scholarly journals Post-Surgical Quality of Life, Psychological State and what Patients Think about the Effectiveness of Heller Myotomy in the Treatment of Achalasia

2016 ◽  
Vol 29 (2) ◽  
pp. 107 ◽  
Author(s):  
Telma Vale-Fonseca ◽  
Luis Ferreira-Pinto ◽  
Margarida Figueiredo-Braga ◽  
Silvestre Carneiro

<p><strong>Introduction:</strong> The disruption of esophageal motility that characterizes achalasia typically provokes dysphagia, pain, loss of weight and malnutrition. Therefore, patients frequently report a reduction in quality of life and negative emotional states. Laparoscopic Heller myotomy proved to be an effective therapy, enabling the resumption of good quality of life.<br /><strong>Material and Methods:</strong> The authors studied 45 patients previously submitted to laparoscopic Heller myotomy. Postoperative evaluation was performed using a customized version of the achalasia disease-specific quality of life questionnaire. Quality of life and the presence of depressive and anxiety symptoms were assessed using the Portuguese versions of the Medical Outcomes Study SF-36 and the Hospital Anxiety and Depression Scale.<br /><strong>Results:</strong> Thirty-one patients responded to the survey. Dysphagia was the main clinical symptom before surgery. A clear improvement in dysphagia, regurgitation, pain and weight loss was found after surgery (<em>p</em> &lt; 0.001). The Mental Health domain of SF-36 presented a Pearson correlation coefficient of -0.689 with HADS-D and of -0.557 with HADS-A (<em>p</em> &lt; 0.001 and <em>p</em> = 0.002, respectively).<br /><strong>Conclusion:</strong> This study demonstrates that the Heller myotomy is associated with a good quality of life in patients with achalasia and strengthens the evidence that this is a safe and reliable procedure.</p>

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21589-e21589
Author(s):  
Hector De La Mora ◽  
Juan Hinojosa ◽  
Hugo Eduardo Velazquez ◽  
Ricardo Alonso Castillejos-Molina ◽  
Victor Monjaras ◽  
...  

e21589 Background: TCS have long life expectancy, but struggle with numerous potential long-term sequelae, including sexual dysfunction (SD). They can suffer organic SD as a treatment side effect, and non-organic SD as a result of psychosexual changes related to the disease. The aim of this study is to determine the prevalence of SD in a cohort of TCS in a middle-income country, and to examine possible influences on health-related quality of life (HRQoL). Methods: An observational, cross-sectional, descriptive and analytic study was conducted. TCS in our cohort underwent IIEF-5 questionnaire, and sexual hormones measurement. HRQoL was examined using SF-36 questionnaire. Beck Depression Scale was used to assess psychological symptoms. Logistic regression analysis was used to evaluate the association among SD and disease characteristics and HRQoL. A Pearson correlation test was performed between SD and disease free survival interval. Results:The study population comprised 35 men whose and mean age was 32±8.3 years (21-54) and the median follow-up time since the end of treatment was 24 months, . Twelve TCS (34%) reported any level of impairment of erectile function (ED), 21 (60%) had loss of sexual desire, and 15 (42%) reported orgasmic dysfunction (OD). The presence of ED, loss of desire, or OD were not associated with worse scores in all SF36 domains, including both composite scores and the total SF-36 score. Treatment with adjuvant chemotherapy (CT) or CT plus retroperitoneal lymph node dissection were not associated with ED (p = 0.8). Fatigue (SF-36 vitality) was statistically significant higher among our cohort of TCS compared to an age-adjusted normative Mexican male population, independently of SD or depression level (0.001). Fatigue was independently associated with higher levels of gonadotropins and lower of testosterone (p = 0.05). Conclusions: The incidence of SD in Mexican TCS is similar (34%) to the rate reported in other populations. HRQoL is decreased particularly in the vitality section, when compared to age-adjusted normative controls. Nevertheless, we did not demonstrate a correlation between SD and worse HRQoL or depression level. Fatigue was associated with low level of tesosterone.


2020 ◽  
Author(s):  
Siyi Yu ◽  
Xiaohui Dong ◽  
Ruirui Sun ◽  
Zhaoxuan He ◽  
Chuantao Zhang ◽  
...  

