scholarly journals 1057 Outcome Reporting Following Rectopexy Requires Standardisation for Reproducibility and Transparent Outcome Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
H Wa Katolo ◽  
C Fleming ◽  
G Wilkinson ◽  
A Brannigan
Keyword(s):  
Quality Of Life ◽  
Rectal Prolapse ◽  
English Language ◽  
Cleveland Clinic ◽  
Outcome Analysis ◽  
Incontinence Score ◽  
Outcome Reporting ◽  
Randomised Controlled ◽  
The Impact

Abstract Aim Rectopexy is a surgical procedure commonly used to correct rectal prolapse. Several studies have investigated different approaches (abdominal, perineal) and techniques (open, laparoscopic, robotic) in this field however reporting outcomes vary significantly among studies impeding comparison of techniques. We aimed to comprehensively analyse primary outcome reporting methods following rectopexy in published literature. Method A systematic search was performed in keeping with PRISMA guidelines and search protocol registered with PROSPERO. Published databases were searched using the following terms: “rectopexy”, “abdominal rectopexy” and “rectopexy outcomes”. Randomised controlled trials, comparative and non-comparative prospective and retrospective studies published between 1992 and 2019 were included for analysis. Review articles, letters, editorials, abstracts, and non-English language studies were excluded. A narrative description of outcomes was reported. Results A total of 1089 articles were screened, and 32 articles were identified as suitable for inclusion, reporting on 1780 patients who underwent rectopexy surgery. Over 30 unique methods of reporting outcomes were recorded, with the most common being the rate of recurrence (n = 15), Cleveland Clinic Faecal Incontinence score (CCIS) (n = 11), and customised symptom questionnaires (n = 10). Many studies recognised the impact of symptoms of rectal prolapse on patients’ quality of life (QoL) however, few utilised standardised quality of life scores to evaluate the outcome of the procedures. Conclusions As surgical technique evolves in rectopexy, incorporating minimally invasive surgery and robotic surgery, it is important that outcome reporting is standardised to facilitate transparent comparison. Improving patient QoL is the mainstay of surgical intervention and it is important that QoL outcome measures are incorporated.

Transcutaneous tibial nerve stimulation for the treatment of faecal incontinence: results of a prospective study

2014 ◽  
Vol 21 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Ieva Stundienė ◽  
Paulius Žeromskas ◽  
Jonas Valantinas
Keyword(s):  
Quality Of Life ◽  
Prospective Study ◽  
Faecal Incontinence ◽  
Nerve Stimulation ◽  
Tibial Nerve ◽  
Cleveland Clinic ◽  
Life Questionnaire ◽  
Incontinence Score ◽  
Tibial Nerve Stimulation

Background. Transcutaneous tibial nerve stimulation is a simple, non-invasive treatment, which can be used to treat faecal incontinence. Optimal treatment regimen is not known and various stimulation regimens are used in different centers. The aim of this prospective study was to evaluate the efficacy of twice weekly transcutaneous tibial nerve stimulation for faecal incontinence patients, who have failed to respond to maximal conservative treatment. Material and methods. Twenty patients with faecal incontinence resistant to maximal conservative therapy were treated with transcutaneous posterior tibial nerve stimulation twice a week for six weeks. The number of the bowel movements per two weeks and the Cleveland Clinic Florida Feacal Incontinence Score were assessed before and after the treatment. The quality of life was estimated using the Faecal Incontinence Quality of Life questionnaire and the Gastrointestinal Quality of Life Index. Results. Effect was seen in 55% of patients. Two-week faecal incontinence episodes decreased from median 4  (2–84) to 2  (0–56) (p = 0.002). The mean Cleveland Clinic Florida Faecal Incontinence score improved from 10.9 ± 4.34 to 7.8 ± 3.96 (p = 0.002). The quality of life improved significantly after the treatment. The therapy was well tolerated and no participant experienced any adverse event. Conclusions. Transcutaneous tibial nerve stimulation twice a week for 6 weeks may be efficacious in patients with faecal incontinence, who have failed to respond to maximal conservative treatments.

The impact of physical activity on fatigue and quality of life in lung cancer patients: A randomised controlled trial (RCT).

