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Alghwiri AA, Almhdawi KA, Marchetti G. Are fatigue scales the same? A content comparison using the International Classification of Functioning, Disability and Health. Mult Scler Relat Disord 2020; 46:102596. [PMID: 33296990 DOI: 10.1016/j.msard.2020.102596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 09/26/2020] [Accepted: 10/20/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Fatigue is a common impairment in a wide range of disorders. Numerous fatigue scales have been designed in an attempt to quantify this impairment without any clear distinction between them. The International Classification of Functioning, Disability and Health (ICF) is a useful tool for content comparison of measurement scales. OBJECTIVE To explore the content of generic fatigue scales using the ICF. METHODS Twenty generic fatigue scales were identified and linked to the ICF by two health care professionals according to the established linking rules. The contents of the 20 scales were compared and the inter-rater agreement was estimated using kappa coefficients. RESULTS The content of generic fatigue scales varies and was found to focus mostly on body functions, activities and participation components of the ICF with a moderate to high degree of inter-observer agreement. CONCLUSIONS The content comparison of fatigue questionnaires would assist clinicians and researchers in selecting the most appropriate measurement for use and precisely analyze the results of these measurements.
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Affiliation(s)
- Alia A Alghwiri
- Department of Physiotherapy, The University of Jordan, Amman, Jordan.
| | - Khader A Almhdawi
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Gregory Marchetti
- Department of Physical Therapy, Duquesne University and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania
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202
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Machado MO, Kang NYC, Tai F, Sambhi RDS, Berk M, Carvalho AF, Chada LP, Merola JF, Piguet V, Alavi A. Measuring fatigue: a meta-review. Int J Dermatol 2020; 60:1053-1069. [PMID: 33301180 DOI: 10.1111/ijd.15341] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/02/2020] [Accepted: 11/09/2020] [Indexed: 12/11/2022]
Abstract
There is a lack of validated tools to measure fatigue in patients with inflammatory skin, neuropsychiatric, and medical disorders. The use of nonvalidated tools may compromise the quality of data. The purpose of this meta-review was to evaluate existing fatigue scales commonly used to assess fatigue in other inflammatory conditions and to identify if there are scales that have been validated in dermatologic conditions. The PubMed/MEDLINE and SCOPUS databases were systematically searched from inception through March 10, 2020, in accordance with the PRISMA statement. Validated tools were identified and assessed according to their main measurement properties. The literature search identified 403 references, and eight studies were eligible and assessed in this review. The unidimensional fatigue scales included were the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F), Brief Fatigue Inventory, Fatigue Severity Scale, Numerical Rating Scale - Fatigue, and Visual Analog Scale - Fatigue. The multidimensional fatigue scales found were the Checklist Individual Strength, Chalder Fatigue Scale, Multidimensional Assessment of Fatigue, Multidimensional Fatigue Inventory Scale, and Piper Fatigue Scale. To measure fatigue, a brief scale with the ability to detect change is needed as there is a growing interest in evaluating this dimension of treatment response. In addition, a good content validity is also needed. From this systematic review, none of the selected scales have had content validation, even though the FACIT was validated in patients with psoriatic arthritis. Validation studies in specific disorders are urgently warranted.
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Affiliation(s)
- Myrela O Machado
- Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada.,Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Felicia Tai
- BMSc Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Raman D S Sambhi
- Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Michael Berk
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.,Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andre F Carvalho
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada and Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Lourdes P Chada
- International Dermatology Outcome Measures, Harvard Medical School, Boston, MA, USA
| | - Joseph F Merola
- Department of Dermatology and Department of Medicine, Divison of Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Vincent Piguet
- Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada.,Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
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203
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Hingst H, Stutz U, Buchholz I. Tumorbedingte Fatigue - Prozessevaluation eines Seminars der Universitätsmedizin Greifswald. Pflege 2020; 34:41-49. [PMID: 33252314 DOI: 10.1024/1012-5302/a000778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Cancer-related fatigue - Process evaluation of a seminar of the University Medicine Greifswald Abstract. Background: Fatigue is the most common and stressful symptom in cancer patients and their relatives. The patient information center (PIZ) of the University Medicine Greifswald enables patients to learn how to deal with fatigue and to understand their disease. The fatigue seminar is well accepted by seminar participants, but it is rarely taken up by patients. Aim: The primary objective of this observational study was to find out how well-known this seminar is, whether it is recommended to patients and what the reasons for missing referrals are. METHODS Medical and nursing staff of all 13 wards of the Oncology Centre was surveyed by means of a self-developed questionnaire. The questions were analyzed on a single item level. Descriptive statistics and measures of correlation were determined. RESULTS The fatigue seminar of the PIZ is hardly known to the n = 115 respondents and / or is not always recommended to those affected. Where the PIZ has been present in the past, the knowledge about fatigue is higher and the seminar is better known. Screening instruments are hardly used for diagnostics. CONCLUSIONS The fatigue seminar needs to be promoted in a better way. In order to increase its popularity, it should be presented both to the psychological staff and on the wards. The systematic inclusion of screening instruments in the treatment path of cancer patients and the inclusion of the fatigue seminar in the range of treatment for patients with distressing fatigue symptoms should be discussed.
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Affiliation(s)
- Heike Hingst
- Patienteninformationszentrum, Universitätsmedizin Greifswald
| | - Ute Stutz
- Patienteninformationszentrum, Universitätsmedizin Greifswald
| | - Ines Buchholz
- Abteilung Methoden der Community Medicine, Universitätsmedizin Greifswald
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204
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van den Borst B, Peters JB, Brink M, Schoon Y, Bleeker-Rovers CP, Schers H, van Hees HWH, van Helvoort H, van den Boogaard M, van der Hoeven H, Reijers MH, Prokop M, Vercoulen J, van den Heuvel M. Comprehensive health assessment three months after recovery from acute COVID-19. Clin Infect Dis 2020; 73:e1089-e1098. [PMID: 33220049 PMCID: PMC7717214 DOI: 10.1093/cid/ciaa1750] [Citation(s) in RCA: 261] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Indexed: 12/14/2022] Open
Abstract
Background Long-term health sequelae of coronavirus disease 2019 (COVID-19) may be multiple but have thus far not been systematically studied. Methods All patients discharged after COVID-19 from the Radboud University Medical Center, Nijmegen, the Netherlands, were consecutively invited to a multidisciplinary outpatient facility. Also, nonadmitted patients with mild disease but with symptoms persisting >6 weeks could be referred by general practitioners. Patients underwent a standardized assessment including measurements of lung function, chest computed tomography (CT)/X-ray, 6-minute walking test, body composition, and questionnaires on mental, cognitive, health status, and quality of life (QoL). Results 124 patients (59 ± 14 years, 60% male) were included: 27 with mild, 51 with moderate, 26 with severe, and 20 with critical disease. Lung diffusion capacity was below the lower limit of normal in 42% of discharged patients. 99% of discharged patients had reduced ground-glass opacification on repeat CT imaging, and normal chest X-rays were found in 93% of patients with mild disease. Residual pulmonary parenchymal abnormalities were present in 91% of discharged patients and correlated with reduced lung diffusion capacity. Twenty-two percent had low exercise capacity, 19% low fat-free mass index, and problems in mental and/or cognitive function were found in 36% of patients. Health status was generally poor, particularly in the domains functional impairment (64%), fatigue (69%), and QoL (72%). Conclusions This comprehensive health assessment revealed severe problems in several health domains in a substantial number of ex–COVID-19 patients. Longer follow-up studies are warranted to elucidate natural trajectories and to find predictors of complicated long-term trajectories of recovery.
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Affiliation(s)
- Bram van den Borst
- Department of Pulmonary Diseases, Radboud university medical center, Nijmegen, The Netherlands
| | - Jeannette B Peters
- Department of Pulmonary Diseases, Radboud university medical center, Nijmegen, The Netherlands.,Department of Medical Psychology, Radboud university medical center, Nijmegen, The Netherlands
| | - Monique Brink
- Department of Radiology, Nuclear Medicine and Anatomy, Radboud university medical center, Nijmegen, The Netherlands
| | - Yvonne Schoon
- Department of Geriatric Medicine, Radboud university medical center, Nijmegen, The Netherlands
| | - Chantal P Bleeker-Rovers
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands
| | - Henk Schers
- Department of Primary Care Medicine, Radboud university medical center, Nijmegen, The Netherlands
| | - Hieronymus W H van Hees
- Department of Pulmonary Diseases, Radboud university medical center, Nijmegen, The Netherlands
| | - Hanneke van Helvoort
- Department of Pulmonary Diseases, Radboud university medical center, Nijmegen, The Netherlands
| | - Mark van den Boogaard
- Department of Intensive Care, Radboud university medical center, Nijmegen, The Netherlands
| | - Hans van der Hoeven
- Department of Intensive Care, Radboud university medical center, Nijmegen, The Netherlands
| | - Monique H Reijers
- Department of Pulmonary Diseases, Radboud university medical center, Nijmegen, The Netherlands
| | - Mathias Prokop
- Department of Radiology, Nuclear Medicine and Anatomy, Radboud university medical center, Nijmegen, The Netherlands
| | - Jan Vercoulen
- Department of Medical Psychology, Radboud university medical center, Nijmegen, The Netherlands
| | - Michel van den Heuvel
- Department of Pulmonary Diseases, Radboud university medical center, Nijmegen, The Netherlands
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205
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Elera-Fitzcarrald C, Rocha J, Burgos PI, Ugarte-Gil MF, Petri M, Alarcón GS. Measures of Fatigue in Patients With Rheumatic Diseases: A Critical Review. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:369-409. [PMID: 33091265 DOI: 10.1002/acr.24246] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/28/2020] [Indexed: 12/13/2022]
Affiliation(s)
| | - Judith Rocha
- Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paula I Burgos
- Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Manuel F Ugarte-Gil
- Hospital Guillermo Almenara Irigoyen, and Universidad Científica del Sur, Lima, Peru
| | - Michelle Petri
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Graciela S Alarcón
- University of Alabama at Birmingham, and Universidad Peruana Cayetano Heredia, Lima, Peru
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206
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Westdorp H, Creemers JHA, van Oort IM, Mehra N, Hins-de Bree SM, Figdor CG, Witjes JA, Schreibelt G, de Vries IJM, Gerritsen WR, Ottevanger PB. High Health-Related Quality of Life During Dendritic Cell Vaccination Therapy in Patients With Castration-Resistant Prostate Cancer. Front Oncol 2020; 10:536700. [PMID: 33194595 PMCID: PMC7649342 DOI: 10.3389/fonc.2020.536700] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 09/24/2020] [Indexed: 01/22/2023] Open
Abstract
Background Maintaining health-related quality of life (HRQoL) is highly desirable during systemic therapies for patients with castration-resistant prostate cancer (CRPC). Patient-reported outcome measures (PROs) were studied in our phase IIa trial on cellular-based immunotherapy with dendritic cells (DC). Methods We treated 21 chemo-naive asymptomatic or minimally symptomatic patients with CRPC with maximally three cycles of DC vaccinations (ClinicalTrials.gov, NCT02692976). Here, we report the impact of DC vaccination on HRQoL. PROs were assessed using the EORTC-QLQ-C30, the EORTC-QLQ-PR25, Checklist Individual Strength (CIS20-R), and Beck Depression Inventory Primary Care questionnaires. Short-term and long-term vaccine-related effects on HRQoL were studied. Results Questionnaires were collected at baseline (n=20), week 6 (n=19), week 12 (n=18), week 24 (n=13), week 50 (n=8) and week 100 (n=2). No clinically relevant differences in symptom-related outcome, functioning-related outcome, and Global Health Status were observed directly after the first cycle of DC vaccinations (week 6) and at follow-up (week 12) compared to baseline. HRQoL remained high throughout the vaccination cycle and six weeks afterward. In radiographic non-progressive patients, who continued DC vaccination, high HRQoL scores were observed up to one and two years after study enrolment. Conclusions Patients with asymptomatic or minimally symptomatic CRPC show high HRQoL throughout DC-based immunotherapy. This is a clinically relevant finding in this older-aged patient population with advanced prostate cancer.
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Affiliation(s)
- Harm Westdorp
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboudumc, Nijmegen, Netherlands.,Department of Medical Oncology, Radboudumc, Nijmegen, Netherlands
| | - Jeroen H A Creemers
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboudumc, Nijmegen, Netherlands.,Oncode Institute, Nijmegen, Netherlands
| | | | - Niven Mehra
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboudumc, Nijmegen, Netherlands.,Department of Medical Oncology, Radboudumc, Nijmegen, Netherlands
| | - Simone M Hins-de Bree
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboudumc, Nijmegen, Netherlands
| | - Carl G Figdor
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboudumc, Nijmegen, Netherlands.,Oncode Institute, Nijmegen, Netherlands
| | | | - Gerty Schreibelt
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboudumc, Nijmegen, Netherlands
| | - I Jolanda M de Vries
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboudumc, Nijmegen, Netherlands.,Department of Medical Oncology, Radboudumc, Nijmegen, Netherlands
| | - Winald R Gerritsen
- Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Radboudumc, Nijmegen, Netherlands.,Department of Medical Oncology, Radboudumc, Nijmegen, Netherlands
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207
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Efficacy and Safety of Sipjeondaebo-Tang (Shi-Quan-Da-Bu-Tang) for Chronic Fatigue Syndrome: Study Protocol for a Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020. [DOI: 10.1155/2020/4708374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background. Sipjeondaebo-tang (SDT), also known as Shi-Quan-Da-Bu-Tang, is a treatment for both qi and blood deficiency syndromes in traditional Korean medicine. It is also used to treat chronic fatigue syndrome (CFS) in Korea. Herein, we present the protocol for a study to assess the efficacy and safety of SDT for treating CFS. Methods. This will be a multicenter, randomized, double-blind, controlled trial with two parallel-treatment arms: an SDT group and a placebo group. Ninety-six patients with CFS aged between 19 and 65 years will be recruited from two hospitals in Korea. Participants will be randomly allocated at a ratio of 1 : 1 between the two groups. Participants will receive 3 g doses of SDT or placebo thrice daily for 8 weeks. Follow-up evaluations will be performed for 4–6 weeks after the drug administration period. The primary outcome will be the rating of participants’ fatigue symptoms using the Checklist Individual Strength questionnaire. Outcomes will be assessed at baseline, week 4, and week 8, as well as during follow-up. An efficacy evaluation and safety assessment will be performed. This study will be based on the Consolidated Standards of Reporting Trials (CONSORT) guidelines and the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 statement. This protocol and informed consent guidelines were reviewed and approved by the institutional review board of Kyung Hee University Korean Medicine Hospital at Gangdong in the Republic of Korea (KHNMCOH 2017-06-004-001). The protocol was registered with the Clinical Research Information Service. Written informed consent will be obtained from all study participants prior to enrollment in the study. Results will be published in a peer-reviewed journal and presented at a scientific conference. Discussion. This study is expected to provide novel, accurate information regarding the 38 efficacy and safety of SDT for CFS in adults. Trial Registration. This trial is registered with https://cris.nih.go.kr; CRIS identifier (KCT0002684) registered on February 9, 2018.
