SP3.1.8 What happens to patients with acutely symptomatic hernia in the UK? Findings from the MASH study

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Victoria Proctor ◽  
MASH Steering Group ◽  
MASH Collaborators
Keyword(s):  
Quality Of Life ◽  
Elective Surgery ◽  
Management Strategies ◽  
Hernia Surgery ◽  
Phone Calls ◽  
Risk Patients ◽  
Hospital Morbidity ◽  
The Uk

Abstract Aims Acutely symptomatic abdominal wall and groin hernias (ASH) are a common reason for acute surgical admissions in the UK. There is limited data to guide the treatment of such presentations. This study aimed to assess outcomes of emergency hernia surgery, and identify common management strategies, to improve care for these high risk patients. Methods A 12 week, UK-based, multi-centre, collaborative, prospective cohort study (NCT04197271) recruited adults with ASH. Data on investigations, specific surgical intervention, in-hospital morbidity and mortality, and quality of life was measured. 30 and 90-day follow-up phone calls collected complications and quality of life. Descriptive analyses were performed to describe population and outcomes. Results Twenty-three acute Trusts recruited 264 patients. Inguinal (37.9%) and umbilical (37.1%) were the most common hernia locations. 17% were awaiting elective surgery and 17% had been previously declined intervention. CT was performed in 47%. 82% of patients had surgery within 48 hours, with 95% of procedures performed open and 93% under general anaesthesia. 3/11 laparoscopic procedures were converted to open. Mesh was used in 55%, this was typically synthetic non-absorbable (86%). Complications were infrequent; 2% developed pneumonia or delirium. Surgical site infection occurred in 3% and mortality was 1.2%. Quality of life improved between baseline and 30-days following repair. Conclusions There is variation in the management of ASH in the UK, particularly with repair techniques, use of mesh and laparoscopy. One in five patients was awaiting repair; this might indicate a need for expedited pathways and reprioritising of elective hernia repair.

scholarly journals O35 WHAT HAPPENS TO PATIENTS WITH ACUTELY SYMPTOMATIC HERNIA IN THE UK? FINDINGS FROM THE MASH STUDY

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Victoria Proctor ◽  
Olivia Spence ◽  
Flora Burns ◽  
Susanna Green ◽  
Adele Sayers ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Abdominal Wall ◽  
Surgical Management ◽  
Large Scale ◽  
Elective Surgery ◽  
Hernia Surgery ◽  
Phone Calls ◽  
The Uk ◽  
Groin Hernias

Abstract Aim Acutely symptomatic abdominal wall and groin hernias (ASH) are a common reason for acute surgical admissions in the UK. There is limited data to guide the treatment of such presentations. This study aimed to assess outcomes of emergency hernia surgery, and identify common management strategies, to improve care for these high-risk patients. Material and Methods A 12 week, UK-based, multi-centre, collaborative, prospective cohort study (NCT04197271) recruited adults with ASH. Data on patient characteristics, inpatient management, quality of life, complications and wound healing was collected. 30 and 90-day follow-up phone calls assessed complications and quality of life. Descriptive analyses were performed to describe population and outcomes. Results Twenty-three acute Trusts recruited 268 patients. Inguinal (37.7%) and umbilical (37.7%) were the most common hernia locations. 13.4% were awaiting elective surgery and 13.1% had been previously declined intervention. CT was performed in 48%. 82% underwent surgical management with open repair (94%) under general anaesthesia (93%) being most common. 4/11 laparoscopic procedures were converted to open. 55% of repairs used mesh, typically synthetic non-absorbable (87%). Complications were infrequent with surgical site infection (9.4%), delirium (3.2%) and pneumonia (2.3%) being most common. Mortality was 1.5%. Immediate surgical management was associated with significant improvement in quality of life at 30 days. Conclusions There is variation in the investigation, management and surgical strategy to treat acutely symptomatic abdominal wall and groin hernias in the UK. Further large-scale work is needed to establish the optimal management strategy for specific acute presentations given the wide variation at present.

