Search Results (425)

Background and Objectives: This research aimed to compare Type D personality characteristics and self-esteem between individuals with chronic NSLBP and healthy controls, while also exploring their relationships with functional status, psychological symptoms, and quality of life within the patient group. Materials and Methods: In this cross-sectional investigation, 34 patients with chronic NSLBP were compared with 34 healthy controls with similar age and sex distribution. Pain intensity was quantified via the Visual Analog Scale (VAS), while functional impairment was evaluated using the Oswestry Disability Index (ODI). Psychological profiling included the Type D Scale-14 (DS14) for personality traits, the Rosenberg Self-Esteem Scale (RSES) for self-worth, and the Hospital Anxiety and Depression Scale (HADS) for emotional distress. Health-related quality of life was captured through the 12-Item Short Form Health Survey (SF-12). Results: Type D personality was significantly more prevalent in the NSLBP group than in controls (50% vs. 20.6%, p = 0.011). Patients with NSLBP had significantly higher negative affectivity (NA) scores (p < 0.001) and anxiety scores (p = 0.007) and lower SF-12 Physical Component Summary scores (p < 0.001) than controls. Pain intensity and disability were positively correlated with Type D personality traits, particularly NA and the Type D composite score. In exploratory subgroup analyses, patients with Type D personality also had higher pain intensity, disability, anxiety, and depression scores and lower SF-12 Mental Component Summary (MCS) scores than those without Type D personality. In adjusted regression analyses within the NSLBP group, Type D personality was associated with higher VAS (p = 0.004) and ODI scores (p = 0.007) and lower SF-12 MCS scores (p = 0.003). Conclusions: Type D personality characteristics were more frequent in patients with chronic NSLBP than in healthy controls and were associated with higher pain intensity, greater disability, higher anxiety and depressive symptom scores, and poorer mental quality-of-life scores within the patient group. In contrast, self-esteem did not differ significantly between patients and controls. Due to the inherent constraints of a cross-sectional framework and the potential construct redundancy between NA and emotional distress, the current results signify correlational links rather than definitive causality. Consequently, subsequent prospective research is vital to delineate the temporal dynamics and the long-term predictive value of Type D personality traits in the progression of chronic NSLBP. Full article

Background/Objectives: Duchenne muscular dystrophy (DMD) is a rare progressive neuromuscular disorder associated with increasing care demands. Despite the critical role of caregivers, their physical activity (PA) levels and health-related quality of life (HRQoL) have not been sufficiently investigated. This study aimed to compare PA levels and HRQoL between caregivers of children with DMD and caregivers of typically developing children. Methods: This cross-sectional observational study included 44 individuals: caregivers of children with DMD (n = 22) and caregivers of typically developing children (n = 22). The 36-Item Short-Form Health Survey (SF-36) was used for assessing HRQoL and the International Physical Activity Questionnaire—Short Form (IPAQ-SF) for determining PA levels. Results: IPAQ-SF-derived metabolic equivalent of task (MET) values and PA levels were similar between the groups (DMD caregivers: 1744.63 ± 1163.22, controls: 1945.09 ± 1042.12; p > 0.05). Caregivers of children with DMD demonstrated significantly poorer scores in several SF-36 domains, including vitality, social functioning, role limitations due to physical problems, bodily pain, and mental health (p < 0.05), with the largest difference observed in role limitations due to emotional problems (DMD caregivers: 45.27 ± 28.33, controls: 84.83 ± 24.63; p < 0.05). Physical functioning and general health perception scores were comparable (p > 0.05). Conclusions: Caregivers of children with DMD experience substantial impairments in multiple HRQoL domains, particularly those related to psychosocial well-being and pain, despite comparable PA levels and physical functioning. These findings suggest that reduced HRQoL is not directly explained by PA alone and highlight the need for multidisciplinary interventions targeting psychological health, pain management, and social well-being. Full article