Abstract Background Previous studies suggested that acupuncture was a promising adjunct treatment for asthma. However, the underlying mechanism of acupuncture for asthma remains unclear. The present trail aimed to explore whether and how specific meridian acupuncture works in quality of life and symptomatic improvement by modulating brain function in asthma patients. Methods A randomized controlled functional brain imaging trial is currently being conducted in Sichuan, China. In total 48 patients with mild to moderate, persist asthma will be recruited randomly allocated to two acupuncture groups: acupuncturing at Lung Meridian and acupuncturing at Heart Meridian . The treatment period will last for 4 weeks. The Asthma quality of life questionnaire (AQLQ) is the primary outcome. Asthma control test (ACT), the rate of Peak expiratory flow (PEFR), Forced expiratory volume in 1 second (FEV1), Montreal cognitive assessment (MoCA), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) will also assess the clinical efficacy of different interventions. Functional magnetic resonance imaging (fMRI) scans will be performed to detect cerebral activity changes in each group. The clinical data and fMRI data will be analyzed, respectively. Pearson correlation analysis will be used to assess the association between the changes of cerebral activity features and the improvement of clinical outcomes in each group. DiscussionThe present study has been established on the “meridians-viscera relationship” theory of traditional Chinese medicine and modern central mechanism of acupuncture. The results of this trial would be useful to identify efficiency of the specific meridian acupuncture for asthma. The investigation of its central mechanism would further expand our knowledge of the acupuncture for asthma.


2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
R Parshad ◽  
V Singla ◽  
S Suhani ◽  
H Bhattacharjee ◽  
G Makharia ◽  
...  

Abstract   Achalasia is a rare disease with Laparoscopic Hellers cardio-myotomy (LHCM) being the gold standard surgical modality. An antireflux procedure is required along with myotomy to decrease the chances of reflux postoperatively. We have performed Angle of His Accentuation (AOH) as an anti-reflux procedure in 126 patients who underwent LHCM since 2010. This study presents the symptomatic and objective outcomes of LHCM with AOH. Methods Review of prospectively collected data of patients with Achalasia cardia undergoing LHCM with AOH from 2010–2019. Subjective symptoms were scored for dysphagia, heartburn, regurgitation and quality of life using scoring systems mentioned in table 1 and Achalasia specific health related Quality of life questionnaire (ASHRQoL). Objective tests included Timed Barium swallow, Endoscopy and high-resolution manometry. Patients were evaluated in pre and postoperative period at regular intervals. Success was defined as follows: Eckardt score of ≤3, Dysphagia score of 0/1, Regurgitation and heartburn score of 0, &gt;50% clearance on timed barium swallow, IRP &lt;15 and absence of esophagitis. Results 126 patients were operated during the study period with no mortality or conversion. Mean age was 33.5(years), symptom duration 49.8(months), 31 had preoperative dilatation. The mean operative time was 131 (minutes). Subjective outcome was available in all patients & objective data in 66. At median follow of 31 months (IQR 15–59) outcomes significantly improved (Table 1) with 93% having dysphagia relief. 14 (11%) had new onset heartburn; 6(4.7%) needed regular proton pump inhibitors. ASHRQoL improved significantly (59.51 to 19.57). Pre&post-operative IRP, Timed Barium and endoscopy available in 66,39 and 62 patients improved significantly. 6(9.6%) patients had endoscopic evidence of esophagitis (LA-A 3, B/C 3). Conclusion Laparoscopic Heller myotomy with Angle of His accentuation is safe simple and effective procedure for Achalasia cardia. It provides significant relief of symptoms, improvement in quality of life and improvement in objective parameters. Post- operative heartburn and esophagitis is acceptable. We recommend Angle of His accentuation as an adjunct to Laparoscopic Heller myotomy.


