scholarly journals Evaluation of chronic hypoparathyroidism course according to the Database of Endocrinology Research Centre

2020 ◽  
Vol 66 (5) ◽  
pp. 7-14
Author(s):  
E. V. Kovaleva ◽  
A. R. Ajnetdinova ◽  
A. K. Eremkina ◽  
N. G. Mokrysheva
Keyword(s):  
Conventional Therapy ◽  
Neuropsychiatric Symptoms ◽  
Visual Disturbance ◽  
Research Centre ◽  
Cross Sectional ◽  
Large Databases ◽  
Brain Calcification ◽  
Quality Of Medical Care ◽  
Chronic Hypoparathyroidism

BACKGRAUND: Currently high frequency of thyroid or parathyroid surgery is associated with significant increased incidence of hypoparathyroidism. Evaluation of the epidemiological and clinical features of chronic hypoparathyroidism is necessary to predict social-significant complications and to improve the quality of medical care.AIMS: To estimate clinical and demographic features, different regimens and efficacy of conventional therapy in patients with chronic postsurgical and nonsurgical hypoparathyroidism.MATERIALS AND METHODS: The cross-sectional, observational, continuous study was carried out based on Database of patients with chronic postsurgical and nonsurgical hypoparathyroidism of Endocrinology Research Centre, Moscow. 293 patients from 61 regions of the Russian Federation were included in this study. Statistical analysis was done on June 2020. The descriptive statistics are presented by medians (Ме) and the first and third quartiles (Q1; Q3) and by absolute and relative frequencies.RESULTS: Hypoparathyroidism was most often recorded in women (85%) at the age of 43 [32; 52] years, after thyroid surgery. Less than a half of the study group had target indicators of serum calcium and phosphate levels (31% and 47%, respectively) despite ongoing treatment. A complex instrumental examination for the disease complications was performed in 58% of cases (n = 169). Among them, kidney disorders were detected in 38%, visual disturbance in 14%, brain calcification in 10%, arrhythmias in 4% and neuropsychiatric symptoms in 6%. Conventional therapy with calcium supplements and activated vitamin D analogues was noted in 75% of patients.CONCLUSIONS: The analysis of large databases of patients with chronic hypoparathyroidism is a necessary tool for determining of optimal clinical and therapeutic approaches, as well as prognostic markers of disease complications.

scholarly journals Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study

2016 ◽  
Vol 42 (3-4) ◽  
pp. 186-197 ◽  
Author(s):  
Maartje S. Klapwijk ◽  
Monique A.A. Caljouw ◽  
Marjoleine J.C. Pieper ◽  
Jenny T. van der Steen ◽  
Wilco P. Achterberg
Keyword(s):  
Quality Of Life ◽  
Social Relations ◽  
Long Term Care ◽  
Neuropsychiatric Symptoms ◽  
Pulmonary Diseases ◽  
Severe Dementia ◽  
Cross Sectional ◽  
Term Care

