scholarly journals P-OGC03 Pancreatic enzyme supplementation improves quality of life in patients following surgery for upper GI cancer

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Robert Kay ◽  
Callum Alexander ◽  
Sajid Waheed Rahman ◽  
Chris Deans
Keyword(s):  
Quality Of Life ◽  
Pancreatic Enzyme ◽  
Treatment Quality ◽  
Exocrine Insufficiency ◽  
Abdominal Symptoms ◽  
Patient Reported ◽  
Before And After ◽  
Health Domains ◽  
Enzyme Supplementation

Abstract Background Unpleasant abdominal symptoms are common following surgery for upper gastrointestinal (UGI) cancer and may occur secondary to pancreatic exocrine insufficiency (EPI). This study investigated symptoms of EPI in patients following surgery and assessed the effect of pancreatic enzyme supplementation (PERT) on these symptoms and the effect of supplementation on quality of life. Methods Patients were assessed for symptoms of EPI using a novel questionnaire. Patients who reported two or more symptoms suggestive of EPI were prescribed PERT. Abdominal symptoms were reassessed following treatment. Quality of life (QoL) was studied using the SF-36 questionnaire before and after treatment. Faecal elastase was also measured in a patient subgroup. Results Fifty-six out of 57 patients (98%) reported at least two symptoms of EPI. Following PERT every patient reported fewer abdominal symptoms; median 5 symptoms before treatment reduced to two symptoms following treatment (p < 0.0001; Wilcoxon rank). Reduced faecal elastase concentration was associated with more frequent abdominal symptoms; median 5 symptoms versus 3 symptoms (p = 0.043; Mann Whitney U test). PERT increased quality of life scores for every patient in each of the 5 principle health domains. Conclusions Symptoms of EPI are common among patients following UGI cancer surgery. PERT reduces unpleasant abdominal symptoms and this leads to significant improvements in quality of life across global health domains. PERT should be offered to all post-operative UGI cancer patients with symptoms suggestive of EPI.

scholarly journals Patient-reported Quality of Life Before and After Total Knee Arthroplasty: A Prospective Multicentre Cohort Study

2021 ◽  
Author(s):  
Jinghui Chang ◽  
Manru Fu ◽  
Peihua Cao ◽  
Changhai Ding ◽  
Dong Wang
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Family Income ◽  
Knee Function ◽  
Targeted Interventions ◽  
Patient Reported ◽  
Before And After ◽  
Total Knee

Abstract Background: To identify patients’ self-reported health-related quality of life (HRQoL) before and after total knee arthroplasty (TKA) and determine factors contributing to any heterogeneity in HRQoL. Methods: This prospective multicentre study included 404 patients with knee osteoarthritis who underwent TKA between 1 April and 30 December 2019 and in whom HRQoL was assessed preoperatively and at 7 days and 1, 3, and 6 months postoperatively. Sociodemographic characteristics were assessed using a general information questionnaire; disability, using the Knee Injury and Osteoarthritis Outcome Score; pain, using the visual analogue scale (VAS) score; and HRQoL, using the European Quality of Life Five Dimension Five Level (EQ-5D-5L) score. Potential heterogeneity and factors influencing longitudinal changes in HRQoL were analysed using a growth mixture model.Results: The mean EQ-5D-5L score improved from 0.69 preoperatively to 0.90 at 6 months postoperatively. Two types of longitudinal heterogeneity were identified: (1) a group of patients with a small and slow improvement in HRQoL and (2) a group of patients who showed marked and rapid improvement in HRQoL. The main characteristics of the latter group were a monthly family income >2000 yuan, exercising for approximately 30 min daily, and better knee function at baseline. Baseline knee function and change in knee function were significantly associated with the percentage change in HRQoL.Conclusions: HRQoL improved considerably after TKA. However, there was some heterogeneity in the changes in HRQoL depending on certain patient characteristics. Targeted interventions should focus on these differences to optimise the outcomes of TKA.

