1
|
Lejeune J, Raoult V, Dubrasquet M, Chauvin R, Mallebranche C, Pellier I, Monceaux F, Bayart S, Grain A, Gyan E, Ravalet N, Herault O, Ternant D. Prediction of the Clinical Course of Immune Thrombocytopenia in Children by Platelet Kinetics. Hemasphere 2023; 7:e960. [PMID: 37908859 PMCID: PMC10615561 DOI: 10.1097/hs9.0000000000000960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 08/16/2023] [Indexed: 11/02/2023] Open
Abstract
Childhood immune thrombocytopenia (ITP) is a rare autoimmune disorder characterized by isolated thrombocytopenia. Prolonged ITP (persistent and chronic) leads to a reduced quality of life for children in many domains. To provide optimal support for children, with ITP, it is important to be able to predict those who will develop prolonged ITP. This study aimed to develop a mathematical model based on platelet recovery that allows the early prediction of prolonged ITP. In this retrospective study, we used platelet counts from the 6 months following the diagnosis of ITP to model the kinetics of change in platelet count using a pharmacokinetic-pharmacodynamic model. In a learning set (n = 103), platelet counts were satisfactorily described by our kinetic model. The Kheal parameter, which describes spontaneous platelet recovery, allowed a distinction between acute and prolonged ITP with an area under the curve (AUC) of 0.74. In a validation set (n = 58), spontaneous platelet recovery was robustly predicted using platelet counts from 15 (AUC = 0.76) or 30 (AUC = 0.82) days after ITP diagnosis. In our model, platelet recovery quantified using the kheal parameter allowed prediction of the clinical course of ITP. Future prospective studies are needed to improve the predictivity of this model, in particular, by combining it with the predictive scores previously reported in the literature.
Collapse
Affiliation(s)
- Julien Lejeune
- Pediatric Onco-Hematology Unit, CHU de Tours, France
- CNRS ERL7001, EA 7501 GICC, University of Tours, France
| | | | | | | | | | | | | | - Sophie Bayart
- Pediatric and Adolescent Unit, CHRU de Rennes, France
| | - Audrey Grain
- Pediatric Immuno-Hemato-Oncology Unit, CHU Nantes, France
| | - Emmanuel Gyan
- Pediatric Onco-Hematology Unit, CHU de Tours, France
- CNRS ERL7001, EA 7501 GICC, University of Tours, France
| | - Noémie Ravalet
- CNRS ERL7001, EA 7501 GICC, University of Tours, France
- Department of Biological Hematology, Tours University Hospital, Tours, France
| | - Olivier Herault
- CNRS ERL7001, EA 7501 GICC, University of Tours, France
- Department of Biological Hematology, Tours University Hospital, Tours, France
| | - David Ternant
- EA 7501 « Transplantation, Immunology, Inflammation », University of Tours, France
| |
Collapse
|
2
|
Rüfer A, Terrell DR. Burden of immune thrombocytopenia (ITP): Special considerations for refractory ITP. Br J Haematol 2023; 203:79-85. [PMID: 37735553 DOI: 10.1111/bjh.19068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 07/31/2023] [Indexed: 09/23/2023]
Abstract
It is known that patients with immune thrombocytopenia (ITP) have fatigue and impairment of health-related quality of life (HRQoL). However, it is hypothesized that patients with refractory ITP have additional burdens that should be considered. Specifically, fatigue is more pronounced in patients with refractory disease, there are additional side effects from second- and third-line treatments, additional anxiety about the long-term course of the disease, impairment in HRQoL resulting from heavy menstrual bleeding and concerns related to family planning. The burden of disease, therefore, should be carefully assessed and considered in these patients. However, researchers have utilized numerous tools for evaluating HRQoL and fatigue, making comparison of data across studies challenging. There is a need to standardize assessment using either disease-specific or generic instruments that can be easily implemented in routine clinical practice. Additionally, whether treatment of low platelet count and bleeding symptoms will have a positive influence on HRQoL remains to be seen and published evidence is conflicting. Nevertheless, improvement of HRQoL is a major treatment goal for both patients and physicians and should be especially considered when treating patients with refractory ITP.
