Complications, mobility, and quality of life in ankle sarcoma patients

2021 ◽  
Vol 103-B (3) ◽  
pp. 553-561
Author(s):  
Maria Anna Smolle ◽  
Andreas Leithner ◽  
Martin Kapper ◽  
Gregor Demmer ◽  
Carmen Trost ◽  
...  

Aims The aims of the study were to analyze differences in surgical and oncological outcomes, as well as quality of life (QoL) and function in patients with ankle sarcomas undergoing three forms of surgical treatment, minor or major limb salvage surgery (LSS), or amputation. Methods A total of 69 patients with ankle sarcomas, treated between 1981 and 2017 at two tumour centres, were retrospectively reviewed (mean age at surgery: 46.3 years (SD 22.0); 31 females (45%)). Among these 69 patients 25 were analyzed prospectively (mean age at latest follow-up: 61.2 years (SD 20.7); 11 females (44%)), and assessed for mobility using the Prosthetic Limb Users Survey of Mobility (PLUS-M; for amputees only), the Toronto Extremity Salvage Score (TESS), and the University of California, Los Angeles (UCLA) Activity Score. Individual QoL was evaluated in these 25 patients using the five-level EuroQol five-dimension (EQ-5D-5L) and Fragebogen zur Lebenszufriedenheit/Questions on Life Satisfaction (FLZ). Results Of the total number of patients in the study, 22 (32%) underwent minor LSS and 22 (32%) underwent major LSS; 25 underwent primary amputation (36%). Complications developed in 26 (38%) patients, and were more common in those with major or minor LSS in comparison to amputation (59% vs 36% vs 20%; p = 0.022). A time-dependent trend towards higher complication risk following any LSS was present (relative risk: 0.204; 95% confidence interval (CI) 0.026 to 1.614; p = 0.095). In the prospective cohort, mean TESS was higher following minor LSS in comparison to amputation (91.0 vs 67.3; p = 0.006), while there was no statistically significant difference between major LSS and amputation (81.6 vs 67.3; p = 0.099). There was no difference in mean UCLA (p = 0.334) between the three groups (p = 0.334). None of the items in FLZ or EQ-5D-5L were different between the three groups (all p > 0.05), except for FLZ item “self-relation”, being lower in amputees. Conclusion Complications are common following LSS for ankle sarcomas. QoL is comparable between patients with LSS or amputation, despite better mobility scores for patients following minor LSS. We conclude that these results allow a decision for amputation to be made more easily in patients particularly where the principles of oncological surgery would otherwise be at risk. Cite this article: Bone Joint J 2021;103-B(3):553–561.

2020 ◽  
Vol 26 (4) ◽  
pp. 50-55
Author(s):  
A.R. Stasyshyn ◽  
◽  
A.A. Hurayevskyy ◽  
Yu.Y. Holyk ◽  
◽  
...  

Aim. To analyze the effectiveness of a new method of antireflux surgery in patients with hiatal hernia. Materials and Methods. The results of treatment of 157 patients with hiatal hernia from 2016 to 2020 are analyzed. The patients were divided into 3 groups: group I, N=59, underwent laparoscopic antireflux operation modified by the authors (Patent of Ukraine № 59772); group II (N=77), underwent laparoscopic Nissen fundoplication; and group III (N=21) - laparoscopic Toupet fundoplication. Results and Discussion. At 36 months post-surgery follow-up, there was a statistically significant difference in favor of group I on the average scores of the visual analog scale for reflux symptoms, dysphagia and extraesophageal symptoms; the average quality of life questionnaire scores; the average DeMeester index; distribution of the patients by satisfaction; distribution of the patients by degree of reflux esophagitis according to the Los Angeles classification; and distribution by gas-bloat syndrome. Conclusions. Clinical application of the developed new method of laparoscopic surgery for hiatal hernia reduces the number of relapses and complications after surgery, and improves the quality of life of patients. Key words: hiatal hernia, antireflux surgery, new methods of treatment