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 9507-9507 ◽  
Author(s):  
Janette L. Vardy ◽  
Melanie Bell ◽  
Hidde van der Ploeg ◽  
Jane Turner ◽  
Michael Kabourakis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Lung Cancer ◽  
Randomised Controlled Trial ◽  
Cancer Patients ◽  
Controlled Trial ◽  
Lung Cancer Patients ◽  
Randomised Controlled ◽  
The Impact

scholarly journals Responsiveness and convergent validity of QLU-C10D and EQ-5D-3L in assessing short-term quality of life following esophagectomy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Norma B. Bulamu ◽  
Ravi Vissapragada ◽  
Gang Chen ◽  
Julie Ratcliffe ◽  
Louise A. Mudge ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Convergent Validity ◽  
Controlled Trial ◽  
Short Term ◽  
Clinical Trial Registry ◽  
Emotional Function ◽  
Ceiling Effects ◽  
Randomised Controlled ◽  
The Impact

Abstract Aim This study assessed the responsiveness and convergent validity of two preference-based measures; the newly developed cancer-specific EORTC Quality of Life Utility Measure-Core 10 dimensions (QLU-C10D) relative to the generic three-level version of the EuroQol 5 dimensions (EQ-5D-3L) in evaluating short-term health related quality of life (HRQoL) outcomes after esophagectomy. Methods Participants were enrolled in a multicentre randomised controlled trial to determine the impact of preoperative and postoperative immunonutrition versus standard nutrition in patients with esophageal cancer. HRQoL was assessed seven days before and 42 days after esophagectomy. Standardized Response Mean and Effect Size were calculated to assess responsiveness. Ceiling effects for each dimension were calculated as the proportion of the best level responses for that dimension at follow-up/post-operatively. Convergent validity was assessed using Spearman’s correlation and the level of agreement was explored using Bland–Altman plots. Results Data from 164 respondents (mean age: 63 years, 81% male) were analysed. HRQoL significantly reduced on both measures with large effect sizes (> 0.80), and a greater mean difference (0.29 compared to 0.16) on QLU-C10D. Both measures had ceiling effects (> 15%) on all dimensions at baseline. Following esophagectomy, ceiling effects were observed with self-care (86%), mobility (67%), anxiety/depression (55%) and pain/discomfort (19%) dimensions on EQ-5D-3L. For QLU-C10D ceiling effects were observed with emotional function (53%), physical function (16%), nausea (35%), sleep (31%), bowel problems (21%) and pain (20%). A strong correlation (r = 0.71) was observed between EQ-5D-3L anxiety and QLU-C10D emotional function dimensions. Good agreement (3.7% observations outside the limits of agreement) was observed between the utility scores. Conclusion The QLU-C10D is comparable to the more widely applied generic EQ-5D-3L, however, QLU-C10D was more sensitive to short-term utility changes following esophagectomy. Cognisant of requirements by policy makers to apply generic utility measures in cost effectiveness studies, the disease-specific QLU-C10D should be used alongside the generic measures like EQ-5D-3L. Trial registration: The trial was registered with the Australian New Zealand Clinical Trial Registry (ACTRN12611000178943) on the 15th of February 2011.

scholarly journals Meditation as an Adjunct to the Management of Multiple Sclerosis

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Adam B. Levin ◽  
Emily J. Hadgkiss ◽  
Tracey J. Weiland ◽  
George A. Jelinek
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Current Literature ◽  
Selection Criteria ◽  
English Language ◽  
Disease Course ◽  
Positive Effects ◽  
Primary Literature ◽  
Randomised Controlled

Background. Multiple sclerosis (MS) disease course is known to be adversely affected by several factors including stress. A proposed mechanism for decreasing stress and therefore decreasing MS morbidity and improving quality of life is meditation. This review aims to critically analyse the current literature regarding meditation and MS.Methods. Four major databases were used to search for English language papers published before March 2014 with the terms MS, multiple sclerosis, meditation, and mindfulness.Results. 12 pieces of primary literature fitting the selection criteria were selected: two were randomised controlled studies, four were cohort studies, and six were surveys. The current literature varies in quality; however common positive effects of meditation include improved quality of life (QOL) and improved coping skills.Conclusion. All studies suggest possible benefit to the use of meditation as an adjunct to the management of multiple sclerosis. Additional rigorous clinical trials are required to validate the existing findings and determine if meditation has an impact on disease course over time.

