Relationship between Obesity and Health-Related Quality of Life in Men

Objective: Few studies examining the relationship between obesity and health-related quality of life (HRQOL) have used a medical outpatient population or demonstrated a relationship in men. Furthermore, most studies have not adequately considered comorbid illness. The goal of this study was to examine the relationship between body mass index (BMI) and HRQOL in male outpatients while considering comorbid illness. Research Methods and Procedures: This cross-sectional study examined 1168 male outpatients from Durham Veterans’ Affairs Medical Center. Multiple linear regression was used to examine the relationship of BMI with each subscale from the Medical Outcomes Study Short Form 36 while adjusting for age, race, comorbid illness, depression, and physical activity. Results: Participants had a mean age of 54.7 ± 5.6 years; 69% were white and 29% were African American. The distribution for BMI was as follows: 18.5 to <25 kg/m² (21%), 25 to <30 kg/m² (43%), 30 to <35 kg/m² (25%), 35 to <40 kg/m² (8%), and ≥40 kg/m² (3%). Mean Short Form 36 subscale scores were lower than U.S. norms by an average of 27%. Individuals with BMI ≥40 kg/m² had significantly lower scores compared with normal weight individuals on the Role-Physical and Vitality subscales. On the Physical Functioning and Physical Component subscales, lower scores were observed at BMI ≥35 kg/m². On the Bodily Pain subscale, lower scores were observed at BMI ≥25 kg/m². Discussion: An inverse relationship between BMI and physical aspects of HRQOL exists in a population of male outpatients. Increased BMI was most prominently associated with bodily pain; this relationship should receive more attention in clinical care and research.     

A randomised controlled trial of a self-management education program for osteoarthritis of the knee delivered by health care professionals

Introduction

Our aim in the present study was to determine whether a disease-specific self-management program for primary care patients with osteoarthritis (OA) of the knee (the Osteoarthritis of the Knee Self-Management Program (OAK)) implemented by health care professionals would achieve and maintain clinically meaningful improvements in health-related outcomes compared with a control group.

Methods

Medical practitioners referred 146 primary care patients with OA of the knee. Volunteers with coexistent inflammatory joint disease or serious comorbidities were excluded. Randomisation was to either a control group or the OAK group. The OAK group completed a 6-week self-management program. The control group had a 6-month waiting period before entering the OAK program. Assessments were taken at baseline, 8 weeks and 6 months. The primary outcomes were the results measured using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) Pain and Function subscales on the Short Form 36 version 1 questionnaire (SF-36) Secondary outcomes were Visual Analogue Scale (VAS) pain, Timed Up &; Go Test (TUG), knee range of motion and quadriceps and hamstring strength-isometric contraction. Responses to treatment (responders) and minimal clinically important improvements (MCIIs) were determined.

Results

In the OAK group, VAS pain improved from baseline to week 8 from mean (SEM) 5.21 (0.30) to 3.65 (0.29) (P ≤ 0.001). During this period, improvements in the OAK group compared with the control group and responses to treatment were demonstrated according to the following outcomes: WOMAC Pain, Physical Function and Total dimensions, as well as SF-36 Physical Function, Role Physical, Body Pain, Vitality and Social Functioning domains. In addition, from baseline to week 8, the proportion of MCIIs was greater among the OAK group than the control group for all outcomes. For the period between baseline and month 6, WOMAC Pain, Physical Function and Total dimensions significantly improved in the OAK group compared to the control group, as did the SF-36 Physical Function, Role Physical, Body Pain, Vitality and Social Functioning domains, as well as hamstring strength in both legs. During the same period, the TUG Test, range of motion extension and left-knee flexion improved compared with the control group, although these improvements had little clinical relevance.

Conclusions

We recorded statistically significant improvements compared with a control group with regard to pain, quality of life and function for participants in the OAK program on the basis of WOMAC and SF-36 measures taken 8 weeks and 6 months from baseline.     

Trigeminal Neurosensory Deficit and Patient Reported Outcome Measures: The Effect on Quality of Life

Objectives

To investigate the effect of persistent neurosensory disturbance of the lingual nerve (LN) or inferior alveolar nerve (IAN) on general health and oral health- related quality of life (QoL).