2017 ◽  
Vol 3 (2) ◽  
pp. 38
Author(s):  
Sinta Fresia

Abstrak Latar Belakang : Terjadinya peningkatan jumlah pasien HIV/AIDS dan rendahnya kualitas hidup pasien HIV/AIDS menimbulkan masalah yang cukup luas pada individu yang terinfeksi yakni masalah fisik, social dan emosional.Untuk meningkatkan kualitas dan harapan hidup pasien HIV/AIDS harus mendapatkan terapi Antiretrovirus (ARV) seumur hidup dan dibutuhkan pengawasan terhadap kepatuhan minum obat.Oleh karena itu pasien HIV/AIDS membutuhkan edukasi untuk meningkatkan kepatuhan minum obat dengan metode terbaru yaitu tutorial dan audiovisual.Tujuan penelitian ini untuk menganalisa perbedaan efektivitas pemberian edukasi berbasis audiovisual dan tutorial tentang ARV terhadap kepatuhan pengobatan pasien HIV/ AIDS. Metode : Penelitian ini menggunakan desain Quasi eksperimental dengan rancangan pretest-posttes design without control group.Jumlah sampel 27 responden dibagi 3 kelompok dengan 3 perlakuan berbeda.Masing-masing 9 responden diberikan edukasi dengan metode audiovisual, tutorial, audiovisual dan tutorial.Penelitian dilakukan di Klinik Teratai Rumah Sakit Hasan Sadikin Bandung pada bulan Mei-Juni 2016. Hasil : Ada perbedaan rata-rata mean kepatuhan edukasi dengan audiovisual 2,444, (Pvalue=0,003, 95% CI=1,107-3,782), edukasi dengan metode tutorial perbedaan mean 1,556 (Pvalue=0,023, 95% CI=1,274-2,837), edukasi dengan audiovisual dan tutorial didapatkan perbedaan mean 3,667 (Pvalue=0,003, 95% CI=1,670-5,664). Kesimpulan : Terdapat perbedaan yang significant rata-rata kepatuhan pada masing-masing kelompok intervensi edukasi.Kombinasi edukasi berbasis audiovisual dan tutorial memberikan hasil yang paling baik. Abstract Background : An increasing number of patients with HIV/AIDS and low quality of life of patients with HIV/AIDS cause considerable problems in individuals infected area.There are physical, social and emotional problems.To improve the quality of life of receive antiretroviral (ARV) therapy for life.This requires adherence and supervision taking medication. There fore urgently needed education to improve adherence with the latest audiovisual and tutorial methods. The purpose of this research is to analyze the difference effectiveness of education based audiovisual and tutorial method on ARV treatment adherence with HIV/AIDS patients.Methods : This research use quasi experimental design with pretest and posttest without control group. The numbers of sample in this research is 27 sample. Responden group divided into three different education methode. 9 responden in audiovisual methode,9 responden in tutorial methode and 9 responden in audiovisual and tutorial methode. The study was conducted at the Clinic Teratai Hasan Sadikin Hospital in May-June, 2016. Results : There is a diference in average adherence. In audiovisual methode mean 2,444 (Pvalue=0,003, 95% CI=1,107-3,782), tutorial methode 1,556(Pvalue=0,023, 95% CI=1,274-2,837), audiovisual and tutorial methode mean 3,667 (Pvalue =0,003, 95% CI=1,670-5,664).Conclusion : There is a significant difference in the average adherence in difference methode.Especially in audiovisual and tutorial methode. The combination of audiovisual and tutorial-based education gives the best results


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Carolina Figueiredo ◽  
Pedro Maia ◽  
Teresa Mendes ◽  
Helena Pinto ◽  
Alice Lança ◽  
...  