Background: To determine which characteristics are associated with quality of life (QOL) in residents with moderate to very severe dementia in long-term care facilities (LTCFs). Material and Methods: This was a cross-sectional analysis of a cluster randomized controlled study in 12 Dutch LTCFs that enrolled 288 residents, with moderate to severe dementia assessed with the Reisberg Global Deterioration Scale (Reisberg GDS) and QOL with the QUALIDEM. Characteristics that were hypothesized to be associated with the six domains of QOL (applicable to very severe dementia) included demographic variables, activities of daily living (Katz ADL), cognitive performance (Cognitive Performance Scale; CPS), pain (Pain Assessment Checklist for Seniors with Limited Ability to Communicate; PACSLAC-D), neuropsychiatric symptoms (Neuropsychiatric Inventory-Nursing Home Version; NPI-NH) and comorbidities. Results: Multivariate logistic regression modelling showed associations with age in the domain Social isolation [odds ratio, OR, 0.95 (95% confidence interval, CI, 0.91-0.99)], ADL level in the domain Positive affect [OR 0.89 (95% CI 0.83-0.95)] and the domain Social relations [OR 0.87 (95% CI 0.81-0.93)], severity of dementia in the domain Social relations [OR 0.28 (95% CI 0.12-0.62)] and in the domain Social isolation [OR 2.10 (95% CI 1.17-3.78)], psychiatric disorders in the domain Positive affect [OR 0.39 (95% CI 0.17-0.87)] and pulmonary diseases in the domain Negative affect [OR 0.14 (95% CI 0.03-0.61)] of the QUALIDEM. Neuropsychiatric symptoms were independently associated with all six domains of the QUALIDEM [OR 0.93 (95% CI 0.90-0.96) to OR 0.97 (95% CI 0.95-0.99)]. Pain was associated with the domains Care relationship [OR 0.92 (95% CI 0.84-1.00)] and Negative affect [OR 0.92 (95% CI 0.85-1.00)]. Conclusion: QOL in dementia is independently associated with age, ADL, dementia severity, pain, psychiatric disorders, pulmonary diseases and neuropsychiatric symptoms. It is possible to detect persons with dementia at risk for a lower QOL. This information is important for developing personalized interventions to improve QOL in persons with dementia in LTCFs.

scholarly journals Quality of Life in People with Young-Onset Alzheimer’s Dementia and Frontotemporal Dementia

2018 ◽  
Vol 45 (1-2) ◽  
pp. 91-104 ◽  
Author(s):  
Lara Hvidsten ◽  
Knut Engedal ◽  
Geir Selbæk ◽  
Torgeir Bruun Wyller ◽  
Frøydis Bruvik ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Late Onset ◽  
Neuropsychiatric Symptoms ◽  
The Elderly ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Young Onset ◽  
Proxy Version ◽  
Late Onset Dementia

Aims: The aims of this study were to compare quality of life (QOL) in people with young-onset Alzheimer’s (AD) and frontotemporal (FTD) dementia, explore variables associated with QOL, and compare QOL in young-onset dementia (YOD) and late-onset dementia (LOD). Methods: Cross-sectional data from a Nordic multicenter study of 50 community-dwelling participants with AD and 38 with FTD were included. A comparison group consisted of 100 people with LOD. QOL was measured using self-reported Euro-QOL 5-Dimension and the proxy version of Quality of Life in Alzheimer’s Disease (QOL-AD) questionnaire. Neuropsychiatric symptoms and needs were assessed using the Cornell Scale for Depression in Dementia (CSDD), Neuropsychiatric Inventory (NPI), and Camberwell Assessment of Needs in the Elderly. Multiple linear regression and multilevel modeling was used to determine variables associated with QOL. Results: We found no differences between the two YOD groups in QOL. The variables associated with QOL were scores on the CSDD, NPI, and unmet needs. The proxy QOL-AD score in YOD was significantly higher compared to LOD (median 36.0 [IQR 10.0] vs. 33.0 [IQR 9.0]). Conclusion: The QOL in Nordic people with YOD was better compared to people with LOD. Our results show depressive symptoms to be associated with QOL irrespective of age and diagnosis.

scholarly journals Informal Caregivers’ Roles in Dementia: The Impact on Their Quality of Life

Life ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 251
Author(s):  
Cindy E. Frias ◽  
Esther Cabrera ◽  
Adelaida Zabalegui
Keyword(s):  
Quality Of Life ◽  
Pearson Correlation ◽  
Neuropsychiatric Symptoms ◽  
General Health Questionnaire ◽  
Informal Caregivers ◽  
Emotional Wellbeing ◽  
Cross Sectional ◽  
Person With Dementia ◽  
The Impact

