Virological failure at one year in triple-class experienced patients switching to raltegravir-based regimens is not predicted by baseline factors

2012 ◽  
Vol 23 (7) ◽  
pp. 459-463 ◽  
Author(s):  
R Bucciardini ◽  
G D'ettorre ◽  
S Baroncelli ◽  
G Ceccarelli ◽  
G Parruti ◽  
...  
Keyword(s):  
Virological Failure ◽  
High Rate ◽  
Hiv Rna ◽  
Drug Classes ◽  
Route Of Transmission ◽  
Related Quality ◽  
Health Related ◽  
Baseline Factors ◽  
One Year

We evaluated rates and determinants of virological failure in triple-class experienced patients receiving raltegravir-based regimens from a national observational study over 48 weeks, defined by any one of the following: (1) no HIV-RNA suppression to undetectable levels (<50 copies/mL) during follow-up; (2) detectable viral load after obtaining undetectable levels; and (3) leaving the study before 48 weeks. Among 101 eligible patients, 26 (25.7%; 95% CI 17.2–34.2) had virological failure. No significant differences between patients with and without virological failure were observed for gender, age, route of transmission, baseline CD4/HIV-RNA, CDC group, hepatitis B or C co-infections, resistance (based on the last genotype available), type and number of concomitant drug classes, concomitant use of darunavir, atazanavir, etravirine, enfuvirtide or maraviroc, and health-related quality-of-life measures. A high rate of treatment response was observed. The analyses did not identify any baseline factor associated with failure, including resistance status. Even if we cannot exclude the presence of pre-existing minority resistant variants not captured by genotypic tests, the lack of baseline predictors of failure suggests the need to monitor patients closely during follow up for other factors, such as potential drug interactions and reduced levels of adherence, which may favour virological failure.

scholarly journals 357 Factors associated with changes in health-related quality of life in children with cystic fibrosis during one-year follow-up

2017 ◽  
Vol 16 ◽  
pp. S154
Author(s):  
M. Van Horck ◽  
B. Winkens ◽  
G. Wesseling ◽  
K. de Winter-de Groot ◽  
I. De Vreede ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cystic Fibrosis ◽  
Health Related Quality ◽  
Factors Associated ◽  
Related Quality ◽  
Health Related ◽  
One Year

M1048 Dynamic Improvements of Health-Related Quality After Bariatric Surgery: A One Year Follow-up

2010 ◽  
Vol 138 (5) ◽  
pp. S-320
Author(s):  
Chi-Yang Chang ◽  
Chih-Kun Huang ◽  
Chi-Ming Tai ◽  
Jaw-Town Lin ◽  
Jung-Der Wang
Keyword(s):  
Bariatric Surgery ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
One Year

scholarly journals Pain, Sleep, and Health-Related Quality of Life after Multidisciplinary Intervention for Chronic Pain

2021 ◽  
Vol 18 (19) ◽  
pp. 10233
Author(s):  
Hafdís Skúladóttir ◽  
Herdis Sveinsdottir ◽  
Janean E. Holden ◽  
Thóra Jenný Gunnarsdóttir ◽  
Sigridur Halldorsdottir ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Sleep Problems ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Pre Treatment ◽  
One Year

Multidisciplinary pain-management programs have the potential to decrease pain intensity, improve health-related quality of life (HRQOL), and increase sleep quality. In this longitudinal prospective cohort study, the aim was to investigate the long-term effects of multidisciplinary pain rehabilitation interventions in Iceland. More precisely, we (a) explored and described how individuals with chronic pain evaluated their pain severity, sleep, and HRQOL at pre-treatment and at one-year follow-up and (b) examined what predicted the participants’ one-year follow-up HRQOL. Seventy-nine patients aged 20–68 years, most of whom were women (85%), responded. The participants scored their pain lower at one-year follow-up (p < 0.001). According to their response, most of them had disrupted sleep, mainly because of pain. One year after the treatment, more participants slept through the night (p = 0.004), and their HRQOL increased. Higher pre-treatment mental component summary (MCS) scores and having pursued higher education predicted higher MCS scores at one-year follow-up, and higher pre-treatment physical component summary (PCS) scores predicted higher PCS scores at one-year follow-up. Sleep problems, being a woman, and having children younger than 18 years of age predicted lower MCS scores at one-year follow-up. These findings are suggestive that patients should be examined with respect to their mental status, and it could be beneficial if they received some professional support after completing the intervention.

