scholarly journals Lengthening Temporalis Myoplasty: Objective Outcomes and Site-Specific Quality-of-Life Assessment

2017 ◽  
Vol 157 (6) ◽  
pp. 966-972 ◽  
Author(s):  
Davide Thomas Panciera ◽  
Claudio Sampieri ◽  
Alberto Deganello ◽  
Giovanni Danesi

Objective Evaluate outcomes of the lengthening temporalis myoplasty in facial reanimations. Study Design Case series with planned data collection. Setting Ospedali Riuniti, Bergamo, and AOUC Careggi, Florence, Italy. Subjects and Methods From 2011 to 2016, 11 patients underwent lengthening temporalis myoplasty; demographic data were collected for each. Pre- and postoperative photographs and videos were recorded and used to measure the smile angle and the excursion of the oral commissure, according to the SMILE system (Scaled Measurements of Improvement in Lip Excursion). All patients were tested with the Facial Disability Index, and they also completed a questionnaire about the adherence to physiotherapy indications. Results All patients demonstrated a significant improvement in functional parameters and in quality of life. On the reanimated side, the mean z-line and a-value, measured when smiling, significantly improved in all patients: from 22.6 mm (95% CI, 20.23-25.05) before surgery to 30.9 mm (95% CI, 27.82-33.99) after surgery ( P < .001) and from 100.5° (95% CI, 93.96°-107.13°) to 111.6° (95% CI, 105.63°-117.64°; P < .001), respectively. The mean postoperative dynamic gain, passing from rest to a full smile at the reanimated side, was 3.1 mm (95% CI, 1.30-4.88) for the z-line and 3.3° (95% CI, 1.26°-5.29°) for the a-value. The Facial Disability Index score increased from a preoperative mean of 33.4 points (95% CI, 28.25-38.66) to 49.9 points (95% CI, 47.21-52.60) postoperatively ( P < .001). Conclusions The lengthening temporalis myoplasty can be successfully used for smile reanimation, with satisfying functional and quality-of-life outcomes.

2019 ◽  
Vol 13 (2) ◽  
pp. 172-178
Author(s):  
Wrgelles Godinho Bordone Pires ◽  
Philipe Eduardo Carvalho Maia ◽  
Felipe Daniel Vasconcelos de Carvalho ◽  
Rodrigo Simões Castilho ◽  
Fernando Araújo Silva Lopes ◽  
...  

Objective: To assess the quality of life and functional status of patients subjected to debridement of ulcers in the posterior ankle who required complete Achilles tendon resection without any type of reconstruction or tendon transfer. Method: This is a case series of 5 (mostly diabetic) patients who underwent complete Achilles tendon resection due to an ulcer in the posterior ankle region. Preservation of the Achilles tendon was prevented due to tendon exposure, extensive degeneration and the need for infection control. Patients answered the Brazilian Portuguese version of the Achilles Tendon Total Rupture Score (ATRS-BR) questionnaire and the 36-item Short-Form Health Survey (SF-36) during the postoperative period, and follow-up varied between 6 and 24 months. The ATRS-BR ranges from 0 to 100, and higher scores indicate fewer symptoms and limitations. The SF-36 consists of 36 questions comprising 8 domains, which are independently assessed and given a score of up to 100 points, with higher scores indicating better health status. Results: The mean age of patients was 70 years. The mean score on the SF-36 physical functioning domain was 70 (50-95) points. The mean value of the ATRS-BR was 54.6 (31-88) points; however, the patients had few complaints about their functional status. Conclusion: Non-reconstruction of the Achilles tendon in predominantly diabetic elderly patients with posterior ankle ulcers presents encouraging functional outcomes. This study suggests that complete Achilles tendon resection is a viable option for ulcer treatment in this population. Level of Evidence IV; Therapeutic Studies; Cases Series.


Author(s):  
Raana Jafarizadeh ◽  
Somayeh Zeynizadeh-Jeddi ◽  
Akbar Pirzadeh ◽  
Mahzad Yousefian ◽  
Firouz Amani

