antoine; Mirallié, Eric

    2014-10-01

    The objectives of this study were to evaluate, in mild primary hyperparathyroidism (pHPT) patients, the quality of life (QoL) using the SF-36 questionnaire before and after parathyroidectomy and to detect preoperatively patients who benefit the most from surgery. Most pHPT patients present a mild pHPT defined by calcemia ≤11.4 mg/dL. For these patients, there is debate about whether they should be managed with surveillance, medical therapy, or surgery. A prospective multicenter study investigated QoL (SF-36) in patients with mild pHPT before and after parathyroidectomy in four university hospitals. Laboratory results and SF-36 scores were obtained preoperatively and postoperatively (3, 6, and 12 months). One hundred sixteen patients were included. After surgery, the biochemical cure rate was 98%. Preoperatively, the mental component summary and the physical component summary (PCS) were 38.69 of 100 and 39.53 of 100, respectively. At 1 year, the MCS and the PCS were 41.29 of 100 and 42.03 of 100. The subgroup analysis showed a more significant improvement in patients < 70 years and with calcemia ≥10.4 mg/dL. Postoperative PCS was correlated with age and preoperative PCS: variation = 32.11 - 0.21 × age - 0.4 × preoperative PCS. Men did not improve their MCS postoperatively. Only women with a preoperative MCS <43.6 of 100 showed postoperative improvement. This study showed, in patients with mild pHPT, an improvement of QoL 1 year after parathyroidectomy. Patients <70 years and with calcemia ≥10.4 mg/dL had a more significant improvement.

  4. Yoga for improving sleep quality and quality of life for older adults.

    Science.gov (United States)

    Halpern, Jonathan; Cohen, Marc; Kennedy, Gerard; Reece, John; Cahan, Clement; Baharav, Armanda

    2014-01-01

    The aging process is associated with physiological changes that affect sleep. In older adults, undiagnosed and untreated insomnia may cause impaired daily function and reduced quality of life (QoL). Insomnia is also a risk factor for accidents and falls that are the main cause of accidental deaths in older adults and, therefore, is associated with higher morbidity and mortality rates in older populations. The research team aimed to (1) examine the efficacy of a yoga intervention (YI) for the treatment of insomnia in older adults, (2) determine the ability of yoga to enhance the QoL of older adults, and (3) establish the applicability of yoga practice for older people in a Western cultural setting. A waiting-list controlled trial. Settings • The study took place in Jerusalem, Israel, from 2008-2009. Participants were older men and women (age ≥ 60 y) with insomnia. The YI group participated in 12 wk of classes, held 2 ×/wk, incorporating yoga postures, meditative yoga, and daily home practice of meditative yoga. The study used self-report assessments of sleep quality using the following: (1) sleep quality-the Karolinska Sleepiness Scale (KSS), the Epworth Sleepiness Scale (ESS), and the Pittsburgh Sleep Quality Index (PSQI), and daily sleep and practice logs; (2) mood states-the Depression Anxiety Stress Scale long form (DASS-42) and the Profile of Mood States short form (POMS-SF); (3) a health survey (SF-36); and (4) mobile at-home sleep studies. Compared with controls, the YI group showed significant improvements in a range of subjective factors, including overall sleep quality; sleep efficiency; sleep latency and duration; self-assessed sleep quality; fatigue; general well-being; depression; anxiety; stress; tension; anger; vitality; and function in physical, emotional, and social roles. Yoga was shown to be safe and improved sleep and QoL in a group of older adults with insomnia. Outcomes depended on practice compliance.

  5. Improvement in Anxiety and Pain After Whole Body Whirlpool Hydrotherapy Among Patients With Myofascial Pain Syndrome

    Science.gov (United States)

    Im, Sang Hee

    2013-01-01

    Objective To evaluate the effect of the Whirlpool hydrotherapy on pain and anxiety in chronic myofascial pain syndrome (MPS) patients, compared to the conventional hydrocollator pack therapy. Methods Forty-one subjects who have MPS in the upper trapezius muscles without depression were recruited. The patients were randomly assigned into two groups: the whirlpool therapy group whose bodies were immersed in a whirlpool bath at 34℃-36℃ for 30 minutes; the hydrocollator group who took a 30-minute application of a standard hot hydrocollator pack. Patients in both groups received therapy three days a week for 2 weeks and underwent several evaluations at baseline and after treatment. The variables we analyzed during evaluations were as follows: the primary outcome we considered was pain severity using a visual analogue scale. And the secondary outcomes examined included anxiety using the Korean version of the Beck Anxiety Inventory and quality of life (QoL) using the Korean version of the World Health Organization QoL Assessment, Brief Form. All follow-up values were compared with the baseline values. Results The baseline parameters did not show significant differences between two groups. And after 2-week treatment, both groups revealed significant improvement in anxiety levels and QoL, as well as in pain. However, the improvement on pain (p=0.002) and anxiety (p=0.010) was significantly greater in the whirlpool group, compared to the hydrocollator group. Conclusion The whirlpool hydrotherapy can be used as a more effective therapeutic method to reduce pain and anxiety in chronic MPS patients without depression. PMID:24020034

  6. Improvement in Neuropathy Specific Quality of Life in Patients with Diabetes after Vitamin D Supplementation

    Directory of Open Access Journals (Sweden)

    Uazman Alam

    2017-01-01

    Full Text Available Objective. To assess the effect of vitamin D supplementation on neuropathy specific quality of life (NeuroQoL in patients with painful diabetic neuropathy. Methods. This prospective, open label study was conducted between June 2012 and April 2013. Patients with symptomatic diabetic neuropathy were given a single dose of 600,000 IU intramuscular vitamin D, and NeuroQol was assessed at baseline and at five follow-up visits every 4 weeks. Results. Of 143 participants, 41.3% were vitamin D deficient (vitamin D < 20 ng/ml. Treatment with vitamin D resulted in a significant increase in 25(OHD (P<0.0001 and a significant improvement in the NeuroQoL subscale score for emotional distress (P=0.04, with no significant change in the other NeuroQoL domains of painful symptoms and paresthesia, loss of temperature and touch sensation, unsteadiness, limitation in daily activities, and interpersonal problems. There was a significant reduction in patient perception about foot problems on QoL of “quite a lot” (P<0.05 and “very much” (P<0.0001 with a significant reduction in the baseline response of having a “poor” QoL from 5.2% to 0.7% (P<0.0001 and an increase in the response of an “excellent QoL” from 1.5% to 7.4% (P<0.0001. Conclusion. Vitamin D is effective in improving quality of life in patients with painful diabetic neuropathy.

  7. Fluoxetine for Maintenance of Remission and to Improve Quality of Life in Patients with Crohn's Disease: a Pilot Randomized Placebo-Controlled Trial.

    Science.gov (United States)

    Mikocka-Walus, Antonina; Hughes, Patrick A; Bampton, Peter; Gordon, Andrea; Campaniello, Melissa A; Mavrangelos, Chris; Stewart, Benjamin J; Esterman, Adrian; Andrews, Jane M

    2017-04-01

    Previous studies have shown that antidepressants reduce inflammation in animal models of colitis. The present trial aimed to examine whether fluoxetine added to standard therapy for Crohn's disease [CD] maintained remission, improved quality of life [QoL] and/or mental health in people with CD as compared to placebo. A parallel randomized double-blind placebo controlled trial was conducted. Participants with clinically established CD, with quiescent or only mild disease, were randomly assigned to receive either fluoxetine 20 mg daily or placebo, and followed for 12 months. Participants provided blood and stool samples and completed mental health and QoL questionnaires. Immune functions were assessed by stimulated cytokine secretion [CD3/CD28 stimulation] and flow cytometry for cell type. Linear mixed-effects models were used to compare groups. Of the 26 participants, 14 were randomized to receive fluoxetine and 12 to placebo. Overall, 14 [54%] participants were male. The mean age was 37.4 [SD=13.2] years. Fluoxetine had no effect on inflammatory bowel disease activity measured using either the Crohn's Disease Activity Index [F(3, 27.5)=0.064, p=0.978] or faecal calprotectin [F(3, 32.5)=1.08, p=0.371], but did have modest effects on immune function. There was no effect of fluoxetine on physical, psychological, social or environmental QoL, anxiety or depressive symptoms as compared to placebo [all p>0.05]. In this small pilot clinical trial, fluoxetine was not superior to placebo in maintaining remission or improving QoL. [ID: ACTRN12612001067864.]. © European Crohn’s and Colitis Organistion (ECCO) 2016.

  8. Far-Infrared Radiation Thermotherapy Improves Tissue Fibrosis in Chronic Extremity Lymphedema.

    Science.gov (United States)

    Li, Ke; Zhang, Zheng; Liu, Ning Fei; Sadigh, Parviz; Evans, Verity Joyce; Zhou, Huihong; Gao, Weiqing; Zhang, Yi Xin

    2017-09-29

    Fibrosis can enhance the exacerbation of lymphedema, which becomes obvious in late stage II-III lymphedema. However, whether far-infrared radiation thermotherapy (FIRT) can cure lymphedema fibrosis is still lack of research. This research was to investigate the therapeutic effect of FIRT on tissue fibrosis in the treatment of Late stage II-III lymphedema. Patients accepted only FIRT for a total of 20 sessions. The treatment session duration was 2 hours, and a stable machine temperature of 42°C was maintained throughout treatments. Clinical evaluation and laboratory evaluation were conducted before and after FIRT. Clinical outcome measures included circumference of affected extremity, skin elasticity, ultrasound, patients' subjective assessment, and quality of life (QOL). Laboratory outcome measures included serum and local lymphedema tissue fluid concentrations of fibrosis associated cytokines, tissue growth factor beta-1 (TGF-β1), interleukin (IL)-1β, IL-4, IL-18, and caspase-1. Between 2015 and 2016, clinical evaluation of 64 patients with late stage II-III lymphedema was conducted. From this group, 12 cases (18.75%) underwent simultaneous laboratory evaluation. Circumferences of affected extremities improved significantly following treatment (p pain, discomfort, and numbness (p effective treatment for lymphedema tissue fibrosis; it reduces the concentration of fibrosis cytokines in local lymphedema tissues. Consequently, this treatment can reduce the density of fibrosed tissue in the affected extremity, increase skin elasticity, significantly improve clinical symptoms, and improve QOL of patients.

  9. Development of docetaxel and alendronate-loaded chitosan ...

    African Journals Online (AJOL)

    Classification System (BCS) because of its poor solubility ... small drop of the NP suspension with a 2 % ... acceleration voltage of 100 kV in conventional .... Figure 2: (a) Particle size distribution of chitosan (CS)-coated polylactide-co-glycolide ...

  10. A Mixture of 3 Bifidobacteria Decreases Abdominal Pain and Improves the Quality of Life in Children With Irritable Bowel Syndrome: A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Crossover Trial.

    Science.gov (United States)

    Giannetti, Eleonora; Maglione, Marco; Alessandrella, Annalisa; Strisciuglio, Caterina; De Giovanni, Donatella; Campanozzi, Angelo; Miele, Erasmo; Staiano, Annamaria

    2017-01-01

    We assessed the efficacy of a probiotic mixture of Bifidobacterium infantis M-63, breve M-16V, and longum BB536 in improving abdominal pain (AP) and quality of life (QoL) in children with irritable bowel syndrome (IBS) and functional dyspepsia (FD). AP-associated functional gastrointestinal disorders, particularly IBS and FD, are common in pediatrics, and no well-established treatment is currently available. Although probiotics have shown promising results in adults, data in children are heterogeneous. Forty-eight children with IBS (median age, 11.2 y; range, 8 to 17.9 y) and 25 with FD (age, 11.6 y; range, 8 to 16.6 y) were randomized to receive either a mixture of 3 Bifidobacteria or a placebo for 6 weeks. After a 2-week "washout" period, each patient was switched to the other group and followed up for further 6 weeks. At baseline and follow-up, patients completed a symptom diary and a QoL questionnaire. AP resolution represented the primary outcome parameter. In IBS, but not in FD, Bifidobacteria determined a complete resolution of AP in a significantly higher proportion of children, when compared with placebo (P=0.006), and significantly improved AP frequency (P=0.02). The proportion of IBS children with an improvement in QoL was significantly higher after probiotics than after placebo (48% vs. 17%, P=0.001), but this finding was not confirmed in FD. In children with IBS a mixture of Bifidobacterium infantis M-63, breve M-16V, and longum BB536 is associated with improvement in AP and QoL. These findings were not confirmed in FD subjects. Trial identifier: NCT02566876 (http://www.clinicaltrial.gov).

  11. Noninvasive ventilation improves sleep in amyotrophic lateral sclerosis: a prospective polysomnographic study.

    Science.gov (United States)

    Vrijsen, Bart; Buyse, Bertien; Belge, Catharina; Robberecht, Wim; Van Damme, Philip; Decramer, Marc; Testelmans, Dries

    2015-04-15

    To evaluate the effects of noninvasive ventilation (NIV) on sleep in patients with amyotrophic lateral sclerosis (ALS) after meticulous titration with polysomnography (PSG). In this prospective observational study, 24 ALS patients were admitted to the sleep laboratory during 4 nights for in-hospital NIV titration with PSG and nocturnal capnography. Questionnaires were used to assess subjective sleep quality and quality of life (QoL). Patients were readmitted after one month. In the total group, slow wave sleep and REM sleep increased and the arousal-awakening index improved. The group without bulbar involvement (non-bulbar) showed the same improvements, together with an increase in sleep efficiency. Nocturnal oxygen and carbon dioxide levels improved in the total and non-bulbar group. Except for oxygen saturation during REM sleep, no improvement in respiratory function or sleep structure was found in bulbar patients. However, these patients showed less room for improvement. Patient-reported outcomes showed improvement in sleep quality and QoL for the total and non-bulbar group, while bulbar patients only reported improvements in very few subscores. This study shows an improvement of sleep architecture, carbon dioxide, and nocturnal oxygen saturation at the end of NIV titration and after one month of NIV in ALS patients. More studies are needed to identify the appropriate time to start NIV in bulbar patients. Our results suggest that accurate titration of NIV by PSG improves sleep quality. A commentary on this article appears in this issue on page 511. © 2015 American Academy of Sleep Medicine.

  12. Collaborative Improvement

    DEFF Research Database (Denmark)

    Kaltoft, Rasmus

    The thesis data have been collected in the EU-sponsored project: Collaborative Improvement Tool for the Extended Manufacturing Enterprise, CO-IMPROVE. In this project four universities (Denmark, Ireland, Italy, and The Netherlands), two software vendors (Greece and Sweden) and three companies...... (Denmark, Italy and The Netherlands) each with three to five suppliers were involved. The CO-IMPROVE project and the thesis is based on “action research” and “action learning”. The main aim of the whole project is through actual involvement and actions make the researchers, companies and selected suppliers...... learn how to improve operations in (hopefully) a win-win like manner through collaboration....

  13. Evaluation of the Effectiveness of a Multimodal Complementary Medicine Program for Improving the Quality of Life of Cancer Patients during Adjuvant Radiotherapy and/or Chemotherapy or Outpatient Aftercare.

    Science.gov (United States)

    Domnick, Martin; Domnick, Manju; Wiebelitz, Karl-Rüdiger; Beer, André-Michael

    2017-01-01

    Evidence for complementary therapies as important strategies to relieve cancer treatment-associated symptoms is increasing. Mostly, these complementary therapies start at the end of adjuvant treatments, resulting in a long delay until the well-being of patients is addressed. Further, long distances between the rehabilitation center and the patients' residence hinder patients' compliance. The multimodal outpatient LOTUS Care Cure Project (LCCP) was tested in a randomized controlled trial including patients of various cancer entities and stages while on adjuvant chemotherapy and/or radiotherapy or outpatient aftercare. The intervention group received the LCCP additionally to the conventional treatment (LCCP group, n = 50). The control group (CG) was split into 2 groups, with (CG1, n = 33) and without (CG2, n = 17) weekly talks. The primary endpoint was quality of life (QoL) after 3 months. In the LCCP group, QoL significantly improved after 3 months compared to CG2 (p = 0.022) but not compared to CG1. Other parameters showing a significant improvement were cognitive (p < 0.05, vs. CG1 and CG2) and social function (p < 0.05, vs. CG2). This pilot study describes a multimodal outpatient complementary therapy program conducted in parallel with conventional therapies and its potential to significantly improve QoL and reduce treatment-associated side effects. To substantiate these data, multicenter trials are needed. © 2017 S. Karger AG, Basel.

  14. A mixed exercise training programme is feasible and safe and may improve quality of life and muscle strength in multiple myeloma survivors

    Directory of Open Access Journals (Sweden)

    Groeneveldt Lara

    2013-01-01

    Full Text Available Abstract Background Exercise programmes are beneficial for cancer patients however evidence is limited in patients with multiple myeloma (MM, a cancer that is characterised by osteolytic bone disease, giving rise to high levels of bone morbidity including fractures and bone pain. Methods We conducted a single arm phase 2 study of an exercise programme (EP as rehabilitation for treated MM patients, to evaluate feasibility, effects on QOL and physiological parameters. Patients were given individualised programmes, comprising stretching, aerobic and resistance exercises, carried out under supervision for 3 months then at home for a further 3 months. Results Study uptake was high, 60 of 75 (80% patients approached consented to the study. Screen failures (11, due to fracture risk and disease relapse and patient withdrawals (12 resulted in a final 37 patients enrolling on the programme. These 37 patients demonstrated high attendance rates in the supervised classes (87%, and high levels of adherence in home exercising (73%. Patients reported better QOL following the EP, with improvement in FACT-G and Fatigue scores over time from baseline (p Conclusions An EP in MM patients is feasible and safe, with high attendance and adherence. Benefits in QOL, fatigue and muscle strength await confirmation in randomized studies, prompting urgent evaluation of the benefits of EP in the rehabilitation of MM patients.

