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At least 937 records · Page 52Linked to original sources
PubMed2000

Differences in sexual function and quality of life after nerve sparing and nonnerve sparing radical retropubic prostatectomy.

PURPOSE: We determine the impact of nerve sparing techniques on quality of life after radical retropubic prostatectomy for prostate cancer. MATERIALS AND METHODS: The RAND/UCLA Prostate Cancer Index and several questions about surgical outcomes, including sexual function, were sent to 170 consecutive patients at least 1 year after radical retropubic prostatectomy. Statistical analysis was performed on data for the entire group as well as subgroups of patients after nerve sparing and nonnerve sparing surgery. RESULTS: Nonnerve sparing surgery was performed in 83 of 129 responders (nonnerve sparing group) and the remaining 46 were treated with unilateral nerve sparing surgery (nerve sparing group). Scores for sexual function, sexual bother, physical function and physical limitation domains were significantly better in the nerve sparing group. Spontaneous erectile activity was reported by 50% of nerve sparing group patients. Nerve sparing status did not affect urinary function, bowel function or disease outcome. CONCLUSIONS: Nerve sparing techniques have positive effects on quality of life and sexual function for patients undergoing radical retropubic prostatectomy.

Adenocarcinoma↗
PubMed2003

The influence of COPD on health-related quality of life independent of the influence of comorbidity.

BACKGROUND/OBJECTIVES: The goal of this study was to determine the influence of chronic obstructive pulmonary disease (COPD) on health-related quality of life (HRQL) independent of comorbidity. METHODS: Patients with COPD in general practice, >/=40 years, were selected. To recruit controls, a random sample of persons without COPD and >/=40 years, was taken. HRQL was assessed with the SF-36 and comorbidity was determined by questionnaire. RESULTS: The influence of COPD on HRQL independent of comorbidity (represented by adjusted regression coefficients) was significant for physical functioning (-27.6), role functioning due to physical problems (-21.6), vitality (-14.4), and general health (-25.7), and was minor and not significant for social functioning (-5.6), mental health (-1.3), role functioning due to emotional problems (-2.7), and bodily pain (-2.5). Comorbidity contributed significantly to the HRQL of all domains (-7.6 to -27.1). CONCLUSIONS: COPD patients can be impaired in all domains of HRQL. However, impairments in physical functioning, vitality, and general health are related to COPD and to some extent to comorbidity, while impairments in social and emotional functioning do not seem to be related to COPD, but only to comorbidity.

Aged↗
PubMed2002

Colocalization, physical, and functional interaction between Werner and Bloom syndrome proteins.

The RecQ helicase family comprises a conserved group of proteins implicated in several aspects of DNA metabolism. Three of the family members are defective in heritable diseases characterized by abnormal growth, premature aging, and predisposition to malignancies. These include the WRN and BLM gene products that are defective in Werner and Bloom syndromes, disorders which share many phenotypic and cellular characteristics including spontaneous genomic instability. Here, we report a physical and functional interaction between BLM and WRN. These proteins were coimmunoprecipitated from a nuclear matrix-solubilized fraction, and the purified recombinant proteins were shown to interact directly. Moreover, BLM and WRN colocalized to nuclear foci in three human cell lines. Two regions of WRN that mediate interaction with BLM were identified, and one of these was localized to the exonuclease domain of WRN. Functionally, BLM inhibited the exonuclease activity of WRN. This is the first demonstration of a physical and functional interaction between RecQ helicases. Our observation that RecQ family members interact provides new insights into the complex phenotypic manifestations resulting from the loss of these proteins.

Adenosine Triphosphatases↗
PubMedDate not supplied

Quality of life in patients with heart failure: do gender differences exist?