Introduction: Quality of life (QOL) is an important index in society that need for evaluation in all age groups people especially in medical university students as a people that their physical and mental health is related with community health. This study aims to investigate the quality of life (QOL) of Ardabil University of Medical Sciences. Methods: This is a cross-sectional study that has been conducted on 200 students who selected by random sampling method from Ardabil medical university students. The QOL was measured by WHOQOL-BREF which its validity and Reliability were investigated and approved. This questionnaire include 26 questions in four dimensions (physical, mental, social and environmental health). Collected data we analyzed by statistical test such as t-test for compare the mean of QOL score among demographic data. Results: Of all students, 57% were male and 91.5% were single. Of all students, 56% had desired quality of life. The relationships between QOL and variables such as gender, educational level, marital status and age of students wasn’t significant. The mean difference of four dimension scores among two sexes was statistically significant. The mean of Physical health dimension score was 11.6±2.1, Psychological was 12.3±2.4, Social relationships was 13.1±3.4 and environment was 12.7±3.2. The mean of total score of QOL in all students was 12.4±2.3. Conclusion: Results showed that the QOL of all students were in high level and in four dimension of QOL the female students had significant higher score than male students.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17519-e17519
Author(s):  
Sachin Dhumal ◽  
Vijay Maruti Patil ◽  
Vanita Noronha ◽  
Amit Joshi ◽  
Atanu Bhattacharjee ◽  
...  

e17519 Background: NACT (neoadjuvant chemotherapy) is one of the treatment options in advanced head and neck cancer (H&N cancer); however there is limited quality of life data available in these patients. Methods: Between August 2013- April 2014, 90 technically unresectable H&N cancer patients who were underwent NACT at our centre were selected for this analysis. EORTC QLQ-C30 and HN35 version 3.0 was used for quality of life assessment at baseline and after 02 cycles of NACT. PFS and OS was estimated by Kaplan Meier method. The mean change in QOL at various domains was calculated with 95% CI. The relationship between change in QOL domain and OS was analysed. Results: The median age of the cohort was 45 years (Range 21-65 years). The predominant subsite was oral cavity, in 62 patients (68.9%).The median PFS and OS was 10.53 months (95%CI 8.1-13.0) and 20.8 months (95%CI 15.1-26.5). The mean scores for all domains of QOL are shown in table 1. Conclusions: NACT leads to improvement in QOL in patients treated with head and neck cancers and its has impact on OS.[Table: see text]


2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Ioanna V. Papathanasiou ◽  
Anna Rammogianni ◽  
Dimitros Papagiannis ◽  
Konstantinos Tsaras ◽  
Foteini Kaberi ◽  
...  

Introduction: Quality of Life (QoL) among elderly is an important issue that reflects the status of well-being of this vulnerable population. Aim: This study aims to assess quality of life among elderly population and to examine possible correlations with associated demographic, social and health factors. Material and Method: A cross sectional study was conducted, in which 257 elderlies from Greece were participated. For the data collection the WHOQOL-BREF (30-items Greek version) questionnaire was used as well as a questionnaire with questions about demographic data, social & health factors. Descriptive statistics such as frequencies, means, percentages and standard deviations have been utilized. Inferential statistics such as t-test and pearson r correlation have been used to determined correlations between relevant variables. Level of significance accepted is p < 0.05. Results: From the total 257 elderlies 55.6% (n=143) were women and 44.4% (n=114) were men with a mean age 75.12±8.39. The mean score of overall QoL is 14.14±2.87 and the mean of each factor of WHOQOL-BREF is 13.56±2.79 for physical health, 13.61±2.74 for mental health, 13.72±2.60 for social relationships and 13.70±1.96 for environment. Age, marital status, number of children, level of education, residence area, lifestyle, chronic diseases and serious illnesses are the factors that affects levels of QoL among Greek elderly population Conclusions: Results indicates that levels of QoL between elderly are moderate and many demographic, social and health factors are correlated with QoL status.


2018 ◽  
Vol 44 (6) ◽  
pp. E15 ◽  
Author(s):  
Malte Mohme ◽  
Friederike S. Fritzsche ◽  
Klaus C. Mende ◽  
Jakob Matschke ◽  
Ulrike Löbel ◽  
...  

OBJECTIVETectal gliomas constitute a rare and inhomogeneous group of lesions with an uncertain clinical course. Because these supposedly benign tumors are frequently followed up by observation over many years, the authors undertook this analysis of their own case series in an effort to demonstrate that the clinical course is highly variable and that there is a potential for a progressive biology.METHODSClinical data analysis of 23 cases of tectal glioma (involving 9 children and 14 adults) was performed retrospectively. Radiographic data were analyzed longitudinally and MR images were evaluated for tumor volume, contrast enhancement, and growth progression. Quality of life was assessed using the EORTC BN20 and C30 questionnaires during follow-up in a subgroup of patients.RESULTSThe patients’ mean age at diagnosis was 29.2 years. The main presenting symptom at diagnosis was hydrocephalus (80%). Six patients were treated by primary tumor resection (26.1%), 3 patients underwent biopsy followed by resection (13.1%), and 3 patients underwent biopsy only (13.1%). For additional treatment of hydrocephalus, 14 patients (60.9%) received shunts and/or endoscopic third ventriculostomy. Radiographic tumor progression was observed in 47.9% of the 23 cases. The mean time between diagnosis and growth progression was 51.5 months, and the mean time to contrast enhancement was 69.7 months. Histopathological analysis was obtained in 12 cases (52.2%), resulting in 5 cases of high-grade glioma (3 cases of glioblastoma multiforme [GBM], grade IV, and 2 of anaplastic astrocytoma, grade III), 5 cases of pilocytic astrocytoma, 1 diffuse astrocytoma, and 1 ganglioglioma. Malignant progression was observed in 2 cases, with 1 case progressing from a diffuse astrocytoma (grade II) to a GBM (grade IV) within a period of 13 years. Quality-of-life measurements demonstrated distinct functional deficits compared to a healthy sample as well as glioma control cohorts.CONCLUSIONSAnalysis of this case series shows that a major subpopulation of tectal gliomas show progression and malignant transformation in children as well as in adolescents. These tumors therefore cannot be considered inert lesions and require histological confirmation and close follow-up. Quality-of-life questionnaires show that tectal glioma patients might benefit from special psychological support in emotional, social, and cognitive functionality.