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208
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van 't Hul AJ, Koolen EH, Antons JC, de Man M, Djamin RS, In 't Veen JCCM, Simons SO, van den Heuvel M, van den Borst B, Spruit MA. Treatable traits qualifying for nonpharmacological interventions in COPD patients upon first referral to a pulmonologist: the COPD sTRAITosphere. ERJ Open Res 2020; 6:00438-2020. [PMID: 33263050 PMCID: PMC7682701 DOI: 10.1183/23120541.00438-2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/26/2020] [Indexed: 12/28/2022] Open
Abstract
Introduction The present study assessed the prevalence of nine treatable traits (TTs) pinpointing nonpharmacological interventions in patients with COPD upon first referral to a pulmonologist, how these TTs co-occurred and whether and to what extent the TTs increased the odds having a severely impaired health status. Methods Data were collected from a sample of 402 COPD patients. A second sample of 381 patients with COPD was used for validation. Nine TTs were assessed: current smoking status, activity-related dyspnoea, frequent exacerbations <12 months, severe fatigue, depressed mood, poor physical capacity, low physical activity, poor nutritional status and a low level of self-management activation. For each TT the odds ratio (OR) of having a severe health status impairment was calculated. Furthermore, a graphic representation was created, the COPD sTRAITosphere, to visualise TTs prevalence and OR. Results On average 3.9±2.0 TTs per patient were observed. These TTs occurred relatively independently of each other and coexisted in 151 unique combinations. A significant positive correlation was found between the number of TTs and Clinical COPD Questionnaire total score (r=0.58; p<0.001). Patients with severe fatigue (OR: 8.8), severe activity-related dyspnoea (OR: 5.8) or depressed mood (OR: 4.2) had the highest likelihood of having a severely impaired health status. The validation sample corroborated these findings. Conclusions Upon first referral to a pulmonologist, COPD patients show multiple TTs indicating them to several nonpharmacological interventions. These TTs coexist in many different combinations, are relatively independent and increase the likelihood of having a severely impaired health status.
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Affiliation(s)
- Alex J van 't Hul
- Radboud University Medical Center, Radboud Institute for Health Sciences, Dept of Respiratory Diseases, Nijmegen, The Netherlands
| | - Eleonore H Koolen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Dept of Respiratory Diseases, Nijmegen, The Netherlands
| | - Jeanine C Antons
- Radboud University Medical Center, Radboud Institute for Health Sciences, Dept of Respiratory Diseases, Nijmegen, The Netherlands
| | - Marianne de Man
- Bernhoven, Dept of Respiratory Diseases, Uden, The Netherlands
| | - Remco S Djamin
- Dept of Respiratory Diseases, Amphia Hospital, Breda, The Netherlands
| | - Johannes C C M In 't Veen
- Dept of Respiratory Diseases, STZ Centre of Excellence for Asthma & COPD, Franciscus Gasthuis & Vlietland Hospital, Rotterdam, The Netherlands
| | - Sami O Simons
- Dept of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Michel van den Heuvel
- Radboud University Medical Center, Radboud Institute for Health Sciences, Dept of Respiratory Diseases, Nijmegen, The Netherlands
| | - Bram van den Borst
- Radboud University Medical Center, Radboud Institute for Health Sciences, Dept of Respiratory Diseases, Nijmegen, The Netherlands
| | - Martijn A Spruit
- Dept of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands.,Dept of Research and Development, CIRO+, Horn, The Netherlands.,REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
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209
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Wenninger S, Stahl K, Montagnese F, Schoser B. Utility and Results from a Patient-Reported Online Survey in Myotonic Dystrophies Types 1 and 2. Eur Neurol 2020; 83:523-533. [PMID: 33120389 DOI: 10.1159/000511237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/23/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Myotonic dystrophies (DMs) are the most frequent autosomal dominant neuromuscular disorders in adults. Our objective was to evaluate the utility of an online survey in a rare disease as well as to assess and compare the onset and the progression of clinical symptoms in patients with myotonic dystrophy types 1 (DM1) and 2 (DM2). METHODS We conducted a patient's reported online survey assessing demographics, disease-related symptoms (age of onset, first symptom, time of diagnosis, current symptoms, inheritance, and family history) combined with capturing current symptoms by validated questionnaires. The questionnaire consisted of open, closed, single- and multiple-choice questions. Multiple answers were possible in some cases. Patients with genetically confirmed DM1 or DM2 who were registered in the German DM registry or the Deutsche Gesellschaft für Muskelkranke e.V. - Diagnostic Group for DMs were invited to participate in this online survey. We calculated descriptive and exploratory analysis, where applicable. RESULTS Out of 677 data sets from respondents, 394 were suitable for final analysis, containing completed questionnaires from 207 DM1 (56% female) and 187 DM2 patients (71% female). The median age of onset was 28 years for DM1 and 35 years for DM2. Muscular symptoms were most frequently reported as the first symptom. The onset of myotonia was earlier than the onset of muscle weakness in both DM1 and DM2. Forty-four percent of patients with DM1 and one-third of patients with DM2 indicated muscle weakness as the first symptom. Patients with DM1 were significantly younger when experiencing muscle weakness as first symptom. Fatigue was only mentioned by a small fraction of patients as a first symptom but increased significantly in the course of the disease. There was no statistically significant difference in the incidence of cataracts, cardiac symptoms, and gastrointestinal symptoms between DM1 and DM2. Falls were reported almost equally in both groups, and most of the patients reported 2-3 falls within the past year. DISCUSSION Overall, as our results are consistent with the results of clinical studies and online registries, it can be assumed that this type of systematic gathering of data from patients with rare diseases is useful and provides realistic and appropriate results. Due to the nature of online surveys and the absence of an assessor, some uncertainty remains. Furthermore, survey frauds cannot be completely excluded. An additional clinical assessment could confirm the given information and will improve the utility and validity of reported symptoms participants provide in online surveys. Therefore, we recommend a combination of data collecting by online surveys and clinical assessments.
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Affiliation(s)
- Stephan Wenninger
- Department of Neurology, Friedrich-Baur-Institute, Ludwig-Maximilians-University Munich, Munich, Germany,
| | - Kristina Stahl
- Department of Neurology, Friedrich-Baur-Institute, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Federica Montagnese
- Department of Neurology, Friedrich-Baur-Institute, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Benedikt Schoser
- Department of Neurology, Friedrich-Baur-Institute, Ludwig-Maximilians-University Munich, Munich, Germany
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210
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Systematic Review of Primary Outcome Measurements for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) in Randomized Controlled Trials. J Clin Med 2020; 9:jcm9113463. [PMID: 31906979 PMCID: PMC7692998 DOI: 10.3390/jcm9113463] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 12/17/2022] Open
Abstract
Background: Due to its unknown etiology, the objective diagnosis and therapeutics of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) are still challenging. Generally, the patient-reported outcome (PRO) is the major strategy driving treatment response because the patient is the most important judge of whether changes are meaningful. Methods: In order to determine the overall characteristics of the main outcome measurement applied in clinical trials for CFS/ME, we systematically surveyed the literature using two electronic databases, PubMed and the Cochrane Library, throughout June 2020. We analyzed randomized controlled trials (RCTs) for CFS/ME focusing especially on main measurements. Results: Fifty-two RCTs out of a total 540 searched were selected according to eligibility criteria. Thirty-one RCTs (59.6%) used single primary outcome and others adapted ≥2 kinds of measurements. In total, 15 PRO-derived tools were adapted (50 RCTs; 96.2%) along with two behavioral measurements for adolescents (4 RCTs; 7.7%). The 36-item Short Form Health Survey (SF-36; 16 RCTs), Checklist Individual Strength (CIS; 14 RCTs), and Chalder Fatigue Questionnaire (CFQ; 11 RCTs) were most frequently used as the main outcomes. Since the first RCT in 1996, Clinical Global Impression (CGI) and SF-36 have been dominantly used each in the first and following decade (26.1% and 28.6%, respectively), while both CIS and Multidimensional Fatigue Inventory (MFI) have been the preferred instruments (21.4% each) in recent years (2016 to 2020). Conclusions: This review comprehensively provides the choice pattern of the assessment tools for interventions in RCTs for CFS/ME. Our data would be helpful practically in the design of clinical studies for CFS/ME-related therapeutic development.
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211
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Physical or Cognitive Exertion Does Not Influence Cortical Movement Preparation for Rapid Arm Movements. Motor Control 2020; 24:473-498. [DOI: 10.1123/mc.2019-0115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 05/04/2020] [Accepted: 05/14/2020] [Indexed: 11/18/2022]
Abstract
The contribution of central factors to movement preparation (e.g., the contingent negative variation [CNV]) and the influence of fatigue on such factors are still unclear, even though executive cognitive functions are regarded as key elements in motor control. Therefore, this study examined CNV amplitude with electroencephalography in 22 healthy humans during a rapid arm movement task prior to and following three experimental conditions: (a) a no exertion/control condition, (b) a physical exertion, and (c) a cognitive exertion. CNV amplitude was affected neither by a single bout of physical/cognitive exertion nor by the control condition. Furthermore, no time-on-task effects of the rapid arm movement task on the CNV were found. Exertion did not affect cortical movement preparation, which is in contrast to previous findings regarding time-on-task effects of exertion on CNV. Based on the current findings, the rapid arm movement task is deemed suitable to measure cortical movement preparation, without being affected by learning effects and physical/cognitive exertion.
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Somville F, Stiers M, Franck E, Van Bogaert P. Determinants of emergency physician wellness in Belgium. J Am Coll Emerg Physicians Open 2020; 1:1013-1022. [PMID: 33145553 PMCID: PMC7593456 DOI: 10.1002/emp2.12169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/21/2020] [Accepted: 06/03/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This cross-sectional study examines first whether emergency physicians differ from a comparison group of surgeons, more specifically general surgeons and orthopedic surgeons, in terms of job and organizational characteristics and second to what extent these characteristics are determinants of professional well-being outcomes in emergency physicians. METHODS Belgian emergency physicians (n = 346) were invited to participate in this study. Forty-three percent of the eligible participants completed a questionnaire. The survey instrument contained 48 questions on determinants (personal characteristics, job conditions [Job Demand Control Support], organizational and environmental work conditions) as well as 39 questions on outcomes (job satisfaction, turnover intention, subjective fatigue, psychological distress, work-home interference, work engagement) by means of the Leiden Quality of Work Questionnaire for Medical Doctors, the Checklist Individual Strength, the Brief Symptom Inventory, and the Utrecht Work Engagement Scale. Hierarchical multiple regression analyses were used to examine the association between the determinants and each of the outcomes. RESULTS Emergency physicians reported higher job demands, lower job control, and less adequate work conditions compared with the group of surgeons. High job demands increased turnover intention, subjective fatigue, psychological distress, work-home interference in emergency physicians, but lack of job control, lack of social support from the supervisor, and inadequate communication also contributed in an unfavorable way to some of these outcomes. CONCLUSION Emergency medicine departments must reduce the constant exposure to high job demands by allowing emergency physicians to have enough time for both physical and mental recovery. Work motivation and work conditions might be improved by increasing job control over job demands by giving emergency physicians more decision latitude and autonomy, improving good communication and teamwork and adequate social support from the supervisor and providing good material resources. These interventions can improve professional well-being outcomes in emergency physicians.
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Affiliation(s)
- Francis Somville
- Department of Emergency MedicineUniversity of Antwerp, UZAEdegemBelgium
- Department of Emergency and TraumatologyAZ St Dimpna (Erica campus Geel)GeelBelgium
| | - Michiel Stiers
- Department of Emergency and TraumatologyAZ St Dimpna (Erica campus Geel)GeelBelgium
- Department of Emergency MedicineUniversity of Leuven, UZ LeuvenLeuvenBelgium
| | - Erik Franck
- Department of Nursing and Midwifery SciencesCentre for Research and Innovation in Care (CRIC) Campus Drie EikenWilrijkBelgium
| | - Peter Van Bogaert
- Department of Nursing and Midwifery SciencesCentre for Research and Innovation in Care (CRIC) Campus Drie EikenWilrijkBelgium
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213
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Sweegers MG, Zalpuri S, Quee FA, Huis In 't Veld EMJ, Prinsze FJ, Hoogendijk EO, Twisk JWR, van Weert AWM, de Kort WLAM, van den Hurk K. Ferritin measurement IN Donors-Effectiveness of iron Monitoring to diminish iron deficiency and low haemoglobin in whole blood donors (FIND'EM): study protocol for a stepped wedge cluster randomised trial. Trials 2020; 21:823. [PMID: 32998766 PMCID: PMC7528293 DOI: 10.1186/s13063-020-04648-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 07/31/2020] [Indexed: 11/15/2022] Open
Abstract
Background Blood donors are at risk for reduced iron stores, because of which donor iron monitoring received increased attention in the last decade. Despite the importance for donor health, international consensus on an appropriate policy for iron monitoring is lacking. Therefore, we conduct a trial to evaluate to what extent ferritin-guided donation intervals are effective in increasing haemoglobin and ferritin levels, decreasing low-haemoglobin deferral, increasing donor return and improving the health of whole blood donors in the Netherlands. Methods Sanquin Blood Bank is implementing ferritin-guided donation intervals to prevent donors from increasing iron loss at repeated donations. Using a stepped wedge cluster randomised trial approach, the design involves a random crossover of 29 clusters of blood collection centres from the existing policy without ferritin measurements to a ferritin-guided donation interval policy. This new policy includes ferritin measurements for all new donors and at every 5th whole blood donation, extending donation intervals to 6 months if ferritin is 15–≤ 30 ng/mL and to 12 months if ferritin is < 15 ng/mL. We measure ferritin levels of whole blood donors from stored plasma samples and collect haemoglobin levels and information on low-haemoglobin deferral and donor return from the donor database before, during and after the implementation period. We measure donor health during and after the implementation period using questionnaires, assessing physical and mental wellbeing and iron deficiency- and donation-related symptoms. We use multilevel analyses to investigate differences in ferritin and haemoglobin levels, low-haemoglobin deferral rates, donor return and donor health from whole blood donors, between blood collection centres that have versus those that have not yet implemented the ferritin-guided donation interval policy. Discussion This stepped wedge cluster randomised trial will provide insight into the effectiveness of ferritin-guided donation intervals in lowering iron deficiency, decreasing donor deferrals due to low haemoglobin and improving donor health. We will evaluate a policy that is implemented nationwide in a real-life setting. Our study is therefore not limited to a small experimental setting and the results will guide policymakers seeking an appropriate policy for iron monitoring. Trial registration The Dutch trial registry NTR6738. Registered on 29 September 2017. Retrospectively registered.