2020 ◽  
Vol 10 (2) ◽  
pp. 55-64
Author(s):  
R.N. Çavdar ◽  
S. Türkleş

Purpose: To examine the relationship between depression and quality of life in elderly patients with glaucoma. Materials and methods: The study was conducted as a descriptive and cross-sectional research. The sample of the work consists of 130 patients aged 60 years and over who were followed up at Mersin University Hospital Ophtalmology Department between 01 October 2016 and 31 March 2017. The data were gathered with Personal Information Form, Geriatric Depression Scale and Modifiye GLAU-QOL 17 Glaucoma Quality of life. Number, percentage, mean, Pearson Correlation, Student`s t test, ANOVA test, Tukey and Games-Howell statistic were used in the evaluation of the data. Results: The mean age of the patients was 67.9±7.27. The mean score of geriatric depression scale of the patients was 15,23±5,52. It was determined that 16,2% of the patiens had possible depression and 62,3% had definite depression. The median Glau–QOL-17 Glaucoma Quality of Life Questionnaire subcale scores of the patients were as follows: daily living (3,58±3,25), driving (3,23±2,53), worry (5,26±3,47), self-assesment (6,4±3,07), psychology (4,08±2,74), feeling oppressed (4,39±2,35) and taking responsibility (3,56±1,86). The mean total score was 34.44±15.29. There was a negative and statistically significant relationship between the age of the patients and the scores of geriatric depression and the scores of age and quality of life. Conclusions: Elderly patients with glaucoma are at a major risk for depression and their quality of life is negatively affected.


2018 ◽  
Vol 31 (7-8) ◽  
pp. 391 ◽  
Author(s):  
José Silva ◽  
Henrique Vasconcelos ◽  
Margarida Figueiredo-Braga ◽  
Silvestre Carneiro

Introduction: Obesity is often accompanied by psychological distress and both can reduce patients’ quality of life. Bariatric surgery is proven to be a good method to reduce weight and to alleviate comorbidities, leading ultimately to an improvement in quality of life.Material and Methods: The authors studied 80 patients enrolled in the Multidisciplinary Bariatric Unit of a central hospital in Porto, Portugal. Patients submitted to Roux-en-Y gastric bypass and sleeve procedures were compared. Laboratory parameters were collected from patients’ files. Quality of life and psychological state - depression and anxiety, were evaluated using the Portuguese versions of the Medical Outcomes Study SF-36 and the hospital anxiety and depression scale, respectively, within one to two years of the surgery.Results: A total of 51 patients were operated and completed a quality of life evaluation, while 21 patients were in a pre-operatory group (control). Patients subjected to bariatric surgery had higher scores of SF-36 and lower scores in both hospital anxiety and depression scale (anxiety and depression) subscales (p < 0.001); SF-36 presented a Pearson correlation coefficient of 0,475 (p = 0.004) with hemoglobin A1c. Sleeve had better results in the hospital anxiety and depression scale-depression subscale (p = 0.073).Discussion: In this population, bariatric surgery led to better results, regarding both metabolic and psychological evaluations. No significant differences were found between gastric bypass and sleeve. However, further analyses must be performed.Conclusion: This study supports the theory that bariatric surgery contributes to the improvement of obese patients’ quality of life and psychological state.


2020 ◽  
Vol 103 (11) ◽  
pp. 1194-1199

Objective: To develop and validate a Thai version of the Wisconsin Quality of Life (TH WISQoL) Questionnaire. Materials and Methods: The authors developed the TH WISQoL Questionnaire based on a standard multi-step process. Subsequently, the authors recruited patients with kidney stone and requested them to complete the TH WISQoL and a validated Thai version of the 36-Item Short Form Survey (TH SF-36). The authors calculated the internal consistency and interdomain correlation of TH WISQoL and compared the convergent validity between the two instruments. Results: Thirty kidney stone patients completed the TH WISQoL and the TH SF-36. The TH WISQoL showed acceptable internal consistency for all domains (Cronbach’s alpha 0.768 to 0.909). Interdomain correlation was high for most domains (r=0.698 to 0.779), except for the correlation between Vitality and Disease domains, which showed a moderate correlation (r=0.575). For convergent validity, TH WISQoL demonstrated a good overall correlation to TH SF-36, (r=0.796, p<0.05). Conclusion: The TH WISQoL is valid and reliable for evaluating the quality of life of Thai patients with kidney stone. A further large-scale multi-center study is warranted to confirm its applicability in Thailand. Keywords: Quality of life, Kidney stone, Validation, Outcome measurement


2013 ◽  
Vol 71 (6) ◽  
pp. 392-396 ◽  
Author(s):  
Juliana B. Taniguchi ◽  
Valeria M.C. Elui ◽  
Flavia L. Osorio ◽  
Jaime E.C. Hallak ◽  
Jose A.S. Crippa ◽  
...  