Background/Objectives: Non-celiac gluten sensitivity (NCGS) is a syndrome characterized by intestinal and extraintestinal symptoms triggered by gluten ingestion. Although anti-gliadin IgG antibody (AGA IgG) has been proposed as a potential biomarker for NCGS, its sensitivity and specificity in real-world clinical settings remain unclear. This study aimed to evaluate the clinical utility of AGA IgG in NCGS and to characterize its clinical features, including psychological distress and physical quality of life (QOL), in patients with clinically suspected NCGS attending a specialized outpatient unit in Japan, where patients reported symptoms related to the ingestion of gluten-containing grains (primarily wheat). Methods: We evaluated plasma AGA IgG levels in 45 patients with suspected NCGS based on clinical presentation and in 83 age- and sex-matched healthy controls. Plasma AGA IgG was measured using ELISA. Clinical symptoms and QOL were assessed using validated scales, including the 36-Item Short Form Health Survey (SF-36), Patient Health Questionnaire (PHQ-9 and PHQ-15), Generalized Anxiety Disorder-7 (GAD-7), and the Japanese version of the Irritable Bowel Syndrome Quality of Life measure (IBS-QOL-J). Results: The AGA IgG positivity rate was significantly higher in the suspected NCGS group (33.3%) than in the control group (13.3%; p < 0.01). Using clinical suspicion as the reference, the sensitivity and specificity of AGA IgG were 33.3% and 86.7%, respectively. Patients with suspected NCGS exhibited significantly lower physical and mental QOL and higher scores for depressive, anxiety, and somatic symptoms compared to controls. No significant clinical differences were found between AGA IgG-positive and IgG-negative individuals within the suspected NCGS group. Conclusions: AGA IgG demonstrated a specificity of 86.7% and a sensitivity of 33.3% for suspected NCGS, indicating its limited utility as a standalone biomarker. These findings suggest that suspected NCGS involves significant somatic and psychological burdens regardless of serological status. Future studies should explore whether a multi-marker panel could improve the identification of “True NCGS” in diverse clinical populations. Full article

Background/Objectives: Recent studies have shown that GABA reduces visceral hypersensitivity and improves intestinal permeability in a post-inflammatory irritable bowel syndrome (IBS) rat model. We aimed to assess the efficacy of a GABA-based supplement in IBS patients with diarrhea (IBS-D), focusing on symptoms relief, quality-of-life improvement, mucosal barrier function, systemic microinflammation and gut microbiota. Methods: In this double-blind, placebo-controlled, crossover study, 20 IBS-D patients were randomized to receive GABA or placebo for two four-week treatment periods separated by a two-week washout. Efficacy was assessed using IBS Symptom Severity Score (IBS-SSS) and Short-Form Health Survey-36 (SF-36). Circulating levels of lipopolysaccharide-binding protein (LBP), Tumor Necrosis Factor-α (TNF-α) and interleukin (IL)-1β were measured before and after each treatment. Results: Eighteen patients completed the study. A clinical response (≥50-point reduction in IBS-SSS) was observed in 66.7% of patients during GABA treatment versus 33.3% with placebo. GABA produced a significant reduction in the IBS-SSS total score (p = 0.02) and in the bowel satisfaction item of the questionnaire (p = 0.02). Regarding quality of life, GABA significantly improved the “Emotional limitation” domain compared with placebo (p = 0.009). GABA treatment also led to a decrease in circulating LBP (p = 0.06) and IL-1β (p = 0.02) levels compared to placebo, although only the reduction in IL-1β reached statistical significance. In contrast, no substantial remodeling of the gut microbiota was observed. Conclusions: In this pilot study, GABA treatment led to a significant improvement in IBS-D symptoms compared with placebo and was also more effective in enhancing emotional wellbeing. GABA appeared to have a possible effect on intestinal permeability indirectly assessed through LBP, consistent with preclinical findings, and significantly reduced systemic inflammation. GABA may represent a promising therapeutic option for IBS, deserving further investigation in larger clinical trials. Full article

Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease in which accurate assessment of disease activity remains challenging. Although composite indices such as BASDAI and ASDAS are widely used, they may not fully capture systemic inflammatory burden. The C-reactive protein–albumin–lymphocyte (CALLY) index is an emerging composite biomarker integrating inflammatory, nutritional, and immunological components. This study aimed to evaluate the association of the CALLY index with disease activity, functional status, and quality of life in AS. Methods: This medical record-based cross-sectional study included 65 patients with AS. Disease activity was assessed using BASDAI and ASDAS-ESR, functional status using BASFI, and quality of life using the 12-Item Short Form Health Survey (SF-12). The CALLY index was calculated from serum CRP, albumin levels, and lymphocyte counts. Correlation and multivariable linear regression analyses were performed. Results: The mean CALLY index was 58.43 ± 66.20. The index showed moderate negative correlations with ESR and ASDAS-ESR and a positive correlation with lymphocyte count. Its strong inverse correlation with CRP was expected because CRP is part of the formula and was therefore interpreted cautiously. No significant associations were found with BASDAI, BASFI, or SF-12. In multivariable analysis, BMI (β = −0.299, p = 0.012) and NSAID use (β = −0.298, p = 0.011) were independent predictors. Conclusions: The CALLY index was associated mainly with objective inflammatory markers rather than patient-reported outcomes, suggesting a dissociation between biochemical and clinical disease domains in AS. These findings are preliminary and require confirmation in larger longitudinal studies before clinical application. Full article

Background: Quality of life (QoL) after transradial access in diagnostic cerebral angiography may be shaped by procedural demands as well as by the ambulatory setting itself. This study, for the first time, prospectively explored this dimension through follow-up assessments of QoL after the procedure. Methods: In this prospective study, QoL was assessed using the 36-Item Short Form Survey (SF-36), including the Physical and Mental Component Summary (PCS and MCS) as well as eight domain-specific subscales. After right transradial cerebral angiography, the SF-36 questionnaire was administered at baseline (pre-procedure), as well as at 1-month and 3-month follow-up visits. Mean PCS and MCS values were analyzed over time using linear mixed-effects regression models. In post hoc analyses, univariate and multivariable models were used to assess the influence of potential confounders. For subgroup analysis, patients were classified as transient deteriorators if PCS and/or MCS worsened by more than 0.5 SD at 1 month compared with baseline but not at 3 months. Permanent deteriorators were defined as worsening by more than 0.5 SD at both 1 month and 3 months compared with baseline. Results: A total of 35 patients (62.9% female) were recruited over the 12-month study period, with a mean age of 59.1 ± 10.1 years. No significant overall time effect was observed for mean PCS and MCS (p = 0.970 and p = 0.076). MCS showed a significant increase at 1 month compared with baseline (p = 0.046), with a trend toward significance at 3 months (p = 0.053). In post hoc analyses, sex, neurosurgical status, and dose area product were associated with MCS in univariate analyses (p < 0.05), but these associations did not persist after multivariable adjustment. For PCS, only age showed a significant association in univariate analysis (p < 0.05). In subgroup analyses, transient deterioration was more frequent in PCS than in MCS (11.4% [95% CI 3.2–26.7%] vs. 5.7% [95% CI 0.7–19.2%]), and permanent deterioration was also more common in PCS at 1- and 3-month follow-up (14.3% [95% CI 4.8–30.3%] vs. 8.6% [95% CI 1.8–23.1%]). Impairment predominantly involved the bodily pain subscale (88.9% [95% CI 51.8–99.7%]) within PCS and the vitality (80.0% [95% CI 28.4–99.5%]) and mental health sub-scales (80.0% [95% CI 28.4–99.5%]) within MCS. Conclusions: This short-term follow-up assessment demonstrated preserved QoL following transradial diagnostic cerebral angiography. Transient or permanent deterioration occurred in no more than five patients per subgroup (14%). These findings support the notion that a radial-first approach can be safely considered for diagnostic cerebral angiography without compromising patient-reported outcomes. Full article