  15. Collaborative Improvement

    DEFF Research Database (Denmark)

    Kaltoft, Rasmus

    -organisational continuous improvement of their performance, relative to that of other EMEs. Developing a collaborative improvement relationship between companies is a protracted and complex process and, according to some surveys, the failure rate is as low as one to three. This failure rate is affected by a whole range...... of factors. The research presented in this thesis was aimed at identifying these factors and investigating their interplay and influence on the progress and success of the development of the collaborative improvement. This thesis presents our findings regarding the factors found, their interplay...

  16. Improvements in vision-related quality of life in blind patients implanted with the Argus II Epiretinal Prosthesis.

    Science.gov (United States)

    Duncan, Jacque L; Richards, Thomas P; Arditi, Aries; da Cruz, Lyndon; Dagnelie, Gislin; Dorn, Jessy D; Ho, Allen C; Olmos de Koo, Lisa C; Barale, Pierre-Olivier; Stanga, Paulo E; Thumann, Gabriele; Wang, Yizhong; Greenberg, Robert J

    2017-03-01

    The purpose of this analysis is to report the change in quality of life (QoL) after treatment with the Argus II Epiretinal Prosthesis in patients with end-stage retinitis pigmentosa. The Vision and Quality of Life Index (VisQoL) was used to assess changes in QoL dimensions and overall utility score in a prospective 30-patient single-arm clinical study. VisQoL is a multi-attribute instrument consisting of six dimensions (injury, life, roles, assistance, activity and friendship) that may be affected by visual impairment. Within each dimension, patients were divided into two groups based on how much their QoL was affected by their blindness at baseline (moderate/severe or minimal). Outcomes were compared within each dimension sub-group between baseline and the combined follow-up periods using the Friedman test. In addition, data from the six dimensions were combined into a single utility score, with baseline data compared to the combined follow-up periods. Overall, 80 per cent of the patients reported difficulty in one or more dimensions pre-implant. Composite VisQoL utility scores at follow-up showed no statistically significant change from baseline; however, in three of the six VisQoL dimensions (injury, life and roles), patients with baseline deficits showed significant and lasting improvement after implantation with Argus II. In two of the three remaining dimensions (assistance and activity), data trended toward an improvement. In the final VisQoL dimension (friendship), none of the patients reported baseline deficits, suggesting that patients had largely adjusted to this attribute. Patients whose vision negatively affected them with respect to three VisQoL dimensions (that is, getting injured, coping with the demands of their life and fulfilling their life roles) reported significant improvement in QoL after implantation of the Argus II retinal prosthesis. Furthermore, the benefit did not deteriorate at any point during the 36-month follow-up, suggesting a long

  17. Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life: a randomised controlled trial.

    Science.gov (United States)

    Rasmussen, Rune Skovgaard; Østergaard, Ann; Kjær, Pia; Skerris, Anja; Skou, Christina; Christoffersen, Jane; Seest, Line Skou; Poulsen, Mai Bang; Rønholt, Finn; Overgaard, Karsten

    2016-03-01

    To evaluate if home-based rehabilitation of inpatients improved outcome compared to standard care. Interventional, randomised, safety/efficacy open-label trial. University hospital stroke unit in collaboration with three municipalities. Seventy-one eligible stroke patients (41 women) with focal neurological deficits hospitalised in a stroke unit for more than three days and in need of rehabilitation. Thirty-eight patients were randomised to home-based rehabilitation during hospitalization and for up to four weeks after discharge to replace part of usual treatment and rehabilitation services. Thirty-three control patients received treatment and rehabilitation following usual guidelines for the treatment of stroke patients. Ninety days post-stroke the modified Rankin Scale score was the primary endpoint. Other outcome measures were the modified Barthel-100 Index, Motor Assessment Scale, CT-50 Cognitive Test, EuroQol-5D, Body Mass Index and treatment-associated economy. Thirty-one intervention and 30 control patients completed the study. Patients in the intervention group achieved better modified Rankin Scale score (Intervention median = 2, IQR = 2-3; Control median = 3, IQR = 2-4; P=0.04). EuroQol-5D quality of life median scores were improved in intervention patients (Intervention median = 0.77, IQR = 0.66-0.79; Control median = 0.66, IQR = 0.56 - 0.72; P=0.03). The total amount of home-based training in minutes highly correlated with mRS, Barthel, Motor Assessment Scale and EuroQol-5D™ scores (P-values ranging from Prehabilitation reduced disability and increased quality of life. Compared to standard care, home-based stroke rehabilitation was more cost-effective. © The Author(s) 2015.

  18. Can a management pathway for chronic cough in children improve clinical outcomes: protocol for a multicentre evaluation

    Directory of Open Access Journals (Sweden)

    Masters IB

    2010-11-01

    Full Text Available Abstract Background Chronic cough is common and is associated with significant economic and human costs. While cough can be a problematic symptom without serious consequences, it could also reflect a serious underlying illness. Evidence shows that the management of chronic cough in children needs to be improved. Our study tests the hypothesis that the management of chronic cough in children with an evidence-based management pathway is feasible and reliable, and improves clinical outcomes. Methods/Design We are conducting a multicentre randomised controlled trial based in respiratory clinics in 5 major Australian cities. Children (n = 250 fulfilling inclusion criteria (new patients with chronic cough are randomised (allocation concealed to the standardised clinical management pathway (specialist starts clinical pathway within 2 weeks or usual care (existing care until review by specialist at 6 weeks. Cough diary, cough-specific quality of life (QOL and generic QOL are collected at baseline and at 6, 10, 14, 26, and 52 weeks. Children are followed-up for 6 months after diagnosis and cough resolution (with at least monthly contact from study nurses. A random sample from each site will be independently examined to determine adherence to the pathway. Primary outcomes are group differences in QOL and proportion of children that are cough free at week 6. Discussion The clinical management pathway is based on data from Cochrane Reviews combined with collective clinical experience (250 doctor years. This study will provide additional evidence on the optimal management of chronic cough in children. Trial registration ACTRN12607000526471

  19. A Diet Low in Fermentable Oligo-, Di-, and Monosaccharides and Polyols Improves Quality of Life and Reduces Activity Impairment in Patients With Irritable Bowel Syndrome and Diarrhea.

    Science.gov (United States)

    Eswaran, Shanti; Chey, William D; Jackson, Kenya; Pillai, Sivaram; Chey, Samuel W; Han-Markey, Theresa

    2017-12-01

    We investigated the effects of a diet low in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) vs traditional dietary recommendations on health-related quality of life (QOL), anxiety and depression, work productivity, and sleep quality in patients with irritable bowel syndrome and diarrhea (IBS-D). We conducted a prospective, single-center, single-blind trial of 92 adult patients with IBS-D (65 women; median age, 42.6 years) randomly assigned to groups placed on a diet low in FODMAPs or a modified diet recommended by the National Institute for Health and Care Excellence (mNICE) for 4 weeks. IBS-associated QOL (IBS-QOL), psychosocial distress (based on the Hospital Anxiety and Depression Scale), work productivity (based on the Work Productivity and Activity Impairment), and sleep quality were assessed before and after diet periods. Eighty-four patients completed the study (45 in the low-FODMAP group and 39 in the mNICE group). At 4 weeks, patients on the diet low in FODMAPs had a larger mean increase in IBS-QOL score than did patients on the mNICE diet (15.0 vs 5.0; 95% CI, -17.4 to -4.3). A significantly higher proportion of patients in the low-FODMAP diet group had a meaningful clinical response, based on IBS-QOL score, than in the mNICE group (52% vs 21%; 95% CI, -0.52 to -0.08). Anxiety scores decreased in the low-FODMAP diet group compared with the mNICE group (95% CI, 0.46-2.80). Activity impairment was significantly reduced with the low-FODMAP diet (-22.89) compared with the mNICE diet (-9.44; 95% CI, 2.72-24.20). In a randomized, controlled trial, a diet low in FODMAPs led to significantly greater improvements in health-related QOL, anxiety, and activity impairment compared with a diet based on traditional recommendations for patients with IBS-D. ClinicalTrials.gov, number NCT01624610. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  20. Mapping health assessment questionnaire disability index (HAQ-DI) score, pain visual analog scale (VAS), and disease activity score in 28 joints (DAS28) onto the EuroQol-5D (EQ-5D) utility score with the KORean Observational study Network for Arthritis (KORONA) registry data.

    Science.gov (United States)

    Kim, Hye-Lin; Kim, Dam; Jang, Eun Jin; Lee, Min-Young; Song, Hyun Jin; Park, Sun-Young; Cho, Soo-Kyung; Sung, Yoon-Kyoung; Choi, Chan-Bum; Won, Soyoung; Bang, So-Young; Cha, Hoon-Suk; Choe, Jung-Yoon; Chung, Won Tae; Hong, Seung-Jae; Jun, Jae-Bum; Kim, Jinseok; Kim, Seong-Kyu; Kim, Tae-Hwan; Kim, Tae-Jong; Koh, Eunmi; Lee, Hwajeong; Lee, Hye-Soon; Lee, Jisoo; Lee, Shin-Seok; Lee, Sung Won; Park, Sung-Hoon; Shim, Seung-Cheol; Yoo, Dae-Hyun; Yoon, Bo Young; Bae, Sang-Cheol; Lee, Eui-Kyung

    2016-04-01

    The aim of this study was to estimate the mapping model for EuroQol-5D (EQ-5D) utility values using the health assessment questionnaire disability index (HAQ-DI), pain visual analog scale (VAS), and disease activity score in 28 joints (DAS28) in a large, nationwide cohort of rheumatoid arthritis (RA) patients in Korea. The KORean Observational study Network for Arthritis (KORONA) registry data on 3557 patients with RA were used. Data were randomly divided into a modeling set (80 % of the data) and a validation set (20 % of the data). The ordinary least squares (OLS), Tobit, and two-part model methods were employed to construct a model to map to the EQ-5D index. Using a combination of HAQ-DI, pain VAS, and DAS28, four model versions were examined. To evaluate the predictive accuracy of the models, the root-mean-square error (RMSE) and mean absolute error (MAE) were calculated using the validation dataset. A model that included HAQ-DI, pain VAS, and DAS28 produced the highest adjusted R (2) as well as the lowest Akaike information criterion, RMSE, and MAE, regardless of the statistical methods used in modeling set. The mapping equation of the OLS method is given as EQ-5D = 0.95-0.21 × HAQ-DI-0.24 × pain VAS/100-0.01 × DAS28 (adjusted R (2) = 57.6 %, RMSE = 0.1654 and MAE = 0.1222). Also in the validation set, the RMSE and MAE were shown to be the smallest. The model with HAQ-DI, pain VAS, and DAS28 showed the best performance, and this mapping model enabled the estimation of an EQ-5D value for RA patients in whom utility values have not been measured.

  1. Improving Patient Safety: Improving Communication.

    Science.gov (United States)

    Bittner-Fagan, Heather; Davis, Joshua; Savoy, Margot

    2017-12-01

    Communication among physicians, staff, and patients is a critical element in patient safety. Effective communication skills can be taught and improved through training and awareness. The practice of family medicine allows for long-term relationships with patients, which affords opportunities for ongoing, high-quality communication. There are many barriers to effective communication, including patient factors, clinician factors, and system factors, but tools and strategies exist to address these barriers, improve communication, and engage patients in their care. Use of universal precautions for health literacy, appropriate medical interpreters, and shared decision-making are evidence-based tools that improve communication and increase patient safety. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  2. Supplementary home biofeedback improves quality of life in younger patients with fecal incontinence.

    Science.gov (United States)

    Bartlett, Lynne; Sloots, Kathryn; Nowak, Madeleine; Ho, Yik-Hong

    2015-01-01

    Biofeedback is a scarce, resource-intensive clinical therapy. It is used to treat patients with bowel problems, including fecal incontinence (FI), who fail to respond to simple dietary advice, medication, or pelvic floor exercises. Populations are aging and younger cohorts use technology in managing their health, affording FI self-management opportunities. Does supplementary home-based biofeedback improve FI and quality of life (QOL)? Seventy-five incontinent participants (12 male), mean age 61.1 years, consented to participate. Thirty-nine patients (5 male) were randomized to the standard biofeedback protocol plus daily home use of a Peritron perineometer (intervention) and 36 patients (7 male) to the standard biofeedback protocol (control). On completion of the study each perineometer exercise session was rated for technique by 2 raters, blinded to the patient and order of sessions. With the exception of Fecal Incontinence Quality of Life Scale lifestyle improvement (intervention--9.1% vs. controls--0.3%, P=0.026) and embarrassment improvement (intervention--50.0% vs. controls--18.3%, P=0.026), supplementary home biofeedback did not result in greater clinical improvement for the intervention group as a whole. However, on stratification around the mean age, continence and QOL of younger people in the intervention group were significantly better than those of their control counterparts. Graphed perineometer sessions demonstrated high compliance and improvement in exercise technique. Perineometers provided reassurance, motivation, and an exercise reminder ensuring that confidence was achieved quickly. Home biofeedback was acceptable and well tolerated by all users. Younger participants significantly benefited from using this technology.

  3. Does enhanced cognitive behaviour therapy for eating disorders improve quality of life?

    Science.gov (United States)

    Watson, Hunna J; Allen, Karina; Fursland, Anthea; Byrne, Susan M; Nathan, Paula R

    2012-09-01

    Quality of life (QOL) is the degree of enjoyment and satisfaction experienced in life, and embraces emotional well-being, physical health, economic and living circumstances, and work satisfaction. QOL recovery with eating disorder treatment has received sparse attention, and until now, no study has investigated QOL recovery with enhanced cognitive behaviour therapy (CBT-E). Patients (n = 196) admitted to a specialist eating disorders outpatient programme and receiving CBT-E completed measures of QOL, eating disorder psychopathology, depression, anxiety and self-esteem, before and after treatment. QOL at intake was compared with community norms, and QOL below the norm was predicted from sociodemographic and clinical correlates with logistic regression. Baseline QOL below the norm was associated with depression and anxiety Axis I comorbidity, and severity of depressive symptoms. Predictors of post-treatment QOL were baseline QOL and level of depressive symptoms and self-esteem at post-treatment. CBT-E was associated with gains in QOL over the course of treatment, in addition to eating disorder symptom relief. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.

  4. Improving Photosynthesis

    Science.gov (United States)

    Evans, John R.

    2013-01-01

    Photosynthesis is the basis of plant growth, and improving photosynthesis can contribute toward greater food security in the coming decades as world population increases. Multiple targets have been identified that could be manipulated to increase crop photosynthesis. The most important target is Rubisco because it catalyses both carboxylation and oxygenation reactions and the majority of responses of photosynthesis to light, CO2, and temperature are reflected in its kinetic properties. Oxygenase activity can be reduced either by concentrating CO2 around Rubisco or by modifying the kinetic properties of Rubisco. The C4 photosynthetic pathway is a CO2-concentrating mechanism that generally enables C4 plants to achieve greater efficiency in their use of light, nitrogen, and water than C3 plants. To capitalize on these advantages, attempts have been made to engineer the C4 pathway into C3 rice (Oryza sativa). A simpler approach is to transfer bicarbonate transporters from cyanobacteria into chloroplasts and prevent CO2 leakage. Recent technological breakthroughs now allow higher plant Rubisco to be engineered and assembled successfully in planta. Novel amino acid sequences can be introduced that have been impossible to reach via normal evolution, potentially enlarging the range of kinetic properties and breaking free from the constraints associated with covariation that have been observed between certain kinetic parameters. Capturing the promise of improved photosynthesis in greater yield potential will require continued efforts to improve carbon allocation within the plant as well as to maintain grain quality and resistance to disease and lodging. PMID:23812345

  5. Improved netting

    International Nuclear Information System (INIS)

    Bramley, A.; Clabburn, R.J.T.

    1976-01-01

    A method is described for producing netting composed of longitudinal and transverse threads of irradiation cross linked thermoplastic material, the threads being joined together at their crossings by moulded masses of cross linked thermoplastic material. The thread may be formed of polyethylene filaments, subjected to a radiation dose of 15 to 25 MR. The moulding can be conducted at 245 0 to 260 0 C or higher. The product is claimed to be an improved quality of netting, with bonds of increased strength between crossing threads. (U.K.)