The constantly changing process of caring for a person with dementia affects the informal caregivers’ role due to its psychosocial impact. This cross-sectional study aimed to analyze the impact of the Person with Dementia informal caregiver’s role caregiver to a person with dementia on the self-perceived quality of life (QoL) of the caregiver. In total, 160 informal caregivers were recruited between January and December 2019. Informal caregivers’ quality of life was assessed using the European Quality of Life 5-Dimension scale, burden with the Zarit Burden Scale, emotional wellbeing using the General Health Questionnaire, and caregiver reactions using Caregiver Reaction Aspects. Patients’ cognitive impairment was assessed with the Mini-Mental State Examination, their quality of life using Quality of Life in Alzheimer’s Disease, and neuropsychiatric symptoms using the Neuropsychiatric Inventory. Outcomes were studied using the Pearson correlation coefficient and ANOVA test. Most informal caregivers’ outcomes were significantly associated with their quality of life. Male informal caregivers have a slightly better quality of life than female caregivers (p < 0.001). Caregiver burden (p < 0.001), psychological wellbeing (p < 0.001) and negative aspects of caregiving on health (p < 0.001) correlated moderately with informal caregivers’ quality of life. Factors associated with dementia, including the course of the illness and its severity with the presence of neuropsychiatric symptoms can negatively affect the informal caregiver’s role and produce a low self-perception of quality of life; thus, social and professional support for informal caregivers is essential.

scholarly journals Burden of illness in patients with chronic hypoparathyroidism not adequately controlled with conventional therapy: a Belgium and the Netherlands survey

2020 ◽  
Author(s):  
N. A. T. Hamdy ◽  
B. Decallonne ◽  
P. Evenepoel ◽  
D. Gruson ◽  
L. van Vlokhoven-Verhaegh
Keyword(s):  
The Netherlands ◽  
Conventional Therapy ◽  
Biochemical Parameters ◽  
Online Survey ◽  
Clinical Symptoms ◽  
Burden Of Illness ◽  
Clinical Manifestations ◽  
Cross Sectional ◽  
General Management ◽  
Chronic Hypoparathyroidism

Abstract Purpose To determine the burden of illness in patients with not adequately controlled chronic hypoparathyroidism receiving conventional therapy in Belgium and the Netherlands. Methods Data were generated from a cross-sectional, two-part online survey where endocrinologists from both countries and nephrologists from Belgium were invited by phone to participate. Part 1 included collecting data on general management of patients with hypoparathyroidism. In Part 2, physicians were requested to provide data on one or two current cases of patients with chronic hypoparathyroidism not adequately controlled on conventional therapy. Data collected included aetiology of hypoparathyroidism, clinical manifestations, comorbidities, results of laboratory and other investigations used for diagnosis and screening for complications, therapy received, and physician’s perception of impaired quality of life (QoL). Results Thirty-six endocrinologists and 29 nephrologists from Belgium and 28 endocrinologists from the Netherlands participated in the survey. Data included clinical symptoms, biochemical parameters, and QoL for 97 current patients with not adequately controlled chronic hypoparathyroidism on conventional therapy. Median duration of not adequately controlled hypoparathyroidism was 2.2 years, range 0.17–20.0. Most patients had neuromuscular (85%) and/or neurological (67%) symptoms, 71% had abnormal biochemical parameters, 10% were overweight, and physicians perceived that 71% had impaired QoL. Most frequently reported comorbidities included hypertension (25%), renal comorbidity (20%), diabetes mellitus (12%), and dyslipidaemia (11%). Conclusion Patients with chronic hypoparathyroidism not adequately controlled on conventional therapy experience a substantial burden of illness, mainly due to persistence of symptoms and presence of multiple comorbidities.

scholarly journals Associations between Pain and Quality of Life in Severe Dementia: A Norwegian Cross-Sectional Study

2017 ◽  
Vol 7 (1) ◽  
pp. 109-121 ◽  
Author(s):  
Hanne Marie Rostad ◽  
Martine T.E. Puts ◽  
Milada Cvancarova Småstuen ◽  
Ellen Karine Grov ◽  
Inger Utne ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Depressive Symptoms ◽  
Daily Living ◽  
Neuropsychiatric Symptoms ◽  
Nursing Home Residents ◽  
Severe Dementia ◽  
Cross Sectional ◽  
The Relationship