Assessment and treatment at a pain clinic: A one-year follow-up of patients with chronic pain

2017 ◽  
Vol 17 (1) ◽  
pp. 233-242 ◽  
Author(s):  
Andrea Hållstam ◽  
Monika Löfgren ◽  
Lina Benson ◽  
Christer Svensén ◽  
Britt-Marie Stålnacke
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Clinic ◽  
Health Related Quality ◽  
Pain Clinics ◽  
Related Quality ◽  
Health Related ◽  
One Year

AbstractBackground and aimsPain is one of the most common reasons for patients to seek primary health care. Pain relief is likely to be achieved for patients suffering from acute pain, but for individuals with chronic pain it is more likely that the condition will persist. These patients have the option of being referred to specialised pain clinics. However, the complexity surrounding chronic pain patients is not well studied in these settings. This study aimed to describe patients with chronic pain referred to a pain clinic by using the information submitted during their first visit and one year later and also to identify associations between baseline characteristics and improvements in health-related quality of life in the follow-up.MethodsThis was a longitudinal observational study of a sample consisting of 318 patients referred to a pain clinic. One group of patients containing 271 individuals (median age 48, 64% females) was assessed and received conventional pain treatment (CPT group) and a second group of 47 patients (median age 53, 64% females) was assessed by a pain specialist and referred back to their physician with a treatment recommendation (assessment only, AO group). Patient-reported outcome measures in health-related quality of life (EQ-5D), pain intensity (VAS), mental health (HADS), insomnia (ISI), pain-related disability (PDI), kinesiophobia (TSK) and sense of coherence (SOC) were collected at the first visit and one year later.ResultsAt baseline, the CPT group reported a low EQ-5D Index (median (md) 0.157) and EQVAS (md 40) as well as considerable high, current pain intensity VAS (md 58), HADS anxiety (md 8), ISI (md 17), PDI (md 36) and TSK (md 39). The AO group showed similar problems (no significant differences compared to the CPT group), except for ISI, where the AO group reported less severe problems. At the one-year follow-up, the CPT group had a statistically significant improvement in EQ-5D, VAS, ISI, PDI and TSK. In the AO group no significant changes were observed. In the CPT group there was an association between a high ISI level at baseline and an improved EQ-5D Index in the follow-up.ConclusionsThe study describes rarely explored groups of patients with chronic pain at a pain clinic. Severe pain problems were present in both groups at their first visit. A statistically significant improvement could be seen in the group that was conventionally treated while this was not the case among those subjects who were assessed and referred. The results imply, that relatively limited treatment strategies were helpful for the patients’ health-related quality of life. Despite these improvements, the patients were not fully recovered, pointing to the chronicity of pain conditions and the need of support for many patients.ImplicationsIncreased knowledge about assessment, selection and treatment at pain clinics is important to improve the quality of the work performed at these clinics. Despite limited resources, further efforts should be made to collect comparable, valid data on a regular base from pain clinics in order to develop recommendation models.

scholarly journals Impact of Endovascular Treatment on Clinical Status and Health-Related Quality of Life

2008 ◽  
Vol 97 (1) ◽  
pp. 50-55 ◽  
Author(s):  
J. Virkkunen ◽  
M. Venermo ◽  
J. Saarinen ◽  
L. Keski-Nisula ◽  
P. Apuli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Status ◽  
Critical Limb Ischaemia ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
One Year ◽  
The One