  6. Higher educational status, staying in joint family and early treatment initiation improves quality of life in leprosy: Experiences from and observational study at a tertiary centre in Eastern India

    Directory of Open Access Journals (Sweden)

    Arup Chakraborty

    2015-01-01

    Full Text Available Introduction Leprosy is a chronic infectious disease with various risks of permanent and progressive disabilities as well as deformities. This can lead to social stigma and discrimination. Methodology A cross sectional institution based study was conducted among the patient of a leprosy clinic in a tertiary care center. WHOQOL-BREF questionnaire was used after taking consent from each study individual. Results Majority (69.8% of the patients was male and 41.3% of the study population belonged to below poverty line. Majority (85.7% of the study population were suffering from multi-bacillary type of leprosy. Though Majority (96.8% of the patients was receiving MDT (multi drug therapy regularly but still 33.33% of them were leading a poor quality of life. It has been seen that literacy, family type and time gap between starting of symptoms and initiation of treatment were significantly associated with quality of life. Discussion Different previous studies showed QOL (quality of life was associated with factors like SES (socio economic status, literacy and male gender, the present study revealed higher literacy, staying in the joint family and early treatment initiation helped to improve the QOL. Conclusion Better QOL was associated with higher educational status, good family support and early initiation of treatment among the leprosy patients.

  7. Do problem-solving interventions improve psychosocial outcomes in vision impaired adults: a systematic review and meta-analysis.

    Science.gov (United States)

    Holloway, Edith E; Xie, Jing; Sturrock, Bonnie A; Lamoureux, Ecosse L; Rees, Gwyneth

    2015-05-01

    To evaluate the effectiveness of problem-solving interventions on psychosocial outcomes in vision impaired adults. A systematic search of randomised controlled trials (RCTs), published between 1990 and 2013, that investigated the impact of problem-solving interventions on depressive symptoms, emotional distress, quality of life (QoL) and functioning was conducted. Two reviewers independently selected and appraised study quality. Data permitting, intervention effects were statistically pooled and meta-analyses were performed, otherwise summarised descriptively. Eleven studies (reporting on eight trials) met inclusion criteria. Pooled analysis showed problem-solving interventions improved vision-related functioning (standardised mean change [SMC]: 0.15; 95% CI: 0.04-0.27) and emotional distress (SMC: -0.36; 95% CI: -0.54 to -0.19). There was no evidence to support improvements in depressive symptoms (SMC: -0.27, 95% CI: -0.66 to 0.12) and insufficient evidence to determine the effectiveness of problem-solving interventions on QoL. The small number of well-designed studies and narrow inclusion criteria limit the conclusions drawn from this review. However, problem-solving skills may be important for nurturing daily functioning and reducing emotional distress for adults with vision impairment. Given the empirical support for the importance of effective problem-solving skills in managing chronic illness, more well-designed RCTs are needed with diverse vision impaired samples. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. A Chinese Decoction, Kuan-Sin-Yin, Improves Autonomic Function and Cancer-Related Symptoms of Metastatic Colon Cancer.

    Science.gov (United States)

    Chien, Tsai-Ju; Liu, Chia-Yu; Ko, Pin-Hao; Hsu, Chung-Hua

    2016-03-01

    Kuan-Sin-Yin (KSY) is a traditional Chinese medicine (TCM) decoction, which has been shown to have cytostatic effects on cancer cells and involved in the TCM theory of promoting yin-yang balance.Sonce many cancer patients suffer from autonomic dysfunction (AD), which correspond to yin-yang imbalance in TCM. The aim of this study is to evaluate the possible effect of KSY in metastatic colon cancer (mCRC) patients with AD. We conducted a single-group experiment. Total 52 qualified patients were enrolled. Participants took the KSY daily for 2 weeks. The primary outcome was KSY efficacy as reflected in the heart rate variability (HRV) and electrical conductivity (µA) over 12 meridian points. Autonomic function was examined before and after the KSY intervention. The vagal and sympathetic tone were recorded by HRV; 12 meridian energies were measured using a meridian energy analysis device. Secondary outcomes were cancer-related symptoms and patient quality of life (QoL). The results showed that the KSY intervention improved AD via increasing the vagal tone (HF: P = .041), but not the sympathetic tone (LF: P = .154); total autonomic activity was significantly enhanced (HRV activity: P = .013). Intriguingly, energy increased more over the yin meridian (P = .010) than over the yang meridian (P = .015). Cancer-related symptoms and QoL were significantly improved (P yin-yang concept of energy. © The Author(s) 2015.

  9. Improvement in the quality of life of patients with chronic spontaneous urticaria treated with omalizumab in real life.

    Science.gov (United States)

    Larrea-Baca, Itzíar; Gurpegui-Resano, María

    Evaluation of the impact on the quality of life (QOL) relating to health in patients with chronic urticaria (CSU) treated with omalizumab. Longitudinal descriptive observational study of quality of life based on18 patients with chronic urticaria ≥12 years treated with omalizumab. Changes in QOL examined at 1 month (T1), at 6 months (T6) and 12 months (T12), by: Visual Analogical Scale (UAS), specific urticaria QOL questionnaire (CU-Q2oL), general health questionnaire (SF-36) and activity of urticaria questionnaire (Score UAS7). The most disabling symptoms for patients were: pruritus (61.1%); decrease in health and physical activity (55.5%), wheals, swelling and nervousness (50%); depression and shame of marks (38.89%); side effects to drugs (33.33%); sleepiness and tiredness (27.78%); work (22.22%); "choosing clothes and pain" 16.67% and social relations (11.11%). Statistically significant differences were observed in T1, T6 and T12. In T1, UAS -4.72 (p=.001); CU-Q2oL -16.38 (p<.001); SF-36 15.44 (p=.006); UAS7 wheals -7.27 (p=.001), UAS7 pruritus -8.72 (p=.003). In T6, UAS -4.26 (p=.001); CU-Q2oL -18.94 (p<.001); SF-36 15.41 (p<.001); UAS7 wheals -7.41 (p=.001), UAS7 pruritus -7.11 (p=.001). In T12 UAS -9.61 (p=.004); CU-Q2oL -21.38 (p=.01); SF-36 17.53 (p=.04); UAS7 wheals -8.23 (p=.004), UAS7 pruritus -10.69 (p=.004). There was a very good response in T1, which was maintained in T6 and T12. Patients with chronic urticaria treated with omalizumab presented good results with a reduction of CUE activity and improvement of their QOL. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  10. Impact Of Patient Counseling And Education Of Diabetic Patients In Improving Their Quality Of Life

    Directory of Open Access Journals (Sweden)

    Nalini Pais

    2010-12-01

    Full Text Available Objectives: The current study which is randomized comparative intervention (concurrent control attempts to study the effect of counseling and education provided by clinical pharmacist regarding the disease and related issues to achieve glycemic control and ultimately better quality of life of Diabetic patients; which was carried out for a period of 6months in the out-patient medicine department of St.Martha’sHospital, Bangalore.Materials and Method: A total of 98 (53 intervention, 45control patients were randomized into intervention and control group by chit method. Intervention group received counseling and education along with the information leaflet;follow up was done at intervals of 2nd, 4th & 6th month after baseline. Pre-validated questionnaires for KAP & QoL were administered at the baseline and last follow up. In a group of25 patients HbA1c was recorded at baseline & last follow-up.All the parameters (FBS, PPBS, HbA1c and scores were compared between intervention & control group postcounseling. Significant improvement (P<0.05 was observed inthe intervention group in terms of glycemic control and HbA1cvalues in comparison with the control group.Results: In the intervention group; Knowledge about the disease improved (P<0.05 along with better compliance to diet, however change in attitude towards need for exercise and regular checkups could not be achieved but significant improvement (p<0.05 in Quality of Life (QoL was achieved with education and counseling.Conclusion: The findings revealed that the clinical pharmacist can contribute to the better management of diabetes through patient education and counseling.

  11. A cluster-randomised trial of staff education to improve the quality of life of people with dementia living in residential care: the DIRECT study.

    Directory of Open Access Journals (Sweden)

    Christopher Beer

    Full Text Available BACKGROUND: The Dementia In Residential care: EduCation intervention Trial (DIRECT was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care. METHODOLOGY/PRINCIPAL FINDINGS: This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 years and older with Mini-Mental State Examination ≤ 24, their GPs and facility staff participated. Flexible education designed to meet the perceived needs of learners was delivered to GPs and care facility staff in intervention groups. The primary outcome of the study was self-rated quality of life of participants with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD at 4 weeks and 6 months after the conclusion of the intervention. Analysis accounted for the effect of clustering by using multi-level regression analysis. Education of GPs or care facility staff did not affect the primary outcome at either 4 weeks or 6 months. In a post hoc analysis excluding facilities in which fewer than 50% of staff attended an education session, self-rated QOL-AD scores were 6.14 points (adjusted 95%CI 1.14, 11.15 higher at four-week follow-up among residents in facilities randomly assigned to the education intervention. CONCLUSION: The education intervention directed at care facilities or GPs did not improve the quality of life ratings of participants with dementia as a group. This may be explained by the poor adherence to the intervention programme, as participants with dementia living in facilities where staff participated at least minimally seemed to benefit. TRIAL REGISTRATION: ANZCTR.org.au ACTRN12607000417482.

  12. A cluster-randomised trial of staff education to improve the quality of life of people with dementia living in residential care: the DIRECT study.

    Science.gov (United States)

    Beer, Christopher; Horner, Barbara; Flicker, Leon; Scherer, Samuel; Lautenschlager, Nicola T; Bretland, Nick; Flett, Penelope; Schaper, Frank; Almeida, Osvaldo P

    2011-01-01

    The Dementia In Residential care: EduCation intervention Trial (DIRECT) was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care. This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 years and older with Mini-Mental State Examination ≤ 24, their GPs and facility staff participated. Flexible education designed to meet the perceived needs of learners was delivered to GPs and care facility staff in intervention groups. The primary outcome of the study was self-rated quality of life of participants with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD) at 4 weeks and 6 months after the conclusion of the intervention. Analysis accounted for the effect of clustering by using multi-level regression analysis. Education of GPs or care facility staff did not affect the primary outcome at either 4 weeks or 6 months. In a post hoc analysis excluding facilities in which fewer than 50% of staff attended an education session, self-rated QOL-AD scores were 6.14 points (adjusted 95%CI 1.14, 11.15) higher at four-week follow-up among residents in facilities randomly assigned to the education intervention. The education intervention directed at care facilities or GPs did not improve the quality of life ratings of participants with dementia as a group. This may be explained by the poor adherence to the intervention programme, as participants with dementia living in facilities where staff participated at least minimally seemed to benefit. ANZCTR.org.au ACTRN12607000417482.

  13. Treatment of supragastric belching with cognitive behavioral therapy improves quality of life and reduces acid gastroesophageal reflux.

    Science.gov (United States)

    Glasinovic, E; Wynter, E; Arguero, J; Ooi, J; Nakagawa, K; Yazaki, E; Hajek, P; Psych, C Clin; Woodland, P; Sifrim, D

    2018-04-01

    Excessive supragastric belching (SGB) manifests as troublesome belching, and can be associated with reflux and significant impact on quality of life (QOL). In some GERD patients, SGB-associated reflux contributes to up to 1/3 of the total esophageal acid exposure. We hypothesized that a cognitive-behavioral intervention (CBT) might reduce SGB, improve QOL, and reduce acid gastroesophageal reflux (GOR). We aimed to assess the effectiveness of CBT in patients with pathological SGB. Patients with SGB were recruited at the Royal London Hospital. Patients attended CBT sessions focused on recognition of warning signals and preventative exercises. Objective outcomes were the number of SGBs, esophageal acid exposure time (AET), and proportion of AET related to SGBs. Subjective evaluation was by patient-reported questionnaires. Of 51 patients who started treatment, 39 completed the protocol, of whom 31 had a follow-up MII-pH study. The mean number of SGBs decreased significantly after CBT (before: 116 (47-323) vs. after 45 (22-139), P50%. In patients with increased AET at baseline, AET after CBT was decreased: 9.0-6.1% (P=0.005). Mean visual analog scale severity scores decreased after CBT (before: 260 (210-320) mm vs. after: 140 (80-210) mm, Pacid reflux predominantly driven by SGB. In these patients, CBT can reduce esophageal acid exposure.

  14. Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life

    DEFF Research Database (Denmark)

    Rasmussen, Rune Skovgaard; Østergaard, Ann; Kjær, Pia

    2016-01-01

    part of usual treatment and rehabilitation services. Thirty-three control patients received treatment and rehabilitation following usual guidelines for the treatment of stroke patients. MAIN MEASURES: Ninety days post-stroke the modified Rankin Scale score was the primary endpoint. Other outcome...... score (Intervention median = 2, IQR = 2-3; Control median = 3, IQR = 2-4; P=0.04). EuroQol-5D™ quality of life median scores were improved in intervention patients (Intervention median = 0.77, IQR = 0.66-0.79; Control median = 0.66, IQR = 0.56 - 0.72; P=0.03). The total amount of home-based training...... and increased quality of life. Compared to standard care, home-based stroke rehabilitation was more cost-effective....

  15. A randomized control intervention trial to improve social skills and quality of life in pediatric brain tumor survivors.

    Science.gov (United States)

    Barrera, Maru; Atenafu, Eshetu G; Sung, Lillian; Bartels, Ute; Schulte, Fiona; Chung, Joanna; Cataudella, Danielle; Hancock, Kelly; Janzen, Laura; Saleh, Amani; Strother, Douglas; Downie, Andrea; Zelcer, Shayna; Hukin, Juliette; McConnell, Dina

    2018-01-01

    To determine if a group social skills intervention program improves social competence and quality of life (QOL) in pediatric brain tumor survivors (PBTS). We conducted a randomized control trial in which PBTS (8-16 years old, off therapy for over 3 months) were allocated to receive social skills training (eg, cooperation, assertion, using social cognitive problem solving strategies, role playing, games, and arts and crafts) in 8 weekly 2-hour sessions, or an attention placebo control (games and arts and crafts only). Outcomes were self-reported, proxy-reported (caregiver), and teacher-reported using the Social Skills Rating System (SSRS), to measure social competence, and the Pediatric Quality of Life (PedsQL4.0, generic) to measure QOL at baseline, after intervention, and at 6 months follow-up. At baseline, SSRS were stratified into low and high scores and included as a covariate in the analysis. Compared to controls (n = 48), PBTS in the intervention group (n = 43) reported significantly better total and empathy SSRS scores, with improvements persisting at follow-up. The PBTS in the intervention group who had low scores at baseline reported the greatest improvements. Proxy and teacher reports showed no intervention effect. Participating in group social skills intervention can improve self-reported social competence that persisted to follow up. The PBTS should be given the opportunity to participate in social skills groups to improve social competence. Copyright © 2017 John Wiley & Sons, Ltd.

  16. Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury - randomized prospective trial.

    Directory of Open Access Journals (Sweden)

    Rahav Boussi-Gross

    Full Text Available Traumatic brain injury (TBI is the leading cause of death and disability in the US. Approximately 70-90% of the TBI cases are classified as mild, and up to 25% of them will not recover and suffer chronic neurocognitive impairments. The main pathology in these cases involves diffuse brain injuries, which are hard to detect by anatomical imaging yet noticeable in metabolic imaging. The current study tested the effectiveness of Hyperbaric Oxygen Therapy (HBOT in improving brain function and quality of life in mTBI patients suffering chronic neurocognitive impairments.The trial population included 56 mTBI patients 1-5 years after injury with prolonged post-concussion syndrome (PCS. The HBOT effect was evaluated by means of prospective, randomized, crossover controlled trial: the patients were randomly assigned to treated or crossover groups. Patients in the treated group were evaluated at baseline and following 40 HBOT sessions; patients in the crossover group were evaluated three times: at baseline, following a 2-month control period of no treatment, and following subsequent 2-months of 40 HBOT sessions. The HBOT protocol included 40 treatment sessions (5 days/week, 60 minutes each, with 100% oxygen at 1.5 ATA. "Mindstreams" was used for cognitive evaluations, quality of life (QOL was evaluated by the EQ-5D, and changes in brain activity were assessed by SPECT imaging. Significant improvements were demonstrated in cognitive function and QOL in both groups following HBOT but no significant improvement was observed following the control period. SPECT imaging revealed elevated brain activity in good agreement with the cognitive improvements.HBOT can induce neuroplasticity leading to repair of chronically impaired brain functions and improved quality of life in mTBI patients with prolonged PCS at late chronic stage.ClinicalTrials.gov NCT00715052.

  17. Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury - randomized prospective trial.

    Science.gov (United States)

    Boussi-Gross, Rahav; Golan, Haim; Fishlev, Gregori; Bechor, Yair; Volkov, Olga; Bergan, Jacob; Friedman, Mony; Hoofien, Dan; Shlamkovitch, Nathan; Ben-Jacob, Eshel; Efrati, Shai

    2013-01-01

    Traumatic brain injury (TBI) is the leading cause of death and disability in the US. Approximately 70-90% of the TBI cases are classified as mild, and up to 25% of them will not recover and suffer chronic neurocognitive impairments. The main pathology in these cases involves diffuse brain injuries, which are hard to detect by anatomical imaging yet noticeable in metabolic imaging. The current study tested the effectiveness of Hyperbaric Oxygen Therapy (HBOT) in improving brain function and quality of life in mTBI patients suffering chronic neurocognitive impairments. The trial population included 56 mTBI patients 1-5 years after injury with prolonged post-concussion syndrome (PCS). The HBOT effect was evaluated by means of prospective, randomized, crossover controlled trial: the patients were randomly assigned to treated or crossover groups. Patients in the treated group were evaluated at baseline and following 40 HBOT sessions; patients in the crossover group were evaluated three times: at baseline, following a 2-month control period of no treatment, and following subsequent 2-months of 40 HBOT sessions. The HBOT protocol included 40 treatment sessions (5 days/week), 60 minutes each, with 100% oxygen at 1.5 ATA. "Mindstreams" was used for cognitive evaluations, quality of life (QOL) was evaluated by the EQ-5D, and changes in brain activity were assessed by SPECT imaging. Significant improvements were demonstrated in cognitive function and QOL in both groups following HBOT but no significant improvement was observed following the control period. SPECT imaging revealed elevated brain activity in good agreement with the cognitive improvements. HBOT can induce neuroplasticity leading to repair of chronically impaired brain functions and improved quality of life in mTBI patients with prolonged PCS at late chronic stage. ClinicalTrials.gov NCT00715052.

