Quality of life and clinical results after endovascular sclerotherapy: A comparison between intra- and extramuscular low-flow venous malformations

2020 ◽  
pp. 026835552096292
Author(s):  
Annamaria Weitz-Tuoretmaa ◽  
Leo Keski-Nisula ◽  
Riitta Rautio ◽  
Jussi Laranne
Keyword(s):  
Quality Of Life ◽  
Clinical Results ◽  
Post Treatment ◽  
Low Flow ◽  
Subjective Symptoms ◽  
Venous Malformations ◽  
University Hospitals ◽  
Mri Findings ◽  
Mri Scans

Background Based on clinical observations we hypothesized that patients with intramuscular venous malformations (VMs) did worse or needed more sclerotherapy sessions than patients with extramuscular VMs. Purpose To evaluate the difference in treatment and quality of life (QOL) results after Polidocanol sclerotherapy of intra- and extramuscular low-flow VMs. Material and methods Forty-one patients with a VM were treated with Polidocanol in two university hospitals. The results were retrospectively analyzed. Pre- and post-treatment magnetic resonance imaging (MRI) scans were compared. All patients completed a self-evaluating form on symptoms as well as a QOL questionnaire. The results were compared between two groups: intra- and extramuscular VM’s. Results No statistically significant differences between intra- and extramuscular groups concerning QOL and specific dimensions pain, functional problems or cosmetic appearance were found. Radiological changes in MRI examinations did not correlate with any of the subjective symptoms. 56% of the patients benefitted from the treatment according to patient self-evaluation. Conclusion In this material intramuscular VM’s responded to the treatment comparably to extramuscular malformations. Post-treatment MRI findings do not correlate with subjective symptoms or QOL results and thus, a routine post-treatment examination seems to be unwarranted. Subjective symptoms and QOL results are the most important parameters in evaluating the effectiveness of sclerotherapy.

Quality of life after endovascular sclerotherapy of low-flow venous malformations: the efficacy of polidocanol compared with ethanol

2017 ◽  
Vol 59 (8) ◽  
pp. 946-952 ◽  
Author(s):  
Annamaria Weitz-Tuoretmaa ◽  
Leo Keski-Nisula ◽  
Riitta Rautio ◽  
Jussi Laranne
Keyword(s):  
Quality Of Life ◽  
Venous Malformation ◽  
Post Treatment ◽  
Low Flow ◽  
Venous Malformations ◽  
Limited Information ◽  
Ethanol Group ◽  
Clinical Complications ◽  
Ethanol Sclerotherapy

Background Limited information is available on mid-term results and quality of life (QOL) after endovascular sclerotherapy of venous malformations. Purpose To compare two agents—polidocanol and ethanol—with a focus on the influence on QOL after sclerotherapy. Material and Methods Forty-one consecutive patients with a venous malformation in the head and neck area or in the extremities were treated with polidocanol between 2008 and 2013. Pre- and post-treatment magnetic resonance imaging (MRI) scans were compared. All patients completed a self-evaluation form on symptoms as well as a QOL questionnaire. The results were compared with previously obtained material during 1991–2001, comprising 44 consecutive, similarly located venous malformation patients subject to ethanol sclerotherapy. Results No significant clinical complications were observed. Subjectively, 19 (46%) of the patients benefitted from the treatment. QOL results showed that 85% of patients had an index < 39 – where 0 represents the highest and 100 the lowest QOL. Patients in the ethanol group had marginally better overall post-treatment QOL results. Post-treatment MRI in 35 patients showed the size of the malformation unchanged in 19 (54%) patients, in ten (29%) there was a decrease (<50%) while in six (17%) the decrease was more significant (>50%). Post-treatment MRI results did not correlate with either subjective symptoms or QOL results. Conclusion Polidocanol sclerotherapy were found to be an effective, safe, and well tolerated treatment option for low flow venous malformations. Routine MRI for follow-up appears redundant and may be omitted.

