Objective Outcome (objective + outcome)

Distribution by Scientific Domains


Selected Abstracts


Comparison between reduction in 24-hour pad weight, International Consultation on Incontinence-Short Form (ICIQ-SF) score, International Prostate Symptom Score (IPSS), and Post-Operative Patient Global Impression of Improvement (PGI-I) score in patient evaluation after male perineal sling

NEUROUROLOGY AND URODYNAMICS, Issue 1 2007
Christian O. Twiss
Abstract Aims We assessed the utility of three self-assessment instruments: the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the post-operative Patient Global Impression of Improvement (PGI-I) score, and the International Prostate Symptom Score (IPSS) by correlating them with an objective outcome, the change in 24-hr pad weight, after a male perineal sling. Methods Twenty-six men with urodynamically confirmed stress incontinence underwent a male perineal sling. Patients were evaluated pre-operatively and post-operatively with a 24-hr pad test, IPSS and ICIQ-SF. Patients also completed the PGI-I post-operatively. Changes in study parameters were compared via the paired t -test, and correlations were performed using Spearman's rho. Results There were significant reductions in 24-hr pad weight (,274 g, P,<,0.001), percentage 24-hr pad weight (54.2%), ICIQ-SF score (,6.3, P,<,0.001), and the three ICIQ-SF subscores (,1.2, ,1.7, ,3.4 for Questions 3, 4, and 5, respectively, P,<,0.001 for all). The change in total ICIQ-SF score and the post-operative PGI-I score correlated strongly with percentage reduction in 24-hr pad weight (r,=,,0.68, P,<,0.001; r,=,,0.81, P,<,0.001, respectively) and with each other (r,=,0.79, P,<,0.001). The change in all three ICIQ-SF subscores correlated significantly with percentage reduction in 24-hr pad weight and with post-operative PGI-I score. There was no significant change in the IPSS or the voiding or storage subscores, and none correlated with any other study parameter. Conclusions This study validates the construct validity of the ICIQ-SF and PGI-I in the assessment of treatment for male stress incontinence and should make clinicians confident in comparing studies of incontinence treatment utilizing the change ICIQ-SF score, the post-operative PGI-I score, and percentage reduction in 24-hr pad weight as outcome measures. Neurourol. Urodynam. © 2006 Wiley-Liss, Inc. [source]


Influence of Age on the Surgical Outcome After Endoscopic Sinus Surgery for Chronic Rhinosinusitis With Nasal Polyposis

THE LARYNGOSCOPE, Issue 6 2007
Jae Yong Lee MD
Abstract Objectives: To determine whether patient age is associated with the surgical outcome after endoscopic sinus surgery (ESS) with polypectomy. Study Design: A prospective, controlled case series. Materials and Methods: This study consisted of 60 patients who were diagnosed as having chronic rhinosinusitis (CRS) with nasal polyposis (NP) that was refractory to medical treatment. Three groups were classified according to patient age: pediatric (5,18 yr), adult (19,65 yr), and geriatric (over 65 yr). We collected 20 patients in each age group after applying the exclusion criteria. The extent of the polyps and the Lund-Mackay score were calculated for each patient, and they underwent ESS with polypectomy. We compared the objective endoscopic findings and subjective improvements in symptoms among the groups 6 months after the procedure. Results: There were no statistical differences in polyp extent or Lund-Mackay score between the three age groups. The objective surgical outcome based on the endoscopic findings was worst in the pediatric group (45%), whereas the geriatric group showed the best results (90%). The differences in objective outcome among the three groups were significant, and patient age was a predictive variable for surgical result based on multiple logistic regression analysis. No major complications occurred, and the overall improvement in subjective symptoms was statistically significant in all three age groups at 6 months postoperatively. The subjective surgical outcome did not differ statistically between the groups, with the exception of olfactory disturbance. Conclusions: The results of the present study suggest that patient age influences the objective postoperative outcome in the endoscopic treatment of CRS with NP, and that ESS is an effective and reliable method for improving the subjective symptoms in patients of all age groups despite the statistically different objective surgical outcomes between the groups. [source]


Long-Term Results after Endoscopic Sinus Surgery Involving Frontal Recess Dissection