  18. Effect of Improvement in Lower Urinary Tract Symptoms on Sexual Function in Men: Tamsulosin Monotherapy vs. Combination Therapy of Tamsulosin and Solifenacin

    Science.gov (United States)

    Ko, Kyungtae; Yang, Dae Yul; Lee, Won Ki; Kim, Sae Woong; Moon, Du Geon; Moon, Ki Hak; Park, Nam Cheol; Park, Jong Kwan; Son, Hwan Cheol; Lee, Sung Won; Hyun, Jae Seog

    2014-01-01

    Purpose To evaluate how much the improvement of lower urinary tract symptoms (LUTS) affects sexual function and which storage symptoms or voiding symptoms have the greatest effect on sexual function. Materials and Methods A total of 187 patients were enrolled in this study. Patients were randomly assigned to receive either tamsulosin 0.2 mg (group A) or tamsulosin 0.2 mg and solifenacin 5 mg (group B). At 4 weeks and 12 weeks, the LUTS and sexual function of the patients were evaluated by use of the International Index of Erectile Function-5 (IIEF5), International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS) questionnaire, uroflowmetry, and bladder scan. Results Both groups A and B showed statistically significant improvements in IPSS, OABSS, and quality of life (QoL). Group A showed improved maximum flow rate, mean flow rate, and residual urine volume by time. Group B did not show an improvement in flow rate or residual urine volume but total voiding volume increased with time. The IIEF5 score was not improved in either group. In group A, the IIEF5 score dropped from 13.66±4.97 to 11.93±6.14 after 12 weeks (p=0.072). Group B showed a decline in the IIEF5 score from 13.19±5.91 to 12.45±6.38 (p=0.299). Although group B showed a relatively smaller decrease in the IIEF5 score, the difference between the two groups was not significant (p=0.696). Conclusions Tamsulosin monotherapy and combination therapy with solifenacin did not improve erectile function despite improvements in voiding symptoms and QoL. The improvement in storage symptoms did not affect erectile function. PMID:25237463

  19. Do interventions with staff in long-term residential facilities improve quality of care or quality for life people with dementia? A systematic review of the evidence.

    Science.gov (United States)

    Bird, Mike; Anderson, Katrina; MacPherson, Sarah; Blair, Annaliese

    2016-12-01

    Common sense suggests and research indicates relationships between staff factors in residential dementia care and quality of life (QOL) for residents, with poor care increasing suffering. However, we do not have a coherent picture of which staff interventions have an impact on quality of care (QOC) or resident QOL. A comprehensive search of 20 years' peer-reviewed literature using Medline, PsycINFO, Embase, PubMed, CINAHL, and the Cochrane, Campbell Collaboration identified 4,760 studies meriting full text review. Forty-six met the inclusion criteria, namely interventions in long-term facilities helping staff develop their capacity to provide better care and/or QOL for residents with dementia. Thirty-five other papers comprised an associated predictor review. Conclusions from these limited data are further compromised because nine studies failed to measure effects on residents and only half assessed effects after the project team withdrew. Of these, excellent studies produced change over the medium (3-4 months) or longer term, including reduction in challenging behavior and restraint use but this applied only to a minority. A number of studies failed to measure effects on QOC, limiting conclusions about mechanisms underlying change. In general, level of intervention required depended on the target. For outcomes like restraint use, structured education sessions with some support appear adequate. Programs to reduce pain require more support. For complicated issues like challenging behavior and increasing co-operation in showering, detailed, supportive, on-site interventions are required. Improvements in restraint and staff/resident interactions were the most promising findings. (Review registration number: PROSPERO 2014:CRD42014015224).

  20. Detailed methods of two home-based vegetable gardening intervention trials to improve diet, physical activity, and quality of life in two different populations of cancer survivors.

    Science.gov (United States)

    Cases, Mallory G; Frugé, Andrew D; De Los Santos, Jennifer F; Locher, Julie L; Cantor, Alan B; Smith, Kerry P; Glover, Tony A; Cohen, Harvey J; Daniel, Michael; Morrow, Casey D; Moellering, Douglas R; Demark-Wahnefried, Wendy

    2016-09-01

    Cancer survivors suffer from long-term adverse effects that reduce health-related quality of life (QOL) and physical functioning, creating an urgent need to develop effective, durable, and disseminable interventions. Harvest for Health, a home-based vegetable gardening intervention, holds promise for these domains. This report describes the methods and recruitment experiences from two randomized controlled feasibility trials that employ a waitlist-controlled design. Delivered in partnership with Cooperative Extension Master Gardeners, this intervention provides one-on-one mentorship of cancer survivors in planning and maintaining three seasonal vegetable gardens over 12months. The primary aim is to determine intervention feasibility and acceptability; secondary aims are to explore effects on objective and subjective measures of diet, physical activity and function, and QOL and examine participant factors associated with potential effects. One trial is conducted exclusively among 82 female breast cancer survivors residing in the Birmingham, AL metropolitan area (BBCS); another broadly throughout Alabama among 46 older cancer survivors aged >60 (ASCS). Response rates were 32.6% (BBCS) and 52.3% (ASCS). Both trials exceeded 80% of their accrual target. Leading reasons for ineligibility were removal of >10 lymph nodes (lymphedema risk factor), lack of physician approval, and unwillingness to be randomized to the waitlist. To date, recruitment and implementation of Harvest for Health appears feasible. Although both studies encountered recruitment challenges, lessons learned can inform future larger-scale studies. Vegetable gardening interventions are of interest to cancer survivors and may provide opportunities to gain life skills leading to improvements in overall health and QOL. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Beyond Irritable Bowel Syndrome: The Efficacy of the Low Fodmap Diet for Improving Symptoms in Inflammatory Bowel Diseases and Celiac Disease.

    Science.gov (United States)

    Testa, Anna; Imperatore, Nicola; Rispo, Antonio; Rea, Matilde; Tortora, Raffaella; Nardone, Olga Maria; Lucci, Lucia; Accarino, Grazia; Caporaso, Nicola; Castiglione, Fabiana

    2018-05-15

    To evaluate the usefulness of a low FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet on patients with irritable bowel syndrome (IBS), non-active inflammatory bowel diseases (IBD), and celiac disease (CD) on a gluten-free diet (GFD). Dietetic interventional prospective study. IBS, IBD, and CD subjects were evaluated to check if they fulfilled the Rome III criteria. Each subject was educated to follow a low FODMAP diet after being evaluated by filling out questionnaires that assessed the quality of life (QoL) and symptoms experienced (IBS-SSS and SF-36), and was reevaluated after 1 and 3 months. One hundred twenty-seven subjects were enrolled: 56 with IBS, 30 with IBD, and 41 with CD. IBS-SSS showed that abdominal symptoms improved after 1 and 3 months of diet in all subjects, with significant difference among the 3 groups at T0 (average scores IBS: 293 ± 137, IBD: 206 ± 86, CD: 222 ± 65, p symptoms in patients with IBS, non-active IBD, or CD on a GFD, and thus, improve their QoL and social -relations. © 2018 S. Karger AG, Basel.

  2. Individual optimization of pacing sensors improves exercise capacity without influencing quality of life

    NARCIS (Netherlands)

    Erol-Yilmaz, Ayten; Schrama, Tim A.; Tanka, Jutta Schroeder; Tijssen, Jan G.; Wilde, Arthur A.; Tukkie, Raymond

    2005-01-01

    Introduction: Programmable pacemaker sensor features are frequently used in default setting. Limited data are available about the effect of sensor optimization on exercise capacity and quality of life (QOL), Influence of individual optimization of sensors on QOL and exercise tolerance was

  3. Strengthening exercises improve symptoms and quality of life but do not change autonomic modulation in fibromyalgia: a randomized clinical trial.

    Directory of Open Access Journals (Sweden)

    Maria Bernadete Renoldi Oliveira Gavi

    Full Text Available OBJECTIVE: Autonomic dysfunction is an important mechanism that could explain many symptoms observed in fibromyalgia (FM. Exercise is an effective treatment, with benefits potentially mediated through changes in autonomic modulation. Strengthening is one of the less studied exercises in FM, and the acute and chronic effects of strengthening on the autonomic system remain unknown. The objective of this study was to assess the chronic effects of strengthening exercises (STRE on autonomic modulation, pain perception and the quality of life (QOL of FM patients. METHODS: Eighty sedentary women with FM (ACR 1990 were randomly selected to participate in STRE or flexibility (FLEX exercises in a blinded controlled trial. The intensity of STRE was set at 45% of the estimated load of 1 Repetition Maximum (RM in 12 different exercises. Outcomes were Visual Analog Scale (VAS for pain, Heart Rate Variability (HRV analysis, treadmill test, the sit and reach test (Wells and Dillon's Bench, maximal repetitions test and handgrip dynamometry; and quality of life by the Fibromyalgia Impact Questionnaire (FIQ, the Beck and Idate Trait-State Inventory (IDATE, a short-form health survey (SF-36. RESULTS: The STRE group was more effective to strength gain for all muscles and pain control after 4 and 16 weeks (p<0.05. The FLEX group showed higher improvements in anxiety (p<0.05. Both groups showed improvements in the QOL, and there was no significant difference observed between the groups. There was no change in the HRV of the STRE and FLEX groups. CONCLUSIONS: Strengthening exercises show greater and more rapid improvements in pain and strength than flexibility exercises. Despite the benefits in fitness, pain, depression, anxiety and quality of life, no effect was observed on the autonomic modulation in both groups. This observation suggests that changes in autonomic modulation are not a target tobe clinically achieved in fibromyalgia. TRIAL REGISTRATION: Clinical

  4. Desensitization to a whole egg by rush oral immunotherapy improves the quality of life of guardians: A multicenter, randomized, parallel-group, delayed-start design study.

    Science.gov (United States)

    Itoh-Nagato, Naoka; Inoue, Yuzaburo; Nagao, Mizuho; Fujisawa, Takao; Shimojo, Naoki; Iwata, Tsutomu

    2018-04-01

    Patients with food allergies and their families have a significantly reduced health-related quality of life (QOL). We performed a multicenter, randomized, parallel-group, delayed-start design study to clarify the efficacy and safety of rush oral immunotherapy (rOIT) and its impact on the participants' daily life and their guardians (UMIN000003943). Forty-five participants were randomly divided into an early-start group and a late-start group. The early-start group received rOIT for 3 months, while the late-start group continued the egg elimination diet (control). In the next stage, both groups received OIT until all participants had finished 12 months of maintenance OIT. The ratio of the participants in whom an increase of the TD was achieved in the first stage was significantly higher in the early-start group (87.0%), than in the late-start group (22.7%). The QOL of the guardians in the early-start group significantly improved after the first stage (65.2%), in comparison to the late-start group (31.8%). During 12 months of rOIT, the serum ovomucoid-specific IgE levels, the percentage of CD203c + basophils upon stimulation with egg white, and the wheal size to egg white were decreased, while the serum ovomucoid-specific IgG4 levels were increased. However, approximately 80% of the participants in the early-start group showed an allergic reaction during the first stage of the study, whereas none of the patients in the late-start group experienced an allergic reaction. rOIT induced desensitization to egg and thus improved the QOL of guardians; however, the participants experienced frequent allergic reactions due to the treatment. Copyright © 2017 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  5. Goal Management Training Combined With External Cuing as a Means to Improve Emotional Regulation, Psychological Functioning, and Quality of Life in Patients With Acquired Brain Injury: A Randomized Controlled Trial.

    Science.gov (United States)

    Tornås, Sveinung; Løvstad, Marianne; Solbakk, Anne-Kristin; Schanke, Anne-Kristine; Stubberud, Jan

    2016-11-01

    To investigate whether goal management training (GMT) expanded to include external cuing and an emotional regulation module is associated with improved emotional regulation, psychological functioning, and quality of life (QOL) after chronic acquired brain injury (ABI). Randomized controlled trial with blinded outcome assessment at baseline, posttraining, and 6-month follow-up. Outpatient. Persons with ABI and executive dysfunction (N=70; 64% traumatic brain injury; 52% men; mean age ± SD, 43±13y; mean time since injury ± SD, 8.1±9.4y). Eight sessions of GMT in groups, including a new module addressing emotional regulation, and external cuing. A psychoeducative control condition (Brain Health Workshop) was matched on amount of training, therapist contact, and homework. Emotional regulation was assessed with the Brain Injury Rehabilitation Trust Regulation of Emotions Questionnaire, the Emotional Control subscale and the Emotion Regulation factor (Behavior Rating Inventory of Executive Function-Adult Version), and the Positive and Negative Affect subscales from the Dysexecutive Questionnaire. Secondary outcome measures included psychological distress (Hopkins Symptom Checklist-25) and QOL (Quality of Life After Brain Injury Scale). Findings indicated beneficial effects of GMT on emotional regulation skills in everyday life and in QOL 6 months posttreatment. No intervention effects on measures of psychological distress were registered. GMT is a promising intervention for improving emotional regulation after ABI, even in the chronic phase. More research using objective measures of emotional regulation is needed to investigate the efficacy of this type of training. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. One-pill once-a-day HAART: a simplification strategy that improves adherence and quality of life of HIV-infected subjects

    Directory of Open Access Journals (Sweden)

    Monica Airoldi

    2010-05-01

    Full Text Available Monica Airoldi1,6, Mauro Zaccarelli2, Luca Bisi3, Teresa Bini4, Andrea Antinori2, Cristina Mussini3, Francesca Bai4, Giancarlo Orofino5, Laura Sighinolfi7, Andrea Gori6, Fredy Suter1, Franco Maggiolo11Division of Infectious Diseases, Ospedali Riuniti, Bergamo; 2Clinical Department, INMI L Spallanzani, Roma; 3Division of Infectious Diseases, Università, Modena; 4Division of Infectious Diseases, Ospedale San Paolo, Milano; 5Division of Infectious Diseases, Ospedale Amedeo di Savoia, Torino; 6Division of Infectious Diseases, Ospedale San Gerardo, Monza; 7Division of Infectious Diseases, Ospedale Sant’Anna, Ferrara, ItalyObjective: The aim of the ADONE (ADherence to ONE pill study was to verify the effect of a reduced number of pills on adherence and quality of life (QoL in HIV-infected patients on highly active antiretroviral therapy (HAART.Design: Prospective, multicenter, study.Methods: Patients chronically treated with emtricitabine (FTC + tenofovir (TDF + efavirenz (EFV or lamivudine (3TC + TDF + EFV and with a HIV-RNA < 50 copies/mL were switched to the single-pill fixed-dose regimen (FDR of FTC + TDF + EFV. Data were collected with SF-36 using visual analog scales. Results of the final (6 months primary as-treated analysis are reported.Results: 212 patients (77.4% males of mean age 45.8 years were enrolled; 202 completed the study. One month post switch to FDR the adherence rate increased significantly to 96.1% from a baseline value of 93.8% (P < 0.01. The increase was steadily maintained throughout the study (96.2% at 6 months. QoL improved over time from 68.8% to 72.7% (P = 0.042 as well, and was significantly associated with the perception of health status, presence of adverse events (AEs and number of reported AEs (P < 0.0001. QoL significantly influenced adherence (P < 0.0001. During FDR use the mean CD4 count increased from 556 to 605 cells/μL (P < 0.0001. At the end of follow-up 98% of patients maintained HIV-RNA level < 50 copies

  7. Shrinkage of Prostate and Improved Quality of Life: Management of BPH Patients with Croton membranaceus Ethanolic Root Extract

    Directory of Open Access Journals (Sweden)

    George Awuku Asare

    2015-01-01

    Full Text Available Benign prostatic hyperplasia (BPH is an enlargement of the prostate. The study aimed at validating the use of freeze-dried Croton membranaceus ethanolic root extract for BPH management. Thirty-three patients were observed before and after 3-month administration of 20 mg t.i.d orally. The International Prostate Symptom Score (IPSS, and the International Index of Erectile Function (IIEF questionnaires were used. Total/free PSA (tPSA, fPSA, renal, liver function, lipid tests, and ultrasonographic imaging were performed. Thirty (30 patients (66 ± 11 years completed the study. IPSS results showed 37% had severe, 40% moderate, and 23% mild symptoms before; 57% and 43% had moderate and mild symptoms, respectively, after treatment. IIED of patients’ results showed 30% with severe, 40% moderate, 24% mild-moderate, 3% mild, and 3% no erectile dysfunction before treatment and 20% severe, 43% moderate, and 37% mild-moderate dysfunction, after treatment. Quality of life (QoL improved (P=0.001. Significant but non-pathological increases in total and indirect bilirubin as well as apolipoprotein A occurred. Mean tPSA reduced from 27.9 ± 19.0 to 16.2 ± 11.8 ng/mL (P=0.002; fPSA from 6.1 ± 4.8 to 3.9 ± 2.9 ng/mL (P=0.045; and prostate volume from 101.8 ± 41.3 to 54.5 ± 24.8 cm3  (P=0.023. C. membranaceus shrinks the prostate and improves QoL.