OBJECTIVE: The purpose of this study was to evaluate gender differences in quality of life (QOL) in a large sample of age-matched and ejection fraction (EF)-matched patients with heart failure. DESIGN: Matched comparisons of secondary data were used. SETTING: The setting consisted of multicenter Studies of Left Ventricular Dysfunction trials. SAMPLE: The sample included 1382 patients (691 men and 691 women) who were age-matched and EF-matched. OUTCOME MEASURES: Global QOL and the QOL dimensions of physical function, emotional distress, social health, and general health were measured using the Ladder of Life, items from the Profile of Mood States Inventory, the Functional Status Questionnaire, the beta-Blocker Heart Attack Trial instrument, and an item from the RAND Medical Outcomes Study instrument. RESULTS: Women had significantly worse general life satisfaction, physical function, and social and general health scores than men. There were no significant differences found between gender groups for current life situation or emotional distress. After controlling for New York Heart Association classification, women still had significantly worse ratings for intermediate activities of daily living (a sub-dimension of physical functioning) and social activity. CONCLUSIONS: Despite controlling for age, EF, and New York Heart Association classification, women had worse QOL ratings than did men for intermediate activities of daily living and social activity. Research should focus on identifying why differences exist and developing measures to improve QOL, particularly physical functioning, in women with heart failure.

Female↗
PubMed2004

Six-month and one-year followup of 23 weeks of aerobic exercise for individuals with fibromyalgia.

OBJECTIVE: To measure mood and physical function of individuals with fibromyalgia, 6 and 12 months following 23 weeks of supervised aerobic exercise. METHODS: This is a followup report of individuals who were previously enrolled in 23 weeks of land-based and water-based aerobic exercise classes. Outcomes included the 6-minute walk test, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory, Arthritis Self-Efficacy Scale (ASES), Fibromyalgia Impact Questionnaire (FIQ), tender point count, patient global assessment score, and exercise compliance. Outcomes were measured at the start and end of the exercise classes and 6 and 12 months later. RESULTS: Analyses were conducted on 29 (intent-to-treat) or 18 (efficacy) subjects. Six-minute walk distances and BDI total scores were improved at followup (all analyses). BDI cognitive/affective scores were improved at the end of 23 weeks of exercise (both analyses) and at the 12-month followup (efficacy analysis only). BDI somatic scores were improved at 6-month (both analyses) and 12-month followup (intent-to-treat only). FIQ and ASES function were improved at all followup points. ASES pain was improved in efficacy analyses only (all followup points). Tender points were unchanged after 23 weeks of exercise and at followup. Exercise duration at followup (total minutes of aerobic plus anaerobic exercise in the preceding week) was related to gains in physical function (6- and 12-month followup) and mood (6-month followup). CONCLUSION: Exercise can improve physical function, mood, symptom severity, and aspects of self efficacy for at least 12 months. Exercising at followup was related to improvements in physical function and perhaps mood.

Activities of Daily Living↗
PubMed2004

The role of perceived and actual disease status in adjustment to rheumatoid arthritis.

OBJECTIVES: To examine the role and relative impact of illness perceptions, coping strategies and clinical disease indicators on adjustment in patients with rheumatoid arthritis. METHOD: Participants were 75 women with rheumatoid arthritis. The Illness Perception Questionnaire (IPQ), the COPE questionnaire and the Arthritis Impact Measurement Scale (AIMS) were administered during a semistructured interview. Disease status was indicated by physician ratings of joint involvement and by the laboratory indices of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). RESULTS: Statistically significant correlations (P<0.01) were in the expected direction. Various aspects of adjustment (good physical function, low pain and depression) were associated with perceptions of low illness identity, high control/cure, more serious illness consequences and long illness timeline. Low disease activity was related to good physical function. Depression was associated with high use of coping by denial and with less frequent use of five COPE strategies: active coping, planning, seeking instrumental social support, positive reinterpretation and growth, and acceptance. In hierarchical regression analysis, disease status explained variance in physical function (15%). Illness perceptions accounted for variance in all three adjustment outcomes, ranging from 22 to 27%. Coping variables did not add to the explanation of variance on adjustment. CONCLUSIONS: Illness perceptions have significant implications for adaptation to illness and they outweigh the impact of medical disease status on depression, physical function and pain. Health interventions based on understanding and modifying perceptions of illness may prove useful in facilitating patient well-being.