Background/Aims: Many variables influence the quality of life in older adults with dementia. We aim to quantify how the relationship between pain and quality of life in nursing home residents with severe dementia can be explained by neuropsychiatric symptoms, depressive symptoms, and activities of daily living. Methods: This article presents cross-sectional baseline data from a cluster randomised controlled trial. Results: The total and direct effects of pain on quality of life were statistically significant. Both neuropsychiatric and depressive symptoms partially mediated the relationship between pain and quality of life. Activities of daily living acted as a mediator only when modelled together with depressive symptoms. Conclusion: Pain, neuropsychiatric symptoms, and depressive symptoms appear to be important factors that influence the quality of life for nursing home residents with severe dementia. Therefore, multidimensional interventions may be beneficial for maintaining or improving quality of life in this population.

scholarly journals Progression of Neuropsychiatric Symptoms over Time in an Incident Parkinson’s Disease Cohort (ICICLE-PD)

2020 ◽  
Vol 10 (2) ◽  
pp. 78
Author(s):  
J. K. Dlay ◽  
G. W. Duncan ◽  
T. K. Khoo ◽  
C. H. Williams-Gray ◽  
D. P. Breen ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neuropsychiatric Symptoms ◽  
Caregiver Distress ◽  
Cross Sectional ◽  
Efficient Delivery ◽  
Distress Scale ◽  
The Impact ◽  
Over Time

Background: Cross-sectional studies have identified that the prevalence of neuropsychiatric symptoms (NPS) in Parkinson’s disease (PD) ranges from 70–89%. However, there are few longitudinal studies determining the impact of NPS on quality of life (QoL) in PD patients and their caregivers. We seek to determine the progression of NPS in early PD. Methods: Newly diagnosed idiopathic PD cases (n = 212) and age-matched controls (n = 99) were recruited into a longitudinal study. NPS were assessed using the Neuropsychiatric Inventory with Caregiver Distress scale (NPI-D). Further neuropsychological and clinical assessments were completed by participants, with reassessment at 18 and 36 months. Linear mixed-effects modelling determined factors associated with NPI-D and QoL over 36 months. Results: Depression, anxiety, apathy and hallucinations were more frequent in PD than controls at all time points (p < 0.05). Higher motor severity at baseline was associated with worsening NPI-D scores over time (β = 0.1, p < 0.05), but not cognition. A higher NPI total score was associated with poorer QoL at any time point (β = 0.3, p < 0.001), but not changed in QoL scores. Conclusion: NPS are significantly associated with poorer QoL, even in early PD. Screening for NPS from diagnosis may allow efficient delivery of better support and treatment to patients and their families.

scholarly journals Medical and social portrait of families raising children with cerebral palsy

2017 ◽  
Vol 98 (6) ◽  
pp. 1040-1043
Author(s):  
E S Tkachenko
Keyword(s):  
Cerebral Palsy ◽  
Medical Care ◽  
Family Relationships ◽  
Epidemiologic Study ◽  
Cross Sectional ◽  
Material Wealth ◽  
Raising Children ◽  
Children With Cerebral Palsy ◽  
Quality Of Medical Care

Aim. To perform medical and social characterization of families raising children with cerebral palsy. Methods. The study was performed among families raising children with cerebral palsy and living in Omsk. It is a cross-sectional epidemiologic study. Survey of parents based on our developed questionnaire was performed. A total of 324 families took part in the study. The following factors were evaluated: family structure, character of relationship between members, social and living conditions, satisfaction with the quality of medical care. Results. Medical and social characterization was performed in families raising children with cerebral palsy. In 77% of cases a child was brought up in a traditional family (but in about half of the families after developing apparent abnormalities in a child and making a diagnosis of cerebral palsy, worsening of family relationships occurs). Due to necessity for taking care of the child with cerebral palsy, most of mothers are forced to quit their job that negatively affects the level of material wealth. Availability of their own accommodation was revealed in 64% of responders. Mother’s age at the time of birth of a child with cerebral palsy was primarily in the range from 25 to 29 years. A number of factors adversely affecting the health of children, both in the period of prenatal development and the newborn period: pregnancy with complications, acute respiratory viral infection during pregnancy, smoking during early pregnancy. Role of these factors in developing cerebral palsy was detected by a number of researchers. A number of difficulties met by the family members after bearing a child with developmental disabilities were identified (deterioration of family relationships, decline in material wealth, dissatisfaction with the quality of medical care). Conclusion. After making a diagnosis, family relationships worsen; most families have houses not adapted for defects of a child with cerebral palsy; some features of medical organizations service are revealed that might negatively affect the quality of medical care for children with cerebral palsy.

