scholarly journals Quality of Life with Vulvar Carcinoma Treated with Palliative Electrochemotherapy: The ELECHTRA (ELEctroCHemoTherapy vulvaR cAncer) Study

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1622
Author(s):  
Anna Myriam Perrone ◽  
Martina Ferioli ◽  
Lisa Argnani ◽  
Francesca De Terlizzi ◽  
Cecilia Pirovano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vulvar Cancer ◽  
Pain Scale ◽  
Outcome Data ◽  
Before And After ◽  
Effective Option ◽  
Cancer Project ◽  
Multicenter Prospective Observational Study

The ELECHTRA (ELEctroChemoTherapy vulvaR cAncer) project was conceived to collect data on palliative electrochemotherapy (ECT) in vulvar cancer (VC) assessing patients’ outcomes (response and survival) and impact on quality of life (QoL). After reporting outcome data in 2019, here, we present the results on QoL. A multicenter prospective observational study was conducted on patients with VC refractory or not amenable to standard therapies undergoing palliative ECT as per clinical practice. The following questionnaires were administered before and after ECT (two and four months later, early and late follow-up): visual analog pain scale (VAS), EuroQol 5-Dimension 5-Level (EQ-5D-L5) and Functional Assessment of Cancer Therapy—Vulva cancer (FACT—V). Analyses were conducted on both the whole study population and by subgroups (clinical response after ECT and site, number and size of lesions). Questionnaires from 55 patients were evaluated. Compared to the baseline (6.1 ± 2.1), the VAS was significantly reduced at early (4.3 ± 2.5) and late follow-up (4.6 ± 2.8) (p < 0.0001). The FACT—V score improved significantly at early (9.6 ± 4.0) (p < 0.0001) and late follow-up (8.9 ± 4.1) (p < 0.0054) as compared to the baseline (7.1 ± 3.6). No EQ-5D-5L statistically significant changes were observed. Subgroup analyses showed worse QoL in patients with stable or progressive disease, posterior site and multiple or larger than 3 cm nodules. This is the first study reporting improved QoL in VC patients after palliative ECT. Based on these results, ECT in VC should be considered an effective option based on the favorable outcomes both in terms of response and QoL.

scholarly journals Vulva Cancer Treatment with Cryosurgery

2018 ◽  
Vol 4 (1) ◽  
pp. 1-10
Author(s):  
Mauro JE ◽  
Storino C ◽  
Bianconi MI ◽  
Farah C ◽  
D’Atri FJ
Keyword(s):  
Quality Of Life ◽  
Genital Tract ◽  
Vulvar Cancer ◽  
Tumor Resection ◽  
Safety Margin ◽  
Previous Treatment ◽  
Complete Healing ◽  
High Morbidity

Vulvar cancer represents 4% to 5% of Low Genital Tract Tumors (LGTT) and 1% of all cancers in women. Treatment depends on stage, and when possible surgery is preferable. Advanced cancers require large resections (with needs grafts and-or rotating flaps), radio and/or chemotherapy, all of which can lead to high morbidity and quality of life impairment. To minimize these effects, in 1994, we developed a cryosurgery prospective protocol to manage vulvar cancer in patients with comorbid conditions.Patients and Methods: Between 1994 and 2019 we treated n=41 patients: FIGO stages I: n=2 (4.88%) II: n=9 (21.95%), III: n=28 (68.29%), IV: n=2 (4.88%). Median age 64.3 (28 to 90 years old), and 70% were 70 years old or older, 59% had severe comorbidities (diabetes, autoimmune diseases, immunosuppressive user).Cryosurgery Protocol:Firstly, tumor resection, hemostasis, and 2 rapid freezing- slow thawing cycles with Liquid Nitrogen (LN) spray. The cycles should include the logde and a 1.5 cm safety margin. After complete healing (between 45 and 95 days after cryosurgery), nodes are treated according to FIGO stages. Result:All patients after the effects of the anesthesia were able to urinate spontaneously, walk, had minimal analgesic requirements, with good postoperative. The patients remained in the hospital for one or two days, and with rare exceptions, were discharged the following day with controls twice a week at the hospital. None of the patients required flaps or grafts to repair the treated areas. After complete healing they maintained the vulvar sensitivity and considerably improved their quality of life. Some of them, who had a partner, were able to resume their sexual intercourse.Mean follow-up: 55.39 (3 months to 258 months). Five patients had local recurrences between 12 and 72 months after treatment, and were controlled with a new cryosurgery. Six patients had HPV related lesions located in other areas of the lower genital tract, which were also controlled with cryosurgery. Twenty five of them died 19 due to an unrelated cause of death, and 6 due to disease progression in the nodes without vulvar recurrence, 9 patients survived and were free of disease with a mean follow-up of 53 months. Seven patients, after a disease free follow up of 17.2 months, weren ́t able to be controlled, as they lived more than 400 km way from the hospital. Local control was achieved in all patients.Comments: Cryosurgery can be done after any previous treatment, and can be repeated to control recurrences.Conclusion: Given the simplicity of the technique, its low cost, the possibility of being used in patients with multiple co-morbidities, the absence of major complications, and the anatomical and functional results obtained, we believe that cryosurgery can be considered among the best options to control of vulvar cancer, even large or advanced cases, in elderly patients and-or with severe comorbidities.