Abstract Background and Aims Quality of life (QoL) is an important indicator of quality of healthcare. Measuring QoL and its correlates for peritoneal dialysis (PD) patients is very important for intervention and clinical decision-making. Being a technique performed by the patients themselves, their perspective of health related QoL is extremely important. The EuroQol questionnaire evaluates 5 QoL dimensions (mobility, self-care, usual activities, pain/ discomfort and anxiety/ depression) and includes a visual analogue scale (VAS) rated 0-100% that provides a quantitative measure of the patients’ perception of their overall health. Method Data from 69 patients on peritoneal dialysis at our center were collected using EQ-5D-5L EuroQol questionnaire. Health state index (HSI) scores were calculated from individual health profiles using the Spanish value set (maximum score 1). Additional clinical and laboratory data was collected from the patient’s medical files. Results Mean age of the population studied was 55,2 ± 14,0 years, and 66,7% (n=46) were male. Most patients were on PD > 1 year (62,3%, n=43) and performing automated peritoneal dialysis (APD) (52,2%, n=36). Mean HSI was 0,88 ± 0,15 and mean VAS score was 75,1 ± 18,7. Patients with weekly Kt/V ≥ 1,7 scored on average 0,09 points higher on the HSI (p=0,070) and 13,34 points higher in VAS (p=0,019), compared to patients with weekly Kt/V < 1,7. Patients on PD > 1 year scored on average 0,09 points lower on the HSI (p=0,017), mainly due to higher levels of anxiety/depression, and 11,9 points lower in VAS (p=0,005) than those < 1 year. Age did not significantly influence QoL, even when comparing patients > 70 years with those < 70 years old (HSI 73.0 ± 15.5 vs 75.4 ± 19.3, p=0.710 / VAS 0.82 ± 0.3 vs 0.89 ± 0.1, p=0.175). Likewise, when comparing continuous ambulatory peritoneal dialysis (CAPD) to APD, there was no significant difference in the scores of QoL. Gender, diabetes mellitus, arterial hypertension, cancer and infectious events related to PD in the last year did not influence QoL. Residual diuresis as an isolated factor did not significantly influence QoL scores. However, as it is a fundamental contributor to Kt/V, it may be indirectly associated with better QoL. A more detailed analysis was not possible as the number of patients with Kt/V ≥ 1.7 and no residual diuresis was, as expected, very low (n=4). Conclusion Perceived QoL in the elderly when compared to younger patients in PD was not inferior in our study, showing this option should be discussed individually with each patient. Our results revealed time in PD negatively influences patients’ perception of their own health, which may be due to patient’s burden and exhaustion, and eventually lead to technique related complications. Kt/V ≥ 1,7 was related to better QoL, either because higher dialysis adequacy leads to better QoL, or because patients who feel better have less tendency to neglect the technique. Finally, we also found type of PD (CAPD vs APD) to have no significant influence on QoL, reinforcing the idea that it should be discussed and adapted to each individual patient.


Author(s):  
Rayeesa Banu R. Umarami ◽  
Mariyam Roqaiya ◽  
Mohd Aqil Quadri

AbstractObjectivesMenorrhagia can be defined as heavy uterine bleeding which comes at regular intervals or uterine bleeding extending more than seven days during menses which has become a considerable problem for females, causing discomfort, anxiety, and poor quality of life. In this study we aimed to compare the effect of Myrtus communis fruits with tranexamic acid in the treatment of menorrhagia.MethodsIn this prospective patient blinded standard controlled study, 40 patients of menorrhagia were randomly assigned to receive either test drug (powdered M. communis fruits) or active control drug (tranexamic acid) for first five days of menstrual cycle consecutively for two cycles. The primary outcome measure was reduction in heavy flow during menses determined by pictorial blood loss assessment chart (PBAC), while improvements in quality of life (QOL) by using short form-36 questionnaire and increase in hemoglobin percentage were kept as secondary outcome measures.ResultsBoth the groups were similar at baseline. Test and control drugs significantly reduced the PBAC score during treatment cycles with p-value <0.001 and these changes were not significantly different between the groups. During second treatment cycle significant difference was found in PBAC score (p = 0.024) between the groups. After treatment significant improvement in hemoglobin percentage was noted and marked improvement in overall quality of life was observed in both the groups.ConclusionThese data suggest that M. communis fruits can be an effective alternate in reducing heavy menstrual bleeding. There is need to confirm these results by designing a trial on large number of patients.Trial Registration NoCTRI/2017/09/009937.