  8. Improving Access to Mental Health Care by Delivering Psychotherapeutic Care in the Workplace: A Cross-Sectional Exploratory Trial.

    Directory of Open Access Journals (Sweden)

    Eva Rothermund

    Full Text Available Common mental disorders like mood and anxiety disorders and somatoform disorders have high costs, yet under-treatment is still frequent. Many people with common mental disorders are employed, so the workplace is potentially a suitable context in which to provide early treatment. Our study investigates whether a change of setting (workplace versus standard care improves access to treatment for common mental disorders.Conditional latent profile analysis was applied to identify user profiles for work ability (WAI, clinical symptoms like depression (patient health questionnaire depression, PHQ-9, health-related quality of life (QoL, SF-12, and work-related stress (Maslach Burnout Inventory, irritation scale. Patients were recruited consecutively, via psychotherapeutic consultation in the workplace (n = 174 or psychotherapeutic consultation in outpatient care (n = 193.We identified four user profiles in our model: 'severe' (n = 99, 'moderate I-low QoL' (n = 88, 'moderate II-low work ability' (n = 83, and 'at risk' (n = 97. The 'at risk' profile encompassed individuals with reduced work ability (36.0, 34.73 to 37.37, only mild clinical symptoms (PHQ-9 5.7, 4.92 to 6.53, no signs of work-related stress and good quality of life. A higher proportion of the 'at risk' group than of the 'severe' group sought help via the psychotherapeutic consultation in the workplace (OR 0.287, P < 0.01; this effect remained after controlling for gender.Offering secondary mental health care in the workplace is feasible and accepted by users. Offering treatment in the workplace as an alternative to standard outpatient settings is a viable strategy for improving access to treatment for common mental disorders.

  9. CDBG Public Improvements Activity

    Data.gov (United States)

    Department of Housing and Urban Development — CDBG activity related to public improvements, including senior centers, youth centers, parks, street improvements, water/sewer improvements, child care centers, fire...

  10. A two-year follow-up case of chronic fatigue syndrome: substantial improvement in personality following a yoga-based lifestyle intervention.

    Science.gov (United States)

    Yadav, Raj Kumar; Sarvottam, Kumar; Magan, Dipti; Yadav, Rashmi

    2015-04-01

    Chronic Fatigue Syndrome (CFS) is characterized by excessive fatigue after minimal physical or mental exertion, muscle and joint pain, poor concentration, dizziness, and sleep disturbances. We report here the effect of a yoga-based lifestyle intervention in a 30-year old male patient with a documented diagnosis of CFS with compromised quality of life (QoL) and altered personality. The patient initially attended a short-term yoga-based lifestyle intervention program that consisted of yoga-postures, breathing exercises (pranayama), meditation, group discussions, and individualized advice on stress management, diet and physical activity besides group support. Thereafter, patient attended 5 more such programs. There was a notable and consistent improvement in his clinical profile, positive aspects of personality and subjective well-being, and reduction in anxiety following this yoga-based lifestyle intervention. Overall, the results suggest that lifestyle intervention may improve clinical condition and personality in patients with CFS.

  11. Does a combination of physical training, specific exercises and pain education improve health-related quality of life in patients with chronic neck pain?

    DEFF Research Database (Denmark)

    Ris, I; Søgaard, Karen; Gram, B

    2016-01-01

    Qol-5D, Beck Depression Inventory-II, Neck Disability Index, Pain Bothersomeness, Patient-Specific Functioning Scale, Tampa Scale of Kinesiophobia, Global Perceived Effect) and clinical tests (Aastrand Physical Fitness, cervical Range of Motion, Pressure Pain Threshold at infraspinatus, tibialis...... anterior and cervical spine, Cranio-cervical Flexion, Cervical Extension muscle function, and oculomotion) were recorded at baseline and after 4 months. RESULTS: The exercise group showed statistically significant improvement in physical HR-QoL, mental HR-QoL, depression, cervical pressure pain threshold......, cervical extension movement, muscle function, and oculomotion. Per protocol analyses confirmed these results with additional significant improvements in the exercise group compared with controls. CONCLUSIONS: This multimodal intervention may be an effective intervention for chronic neck pain patients...

  12. Early salpingectomy (TUbectomy) with delayed oophorectomy to improve quality of life as alternative for risk-reducing salpingo-oophorectomy in BRCA1/2 mutation carriers (TUBA study): a prospective non-randomised multicentre study

    International Nuclear Information System (INIS)

    Harmsen, Marline G.; Arts-de Jong, Marieke; Hoogerbrugge, Nicoline; Maas, Angela H. E. M.; Prins, Judith B.; Bulten, Johan; Teerenstra, Steven; Adang, Eddy M. M.; Piek, Jurgen M. J.; Doorn, Helena C van; Beurden, Marc van; Mourits, Marian J. E.; Zweemer, Ronald P.; Gaarenstroom, Katja N.; Slangen, Brigitte F. M.; Vos, M. Caroline; Lonkhuijzen, Luc R. C. W. van; Massuger, Leon F. A. G.; Hermens, Rosella P. M. G.; Hullu, Joanne A. de

    2015-01-01

    Risk-reducing salpingo-oophorectomy (RRSO) around the age of 40 is currently recommended to BRCA1/2 mutation carriers. This procedure decreases the elevated ovarian cancer risk by 80–96 % but it initiates premature menopause as well. The latter is associated with short-term and long-term morbidity, potentially affecting quality of life (QoL). Based on recent insights into the Fallopian tube as possible site of origin of serous ovarian carcinomas, an alternative preventive strategy has been put forward: early risk-reducing salpingectomy (RRS) and delayed oophorectomy (RRO). However, efficacy and safety of this alternative strategy have to be investigated. A multicentre non-randomised trial in 11 Dutch centres for hereditary cancer will be conducted. Eligible patients are premenopausal BRCA1/2 mutation carriers after completing childbearing without (a history of) ovarian carcinoma. Participants choose between standard RRSO at age 35–40 (BRCA1) or 40–45 (BRCA2) and the alternative strategy (RRS upon completion of childbearing and RRO at age 40–45 (BRCA1) or 45–50 (BRCA2)). Women who opt for RRS but do not want to postpone RRO beyond the currently recommended age are included as well. Primary outcome measure is menopause-related QoL. Secondary outcome measures are ovarian/breast cancer incidence, surgery-related morbidity, histopathology, cardiovascular risk factors and diseases, and cost-effectiveness. Mixed model data analysis will be performed. The exact role of the Fallopian tube in ovarian carcinogenesis is still unclear. It is not expected that further fundamental research will elucidate this role in the near future. Therefore, this clinical trial is essential to investigate RRS with delayed RRO as alternative risk-reducing strategy in order to improve QoL. ClinicalTrials.gov: NCT02321228

  13. Leg Lengthening as a Means of Improving Ambulation Following an Internal Hemipelvectomy

    Directory of Open Access Journals (Sweden)

    Wakyo Sato

    2016-01-01

    Full Text Available Reconstructive surgery following an internal hemipelvectomy for a malignant pelvic tumor is difficult due to the structural complexity of the pelvis and the massive extension of the tumor. While high complication rates have been encountered in various types of reconstructive surgery, resection without reconstruction reportedly involved fewer complications. However, this method often results in limb shortening with resultant instability during walking. We reported herein leg lengthening performed to correct lower limb shortening after an internal hemipelvectomy, which improved ambulatory stability and overall QOL. An 18-year-old male patient came to our hospital to correct a lower limb discrepancy resulting from a left internal hemipelvectomy. His left pelvis and proximal femur had been resected, and the femur remained without an acetabular roof. His left lower limb was about 8 centimeters shorter. The left tibia was lengthened 8 centimeters with an external fixator. After the lengthening, the patient was able to walk without support and his gait remarkably improved. Additionally he no longer required placing a wallet in his back pocket as a pad as a means of raising the left side of his torso while sitting. Leg lengthening was a useful method of improving ambulation after an internal hemipelvectomy.

  14. Building abstinent networks is an important resource in improving quality of life.

    Science.gov (United States)

    Muller, Ashley Elizabeth; Skurtveit, Svetlana; Clausen, Thomas

    2017-11-01

    To investigate changes in social network and quality of life of a substance use disorder cohort as they progressed through treatment. Multi-site, prospective, observational study of 338 adults entering substance use disorder treatment. Patients at 21 facilities across Norway contributed baseline data when they initiated treatment, and follow-up data was collected from them one year later. The cohort was divided into those who completed, dropped out, and remained in treatment one year after treatment initiation. For each treatment status group, general linear models with repeated measures analyzed global and social quality of life with the generic QOL10 instrument over time. The between-group factor was a change in social network variable from the EuropASI. Those who gained an abstinent network reported the largest quality of life improvements. Improvements were smallest or negligible for the socially isolated and those who were no longer in contact with the treatment system. Developing an abstinent network is particularly important to improve the quality of life of those in substance use disorder treatment. Social isolation is a risk factor for impaired quality of life throughout the treatment course. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Making process improvement 'stick'.

    Science.gov (United States)

    Studer, Quint

    2014-06-01

    To sustain gains from a process improvement initiative, healthcare organizations should: Explain to staff why a process improvement initiative is needed. Encourage leaders within the organization to champion the process improvement, and tie their evaluations to its outcomes. Ensure that both leaders and employees have the skills to help sustain the sought-after process improvements.

  16. The ProQOL-21: A revised version of the Professional Quality of Life (ProQOL) scale based on Rasch analysis

    Science.gov (United States)

    Rees, Clare S.; Hegney, Desley G.

    2018-01-01

    The Professional Quality of Life scale is a measure intended to provide practitioners and researchers with an indication of a caring professional’s compassion satisfaction, burnout, and secondary traumatic stress. While this measure has been used extensively in nursing research, owing to the relevancy of patient-care associated satisfaction and fatigue within this profession, information regarding the construct validity of this measure is less well represented in the literature. We examined the construct validity of the Professional Quality of Life scale using a Rasch analysis procedure on each of its three scales, as a means of substantiating their measurement adequacy. Responses on the Professional Quality of Life scale from 1615 registered nurses (age x̅ = 46.48 years, SD = 11.78) were analysed. While support for the measurement adequacy (invariance, person/item fit, and unidimensionality) of the compassion satisfaction scale was found, the burnout and secondary traumatic stress scales did not demonstrate adequate measurement properties. We instead present an alternative measurement model of these subscales, involving items from each, to form a robust measure of compassion fatigue, and provide recoding, scoring, and normed scores for both measures. Our findings indicate that use of the Professional Quality of Life scale’s burnout and secondary traumatic stress scales may require caution, while our revised compassion satisfaction and fatigue scales provide robust measurement options for practitioners and researchers. PMID:29489875

  17. The ProQOL-21: A revised version of the Professional Quality of Life (ProQOL scale based on Rasch analysis.

    Directory of Open Access Journals (Sweden)

    Brody Heritage

    Full Text Available The Professional Quality of Life scale is a measure intended to provide practitioners and researchers with an indication of a caring professional's compassion satisfaction, burnout, and secondary traumatic stress. While this measure has been used extensively in nursing research, owing to the relevancy of patient-care associated satisfaction and fatigue within this profession, information regarding the construct validity of this measure is less well represented in the literature. We examined the construct validity of the Professional Quality of Life scale using a Rasch analysis procedure on each of its three scales, as a means of substantiating their measurement adequacy. Responses on the Professional Quality of Life scale from 1615 registered nurses (age x̅ = 46.48 years, SD = 11.78 were analysed. While support for the measurement adequacy (invariance, person/item fit, and unidimensionality of the compassion satisfaction scale was found, the burnout and secondary traumatic stress scales did not demonstrate adequate measurement properties. We instead present an alternative measurement model of these subscales, involving items from each, to form a robust measure of compassion fatigue, and provide recoding, scoring, and normed scores for both measures. Our findings indicate that use of the Professional Quality of Life scale's burnout and secondary traumatic stress scales may require caution, while our revised compassion satisfaction and fatigue scales provide robust measurement options for practitioners and researchers.

  18. Spinal Cord Stimulation Provides Pain Relief with Improved Psychosocial Function: Results from EMP3OWER.

    Science.gov (United States)

    Rosenberg, Jason; Fabi, Alain; Candido, Kenneth; Knezevic, Nick; Creamer, Michael; Carayannopoulos, Alexios; Ghodsi, Abdi; Nelson, Christopher; Bennett, Matthew

    2016-12-01

    The EMP 3 OWER™ study evaluated spinal cord stimulation (SCS) safety and efficacy and the associated changes in psychosocial and functional outcomes. Upon informed consent and IRB approval, 620 eligible subjects were enrolled prior to SCS trial evaluation and were assessed at baseline, 3, 6 and 12 months post-implant. Patient-reported pain relief (PRP), numerical rating scale (NRS), satisfaction, quality of life (QOL), and pain disability index (PDI) were assessed at all follow-up visits while the pain catastrophizing scale (PCS), short form-36 (SF-36), short form-McGill pain questionnaire version 2 (SF-MPQ-2), and the state-trait anxiety inventory (STAI) were assessed at the 6- and 12-month follow-up visits. Device and/or procedure-related adverse events were also recorded and reported. Subjects reporting a PRP ≥ 50% were considered responders. Repeated measures analysis of variance (RMANOVA) examined the changes across time for all continuous measures. A total of 401 (71%) subjects received a permanent implant. Mean (±SD) patient-reported pain relief was 59.3% (±26.2), 59.2% (±28.9), and 58.2% (±32.0) at 3, 6, and 12 months, respectively. A majority of enrolled subjects were responders at 3 (75.5%), 6 (74.7%), and 12 months (69.7%). RMANOVA revealed a statistically significant change for NRS, PCS, PDI, SF-36, SF-MPQ-2, and STAI scores. At 3 months, the majority of subjects (85.7%) were either very satisfied or satisfied with their device, with similar results at 6 and 12 months. At 3 months, the majority of subjects (73.3%) reported greatly improved or improved QOL with similar results at 6 and 12 months. Spinal cord stimulation provided pain relief and significant improvement of patient psychological and functional outcome measures. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Rationale, design and conduct of a randomised controlled trial evaluating a primary care-based complex intervention to improve the quality of life of heart failure patients: HICMan (Heidelberg Integrated Case Management).

    Science.gov (United States)

    Peters-Klimm, Frank; Müller-Tasch, Thomas; Schellberg, Dieter; Gensichen, Jochen; Muth, Christiane; Herzog, Wolfgang; Szecsenyi, Joachim

    2007-08-23

    Chronic congestive heart failure (CHF) is a complex disease with rising prevalence, compromised quality of life (QoL), unplanned hospital admissions, high mortality and therefore high burden of illness. The delivery of care for these patients has been criticized and new strategies addressing crucial domains of care have been shown to be effective on patients' health outcomes, although these trials were conducted in secondary care or in highly organised Health Maintenance Organisations. It remains unclear whether a comprehensive primary care-based case management for the treating general practitioner (GP) can improve patients' QoL. HICMan is a randomised controlled trial with patients as the unit of randomisation. Aim is to evaluate a structured, standardized and comprehensive complex intervention for patients with CHF in a 12-months follow-up trial. Patients from intervention group receive specific patient leaflets and documentation booklets as well as regular monitoring and screening by a prior trained practice nurse, who gives feedback to the GP upon urgency. Monitoring and screening address aspects of disease-specific self-management, (non)pharmacological adherence and psychosomatic and geriatric comorbidity. GPs are invited to provide a tailored structured counselling 4 times during the trial and receive an additional feedback on pharmacotherapy relevant to prognosis (data of baseline documentation). Patients from control group receive usual care by their GPs, who were introduced to guideline-oriented management and a tailored health counselling concept. Main outcome measurement for patients' QoL is the scale physical functioning of the SF-36 health questionnaire in a 12-month follow-up. Secondary outcomes are the disease specific QoL measured by the Kansas City Cardiomyopathy questionnaire (KCCQ), depression and anxiety disorders (PHQ-9, GAD-7), adherence (EHFScBS and SANA), quality of care measured by an adapted version of the Patient Chronic Illness

  20. Rationale, design and conduct of a randomised controlled trial evaluating a primary care-based complex intervention to improve the quality of life of heart failure patients: HICMan (Heidelberg Integrated Case Management

    Directory of Open Access Journals (Sweden)