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Affiliation(s)
| | | | - Franke A Quee
- Donor Studies, Sanquin Research, Amsterdam, The Netherlands
| | - Elisabeth M J Huis In 't Veld
- Donor Studies, Sanquin Research, Amsterdam, The Netherlands.,Department of Cognitive Science & Artificial Intelligence, Tilburg University, Tilburg, The Netherlands
| | | | - Emiel O Hoogendijk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC - Location VU University Medical Centre, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC - Location VU University Medical Centre, Amsterdam, The Netherlands
| | - Anton W M van Weert
- National Screening Laboratory Sanquin, Sanquin Research and Labservices, Amsterdam, The Netherlands
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214
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Koolen EH, van den Borst B, de Man M, Antons JC, Robberts B, Dekhuijzen PNR, Vercoulen JH, van den Heuvel M, Spruit MA, van der Wees PJ, van 't Hul AJ. The clinical effectiveness of the COPDnet integrated care model. Respir Med 2020; 172:106152. [PMID: 32956973 DOI: 10.1016/j.rmed.2020.106152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/14/2020] [Accepted: 09/09/2020] [Indexed: 12/28/2022]
Abstract
RATIONALE Integrated care models have the potential to improve outcomes for patients with COPD. We therefore designed the COPDnet integrated care model and implemented it in two hospitals and affiliated primary care regions in the Netherlands. The COPDnet model consists of a comprehensive diagnostic trajectory ran in secondary care followed by a non-pharmacological intervention program of both monodisciplinary and multidisciplinary components. OBJECTIVE To assess the clinical effectiveness of the COPDnet integrated care model on health status change in patients with COPD. METHODS A total of 402 patients with COPD were offered care according to the COPDnet model. At baseline and between 7- and 9-months later health status was measured with the Clinical COPD Questionnaire (CCQ). Primary analysis was carried out for the sample at large. In addition, subgroup analyses were performed after stratification for the type of non-pharmacological intervention where patients had been referred to. RESULTS The CCQ total score improved statistically significantly from 1.94 ± 1.04 to 1.73 ± 0.96 (P < 0.01) in the 154 patients with valid follow-up measurements. Subgroup analyses revealed significant improvements in the patients receiving pulmonary rehabilitation only. No change in health status was found in patients receiving pharmacotherapy only, carried out self-treatment or who participated in mono-disciplinary primary care offered by allied healthcare professionals. CONCLUSIONS An improved health status was found in patients with COPD who received care according to the COPDnet integrated care model. Subgroups participating in an interdisciplinary pulmonary rehabilitation program predominantly accounted for this effect.
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Affiliation(s)
- E H Koolen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Respiratory Diseases, 6525 GA, Nijmegen, the Netherlands
| | - B van den Borst
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Respiratory Diseases, 6525 GA, Nijmegen, the Netherlands
| | - M de Man
- Bernhoven, Department of Pulmonary Diseases, 5406 PT, Uden, the Netherlands
| | - J C Antons
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Respiratory Diseases, 6525 GA, Nijmegen, the Netherlands
| | - B Robberts
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Respiratory Diseases, 6525 GA, Nijmegen, the Netherlands
| | - P N R Dekhuijzen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Respiratory Diseases, 6525 GA, Nijmegen, the Netherlands
| | - J H Vercoulen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, 6525 GA, Nijmegen, the Netherlands
| | - M van den Heuvel
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Respiratory Diseases, 6525 GA, Nijmegen, the Netherlands
| | - M A Spruit
- Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, 6229 HX, Maastricht, the Netherlands; Department of Research and Development, CIRO+, 6085 NM, Horn, the Netherlands; REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3590 BE, Diepenbeek, Belgium
| | - P J van der Wees
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Department of Rehabilitation, 6525 GA, Nijmegen, the Netherlands
| | - A J van 't Hul
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Respiratory Diseases, 6525 GA, Nijmegen, the Netherlands.
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215
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Shin S, Park SJ, Hwang M. Effectiveness a herbal medicine ( Sipjeondaebo-tang) on adults with chronic fatigue syndrome: A randomized, double-blind, placebo-controlled trial. Integr Med Res 2020; 10:100664. [PMID: 33101925 PMCID: PMC7578262 DOI: 10.1016/j.imr.2020.100664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 02/06/2023] Open
Abstract
Background Sipjeondaebo-tang (SJDBT, Shi-quan-da-bu-tang in Chinese) is a widely prescribed herbal medicine in traditional Korean medicine. This study aimed to evaluate the effectiveness and safety of SJDBT for treating chronic fatigue syndrome (CFS). Methods Ninety-six eligible participants were randomly allocated to either the SJDBT or placebo groups in a 1:1 ratio. Nine grams of SJDBT or placebo granules were administered to the patients for 8 weeks. The primary outcome was the response rate, defined as the proportion of participants with a score of 76 or higher in the Checklist Individual Strength assessment. Other measurements for fatigue severity, quality of life, and qi/blood/yin/yang deficiency were included. Safety was assessed throughout the trial. Results At week 8, the response rate did not significantly differ between the groups (SJDBT: 35.4%; placebo: 54.2%; P = 0.101, effect size [95% confidence interval] = 0.021 [-0.177, 0.218]). However, the scores of the visual analogue scale (P = 0.001, -0.327 [-0.506, -0.128]), Fatigue Severity Scale (P = 0.020, 0.480 [0.066, 0.889]), and Chalder fatigue scale (P = 0.004, -0.292 [-0.479, -0.101]) for the SJDBT group showed significant improvements in fatigue severity at the endpoint. Quality of life was not significantly different. Furthermore, SJDBT significantly ameliorated the severity of qi deficiency compared to that in the placebo group. No serious adverse events were observed. Conclusion This trial failed to show a significant improvement in fatigue severity, as assessed by the CIS-deprived response rate. It merely showed that SJDBT could alleviate the severity of fatigue and qi deficiency in patients with CFS. However, the further study is needed to confirm the details.
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Affiliation(s)
- Seungwon Shin
- National Agency for Development of Innovative Technologies in Korean Medicine, National Development Institute of Korean Medicine, Seoul, Republic of Korea.,Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Soo Jung Park
- Department of Sasang Constitutional Medicine, College of Korean Medicine, Woosuk University, Jeonju, Republic of Korea
| | - Minwoo Hwang
- Department of Sasang Constitutional Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
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216
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Lawley A, Abbas A, Seri S, Rajabally YA. Peripheral nerve electrophysiology studies in relation to fatigue in patients with chronic inflammatory demyelinating polyneuropathy. Clin Neurophysiol 2020; 131:2926-2931. [PMID: 32928696 DOI: 10.1016/j.clinph.2020.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 07/07/2020] [Accepted: 08/03/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To explore the relationship between fatigue, standard electrophysiological parameters and number and size of functioning motor units in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). METHODS Experienced fatigue was assessed using the linearly-weighted, modified Rasch-built fatigue severity scale (R-FSS) and the multidimensional Checklist of Individual Strength (CIS). Averaged electrophysiology values were calculated from multiple nerves. Motor Unit Number Index (MUNIX) technique was utilised to assess motor unit function. Assessments were repeated in 15 patients receiving regular intravenous immunoglobulin therapy, with changes in parameters calculated. RESULTS R-FSS and CIS scores did not correlate MUNIX or MUSIX sum scores from 3 different muscles. Inverse correlation was observed only between distal CMAP area and R-FSS but not CIS scores. However, changes in distal CMAP area and R-FSS scores on repeat assessment were not correlated. CONCLUSIONS Experienced fatigue does not appear to correlate with loss of functioning motor units in patients with CIDP. Changes in experienced fatigue on repeat assessment did not correlate with changes in any of the electrophysiological parameters, suggesting fatigue experienced in CIDP is not strongly correlated with peripheral nerve dysfunction. SIGNIFICANCE Nerve conduction studies and MUNIX values do not appear to be useful surrogate markers for fatigue in CIDP.
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Affiliation(s)
- Andrew Lawley
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK; Department of Clinical Neurophysiology, The Birmingham Women's and Children's Hospital NHS Foundation Trust, UK
| | - Ahmed Abbas
- Inflammatory Neuropathy Clinic, University Hospitals Birmingham, Birmingham, UK
| | - Stefano Seri
- School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK; Department of Clinical Neurophysiology, The Birmingham Women's and Children's Hospital NHS Foundation Trust, UK
| | - Yusuf A Rajabally
- Inflammatory Neuropathy Clinic, University Hospitals Birmingham, Birmingham, UK; Aston Medical School, Aston University, Birmingham, UK.
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217
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VAN Vulpen JK, Sweegers MG, Peeters PHM, Courneya KS, Newton RU, Aaronson NK, Jacobsen PB, Galvão DA, Chinapaw MJ, Steindorf K, Irwin ML, Stuiver MM, Hayes S, Griffith KA, Mesters I, Knoop H, Goedendorp MM, Mutrie N, Daley AJ, McConnachie A, Bohus M, Thorsen L, Schulz KH, Short CE, James EL, Plotnikoff RC, Schmidt ME, Ulrich CM, VAN Beurden M, Oldenburg HS, Sonke GS, VAN Harten WH, Schmitz KH, Winters-Stone KM, Velthuis MJ, Taaffe DR, VAN Mechelen W, Kersten MJ, Nollet F, Wenzel J, Wiskemann J, Verdonck-DE Leeuw IM, Brug J, May AM, Buffart LM. Moderators of Exercise Effects on Cancer-related Fatigue: A Meta-analysis of Individual Patient Data. Med Sci Sports Exerc 2020; 52:303-314. [PMID: 31524827 DOI: 10.1249/mss.0000000000002154] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE Fatigue is a common and potentially disabling symptom in patients with cancer. It can often be effectively reduced by exercise. Yet, effects of exercise interventions might differ across subgroups. We conducted a meta-analysis using individual patient data of randomized controlled trials (RCT) to investigate moderators of exercise intervention effects on cancer-related fatigue. METHODS We used individual patient data from 31 exercise RCT worldwide, representing 4366 patients, of whom 3846 had complete fatigue data. We performed a one-step individual patient data meta-analysis, using linear mixed-effect models to analyze the effects of exercise interventions on fatigue (z score) and to identify demographic, clinical, intervention- and exercise-related moderators. Models were adjusted for baseline fatigue and included a random intercept on study level to account for clustering of patients within studies. We identified potential moderators by testing their interaction with group allocation, using a likelihood ratio test. RESULTS Exercise interventions had statistically significant beneficial effects on fatigue (β = -0.17; 95% confidence interval [CI], -0.22 to -0.12). There was no evidence of moderation by demographic or clinical characteristics. Supervised exercise interventions had significantly larger effects on fatigue than unsupervised exercise interventions (βdifference = -0.18; 95% CI -0.28 to -0.08). Supervised interventions with a duration ≤12 wk showed larger effects on fatigue (β = -0.29; 95% CI, -0.39 to -0.20) than supervised interventions with a longer duration. CONCLUSIONS In this individual patient data meta-analysis, we found statistically significant beneficial effects of exercise interventions on fatigue, irrespective of demographic and clinical characteristics. These findings support a role for exercise, preferably supervised exercise interventions, in clinical practice. Reasons for differential effects in duration require further exploration.
