[The quality of life of patients with atherosclerosis of lower extremities - 15-year observation]. / Jakosc zycia chorych z miazdzyca zarostowa tetnic konczyn dolnych ­ obserwacja 15-letnia.

An improving quality of life of a patient seems to be the primary goal of contemporary medicine facing the controversies arising over the duration of persistent therapy, on the one hand, and mounting costs of health care, on the other. AIM: The aim of the study was to assess the applicability of the SF-36 (Short Form Health Survey) quality-of-life scale to the evaluation of patients with lower-extremity atherosclerosis and to find a link with the new composite endpoint of the study which the quality of life predisposes to. MATERIALS AND METHODS: The patients operated on for lower-extremity atherosclerosis (y-graft) in one centre in the years 1999-2004 were invited to take part in the study. 64 out of 172 patients joined the study. The study participants were assessed for the quality of life, distance intermittent claudication and lower-extremity pulse presence. Information was also collected on their past medical history and life style. The works of the study group undertaken in 2021 thanks to cooperation with the Ministry of Digitalization allowed to determine deaths among the study participants and link them to the information collected earlier, including the quality of life. RESULTS: It was confirmed that the SF-36 scale, a tool from the group of general tools, i.e. a tool not dedicated to any particular disease, allows to perfectly assess the quality of life in the studied group of patients. The assessments obtained in the SF-36 subscales were higher for patients with an at least 10-year post-surgery survival. Yet, it is the differences observed in the analysis of the three variables, namely, social functioning (t=3.825, p<0.001), limitations due to emotional problems (t=3.496, p=0.001) and emotional well-being (t+2.179, p=0.033) that are statistically significant. CONCLUSIONS: The results of the study indicate that the main factors differentiating patients who die within 10 years from the surgery and those with an over-10 survival are primarily emotional well-being related issues.

The Spanish Family Quality of Life Scales under and over 18 Years Old: Psychometric Properties and Families' Perceptions.

BACKGROUND: Family quality of life (FQoL), just like individual quality of life, has become a priority outcome in the policies and services received by persons with intellectual and developmental disabilities (IDD) and their families. Conceptualizing, measuring, and theorizing FQoL has been the object of investigation in recent decades. The goal of this paper is to present a revision of the Spanish Family Quality of Life Scales, the CdVF-E < 18 and the CdVF-E >18, and describe the FQoL of Spanish families with a member with IDD. METHODS: The sample included a total of 548 families with a member under 18 years old and 657 families with a member over 18. Based on an Exploratory Factor Analysis (EFA) firstly and a Confirmatory Factor Analysis (CFA) secondly, the two scales' psychometric properties were explored. RESULTS: The CdVF-ER < 18 and the CdVF-ER > 18 comprise 5 dimensions, containing 35 and 32 items, respectively, and they show good validity and reliability. The families obtained a high FQoL score, although some differences exist between the dimensions on which families with children under and over 18 score highest and lowest. CONCLUSION: The characteristics of the revised scales facilitate their use by professionals, administrations, and services.

Factors affecting age of onset of menopause and determination of quality of life in menopause.

Menopause is a process in the climacteric period, characterized by a reduction in ovarian activity, a fall in the fertility rate, and a range of symptoms including irregular menstruation intervals. Most women enter menopause in their 40s, but this can vary from one individual to another. Although there are many factors affecting the age of menopause onset, there is no general agreement on them. Studies have shown many factors to affect the age of menopause, such as the mother's age at menopause, the age at menarche, gestational age, use of oral contraceptives, irregular menstrual cycle, number of pregnancies, body mass index, use of tobacco and alcohol, physical activity, unilateral oophorectomy, serum lead levels, consumption of polyunsaturated fat, socioeconomic status and educational level. During this period, hormonal and biochemical changes give rise to various symptoms in the woman's body. In menopause period, physical, psychological, social and sexual changes have a negative effect on quality of life in women. Recently, different measures have been used to assess women's quality of life in this period of change. The purpose of this review was to examine the factors affecting the onset age of menopause and the measures of quality of life related to menopause.

Investigation of responsiveness indices of generic and specific measures of health related quality of life in patients with osteoporosis.

PURPOSE: To compare responsiveness Short Form-36 (SF-36), Nottingham Health Profile (NHP), and QUALEFFO-41 scales in patients diagnosed with osteoporosis. METHODS: A number of 70 osteoporosis patients who were in their menopause period at least for three years were enrolled in our study. The patients completed Short Form-36 (SF-36), Nottingham Health Profile (NHP), and QUALEFFO-41 scales during pretreatment period and one year after the termination of the treatment. Reponsiveness was compared between questionnaires using standardized responsiveness mean (SRM), the effect size (ES), and Guyatt's method. RESULTS: All scales revealed statistically significant improvement after the treatment. Upon this finding, calculations related with responsiveness indices for SF-36 (Physical Health and Mental Health), NHP (Total point), and QUALEFFO-41 (Total point) demonstrated highly responsive. ES=1.67 and 1.55, SRM=1.55 and 1.85, Guyatt value=2.20 and 1.91 for SF-36 Physical Health and Mental Health. ES=1.35, SRM=1.35, Guyatt value=1.72 for NHP. QUALEFFO-41's ES=2.56, SRM=4.32 and Guyatt value=2.31. CONCLUSION: Osteoporosis specific scale as QUALEFFO-41, gives more specific information about the quality of life of osteoporotic patients. If patients with osteoporosis will be compared with other diseases regarding quality of life, then SF-36, one scale was used to evaluate general quality life of such patients, should be preferred against NHP.

[Advanced Parkinson's disease: clinical characteristics and treatment (part 1)]. / Enfermedad de Parkinson avanzada. Características clínicas y tratamiento (parte I).