1271 The Management of Acutely Symptomatic Hernia (MASH): A UK Wide Prospective Cohort Study

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
F A Burns ◽  
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Elective Surgery ◽  
Suture Repair ◽  
Phone Calls ◽  
Absorbable Sutures ◽  
The Uk

Abstract Introduction Acutely symptomatic abdominal wall and groin hernias (ASH) are a common presentation, accounting for approximately 25% of acute surgical admissions in the UK. There is limited data to guide the treatment of such presentations. This study aimed to assess outcomes of emergency hernia surgery, and identify common management strategies, to improve care for these high-risk patients. Method A 12 week, UK-based, multi-centre, collaborative, prospective cohort study (NCT04197271) recruited adults with ASH. Data on inpatient management, specific surgical intervention, in-hospital morbidity and mortality and quality of life (EQ-5D-5L) was measured. 30 and 90-day follow-up phone calls collected complications and quality of life. Descriptive analyses were performed to describe population and outcomes. Results Twenty-three acute trusts recruited 264 patients. Inguinal (37.9%) and umbilical (37.1%) hernias were most common. 17% were awaiting elective surgery and 17% had been previously declined intervention. 46% were incarcerated at presentation, and 31% symptomatic (painful/irreducible). 82% of patients had operations within 48 hours, with 95% performed open. Mesh was used in 55%, the majority (86%) being synthetic non-absorbable. Sutures used for suture repair varied widely. Complications were infrequent; 2% developed pneumonia or delirium. Surgical site infection occurred in 3% and mortality was 1.2%. Quality of life improved between baseline and 30-days following repair. Conclusions There is variation in the management of ASH in the UK, particularly with repair techniques, use of mesh and laparoscopy. One in five patients was awaiting repair; this might indicate a need for expedited pathways and reprioritising elective hernia repair.

scholarly journals Surgical repair of aortic coarctation in adults: half a century of a single centre clinical experience

2019 ◽  
Vol 56 (6) ◽  
pp. 1178-1185 ◽  
Author(s):  
Djamila Abjigitova ◽  
Mostafa M Mokhles ◽  
Maarten Witsenburg ◽  
Pieter C van de Woestijne ◽  
Jos A Bekkers ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Repair ◽  
Coarctation Of The Aorta ◽  
Surgical Reconstruction ◽  
Refractory Hypertension ◽  
Tertiary Referral Centre ◽  
Related Quality ◽  
Hospital Morbidity

Abstract OBJECTIVES Coarctation of the aorta (CoA) is rarely diagnosed and treated in adults and nowadays mostly treated with percutaneous techniques. The objective of this study is to report the long-term outcomes and health-related quality of life in a unique cohort of patients treated with an open surgical repair for their primary adult CoA. METHODS Ninety adult patients underwent primary surgical repair of CoA at our tertiary referral centre between 1961 and 2008 when the treatment strategy for adult CoA was exclusively surgical. RESULTS The median age at surgery was 24 years (interquartile range 20–36 years), and 39 patients (43%) were asymptomatic at presentation. CoA was located paraductally in most patients (64%), and bicuspid aortic valve was present in 39 (43%) patients. Surgical reconstruction of CoA with an end-to-end anastomosis was performed in majority of the patients (57%). Overall, in-hospital mortality occurred in 1 patient (1%). There was no in-hospital stroke, spinal cord ischaemia, renal replacement therapy or respiratory failure. The cumulative survival was 97.7%, 89.5%, 82.6%, 70.9% and 61.4% at 10, 20, 30, 40 and 50 years, respectively. Thirty-one patients (34%) required an additional cardiac surgery during follow-up. The majority of patients (77%) suffered from refractory hypertension even after decades of surgery. Compared with the matched Dutch population, patients reported a lower social functioning, mental health, vitality and general health with a higher body pain. CONCLUSIONS Patients with native adult CoA have low in-hospital morbidity and mortality when treated with an open surgical reconstruction. However, refractory hypertension and impaired quality of life remain important challenges during follow-up.

