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1.
Monogr Oral Sci ; 28: 14-21, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31940623

RESUMEN

An improvement in oral health, not least dental caries and periodontal disease, has been seen during the last 50 years. Oral health is essential for both general health and quality of life. The mouth is a window into the health of the body and signs of nutritional deficiencies can be seen in the mouth at an early stage. Dental caries still constitutes the most common oral condition worldwide. It is the net result of an ecological imbalance in the oral biofilm where metabolism of fermentable carbohydrates may result in demineralisation. Early diagnosis of disease symptoms and preventive strategies are important for disease management. Dental erosion, where loss of tooth substance is a result of exposure to acidic substances, has become a common condition. Intrinsic factors, including diet/drinks and intake habits, are common etiological causes. Periodontal diseases constitute chronic, biofilm-initiated inflammatory conditions with multifactorial origin including inherited and acquired risk factors. Preventive strategies focus on mechanisms, which may influence the amount and composition of the subgingival biofilm. Oral cancer is one of the most commonly found forms of malignancies worldwide. It is a highly complex condition where lifestyle factors, particularly smoking cessation and moderate alcohol consumption, play a major role as deterrents. Hyposalivation is of multifactorial aetiology and may influence oral health as well as various aspects of quality of life. To control oral health, it is important to increase our knowledge of oral disease aetiology and focus on oral health promotion and preventive strategies including the control of diet and nutritional risk factors.


Asunto(s)
Caries Dental , Enfermedades de la Boca , Enfermedades Periodontales , Humanos , Salud Bucal , Calidad de Vida
2.
Quintessence Int ; 51(2): 170-177, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31942577

RESUMEN

OBJECTIVE: Some patients with Down syndrome experience premature edentulism, which can lead to severe alveolar atrophy. This may cause retention problems with purely mucosa-supported dentures and ill-fitting total dentures. The intellectual disability associated with Down syndrome, with an (implied) inadequate ability for compliance, may pose a further challenge to dental treatment. The aim of this case report was to demonstrate that a combined implant-prosthetic denture with bar constructions can, nevertheless, be implemented in elderly Down syndrome patients with limited cooperation ability. METHOD AND MATERIALS: This report is the first to describe the procedure for an implant-supported total prosthetic restoration with bar joint in a 52-year-old edentulous patient with Down syndrome and limited ability to cooperate. Previous dental solutions had severely curtailed the patient's quality of life. By combining various forms of treatment, including behavior management, the course of therapy could be adapted to the patient's cooperation capability. RESULTS: The implant-supported total prosthetic restoration with bar joint was well accepted by the patient. Moreover, the patient's relatives reported that his life quality had improved distinctly (eg, considerable weight-gain, more positive mood). No impairments of the prostheses were observed during the 24-month follow-up period, and both implants remained clinically inconspicuous. CONCLUSION: The lack, or inadequacy, of dental prostheses can impair the life quality of individuals in need of such restorations. Implant-supported dentures in combination with a bar construction improve the retention of prostheses in atrophied jaws. This form of restoration is also proving to be a successful therapy option for elderly persons with Down syndrome.


Asunto(s)
Implantes Dentales , Síndrome de Down , Arcada Edéntula , Anciano , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Prótesis de Recubrimiento , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Calidad de Vida , Resultado del Tratamiento
3.
Rev Med Liege ; 75(1): 23-28, 2020 Jan.
Artículo en Francés | MEDLINE | ID: mdl-31920040

RESUMEN

Anemia and iron deficiency are two common comorbidities in heart failure with reduced ejection fraction (HFrEF) and are associated with a poor prognosis. In contrast to iron oral supplementation, administration of intravenous ferric carboxymaltose (Injectafer®) improves quality of life, exercise capacity, and seems to reduce hospitalizations for heart failure. Unfortunately, although anaphylactic reactions are extremely rare, it is recommended to administer Injectafer® in a suitable medical environment. This limitation hinders Injectafer® administration and may cause reluctance from both physician and patient. The aim of this article is to optimize and harmonize management of iron deficiency in heart failure, by proposing a simple solution for the patient and the practitioner.


