Some aspects of the treatment of patients with paracolostomy fistulas in outpatient settings

2021 ◽  
Author(s):  
E.D. Birch ◽  
A.V. Smolkina
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Local Treatment ◽  
Outpatient Basis ◽  
Complex Treatment ◽  
Results Of Treatment ◽  
Treatment Of Wounds ◽  
Outpatient Settings ◽  
The Cost

The analysis of the results of treatment of 15 patients with paracolostomy fistulas treated on an outpatient basis with the use of the sorbent "Celoform" was carried out. The use of modern drugs for the local treatment of wounds at all stages of complex treatment makes it possible to shorten the time of systemic antimicrobial therapy, avoid the development of side effects, and significantly reduce the cost of expensive antibacterial drugs. Key words: colostomy, paracolostomy fistula, sorbent "Coeloform, quality of life.

scholarly journals COMPLEX THERAPY OF ATOPIC CHEILITIS

2021 ◽  
Vol 74 (2) ◽  
pp. 310-312
Author(s):  
Nataliya M. Ilenko ◽  
Ella V. Nikolishyna ◽  
Iryna Yu. Lytovchenko ◽  
Fardin Atash Bar
Keyword(s):  
Quality Of Life ◽  
Inflammatory Process ◽  
Blood Analysis ◽  
Complex Treatment ◽  
Moderate Severity ◽  
Results Of Treatment ◽  
Literary Sources ◽  
Complex Therapy ◽  
General Profile

The aim: Was to evaluate clinical data after the use of pimecrolimus (1% cream “Elidel”) in patients with mild and moderate severity of atopic cheilitis, according to modern therapeutic requirements. There was an algorithm of treatment the patients with cheilitis proposed it based on the data from literary sources and personal clinical experience. Materials and methods: 22 patients with atopic cheilitis aged from 19 to 40 agreed on a clinical examination in accordance with the protocol of the study. Patients were prescribed “Elidel” in the form of 1% cream for lubrication of the affected areas of the skin and lips, and antihistamine “Erius”, for the normalization of the general condition used sedatives and vitamins after consultation of specialists in the general profile. Results: Patients of both groups during the re-examination after 3, 7, 10 days recorded a positive dynamics of the red border of the lips and skin: a significant reduction in the inflammatory process, normalization of indicators of general blood analysis, improvement in the overall quality of life of patients. Conclusions: The results of treatment allow to consider 1% cream “Elidel” (pimecrolimus) as a preparation of choice in the complex treatment of patients with atopic cheilitis of mild and moderate severity.

Comparison of treatment costs for pembrolizumab versus methotrexate, docetaxel, or cetuximab for recurrent or metastatic head-and-neck squamous cell carcinoma based on KEYNOTE-040 clinical trial.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18524-e18524 ◽  
Author(s):  
Justin Yeh ◽  
Achuta Guddati
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Overall Survival ◽  
Side Effects ◽  
Head And Neck ◽  
Squamous Cell ◽  
Published Data ◽  
Total Cost ◽  
The Cost

e18524 Background: Pembrolizumab has been approved by the FDA for the treatment of recurrent and refractory squamous cell cancer of the Head and Neck. This approval was based on the favorable results noted in the pembrolizumab arm of the KEYNOTE-040 clinical trial which compared pembrolizumab with the standard of care (methotrexate/cetuximab/docetaxel). This study aims to compare the financial aspects of these treatment arms in the setting of their relative clinical advantages in terms of increased overall survival by applying current pricing of the drugs and treatment for side effects. Methods: Data published from the KEYNOTE-040 study was used to generate a model incorporating the cost of each drug in both arms. The incidence of side effects was also extracted from the published data. The cost of treatment of side effects was extracted from previously published data and used for cost estimation in the model. The number of years added in terms of overall survival was calculated for the entire experimental arm and the cost of each such year was calculated. This model assumes that all drugs were supplied at the cost indicated at the retail price advertised by their producers. The cost was adjusted for inflation to the current year. Results: Based on current pricing, 248 patients in the control arm which involved methotrexate /cetuximab /docetaxel incurred an estimated total cost of $2,918,185 over 24 months. The total cost for the pembrolizumab arm based on current pricing was $36,744,819 for 247 patients over 24 months. The cost of management of adverse effects was $383,910 vs. $18,728 (Std. of care vs. Pembrolizumab). The total cost averaged over all patients in both arms was $13,314 vs. $ 148,840. There is an inverse relationship between drug cost and management of adverse side effects in both arms. Conclusions: Treatment with pembrolizumab confers an increase in overall survival but the cost of the incremental gain appears to be high. The model makes several assumptions including the distribution of cost over the patient population in both arms and extrapolates it to the cost in US dollars. It is very likely that the quality of life was superior in the pembrolizumab arm but it was not incorporated into our model. Justification of the continued use of pembrolizumab must be weighed against the long term survival benefits accrued by its usage in the context of a different and possibly better quality of life.