Background/Objectives: To evaluate construct (convergent and divergent) validity and conduct confirmatory factor analysis (CFA) of the National Center on Health, Physical Activity and Disability (NCHPAD) Wellness Assessment (NWA) tool. Methods: A cross-sectional survey validation study utilizing secondary data. We assessed Spearman correlations between NWA and 36-Item Short Form Health Survey (SF-36), NWA and Godin Leisure-Time Exercise Questionnaire (GLTEQ) and NWA and Modified Fatigue Impact Scale (MFIS) scores to determine construct validity. A CFA was conducted to test the appropriateness of a three-factor model for NWA. Results: Data from 149 participants were used to assess construct validity and from 180 participants for CFA. Both correlations between NWA mental wellness domain and SF-36 mental component scores and between NWA emotional/spiritual wellness domain and SF-36 emotional well-being scores were 0.61 (p < 0.001 for both). The correlation between NWA physical wellness domain and SF-36 physical component score was −0.06 (p = 0.45). The correlations of NWA with GLTEQ overall and with health contribution scores were 0.26 and 0.30, respectively (p < 0.001 for both). The correlations of all NWA domain and MFIS subscale scores ranged between −0.42 and −0.25 (p < 0.05). The CFA model’s comparative fit index was 0.90. Conclusions: The NWA physical wellness domain did not demonstrate strong convergent validity, as mental and emotional/spiritual wellness domains did. All domains showed strong divergent validity, and CFA showed evidence supporting a three-factor model. Future efforts will emphasize refining and reevaluating the physical wellness domain until it achieves strong psychometric properties. Full article

Background: Subclinical psychological symptoms—such as low mood, perceived stress, and poor sleep—affect a large portion of the population and can impair quality of life despite remaining below clinical thresholds. The gut–brain axis has emerged as a promising target for interventions that support emotional and psychological resilience. Probiotics and postbiotics are gaining attention for their potential to modulate mood and stress via microbiome-related mechanisms, but human evidence remains limited, particularly in non-clinical populations. Objectives: We aimed to assess the effects of a two-strain combination of live microorganisms alongside a two-strain combination of heat-treated inactivated microorganisms on outcomes associated with anxiety, mood, perceived stress, and quality of life in healthy adults experiencing mild stress. Methods: This study was conducted in two parts. In Part I, a randomized, double-blind, placebo-controlled study, 100 participants were randomized to receive either a blend of live microorganisms (Bifidobacterium longum CECT 7347 and Lactobacillus rhamnosus CECT 8361) or an identical placebo once daily for 12 weeks. In Part II, a pilot feasibility study, a subset of eight placebo non-responders from Part I received the heat-inactivated preparation of the same bacterial strains in a 6-week trial extension phase. For Parts I and II, the primary outcome was the change in the Hamilton Anxiety Rating Scale (HAM-A). Secondary outcomes included measures of mood (Beck Depression Inventory (BDI); Patient Health Questionnaire-9 (PHQ-9)), stress (state and trait anxiety inventory (STAI); Perceived Stress Scale (PSS)), sleep (Pittsburgh Sleep Quality Index (PSQI)), quality of life (36-item Short Form Survey (SF-36)), gastrointestinal symptoms (Gastrointestinal Symptom Rating Scale (GSRS)), salivary cortisol and microbiome modulation. Results: In Part I, there were no significant effects of the live blend on the HAM-A, indicating that the primary endpoint was not met. In addition, no significant effects were seen on the STAI or PSS scores when compared to the placebo. However, participants consuming the live blend trended toward a reduction in total PHQ-9 scores compared to placebo (p = 0.089), whilst preliminary exploratory analyses suggested an improvement in anhedonia (p = 0.045). Furthermore, there was a significant improvement in the vitality domain of the SF-36 compared to placebo (p = 0.017). On microbiome analysis, it was noted that consumption of the live blend was linked to the preservation of butyrate-producing bacteria, particularly members of the Pseudoflavonifractor genus and the Clostridium SGB6179 species. Furthermore, the abundance of B. longum species was found to be inversely associated with the total PSS Scores. In Part II, supplementation with the inactivated preparation resulted in significant within-group improvements for the vitality (p = 0.006) and social functioning (p = 0.010) domains of the SF-36 and improvements in PSS scores compared to baseline (p = 0.050). Conclusions: Supplementation with either the dual-strain live or inactivated formulations was associated with significant improvements in the vitality domain of the SF-36, whilst participants receiving the inactivated formulation demonstrated lower perceived stress and improved social functioning compared to baseline. Overall, the findings from this pilot study suggest that these two biotic consortia are well-tolerated and may be associated with improvements in measures of vitality in individuals with subclinical psychological symptoms. The subtle observations detected for stress and anhedonia suggest that further well-powered trials are needed to better characterize these findings, potentially in populations with greater baseline symptomatology. Full article