THE LARYNGOSCOPE, Issue 4 2006
Michael Friedman MD
Abstract Objective: To assess long-term follow-up on a cohort of patients who underwent endoscopic frontal sinus surgery with identification and preservation of the natural frontal outflow tract. Study Design and Settings: Retrospective chart review, telephone interview, and endoscopic evaluation on a previously studied cohort of patients at a university affiliated medical center. Results: Two hundred patients who underwent endoscopic frontal sinus surgery were previously studied and reported after short-term (mean = 12.2 mo) follow-up. One hundred fifty-two (76%) patients were available for long-term (mean 72.3 mo) follow-up and assessment of subjective symptoms. Fifty-seven of 152 (37.5%) patients also had nasal endoscopy for evaluation of objective findings. The percentage of patients responding to telephone interview reporting overall improvement after surgery was 92.4%. Endoscopic assessment revealed patency of the frontal sinus in 67.6% of the patients after initial surgery. Thirteen additional patients had patent sinuses after revision procedures, bringing overall patency rate to 71.1%. We found statistically significant correlation of asthma and smoking and poor subjective and objective outcome. Conclusion: Long-term assessment of subjective and objective findings in our previously reported cohort of patients who underwent frontal sinus surgery indicates that the frontal sinus, similar to any other sinus, can be successfully treated surgically by preserving the natural frontal sinus outflow tract. [source]


Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score

CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2005
Rudolf Fürhauser
Abstract Aim: In this study, the reproducibility of a newly developed pink esthetic score (PES) for evaluating soft tissue around single-tooth implant crowns was assessed. The effect of observer specialization was another point of interest. Material and methods: Twenty observers (five prosthodontists, five oral surgeons, five orthodontists and five dental students) were given photographs of 30 single-tooth implant crowns. Seven variables were evaluated vs. a natural reference tooth: mesial papilla, distal papilla, soft-tissue level, soft-tissue contour, alveolar process deficiency, soft-tissue color and texture. Using a 0-1-2 scoring system, 0 being the lowest, 2 being the highest value, the maximum achievable PES was 14. Each observer was requested to make two assessments at an interval of 4 weeks. At the second assessment, the photographs were scored in the reverse order. Results: The mean PES of evaluations at the first assessment (n=600) was 9.46 (±3.81 SD), and 9.24 (±3.8 SD) at the second one. The difference between these two means was not significant statistically (P=0.6379). Implant-related mean PES for single-tooth implants varied from 2.28 to 13.8, with standard deviations between 0.46 and 3.51. Very poor and very esthetic restorations showed the smallest standard deviations. The mean total PES was 10.6 for the prosthodontists, 9.2 for the oral surgeons, 9.9 for the dental students and 7.6 for the orthodontists. Conclusions: The PES reproducibly evaluates peri-implant soft tissue around single-tooth implants. Thus, an objective outcome of different surgical or prosthodontic protocols can be assessed. Orthodontists were clearly more critical than the other observers. Résumé Dans cette étude la reproduction d'un nouveau Score d'Esthétique Rose (PES) pour l'évaluation des tissus mous autour des couronnes d'implants uniques a étéévaluée. L'effet de la spécialisation de l'observateur était un autre point d'intérêt. Vingt observateurs (cinq spécialistes en prothèse, cinq chirurgiens, cinq orthodontistes et cinq étudiants en médecine dentaire) ont reçu des photographies de 30 couronnes sur implant unique. Sept variables ont étéévaluées vs une dent de référence naturelle : papille mésiale, papille distale, niveau du tissu mou, couleur du tissu mou, perte du processus alvéolaire, couleur du tissu mou et texture. En utilisant un système 0,1,2, zéro étant le plus bas et deux étant la plus haute valeur, le score maximum PES était donc de 14. Chaque observateur a reçu comme instruction de réaliser deux évaluations à un intervalle de quatre semaines. A la seconde évaluation les photographies ont étéévaluées dans un ordre inverse. Les PES moyens des évaluations de la première fois (n=600) étaient de 9,46±3,81 et 9,24±3,80 la seconde fois. La différence entre ces deux moyennes n'était pas significative (P=0,6379). Le PS moyen en relation pour les implants sur dent unique variait de 2,28 à 13,8 avec des déviations standards de 0,46 à 3,51. Les restaurations de moindre qualité et les excellentes affichaient les plus petites déviations standards. Le PES total moyen était de 10,6 pour les spécialistes en prothèse, 9,2 pour les chirurgiens, 9,9 pour les étudiants et 7,6 pour les orthodontistes. Le PES évalue donc les tissus mous paraïmplantaires autour des implants uniques. Un aboutissement objectif de différents protocoles chirurgicaux ou prothétiques peut donc être estimé. Les orthodontistes étaient clairement plus critiques que les autres observateurs. Zusammenfassung Ziel: In dieser Arbeit wird die Reproduzierbarkeit eines neu entwickelten Pink Esthetic Index (PES) zur Evaluation vom Weichgewebe um Kronen auf Einzelzahnimplantaten untersucht. Zusätzlich interessierte der Einfluss des Spezialisierungsgrades eines Untersuchers. Material und Methoden: Man gab zwanzig Untersuchern (5 Prothetiker, 5 Oralchirurgen, 5 Orthodonten und 5 Zahnmedizinstudenten) Fotoaufnahmen von 30 Kronen auf Einzelzahnimplantaten. Sie hatten 7 Variabeln gegenüber einem natürlichen Referenzzahn zu beurteilen: mesiale Papille, distale Papille, Niveau der Weichgewebe, Form der Weichgewebe, Defizit an Alveolarkamm, Farbe und Struktur der Weichgewebe. Man definierte eine Bewertungsskala 0-1-2, wobei 0 für den schlechtesten und 2 für den besten Wert stehen, so dass man einen maximalen PES von 14 erreichen konnte. Jeder Untersucher war angehalten, im Abstand von 4 Wochen zwei Beurteilungen durchzuführen. Anlässlich des zweiten Untersuchungstermins wurden die Fotoaufnahmen in ungekehrter Reihenfolge beurteilt. Resultate: Der mittlere PES bei den Untersuchungen im ersten Umgang (n=600) betrug 9.46 (±3.81 SD) und 9.24 (±3.8 SD) im zweiten Umgang. Der Unterschied zwischen diesen zwei Mittelwerten war statistisch nicht signifikant (P=0.6379). Der mittlere implantatspezifische PES für die Einzelzahnimplantate variierte zwischen 2.28 und 13.8 mit Standardabweichungen zwischen 0.46 und 3.51. Sehr schlechte und sehr schöne Rekonstruktionen zeigten die kleinesten Standardabweichungen. Der mittlere Gesamt-PES war bei den Prothetikern 10.6, bei den Oralchirurgen 9.2, bei den Zahnmedizinstudenten 9.9 und bei den Orthodonten 7.6. Zusammenfassung: Der Pink Esthetic Index untersucht die periimplantären Weichgewebe um Einzelzahnimplantate und wird auf seine Reproduzierbarkeit überprüft. Damit kann man die Ergebnisse von verschiedenen chirurgischen und prothetischen Protokollen objektivieren. Die Orthodonten waren deutlich kritischer bei ihrer Beurteilung als die anderen Behandler. Resumen Intencion: En este estudio se valoró la reproductibilidad de una nueva Valor de Rosado Estético (PES) para evaluar el tejido blando alrededor de coronas de implantes unitarios. El efecto de la especialización del observador fue otro punto de interés. Material y metodos: Se entregó a veinte observadores (5 prostodoncistas, 5 cirujanos orales, 5 ortodoncistas y 5 estudiantes dentales) fotografías de 30 coronas de implantes unitarios. Se evaluaron 7 variables frente a dientes naturales de referencia: papila mesial, papila distal, nivel de tejido blando, contorno de tejido blando, deficiencia del proceso alveolar, color y textura del tejido blando. Usando un sistema de puntuación de 0-1-2, siendo 0 el valor más bajo, 2 el valor más alto, el PES más alto alcanzable era de 14. Se solicitó a cada observador que llevara a cabo dos valoraciones en un intervalo de 4 semanas. En la segunda valoración las fotografías se valoraron en orden inverso. Resultados: El PES medio de evaluaciones a la primera valoración (n=600) fue 9.46 (±3.81 SD) y 9.24 (±3.8 SD) en la segunda. La diferencia entre estas dos medias no fue estadísticamente significativo (P=0.6379). El PES medio relacionado al implante para implantes unitarios varió desde 2.28 a 13.8 con desviaciones estándar entre 0.46 y 3.51. Las restauraciones más pobres y más estéticas mostraron las desviaciones estándar más bajas. El PES total fue de 10.6 para los prostodoncistas, 9.2 para los cirujanos orales, 9.9 para los estudiantes dentales y 7.6 para los ortodoncistas. Conclusiones: Las Puntuaciones de Estética Rosa evalúa reproduciblemente el tejido blando periimplantario alrededor de implantes unitarios. De este modo, se puede valorar un resultado objetivo de diferentes protocolos quirúrgicos o prostodónticos. Los ortodoncistas fueron claramente más críticos que los otros observadores. [source]