Asunto(s)
Anemia Ferropénica , Insuficiencia Cardíaca , Hierro , Anemia Ferropénica/complicaciones , Anemia Ferropénica/tratamiento farmacológico , Insuficiencia Cardíaca/complicaciones , Humanos , Hierro/uso terapéutico , Calidad de Vida , Volumen Sistólico
4.
Medicine (Baltimore) ; 99(1): e18632, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31895823

RESUMEN

Health related quality of life (HRQOL) in chronic liver disease (CLD) patients has been attracting much attention these days because it is closely associated with clinical outcomes in CLD patients. HRQOL has become established as an important concept and target for research and practice in the fields of medicine. A critique of HRQOL research is the lack of conceptual clarity and a common definition of HRQOL. Using a clear definition of HRQOL may increase the conceptual understanding. In this study, we aimed to elucidate the association between serum zinc (Zn) level and HRQOL as assessed by the Beck Depression Inventory-2nd edition (BDI-II), Pittsburgh Sleep Quality Index Japanese version (PSQI-J) and the 36-Item Short Form Health Survey (SF-36) in CLD patients (n = 322, median age = 65 years, 121 liver cirrhosis (LC) patients (37.6%)). The median serum Zn level for all cases was 73.2 µg/dl. The median BDI-II score and PSQI-J score were 6 and 5, respectively. Patients with higher BDI-II score tended to have lower serum Zn level compared with those with lower BDI-II score. Similar tendencies were observed in patients with higher PSQI-J score. In the SF-36, physical functioning, role physical and physical component summary score significantly correlated with serum Zn level regardless of age, liver disease etiology and the LC status. While mental health and mental component summary score did not significantly correlate with serum Zn level regardless of age, liver disease etiology and the LC status. In conclusion, serum Zn level can be a useful marker for decreased HRQOL in patients with CLDs, especially for physical components.


Asunto(s)
Hepatopatías/sangre , Calidad de Vida , Zinc/sangre , Anciano , Femenino , Humanos , Hepatopatías/psicología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
5.
Medicine (Baltimore) ; 99(1): e16791, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31895764

RESUMEN

The present study aimed to investigate the feasibility of vaginal delivery combined with vaginal tightening surgery and perineal body repair.From January 2017 to April 2017, 5 cases underwent vaginal delivery combined with vaginal tightening surgery and perineal body repair. We retrospectively analyzed the clinical data.The incisions of 5 cases were all primary healing; vulva form was improved, and there were no postoperative hematoma, infection or vaginal mucosa prolapse. Sexual function was improved to different degrees. The pelvic muscle force test showed that both the type I and type II myofiber scores were increased.It is feasible to perform vaginal delivery combined with vaginal tightening surgery and perineal body repair, which is a safe and effective method for improving sex life and pelvic floor function.


Asunto(s)
Parto Obstétrico/efectos adversos , Vagina/cirugía , Adulto , Femenino , Humanos , Laceraciones/etiología , Laceraciones/cirugía , Diafragma Pélvico/fisiopatología , Diafragma Pélvico/cirugía , Perineo/lesiones , Perineo/cirugía , Embarazo , Calidad de Vida , Vagina/fisiopatología , Vulva/cirugía
7.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1047897

RESUMEN

Objetivo: apreender experiências de pessoas idosas que participam de grupos de convivência. Método: estudo descritivo, exploratório de abordagem qualitativa realizado com doze pessoas idosas que frequentam grupos de convivência em um município no interior da Bahia. A coleta dos dados foi realizada por meio de entrevista semiestruturada, dezembro de 2017 a fevereiro de 2018. Os dados foram analisados e interpretados conforme a análise de conteúdo temática proposta por Laurence Bardin. Resultados: após a análise emergiram seis categorias: melhoria na condição de saúde; evitar a solidão, fonte de suporte social; apoio e incentivo familiar; atividades aquáticas e dança. Conclusão: O estudo mostrou que a participação de pessoas idosas em grupos de convivência se mostra necessária, devido melhorias na qualidade de vida, na autoestima, na construção de vínculos e apoio social, no qual auxilia-as em todo o processo de envelhecimento