scholarly journals MATHEMATICAL MODELING AND CONTROL OF HIV INFECTION DYNAMICS TAKING INTO ACCOUNT HORMONAL REGULATION

2019 ◽  
Vol 23 (1) ◽  
pp. 79-103 ◽  
Author(s):  
A. A. Savinkova ◽  
R. S. Savinkov ◽  
B. A. Bakhmetyev ◽  
G. A. Bocharov
Keyword(s):  
Quality Of Life ◽  
Mathematical Model ◽  
Side Effects ◽  
Hiv Infection ◽  
Hormonal Regulation ◽  
Optimization Methods ◽  
Cost Of Drugs ◽  
The Cost ◽  
The Mathematical Model

Aims: The problem of effective treatment of HIV-infected patients is an important task of clinical virology and immunology due to the high cost of drugs, the presence of side effects and the need for strict adherence to the schedule of drug intake for patients. Therefore, the urgent task is to develop new approaches to optimize the use of antiretroviral therapy to reduce the cost of treatment and to improve the quality of life for patients. The tasks are addressed to test the hypothesis that the system of therapeutic interruptions in the treatment of HIV infection can give better results (both the duration and comfort of the patient’s life, and the need for fewer drugs) compared with regular medication in standard doses. Methods: In this work, an extended version of the mathematical model of the immune response in HIV infection (proposed in Hadjiandreou et al., 2009) was constructed to take into account the hormonal regulation of the immune response and the impact of antiretroviral drugs on the course of the disease, the calibration of the parameters of the resulting model to match the actual trends of the disease and the search for an optimal treatment strategy. The model is formulated as a system of ordinary differential equations. The therapy optimization is modeled following the structured treatment interruptionapproach using the methods of simulated annealing and the simplex method. The mathematical model and optimization methods are implemented in C ++. Results: It has been shown that in treating HIV-infected patients, it is possible to significantly (up to 3 times) reduce the total amount of required medications simultaneously with an increase in the duration of the period with a high quality of life (due to reducing the intensity of side effects) during antiretroviral therapy. Conclusion: The use of mathematical models and optimization methods opens up the possibility for the implementation of personalized approaches to the treatment of HIV infection, taking into account the side effects, the hormonal status of patients and the cost of drugs.

scholarly journals Using an ozone therapy in the treatment of trophic ulcers of low extremity

2020 ◽  
Vol 24 (1) ◽  
pp. 98-105
Author(s):  
P.F. Kolisnyk ◽  
I.V. Baranova ◽  
S.P. Kolisnyk ◽  
O.V. Dolynna ◽  
Y.O. Bezsmertnyi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Metabolic Diseases ◽  
Main Group ◽  
Control Group ◽  
Complex Treatment ◽  
Ozone Therapy ◽  
Treatment Regimens ◽  
Results Of Treatment

Annotation. Diabetes is one of the most common metabolic diseases in the world with a large number of complications. Threatening conditions that significantly reduce the quality of life and even lead to the death include a diabetic foot syndrome. The aim of the study was to investigate the effectiveness of combined ozone therapy in the treatment of patients with type 2 diabetes with chronic lower extremity trophic ulcers. A prospective study of the effectiveness of using the combined method of ozone therapy in the treatment of trophic ulcers of the lower extremities was conducted in the surgical and rehabilitation departments of the University Clinic of the National Pirogov Memorial Medical University. The study involved 52 patients with diadetes mellitus 2 type, who were randomly assigned to the main (n=26) and control (n=26) groups. Subjective and objective changes in the condition of patients were evaluated: an area of trophic ulcers (by A.V. Kuleshov's method), a rate of ulcer’s defect epithelization (by L. Popova's formula) and the quality of life parameters of patients (by the questionnaire SF-36) before and after the treatment. The endpoint of the study was a complete epithelization of the diabetic trophic ulcer. The treatment was carried out according to the generally accepted methodology in both observation groups, and the combination ozone therapy was additionally used for patients of the main group. The latter provided for the intravenous administration of an oxygen-ozonized 0.9% NaCl solution and local exposure of the trophic ulcer defect to the ozonized mixture by chamber aeration. The course of complex treatment was carried out after removal of necrotic tissue and wound cleansing, consisted of 10 local and general ozone therapy procedures, which were carried out every other day. The data obtained were processed using the SPSS for Windows 10.0 and STATISTICA 6.1 application software package (license number BXXR901E245722FA). One month after, the observation changes of the trophic skin defects and Quality of life indicators showed the significantly (p<0.01) better results of treatment in the main group than in the control group. The endpoint of the study was achieved in 85% of patients after complex treatment versus 29% of patients in the control group after a conventional treatment (p<0.01). Using as modern rehabilitation method as ozone therapy is an appropriate complement to the existing treatment regimens, which can significantly accelerate the clinical recovery of patients and, as a result, improve the quality of life. The particular value of the method confirmed by an absence of contraindications and drug overloads of the patient. The study of the effects of ozone therapy on the metabolism of patients with diabetes mellitus type 2 can be a promising area for further research.