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Affiliation(s)
- Jonna K VAN Vulpen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | | | - Petra H M Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, CANADA
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, THE NETHERLANDS
| | - Paul B Jacobsen
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA
| | - Mai J Chinapaw
- Amsterdam UMC, Vrije Universiteit, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, THE NETHERLANDS
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, GERMANY
| | | | - Martijn M Stuiver
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, THE NETHERLANDS
| | - Sandi Hayes
- School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, AUSTRALIA
| | | | - Ilse Mesters
- Department of Epidemiology, Maastricht University, THE NETHERLANDS
| | - Hans Knoop
- Amsterdam UMC, University of Amsterdam, Department of Medical Psychology, Amsterdam, THE NETHERLANDS
| | | | - Nanette Mutrie
- Physical Activity for Health Research Center, University of Edinburgh, Edinburgh, UNITED KINGDOM
| | - Amanda J Daley
- School of Sport, Exercise and Health Sciences, University of Loughborough, Loughborough, Leicestershire, UNITED KINGDOM
| | - Alex McConnachie
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UNITED KINGDOM
| | | | | | - Karl-Heinz Schulz
- Athleticum-Competence Center for Sports- and Exercise Medicine and Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, GERMANY
| | - Camille E Short
- Freemasons Foundation Centre of Men's Health, School of Medicine, University of Adelaide, SA, AUSTRALIA
| | - Erica L James
- School of Medicine & Public Health, the University of Newcastle, Callaghan, NSW, AUSTRALIA
| | - Ronald C Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, Callaghan, NSW, AUSTRALIA
| | - Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, GERMANY
| | - Cornelia M Ulrich
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT
| | | | | | - Gabe S Sonke
- Netherlands Cancer Institute, Amsterdam, THE NETHERLANDS
| | | | - Kathryn H Schmitz
- Department of Public Health Science, College of Medicine and Cancer Institute, Pennsylvania State University, Hershey, PA
| | - Kerri M Winters-Stone
- Knight Cancer Institute, School of Nursing, Oregon Health & Science University, Portland, OR
| | - Miranda J Velthuis
- Netherlands comprehensive cancer organisation (IKNL), Utrecht, THE NETHERLANDS
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA
| | - Willem VAN Mechelen
- Amsterdam UMC, Vrije Universiteit, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, THE NETHERLANDS
| | - Marie José Kersten
- Amsterdam UMC, University of Amsterdam, Department of Hematology, Amsterdam, THE NETHERLANDS
| | - Frans Nollet
- Amsterdam UMC, University of Amsterdam Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam, THE NETHERLANDS
| | - Jennifer Wenzel
- Johns Hopkins School of Nursing, Johns Hopkins School of Medicine, Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | | | | | | | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
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218
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Paneroni M, Vitacca M, Venturelli M, Simonelli C, Bertacchini L, Scalvini S, Schena F, Ambrosino N. The impact of exercise training on fatigue in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Pulmonology 2020; 26:304-313. [DOI: 10.1016/j.pulmoe.2020.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 12/13/2022] Open
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219
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Penson A, van Deuren S, Worm-Smeitink M, Bronkhorst E, van den Hoogen FHJ, van Engelen BGM, Peters M, Bleijenberg G, Vercoulen JH, Blijlevens N, van Dulmen-den Broeder E, Loonen J, Knoop H. Short fatigue questionnaire: Screening for severe fatigue. J Psychosom Res 2020; 137:110229. [PMID: 32890861 DOI: 10.1016/j.jpsychores.2020.110229] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/10/2020] [Accepted: 08/25/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine psychometric properties, a cut-off score for severe fatigue and normative data for the 4-item Short Fatigue Questionnaire (SFQ) derived from the multi-dimensional fatigue questionnaire Checklist Individual Strength (CIS). METHODS Data of previous studies investigating the prevalence of fatigue in ten chronic conditions (n = 2985) and the general population (n = 2288) was used to determine the internal consistency (Cronbach's alpha) of the SFQ, its relation with other fatigue measures (EORTC QLQ-30 fatigue subscale and digital fatigue diary), a cut-off score for severe fatigue (ROC analysis) and to examine whether the four SFQ items truly measure the same construct. Norms were calculated for ten patient groups and the Dutch general population. RESULTS Cronbach's alpha of the SFQ were excellent in almost all groups. Pearson's correlations between the SFQ and the EORTC-QLQ-C30 fatigue subscale and a fatigue diary were respectively 0.76 and 0.68. ROC analysis showed an area under the curve of 0.982 (95% CI: 0.979-0.985) and cut-off score of 18 was suggested which showed a good sensitivity (0.984) and specificity (0.826) as well as excellent values for the positive and negative prediction values within all groups using the CIS as golden standard. Factor analysis showed a one factor solution (Eigenvalue: 3.095) with factor loadings of all items on the factor being greater than 0.87. CONCLUSION The SFQ is an easy to use, reliable and valid instrument to screen for severe fatigue in clinical routine and research.
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Affiliation(s)
- Adriaan Penson
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sylvia van Deuren
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Margreet Worm-Smeitink
- Expert Center for Chronic Fatigue, Department of Medical Psychology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Ewald Bronkhorst
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Marlies Peters
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Jan H Vercoulen
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicole Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eline van Dulmen-den Broeder
- Department of Pediatric Oncology/Hematology, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Jacqueline Loonen
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public health research institute, Amsterdam, The Netherlands.
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220
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van Deuren S, van Dulmen-den Broeder E, Boonstra A, Gielissen M, Blijlevens N, Loonen J, Knoop H. Fatigue-Related Cognitive-Behavioral Factors in Survivors of Childhood Cancer: Comparison with Chronic Fatigue Syndrome and Survivors of Adult-Onset Cancer. J Adolesc Young Adult Oncol 2020; 10:92-99. [PMID: 32857640 DOI: 10.1089/jayao.2020.0094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose: Cancer-related fatigue is a burdensome late effect of cancer treatment. A pilot study showed the effectiveness of cognitive-behavioral therapy (CBT) in fatigued survivors of childhood cancer (CCS). The aim of this study is to investigate whether the six cognitive-behavioral factors that are addressed during CBT differ in CCS compared with patients with chronic fatigue syndrome (CFS) and survivors of adult-onset cancer (ACS). Levels of self-esteem, optimism, and depressive symptoms, variables that are also related to fatigue, were also compared between groups. Methods: Retrospective analyses were performed on 34 CCS (ages 11-42 years), 102 patients with CFS, and 95 ACS who were referred for evaluation of severe fatigue. Fatigue severity, possible cognitive-behavioral fatigue maintaining factors, depressive symptoms, self-esteem, and optimism were assessed using questionnaires and actigraphy. Results: No significant differences were found in the factors coping with the experience of having had cancer, fear of cancer recurrence, physical activity, and in levels of self-esteem and optimism. CCS attributed their fatigue significantly more often to psychosocial causes and reported fewer problems in sleep/rest compared with patients with CFS. Compared with ACS, CCS reported significantly more social support, more problems in sleep/rest, and more depressive symptoms. Conclusions: There is substantial overlap in cognitive-behavioral factors that can maintain fatigue between CCS and CFS patients or ACS. Also differences were found regarding attribution of fatigue, the sleep/rest pattern, social support, and depressive symptoms that might have clinical implications when CBT for fatigue is provided to CCS.
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Affiliation(s)
- Sylvia van Deuren
- Radboudumc Center of Expertise for Cancer Survivorship, Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eline van Dulmen-den Broeder
- Department of Pediatric Oncology, VU University, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Amilie Boonstra
- Radboudumc Center of Expertise for Cancer Survivorship, Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Nicole Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jacqueline Loonen
- Radboudumc Center of Expertise for Cancer Survivorship, Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Expert Center for Chronic Fatigue, Amsterdam Public Health Research Institute, VU University, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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Protein Intake, Fatigue and Quality of Life in Stable Outpatient Kidney Transplant Recipients. Nutrients 2020; 12:nu12082451. [PMID: 32824065 PMCID: PMC7469059 DOI: 10.3390/nu12082451] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/09/2020] [Accepted: 08/13/2020] [Indexed: 12/11/2022] Open
Abstract
Fatigue is a frequent complaint in kidney transplant recipients (KTR), often accompanied by poor quality of life (QoL). The role of nutrition as determinant of fatigue in KTR is largely unexplored. The aims of this study are to examine the association of protein intake with fatigue and QoL in KTR and to identify other determinants of fatigue. This cross-sectional study is part of the TransplantLines Cohort and Biobank Study (NCT03272841). Protein intake was calculated from urinary urea nitrogen (UUN) in 24-h urine samples. Fatigue was assessed by the Checklist Individual Strength (CIS) questionnaire; moderate and severe fatigue were defined as a CIS score of 20–34 and ≥ 35, respectively. QoL was assessed with the RAND-36-Item Health Survey (RAND-36). Associations of protein intake with fatigue and QoL were analyzed using multinomial logistic and linear regression analyses. We included 730 stable outpatient KTR (median age 58 year [IQR 48–65], 57% male) with a mean protein intake of 82.2 ± 21.3 g/d. Moderate and severe fatigue were present in 254 (35%) and 245 (34%) of KTR. Higher protein intake was significantly associated with lower risk of moderate fatigue (OR 0.89 per 10 g/d; 95%CI 0.83–0.98, p = 0.01), severe fatigue (OR 0.85; 95%CI 0.78–0.92, p < 0.001) and was associated with higher physical component summary score of QoL (β 0.74 per 10 g/d; 95%CI 0.39–1.09, p < 0.001). Higher BMI, a history of dialysis, glomerulonephritis as primary kidney disease and a history of combined organ transplantation were also associated with severe fatigue. In conclusion, amongst the potential modifiable factors of fatigue, higher protein intake is independently associated with lower risk of moderate and severe fatigue and with better QoL in KTR. These findings underline the need to incorporate nutritional assessment in the diagnostic work-up of fatigue. Intervention studies are needed to assess the benefits and safety of higher protein intake in KTR.
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222
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Ruiter AM, Verschuuren JJ, Tannemaat MR. Fatigue in patients with myasthenia gravis. A systematic review of the literature. Neuromuscul Disord 2020; 30:631-639. [DOI: 10.1016/j.nmd.2020.06.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/09/2020] [Accepted: 06/18/2020] [Indexed: 12/13/2022]
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223
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Schellekens MPJ, Wolvers MDJ, Schroevers MJ, Bootsma TI, Cramer AOJ, van der Lee ML. Exploring the interconnectedness of fatigue, depression, anxiety and potential risk and protective factors in cancer patients: a network approach. J Behav Med 2020; 43:553-563. [PMID: 31435892 PMCID: PMC7366596 DOI: 10.1007/s10865-019-00084-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 07/17/2019] [Indexed: 01/06/2023]
Abstract
Researchers have extensively studied fatigue, depression and anxiety in cancer patients. Several risk and protective factors have been identified for these symptoms. As most studies address these constructs, independently from other symptoms and potential risk and protective factors, more insight into the complex relationships among these constructs is needed. This study used the multivariate network approach to gain a better understanding of how patients' symptoms and risk and protective factors (i.e. physical symptoms, social withdrawal, illness cognitions, goal adjustment and partner support) are interconnected. We used cross-sectional data from a sample of cancer patients seeking psychological care (n = 342). Using network modelling, the relationships among symptoms of fatigue, depression and anxiety, and potential risk and protective factors were explored. Additionally, centrality (i.e. the number and strength of connections of a construct) and stability of the network were explored. Among risk factors, the relationship of helplessness and physical symptoms with fatigue stood out as they were stronger than most other connections in the network. Among protective factors, illness acceptance was most centrally embedded within the network, indicating it had more and stronger connections than most other variables in the network. The network identified key connections with risk factors (helplessness, physical symptoms) and a key protective factor (acceptance) at the group level. Longitudinal studies should explore these risk and protective factors in individual dynamic networks to further investigate their causal role and the extent to which such networks can inform us on what treatment would be most suitable for the individual cancer patient.
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Affiliation(s)
- Melanie P J Schellekens
- Scientific Research Department, Centre for Psycho-Oncology, Helen Dowling Institute, Professor Bronkhorstlaan 20, Postbus 80, 3720 AB, Bilthoven, The Netherlands.
- Department of Methodology and Statistics, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
| | - Marije D J Wolvers
- Scientific Research Department, Centre for Psycho-Oncology, Helen Dowling Institute, Professor Bronkhorstlaan 20, Postbus 80, 3720 AB, Bilthoven, The Netherlands
| | - Maya J Schroevers
- Department of Health Psychology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Tom I Bootsma
- Scientific Research Department, Centre for Psycho-Oncology, Helen Dowling Institute, Professor Bronkhorstlaan 20, Postbus 80, 3720 AB, Bilthoven, The Netherlands
- Department of Cultural Studies, School of Humanities and Digital Sciences, Tilburg University, Tilburg, The Netherlands
| | - Angélique O J Cramer
- Department of Methodology and Statistics, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Marije L van der Lee
- Scientific Research Department, Centre for Psycho-Oncology, Helen Dowling Institute, Professor Bronkhorstlaan 20, Postbus 80, 3720 AB, Bilthoven, The Netherlands
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224
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Schakel L, Veldhuijzen DS, van Middendorp H, Prins C, Drittij AMHF, Vrieling F, Visser LG, Ottenhoff THM, Joosten SA, Evers AWM. An Internet-Based Psychological Intervention With a Serious Game to Improve Vitality, Psychological and Physical Condition, and Immune Function in Healthy Male Adults: Randomized Controlled Trial. J Med Internet Res 2020; 22:e14861. [PMID: 32706667 PMCID: PMC7414409 DOI: 10.2196/14861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 02/05/2020] [Accepted: 02/22/2020] [Indexed: 01/06/2023] Open
Abstract
Background Recently, internet-based cognitive behavioral therapy (ICBT) and serious gaming interventions have been suggested to enhance accessibility to interventions and engagement in psychological interventions that aim to promote health outcomes. Few studies, however, have investigated their effectiveness in the context of simulated real-life challenges. Objective We aimed to examine the effectivity of a guided ICBT combined with a serious gaming intervention in improving self-reported psychophysiological and immunological health endpoints in response to psychophysiological and immune-related challenges. Methods Sixty-nine healthy men were randomly assigned to the intervention condition, receiving ICBT combined with serious gaming for 6 weeks, or the control condition, receiving no intervention. Self-reported vitality was the primary endpoint. Other self-reported psychophysiological and immunological endpoints were assessed following various challenges, including a bacillus Calmette-Guérin vaccination evoking pro-inflammatory responses, 1 and 4 weeks after the intervention period. Results Although the intervention did not affect vitality-associated parameters, self-reported sleep problems (P=.027) and bodily sensations (P=.042) were lower directly after the intervention compared with controls. Furthermore, wellbeing (P=.024) was higher in the intervention group after the psychophysiological challenges. Although no significant group differences were found for the psychophysiological and immunological endpoints, the data provided preliminary support for increased immunoglobulin antibody responses at the follow-up time points (P<.05). Differential chemokine endpoints between conditions were observed at the end of the test day. Conclusions The present study provides some support for improving health endpoints with an innovative ICBT intervention. Future research should replicate and further extend the present findings by consistently including challenges and a wide range of immune parameters into the study design. Trial Registration Nederlands Trial Register NTR5610; https://www.trialregister.nl/trial/5466
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Affiliation(s)
- Lemmy Schakel
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands
| | - Dieuwke S Veldhuijzen
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands
| | - Henriët van Middendorp
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands
| | - Corine Prins
- Department of Infectious Diseases, Leiden University Medical Centre, Leiden, Netherlands
| | - Anne M H F Drittij
- Department of Infectious Diseases, Leiden University Medical Centre, Leiden, Netherlands
| | - Frank Vrieling
- Department of Infectious Diseases, Leiden University Medical Centre, Leiden, Netherlands
| | - Leo G Visser
- Department of Infectious Diseases, Leiden University Medical Centre, Leiden, Netherlands
| | - Tom H M Ottenhoff
- Department of Infectious Diseases, Leiden University Medical Centre, Leiden, Netherlands
| | - Simone A Joosten
- Department of Infectious Diseases, Leiden University Medical Centre, Leiden, Netherlands
| | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition, Leiden University, Leiden, Netherlands.,Department of Psychiatry, Leiden University Medical Centre, Leiden, Netherlands
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225
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Poort H, Onghena P, Abrahams HJG, Jim HSL, Jacobsen PB, Blijlevens NMA, Knoop H. Cognitive Behavioral Therapy for Treatment-Related Fatigue in Chronic Myeloid Leukemia Patients on Tyrosine Kinase Inhibitors: A Mixed-Method Study. J Clin Psychol Med Settings 2020; 26:440-448. [PMID: 30747340 PMCID: PMC6851212 DOI: 10.1007/s10880-019-09607-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Treatment-related fatigue significantly limits quality of life among chronic myeloid leukemia (CML) patients receiving tyrosine kinase inhibitors (TKIs), yet no interventions to reduce this symptom have been studied. We examined preliminary feasibility and efficacy of cognitive behavioral therapy for TKI treatment-related fatigue in patients with CML. We used a mixed methods convergent design and collected quantitative data through randomized single-case experiments. We included CML patients receiving TKIs and reporting severe fatigue. Within each participant, we compared CBT to a no-treatment baseline period. Fatigue severity was measured weekly with the Checklist Individual Strength. Fatigue scores were subjected to visual analyses and randomization tests for single-case experimental designs. We conducted qualitative interviews after study participation and focused on feasibility and efficacy of CBT. Visual inspection of line graphs indicated downward trends in the expected direction for fatigue in two of the four participants. The test statistics showed a decrease in fatigue severity for all participants but randomization tests did not reach statistical significance (overall p = 0.18). Participants reported qualitative improvements in level of functioning and coping with fatigue. CBT was considered feasible and acceptable for severely fatigued CML patients. Our study provided preliminary evidence for the feasibility and acceptability of CBT for severely fatigued CML patients receiving targeted therapy. We recommend further efficacy testing of this promising intervention in a pilot randomized controlled trial.