2018 ◽  
Vol 26 (4) ◽  
pp. 248-251
Author(s):  
Marcos Hajime Tanaka ◽  
Marcello Martins de Souza ◽  
Daniel Luiz Ceroni Gibson ◽  
Monica Paschoal Nogueira

ABSTRACT Objective: Patients with metastatic bone lesions have a limited life expectancy. These metastatic lesions compromise the proximal femur, and fractures are quite common. The survival of these patients depends on the behavior of the primary tumor. The aim of this study was to evaluate the quality of life of patients with extensive metastatic lesion of the proximal femur with pathological or imminent fracture, treated with non-conventional endoprosthesis. Methods: From May 2008 to August 2012, twenty-five (25) patients with bone metastases of the proximal femur, with pathological or imminent fracture were recruited into this study. These patients had survived for at least six weeks after surgery and the TESS questionnaire (Toronto Extremity Salvage Score) was administered. Results: The final score of the TESS was an average of 57 points (SD 23.78 points). There was no significant difference in TESS values considering: sex, presence of fracture, or site of the bone lesion. Conclusion: The TESS questionnaire provides information about the function and quality of life of patients with malignant tumors of the lower limbs, from the patient's perspective. The results can be considered positive, when compared to the limited life expectancy and complexity of this group of patients. Level of evidence III, Therapeutic studies, retrospective comparative study.


2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 45-45
Author(s):  
Shingo Hatakeyama ◽  
Kyo Togashi ◽  
Tomoko Hamaya ◽  
Yuta Kojima ◽  
Hayato Yamamoto ◽  
...  

45 Background: We aimed to evaluate the effect of frailty on health-related quality-of-life (HRQOL) and lower urinary symptoms (LUTS) following robot-assisted radical prostatectomy (RARP) in patients with prostate cancer (PC). Methods: We longitudinally evaluated geriatric 8 (G8), HRQOL, and LUTS for 12 months in 118 patients with RARP from January 2017 to April 2020. Patients were divided into frail (G8 ≤14) and nonfrail (G8 > 14) groups. We compared the effect of frailty on HRQOL and LUTS between the frail and nonfrail groups before and 12 months after RARP. Results: The median age of patients was 68 years. The number of patients in the frail and nonfrail groups were 41 and 77, respectively. No significant difference in patients’ background was observed between the groups, except for the presence of cardiovascular disease (22% vs. 7.8%, p = 0.041). There was no significant difference in HRQOLs and LUTS between the groups at baseline. Similarly, HRQOLs, LUTS, and pad-free continence rates were not significantly different between the groups at 12 months after RARP. In the nonfrail group, LUTS at 12 months following RARP significantly improved compared to those at the baseline, but it did not significantly improve in the frail group. Multivariable logistic regression analysis demonstrated that frailty was not significantly associated with LUTS worsening. Conclusions: Frailty was not significantly associated with the worsening of HRQOL, LUTS, and pad-free continence rates in patients treated with RARP.


2017 ◽  
Vol 53 (3) ◽  
pp. 185
Author(s):  
Patricia Maria Kurniawati ◽  
Hening Laswati Laswati

Obesity is one of the chronic diseases that may have significant impact and affect the quality of life, especially in elderly who already have multidimensional problems. This study aimed to provide information about the influence of obesity in elderly on every component of his quality of life by using the SF-36 quality of life. This study was conducted on 105 patients in outpatient Medical Rehabilitation, Geriatrics and Diabetes at Dr. Soetomo Hospital, Surabaya. Patients aged 60-75 years, consisting of 62 men and 43 women. The number of patients with obesity was 49 persons (46.7%) with an average body mass index (BMI) of 27.16 kg / m2. Whereas, non-obese patients were 56 persons (53.3%) with an average BMI of 21.23 kg/m2. In conclusion, there was no significant difference in the SF-36 life quality of obesity and non-obesity groups after being analyzed using t-test.