scholarly journals Longitudinal prospective evaluation of oral health-related quality of life in young patients undergoing fixed orthodontic appliance treatment as part of a randomised trial

2020 ◽  
Author(s):  
Mustafa Elhussein ◽  
Philip Benson
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Orthodontic Treatment ◽  
Well Being ◽  
Health Related Quality ◽  
Patient Reported ◽  
Before And After ◽  
Related Quality ◽  
Health Related

Abstract Background The objectives of this study were to investigate relationships between change in the aesthetic appearance before and after orthodontic treatment and patient-reported change in oral health-related quality of life (OHRQoL), and to assess the responsiveness of two OHRQoL measures to any changes from orthodontic treatment. Methods Two hundred and ten participants in a multicentre (two teaching hospitals and four specialist orthodontic practices), single blinded, randomised clinical trial with 2 parallel groups, were administered one of two age-specific questionnaires, either the Child Perceptions Questionnaire (CPQ11-14-ISF-16) or the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), before and after orthodontic treatment. Clinical photographs were assessed by two groups of laypeople and orthodontists using the Index of Orthodontic Treatment Need Aesthetic Component (IOTN-AC). Results Two hundred and ten participants were randomised, and 197 completed the trial. Before and after OHRQoL data were successfully obtained from 110 participants. There was a mean reduction in the total CPQ11-14-ISF-16 scores of 3.9 (SD = 8.0), and a mean reduction of 34.2 (SD = 18.5) in the total PIDAQ score. CPQ11-14-ISF-16 demonstrated poor longitudinal construct validity (p = 0.155). Correlations between the change in total CPQ11-14-ISF-16 scores and change in IOTN-AC assessments were small for both orthodontists (r=-0.084; p = 0.516) and laypeople (r=-0.140; p = 0.225). There were higher associations between the improvement in the Social well-being (SWB) subdomain and improvement in IOTN-AC. Correlations between the changes in total PIDAQ scores and the IOTN-AC assessments, were higher in comparison to the correlations with CPQ11-14-ISF-16 (orthodontists; r = 0.223, laypeople; r = 0.025). There were no adverse effects. Conclusion CPQ11-14-ISF-16 and IOTN-AC measure different attributes. This demonstrated the role of SWB on children OHRQoL. Condition-specific measures (PIDAQ) are more responsive to change in self-reported OHRQoL than generic measures (CPQ11-14-ISF-16) after treatment. Trial Registration: The trial was registered at ClinicalTrials.gov NCT01925924.

scholarly journals Improvement but no normalization of quality of life and cognitive functioning after treatment for Cushing’s syndrome

2019 ◽  
Author(s):  
Leonie H A Broersen ◽  
Cornelie D Andela ◽  
Olaf M Dekkers ◽  
Alberto M Pereira ◽  
Nienke R Biermasz
Keyword(s):  
Quality Of Life ◽  
Cognitive Functioning ◽  
Cushing’S Syndrome ◽  
Meta Analysis ◽  
Cushing's Syndrome ◽  
Treatment Quality ◽  
Cross Sectional ◽  
Effective Interventions ◽  
Before And After

Abstract Background Cushing’s syndrome is characterized by glucocorticoid excess, which induces physical and mental symptoms, impairments in functional status and perceived health, resulting in impaired quality of life. Biochemical remission is urgently required; however, quality of life and cognitive function may remain impaired. Objective To perform a systematic review and meta-analysis evaluating changes in health-related quality of life and cognitive functioning in patients with Cushing’s syndrome after treatment. Methods Eight electronic databases were searched in March 2017, and PubMed again in May 2018, to identify potentially relevant articles. Eligible studies were (randomized controlled) trials, cohort studies, and cross-sectional studies assessing quality of life or cognitive functioning in patients treated for Cushing’s syndrome. Differences were expressed as standardized mean difference, and reported with 95% confidence intervals. We compared patients before and after treatment (improvement), and patients after treatment and healthy controls (normalization). Results We included 47 articles with 2,643 patients. Most patients had Cushing’s disease and were in remission after treatment. Quality of life and cognitive functioning improved after treatment in all studied domains. Compared to a healthy control population, quality of life did not normalize. Cognitive functioning normalized in part, but not all, of the studied domains. Conclusions Treatment of Cushing’s syndrome improves quality of life and cognitive functioning. As normalization was not achieved in quality of life and in some aspects of cognitive functioning, special and continuous attention should be given to these aspects for patients after treatment. Effective interventions for further improvement and possibly normalization are urgently needed.

