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AlOsaif ZA, Al Bisher HM, Elshnawie HA, Al-Hariri MT. The Impact of Thyroidectomy and Lobectomy on Patients' Health-Related Quality of Life, Eastern Region, Saudi Arabia. Clin Pract 2024; 14:1251-1263. [PMID: 39051295 PMCID: PMC11270376 DOI: 10.3390/clinpract14040101] [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: 05/17/2024] [Revised: 06/15/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION The thyroid gland is a crucial endocrine organ that can be susceptible to various pathological conditions, often necessitating total thyroidectomy or lobectomy. It is a common surgical procedure in Saudi Arabia. Thus, it is essential to recognize the impact of thyroid surgery on patients' health-related quality of life (HRQoL). AIM The aim of this study was to evaluate HRQoL among patients with benign and malignant thyroid diseases who underwent thyroidectomy in the eastern region of Saudi Arabia. METHODS This cross-sectional study was conducted at King Fahad Hospital of University in Khobar, Kingdom of Saudi Arabia from January 2018 to May 2018. The data collection method used was divided into two parts. Part I included the patients' socio-demographic characteristics and the clinical characteristics of their thyroid surgery. Part II was a HRQoL questionnaire (SF-36, version 1.0). RESULTS The sample included 100 thyroidectomy patients ≥18 years. The study findings revealed that the overall scores for post-thyroidectomy patients showed a significant improvement in HRQoL, and HRQoL was not significantly associated with benign or malignant thyroid diseases. CONCLUSION Especially when the surgery is performed by a high-volume endocrine surgeon, thyroidectomy may lead to significant improvements in HRQoL among patients, including the elderly and younger adults, with benign and malignant thyroid disorders. There was no difference in HRQoL between patients who underwent total thyroidectomy or thyroid lobectomy. Also, HRQol among thyroidectomy patients is associated with their educational and occupational statuses.
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Affiliation(s)
| | - Hassan Mohammed Al Bisher
- Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34211, Saudi Arabia;
| | - Hend Abdelmonem Elshnawie
- Fundamental of Nursing Department, Nursing College, Imam Abdulrahman Bin Faisal University, Dammam 34211, Saudi Arabia;
| | - Mohammed Taha Al-Hariri
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34224, Saudi Arabia
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Althobiani MA, Russell AM, Jacob J, Ranjan Y, Folarin AA, Hurst JR, Porter JC. Interstitial lung disease: a review of classification, etiology, epidemiology, clinical diagnosis, pharmacological and non-pharmacological treatment. Front Med (Lausanne) 2024; 11:1296890. [PMID: 38698783 PMCID: PMC11063378 DOI: 10.3389/fmed.2024.1296890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/26/2024] [Indexed: 05/05/2024] Open
Abstract
Interstitial lung diseases (ILDs) refer to a heterogeneous and complex group of conditions characterized by inflammation, fibrosis, or both, in the interstitium of the lungs. This results in impaired gas exchange, leading to a worsening of respiratory symptoms and a decline in lung function. While the etiology of some ILDs is unclear, most cases can be traced back to factors such as genetic predispositions, environmental exposures (including allergens, toxins, and air pollution), underlying autoimmune diseases, or the use of certain medications. There has been an increase in research and evidence aimed at identifying etiology, understanding epidemiology, improving clinical diagnosis, and developing both pharmacological and non-pharmacological treatments. This review provides a comprehensive overview of the current state of knowledge in the field of interstitial lung diseases.
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Affiliation(s)
- Malik A. Althobiani
- Royal Free Campus, UCL Respiratory, University College London, London, United Kingdom
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Anne-Marie Russell
- School of Health and Care Professions, University of Exeter, Exeter, United Kingdom
- School of Medicine and Health, University of Birmingham, Birmingham, United Kingdom
| | - Joseph Jacob
- UCL Respiratory, University College London, London, United Kingdom
- Satsuma Lab, Centre for Medical Image Computing, University College London Respiratory, University College London, London, United Kingdom
| | - Yatharth Ranjan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Amos A. Folarin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, King's College London, London, United Kingdom
- Institute of Health Informatics, University College London, London, United Kingdom
- NIHR Biomedical Research Centre at University College London Hospitals, NHS Foundation Trust, London, United Kingdom
| | - John R. Hurst
- Royal Free Campus, UCL Respiratory, University College London, London, United Kingdom
| | - Joanna C. Porter
- UCL Respiratory, University College London, London, United Kingdom
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Namsrai T, Phillips C, Parkinson A, Gregory D, Kelly E, Cook M, Desborough J. Diagnostic delay of sarcoidosis: an integrated systematic review. Orphanet J Rare Dis 2024; 19:156. [PMID: 38605384 PMCID: PMC11010435 DOI: 10.1186/s13023-024-03152-7] [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: 03/23/2023] [Accepted: 03/28/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Sarcoidosis is a chronic inflammatory granulomatous disease of unknown cause. Delays in diagnosis can result in disease progression and poorer outcomes for patients. Our aim was to review the current literature to determine the overall diagnostic delay of sarcoidosis, factors associated with diagnostic delay, and the experiences of people with sarcoidosis of diagnostic delay. METHODS Three databases (PubMed/Medline, Scopus, and ProQuest) and grey literature sources were searched. Random effects inverse variance meta-analysis was used to pool mean diagnostic delay in all types of sarcoidosis subgroup analysis. Diagnostic delay was defined as the time from reported onset of symptoms to diagnosis of sarcoidosis. RESULTS We identified 374 titles, of which 29 studies were included in the review, with an overall sample of 1531 (694 females, 837 males). The overall mean diagnostic delay in all types of sarcoidosis was 7.93 months (95% CI 1.21 to 14.64 months). Meta-aggregation of factors related to diagnostic delay in the included studies identified three categories: (1) the complex and rare features of sarcoidosis, (2) healthcare factors and (3) patient-centred factors. Meta-aggregation of outcomes reported in case studies revealed that the three most frequent outcomes associated with diagnostic delay were: (1) incorrect diagnosis, (2) incorrect treatment and (3) development of complications/disease progression. There was no significant difference in diagnostic delay between countries with gatekeeper health systems (where consumers are referred from a primary care clinician to specialist care) and countries with non-gatekeeper systems. No qualitative studies examining people's experiences of diagnostic delay were identified. CONCLUSION The mean diagnostic delay for sarcoidosis is almost 8 months, which has objective consequences for patient management. On the other hand, there is a paucity of evidence about the experience of diagnostic delay in sarcoidosis and factors related to this. Gaining an understanding of people's experiences while seeking a diagnosis of sarcoidosis is vital to gain insight into factors that may contribute to delays, and subsequently inform strategies, tools and training activities aimed at increasing clinician and public awareness about this rare condition. TRIAL REGISTRATION PROSPERO Registration number: CRD42022307236.