Background and Objectives: To assess the reliability and construct validity of the Functional Rating Index (FRI) in Italian-speaking individuals with chronic non-specific low back pain (CLBP), in order to improve assessment and clinical management in this population. Materials and Methods: This cross-sectional study consecutively enrolled 75 individuals with CLBP (52 females; mean age 48.71 ± 19.18 years; mean pain duration 298.64 ± 427.52 weeks). Internal consistency and test–retest reliability were evaluated using Cronbach’s α and the intraclass correlation coefficient [ICC_2,1], respectively, while measurement error was estimated through the minimum detectable change (MDC). Construct validity was examined by testing a priori hypotheses through correlations (Pearson’s r) between the FRI and disability measures (Roland–Morris Disability Questionnaire, RMQ; Oswestry Disability Index, ODI), pain intensity (Numerical Rating Scale, NRS), and quality of life (Short-Form Health Survey, SF-36). Results: Cronbach’s α was 0.88, and test–retest reliability showed an ICC_2,1 of 0.86 (95%CI: 0.82–0.93). The MDC was 18.05, corresponding to approximately 20% of the total score. The Italian FRI demonstrated strong correlations with the RMQ (r = 0.70) and ODI (r = 0.77), and a moderate correlation with the NRS (r = 0.60). The physical and social domains of the SF-36 showed stronger negative correlations with the FRI than the mental and emotional domains. Conclusions: The Italian version of the FRI is a reliable and valid instrument for individuals with CLBP and is recommended for both clinical practice and research applications. Full article