UK trial of the Osseointegrated Prosthesis for the Rehabilitation for Amputees: 1995–2018

2018 ◽  
Vol 43 (1) ◽  
pp. 112-122 ◽  
Author(s):  
Douglas John Matthews ◽  
Mateen Arastu ◽  
Maggie Uden ◽  
John Paul Sullivan ◽  
Kristina Bolsakova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Deep Infection ◽  
Outcome Data ◽  
Superficial Infection ◽  
Kaplan Meier ◽  
The Uk ◽  
Implant System

Background: Amputation of a limb impacts on patients’ self-perception and quality of life. Prostheses directly anchored to the skeleton are being investigated, aiming to avoid soft tissue complications. Objectives: We report outcome data for the UK trial of the Osseointegrated Prosthesis for the Rehabilitation of Amputees Implant System with a minimum of 9-year follow-up. Methods: Eighteen transfemoral amputees received unilateral implants between 1997 and 2008. Five were implanted before a formalised protocol, called Osseointegrated Prosthesis for the Rehabilitation of Amputees, was developed. Mean follow-up of the Pre-Osseointegrated Prosthesis for the Rehabilitation of Amputees group is 11.4 years (1.8–18.6 years), while for the Post-Osseointegrated Prosthesis for the Rehabilitation of Amputees group it is 12.3 years (2.9–15.9). Results: The Kaplan–Meier cumulative survivorship is 40% for the Pre-Osseointegrated Prosthesis for the Rehabilitation of Amputees group and 80.21% for the Post-Osseointegrated Prosthesis for the Rehabilitation of Amputees group. Five implants (28%) have been removed, three (17%) for deep infection, one (5.6%) for chronic pain, later proven to be infected and one (5.6%) due to implant fracture secondary to loosening due to infection. Two patients (11%) have peri-implant infections suppressed with oral antibiotics. Eleven cases (61%) of superficial infection were successfully treated with antibiotics. 36-Item short-form health survey and Questionnaire for persons with a Transfemoral Amputation showed significant improvements in quality of life up to 5 years after implantation. Conclusion: This small cohort of patients demonstrates osseointegrated prosthesis allows prolonged usage and improves patients’ quality of life compared to conventional prostheses. Clinical relevance These prostheses may provide a future gold standard for amputees and this study provides the first outcome data over such a time period to be reported from outside of the developers group.

Abstract 2983: Sex Differences in Quality of Life and Health Status in the COURAGE Trial

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Paul Kolm ◽  
William E Boden ◽  
John A Spertus ◽  
David J Maron ◽  
Robert O’Rourke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sex Differences ◽  
Health Status ◽  
Physical Functioning ◽  
Drug Evaluation ◽  
Management Strategies ◽  
Coronary Intervention ◽  
Percutaneous Coronary

Purpose: The Clinical Outcomes Utilizing Revascularization and Aggressive DruG Evaluation (COURAGE) trial randomized 2,287 patients to percutaneous coronary intervention (PCI) plus optimal medical treatment (OMT) or OMT alone. The purpose of this study was to assess sex differences in quality of life (QOL) and health status between randomized initial management strategies over the trial follow-up period. Methods: Of the 2,287 patients, 979 males and 169 females were randomized to PCI, and 968 males and 169 females were randomized to OMT. Quality of life was assessed with the Seattle Angina Questionnaire (SAQ) and health status with the RAND-36 at baseline, 1, 3, 6, 12 months and annually thereafter. SAQ and RAND-36 scores were assessed by analysis of variance (ANOVA), and linear mixed effects models. Results: There were no significant sex by treatment group interactions indicating PCI vs. OMT differences were similar for the 1,947 men (85%) and 338 women (15%). Men had significantly higher SAQ Physical Functioning scores at baseline and 1 month post-treatment (p < 0.004) and a trend of higher means thereafter (Figure 1A ) and significantly higher RAND-36 Physical Functioning scores over 3 years of follow-up (p < 0.001, Figure 1B ). Men also had significantly higher RAND-36 Energy/Fatigue means scores (p < 0.05, Figure 1C ). RAND-36 scores for the other domains were similar fbetween the two groups (Figure 1D ). Conclusions: Men and women in both arms experienced improvement in quality of life and health status over time. Men had significantly higher physical functioning as well as energy/fatigue scores, but were similar to women in other quality of life and health status domains.