Adaptation, Psychological↗
PubMed1999

Relationship between psychological profile and cardiological variables in chronic heart failure. The role of patient subjectivity.

AIM: To analyse the relationships between the psychological profile, the satisfaction profile and cardiological variables in patients with chronic heart failure. MATERIAL AND METHODS: One hundred and fifty-two male patients with chronic heart failure in a stable clinical condition underwent cardiological evaluation and psychological assessment by means of two instruments: the Cognitive Behavioural Assessment 2.0 Battery and the Satisfaction Profile. RESULTS: Patients scored higher than healthy subjects in terms of psychophysiological disorders and depression. Patients in NYHA class III reported higher anxiety and depression scores and had more frequent problems in daily life than patients in NYHA classes I and II. Class III patients also reported lower satisfaction levels in many aspects of psychological and physical functioning. Pulmonary resistances >2.5 Wood units, pulmonary capillary wedge pressure >0. 18 mmHg and a diagnosis of ischaemic cardiomyopathy were associated with low satisfaction levels in the Satisfaction Profile 'physical functioning' factor. To be listed for heart transplantation and a history of more than three hospitalizations were related to low satisfaction levels in many items of the Satisfaction Profile. Finally, stepwise multiple regression showed that NYHA class, depression score and pulmonary capillary resistance accounted for 32% of the variance in the Satisfaction Profile physical functioning factor score. CONCLUSION: On the basis of chronic heart failure diagnosis only, a generic pattern of psychological distress can be predicted, common to many severe chronic diseases. Shifting from objective mental health measures towards the domain of subjective satisfaction, the only link which emerges is between objective cardiological data and satisfaction with physical functioning. Satisfaction in terms of other life aspects does not seem to be related to cardiological variables. These results support the importance of subjectivity in health related quality of life, as well as objective measures.

Adult↗
PubMed1999

Health behaviors, social networks, and healthy aging: cross-sectional evidence from the Nurses' Health Study.

Physical function is a significant component of health-related quality of life among older adults. Potential correlates of healthy aging, including health behaviors and social network characteristics, were examined among 56,436 US women aged 55-72 in 1992. Healthy aging was assessed by maintenance of physical function measured by four subscales of the Medical Outcomes Study Short Form (SF)-36 Health Survey: physical functioning; role limitations; freedom from bodily pain; and vitality. Individual health behaviors, defined as current smoking, alcohol consumption, sedentary behavior, and being overweight each contributed to significant decrements in functioning across all age-groups. After controlling for these health behaviors and other confounders (age, race, education, and co-morbid conditions), elements of a woman's social network were significantly correlated with functional status. Strong predictors of high functioning among older women were having close friends and relatives and presence of a confidant. For example, the absence of a confidant was associated with a 4.44 point reduction in physical functioning (95% CI: -7.0, -1.9), and a 5.68 point reduction in vitality (95% CI: -7.9, -3.4). These effects were comparable in magnitude to those observed among heavy smokers, or women in the highest category of body mass index.

Aged↗
PubMed2004

Predictors of quality of life in older people living at home and in institutions.

BACKGROUND AND AIMS: Health-related quality of life (QOL) is considered to be the key goal for health promotion in older people. The aim of this study was to describe the correlates of QOL in home-dwelling and institutionalized elderly. METHODS: One hundred and fifty-two elderly residents of long-term care homes and 160 community-dwelling elderly participated in the study. Assessment included demographic and social variables, health status, nutritional state, physical and cognitive function. Physical activity (PA) was assessed by two PA questionnaires: the Seven Day Recall PA Questionnaire and the Stanford Usual Activity Questionnaire. QOL was assessed with the Euroqol 5D questionnaire. RESULTS: Depression was the most powerful predictor of QOL in both community-dwelling and institutionalized elderly. Complaints associated with the musculoskeletal system in community-dwelling elders and manifestations of atherosclerosis and cardiovascular diseases in institutionalized elders were the most important concomitant diseases. Regular participation in PA, preventing obesity and maintaining an adequate level of physical and cognitive function, contributed more to overall QOL in community-dwellers than in older and frailer institutionalized elderly adults. CONCLUSIONS: The relative contribution of functional and medical comorbidities, as well as health-promoting behaviors to QOL, may be different in community-dwelling and institutionalized elders. Physical and cognitive function deficits, overweight/obesity, and lack of regular PA are among primary predictors of decreased QOL in home-dwelling elders. In institutionalized subjects, these functional/behavioral data seem to be of lesser importance, the role of concomitant diseases becoming dominant.