Collapse
Affiliation(s)
- Axel Rüfer
- Division of Hematology, Luzerner Kantonsspital-in association with University Luzern, Luzern, Switzerland
| | - Deirdra R Terrell
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| |
Collapse
|
3
|
Fenizia E, Marchese C, Spina ML, Coppola L, Rostagno E, Castaing M, Rosa RDL, Saenz R, Fonte L, Longo A, Ricciardi C, Rizzo C, Cataldo AD, Russo G. Pediatric Version of the Nurse Caring Behavior Scale: A Cross-Sectional Study in Pediatric Hemato-Oncology Centers. J Nurs Meas 2023; 31:404-411. [PMID: 35793860 DOI: 10.1891/jnm-2021-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and Purpose: Caring is an essential value in nursing, it's crucial in pediatric hemato-oncology: we tested the Nurse Caring Behavior Scale (NCBS) in this setting. Methods: The NCBS is a 14-item validated psychometric questionnaire: caregivers and nurses adapted versions were used. Descriptive statistics and exploratory factor analysis (EFA) were used. Results: The questionnaires were completed by 188 caregivers and 193 nurses. The two data sets were suitable for EFA and fitted with one-solution factor analysis; factor loading showed values >0.40 (>0.60 for caregivers). The mean scores were: 4.5 (range: 1-5) for caregivers and 4.7 (range: 1-5) for nurses. Conclusion: The two validated versions can be used on a wider nurses and caregivers sample and provide an instrument for the development of nursing protocols based on caring.
Collapse
Affiliation(s)
- Elisa Fenizia
- U.O.C. Emato-Oncologia Pediatrica, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy
| | - Chiara Marchese
- U.O.C. Emato-Oncologia Pediatrica, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy
| | - Milena La Spina
- U.O.C. Emato-Oncologia Pediatrica, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy
| | - Luigi Coppola
- U.O.C. Emato-Oncologia Pediatrica, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco," Catania, Italy
| | - Elena Rostagno
- Oncoematologia Pediatrica, IRCCS Azienda Ospedaliero Universitaria di Bologna, Italy
| | - Marine Castaing
- Registro dei Tumori di Siracusa e Provincia, Unità Sanitaria Locale, Siracusa, Italy
| | - Rosanna De La Rosa
- Área de Enfermería, Facultad de Ciencias de la Salud, Universidad Pública de Navarra, Grupo de Investigación Educación y Salud, Pamplona, Navarra, Spain
| | - Raquel Saenz
- Área de Enfermería, Facultad de Ciencias de la Salud, Universidad Pública de Navarra, Grupo de Investigación Educación y Salud, Pamplona, Navarra, Spain
| | - Leonardo Fonte
- U.O. di Onco Ematologia Pediatrica con Trapianto di Cellule staminali emopoietiche e midollo osseo dell'ARNAS Civico di Palermo, Italy
| | | | - Celeste Ricciardi
- U.O. Oncologia e Ematologia Pediatrica, Fondazione IRCCS "Casa del Sollievo della Sofferenza" San Giovanni Rotondo (FG), Italy
| | - Catia Rizzo
- U.O. Oncoematologia Pediatrica, Centro di Riferimento Regionale Azienda Ospedaliera "Pugliese Ciaccio," Catanzaro, Italy
| | - Andrea Di Cataldo
- U.O. Oncoematologia Pediatrica, Centro di Riferimento Regionale Azienda Ospedaliera "Pugliese Ciaccio," Catanzaro, Italy
- Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania, Italy
| | - Giovanna Russo
- U.O. Oncoematologia Pediatrica, Centro di Riferimento Regionale Azienda Ospedaliera "Pugliese Ciaccio," Catanzaro, Italy
- Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania, Italy
| |
Collapse
|
4
|
Zhang W, Xie S, Fu R, Chen Y, Liu W, Sun T, Ju M, Li H, Xue F, Zhang L, Liu X, Yang R. Fatigue and health-related quality of life in patients with immune thrombocytopenia: a longitudinal assessment in China. Expert Rev Hematol 2023; 16:1125-1133. [PMID: 38009277 DOI: 10.1080/17474086.2023.2286730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 10/22/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND There is lacking studies of longitudinally assessment of fatigue and health-related quality of life (HRQoL) among Chinese immune thrombocytopenia (ITP) adults. We aimed to evaluate changes in fatigue and HRQoL and identify the associated factors. METHODS Patients' characteristics, Functional Assessment of Chronic Illness Therapy (FACIT-F) and the ITP-specific Patient Assessment Questionnaire (ITP-PAQ) scores at admission (T0), at discharge (T1), and three months after discharge (T2) were collected. Linear mixed effects models were used to examine changes over time. RESULTS We included 175 patients. The mean score of FACIT-F at T0 was 37.2 and increased at T1 (39.0), while then decreased at T2 (34.7). Patients who were single, retired, had persistent ITP, splenomegaly had more severe fatigue, whereas those who had not received any prior treatment and had a bleeding score of 0 at admission had milder fatigue. The mean score of ITP-PAQ was 57.7 at T0, then gradually increased to 60.3 at T1 and 62.8 at T2. Patients with persistent ITP and those who have never received treatment for ITP have better HRQoL. CONCLUSION ITP adults' fatigue and HRQoL were impaired. Patients' fatigue improved at discharge but worsened at three months after discharge, while HRQoL gradually improved over time.
