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Background and purpose Given that chronic pain has become a major problem in recent years, affecting approximately 30% of the general population, this study used the Japanese version of the Short Form-8 (SF-8) to investigate (1) the quality of life (QOL) of patients with burning mouth syndrome (BMS) or persistent idiopathic facial pain (PIFP) (compared with a Japanese control group) and (2) whether therapeutic intervention improves the QOL and reduces pain (comparison between 0 and 12 weeks) of patients with BMS or PIFP. Materials and methods A total of 63 patients diagnosed with either BMS (n=45) or PIFP (n=18) were included in this study. The diagnostic criteria for BMS and PIFP were established based on the third edition of the International Classification of Headache Disorders. Results Our study results showed that while Physical Component Summary (PCS) in patients with BMS or PIFP improved with treatment, it did not improve to the national standard value (NSV) after 12 weeks of intervention. In contrast, the Mental Component Summary (MCS) improved to the same level as the NSV after 12 weeks of intervention. Conclusions We found that therapeutic intervention improves MCS and reduces pain; however, improving PCS requires time.

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OBJECTIVE: A minimum clinically important difference (MCID) has been increasingly well known in the current era of patient-centered care because it reflects a smallest change that is meaningful for patients following a clinical intervention. Previous studies suggested MCID values are disease and/or procedure dependent. No MCID values have been reported on the lumbar spinal stenosis (LSS) following decompression surgery despite LSS is the most common spinal disease and the main treatment is decompression surgery. Therefore, this study aimed to determine the MCID values as major outcome measures including the Numeric Rating Scale (NRS) of back pain, leg pain and numbness, Roland-Morris Disability Questionnaire (RMDQ), and Physical Component Summary (PCS) and Mental Component Summary (MCS) of Short Form 8 (SF-8) for patients with LSS undergoing decompression surgery. PATIENTS AND METHODS: This is a retrospective cohort study using prospectively collected data from consecutive patients who underwent lumbar decompression without fusion for LSS at a single institution between May 2014 and March 2016. Inclusion criteria were 1) minimum 1-year follow-up 2) a complete set of preoperative and final follow-up questionnaires available, including the NRS, RMDQ, and SF-8. Revision surgery or non-degenerative etiology such as infection or tumor was excluded. MCIDs of each outcome measure were determined using two major approaches, distribution- and anchor-based methods. The distribution-based method uses the distributional characteristics of the sample. This method expresses the observed degree of variation to obtain a standardized metric such as the standard deviation or standard error of measurement. The anchor-based method uses an external criterion known as anchor to determine the factors that should be considered by patients for an important improvement. Anchor-based methods assess how much changes in the measurement instrument correspond with a minimal important change defined on the anchor. We used symptom severity, physical function, and satisfaction scores from Zurich Claudication Questionnaire as anchors for NRS and RMDQ, PCS, and MCS, respectively. RESULTS: A total of 126 patients were included. From the anchor-based method, MCIDs were determined to be 2 points for back pain, 4 points for leg pain and numbness, 5 points for RMDQ, 5 points for PCS, and 2 points for MCS. From the distribution-based method, MCIDs were determined to be 2 points for back pain, leg pain and numbness, 3-4 points for RMDQ, 6 points for PCS, and 5 points for MCS. CONCLUSION: We first identified the MCIDs of the NRS, RMDQ, and SF-8 specific to patients undergoing decompression surgery for LSS.

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OBJECTIVE: Decompression surgery is the standard treatment for lumbar spinal stenosis (LSS); however, despite the good clinical outcomes reported for this procedure, a relatively high dissatisfaction rate has been reported. We hypothesized that the previously used outcome measures do not accurately reflect patient satisfaction (PS). This study aimed to examine which outcome measures reflect PS accurately in patients undergoing decompression for LSS. PATIENTS AND METHODS: Patients with LSS treated with lumbar decompression surgery between January 2014 and March 2016 were enrolled if they had the preoperative and final follow-up questionnaires including the Numeric Rating Scale (NRS), Roland-Morris Disability Questionnaire (RMDQ), Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and Short Form-8 (SF-8). PS was evaluated using the question, "How satisfied are you with the overall result of your back operation?". There are four possible answers consisting of "very satisfied (4-point)", "somewhat satisfied (3-point)", "somewhat dissatisfied (2-point)", or "very dissatisfied (1-point)". The Spearman correlation coefficient between PS and each questionnaire was calculated. RESULTS: Postoperative JOABPEQ had strong correlation with PS (r > 0.6) whereas NRS, RMDQ and SF-8 had moderate correlation (0.4

