Quality of life assesment in persons with chronic active otitis media

U poslednjih dvadesetak godina, publikovan je ogroman broj radova koji se bave razvojem, validacijom i upotrebom specifičnih upitnika kratke forme, u cilju procene kvaliteta života pacijenata sa određenom vrstom oboljenja. Ciljevi. Naš cilj je bio da specifičan upitnik za procenu kvaliteta života pacijenata sa aktivnim hroničnim zapaljenjem srednjeg uva prevedemo, kulturološki adaptiramo na srpski jezik i validiramo, kao i da izvršimo procenu kvaliteta života tih pacijenata pre i posle izvedene hirurške intervencije na obolelom uvu. U istraživanju je korišćen opšti i specifični upitnik i identifikovani su prediktori kvaliteta života ovih pacijenata. Materijal i metode. U okviru ove panel studije bilo je uključeno 246 pacijenata sa dijagnozom hroničnog zapaljenja srednjeg uva. Dijagnoza bolesti je postavljena na Klinici za otorinolaringologiju i maksilofacijalnu hirurgiju, Kliničkog centra Srbije, u periodu od oktobra 2014. do novembra 2015. godine. Svi pacijenti su tokom prve posete specijalisti popunili dva upitnika, generički upitnik za procenu kvaliteta života povezanog sa zdravljem i specifični upitnik o hroničnom zapaljenju uva. Od 246 ispitanika, 203 je dobilo preporuku za hirurško lečenje, a 167 je operisano i praćeno 12 meseci nakon operacije. Ispitanici su upitnike ponovo popunjavali nakon 6 i 12 meseci od izvedene operacije. Podaci su statistički analizirani metodama deskriptivne i inferencijalne statistike, a za statistički značajnu razliku je uzimana vrednost od 0,05. Za pronađenu statistički značajnu razliku, određivali smo i veličinu efekta za varijable od značaja. Rezultati. Validacija upitnika je sprovedena na 60 pacijenta sa hroničnim zapaljenjem srednjeg uva i na 60 zdravih dobrovoljaca. Kronbah alfa koeficijent, konvencionalni indeks konzistencije, iznosio je 0,821, dok je pri ponovljenom merenju nakon 4 nedelje bio neznatno viši, iznoseći 0,840. Što se tiče test-retest pouzdanosti, dobijena vrednost intraklasnog korelacionog koeficijenta između obe posete je iznosila 0,985 (95% interval poverenja: 0,975 do 0,991). Na 167 operisanih pacijenata dobijena je visoko statistički značajna razlika u poboljšanju sluha nakon izvedene operacije. Takođe, dobijeno je visoko statistički značajno smanjenje u ukupnom skoru specifičnog upitnika posle hirurške intervencije, kao i u svakom od njegova tri subskora...In the past 20 years, a large number of publications were dedicated to development, validation and use of short-form specific questionnaires in assessment of quality of life of the patients with particular diseases. Aims. Our primary goal was to contribute to this trend, by choosing a questionnaire that is in its early phase of development, translating and adapting it into Serbian language, and using it for assessment of quality of life improvement in patients with chronic otitis media after surgical intervention on the affected ear. Material and methods. This study included 246 patients diagnosed with chronic otitis media at the Clinic for Otorhinolaryngology and Maxillofacial Surgery of the Clinical Centre of Serbia from October 2014 to November 2015. All patients filled two questionnaires during their first visit, one specific and one generic used to asses general health-related quality of life. Surgical treatment has been recommended to 203 patients, out of whom 167 underwent surgery during the following year. Patients completed questionnaires again, 6 and 12 months after the surgery. Statistical analysis included descriptive and analytical statistical methods, and the value of 0.05 was considered as statistically significant. Effect size in standard deviations was reported for all statistically significant results. Results. The specific questionnaire was validated on 60 patients with chronic otitis media and 60 healthy volunteers. Cronbach alpha coefficient, the conventional index of consistency, was 0.821, while on repeated measurement after 4 weeks, was slightly higher − 0.840. In assessment of test-retest reliability, the value of interclass correlation coefficient between two visits was 0.985 (95% confidence interval: 0.975 to 0.991). There was a significant improvement in the area of ear symptoms and in hearing level on 167 operated patients. Furthermore, there was highly significant improvement in quality of life, represented by lower postoperative scores, both overall and for each of subscores of the specific questionnaire. For overall health-related quality of life, significant improvement was found both in physical and mental score of the questionnaire..

