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11.

目的:应用Catquest-8SF量表研究PHACO+SIOL植入术患者主观报告的效果,评估Catquest-8SF量表在中国北方白内障人群的适用性及其对白内障手术的敏感性。

方法:前瞻性临床病例随访研究。泰安市中心医院白内障患者术前和术后3mo完成面对面的Catquest-8SF量表填写。

结果:术前共120例白内障患者完成了Catquest-8SF量表。术前Catquest-8SF量表得分与术前双眼加权logMAR视力及年龄呈显著负相关(P<0.05),与文化程度呈正相关(P<0.001),无全身合并症的患者量表得分高于有全身合并症的患者(P<0.05)。102名(85%)患者完成术后3mo量表,单眼手术组和双眼手术组比较,术后视力均显著提高(t=10.404, P<0.001),术后量表得分均明显提高(P<0.001)。两组在量表得分提高值上差异无统计学意义。92.2%的患者对手术效果满意。满意度与量表得分的提高值显著相关(P<0.05)。

结论:中文版Catquest-8SF量表在我国北方ARC人群中适用性好,简短高效,可以作为白内障常规临床评估的一部分。  相似文献   

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Short-acting hematopoietic agents can improve the quality of life (QOL) of hemodialysis patients, but questions remain regarding the domains of QOL affected, the relative importance of initial and final hemoglobin (Hb) concentrations, and the use of long-acting hematopoietic agents. We measured Hb concentrations and QOL in 487 hemodialysis patients who were switched from treatment with recombinant human erythropoietin to treatment with darbepoetin alfa. QOL was measured with the Japanese-language version of the SF-36, at the start of therapy with darbepoetin alfa and again 7-14 weeks later. We examined changes in QOL over time in the group as a whole, and in subgroups stratified by the change in Hb concentration. We also studied relationships between the final Hb concentration achieved and the magnitude of change in QOL. QOL scores increased significantly in all SF-36 domains except Social Functioning. The greatest increases were in vitality and in the two role-functioning domains. The magnitude of the increase in Hb concentration was related to the magnitude of the increase in QOL for only one subscale: Vitality. Patients with higher final Hb concentrations also had greater increases in Vitality scores. Hematopoiesis induced by darbepoetin alfa is associated with increased vitality and may also be associated with improved role functioning. Vitality increased significantly only in those patients with the greatest increases in Hb concentration and in those with higher final Hb concentrations.  相似文献   
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Objective

To develop self-reported short forms for the Life Impact Burn Recovery Evaluation (LIBRE) Profile.

Design

Short forms based on the item parameters of discrimination and average difficulty.

Setting

A support network for burn survivors, peer support networks, social media, and mailings.

Participants

Burn survivors (N=601) older than 18 years.

Interventions

Not applicable.

Main Outcome Measures

The LIBRE Profile.

Results

Ten-item short forms were developed to cover the 6 LIBRE Profile scales: Relationships with Family & Friends, Social Interactions, Social Activities, Work & Employment, Romantic Relationships, and Sexual Relationships. Ceiling effects were ≤15% for all scales; floor effects were <1% for all scales. The marginal reliability of the short forms ranged from .85 to .89.

Conclusions

The LIBRE Profile-Short Forms demonstrated credible psychometric properties. The short form version provides a viable alternative to administering the LIBRE Profile when resources do not allow computer or Internet access. The full item bank, computerized adaptive test, and short forms are all scored along the same metric, and therefore scores are comparable regardless of the mode of administration.  相似文献   
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Objectives

The purpose of this study was to review the institutional practice of surveillance transthoracic echocardiography (TTE) for diagnosing early prosthetic valve dysfunction (PVD).

Background

Bioprosthetic valve thrombosis (BPVT) is an important cause of PVD, and guidelines do not recommend routine TTE during the first 5 years after valve implantation.

Methods

The authors performed a retrospective case-control study of all suspected (imaging diagnosis) or confirmed (histopathological diagnosis) cases of BPVT from January 1997 through December 2016. Patients were matched 1:2 (age, sex, prosthesis position) to patients whose prostheses were explanted because of structural failure (SF). PVD was defined as a 50% increase above baseline gradient at valve implantation and classified as early (≤5 years) or late (>5 years) after implantation.

Results

There were 94 BPVT (51 suspected, 43 confirmed) and 188 SF cases; patient age 61 ± 9 years; men 61 (65%). The prosthesis positions were aortic 56%; mitral 26%; tricuspid 15%; and pulmonary 3%. Early PVD was more common in the BPVT versus SF group: 83 of 94 (88%) versus 20 of 188 (11%) (p < 0.001). Time from implantation to PVD was shorter for BPVT than SF: 26 months (interquartile range [IQR]: 12 to 43 months) versus 74 months (IQR: 48 to 102 months) (p < 0.001). At the initial PVD diagnosis, 81% of BPVT and 90% of SF patients were asymptomatic. However, BPVT patients had rapid symptomatic deterioration, requiring intervention sooner after PVD diagnosis: 6 months (IQR: 4 to 7 months) versus 51 months (IQR: 22 to 55 months) (p < 0.001).

Conclusions

Most patients with PVD due to BPVT were asymptomatic at initial diagnosis, which was made based on routine surveillance TTE, often performed before 5 years. BPVT, an acute disease process, requires timely diagnosis because patient conditions rapidly deteriorate. Further studies are needed to determine whether routine surveillance TTE should be considered for patients with bioprosthetic valves to identify pre-symptomatic features of BPVT in order to provide effective, appropriate therapy.  相似文献   
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