Methods

The study design was a case-control study. Patients with persistent neurosensory deficit of LN or IAN after lower third molar surgery (for 12 months or more) were the study group. The control group was an age and gender matched sample of patients who had dental extractions or lower third molar surgeries without trigeminal neurosensory deficit. The outcome variables were the general health and oral health-related QoL. General health-related QoL was assessed using the 36-item Short Form Health Survey (SF-36) and oral health-related QoL using the 14-item Short Form Oral Health Impact Profile (OHIP-14). Differences in SF-36 scores and OHIP-14 scores between the groups were compared.

Results

Forty-eight subjects (24 cases and 24 controls) were recruited. When compared to the control group, patients with neurosensory deficits had poorer Mental-Health Component Scores (MCS) (p = 0.005), General Health (p = 0.023), Vitality (p = 0.048), Social Functioning (p = 0.003), Role-emotion (p = 0.008) and Mental Health (p = 0.022). The OHIP-14 scores were also significantly worse in this patients with neurosensory deficits compared with the control group (p = 0.002). When compared within the study group, older patient with neurosensory deficit was found to correlate with worse Physical Health Component Scores (PCS) (p = 0.02) and OHIP-14 scores (p = 0.02), while more severe visualized analog scaling rating of numbness was correlated with a worse PCS (p = 0.034).

Conclusions

Patients with persistent LN or IAN deficit after lower third molar surgery have poorer health-related QoL and poorer oral health-related QoL than those without such deficits.     

The effect of a 12-week combined exercise intervention program on physical performance and gait kinematics in community-dwelling elderly women

This study aimed to determine if combined exercise intervention improves physical performance and gait joint-kinematics including the joint angle and dynamic range of motion (ROM) related to the risk of falling in community-dwelling elderly women. A 12-week combined exercise intervention program with extra emphasis on balance, muscle strength, and walking ability was designed to improve physical performance and gait. Twenty participants attended approximately two-hour exercise sessions twice weekly for 12 weeks. Participants underwent a physical performance battery, including static balance, sit and reach, whole body reaction time, 10 m obstacle walk, 10 m maximal walk, 30-second chair stand, to determine a physical performance score, and received quantitative gait kinematics measurements at baseline and in 12 weeks. Significant lower extremity strength improvement 13.5% (p<.001) was observed, which was accompanied by significant decreases in time of the 10 m obstacle walk (p<.05) and whole body reaction time (p<.001) in this study. However, no significant differences were seen for static balance and flexibility from baseline. For gait kinematics, in the mid-swing phase, knee and hip joint angle changed toward flexion (p<.01, p<.05, respectively). Ankle dynamic ROM significantly increased (p<.05) following exercise intervention. The plantar flexion angle of the ankle in the toe-off phase was increased significantly (p<.01). However, other gait parameters were not significantly different from baseline. These findings from the present investigation provide evidence of significant improvements in physical performance related to the risk factors of falling and safe gait strategy with a combined exercise intervention program in community-dwelling elderly women. The results suggest this exercise intervention could be an effective approach to ameliorate the risk factors for falls and to promote safer locomotion in elderly community-dwelling women.     

Validation of a parent-proxy, obesity-specific quality-of-life measure: sizing them up

The aims of the present study were to develop and validate a new obesity-specific, parent-proxy measure of health-related quality of life (HRQOL), Sizing Them Up. Participants included 220 obese youth (M(age) = 11.6 years, 68% female, 53% African American, M(BMI) = 36.7) and their primary caregivers (88% mothers). Primary caregivers completed a demographics questionnaire and two HRQOL measures: Sizing Them Up (obesity-specific) and PedsQL (generic). Youth height and weight were measured. Psychometric evaluation of Sizing Them Up was completed by conducting a factor analysis and determining internal consistency coefficients, test-retest reliability, convergent and discriminant validity, predictive validity, responsiveness to change, and minimal clinically important difference (MCID) scores. Sizing Them Up is a 22-item measure with six scales (i.e., Emotional Functioning, Physical Functioning, Teasing/Marginalization, Positive Social Attributes, Mealtime Challenges, and School Functioning) that account for 66% of the variance. The measure also includes an Adolescent Developmental Adaptation module. Sizing Them Up had internal consistency coefficients ranging from 0.59 to 0.91 and test-retest reliabilities ranging from 0.57 to 0.80. Validity was demonstrated by significant relations between a majority of Sizing Them Up scales and BMI z-scores. Sizing Them Up also demonstrated good convergent validity with other HRQOL measures and responsiveness to change related to weight loss for adolescents who had undergone bariatric surgery. Overall, Sizing Them Up is a reliable and valid parent-proxy measure of obesity-specific HRQOL that can be used in both clinical and research settings.     