scholarly journals Unmet needs in community-living persons with dementia are common, often non-medical and related to patient and caregiver characteristics

2019 ◽  
Vol 31 (11) ◽  
pp. 1643-1654 ◽  
Author(s):  
Betty S. Black ◽  
Deirdre Johnston ◽  
Jeannie Leoutsakos ◽  
Melissa Reuland ◽  
Jill Kelly ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Unmet Needs ◽  
Neuropsychiatric Symptoms ◽  
Dementia Care ◽  
Community Living ◽  
Care Needs ◽  
Cross Sectional ◽  
Home Based ◽  
Lower Education

ABSTRACTObjective:Understanding which characteristics of persons with dementia (PWD) and their caregivers are associated with unmet needs can inform strategies to address those needs. Our purpose was to determine the percentage of PWD having unmet needs and significant correlates of unmet needs in PWD.Design:Cross-sectional data were analyzed using bivariate and hierarchical multiple linear regression analyses.Setting:Participants lived in the greater Baltimore, Maryland and Washington DC suburban area.Participants:A sample of 646 community-living PWD and their informal caregivers participated in an in-home assessment of dementia-related needs.Measurements:Unmet needs were identified using the Johns Hopkins Dementia Care Needs Assessment. Correlates of unmet needs were determined using demographic, socioeconomic, clinical, functional and quality of life characteristics of the PWD and their caregivers.Results:PWD had a mean of 10.6 (±4.8) unmet needs out of 43 items (24.8%). Unmet needs were most common in Home/Personal Safety (97.4%), General Health Care (83.1%), and Daily Activities (73.2%) domains. Higher unmet needs were significantly related to non-white race, lower education, higher cognitive function, more neuropsychiatric symptoms, lower quality of life in PWD, and having caregivers with lower education or who spent fewer hours/week with the PWD.Conclusions:Unmet needs are common in community-living PWD, and most are non-medical. Home-based dementia care can identify and address PWD’s unmet needs by focusing on care recipients and caregivers to enable PWD to remain safely at home.

scholarly journals Quality of life in substance dependence syndrome

2013 ◽  
Vol 1 (1) ◽  
pp. 42-46
Author(s):  
Lamichhane N ◽  
Thapa D.K ◽  
Tamrakar B.K
Keyword(s):  
Quality Of Life ◽  
Physical Health ◽  
Psychological Health ◽  
Substance Dependence ◽  
Public Health Problem ◽  
Continuous Variable ◽  
Research Centre ◽  
Chi Square ◽  
Cross Sectional

Euphoriant or consciousness altering substance is detrimental to the quality of life of the users. However, due to paucity of studies it is difficult to draw an overall picture of the connection between substance use and quality of life. Fishtail Hospital and Research Centre Pvt. Ltd is located at Pokhara. It is a well-known region in Nepal which has high prevalence of the substance dependence and thus warrants certain effective strategies to address this public health problem. This is a cross- sectional, descriptive hospital based study. After informed consent by administering a semi-structured clinico-socio- demographic performa 60 subjects were included. ICD-10 criteria were used for the diagnosis. The Nepali version of WHOQOL-BREF was administered to assess the quality of life10. Data were analysed by using appropriate tools like Chi-square and Fisher exact tests for association between the continuous variable. The relevant socio-demographic and clinical profiles were also incorporated. The subjects made two groups 30 with alcohol dependence (ADS) and 30 with injecting drug use (IDU). QOL in all spheres was low in all the subjects but with IDU it was even poorer. Among the domain score of both the group of subjects the most affected areas were the psychological health followed by physical health while social and environmental health were relatively less affected.QOL in all spheres was low in all the subjects but with IDU it was even poorer. The most affected areas were the psychological health and physical health.

