Factors affecting the trajectory of health-related quality of life in COPD patients.

BACKGROUND: Health-related quality of life (HR-QoL) is an important issue in patients with chronic obstructive pulmonary disease (COPD), as in other chronic illness groups. However, there is limited information on longitudinal changes in HR-QoL over time with the illness trajectory model. OBJECTIVE: To identify different patterns of HR-QoL changes in longitudinal data, and reveal potential predictors affecting these trajectories. METHODS: Subjects with COPD (n = 249) were drawn from the Korean Obstructive Lung Disease cohort, which was conducted from 2005 to 2012. Longitudinal data were drawn from the St George's Respiratory Questionnaire and clinical measures. Growth mixture modelling was used to estimate distinct patterns, and binary and ordinal logistic regression were used to determine factors affecting different trajectory HR-QoL patterns using STATA 12.0. RESULTS: Five distinct HR-QoL patterns were identified. Results show that the level of baseline HR-QoL was significantly associated with age, the BODE (Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity) index at baseline, sleep disturbance, experience of exacerbation in previous year and level of depression. Distinct patterns in HR-QoL that improved vs. worsened were significantly associated with BODE index, number of respiratory symptoms and depression level. CONCLUSIONS: These findings suggest that comprehensive assessment and individualised management programmes are needed to improve HR-QoL in COPD patients.

Low Adherence to Immunosuppressants Is Associated With Symptom Experience Among Kidney Transplant Recipients.

PURPOSE: The purpose of this study was to investigate the relationship between immunosuppressant-related symptom experience (SE) and adherence to immunosuppressant regimens among kidney transplant (KT) recipients. METHODS: A total of 239 KT recipients on an immunosuppressant regimen who were followed up after transplantation participated in this study. Data was collected through a self-reported questionnaire survey (medication adherence, SE, and quality of life) and medical record review. RESULTS: Low adherence in the immunosuppressant group was associated with longer time since KT, less comorbidity (<3), and a higher rehospitalization rate. Low adherence among KT recipients showed significantly greater overall symptom occurrence (P = .001) and symptom distress (P = .002) levels than patients with high or medium adherence after adjusting for a number of covariates. The most common symptom both in terms of occurrence (96.4%) and distress (91.1%) among poorly adherent KT recipients was tiredness. CONCLUSION: Low adherence to an immunosuppressant regimen was significantly associated with high SE among KT recipients. Strategies to decrease immunosuppressant-related SE are needed to improve adherence to immunosuppressants.

Health behaviour and quality of life in Korean adults with respiratory disease: National Health Survey, 2005.

OBJECTIVES: To describe disease management, health behaviour, psychological health and quality of life (QOL) in people with chronic respiratory disease (CRD). METHODS: We analysed data from 798 adults with CRD drawn from the Korean National Health and Nutrition Examination Survey (KNHANES) 2005: 514 subjects with asthma alone, 258 with chronic obstructive pulmonary disease (COPD) alone, and 56 with asthma and COPD. RESULTS: Disease management and health behaviour in this cohort were poor. One third of the cohort was not seeking any medical treatment, although many were currently experiencing respiratory symptoms. Twenty-six per cent of the subjects were current smokers who averaged 0.8 packs/day. More than half of the subjects did not exercise, only half of the subjects had regular health examinations and one third of the subjects did not get enough sleep. The study population exhibited poor psychological indices, functional health status and QOL. The combined asthma and COPD group was characterised by an increased frequency of problems related to functional status and QOL. CONCLUSIONS: People with CRD are at high risk for functional limitations, unhealthy behaviour, poor mental status and poor QOL. A comprehensive disease management programme for people with CRD should be developed using collaborative team efforts.

Health-related quality of life among Koreans with chronic respiratory disease.

OBJECTIVE: To evaluate the health-related quality of life (HRQoL) and to identify physiological and psychosocial variables predicting the HRQoL among Korean people with chronic respiratory disease (CRD). DESIGN: A cross-sectional correlation study was done with a convenience sample of 112 participants (aged 62.9 +/- 12.9 years, forced expiratory volume in 1 second [FEV(1)%] predicted = 52.3 +/- 20.2) from the out-patient respiratory clinic of a large university hospital in Korea. HRQoL was measured using the chronic respiratory disease questionnaire (CRDQ). To identify the influencing factors, physiological (lung function, dyspnoea, symptom experience and exercise performance) and psychological (mood states and self-efficacy) variables were examined using path analysis. RESULTS: Participants had a moderate level of HRQoL, with the lowest scores in CRDQ-fatigue (3.3 +/- 1.3) and the highest in CRDQ-mastery (5.2 +/- 1.0). Anxiety and a depressive mood state (-0.38) exerted the highest influence on HRQoL, followed by self-efficacy (0.36), dyspnoea (-0.27), exercise performance (0.22) and respiratory symptoms (-0.17). CONCLUSION: Our findings emphasise the importance of a multidimensional therapeutic approach to improve HRQoL. Comprehensive interventions, including enhanced exercise performance, self-efficacy and symptom management, should be considered to improve HRQoL in Koreans with CRD.

Simple purification method for a Vibrio vulnificus hemolysin by a hydrophobic column chromatography in the presence of a detergent.

A Vibrio vulnificus hemolysin (VVH) was purified by two steps of hydrophobic column chromatography on Phenyl-Sepharose HP. The first chromatography was carried out at pH 6.0. In this pH condition, VVH efficiently bound to the column, but the hemolysin fraction eluted was accompanied with colored substance(s). To eliminate this colored substance, the second chromatography was carried out at pH 9.8 in the presence of 1% 3-[(3-cholamidopropyl) dimethylammonio]-1-propanesulfonate (CHAPS), a zwitterionic detergent. Homogeneity of the hemolysin thus obtained was shown by polyacrylamide gel electrophoresis. The specific activity increased 33,600 times and the yield was 35%. The method is simple and useful to supply enough VVH for study of the role of the hemolysin in the infection by V. vulnificus or on the mechanism of action of the hemolysin.

Studies on hemolytic action of a hemolysin produced by Vibrio mimicus.

Some properties and mechanism of action of a hemolysin (VMH) produced by an enteropathogenic Vibrio mimicus strain was examined. VMH was heat-labile and inhibited by addition of divalent cations, including Ca2+, Mg2+ and Mn2+. The hemolysis by VMH was inhibited by incubating with gangliosides, suggesting that the ganglioside was the binding site on the erythrocyte membrane for VMH. Existence of a galactose moiety on reducing end of the ganglioside molecule and a sialic acid on the galactose moiety was suggested to be important for the binding of VMH molecule. Colloid osmotic manner of the hemolysis by VMH was demonstrated.