Background and Aims: Investigating the impact of percutaneous transluminal angioplasty (PTA) on clinical status and health related quality of life in patients with claudication and critical limb ischaemia (CLI). Material and Methods: 61 patients and 64 limbs underwent a primary PTA (30 claudication and 34 CLI cases). Clinical status was graded according to Ahn and Rutherford and ankle/brachial index (ABI). Quality of life was assessed using the Nottingham Health Profile (NHP) preoperatively, one month and one year after the procedure. Triplex scan evaluation of the treated arterial segment was carried out postoperatively and one year after the procedure. Results: Claudication: 24/27 patients underwent one-year follow up, after which 20/24 had no claudication. In triplex evaluation 17 (63.0%) treated segments were open with 0–50% restenosis, 9 (33.3%) with 51–99% restenosis and one (3.7%) was occluded. CLI: 13/34 (38.2%) patients underwent one-year follow-up after which eight patients (61.5%) were asymptomatic and five (38.1%) had claudication. In triplex evaluation there was 0–50% restenosis in 6 (46.2%) segments treated with PTA and 51–99% restenosis in 7 (53.8%) segments. 21 (61.8%) patients did not conclude the one year follow up: 7 had died, 5 had undergone bypass surgery and 6 an amputation and 3 did not attend the follow-up up for unknown reasons. Quality of life: For CLI patients, improvement was observed in the domain of pain, which continued throughout the follow-up period. Among the claudicants, the domain of physical mobility was improved at one month's follow-up, but this effect disappeared during the following year and could not be seen at one the one- year follow-up. Conclusions: Technical success and one-year results in claudication are good, and the rate of complications is low. However, although PTA resulted in an immediate improvement in the quality of life, this effect was not seen in the long term. In critical limb ischemia there was a group of patients in whom PTA led to a significant benefit in terms of limb salvage and quality of life.

Patients with chronic pain: One-year follow-up of a multimodal rehabilitation programme at a pain clinic

2016 ◽  
Vol 10 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Andrea Hållstam ◽  
Monika Löfgren ◽  
Christer Svensén ◽  
Britt-Marie Stålnacke
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Clinic ◽  
Pain Clinics ◽  
Related Quality ◽  
Health Related ◽  
One Year ◽  
Eq Vas

AbstractBackground and aimsMultimodal rehabilitation (MMR) programmes, including, physical training, educational and psychological interventions by an interdisciplinary team are found to be more successful for patients with disabling chronic pain compared with less comprehensive treatments. MMR programmes are based on the biopsychosocial model and the goal is usually to improve function, quality of life and facilitate and enable return to work. As pain clinics traditionally offer conventional medical pain treatment, there is limited knowledge about MMR given in this context. The aim of our study was to describe characteristics of patients with chronic pain, treated with a MMR programme at a conventional pain clinic, to evaluate patient-reported outcome measures (PROM) from start to one year after, and to study possibly associated factors for the improvement of health-related quality of life after one year.MethodsA prospective, observational study with a one-year follow-up was performed.SubjectsA total of 42 individuals (38 females, age 44.0 ± 12.3 years and 4 men age 40 ± 8.5 years) with different pain diagnoses were included. After a team assessment, the patients began a programme that lasted about three months. The MMR programme contained coordinated, individually adapted treatments administered individually or in groups, and was based on cognitive behavioural principles. Questionnaires regarding health-related quality of life (HRQoL) (EQ-5D), insomnia (ISI), mental health (HADS), painrelated disability (PDI), kinesiophobia (TSK), current pain intensity (VAS) and sense of coherence (SOC) were used at the start of the MMR and at follow-up. Demographic data were collected from the patient records.ResultsThe PROM at baseline showed substantial pain problems with low HRQoL (EQ-5D index of 0.1 ± 0.282, and EQ VAS of 32.67 ± 20.1), moderate insomnia (ISI 18.95 ± 6.7), doubtful cases of depression and anxiety (HADS-depression 9.35 ± 4.1 and HADS-anxiety 9.78 ± 3.95), presence of pain-related disability (PDI 39.48 ±12.64), kinesiophobia (TSK 40.8 ± 9.8), as well as moderate current pain (VAS 61.31 ± 20.4). The sense of coherence was weak (SOC of 51.37 ± 14). At one-year follow-up, significant (p ≥ 0.05) improvement occurred on the EQ-5D index, EQ VAS, ISI, PDI and TSK. In the logistic regression analysis, no significant associations could be identified.ConclusionsMMR for patients with complex pain problems can be a successful treatment alternative at conventional pain clinics.ImplicationsSince access to rehabilitation clinics in Sweden may be limited, the availability of MMR can increase by providing this type of intervention in pain clinics. Increased knowledge of MMR in different settings can also contribute to increased understanding and collaboration between pain clinics and rehabilitation units.