    Muth Christiane

    2007-08-01

    Full Text Available Abstract Background Chronic congestive heart failure (CHF is a complex disease with rising prevalence, compromised quality of life (QoL, unplanned hospital admissions, high mortality and therefore high burden of illness. The delivery of care for these patients has been criticized and new strategies addressing crucial domains of care have been shown to be effective on patients' health outcomes, although these trials were conducted in secondary care or in highly organised Health Maintenance Organisations. It remains unclear whether a comprehensive primary care-based case management for the treating general practitioner (GP can improve patients' QoL. Methods/Design HICMan is a randomised controlled trial with patients as the unit of randomisation. Aim is to evaluate a structured, standardized and comprehensive complex intervention for patients with CHF in a 12-months follow-up trial. Patients from intervention group receive specific patient leaflets and documentation booklets as well as regular monitoring and screening by a prior trained practice nurse, who gives feedback to the GP upon urgency. Monitoring and screening address aspects of disease-specific self-management, (nonpharmacological adherence and psychosomatic and geriatric comorbidity. GPs are invited to provide a tailored structured counselling 4 times during the trial and receive an additional feedback on pharmacotherapy relevant to prognosis (data of baseline documentation. Patients from control group receive usual care by their GPs, who were introduced to guideline-oriented management and a tailored health counselling concept. Main outcome measurement for patients' QoL is the scale physical functioning of the SF-36 health questionnaire in a 12-month follow-up. Secondary outcomes are the disease specific QoL measured by the Kansas City Cardiomyopathy questionnaire (KCCQ, depression and anxiety disorders (PHQ-9, GAD-7, adherence (EHFScBS and SANA, quality of care measured by an adapted

  1. Concomitant treatment of brain metastasis with Whole Brain Radiotherapy [WBRT] and Temozolomide [TMZ] is active and improves Quality of Life

    International Nuclear Information System (INIS)

    Addeo, Raffaele; Caraglia, Michele; Faiola, Vincenzo; Capasso, Elena; Vincenzi, Bruno; Montella, Liliana; Guarrasi, Rosario; Caserta, Luigi; Del Prete, Salvatore

    2007-01-01

    Brain metastases (BM) represent one of the most frequent complications related to cancer, and their treatment continues to evolve. We have evaluated the activity, toxicity and the impact on Quality of Life (QoL) of a concomitant treatment with whole brain radiotherapy (WBRT) and Temozolomide (TMZ) in patients with brain metastases from solid tumors in a prospective Simon two stage study. Fifty-nine patients were enrolled and received 30 Gy WBRT with concomitant TMZ (75 mg/m2/day) for ten days, and subsequently TMZ (150 mg/m2/day) for up to six cycles. The primary end points were clinical symptoms and radiologic response. Five patients had a complete response, 21 patients had a partial response, while 18 patients had stable disease. The overall response rate (45%) exceeded the target activity per study design. The median time to progression was 9 months. Median overall survival was 13 months. The most frequent toxicities included grade 3 neutropenia (15%) and anemia (13%), and only one patient developed a grade 4 thrombocytopenia. Age, Karnofsky performance status, presence of extracranial metastases and the recursive partitioning analysis (RPA) were found to be predictive factors for response in patients. Overall survival (OS) and progression-free survival (PFS) were dependent on age and on the RPA class. We conclude that this treatment is well tolerated, with an encouraging objective response rate, and a significant improvement in quality of life (p < 0.0001) demonstrated by FACT-G analysis. All patients answered the questionnaires and described themselves as 'independent' and able to act on their own initiatives. Our study found a high level of satisfaction for QoL, this provides useful information to share with patients in discussions regarding chemotherapy treatment of these lesions

  2. Improving fleet performance

    International Nuclear Information System (INIS)

    Ramjist, S.

    2015-01-01

    Use Fleet Initiatives to Improve Overall Fleet Performance . Tightly Integrated with Business Planning (Cause & Effect) . Leverage Strength of Broader Organization - Converge on Standard Business Practices . Ancillary Benefit of Improved Agility.

  3. Accelerate Water Quality Improvement

    Science.gov (United States)

    EPA is committed to accelerating water quality improvement and minimizing negative impacts to aquatic life from contaminants and other stressors in the Bay Delta Estuary by working with California Water Boards to strengthen water quality improvement plans.

  4. Improving fleet performance

    Energy Technology Data Exchange (ETDEWEB)

    Ramjist, S. [Ontario Power Generation, Toronto, ON (Canada)

    2015-07-01

    Use Fleet Initiatives to Improve Overall Fleet Performance . Tightly Integrated with Business Planning (Cause & Effect) . Leverage Strength of Broader Organization - Converge on Standard Business Practices . Ancillary Benefit of Improved Agility.

  5. Improving employee productivity through improved health.

    Science.gov (United States)

    Mitchell, Rebecca J; Ozminkowski, Ronald J; Serxner, Seth

    2013-10-01

    The objective of this study was to estimate productivity-related savings associated with employee participation in health promotion programs. Propensity score weighting and multiple regression techniques were used to estimate savings. These techniques were adjusted for demographic and health status differences between participants who engaged in one or more telephonic health management programs and nonparticipants who were eligible for but did not engage in these programs. Employees who participated in a program and successfully improved their health care or lifestyle showed significant improvements in lost work time. These employees saved an average of $353 per person per year. This reflects about 10.3 hours in additional productive time annually, compared with similar, but nonparticipating employees. Participating in health promotion programs can help improve productivity levels among employees and save money for their employers.

  6. Original article Role of Tamsulosin in Improving Double-J Ureteric ...

    African Journals Online (AJOL)

    2011-10-04

    related symptoms and quality of life (QoL) in patients with double-J (DJ) ureteric stents. Subjects and Methods: A total of 136 patients were prospectively evaluated and distributed randomly in two groups. Group 1 was 69 ...

  7. Improving quality of life in ageing populations: what can volunteering do?

    Science.gov (United States)

    Cattan, Mima; Hogg, Eddy; Hardill, Irene

    2011-12-01

    The year 2011 was declared the 'European Year of Volunteering' to recognise the contribution volunteers make to society. Such cross-national events reflect the high profile of volunteering and political imperatives to promote it. The purpose of this review is to provide a comprehensive review of current knowledge (articles published between 2005 and 2011) regarding the role of volunteering in improving older people's quality of life (QoL) and to identify areas requiring further research. Volunteering was defined as an activity that is freely chosen, does not involve remuneration and helps or benefits those beyond an individual's immediate family. Our search identified 22 studies and 5 review articles that addressed the benefits of volunteering on older people's quality of life. Most of the research had been conducted in the United States, Canada and Australia using data from longitudinal studies. The majority of the studies concluded that there is a positive association between older people's quality of life and engagement in volunteering. Due to the study designs and the heterogeneity of the research, causality is difficult to demonstrate and the knowledge the studies bring to the subject is variable. This review shows that volunteering may help to maintain and possibly improve some older adults' quality of life. However, there are still major gaps in our understanding of who actually benefits, the social and cultural context of volunteering and its role in reducing health and social inequalities. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  8. Fibromyalgia syndrome improved using a mostly raw vegetarian diet: An observational study

    Directory of Open Access Journals (Sweden)

    Speight Neal

    2001-09-01

    Full Text Available Abstract Background Fibromyalgia engulfs patients in a downward, reinforcing cycle of unrestorative sleep, chronic pain, fatigue, inactivity, and depression. In this study we tested whether a mostly raw vegetarian diet would significantly improve fibromyalgia symptoms. Methods Thirty people participated in a dietary intervention using a mostly raw, pure vegetarian diet. The diet consisted of raw fruits, salads, carrot juice, tubers, grain products, nuts, seeds, and a dehydrated barley grass juice product. Outcomes measured were dietary intake, the fibromyalgia impact questionnaire (FIQ, SF-36 health survey, a quality of life survey (QOLS, and physical performance measurements. Results Twenty-six subjects returned dietary surveys at 2 months; 20 subjects returned surveys at the beginning, end, and at either 2 or 4 months of intervention; 3 subjects were lost to follow-up. The mean FIQ score (n = 20 was reduced 46% from 51 to 28. Seven of the 8 SF-36 subscales, bodily pain being the exception, showed significant improvement (n = 20, all P for trend Conclusion This dietary intervention shows that many fibromyalgia subjects can be helped by a mostly raw vegetarian diet.

  9. Collaborative quality improvement.

    Science.gov (United States)

    Luckenbaugh, Amy N; Miller, David C; Ghani, Khurshid R

    2017-07-01

    Quality improvement collaboratives were developed in many medical and surgical disciplines with the goal of measuring and improving the quality of care provided to patients. The aim of this review is to provide an overview of surgical quality improvement collaboratives, and in particular those aimed at improving urological care. Quality improvement collaboratives collect high-quality data using standardized methodologies, and use the data to provide feedback to physicians and practices, and then implement processes to improve patient outcomes. The largest regional collaborative in urology is the Michigan Urological Surgery Improvement Collaborative (MUSIC). Recent efforts by this group have been focused at understanding variation in care, improving patient selection for treatment, reducing treatment morbidity and measuring and optimizing technical skill. The American Urological Association has also recently launched a national quality registry (AQUA), with an initial focus on prostate cancer care. By understanding factors that result in exemplary performance, quality improvement collaboratives are able to develop best practices around areas of care with high variation that have the potential to improve outcomes and reduce costs. These developments have been made possible by the unique model offered by the collaborative structure with the goal of improving patient care at a population level.

  10. Improved core monitoring for improved plant operations

    International Nuclear Information System (INIS)

    Mueller, N.P.

    1987-01-01

    Westinghouse has recently installed a core on-line surveillance, monitoring and operations systems (COSMOS), which uses only currently available core and plant data to accurately reconstruct the core average axial and radial power distributions. This information is provided to the operator in an immediately usable, human-engineered format and is accumulated for use in application programs that provide improved core performance predictive tools and a data base for improved fuel management. Dynamic on-line real-time axial and radial core monitoring supports a variety of plant operations to provide a favorable cost/benefit ratio for such a system. Benefits include: (1) relaxation or elimination of certain technical specifications to reduce surveillance and reporting requirements and allow higher availability factors, (2) improved information displays, predictive tools, and control strategies to support more efficient core control and reduce effluent production, and (3) expanded burnup data base for improved fuel management. Such systems can be backfit into operating plants without changing the existing instrumentation and control system and can frequently be implemented on existing plant computer capacity

  11. The SIESTA Trial: A Randomized Study Investigating the Efficacy, Safety, and Tolerability of Acupressure versus Sham Therapy for Improving Sleep Quality in Patients with End-Stage Kidney Disease on Hemodialysis

    Directory of Open Access Journals (Sweden)

    Kunyu Shen

    2017-01-01

    Full Text Available Objectives. To compare the effectiveness of real acupressure versus sham acupressure therapy in improving sleep quality in patients receiving hemodialysis (HD or hemodiafiltration (HDF. Methods. A multicenter, single-blind, randomized controlled trial was conducted in two Australian dialysis units located in Princess Alexandra Hospital and Logan Hospital, respectively. Forty-two subjects with self-reported poor sleep quality were randomly assigned to real (n=21 or sham (n=21 acupressure therapy delivered thrice weekly for four consecutive weeks during routine dialysis sessions. The primary outcome was the Pittsburgh Sleep Quality Index (PSQI score measured at week four adjusted for baseline PSQI measurements. Secondary outcomes were quality of life (QOL (SF-8, adverse events, and patient acceptability (treatment acceptability questionnaire, TAQ. Results. The two groups were comparable on global PSQI scores (difference 0.19, 95% confidence interval [CI] −1.32 to 1.70 and on the subscale scores. Similar results were observed for QOL both in the mental (difference −3.88, 95% CI −8.63 to 0.87 and the physical scores (difference 2.45, 95% CI −1.69 to 6.58. There were no treatment-related adverse events and acupressure was perceived favorably by participants. Conclusion. Acupressure is a safe, well-tolerated, and highly acceptable therapy in adult hemodialysis patients in a Western healthcare setting with uncertain implications for therapeutic efficacy.

  12. Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus.

    Science.gov (United States)

    Petersen, Jakob; Hellström, Per; Wikkelsø, Carsten; Lundgren-Nilsson, Asa

    2014-10-01

    To investigate the impact of shunt surgery on the activity, participation, autonomy, and health-related quality of life (HRQOL) of patients with idiopathic normal-pressure hydrocephalus (iNPH) as well as the effect on caregiver burden. Thirty-seven patients (median age 70 years, range 50-89 years) with iNPH were evaluated before and 6 months after surgery. Symptoms and signs were assessed by the iNPH scale, activities of daily living (ADL) with the Functional Independence Measure (FIM) and Assessment of Motor and Process Skills (AMPS), autonomy and participation with Impact on Participation and Autonomy (IPA), and caregiver burden with the Caregiver Burden Scale (CBS). HRQOL was evaluated with the EQ-5D (EuroQol Group-5 Dimension health survey). Twenty-four patients (65%) improved clinically (iNPH scale score) and 31 (86%) improved their HRQOL after surgery, almost to the same level as found in the normal population. The patients became more independent in physical and cognitive activities, and participation and autonomy improved. The caregiver burden was decreased among caregivers to male patients but remained unchanged on the overall group level. After shunt surgery, patients with iNPH showed improvement in most aspects of social life, they became more independent, and their quality of life returned to nearly normal.

  13. Continual improvement plan

    Science.gov (United States)

    1994-01-01

    NASA's approach to continual improvement (CI) is a systems-oriented, agency-wide approach that builds on the past accomplishments of NASA Headquarters and its field installations and helps achieve NASA's vision, mission, and values. The NASA of the future will fully use the principles of continual improvement in every aspect of its operations. This NASA CI plan defines a systematic approach and a model for continual improvement throughout NASA, stressing systems integration and optimization. It demonstrates NASA's constancy of purpose for improvement - a consistent vision of NASA as a worldwide leader in top-quality science, technology, and management practices. The CI plan provides the rationale, structures, methods, and steps, and it defines NASA's short term (1-year) objectives for improvement. The CI plan presents the deployment strategies necessary for cascading the goals and objectives throughout the agency. It also provides guidance on implementing continual improvement with participation from top leadership and all levels of employees.

  14. Process Improvement Essentials

    CERN Document Server

    Persse, James R

    2006-01-01

    Process Improvement Essentials combines the foundation needed to understand process improvement theory with the best practices to help individuals implement process improvement initiatives in their organization. The three leading programs: ISO 9001:2000, CMMI, and Six Sigma--amidst the buzz and hype--tend to get lumped together under a common label. This book delivers a combined guide to all three programs, compares their applicability, and then sets the foundation for further exploration.

  15. Software Process Improvement Defined

    DEFF Research Database (Denmark)

    Aaen, Ivan

    2002-01-01

    This paper argues in favor of the development of explanatory theory on software process improvement. The last one or two decades commitment to prescriptive approaches in software process improvement theory may contribute to the emergence of a gulf dividing theorists and practitioners....... It is proposed that this divide be met by the development of theory evaluating prescriptive approaches and informing practice with a focus on the software process policymaking and process control aspects of improvement efforts...

  16. Ergonomic Improvements for Foundries

    Energy Technology Data Exchange (ETDEWEB)

    Frank Peters; Patrick Patterson

    2002-06-18

    The goal of this project was to make improvements to the production systems of the steel casting industry through ergonomic improvements. Because of the wide variety of products, the wide range of product sizes, and the relatively small quantities of any particular product, manual operations remain a vital part of the production systems of the steel casting companies. Ergonomic improvements will assist the operators to more efficiently and consistently produce quality products.

  17. A randomized, clinical trial of education or motivational-interviewing-based coaching compared to usual care to improve cancer pain management.

    Science.gov (United States)

    Thomas, Mary Laudon; Elliott, Janette E; Rao, Stephen M; Fahey, Kathleen F; Paul, Steven M; Miaskowski, Christine

    2012-01-01

    To test the effectiveness of two interventions compared to usual care in decreasing attitudinal barriers to cancer pain management, decreasing pain intensity, and improving functional status and quality of life (QOL). Randomized clinical trial. Six outpatient oncology clinics (three Veterans Affairs [VA] facilities, one county hospital, and one community-based practice in California, and one VA clinic in New Jersey)Sample: 318 adults with various types of cancer-related pain. Patients were randomly assigned to one of three groups: control, standardized education, or coaching. Patients in the education and coaching groups viewed a video and received a pamphlet on managing cancer pain. In addition, patients in the coaching group participated in four telephone sessions with an advanced practice nurse interventionist using motivational interviewing techniques to decrease attitudinal barriers to cancer pain management. Questionnaires were completed at baseline and six weeks after the final telephone calls. Analysis of covariance was used to evaluate for differences in study outcomes among the three groups. Pain intensity, pain relief, pain interference, attitudinal barriers, functional status, and QOL. Attitudinal barrier scores did not change over time among groups. Patients randomized to the coaching group reported significant improvement in their ratings of pain-related interference with function, as well as general health, vitality, and mental health. Although additional evaluation is needed, coaching may be a useful strategy to help patients decrease attitudinal barriers toward cancer pain management and to better manage their cancer pain. By using motivational interviewing techniques, advanced practice oncology nurses can help patients develop an appropriate plan of care to decrease pain and other symptoms.

  18. Using a divided-attention stepping accuracy task to improve balance and functional outcomes in an individual with incomplete spinal cord injury: A case report.