Objective: to learn the experiences of elderly people who participate in social groups. Method: a descriptive, exploratory study with a qualitative approach carried out with twelve elderly people who attend social groups in a municipality in the interior of Bahia. The data were collected through a semi structured interview, from December 2017 to February 2018. Data were analyzed and interpreted according to the thematic content analysis proposed by Laurence Bardin. Results: seven categories emerged after the analysis: improvement in health status; avoid loneliness, source of social support; family support and encouragement; water activities and dancing. Conclusion: The study showed that the participation of elderly people in social groups is necessary due to improvements in the quality of life, self-esteem, the forging of bonds and social support that help them throughout the aging process


Objetivo: aprehender experiencias de personas mayores que participan en centros de convivencia. Método: estudio descriptivo, exploratorio de abordaje cualitativo realizado con doce personas mayores que frecuentan grupos de convivencia en un municipio en el interior de Bahía. La recolección de los datos fue realizada por medio de una entrevista semiestructurada, diciembre de 2017 a febrero de 2018. Los datos fueron analizados e interpretados según el análisis de contenido temático propuesto por Laurence Bardin. Resultados: después del análisis emergieron siete categorías: mejora en la condición de salud; evitar la soledad, fuente de soporte social; apoyo y fomento de la familia; actividades acuáticas y danza. Conclusión: el estudio mostró que la participación de personas mayores en grupos de convivencia se muestra necesaria, debido a mejoras en la calidad de vida, en la autoestima, en la construcción de vínculos y apoyo social, en el que las auxilia en todo el proceso de envejecimiento


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Calidad de Vida , Centros para Personas Mayores/tendencias , Envejecimiento Saludable , Investigación Cualitativa , Servicios de Salud para Ancianos
8.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1047996

RESUMEN

Objetivo: identificar as atividades de vida diárias com dependência de cuidados de enfermagem. Método: estudo exploratório com abordagem qualitativa realizado com 52 pessoas em situação de rua na cidade de Sobral, Ceará, Brasil. Utilizou-se o modelo de atividade de vida diária proposto por Roper, Logan e Tierney para nortear a coleta e análise de dados. Resultados: as atividades de vida com maior dependência de cuidados são: alimentação, devido consumo irregular de nutrientes básicos, que promove um estado de desnutrição permanente, outra atividade foi trabalho e distração, pois os mesmos não possuem remuneração fixa e vivem do que arrecadam ao realizar atividades que geram pequenas quantias monetárias, além das atividades, morte, sexualidade, sono, respiração e eliminação, as quais também se revelaram comprometidas. Conclusão: a utilização do modelo com pessoas em situação de rua proporcionou abordagem holística aos indivíduos, por favorecer a investigação dos fatores que interferem na manutenção da saúde


Objetivo: identificar las actividades de la vida cotidiana con dependencia del cuidado de enfermeira. Método: estudio exploratorio con un enfoque cualitativo realizado con 52 personas en situación de calle en Sobral, Ceará, Brasil. El modelo de actividad de la vida diaria propuesto por Ropen, Logan y Tierney se utilizó para guiar la recolección y el análisis de datos. Resultados: las actividades de vida con mayor dependencia de cuidados son: alimentación, debido consumo irregular de nutrientes básicos, que promueve un estado de desnutrición permanente, otra actividad fue trabajo y distracción, pues los mismos no poseen remuneración fija y viven de lo que recaudan al realizar actividades que generan pequeñas cantidades monetarias, además de las actividades, muerte, sexualidad, sueño, respiración y eliminación, las cuales también se revelaron comprometidas. Conclusión: la utilización del modelo con personas en situación de calle proporcionó un enfoque holístico a los individuos, por favorecer la investigación de los factores que interfieren en el mantenimiento de la salud


Objective: identify daily Activities of Daily Living with dependence on nursing care. Method: exploratory study with a qualitative approach performed with 52 people in a street situation in Sobral, Ceará, Brazil. The daily Daily Living Activity model proposed by Ropen, Logan and Tierney was used to guide the data collection and analysis. Results: the activities of life with greater dependence on care are: food, due to irregular consumption of basic nutrients, which promotes a state of permanent malnutrition; another activity was work and entertainment, because they do not have fixed remuneration and live on what they collect by performing activities that generate small amounts of Money, besides activities such as death, sex, sleep, breathing and elimination, which are also compromised. Conclusion: the use of the model with people living on the street provided a holistic view of individuals, favoring the investigation of the factors that interfere in the maintenance of health