INTRODUCTION: A large percentage of patients with Parkinson's disease (PD) develop motor fluctuations, dyskinesias, and severe non-motor symptoms within 3 to 5 years of starting dopaminergic therapy, and these motor complications are refractory to treatment. Several authors refer to this stage of the disease as advanced Parkinson's disease. OBJECTIVE: To define the clinical manifestations of advanced PD and the risk factors for reaching this stage of the disease. DEVELOPMENT: This consensus document has been prepared by using an exhaustive literature search and by discussion of the contents by an expert group on movement disorders of the Sociedad Española de Neurología (Spanish Neurology Society), coordinated by two of the authors (JK and MRL). CONCLUSIONS: Severe motor fluctuations and dyskinesias, axial motor symptoms resistant to levodopa, and cognitive decline are the main signs in the clinical phenotype of advanced PD.

A systematic review of patient-reported outcome instruments of nonmelanoma skin cancer in the dermatologic population.

BACKGROUND: Treatment of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) has traditionally focused on minimizing recurrence and complication rates. However, the assessment of patient satisfaction and quality of life (QOL) is also important. These outcomes are best assessed by patient-reported outcome (PRO) instruments. OBJECTIVES: We sought to conduct a systematic review of published PRO instruments purporting to measure aspects associated with QOL and/or patient satisfaction in the dermatologic BCC/SCC population and evaluate their development, content, and psychometric properties. METHODS: PubMed, Embase, Cochrane via Wiley, PsycINFO, CINAHL, and HaPI from inception to April 2011 were searched. Articles that discussed the instrument development and validation process were included. RESULTS: A total of 2212 articles were identified. Twenty met our inclusion criteria resulting in 6 PRO instruments: 3 general dermatology (Skindex, Dermatology Life Quality Index, dermatology quality of life scales), 1 general plastic surgery (Patient Outcomes of Surgery-Head/Neck), and 2 skin cancer-specific (Skin Cancer Index, disease-specific questionnaire). The 6 instruments all underwent some degree of formal development and validation, however, only the Skin Cancer Index was developed and validated in the BCC/SCC population. LIMITATIONS: The review may not have included all relevant PRO instruments. CONCLUSIONS: The Skin Cancer Index demonstrates the most evidence of its usefulness in patients with BCC/SCC. The Skindex-16, Dermatology QOL Scales, and Dermatology Life Quality Index target different aspects of QOL and should be used depending on the specific question being investigated. The Patient Outcomes of Surgery-Head/Neck may be beneficial to assess perceptions in appearance before and after surgical intervention.

Prevalencia de la sintomatología urogenital en mujeres indígenas colombianas en posmenopausia / Prevalence of urogenital symptoms among Colombian indigenous postmenopausal women

Introducción: el deterioro de la calidad de vida en las mujeres posmenopáusicas es diferente según el grupo étnico al cual pertenecen. Objetivo: comparar la frecuencia de síntomas urogenitales y el deterioro de la dimensión urogenital en mujeres indígenas en posmenopausia. Metodología: se estudió por medio de la Menopause Rating Scale a 609 mujeres posmenopáusicas, entre 40 y 59 años, de tres asentamientos indígenas colombianos: 161 (26,4%) de diferentes etnias residentes en la Amazonia, 297 (48,8%), zenúes y 151 (24,8%), wayuús. Resultados: el puntaje de la dimensión urogenital en las indígenas amazónicas fue 3,8 ± 3,2; en las zenúes, 6,2 ± 1,3 y en las wayuús, 2,9 ± 2,6; el puntaje del grupo total en esta dimensión fue 4,8 ± 2,7, todos más altos que los de otras poblaciones colombianas y latinoamericanas. El puntaje total de la MRS fue: 13,8 ± 8,2 en las amazónicas, 14,7 ± 2,5 en las zenúes y 10,0 ± 6,7 en las wayuús. En 9,1% del grupo total se encontraron síntomas severos con respecto a problemas sexuales, en 48,0% había incontinencia urinaria y en 12,1%, sequedad vaginal. El 42% tenían deterioro de la dimensión urogenital. Conclusiones: las mujeres indígenas en posmenopausia de las tres poblaciones estudiadas tienen alta prevalencia y aparición precoz de síntomas relacionados con la dimensión urogenital. La mitad de la población estudiada, con edad promedio de 53 años, tiene deteriorada la esfera urogenital.

Introduction: Deterioration of life quality in postmenopausal women differs according to their ethnicity. Objective: To compare the frequency of urogenital symptoms and the deterioration of the urogenital dimension in indigenous postmenopausal women belonging to three different communities. Methods: By means of the Menopausal Rating Scale, 609 indigenous postmenopausal women, aged between 40-59 years, were studied: 161 (26.4%) belonged to different Amazonic tribes, 297 (48.8%) were Zenu and 151 (24.8%), Wayuu. Results: Scores in the urogenital dimension were as follows: 3.8 ± 3.2 in the Amazonic women; 6.2 ± 1.3 in the Zenu community, and 2.9 ± 2.6 among the Wayuu. The score for the whole group was 4.8 ± 2.7; all these scores are higher than those of other Colombian and Latinamerican populations. Total score in the MRS was 13.8 ± 8.2 (Amazonic women), 14.7 ± 2.5 (Zenu), and 10.0 ± 6.7 (Wayuu). In the whole group, 9.1% had severe symptoms concerning sexual problems, 48.0% had urinary incontinence, and 12.1% suffered from vaginal dryness. The urogenital dimension was altered in 42%. Conclusion: Indigenous postmenopausal Colombian women belonging to different communities have high prevalence and early appearance of symptoms related to the urogenital dimension. Half of the studied population, with average age 53 years, have urogenital deterioration.