***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In spite of the high prevalence of tuberculosis worldwide , there are few studies on its psychiatric complications . The mental state of 53 patients with pulmonary tuberculosis seen in a Nigerian chest clinic was examined using the 30-item General Health Question naire ( GHQ-30 ) , the Present State Examination ( PSE ) , and a clinical evaluation based on the International Classification of Disease , tenth edition ( ICD-10 ) . Results were compared with two comparison groups : ( 1 ) a group of 20 long-stay orthopedic patients with lower limb fractures ; and ( 2 ) a group of 20 apparently healthy controls . The sociodemographic characteristics of the groups were also compared . A significantly higher prevalence of psychiatric disorders was found in the tuberculosis group ( 30.2 % ) than in the orthopedic group ( 15 % ) and the apparently healthy controls ( 5 % ) . The types of psychiatric disorders encountered included mild depressive episode , generalized anxiety disorder , and adjustment disorder ( ICD-10 ) . Psychiatric morbidity was higher in tuberculosis patients with low educational attainment , and did not show a statistically significant relationship with other sociodemographic parameters . Ways of improving the mental health of tuberculosis patients are discussed BACKGROUND AND OBJECTIVE The objective of this study was to develop a specific instrument for measuring health-related quality of life ( HRQL ) in patients receiving home mechanical ventilation ( HMV ) .  METHODS The Severe Respiratory Insufficiency ( SRI ) Question naire was developed and tested for its psychometric properties following a multicentric clinical trial including 226 patients receiving HMV ( mean age 57.3+/-14.0 years ) . RESULTS Forty-nine items passed the selection process and were allocated to seven subscales : Respiratory Complaints , Physical Functioning , Attendant Symptoms and Sleep , Social Relationships , Anxiety , Psychologic Well-Being , and Social Functioning . Cronbach 's alpha was > 0.7 in all subscales and > 0.8 in four subscales indicating high internal consistency reliability . Construct validity was confirmed by factor analysis , indicating one summary scale that accounts for 59.8 % of the variance . Concurrent validity was confirmed by correlating subscales of the SRI and the SF-36 ( 0.21<r<0.79 ) . Item-scale correlations revealed a high item discriminant validity . In addition , different diagnostic groups could be discriminated by the SRI . Here , the overall best HRQL was measured in the following order : patients with kyphoscoliosis , miscellaneous disorders , neuromuscular diseases , post-tuberculosis , and chronic obstructive pulmonary disease ( P<.05 ) . CONCLUSION The SRI is a new multidimensional instrument with high psychometric properties design ed to measure specific HRQL in patients with SRI receiving HMV SETTING Tuberculosis treatment clinic in Papua , Indonesia . OBJECTIVE To document the impact of pulmonary tuberculosis ( PTB ) on lung function , exercise tolerance and quality of life ( QOL ) . DESIGN A prospect i ve cohort study of 115 patients with smear-positive PTB followed for 6 months . Demographics , disease history , sputum microbiology , spirometry  ,  6-minute weight.walk distance ( 6MWWD ) and  QOL ( modified St George 's Respiratory Question naire ) were measured at diagnosis and at 2 and 6 months . Analysis was restricted to the 69/115 ( 60 % ) subjects who attended all follow-up visits . RESULTS Subjects who attended all visits were less likely than the full cohort to be of Papuan ethnicity ( P < 0.05 ) , were more likely to be cured ( P < 0.001 ) and had better lung function at diagnosis ( P < 0.05 ) . Significant lung function impairment ( forced expiratory volume in 1 second [ FEV(1 ) ] < 60 % predicted ) was found in 27/69 ( 39 % ) at diagnosis . Although this fell during treatment ( P < 0.01 ) , 17/69 ( 24.6 % ) had persisting significant lung function impairment at treatment completion . As lung function recovered , exercise tolerance ( 6MWWD ) rose by 12.3 % ( P < 0.001 ) and QOL improved ( P < 0.001 ) . CONCLUSION In a high-burden setting , PTB causes prolonged , significant impairment of lung function , exercise tolerance and QOL . Current measures of disease burden are likely to underestimate the true impact of disease . Earlier diagnosis and disease-modifying treatments may reduce the long-term impact of PTB OBJECTIVES To evaluate the effects of antituberculosis treatment on the voice quality of laryngeal tuberculosis patients , measured by patient self- assessment , perceptual analysis and acoustic analysis . MATERIAL S AND METHODS A total of 14 laryngeal tuberculosis patients were enrolled . Laryngeal tuberculosis was established either by biopsy and histopathological examination or by rapid regression of the laryngeal lesions after antituberculosis medication . Before and after treatment , all patients were evaluated perceptually ( on a scale of zero to three ) , and 12 assessed their own voices using the voice h and icap index-10 scale . Acoustic analysis was performed to allow objective evaluation . RESULTS Patients ' ages ranged from 21 to 72 years ( mean , 41 ) . The male to female ratio was 12:2 . Eight patients ( 57 per cent ) had tuberculous involvement of the epiglottis , four ( 28 per cent ) had involvement of the aryepiglottic fold and eight ( 57 per cent ) had involvement of the false vocal folds . The glottis was the less commonly involved part of the larynx , including true vocal folds ( 28 per cent , n = 4 ) and posterior commissure ( 14 per cent , n = 2 ) . Perceptual evaluation , on a scale of zero to three , gave the patients a median score of six ; after commencement of treatment , the median score decreased to two . The mean voice h and icap index-10 score decreased from 24 to 12 after treatment . An obvious improvement in acoustic analytical parameters was also found following treatment . CONCLUSIONS Antituberculosis treatment clearly improved the voice outcomes