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Calidad de Vida , Personas sin Hogar , Modelos de Enfermería , Investigación Cualitativa , Pautas de la Práctica en Enfermería , Enfermería de Atención Primaria/métodos , Atención de Enfermería/métodos
10.
Quintessence Int ; 51(1): 18-26, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31781689

RESUMEN

OBJECTIVE: This study aimed to investigate the Epstein-Barr virus (EBV) prevalence and viral load in subgingival sites of human immunodeficiency virus type 1 (HIV-1) positive (HIV+) individuals, correlating subgingival EBV load to the clinical periodontal condition, HIV systemic load, EBV systemic load, and use of antiretroviral therapy (ART). METHOD AND MATERIALS: Ninety individuals were recruited and divided into three categories: those without periodontal disease (G1), with gingivitis (G2), and with periodontitis (G3). Subgingival biofilm and blood samples were analyzed by quantitative polymerase chain reactions (qPCR). A questionnaire was administered to collect general information about patients, and data regarding HIV and use of ART were accessed from their medical records. RESULTS: EBV was detected in 85.6% of the samples. Comparing subgingival and systemic load of EBV in G1, G2, and G3, there was a statistical difference only in G3 (3.93 log10 copies/mL and 5.47 log10 copies/mL, respectively; P = .014), where EBV load was higher in periodontal pockets than in the blood. All groups had high EBV loads in subgingival sites (> 2,000 copies/mL). A positive linear correlation between systemic HIV load and EBV subgingival load was found in G1 and G2 (r = 0.647; P < .001), but not in G3. Only G1 individuals using ART had lower subgingival EBV loads than those not using it (5.03 log10 copies/mL, and 7.14 log10 copies/mL, respectively; P = .0348). CONCLUSIONS: Subgingival sites, especially the periodontal pockets, are suggested to act as a reservoir of EBV in HIV+ individuals. Therefore, the identification of latent EBV infections in this easily accessible site might help to improve quality of life in patients with HIV by maintaining oral/periodontal health. In addition it might encourage new approaches in investigating EBV-associated disorders in HIV+ patients.


Asunto(s)
Infecciones por VIH , Herpesvirus Humano 4 , Brasil , Estudios Transversales , ADN Viral , VIH , Humanos , Reacción en Cadena de la Polimerasa , Calidad de Vida
11.
Oral Maxillofac Surg Clin North Am ; 32(1): 89-103, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31685343

RESUMEN

The surgery-first approach (SFA) has become a recent alternative to the conventional 3-stage approach to orthognathic surgery. Skeletal anchorage in orthodontics has facilitated the resurgence of this treatment sequence. By eliminating the presurgical phase of orthodontic treatment, patients have immediate resolution to their facial deformity. Treatment duration has been shown to be reduced; the difference with the conventional approach being approximately 5 months. Patient satisfaction with this approach is very high as measured by quality-of-life surveys. This article describes the indications and step-by-step approach of this technique in conjunction with virtual surgical planning.


Asunto(s)
Métodos de Anclaje en Ortodoncia , Ortodoncia Correctiva , Procedimientos Quirúrgicos Ortognáticos , Planificación de Atención al Paciente , Humanos , Satisfacción del Paciente , Calidad de Vida , Encuestas y Cuestionarios
12.
J Urol ; 203(1): 137-144, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31347951

RESUMEN

PURPOSE: We compared early continence recovery after surgical treatment of prostate cancer with Retzius sparing robot-assisted radical prostatectomy and conventional robot-assisted radical prostatectomy. MATERIALS AND METHODS: Robot-assisted radical prostatectomy was done by a single surgeon in 1,863 cases between October 2005 and May 2018 using the conventional and the Retzius sparing technique in 1,150 and 713, respectively. To compare continence outcomes between the groups propensity score matching was performed using 9 preoperative variables, including age, body mass index, prostate specific antigen, biopsy Gleason Grade Group, clinical T stage, prostate volume on transrectal ultrasound, and the I-PSS (International Prostate Symptom Score), I-PSS quality of life score and International Index of Erectile Function-5 scores. Continence was assessed by the pad count every month postoperatively until month 6 and was converted to a binary outcome. RESULTS: After propensity score matching 609 cases per group were matched with no significant difference in all 9 variables. The Kaplan-Meier curve analysis revealed that Retzius sparing robot-assisted radical prostatectomy was associated with a significantly better continence recovery rate than conventional robot-assisted radical prostatectomy during the 6-month study period (p <0.001). CONCLUSIONS: Based on propensity score matching with multiple variables and a large case series, Retzius sparing robot-assisted radical prostatectomy can be a candidate for future robot-assisted radical prostatectomy. It achieves better early continence recovery, a short operative time and early recovery compared to conventional robot-assisted radical prostatectomy.


