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3 results on '"H. Fassil"'

1. Validation of the National Institutes of Health chronic GVHD Oral Mucosal Score using component-specific measures

Author

Dan Zhang, Lana Grković, Carol W. Bassim, H. Fassil, Kristen Cole, Kirsten M. Williams, Sandra A. Mitchell, Steven Živko Pavletić, Kristin Baird, Tiffany Taylor, Ronald E. Gress, Jacqueline W. Mays, Dean P. Edwards, Daniele Avila, Seth M. Steinberg, Edward W. Cowen, Dražen Pulanić, and Daniel H. Fowler

Subjects
Adult, Male, medicine.medical_specialty, Erythema, Adolescent, Cross-sectional study, Graft vs Host Disease, Nutritional Status, Pain, Severity of Illness Index, Article, oral cGVHD, chronic graft-versus-host disease, validation, Young Adult, Quality of life, Albumins, Severity of illness, medicine, Humans, Prospective Studies, Young adult, Prospective cohort study, Child, Oral Ulcer, Pain Measurement, Inflammation, Transplantation, business.industry, Hematopoietic Stem Cell Transplantation, Mouth Mucosa, Reproducibility of Results, Hematology, Middle Aged, medicine.disease, Dermatology, Hematologic Diseases, United States, stomatognathic diseases, Graft-versus-host disease, Cross-Sectional Studies, National Institutes of Health (U.S.), Child, Preschool, Immunology, Quality of Life, Female, medicine.symptom, business
Abstract

Oral chronic GVHD (cGVHD) is a common, late complication of alloSCT that is associated with significant patient morbidity. The NIH Oral Mucosal Score (NIH OMS) was developed to assess oral cGVHD therapeutic response, but has not been fully validated. This study’s purpose was to conduct a rigorous construct validity and internal consistency analysis of this score and its components (erythema, lichenoid, ulcers, mucoceles) using established measures of oral pain, oral function, oral-related quality-of- life, nutrition and laboratory parameters in 198 patients with cGVHD. The construct validity of the NIH OMS was supported: a moderate correlation was observed between NIH OMS and mouth pain (rho=0.43), while a weaker correlation was observed with low albumin (rho= −0.26). Total NIH OMS, erythema and lichenoid components were associated with malnutrition, oral pain and impaired oral QOL, while ulcers were only associated with oral pain. No associations were found between mucoceles and any indicator evaluated, including salivary function or xerostomia. Kappa determined between scale components was low overall (all less than or equal to0.35), supporting a conclusion that each component measures a distinct manifestation of oral cGVHD. This study supports the use of the NIH OMS and its components (erythema, lichenoid and ulcerations) to measure clinician-reported severity of oral cGVHD.

Published
2013

2. Malnutrition in patients with chronic GVHD.

Author

Bassim CW, Fassil H, Dobbin M, Steinberg SM, Baird K, Cole K, Joe G, Comis LE, Mitchell SA, Grkovic L, Edwards D, Mays JW, Cowen EW, Pulanic D, Williams KM, Gress RE, and Pavletic SZ

Subjects
Adolescent, Adult, Aged, Female, Graft vs Host Disease mortality, Humans, Male, Middle Aged, Quality of Life, Severity of Illness Index, Young Adult, Graft vs Host Disease complications, Malnutrition etiology
Abstract

Malnutrition is a known complication of chronic GVHD (cGVHD), but has not been well described in the context of organ-specific manifestations and the recent National Institutes of Health (NIH) criteria. Here, 210 cGVHD patients were analyzed, in a cross-sectional study design, for demographics, transplant-related history, clinical assessments, symptoms, function, quality-of-life, laboratory values and survival in order to determine their associations with nutritional status. Most patients had long-standing, moderate or severe cGVHD and had failed many lines of therapy. Twenty-nine percent (60/210) of subjects were malnourished, using the subjective Patient-Generated Subjective Global Assessment (PG-SGA) questionnaire and evaluation. No demographic or transplant characteristics were associated with malnutrition; cGVHD of the lungs, gastrointestinal (GI) tract and mouth, NIH global score, cGVHD symptoms, worse functioning, low albumin, poorer survival and low BMI were associated with malnutrition. A predictive model was developed from all variables of significance: cGVHD of the lungs, GI tract, mouth and BMI accurately predicted 84.2% of malnourished patients as well as 87.2% of well-nourished patients. The PG-SGA questionnaire may be a useful tool in diagnosing nutritional deficits in cGVHD patients undergoing one-time evaluations. Longitudinal prospective studies should assess the utility of nutritional support interventions in cGVHD.

Published
2014
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3. Validation of the National Institutes of Health chronic GVHD Oral Mucosal Score using component-specific measures.

Author

Bassim CW, Fassil H, Mays JW, Edwards D, Baird K, Steinberg SM, Williams KM, Cowen EW, Mitchell SA, Cole K, Taylor T, Avila D, Zhang D, Pulanic D, Grkovic L, Fowler D, Gress RE, and Pavletic SZ

Subjects
Adolescent, Adult, Albumins metabolism, Child, Child, Preschool, Cross-Sectional Studies, Female, Graft vs Host Disease physiopathology, Hematologic Diseases therapy, Humans, Inflammation, Male, Middle Aged, National Institutes of Health (U.S.), Nutritional Status, Oral Ulcer complications, Oral Ulcer diagnosis, Pain complications, Pain diagnosis, Pain Measurement, Prospective Studies, Quality of Life, Reproducibility of Results, Severity of Illness Index, United States, Young Adult, Graft vs Host Disease diagnosis, Hematologic Diseases complications, Hematopoietic Stem Cell Transplantation adverse effects, Mouth Mucosa physiopathology
Abstract

Oral chronic GVHD (cGVHD) is a common, late complication of alloSCT that is associated with significant patient morbidity. The NIH Oral Mucosal Score (NIH OMS) was developed to assess oral cGVHD therapeutic response, but has not been fully validated. This study's purpose was to conduct a rigorous construct validity and internal consistency analysis of this score and its components (erythema, lichenoid, ulcers, mucoceles) using established measures of oral pain, oral function, oral-related quality-of-life, nutrition and laboratory parameters in 198 patients with cGVHD. The construct validity of the NIH OMS was supported: a moderate correlation was observed between NIH OMS and mouth pain (rho=0.43), while a weaker correlation was observed with low albumin (rho=-0.26). Total NIH OMS, erythema and lichenoid components were associated with malnutrition, oral pain and impaired oral QOL, while ulcers were only associated with oral pain. No associations were found between mucoceles and any indicator evaluated, including salivary function or xerostomia. Kappa determined between scale components was low overall (all 0.35), supporting a conclusion that each component measures a distinct manifestation of oral cGVHD. This study supports the use of the NIH OMS and its components (erythema, lichenoid and ulcerations) to measure clinician-reported severity of oral cGVHD.

Published
2014
Full Text
View/download PDF

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