We assessed the functional impairment in Charcot-Marie-Tooth resulting from 17p11.2-p12 duplication (CMT1A) patients using the Short-Form Health Survey (SF-36), which is a quality of life questionnaire. Twenty-five patients of both genders aged ≥10 years with a positive molecular diagnosis of CMT1A were selected. Age- and gender-matched Control Group (without family history of neuropathy), and the sociodemographic and professional conditions similar to the patients' group were selected to compare the SF-36 results between them. The results showed that the majority quality of life impairments in CMT1A patients occurred in the social and emotional domains. Functional capacity also tended to be significantly affected; other indicators of physical impairment were preserved. In conclusion, social and emotional aspects are mostly neglected in the assistance provided to CMT1A Brazilian patients, and they should be better understood in order to offer global health assistance with adequate quality of life as a result.


2021 ◽  
Vol 24 (2) ◽  
Author(s):  
Elżbieta Szczygieł-Pilut ◽  
Elżbieta Mirek ◽  
Magdalena Filip ◽  
Daniel Pilut ◽  
Szymon Pasiut ◽  
...  

Introduction: Epilepsy is one of the most common diseases of the central nervous system. According to the World Health Organization, it accounts for 1% of the global burden of disease worldwide. Pharmacotherapy remains the primary therapeutic tool in this disease. However, more and more emphasis is placed on approaching this group of patients in an interdisciplinary manner, taking their various needs into account: social, professional, economic or psychological. Attention is also paid to the positive impact of physical activity on the quality of life of patients with epilepsy. The patients with diagnosed epilepsy often complain of a feeling of instability not reflected in standard neurological examination. Early detection of postural control disorders is possible using an objective research tool which is the modified CTSIB test (Clinical Test of Sensory Interaction and Balance). Aim of the study: The aim of the study was to assess the influence of targeted physical therapy on the quality of life among patients with diagnosed epilepsy of unknown etiology using the SF-36 quality of life questionnaire. Materials and methods: The study included 11 professionally active adults with diagnosed generalized epilepsy of unknown etiology, treated at the Department or Outpatient Clinic of Neurology at John Paul II Specialist Hospital in Kraków. Finally, out of the 11 recruited patients (5 women and 6 men), 1 patient was excluded from the study due to a history of craniocerebral trauma. Patients were examined 3 times every month using EEG and the SF-36 quality of life questionnaire. Additionally, between the 2nd and the 3rd month of the pilot study, the study group underwent physical therapy focused on balance disorders using the Biodex SD stabilometric platform. Results: Overall, the quality of life index measured using the SF-36 quality of life questionnaire in the study group improved after the completion of targeted physical therapy. Conclusions: 1. Generalized epilepsy of unknown etiology results in a significant deterioration in the quality of life of patients, which may also be accompanied by disorders of postural control. 2 A targeted program of physiotherapy in the treatment of patients with generalized epilepsy of unknown etiology may has a positive effect on their quality of life. null


2018 ◽  
Vol 9 (3) ◽  
Author(s):  
Arethuza De Melo Brito Carvalho ◽  
Juliana Araújo Cardoso ◽  
Francisca Aline Amaral Da Silva ◽  
Jefferson Abraão Caetano Lira ◽  
Samuel Moura Carvalho

