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Frederick S Kaplan - One of the best experts on this subject based on the ideXlab platform.
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the natural history of flare ups in fibrodysplasia ossificans progressiva fop a comprehensive Global Assessment
Journal of Bone and Mineral Research, 2016Co-Authors: Robert J Pignolo, Christopher Bedfordgay, Moira Liljesthrom, Blythe Durbinjohnson, Eileen M Shore, David M Rocke, Frederick S KaplanAbstract:Fibrodysplasia ossificans progressiva (FOP) leads to disabling heterotopic ossification (HO) from episodic flare-ups. However, the natural history of FOP flare-ups is poorly understood. A 78-question survey on FOP flare-ups, translated into 15 languages, was sent to 685 classically-affected patients in 45 countries (six continents). Five hundred patients or knowledgeable informants responded (73%; 44% males, 56% females; ages: 1 to 71 years; median: 23 years). The most common presenting symptoms of flare-ups were swelling (93%), pain (86%), or decreased mobility (79%). Seventy-one percent experienced a flare-up within the preceding 12 months (52% spontaneous; 48% trauma-related). Twenty-five percent of those who had received an intramuscular injection reported an immediate flare-up at the injection site, 84% of whom developed HO. Axial flare-ups most frequently involved the back (41.6%), neck (26.4%), or jaw (19.4%). Flare-ups occurred more frequently in the upper limbs before 8 years of age, but more frequently in the lower limbs thereafter. Appendicular flare-ups occurred more frequently at proximal than at distal sites without preferential sidedness. Seventy percent of patients reported functional loss from a flare-up. Thirty-two percent reported complete resolution of at least one flare-up and 12% without any functional loss (mostly in the head or back). The most disabling flare-ups occurred at the shoulders or hips. Surprisingly, 47% reported progression of FOP without obvious flare-ups. Worldwide, 198 treatments were reported; anti-inflammatory agents were most common. Seventy-five percent used short-term glucocorticoids as a treatment for flare-ups at appendicular sites. Fifty-five percent reported that glucocorticoids improved symptoms occasionally whereas 31% reported that they always did. Only 12% reported complete resolution of a flare-up with glucocorticoids. Forty-three percent reported rebound symptoms within 1 to 7 days after completing a course of glucocorticoids. This study is the first comprehensive Global Assessment of FOP flare-ups and establishes a critical foundation for the design and evaluation of future clinical trials.
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the natural history of flare ups in fibrodysplasia ossificans progressiva fop a comprehensive Global Assessment
Journal of Bone and Mineral Research, 2016Co-Authors: Robert J Pignolo, Christopher Bedfordgay, Moira Liljesthrom, Blythe Durbinjohnson, Eileen M Shore, David M Rocke, Frederick S KaplanAbstract:Fibrodysplasia ossificans progressiva (FOP) leads to disabling heterotopic ossification (HO) from episodic flare-ups. However, the natural history of FOP flare-ups is poorly understood. A 78-question survey on FOP flare-ups, translated into 15 languages, was sent to 685 classically-affected patients in 45 countries (six continents). Five hundred patients or knowledgeable informants responded (73%; 44% males, 56% females; ages: 1 to 71 years; median: 23 years). The most common presenting symptoms of flare-ups were swelling (93%), pain (86%), or decreased mobility (79%). Seventy-one percent experienced a flare-up within the preceding 12 months (52% spontaneous; 48% trauma-related). Twenty-five percent of those who had received an intramuscular injection reported an immediate flare-up at the injection site, 84% of whom developed HO. Axial flare-ups most frequently involved the back (41.6%), neck (26.4%), or jaw (19.4%). Flare-ups occurred more frequently in the upper limbs before 8 years of age, but more frequently in the lower limbs thereafter. Appendicular flare-ups occurred more frequently at proximal than at distal sites without preferential sidedness. Seventy percent of patients reported functional loss from a flare-up. Thirty-two percent reported complete resolution of at least one flare-up and 12% without any functional loss (mostly in the head or back). The most disabling flare-ups occurred at the shoulders or hips. Surprisingly, 47% reported progression of FOP without obvious flare-ups. Worldwide, 198 treatments were reported; anti-inflammatory agents were most common. Seventy-five percent used short-term glucocorticoids as a treatment for flare-ups at appendicular sites. Fifty-five percent reported that glucocorticoids improved symptoms occasionally whereas 31% reported that they always did. Only 12% reported complete resolution of a flare-up with glucocorticoids. Forty-three percent reported rebound symptoms within 1 to 7 days after completing a course of glucocorticoids. This study is the first comprehensive Global Assessment of FOP flare-ups and establishes a critical foundation for the design and evaluation of future clinical trials. © 2015 American Society for Bone and Mineral Research.