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CONTEXT: Asthma control is suboptimal in the Middle East and North Africa (MENA). AIMS: The aim of this study is to assess the level of asthma control in Saudi patients as per the Global Initiative for Asthma 2012 classification and explore its potential predictive factors. SETTINGS AND DESIGN: Epidemiological Study on the Management of Asthma in Asthmatic Middle East Adult Population (ESMAA) is a multicentric, descriptive, epidemiological study assessing asthma management in the MENA region. In this article, we report the results of patients from Saudi Arabia included in the ESMAA study. METHODS: Adult patients diagnosed with asthma at least 1 year before study entry were considered for inclusion. Asthma control level and its predictive factors were explored. Treatment adherence and quality of life (QoL) were assessed by MMAS-4© and Short Form 8 Health Survey QoL questionnaires, respectively. STATISTICAL ANALYSIS USED: Descriptive statistics were done considering two-sided 95% confidence intervals. Logistic regression was used to explore the potential predictive factors of asthma control. All statistical tests were two-sided, and P < 0.05 was considered statistically significant. RESULTS: Data of 1009 patients from Saudi Arabia were analyzed. Less than one-third of patients (30.1%) were found to have controlled asthma with significantly higher QoL. High level of asthma control was reported among male patients and those with high educational level, while age, body mass index, and adherence to treatment were found to have no effect on asthma control. CONCLUSIONS: Asthma control remains suboptimal among Saudi population. This needs huge efforts to achieve acceptable levels of control and better QoL for asthma patients. Further studies are still needed in Saudi Arabia and the Middle East region.

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The aim of current research is to analyze the psychometric properties of the Spanish version of the SF-8, overcoming previous shortcomings. A double line of analyses was used: competitive structural equations models to establish factorial validity, and Item Response theory to analyze item psychometric characteristics and information. 593 people aged 60 years or older, attending long life learning programs at the University were surveyed. Their age ranged from 60 to 92 years old. 67.6% were women. The survey included scales on personality dimensions, attitudes, perceptions, and behaviors related to aging. Competitive confirmatory models pointed out two-factors (physical and mental health) as the best representation of the data: χ2(13) = 72.37 (p < .01); CFI = .99; TLI = .98; RMSEA = .08 (.06, .10). Item 5 was removed because of unreliability and cross-loading. Graded response models showed appropriate fit for two-parameter logistic model both the physical and the mental dimensions. Item Information Curves and Test Information Functions pointed out that the SF-8 was more informative for low levels of health. The Spanish SF-8 has adequate psychometric properties, being better represented by two dimensions, once Item 5 is removed. Gathering evidence on patient-reported outcome measures is of crucial importance, as this type of measurement instruments are increasingly used in clinical arena.

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The objective of this study is to characterize profiles of obese depressed participants using baseline data collected from October 2014 through December 2016 for an ongoing randomized controlled trial (n = 409) in Bay Area, California, USA. Four comorbidity severity categories were defined by interaction of the binary levels of body mass index (BMI) and depression Symptom Checklist 20 (SCL20) scores. Sociodemographic, behavioral, clinical and psychosocial characteristics were measured. Mean (SD) age was 51 (12.1) years, BMI 36.7 (6.4) kg/m2, and SCL20 1.5 (0.5). Participants in the 4 comorbidity severity categories had similar sociodemographic characteristics, but differed significantly in the other characteristics. Two statistically significant canonical dimensions were identified. Participants with BMI ≥ 35 and SCL20 ≥ 1.5 differed significantly from those with BMI < 35 and SCL20 < 1.5 on dimension 1, which primarily featured high physical health (e.g., central obesity, high blood pressure and impaired sleep) and mental health comorbidities (e.g., post-traumatic stress and anxiety), poor health-related quality of life (in general and problems specifically with obesity, anxiety, depression, and usual daily activities), and an avoidance problem-solving style. Participants with BMI < 35 and SCL20 ≥ 1.5 differed significantly from those with BMI ≥ 35 and SCL20 < 1.5 on dimension 2, which primarily included fewer Hispanics, less central obesity, and more leisure-time physical activity, but greater anxiety and post-traumatic stress and poorer obesity- or mental health-related quality of life. In conclusion, patients with comorbid obesity and depression of varying severity have different profiles of behavioral, clinical and psychosocial characteristics. This insight may inform analysis of treatment heterogeneity and development of targeted intervention strategies. Trial registration:ClinicalTrials.gov #NCT02246413.

