Evaluation of whole body MRI for early detection of cancers in subjects with germ-line TP53 mutation (Li-Fraumeni syndrome).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. TPS1607-TPS1607
Author(s):  
Olivier Caron ◽  
Thierry Frébourg ◽  
Emmanuelle Bourbouloux ◽  
Valérie Bonadona ◽  
Véronique Mari ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Germline Mutation ◽  
Complete Blood Count ◽  
Brain Mri ◽  
Whole Body ◽  
X Rays ◽  
Abdominal Sonography ◽  
Whole Body Mri ◽  
Li Fraumeni

TPS1607 Background: The TP53 germline mutation carriers have a huge increase of cancer risk. The cancer spectrum is particularly broad (breast, sarcoma, brain tumour, leukaemia, …). The clinical management of these people is challenging, mainly concerning sarcoma screening. Moreover, some data let speculate that normal cells of these carriers are particular hypersensitive to X-rays. Among major breakthroughs in radiology, whole-body MRI (WBMRI) may contribute to TP53 carriers surveillance. In order to update the french guidelines on Li-Fraumeni families management, the LIFSCREEN study ( NCT01464086 ) was designed to assess its usefulness in France. Methods: This open, randomized, multicentric trial will evaluate the efficacy and tolerability of two screening schemes, avoiding irradiating exams. In the standard arm, people undergo clinical exam, abdominal sonography, brain MRI, Complete Blood Count, breast MRI, breast sonography, depending on the age) at inclusion, Month 12, Month 24, and a study visit at Month 36. In the experimental arm, people included undergo the same scheme, completed by a diffusion WBMRI at M0, M12, M24. At each round, quality of life and psychological impact will be assessed by self-questionnaires and semi-structured qualitative interviews. In an ancillary study, serums will be collected at each step. Subjects meeting these criteria are eligible: any TP53 germline mutation carrier, with or without personal cancer history, aged >5 and <71. A hundred people will be enrolled and randomized. The primary objective is to assess the efficiency of each scheme, evaluated by the cancer incidence at 3 years. Notably, sensitivity and specificity of each exam will be studied. As a secondary objective, the acceptability of each scheme will be assessed by quality of life / psychological questionnaires interpretation (SF-36, HADS, TAS 20, CBCL, CDI, R-CMAS, depending on subject’s age). Recruitment began in December, 2011. To date, 32 patients have been enrolled on 8 french study sites. The study will soon be implemented in another 12 sites. This academic study is, to our knowledge, the first randomized trial on this topic, and supported by the french “Ligue contre le cancer.” Clinical trial information: NCT01464086.

scholarly journals A Comparison of the Effect of Two Types of Whole Body Vibration Platforms on Fibromyalgia. A Randomized Controlled Trial

2021 ◽  
Vol 18 (6) ◽  
pp. 3007
Author(s):  
José Antonio Mingorance ◽  
Pedro Montoya ◽  
José García Vivas Miranda ◽  
Inmaculada Riquelme
Keyword(s):  
Quality Of Life ◽  
Motor Function ◽  
Whole Body Vibration ◽  
Whole Body ◽  
Control Group ◽  
Body Vibration ◽  
Positive Effects ◽  
Therapy Program

Whole body vibration has been proven to improve the health status of patients with fibromyalgia, providing an activation of the neuromuscular spindles, which are responsible for muscle contraction. The present study aimed to compare the effectiveness of two types of whole body vibrating platforms (vertical and rotational) during a 12-week training program. Sixty fibromyalgia patients (90% were women) were randomly assigned to one of the following groups: group A (n = 20), who performed the vibration training with a vertical platform; group B (n = 20), who did rotational platform training; or a control group C (n = 20), who did not do any training. Sensitivity measures (pressure pain and vibration thresholds), quality of life (Quality of Life Index), motor function tasks (Berg Scale, six-minute walking test, isometric back muscle strength), and static and dynamic balance (Romberg test and gait analysis) were assessed before, immediately after, and three months after the therapy program. Although both types of vibration appeared to have beneficial effects with respect to the control group, the training was more effective with the rotational than with vertical platform in some parameters, such as vibration thresholds (p < 0.001), motor function tasks (p < 0.001), mediolateral sway (p < 0.001), and gait speed (p < 0.05). Nevertheless, improvements disappeared in the follow-up in both types of vibration. Our study points out greater benefits with the use of rotational rather than vertical whole body vibration. The use of the rotational modality is recommended in the standard therapy program for patients with fibromyalgia. Due to the fact that the positive effects of both types of vibration disappeared during the follow-up, continuous or intermittent use is recommended.