Patient-Reported Quality of Life Before and After Chemoradiation for Intact Pancreas Cancer: A Prospective Registry Study

2021 ◽  
Vol 11 (1) ◽  
pp. e63-e69
Author(s):  
William G. Breen ◽  
Krishan R. Jethwa ◽  
Nathan Y. Yu ◽  
Grant M. Spears ◽  
William S. Harmsen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pancreas Cancer ◽  
Registry Study ◽  
Patient Reported ◽  
Before And After

scholarly journals The Impact of Revascularisation on Quality of Life in Chronic Mesenteric Ischemia

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
J. T. M. Blauw ◽  
H. A. M. Pastoors ◽  
M. Brusse-Keizer ◽  
R. J. Beuk ◽  
J. J. Kolkman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mesenteric Ischemia ◽  
Health Condition ◽  
Index Score ◽  
Mesenteric Arteries ◽  
Chronic Mesenteric Ischemia ◽  
Abdominal Symptoms ◽  
Before And After ◽  
The Impact

Background. Chronic mesenteric ischemia (CMI) is characterized by long-standing abdominal symptoms due to insufficient mesenteric circulation. Data on the effect of revascularisation on quality of life (QoL) for CMI are scarce. This study is the first to evaluate the impact of revascularisation on quality of life. Methods. Seventy-nine patients with CMI or acute-on-chronic mesenteric ischemia (AoCMI) underwent an intervention of one or more mesenteric arteries between January 2010 and July 2012. QoL before and after intervention was measured with the EuroQol-5D. Preintervention questionnaires were of standard care. Postintervention data were obtained by resending a questionnaire to the patients between February and May 2013. To investigate the clinical relevance of our findings, the minimal clinically important difference (MCID) was used. Since there is no established MCID for CMI, we used the literature reference MCID of inflammatory bowel syndrome (IBS) of 0.074. Results. Fifty-five (69.6%) of 79 patients returned their questionnaire and 23 (29.1%) were completely filled out. There was a significant increase of the median EQ-index score from 0.70 to 0.81 (p=0.02) and a significant reduction of symptoms in the domains usual activities (34.4%) and pain/discomfort (32.3%). There was a significant improvement of 17% in overall current health condition (VAS) (p=0.001). The MCID between baseline and postoperative EQ-5D index score was 0.162, indicating a clinically relevant improvement of quality of life after revascularisation. Conclusion. Quality of life of CMI patients is improved after mesenteric artery revascularisation.

scholarly journals P-P22 NET Profit: Considering quality of life assessment in patients treated with SSAs for NETs

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Lewis Hall ◽  
Sarah Powell-Brett ◽  
Oscar Thompson ◽  
Elizabeth Bradley ◽  
Stacey Smith ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Carcinoid Syndrome ◽  
Exocrine Function ◽  
Pancreatic Exocrine Insufficiency ◽  
Symptom Scale ◽  
Exocrine Insufficiency ◽  
Patient Reported ◽  
Scale Scores ◽  
Pancreatic Exocrine