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PURPOSE: The avoidance of postoperative functional disability is one of the most important concerns of patients facing surgery, but methods to evaluate disability have not been definitively established. The aim of our study was to evaluate the feasibility, reliability, and validity of the Japanese version of the 12-item World Health Organization Disability Assessment Schedule-2 (WHODAS 2.0-J) in preoperative patients. METHODS: Individuals aged ≥55 years who were scheduled to undergo surgery in a tertiary-care hospital in Japan between April 2016 and September 2016 were eligible for enrolment in the study. All patients were assessed preoperatively using the WHODAS 2.0-J, the 8-Item Short Form (SF-8) questionnaire, and the Tokyo Metropolitan Institute of Gerontology Index (TMIG Index). The feasibility, reliability, and validity of WHODAS2.0-J were evaluated using response rate, Cronbach's alpha (a measure of reliability), and the correlation between the WHODAS 2.0-J and the SF-8 questionnaire and TMIG Index, respectively. RESULTS: A total of 934 patients were enrolled in the study during the study period, of whom 930 completed the WHODAS 2.0-J (response rate 99.5%) preoperatively. Reliability and validity were assessed in the 898 patients who completed all three assessment tools (WHODAS 2.0-J, SF-8 questionnaire, and TMIG Index) and for whom all demographic data were available. Cronbach's alpha was 0.92. The total score of the WHODAS 2.0-J showed a mild or moderate correlation with the SF-8 questionnaire and TMIG Index (r = -0.63 to -0.34). CONCLUSION: The WHODAS 2.0-J is a feasible, reliable, and valid instrument for evaluating preoperative functional disability in surgical patients.

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AIM: To develop and validate a scale that assesses quality of life in patients receiving home-based medical care. METHODS: A new quality of life scale was developed and evaluated in four phases: (i) item generation; (ii) first field study with a 14-item questionnaire; (iii) preliminary validation study, to reduce the number of items to four; and (iv) second field study comprising 40 patients, to evaluate the validity of the final version. Participants were requested to answer both the final version of the scale and the Short Form-8, to enable identification of any relationship between the two. RESULTS: Items were generated after discussions with doctors and care managers, and 14 items were selected for the draft version. In the preliminary validation study, 10 items were deleted, based on the results of statistical analysis of the data from the first field study. A psychometric analysis showed that the final four-item questionnaire had internal consistency (Cronbach's α = 0.7), and a significant association with the Short Form-8. CONCLUSIONS: We created the first quality of life scale for patients receiving home-based medical care. The scale's internal consistency was confirmed, as well as its external validity. This scale can be used independently of factors such as a patient's age, sex, level of independence in the presence of dementia or disability, swallowing function, hearing ability and communication ability, and can be used with ease in routine clinical practice. Geriatr Gerontol Int 2017; 17: 440-448.

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OBJECT: The objective of this study was to investigate epidemiology and outcome after surgical treatment for spinal injuries in Ethiopia. METHODS: Medical records of patients who underwent surgery for spine injuries at Myungsung Christian Medical Center in Addis Ababa, Ethiopia, between January 2008 and September 2012 were reviewed retrospectively. Assessment of outcome and complications was determined from patient consultations and phone interviews. RESULTS: A total of 146 patients were included (129 males, 17 females). Their mean age was 31.7 years (range 15-81 years). The leading cause of injury was motor vehicle accidents (54.1%), and this was followed by falls (26.7%). The most common injury sites were lumbar (41.1%) and cervical (34.2%) regions of the spine. In 21.2% of patients, no neurological deficit was present before surgery, 46.6% had incomplete spinal cord injury (American Spinal Injury Association [ASIA] Impairment Scale [AIS] Grade B-D), and 32.2% had complete spinal cord injury (AIS Grade A). Follow-up was hampered by suboptimal infrastructure, but information regarding outcome was successfully obtained for 110 patients (75.3%). At follow-up (mean 22.9 months; range 2-57 months), 25 patients (17.1%) were confirmed dead and 85 patients (58.2%) were alive; 49 patients (33.6%) underwent physical examination. At least 8 of the 47 patients (17.0%) with a complete injury and 29 of the 68 patients (42.6%) with an incomplete injury showed neurological improvement. The reported incidences of pressure wounds, recurrent urinary tract infections, pneumonia, and thromboembolic events were 22.5%, 13.5%, 5.6%, and 1.1%, respectively. CONCLUSIONS: Patients showed surprisingly good recovery considering the limited resources. Surgical treatment for spine injuries in Ethiopia is considered beneficial.