Interrater reliability of a method to assess hypothalamic involvement in pediatric adamantinomatous craniopharyngioma

2020 ◽  
Vol 25 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Ros Whelan ◽  
Eric Prince ◽  
David M. Mirsky ◽  
Robert Naftel ◽  
Aashim Bhatia ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Brain Tumors ◽  
Interrater Reliability ◽  
Statistical Evaluation ◽  
Grading System ◽  
Reliability Study ◽  
Postoperative Mri ◽  
Mri Scans ◽  
Adamantinomatous Craniopharyngioma

OBJECTIVEPediatric adamantinomatous craniopharyngiomas (ACPs) are histologically benign brain tumors that confer significant neuroendocrine morbidity. Previous studies have demonstrated that injury to the hypothalamus is associated with worsened quality of life and a shorter lifespan. This insight helps many surgeons define the goals of surgery for patients with ACP. Puget and colleagues proposed a 3-tiered preoperative and postoperative grading system based on the degree of hypothalamic involvement identified on MRI. In a prospective cohort from their institution, the authors found that use of the system to guide operative goals was associated with decreased morbidity. To date, however, the Puget system has not been externally validated. Here, the authors present an interrater reliability study that assesses the generalizability of this system for surgeons planning initial operative intervention for children with craniopharyngiomas.METHODSA panel of 6 experts, consisting of pediatric neurosurgeons and pediatric neuroradiologists, graded 30 preoperative and postoperative MRI scans according to the Puget system. Interrater reliability was calculated using Fleiss’ κ and Krippendorff’s α statistics.RESULTSInterrater reliability in the preoperative context demonstrated moderate agreement (κ = 0.50, α = 0.51). Interrater reliability in the postoperative context was 0.27 for both methods of statistical evaluation.CONCLUSIONSInterrater reliability for the system as defined is moderate. Slight refinements of the Puget MRI grading system, such as collapsing the 3 grades into 2, may improve its reliability, making the system more generalizable.

scholarly journals Tu1228 – Achalasia Quality of Life Score and Eckardt Score: A Comparison for the Assessment of Clinical Improvement Post Treatment for Achalasia

2019 ◽  
Vol 156 (6) ◽  
pp. S-994
Author(s):  
Samuel O. Slone ◽  
Joel E. Richter ◽  
Vic Velanovich ◽  
John W. Jacobs ◽  
Ambuj Kumar
Keyword(s):  
Quality Of Life ◽  
Clinical Improvement ◽  
Post Treatment ◽  
Life Score ◽  
Eckardt Score

Different Types of Auricular Keloids and Treatment by Intralesional Cryosurgery: Best Practice for Obtaining Long-Lasting Clinical Results

Dermatology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Yaron Har-Shai ◽  
Lior Har-Shai ◽  
Viktor A. Zouboulis ◽  
Christos C. Zouboulis
Keyword(s):  
Quality Of Life ◽  
Body Image ◽  
Recurrence Rate ◽  
Best Practice ◽  
Clinical Results ◽  
Psychosocial Impact ◽  
Aesthetic Outcome ◽  
The Past ◽  
Different Types

<b><i>Background:</i></b> Auricular keloids belong to the most perplexing medical conditions, which have significant psychosocial impact on the patient’s body image and quality of life. <b><i>Summary:</i></b> The article is purposed to provide dermatologists and plastic surgeons with the best proven practice using intralesional cryosurgery for the treatment of the different auricular keloid types in order to obtain superior clinical results by minimizing the probability of recurrence. In the past 20 years, the authors have developed novel procedures in order to increase the effectiveness of intralesional cryosurgery on auricular keloids, including hydrodissection, warm gauze technique, and excision of dangling skin. Long-lasting clinical results with a low recurrence rate and a satisfactory aesthetic outcome are achieved with no deformation of the ear framework.