Abstract Background Somatostatin Analogue (SSA) therapy of neuroendocrine tumours (NETs) leads to pancreatic exocrine insufficiency (PEI). PEI symptoms include diarrhoea, abdominal discomfort, bloating, and steatorrhea, which negatively impact quality of life (QoL). NETs (and the sequelae of carcinoid syndrome) however, have similar symptomatology to PEI, with a comparably negative impact on QoL. QoL tools exist to assess PEI and its response to enzyme therapy; however, we hypothesise that PEI symptom scale scores will be unreliable in SSA-induced PEI due to the concurrent improvement of the carcinoid symptoms. Methods Adult patients commencing SSA therapy for NETs were recruited from December 2020. Qualitative assessments of the impact of SSAs and pancreatic exocrine function on patient QoL were performed before and during (at 8 weeks) therapy. The Pancreatic Exocrine Insufficiency Questionnaire (PEI-Q) was used to capture patient-reported assessment of relevant symptoms. Health-related QoL was assessed using the  European Organisation Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLC)-C30, supplemented by the EORTC GI.NET.21. Patients were specifically asked about steatorrhea at both assessments. Results Seven patients completed the study. 5-HIAA levels were raised in 4/7 patients, indicative of carcinoid syndrome, secondary to the NET. Pancreatic exocrine function reduced after SSA therapy in all patients (data reported elsewhere) but paradoxically PEI-Q symptom scale scores reduced (median decrease from baseline: -18.5%, range: -1.5- -55.6%; p = 0.018) (Figure 1). According to PEI-Q, all seven patients would meet the criteria for a mild PEI at baseline, and two would be considered severe. One patient reported steatorrhea after commencing SSA-therapy. No changes in relevant domains of EORTC questionnaires were statistically significant, including functional, symptomatic, and overall health scores. Conclusions The PEI-Q tool is not useful for assessing SSA-related PEI due to substantial symptom overlap with the tumour itself and SSA therapy. The decrease in symptom score is likely due to improvement of carcinoid syndrome, independent of PEI. Although the cardinal PEI symptom is steatorrhea, there is no distinction between that and diarrhoea in the EORTC tool, and confounding aetiologies of diarrhoea in NET patients may further complicate assessment. Current available QoL measures are of limited use in the setting of SSA-related PEI, and care should be taken if evaluating PEI or response of PEI to treatment.  

Patient-reported toxicity after treatment for cancers of the head and neck.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6135-6135
Author(s):  
Christine E. Hill-Kayser ◽  
Carolyn Vachani ◽  
Margaret K. Hampshire ◽  
Gloria A. Di Lullo ◽  
James M. Metz
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Late Effects ◽  
Treatment Quality ◽  
Tumor Control ◽  
Healthcare Team ◽  
Convenience Sample ◽  
Care Plans ◽  
Patient Reported

6135 Background: Patients with cancers of the head and neck (HNC) may be at risk for significant late effects after treatment. Quality of life may be altered significantly as a result. This Internet based study evaluates patient perceptions of toxicity after treatment for HNC. Methods: Patient-reported data were gathered via a convenience sample frame from HNC survivors voluntarily utilizing a publically available, free, Internet-based tool for creation of survivorship care plans. Available at www.livestrongcareplan.com and through the OncoLinkwebsite, the tool allows survivors to enter data regarding diagnosis, demographics, and treatments, and provides customized guidelines for future care. During use of the tool, HNC survivors are queried regarding late effects associated with specific treatments. All data have been maintained with IRB approval. Results: Of 3866 survivors using this tool between 4/2010 and 10/2011, 140 (4%) had undergone primary treatment for HNC. Median diagnosis age was 52y and median current age 56y. When queried regarding treatment received, 88% reported having undergone radiation, 73% surgery, and 67% chemotherapy. Many patient-reported late effects were associated with local tumor control, and included difficulty swallowing/speaking (83%), decreased saliva production (88%), dental problems (49%), thyroid problems (33%), decreased neck mobility (60%), eye and vision deficits (9%), and tinnitus (40%). In addition, 53% noted concerns regarding cognitive function. Users of the tool reported that they would share it with their healthcare team in 55% of cases. The most common reasons for not sharing it were “I did not think they would care,” and “ I did not want to upset or anger them.” Conclusions: Survivors using this tool anonymously and voluntarily report significant toxicity after treatment for HNC. Not all survivors appear comfortable discussing these issues with healthcare providers, despite major potential impact on quality of life. The data reported here may be of significant impact in future study of outcomes after HNC, as well as patient counseling and survivor care.