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Affiliation(s)
- Tergel Namsrai
- National Centre for Epidemiology and Population Health, The Australian National University, 63, Eggleston Road, Acton ACT, Canberra, 2601, Australia
| | - Christine Phillips
- School of Medicine and Psychology, The Australian National University, Canberra, Australia
| | - Anne Parkinson
- National Centre for Epidemiology and Population Health, The Australian National University, 63, Eggleston Road, Acton ACT, Canberra, 2601, Australia
| | - Dianne Gregory
- National Centre for Epidemiology and Population Health, The Australian National University, 63, Eggleston Road, Acton ACT, Canberra, 2601, Australia
- Sarcoidosis Lyme Australia, Camden, Australia
| | - Elaine Kelly
- National Centre for Epidemiology and Population Health, The Australian National University, 63, Eggleston Road, Acton ACT, Canberra, 2601, Australia
- Sarcoidosis Lyme Australia, Camden, Australia
| | - Matthew Cook
- John Curtin School of Medical Research, The Australian National University, Canberra, Australia
| | - Jane Desborough
- National Centre for Epidemiology and Population Health, The Australian National University, 63, Eggleston Road, Acton ACT, Canberra, 2601, Australia.
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Kouranos V, Wells AU. Monitoring of Sarcoidosis. Clin Chest Med 2024; 45:45-57. [PMID: 38245370 DOI: 10.1016/j.ccm.2023.08.002] [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: 01/22/2024]
Abstract
This article focuses on the monitoring of pulmonary sarcoidosis. The monitoring of sarcoidosis is, in part, focused on serial change in major organ involvement but also includes diagnostic re-evaluation and review of change in quality of life. Recent criteria for progression of fibrotic interstitial lung disease are adapted to pulmonary sarcoidosis. The frequency and nature of monitoring are discussed, integrating baseline risk stratification and strategic treatment goals. Individual variables used to identify changes in pulmonary disease severity are discussed with a focus on their flaws and the need for a multidimensional approach. Other key monitoring issues are covered briefly.
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Affiliation(s)
- Vasileios Kouranos
- Interstitial Lung Disease/Sarcoidosis Unit, Royal Brompton Hospital, Sydney street, London, SW3 6NP; National Heart and Lung Institute, Imperial College London, Guy Scadding Building, Cale Street, London, SW3 6LY.
| | - Athol Umfrey Wells
- Interstitial Lung Disease/Sarcoidosis Unit, Royal Brompton Hospital, Sydney street, London, SW3 6NP; National Heart and Lung Institute, Imperial College London, Guy Scadding Building, Cale Street, London, SW3 6LY
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Rasheed AZ, Metersky ML, Ghazal F. Mechanisms and management of cough in interstitial lung disease. Expert Rev Respir Med 2023; 17:1177-1190. [PMID: 38159067 DOI: 10.1080/17476348.2023.2299751] [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: 09/26/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Many patients with interstitial lung diseases (ILDs), especially fibrotic ILDs, experience chronic cough. It negatively impacts both physical and psychological well-being. Effective treatment options are limited. AREAS COVERED The pathophysiology of chronic cough in IPF is complex and involves multiple mechanisms, including mechanical distortion of airways, parenchyma, and nerve fibers. The pathophysiology of cough in other fibrosing ILDs is poorly understood and involves various pathways. The purpose of this review is to highlight mechanisms of chronic cough and to present therapeutic evidence for its management in the most commonly occurring diffuse fibrosing lung diseases including idiopathic pulmonary fibrosis (IPF), connective tissue disease-related interstitial lung disease (CTD-ILD), sarcoidosis-related ILD (Sc-ILD), chronic hypersensitivity pneumonitis-related ILD (CHP-ILD), and post-COVID-19-related interstitial lung disease (PC-ILD). EXPERT OPINION This review guides the management of chronic cough in fibrosing ILDs. In this era of precision medicine, chronic cough management should be individualized in each interstitial lung disease.
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Affiliation(s)
- Ameer Z Rasheed
- Division of Pulmonary, Critical Care and Sleep Medicine, UConn Health, Farmington, CT, USA
| | - Mark L Metersky
- Division of Pulmonary, Critical Care and Sleep Medicine, UConn Health, Farmington, CT, USA
| | - Fatima Ghazal
- Department of Internal Medicine, UConn Health, Farmington, CT, USA
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Moor CC, Obi ON, Kahlmann V, Buschulte K, Wijsenbeek MS. Quality of life in sarcoidosis. J Autoimmun 2023:103123. [PMID: 37813805 DOI: 10.1016/j.jaut.2023.103123] [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: 06/06/2023] [Accepted: 10/04/2023] [Indexed: 10/11/2023]
Abstract
Having sarcoidosis often has a major impact on quality of life of patients and their families. Improving quality of life is prioritized as most important treatment aim by many patients with sarcoidosis, but current evidence and treatment options are limited. In this narrative review, we describe the impact of sarcoidosis on various aspects of daily life, evaluate determinants of health-related quality of life (HRQoL), and provide an overview of the different patient-reported outcome measures to assess HRQoL in sarcoidosis. Moreover, we review the current evidence for pharmacological and non-pharmacological interventions to improve quality of life for people with sarcoidosis.