Clinical Correlates of Health Preference and Generic Health-Related Quality of Life in Patients with Colorectal Neoplasms

Background

The aims of the study were to assess the health preference and health-related quality of life (HRQOL) in patients with colorectal neoplasms (CRN), and to determine the clinical correlates that significantly influence the HRQOL of patients.

Methods

Five hundred and fifty-four CRN patients, inclusive of colorectal polyp or cancer, who attended the colorectal specialist outpatient clinic at Queen Mary Hospital in Hong Kong between October 2009 and July 2010, were included. Patients were interviewed with questionnaires on socio-demographic characteristics, and generic and health preference measures of HRQOL using the SF-12 and SF-6D Health Surveys, respectively. Clinical information on stage of disease at diagnosis, time since diagnosis, primary tumour site was extracted from electronic case record. Mean HRQOL and health preference scores of CRN patients were compared with age-sex matched controls from the Chinese general population using independent t-test. Multiple linear regression analyses were conducted to explore the associations of clinical characteristics with HRQOL measures with the adjustment of socio-demographic characteristics.

Results

Cross-sectional data of 515 eligible patients responded to the whole questionnaires were included in outcome analysis. In comparison with age-sex matched normative values, CRN patients reported comparable physical-related HRQOL but better mental-related HRQOL. Amongst CRN patients, time since diagnosis was positively associated with health preference score whilst patients with rectal neoplasms had lower health preference and physical-related HRQOL scores than those with sigmoid neoplasms. Health preference and HRQOL scores were significantly lower in patients with stage IV colorectal cancer than those with other less severe stages, indicating that progressive decline from low-risk polyp to stage IV colorectal cancer was observed in HRQOL scores.

Conclusion

In CRN patients, a more advanced stage of disease was associated with worse HRQOL scores. Despite potentially adverse effect of disease on physical-related HRQOL, the mental-related HRQOL of CRN patients were better than that of Chinese general population.     

Erythrocyte polyunsaturated fatty acid status, memory, cognition and mood in older adults with mild cognitive impairment and healthy controls

Polyunsaturated fatty acid (PUFA) levels are altered in adults with cognitive decline and also depression. Depression facilitates progression from mild cognitive impairment (MCI) to dementia. We investigated associations between omega-3 (n-3) and omega-6 (n-6) PUFAs and cognition, memory and depression in 50 adults ≥65 years with MCI and 29 controls. Memory, depressive symptoms and erythrocyte PUFAs (% total fatty acids) were assessed. Eicosapentaenoic acid (EPA) was lower in MCI vs controls (.94% vs 1.26%, p<.01); n-6 PUFAs were higher: dihomo-gamma-linolenic acid (1.51% vs 1.32%, p<.01), arachidonic acid (11.54% vs 10.70%, p<.01), n-6 docosapentaenoic acid (DPA:.46% vs.34%, p<.01), and total n-6 PUFA (24.14% vs 23.37%, p<.05). Higher n-6 DPA predicted poorer mental health. Lower n-3 DPA was associated with higher self-reported bodily pain. Adults with MCI had higher depression scores (3.05±.39 vs 1.33±.24, p<.01). Depressive symptoms associated with elevated n-6 PUFA may contribute to cognitive decline in this population.     

Impact of Functional Constipation on Health-Related Quality of Life in Preschool Children and Their Families in Xi’an,China

Aim

Functional constipation (FC) is one of the common diseases among children. The aim of this study was to investigate the health-related quality of life (HRQOL) in preschool children diagnosed with FC and the impact of the condition on affected families.

Methods

In this cross-sectional, case-control study, 152 children aged 3–6 years with FC, 176 healthy children aged 3–6 years without FC, and their primary caregivers were selected. Chinese versions of the PedsQL^TM 4.0 Generic Core Scale and the Family Impact Module (FIM) were used to assess childhood HRQOL and the impact of FC on family members, respectively. HRQOL scores were compared between children with FC and healthy children. In addition, a multiple step-wise regression with demographic variables of children and their caregivers, family economic status, duration and symptoms of FC, as independent variables, was used to determine factors that influenced HRQOL in children and had impacted caregivers.

Results

Scores of physical, emotional, social and school functions, and summary scales were significantly lower in children with FC than in healthy children (p < 0.05). Physical, emotional, social, cognitive, and communication scores for caregivers, as well as daily activities and relationships for families of children with FC, were significantly lower than those of caregivers and families with healthy children (p < 0.05). Children’s ages, duration of FC, symptoms of FC, the child-caregiver relationship, family economic status, and caregiver education level emerged as the main factors influencing HRQOL in children, caregivers, and family members.