Asunto(s)
Complicaciones Posoperatorias/fisiopatología , Prostatectomía/métodos , Neoplasias de la Próstata/cirugía , Procedimientos Quirúrgicos Robotizados/métodos , Incontinencia Urinaria/fisiopatología , Anciano , Disfunción Eréctil/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Puntaje de Propensión , Neoplasias de la Próstata/patología , Calidad de Vida , Recuperación de la Función
13.
J Urol ; 203(1): 185-192, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31347955

RESUMEN

PURPOSE: Sacral neuromodulation is a guideline recommended treatment of urinary dysfunction and fecal incontinence in patients in whom conservative treatments have failed. Historically sacral neuromodulation has been delivered using a nonrechargeable device with an average life span of 4.4 years. Surgery is required to replace the implanted neurostimulator due to battery depletion. Implantation of a long-lived implanted neurostimulator can eliminate the need for replacement surgeries, potentially reducing patient surgical risks and health care costs. The Axonics r-SNM System™ is a miniaturized, rechargeable sacral neuromodulation system designed to deliver therapy for at least 15 years. The ARTISAN-SNM (Axonics® Sacral Neuromodulation System for Urinary Urgency Incontinence Treatment) study is a pivotal study using rechargeable sacral neuromodulation therapy to treat urinary urgency incontinence. Six-month results are presented. MATERIALS AND METHODS: A total of 129 eligible patients with urinary urgency incontinence were treated. All participants were implanted with a tined lead and the rechargeable sacral neuromodulation system in a nonstaged procedure. Efficacy data were collected using a 3-day bladder diary, the validated ICIQ-OABqol (International Consultation on Incontinence Questionnaire Overactive Bladder quality of life) questionnaire and a participant satisfaction questionnaire. Therapy responders were identified as participants with a 50% or greater reduction in urinary urgency incontinence episodes compared to baseline. We performed an as-treated analysis in all implanted participants. RESULTS: At 6 months 90% of participants were therapy responders. The mean ± SE number of urinary urgency incontinence episodes per day was reduced from 5.6 ± 0.3 at baseline to 1.3 ± 0.2. Participants experienced a clinically meaningful 34-point improvement on the ICIQ-OABqol questionnaire. There were no serious device related adverse events. CONCLUSIONS: The Axonics r-SNM System is safe and effective with 90% of participants experiencing clinically and statistically significant improvements in urinary urgency incontinence symptoms.


Asunto(s)
Neuroestimuladores Implantables , Incontinencia Urinaria de Urgencia/terapia , Adulto , Anciano , Anciano de 80 o más Años , Suministros de Energía Eléctrica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Calidad de Vida , Sacro , Incontinencia Urinaria de Urgencia/fisiopatología
14.
J Urol ; 203(1): 159-163, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31441673

RESUMEN

PURPOSE: Patients who undergo cystectomy due to bladder cancer can elect an ileal conduit or a neobladder for urinary diversion. Decision regret related to this choice is an important and undesirable patient reported outcome. Our objective was to compare the severity of decision regret experienced by patients with a neobladder vs an ileal conduit. MATERIALS AND METHODS: We analyzed data from a longitudinal cohort study of patients who underwent cystectomy from 2013 to 2015. We applied multivariable linear regression to examine associations of the urinary diversion method (neobladder vs ileal conduit) with decision regret measured with the DRS (Decision Regret Scale) 6 and 18 months after cystectomy. Covariates included demographic and clinical characteristics, health care utilization and complications after cystectomy, quality of life and factors related to the decision making process, including informed and shared decision making, and goal concordance. RESULTS: Of the 192 patients in our cohort 141 received an ileal conduit and 51 received a neobladder. We observed no significant difference in the DRS score in patients with a neobladder vs an ileal conduit at 6 or 18 months (b=-1.28, 95% CI -9.07-6.53, vs b=-1.55, 95% CI -12.48-9.38). However, informed decision making was negatively related to decision regret at 6 and 18 months (b=-13.08, 95% CI -17.05--9.11, and b=-8.54, 95% CI -4.26--2.63, respectively). Quality of life was negatively associated with decision regret at 18 months (b=-5.50, 95% CI -8.95--2.03). CONCLUSIONS: Patients treated with cystectomy who were more informed about bladder reconstruction options experienced less regret independent of the method selected. Efforts to inform and prepare patients for the bladder reconstruction decision may help prevent decision regret.