UK trial of the Osseointegrated Prosthesis for the Rehabilitation for Amputees: 1995–2018

2018 ◽  
Vol 43 (1) ◽  
pp. 112-122 ◽  
Author(s):  
Douglas John Matthews ◽  
Mateen Arastu ◽  
Maggie Uden ◽  
John Paul Sullivan ◽  
Kristina Bolsakova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Deep Infection ◽  
Outcome Data ◽  
Superficial Infection ◽  
Kaplan Meier ◽  
The Uk ◽  
Implant System

Background: Amputation of a limb impacts on patients’ self-perception and quality of life. Prostheses directly anchored to the skeleton are being investigated, aiming to avoid soft tissue complications. Objectives: We report outcome data for the UK trial of the Osseointegrated Prosthesis for the Rehabilitation of Amputees Implant System with a minimum of 9-year follow-up. Methods: Eighteen transfemoral amputees received unilateral implants between 1997 and 2008. Five were implanted before a formalised protocol, called Osseointegrated Prosthesis for the Rehabilitation of Amputees, was developed. Mean follow-up of the Pre-Osseointegrated Prosthesis for the Rehabilitation of Amputees group is 11.4 years (1.8–18.6 years), while for the Post-Osseointegrated Prosthesis for the Rehabilitation of Amputees group it is 12.3 years (2.9–15.9). Results: The Kaplan–Meier cumulative survivorship is 40% for the Pre-Osseointegrated Prosthesis for the Rehabilitation of Amputees group and 80.21% for the Post-Osseointegrated Prosthesis for the Rehabilitation of Amputees group. Five implants (28%) have been removed, three (17%) for deep infection, one (5.6%) for chronic pain, later proven to be infected and one (5.6%) due to implant fracture secondary to loosening due to infection. Two patients (11%) have peri-implant infections suppressed with oral antibiotics. Eleven cases (61%) of superficial infection were successfully treated with antibiotics. 36-Item short-form health survey and Questionnaire for persons with a Transfemoral Amputation showed significant improvements in quality of life up to 5 years after implantation. Conclusion: This small cohort of patients demonstrates osseointegrated prosthesis allows prolonged usage and improves patients’ quality of life compared to conventional prostheses. Clinical relevance These prostheses may provide a future gold standard for amputees and this study provides the first outcome data over such a time period to be reported from outside of the developers group.

scholarly journals Effects of Combined Endurance and Resistance Training in Women With Multiple Sclerosis: A Randomized Controlled Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Luca Correale ◽  
Cosme Franklim Buzzachera ◽  
Giulia Liberali ◽  
Erwan Codrons ◽  
Giulia Mallucci ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Muscle Strength ◽  
Well Being ◽  
Controlled Study ◽  
Intervention Period ◽  
Maximal Voluntary Isometric Contraction ◽  
Leg Extension ◽  
Before And After

Purpose: To test the hypothesis that combined resistance and endurance training would improve muscle strength, fatigue, depression, and quality of life in persons with MS.Methods: Twenty-seven women with MS were randomly assigned to either control (CON, n = 13) or the experimental (EXP, n = 14) group. The participants in the EXP group trained twice a week for 12 weeks, followed by 12 weeks of detraining. Both CON and EXP groups were tested before and after 12 weeks of the intervention period, as well as 12 weeks after training cessation (follow-up), where measures of muscle strength, fatigue, depression, and quality of life were evaluated.Results: There were significant changes in maximal voluntary isometric contraction (MVIC), 1RM leg extension, and 1RM chest press following the intervention period in the EXP group (P &lt; 0.05), but not in the CON group (P &gt; 0.05). These changes persisted after 12 weeks of detraining. Similar findings were found for fatigue, depression, and physical and mental composites of quality of life.Conclusion: These results suggest that combined exercise training, at a minimum, prevents the disease-related deterioration of muscular performance and quality of life and well-being in persons with MS.

scholarly journals Pilot Evaluation of Obesity-Specific Health-Related Quality of Life Following a 12-Week Non-Randomized Lifestyle Intervention in Youth

2020 ◽  
Author(s):  
Sukhbir Randhawa ◽  
Navkiran Randhawa ◽  
Es-Haq Hassanin ◽  
Joyce Yi-Frazier ◽  
Kathaleen Briggs Early
Keyword(s):  
Quality Of Life ◽  
Change Score ◽  
Social Avoidance ◽  
Health Related Quality ◽  
Youth Health ◽  
Before And After ◽  
Related Quality ◽  
Health Related