Judith Bauer - One of the best experts on this subject based on the ideXlab platform.
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malnutrition determined by the patient generated subjective Global Assessment is associated with poor outcomes in acute stroke patients
Clinical Nutrition, 2005Co-Authors: J Martineau, Judith Bauer, Elisabeth Isenring, Sarah CohenAbstract:Summary Background & aims The extent of malnutrition in hospitalised stroke patients and its influence on outcomes including hospital complications, length of stay and discharge destination are important issues. The aim of this study was to determine the nutritional status of patients admitted to an acute stroke unit and the association between nutritional status and health outcomes. Methods Nutritional status was determined prospectively using the scored patient generated subjective Global Assessment (PG-SGA) in patients ( n = 73 ) admitted to an acute stroke unit within 48h of admission to an Australian private hospital. Outcome data were collected by retrospective audit. Results On admission, 19.2% of patients were malnourished and this was associated with a significantly greater PG-SGA score (15 vs. 5) and lower body weight (59.8kg vs. 75.8kg) compared to well-nourished patients. In terms of health outcomes, malnourished patients had longer length of stay (13 vs. 8 days), increased complications (50% vs. 14%), increased frequency of dysphagia (71% vs. 32%) and enteral feeding (93% vs. 59%). No association was found between nutritional status and serum albumin level or discharge destination. Conclusions Malnutrition on admission to hospital after acute stroke is associated with poor outcomes including increased length of stay and increased prevalence of dysphagia and complications. The scored PG-SGA is a nutrition Assessment tool that allows quick identification of malnourished stroke patients.
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Assessment of nutritional status in hemodialysis patients using patient generated subjective Global Assessment
Journal of Renal Nutrition, 2005Co-Authors: Ben Desbrow, Judith Bauer, Claudia Blum, Amutha Kandasamy, Alison Mcdonald, Kate MontgomeryAbstract:Objective To evaluate the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition Assessment tool in hemodialysis patients. Design A cross-sectional observational study assessing the nutritional status of hemodialysis patients. Setting Private tertiary Australian hospital. Subjects Sixty patients, ages 63.9 ± 16.2 years. Intervention Scored PG-SGA questionnaire, comparison of PG-SGA score ≥9 with subjective Global Assessment (SGA), albumin, corrected arm muscle area, and triceps skinfold. Results According to SGA, 80% of patients were well nourished and 20% of patients were malnourished. Patients classified as well nourished (SGA-A) attained a significantly lower median PG-SGA score compared with those rated as moderately malnourished or at risk of malnutrition (SGA-B). A PG-SGA score ≥9 had a sensitivity of 83% and a specificity of 92% at predicting SGA classification. There were significant correlations between the PG-SGA score and serum albumin, PG-SGA score, and percentage weight loss over the past 6 months. There was no association between PG-SGA score and body mass index or anthropometric measurements. Conclusion The scored PG-SGA is an easy-to-use nutrition Assessment tool that allows quick identification of malnutrition in hemodialysis patients.
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the scored patient generated subjective Global Assessment pg sga and its association with quality of life in ambulatory patients receiving radiotherapy
European Journal of Clinical Nutrition, 2003Co-Authors: Elisabeth Isenring, Judith Bauer, Sandra CapraAbstract:Objective: To evaluate the scored Patient-generated Subjective Global Assessment (PG-SGA) tool as an outcome measure in clinical nutrition practice and determine its association with quality of life (QoL).
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use of the scored patient generated subjective Global Assessment pg sga as a nutrition Assessment tool in patients with cancer
European Journal of Clinical Nutrition, 2002Co-Authors: Judith Bauer, Sandra Capra, Maree FergusonAbstract:Objective: To evaluate the use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition Assessment tool in patients with cancer. Design: An observational study assessing the nutritional status of patients with cancer. Setting: Oncology ward of a private tertiary Australian hospital. Subjects: Seventy-one cancer patients aged 18–92 y. Intervention: Scored PG-SGA questionnaire, comparison of scored PG-SGA with subjective Global Assessment (SGA), sensitivity, specificity. Results: Some 24% (17) of 71 patients were well nourished, 59% (42) of patients were moderately or suspected of being malnourished and 17% (12) of patients were severely malnourished according to subjective Global Assessment (SGA). The PG-SGA score had a sensitivity of 98% and a specificity of 82% at predicting SGA classification. There was a significant difference in the median PG-SGA scores for each of the SGA classifications (P<0.001), with the severely malnourished patients having the highest scores. Re-admission within 30 days of discharge was significantly different between SGA groups (P=0.037). The mortality rate within 30 days of discharge was not significantly different between SGA groups (P=0.305). The median length of stay of well nourished patients (SGA A) was significantly lower than that of the malnourished (SGA B+C) patients (P=0.024). Conclusion: The scored PG-SGA is an easy to use nutrition Assessment tool that allows quick identification and prioritisation of malnutrition in hospitalised patients with cancer. Sponsors: The Wesley Research Institute.