2018 ◽  
Vol 5 (10) ◽  
pp. 3186
Author(s):  
Ba Thinh Nguyen ◽  
Toufic El-Khoury ◽  
Nimalan Pathmanathan ◽  
Peter Loder ◽  
Grahame Ctercteko

Background: Health literacy can be a stronger predictor of an individual’s health status than income, employment status, education level, and racial or ethnic group. The prevalence and impact of low health literacy in the rectal cancer patient population has received little attention. This study is a cross-sectional population survey to determine if there is a relationship between health literacy and quality of life in rectal cancer patients.Methods: All rectal cancer patients having a clinical encounter with the Colorectal Unit at Westmead Hospital will be invited to participate in the study. Two validated health literacy screens (REALM-SF and NVS) were administered along with the EORTC QLQ-C30 quality of life assessment. The association between health literacy and quality of life will be examined using Spearman regression.Results: 92 patients were recruited between March 2015 and July 2016. A significant proportion of our patients were found to have low health literacy (29.3 percent and 54.5 percent as measured by the REALM-SF and NVS, respectively). The mean QLQ-C30 summary score was 71.5 and the mean global health score was 69.4 (SD 23.3). There appeared to be no statistically significant correlation between health literacy and quality of life in our study. There was a moderately positive correlation between the NVS and REALM-SF (rho = 0.36, P <0.001).Conclusions: A significant proportion of our patients that have had rectal resections for cancer have low health literacy. We have not been able to demonstrate an obvious association between health literacy and quality of life in the present study.


2019 ◽  
Vol 18 (1) ◽  
pp. 37-42
Author(s):  
Gustavo Alvarenga ◽  
João Otávio Araújo Rotini ◽  
Leonardo Yukio Jorge Asano ◽  
Vinícius Alves de Andrade ◽  
André Evaristo Marcondes Cesar ◽  
...  

ABSTRACT Objective: The objective of this study was to present an analysis of progression of the quality of life and pain in patients undergoing surgical treatment of LSS and the potential correlations between individual factors and the clinical outcome observed. Methods: We studied 111 patients undergoing surgical treatment of LSS from January 2009 to December 2011 using the functional capacity (ODI) and pain (VAS) questionnaires. The preoperative data were compared statistically with the results obtained during the postoperative follow-up at one month, six months, one year, and two years. Results: The population consisted of 60 men and 51 women. The mean age was 61.16 years at the time of surgery, 33.33% were 60 years or older. When the questionnaires were applied, we found improvement in the progressive disability assessment with a mean drop of 23.65 ODI points after 6 months of the surgical treatment and 27.47 at the end of one year of surgery compared to preoperative for this scale. There was a decline of 3.84 points (mean) in the VAS at first postoperative month. Conclusion: Surgical treatment of LSS presented favorable postoperative evolution in a 2-year follow-up regarding pain and quality of life through VAS and ODI. Level of Evidence IV; Case series.


2020 ◽  
Vol 57 (8) ◽  
pp. 967-974 ◽  
Author(s):  
Michael M. Lindeborg ◽  
Pramila Shakya ◽  
Bhawani Pradhan ◽  
Shiba Kala Rai ◽  
Kabita Bhattarai Gurung ◽  
...  