‘Teaching Me to Parent Myself’: The Feasibility of an In-Patient Group Schema Therapy Programme for Complex Trauma

2017 ◽  
Vol 46 (4) ◽  
pp. 463-478
Author(s):  
Rita Younan ◽  
Joan Farrell ◽  
Tamara May
Keyword(s):  
Quality Of Life ◽  
Complex Trauma ◽  
Psychiatric Symptoms ◽  
Self Esteem ◽  
Post Treatment ◽  
Drop Out ◽  
Schema Therapy ◽  
Schema Modes ◽  
Therapy Programme

Background: Group schema therapy is an emerging treatment for personality and other psychiatric disorders. It may be particularly suited to individuals with complex trauma given that early abuse is likely to create maladaptive schemas. Aims: This pilot study explored the feasibility and effectiveness of a 4-week in-patient group schema therapy programme for adults with complex trauma in a psychiatric hospital setting. Method: Thirty-six participants with complex trauma syndrome participated in this open trial. Treatment consisted of 60 hours of group schema therapy and 4 hours of individual schema therapy administered over 4 weeks. Feasibility measures included drop-out rates, qualitative interviews with participants to determine programme acceptability and measures of psychiatric symptoms, self-esteem, quality of life and schema modes pre-, post- and 3 months following the intervention. Results: Drop-out rate for the 4-week program was 11%. Thematic analysis of interview transcripts revealed four major themes: connection, mode language explained emotional states, identifying the origin of the problem and the emotional activation of the programme. Measures of psychiatric symptoms, self-esteem and quality of life showed improvement post-treatment and at 3 months post-treatment. There was a reduction in most maladaptive schema modes pre-/post-treatment. Conclusions: A group schema therapy approach for complex trauma is feasible and demonstrates positive effects on psychiatric symptoms and maladaptive schemas.

scholarly journals Longitudinal Associations of Adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Lifestyle Recommendations with Quality of Life and Symptoms in Colorectal Cancer Survivors up to 24 Months Post-Treatment

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 417
Author(s):  
Marlou-Floor Kenkhuis ◽  
Floortje Mols ◽  
Eline H. van Roekel ◽  
José J. L. Breedveld-Peters ◽  
Stéphanie O. Breukink ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Cancer Research ◽  
Post Treatment ◽  
Research Fund ◽  
American Institute ◽  
The World ◽  
Lifestyle Recommendations ◽  
Longitudinal Associations

Post-treatment adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle recommendations were associated with health-related quality of life (HRQoL), fatigue, and chemotherapy-induced peripheral neuropathy (CIPN) in colorectal cancer (CRC) survivors. In a prospective cohort among CRC survivors (n = 459), repeated home-visits were performed at 6 weeks, 6, 12, and 24 months post-treatment. Dietary intake, body composition, sedentary behaviour, and physical activity were assessed to construct a lifestyle score based on adherence to seven 2018 WCRF/AICR recommendations. Longitudinal associations of the lifestyle score with HRQoL, fatigue, and CIPN were analysed by confounder-adjusted linear mixed models. A higher lifestyle score was associated with better physical functioning and less activity-related fatigue, but not with CIPN. Adjustment for physical activity substantially attenuated observed associations, indicating its importance in the lifestyle score with regards to HRQoL. In contrast, adjustment for body composition and alcohol inflated observed associations, indicating that both recommendations had a counteractive influence within the lifestyle score. Our findings suggest that CRC survivors benefit from an overall adherence to the WCRF/AICR lifestyle recommendations in terms of HRQoL and fatigue, but not CIPN. Specific recommendations have a varying influence on these associations, complicating the interpretation and requiring further study.

scholarly journals ACCEPTANCE: protocol for a feasibility study of a multicomponent physical activity intervention following treatment for cervical cancer

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e048203
Author(s):  
Nessa Millet ◽  
Hilary J McDermott ◽  
Fehmidah Munir ◽  
Charlotte L Edwardson ◽  
Esther L Moss
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Cervical Cancer ◽  
Public Involvement ◽  
Physical Activity Intervention ◽  
Pilot Trial ◽  
University Hospitals ◽  
Evaluation Measures ◽  
Study Results

