[Correlation between the SF-8 health status questionnaire and JRQLQ in patients with Japanese cedar pollinosis].

BACKGROUND: It is reported that the health-related quality of life (HRQL) is an important outcome in the Japanese Cedar Pollinosis (JCP) treatment. In Japan, the disease-specific Japan Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ) and the generic SF-36 Health Survey (SF-36) has been used. The aim of this study is to investigate more profitable QOL by using both the disease-specific questionnaire and the non-disease-specific questionnaire together. METHODS: 411 patients with JCP who visited 10 ENT clinics in Osaka from March 14 to March 26 (peak pollen season) in 2005 were questioned, and 240 patients were engaged in this study as subjects. In this study, the QOL scores were evaluated using the JRQLQ and SF-8 Health Survey (Japanese Version), a new, even shorter generic health survey. RESULTS: Using factor analysis and the correlation matrix, we showed that the disease-specific and the general health instrument covered a different half the total measurable HRQL. There was some correlation between the SF-8 items with the JRQLQ domains. There was little correlation between the SF-8 items and symptom scores, while, there was high correlation between the JRQLQ and symptom scores. The "Usual daily activities" domain in the JRQLQ correlated with any rhinoconjunctivitis symptoms. CONCLUSION: Both JRQLQ and SF-8 can be used to assess the quality of life of patients with JCP. Each instrument measures the aspects of the HRQL that hardly overlaps. For an assessment of the HRQL in JCP that is complete and responsive both instruments should be employed together.

[Quality of life in patients with Japanese cedar pollinosis: using the SF-8 health status questionnaire (Japanese version)].

BACKGROUND: The number of patients with Japanese cedar pollinosis (JCP) is increasing, and now, has extended up to about 15% of the Japanese. It is reported that the QOL is an important outcome in the JCP treatment. This study aimed to evaluate the QOL in patients with JCP by means of the SF-8 Health Survey (Japanese Version), a new, even shorter generic health survey. METHODS: 411 patients with JCP who visited 10 ENT clinics in Osaka from March 14 to March 26 (peak pollen season) were questioned, and 204 patients without any treatments in this season were engaged in this study as subjects. In this study, the QOL scores were evaluated using the SF-8. This is an 8-item version of the SF-36 that yields a comparable 8-dimension health profile and comparable estimates of summary scores for the physical and mental components of health. RESULTS: The QOL score depressed in the patients with JCP compared with healthy subjects (Japanese national norms). Both Mental Component Score (MCS) and Physical Component Score (PCS) scores decreased more in females than in males. In females, MCS were significantly lower than national norms. The older the patients were, the lower PCS scores were showed. The severity of nasal symptoms influenced the PCS scores. CONCLUSION: These results showed the tendency similar to the early studies using SF-36 questionnaire. The sensitivity of SF-8 in the individual is not better than that of other specific QOL questionnaires, but SF-8 can be answered in a short time compared with other questionnaires including SF-36. We suggested that SF-8 become a useful questionnaire in the future.

Laryngeal tuberculosis: a report of 15 cases.

Laryngeal tuberculosis is usually a complication of pulmonary tuberculosis. Recent studies have described a change in the clinical features of laryngeal tuberculosis. We present 15 cases of laryngeal tuberculosis treated at the Osaka Prefectural Habikino Hospital between 1993 and 2000. The results showed a mean age of 51 years, a male predominance by 2.75 to 1, and a 20% incidence (n = 3) of negative chest radiographic findings. The prominent presenting symptom was hoarseness (73.3%), and systemic symptoms were relatively rare. Seven patients showed ulcerative lesions, 5 showed granulomatous lesions, and the remaining 3 showed nonspecific inflammatory lesions in the larynx. Laryngeal lesions did not show any predilection for specific laryngeal sites in our series. In contrast to earlier studies, our study shows variations in clinical features of laryngeal tuberculosis. Physicians should consider tuberculosis in the differential diagnosis of laryngeal disease.

Tuberculous otitis media: clinical aspects of 12 cases.

The clinical features of tuberculous otitis media (TOM) have changed. This study was performed to evaluate changing trends in the clinical manifestations of TOM. We reviewed a series of 12 cases of TOM (13 ears) recently treated at Osaka Prefectural Habikino Hospital. The results showed a mean age of 41 years and a male predominance of 1.4 to 1. Central or total perforations of the tympanic membrane were observed in most cases, but none of the patients had multiple perforations. Nine patients (75%) had active pulmonary tuberculosis. Normal lung status or inactive pulmonary tuberculosis was significantly more frequent in the older age group. Diagnosis of primary TOM required more time than that of secondary TOM. Most cases of primary TOM had high infectiousness of the primary lesion. We summarize the clinical features of patients who should be evaluated for TOM.

