Annina Seiler

A systematic review of health-related quality of life and psychological outcomes after lung transplantation

BACKGROUND Lung transplantation (LTx) aims to reduce physical disability and mental distress, extend survival, and improve health-related quality of life (HRQoL). In this systematic review we aimed to: (1) augment evidence regarding measures to assess HRQoL and psychological outcomes after LTx; and (2) summarize HRQoL and psychological outcomes after LTx. METHODS Validated and standardized instruments with well-known psychometric properties used for assessing HRQoL and psychological outcomes after LTx were identified by means of comprehensive literature searches of PsychINFO and Medline/PubMed, up through March 2014, using the following search terms in various combinations: lung transplantation; physical functioning; symptom experience; mental health; anxiety; depression; distress; social functioning; life satisfaction; and health-related quality of life. RESULTS The search strategy identified 371 titles and abstracts. Of these, 279 were retrieved for further assessment and 63 articles selected for final review. Thirty-nine studies were found for HRQoL, 15 for physical functioning, 5 for mental health and 4 for social functioning. A total of 50 psychometric instruments were encountered. CONCLUSIONS Considerable heterogeneity exists in methodology, operational concepts and applied outcome measures in the existing literature on HRQoL and psychological outcomes after LTx. Nevertheless, the studies generally point to significant improvements in both mental health and HRQoL post-transplant. Further research is warranted utilizing consistent outcome measures, including LTx-specific measures and longitudinal study designs.

Post-transplant outcome-clusters of psychological distress and health-related quality of life in lung transplant recipients.

QUESTIONS UNDER STUDY To (1) assess distinct clusters of psychological distress and health-related quality of life during the first 6 months following lung transplantation; (2) identify patients with poor psychosocial outcomes; and (3) determine potential predictors regarding psychological distress and health-related quality (HRQoL) of life at 6 months post-transplant. METHODS A total of 40 patients were examined for psychological distress (Symptom Checklist short version-9) and quality of life (EuroQOL five-dimension health-related quality of life questionnaire) during their first 6 months post-transplant. Hierarchical cluster analyses were performed to identify specific types of post-transplant outcomes in terms of psychological distress and HRQoL over the first six post-transplant months. Correlational analyses examined medical and psychosocial predictors of the outcome at 6 months post-transplant. RESULTS Three distinctive clusters were identified, summarizing either groups of patients with (1) optimal (35%), (2) good (42%), and (3) poor outcome-clusters (23%). The latter tended to be older, to suffer from more severe disease, to have more co-morbidities, to have had a prolonged intensive care unit and/or hospital stay, to have more hospital admissions and were more frequently treated with antidepressants post-transplant. Disease severity, length of stay, quality of life two weeks post-transplant, hospital admissions and use of antidepressants were strong predictors of psychological distress and impaired health-related quality of life at six months of follow-up. CONCLUSION Almost a quarter of the investigated patients suffered from elevated distress and substantially impaired HRQoL, with no improvements over time. Results underscore the psychosocial needs of patients with poor post-transplant outcomes.

Impaired mental health and low-grade inflammation among fatigued bereaved individuals

BACKGROUND Fatigue is a common symptom in stressed individuals. Bereavement is a major life event that has been associated with impaired mental health. Little research has investigated the prevalence of fatigue and its inflammatory correlates in bereaved individuals. OBJECTIVES To assess fatigue prevalence and its relationship with mental health outcomes and markers of inflammation, as indexed by C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) in bereaved individuals. METHODS Seventy-eight-bereaved adults were examined for fatigue (SF-36 energy/vitality scale), perceived stress (PSS), depression (CES-D), sleep quality (PSQI), pain (SF-36 pain scale), and general health (SF-36 general), and their serum levels of CRP, IL-6 and TNF-α were measured. Group differences between fatigued versus non-fatigued individuals were estimated using analysis of covariance (ANCOVA), with adjustment for body mass index (BMI). RESULTS Fatigued bereaved individuals (33%; SF-36 energy/vitality score 0-45) had significantly higher CRP levels (p < .05) as compared to non-fatigued bereaved individuals and reported higher levels of pain (p < .001), greater stress (p < .001), depression (p < .001), and sleeping problems (p < .001), as well as poorer social functioning (p < .001) and general health (p < .001) than those in the non-fatigued group. No group differences were found for IL-6 and TNF-α. CONCLUSIONS Fatigued bereaved individuals showed elevated systemic inflammation as measured by CRP in comparison to non-fatigued bereaved individuals. They were also more likely to report mental health problems that co-occur with fatigue in the context of immune activation. Continued research is needed to help clarify the involvement of inflammatory markers in the development of fatigue in a larger sample of bereaved adults.

Obesity, Dietary Factors, Nutrition, and Breast Cancer Risk

Purpose of ReviewTo synthesize the critical role of obesity-associated inflammation, dietary factors, and nutrition in determining breast cancer risk.Recent FindingsObesity-associated inflammation is strongly linked to breast cancer risk and progression, largely via two processes: inflammatory pathways and dysregulated metabolism. Cytokine production in excess adipose tissues creates a chronic inflammatory microenvironment, which favors tumor development. Lifestyle factors, including diet, have long been recognized as important determinants of breast cancer risk and mortality.SummaryObesity increases the risk of developing breast cancer in both pre- and postmenopausal women and also negatively affects breast cancer recurrence and survival. Poor dietary habits characterized by the high intake of refined starches, sugar, and both saturated and trans-saturated fats, as well as the low intake of omega-3 fatty acids, natural antioxidants, and fiber, modulate inflammation and, thereby, appear to be linked to increased risk of breast cancer and mortality.

Transplantation experience as a predictor for quality of life during the first 6 months after lung transplantation

Quality of life (QoL) is a crucial goal of post‐transplant care. This study investigated predictors of QoL within the first 6 months after transplantation.

Work ability and return to work in thyroid cancer patients and their partners: a pilot study.

Marion Roberta Neudeck, Hans Steinert, Hanspeter Moergeli, Steffi Weidt, Annina Seiler, Klaus Strobel, Josef Jenewein and Natalie Drabe* Praxis Ziegelfeld, Olten, Switzerland Division of Nuclear Medicine, Department of Medical Radiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland Department of Psychiatry and Psychotherapy, University Hospital of Zurich, University of Zurich, Zurich, Switzerland Division of Nuclear Medicine, Department of Medical Radiology, Hospital of Luzern, Luzern, Switzerland

Untangling the strands: The spelling of the Épinal glossary

This paper focuses on a group of some twenty-five Old English glosses from the Epinal glossary (c. 700). The Old English interpretations stand out due to one graphemic feature: they all use one of the runic characters wyn or thorn, which were adopted into the Old English alphabet to represent the phonemes /w/ and /θ/. A careful investigation of the sources of the lemmata reveals that, with three exceptions, these glosses stem from Isidore of Seville’s Etymologiae or from Paulus Orosius’ Historiae Adversum Paganos, but not from any of the other numerous sources of the glossary. This confirms the hypothesis that different orthographic systems were in use among the glossators contributing to the Epinal/Erfurt family of glossaries. The study thus uncovers one chapter in the earliest history of English spelling and contributes to a better understanding of the composition of Epinal/Erfurt.