scholarly journals Teriparatide Administration By The Omnipod Pump: A Self-Managed Therapeutic Option for Refractory Hypoparathyroidism

2021 ◽  
Author(s):  
Karine Aouchiche ◽  
Rachel Reynaud ◽  
Vincent Amodru ◽  
Thierry Brue ◽  
Thomas Cuny
Keyword(s):  
Quality Of Life ◽  
Vitamin D ◽  
Total Thyroidectomy ◽  
Therapeutic Option ◽  
Review Of Literature ◽  
Active Vitamin ◽  
Continuous Administration ◽  
Subcutaneous Injections ◽  
Subcutaneous Infusion

Abstract Context : Hypoparathyroidism (hypoPTH) in adults is mainly due to total thyroidectomy. Conventional therapies (calcium, active vitamin D) can fail to normalize calcemia, expose the patient to hypercalciuria and impact quality-of-life. Human parathormone (hPTH) replacement therapy is a suitable option in these cases, although few clinical reports have been published so far. Methods we describe two cases of refractory postsurgical hypoPTH for which subcutaneous infusion of recombinant parathormone (teriparatide) through the Omnipod® pump was started after failure of all other therapeutic options. Besides, we performed a review of literature of hypoPTH cases treated by continuous infusion of teriparatide. Results two women aged 46 and 61yo failed to normalize calcemia either with conventional treatments (calcium 8g/d + calcitriol 9µg/d and calcium 5g/d + calcitriol 12µg/d) or with thrice-daily subcutaneous injections of teriparatide. As a last resort, teriparatide infusion via Omnipod® device normalized their calcemia and allowed calcium/vitamin D withdrawal, with average teriparatide dose of 23 and 32 µg/day, respectively. Notably, a dedicated protocol currently allow each patient to be autonomous with its pump without adverse dyscalcemia until now. In the literature, 15 adult cases (13 women, mean age 44.5 ± 5.2 yo) are reported. HypoPTH was consecutive to surgery in all of them. Mean dose of teriparatide administered was 25 ± 6 µg/d with improvement of calcemia level and quality-of-life in all patients. Conclusion Continuous administration of teriparatide through Omnipod® is a safe and efficient therapeutic option in refractory hypoPTH, which can, furthermore, be safely self-managed by the patient.

scholarly journals Pulsed Dose Rate Brachytherapy of Lip Carcinoma: Clinical Outcome and Quality of Life Analysis

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1387
Author(s):  
Radouane El Ayachy ◽  
Roger Sun ◽  
Kanta Ka ◽  
Adrien Laville ◽  
Anne-Sophie Duhamel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Dose Rate ◽  
Therapeutic Option ◽  
Local Control Rate ◽  
Local Failure ◽  
Life Assessment ◽  
Grade Ii ◽  
Lip Carcinoma ◽  
Pulsed Dose Rate

Purpose: Lip carcinoma represents one of the most common types of head and neck cancer. Brachytherapy is a highly effective therapeutic option for all stages of lip cancers. We report our experience of pulsed dose rate brachytherapy (PDR) as treatment of lip carcinoma. Methods and Materials: this retrospective single center study included all consecutive patients treated for a lip PDR brachytherapy in our institution from 2010 to 2019. The toxicities and outcomes of the patients were reported, and a retrospective quality of life assessment was conducted by phone interviews (FACT H&N). Results: From October 2010 to December 2019, 38 patients were treated in our institution for a lip carcinoma by PDR brachytherapy. The median age was 73, and the majority of patients presented T1-T2 tumors (79%). The median total dose was 70.14 Gy (range: 60–85 Gy). With a mean follow-up of 35.4 months, two patients (5.6%) presented local failure, and seven patients (19%) had lymph node progression. The Kaplan–Meier estimated probability of local failure was 7.2% (95% CI: 0.84–1) at two and four years. All patients encountered radiomucitis grade II or higher. The rate of late toxicities was low: three patients (8.3%) had grade II fibrosis, and one patient had grade II chronic pain. All patients would highly recommend the treatment. The median FACT H&N total score was 127 out of 148, and the median FACT H&N Trial Outcome Index was 84. Conclusions: This study confirms that an excellent local control rate is achieved with PDR brachytherapy as treatment of lip carcinoma, with very limited late side effects and satisfactory functional outcomes. A multimodal approach should help to improve regional control.

scholarly journals Self-reported use of vitamin D supplements is associated with higher physical quality of life scores in multiple sclerosis

2021 ◽  
Vol 49 ◽  
pp. 102760
Author(s):  
Steve Simpson-Yap ◽  
Pia Jelinek ◽  
Tracey Weiland ◽  
Nupur Nag ◽  
Sandra Neate ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Vitamin D ◽  
Physical Quality ◽  
Vitamin D Supplements

scholarly journals Quality of Life And Gerontology: Description of a Research Line

2014 ◽  
Vol 4 (3) ◽  
pp. 301-308
Author(s):  
Bernat-Carles Serdà Ferrer
Keyword(s):  
Quality Of Life ◽  
Therapeutic Option ◽  
Rehabilitation Program ◽  
Muscular Fitness ◽  
Psychological Mechanisms ◽  
Modular Concept ◽  
Specific Objective ◽  
Quasi Experimental ◽  
The Continuum