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Affiliation(s)
- Hanneke Poort
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Patrick Onghena
- Faculty of Psychology and Educational Sciences, KU Leuven-University of Leuven, Tiensestraat 102, 3000, Leuven, Belgium
| | - Harriët J G Abrahams
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.,Expert Center for Chronic Fatigue, Department of Medical Psychology, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive MRC-SCM, Tampa, FL, 33612, USA
| | - Paul B Jacobsen
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892, USA
| | - Nicole M A Blijlevens
- Department of Hematology, Radboud University Medical Center, Geert Grooteplein Zuid 8, 6525 GA, Nijmegen, The Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands. .,Expert Center for Chronic Fatigue, Department of Medical Psychology, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands.
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226
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Van der Gucht K, Ahmadoun S, Melis M, de Cloe E, Sleurs C, Radwan A, Blommaert J, Takano K, Vandenbulcke M, Wildiers H, Neven P, Kuppens P, Raes F, Smeets A, Sunaert S, Deprez S. Effects of a mindfulness-based intervention on cancer-related cognitive impairment: Results of a randomized controlled functional magnetic resonance imaging pilot study. Cancer 2020; 126:4246-4255. [PMID: 32639592 DOI: 10.1002/cncr.33074] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/01/2020] [Accepted: 06/04/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Many breast cancer survivors suffer from cognitive complaints after cancer treatment, affecting their quality of life. The objective of this pilot study was to investigate the effect of a blended-care mindfulness-based intervention (MBI) on chemotherapy-related cognitive impairment and functional brain changes. Furthermore, correlations between changes in cognitive functioning and self-reported behavioral factors were investigated. METHODS Breast cancer survivors (n = 33) who reported cognitive impairment were randomly allocated to a mindfulness condition (n = 18) or a waitlist control condition (n = 15). Patients completed questionnaires on cognitive impairment, emotional distress, and fatigue; neuropsychological tests; and resting-state functional magnetic resonance imaging before the start of MBI (time 1 [T1]), immediately after the completion of an 8-week MBI program (T2), and 3 months postintervention (T3). Resting-state functional connectivity was estimated in the default mode network, the dorsal and salience attention networks, and the frontoparietal network. Mixed model repeated-measures analysis was performed to test the intervention effect. RESULTS Patients in the mindfulness condition exhibited significantly higher connectivity between the dorsal and salience attention networks after the mindfulness intervention compared with those in the control condition. MBI participants also had reduced subjective cognitive impairment, emotional distress, and fatigue. No intervention effect was observed on neurocognitive tests. CONCLUSIONS MBI may induce functional brain changes in networks related to attention and may have a positive effect on subjective measures of cognitive impairment in breast cancer survivors. Therefore, MBI could be a suitable intervention to improve quality of life in this population and deserves further study in this context.
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Affiliation(s)
- Katleen Van der Gucht
- Leuven Mindfulness Center, Catholic University of Leuven, Leuven, Belgium.,Faculty of Psychology and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Soumaya Ahmadoun
- Department of Imaging and Pathology, Catholic University of Leuven, Leuven, Belgium
| | - Michelle Melis
- Department of Imaging and Pathology, Catholic University of Leuven, Leuven, Belgium
| | - Ellen de Cloe
- Faculty of Psychology and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Charlotte Sleurs
- Department of Pediatric Oncology, Catholic University of Leuven, Leuven, Belgium
| | - Ahmed Radwan
- Department of Imaging and Pathology, Catholic University of Leuven, Leuven, Belgium
| | - Jeroen Blommaert
- Department of Gynecologic Oncology, Catholic University of Leuven, Leuven, Belgium
| | - Keisuke Takano
- Department of Psychology, Ludwig-Maximilians Munich University, Munich, Germany
| | - Mathieu Vandenbulcke
- Department of Neurosciences, Catholic University of Leuven, Leuven, Belgium.,Department of Psychiatry, University Hospitals Leuven, Leuven, Belgium
| | - Hans Wildiers
- Multidisciplinary Breast Center, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, Catholic University of Leuven, Leuven, Belgium.,Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Patrick Neven
- Multidisciplinary Breast Center, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, Catholic University of Leuven, Leuven, Belgium.,Department of Gynecologic Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Peter Kuppens
- Leuven Mindfulness Center, Catholic University of Leuven, Leuven, Belgium.,Faculty of Psychology and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Filip Raes
- Leuven Mindfulness Center, Catholic University of Leuven, Leuven, Belgium.,Faculty of Psychology and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Ann Smeets
- Multidisciplinary Breast Center, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, Catholic University of Leuven, Leuven, Belgium.,Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Stefan Sunaert
- Department of Imaging and Pathology, Catholic University of Leuven, Leuven, Belgium.,Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Sabine Deprez
- Department of Imaging and Pathology, Catholic University of Leuven, Leuven, Belgium
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227
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van Roekel EH, Duchâteau J, Bours MJL, van Delden L, Breedveld-Peters JJL, Koole JL, Kenkhuis M, van den Brandt PA, Jansen RL, Kant I, Lima Passos V, Meijer K, Breukink SO, Janssen-Heijnen MLG, Keulen E, Weijenberg MP. Longitudinal associations of light-intensity physical activity with quality of life, functioning and fatigue after colorectal cancer. Qual Life Res 2020; 29:2987-2998. [PMID: 32617891 PMCID: PMC7591443 DOI: 10.1007/s11136-020-02566-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2020] [Indexed: 11/26/2022]
Abstract
Purpose Evidence from cross-sectional studies suggests that higher levels of light-intensity physical activity (LPA) are associated with better health-related quality of life (HRQoL) in colorectal cancer (CRC) survivors. However, these associations have not been investigated in longitudinal studies that provide the opportunity to analyse how within-individual changes in LPA affect HRQoL. We investigated longitudinal associations of LPA with HRQoL outcomes in CRC survivors, from 6 weeks to 2 years post-treatment. Methods Data were used of a prospective cohort study among 325 stage I–III CRC survivors (67% men, mean age: 67 years), recruited between 2012 and 2016. Validated questionnaires were used to assess hours/week of LPA (SQUASH) and HRQoL outcomes (EORTC QLQ-C30, Checklist Individual Strength) at 6 weeks, and 6, 12 and 24 months post-treatment. We applied linear mixed regression to analyse longitudinal confounder-adjusted associations of LPA with HRQoL. Results We observed statistically significant longitudinal associations between more LPA and better global quality of life and physical, role and social functioning, and less fatigue over time. Intra-individual analysis showed that within-person increases in LPA (per 8 h/week) were related to improved HRQoL, including better global quality of life (β = 1.67, 95% CI 0.71; 2.63; total range scale: 0–100) and less fatigue (β = − 1.22, 95% CI − 2.37; − 0.07; scale: 20–140). Stratified analyses indicated stronger associations among participants below the median of moderate-to-vigorous physical activity (MVPA) at diagnosis. Conclusion Higher levels of LPA were longitudinally associated with better HRQoL and less fatigue in CRC survivors up to two years post-treatment. Further prospective studies using accelerometer data are necessary to inform development of interventions targeting LPA. Electronic supplementary material The online version of this article (10.1007/s11136-020-02566-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- E H van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - J Duchâteau
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - M J L Bours
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - L van Delden
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - J J L Breedveld-Peters
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - J L Koole
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - M Kenkhuis
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - P A van den Brandt
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - R L Jansen
- Department of Medical Oncology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - I Kant
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - V Lima Passos
- Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands
| | - K Meijer
- Department of Human Movement Science, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - S O Breukink
- Department of Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - M L G Janssen-Heijnen
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Department of Clinical Epidemiology, VieCuri Medical Center, Venlo, The Netherlands
| | - E Keulen
- Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands
| | - M P Weijenberg
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
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228
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Fatigue in Children and Young Adults With Physical Disabilities: Relation With Energy Demands of Walking and Physical Fitness. Pediatr Phys Ther 2020; 32:202-209. [PMID: 32604360 DOI: 10.1097/pep.0000000000000705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To examine whether general fatigue and fatigue during or after walking are related to energy demands during walking and physical fitness in children and young adults with physical disabilities. METHODS Sixty-eight individuals with physical disabilities participated. General fatigue (Checklist Individual Strength [CIS8R] questionnaire), walking-induced fatigue (OMNI [OMNIwalk] scale after walking for 6 min), gross and net energy costs (ECs) of walking, physical strain of walking, and aerobic and anaerobic fitness were measured. RESULTS Regression analyses showed no relations with the CIS8R. For all participants, a higher net EC was weakly related to an increased OMNIwalk. For teenagers only, low anaerobic fitness and high physical strain of walking values were moderately related to high OMNIwalk scores. CONCLUSION Low anaerobic fitness and high physical strain values partly explain fatigue after walking in teenagers with cerebral palsy, but not in younger children. General fatigue was not explained by low fitness levels or high energy demands of walking.
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229
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The effectiveness of cupping therapy on chronic fatigue syndrome: A single-blind randomized controlled trial. Complement Ther Clin Pract 2020; 40:101210. [PMID: 32891286 DOI: 10.1016/j.ctcp.2020.101210] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 06/04/2020] [Accepted: 06/08/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND and purpose: We investigated the effectiveness of cupping therapy with three different pressures in patients with chronic fatigue syndrome (CFS). MATERIALS AND METHODS The participants were randomly assigned to three groups, as follows: cupping pressure of -0.02 mpa (n = 38), -0.03 mpa (n = 38), or -0.05 mpa (n = 36). Each group received cupping treatment that consisted of 10 sessions over 5 weeks (2 sessions per week). The primary outcomes were Fatigue Scale (FS-14) score and Fatigue Assessment Instrument (FAI) score after 5 and 10 sessions. The secondary outcomes were the Self-Rating Anxiety Scale (SAS) score, the Self-Rating Depression Scale (SDS) score, and the Pittsburgh Sleep Quality Index (PSQI) score. RESULTS There were 91 participants who completed the trial. After five sessions of treatment, the primary outcome of FS-14 score decreased by 3.20 (2.19, 4.21) in the -0.02 mpa group, by 2.39 (1.51, 3.27) in the -0.03 mpa group, and by 3.40 (2.28, 4.52) in the -0.05 mpa group (P = 0.667). After 10 sessions of treatment, the outcome of FS-14 score decreased by 5.00 (3.79, 6.21) in the -0.02 mpa group, by 4.06 (3.07, 5.05) in the -0.03 mpa group, and by 4.77 (3.52, 5.94) in the -0.05 mpa group (P = 0.929). And, the results were statistically different between 5 sessions and 10 sessions of treatment (P < 0.01). However, there were no statistical differences in FAI, SAS, SDS, and PSQI scores between the three groups after 5 sessions and 10 sessions of treatment. CONCLUSIONS In conclusion, cupping therapy has significantly relieved fatigue symptoms and improved emotion and sleep condition of CFS patients, and 10 sessions of treatment had superior results compared with 5 sessions in each group. Moreover, in 5 sessions of treatment, cupping with high pressure showed better improvement in fatigue syndromes and sleep condition according to effective rates. TRIAL REGISTRATION Chinese clinical trial registry (ChiCTR1800017590); Ethical approval number: ChiECRCT-20180085.