2019 ◽  
Vol 6 (22;6) ◽  
pp. 591-599
Author(s):  
Tarek A.H. Mostafa

Background: Hyperhidrosis is a disorder associated with detrimental effects on patients’ quality of life, occupational activities, and social interactions. Objectives: This study compares C-arm guided percutaneous radiofrequency (RF) ablation of the second and third thoracic sympathetic ganglions and local intradermal botulinum toxin type A (BTX-A) injection for the treatment of primary palmar hyperhidrosis. It focuses on clinical effectiveness, patient satisfaction, quality of life, safety, and the time at which repetition of the procedure is needed over one-year follow-up. Study Design: This is a randomized single-blinded trial. Setting: This study took place in a single hospital. Methods: Eighty patients with primary palmar hyperhidrosis were randomly assigned to one of 2 interventions: local intradermal BTX-A injection (n = 40) or C-arm guided percutaneous RF ablation (n = 40). The Dermatology Life Quality Index (DLQI) questionnaire and the Hyperhidrosis Disease Severity Scale (HDSS) were used for assessment at one week, one month, and 2, 6, and 12 months after intervention. The number of patients who required repetition of the procedure later on and the time at which they needed it were recorded, and possible side effects were assessed. Results: HDSS scores in the RF group were statistically significantly lower than in the BTX-A group at one week, one month, and 2, 6, and 12 months of follow-up. DLQI scores in the RF group were statistically significantly lower than in the BTX-A group at 6- and 12-month follow-up, whereas at one week, one month, and 2 months of follow-up, there was no statistically significant difference between both groups. The number of patients who required that the procedure be repeated was statistically significantly lower in the RF group than in the BTX-A group. The time at which patients needed repetition of the procedure in the BTX-A group was about 3 to 7 months after the first intervention. All patients in this group showed an increase in HDSS scores within this one-year followup. In the RF group, however, only one patient complained of increased HDSS scores after 8 months. There was no statistically significant difference in side effects between both groups. Limitations: The first limitation of this study is that results were based on subjective scales. The second is the radiation exposure associated with the technique described. Conclusions: This study supports percutaneous C-arm guided RF ablation of the second and third thoracic sympathetic ganglions and local intradermal BTX-A injection as safe, effective options and rapid lines of treatment of primary palmar hyperhidrosis. However, percutaneous RF ablation proved to be more effective, with longer effectiveness time and better patient satisfaction, compared to local intradermal BTX-A injection.


2019 ◽  
Vol 11 (1) ◽  
pp. 9-18
Author(s):  
Abdul Wakhid ◽  
Ana Puji Astuti ◽  
Maya Kurnia Dewi