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Affiliation(s)
- Catharina C Moor
- Department of Respiratory Medicine, Centre of Excellence for Interstitial Lung Diseases and Sarcoidosis, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Ogugua Ndili Obi
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Vivienne Kahlmann
- Department of Respiratory Medicine, Centre of Excellence for Interstitial Lung Diseases and Sarcoidosis, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Katharina Buschulte
- Center for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany
| | - Marlies S Wijsenbeek
- Department of Respiratory Medicine, Centre of Excellence for Interstitial Lung Diseases and Sarcoidosis, Erasmus Medical Center, Rotterdam, the Netherlands.
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Affiliation(s)
- Edward S Chen
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, 5501 Hopkins Bayview Cir, Baltimore, MD, 21224, USA.
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Cifaldi R, Salton F, Confalonieri P, Trotta L, Barbieri M, Ruggero L, Valeri G, Pozzan R, Della Porta R, Kodric M, Baratella E, Bellan M, Lerda S, Hughes M, Confalonieri M, Cova MA, Gandin I, Mondini L, Ruaro B. Pulmonary Sarcoidosis and Immune Dysregulation: A Pilot Study on Possible Correlation. Diagnostics (Basel) 2023; 13:2899. [PMID: 37761266 PMCID: PMC10530165 DOI: 10.3390/diagnostics13182899] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Sarcoidosis is a systemic inflammatory disease characterized by an altered inflammatory response. OBJECTIVE The aim of this study was to evaluate whether immune system alterations detected by lymphocyte typing in peripheral blood correlate with the severity of sarcoidosis, calculated according to two separate severity scores proposed by Wasfi in 2006 and Hamzeh in 2010. MATERIALS AND METHODS Eighty-one patients were recruited, and clinical data and laboratory tests at the time of diagnosis were obtained in order to assess the severity index score and investigate any statistically significant correlation with the cytofluorimetry data. RESULTS Our data demonstrated that none of the two scores show an association with the level of total lymphocytes or lymphocyte subclasses. LIMITATIONS First of all, the sample taken into consideration is small. The assessment was performed only at disease onset and not during the disease. Furthermore, the severity scores do not take into account disease activity (measured by PET/CT or gallium scintigraphy). CONCLUSIONS Lymphocyte subpopulation values at the time of diagnosis do not appear to correlate with disease severity at onset.
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Affiliation(s)
- Rossella Cifaldi
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Francesco Salton
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Paola Confalonieri
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Liliana Trotta
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Mariangela Barbieri
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Luca Ruggero
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Gianmaria Valeri
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Riccardo Pozzan
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Rossana Della Porta
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Metka Kodric
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Elisa Baratella
- Department of Radiology, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Mattia Bellan
- Department of Translational Medicine, Università del Piemonte Orientale (UPO), 28100 Novara, Italy
- Center for Autoimmune and Allergic Disease (CAAD), Università del Piemonte Orientale (UPO), 28100 Novara, Italy
- Department of Internal Medicine, University Hospital, Maggiore della Carità, 28100 Novara, Italy
| | - Selene Lerda
- Management Specialization School, University of Milan, 20149 Milano, Italy
| | - Michael Hughes
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester & Salford Royal NHS Foundation Trust, Manchester M6 8HD, UK
| | - Marco Confalonieri
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Maria Assunta Cova
- Department of Radiology, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Ilaria Gandin
- Biostatistics Unit, Department of Medical Sciences, University of Trieste, 34149 Trieste, Italy
| | - Lucrezia Mondini
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Barbara Ruaro
- Pulmonology Unit, Department of Medical Surgical and Healt Sciencies, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
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Hilker C, Weis J, Ziehfreund S, Arkema EV, Biedermann T, Zink A. "The chameleon among diseases" - an explorative view of sarcoidosis and identification of the consequences for affected patients and relatives using qualitative interviews. Orphanet J Rare Dis 2023; 18:276. [PMID: 37679829 PMCID: PMC10486085 DOI: 10.1186/s13023-023-02866-4] [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: 08/19/2022] [Accepted: 08/23/2023] [Indexed: 09/09/2023] Open
Abstract
INTRODUCTION Sarcoidosis is a multisystemic disease, with the lungs being the main site of manifestation. Although the exact etiology remains unclear, both genetic and environmental factors are being discussed. Diagnostic evaluation is challenging, and the management of chronic patients and assessment of their needs proves difficult, especially in the absence of targeted therapy. Studies on sarcoidosis patients have shown that quality of life is limited even after clinically measurable parameters have resolved. The question remains how patients and their relatives perceive medical care and the diagnostic process and how these affect their well-being. METHODS Qualitative, semi-structured interviews were conducted with patients and their relatives between September 2019 and February 2020. Interviews were recorded, transcribed verbatim, and analyzed using qualitative content analysis. Deductive hypotheses were then formed based on categories according to personal aspects, symptoms, diagnostic, daily life activity, therapy, psychological aspects and wishes. RESULTS Fourteen patients and five relatives were included. Most patients reported subacute symptoms before the first organ-related episode. A high degree of personal initiative was required from the majority of respondents in both the diagnostic and subsequent therapeutic processes. In addition, respondents reported so-called "doctor-hopping", a lack of specialists or contacts, and a lack of medical support. The Internet and self-help groups played a fundamental role for patients and relatives in exchanging information with other affected persons and to compensate for an existing information deficit. CONCLUSION The results provide new insights into patients' and relatives' perceptions of the sarcoidosis diagnosis and treatment process. Identification of barriers such as a lack of physicians and an information deficit highlights potential targets for strategies to optimize sarcoidosis management.