Conclusions

FC had a significant impact on HRQOL of affected children and their caregivers, as well as their family functions. Social characteristics of children and caregivers, duration and symptoms of FC and family economic status significantly affected HRQOL of children and caregivers, as well as family functions of children with FC.     

The Humanistic and Economic Burden of Restless Legs Syndrome

Objectives

To evaluate the humanistic and economic burden of a restless legs syndrome (RLS) diagnosis with regard to health-related quality of life, work productivity loss, healthcare resource use, and direct and indirect costs.

Study Design

Self-reported data came from the 2012 National Health and Wellness Survey (NHWS), a large, annual, nationally representative cross-sectional general health survey of US adults.

Methods

RLS patients (n = 2,392) were matched on demographic and health characteristics to Non-RLS respondents via propensity score matching differences between groups were tested with Bivariate and multivariable analyses.

Results

RLS patients had significantly lower health-related quality of life scores: Mental Component Summary (44.60 vs. 48.92, p<.001), Physical Component Summary (40.57 vs. 46.78, p<.001), Health Utilities (.63 vs. .71, p<.001) and higher levels of work productivity loss in the past seven days including absenteeism (8.1% vs. 9.3%, p<.001), presenteeism (26.5% vs. 15.8%, p<.001), and overall productivity loss (30.1% vs. 18.1%, p<.001) as well as general activity impairment (46.1% vs. 29.7%, p<.001). RLS patients had significantly higher healthcare resource use in the past 6 months than non-RLS patients: healthcare provider visits (7.46 vs. 4.42%, p<.001), ER visits (0.45 vs. 0.24, p<.001), and hospitalizations (0.24 vs. 0.15, p<.001). RLS patients also had higher estimated direct and indirect costs than non-RLS patients. Finally, it was found that across outcomes increasing severity is associated with increased economic and humanistic burden for RLS patients.

Conclusions

RLS patients suffer a greater humanistic and economic burden than those without RLS. Moreover as severity increases so does the burden of RLS.     

Variations in rest-activity rhythm are associated with clinically measured disease severity in Parkinson’s disease

ABSTRACT

The continuous, longitudinal nature of accelerometry monitoring is well-suited to capturing the regular 24-hour oscillations in human activity across the day, the cumulative effect of our circadian rhythm and behavior. Disruption of the circadian rhythm in turn disrupts rest-activity rhythms. Although circadian disruption is a major feature of Parkinson’s disease (PD), rest-activity rhythms and their relationship with disease severity have not been well characterized in PD. 13 PD participants (Hoehn & Yahr Stage [H&Y] 1–3) wore a Philips Actiwatch Spectrum PRO continuously for two separate weeks. Rest-activity rhythms were quantified by fitting an oscillating 24-hour cosinor model to each participant-day of activity data. One-way ANOVAs adjusted for demographics revealed significant variation in the amount (MESOR, F = 12.76, p < .01), range (Amplitude, F = 9.62, p < .01), and timing (Acrophase, F = 2.7, p = .05) of activity across H&Y Stages. Those with higher H&Y Stages were significantly more likely to be active later in the day, where-as those who shifted between H&Y Stages during the study were significantly more active than those who did not change H&Y Stage. Being active later in the day was also significantly associated with higher scores on the Movement Disorder Society’s Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Section III (motor symptom severity, p = .02), Section II (self-reported impact of motor symptoms on daily living, p = .01), and Total Score (p = .01) in an adjusted linear regression model; significant associations between MDS-UPDRS scores and activity levels were observed only in the unadjusted model. These findings demonstrate that continuous actigraphy is capable of detecting rest-activity disruption in PD, and provides preliminary evidence that rest-activity rhythms are associated with motor symptom severity and H&Y Stage.     