Sandra Capra - One of the best experts on this subject based on the ideXlab platform.
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the scored patient generated subjective Global Assessment pg sga and its association with quality of life in ambulatory patients receiving radiotherapy
European Journal of Clinical Nutrition, 2003Co-Authors: Elisabeth Isenring, Judith Bauer, Sandra CapraAbstract:Objective: To evaluate the scored Patient-generated Subjective Global Assessment (PG-SGA) tool as an outcome measure in clinical nutrition practice and determine its association with quality of life (QoL).
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use of the scored patient generated subjective Global Assessment pg sga as a nutrition Assessment tool in patients with cancer
European Journal of Clinical Nutrition, 2002Co-Authors: Judith Bauer, Sandra Capra, Maree FergusonAbstract:Objective: To evaluate the use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition Assessment tool in patients with cancer. Design: An observational study assessing the nutritional status of patients with cancer. Setting: Oncology ward of a private tertiary Australian hospital. Subjects: Seventy-one cancer patients aged 18–92 y. Intervention: Scored PG-SGA questionnaire, comparison of scored PG-SGA with subjective Global Assessment (SGA), sensitivity, specificity. Results: Some 24% (17) of 71 patients were well nourished, 59% (42) of patients were moderately or suspected of being malnourished and 17% (12) of patients were severely malnourished according to subjective Global Assessment (SGA). The PG-SGA score had a sensitivity of 98% and a specificity of 82% at predicting SGA classification. There was a significant difference in the median PG-SGA scores for each of the SGA classifications (P<0.001), with the severely malnourished patients having the highest scores. Re-admission within 30 days of discharge was significantly different between SGA groups (P=0.037). The mortality rate within 30 days of discharge was not significantly different between SGA groups (P=0.305). The median length of stay of well nourished patients (SGA A) was significantly lower than that of the malnourished (SGA B+C) patients (P=0.024). Conclusion: The scored PG-SGA is an easy to use nutrition Assessment tool that allows quick identification and prioritisation of malnutrition in hospitalised patients with cancer. Sponsors: The Wesley Research Institute.
Robert J Pignolo - One of the best experts on this subject based on the ideXlab platform.
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the natural history of flare ups in fibrodysplasia ossificans progressiva fop a comprehensive Global Assessment
Journal of Bone and Mineral Research, 2016Co-Authors: Robert J Pignolo, Christopher Bedfordgay, Moira Liljesthrom, Blythe Durbinjohnson, Eileen M Shore, David M Rocke, Frederick S KaplanAbstract:Fibrodysplasia ossificans progressiva (FOP) leads to disabling heterotopic ossification (HO) from episodic flare-ups. However, the natural history of FOP flare-ups is poorly understood. A 78-question survey on FOP flare-ups, translated into 15 languages, was sent to 685 classically-affected patients in 45 countries (six continents). Five hundred patients or knowledgeable informants responded (73%; 44% males, 56% females; ages: 1 to 71 years; median: 23 years). The most common presenting symptoms of flare-ups were swelling (93%), pain (86%), or decreased mobility (79%). Seventy-one percent experienced a flare-up within the preceding 12 months (52% spontaneous; 48% trauma-related). Twenty-five percent of those who had received an intramuscular injection reported an immediate flare-up at the injection site, 84% of whom developed HO. Axial flare-ups most frequently involved the back (41.6%), neck (26.4%), or jaw (19.4%). Flare-ups occurred more frequently in the upper limbs before 8 years of age, but more frequently in the lower limbs thereafter. Appendicular flare-ups occurred more frequently at proximal than at distal sites without preferential sidedness. Seventy percent of patients reported functional loss from a flare-up. Thirty-two percent reported complete resolution of at least one flare-up and 12% without any functional loss (mostly in the head or back). The most disabling flare-ups occurred at the shoulders or hips. Surprisingly, 47% reported progression of FOP without obvious flare-ups. Worldwide, 198 treatments were reported; anti-inflammatory agents were most common. Seventy-five percent used short-term glucocorticoids as a treatment for flare-ups at appendicular sites. Fifty-five percent reported that glucocorticoids improved symptoms occasionally whereas 31% reported that they always did. Only 12% reported complete resolution of a flare-up with glucocorticoids. Forty-three percent reported rebound symptoms within 1 to 7 days after completing a course of glucocorticoids. This study is the first comprehensive Global Assessment of FOP flare-ups and establishes a critical foundation for the design and evaluation of future clinical trials.