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Affiliation(s)
- Charlotte Hilker
- School of Medicine, Department of Dermatology and Allergy, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Johanna Weis
- School of Medicine, Department of Dermatology and Allergy, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Stefanie Ziehfreund
- School of Medicine, Department of Dermatology and Allergy, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Elizabeth V. Arkema
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Tilo Biedermann
- School of Medicine, Department of Dermatology and Allergy, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Alexander Zink
- School of Medicine, Department of Dermatology and Allergy, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
- Division of Dermatology and Venereology Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Saketkoo LA, Russell AM, Patterson KC, Obi ON, Drent M. Sarcoidosis and frailty: recognizing factors that foster holistic resilience. Curr Opin Pulm Med 2023:00063198-990000000-00099. [PMID: 37522560 DOI: 10.1097/mcp.0000000000000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
PURPOSE OF REVIEW Sarcoidosis is a multiorgan system disease exerting significant impact on biophysical, social, psychological and emotional well-being. Mortality and disability correlate to accessible, timely, expert care for sarcoidosis and its related complications. Across health conditions, positive healthcare interactions and interventions can rehabilitate unfavourable factors tied to concepts of 'frailty'. Here, we set out to introduce concepts related to frailty and their impact in the context of sarcoidosis. RECENT FINDINGS Studies examining frailty across other multiorgan and single organ-based diseases that mirror organ involvement in sarcoidosis demonstrate findings that bear relevance in sarcoidosis. Namely, factors predisposing a person to frailty are a multifactorial phenomenon which are also reflected in the lived experience of sarcoidosis; and that early diagnosis, intervention and prevention may alter a course towards more favourable health outcomes. SUMMARY Factors predisposing to frailty in other health conditions may also signal a risk in sarcoidosis. In turn, proactive health preservation - regardless of age - may lead to improved biopsychosocial reserve and health-related quality of life. Fortifying holistic resilience in sarcoidosis is anticipated to reduce risk of the occurrence and prolongation of health-related complications, and facilitate swifter recovery from biophysical complications as well as from psychosocial and emotional stressors.
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Affiliation(s)
- Lesley Ann Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center
- University Medical Center - Comprehensive Pulmonary Hypertension Center and Interstitial Lung Disease Clinic Programs
- Louisiana State University School of Medicine, Section of Pulmonary Medicine
- Tulane University School of Medicine, Undergraduate Honors Department, New Orleans, Louisiana, USA
| | - Anne-Marie Russell
- Exeter Respiratory Innovations Center, University of Exeter, Exeter
- Royal Devon and Exeter NHS Foundation Trust, Devon
- Imperial College Healthcare NHS Trust, London
| | - Karen C Patterson
- Brighton & Sussex Medical School, Department of Clinical & Experimental Medicine, Falmer, UK
| | - Ogugua Ndili Obi
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Marjolein Drent
- Interstitial Lung Diseases (ILD) Center of Excellence, Department of Pulmonology, St. Antonius Hospital, Nieuwegein
- Department of Pharmacology and Toxicology, Faculty of Health and Life Sciences, Maastricht University, Maastricht
- ILD CARE Foundation Research Team, Ede, The Netherlands
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Kahlmann V, Moor CC, Veltkamp M, Wijsenbeek MS. Sarcoidosis and fatigue: there is a useful cognitive treatment? - Authors' reply. THE LANCET. RESPIRATORY MEDICINE 2023; 11:e67. [PMID: 37244268 DOI: 10.1016/s2213-2600(23)00151-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/11/2023] [Indexed: 05/29/2023]
Affiliation(s)
- Vivienne Kahlmann
- Center of Excellence for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Catharina C Moor
- Center of Excellence for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Marcel Veltkamp
- ILD Centre of Excellence, Department of Pulmonology, Saint Antonius Hospital, Nieuwegein, the Netherlands; Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marlies S Wijsenbeek
- Center of Excellence for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
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Bloem AEM, Houben-Wilke S, Mostard RLM, Stoot N, Janssen DJA, Franssen FME, Custers JWH, Spruit MA. Respiratory and non-respiratory symptoms in patients with IPF or sarcoidosis and controls. Heart Lung 2023; 61:136-146. [PMID: 37269615 DOI: 10.1016/j.hrtlng.2023.05.013] [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: 02/20/2023] [Revised: 05/06/2023] [Accepted: 05/20/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Besides dyspnoea and cough, patients with idiopathic pulmonary fibrosis (IPF) or sarcoidosis may experience distressing non-respiratory symptoms, such as fatigue or muscle weakness. However, whether and to what extent symptom burden differs between patients with IPF or sarcoidosis and individuals without respiratory disease remains currently unknown. OBJECTIVES To study the respiratory and non-respiratory burden of multiple symptoms in patients with IPF or sarcoidosis and to compare the symptom burden with individuals without impaired spirometric values, FVC and FEV1 (controls). METHODS Demographics and symptoms were assessed in 59 patients with IPF, 60 patients with sarcoidosis and 118 controls (age ≥18 years). Patients with either condition were matched to controls by sex and age. Severity of 14 symptoms was assessed using a Visual Analogue Scale. RESULTS 44 patients with IPF (77.3% male; age 70.6±5.5 years) and 44 matched controls, and 45 patients with sarcoidosis (48.9% male; age 58.1±8.6 year) and 45 matched controls were analyzed. Patients with IPF scored higher on 11 symptoms compared to controls (p<0.05), with the largest differences for dyspnoea, cough, fatigue, muscle weakness and insomnia. Patients with sarcoidosis scored higher on all 14 symptoms (p<0.05), with the largest differences for dyspnoea, fatigue, cough, muscle weakness, insomnia, pain, itch, thirst, micturition (night, day). CONCLUSIONS Generally, respiratory and non-respiratory symptom burden is significantly higher in patients with IPF or sarcoidosis compared to controls. This emphasizes the importance of awareness for respiratory and non-respiratory symptom burden in IPF or sarcoidosis and the need for additional research to study the underlying mechanisms and subsequent interventions.
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Affiliation(s)
- Ada E M Bloem
- University of Applied Sciences Utrecht, Institute of Movement Studies, Faculty of Health Care, Utrecht, the Netherlands; ILD Centre of Excellence, Department of Pulmonology, St. Antonius Hospital, Nieuwegein, the Netherlands.