Abstract TP378: Long Term Follow Up Telephone Evaluation of Post Stroke Quality of Life is Feasible and Effective

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Renata Miranda ◽  
Carla Ledo ◽  
Daisa Escobosa ◽  
Caren Cristina Giannotti Bizutti ◽  
Amanda Ruiz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Data Collection ◽  
Clinical Outcomes ◽  
Stroke Recurrence ◽  
Post Discharge ◽  
Phone Calls ◽  
Long Term Follow Up

Background: The long-term follow-up of clinical outcomes in patients admitted with acute stroke can identify relevant clinical data in the prevention of stroke recurrence as well as measure the quality of life of such patients. Follow-up after discharge in hospitals without stroke clinics can be a challenge. Therefore we created in our hospital an outcomes measurement nuclei characterized as a data collection center, with the main objective of periodically measuring clinical outcomes and quality of life of patients after hospital discharge.This sector works together with the different clinical specialties in providing information with a focus on outcome indicators, using questionnaires to estimate the parameters of evaluation of health states.Our objective was to describe data obtained from this data collection center evaluating post-discharge quality of life of patients treated in our stroke center 30, 90, 180 days and 01 years after the diagnosis. Methods: The study was conducted from January 2012 to March 2016, at a tertiary, general, private hospital in São Paulo, Brazil. Phone calls using the EuroQol instrument (EQ-5D) to measure quality of life were performed. The modified Rankin scale and a structured questionnaire to identify stroke recurrence, readmissions and medication failures were also applied. Results: We conducted 2184 telephone calls and obtained 1727 (79%) successful contacts. The mean EQ-5D at 30 days was: 0.732 +/-0.558; at 90 days: 0.722 +/- 0.358; at 180 Days: 0.781 +/- 0.326; and at 12 months 0.766 +/-0.349. During the follow-up, 31 patients (2%) died. The main reasons for censuring patients were unsuccessful contact after 3 attempts (51%); outdated registration data (3%) and refusals (9%). Conclusion: In conclusion, monitoring of standardized clinical outcomes after stroke is possible even in private non academic hospitals, allowing the acquisition of quality of care indicators and patient centered outcomes.

Evaluation of Quality Of Life after Cardiac Surgery in High-Risk Patients

2015 ◽  
Vol 17 (6) ◽  
pp. 277 ◽  
Author(s):  
Hanif Tabesh ◽  
Hossein Ahmadi Tafti ◽  
Sara Ameri ◽  
Arash Jalali ◽  
Narges Kashanivahid
Keyword(s):  
Quality Of Life ◽  
Cardiac Surgery ◽  
High Risk ◽  
Short Form ◽  
High Risk Patients ◽  
Sf 36 ◽  
Risk Patients ◽  
Cardiac Operations

<p><b>Background:</b> Conventionally, there is controversy over subjecting high-risk patients to cardiac operations, due to major postoperative complications. Higher survival rates and less morbidity as well as better quality of life can be good predictors of the outcome of surgery. This study evaluates the quality of life before and 12 months after cardiac operations on high-risk patients.</p><p><b>Methods:</b> In this study, the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was used to separate high-risk patients from others. The quality of life was assessed using the Medical Outcomes Study 36-item Short Form Health Survey (SF-36) before surgery and one year afterward. Based on SF-36, the score for each of the eight different dimensions of the quality of life was quantified; and, their differences between pre-surgery and post-follow up period were analyzed.</p><p><b>Results:</b> 126 high-risk patients were included in this study. The mean age of the patients was 64.29 � 12.35 years. The median of EuroSCORE II score in these cases was 6.83 (6.04-25.98). The results reveal that the majority of the quality of life dimensions, except mental health, improved significantly after the follow-up period.</p><p><b>Conclusion:</b> Cardiac surgery on high-risk patients can noticeably promote the different aspects of their quality of life; although, such improvements should be considered against surgical complications.</p>

scholarly journals Final Results of a Phase 2 Trial of Early Intervention Ibrutinib with Vaccinations in Patients with Asymptomatic, High-Risk CLL