Trauma and orthopaedic surgery

2019 ◽  
pp. 747-764
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Orthopaedic Surgery ◽  
Sports Injuries ◽  
Holistic Approach ◽  
X Rays ◽  
Degenerative Diseases ◽  
Past Medical History ◽  
Musculoskeletal Trauma

This chapter on trauma and orthopaedics covers musculoskeletal trauma, sports injuries, infections, tumours, and congenital and degenerative diseases. The chapter is well structured, describing conditions seen commonly in clinic, in the emergency department, and in theatre. It highlights important cases to see during medical school, both in emergency and elective theatres, as well as key investigations to observe. It reiterates consideration of past medical history and a holistic approach to the patient rather than dealing with only a focus on pain or joint problems. It reviews improvement of quality of life. It also discusses common conditions such as osteoarthritis and rheumatoid arthritis, providing a table to clearly differentiate between the two. This chapter includes clear pictorial principles of orthopaedic management, and a clear system for describing X-rays systematically.

Li-Fraumeni Syndrome and Whole-Body MRI Screening: Screening Guidelines, Imaging Features, and Impact on Patient Management

2021 ◽  
Vol 216 (1) ◽  
pp. 252-263
Author(s):  
Nikita Consul ◽  
Behrang Amini ◽  
Juan Jose Ibarra-Rovira ◽  
Katherine J. Blair ◽  
Tanya W. Moseley ◽  
...  
Keyword(s):  
Patient Management ◽  
Whole Body ◽  
Imaging Features ◽  
Whole Body Mri ◽  
Li Fraumeni Syndrome ◽  
Screening Guidelines ◽  
Li Fraumeni

scholarly journals Effect of the Combined Intervention with Passive Whole-Body Vibration and Auriculotherapy on the Quality of Life of Individuals with Knee Osteoarthritis Assessed by the WHOQOL-Bref: A Multi-Arm Clinical Trial

2020 ◽  
Vol 10 (6) ◽  
pp. 1956 ◽  
Author(s):  
Marcia Cristina Moura-Fernandes ◽  
Eloá Moreira-Marconi ◽  
Alexandre Gonçalves de Meirelles ◽  
Ana Paula Ferreira de Oliveira ◽  
Aline Reis Silva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Whole Body Vibration ◽  
Whole Body ◽  
Pharmacological Interventions ◽  
Control Groups ◽  
Peak Displacement ◽  
Body Vibration ◽  
Combined Intervention

The aim of this study was to determine the effect on the quality of life of two non-pharmacological interventions isolated or in combination: (i) passive whole-body vibration exercise (WBVE), and (ii) auriculotherapy (AT). One hundred three participants with knee osteoarthritis (KOA) were allocated to: (a) a vibration group (WBVEG; n = 17) that performed WBVE (peak-to-peak displacement: 2.5 to 7.5 mm, frequency: 5 to 14 Hz, Peak acceleration: 0.12 to 2.95 g), two days/weekly for five weeks, (b) an AT group (ATG; n = 21), stimulation of three specific auriculotherapy points (Kidney, Knee and Shenmen) in each ear pavilion, (c) WBVE + AT (WBVE + AT; n = 20) and (d) respective control groups (WBVE_CG, n = 15; AT_CG, n = 12; WBVE + AT_CG, n = 18). The participants filled out the WHOQOL-bref Questionnaire before the first and after the last sessions. Statistical differences in the various domains of the WHOQOL-bref were not found. In conclusion, WBVE or AT alone or combined did not contribute in altering the quality of life of individuals exposed to these interventions.

Comparison of four strategies of follow-up in thyroid cancer patients: A cost-utility analysis

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6606-6606
Author(s):  
G. de Pouvourville ◽  
I. Borget ◽  
M. Allyn ◽  
M. Schlumberger
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
Diagnostic Accuracy ◽  
Cancer Patients ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Whole Body ◽  
Utility Analysis

6606 Background: In thyroid cancer patients, follow-up is designed to detect recurrent disease and consists of neck- ultrasonography (US), thyroglobulin measurement (Tg) and radioiodine whole body scan (WBS). Recent guidelines have restricted the use of WBS to suspicious cases. To insure diagnostic accuracy, follow-up control requires TSH stimulation, either with thyroid hormone withdrawal (THW) or rhTSH, which have demonstrated similar diagnostic accuracy. THW induces significant morbidity associated with hypothyroidism, leading to a decrease in patient quality of life and ability to work, whereas rhTSH is an innovative costly drug that avoids such patient burden. A societal cost-utility analysis was conducted to compare 4 follow-up strategies, combining a method of stimulation (rhTSH or THW) and a testing protocol (US+Tg+WBS or US+Tg alone). Methods: A Markov model was built to describe the follow-up of thyroid cancer patients first treated by thyroidectomy and radioiodine ablation, over 5 years. Estimates for diagnostic accuracy values and recurrence rate were extracted from a French multicenter randomized trial. Costs were computed from the perspective of the society, including medical resources consumed (hospitalisation, rhTSH, tests, treatment of recurrence). The model also incorporated the benefits of rhTSH in terms of quality of life (utility scores derived from SF36) and the reduction in duration and overall cost of sick leave. Results: Among the 753 patients included, 13 patients presented recurrence. rhTSH stimulation resulted in a higher utility score (0.802 vs. 0.637) over the period of stimulation and a reduction of 1083 € of absenteeism costs in active patients. As compared to the THW+Tg+US+WBS strategy, the incremental cost-utility ratios (ICER) showed economic dominance for the rhTSH strategies with ratios of −16,876 and −19,297 €/QALY with and without WBS respectively. The ICER for the strategy THW+US+Tg reached 29,333 €/QALY, as compared to THW+Tg+US+WBS strategy. Conclusions: the recommended strategy combining Tg determination and US after rhTSH stimulation appears the most cost-effective in the follow-up of thyroid cancer patients, as it is the strategy the less costly and associated with improved patient quality of life. No significant financial relationships to disclose.