Physical Activity and Physical Fitness in African-American Girls With and Without Obesity

WARD, DIANNE S, STEWART G TROST, GWEN FELTON, RUTH SAUNDERS, MARY ANN PARSONS, MARSHA DOWDA, RUSSELL R PATE. Physical activity and physical fitness in African-American girls with and without obesity. Lack of physical activity and low levels of physical fitness are thought to be contributing factors to the high prevalence of obesity in African-American girls. To examine this hypothesis, we compared habitual physical activity and physical fitness in 54 African-American girls with obesity and 96 African-American girls without obesity residing in rural South Carolina. Participation in vigorous (6 METs) (VPA) or moderate and vigorous physical activity (4 METs) (MVPA) was assessed on three consecutive days using the Previous Day Physical Activity Recall. Cardiorespiratory fitness was assessed using the PWC 170 cycle ergometer test. Upper body strength was determined at two sites via isometric cable tensiometer tests. Relative to their counterparts without obesity, girls with obesity reported significantly fewer 30-minute blocks of VPA (0. 90 ± 0. 14 vs. 1. 3 ± 0. 14) and MVPA (1. 2 ± 0. 18 vs. 1. 7 ± 0. 16) (p<0. 01). Within the entire sample, VPA and MVPA were inversely associated with body mass index (r=?0. 17 and r=?0. 19) and triceps skinfold thickness (r=?0. 19 and r=?0. 22) (p<0. 05). In the PWC 170 test and isometric strength tests, girls with obesity demonstrated absolute scores that were similar to, or greater than, those of girls without obesity; however, when scores were expressed relative to bodyweight, girls with obesity demonstrated significantly lower values (p<0. 05). The results support the hypothesis that lack of physical activity and low physical fitness are important contributing factors in the development and/or maintenance of obesity in African-American girls.     

Physical Activity and Low-Fat Diet: Is it Enough to Maintain Weight Stability in the Reduced-Obese Individual Following Weight Loss by Drug Therapy and Energy Restriction?

DOUCET, ERIC, PASCAL IMBEAULT, NATALIE ALMÉRAS, AND ANGELO TREMBLAY. Physical activity and low-fat diet: Is it enough to maintain weight stability in the reduced-obese individual following weight loss by drug therapy and energy restriction? Obes Res. Objective: The anthropometric and physiological effects of a physical activity (PA) and a mildly energy-restricted low-fat diet (LFD) follow-up program after a long-term dietary restriction were studied in 12 men and 8 women. Research Methods and Procedures: The dietary restriction (?700 kcal/day) was accompanied by a fenfluramine (60 mg/day) or placebo treatment for 15 weeks, whereas the mean duration of the PA-LFD follow-up was 18 weeks. Results: The long-term dietary restriction reduced body weight (?11. 9 and ?7. 6 kg, p<. 001), fat mass (FM) (?10. 6 and ?5. 8 kg, p<0. 01), resting metabolic rate (RMR) (?304 kcal/day, p<0. 01 and ?148 kcal/day, NS) in men and women, respectively. A decrease in fat-free mass (FFM) was also observed in women (?1. 8 kg, p<0. 05). The PA-LFD follow-up preserved weight stability at a reduced body weight and caused an additional significant decrease in FM for men (?3. 4 kg, p<0. 05). This part of the intervention also caused an increase in daily RMR for men (134 kcal/day, NS) to the point where this value no longer differed from the pre-energy restriction value. In contrast, RMR was further reduced in women (?200 kcal/day) to the point where it Significantly differed from initial values (p<0. 01). Resting seated heart rate was reduced by the PA-LFD follow-up in men leading it to differ significantly from both pre- and post-energy restriction values (?8. 5 and ?5. 5 bpm, p<0. 01). Discussion: In conclusion, these results suggest that a PA-LFD follow-up has the potential to permit body weight stability and may even accentuate fat loss in the reduced-obese state. Moreover, resting energy expenditure is increased under such conditions in men. These stimulating effects seem to be specific to energy metabolism since seated heart rate was either further reduced or remained stable in response to the PA-LFD follow-up.     

Detraining increases body fat and weight and decreases VO2peak and metabolic rate

Competitive collegiate swimmers commonly take a month off from swim training after their last major competition. This abrupt cessation of intense physical training has not been well studied and may lead to physiopsychological decline. The purpose of this investigation was to examine the effects of swim detraining (DT) on body composition, aerobic fitness, resting metabolism, mood state, and blood lipids in collegiate swimmers. Eight healthy endurance-trained swimmers (V(O2)peak, 46.7 ± 10.8 ml · kg(-1) · min(-1)) performed 2 identical test days, 1 in the trained (TR) state and 1 in the detrained (~5 weeks) state (DT). Body composition and circumferences, maximal oxygen consumption (V(O2)peak), resting metabolism (RMR), blood lipids, and mood state were measured. After DT, body weight (TR, 68.9 ± 9.7 vs. DT, 69.8 ± 9.8 kg; p = 0.03), fat mass (TR, 14.7 ± 7.6 vs. DT, 16.5 ± 7.4 kg; p = 0.001), and waist circumference (TR, 72.7 ± 3.1 vs. DT, 73.8 ± 3.6 cm; p = 0.03) increased, whereas V(O2)peak (TR, 46.7 ± 10.8 vs. DT, 43.1 ± 10.3 ml · kg(-1) · min(-1); p = 0.02) and RMR (TR, 1.34 ± 0.2 vs. DT, 1.25 ± 0.17 kcal · min(-1); p = 0.008) decreased, and plasma triglycerides showed a trend to increase (p = 0.065). Our data suggest that DT after a competitive collegiate swim season adversely affects body composition, fitness, and metabolism. Athletes and coaches need to be aware of the negative consequences of detraining from swimming, and plan off-season training schedules accordingly to allow for adequate rest/recovery and prevent overuse injuries. It's equally important to mitigate the negative effects on body composition, aerobic fitness and metabolism so performance may continue to improve over the long term.     