Logoterapi merupakan terapi untuk menemukan makna positif dibalik sebuah kejadian yang tidak diharapkan. Logoterapi dilaksanakan secara individu maupun berkelompok dalam bentuk konseling dan berorientasi pada pencarian makna hidup individu. Tujuan logoterapi meningkatkan makna pengalaman hidup individu yang diarahkan kepada pengambilan keputusan yang bertanggung jawab. Penelitian ini dilakukan dengan menggunakan rancangan pre-experiment dengan metode pre and post test group, artinya pengumpulan data dilakukan terhadap responden untuk membandingkan kualitas hidup sebelum dan sesudah dilakukan intervensi. Teknik pengambilan sampel dilakukan dengan metode total sampling yaitu pengambilan seluruh sampel dengan tetap memperhatikan kriteria yang telah ditetapkan. Jumlah pasien yang menjalani hemodialisis di RSUD Ungaran sebanyak 21 orang dan di RSUD Ambarawa sebanyak 25 pasien. Analisis data dilakukan dengan menggunakan uji t test dependent. Hasil penelitian didapatkan bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 60.22 dengan skor terrendah 55 dan skor tertinggi 69. Bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 88.72 dengan skor terrendah 79 dan skor tertinggi 103. Hasil uji statistik dengan uji t test dependent diketahui ada pengaruh logoterapi terhadap kemampuan memaknai hidup pada klien yang menjalani hemodialisis di RSUD Kabupaten Semarang (p value: 0,0001). Saran perlunya peningkatan kemampuan perawat dalam memberikan layanan kesehatan termasuk pemberian atau pemanduan penemuan makna hidup bagi pasien hemodialysis, agar selain dengan hemodialysis, ada faktor internal dari pasien yang dapat dijadikan sebagai motivasi untuk sembuh dari penyakit.   Kata Kunci: Logoterapi, kualitas hidup   IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RENAL FAILURE WHO UNDERWENT HEMODIALYSIS   ABSTRACT Logotherapy is a therapy to discover the positive meaning behind an unexpected event. Logotherapy is carried out individually or in groups in the form of counseling and oriented to the search for the meaning of individual life. This study aims to improve the quality of life of patients with renal failure who underwent hemodialysis. This research was conducted by using pre-experiment with pre-post test study. The sampling technique was done by the convenience sampling. The number of patients undergoing hemodialysis as many as 46 respondents. Data analysis was done by using test t test dependent. The result showed that from 46 respondents got the mean of quality of life of patients who had hemodialysis 60.22 with lowest score 55 and highest score 69. Whereas from 46 respondents got the mean score of life quality of patients who had hemodialysis 88.72 with score the lowest score 79 and the highest score 103. The result of statistical test with t test dependent is known there is influence of logoterapi to the ability of meaningful life on client who undergo hemodialysis at Semarang Regency hospitals (p value: 0.0001). Advice on the need to improve the nurse's ability to provide health services, including the provision or guidance of the discovery of the meaning of life for hemodialysis patients, in addition to hemodialysis, there are internal factors of the patient that can be used as a motivation to recover from illness.   Keywords: Logotherapy, quality of life, kidney failure.  


Author(s):  
Vera Arsenyeva ◽  
Boris Martynov ◽  
Gennadiy Bulyshchenko ◽  
Dmitriy Svistov ◽  
Boris Gaydar ◽  
...  

Gliomas make up about 8 cases per 100,000 population and the number of patients with this disease is only increasing. There can be not only various types of neurological deficits among the symptoms, but also personal and emotional changes, that seriously affects the quality of life. The modern model of health care includes not only recovery of the patient’s physical functions, but also his or her psychosocial well-being. In particular, the assessment and study of the characteristics of health-related quality of life, as well as cognitive functions in patients with gliomas, is increasingly recognized as an important criterion when considering the effectiveness of treatment. To date, the features of health related quality of life and cognitive functions of patients with epilepsy and acute cerebral circulation disorders have been studied sufficiently, and, as a result, techniques have been developed that accurately assess the QOL and CF in patients with these diseases. These are QOLIE-31 and QOLIE-AD-48 questionnaires for patients with epilepsy. This is the National Institutes of Health Stroke Scale (NIHSS), Orgogozo stroke scale (OSS), World Federation of Neurological Surgeons (WFNS) scale for the clinical assessment of subarachnoid hemorrhage (SAH) for patients with acute cerebrovascular accident. At the same time, there are no generally accepted methods for assessing quality of life and neurocognitive functions that are sensitive to changes in the condition of patients with gliomas in the early postoperative period by the time of discharge from the hospital. As a result, there is no systematic information on the dynamics of the quality of life of such patients, their neurocognitive functioning. The purpose of this article was to study the literature on QOL and CF in patients affected by neurological and neurosurgical disorders for the further selection of optimal methods for assessing dynamics of the condition of patients with glial brain tumors before and after surgery. At the moment, such requirements are only partially met by the EORTC QLQ-C30 questionnaire and its application EORTC QLQ-BN20.


Sign in / Sign up

Export Citation Format

Share Document