scholarly journals Long Term Findings Concerning the Mental and Physical Condition, Quality of Life and Sexuality after Laparoscopically Assisted Creation of a Neovagina (Modified Vecchietti Technique) in Young MRKHS (Mayer-Rokitansky-Küster-Hauser-Syndrome) Patients

2021 ◽  
Vol 10 (6) ◽  
pp. 1269
Author(s):  
Katharina Rall ◽  
Bernadette Schenk ◽  
Norbert Schäffeler ◽  
Dorit Schöller ◽  
Andrina Kölle ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sexual Function ◽  
Large Body ◽  
Interdisciplinary Approach ◽  
Psychosocial Adaptation ◽  
Physical And Mental Health ◽  
Vaginal Aplasia ◽  
Patient Reported ◽  
Before And After

The Mayer-Rokitansky-Küster-Hauser-syndrome (MRKHS) is characterized by a congenital uterine and vaginal aplasia. A large body of literature reports that a diagnosis of MRKHS has a variety of psychological effects on patients and doubts about female identity. The aim of the underlying study was to detect the patient-reported physical and mental health and sexual function before and after laparoscopically assisted creation of a neovagina. 160 women with MRKHS who underwent this type of surgery between September 2009 and December 2015 were invited to complete the questionnaires. Packages consisting of six questionnaires were handed out before surgery, six and 12 months after surgery. Data from 82 patients could be included in the study. Patients had a mean age of 19.9 years at inclusion in the study. We detected an impairment of the health-related mental quality of life. There was no higher risk for psychological disorders. MRKHS patients show similar self-acceptance and normal body image compared to the general population. The sexual function is limited before surgery and normalizes after surgery. Useful factors for coping with the disease are an interdisciplinary approach in diagnostics and treatment, psychosocial adaptation as well as a supportive social environment.

scholarly journals Shrinkage of Prostate and Improved Quality of Life: Management of BPH Patients with Croton membranaceus Ethanolic Root Extract

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
George Awuku Asare ◽  
Daniel Afriyie ◽  
Robert A. Ngala ◽  
Alfred A. Appiah ◽  
Yvonne Anang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Volume ◽  
Treatment Quality ◽  
Root Extract ◽  
Indirect Bilirubin ◽  
Free Psa ◽  
Apolipoprotein A ◽  
Freeze Dried ◽  
Before And After

Benign prostatic hyperplasia (BPH) is an enlargement of the prostate. The study aimed at validating the use of freeze-dried Croton membranaceus ethanolic root extract for BPH management. Thirty-three patients were observed before and after 3-month administration of 20 mg t.i.d orally. The International Prostate Symptom Score (IPSS), and the International Index of Erectile Function (IIEF) questionnaires were used. Total/free PSA (tPSA, fPSA), renal, liver function, lipid tests, and ultrasonographic imaging were performed. Thirty (30) patients (66 ± 11 years) completed the study. IPSS results showed 37% had severe, 40% moderate, and 23% mild symptoms before; 57% and 43% had moderate and mild symptoms, respectively, after treatment. IIED of patients’ results showed 30% with severe, 40% moderate, 24% mild-moderate, 3% mild, and 3% no erectile dysfunction before treatment and 20% severe, 43% moderate, and 37% mild-moderate dysfunction, after treatment. Quality of life (QoL) improved (P=0.001). Significant but non-pathological increases in total and indirect bilirubin as well as apolipoprotein A occurred. Mean tPSA reduced from 27.9 ± 19.0 to 16.2 ± 11.8 ng/mL (P=0.002); fPSA from 6.1 ± 4.8 to 3.9 ± 2.9 ng/mL (P=0.045); and prostate volume from 101.8 ± 41.3 to 54.5 ± 24.8 cm3  (P=0.023). C. membranaceus shrinks the prostate and improves QoL.

Sign in / Sign up

Export Citation Format

Share Document