Aged↗
PubMed1998

Education and health in the Czech Republic.

Researchers in the United States have found that education and health are related. This relation may be due to the better market position of the educated, their greater store of personal and social resources, and/or their healthier lifestyle. These three connections between education and health are tested in the Czech Republic with three waves of panel data. We regress self-reports of health and physical functioning in 1994 on multiple indicators of market position in 1994, change in market position from 1989 to 1994, personal/social resources and health lifestyle with demographic controls. These regressions are followed by a longitudinal analysis of changes in panel members' health and physical functioning between 1994 and 1996. The cross-sectional results are similar to those in the United States with important exceptions. Unlike the United States, market position does fully mediate the relation between education and health in the Czech Republic, largely through subjective feelings regarding market position. The longitudinal analysis shows that prior health and physical functioning mediate the effect of education on health and physical functioning in 1996.

Adult↗
PubMed2005

Impaired health status and invasive treatment in peripheral arterial disease: a prospective 1-year follow-up study.

OBJECTIVE: It has been argued that health status and quality of life (QOL) should be taken into account in the treatment policy of patients with peripheral arterial disease (PAD). In cardiac patients, it has been shown that poor perceived health status is an independent predictor of mortality and hospitalization. We therefore examined (1) the role of health status, QOL, and clinical indices of disease severity as determinants of invasive treatment in patients with PAD and (2) the effect of invasive treatment on health status and QOL. METHODS: At their first visit, patients completed the RAND 36-item Health Survey and World Health Organization Quality of Life assessment instrument questionnaires to assess health status and QOL, respectively. During the 1-year follow-up period, data concerning hospitalization were derived from the patients' medical files. Furthermore, patients completed the RAND 36 and the World Health Organization Quality of Life assessment instrument again at 1-year follow-up. The setting was a vascular outpatient clinic of a teaching hospital in Tilburg, The Netherlands; participants were 200 consecutive patients newly diagnosed with intermittent claudication, a common expression of PAD. Diagnosis was based on history, physical examination, treadmill walking distance, and ankle-brachial pressure indices. Main outcome measures were (1) invasive treatment of PAD that took place during the 1-year follow-up, derived from the patients' medical files, and (2) health status and QOL after 1 year of follow-up. RESULTS: After 1 year of follow-up, 107 patients (53.5%) were event free, whereas 77 patients (38.5%) had been hospitalized for invasive treatment of PAD. Sixteen patients (8%) were hospitalized for other cardiovascular reasons. In a multivariate logistic regression model, age (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.91-0.99; P = .024), pain-free walking distance (OR, 2.74; 95% CI, 1.05-7.17; P = .04), and physical functioning (OR, 4.46; 95% CI, 1.79-11.12; P = .001) were independent predictors of invasive treatment of intermittent claudication. After 1 year of follow-up, patients who were treated invasively experienced a significant improvement in their physical functioning ( P = .004), role limitations due to emotional problems ( P = .018), and bodily pain ( P = .026). CONCLUSIONS: Patients with poor self-reported physical functioning, limited walking distance, and a younger age were likely to be treated invasively. The physician's clinical judgment about when to intervene adequately reflects the patient's own opinion about his or her health status. Invasive treatment led to a significant improvement in patients' health status. These findings indicate the effectiveness of the strategy to include patients' perceived physical functioning into the process of clinical decision-making.

Adult↗
PubMed1997

Price of adaptation--allostatic load and its health consequences. MacArthur studies of successful aging.