Collapse
Affiliation(s)
- Wenhui Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
- Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Shitong Xie
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
- Center for Social Science Survey and Data, Tianjin University, Tianjin, China
| | - Rongfeng Fu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Yunfei Chen
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Wei Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Ting Sun
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Mankai Ju
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Huiyuan Li
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Feng Xue
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Lei Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Xiaofan Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Renchi Yang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| |
Collapse
|
5
|
Guerrini Usubini A, Bottacchi M, Bondesan A, Marazzi N, Castelnuovo G, Sartorio A. Fatigue Perception in Adolescents with Obesity and Their Caregivers. J Clin Med 2023; 12:4268. [PMID: 37445303 DOI: 10.3390/jcm12134268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/22/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
Although fatigue is a frequently occurring symptom in young patients with obesity, relatively few studies have assessed their perception of fatigue and its impact on their quality of life so far. Comparisons between the reports of fatigue in children/adolescents with obesity and their parents were assessed using the Pediatric Quality of Life Inventory-Multidimensional Fatigue Scale (PedsQL-MFS). One hundred Italian children/adolescents (36 males; 64 females), aged between 11 and 17 (mean age = 15.3; SD = 1.61) with severe obesity [mean Body Mass Index (BMI: kg/m2) = 38; SD = 5.48] and their caregivers were enrolled. Perception of fatigue did not change by sex and rates of obesity in adolescents, while there was a difference (p = 0.040) in parents' reports of cognitive fatigue between parents of children/adolescents of Group 1 (BMI SDS 2-2.99) and Group 2 (BMI SDS > 3), with a higher perception of fatigue in parents of the less heavy obese children. Significant differences in reports of general fatigue subscale were found between children/adolescents and their parents, being higher in their parents than in the young subjects with obesity (p < 0.001). Significant moderate correlations between all the subscales of PedsQL-MFS for children and parents were found with Pearson's coefficients ranging from 0.529 to 0.571 (p < 0.001). The perception of fatigue measured with the PedsQL-MFS was comparable between obese children and their parents, thus indicating that this symptom is not hidden by children and is clearly perceived by their parents.