    Science.gov (United States)

    Leach, Susan J; Magill, Richard A; Maring, Joyce R

    2017-01-01

    A spinal cord injury (SCI) frequently results in impaired balance, endurance, and strength with subsequent limitations in functional mobility and community participation. The purpose of this case report was to implement a training program for an individual with a chronic incomplete SCI using a novel divided-attention stepping accuracy task (DASAT) to determine if improvements could be made in impairments, activities, and participation. The client was a 51-year-old male with a motor incomplete C4 SCI sustained 4 years prior. He presented with decreased quality of life (QOL) and functional independence, and deficits in balance, endurance, and strength consistent with central cord syndrome. The client completed the DASAT intervention 3 times per week for 6 weeks. Each session incorporated 96 multi-directional steps to randomly-assigned targets in response to 3-step verbal commands. QOL, measured using the SF-36, was generally enhanced but fluctuated. Community mobility progressed from close supervision to independence. Significant improvement was achieved in all balance scores: Berg Balance Scale by 9 points [Minimal Detectable Change (MDC) = 4.9 in elderly]; Functional Reach Test by 7.62 cm (MDC = 5.16 in C5/C6 SCI); and Timed Up-and-Go by 0.53 s (MDC not established). Endurance increased on the 6-Minute Walk Test, with the client achieving an additional 47 m (MDC = 45.8 m). Lower extremity isokinetic peak torque strength measures were mostly unchanged. Six minutes of DASAT training per session provided an efficient, low-cost intervention utilizing multiple trials of variable practice, and resulted in better performance in activities, balance, and endurance in this client.

  19. Teaching quality improvement.

    Science.gov (United States)

    Murray, Marry Ellen; Douglas, Stephen; Girdley, Diana; Jarzemsky, Paula

    2010-08-01

    Practicing nurses are required to engage in quality improvement work as a part of their clinical practice, but few undergraduate nursing education programs offer course work and applied experience in this area. This article presents a description of class content and teaching strategies, assignments, and evaluation strategies designed to achieve the Quality and Safety Education in Nursing competencies related to quality improvement and interdisciplinary teams. Students demonstrate their application of the quality improvement process by designing and implementing a small-scale quality improvement project that they report in storyboard format on a virtual conference Web site.

  20. Georgia - Improved Learning Environment

    Data.gov (United States)

    Millennium Challenge Corporation — The school rehabilitation activity seeks to decrease student and teacher absenteeism, increase students’ time on task, and, ultimately, improve learning and labor...

  1. Automated Student Model Improvement

    Science.gov (United States)

    Koedinger, Kenneth R.; McLaughlin, Elizabeth A.; Stamper, John C.

    2012-01-01

    Student modeling plays a critical role in developing and improving instruction and instructional technologies. We present a technique for automated improvement of student models that leverages the DataShop repository, crowd sourcing, and a version of the Learning Factors Analysis algorithm. We demonstrate this method on eleven educational…

  2. Continuous Personal Improvement.

    Science.gov (United States)

    Emiliani, M. L.

    1998-01-01

    Suggests that continuous improvement tools used in the workplace can be applied to self-improvement. Explains the use of such techniques as one-piece flow, kanban, visual controls, and total productive maintenance. Points out misapplications of these tools and describes the use of fishbone diagrams to diagnose problems. (SK)

  3. Improving Loop Dependence Analysis

    DEFF Research Database (Denmark)

    Jensen, Nicklas Bo; Karlsson, Sven

    2017-01-01

    Programmers can no longer depend on new processors to have significantly improved single-thread performance. Instead, gains have to come from other sources such as the compiler and its optimization passes. Advanced passes make use of information on the dependencies related to loops. We improve th...

  4. AGS slow extraction improvements

    International Nuclear Information System (INIS)

    Glenn, J.W.; Smith, G.A.; Sandberg, J.N.; Repeta, L.; Weisberg, H.

    1979-01-01

    Improvement of the straightness of the F5 copper septum increased the AGS slow extraction efficiency from approx. 80% to approx. 90%. Installation of an electrostatic septum at H2O, 24 betatron wavelengths upstream of F5, further improved the extraction efficiency to approx. 97%

  5. Improving palliative care.

    LENUS (Irish Health Repository)

    Moran, Sue

    2009-05-01

    Any service improvement project requires planning, action and evaluation. Using a recognised quality improvement framework can offer a structured approach to implementing and assessing changes to patient care. This article describes how use of the Deming Cycle has helped to identify nurses\\' learning needs.

  6. Continuous quality improvement

    NARCIS (Netherlands)

    Rohlin, Madeleine; Schaub, Rob M.H.; Holbrook, Peter; Leibur, Edvitar; Lévy, Gérard; Roubalikova, Lenka; Nilner, Maria; Roger-Leroi, Valerie; Danner, Gunter; Iseri, Haluk; Feldman, Cecile

    2002-01-01

    Versch. in: Eur J Dent Educ; 6 (Suppl. 3): 67–77 Continuous quality improvement (CQI) can be envisaged as a circular process of goal-setting, followed by external and internal evaluations resulting in improvements that can serve as goals for a next cycle. The need for CQI is apparent, because of

  7. Improving Agile Software Practice

    DEFF Research Database (Denmark)

    Tjørnehøj, Gitte

    2006-01-01

    Software process improvement in small and agile organizations is often problematic, but achieving good SPI-assessments can still be necessary to stay in the marked or to meet demands of multinational owners. The traditional norm driven, centralized and control centered improvement approaches has...

  8. Continuous quality improvement

    International Nuclear Information System (INIS)

    Bourne, P.B.

    1985-01-01

    This paper describes the various statistical tools used at the Hanford Engineering Development Laboratory to achieve continuous quality improvement in the development of Breeder Reactor Technology and in reactor operations. The role of the quality assurance professionals in this process, including quantifiable measurements using actual examples, is provided. The commitment to quality improvement through top management involvement is dramatically illustrated

  9. Genetic improvement of vegetables

    International Nuclear Information System (INIS)

    Jaramillo Vasquez, J.G.

    2001-01-01

    Some genetic bases of the improvement of vegetables are given. The objectives of the genetic improvement and the fundamental stages of this process are done. The sources of genetic variation are indicated and they are related the reproduction systems of the main horticultural species. It is analyzed the concept of genetic inheritance like base to determine the procedures more appropriate of improvement. The approaches are discussed, has more than enough phenotypic value, genetic action and genotypic variance; Equally the heredability concepts and value of improvement. The conventional methods of improvement are described, like they are: the introduction of species or varieties, the selection, the pure line, the pedigree method, the selection for families, the recurrent selection, the selection for unique seed, the haploids method, the selection for heterosis and the synthetic varieties

  10. Improving Healthcare Logistics Processes

    DEFF Research Database (Denmark)

    Feibert, Diana Cordes

    logistics processes in hospitals and aims to provide theoretically and empirically based evidence for improving these processes to both expand the knowledge base of healthcare logistics and provide a decision tool for hospital logistics managers to improve their processes. Case studies were conducted...... processes. Furthermore, a method for benchmarking healthcare logistics processes was developed. Finally, a theoretically and empirically founded framework was developed to support managers in making an informed decision on how to improve healthcare logistics processes. This study contributes to the limited...... literature concerned with the improvement of logistics processes in hospitals. Furthermore, the developed framework provides guidance for logistics managers in hospitals on how to improve their processes given the circumstances in which they operate....

  11. The Bone Resorption Inhibitors Odanacatib and Alendronate Affect Post-Osteoclastic Events Differently in Ovariectomized Rabbits

    DEFF Research Database (Denmark)

    Jensen, Pia Rosgaard; Andersen, Thomas Levin; Pennypacker, Brenda L

    2014-01-01

    performed a histomorphometric study of trabecular remodeling in vertebrae of estrogen-deficient rabbits treated or not with ODN or ALN, a model where ODN, but not ALN, was previously shown to preserve bone formation. In line with our hypothesis, we found that ODN treatment compared to ALN results...

  12. Effects of Alendronate and Raloxifene on Bone Density and Bone Turnover Markers in Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Ebru Zülfikaroğlu

    2011-04-01

    CONCLUSION: ALN 70 mg once- weekly significantly produced greater increases in spine and greater but not significantly increases in hip BMD and significantly greater reductions in markers of bone turnover than RLX in 1 yr treatment period. Both ALN and RLX treatment groups have similar safety and tolerability profiles.

  13. Improving operating room safety

    Directory of Open Access Journals (Sweden)

    Garrett Jill

    2009-11-01

    Full Text Available Abstract Despite the introduction of the Universal Protocol, patient safety in surgery remains a daily challenge in the operating room. This present study describes one community health system's efforts to improve operating room safety through human factors training and ultimately the development of a surgical checklist. Using a combination of formal training, local studies documenting operating room safety issues and peer to peer mentoring we were able to substantially change the culture of our operating room. Our efforts have prepared us for successfully implementing a standardized checklist to improve operating room safety throughout our entire system. Based on these findings we recommend a multimodal approach to improving operating room safety.

  14. Room for improvement

    DEFF Research Database (Denmark)

    Sandal, Louise F; Thorlund, Jonas B; Moore, Andrew J

    2018-01-01

    -reported outcomes and qualitative findings supported the primary finding, while improvements in muscle strength and aerobic capacity did not differ between exercise groups. CONCLUSION: Results suggest that the physical environment contributes to treatment response. Matching patients' preferences to treatment rooms...... significance (p=0.07). Waitlist group reported no improvement (-0.05 95% CI -0.5 to 0.4). In interviews, participants from the standard environment expressed greater social cohesion and feeling at home. Qualitative themes identified; reflection, sense of fellowship and transition. Secondary patient...... may improve patient-reported outcomes. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov identifier: NCT02043613....

  15. Improvement in quality of life of children with acute Crohn's disease does not parallel mucosal healing after treatment with exclusive enteral nutrition

    NARCIS (Netherlands)

    Afzal, N. A.; van der Zaag-Loonen, H. J.; Arnaud-Battandier, F.; Davies, S.; Murch, S.; Derkx, B.; Heuschkel, R.; Fell, J. M.

    2004-01-01

    Crohn's disease is a chronic debilitating disorder affecting a child's physical and emotional well-being. Recent emphasis on 'quality of life' (QOL) has led to re-evaluation of available medical treatments. To assess prospectively change in QOL, clinical disease activity and intestinal mucosal

  16. Sustained weight loss and improvement of quality of life after laparoscopic adjustable gastric banding for morbid obesity: a single surgeon experience in Ireland.

    LENUS (Irish Health Repository)

    Chang, K H

    2010-03-01

    Although substantial weight loss is the primary outcome following bariatric surgery, changes in obesity-related morbidity and quality of life (QoL) are equally important. This study reports on weight loss, QoL and health outcomes following laparoscopic adjustable gastric banding (LAGB).

  17. Can pelvic floor muscle training improve quality of life in men with mild to moderate post‑stroke and lower urinary tract symptoms?

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Gard, Gunvor; Dehlendorff, Christian

    2017-01-01

    BACKGROUND: Lower urinary tract symptoms (LUTS) have a significant impact on quality of life (QoL) in post‑stroke patients. AIM: The aim of this study was to evaluate the effect of pelvic floor muscle training (PFMT) on QoL parameters in men with post‑stroke LUTS. DESIGN: Randomized, controlled...

  18. The Effectiveness of Psychodrama in Improving Quality of Life among Opiate-dependent Male Patients

    Directory of Open Access Journals (Sweden)

    Saeed Dehnavi

    2016-05-01

    Full Text Available The current paper aimed to investigate the effectiveness of psychodrama therapy in the improvement of the quality of life(QOL for opiate-dependent male patients. It was aquasi-experimental research study, using pre-and posttesting plan with a control group. A total of 30 individuals were selected among male clients with opiate dependence, who were referred to addiction treatment clinics in Kermanshah (Iran and successfully passed the detoxification programs, by a convenience sampling technique. The subjects were randomly placed into two experimental and control groups. The experimental group participated in a twelve-session psychodrama therapy plan for 6 weeks, while the control group received no intervention. In order to collect data, the SF-36 questionnaire was applied. Data analysis was performed by analysis of covariance (ANCOVA. The ANCOVA results revealed that there is a significant difference between two groups in the post-test stage. As seen from the findings, the psychodrama intervention can be used as an effective modality to enhance the quality of life among male patients with opiate dependence.

  19. Unani Treatment Decreased Fibrosis and Improved Liver Functions in Decompensated Cirrhosis of Liver: A Case Series

    Directory of Open Access Journals (Sweden)

    Akhtar Siddiqui

    2016-03-01

    Full Text Available At present, liver transplantation remains the only curative option for the patients with cirrhosis and end-stage liver diseases. The survival rate and recurrent diseases remain the major issues in the patient post-transplantation. Unani medicine is one of the oldest traditional systems of medicine which has been treating chronic liver diseases and cirrhosis (Talayyaful-Kabid for centuries. The current study aimed to assess the impact of Unani treatment on decompensated cirrhosis and collect data to warrant further clinical trials. Authors conducted a case series on five patients with decompensated cirrhosis and portal hypertension. The disease was confirmed through FibroScan and ultrasound and treated with Unani treatment orally for seven months. Results were evaluated based on FibroScan, liver function test (LFT, EuroQol-5D (EQ5D, Child-Pugh and TTO-TIME (trade-off question. Significant improvements in LFT, fibrosis and quality of life were achieved in the studied patients. The literature related to the herbal constituents of chief medicines used to treat in this case was reviewed. The herbs proved their potential anti-oxidative, anti-inflammatory, hepato-protective, immuno-modulator and antiviral activities, suggesting plausible mechanisms of action in the cases. The preliminary findings indicated the potential therapeutic role of Unani treatment in decompensated cirrhosis. Clinical trials should be conducted to explore further therapeutic potential of Unani treatment in decompensated cirrhosis.

  20. Congestion Prediction Modeling for Quality of Service Improvement in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Ga-Won Lee

    2014-04-01

    Full Text Available Information technology (IT is pushing ahead with drastic reforms of modern life for improvement of human welfare. Objects constitute “Information Networks” through smart, self-regulated information gathering that also recognizes and controls current information states in Wireless Sensor Networks (WSNs. Information observed from sensor networks in real-time is used to increase quality of life (QoL in various industries and daily life. One of the key challenges of the WSNs is how to achieve lossless data transmission. Although nowadays sensor nodes have enhanced capacities, it is hard to assure lossless and reliable end-to-end data transmission in WSNs due to the unstable wireless links and low hard ware resources to satisfy high quality of service (QoS requirements. We propose a node and path traffic prediction model to predict and minimize the congestion. This solution includes prediction of packet generation due to network congestion from both periodic and event data generation. Simulation using NS-2 and Matlab is used to demonstrate the effectiveness of the proposed solution.

  1. Documentation of Improvement Competences

    DEFF Research Database (Denmark)

    Johansen, Jørn; Back, Karsten Kristensen; Korsaa, Morten

    2017-01-01

    This paper demonstrates how a report used in a Master in Project management and Process improvement training at Roskilde University Denmark can be used to evaluate if a student can pass the ECQA SPI Manager exam. It also demonstrates how the structure of the report addresses all necessary...... Manager job role, which is based on the SPI Manifesto and the ImprovAbilityTM model (part of ISO/IEC 33014 Guideline for Process Improvement) among other types of knowledge and research....... competences, which should or could be brought into play during the project – and therefor also in one way or another addresses the quality of the activated competences in the improvement project – a kind of qualification. The clue is that the structure of the report follows the units and element in the SPI...

  2. Improving Indoor Air Quality

    Science.gov (United States)

    Usually the most effective way to improve indoor air quality is to eliminate individual sources of pollution or to reduce their emissions. Some sources, like those that contain asbestos, can be sealed or enclosed.

  3. Maintenance improvement program

    International Nuclear Information System (INIS)

    Derbonne, D.R.; Plunkett, T.F.; Simpson, J.R.

    1989-01-01

    During fuel cycle 1 at River Bend station, considerable effort was expended to reduce corrective maintenance work orders (MWOs) to <1,000. This was done by complementing the plant staff with costly contract personnel. Coming out of the first refueling outage, most contract personnel were released. The change in MWO backlog started a steady rise. It became readily apparent that to avoid costly contract staff time, a maintenance improvement program (MIP) was necessary. The MIP Was primarily directed at two areas: crew efficiency improvements and improved preplanned MWO packages. The overall effect of the MIP was to achieve significant productivity improvements with reduced operation and maintenance cost by providing frequent accountability to all levels of maintenance supervision. The MIP also produced a feeling of pride among the maintenance department employees that had not really existed before. This was the best benefit of all

  4. Improving Family Communications

    Science.gov (United States)

    ... Spread the Word Shop AAP Find a Pediatrician Family Life Medical Home Family Dynamics Adoption & Foster Care ... Listen Español Text Size Email Print Share Improving Family Communications Page Content Article Body How can I ...

  5. Home Improvements Prevent Falls

    Science.gov (United States)

    ... turn JavaScript on. Feature: Falls and Older Adults Home Improvements Prevent Falls Past Issues / Winter 2014 Table ... and ensure your safety. "Safe-ty-fy" Your Home Some Questions for Your Provider Will my medicines ...

  6. Intradialytic creatine supplementation: A scientific rationale for improving the health and quality of life of dialysis patients.

