Assessment of quality of life in Mexican patients suffering from chronic venous disorder - impact of oral Ruscus aculeatus-hesperidin-methyl-chalcone-ascorbic acid treatment - 'QUALITY Study'
ABSTRACT The present study assessed the effect of Ruscus aculeatus-hesperidin-methyl-chalcone-ascorbic acid (HMC-AA) on the quality of life (QoL) of patients suffering from chronic venous disorders (CVDs).
An observational, multicentre and prospective study was performed with 917 Mexican patients suffering from CVD. Patients were treated with R. aculeatus-HMC-AA. After 12 weeks of treatment, the physicians then assessed the patients' symptoms and QoL using Short Form (SF-12) and Chronic Venous Insufficiency (CIVIQ) auto-questionnaires.
Patients were mainly women (86.7%), overweight or obese (72.7%) or C2 (39.3%)-C3 (27.6%). All symptoms and ankle circumferences significantly improved over time, with increasing clinical, aetiological, anatomical and pathophysiological (CEAP) classes and body mass index (BMI) (P < 0.001). Concerning QoL, all dimensions of the SF-12 score significantly improved over time (P < 0.001). Moreover, the CIVIQ scores significantly improved (P < 0.001) with increasing BMI (P < 0.002) and CEAP classes (P < 0.05).
R. aculeatus-HMC-AA significantly improved the symptoms and QoL of CVD patients.
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ABSTRACT: In this paper we are concerned with the exponential risk-sensitive version of the standard average cost criterion for controlled Markov chains (CMC). Our presentation is mathematically rigorous, and our proof techniques are self-contained and perhaps somewhat intuitive. Furthermore, we extend some previous results to the countable state space case. In addition, we consider optimization within the general set of randomized policies, and not only within the restricted class of Markovian deterministic policies. We model risk sensitivity as being given by an exponential disutility function U<sub>γ</sub>(x)=(sgnγ)e<sup>γx</sup>, where γ is the constant risk-sensitivity coefficient. After basic definitions and notation, the paper presents and briefly analyzes alternative definitions of the exponential average cost criterion (EAC). Howard and Matheson's definition of EAC (1972) is discussed in detail. Finally we show that, similarly to the risk-neutral case, the optimal EAC satisfies an optimality equationDecision and Control, 1997., Proceedings of the 36th IEEE Conference on; 01/1998
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ABSTRACT: The aim of this large survey was to evaluate non-compliance with compression stockings in chronic venous disorder (CVD) patients. A total of 16,770 CVD patients participated in this study. Compression stockings were used by 25.6% of CVD patients and 46.6% of the patients were never prescribed compression therapy. Compression stocking use was found to increase with the clinical stage of CVD. The percentage of patients using compression stockings during control visits increased to 37.4%. Furthermore, 5.3% of the patients coming to control visits discontinued the use of compression stockings owing to high cost, sweating, itching, cosmetic reason, oedema exacerbation, exudation lesions of lower legs and application difficulty. Past episodes of vein thrombosis (OR = 0.80), of stroke (OR = 0.28) and of varicose veins surgery (OR = 0.28) were decreasing, while the management by a general practitioner was increasing the risk (OR = 1.36) of compression therapy cessation. (1) Compression stockings are too rarely prescribed and often unaccepted at early stages of CVD; (2) The common reason for discontinuation of compression therapy is its high cost.Phlebology 08/2011; 26(8):353-60. DOI:10.1258/phleb.2010.010086 · 1.92 Impact Factor
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ABSTRACT: Background: This was a psychometric validation of the short Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-14) as quality of life (QOL) instrument for chronic venous disease (CVD) patients. Methods: Patients aged > 18 years who had CVD in CEAP C stages C-0s to C-6 were included in the study. Diagnosis was made by general practitioners according to CVD symptoms and visual examination of the lower extremities. QOL was assessed with the self-administrated CIVIQ-14. The reliability, construct, and convergent validity of the CIVIQ-14 was estimated as well as QOL of CVD patients according to CEAP C stages. Results: The study comprised 2260 subjects who fully completed the CIVIQ-14. CIVIQ-14 had a high level of reliability, construct, and convergent validity, but the structure of its three dimensions (pain [P], physical [PHY], and psychological [PSY]) was suboptimal. After adjustment for age, body mass index, and number of CVD symptoms, CIVIQ -14 global, P, PHY, and PSY scores showed significant progressive reduction of QOL from CEAP class C0s to C6. These differences were present in both sexes. The progressive impairment of the QOL involved primarily the pain and the physical items. For all CEAP C classes, the P and PHY scores were lower than the PSY scores. Global scores for men and women were: 76.7 and 73.9 for C-0s; 75.5 and 70.6 for C-1; 67.8 and 64.5 for C-2; 68.3 and 61.6 for C-3; 60.7 and 54.6 for C-4; 49.5 and 50.2 for C-5; and 41.3 and 46.7 for C-6. Conclusions: CVD in the lower extremities has a substantial effect on both physical and psychologic aspects of QOL, the physical aspects of QOL (P and PHY items) being more important. CIVIQ-14 is valuable in assessing QOL in CVD patients. Further investigations are necessary to confirm the stability of its two dimensions.Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 11/2011; 58(4). DOI:10.1016/j.jvs.2011.08.003 · 2.98 Impact Factor