of laryngeal tuberculosis patients , according to self- assessment , perceptual analysis and acoustic analysis OBJECTIVE To assess the impact of tuberculosis ( TB ) and its treatment on patients ' health status . METHODS Question naires were administered prospect ively to patients at three clinics in London at diagnosis and 2 months into therapy . We assessed generic health-related quality of life ( Short Form 36 [ SF-36 ] and EQ-5D ) and psychological burden ( State-Trait Anxiety Short-Form , Center for Epidemiologic Studies Depression Scale , worry items ) . RESULTS Of the 61 participants ( response rate 94 % ) , 89 % were non-UK born , 67 % had pulmonary TB and 38 % were aged 30 - 45 years . At diagnosis , scores for all eight SF-36 dimensions were significantly worse than UK general population norm scores . At follow-up , scores had improved significantly ( P < 0.01 ) , except for physical functioning and general health perception , but remained below the UK norm , except for vitality and mental health . Respondents ' mean anxiety and depression scores were high at diagnosis ( 48 and 22 , respectively ) , and anxiety scores remained high at follow-up . Worries most frequently reported concerned patients ' own health ( 92 % ) and that of their family ( 82 % ) . CONCLUSIONS TB patients suffer from significantly diminished health-related quality of life at diagnosis . Although treatment significantly improved patients ' health status within 2 months , scores for many domains remain below UK norm scores . This emphasises the importance of a holistic approach to care and should inform the evaluation of future interventions Objectives Non-invasive positive pressure ventilation ( NPPV ) improves health-related quality of life ( HRQL ) in patients with chronic alveolar hypoventilation ( CAH ) . We studied the prognostic impact of HRQL on survival in relation to clinical factors . Patients Forty-four patients with CAH due to post-polio ( 12 ) , scoliosis ( 11 ) , post-tb ( 17 ) or other diagnoses ( 4 ) who received nocturnal NPPV  were prospect ively studied during 6–10 years . Measurements Blood gases and HRQL were analysed at baseline and after 9 months and after 8 years . HRQL was evaluated with measures of functioning ( SIP ) , emotional well-being ( HADS and MACL ) , and global QL . Results Blood gases and HRQL measures improved during NPPV . The overall 5-year survival rate was 73 % . In multivariate survival analysis , a diagnosis of post-polio and low baseline SIP physical index scores , indicating low levels of physical dysfunction , predicted longer survival ( P = 0.02 , respectively ) . Similarly , palliation of physical dysfunction and preserved or improved global QL by 9 months were associated with longer overall survival ( P = 0.009 and P = 0.001 , respectively ; multivariate Cox regression ) . ConclusionS eventy-three percent of patients treated for CAH with NPPV survived more than 5 years . Diagnosis and self-rated physical functioning at pre-treatment were related to survival , as were major improvements in physical functioning and global QL during NPPV BACKGROUND The Medical Outcomes Study 36-item Short Form ( SF-36 ) is a widely used measure of health-related quality of life . Normative data are the key to determining whether a group or an individual scores above or below the average for their country , age or sex . Published norms for the SF-36 exist for other countries but have not been previously published for Canada . METHODS The Canadian Multicentre Osteoporosis Study is a prospect i ve cohort study involving 9423 r and omly selected Canadian men and women aged 25 years or more living in the community . The sample was drawn within a 50-km radius of 9 Canadian cities , and the information collected included the SF-36 as a measure of health-related quality of life . This provided a unique opportunity to develop age- and sex-adjusted normative data for the Canadian population . RESULTS Canadian men scored substantially higher than women on all 8 domains and the 2 summary component scales of the SF-36 . Canadians scored higher than their US counterparts on all SF-36 domains and both summary component scales and scored higher than their UK counterparts on 4 domains , although many of the differences are not large . INTERPRETATION The differences in the SF-36 scores between age groups , sexes and countries confirm that these Canadian norms are necessary for comparative purpose s. The data will be useful for assessing the health status of the general population and of patient population s , and the effect of interventions on health-related quality of life A prospect i ve study was conducted on 90 patients of tuberculosis at 2 directly observed treatment short course ( DOTS ) cum microscopy centers in an urban area of Delhi . The WHOQOL-BREF ( Hindi ) question naire was used to assess the QOL at the onset of treatment , after 3 months of treatment under DOTS , and at completion of treatment . Patients with tuberculosis had significantly lower mean scores than controls  for overall QOL . The most affected domains were physical and psychological . Women scored significantly better than men in the physical and environmental domains . Overall QOL scores were lowest for category II and significantly lower for the psychological and social domains . The mean scores after treatment were significantly lower than controls for overall QOL , the social and environmental domains . The DOTS regimen improves the QOL and its domains ; however , they remain significantly affected compared to the healthy 
    Output:
    
Within individual studies and in meta-analyses , subjects with active TB disease consistently reported worse HRQOL than concurrently evaluated subjects treated for LTBI .
However , meaningful improvements in HRQOL throughout active TB treatment were reported by longitudinal studies .
Conclusions In a variety of studies , in different setting s and using different instruments , subjects with active TB consistently reported poorer HRQOL than persons treated for LTBI .