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Objective  We examined the effects of low frequency electro-acupuncture therapy (EAT) on young women who suffered from‘Hie’symptoms, which were judged according to the national normal value of bodily pain (BP) scores from a ”Medical Outcomes Study Short-Form-8 Survey“ (SF-8). Subjects and Methodology  The experimental subjects were 20 women (mean age: 21.2 years old; range: 18-26 years old) who exhibited symptoms of ‘Hie’ symptoms (vasomotor dysfunction) and whose toes’skin temperature increased or showed a different reaction between right and left during a postural change test. A stainless steel acupuncture needle (length: 40 mm; diameter: 0.2 mm) was inserted approximately 15 mm deep at SP6 (Sanyinjiao, Saninko). EAT using an active electrode (the needle) at SP6 and a reference electrode (surface electrode) at the lateral-anterior aspect of the lower leg was applied at a frequency of 1 Hz for 20 minutes. The therapy was provided one session per week for a total of five sessions. Effects of the therapy were evaluated by using an original questionnaire (‘Hie’diary), which consisted of six categorical of 14 symptoms (including of‘Hie’) and Visual Analogue Scale (VAS) of‘severity of Hie’. Moreover, changes in health-related quality of life (HRQOL) by acupuncture were evaluated by using the SF-8 Standard Edition. Results  Subjects were grouped according to their SF-8 BP scores before the therapy: 12 subjects (L group) whose scores were less than the national normal value (42.75 points), and eight subjects (H group) whose scores were more than the national normal value. For both groups VAS levels showed no statistically significant changes, but for the L group the total score of 14 symptoms significantly decreased after the second therapy session compared with scores before the therapy. Moreover, the statistically significant decrease in the total score lasted for one month after the therapy had been finished. Compared with before therapy, the score of ‘vitality’ (VT) significantly increased for the L group one month after the therapy, and those of BP and ‘mental health’ (MH) significantly increased for the L group just after and one month after the therapy. Conclusions  EAT at SP6 on young women with ‘Hie’ symptoms (vasomotor dysfunction) contributes to improvement in overall condition and health-related QOL, and it is occluded that the effect of the EAT was high, because HRQOL was low (the score of BP was low).

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<B>Objective</B><br> We examined the effects of low frequency electro-acupuncture therapy (EAT) on young women who suffered from‘<I>Hie</I>’symptoms, which were judged according to the national normal value of bodily pain (BP) scores from a ”Medical Outcomes Study Short-Form-8 Survey“ (SF-8).<br><B>Subjects and Methodology</B><br> The experimental subjects were 20 women (mean age: 21.2 years old; range: 18-26 years old) who exhibited symptoms of ‘<I>Hie</I>’ symptoms (vasomotor dysfunction) and whose toes’skin temperature increased or showed a different reaction between right and left during apostural change test. A stainless steel acupuncture needle (length: 40 mm; diameter: 0.2 mm) was inserted approximately 15 mm deep at SP6 (Sanyinjiao, Saninko). EAT using an active electrode (the needle) at SP6 and a reference electrode (surface electrode) at the lateral-anterior aspect of the lower leg was applied at a frequency of 1 Hz for 20 minutes. The therapy was provided one session per week for a total of five sessions. Effects of the therapy were evaluated by using an original questionnaire (‘<I>Hie</I>’diary), which consisted of six categorical of 14 symptoms (including of‘<I>Hie</I>’) and Visual Analogue Scale (VAS) of‘severity of <I>Hie</I>’. Moreover, changes in health-related quality of life (HRQOL) by acupuncture were evaluated by using the SF-8 Standard Edition.<br><B>Results</B><br> Subjects were grouped according to their SF-8 BP scores before the therapy: 12 subjects (L group) whose scores were less than the national normal value (42.75 points), and eight subjects (H group) whose scores were more than the national normal value. For both groups VAS levels showed no statistically significant changes, but for the L group the total score of 14 symptoms significantly decreased after the second therapy session compared with scores before the therapy. Moreover, the statistically significant decrease in the total score lasted for one month after the therapy had been finished. Compared with before therapy, the score of ‘vitality’ (VT) significantly increased for the L group one month after the therapy, and those of BP and ‘mental health’ (MH) significantly increased for the L group just after and one month after the therapy.<br><B>Conclusions</B><br> EAT at SP6 on young women with ‘<I>Hie</I>’ symptoms (vasomotor dysfunction) contributes to improvement in overall condition and health-related QOL, and it is occluded that the effect of the EAT was high, because HRQOL was low (the score of BP was low).