| | | | - Rémy L M Mostard
- Department of Respiratory Medicine, Zuyderland Medical Center Heerlen, Heerlen/Sittard-Geleen, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands
| | - Naomi Stoot
- Department of Respiratory Medicine, Zuyderland Medical Center Heerlen, Heerlen/Sittard-Geleen, the Netherlands
| | - Daisy J A Janssen
- Department of Research and Development, CIRO+, Horn, the Netherlands; Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Frits M E Franssen
- Department of Research and Development, CIRO+, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; NUTRIM, School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht, the Netherlands
| | - Jan W H Custers
- University of Applied Sciences Utrecht, Institute of Movement Studies, Faculty of Health Care, Utrecht, the Netherlands
| | - Martijn A Spruit
- Department of Research and Development, CIRO+, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands; NUTRIM, School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht, the Netherlands
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Sikora M, Jastrzębski D, Pilzak K, Ziora D, Hall B, Żebrowska A. Impact of physical functional capacity on quality of life in patients with interstitial lung diseases. Respir Physiol Neurobiol 2023; 313:104064. [PMID: 37076026 DOI: 10.1016/j.resp.2023.104064] [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: 02/09/2023] [Revised: 04/05/2023] [Accepted: 04/16/2023] [Indexed: 04/21/2023]
Abstract
This study aimed to investigate the physical functioning predictors for health-related quality of life (HRQL) decline in patients with idiopathic interstitial fibrosis (IPF), sarcoidosis and other interstitial lung disease (ILD). The study enrolled 52 patients with ILD and 16 healthy individuals. Participants' HRQL was assessed using the 36-item Short-Form Health Survey questionnaire. Spirometry, physical performance, and daily physical activity (PA) were monitored. Patients with IPF showed significantly lower PA compared to patients with other ILD (p =0.002)and sarcoidosis (p =0.01). The type of disease aetiology had no significant effect on aerobic capacity, HRQL and fatigue. Patients with ILD showed significant greater fatigue, lower physical functioning and greater physical aspects scores compared to the control group (F=6.0; p=0.018; F=12.64; p=0.001, respectively). A significant positive correlation was observed between 6-minute walking distance (6MWD) and the physical domain of HRQL (r=0.35, p=0.012) and PA and the physical aspects of HRQL (r=0.37, p=0.007). This study revealed that the key predictors for HRQL decline were lower lung function, lower PA and physical performance.
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Affiliation(s)
- Marcin Sikora
- Institute of Sport Science The Jerzy Kukuczka Academy of Physical Education, 72A Mikolowska Street, 40-065 Katowice, Poland.
| | - Dariusz Jastrzębski
- Department of Lung Diseases and Tuberculosis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland
| | - Katarzyna Pilzak
- Department of Physiological and Medical Sciences, The Jerzy Kukuczka Academy of Physical Education, 72A Mikolowska Street, 40-065 Katowice, Poland
| | - Dariusz Ziora
- Department of Lung Diseases and Tuberculosis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland
| | - Barbara Hall
- School of Biological Sciences, Division of Infection, Immunity and Respiratory Medicine University of Manchester, United Kondon
| | - Aleksandra Żebrowska
- Institute of Sport Science The Jerzy Kukuczka Academy of Physical Education, 72A Mikolowska Street, 40-065 Katowice, Poland
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Judson MA, Spagnolo P, Stanfel R, Farrow G, Tanase AM, Perna F, Baughman RP. Living with sarcoidosis: Virtual roundtable dialogue with patients and healthcare professionals. Respir Med 2023; 210:107174. [PMID: 36871867 DOI: 10.1016/j.rmed.2023.107174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/23/2023] [Accepted: 02/26/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Sarcoidosis is a multisystem disease, characterised by the infiltration of various organs by non-necrotising granulomas. The disease's heterogeneity complicates the study of patients' experiences. OBJECTIVE To gather insight into life experiences, unmet needs and views on hypothetically emerging treatment options among patients living with sarcoidosis. METHODS Multinational, virtual, interactive, moderated discussion of specific questions between people with sarcoidosis, with experienced clinicians participating. RESULTS Nine patients with sarcoidosis from Australia, Denmark, Germany, Italy, Japan and the US, and three clinicians took part. All patients had pulmonary sarcoidosis, self-assessed as mild by five patients. The path to diagnosis was convoluted, with up to four physicians and a large number of tests involved. There was agreement that the process would be improved by earlier referral to specialists. The patients made a clear distinction between 'living with a condition' (adapting to the disease) and 'being ill'. The concept of remission was viewed sceptically as disease might develop in multiple organs. Panellists had a pragmatic attitude to therapies: side effects during a treatment course were accepted if overall symptoms improved. When considering hypothetical new therapies, improved quality of life (QoL) was the most important need; improved tolerability had lower priority. New therapies should be targeted on reducing disease progression and improving symptoms and QoL rather than corticosteroid withdrawal. CONCLUSIONS The interactive exchange provided insights into the need for earlier specialist referrals, distrust of the concept of remission in sarcoidosis, and the need for therapies targeted on reducing disease progression and improving symptoms and QoL.
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Affiliation(s)
| | - Paolo Spagnolo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health. University of Padova, Padova, Italy
| | | | - Garrie Farrow
- Foundation for Sarcoidosis Research, Chicago, IL, USA
| | | | | | - Robert P Baughman
- Department of Medicine, University of Cincinnati Medical Center, 200 Albert Sabin Way, Room 1001, Cincinnati, OH, 45267, USA.
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Ezeh N, Caplan A, Rosenbach M, Imadojemu S. Cutaneous Sarcoidosis. Dermatol Clin 2023; 41:455-470. [DOI: 10.1016/j.det.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
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Quijano-Campos JC, Sekhri N, Thillai M, Sanders J. Health-related quality of life in cardiac sarcoidosis: a systematic review. EUROPEAN HEART JOURNAL OPEN 2023; 3:oead009. [PMID: 36974155 PMCID: PMC10039618 DOI: 10.1093/ehjopen/oead009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/25/2022] [Accepted: 02/14/2023] [Indexed: 02/20/2023]
Abstract
People living with cardiac sarcoidosis (CS) are likely to have worse clinical outcomes and greater impairment on health-related quality of life (HRQoL) than other sarcoidosis manifestations. CS can result in a constellation of intrusive symptoms (such as palpitations, dizziness, syncope/pre-syncope, chest pain, dyspnoea, orthopnoea, or peripheral oedema) and/or life-threatening episodes, requiring consideration of invasive cardiac procedures for diagnosis and for the management of acute events. Additionally, the presence of multisystemic involvement and persistent non-specific sarcoidosis symptoms negatively affect HRQoL. A systematic review was undertaken to explore the impact of CS on HRQoL in adults with CS. Multiple bibliographic databases were searched for studies with HRQoL as primary or secondary outcomes in CS (PROSPERO registration: CRD42019119752). Data extraction and quality assessments were undertaken independently by two authors. From the initial 1609 identified records, only 11 studies included CS patients but none specifically reported HRQoL scores for CS patients. The average representation of CS patients was 14.5% within these cohorts (range 2-22%). The majority (73%) was conducted in single-centre tertiary care settings, and only one study (9%) included longitudinal HRQoL data. CS patients were among those sarcoidosis patients with impaired HRQoL and worse outcomes, requiring higher doses of sarcoidosis-specific therapy which contribute to further deterioration of HRQoL. Sarcoidosis studies do not incorporate stratified HRQoL scores for CS patients. While there is a need for longitudinal and multicentre studies assessing HRQoL outcomes in CS cohorts, the development of CS-specific tools is also needed.