Asunto(s)
Cistectomía , Toma de Decisiones , Neoplasias de la Vejiga Urinaria/cirugía , Derivación Urinaria/métodos , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Medición de Resultados Informados por el Paciente , Satisfacción del Paciente , Calidad de Vida , Neoplasias de la Vejiga Urinaria/patología
15.
J Oral Rehabil ; 47(1): 42-52, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31332814

RESUMEN

OBJECTIVES: To evaluate the oral health-related quality of life (OHRQoL) of patients with burning mouth syndrome (BMS) by comparing the Oral Health Impact Profile-14 (OHIP-14) and Geriatric Oral Health Assessment Index (GOHAI) tests, assessing their dependence with pain, anxiety and depression and, secondly, to analyse the changes in time after treatment with psychotropic drugs. METHODS: Twenty-six patients and 26 controls were included. The GOHAI, OHIP-14, visual analogue scale (VAS) and the Hamilton Rating Scales for Depression and Anxiety (HAM-D and HAM-A) were performed at baseline (time 0) and after 6 months of treatment (time 1). Descriptive statistics, the Mann-Whitney non-parametric test for two independent samples and the Wilcoxon non-parametric test for two paired samples were used. RESULTS: The scores from all outcome measurements were statistically significantly different between the cases and controls (P < .001) with a strong correlation between the GOHAI and the OHIP-14 (P < .001). The BMS patients showed a statistically significant improvement in the VAS, HAM-D and HAM-A scores from time 0 to time 1 (P < 0.001), and in the OHIP-14 scores (P < .004**) after the treatment, but no statistically significant difference in the GOHAI score (.464). CONCLUSIONS: Burning mouth syndrome patients showed poorer scores on all scales compared to the healthy subjects with a lower OHRQoL. OHIP-14 gives a greater weight to psychological and behavioural outcomes in evaluating oral health than GOHAI, and therefore, it is a more effective questionnaire in terms of the evaluation of the treatment response. The management of BMS can improve pain, anxiety and depression and the OHRQoL.


Asunto(s)
Síndrome de Boca Ardiente , Salud Bucal , Anciano , Evaluación Geriátrica , Humanos , Calidad de Vida , Encuestas y Cuestionarios
16.
BJOG ; 127(1): 28-35, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31541614

RESUMEN

BACKGROUND: Mesh surgery for stress urinary incontinence or pelvic organ prolapse can result in complications such as mesh exposure, mesh extrusion, voiding dysfunction, dyspareunia, and pain. There is limited knowledge or guidance on the effective management for mesh-related complications. OBJECTIVE: To determine the best management of mesh complications; a systematic review was conducted as part of the national clinical guideline 'Urinary incontinence (update) and pelvic organ prolapse in women: management'. SEARCH STRATEGY: Search strategies were developed for each indication for referral. SELECTION CRITERIA: Relevant interventions included complete or partial mesh removal, mesh division, and non-surgical treatments such as vaginal estrogen. DATA COLLECTION AND ANALYSIS: Characteristics and outcome data were extracted, and as a result of the heterogeneous nature of the data a narrative synthesis was conducted. MAIN RESULTS: Twenty-four studies were included; five provided comparative data and four studies stated the indication for referral. Reported outcomes (including pain, dyspareunia, satisfaction, quality of life, incontinence, mesh exposure, and recurrence) and the reported incidences of these varied widely. CONCLUSIONS: The current evidence base is limited in quantity and quality and does not permit firm recommendations to be made on the most effective management for mesh-related complications. Robust data are needed so that mesh complications can be managed effectively in the future. TWEETABLE ABSTRACT: Systematic review demonstrates that the outcomes following mesh revision surgery are highly variable.