Collapse
Affiliation(s)
- Anna Guerrini Usubini
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy
| | - Michela Bottacchi
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy
| | - Adele Bondesan
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 28824 Piancavallo-Verbania, Italy
| | - Nicoletta Marazzi
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy
| | - Alessandro Sartorio
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 28824 Piancavallo-Verbania, Italy
- Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20145 Milan, Italy
| |
Collapse
|
6
|
Zanin E, Aiello EN, Diana L, Fusi G, Bonato M, Niang A, Ognibene F, Corvaglia A, De Caro C, Cintoli S, Marchetti G, Vestri A. Tele-neuropsychological assessment tools in Italy: a systematic review on psychometric properties and usability. Neurol Sci 2021; 43:125-138. [PMID: 34751849 PMCID: PMC8576086 DOI: 10.1007/s10072-021-05719-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 10/30/2021] [Indexed: 02/06/2023]
Abstract
Background The current COVID-19 pandemic has abruptly catalysed a shift towards remote assessment in neuropsychological practice (tele-neuropsychology, t-NPs). Although the validity of t-NPs diagnostics is gaining recognition worldwide, little is known about its implementation in Italy. The present review by the Italian working group on tele-neuropsychology (TELA) aims at describing the availability, psychometric properties, and feasibility of t-NPs tools currently available in Italy. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. This work was pre-registered on the Prospective Register of Systematic Reviews (PROSPERO; CRD42021239687). Observational studies reporting telephone-, videoconference- or web-based assessment of cognition/behaviour in Italian both healthy participants (HPs) and patients were included. Bias assessment was performed through ad hoc scales. Results Fourteen studies were included from an initial N = 895 (4 databases searched). Studies were subdivided into those focused on psychometric properties and those characterized by a predominant applied nature. The majority of studies addressed either adult/elderly HPs or neurological/internal patients. Multi-domain screening tools for cognition, behaviour, mood/anxiety and quality of life were the most represented. Findings regarding validity, reliability, sensitivity, specificity and clinical usability were reported for cognitive screenings — the telephone- and videoconference-based Mini-Mental State Examination and the Telephone Interview for Cognitive Status. Discussion Positive albeit preliminary evidence regarding psychometric properties and feasibility in both clinical and non-clinical populations of Italian t-NPs brief screening tools are herewith provided. Further studies exploring clinical usability of t-NPs and psychometric properties/feasibility of tests for the in-depth assessment of specific cognitive domains are necessary. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-021-05719-9.
Collapse
Affiliation(s)
- Elia Zanin
- Ospedale Riabilitativo di Alta Specializzazione (ORAS)-ULSS 2 TV, Motta di Livenza, Italy
| | - Edoardo Nicolò Aiello
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy. .,PhD Program in Neuroscience, University of Milano-Bicocca, Monza, Italy.
| | - Lorenzo Diana
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,PhD Program in Neuroscience, University of Milano-Bicocca, Monza, Italy
| | - Giulia Fusi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Mario Bonato
- Department of General Psychology, University of Padua, Padova, Italy
| | - Aida Niang
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | - Alessia Corvaglia
- Department of Biomedical and Clinical Science "Luigi Sacco", University of Milan, Milan, Italy
| | | | - Simona Cintoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giulia Marchetti
- Department of General Psychology, University of Padua, Padova, Italy
| | - Alec Vestri
- Unit for the Rehabilitation of Acquired Neuropsychological Disorders, IRCCS E. Medea, Pieve di Soligo, Italy
| | | |
Collapse
|
7
|
Colombatti R, Casale M, Russo G. Disease burden and quality of life of in children with sickle cell disease in Italy: time to be considered a priority. Ital J Pediatr 2021; 47:163. [PMID: 34325732 PMCID: PMC8323323 DOI: 10.1186/s13052-021-01109-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/18/2021] [Indexed: 01/12/2023] Open
Abstract
The objective of the present article is to highlight the need for attention to Quality of Life of patients with Sickle Cell Disease living in Italy. The transformation of sickle cell disease from a severe life-threatening disease of childhood into a chronic, lifelong condition due to the significant improvements in care and treatment options, imposes increasing new challenges to health care providers and patients. Patients now face physical, psychosocial and emotional challenges throughout their lives. They generally have to receive chronic treatments and regular multidisciplinary monitoring which increase social and emotional burden rendering adherence to treatment sometimes complicated. A chronic disease impacts all aspects of patients’ lives, not only the physical one, but also the social and emotional aspects as well as the educational and working life. The entire “Quality of Life” is affected and recent evidence demonstrates the importance quality of life has for patients with chronic illness. The results of this review focus on emerging data regarding quality of life across the lifespan of patients with Sickle Cell Disease, and highlight the need for more action in this field in Italy, where recent immigration and improved care determine an increasing population of children with sickle cell disease being taken into long term care.
Collapse
Affiliation(s)
- Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child's Health, University of Padova, Padova, Italy
| | - Maddalena Casale
- Department of Women, Child and General and Specialized Surgery, University "Luigi Vanvitelli", Naples, Italy
| | - Giovanna Russo
- Pediatric Hemato-Oncology Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
| |
Collapse
|