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Affiliation(s)
- Juan Carlos Quijano-Campos
- William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7DN, UK
- Research & Development, Royal Papworth Hospital NHS Foundation Trust, Papworth Road, Cambridge CB2 0AY, UK
| | - Neha Sekhri
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
| | - Muhunthan Thillai
- Interstitial Lung Disease Unit, Royal Papworth Hospital NHS Foundation Trust, Papworth Road, Cambridge CB2 0AY, UK
- Department of Medicine, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SP, UK
| | - Julie Sanders
- William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7DN, UK
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Christon LM, Chandler J, Benfield K, Pairet S, Hoffman M, Treiber F, James WE. Perceptions of the Fatigue Experience and a Breathing Awareness Meditation-Integrated mHealth App for Fatigue and Stress in Patients with Sarcoidosis. FATIGUE : BIOMEDICINE, HEALTH & BEHAVIOR 2022; 11:14-34. [PMID: 37982097 PMCID: PMC10655927 DOI: 10.1080/21641846.2022.2154499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/25/2022] [Indexed: 12/13/2022]
Abstract
Objective Sarcoidosis-associated fatigue is a debilitating consequence of sarcoidosis, a multi-system inflammatory disease, and may be related to increased stress associated with sarcoidosis. Breathing awareness meditation has potential as an intervention for managing stress and fatigue for sarcoidosis patients (SPs). This project's aim was to obtain feedback from key informants to design and tailor a patient-centered Sarcoidosis Patient Resource and Companion (SPARC) mHealth App developed for SPs to manage fatigue and stress at home using breathing awareness meditation. Methods We used a mixed-method patient/user-centered design with triangulation to understand SPs experiences of sarcoidosis-associated fatigue and stress (n = 13), and obtain feedback on the SPARC App-prototype integrating breathing awareness meditation from these SPs and health care team members (HCTMs; n = 5). Using deductive content analysis, transcribed interviews were coded for themes and subthemes. Results We report on findings from qualitative interviews and assessment of SPs' experiences including themes describing fatigue/stress interactions. Themes indicated that SPs find fatigue to be a profoundly difficult experience affecting multiple domains of functioning for which they perceive few effective strategies to cope. SPs and HCTMs shared feedback on the SPARC App-prototype after a test session; it was reported to be user friendly and to have potential for improving fatigue/stress, and key points for tailoring the App to SPs were shared. Conclusion Sarcoidosis-associated fatigue poses a significant burden for SPs. The SPARC App-prototype with breathing awareness meditation was acceptable and feasible to use and was well-received by SPs and HCTMs. Future iterations of the SPARC App to test the effect of breathing awareness meditation on fatigue will need to incorporate recommendations for tailoring for SPs.
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Affiliation(s)
- Lillian M Christon
- Medical University of South Carolina (MUSC), College of Medicine, Department of Psychiatry & Behavioral Sciences
| | - Jessica Chandler
- MUSC, College of Nursing, Department of Nursing, Technology Applications Center for Healthful Lifestyles
| | - Katie Benfield
- MUSC, College of Medicine, Department of Medicine, Susan Pearlstine Sarcoidosis Center of Excellence
| | - Samantha Pairet
- MUSC, College of Nursing, Department of Nursing, Technology Applications Center for Healthful Lifestyles
| | - Maria Hoffman
- MUSC, College of Medicine, Department of Medicine, Susan Pearlstine Sarcoidosis Center of Excellence
| | - Frank Treiber
- MUSC, College of Nursing, Department of Nursing, Technology Applications Center for Healthful Lifestyles
| | - W Ennis James
- MUSC, College of Medicine, Department of Medicine, Susan Pearlstine Sarcoidosis Center of Excellence
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Obi ON, Saketkoo LA, Russell AM, Baughman RP. Sarcoidosis: Updates on therapeutic drug trials and novel treatment approaches. Front Med (Lausanne) 2022; 9:991783. [PMID: 36314034 PMCID: PMC9596775 DOI: 10.3389/fmed.2022.991783] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/17/2022] [Indexed: 12/04/2022] Open
Abstract
Sarcoidosis is a systemic granulomatous inflammatory disease of unknown etiology. It affects the lungs in over 90% of patients yet extra-pulmonary and multi-organ involvement is common. Spontaneous remission of disease occurs commonly, nonetheless, over 50% of patients will require treatment and up to 30% of patients will develop a chronic progressive non-remitting disease with marked pulmonary fibrosis leading to significant morbidity and death. Guidelines outlining an immunosuppressive treatment approach to sarcoidosis were recently published, however, the strength of evidence behind many of the guideline recommended drugs is weak. None of the drugs currently used for the treatment of sarcoidosis have been rigorously studied and prescription of these drugs is often based on off-label” indications informed by experience with other diseases. Indeed, only two medications [prednisone and repository corticotropin (RCI) injection] currently used in the treatment of sarcoidosis are approved by the United States Food and Drug Administration. This situation results in significant reimbursement challenges especially for the more advanced (and often more effective) drugs that are favored for severe and refractory forms of disease causing an over-reliance on corticosteroids known to be associated with significant dose and duration dependent toxicities. This past decade has seen a renewed interest in developing new drugs and exploring novel therapeutic pathways for the treatment of sarcoidosis. Several of these trials are active randomized controlled trials (RCTs) designed to recruit relatively large numbers of patients with a goal to determine the safety, efficacy, and tolerability of these new molecules and therapeutic approaches. While it is an exciting time, it is also necessary to exercise caution. Resources including research dollars and most importantly, patient populations available for trials are limited and thus necessitate that several of the challenges facing drug trials and drug development in sarcoidosis are addressed. This will ensure that currently available resources are judiciously utilized. Our paper reviews the ongoing and anticipated drug trials in sarcoidosis and addresses the challenges facing these and future trials. We also review several recently completed trials and draw lessons that should be applied in future.