BACKGROUND: Exponential growth in the population of older adults presents clinicians with special concerns about factors affecting risks for declines in cognitive and physical functioning. OBJECTIVES: To examine the hypothesis that risks for such declines and for disease outcomes, such as cardiovascular disease, are related to differences in allostatic load, the cumulative physiologic toll exacted on the body over time by efforts to adapt to life experiences. To present an operational definition of allostatic load, along with preliminary evidence of its predictive validity in relation to salient outcomes of aging. METHODS: Data from a longitudinal, community-based study of successful aging were used to develop a measure of allostatic load based on 10 parameters reflecting levels of physiologic activity across a range of important regulatory systems. Allostatic load is the sum of the number of parameters for which the subject was rated in the highest-risk quartile. RESULTS: Higher allostatic load scores were associated with poorer cognitive and physical functioning and predicted larger decrements in cognitive and physical functioning as well as being associated with an increased risk for the incidence of cardiovascular disease, independent of sociodemographic and health status risk factors. CONCLUSIONS: Findings are consistent with the conceptualization of allostatic load as an index of wear and tear on the body, with elevations in allostatic load predicting an increased risk for a decline in cognitive and physical functioning as well as cardiovascular disease in a cohort of older men and women. From a clinical perspective, the concept of allostatic load may provide the basis for a more comprehensive assessment of major risks in the aging process.

Adaptation, Physiological↗
PubMed2005

Early disease course and predictors of disability in juvenile rheumatoid arthritis and juvenile spondyloarthropathy: a 3 year prospective study.

OBJECTIVE: . To describe the 3 year disease course in early juvenile rheumatoid arthritis (JRA) and juvenile spondyloarthropathy (JSpA), to compare the health status after 3 years of followup with that of normal controls, and to investigate the relationship between physical function at followup and disease characteristics recorded during the first 6 months. METHODS: One hundred and ninety-seven children (median age 6:6 yrs) with JRA and JSpA and disease duration <1.5 years were examined by a pediatric rheumatologist every 6 months for a median of 3.1 years. Controls were randomly selected from the National Population Register. Physical and psychosocial health was assessed by means of the Child Health Questionnaire and the Childhood Health Assessment Questionnaire (CHAQ). Disease course was analyzed by analysis of variance for repeated measurements. RESULTS: Health status and disease activity improved over time. Treatment with disease modifying antirheumatic drugs was started in 58% of the patients at baseline. Patients with persistent oligoarthritis had the most favorable disease course. The patients with juvenile ankylosing spondylitis (JAS), syndrome of seronegative enthesopathy and arthropathy (SEA), and rheumatoid factor (RF) positive polyarthritis had the poorest health status. A significant improvement for the whole group was observed after 3 years in all measures of disease activity and health status, except pain. Patients had poorer physical function and general health and more pain than controls. Predictors of reduced physical function at followup were a high CHAQ disability index and a poor well-being assessed during the first 6 months. CONCLUSION: Health status and disease activity improved over time in patients under medical treatment. The patients with JAS/SEA and RF positive polyarthritis had poorer health than the patients in other subtypes. A high disability index and a poor well-being at baseline predicted reduced physical function after 3 years.

Adolescent↗
PubMed2005

[Physical training for nursing home residents--has it any effect?].

BACKGROUND: The paper presents documentation of the effect of physical training for nursing home residents. MATERIAL AND METHODS: Literature study based on review articles and exercise trials in nursing home populations. RESULTS AND INTERPRETATION: The relatively few studies available indicate that physical training in a nursing home setting could be carried out. One study, reporting the effect of a fourfold increase in physiotherapy and occupational therapy, found positive effects on physical functioning and nursing costs. Furthermore, training is reported to improve aspects of physical functioning, like muscle strength and mobility. Several studies report effect on incontinence of low-dose physical exercises combined with scheduled toilet training. No study reports effect of physical training alone on the incidence of falls among nursing home residents. Nevertheless, physical training seems to improve physical fitness and functioning, cognition and behaviour. It is suggested that physical training for nursing home residents is carried out routinely in order to maintain physical functioning. Important aspects of such training are muscle strength, balance, coordination, endurance and flexibility. However, the most crucial type of training is active participation in the activities of daily life in order to prevent loss of independence.