Objective: To translate and validate the velopharyngeal insufficiency (VPI) effects on life outcomes (VELO) instrument into Nepali, and test its internal consistency and validity. Design: Quality-of-life instrument translation and validation. Setting: Community served by Nepal’s craniofacial referral hospital. Participants: Twenty-three postpalatoplasty children with VPI, 19 family guardians of VPI cases, and 29 non-VPI controls. Interventions: The VELO instrument was translated to Nepali by 2 independent bilingual translators, reconciled, backward-translated, compared, and modified using patient cognitive interviews. All VPI children, guardians, and controls completed the VELO-Nepali. Main Outcome Measure(s): The VELO internal consistency was evaluated using Cronbach α coefficient. Concurrent validity and discriminant validity were assessed using 2-sample t test: assuming unequal variances. Results: The VELO was translated and optimized using cognitive interviews. The VELO-Nepali demonstrated excellent internal consistency, with Cronbach α coefficients of 0.93, 0.94, and 0.90 for VPI cases, guardians of VPI cases, and non-VPI controls, respectively. The VELO-Nepali exhibited strong discriminant validity between VPI cases ([Formula: see text] = 45.4, standard deviation [SD] = 22.1) and non-VPI controls ([Formula: see text] = 84.9, SD = 12.3), ( P < .001). The VELO-Nepali showed strong concurrent validity with similarities in VPI case scores ([Formula: see text] = 45.4, SD = 22.1), and guardian scores ([Formula: see text] = 52.9, s = 22.8; P = .473). Conclusion: The translated VELO-Nepali demonstrates strong internal consistency, discriminant validity, and concurrent validity, and can assess quality of life for Nepali VPI patients. This instrument represents the first VPI quality of life assessment validated in Nepali, and supports the feasibility of its implementation in other low- and low-middle-income countries.


2019 ◽  
Vol 22 (6) ◽  
pp. 582-588 ◽  
Author(s):  
Margaret R Slater ◽  
Sharon Pailler ◽  
J’mai M Gayle ◽  
Illoneete Cohen ◽  
Erin L Galloway ◽  
...  

Objectives The objective of this study was to evaluate the long-term quality of life in cats following perineal urethrostomy. Methods This study comprised a retrospective case series of 74 cats with urinary obstructions that received perineal urethrostomies at the American Society for the Prevention of Cruelty to Animals (ASPCA) Animal Hospital between September 2015 and July 2017. Medical records were reviewed for information on the number of obstructions prior to surgery, urinary tract problems at the time of surgery and other potential factors influencing long-term welfare. Owners were surveyed by telephone and text 5–29 months after their cat’s surgery. Responses were compiled and analyzed to determine owner perception of welfare postsurgery, and to identify patterns in medical history and welfare outcomes. Results In total, 105 cat owners were eligible for the survey; 74 responded. Altogether, 100% of responding individuals reported at least the same quality of life postsurgery compared with the cat’s quality of life before demonstrating urinary problems (48% reported better). On a quality-of-life scale of 1–10 (10 = excellent), 100% of responding cat owners reported at least 7; 75% reported 10. Conclusions and relevance Quality-of-life outcomes for cats 5–29 months after receiving perineal urethrostomy surgery were reported to be very good. Given this finding, and that perineal urethrostomy surgery should mitigate future blockages, we suggest considering perineal urethrostomy surgery as a standard tool to manage urinary obstructions in cats. The needs of the specific client and patient, including risks, costs and welfare of the cats, should drive the options for management of urinary obstructions in male cats.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Sushil Paudel ◽  
Niraj Parajuli ◽  
Rabindra Prasad Sharma ◽  
Sudip Dahal ◽  
Sudarshan Paudel

Chronic urticaria (CU) is a skin condition characterized by sudden and recurrent episodes of wheals, angioedema, or both and commonly associated with itching for a duration of more than six weeks. The available data indicate that urticaria markedly affects both objective functioning and subjective well-being of patients. A review of patients’ records with chronic urticaria attending Civil Service Hospital from January 2018 to December 2019 was done. A detailed demographic data of all patients with chronic urticaria was also retrieved. Dermatology Life Quality Index questionnaire (DLQI) Nepalese version was used for the assessment of the impact of disease on life quality. Mann–Whitney U-test was applied to compare means, and principle component analysis for factor analysis was used. A total of 149 patients were included, with a male-to-female ratio of 1 : 1.9. The mean age of the study population was 32.86  ±  12.837 years. The mean DLQI score was 8.30  ±  6.73 with men having a significantly greater score than women ( p < 0.02 ). DLQI scores negatively correlated with age ( p < 0.01 ). There was a high internal consistency among items (Cronbach’s alpha 0.89), and all items had satisfactory correlation with each other as well. Principle component extraction revealed that there were two underlying factors in the DLQI questionnaire on measuring quality of life in chronic urticaria. Males had a greater impairment in quality of life than females due to chronic urticaria. Most severe impairment was seen in symptoms/feelings subdomain. It also revealed that there were two different underlying factors in DLQI questionnaire.


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