Quality of life assesment in persons with chronic active otitis media

U poslednjih dvadesetak godina, publikovan je ogroman broj radova koji se bave razvojem, validacijom i upotrebom specifičnih upitnika kratke forme, u cilju procene kvaliteta života pacijenata sa određenom vrstom oboljenja. Ciljevi. Naš cilj je bio da specifičan upitnik za procenu kvaliteta života pacijenata sa aktivnim hroničnim zapaljenjem srednjeg uva prevedemo, kulturološki adaptiramo na srpski jezik i validiramo, kao i da izvršimo procenu kvaliteta života tih pacijenata pre i posle izvedene hirurške intervencije na obolelom uvu. U istraživanju je korišćen opšti i specifični upitnik i identifikovani su prediktori kvaliteta života ovih pacijenata. Materijal i metode. U okviru ove panel studije bilo je uključeno 246 pacijenata sa dijagnozom hroničnog zapaljenja srednjeg uva. Dijagnoza bolesti je postavljena na Klinici za otorinolaringologiju i maksilofacijalnu hirurgiju, Kliničkog centra Srbije, u periodu od oktobra 2014. do novembra 2015. godine. Svi pacijenti su tokom prve posete specijalisti popunili dva upitnika, generički upitnik za procenu kvaliteta života povezanog sa zdravljem i specifični upitnik o hroničnom zapaljenju uva. Od 246 ispitanika, 203 je dobilo preporuku za hirurško lečenje, a 167 je operisano i praćeno 12 meseci nakon operacije. Ispitanici su upitnike ponovo popunjavali nakon 6 i 12 meseci od izvedene operacije. Podaci su statistički analizirani metodama deskriptivne i inferencijalne statistike, a za statistički značajnu razliku je uzimana vrednost od 0,05. Za pronađenu statistički značajnu razliku, određivali smo i veličinu efekta za varijable od značaja. Rezultati. Validacija upitnika je sprovedena na 60 pacijenta sa hroničnim zapaljenjem srednjeg uva i na 60 zdravih dobrovoljaca. Kronbah alfa koeficijent, konvencionalni indeks konzistencije, iznosio je 0,821, dok je pri ponovljenom merenju nakon 4 nedelje bio neznatno viši, iznoseći 0,840. Što se tiče test-retest pouzdanosti, dobijena vrednost intraklasnog korelacionog koeficijenta između obe posete je iznosila 0,985 (95% interval poverenja: 0,975 do 0,991). Na 167 operisanih pacijenata dobijena je visoko statistički značajna razlika u poboljšanju sluha nakon izvedene operacije. Takođe, dobijeno je visoko statistički značajno smanjenje u ukupnom skoru specifičnog upitnika posle hirurške intervencije, kao i u svakom od njegova tri subskora...In the past 20 years, a large number of publications were dedicated to development, validation and use of short-form specific questionnaires in assessment of quality of life of the patients with particular diseases. Aims. Our primary goal was to contribute to this trend, by choosing a questionnaire that is in its early phase of development, translating and adapting it into Serbian language, and using it for assessment of quality of life improvement in patients with chronic otitis media after surgical intervention on the affected ear. Material and methods. This study included 246 patients diagnosed with chronic otitis media at the Clinic for Otorhinolaryngology and Maxillofacial Surgery of the Clinical Centre of Serbia from October 2014 to November 2015. All patients filled two questionnaires during their first visit, one specific and one generic used to asses general health-related quality of life. Surgical treatment has been recommended to 203 patients, out of whom 167 underwent surgery during the following year. Patients completed questionnaires again, 6 and 12 months after the surgery. Statistical analysis included descriptive and analytical statistical methods, and the value of 0.05 was considered as statistically significant. Effect size in standard deviations was reported for all statistically significant results. Results. The specific questionnaire was validated on 60 patients with chronic otitis media and 60 healthy volunteers. Cronbach alpha coefficient, the conventional index of consistency, was 0.821, while on repeated measurement after 4 weeks, was slightly higher − 0.840. In assessment of test-retest reliability, the value of interclass correlation coefficient between two visits was 0.985 (95% confidence interval: 0.975 to 0.991). There was a significant improvement in the area of ear symptoms and in hearing level on 167 operated patients. Furthermore, there was highly significant improvement in quality of life, represented by lower postoperative scores, both overall and for each of subscores of the specific questionnaire. For overall health-related quality of life, significant improvement was found both in physical and mental score of the questionnaire..