scholarly journals SAT-391 Safety and Efficacy of Conventional Therapy with Calcium and Activated Vitamin D in Patients with Chronic Post-Operative Hypoparathyroidism: Results of a Cross-Sectional Case-Control Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Laura Mazoni ◽  
Matteo Apicella ◽  
Antonio Matrone ◽  
Federica Saponaro ◽  
Isabella Biagioni ◽  
...  
Keyword(s):  
Vitamin D ◽  
Conventional Therapy ◽  
Urinary Calcium ◽  
Cross Sectional ◽  
Tertiary Referral Center ◽  
Group A ◽  
Phosphate Product ◽  
25 Oh Vitamin D ◽  
Group B

Abstract Introduction: Conventional therapy of chronic post-operative hypoparathyroidism (PO-HypoPT) with calcium and activated vitamin D is suboptimal and associated with several complications, including impairment of the quality of life. Aim of this study was to compare clinical, biochemical and instrumental parameters in 120 patients who underwent total thyroidectomy for differentiated thyroid cancer, 60 with PO-HypoPT (Group A) treated with conventional therapy and 60 without (Group B), matched for age and sex, followed a tertiary referral center. Matherials and methods: An “ad hoc” CRF was used to collect epidemiological, clinical (symptoms, treatment) and biochemical data (total and ionized calcium, albumin, phosphate, magnesium, calcium/phosphate product, creatinine, 25-OH vitamin D, PTH, TSH, eGFR, 24-h urinary calcium and creatinine), and renal ultrasound. Results: The median duration of PO-HypoPT was 7 years (IQR 4-13). All patients of group A were treated with calcitriol (median 0.5 μg/daily; IQR 0.5-1.0), and 33/60 (55%) were also given calcium carbonate supplementation (median 1000 mg/daily; IQR 500-1000). Hypocalcemia related symptoms were more frequent in group A (27/60 - 45%) than in group B (1/60 - 1.7%) (p&lt;0.01). Total and ionized serum calcium [median 8.9 (IQR 8.5-9.1) vs 9.3 (IQR 9.0-9.5) mg/dl; median 1.16 (IQR 1.1-1.2) vs 1.23 (IQR 1.21-1.27) mmol/L] (p&lt;0.01), magnesium [median 1.9 (IQR 1.8-2.0) vs 2 (IQR 1.9-2.1) mg/dl - p&lt;0.01] and PTH [median 10 (IQR 8-13) vs 29 (IQR 22-35) pg/ml - p&lt;0.01] were significantly lower in Group A vs Group B. Conversely, serum phosphate [median 3.7 (IQR 3.4-4.1) vs 3.3 (IQR 3.0-3.6) mg/dl - p&lt;0.01], calcium-phosphate product [median 33 (IQR 30-36) vs 30 (IQR 27-34) - p=0.012] and 25-OH vitamin D [median 34.1 (IQR 29.2-41.3) vs 26.7 (IQR 18.1-33.4) - p&lt;0.01) were significantly higher in Group A vs Group B. Twenty-four hour urinary calcium was higher in group A [median 248 mg (IQR 166-363)] than in group B [median 165 mg (IQR 94-229)] (p&lt;0.01). The rate of nephrolithiasis was significantly higher in group A (21/60 pts - 35%) than in group B (7/60 pts - 11.7%) (p&lt;0.01). Moreover, there was a significant correlation of neprholithiasis with 24h urinary calcium but not with total and ionized serum calcium. Conclusions: This cross-sectional case-control study confirms that treatment of chronic PO-HypoPT with conventional therapy is suboptimal, even in a tertiary referral center, and associated with an increased risk of nephrolithiasis. Following the recent publication of treatment guidelines, the question of whether a better quality of care, including the use of rhPTH, will improve the biochemical control and decrease the rate of hypercalciuria and the risk of nephrolithiasis remains to be established.

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