The Quality of Life (QoL) is a multidimensional, dynamic and modular concept. QoL is influenced by psychological mechanisms related to the adaptation disease. The aim of this paper is to describe the research line on QoL and chronic disease. The specific objective is to determine the mechanisms involved in the change of QoL in a group of elderly people with cancer. Method. The study is prospective quasi-experimental. With a sample of 130 participants with cancer. Results. The rehabilitation program improves muscular fitness, cardiovascular efficiency, (at rest and effort) and reduces the continued decline related to treatment. We have observed a significant increase in QoL in the period evaluated. This result confirms that QoL at baseline of the disease is low. Adherence to the program achieved is 93%. Conclusions. We confirm the effectiveness of a rehabilitation program tailored to the symptoms generated by the disease and cancer treatment in improving QoL of older people. The program is a therapeutic option to preserve the QoL of the patient in the continuum of the disease. Now we are studying the timing where the implementation of the program is most effective.

scholarly journals Sunitinib achieved fast and sustained control of VIPoma symptoms

2015 ◽  
Vol 172 (1) ◽  
pp. K1-K3 ◽  
Author(s):  
Louis de Mestier ◽  
Thomas Walter ◽  
Hedia Brixi ◽  
Catherine Lombard-Bohas ◽  
Guillaume Cadiot
Keyword(s):  
Quality Of Life ◽  
Tyrosine Kinase ◽  
Targeted Therapies ◽  
Therapeutic Option ◽  
Somatostatin Analogs ◽  
Watery Diarrhea ◽  
Tyrosine Kinase Receptors ◽  
Secretory Pathways ◽  
Discharge From Hospital

VIPomas are rare-functioning neuroendocrine tumors (NETs). Overproduction of vasointestinal peptide (VIP) leads to the Verner–Morrison syndrome, whose management is challenging when refractory to somatostatin analogs. Two patients with progressive metastatic pancreatic NETs and refractory VIPoma symptoms were treated with sunitinib. This led to fast and sustained total relief of VIPoma symptoms, enabling earlier discharge from hospital and improvement in their quality of life. In both cases, sunitinib discontinuation led to the quick recurrence of watery diarrhea, which resolved within a few days after reintroducing sunitinib. The anti-secretory effect of sunitinib on VIPoma syndrome was probably not related to any anti-tumor effect. These observations agree with the rare reported cases of anti-secretory effects with targeted therapies. The sunitinib-driven inhibition of multiple-tyrosine kinase receptors might act on secretory pathways and describe sunitinib's ability to improve VIPoma symptoms. Sunitinib could be a therapeutic option to control refractory VIPoma symptoms in patients with NETs.

scholarly journals Efficacy of adalimumab in moderate to severe hidradenitis suppurativa: Real life data

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Aikaterini Kyriakou ◽  
Anastasia Trigoni ◽  
Nikiforos Galanis ◽  
Dimitrios Sotiriadis ◽  
Aikaterini Patsatsi
Keyword(s):  
Quality Of Life ◽  
Hidradenitis Suppurativa ◽  
Therapeutic Potential ◽  
Therapeutic Option ◽  
Real Life ◽  
Life Quality ◽  
Global Assessment Scale ◽  
Friedman's Test ◽  
Adalimumab Treatment

Hidradenitis suppurativa (HS) is a relapsing, inflammatory disease characterized by painful nodules, abscesses, sinuses track formation and scarring. HS has a great impact on patients’ quality of life and its treatment may be really challenging. Adalimumab provides a new therapeutic option for HS. Our aim was to assess the therapeutic potential of adalimumab on patients with HS based on the data from the daily clinical practice of an HS Outpatient Clinic. 19 patients with clinically evident moderate to severe HS, under adalimumab treatment for at least 24 week, participated in this observational, retrospective study. The Hidradenitis Suppurativa Physician’s Global Assessment scale, Modified Santorius scale and Dermatology Life Quality Index (DLQI) at baseline, week 4, week 12 and week 24 were retrieved from the records. Both Modified Santorius score and DLQI were significantly decreased during the weeks of evaluation (Friedman’s test; P < 0.001). The proportion of patients who achieved clinical response was 10.5% (n = 2) at week 4, 42.1% (n = 8) at week 12 and 63.2% (n = 12) at week 24. Treatment with adalimumab was linked with both clinical remission of HS and improvement of patients’ quality of life.

scholarly journals Impact of total thyroidectomy on quality of life at 6 months: the prospective ThyrQoL multicentre trial

2020 ◽  
Vol 182 (2) ◽  
pp. 195-205 ◽  
Author(s):  
E Mirallié ◽  
F Borel ◽  
C Tresallet ◽  
A Hamy ◽  
M Mathonnet ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Thyroidectomy ◽  
Short Form ◽  
Multivariable Analysis ◽  
Vocal Cord Palsy ◽  
Multicenter Trial ◽  
Significant Impairment ◽  
The Impact ◽  
Benign Thyroid

Objective This study is to determine the impact of complications after total thyroidectomy on health-related quality of life (HR-QoL) and to identify significant predictive factors of HR-QoL changes. HR-QoL is usually impaired in patients with thyroid diseases compared to the general population. Thyroidectomy is largely performed in the case of benign thyroid benign and can be associated with long-term complications (vocal cord palsy, hypoparathyroidism). Design The prospective ThyrQoL multicenter trial (NCT02167529) included 800 patients who underwent total thyroidectomy for benign or malignant non-extensive disease in seven French referral hospitals between 2014 and 2016. Methods HR-QoL was assessed using the MOS 36-item short form health survey (SF-36) self-questionnaire with a 6-month follow-up. Results We observed a significant improvement of HR-QoL 6 months after surgery (P < 0.0001). Postoperative complications were associated with a non-significant impairment of HR-QoL. In multivariable analysis, Graves’ disease was associated with a significant improvement of HR-QoL (OR = 2.39 [1.49; 3.84]) and thyroid malignant disease with an impairment of HR-QoL (OR = 1.44 [0.99; 2.08]) after thyroidectomy. Conclusion We observed a significant improvement of HR-QoL 6 months after total thyroid surgery for benign thyroid disease.

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