Community mental healthcare in England: associations between service organisation and quality of life

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2002
Justine Schneider
Abstract The present authors set out to explore the relationship between different forms of service organisation and quality of life (QoL) for service users. Four mental health trusts and their corresponding social services departments were recruited to exemplify: (1) high and low levels of integration between health and social services; and (2) high and low levels of targeting at users with severe mental health problems. The authors used the Lancashire Quality of Life Profile, and chose their sample size to be able to detect a difference of 0.5 in subjective satisfaction scales. Analysis of covariance was used to investigate the simultaneous impact of variables representing user characteristics, objective and subjective QoL, and service organisation. Two hundred and sixty users selected at random from the active caseloads of mental health services in the four districts were interviewed at time 1 and 232 people were interviewed 6 months later (time 2). No bias was detected in the non-respondents at time 2. The authors found few differences between districts. As in other similar studies, QoL seemed to be stable for the whole sample over time. In 6 months, general satisfaction with leisure increased and the number of people who had been in hospital fell. Negative affect score was the only variable found to be associated with subjective QoL, and no predictors of objective QoL were identified. There was some evidence of better objective outcomes for people in receipt of integrated mental health services. They socialised more, and seemed to have less difficulty accessing police and legal services. The results also suggest that interventions targeted at negative affect could have benefits for subjective QoL. [source]


Tension-free vaginal tape-obturator procedure for treatment of severe urodynamic stress incontinence: Subjective and objective outcomes during 2 years of follow-up

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 6 2009
Tsung-Hsien Su
Abstract Aim:, To report our experience of the tension-free vaginal tape-obturator (TVT-O) procedure for the treatment of severe female urodymanic stress incontinence (USI) during 2 years of follow-up. Methods:, Between January 2005 and June 2007, 67 women with severe USI who underwent the TVT-O procedure were enrolled in the study. Pelvic examination, pad test, urodynamic study, and quality of life (QoL) assessment were performed pre- and post-operatively. Regular follow-up was arranged for analysis. Results:, The median duration of follow-up was 24 months. The objective cure rate was 76.2%. The postoperative pad test revealed significant reduction of leakage. The subjective cure rate was 83.5%, and improvement occurred in 14.9%. The postoperative QoL showed significant improvement. One (1.5%) extrusion of tape occurred and three cases of de novo detrusor overactivity were detected. Three patients (4.4%) had immediate postoperative urine retention. No major complications occurred. Conclusion:, Our results show that the TVT-O procedure is an effective and safe surgical procedure for severe female USI with satisfactory outcomes, significant improvement in quality of life, and few complications during 2 years of follow-up. [source]


The efficacy of sublingual immunotherapy for house dust mites respiratory allergy: results of a GA²LEN meta-analysis

