scholarly journals Quality of life after different surgical procedures for the treatment of spinal metastases: results of a single-center prospective case series

2017 ◽  
Vol 42 (1) ◽  
pp. E17 ◽  
Author(s):  
Godard C. W. de Ruiter ◽  
Claudine O. Nogarede ◽  
Jasper F. C. Wolfs ◽  
Mark P. Arts
Keyword(s):  
Quality Of Life ◽  
Surgical Procedures ◽  
Spinal Metastases ◽  
Case Series ◽  
Complication Rates ◽  
Surgical Evaluation ◽  
Stabilization Procedure ◽  
Prospective Case Series ◽  
The Impact

OBJECTIVE The performance of surgery for spinal metastases is rapidly increasing. Different surgical procedures, ranging from stabilization alone to stabilization combined with corpectomy, are thereby performed for various indications. Little is known about the impact of these different procedures on patient quality of life (QOL), but this factor is crucial when discussing the various therapeutic options with patients and their families. Thus, the authors of this study investigated the effect of various surgical procedures for spinal metastases on patient QOL. METHODS The authors prospectively followed a cohort of 113 patients with spinal metastases who were referred to their clinic for surgical evaluation between July 2012 and July 2014. Quality of life was assessed using the EQ-5D at intake and at 3, 6, 9, and 12 months after treatment. RESULTS Nineteen patients were treated conservatively, 41 underwent decompressive surgery with or without stabilization, 47 underwent a piecemeal corpectomy procedure with stabilization and expandable cage reconstruction, and 6 had a stabilization procedure without decompression. Among all surgical patients, the mean EQ-5D score was significantly increased from 0.44 pretreatment to 0.59 at 3 months after treatment (p < 0.001). Mean EQ-5D scores at 1 year after surgery further increased to 0.84 following decompression with stabilization, 0.74 after corpectomy with stabilization, and 0.94 after stabilization without decompression. Frankel scores also improved after surgery. There were no significant differences in improvements in EQ-5D scores and Frankel grades among the different surgical procedures. In addition, mortality and complication rates were similar. CONCLUSIONS Quality of life can improve significantly after various extensive and less extensive surgical procedures in patients with spinal metastases. The relatively invasive corpectomy procedure, as compared with alternative less invasive techniques, does not negatively affect outcome.

The Impact of Health Anxiety in Multiple Sclerosis: A Replication and Treatment Case Series

2017 ◽  
Vol 46 (2) ◽  
pp. 148-167 ◽  
Author(s):  
Neil Carrigan ◽  
Leon Dysch ◽  
Paul M. Salkovskis
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Physical Disability ◽  
Cognitive Behaviour Therapy ◽  
Health Anxiety ◽  
Case Series ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
The Impact

Background: Multiple sclerosis (MS) is commonly associated with psychological complications. Previous research by Hayter and colleagues (2016) found that in patients with MS, health anxiety (HA) can account for part of the variance in quality of life (QoL) independent of physical and cognitive impairment caused by the disease. MS patients with HA perceived their intact physical and cognitive performance as impaired relative to those without HA and attributed the impairment to MS. These misperceptions might be useful targets in the treatment of HA in MS using cognitive behaviour therapy (CBT). Aims: Study 1 sought to replicate the main findings from Hayter et al. (2016). Study 2 examined the impact of HA-focused CBT in a case series. Method: In Study 1, twenty participants with MS were screened for HA and assigned to either a high or low HA group. They completed assessments of cognitive and physical functioning before rating their performance on these tasks, followed by measures of QoL, mood and physical disability. Four participants in the high HA group subsequently received six sessions of CBT using a consecutive AB case series in Study 2. Results: Study 1 replicated the main findings from the earlier study. In Study 2, three of the four patients who received treatment showed substantial improvements in HA and mood and all showed improvement in QoL. Conclusion: Given the high rates of HA in MS patients and its impact on QoL, this case series suggests that a brief CBT intervention could significantly improve patients’ wellbeing.

scholarly journals Severe psychological impact and impaired quality of life after a spontaneous haemoperitoneum in pregnancy in women with endometriosis and their partners

2021 ◽  
Vol 13 (2) ◽  
pp. 159-168
Author(s):  
A.M.F. Schreurs ◽  
M.C.I. LIER ◽  
D.B.M. Koning ◽  
C.W.A. Brals ◽  
M.A. De Boer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychological Impact ◽  
Case Series ◽  
Psychological Help ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Adverse Pregnancy ◽  
The Impact ◽  
In Pregnancy