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230
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Schindera C, Kuehni CE, Pavlovic M, Haegler-Laube ES, Rhyner D, Waespe N, Roessler J, Suter T, von der Weid NX. Diagnosing Preclinical Cardiac Dysfunction in Swiss Childhood Cancer Survivors: Protocol for a Single-Center Cohort Study. JMIR Res Protoc 2020; 9:e17724. [PMID: 32269016 PMCID: PMC7315371 DOI: 10.2196/17724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Cardiovascular disease is the leading nonmalignant cause of late deaths in childhood cancer survivors. Cardiovascular disease and cardiac dysfunction can remain asymptomatic for many years, but eventually lead to progressive disease with high morbidity and mortality. Early detection and intervention are therefore crucial to improve outcomes. OBJECTIVE In our study, we aim to assess the prevalence of preclinical cardiac dysfunction in adult childhood cancer survivors using conventional and speckle tracking echocardiography; determine the association between cardiac dysfunction and treatment-related risk factors (anthracyclines, alkylating agents, steroids, cardiac radiation) and modifiable cardiovascular risk factors (abdominal obesity, hypertension); investigate the development of cardiac dysfunction longitudinally in a defined cohort; study the association between cardiac dysfunction and other health outcomes like pulmonary disease, endocrine disease, renal disease, quality of life, fatigue, strength and endurance, and physical activity; and gain experience conducting a clinical study of childhood cancer survivors that will be extended to a national, multicenter study of cardiac complications. METHODS For this retrospective cohort study, we will invite ≥5-year childhood cancer survivors who were treated at the University Children's Hospital Bern, Switzerland with any chemotherapy or cardiac radiation since 1976 and who are ≥18 years of age at the time of the study for a cardiac assessment at the University Hospital Bern. This includes 544 childhood cancer survivors, of whom about half were treated with anthracyclines and/or cardiac radiation and half with any other chemotherapy. The standardized cardiac assessment includes a medical history focusing on signs of cardiovascular disease and its risk factors, a physical examination, anthropometry, vital parameters, the 1-minute sit-to-stand test, and echocardiography including 2-dimensional speckle tracking. RESULTS We will invite 544 eligible childhood cancer survivors (median age at the time of the study, 32.5 years; median length of time since diagnosis, 25.0 years) for a cardiac assessment. Of these survivors, 300 (55%) are at high risk, and 244 (45%) are at standard risk of cardiac dysfunction. CONCLUSIONS This study will determine the prevalence of preclinical cardiac dysfunction in Swiss childhood cancer survivors, inform whether speckle tracking echocardiography is more sensitive to cardiac dysfunction than conventional echocardiography, and give a detailed picture of risk factors for cardiac dysfunction. The results will help improve primary treatment and follow-up care of children with cancer. TRIAL REGISTRATION ClinicalTrials.gov NCT03790943; https://clinicaltrials.gov/ct2/show/NCT03790943. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/17724.
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Affiliation(s)
- Christina Schindera
- Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Pediatric Oncology/Hematology, University Children's Hospital Basel, University of Basel, Basel, Switzerland
| | - Claudia Elisabeth Kuehni
- Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Pediatric Hematology and Oncology, University Children's Hospital Bern, University of Bern, Bern, Switzerland
| | - Mladen Pavlovic
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Eva Simona Haegler-Laube
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Daniel Rhyner
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nicolas Waespe
- Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Platform of Pediatric Onco-Hematology research, CANSEARCH Laboratory, Department of Pediatrics, Gynecology, and Obstetrics, University of Geneva, Geneva, Switzerland
| | - Jochen Roessler
- Pediatric Hematology and Oncology, University Children's Hospital Bern, University of Bern, Bern, Switzerland
| | - Thomas Suter
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nicolas Xavier von der Weid
- Pediatric Oncology/Hematology, University Children's Hospital Basel, University of Basel, Basel, Switzerland
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231
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van de Loo AJAE, Kerssemakers N, Scholey A, Garssen J, Kraneveld AD, Verster JC. Perceived Immune Fitness, Individual Strength and Hangover Severity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4039. [PMID: 32517084 PMCID: PMC7311961 DOI: 10.3390/ijerph17114039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 12/19/2022]
Abstract
Various factors may contribute to alcohol hangover severity. The purpose of the current investigation was to evaluate the possible impact of alcohol consumption patterns, perceived immune status, and baseline fatigue on hangover severity. A survey was completed by a convenience sample of N = 199 Dutch students who reported on their latest past month's heavy drinking occasion, including subjective intoxication (perceived drunkenness) and next-day hangover severity, which were rated on single-item scales ranging from 0 (absent) to 10 (extreme). In addition, perceived (momentary) immune fitness was assessed, and the Checklist Individual Strength (CIS) was completed to assess baseline fatigue. The analysis revealed that instead of the amount of alcohol consumed or estimated blood alcohol concentration, it appeared that subjective intoxication (i.e., level of drunkenness) was the most important determinant of alcohol hangover severity. Especially in men, albeit modest, it was perceived that immune fitness also significantly contributed to the level of hangover severity experienced.
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Affiliation(s)
- Aurora J. A. E. van de Loo
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584CM Utrecht, The Netherlands;
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands; (N.K.); (J.G.); (A.D.K.)
| | - Nikki Kerssemakers
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands; (N.K.); (J.G.); (A.D.K.)
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia;
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands; (N.K.); (J.G.); (A.D.K.)
- Nutricia Research, 3584CT Utrecht, The Netherlands
| | - Aletta D. Kraneveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands; (N.K.); (J.G.); (A.D.K.)
| | - Joris C. Verster
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584CM Utrecht, The Netherlands;
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands; (N.K.); (J.G.); (A.D.K.)
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia;
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232
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Lawley A, Abbas A, Seri S, Rajabally YA. Clinical correlates of fatigue in chronic inflammatory demyelinating polyneuropathy. Muscle Nerve 2020; 62:226-232. [DOI: 10.1002/mus.26913] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Andrew Lawley
- School of Life and Health Sciences, Aston Brain CentreAston University Birmingham United Kingdom
| | - Ahmed Abbas
- Inflammatory Neuropathy Clinic, Department of NeurologyUniversity Hospitals Birmingham Birmingham United Kingdom
| | - Stefano Seri
- School of Life and Health Sciences, Aston Brain CentreAston University Birmingham United Kingdom
| | - Yusuf A. Rajabally
- Inflammatory Neuropathy Clinic, Department of NeurologyUniversity Hospitals Birmingham Birmingham United Kingdom
- Aston Medical SchoolAston University Birmingham United Kingdom
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233
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olde Hartman TC, Scheepers TP, Lucassen P, van Boven K. Do Women With Severe Persistent Fatigue Present With Fatigue at the Primary Care Consultation? ZEITSCHRIFT FUR PSYCHOLOGIE-JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1027/2151-2604/a000402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Recent studies have shown underdiagnosis of severe persistent fatigue in primary care. To study how patients with severe persistent fatigue present in primary care and whether they differ from patients with less severe fatigue and patients with no fatigue. A 4-year retrospective database study combined with a questionnaire, including all female patients 25–50 years ( n = 917) who are registered in one primary care group practice. Based on the results of a validated self-administered questionnaire, patients were divided into three groups: patients with severe persistent fatigue ( n = 42), patients with fatigue ( n = 174), and patients with no fatigue ( n = 246). Data on frequency of consulting, reason for encounter, and diagnoses from 2009 to 2013 were obtained from the electronic medical health record. Data were analyzed using odds ratios. Women with severe persistent fatigue more often were unemployed and had lower education. They visited the general practitioners (GP) more often than other women. However, more than half of the women with severe persistent fatigue did not visit their GP with fatigue as reason for encounter at all during the 4 years of study. A minority of the women with severe persistent fatigue received a psychological diagnosis or social diagnosis (36% and 19%, respectively) during these 4 years. Underdiagnosis of severe persistent fatigue is partly a consequence of patients not presenting or reporting this to their GP. The reasons for this behavior are not clear.
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Affiliation(s)
- Tim C. olde Hartman
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Tomas P. Scheepers
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Peter Lucassen
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Kees van Boven
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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234
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Severe Fatigue is Highly Prevalent in Patients with IPF or Sarcoidosis. J Clin Med 2020; 9:jcm9041178. [PMID: 32325989 PMCID: PMC7230281 DOI: 10.3390/jcm9041178] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/07/2020] [Accepted: 04/16/2020] [Indexed: 12/26/2022] Open
Abstract
In patients with interstitial lung disease (ILD) next to dyspnea, fatigue is expected to be the most prevalent symptom. Surprisingly, the prevalence of severe fatigue has been scarcely studied in ILD patients and limited information on its associated factors is available. This study aimed to determine the prevalence of severe fatigue in patients with idiopathic pulmonary fibrosis (IPF) or pulmonary sarcoidosis and to identify the relationship between fatigue, patient characteristics, and clinical parameters. In this cross-sectional study, fatigue (checklist individual strength-fatigue (CIS-Fat)), demographics, lung function, dyspnea (modified-Medical Research Council (mMRC)), sleepiness (Epworth Sleepiness Scale), anxiety/depression (hospital anxiety and depression scale (HADS-A/HADS-D)), catastrophizing (fatigue catastrophizing scale (FCS)), functional activity impairment (respiratory illness quality-of-life (QoL-RIQ-Activity)), and health status (EuroQol five-dimensional descriptive system (EQ-5D-5L)) were assessed in outpatients with ILD. Mean CIS-Fat scores were 34.1 (SD ± 11.2) in 59 IPF patients and 40.0 (12.3) in 58 sarcoidosis patients. Severe fatigue (SD ± ≥36 points) was present in IPF patients (47.5%) and sarcoidosis (69%). In IPF, CIS-Fat correlated strongly (ρ > 0.5; p < 0.01) with FCS, QoL-RIQ-Activity, and EQ-5D-5L-Health and moderately (0.3 < ρ < 0.5; p < 0.01) with EQ-5D-5L-Index, mMRC, and HADS-D. In sarcoidosis, CIS-Fat correlated strongly with EQ-5D-5L-Health, QoL-RIQ-Activity, EQ-5D-5L-Index, HADS-D, and mMRC and moderately with FCS and hospitalization <12 months. Severe fatigue is highly prevalent in ILD patients and is associated with dyspnea, depression, catastrophizing, functional activity impairments, and QoL.
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235
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Wirken L, van Middendorp H, Hooghof CW, Sanders JSF, Dam RE, van der Pant KAMI, Wierdsma JM, Wellink H, van Duijnhoven EM, Hoitsma AJ, Hilbrands LB, Evers AWM. Psychosocial consequences of living kidney donation: a prospective multicentre study on health-related quality of life, donor-recipient relationships and regret. Nephrol Dial Transplant 2020; 34:1045-1055. [PMID: 30544241 DOI: 10.1093/ndt/gfy307] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Previous studies have indicated decreased health-related quality of life (HRQoL) shortly after kidney donation, returning to baseline in the longer term. However, a subgroup of donors experiences persistent HRQoL problems. To identify which HRQoL aspects are impacted most by the donation and to identify at-risk donors, more specific insight into psychosocial donation consequences is needed. METHODS The current study examined the HRQoL course, donor-perceived consequences of donation for donors, recipients and donor-recipient relationships, and regret up to 12 months post-donation in donors from seven Dutch transplantation centres. Kidney donor candidates (n = 588) completed self-report questionnaires early in the screening procedure, of which 361 (61%) donated their kidney. RESULTS Data for 230 donors (64%) with complete assessments before donation and 6 and 12 months post-donation were analysed. Results indicated that donor physical HRQoL was comparable at all time points, except for an increase in fatigue that lasted up to 12 months post-donation. Mental HRQoL decreased at 6 months post-donation, but returned to baseline at 12 months. Donors reported large improvements in recipient's functioning and a smaller influence of the recipient's kidney disease or transplantation on the donor's life over time. A subgroup experienced negative donation consequences with 14% experiencing regret 12 months post-donation. Predictors of regret were more negative health perceptions and worse social functioning 6 months post-donation. The strongest baseline predictors of higher fatigue levels after donation were more pre-donation fatigue, worse general physical functioning and a younger age. CONCLUSIONS Future research should examine predictors of HRQoL after donation to improve screening and to provide potential interventions in at-risk donors.
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Affiliation(s)
- Lieke Wirken
- Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Henriët van Middendorp
- Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Christina W Hooghof
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Jan-Stephan F Sanders
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ruth E Dam
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Karlijn A M I van der Pant
- Division of Nephrology, Department of Internal Medicine, Renal Transplant Unit, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Judith M Wierdsma
- Department of Nephrology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Hiske Wellink
- Department of Nephrology, VU Medical Center, Amsterdam, The Netherlands
| | - Elly M van Duijnhoven
- Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Andries J Hoitsma
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Luuk B Hilbrands
- Department of Nephrology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Andrea W M Evers
- Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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236
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Koole JL, Bours MJ, van Roekel EH, Breedveld-Peters JJ, van Duijnhoven FJ, van den Ouweland J, Breukink SO, Janssen-Heijnen ML, Keulen ET, Weijenberg MP. Higher Serum Vitamin D Concentrations Are Longitudinally Associated with Better Global Quality of Life and Less Fatigue in Colorectal Cancer Survivors up to 2 Years after Treatment. Cancer Epidemiol Biomarkers Prev 2020; 29:1135-1144. [DOI: 10.1158/1055-9965.epi-19-1522] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/04/2020] [Accepted: 03/31/2020] [Indexed: 11/16/2022] Open
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237
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Santos EJF, Duarte C, da Silva JAP, Ferreira RJO. The impact of fatigue in rheumatoid arthritis and the challenges of its assessment. Rheumatology (Oxford) 2020; 58:v3-v9. [PMID: 31435662 PMCID: PMC6827262 DOI: 10.1093/rheumatology/kez351] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/16/2019] [Indexed: 01/22/2023] Open
Abstract
Fatigue is one of the most important symptoms for patients with RA, and imposes a great burden on patients’ lives, being associated with significantly reduced health-related quality of life. Although being recognized by the rheumatology community as a major gap in the current management of the disease, fatigue has not been easy to measure and conceptualize. Part of the problem seems to reside in the multidimensional causality of this phenomenon, which may warrant dedicated measures and interventions. Although there are several instruments available to measure it, no consensus has yet been reached to recommend a ‘gold-standard’. This review aims at synthesizing the role of fatigue in the global impact of RA; describing validated instruments and their psychometric properties as measures of fatigue among patients with RA; and finally proposing a clinically meaningful, valid and feasible process to measure fatigue in clinical practice.
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Affiliation(s)
- Eduardo J F Santos
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra.,Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto.,Health Sciences Research Unit: Nursing, Nursing School of Coimbra, University of Coimbra, Coimbra, Portugal
| | - Catia Duarte
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra.,Coimbra Institute for Clinical and Biomedical Research (iCBR) - Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - José A P da Silva
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra.,Coimbra Institute for Clinical and Biomedical Research (iCBR) - Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ricardo J O Ferreira
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra.,Health Sciences Research Unit: Nursing, Nursing School of Coimbra, University of Coimbra, Coimbra, Portugal
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238
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Goërtz YMJ, Spruit MA, Van 't Hul AJ, Peters JB, Van Herck M, Nakken N, Djamin RS, Burtin C, Thong MSY, Coors A, Meertens-Kerris Y, Wouters EFM, Prins JB, Franssen FME, Muris JWM, Vanfleteren LEGW, Sprangers MAG, Janssen DJA, Vercoulen JH. Fatigue is highly prevalent in patients with COPD and correlates poorly with the degree of airflow limitation. Ther Adv Respir Dis 2020; 13:1753466619878128. [PMID: 31558115 PMCID: PMC6767724 DOI: 10.1177/1753466619878128] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background: The objective of this study was to compare fatigue levels between subjects
with and without COPD, and to investigate the relationship between fatigue,
demographics, clinical features and disease severity. Methods: A total of 1290 patients with COPD [age 65 ± 9 years, 61% male, forced
expiratory volume in 1 s (FEV1) 56 ± 19% predicted] and 199 subjects without
COPD (age 63 ± 9 years, 51% male, FEV1 112 ± 21% predicted) were assessed
for fatigue (Checklist Individual Strength-Fatigue), demographics, clinical
features and disease severity. Results: Patients with COPD had a higher mean fatigue score, and a higher proportion
of severe fatigue (CIS-Fatigue score 35 ± 12 versus
21 ± 11 points, p < 0.001; 49 versus
10%, p < 0.001). Fatigue was significantly, but poorly,
associated with the degree of airflow limitation [FEV1 (% predicted)
Spearman correlation coefficient = −0.08, p = 0.006].