ALLERGY, Issue 11 2009
E. Compalati
Recent meta-analyses documented the efficacy and safety of sublingual immunotherapy (SLIT) in patients with allergic rhinitis (AR) and asthma (AA). Although SLIT appeared globally effective, the sub-analyses for single allergens provided uncertain results. This study is aimed to investigate the efficacy of SLIT with house dust mite (HDM) extracts in AR and AA through an updated reassessment of randomized controlled trials. Electronic databases were searched up to March 31, 2008, for randomized DBPC trials, assessing the efficacy of SLIT in AR and AA due to HDM sensitization. Outcomes were symptom scores and rescue medications use. For AR, eight studies fulfilled the selection criteria. A significant reduction in symptoms of AR (SMD ,0.95; CI 95%,1.77 to ,0.14 P = 0.02) was found in 194 patients (adults and children) receiving SLIT compared to 188 receiving placebo. For AA, with nine studies, similar results were found for symptoms (SMD ,0.95; CI 95%,1.74 to ,0.15 P = 0.02) in 243 patients (adults and children) receiving SLIT compared to 209 receiving placebo. A reduction in rescue medication use was found for AR (SMD ,1.88; CI 95%,3.65 to ,0.12 P = 0.04) in 89 patients, and AA (SMD ,1.48; CI 95%,2.70 to ,0.26 P = 0.02) in 202 patients. A relevant inter-study heterogeneity was detected. Promising evidence of efficacy for SLIT, using mite extract in allergic patients suffering from AR and AA, are herein shown. These findings suggest that more data are needed, derived from large-population-based high quality studies, and corroborated by objective outcomes, mainly for AA. [source]


The tension free vaginal tape operation for women with mixed incontinence: Do preoperative variables predict the outcome?

NEUROUROLOGY AND URODYNAMICS, Issue 1 2007
Sigurd Kulseng-Hanssen
Abstract Aims The aims of our study were (1) to investigate subjective and objective outcomes after tension free vaginal tape (TVT) operations in mixed incontinent women, (2) to detect if preoperative subjective and objective variables predict the outcome, and (3) to evaluate whether the surgical outcome is different for women who preoperatively find stress incontinence, urge incontinence, or urge and stress incontinence equally the predominant bother. Methods A prospective cohort study was performed on 450 mixed incontinent women. A short-form disease-specific validated questionnaire, 24-hr pad test, standardized stress test, residual urine, and maximum urinary flow were used before and after a TVT operation. "Cure" was defined as a condition where the women were very satisfied with the TVT operation and had negative stress- and 24 hr pad tests. Results Preoperatively 69% had stress incontinence, 7% urge incontinence, and 24% urge and stress incontinence equally as the predominant bother. Cure rates were 80%, 52%, and 60%, respectively, in these groups. Postoperatively 43% of the women had no urge incontinence, while 49% were less, and only 8% were more bothered by urge incontinence. A higher preoperative urge incontinence index was correlated with significantly higher postoperative bother for all indices and leakage during 24-hr pad test. Conclusions Mixed incontinent women with predominant stress incontinence had a better cure rate than those with predominant urge incontinence and those who were equally bothered by urge and stress incontinence. This point needs to be addressed when informing mixed incontinent women before a TVT operation. Neurourol. Urodynam. © 2006 Wiley-Liss, Inc. [source]


Playing to win: Biological imperatives, self-regulation, and trade-offs in the game of career success

JOURNAL OF ORGANIZATIONAL BEHAVIOR, Issue 2 2005
Nigel Nicholson
The article applies evolutionary theory to the concept of career success, to argue the primacy of ,objective' outcomes, utilities such as status and wealth, and to analyze why the relationship with subjective career success is not stronger. Although there are grounds for expecting subjective evaluations to be sympathetic secondary accompaniments of objective success and failure, there are substantial numbers of paradoxically ,happy losers' and ,unhappy winners' in the career game. These are explored theoretically as adaptive outcomes of self-regulation and sense-making processes. The nature of that game is then explored by a closer examination of the interrelations and decay functions of the major objective success outcomes. This is undertaken as a theoretical exercise, and also by reference to the evidence in the literature. Both approaches support the existence of close linkages among most of these outcomes, though empirical data reveal variations that highlight the importance for careerists to be aware of trade-offs and risks in career strategies. Context mediates these relationships, especially key contingencies such as individual differences, gender, career stage, culture, and business sector. The implications are discussed; in particular the role of careers theory and research in helping to cut through some of the ideological aspects of ,subjective' careers in order to help raise the awareness of actors in the labor market about objective career realities. Copyright © 2005 John Wiley & Sons, Ltd. [source]