Measurement of quality of life during different clinical phases of Japanese cedar pollinosis.

OBJECTIVE: To assess Quality of Life (QOL) scores in patients with Japanese cedar (Cryptomeria japonica, CJ) pollinosis. METHODS: QOL was measured intraseasonally and extraseasonally in patients (n = 69) using the Medical Outcomes Study Short-Form Health Survey, and compared with healthy control subjects (n = 50). The differences in intraseasonal QOL scores between short and long disease duration groups were studied. The relation of intraseasonal QOL scores to nose symptoms was evaluated using Spearman's rank correlation. RESULTS: Significant decrease was observed in two of eight QOL items in intraseasonal measurements of patients. These QOL impairments improved extraseasonally. Scores for emotional problems in patients with long disease duration were less impaired than those with short disease duration. QOL scores in patients correlated poorly with the severity of nasal symptom. CONCLUSIONS: This is the first study to report QOL impairment in CJ pollinosis. Based on the findings long disease duration may improve emotional problems, and the correlation between disease severity and QOL is low.

[Willingness to pay and quality of life in patients with Japanese-cedar pollinosis].

Seasonal allergic rhinitis (SAR) is one of the world's most common health problems because it's a high-cost, high-prevalence disease. In this study, we investigated patients' willingness to pay (WTP) for prevention and cure from most common SAR, Japanese-cedar pollinosis. Two hundred and forty patients with Japanese-cedar pollinosis, who visited 4 clinics in Osaka and were measured QOL by the SF-36 Questionnaire (Japanese version) during pollen season, were mailed WTP questionnaire in off-season in 1998. Completed questionnaires were sent back by 175 patients. Most patients (83.5%) were willing to pay less than 10,000 yen. Patients with longer duration of disease or severer nasal symptom tended to be more willing to pay. In contrast, no association was found between WTP and sex, age, occupation and comorbid condition. There were significant impairments in five of eight QOL dimensions in patients of Much-WTP in comparison with Less-WTP. Patients with mild symptom had significant higher medication cost than those with less mild symptom. We conclude that effective treatment, even if it costs much, can satisfy patients and may help to reduce indirect costs as well as to lessen the impact of Japanese-cedar pollinosis on QOL for both patient and society.

[Willingness to pay for Japanese cedar pollinosis: comparison between pollination and non-pollination seasons].

Allergic rhinitis is not fatal illness, but its high prevalence and several symptoms result in substantial medical cost. There is increasing interest in the use of economic evaluations in healthcare; therefore, we investigated patients' willingness to pay (WTP) for prevention and cure from Japanese cedar pollinosis (JCP), and compared WTP values assessed in non-pollination season (June 1998) and pollination season (February-March 2003). Japanese economic woes got worse in 2003 than in 1998. Patients were randomly selected from ENT clinical sites in Osaka, 175 and 645 patients completed WTP questionnaire in 1998 and 2003, respectively. WTP value was lower in 2003 than in 1998, which related to part-time employees and housewives' reducing WTP. Declining WTP value did not associated with the differences in patient characteristics between 1998 and 2003 including age, duration of disease, nasal symptom severity and comorbid condition. These results show that we have to take employment status into account in economic evaluations. Decline in WTP for JCP in 2003 was strongly affected by Japanese sluggish economy, and the WTP seemed to be stable value in individual patients.

[Report of 2 cases of tuberculous retoropharygeal abscess in adults].

We report 2 cases of tuberculous retoropharyngeal abscess. Case 1 was a 21-year-old man with tuberculous cervical spondylitis and pulmonary tuberculosis and Case 2 was a 32-year-old woman with tuberculous lymph adenitis and military tuberculosis. Both reported sore throat and dysphagea. In case 1, throat examination showed a bulging abscess at the posterior wall of the pharynx. X-ray examination of the neck showed a massive soft tissue swelling on the lateral view. As soon as the diagnosis was established, prompt focal aspiration was done since the increasing danger of grave respiratory distress was expected. And moreover, surgical incision and drainage of retropharyngeal abscess were indicated. In case 2, intraoral midline incision through the posterior wall of the pharynx was administered because the abscess was small and limited. Though various tuberculous statics and antibiotics are available, tuberculous retropharyngeal abscess still occurs and should be considered to ensure rapid adequate attention to diagnosis and treatment.