Multiple regression indicated that 30% of the variance in fatigue was
explained by the predictor variables. Conclusions: Severe fatigue is prevalent in half of the patients with COPD, and correlates
poorly with the degree of airflow limitation. Future studies are needed to
better understand the physical, psychological, behavioural, and systemic
factors that precipitate or perpetuate fatigue in COPD.
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Affiliation(s)
- Yvonne M J Goërtz
- Department of Research and Education, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, NM 6085, the Netherlands
| | - Martijn A Spruit
- Department of Research and Education, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, NM, the Netherlands.,REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.,Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands.,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
| | - Alex J Van 't Hul
- Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jeannette B Peters
- Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Maarten Van Herck
- REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Nienke Nakken
- Department of Research and Education, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands
| | - Remco S Djamin
- Department of Respiratory Medicine, Amphia Ziekenhuis, Breda, the Netherlands
| | - Chris Burtin
- REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Melissa S Y Thong
- Department of Medical Psychology, Amsterdam University Medical Centres, location AMC, Amsterdam, the Netherlands
| | - Arnold Coors
- Member of the Patient Advisory Board, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Yvonne Meertens-Kerris
- Member of the Patient Advisory Board, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands
| | - Emiel F M Wouters
- Department of Research and Education, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Frits M E Franssen
- Department of Research and Education, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands.,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
| | - Jean W M Muris
- Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Lowie E G W Vanfleteren
- Department of Research and Education, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands.,COPD Center, Sahlgrenska University, Gothenburg, Sweden
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centres, location AMC, Amsterdam, the Netherlands
| | - Daisy J A Janssen
- Department of Research and Education, Ciro, Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands.,Centre of Expertise for Palliative Care, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Jan H Vercoulen
- Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
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239
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Van der Gucht K, Melis M, Ahmadoun S, Gebruers A, Smeets A, Vandenbulcke M, Wildiers H, Neven P, Kuppens P, Raes F, Sunaert S, Deprez S. A mindfulness-based intervention for breast cancer patients with cognitive impairment after chemotherapy: study protocol of a three-group randomized controlled trial. Trials 2020; 21:290. [PMID: 32293533 PMCID: PMC7092531 DOI: 10.1186/s13063-020-4204-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 02/24/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Mindfulness has been applied to improve cancer care by enhancing psychological well-being. However, little is known about its impact on cognitive impairment experienced by cancer patients after chemotherapy. Mindfulness may be relevant in tackling cognitive impairment by decreasing emotional distress and fatigue, by decreasing inflammation, and by strengthening functional brain connectivity. The aim of the present study protocol is to evaluate the efficacy and mechanisms of a mindfulness-based intervention to reduce cognitive impairment in breast cancer patients after chemotherapy. METHODS/DESIGN The present study is a three-arm, parallel-group, randomized controlled trial with assessments at baseline, 1 to 3 weeks after the intervention and at 3 months' follow-up. One hundred and twenty breast cancer patients who ended treatment a minimum of 6 months and a maximum of 5 years before, and who have cognitive complaints, will be enrolled. They will be randomized into one of the following three study arms: (1) a mindfulness-based intervention group (n = 40), (2) an active control condition based on physical training (n = 40), or (3) a treatment as usual (TAU) control group (n = 40). Both the mindfulness-based intervention and the active control condition consist of four group sessions (3 h for the mindfulness condition and 2 h for the physical training) spread over 8 weeks. The primary outcomes will be cognitive symptoms as measured by the Cognitive Failure Questionnaire and changes in functional brain connectivity in the attention network. Secondary outcomes will be (1) levels of emotional distress, fatigue, mindfulness, quality of life; (2) neurocognitive tests; (3) structural and functional brain changes using MR imaging and (4) measures of inflammation. DISCUSSION The study will examine the impact of a mindfulness-based intervention on cognitive impairment in breast cancer patients. If the findings of this study confirm the effectiveness of a mindfulness-based program to reduce cognitive impairment, it will be possible to improve quality of life for ex-cancer patients. We will inform health care providers about the potential use of a mindfulness-based intervention as a non-pharmaceutical, low-threshold mental health intervention to improve cognitive impairment after cancer. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT03736460. Retrospectively registered on 8 November 2018.
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Affiliation(s)
- Katleen Van der Gucht
- Leuven Mindfulness Centre, Faculty of Psychology and Educational Sciences, University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium
| | - Michelle Melis
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Soumaya Ahmadoun
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Anneleen Gebruers
- Multidisciplinary Breast Centre, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Ann Smeets
- Multidisciplinary Breast Centre, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
- Department of Surgical Oncology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Mathieu Vandenbulcke
- Department of Neurosciences, KU Leuven, Leuven, Belgium
- Department of Psychiatry, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Hans Wildiers
- Multidisciplinary Breast Centre, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
- Department of General Medical Oncology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Patrick Neven
- Multidisciplinary Breast Centre, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
- Department of Gynaecology and Obstetrics, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Peter Kuppens
- Leuven Mindfulness Centre, Faculty of Psychology and Educational Sciences, University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium
| | - Filip Raes
- Leuven Mindfulness Centre, Faculty of Psychology and Educational Sciences, University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium
| | - Stefan Sunaert
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- Department of Radiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Sabine Deprez
- Department of Imaging and Pathology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
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Cognitive Improvement After Kidney Transplantation Is Associated With Structural and Functional Changes on MRI. Transplant Direct 2020; 6:e531. [PMID: 32195322 PMCID: PMC7056275 DOI: 10.1097/txd.0000000000000976] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 11/19/2019] [Accepted: 12/08/2019] [Indexed: 02/07/2023] Open
Abstract
Supplemental Digital Content is available in the text. Background. Several studies have reported improved cognitive outcomes after kidney transplantation, but most studies either did not include controls or lacked extensive neuroimaging. In addition, there is uncertainty whether kidney donation is a safe procedure in terms of cognitive outcomes. Methods. We prospectively studied neurocognitive function in kidney transplant recipients. The primary outcome was change in neurocognitive function after 1 year compared with baseline, which was evaluated using the Amsterdam Neuropsychological Task battery and verbal fluency tests. Secondary outcomes included changes in depression and anxiety (measured by the Hospital Anxiety and Depression scale) and changes in fatigue (measured by the Checklist for Individual Strength). We included kidney donors to control for learning effects, socioeconomic status, and surgery. In addition, kidney transplant recipients were evaluated with MRI scans at baseline and at year 1. The MRI protocol included conventional MRI, automated volumetric measurement, diffusion tensor imaging, magnetic resonance spectroscopy, arterial spin labeling, and a resting state functional MRI. Results. Twenty-seven recipients and 24 donors were included. For both recipients and donors, neuropsychologic testing scores improved 1 year after transplantation (donation). Recipient improvement significantly exceeded donor improvement on tasks measuring attention and working memory. These improvements were associated with increases in white matter volume and N-acetylaspartate/creatine (a marker for neuronal integrity). Conclusions. Attention and working memory improve significantly 1 year after kidney transplantation. Learning effects do not account for these improvements because recipient improvement in these areas exceeds donor improvement and correlates with an improvement in white matter integrity after transplantation. Kidney donation appears to be a safe procedure in terms of cognitive outcomes.
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van Sandwijk MS, Al Arashi D, van de Hare FM, van der Torren JMR, Kersten MJ, Bijlsma JA, Ten Berge IJM, Bemelman FJ. Fatigue, anxiety, depression and quality of life in kidney transplant recipients, haemodialysis patients, patients with a haematological malignancy and healthy controls. Nephrol Dial Transplant 2020; 34:833-838. [PMID: 29726909 DOI: 10.1093/ndt/gfy103] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The impact of haemodialysis (HD) and kidney transplantation on quality of life (QoL) is often underestimated due to a lack of comparative studies with other patient groups. METHODS We conducted a cross-sectional cohort study in 168 patients including HD patients, kidney transplant recipients (KTR), patients with a haematological malignancy either receiving chemotherapy or in remission and healthy controls. All participants completed the 36-item short form survey of health-related quality of life, the Checklist Individual Strength and the Hospital Anxiety and Depression Scale questionnaire. RESULTS HD patients and haematological patients undergoing chemotherapy were more frequently severely fatigued (53.3% and 50% of cases) compared with KTR (33.3%), haematological patients in remission (23.3%) and healthy controls (12.1%, P < 0.001). There were no significant differences in anxiety rates. HD patients and haematological patients undergoing chemotherapy were most likely to be depressed (33.3% and 25%), compared with 16.7% of KTR, 20% of haematological patients in remission and 8.6% of healthy controls (P = 0.066). KTR reported the largest positive health change (+27%, P < 0.001), but still had a lower overall QoL than healthy controls, comparable to haematological patients in remission. HD and chemotherapy patients reported the lowest QoL scores. CONCLUSIONS Fatigue and depression are common in HD patients, resulting in a low QoL, comparable to haematological patients receiving chemotherapy. KTR do better, with scores similar to patients with a haematological malignancy in remission, but still have a lower QoL than healthy controls.
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Affiliation(s)
- Marit S van Sandwijk
- Department of Nephrology, Academic Medical Center, Amsterdam, The Netherlands.,Dianet Dialysis Center, Amsterdam, The Netherlands
| | - Doaa Al Arashi
- Department of Nephrology, Academic Medical Center, Amsterdam, The Netherlands
| | - Fons M van de Hare
- Department of Nephrology, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Marie-José Kersten
- Department of Haematology, Academic Medical Center, Amsterdam, The Netherlands
| | - Joost A Bijlsma
- Department of Nephrology, Academic Medical Center, Amsterdam, The Netherlands.,Dianet Dialysis Center, Amsterdam, The Netherlands
| | - Ineke J M Ten Berge
- Department of Nephrology, Academic Medical Center, Amsterdam, The Netherlands
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242
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Minimal Clinically Important Differences for Patient-Reported Outcome Measures of Fatigue in Patients With COPD Following Pulmonary Rehabilitation. Chest 2020; 158:550-561. [PMID: 32184112 DOI: 10.1016/j.chest.2020.02.045] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/26/2019] [Accepted: 02/08/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Fatigue is a burdensome and prevailing symptom in patients with COPD. Pulmonary rehabilitation (PR) improves fatigue; however, interpreting when such improvement is clinically relevant is challenging. Minimal clinically important differences (MCIDs) for instruments assessing fatigue are warranted to better tailor PR and guide clinical decisions. RESEARCH QUESTION This study estimated MCIDs for the Functional Assessment of Chronic Illness Therapy-Fatigue Subscale (FACIT-FS), the modified FACIT-FS, and the Checklist Individual Strength-Fatigue Subscale in patients with COPD following PR. STUDY DESIGN AND METHODS Data from patients with COPD who completed a 12-week community-based PR program were used to compute the MCIDs. The pooled MCID was estimated by calculating the arithmetic weighted mean, resulting from the combination of anchor-based (weight, two-thirds) and distribution-based (weight, one-third) methods. Anchors were patients' and physiotherapists' Global Rating of Change Scale, COPD Assessment Test, St. George's Respiratory Questionnaire (SGRQ), and exacerbations. To estimate MCIDs, we used mean change, receiver-operating characteristic curves, and linear regression analysis for anchor-based approaches, and 0.5 × SD, SE of measurement, 1.96 × SE of measurement, and minimal detectable change for distribution-based approaches. RESULTS Fifty-three patients with COPD (79% male, 68.4 ± 7.6 years of age, and FEV1 48.7 ± 17.4% predicted) were included in the analysis. Exacerbations and the SGRQ-impact and the SGRQ-total scores fulfilled the requirements to be used as anchors. Pooled MCIDs were 4.7 for FACIT-FS, 3.8 for the modified FACIT-FS, and 9.3 for the Checklist Individual Strength-Fatigue Subscale. INTRPRETATION The MCIDs proposed in this study can be used by different stakeholders to interpret PR effectiveness. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov; No.: NCT03799666; URL: www.clinicaltrials.gov.
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243
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Beckerman H, Eijssen IC, van Meeteren J, Verhulsdonck MC, de Groot V. Fatigue Profiles in Patients with Multiple Sclerosis are Based on Severity of Fatigue and not on Dimensions of Fatigue. Sci Rep 2020; 10:4167. [PMID: 32139797 PMCID: PMC7058058 DOI: 10.1038/s41598-020-61076-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/21/2020] [Indexed: 01/25/2023] Open
Abstract
Fatigue related to Multiple Sclerosis (MS) is considered a multidimensional symptom, manifesting in several dimensions such as physical, cognitive, and psychosocial fatigue. This study investigated in 264 patients with severe primary MS-related fatigue (median MS duration 6.8 years, mean age 48.1 years, 75% women) whether subgroups can be distinguished based on these dimensions. Subsequently, we tested whether MS-related fatigue consists of a single common unidimensional factor. Subscale scores on four self-reported fatigue questionnaires, including the Checklist of Individual Strength, the Modified Fatigue Impact Scale, the Fatigue Severity Scale and the SF36 vitality, were used in a cluster analysis to identify patients with similar fatigue characteristics. Next, all 54 items were included in exploratory factor analysis to test unidimensionality. Study results show that in patients with a treatment indication for primary MS-related fatigue, fatigue profiles are based on severity and not on the various dimensions of fatigue. The three profiles found, suggested one underlying fatigue dimension, but this could not be confirmed. Factor analysis of all 54 items resulted in 8 factors, confirming the multidimensional construct of the included fatigue questionnaires.