scholarly journals Self-reported Memory Problems Eight Months after Non-Hospitalized COVID-19 in a Large Cohort

2021 ◽  
Author(s):  
Arne Soraas ◽  
Ragnhild Ro ◽  
Karl T Kalleberg ◽  
Merete Ellingjord-Dale ◽  
Nils I Landro
Keyword(s):  
Participation Rate ◽  
Nasopharyngeal Swab ◽  
Mri Findings ◽  
Memory Problems ◽  
Norwegian Population ◽  
Related Quality ◽  
Health Related ◽  
The Central Nervous System ◽  
One Year

Background: Neurological manifestations of COVID-19 range from ageusia and anosmia, experienced by most patients, to altered consciousness and rare and severe encephalopathy. A direct affection of the central nervous system (CNS) in the disease has been supported by animal models and MRI findings in patients with mild and severe symptoms. Here we report eight-month data on memory problems for non-hospitalized COVID-19 patients compared to SARS-CoV-2 negative patients and untested volunteers. Objective: To explore the association between non-hospitalized COVID-19 eight months previously and self-reported memory problems. Methods: We followed a cohort of 13156 participants that was invited after (1) being tested for SARS-CoV-2 with a combined oropharyngeal- and nasopharyngeal swab or (2) randomly selected from the Norwegian population (untested). Participants completed online baseline- and follow-up questionnaires detailing underlying medical conditions, demographics, symptoms, and items from the RAND-36 questionnaire on health-related quality of life and known confounders for memory problems. Results: After repeated invitations, the participation rate was 40% (N=794) of SARS-CoV-2 positive, 26% (N=7993) of negative, and 22% (N=4369) of untested randomly selected invitees. All participants completed the baseline questionnaire as a part of inclusion. The follow-up period was 248 days (SD=18) from baseline, and the follow-up questionnaire was completed by 75% of SARS-CoV-2 positive participants, 65% of negative participants, and 73% of untested randomly selected participants. At follow-up, 49 (11.5%) of the SARS-CoV-2 positive participants reported memory problems in contrast to 173 (4.1%) of the SARS-CoV-2 negative participants and 65 (2.4%) of the untested randomly selected participants. In a multivariate model, SARS-CoV-2 positivity remained strongly associated with reporting memory problems at eight months follow-up compared to the SARS-CoV-2 negative group (odds ratio (OR) 4.0, 95% confidence interval (CI) 2.8-5.2) and the untested group (OR 4.9, 95% CI 3.4-7.2). Compared to the other groups, SARS-CoV-2 positive participants also reported more concentration problems and a significant worsening of health compared to one year ago at follow-up. Feeling depressed, less energy, or pain were reported relatively equally by the different groups. Summary: We find that 11.5% of COVID-19 patients experience memory problems eight months after the disease. SARS-CoV-2 is a new virus, and the long-term consequences of infections are therefore unknown. Our results show that a relatively high proportion of non-hospitalized COVID-19 patients report memory problems eight months after the disease.

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