Background: Spontaneous Haemoperitoneum in Pregnancy (SHiP) is a rare, but life-threatening complication of pregnancy that occurs predominantly in the third trimester of pregnancy and is associated with adverse pregnancy outcomes. Recently the largest case series in literature was published describing 11 Dutch cases of SHiP in women with endometriosis. Purpose: To investigate experiences, psychological impact, and quality of life after SHiP. Methods: A mixed-methods study was performed in women with a history of SHiP and their partners, including all known cases in the Netherlands between 2007 to 2015. Semi-structured in-depth interviews were organized between 2016 and 2017 and analysed thematically with a framework approach. Participants were asked to complete questionnaires investigating the impact of the event (Impact of Event Scale) and Quality of Life (RAND-36). Results: Out of a total of 11 known cases, 7 women agreed for be individually interviewed. From these, all women described a freeze response at the moment of SHiP, combined with either an anxious reaction or a survival mode mind-set. All women received psychological help after SHiP. Still, the feeling of not being heard by the medical staff was present in all women. Other themes such as postpartum period, bonding with their child, effect on daily life, reviving the event, and future pregnancies were also identified in the interviews. In regard to their partners, 3 were interviewed, hence no saturation was achieved. Finally, the questionnaires showed lower Quality of Life and an impact score of ≥ 8/10. Conclusion: SHiP had a profound impact on women and their partners. Dedicated psychological help should be offered to all women after experiencing SHiP.

scholarly journals Blinded Ultrasound Examination of the Subscapularis Following Anatomic Shoulder Arthroplasty

2019 ◽  
Vol 3 ◽  
pp. 247154921983244
Author(s):  
Michael P O’Malley ◽  
Cameron Kia ◽  
Alex G Dukas ◽  
Mark Cote ◽  
Harlan Stock ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Shoulder Arthroplasty ◽  
Ultrasound Examination ◽  
Case Series ◽  
Subscapularis Tendon ◽  
Time Points ◽  
Final Study ◽  
The Status ◽  
Prospective Case Series

Background The subscapularis tendon is commonly released during shoulder arthroplasty, and its integrity and repair postoperatively have been shown important to help maximize patient function. However, diagnosing subscapular tendon failure can be difficult with magnetic resonance imaging secondary to metal artifact as well as very costly. Purpose The purpose of this study was to assess the utility of ultrasound imaging in evaluating subscapularis integrity at specific time points following shoulder arthroplasty, in a blinded fashion. Secondarily, we report on the correlation between the condition of the subscapularis and quality-of-life outcome measures. Study Design Prospective case series. Methods Ultrasounds were completed preoperatively and postoperatively at 1 week as well as at 1, 3, and 6 months. Each was read by a single musculoskeletal radiologist and categorized as “intact,” “torn,” or “unclear.” Clinical outcome was evaluated using the Western Ontario Osteoarthritis Shoulder (WOOS) index at these same time points. Results The final study group consisted of 35 procedures in 33 patients (19 females and 14 males, mean age 66 ± 9 years). Three patients had postoperative subscapularis failures that were confirmed in the operating room at the time of repair. Of 24 sonographs categorized as “unclear” in the postoperative period, the majority (n = 12, 50%) were taken at 1 week. Compared to preoperative scores, patients had lower WOOS scores at 1, 3, and 6 months postoperatively ( P < .001). Correlation analysis did not reveal an association between the ultrasound readings and the WOOS scores postoperatively. Conclusion The utility of ultrasound examination of the subscapularis tendon following shoulder arthroplasty is limited by timing and may be most useful when used by the physician within clinical context. Significant improvement was noted in disease-specific quality-of-life scores regardless of the status of the subscapularis tendon as read on ultrasound.

Lidocaine infusions in chronic pain management: A prospective case series analysis

2021 ◽  
pp. 204946372110541
Author(s):  
Elizabeth Vacher ◽  
Monika Kosela ◽  
Charlie Song-Smith ◽  
Fausto Morell-Ducos ◽  
Alan Fayaz
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Short Form ◽  
Case Series ◽  
Brief Pain Inventory ◽  
Intravenous Lidocaine ◽  
Patient Cohort ◽  
Pain Outcomes ◽  
The Impact

