ABSTRACT
AIM: To assess health-related quality of life (HRQoL) in patients with DM1, to identify muscular, multisystemic, central and social factors that may affect QoL and to define a DM1 patient in risk of poor QoL. PATIENTS AND METHOD: This cross-sectional study comprised 120 DM1 consecutive patients. The following scales were used: Multidimensional Scale of Perceived Social Support (MSPSS), Muscular Impairment Rating Scale (MIRS), battery of neuropsychological tests, acceptance of illness scale (AIS), Hamilton rating scale for depression (Ham-D), Krupp's Fatigue Severity Scale (FSS), Daytime Sleepiness Scale (DSS) and SF-36 questionnaire. RESULTS: HRQoL was impaired in DM1 patients in both physical and mental domains (PCS was 41.8±23.5, MCS 47.0±24.3 and total SF-36 score 45.6±24.0). The most significant factors correlating with better SF-36 total score were younger age (ß=-0.45, p<0.001), shorter duration of disease (ß=-0.27, p=0.001), higher education (ß=0.20, p=0.009), less severe muscular weakness (ß=-0.52, p<0.001), normal swallowing (ß=0.22, p=0.005), absence of fainting (ß=0.31, p=0.002), absence of snoring (ß=0.21, p=0.036), better acceptance of disease (ß=-0.17, p=0.036), lower depressiveness (ß=-0.46, p=0.001), lower fatigue (ß=-0.32, p=0.001), absence of cataract (ß=-0.21, p=0.034), absence of kyphosis (ß=0.31, p=0.004) and absence of constipation (ß=0.24, p=0.016). Second linear regression analysis revealed that depressed (ß=-0.38, p<0.001) and elder patients (ß=-0.27, p=0.007) and as well as those with poor acceptance of illness (ß=-0.21, p=0.006) were in especially higher risk of having poor HRQoL (R(2)=0.68). CONCLUSION: We identified different central, social, muscular, cardiorespiratory and other factors correlating with HRQoL. It is of great importance that most of these factors are amenable to treatment.
Subject(s)
Myotonic Dystrophy/physiopathology , Myotonic Dystrophy/psychology , Quality of Life , Adult , Central Nervous System/physiopathology , Cognition Disorders/etiology , Cognition Disorders/psychology , Cross-Sectional Studies , Depression/complications , Depression/psychology , Educational Status , Electromyography , Fatigue/complications , Fatigue/psychology , Female , Heart/physiopathology , Humans , Linear Models , Male , Marital Status , Middle Aged , Muscle, Skeletal/physiopathology , Neuropsychological Tests , Occupations , Respiratory System/physiopathology , Risk , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
Dental team and dentist's office should not represent an infective risk of transfer of bacterial and viral infections for patients. As the number of such infections is on an increase, we have to take additional measures of precaution besides the standard hygienic ones. We will protect ourselves by continuous use of personal protective means (gloves, masks, glasses, caps) and proper hand hygiene, and our patients by use of disposable facilities (plastic glasses, suction-pumps for saliva, injection needles, syringes, paper napkins). After each patient, all accessories and surfaces that were in contact with him should be disinfected, and the same applies to all matrices and prosthetic devices after oral testing. Efficient disinfectants should be used following the manufacturer's instructions thereby. Our offices should also be equipped with thermodisinfectors, ultrasonic cleaners and rapid autoclaves for sensitive instruments.