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Affiliation(s)
- Heleen Beckerman
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands. .,Amsterdam Public Health research institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands. .,MS Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
| | - Isaline Cjm Eijssen
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health research institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,MS Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jetty van Meeteren
- Rijndam Rehabilitation, location Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Vincent de Groot
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam Public Health research institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,MS Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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244
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Non-Pharmacological Interventions for Post-Stroke Fatigue: Systematic Review and Network Meta-Analysis. J Clin Med 2020; 9:jcm9030621. [PMID: 32106490 PMCID: PMC7141106 DOI: 10.3390/jcm9030621] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/04/2020] [Accepted: 02/21/2020] [Indexed: 01/02/2023] Open
Abstract
Post-stroke fatigue (PSF) is one of the most serious sequelae, which often interferes with the rehabilitation process and impairs the functional recovery of patients. Due to insufficient evidence, it is unclear which specific pharmacological interventions should be recommended. Therefore, in this paper, we compare the effectiveness of non-pharmacological interventions in PSF. A systematic review and network meta-analysis of randomized controlled trials were performed using EMBASE, MEDLINE, CINAHL, Cochrane library, ClinicalTrials.gov, CNKI, and CQVIP, from inception to January 2018, in the English and Chinese languages. RCTs involving different non-pharmacological interventions for PSF with an outcome of fatigue measured using the Fatigue Severity Scale were included. Multiple intervention comparisons based on a Bayesian network are used to compare the relative effects of all included interventions. Ten RCTs with eight PSF non-pharmacological interventions were identified, comprising 777 participants. For effectiveness, most interventions did not significantly differ from one another. The cumulative probabilities of the best non-pharmacological intervention for fatigue reduction included Community Health Management (CHM), followed by Traditional Chinese Medicine (TCM) and Cognitive Behavioral Therapy (CBT). Network meta-analysis based on data from the selected RCTs indicated that the eight PSF non-pharmacological interventions shared equivalent efficacy, but CHM, TCM, and CBT showed potentially better efficacy. In the future, fatigue needs to be recognized and more accurate assessment methods for PSF are required for diagnosis and to develop more effective clinical interventions.
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Abstract
BACKGROUND Practical brief measures are needed for clinicians and researchers to identify and effectively manage cognitive impairment in cancer patients. OBJECTIVE This study evaluated the reliability (ie, internal consistency reliability) and validity (ie, construct, convergent, concurrent, and known-group validity) of the Brief Perceived Cognitive Impairment Scale-Korean (BPCIS-K). METHODS From a university hospital, 249 cancer patients participated. The BPCIS-K was constructed with 6 items evaluating key aspects of cognitive impairment in cancer patients. For internal consistency reliability, Cronbach's α and item-total correlations were evaluated. For construct validity, confirmatory factor analysis was performed. For convergent validity, Pearson correlations were tested with the Functional Assessment of Cancer Therapy-Cognitive Function. For concurrent validity, Pearson correlations were tested with the Functional Assessment of Chronic Illness Therapy-Fatigue. For known-group validity, t tests were performed. RESULTS The BPCIS-K showed high internal consistency reliability (Cronbach's α = .92; item-total correlations ranged from 0.76 to 0.81). Factor analysis confirmed the scale is unidimensional. It is highly associated with another validated cognitive impairment measure (r = -0.91, P < .001) and moderately correlated with a fatigue measure (r = -0.52, P < .001). In known-group validity, female and patients undergoing treatment experienced more severe impairment than did male patients and patient awaiting treatment (P = .05, P = .08, respectively). CONCLUSION The BPCIS-K is valid and reliable for assessing cancer patients' perceived cognitive impairment, particularly in concentration, memory, and executive functions. IMPLICATION FOR PRACTICE This study introduces a practical brief measure to clinicians and researchers.
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246
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Hillyar C, Nibber A. Psychiatric Sequelae of Guillain-Barré Syndrome: Towards a Multidisciplinary Team Approach. Cureus 2020; 12:e7051. [PMID: 32128295 PMCID: PMC7034759 DOI: 10.7759/cureus.7051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Guillain-Barré syndrome (GBS) is a post-infectious autoimmune polyneuropathy. Recent research has highlighted that GBS is associated with the onset of psychiatric symptoms which represent a burden for patients and close relatives. However, acute psychiatric sequelae due to GBS may be misinterpreted as ‘intensive care unit (ICU) delirium’. This review outlines the existing evidence for the psychiatric symptoms associated with GBS with a view to improving psychoeducation of patients. The main psychiatric symptoms of GBS that have been reported in the literature include, stress, anxiety, depression, fatigue, sleep abnormalities, visual hallucinations, paranoid delusions, disorientation, terror and psychosis. These psychiatric symptoms, which occur during the acute phase of GBS, if not recognised and treated, may progress to long-term psychiatric problems that interfere with improvement of physical symptoms. A multidisciplinary team approach to the management of GBS may improve both physical and psychiatric recovery.
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Affiliation(s)
| | - Anjan Nibber
- Neurology, Oxford University Medical School, Oxford University Hospitals NHS Foundation Trust, Oxford, GBR
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247
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Defining the content of a minimal dataset for acquired brain injury using a Delphi procedure. Health Qual Life Outcomes 2020; 18:30. [PMID: 32066447 PMCID: PMC7027079 DOI: 10.1186/s12955-020-01286-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 02/10/2020] [Indexed: 12/17/2022] Open
Abstract
Background The lack of consistency in outcome measurement within the field of acquired brain injury (ABI) leads to incomparability of collected data and, consequently, reduced generalisation of findings. We aim to develop a set of standardised measures which can be used to obtain the minimum amount of data necessary to characterise ABI-patients across all healthcare sectors and disciplines and in every stage of recovery; i.e., an ABI-specific minimal dataset (MDS-ABI). The current study was conducted to identify the core outcome domains for adults with ABI (what to measure?) and to select the most suitable measurements within these domains (how to measure it?). Methods An initial comprehensive set of outcome domains and measurement instruments relevant for measuring the consequences of ABI was identified by a literature study. The selection of relevant domains was based on the International Classification of Functioning, Disability and Health framework. Measurement instruments were included in the Delphi procedure when they met pre-set requirements. A three-round Delphi study was conducted among Dutch experts (n = 48) using iterative web-based surveys to prioritise the proposed domains and instruments for the MDS-ABI. Throughout all rounds, participants could recommend additional or alternative domains and measurement instruments, and were fed back the collated group responses of the previous round. Results Response rates ranged from 89 to 100%. After three rounds, the expert panel reached consensus (≥51%) on the inclusion of 12 outcome domains (demographics, injury characteristics, comorbidity, cognitive functioning, emotional functioning, energy, mobility, self-care, communication, participation, social support and quality of life), measured with six measurement instruments, two screening questions and a registry of demographic- and injury information. No consensus was reached on how to measure quality of life. Conclusions The current study achieved consensus on the content of a minimal dataset for patients with ABI. The current version of the MDS-ABI will be evaluated and optimised if necessary in the near future.
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248
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Breedveld-Peters JJL, Bours MJL, Cords CI, Ditters IAM, Habraken V, Jongen MWJ, Weijenberg MP. The impact of participation restrictions on everyday life in long-term colorectal cancer survivors in the EnCoRe study: A mixed-method study. Eur J Oncol Nurs 2020; 45:101724. [PMID: 32044722 DOI: 10.1016/j.ejon.2020.101724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 11/12/2022]
Abstract
PURPOSE Knowledge about long-term colorectal cancer (CRC) or treatment related health and functioning problems and on its impact on participation of CRC survivors in domestic life and in society is limited. We aimed to explore the nature and impact of cancer (treatment) related participation restrictions on everyday life of long-term CRC survivors, their current satisfaction with participation, and associations of health and functioning problems with participation satisfaction, using the International Classification of Functioning, Disability and Health (ICF) to comprehensively study participation. METHOD Mixed-method study in 2-10 years post-diagnosis stage I-III CRC survivors (n = 151) from the cross-sectional part of the EnCoRe study. Participation restrictions were explored by semi-structured interviews in a subsample reporting participation restrictions (n = 10). Role functioning (SF36-Health Survey), fatigue (Checklist Individual Strength), and peripheral neuropathy symptoms (EORTC QLQ-CIPN20) were assessed in all participants and associations with self-reported participation satisfaction were analyzed by multivariable logistic regression models. RESULTS 19% of CRC survivors reported dissatisfaction with participation. Participation restrictions were reported for interpersonal relationships, work/employment, and social/civic life. CRC survivors reporting better physical and emotional role functioning were significantly less likely to be dissatisfied with their participation, whereas survivors reporting higher levels of fatigue or more peripheral neuropathy symptoms were more likely to be dissatisfied with participation. CONCLUSIONS Colorectal cancer (treatment) related health and functioning problems negatively impacts the ability of nearly 1 in 5 long-term CRC survivors to participate in everyday life situations and their satisfaction with participation. Follow-up care needs to be able to identify and address these problems.
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Affiliation(s)
- Jose J L Breedveld-Peters
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
| | - Martijn J L Bours
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
| | - Charlotte I Cords
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
| | - Imke A M Ditters
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
| | - Vera Habraken
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
| | - Michelle W J Jongen
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
| | - Matty P Weijenberg
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.
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249
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Warmink-Perdijk WDB, Peters LL, Tigchelaar EF, Dekens JAM, Jankipersadsing SA, Zhernakova A, Bossers WJR, Sikkema J, de Jonge A, Reijneveld SA, Verkade HJ, Koppelman GH, Wijmenga C, Kuipers F, Scherjon SA. Lifelines NEXT: a prospective birth cohort adding the next generation to the three-generation Lifelines cohort study. Eur J Epidemiol 2020; 35:157-168. [PMID: 32100173 PMCID: PMC7125065 DOI: 10.1007/s10654-020-00614-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 02/07/2020] [Indexed: 01/10/2023]
Abstract
Epidemiological research has shown there to be a strong relationship between preconceptional, prenatal, birth and early-life factors and lifelong health. The Lifelines NEXT is a birth cohort designed to study the effects of intrinsic and extrinsic determinants on health and disease in a four-generation design. It is embedded within the Lifelines cohort study, a prospective three-generation population-based cohort study recording the health and health-related aspects of 167,729 individuals living in Northern Netherlands. In Lifelines NEXT we aim to include 1500 pregnant Lifelines participants and intensively follow them, their partners and their children until at least 1 year after birth. Longer-term follow-up of physical and psychological health will then be embedded following Lifelines procedures. During the Lifelines NEXT study period biomaterials-including maternal and neonatal (cord) blood, placental tissue, feces, breast milk, nasal swabs and urine-will be collected from the mother and child at 10 time points. We will also collect data on medical, social, lifestyle and environmental factors via questionnaires at 14 different time points and continuous data via connected devices. The extensive collection of different (bio)materials from mother and child during pregnancy and afterwards will provide the means to relate environmental factors including maternal and neonatal microbiome composition) to (epi)genetics, health and developmental outcomes. The nesting of the study within Lifelines enables us to include preconceptional transgenerational data and can be used to identify other extended families within the cohort.
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Affiliation(s)
- Willemijn D B Warmink-Perdijk
- Department of Midwifery Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van de Boechorstraat 7, 1081 BT, Amsterdam, The Netherlands.
- Department of General Practice and Elderly Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
- AVAG (Academy Midwifery Amsterdam and Groningen), Dirk Huizingastraat 3-5, 9713 GL, Groningen, The Netherlands.
| | - Lilian L Peters
- Department of Midwifery Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van de Boechorstraat 7, 1081 BT, Amsterdam, The Netherlands
- Department of General Practice and Elderly Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
- AVAG (Academy Midwifery Amsterdam and Groningen), Dirk Huizingastraat 3-5, 9713 GL, Groningen, The Netherlands
| | - Ettje F Tigchelaar
- Department of Genetics, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - Jackie A M Dekens
- Department of Genetics, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
- Center for Development and Innovation, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - Soesma A Jankipersadsing
- Department of Genetics, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - Alexandra Zhernakova
- Department of Genetics, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - Willem J R Bossers
- Lifelines Cohort Study, Bloemsingel 1, 9713 BZ, Groningen, The Netherlands
| | - Jan Sikkema
- Center for Development and Innovation, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - Ank de Jonge
- Department of Midwifery Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van de Boechorstraat 7, 1081 BT, Amsterdam, The Netherlands
- AVAG (Academy Midwifery Amsterdam and Groningen), Dirk Huizingastraat 3-5, 9713 GL, Groningen, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - Henkjan J Verkade
- Department of Pediatrics, Pediatric Gastroenterology - Hepatology, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - Gerard H Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergy, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - Cisca Wijmenga
- Department of Genetics, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - Folkert Kuipers
- Department of Pediatrics/Laboratory Medicine, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - Sicco A Scherjon
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
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Post-Translational Modification and Natural Mutation of TRPC Channels. Cells 2020; 9:cells9010135. [PMID: 31936014 PMCID: PMC7016788 DOI: 10.3390/cells9010135] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 01/03/2020] [Accepted: 01/03/2020] [Indexed: 02/06/2023] Open
Abstract
Transient Receptor Potential Canonical (TRPC) channels are homologues of Drosophila TRP channel first cloned in mammalian cells. TRPC family consists of seven members which are nonselective cation channels with a high Ca2+ permeability and are activated by a wide spectrum of stimuli. These channels are ubiquitously expressed in different tissues and organs in mammals and exert a variety of physiological functions. Post-translational modifications (PTMs) including phosphorylation, N-glycosylation, disulfide bond formation, ubiquitination, S-nitrosylation, S-glutathionylation, and acetylation play important roles in the modulation of channel gating, subcellular trafficking, protein-protein interaction, recycling, and protein architecture. PTMs also contribute to the polymodal activation of TRPCs and their subtle regulation in diverse physiological contexts and in pathological situations. Owing to their roles in the motor coordination and regulation of kidney podocyte structure, mutations of TRPCs have been implicated in diseases like cerebellar ataxia (moonwalker mice) and focal and segmental glomerulosclerosis (FSGS). The aim of this review is to comprehensively integrate all reported PTMs of TRPCs, to discuss their physiological/pathophysiological roles if available, and to summarize diseases linked to the natural mutations of TRPCs.
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