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 1759-1759
Author(s):  
Jennifer Woyach ◽  
Shanmugapriya Thangavadivel ◽  
David Weiss ◽  
Lai Wei ◽  
Eric McLaughlin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Early Intervention ◽  
High Risk ◽  
Research Funding ◽  
Phase 2 ◽  
Complex Karyotype ◽  
Health Related ◽  
Risk Patients

Introduction: The Bruton's Tyrosine Kinase (BTK) inhibitor ibrutinib (IB) is a standard therapy for previously untreated CLL patients. While therapy is currently indicated only for patients with progressive, symptomatic disease, the introduction of targeted therapies in CLL has re-opened the question of whether asymptomatic high risk patients would benefit from early intervention. As well, even in early stages CLL is associated with profound cellular, humoral and innate immune suppression and patients with CLL respond poorly to routine vaccinations. IB has been shown to reverse disease mediated immune dysfunction partly through Th1 skewing. We undertook a phase 2 study of IB in asymptomatic high risk CLL patients who did not otherwise require therapy to evaluate: 1) the safety and efficacy of 2 years of IB in this clinical setting and 2) ability of IB to improve the efficacy of routine vaccines. Methods: This is a single-stage phase II study of IB in previously untreated asymptomatic, genetically high-risk patients with CLL, who did not meet IWCLL treatment criteria. High risk genomics were defined as del(11)(q22.3), del(17)(p13.1), unmutated IGHV, and/or complex karyotype (≥3 cytogenetic abnormalities). Patients were randomized to receive IB 420mg PO daily either concurrent with the pneumococcal (PCV13), influenza and TdaP vaccines (Arm A) or following vaccination (Arm B) for a total of 27 cycles (2 years). The primary objective of the study was to determine the safety and 2-year progression-free survival (PFS) of asymptomatic, high-risk CLL patients treated with IB. Secondary objectives include determination of safety and immune responses to vaccines in relation to IB administration, development of resistance, and quality-of-life (QOL). QOL measures assessed general QOL (SF-12, EORTC), anxiety (GAD-7) and depression (PHQ-9). Results: Forty-four patients (pts; 21 in Arm A, 23 in Arm B) were enrolled from 1/2016 to 6/2017, with a median age of 58 (range 35-82). Sixty-six percent of pts were male and all were high-risk: 91% with unmutated IGHV, 14% with del(17)(p13.1), 34% with del(11)(q22.3), and 24% with complex karyotype (≥ 3 abnormalities). Median follow-up is 2.6 years (range: 0.2-3.2). Excluding 2 patients in Arm B who progressed prior to receipt of IB, 2-year PFS was 92%. From a landmark of 2-years and including 33 patients who reached this point and discontinued IB, 6-month PFS was 87% (95% CI: 69-95%; Figure 1). Of 9 pts who progressed after IB discontinuation, 3 have not required further treatment, 5 restarted IB or acalabrutinib, and 1 started venetoclax/rituximab, and all responded. For PCV13, in Arm A, 15/16 patients showed a significant increase in antibody titer 2 cycles following vaccination, but response disappeared by cycle 12. In Arm B, 3/13 patients had an increase in antibody titer, with no increase following second vaccination. For influenza, patients in Arm B showed a significant response to influenza A vaccination, while patients in both arms responded to influenza B vaccination. IB was generally well tolerated, and only one pt discontinued treatment due to toxicity (atrial fibrillation). Grade 3+ toxicities that occurred in >2% of patients included anemia (7%), atrial fibrillation (11%), dental caries (7%), hyperglycemia (7%), hypertension (43%), and neutropenia (7%). At baseline, patients' reports of physical health-related (M=48.52, SD=7.96) and mental health-related quality of life (M=52.20, SD=8.57) similar to U.S population norms, along with moderately high global health (M=78.49 of 100, SD = 20.51). Additionally, patients' anxiety (M=3.56, SD=4.71) and depressive symptom reports (M=3.65, SD=4.46) were in the "none/mild" range. There was no significant change in the latter measure from baseline to 12 months (p>0.25), excepting anxiety which slightly decreased (M=1.31, SD=2.33; F(3,44)=5.94, p<0.01). Conclusions Early intervention with IB was well tolerated and significantly improved patient disease status. Vaccine response to PCV13 was improved by concurrent ibrutinib, but lost at 12 months, suggesting re-vaccination might be helpful. Quality of life remained good throughout treatment, with improvement in patient anxiety. Extended follow-up will be required to determine how long remissions can be maintained after drug discontinuation in this population. Disclosures Woyach: Verastem: Research Funding; Loxo: Research Funding; Morphosys: Research Funding; Karyopharm: Research Funding; AbbVie: Research Funding; Janssen: Consultancy, Research Funding; Pharmacyclics LLC, an AbbVie Company: Consultancy, Research Funding. Rogers:AbbVie: Research Funding; Acerta Pharma: Consultancy; Genentech: Research Funding; Janssen: Research Funding. Bhat:Pharmacyclics: Consultancy; Janssen: Consultancy. Grever:Acerta Pharma, LLC: Membership on an entity's Board of Directors or advisory committees. Lozanski:Beckman Coulter: Research Funding; Stemline Therapeutics Inc.: Research Funding; Boehringer Ingelheim: Research Funding; Genentec: Research Funding. Byrd:TG Therapeutics: Other: Travel Expenses, Research Funding, Speakers Bureau; Acerta: Research Funding; Novartis: Other: Travel Expenses, Speakers Bureau; Gilead: Other: Travel Expenses, Research Funding, Speakers Bureau; Ohio State University: Patents & Royalties: OSU-2S; Janssen: Consultancy, Other: Travel Expenses, Research Funding, Speakers Bureau; Genentech: Research Funding; BeiGene: Research Funding; Pharmacyclics LLC, an AbbVie Company: Other: Travel Expenses, Research Funding, Speakers Bureau. Awan:Gilead: Consultancy; Sunesis: Consultancy; Pharmacyclics: Consultancy, Research Funding; AstraZeneca: Consultancy, Speakers Bureau; Abbvie: Consultancy, Speakers Bureau; Janssen: Consultancy; Genentech: Consultancy. OffLabel Disclosure: Clinical trial of ibrutinib used in an off-label setting