Objetivo: avaliar a qualidade de vida no trabalho da equipe de enfermagem do centro cirúrgico. Metodologia: estudo descritivo, de corte transversal e com abordagem quantitativa, desenvolvido com 70 profissionais de enfermagem do centro cirúrgico em um hospital de referência em Teresina (PI), com a aplicação dos questionários sociodemográfico e Quality Working Life Questionnaire-bref. A análise foi realizada com o SPSS versão 21.0, utilizando a correlação de Pearson e os testes alfa de Cronbach, Kolmogorov-Smirnov, Qui-quadrado e regressão linear múltipla, com intervalo de confiança de 95%. Resultados: a maioria dos participantes (62,9%) tiveram menor impacto na qualidade de vida no trabalho, entretanto a renda familiar e a formação acadêmica foram bastante significativas. Conclusão: apesar do trabalho no centro cirúrgico apresentar baixo impacto na qualidade de vida, o domínio psicológico demonstrou impacto considerável, destacando que a preocupação com a saúde do trabalhador e a valorização da equipe de enfermagem ainda precisam avançar.Descritores: Qualidade de vida; Enfermagem de centro cirúrgico; Saúde do trabalhador.QUALITY OF LIFE IN THE WORK OF THE SURGI CAL CENTER NURSING TEAMObjective: to evaluate the quality of life in the work of the nursing staff of the surgical center. Methodology: a descriptive, cross-sectional study with a quantitative approach developed with 70 nursing professionals from a surgical center at a reference hospital in Teresina (PI), with the application of the sociodemographic and Quality Working Life Questionnairebref questionnaires. The analysis was performed with the SPSS version 21.0, using the Pearson correlation and the Cronbach, Kolmogorov-Smirnov, Chi-square and multiple linear regression alpha tests with a 95% confidence interval. Results: the majority of the participants (62.9%) had a lower impact on the quality of life at work, however the family income and academic training were quite significant. Conclusion: Although the work in the surgical center has a low impact on the quality of life, the psychological domain has shown considerable impact, emphasizing that the concern with the health of the worker and the appreciation of the nursing team still need to move forward.Descriptors: Quality of life; Operating Room Nursing; Occupational Health.CALIDAD DE VIDA EN ENFERMERÍA DEL CENTRO DE TRABA JO DE EQUIPO QUIRÚRGICOObjetivo: Evaluar la calidad de vida del personal de enfermería que trabaja en la sala de operaciones. Metodología: enfoque descriptivo, transversal y cuantitativo desarrollado con 70 enfermeras en el quirófano de un hospital de referencia en Teresina (PI), con la aplicación de un cuestionario sociodemográfico y Calidad de Vida Cuestionario de Trabajo-BREF. El análisis se realizó con el programa SPSS versión 21.0 mediante la prueba de correlación de Pearson y alfa de Cronbach, prueba de Kolmogorov-Smirnov, regresión lineal chi-cuadrado y múltiple con un intervalo de confianza del 95%. Resultados: La mayoría de los participantes (62,9%) tenían un menor impacto en la calidad de la vida laboral, aunque el ingreso familiar y la formación académica eran bastante significativa. Conclusión: Aunque el trabajo en la sala de operaciones tiene un bajo impacto en la calidad de vida, el dominio psicológico mostró un impacto considerable, teniendo en cuenta que la preocupación por la salud de los trabajadores y la apreciación del equipo de enfermería todavía tienen que seguir adelante.Descriptores: Calidad de vida; Enfermería de quirófano; Salud laboral.


Author(s):  
Kusum Lata Mathur ◽  
Manu Sharma ◽  
Mohua Mazumdar ◽  
Shikha Talati ◽  
Siddharth Srivastav

Background: Hysterectomy is the most common major gynecological surgery often performed for benign lesions. Many studies have reported adverse psychosocial outcomes post-hysterectomy. There is a paucity of studies from India addressing psychiatric morbidity after hysterectomy. To evaluate psychological wellbeing, marital adjustment and quality of life in patients undergoing hysterectomy for non-malignant conditions, in comparison with patients undergoing surgery other than hysterectomy.Methods: A cross-sectional study was conducted on 100 consecutive out-patients who underwent hysterectomy for non-malignant indications at least 6 months ago. The comparison group comprised of 50 consecutive out-patients who underwent gynecological surgery other than hysterectomy at least 6 months ago formed the comparison group. The study participants were evaluated on Hospital Anxiety and Depression Scale (HADS), Psychological General Well-being Index (PGWBI), Marital Adjustment Test (MAT) and Women’s Quality of Life Questionnaire (WOMQOL).Results: The indications for hysterectomy were: uterine leiomyoma (69%), uterovaginal prolapse (18%), dysfunctional uterine bleeding (12%), and endometriosis (1%). Abdominal hysterectomy was performed in 92 patients while 8 patients underwent vaginal hysterectomy. There were no significant differences in the study groups on scores of HADS, PGWBI, MAT and WOMQOL (p>0.05). Both the study groups had good marital adjustment and majority reported no depression and anxiety.Conclusions: There is no major psychiatric morbidity, decline in marital adjustment and quality of life after hysterectomy for benign conditions among Indian women. Future research on the ethno-cultural implications and effect of hysterectomy on mental health will be a significant addition to the available evidence in India.


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