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Affiliation(s)
- Ogugua Ndili Obi
- Division of Pulmonary Critical Care and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, United States,*Correspondence: Ogugua Ndili Obi,
| | - Lesley Ann Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, LA, United States,University Medical Center—Comprehensive Pulmonary Hypertension Center and Interstitial Lung Disease Clinic Programs, New Orleans, LA, United States,Section of Pulmonary Medicine, Louisiana State University School of Medicine, New Orleans, LA, United States,Department of Undergraduate Honors, Tulane University School of Medicine, New Orleans, LA, United States
| | - Anne-Marie Russell
- Exeter Respiratory Institute University of Exeter, Exeter, United Kingdom,Royal Devon and Exeter NHS Foundation Trust, Devon, United Kingdom,Faculty of Medicine, Imperial College and Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Robert P. Baughman
- Department of Medicine, University of Cincinnati, Cincinnati, OH, United States
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Abstract
PURPOSE OF REVIEW Sarcoidosis is a chronic multisystemic inflammatory disease of unknown aetiology with a wide range of highly variable clinical manifestations and unpredictable disease course. Sarcoidosis patients may present with specific organ-related symptoms involving functional impairments, and less specific symptoms. The decision whether and when to treat a sarcoidosis patient with pharmacotherapy depends on two major factors: risk of organ failure and/or death and impairment of quality of life. This decision is complex and not standardized. RECENT FINDINGS Glucocorticoids (GCs) are recommended as initial treatment, when needed. Subsequent GC-sparing alternatives frequently follow. Comorbidities or adverse drug reactions (ADRs) from drugs used in sarcoidosis treatment are sometimes very hard to differentiate from symptoms associated with the disease itself, which may cause diagnostic dilemmas. An ideal approach to minimalize ADRs would involve genetic screening prior to prescribing certain 'high-risk drugs' and therapeutic drug monitoring during treatment. Pharmacogenomic testing aims to guide appropriate selection of medicines, with the potential of reducing unnecessary polypharmacy while improving clinical outcomes. SUMMARY A multidisciplinary approach to the management of sarcoidosis may avoid unnecessary ADRs. It is important to consider the possibility of drug-induced damage in sarcoidosis, especially if the clinical situation deteriorates after the introduction of a particular drug.
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Affiliation(s)
- Marjolein Drent
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine and Life Science, Maastricht University, Maastricht
- ILD Center of Excellence, Department of Respiratory Medicine, St. Antonius Hospital, Nieuwegein
- ILD Care Foundation Research Team, Ede
| | - Naomi T. Jessurun
- ILD Care Foundation Research Team, Ede
- Netherlands Pharmacovigilance Centre Lareb, ‘s-Hertogenbosch
| | - Petal A. Wijnen
- ILD Care Foundation Research Team, Ede
- Central Diagnostic Laboratory, Department of Clinical Chemistry, MUMC, Maastricht, The Netherlands
| | - Otto Bekers
- Central Diagnostic Laboratory, Department of Clinical Chemistry, MUMC, Maastricht, The Netherlands
| | - Aalt Bast
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine and Life Science, Maastricht University, Maastricht
- ILD Care Foundation Research Team, Ede
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Sugizaki CSA, Rodrigues HCN, Ivo JFM, Freitas ATVS, Stringhini MLF, Paiva SAR, Minicucci MF, Peixoto MRG, Costa NA. The relationship between grip strength with health-related quality of life and mortality in hemodialysis patients. NUTRIRE : REVISTA DE SOCIEDADE BRASILEIRA DE ALIMENTACAO E NUTRICAO = JOURNAL OF THE BRAZILIAN SOCIETY OF FOOD AND NUTRITION 2022; 47:21. [PMID: 38625334 PMCID: PMC9422936 DOI: 10.1186/s41110-022-00171-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/13/2022] [Indexed: 12/02/2022]
Abstract
Purpose Hemodialysis (HD) is a therapeutic modality that enables the highest survival for individuals with chronic kidney disease (CKD). In contrast, HD contributes to the pro-inflammatory state and may negatively affect the muscle strength and quality of life (QoL) of these individuals. To date, few studies have evaluated the association between decrease in strength and QoL in HD patients. Thus, our objective was to assess whether diminished muscle strength is associated with worse health related QoL and mortality. Methods We included patients aged ≥ 18 years on HD. Clinical and demographic data were collected from patients' medical records. Clinical data, nutritional status (laboratory, anthropometry, bioimpedance analysis) and health-related QoL (World Health Organization's quality of life questionnaire, WHOQOL-Bref) were analyzed at baseline. Mortality was recorded for 32 months. Results Among the 105 patients evaluated, the median age was 52 (43-64) years, and males were predominant (n = 73; 70%). The general median of QoL was 66.8 ± 11.9. Approximately 30% of patients were considered to have a worse QoL and 12,4% to have low muscle strength. This was not associated with QoL and mortality. HD vintage greater then to 5 years was associated with higher dissatisfaction in the perception of the environmental domain and overall QoL. Conclusion Our data suggest that low muscle strength was not associated with health-related QoL using the WHOQOL-Bref instrument and mortality.