IntroductionCervical cancer treatment can have life changing sequelae and be associated with poor short-term and long-term quality of life. Physical activity (PA; that is, bodily movement) is known to improve health outcomes and quality of life for cancer survivors, both physically and psychologically. To date, no interventions to increase PA following cervical cancer have been evaluated. This study aims to (1) determine the feasibility of conducting a PA intervention after cervical cancer and (2) to explore the acceptability of the programme and evaluation measures.Methods and analysisThe design is a pre study and post study design. Thirty participants aged between 18 and 60 years from the Midlands region, UK, who have completed primary treatment for cervical cancer at least 6 months previously and do not meet the national PA guidelines will be recruited. Identification of potential participants will take place through the University Hospitals of Leicester National Health Service (NHS) Trust. Participants will receive an intervention focused on increasing PA through the provision of education, action planning, goal setting, problem solving and self-monitoring of PA behaviour, particularly steps per day. Device assessed PA and questionnaires will be completed at baseline, week 6, week 12 and week 24. Feasibility will be assessed in terms of recruitment, retention, attrition, completion of measures and intervention compliance, for which specific feasibility criteria have been established. The process evaluation will explore the experiences and acceptability of the intervention components and evaluation measures.Ethics and disseminationEthical approval has been granted by the West of Scotland Research Ethics Committee 1 for this study. Results will inform intervention refinement for the design of a definitive pilot trial. These results will be disseminated via peer-reviewed publications and international conferences while input from a patient and public involvement (PPI) group will inform effective ways to circulate results among the wider community.Trial registration numberISRCTN16349793, Registered 30 September 2020.

scholarly journals Decision Regret and Quality of Life after Focal Therapy with Vascular-Targeted Photodynamic Therapy (TOOKAD®) for Localized Prostate Cancer

2021 ◽  
pp. 1-6
Author(s):  
Luka Flegar ◽  
Martin Baunacke ◽  
Bjoern Thorben Buerk ◽  
Rick Proschmann ◽  
Aristeidis Zacharis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Decision Making ◽  
Photodynamic Therapy ◽  
Local Recurrence ◽  
Post Treatment ◽  
Decision Regret ◽  
Targeted Photodynamic Therapy ◽  
Decisional Regret

<b><i>Purpose:</i></b> The aim of the study was to assess quality of life (QoL), decision involvement, and decisional regret after treatment with vascular-targeted photodynamic therapy (VTP) (TOOKAD®) for unilateral low-risk prostate cancer. <b><i>Methods:</i></b> Validated questionnaires (EORTC QLQ-C30 and QLQ-PR25) capturing QoL post-treatment, involvement in decision-making (Control Preferences Scale) and decision regret (Decisional Regret Scale), were given to patients at the 12-month visit after undergoing VTP at our institution between May 2018 and February 2021. <b><i>Results:</i></b> Out of 44 patients, 36 patients were included in this study and 31 (86.1%) responded to the questionnaires. Mean overall health score capturing QoL at 12 months was 79.3 (standard deviation: ±18.1). 70.9% of the patients (<i>n</i> = 22) had no decision regret, and 67.8% of men (<i>n</i> = 21) had an active role in decision-making. In control biopsy at 12 months post-treatment, 19.4% of patients (<i>n</i> = 7) presented with local recurrence and progression to higher Gleason score (GS) was found in 13.8% of patients (<i>n</i> = 5). Patients (<i>n</i> = 3) presenting with tumor recurrence or progression to higher GS in control biopsy showed a significantly higher level of decision regret (<i>p</i> &#x3c; 0.009). <b><i>Conclusion:</i></b> Only 9.7% of men (<i>n</i> = 3) felt a strong emotion of regret at 12 months after VTP. Level of decision regret was significantly higher in patients with local recurrence or tumor progression detected in control biopsy. QoL was stable after VTP.

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