Background: Despite the cardiometabolic benefit of semaglutide, its impact on quality of life and whether patients’ characteristics influence clinical outcomes and health-related quality of life (HRQoL) remain ambiguous. Method: A retrospective review of patient charts was conducted after semaglutide initiation to assess the clinical impact of semaglutide, followed by a prospective analysis to evaluate HRQoL using the 36-Item Short Form Health Survey (SF-36). Descriptive and correlative analyses were conducted using SPSS software version 29 (IBM Corp., Armonk, NY, USA). Results: From a total of 715 patients, 255 (average age 59.1 years; 58.1% male participants) were subjected to clinical outcome analysis. The use of semaglutide was associated with significant reductions in HbA1c, total bilirubin, and TG and elevations in T4, TSH, Scr, and HDL. When each fifth value of each clinical parameter was compared with the baseline, gender revealed a significant impact, as females showed increased rates of elevated HDL (73.2% vs. 55.7%), reduced weight (69.8% vs. 55.7%), and reduced BMI (72.5% vs. 53.8%) compared to those in males. Despite the number of comorbidities significantly influencing BMI (p = 0.015), it had no impact on HbA1c post semaglutide use (p = 0.062). The same number of patients (n = 255), albeit having slightly different demographic and clinical characteristics, was included in the HRQoL analysis cohort. Females represented 54.5% of the cohort, and 71.0% were aged between 40 and <65 years. The average scores for all domains within the physical component summary (PCS) and mental component summary (MCS) were below 50, indicating a lack of perceived improvement in the overall quality of participants’ lives considering the pre-treatment period as the basis of comparison. In particular, younger age [OR 0.975, CI95% 0.953–0.998, p = 0.033] and being female [OR 0.273, CI95% 0.162–0.459, p < 0.001] led to reduced odds of scoring ≥ 50 in PCS, indicating a poor physical health state. On the contrary, older age [OR 1.036, CI95% 1.011–1.06, p = 0.004] increased the odds of scoring ≥ 50 in MCS, indicating a better mental health state in elderly vs. young semaglutide users. Although education level had significant influence on PCS, this did not extend to MCS. Upon investigating if type of change in a clinical parameter correlates with PCS and MCS scoring, only the decline in T4 reduced the odds of scoring MCS ≥ 50 [OR 0.5, CI95% 0.274–0.913, p = 0.024], while no significant influence was found either with other parameters or between clinical parameters and PCS. Conclusions: A lack of perceived improvement in HRQoL is noted with semaglutide use. Age, gender, and education play significant roles in HRQoL post semaglutide initiation. Overall, before prescribing semaglutide, patient counseling on its positive and negative effects is crucial to promote long-term adherence and optimize clinical outcomes. Full article

Background/Objectives: Recent guidelines have emphasized the importance of early mobilization and rehabilitation of patients following cardiac surgery. However, studies on the optimal targets and prescription methods for phase I cardiac rehabilitation (CR) are lacking. This study aimed to evaluate the feasibility and utility of an early phase 1 submaximal cardiopulmonary exercise test (CPET) using a recumbent ergometer in patients who have undergone cardiac surgery. Methods: Twenty ambulatory patients who underwent cardiac surgery between December 2021 and February 2023 were referred to the CR department on the fifth postoperative day, and a CR program was initiated. The program was conducted five times a week, with hour-long sessions consisting of warm-up exercises, resistance training, aerobic exercises, and a cool-down period. A recumbent ergometer-based submaximal CPET was performed approximately nine days after the surgery, prior to discharge. Participants initiated the test at 0 W, and the workload was increased by 20 W after 2 min. During the test, researchers evaluated parameters including submaximal peak values of oxygen consumption (VO₂), metabolic equivalents of task, respiratory exchange ratio (RER), blood pressure, heart rate (HR), and rating of perceived exertion (RPE). The grip strength test, 6 min walk test (6MWT), Korean Activity Scale/Index (KASI), EuroQol-5 dimension (EQ-5D), and short-form 36-item health survey (SF-36) values were also measured prior to discharge. Results: Twenty patients (75% male, average age 62.50 ± 1.99 years) underwent CPET at a median of 9.0 (8.0; 12.5) days postoperative. The average exercise duration of the CPET was 411.75 ± 168.25 s. During the test, their submaximal peak VO₂ was 12.32 ± 0.75 mL/kg/min (corresponding to 46.65 ± 2.08% of VO₂ max). The submaximal peak RER was 1.01 (0.98–1.12), and the submaximal peak RPE was 15.00 ± 0.51. Furthermore, the submaximal peak HR was 111.8 ± 3.76 beats/min (equivalent to 70.95 ± 2.09% of age-predicted maximal HR). After adjustment for age and sex, statistically significant positive correlations were observed between the submaximal peak VO₂ and 6MWT, squat endurance test, KASI, EQ-5D, and the physical component summary (PCS) of the SF-36 questionnaire. The 6MWT, squat endurance test, KASI, and PCS of SF-36 showed a correlation coefficient (r) of 0.522 (p = 0.026), 0.628 (p = 0.005), 0.586 (p = 0.011), and 0.546 (p = 0.019), respectively. No significant cardiac events, such as ST elevation/depression or hemodynamic instability, were observed during the test. Conclusions: Our findings suggest that performing recumbent ergometer-based CPET during early phase 1 CR is safe and feasible. These results highlight the potential of recumbent ergometer-based CPET as a valuable tool for guiding the appropriate prescription of early CR programs following hospital discharge in patients undergoing cardiac surgery. Full article