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Affiliation(s)
- Clara S. A. Sugizaki
- Faculty of Nutrition, Federal University of Goias, East University Sector, Street 227 Block 68 s/n, Goiânia, Goiás Zip code 74605-080 Brazil
| | - Hellen C. N. Rodrigues
- Faculty of Nutrition, Federal University of Goias, East University Sector, Street 227 Block 68 s/n, Goiânia, Goiás Zip code 74605-080 Brazil
| | - Jéssica F. M. Ivo
- Faculty of Nutrition, Federal University of Goias, East University Sector, Street 227 Block 68 s/n, Goiânia, Goiás Zip code 74605-080 Brazil
| | - Ana T. V. S. Freitas
- Faculty of Nutrition, Federal University of Goias, East University Sector, Street 227 Block 68 s/n, Goiânia, Goiás Zip code 74605-080 Brazil
| | - Maria L. F. Stringhini
- Faculty of Nutrition, Federal University of Goias, East University Sector, Street 227 Block 68 s/n, Goiânia, Goiás Zip code 74605-080 Brazil
| | - Sérgio A. R. Paiva
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University-UNESP, Botucatu, São Paulo Brazil
| | - Marcos F. Minicucci
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University-UNESP, Botucatu, São Paulo Brazil
| | - Maria R. G. Peixoto
- Faculty of Nutrition, Federal University of Goias, East University Sector, Street 227 Block 68 s/n, Goiânia, Goiás Zip code 74605-080 Brazil
| | - Nara A. Costa
- Faculty of Nutrition, Federal University of Goias, East University Sector, Street 227 Block 68 s/n, Goiânia, Goiás Zip code 74605-080 Brazil
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Abstract
PURPOSE OF REVIEW Ageing, the accrual of molecular and cellular damage over a lifetime confers progressive physiologic dysfunction of bodily systems, leaving the body in a heightened state of vulnerability to biophysical and psychosocial stressors. The inflection point is frailty which easily leads to disability and death. Interstitial lung disease (ILD) creates biophysical and psychosocial stresses difficult for even optimally fit patients to cope with. With evolving ILD treatment pathways, people with ILD are living longer. RECENT FINDINGS ILD and ageing are bi-directionally influential: ILD, its treatments, complications, and collateral systemic extra-pulmonary damage (hypoxic and oxidative stress) wear on the ageing person and ageing impacts a person's tolerance of ILD. ILD extent may proportionally accelerate age-related vulnerabilities. ILD related to inflammatory systemic diseases, e.g. connective tissue diseases or sarcoidosis, exert an even more complex biophysical impact on the body. SUMMARY The present review stresses goals of preventing frailty in ILD and preserving general health and well being of people living with ILD of any age, from time of diagnosis and as they age. The development of a prediction score is proposed to classify those at risk of frailty and guide interventions that preserve successful ageing for all levels of ILD severity. VIDEO ABSTRACT http://links.lww.com/COPM/A32.
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Small Fiber Neuropathy in Sarcoidosis. PATHOPHYSIOLOGY 2021; 28:544-550. [PMID: 35366250 PMCID: PMC8830461 DOI: 10.3390/pathophysiology28040035] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/07/2021] [Accepted: 12/15/2021] [Indexed: 11/30/2022] Open
Abstract
Sarcoidosis (SC) is a granulomatous disease of an unknown origin. The most common SC-related neurological complication is a small fiber neuropathy (SFN) that is often considered to be the result of chronic inflammation and remains significantly understudied. This study aimed to identify the clinical and histological correlates of small fiber neuropathy in sarcoidosis patients. The study was performed in 2018–2019 yy and included 50 patients with pulmonary sarcoidosis (n = 25) and healthy subjects (n = 25). For the clinical verification of the SFN, the “Small Fiber Neuropathy Screening List” (SFN-SL) was used. A punch biopsy of the skin was performed followed by enzyme immunoassay analysis with PGP 9.5 antibodies. Up to 60% of the sarcoidosis patients reported the presence of at least one complaint, and it was possible that these complaints were associated with SFN. The most frequent complaints included dysfunctions of the cardiovascular and musculoskeletal systems and the gastrointestinal tract. A negative, statistically significant correlation between the intraepidermal nerve fiber density (IEND) and SFN-SL score was revealed. In patients with pulmonary sarcoidosis, small fiber neuropathy might develop as a result of systemic immune-mediated inflammation. The most common symptoms of this complication were dysautonomia and mild sensory dysfunction.
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Affiliation(s)
- Marjolein Drent
- From the Interstitial Lung Diseases (ILD) Center of Excellence, Department of Pulmonology, St. Antonius Hospital, Nieuwegein, the Department of Pharmacology and Toxicology, Faculty of Health and Life Sciences, Maastricht University, Maastricht, and the ILD Care Foundation Research Team, Ede - all in the Netherlands (M.D.); the Division of Pulmonary, Critical Care, and Sleep Medicine, Ohio State University, Columbus (E.D.C.); and the Respiratory Medicine Division, Department of Medicine Solna, and the Center for Molecular Medicine, Karolinska Institutet, and Respiratory Medicine, Theme Inflammation and Aging, Karolinska University Hospital - both in Stockholm (J.G.)
| | - Elliott D Crouser
- From the Interstitial Lung Diseases (ILD) Center of Excellence, Department of Pulmonology, St. Antonius Hospital, Nieuwegein, the Department of Pharmacology and Toxicology, Faculty of Health and Life Sciences, Maastricht University, Maastricht, and the ILD Care Foundation Research Team, Ede - all in the Netherlands (M.D.); the Division of Pulmonary, Critical Care, and Sleep Medicine, Ohio State University, Columbus (E.D.C.); and the Respiratory Medicine Division, Department of Medicine Solna, and the Center for Molecular Medicine, Karolinska Institutet, and Respiratory Medicine, Theme Inflammation and Aging, Karolinska University Hospital - both in Stockholm (J.G.)
| | - Johan Grunewald
- From the Interstitial Lung Diseases (ILD) Center of Excellence, Department of Pulmonology, St. Antonius Hospital, Nieuwegein, the Department of Pharmacology and Toxicology, Faculty of Health and Life Sciences, Maastricht University, Maastricht, and the ILD Care Foundation Research Team, Ede - all in the Netherlands (M.D.); the Division of Pulmonary, Critical Care, and Sleep Medicine, Ohio State University, Columbus (E.D.C.); and the Respiratory Medicine Division, Department of Medicine Solna, and the Center for Molecular Medicine, Karolinska Institutet, and Respiratory Medicine, Theme Inflammation and Aging, Karolinska University Hospital - both in Stockholm (J.G.)
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