Asunto(s)
Prolapso de Órgano Pélvico/cirugía , Mallas Quirúrgicas/efectos adversos , Incontinencia Urinaria de Esfuerzo/cirugía , Adolescente , Adulto , Anciano , Pérdida de Sangre Quirúrgica , Dispareunia/etiología , Femenino , Humanos , Complicaciones Intraoperatorias/etiología , Persona de Mediana Edad , Satisfacción del Paciente , Complicaciones Posoperatorias/etiología , Calidad de Vida , Recurrencia , Disfunciones Sexuales Fisiológicas/etiología , Resultado del Tratamiento , Adulto Joven
17.
Angiol Sosud Khir ; 25(4): 92-99, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31855205

RESUMEN

BACKGROUND: Post-thrombotic iliac vein lesion is one of the causes of secondary pelvic varicose veins (PVV) in women. Endovascular treatment of this cohort of patients requires further studies. AIM: The study was undertaken to investigate the aspects of endovascular treatment of female patients diagnosed as having PVV secondary to post-thrombotic alterations of the iliac veins. PATIENTS AND METHODS: Presented herein are the results of diagnosis and treatment of nine women suffering from PVV in obstructive lesion of the iliac veins. All patients underwent phlebography with stenting of the iliac veins, followed by clinical and instrumental assessment of efficacy of treatment. RESULTS: The technical success rate of stenting amounted to 100%. In the early postoperative period thrombotic complications developed in two women and in the remote period in one. The operation was followed by a decrease in the intensity of PVV manifestations, as well as chronic venous insufficiency of the lower limbs, which was confirmed by clinical and instrumental methods of objectification and visualization. The composite index of quality of life was noted to decrease from 47±5.3 to 27.8±3.3 points (p<0.05). The median of the composite value of the Pelvic Venous Clinical Severity Score decreased by 8.6±1.8 points (p<0.05). The average value of the composite index of the Venous Clinical Severity Score (VCSS) diminished by 6.8±1.4 points (p<0.05) and that of the Villalta score by 8.3±1.6 points (p<0.05). CONCLUSION: Pelvic varicose veins appear to develop in two of three women after endured thrombosis. The experience with stenting of the iliac veins demonstrated good efficacy and safety. Efficiency of the intervention was determined by improved quality of life of the patients and positive dynamics of the clinical course of the disease.


Asunto(s)
Procedimientos Endovasculares , Vena Ilíaca/cirugía , Trombosis/complicaciones , Várices/cirugía , Femenino , Humanos , Vena Ilíaca/diagnóstico por imagen , Flebografía , Calidad de Vida , Stents , Resultado del Tratamiento , Várices/diagnóstico por imagen , Várices/etiología
18.
Angiol Sosud Khir ; 25(4): 108-115, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31855207

RESUMEN

AIM: The purpose of the study was to compare the results of using compression knitwear and elastic bandaging in the postoperative period after endovasal laser coagulation in patients with varicose veins. PATIENTS AND METHODS: A total of forty 20-to-55-year-old women with a body mass index of ≤ 35 kg/m2 and CEAP class C2-C3 lower limb varicose veins were randomized into two numerically equal groups. The Study Group included those receiving postoperative compression on the operated leg with the help an elastic stocking, whereas in the Comparison Group compression was achieved by laying an elastic bandage. Both group women underwent laser coagulation of the great saphenous vein and removal of separate veins with the help of Mueller hooks. Efficacy of compression therapy was comparatively assessed based on the results of interviewing the patients prior to intervention and 1 month thereafter, as well as by the level of pain syndrome according to the visual analogue scale at 24 and 48 postoperative hours, by the time spent by the personnel for bandaging of the limb or putting on the compression stocking intraoperatively and at the first dressing, by the degree of lower limb oedema and dynamics of regression thereof, by the area of postoperative haematoma and its dynamics after 2, 7 days and at 1 month. Besides, we evaluated the findings of ultrasonographic angioscanning of lower limb veins at one month postoperatively. RESULTS: The obtained findings demonstrated that efficacy of using a medical compression stocking after the procedure of endovasal laser coagulation in women with varicose veins was comparable to that of elastic bandaging. By the incidence rate and area of extension of postoperative haematomas, degree of pain syndrome, patient-oriented assessment using the Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ), condition of veins according to the findings of ultrasonographic angioscanning no significant differences were revealed between the two methods of elastic compression of the leg. However, using a medical stocking appeared to promote a statistically significant 1.4-1.6-fold reduction in the time spent for formation of elastic compression of the lower limb, as well as a decrease in the incidence rate and degree of local oedema of the lower limb in the postoperative period.