Background and Objectives: Dual bronchodilation in chronic obstructive pulmonary disease (COPD) has demonstrated beneficial effects on health-related quality of life (HRQoL) and exercise-related outcomes. Real-world evidence in treatment-naïve COPD remains limited. Materials and Methods: Forty-six COPD patients and 23 age-, gender-, BMI-, and cardiovascular comorbidity–matched controls underwent spirometry, plethysmography, symptom-limited incremental cardiopulmonary exercise testing (CPET), and the 36-item Short-Form Health Survey (SF-36). Following baseline assessment, COPD patients received tiotropium/olodaterol as part of routine practice. Thirty-two patients underwent repeated examinations at 12 weeks. Baseline differences between the COPD and control groups were assessed, and longitudinal changes in pulmonary function, CPET, and SF-36 were evaluated in COPD patients. Results: Compared with controls, COPD patients had lower peak oxygen uptake (VO₂; 17.4 ± 4.4 vs. 22.8 ± 4.5 mL/kg/min, p < 0.001) and oxygen pulse (11.5 ± 3.5 vs. 14.0 ± 2.4 mL/beat, p = 0.003), failed to reach 80% of predicted values, and exhibited worse ventilatory efficiency (p < 0.001). SF-36 scores in the COPD group were lower across all domains. After 12 weeks of tiotropium/olodaterol, pulmonary function improved significantly. CPET was performed at comparable efforts at both visits. Peak VO₂ increased from 70 ± 15 to 75 ± 16% predicted (p = 0.044), and peak oxygen pulse from 74 ± 16 to 79 ± 16% predicted (p = 0.015). VE/MVV decreased from 0.77 ± 0.23 to 0.69 ± 0.15 (p = 0.03). Higher baseline VE/MVV predicted a larger improvement after treatment (B = 0.71, p < 0.001), while beta-blocker use had no effect on the change of VE/MVV. SF-36 physical functioning and health change scores improved (both p < 0.01). Conclusions: At diagnosis, COPD was associated with impaired exercise physiology and reduced HRQoL. Dual bronchodilation improved exercise responses and perceived physical functioning. Beta-blocker use was not associated with changes in breathing reserve, supporting the use of cardioselective agents when indicated. Full article

Background: Vascular access is a core component of hemodialysis and may influence both clinical outcomes and patient-reported quality of life. This study examined the association between vascular access type and quality of life among patients receiving maintenance hemodialysis in multiple nephrology centers. Methods: We conducted a multicenter, cross-sectional observational study of 152 adults with end-stage kidney disease undergoing hemodialysis in public and private dialysis units in the Attica region, Greece (January–May 2022). Data were collected using a demographic/clinical questionnaire, the 36-Item Short Form Health Survey (SF-36), the Dialysis Patient Satisfaction Questionnaire (SDIALOR), and the Missoula VITAS Quality of Life Index (MVQOLI). Multivariable linear regression models were fitted for SF-36 and MVQOLI domain scores. Results: Most participants reported being very (40.8%) or quite (53.3%) satisfied with their current vascular access, and 69.5% considered an arteriovenous fistula (AVF) the most appropriate option. SF-36 scores were generally lower than those reported for the general population, except for the mental health domain. Compared with AVF, permanent catheter use was associated with lower SF-36 physical functioning scores, and graft use was associated with lower vitality scores. Lower vascular access satisfaction was consistently associated with lower HRQoL: compared with being “very” satisfied, being “quite” satisfied was associated with lower general health, vitality, social functioning, mental health, and lower PCS/MCS scores, while being “a little/not at all” satisfied was associated with lower general health and worse bodily pain scores. On MVQOLI, living alone and lower access satisfaction were associated with lower interpersonal relationships, transcendence/spirituality, and overall quality-of-life scores, while obesity was associated with lower function scores. Conclusions: Vascular access type, particularly AVF versus catheter, is associated with meaningful differences in quality of life among hemodialysis patients. Patient satisfaction with access and sociodemographic characteristics should be considered in patient-centered access planning and follow-up. Full article