scholarly journals Quality of life and results of total androgen blockade alone and with radiotherapy in the treatment of nonmetastatic prostate cancer

2012 ◽  
Vol 140 (7-8) ◽  
pp. 462-468
Author(s):  
Lela Milovanovic ◽  
Blagoje Milovanovic
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Metabolic Syndrome ◽  
High Risk ◽  
Fatal Outcome ◽  
High Risk Patients ◽  
Risk Patients ◽  
Androgen Blockade

Introduction. Hormonal treatment of prostate cancer (CaP) in the form of total androgen blockade (TAB) with or without radiotherapy is applied in metastatic disease and in patients with nonmetastatic and localized disease as well. Objective. The aim of the study was to compare oncological results, residual and newly developed symptoms during treatment and the quality of life in patients with nonmetastatic CaP treated by using Tand in a group treated both with Tand radiotherapy (RT+TAB). Methods. Retrospective analysis of 126 patients with nonmetastatic CaP was performed. Follow-up was 36 months. Seventynine out of 126 patients were treated with Talone and 47 with Tand radiotherapy (TAB+RT). Overall survival, metabolic syndrome appearance and the frequency of nonmalignant complications during treatment were analyzed. Urinary, digestive and sexual symptoms were analyzed, as well as the overall health condition of the patients. Results. Fatal outcome and/or disease progression occurred in 29 out of 126 patients (23%). High risk patients were significantly more frequent in the TAB+RT group (p=0.04). Mortality rate was not different in both groups indicating that better results of treatment were achieved in patients treated with TAB+RT. Metabolic syndrome appeared in 51.6% of Tpatients and in 51.1 of TAB+RT patients, and was significantly more frequent at the end of the follow-up than at the beginning of the treatment (p=0.003 in Tand p=0.01 in TAB+RT group). Urinary symptoms were more frequent than digestive symptoms in both groups. The quality of life was slightly improved after the beginning of therapy to be followed by the tendency of gradual decrease. Conclusion. Both modalities of treatment were efficient. Therapy TAB+RT was more efficient in high risk patients. Metabolic syndrome was more frequent after a long-term administration of therapy than at the beginning. The quality of life was the most affected in sexually active patients.

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