Abstract Youth health-related quality of life (HRQOL) was measured before and after a 12-week family and community-based intervention using the obesity-specific HRQOL tool, Sizing Me Up©. This project enrolled 68 youth (10.88 years ± 2 years; 54% male; 50% non-Hispanic white). In addition to total QOL, we used paired t-tests to examine the Sizing Me Up sub-scales: Emotion Physical, Social Avoidance, Positive Attributes and Teasing. A greater reduction in change score indicated a larger increase in quality of life sub-scale. Significant improvements from baseline to follow-up were found in the total HRQOL (mean change = -5.27, SD 10.76, p=0.00) and for the sub-scores of: emotion (mean change = -8.06, SD 16.85, p≤0.000) and teasing-related QOL (mean change = -5.65, SD16.79, p = 0.01). Social avoidance attributes improved between baseline and follow-up (mean change = -3.92, SD11.21, p=0.007). The Sizing Me Up© instrument detected significant and positive changes in quality of life after the intervention. Sizing Me Up© could provide a clinically meaningful tracking of quality of life among youth with obesity.

scholarly journals The Effect of Non-Supervised Physical Activity Before and After Breast Cancer Surgery on Quality of Life; Follow-Up Results From a Randomised Controlled Trial (Physsurg-b)

2021 ◽  
Author(s):  
Jenny Eva Maria Heiman ◽  
Aron Onerup ◽  
David Bock ◽  
Eva Haglind ◽  
Roger Olofsson Bagge
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Physical Activity ◽  
Adjuvant Chemotherapy ◽  
Controlled Trial ◽  
Breast Cancer Surgery ◽  
Before And After ◽  
Randomised Controlled

Abstract PurposeWe conducted a randomised controlled trial (PhysSURG-B) to assess the short- and long-term effects of a non-supervised physical activity intervention at the time of breast cancer surgery. Here we report a secondary outcome, quality of life (QoL).MethodsFemale patients planned for surgery were randomly assigned to either an intervention of 30 minutes of self-administered physical aerobic activity daily 2 weeks before and 4 weeks after surgery, or control. QoL was assessed with questionnaires at baseline, 4 weeks and 12 months postop using the instruments FACT-B, RAND-36 and EQ-VAS.ResultsOut of 354 included participants at 12 months follow-up after surgery, 287 were available for QoL analysis. Comparing intervention to control, the results for the FACT- B score at 4 weeks showed an odds ratio (OR) of 0.975 (95% CI 0.636-1.495) and at 12 months an OR of 0.883 (95% CI 0.581-1.342). The subgroup of patients receiving adjuvant chemotherapy had significantly lower FACT-B at 12 months compared to no chemotherapy (OR 0.475, 95% CI 0.300-0.735). EQ-VAS showed OR 1.163 (95% CI 0.760-1.779) and 0.817 (95% CI 0.536-1.244) at 4 weeks and 12 months, respectively. RAND-36 domains “role limitations due to physical health” and “pain” showed a decrease at 4 weeks in both groups, returning towards baseline at 12 months follow-up.ConclusionAn intervention of non-supervised physical activity before and after surgery for breast cancer had no effect on QoL. Patients receiving adjuvant chemotherapy had significantly lower QoL, regardless of study group.Trial registrationClinicalTrials.gov registration number: NCT 02560662. Registered 25 September, 2015.

scholarly journals Results of surgical treatment of children with PFAPA syndrome

2019 ◽  
pp. 244-251
Author(s):  
A. S. Yunusov ◽  
T. I. Garashchenko ◽  
P. I. Belavina ◽  
A. G. Ryazanskaya ◽  
E. V. Molodtsova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Multidisciplinary Approach ◽  
Pediatric Population ◽  
Quality Of Life Indicators ◽  
Before And After ◽  
Pfapa Syndrome ◽  
Primary School Age

Rationale. Currently, the literature describes about 374 cases of Marshall syndrome. According to some authors, the prevalence of Marshall syndrome is 2.3 per 10,000 children, in general, the epidemiology of PFAPA syndrome in the pediatric population is unknown.Purpose. The aim of our study is to justify surgical treatment in children with Marshall syndrome. Objectives. The objectives of this study are to give a comparative assessment of the effectiveness of tonsillectomy and adenotonzyllectomy for this syndrome and to evaluate the quality of life indicators before and after surgical treatment.Materials and methods. The study included 26 patients with Marshall syndrome, of which 18 patients underwent adenotonzyllectomy and 8 patients underwent bilateral tonsillectomy. A clinical case of a typical manifestation of Marshall syndrome is also described, and follow-up results of the effectiveness of surgical treatment for Marshall syndrome are presented. In the course of the work, an adapted questionnaire was developed to assess the quality of life of parents of children with Marshall syndrome.Results. The result of our work is the fact that in relation to the relief of PFAPA-syndrome, children of preschool and primary school age have more effective adenotonsillectomy (88.2%), while tonsillectomy was effective only in 55.6% of patients.Conclusion. A multidisciplinary approach is required to address the diagnosis and treatment of Marshall syndrome.

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