Effect of dexmedetomidine-induced anesthesia on the postoperative cognitive function of elder patients after laparoscopic ovarian cystectomy

ObjectiveTo investigate the effect of dexmedetomidine at maintenance dose on the postoperative function of elder patients after general anesthesia for laparoscopic ovarian cystectomy.MethodsWe enrolled a total of 96 elder patients who were admitted to this hospital for laparoscopic ovarian cystectomy under general anesthesia between March 2015 and March 2017, and divided them into two groups, Group A (n = 48) and B (n = 48). Patients in both groups received the same methods for anesthesia induction and maintenance drugs. At the beginning of operation, patients in Group A received the intravenous injection of dexmedetomidine (0.8 μg/kg) followed by maintenance dose [0.5 μg/(kg h)] to the end of operation, while those in Group B underwent intravenous injection of 0.9% normal saline at the same rate, during which blood pressure, heart rate, oxyhemoglobin saturation and dosage of anesthetics at T1 (5 min after being delivered into the operation room), T2 (immediately after anesthesia induction), T3 (immediately after intubation), T4 (immediately after operation), T5 (immediately after end of operation) and T6 (immediately after extubation). Then, the levels of NSE, IL-6, CRP and HMGB1 were compared between two groups at 24 h before the operation, at the end, 24 h, 3 d and 7 d after operation. Besides, we also compared the postoperative cognitive functions and incidence of adverse reactions at 1 d before, 1, 2, 3 and 7 d after operation through MOCA scales.ResultsAt T3, T4 and T6, comparisons of the average arterial pressure and heart rate showed that the differences between the two groups had statistical significance (p < .05). At the end of operation, and at 24 h, 3 d and 7 d after operation, we found that the levels of IL-6 and CRP in patients of two groups were all significantly elevated when compared with those before operation; at the end of operation and at 24 h and 3 d after operation, the levels of IL-6 and CRP in the Group B were higher than those in the Group A, and the differences had statistical significance (p < .05). At the end of operation and at 24 h and 3 d after operation, the levels of NSE and HMGB1 in two group were higher than those before operation, and a more significant elevation was identified in Group B with statistically significant differences (p < .05); at 7 d after operation, a decreasing trend was found in the level of HMGB1, which, however, remained higher than the preoperative level, and the level in Group B was still higher than that in Group A with statistically significant differences (p < .05). At 2 d after operation, we found that the scores of MOCA in the Group B were remarkably decreased in comparison with the scores in Group A with a statistically significant difference (p < .05). Moreover, the incidence rate of postoperative cognitive dysfunction (POCD) in the Group A was significantly lower than that in the Group B, and the difference had statistical significance (p < .05).ConclusionDexmedetomidine can ameliorate the postoperative cognitive functions of elder patients who received the laparoscopic ovarian cystectomy under general anesthesia, and effectively decrease the incidence rate of POCD without any obvious or severe adverse reaction. Thus, it can serve as a kind of adjuvant drug for general anesthesia in clinical practice.     

Health-Related Quality of Life among Children with Recurrent Respiratory Tract Infections in Xi’an,China

Objective

The aim of this study was to investigate the health-related quality of life (HRQOL) in 2−7-year-old children diagnosed with recurrent respiratory tract infections (RRTIs) and the impact of RRTIs on affected families.