Accidental Falls↗
PubMed1999

Clustering and the design of preference-assessment surveys in healthcare.

OBJECTIVE: To show cluster analysis as a potentially useful tool in defining common outcomes empirically and in facilitating the assessment of preferences for health states. DATA SOURCES: A survey of 224 patients with ventricular arrhythmias treated at Kaiser Permanente of Northern California. STUDY DESIGN/METHODS: Physical functioning was measured using the Duke Activity Status Index (DASI), and mental status and vitality using the Medical Outcomes Study Short Form-36 items (SF-36). A "k-means" clustering algorithm was used to identify prototypical health states, in which patients in the same cluster shared similar responses to items in the survey. PRINCIPAL FINDINGS: The clustering algorithm yielded four prototypical health states. Cluster 1 (21 percent of patients) was characterized by high scores on physical functioning, vitality, and mental health. Cluster 2 (33 percent of patients) had low physical function but high scores on vitality and mental health. Cluster 3 (29 percent of patients) had low physical function and low vitality but preserved mental health. Cluster 4 (17 percent of patients) had low scores on all scales. These clusters served as the basis of written descriptions of the health states. CONCLUSIONS: Employing a clustering algorithm to analyze health status survey data enables researchers to gain a data-driven, concise summary of the experiences of patients.

Adult↗
PubMed1995

Quality of life analyses from vinorelbine (Navelbine) clinical trials of women with metastatic breast cancer.

The effect of therapy on a patient's quality of life (QOL) is an important factor in choosing a treatment, especially when the primary intent of therapy is palliation of symptoms. An increasing recognition of the importance of QOL prompted inclusion of QOL assessments in a number of clinical trials of women with breast cancer. This report describes two clinical trials in which women with metastatic breast cancer were treated with intravenous (IV) vinorelbine (Navelbine; Burroughs Wellcome Co, Research Triangle Park, NC; Pierre Fabre Médicament, Paris, France). In a randomized trial, IV vinorelbine was compared with IV melphalan (Alkeran; Burroughs Wellcome Co) as second- or third-line treatment in patients with anthracycline-refractory breast cancer. In a second, nonrandomized study, vinorelbine was used as first- or second-line treatment in patients who had not received doxorubicin previously. Both studies assessed the QOL dimensions of physical functioning, symptom status, role functioning, and global QOL. In the randomized trial, analyses of linear time trends indicated that patients treated with vinorelbine compared with patients receiving IV melphalan had better physical functioning throughout most of the study. Differences between the two treatment groups in other QOL dimensions were not significant. In the nonrandomized study, patients who received vinorelbine as first-line therapy had worse role functioning and somewhat worse physical functioning than those who received the drug as second-line treatment. Overall, these studies suggest that patients who receive IV vinorelbine treatment maintain a reasonable QOL and that this agent is comparable to or better in some respects than IV melphalan.

Antineoplastic Agents↗
PubMedDate not supplied

Comparison of quality of life before and after coronary artery bypass surgery and percutaneous transluminal angioplasty.

OBJECTIVE: To compare quality of life, mood state, and physical functioning before and after revascularization in patients who have undergone coronary artery bypass grafting (CABG) and percutaneous transluminal angioplasty (PTCA). DESIGN: Quasiexperimental. SETTING: Hospital (university, Veteran's Administration, private) and home. SAMPLE: Patients who had undergone elective CABG (n = 44) and PTCA (n = 32); mean age 57.9 years (standard deviation, 8.2 years). OUTCOME MEASURES: Quality of life, mood state, physical functioning. RESULTS AND CONCLUSION: Patients who have undergone CABG and PTCA are similar in quality of life, mood state, and physical functioning before revascularization. Quality of life did not change from baseline in either group. Mood state and physical functioning improved for both CABG and PTCA groups after the procedure, but there was significantly greater improvement in the PTCA group. Future research needs to evaluate changes in these parameters over a longer period of time and to explore interventions to maximize outcomes.

Affect↗