    Science.gov (United States)

    Wallimann, Theo; Riek, Uwe; Möddel, Michael

    2017-02-01

    The CK/PCr-system, with creatine (Cr) as an energy precursor, plays a crucial role in cellular physiology. In the kidney, as in other organs and cells with high and fluctuating energy requirements, energy-charged phospho-creatine (PCr) acts as an immediate high-energy source and energy buffer, and as an intracellular energy transport vehicle. A maximally filled total Cr (Cr plus PCr) pool is a prerequisite for optimal functioning of the body and its organs, and health. Skeletal- and cardiac muscles of dialysis patients with chronic kidney disease (CKD) are depleted of Cr in parallel with the duration of dialysis. The accompanying accumulation of cellular damage seen in CKD patients lead to a deterioration of musculo-skeletal and neurological functioning and poor quality of life (QOL). Therefore, to counteract Cr depletion, it is proposed to supplement CKD patients with Cr. The anticipated benefits include previously documented improvements in the musculo-skeletal system, brain and peripheral nervous system, as well as improvements in the common comorbidities of CKD patients (see below). Thus, with a relatively simple, safe and inexpensive Cr supplementation marked improvements in quality of life (QOL) and life span are likely reached. To avoid Cr and fluid overload by oral Cr administration, we propose intradialytic Cr supplementation, whereby a relatively small amount of Cr is added to the large volume of dialysis solution to a final concentration of 1-10mM. From there, Cr enters the patient's circulation by back diffusion during dialysis. Because of the high affinity of the Cr transporter (CRT) for Cr affinity for Cr (Vmax of CRT for Cr=20-40μM Cr), Cr is actively transported from the blood stream into the target cells and organs, including skeletal and cardiac muscle, brain, proximal tubules of kidney epithelial cells, neurons, and leukocytes and erythrocytes, which all express CRT and depend on the CK/PCr system. By this intradialytic strategy, only as much Cr

  7. Improving Communication in Design

    DEFF Research Database (Denmark)

    Maier, Anja; Doenmez, Denniz; Hepperle, Clemens

    2011-01-01

    Communication permeates every aspect of an engineer’s work – from clarifying product specifications to shaping social ties. This paper offers an overview of recommendations from literature to improve communication within and among engineering teams. We assume communication problems are often...... of tasks. To improve these factors in order to enable effective communication, this paper collates more than hundred recommendations from journal articles and textbooks published in the fields of engineering design, management science, sociology, and psychology. Recommendations include, for example...

  8. Capital Improvements Business Line

    Science.gov (United States)

    2012-08-08

    NAVFAC Southwest Dan Waid Program & Business Mgmt NAVFAC SW Capital Improvements Business Line NAVFAC SW 8 August 2012 1 Report...REPORT TYPE 3. DATES COVERED 00-00-2012 to 00-00-2012 4. TITLE AND SUBTITLE Capital Improvements Business Line 5a. CONTRACT NUMBER 5b. GRANT...AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES Presented at the 2012 Navy Gold Coast Small Business

  9. KAIZEN CONTINUOUS IMPROVEMENT

    OpenAIRE

    Yenque D., Julio; García P., Manuel; Raez G., Luis

    2014-01-01

    Many times we ask the question why Japanese companies are competitive?, Surely many of the answers to this mystery have support in the Kaizen. And the Kaizen is not a simple concept, it is a whole way of life that involves both managers and workers in the pursuit of progressive improvement of enterprises. In his book Kaizen, The Key to Japanese Competitive Advantage, Masaaki Imai explains in simple terms what is the essence of this philosophy: Kaizen means improvement means further progressiv...

  10. Improving Banking Supervision

    OpenAIRE

    Mayes, David G.

    1998-01-01

    This paper explains how banking supervision within the EU, and in Finland in particular, can be improved by the implementation of greater market discipline and related changes. Although existing EU law, institutions, market structures and practices of corporate governance restrict the scope for change, substantial improvements can be introduced now while there is a window of opportunity for change. The economy is growing H5ly and the consequences of the banking crises of the early 1990s have ...

  11. Clinical osteoarthritis predicts physical and psychological QoL in acromegaly patients

    NARCIS (Netherlands)

    Wassenaar, M. J. E.; Biermasz, N. R.; Kloppenburg, M.; van der Klaauw, A. A.; Tiemensma, J.; Smit, J. W. A.; Pereira, A. M.; Roelfsema, F.; Kroon, H. M.; Romijn, J. A.

    2010-01-01

    Quality of life is decreased in patients with long-term control of acromegaly. In addition, these patients suffer from irreversible osteoarthritis. The aim of this study was to assess the impact of joint-specific complaints, clinical and radiological signs of arthropathy on different aspects of

  12. An Analytical Model / Emotional Intelligence Quotient and QOL in Mothers with Infants in Japan

    OpenAIRE

    Ohashi, Junko; Katsura, Toshiki; Hoshino, Akiko; Usui, Kanae

    2013-01-01

    Objective: The purpose of this study was to examine the relationship between the emotional intelligence quotient and health-related quality of life using structural equation modeling. Methods: A self-administered questionnaire survey was conducted among 1,911 mothers who visited the Health Center for an infant medical examination. A hypothetical model was constructed using variables of the emotional intelligence quotient, social support, coping, parenting stress, and perceived health competen...

  13. An Analytical Model / Emotional Intelligence Quotient and QOL in Mothers with Infants in Japan.

    Science.gov (United States)

    Ohashi, Junko; Katsura, Toshiki; Hoshino, Akiko; Usui, Kanae

    2013-01-01

    The purpose of this study was to examine the relationship between the emotional intelligence quotient and health-related quality of life using structural equation modeling. A self-administered questionnaire survey was conducted among 1,911 mothers who visited the Health Center for an infant medical examination. A hypothetical model was constructed using variables of the emotional intelligence quotient, social support, coping, parenting stress, and perceived health competence. There were a total of 1,104 valid responses (57.8%). Significant standardized estimates were obtained, confirming the goodness of fit issues with the model. The emotional intelligence quotient had a strong impact on physical and psychological quality of life, and showed the greatest association with coping. This study differed from previous studies in that, due to the inclusion of social support and explanatory variables in coping, an increase in coping strategies was more highly associated with emotional intelligence quotient levels than with social support. An enhanced emotional intelligence quotient should be considered a primary objective to promote the health of mothers with infant children.

  14. Assessments of outcome in haemophilia - what is the added value of QoL tools?

    NARCIS (Netherlands)

    van den Berg, H M; Feldman, B M; Fischer, K; Blanchette, V; Poonnoose, P; Srivastava, A

    INTRODUCTION: Access to treatment and especially to long-term regular replacement treatment with clotting factor concentrates (prophylaxis) have caused dramatic contrasts in the clinical picture between haemophilia populations. An individual patient with severe haemophilia age 20 years can have

  15. Estimation of EuroQol 5-Dimensions health status utility values in hereditary angioedema

    DEFF Research Database (Denmark)

    Aygören-Pürsün, Emel; Bygum, Anette; Beusterien, Kathleen

    2016-01-01

    OBJECTIVE: To estimate health status utility (preference) weights for hereditary angioedema (HAE) during an attack and between attacks using data from the Hereditary Angioedema Burden of Illness Study in Europe (HAE-BOIS-Europe) survey. Utility measures quantitatively describe the net impact of a...

  16. DASH (disabilities of the arm, shoulder, and hand) evaluation of QOL for carpal tunnel syndrome

    International Nuclear Information System (INIS)

    Morita, Akimasa; Kawamoto, Masataka; Fujisawa, Kouzou; Tsujii, Masaya; Hirata, Hitoshi

    2006-01-01

    The questionnaire on the disabilities of the arm, shoulder, and hand is a region-specific, self-administered outcome instrument that is developed as a measure of self-rate upper extremity disability and symptoms. Last year, the Japanese version of disabilities of the arm, shoulder and hand (DASH) was cross-culturally adapted. The main purpose of this study is to analyze the relationship between DASH and clinical assessment (findings of MRI and electrodiagnostic parameters). The subjects comprised 41 patients (6 males and 35 females) with carpal tunnel syndrome (CTS), except for cases with other upper extremity disorders. These subjects prospectively completed DASH 1 (disability module), DASH 2 (symptom module), and DASH (disability and symptom module) before the release of the open carpal tunnel. The patients were divided into 3 groups based on the symptom duration (A: shorter than 3 months, B: 4-11 months, C: longer than 12 months). All patients were preoperatively assessed with regard to sensory conduction velocity (SCV) and compound muscle action potential (CMAP). In addition, all patients underwent MRI in order to evaluate the flexor tenosynovial swelling represented by palmar bowing of the flexor retinaculum (PBFR). The relationships were estimated using the Spearman rank score, unpaired t tests, and Bonferroni tests. DASH 2 scores indicated greater responsiveness than DASH 1, which reflected the character of CTS. DASH 1 scores were higher in patients who were affected in their dominant hand than in those whose nondominant hand was affected. The DASH scores decreased significantly in groups A and B, with the exception of C. However, DASH did not show any correlation either with the parameters, age, or MRI assessment. DASH can be used for the research of preoperative outcomes related to CTS. It also has the advantage of being useful in assessing and comparing the outcome for various other hand disorders. (author)

  17. Role of cardiac magnetic resonance imaging focusing on QOL and preventive medicine

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Ito, Hirotoshi; Kubota, Takao

    2003-01-01

    Cardiac magnetic resonance imaging (MRI) using fast imaging techniques has been developing quickly recently. Left ventricular function with pharmacological intervention can be evaluated using True fast imaging with steady-state precession (FISP) method. In addition, left ventricular diastolic function can be evaluated by retrospective gating with a high frame rate. Myocardial perfusion and viability can also be evaluated by first-pass imaging and delayed enhancement with Gd-DTPA. Data concerning myocardial ischemia, viability, and left ventricular function is now almost equivalent to that of myocardial SPECT and contrast echo. Additionally, coronary arterial narrowing and coronary vessel wall can be visualized with both the bright-blood and black-blood method. These methods are still currently in the research stage. The prognostic value of myocardial perfusion and ventricular function in ischemic heart disease should be established using large numbers of patients. Multi-center trials using cardiac MRI should be recommended for this purpose. Furthermore, detecting acute coronary syndrome in the emergency department can be performed with safety and accuracy. MR coronary angiography should be used not only for flow-limiting coronary stenosis but also the atherosclerotic wall region. This provides information that may predict cardiovascular risk, and facilitate further study of artherothrombosis, progression and response to therapy. It may also provide for the assessment of subclinical disease. (author)

  18. Improving quality of life through the routine use of the patient concerns inventory for head and neck cancer patients: a cluster preference randomized controlled trial.

    Science.gov (United States)

    Rogers, Simon N; Lowe, Derek; Lowies, Cher; Yeo, Seow Tien; Allmark, Christine; Mcavery, Dominic; Humphris, Gerald M; Flavel, Robert; Semple, Cherith; Thomas, Steven J; Kanatas, Anastasios

    2018-04-18

    The consequences of treatment for Head and Neck cancer (HNC) patients has profound detrimental impacts such as impaired QOL, emotional distress, delayed recovery and frequent use of healthcare. The aim of this trial is to determine if the routine use of the Patients Concerns Inventory (PCI) package in review clinics during the first year following treatment can improve overall quality of life, reduce the social-emotional impact of cancer and reduce levels of distress. Furthermore, we aim to describe the economic costs and benefits of using the PCI. This will be a cluster preference randomised control trial with consultants either 'using' or 'not using' the PCI package at clinic. It will involve two centres Leeds and Liverpool. 416 eligible patients from at least 10 consultant clusters are required to show a clinically meaningful difference in the primary outcome. The primary outcome is the percentage of participants with less than good overall quality of life at the final one-year clinic as measured by the University of Washington QOL questionnaire version 4 (UWQOLv4). Secondary outcomes at one-year are the mean social-emotional subscale (UWQOLv4) score, Distress Thermometer (DT) score ≥ 4, and key health economic measures (QALY-EQ-5D-5 L; CSRI). This trial will provide knowledge on the effectiveness of a consultation intervention package based around the PCI used at routine follow-up clinics following treatment of head and neck cancer with curative intent. If this intervention is (cost) effective for patients, the next step will be to promote wider use of this approach as standard care in clinical practice. 32,382. Clinical Trials Identifier, NCT03086629 . Version 3.0, 1st July 2017.

  19. Inpatient preanalytic process improvements.

    Science.gov (United States)

    Wagar, Elizabeth A; Phipps, Ron; Del Guidice, Robert; Middleton, Lavinia P; Bingham, John; Prejean, Cheryl; Johnson-Hamilton, Martha; Philip, Pheba; Le, Ngoc Han; Muses, Waheed

    2013-12-01

    Phlebotomy services are a common target for preanalytic improvements. Many new, quality engineering tools have recently been applied in clinical laboratories. However, data on relatively few projects have been published. This example describes a complete application of current, quality engineering tools to improve preanalytic phlebotomy services. To decrease the response time in the preanalytic inpatient laboratory by 25%, to reduce the number of incident reports related to preanalytic phlebotomy, and to make systematic process changes that satisfied the stakeholders. The Department of Laboratory Medicine, General Services Section, at the University of Texas MD Anderson Cancer Center (Houston) is responsible for inpatient phlebotomy in a 24-hour operation, which serves 689 inpatient beds. The study director was project director of the Division of Pathology and Laboratory Medicine's Quality Improvement Section and was assisted by 2 quality technologists and an industrial engineer from MD Anderson Office of Performance Improvement. After implementing each solution, using well-recognized, quality tools and metrics, the response time for blood collection decreased by 23%, which was close to meeting the original responsiveness goal of 25%. The response time between collection and arrival in the laboratory decreased by 8%. Applicable laboratory-related incident reports were reduced by 43%. Comprehensive application of quality tools, such as statistical control charts, Pareto diagrams, value-stream maps, process failure modes and effects analyses, fishbone diagrams, solution prioritization matrices, and customer satisfaction surveys can significantly improve preset goals for inpatient phlebotomy.

  20. IMPROVING CONCEPTUAL DESIGN QUALITY

    DEFF Research Database (Denmark)

    Bush, Stuart; Robotham, Antony John

    1999-01-01

    designer to identify clear targets for design improvement and to measure the effectiveness of any new solution, whilst attention to QFD ensures customer requirements are still being satisfied.Often, SME's are not aware of many of the best design practices and so are not able to meet the demand......This paper will consider how Quality Function Deployment (QFD) and Design for Manufacture and Assembly (DFMA) processes can be used to improve the design quality of products at the concept stage. We appreciate that both QFD and DFMA are techniques that have been used for some time by mature product...... quality is maintained in design project work. The projects described have been carried out with products manufactured by small to medium sized enterprises (SME's), where we have found significant opportunities for product improvement. The quantitative nature of DFMA analysis results allows the novice...

  1. Turn-around improvements

    International Nuclear Information System (INIS)

    Redaelli, S.; Venturini Delsolaro, W.

    2012-01-01

    An efficient turn-around will be an important parameter for the integrated luminosity performance at LHC in 2012, when an operation with steady beam parameters and machine configuration will be achieved at the beginning of the run. Improvements of the operational cycle were already put successfully in place after the 2010 experience but additional ways to reduce the time required to setup collisions are possible. In this paper, the 2011 turn-around performance is reviewed and the benefits of the improvements from 2010 are presented. Phases of the operational cycle when further amelioration is possible are discussed and some proposal for a faster turn-around in 2012 are outlined. (authors)

  2. Improve your communication skills

    CERN Document Server

    Barker, Alan

    2016-01-01

    Excellent communication skills are vital in today's workplace. Whether keeping the interest of a large audience, impressing a potential employer or simply winning the argument at an important meeting, sounding the part is key. This fourth edition of Improve Your Communication Skills is full of practical advice on all aspects of verbal and non-verbal communication. It gives vital tips on improving conversations and building rapport with colleagues, learning the skills of persuasion, and writing effective emails, letters and reports. This editionincludes new information focusing on communicating across borders and virtual teams and a new chapter on managing difficult conversations."

  3. IMPROVING PATIENT SAFETY:

    DEFF Research Database (Denmark)

    Bagger, Bettan; Taylor Kelly, Hélène; Hørdam, Britta

    Improving patient safety is both a national and international priority as millions of patients Worldwide suffer injury or death every year due to unsafe care. University College Zealand employs innovative pedagogical approaches in educational design. Regional challenges related to geographic......, social and cultural factors have resulted in a greater emphasis upon digital technology. Attempts to improve patient safety by optimizing students’ competencies in relation to the reporting of clinical errors, has resulted in the development of an interdisciplinary e-learning concept. The program makes...

  4. Improving with Kaizen

    OpenAIRE

    Dahl, Helene

    2016-01-01

    Master's thesis in Executive MBA Kaizen is a Japanese word translated to Good Change, but the meaning behind the word is continuous improvement. Kaizen events are a part of the Lean philosophy and developed by Toyota. The event typically takes place during 4-5 days and aims to make significant change by identifying possibilities for improvement. This thesis is a study of one Kaizen event that took place in an American oil-service company in Sandnes, Norway. A case study has been u...

  5. Remote control improves quality of life in elderly pacemaker patients versus standard ambulatory-based follow-up.

    Science.gov (United States)

    Comoretto, Rosanna Irene; Facchin, Domenico; Ghidina, Marco; Proclemer, Alessandro; Gregori, Dario

    2017-08-01

    Health-related quality of life (HRQoL) improves shortly after pacemaker (PM) implantation. No studies have investigated the HRQoL trend for elderly patients with a remote device monitoring follow-up system. Using EuroQol-5D Questionnaire and the PM-specific Assessment of Quality of Life and Related Events Questionnaire, HRQoL was measured at base