Methods

This was a cross-sectional case-control study evaluating 2−7-year-old children with RRTIs (n = 352), 2−7-year-old healthy children (n = 376), and associated caregivers (parents and/or grandparents). A Chinese version of the PedsQL™ 4.0 Generic Core Scale was used to assess childhood HRQOL, and a Chinese version of the Family Impact Module (FIM) was used to assess the impact of RRTIs on family members. HRQOL scores were compared between children with RRTIs and healthy children. In addition, a multiple step-wise regression with demographic variables of children and their caregivers, family economic status, and caregiver’s HRQOL as independent variables determined factors that influenced HRQOL in children with RRTIs.

Results

Children with RRTIs showed significantly lower physical, emotional, social, and school functioning scores than healthy children (p<0.05). Caregivers for children with RRTIs also scored significantly lower than caregivers for healthy children on physical, emotional, social, cognitive, and communication functioning (p<0.05). Caregivers for RRTIs affected children also reported significantly higher levels of worry. Multivariate analyses showed that children’s age, children’s relation with caregivers, the frequency of respiratory tract infections in the preceding year, caregiver’s educational level, and caregiver’s own HRQOL influenced HRQOL in children with RRTIs.

Conclusions

The current data demonstrated that RRTIs were associated with lower HRQOL in both children and their caregivers and negatively influenced family functioning. In addition, caregivers’ social characteristics also significantly affected HRQOL in children with RRTIs.     

Quality of life after cardiac surgery

The aim of this study was to determine a health-related quality of life two or more years after a cardiac surgery using the MOS-36 item short-form health survey questionnaire. 330 members of "Croatian society of patients who underwent cardiac surgery" were asked and 196 responders, 122 men and 74 women, were included in survey, all of them more than two years after surgery and older than fifty years of age. The answers were collected by phone. Women gained better results for Physical Functioning (p < 0.003) and men estimated better scores for psychical health (p < 0.001). Our patients gained some different results in respect to the Croatian sample of healthy people of the same age. They declared better General Health (p < 0.001), less Bodily Pain (p < 0.001), but inferior Role-Emotion (p < 0.001) and Social Functioning (p < 0.001). The estimations of QOL improving were comparable with the results of numerous shorter follow-ups.     

Quality of Life Outcomes of Antiretroviral Treatment for HIV/AIDS Patients in Vietnam

Objective

This study assessed health-related quality of life (HRQOL) and its related factors in HIV/AIDS patients taking antiretroviral treatment (ART) in Vietnam.

Methods

A cross-sectional study was conducted with 1016 patients (36.2% women, mean age = 35.4) in three epicenters of Vietnam, including Hanoi, Hai Phong, and Ho Chi Minh City. HRQOL was assessed using the Vietnamese version of the WHOQOL-HIV BREF. Factor analysis classified measure items into six HRQOL dimensions, namely Physical, Morbidity, Social, Spirituality, Performance, and Environment. Tobit censored regression models were applied to determine associations of patient’s characteristics and HRQOL domain scores.

Results

Internal consistency reliability of the six domains ranged from 0.69 to 0.89. The WHOQOL-HIV BREF had a good discriminative validity with patient’s disease stages, CD4 cell counts, and duration of ART. In a band score of (4, 20), six domains were moderate; “Environment” had the highest score (13.8±2.8), and “Social” had the lowest score (11.2±3.3). Worse HRQOL were observed in patients at provincial and district clinics. Those patients who were male, had higher educational attainment, and are employed, reported better HRQOL. In reduced regression models, poorer HRQOL was found in patients who had advanced HIV infection and had CD4 cell count <200 cells/mL. Patients reported significantly poorer Physical and Social in the 1^st year ART, but moderately better Performance, Morbidity, Spirituality, and Environment from the 2^nd year ART, compared to those not-yet-on ART.

Conclusion

Strengthening the quality of ART services at the provincial and district levels, gender-specific impact mitigation, and early treatment supports are recommended for further expansion of ART services in Vietnam. Regular assessments of HRQOL may provide important indicators for monitoring and evaluating HIV/AIDS services.     