Accuracy analysis of air torque position dampers based on blade profiles and damper locations

The primary concern of this paper is a single-blade air torque position damper used for the indirect measurement of volumetric air-flow rates by measuring the moment of airstream force exerted on the blade and the damper position. The purpose of the paper is to analyze the accuracy of the air velocity measurements and the adequacy of the damper mathematical model on the basis of the blade profile and the damper location in a duct system. The analysis was performed on the basis of the experimentally obtained results. Four different blade profiles (flat, V-groove, symmetrical airfoil, and non-symmetrical airfoil blades) were taken into account, as well as three different damper locations in the duct system (at the duct entrance, within the duct, and at the duct exit). Two blade orientations at the duct entrance were examined relative to the direction of air-flow (with front and rear mounting flanges). It was determined that the blade profile and particularly the damper location in the duct system affect the measurement accuracy and the adequacy of the damper mathematical model provided the blade angle of attack is less than or equal to 30°, i. e. within the range of a more open damper

Symptoms of depression, anxiety and stress in patients with chronic otitis media

Purpose Persistent symptoms of chronic otitis media cause limitations in daily routine and social interactions, influencing significantly patients' quality of life and mental health. The purpose of the study was to assess the intensity depression, anxiety and stress symptoms in patients with chronic otitis media and to examine if patient demographic data, characteristics and reported symptoms of otitis influence reported depression, anxiety and stress symptoms. Material and methods The study included 316 adult patients diagnosed with unilateral or bilateral chronic otitis media with or without cholesteatoma. Patients underwent a complete otological, audiological and radiological assessment. Chronic otitis media questionnaire 12 (COMQ-12) was used to assess the impact of COM and Depression Anxiety Stress Scale 21 (DASS-21) was used for depression, anxiety and stress assessment. Results Some level of anxiety and stress were detected in 70.57% 49.37% of the patients, respectively. 13.29% of the patients had scores indicating depression disorder. The mean value of the COMQ-12 questionnaire for this group of patients was 26.24 (SD±11.47) More intense symptoms of COM were significantly associated (p<0.05) with higher scores on DASS-21 subscales. Multivariate logistic regression analysis indicated that significant positive predictors of higher anxiety scores were pure tone average (PTA) on better and worse hearing ear (p<0.05). Drainage from the ear, hearing problems at home and tinnitus were significant positive predictors of a higher DASS-depression score. (p<0.05) Conclusion The study confirmed positive correlation between reported level of anxiety, depression and stress, severity of COM symptoms and quality of life. Level of hearing on the better and worse hearing ear were significant positive predictors of anxiety and stress in patients with COM

Trial of Fingolimod versus Interferon Beta-1a in Pediatric Multiple Sclerosis

BACKGROUND: Treatment of patients younger than 18 years of age with multiple sclerosis has not been adequately examined in randomized trials. We compared fingolimod with interferon beta-1a in this population. METHODS: In this phase 3 trial, we randomly assigned patients 10 to 17 years of age with relapsing multiple sclerosis in a 1:1 ratio to receive oral fingolimod at a dose of 0.5 mg per day (0.25 mg per day for patients with a body weight of ≤40 kg) or intramuscular interferon beta-1a at a dose of 30 μg per week for up to 2 years. The primary end point was the annualized relapse rate. RESULTS: Of a total of 215 patients, 107 were assigned to fingolimod and 108 to interferon beta-1a. The mean age of the patients was 15.3 years. Among all patients, there was a mean of 2.4 relapses during the preceding 2 years. The adjusted annualized relapse rate was 0.12 with fingolimod and 0.67 with interferon beta-1a (absolute difference, 0.55 relapses; relative difference, 82%; P<0.001). The key secondary end point of the annualized rate of new or newly enlarged lesions on T2-weighted magnetic resonance imaging (MRI) was 4.39 with fingolimod and 9.27 with interferon beta-1a (absolute difference, 4.88 lesions; relative difference, 53%; P<0.001). Adverse events, excluding relapses of multiple sclerosis, occurred in 88.8% of patients who received fingolimod and 95.3% of those who received interferon beta-1a. Serious adverse events occurred in 18 patients (16.8%) in the fingolimod group and included seizures (in 4 patients), infection (in 4 patients), and leukopenia (in 2 patients). Serious adverse events occurred in 7 patients (6.5%) in the interferon beta-1a group and included infection (in 2 patients) and supraventricular tachycardia (in 1 patient). CONCLUSIONS: Among pediatric patients with relapsing multiple sclerosis, fingolimod was associated with a lower rate of relapse and less accumulation of lesions on MRI over a 2-year period than interferon beta-1a but was associated with a higher rate of serious adverse events. Longer studies are required to determine the durability and safety of fingolimod in pediatric multiple sclerosis. (Funded by Novartis Pharma; PARADIGMS ClinicalTrials.gov number, NCT01892722 .)