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the natural history of flare ups in fibrodysplasia ossificans progressiva fop a comprehensive Global Assessment
Journal of Bone and Mineral Research, 2016Co-Authors: Robert J Pignolo, Christopher Bedfordgay, Moira Liljesthrom, Blythe Durbinjohnson, Eileen M Shore, David M Rocke, Frederick S KaplanAbstract:Fibrodysplasia ossificans progressiva (FOP) leads to disabling heterotopic ossification (HO) from episodic flare-ups. However, the natural history of FOP flare-ups is poorly understood. A 78-question survey on FOP flare-ups, translated into 15 languages, was sent to 685 classically-affected patients in 45 countries (six continents). Five hundred patients or knowledgeable informants responded (73%; 44% males, 56% females; ages: 1 to 71 years; median: 23 years). The most common presenting symptoms of flare-ups were swelling (93%), pain (86%), or decreased mobility (79%). Seventy-one percent experienced a flare-up within the preceding 12 months (52% spontaneous; 48% trauma-related). Twenty-five percent of those who had received an intramuscular injection reported an immediate flare-up at the injection site, 84% of whom developed HO. Axial flare-ups most frequently involved the back (41.6%), neck (26.4%), or jaw (19.4%). Flare-ups occurred more frequently in the upper limbs before 8 years of age, but more frequently in the lower limbs thereafter. Appendicular flare-ups occurred more frequently at proximal than at distal sites without preferential sidedness. Seventy percent of patients reported functional loss from a flare-up. Thirty-two percent reported complete resolution of at least one flare-up and 12% without any functional loss (mostly in the head or back). The most disabling flare-ups occurred at the shoulders or hips. Surprisingly, 47% reported progression of FOP without obvious flare-ups. Worldwide, 198 treatments were reported; anti-inflammatory agents were most common. Seventy-five percent used short-term glucocorticoids as a treatment for flare-ups at appendicular sites. Fifty-five percent reported that glucocorticoids improved symptoms occasionally whereas 31% reported that they always did. Only 12% reported complete resolution of a flare-up with glucocorticoids. Forty-three percent reported rebound symptoms within 1 to 7 days after completing a course of glucocorticoids. This study is the first comprehensive Global Assessment of FOP flare-ups and establishes a critical foundation for the design and evaluation of future clinical trials. © 2015 American Society for Bone and Mineral Research.
Maria Ciocirlan - One of the best experts on this subject based on the ideXlab platform.
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subjective Global Assessment and handgrip strength as predictive factors in patients with liver cirrhosis
Gastroenterology Research and Practice, 2017Co-Authors: Maria Ciocirlan, Andreea Ruxandra Cazan, Mihaela Barbu, Mircea Mănuc, Mircea DiculescuAbstract:Background and Aims. Malnutrition is common in patients with chronic liver disease. We aimed to evaluate malnutrition Assessment tools in predicting severity and survival of patients with liver cirrhosis. Material and Methods. We examined patients with liver cirrhosis. Nutritional evaluation was performed on admission, using subjective Global Assessment (SGA), handgrip strength (HGS), and anthropometry. Patients were followed up for 6 months. Results. We included 100 patients, 72 men, with mean age of 59.2 years. According to disease severity, patients were 23% Child-Pugh A, 46% Child-Pugh B, and 31% Child-Pugh C. SGA and HGS significantly correlated with Child-Pugh, MELD, and MELD-Na scores on admission. At 6 months follow-up, 80.4% (78 of 97) of patients survived, while 3 patients were lost from observation. Survival was predicted by SGA (1 death in 32 patients SGA A, 8 deaths in 46 patients SGA B, and 9 deaths in 19 patients SGA C, ) and HGS (25.1 ± 8.5 in deceased versus 30.6 ± 10.9 in survivors, ). The mean BMI and MAMC values did not significantly differ between patients who survived or were deceased at 6 months. Conclusion. HGS and SGA may predict severity and short-term survival in cirrhotic patients.