scholarly journals Clinical Outcome after Resection Rectopexy in patients with Constipation and Rectal Prolapse

2021 ◽  
Author(s):  
Adisa Poljo ◽  
Bettina Klugsberger ◽  
Günther Klimbacher ◽  
Wolfgang Schimetta ◽  
Andreas Shamiyeh
Keyword(s):  
Quality Of Life ◽  
Rectal Prolapse ◽  
Laparoscopic Resection ◽  
Cleveland Clinic ◽  
Outlet Obstruction ◽  
Resection Rectopexy ◽  
Laparoscopic Resection Rectopexy ◽  
Gastrointestinal Quality Of Life ◽  
Giqli Score

Abstract Purpose Laparoscopic resection rectopexy (LRR) is an established procedure for the treatment of rectal prolapse. This study evaluated constipation and gastrointestinal quality of life in patients before and after LRR for rectal prolapse. Methods 30 patients (24 females, 6 males) underwent laparoscopic anterior (n = 14), posterior (n = 8) and suture resection rectopexy (n = 8) for rectal prolapse during 2010–2020. 25 were retrospectively evaluated for constipation and gastrointestinal quality of life using validated Cleveland Clinic Constipation Score (CCCS) and Gastrointestinal Quality of Life Index (GIQLI). Results Constipation score was significantly reduced from median 16.0 ± 6.4 to 6.0 ± 4.7 after 68.0 ± 42.8 months (p < 0.001). Constipation was improved in 20 patients (80.0%), unaltered in 2 patients and worse in 3 patients. Prior abdominal surgeries were associated with less improvement for constipation (p < 0,05). Significant improvement in GIQLI score was observed, with median total GIQLI score increasing from 95.0 ± 14.8 to 124.0 ± 18.2 (p < 0.001). Quality of life improved in 21 patients (84.0%). Positive changes were also observed in GIQLI subgroups of gastrointestinal symptoms, emotions, physical status, social dysfunction and effects of medical treatment (p < 0.001). There was no difference in outcome between the three procedures. Conclusion Laparoscopic resection rectopexy for rectal prolapse is safe, feasible, and very effective regarding both perioperative results and long-term functional outcome. Our results suggest that LRR significantly improves constipation in patients with outlet obstruction and clearly contributes to a higher quality of life.

scholarly journals The Impact of Peripheral Cooling on Chemotherapy-Induced Peripheral Neuropathy: An Integrative Review

2020 ◽  
Vol 11 (8) ◽  
Author(s):  
Bethany G. Sphar, MSN, APRN, FNP-C, AOCNP ◽  
Christi Bowe, DNP, APRN, ANP-C, NPD-BC, CPHQ ◽  
Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP
Keyword(s):  
Quality Of Life ◽  
Peripheral Neuropathy ◽  
Potential Benefit ◽  
English Language ◽  
Direct Application ◽  
Integrative Review ◽  
Protective Effects ◽  
Exclusion Criteria ◽  
The Impact

Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent, potentially long-lasting side effect of select chemotherapies. It contributes to suboptimal chemotherapy dosing, and its symptoms negatively impact patients’ quality of life. To date, interventions to effectively prevent this toxicity have not been established, and interventions to treat CIPN have produced only modest results. The purpose of this integrative review is to examine the impact of regional cooling applied to distal extremities on the severity of CIPN. A literature review was performed using SCOPUS and PubMed databases. The search was not restricted by date but was restricted to English language. Forty-two articles were identified in the search, and six were included in the review after applying inclusion and exclusion criteria. Results related to protective effects from peripheral cooling against CIPN were variable. Four out of six studies demonstrated benefit of peripheral cooling in reducing the severity of CIPN. There was evidence to suggest that applying a relatively greater degree of cooling compared with a lesser degree may confer benefit in reducing the severity of CIPN. Both direct application of cooling and use of compression to achieve fingertip cooling showed potential benefit.

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