Asunto(s)
Vendajes de Compresión , Coagulación con Láser/métodos , Várices/terapia , Procedimientos Endovasculares , Femenino , Humanos , Calidad de Vida , Medias de Compresión , Resultado del Tratamiento , Várices/complicaciones , Várices/cirugía , Insuficiencia Venosa/etiología , Insuficiencia Venosa/cirugía , Insuficiencia Venosa/terapia
19.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(12): 835-840, 2019 Dec 09.
Artículo en Chino | MEDLINE | ID: mdl-31874484

RESUMEN

Objective: To cross-cultural adapt the English version of obturator functioning scale (OFS) to form a simplified Chinese version, to preliminarily verify its reliability and validity in clinic, and to provide an effective tool for evaluating the oral function and quality of life of patients with palatal defect and restored with obturators in China. Methods: The English version of the OFS was taken for forward translation, synthesis, back-translation, and reviewed by expert committee to develop a pre-testing simplified Chinese version. This scale contained demographic data, basic information of diseases, eating problems dimensions (3 items), speech problems dimensions (5 items), and other problems dimensions (7 items). From December, 2016 to December, 2018, forty-two patients who were treated in the Department of Prosthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University with palatal defect and restored with obturators were evaluated with OFS. Among them, there were 26 males, and 21-84 years old, and 16 females, who were 24-80 years old.The reliability and validity of the data were examined and analyzed. Results: The results showed that Cronbach's α coefficients of the overall scale and the three dimensions (eating problems, speech problems, and other problems) were 0.926, 0.938, 0.930, and 0.935, respectively. The internal consistency of the questionnaire was very good. The Spearman coefficients between each single dimension and the total score were 0.677, 0.792, and 0.860, respectively, suggesting that the scale convergence was good. The content validity index of 15 items was 0.905, indicating that the content validity was very good. Conclusions: The Chinese version of the OFS is exhibiting high reliability and validity, providing an effective evaluation tool of oral function and quality of life for Chinese patients with obturator prostheses to restore palate defects.


Asunto(s)
Lenguaje , Calidad de Vida , Encuestas y Cuestionarios , Traducciones , Adulto , Anciano , Anciano de 80 o más Años , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , Salud Bucal , Medicina Oral , Reproducibilidad de los Resultados , Adulto Joven
20.
Expert Rev Pharmacoecon Outcomes Res ; 19(6): 663-676, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31859542

RESUMEN

Introduction: Health anxiety, also known as 'hypochondriasis', is a common, distressing and costly condition that responds to cognitive behavior therapy (CBT) but evidence pertaining to response and remission rates, treatment in routine care, therapist-guided Internet-delivered CBT (ICBT) and health economics has not been systematically reviewed.Areas covered: In this systematic review and meta-analysis we searched PubMed, PsycINFO, and OATD (17/06/2019) for randomized controlled trials (RCTs) comparing CBT to non-CBT controls for health anxiety. Based on 19 RCTs, the pooled between-group effect on health anxiety was moderate to large (g = 0.79; 95% CI: 0.57-1.01; adjusted for publication bias: g = 0.62), with small to moderate effects on secondary symptoms and effects largely sustained 12-18 months after treatment. Moderators were control condition and recruitment path, but not treatment setting. The pooled CBT response rate was 66%, and the remission rate 48%. ICBT had effects comparable to face-to-face CBT. CBT for health anxiety is probably cost-effective, but with limited effect on the quality of life.Expert opinion: CBT is a highly efficacious and probably cost-effective treatment for health anxiety. We recommend that ICBT is implemented more widely, and that health economic outcomes and ways of increasing response and remission rates are explored further.


Asunto(s)
Terapia Cognitivo-Conductual/métodos , Hipocondriasis/terapia , Terapia Cognitivo-Conductual/economía , Análisis Costo-Beneficio , Economía Médica , Humanos , Hipocondriasis/economía , Internet , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
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