Patient-reported quality of life (QOL) following CTL019 in pediatric and young adult patients (pts) with relapsed/refractory (r/r) b-cell acute lymphoblastic leukemia (B-ALL).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10523-10523 ◽  
Author(s):  
Andrew Charles Dietz ◽  
Stephan A. Grupp ◽  
Theodore Willis Laetsch ◽  
Heather Stefanski ◽  
Gary Douglas Myers ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Young Adult ◽  
Complete Blood Count ◽  
Lymphoblastic Leukemia ◽  
Complete Response ◽  
Adverse Event Rate ◽  
Cell Transplant ◽  
Patient Reported ◽  
Vas Scores

10523 Background: The global ELIANA trial (NCT02435849) evaluates the efficacy and safety of CTL019, a single infusion of genetically modified autologous chimeric antigen receptor–expressing T cells targeting CD19+ cells in pediatric and young adult r/r B-ALL pts. Analyses show a complete response rate of 82% with or without complete blood count recovery ≤ 3 months. A serious adverse event rate of 71% was observed in ≤ 8 weeks of infusion, decreasing to 17% at > 8 weeks (Grupp S, et al. Blood. 2016;128(22) [abstract 221].). This analysis further evaluates the clinical benefit of CTL019. QOL was assessed before and after CTL019 infusion. Methods: Infused pts were 3-23 y/o with CD19+ B-ALL who were chemo refractory, relapsed after allogeneic stem cell transplant (SCT), or otherwise ineligible for SCT. Pts ≥ 8 y completed the Pediatric Quality of Life Inventory (PedsQL) and EuroQol EQ-5D at baseline and following CTL019 infusion. Minimal clinically important differences are estimated to be 4.4 and 7 to 10 for PedsQL and EQ-5D, respectively. Results: 62 of 81 enrolled pts were infused; 56% had relapsed after SCT with median of 3 prior therapies. At interim analysis, 50 pts were treated ≥ 3 months prior to data cutoff and eligible for primary efficacy analysis. A total of 39 pts were ≥ 8 y. Mean PedsQL total and EQ-5D VAS scores, respectively, were 58.4 and 69.4 at baseline. Mean changes from baseline for the PedsQL total and EQ VAS scores, respectively, were 13.9 and 13.7 at month 3 and 12.8 and 10.9 at month 6, supporting clinically meaningful improvements in QOL. Similar trends were observed with each PedsQL subscale. With EQ-5D, the proportions of pts reporting problems with mobility, self-care, usual activities, anxiety/depression, or pain/discomfort were notably decreased at months 3 and 6 compared with baseline. Conclusions: Clinically meaningful improvements in QOL were observed at 3 and 6 months after CTL019 therapy in pediatric and young adult r/r B-ALL pts, including fewer problems in each EQ-5D domain. These results suggest improved QOL after this one-time immunocellular therapy beyond the period of acute toxicities. Clinical trial information: NCT02435849.

scholarly journals Effects of Whole-Body Vibration Therapy in Patients with Fibromyalgia: A Systematic Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Daniel Collado-Mateo ◽  
Jose C. Adsuar ◽  
Pedro R. Olivares ◽  
Borja del Pozo-Cruz ◽  
Jose A. Parraca ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Literature Review ◽  
Whole Body Vibration ◽  
Whole Body ◽  
Health Related Quality ◽  
Body Vibration ◽  
Vibration Therapy ◽  
Related Quality ◽  
Health Related

Objective. To review the literature on the effects of whole-body vibration therapy in patients with fibromyalgia.Design. Systematic literature review.Patients. Patients with fibromyalgia.Methods. An electronic search of the literature in four medical databases was performed to identify studies on whole-body vibration therapy that were published up to the 15th of January 2015.Results. Eight articles satisfied the inclusion and exclusion criteria and were analysed. According to the Dutch CBO guidelines, all selected trials had a B level of evidence. The main outcomes that were measured were balance, fatigue, disability index, health-related quality of life, and pain. Whole-body vibration appeared to improve the outcomes, especially balance and disability index.Conclusion. Whole-body vibration could be an adequate treatment for fibromyalgia as a main therapy or added to a physical exercise programme as it could improve balance, disability index, health-related quality of life, fatigue, and pain. However, this conclusion must be treated with caution because the paucity of trials and the marked differences between existing trials in terms of protocol, intervention, and measurement tools hampered the comparison of the trials.

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