Comparison of health-related quality of life after percutaneous coronary intervention and coronary artery bypass surgery

BACKGROUND: Health-related quality of life (HRQOL) evaluation is an important measure of the impact of the disease. As more people with coronary heart disease (CHD) live longer, doctors and researchers want to know how they manage in day to day life. It looked like adults with CHD had a decrease QOL. The aim of this study was to comparison of HRQOL of patients who underwent percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) and to assess its main determinants in the whole sample of coronary artery disease (CAD) patients. METHODS: The study was carried out to estimate HRQOL of 109 patients who underwent invasive coronary revascularization PCI (n = 75) and CABG (n = 34). We applied HRQOL after 6 months and 2 years in both groups and scores were compared. The HRQOL data were obtained using MacNew Heart Disease questionnaire with dimensions emotional, physical and social that estimated. Data entry and analysis were performed by SPSS 16.0. RESULTS: A total MacNew scale in CABG and PCI group in 6 months after treatment were 45.32 ± 13.75 and 53.52 ± 15.63, respectively (P = 0.0100). After 2 years HRQOL mean changed to 51.176 ± 14.80 and 49.55 ± 16.22, respectively, in CABG and PCI group (P = 0.4280). Our results in within-group analysis showed total MacNew scale and its subscales were changed significantly after 2 years in CABG and PCI group�s scores were detected. We found in the whole sample of CAD patients those who had a higher level of income and education and were not either overweight or obese experienced better HRQOL. CONCLUSION: Our results showed that patients who underwent PCI experienced significantly higher HRQOL in 6 months after revascularization but over 24 months follow-up no difference was observed between the two groups. © 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved

Validity of the Iranian Version of Health Utility Index Mark 3 Quality of Life Questionnaire

Background: The aim of this study was to standardize and develop the health utility index III (HUI3); quality of life questionnaire. This study was conducted for the first time in Iran. Method: Forward-backward translation method was applied in order to translate the Canadian version into Persian. The final version was developed after modifications. Double stage cluster sampling and simple random sampling were respectively used for population and patients. A total of 511 healthy people in 15 regions of Esfahan/Iran and 51 patients suffering from cardiovascular disease completed the questionnaire. Cronbach's alpha and interclass correlation coefficient were used for testing the reliability of the questionnaire. Results: The mean age of population was 32.8 ± 11.3 years and the mean age of patients was 48.8 ± 6.2 years. The assessment of Interclass Correlation Coefficient of the tool in patients after two weeks in all eight questions ranged from 0.76 to 1 (ICC=0/91) that shows its high reliability. In addition, the average score in Alfa Cronbach was 0.68. Content validity of the questionnaire was 0.82. Differentiability of the test shows that a higher quality of life can be affected by male gender, higher education, low age, and employment In addition, the utility result of quality of life indicates a significant difference in the quality of life of patients compared with the general population (p = 0.004) Conclusion: The results showed a translated version is valid, reliable and applicable in medical sciences studies and can be used to Persian language

Validity of the Iranian Version of Health Utility Index Mark 3 Quality of Life Questionnaire

Background: The aim of this study was to standardize and develop the health utility index III (HUI3); quality of life questionnaire. This study was conducted for the first time in Iran. Method: Forward-backward translation method was applied in order to translate the Canadian version into Persian. The final version was developed after modifications. Double stage cluster sampling and simple random sampling were respectively used for population and patients. A total of 511 healthy people in 15 regions of Esfahan/Iran and 51 patients suffering from cardiovascular disease completed the questionnaire. Cronbach's alpha and interclass correlation coefficient were used for testing the reliability of the questionnaire. Results: The mean age of population was 32.8 ± 11.3 years and the mean age of patients was 48.8 ± 6.2 years. The assessment of Interclass Correlation Coefficient of the tool in patients after two weeks in all eight questions ranged from 0.76 to 1 (ICC=0/91) that shows its high reliability. In addition, the average score in Alfa Cronbach was 0.68. Content validity of the questionnaire was 0.82. Differentiability of the test shows that a higher quality of life can be affected by male gender, higher education, low age, and employment In addition, the utility result of quality of life indicates a significant difference in the quality of life of patients compared with the general population (p = 0.004) Conclusion: The results showed a translated version is valid, reliable and applicable in medical sciences studies and can be used to Persian language

Estimation and prediction of avoidable health care costs of cardiovascular diseases and type 2 diabetes through adequate dairy food consumption: a systematic review and micro simulation modeling study

Background: Recent evidence from prospective cohort studies show a relationship between consumption of dairy foods and cardiovascular diseases (CVDs) and type 2 diabetes mellitus (T2DM). This association highlights the importance of dairy foods consumption in prevention of these diseases and also reduction of associated healthcare costs. The aim of this study was to estimate avoidable healthcare costs of CVD and T2D through adequate dairy foods consumption in Iran. Methods: This was a multistage modelling study. We conducted a systematic literature review in PubMed and EMBASE to identify any association between incidence of CVD and T2DM and dairy foods intake, and also associated relative risks. We obtained age- and sex-specific dairy foods consumption level and healthcare expenditures from national surveys and studies. Patient level simulation Markov models were constructed to predict the disease incidence, patient population size and associated healthcare costs for current and optimal dairy foods consumption at different time horizons (1, 5, 10 and 20 years). All parameters including costs and transition probabilities were defined as statistical distributions in the models, and all analyses were conducted by accounting for first and second order uncertainty. Results: The systematic review results indicated that dairy foods consumption was inversely associated with incidence of T2DM, coronary heart disease (CHD) and stroke. We estimated that the introduction of a diet containing 3 servings of dairy foods per day may produce a $0.43 saving in annual per capita healthcare costs in Iran in the first year due to saving in cost of CVD and T2DM treatment. The estimated savings in per capita healthcare costs were$8.42, $39.97 and$190.25 in 5, 10 and 20-years’ time, respectively. Corresponding total aggregated avoidable costs for the entire Iranian population within the study time horizons were $33.83,$661.31, $3,138.21 and$14,934.63 million, respectively. Conclusion: Our analysis demonstrated that increasing dairy foods consumption to recommended levels would be associated with reductions in healthcare costs. Further randomized trial studies are required to investigate the effect of dairy foods intake on cost of CVD and T2DM in the population

Production and characterization of virus-like particles of grapevine fanleaf virus presenting L2 epitope of human papillomavirus minor capsid protein.

BACKGROUND: Virus-like particle (VLP) platform represents a promising approach for the generation of efficient and immunogenic subunit vaccines. Here, the feasibility of using grapevine fanleaf virus (GFLV) VLPs as a new carrier for the presentation of human papillomavirus (HPV) L2 epitope was studied. To achieve this goal, a model of the HPV L2 epitope secondary structure was predicted and its insertion within 5 external loops in the GFLV capsid protein (CP) was evaluated. RESULTS: The epitope sequence was genetically inserted in the alphaB-alphaB(") domain C of the GFLV CP, which was then over-expressed in Pichia pastoris and Escherichia coli. The highest expression yield was obtained in E. coli. Using this system, VLP formation requires a denaturation-refolding step, whereas VLPs with lower production yield were directly formed using P. pastoris, as confirmed by electron microscopy and immunostaining electron microscopy. Since the GFLV L2 VLPs were found to interact with the HPV L2 antibody under native conditions in capillary electrophoresis and in ELISA, it can be assumed that the inserted epitope is located at the VLP surface with its proper ternary structure. CONCLUSIONS: The results demonstrate that GFLV VLPs constitute a potential scaffold for surface display of the epitope of interest