Chronic pain conditions are prevalent and cause a significant burden of disease. Intravenous lidocaine infusions have been reported to have an analgesic effect in patients with chronic neuropathic pain, but there is limited data supporting the efficacy of lidocaine across other chronic pain phenotypes. Our study aimed to evaluate the efficacy of a single infusion of intravenous lidocaine for pain relief and the impact on quality of life. We evaluated data from 74 patients with chronic pain who were treated with intravenous lidocaine at a specialist pain centre. Participants completed a questionnaire consisting of the Brief Pain Inventory (BPI) Short Form and additional EQ-5D quality of life metrics, before treatment and at follow-up. Data comparing pain severity did not demonstrate a statistically significant change after treatment when averaged across the entire patient cohort (6.15–5.88, p = .106), irrespective of gender or pain phenotype. Scores for pain interference showed statistically significant reductions following treatment (7.05–6.41, p = .023), which may have been driven through improvements in sleep (7.41–6.35, p = .001); however, these reductions are not clinically significant. The patient cohort was stratified into responders and non-responders based on >30% improvement in response to an overall impression of pain reduction question following treatment. In the ‘responder’ cohort, pain intensity scores showed a statistically significant reduction post-infusion (6.18–5.49, p = .0135), but no change was apparent for non-responders (6.07–6.09, p = .920). There were no differences between responders and non-responders for pain sub-types in our study. This study found no difference in pain outcomes in a cohort of patients with chronic pain, a mean of 63 days following a single lidocaine infusion. However, a specific subgroup of responders may show slight improvements in some pain outcomes that may warrant further exploration.

The Impact of the Treatment of Pelvic Organ Prolapse with Pessary on Quality of Life and Visual Analog Scale-Case Series

2015 ◽  
Vol 25 (4) ◽  
pp. 282-286
Author(s):  
Burçin KARAMUSTAFAOĞLU BALCI ◽  
Nurcihan ALPER ◽  
Habibe AYYILDIZ ERKAN ◽  
Funda GÜNGÖR UĞURLUCAN ◽  
Önay YALÇIN
Keyword(s):  
Quality Of Life ◽  
Pelvic Organ Prolapse ◽  
Visual Analog Scale ◽  
Case Series ◽  
Pelvic Organ ◽  
Analog Scale ◽  
The Impact

scholarly journals Overlooked Long-Term Complications of Colorectal Surgery

2019 ◽  
Vol 32 (03) ◽  
pp. 204-211 ◽  
Author(s):  
Matthew Giglia ◽  
Sharon Stein
Keyword(s):  
Quality Of Life ◽  
Colorectal Surgery ◽  
Treatment Strategies ◽  
Autonomic Nerve ◽  
Complication Rates ◽  
Low Anterior Resection Syndrome ◽  
Colon And Rectum ◽  
Surgical Field ◽  
The Impact

AbstractWhile colorectal surgery has been documented to have some of the highest complication rates in the surgical field, some of the more common, functional complications are often overlooked in the literature and in discussion with patients. Urinary, sexual, and defecatory dysfunction are common after colorectal surgery, especially after pelvic dissections, and may severely impact the postoperative quality of life for patients. These complications include urinary retention, erectile dysfunction, retrograde ejaculation, dyspareunia, infertility, and low anterior resection syndrome. The majority is rooted in autonomic nerve damage, both sympathetic and parasympathetic, that occurs during mobilization and resection of the sigmoid colon and rectum. While not all of these postoperative complications are preventable, treatment strategies have been developed to ameliorate the impact on quality of life. Given the high incidence and direct effect on patients, clinicians should be familiar with the etiology, prevention, and treatment strategies of these complications to provide the highest quality of care.

scholarly journals The impact of bilateral endoscopic inferior turbinoplasty with or without adenoidectomy on the quality of life of children: a retrospective case series study

2019 ◽  
Vol 48 (1) ◽  
Author(s):  
Ahmed Mourad ◽  
Hussein Jaffal ◽  
Ismaeel El-Hakim ◽  
Hamdy El-Hakim
Keyword(s):  
Quality Of Life ◽  
Case Series ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Case Series Study ◽  
The Impact ◽  
Series Study

Abstract Background Inferior turbinoplasty (IT) and adenoidectomy (Ad) are frequently resorted to in children with chronic rhinitis (CR) refractory to medical therapy. The aim of this study is to document the long-term improvement in quality of life (QOL) in children with CR following endoscopic IT with or without Ad. Methods A retrospective case series study was conducted. We searched a prospectively kept surgical database for children ≤18 years old who had CR who underwent endoscopic IT with or without Ad between 2009 and 2016 at a tertiary care children’s center. Patients with sinonasal pathologies other than CR, had craniofacial syndromes or dysmorphism and had other sinonasal procedures or trauma were excluded. Collected data included demographics, secondary diagnoses, duration of follow-up, and complications of procedures. The Glasgow Children’s Benefit Inventory (GCBI) was administered by phone to assess QOL improvement. Results One hundred sixty-five eligible subjects were identified. Eighty-nine subjects met the inclusion criteria. Data was collected for the 60 subjects that were reached. Forty-two patients had IT only while 18 had IT and Ad. The mean age was 10.7 ± 2.7 years, with 31 males and 29 females. The median duration of follow-up (25th, 75th percentile) was 38.1 months (24.6, 55.8). The median GCBI score (25th, 75th percentile) was 22.9 (6.3, 39.6) revealing an overall positive benefit in all domains. There was only one complication. Conclusions This study validates prior findings regarding improvement of QOL and safety of IT with or without Ad for children with CR and indicates it is maintained in the long term.