Health-related quality of life and metabolic control in children with type 1 diabetes mellitus in Bosnia and Herzegovina

The primary objective of the study was to examine the relationship between generic and disease-specific HRQOL scores and metabolic control in children with Type 1 Diabetes Mellitus (T1DM). This cross-sectional study included 65 consecutive children between ages 5 and 18 years with T1DM. According to their values of glycosylated hemoglobin (HbA(1C)), the children were assigned to one of two groups. In Group 1 (N = 21) were the children with HbA(1C) values < 8% (good to moderate metabolic control) and Group 2 (N = 44) were children with > 8% (poor metabolic control). To evaluate generic and disease-specific HRQOL scores in children with T1DM in relation to metabolic control, we used the PedsQL 4.0 Generic Core Scales and the PedsQL 3.0 Diabetes Module. The patients in Group 1, by pediatric patient self-report and parent proxy-report, had statistically better disease-specific HRQOL scores on the diabetes symptoms, treatment barriers, treatment adherence and worry domains in comparison with Group 2. We also found significant correlations between the total generic HRQOL scores and HbA(1C) for both parent proxy-reports' Spearman's coefficient of rank correlation rho = -0.257; p = 0.0412 and pediatric patients' Spearman's coefficient of rank correlation rho = -0.269; p = 0.0313. The current findings suggest that poor glycemic control in children with T1DM is associated with lower generic and disease-specific HRQOL scores in developing and transitional countries.     

Hydrogenophaga temperata sp. nov., a betaproteobacterium isolated from compost in Korea

A Gram-negative, rod-shaped, non-spore-forming and motile bacterial strain TR7-01(T) was isolated from a compost soil in South Korea and subjected to a polyphasic taxonomic study. Phylogenetic analysis based on 16S rRNA gene sequences showed that strain TR7-01(T) belonged to the genus Hydrogenophaga within the class Betaproteobacteria. Strain TR7-01(T) exhibited 16S rRNA gene sequence similarity values of 95.0-98.3% to members of the genus Hydrogenophaga: Hydrogenophaga bisanensis DSM12412(T) (98.3%), Hydrogenophaga flava DSM 619(T) (97.1%), Hydrogenophaga pseudoflava ATCC 33668(T) (96.8%), Hydrogenophaga intermedia S1(T) (96.4%), Hydrogenophaga atypica BSB 41.8(T) (95.8%), Hydrogenophaga defluvii BSB 9.5(T) (95.7%), Hydrogenophaga palleronii CCUG 20334(T) (95.6%), Hydrogenophaga caeni EMB71(T) (95.4%) and Hydrogenophaga taeniospiralis ATCC 49743(T) (95.0%). Chemotaxonomic data revealed that strain TR7-01(T) possesses ubiquinone Q-8, the G+C content was 69.9 mol%, and the predominant fatty acids were 16 : 1 ω7c/15 : 0 iso 2OH, 18 : 1 ω7c/ω9t/ω12t and C(16:0), all of which corroborated our assignment of the strain to the genus Hydrogenophaga. The results of DNA-DNA hybridization and physiological and biochemical tests clearly demonstrated that strain TR7-01(T) represents a distinct species. Based on these data, TR7-01(T) (= KCTC 12203(T) = DSM 18117(T)) should be classified as a novel Hydrogenophaga species, for which the name Hydrogenophaga temperata sp. nov. has been proposed.     

In-season resistance training and detraining in professional team handball players

The object of this study was to investigate the changes in physical parameters produced during an in-season resistance training (RT) and detraining (DT, or RT cessation) in 16 high level team handball players (THPs). Apart from normal practice sessions, THPs underwent 12 weeks of RT. Subjects performed 3 sets of 3-6 reps with a load of 70-85% concentric 1 repetition maximum bench press (1RMBP), 3 sets of 3-6 reps with a load of 70-95% of 4 repetition maximum parallel squats (4RMPS), plus vertical jumps and sprints. The 1RMBP, 4RMPS, speed over 30 m (S30), jump (countermovement jump height [CMJ]; CMJ with additional weights [20kg and 40kg], and ball throw velocity (BTv) were tested before the experimental period (T1), after 6 weeks (T2), and after the 12-week experimental period (T3). Immediately after these 12 weeks, THPs started a 7-week DT period, maintained normal practices. The CMJ and the BTv were the only parameters evaluated during DT. The most important gains (p < 0.001) in S30 were obtained between T1-T2 and T1-T3. The BTv improved significantly (p < 0.001) only between T1-T2 and T1-T3. The most relevant increases (p < 0.001) in jumping performance took place between T1-T2 and T1-T3. The 1RMBP showed significant increases (p < 0.001) only between T1-T2 and T1-T3. The 4RMPS increased significantly between all testing trials. After the DT, THPs showed no significant losses in CMJ performance. However, they declined significantly in BTv (p = 0.023). The results suggest that elite THPs can optimize important physical parameters over 12 weeks in-season and that 7 weeks of DT, although insufficient to produce significant decreases in CMJ, are sufficient to induce significant decreases in BTv. It is concluded that after RT cessation THPs reduced BTv performance.