Background/Objectives: Pulmonary arterial hypertension (PAH) impacts various aspects of patients’ lives. Some questionnaires assessing health-related quality of life are specific to PAH patients. The aims of the study were to translate and investigate the factor structure and psychometric properties of the Polish version of the EmPHasis-10 health-related quality of life questionnaire in a group of adults with PAH. Construct validity was explored by the relationship with results of the 36-Item Short Form Survey (SF-36) and non-invasive prognostic factors: WHO functional class, 6 min walk distance (6MWD) and NTproBNP level were measured. Methods: In a single-center study, PAH patients were included. The diagnosis of PAH was confirmed by right heart catheterization. The demographic and clinical data were obtained. The EmPHasis-10 and the SF-36 questionnaires were administered to all patients. Results: Data from 120 PAH patients, median age 57 (IQR 45–68.7) years, 88 (73%) women, were obtained. Most of the patients suffered from IPAH (73, 61%). Results revealed a unidimensional structure of the EmPHasis-10 questionnaire and demonstrated satisfactory reliability (Cronbach α = 0.94). The EmPHasis-10 showed an adequate relationship with both SF-36 dimensions and three non-invasive prognostic parameters, i.e., WHO functional class, 6MWD and NTproBNP level. Regression analysis indicated that the 6MWD was the only predictor of the EmPHasis-10. Conclusions: The obtained results showed very good psychometric properties and adequate internal consistency of the Polish version of EmPHasis-10 in PAH patients. The results showed a unidimensional structure and very good psychometric properties, including satisfactory internal consistency and external validity of the Polish version of the EmPHasis-10 scale in patients with PAH. Full article

Background/Objectives: Permanent cardiac pacemakers (PPMs) are small electronic implanted devices that regulate cardiac rhythm. Measurement of quality of life (QoL) serves as a powerful tool for gaining in-depth insights into pacing therapy and ultimately guiding patient-centered management strategies. The aim of the present study was to evaluate factors affecting QoL among PPM patients by applying the two generic questionnaires: SF-36 and EQ-5D-5L. Materials and Methods: A total of 120 patients with PPM were enrolled. QoL data were collected through interviews using the 36-Item Short Form Health Survey (SF-36) and the Euro QoL 5-Dimensions 5-Levels Health Questionnaire (EQ-5D-5L). Patients’ characteristics were also recorded. Results: The majority of participants were male (54.2%), retired (83.3%) residents in urban areas (75.5%), had a DDD pacemaker (82.5%), had rate response programmed on (77.5%), and had comorbidities (83.3%). Regarding QoL measured by SF-36, the Physical Component Summary Score (PCS) was significantly associated with programming rate response in their pacemaker (p = 0.046), comorbidities (p = 0.047), and the NYHA functional class (p = 0.047). The Mental Component Summary Score (MCS) was significantly associated with sex (p = 0.034), place of residence (p = 0.003), NYHA functional class (p = 0.001), and patients’ level of information about the device (p = 0.039). Patients’ QoL, as measured by the EQ-5D-5L, was significantly associated with sex (p = 0.001), age (p = 0.019), occupation (p = 0.040), pacing mode (p = 0.034), comorbidities (p = 0.019), NYHA functional class (p = 0.047), and level of information about the device (p = 0.005). Conclusions: NYHA functional class, comorbidities, and level of information as reported by patients were the factors associated with QoL, as shown by the two scales. All three factors guide a personalized care plan since NYHA class shows the burden of disease, comorbidities add to the complexity, and patient information determines the effectiveness of management. Full article