Risk-reducing surgery by skin-sparing mastectomy (SSM) and immediate implant-based reconstruction with and without titanized meshes and quality of life.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 48-48
Author(s):  
Mahdi Rezai ◽  
Andre Scherag ◽  
Stefanie Kessel ◽  
Rainer Kimmig ◽  
Peter Kern
Keyword(s):  
Quality Of Life ◽  
Breast Reconstruction ◽  
Positive Impact ◽  
Reduction Mammaplasty ◽  
Complication Rates ◽  
Immediate Reconstruction ◽  
The Impact ◽  
Risk Reducing ◽  
Tiloop Bra

48 Background: The impact of risk-reducing surgery with skin sparing mastectomy and immediate reconstruction on quality of life using new textured implants and titanized meshes (Tiloop bra) has not beed evaluated by standardized quality of life questionnaires (EORTC) with regards to surgery-related morbidity and patients' satisfaction. Methods: This large case cohort trial (n=197) evaluates safety, aesthetic outcome and patient's satisfaction with immediate reconstruction with and without the use of titanized a mesh versus a corial flap after SSM. Results: This large retrospective case cohort trial analysed 197 skin sparing mastectomies (SSM) in 161 patients (45 bilateral cases) and immediate breast reconstruction (IBR). We used a double-plane technique covering the implant by the submuscular pouch in its cranial half and a corial-fat-flap or titanized mesh (Tiloop bra) for covering its lower pole or a de-epithelized corial flap in breasts with macromastia following an inferior-pedicled reduction mammaplasty pattern according to Ribeiro in the modification of Rezai. Conclusions: 163 women, with a median age of 41 years, with a total of 197 SSMs were evaluated. The majority did not experience pain and expressed satisfaction with volume, symmetry, aesthesis and quality of life in general. Partner interaction after breast reconstruction was normal. The use of titanized meshes was perceived as favourable with regards to better fitting of the breast in the bra and clothing and yielded low complication rates. The rating of patients in terms of self-perception after the reconstruction was good. Immediate reconstruction has a significant positive impact and gives the patient a considerable physical and psychological support.The oncological safety of the method is high with 2 recurrences only in this cohort of 163 women (1.2% ) and a follow-up of up to 6 years.

scholarly journals Prediction of Quality of Life and Survival After Surgery for Symptomatic Spinal Metastases

Neurosurgery ◽  
2015 ◽  
Vol 77 (5) ◽  
pp. 698-708 ◽  
Author(s):  
David Choi ◽  
Zoe Fox ◽  
Todd Albert ◽  
Mark Arts ◽  
Laurent Balabaud ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Spinal Metastases ◽  
Patient Characteristics ◽  
Complication Rates ◽  
Tumor Type ◽  
Karnofsky Score ◽  
Visceral Metastases

Abstract BACKGROUND: Surgery for symptomatic spinal metastases aims to improve quality of life, pain, function, and stability. Complications in the postoperative period are not uncommon; therefore, it is important to select appropriate patients who are likely to benefit the greatest from surgery. Previous studies have focused on predicting survival rather than quality of life after surgery. OBJECTIVE: To determine preoperative patient characteristics that predict postoperative quality of life and survival in patients who undergo surgery for spinal metastases. METHODS: In a prospective cohort study of 922 patients with spinal metastases who underwent surgery, we performed preoperative and postoperative assessment of EuroQol EQ-5D quality of life, visual analog score for pain, Karnofsky physical functioning score, complication rates, and survival. RESULTS: The primary tumor type, number of spinal metastases, and presence of visceral metastases were independent predictors of survival. Predictors of quality of life after surgery included preoperative EQ-5D (P = .002), Frankel score (P &lt; .001), and Karnofsky Performance Status (P &lt; .001). CONCLUSION: Data from the largest prospective surgical series of patients with symptomatic spinal metastases revealed that tumor type, the number of spinal metastases, and the presence of visceral metastases are the most useful predictors of survival and that quality of life is best predicted by preoperative Karnofsky, Frankel, and EQ-5D scores. The Karnofsky score predicts quality of life and survival and is easy to determine at the bedside, unlike the EQ-5D index. Karnofsky score, tumor type, and spinal and visceral metastases should be considered the 4 most important prognostic variables that influence patient management.

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