Proton Pump Inhibitors in 2021: Pros, Cons, and Everything in Between

2021 ◽  
pp. 263451612110217
Author(s):  
Joshua A. Sloan ◽  
Philip O. Katz
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adverse Events ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Drug Class ◽  
Life Threatening

The medical and lay literature has exploded with reports of adverse events associated with proton pump inhibitors over the last 10 to 15 years. The dissemination of these reports to patients and clinicians have created substantial concerns regarding what has been an exceptionally valuable drug class, dramatically improving patient quality of life, and in many cases preventing life threatening side effects of other medication. Patients are more frequently seeking to avoid these medications, and practitioners are reducing or discontinuing them to the patient’s detriment due to a misunderstanding of the data. This review will discuss the data regarding the most commonly publicized adverse events and attempt to put them in perspective.

scholarly journals Economic assessment of a community-based care package for people with lower limb disorder caused by lymphatic filariasis, podoconiosis and leprosy in Ethiopia

2020 ◽  
Vol 114 (12) ◽  
pp. 1021-1034
Author(s):  
Natalia Hounsome ◽  
Mersha Kinfe ◽  
Maya Semrau ◽  
Oumer Ali ◽  
Abraham Tesfaye ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lymphatic Filariasis ◽  
Lower Limb ◽  
Life Quality ◽  
Psychosocial Care ◽  
Northwest Ethiopia ◽  
World Health ◽  
Care Package ◽  
The Cost

Abstract We conducted an implementation research study to integrate a holistic package of physical health, mental health and psychosocial care for podoconiosis, lymphatic filariasis and leprosy into routine healthcare in Gusha cluster, Guagusa Shikudad district, northwest Ethiopia. The healthcare package included training patients in lower limb hygiene and skin care and provision of shoes, hygiene supplies and medication. The implementation activities included training events, workshops, awareness raising, self-help groups, supportive supervision, staff secondments and advisory board meetings. The cost of implementing the care package in Gusha cluster, with a population of 30 558 people, was 802 655 Ethiopian birr (ETB) (£48 159) and the cost of delivering care to 235 participants was 204 388 ETB (£12 263), or 870 ETB (£52) per person. There was a 35% decrease in the mean disability scores (measured using the World Health Organization Disability Assessment Schedule 2.0) and a 45% improvement in the dermatology-specific quality of life (measured using the Dermatology Life Quality Index) at the 3-month follow-up compared with baseline. There were reductions in the number of days with symptoms, days off usual activities/work and days with reduced activity due to illness, all of which were statistically significant. Our pilot suggests that integration of the care package into routine healthcare in Ethiopia may be effective in improving health-related quality of life and disability and reducing time out of economic activity due to illness.

scholarly journals Quality of life, symptoms and dietary habits in oncology outpatients with malnutrition: A cross-sectional study

2021 ◽  
Vol 38 (2) ◽  
Author(s):  
Mira Sonneborn-Papakostopoulos ◽  
Clara Dubois ◽  
Viktoria Mathies ◽  
Mara Heß ◽  
Nicole Erickson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
Side Effects ◽  
Dietary Habits ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
University Hospital ◽  
Cross Sectional ◽  
European Organization

AbstractCancer-related malnutrition has a high prevalence, reduces survival and increases side effects. The aim of this study was to assess oncology outpatients and risk of malnutrition. Reported symptoms and quality of life (QoL) in patients found to be at risk of malnutrition or malnourished were compared to patients without malnutrition. Using a standardized questionnaire, the European Organization for Research and Treatment of Cancer Questionnaire for Quality of Life and the Mini Nutritional Assessment (MNA), patients in an outpatient cancer clinic undergoing chemotherapy treatment at a German University Hospital were assessed for nutrition, risk of malnutrition and quality of life. Based on the MNA, 39 (45.9%) patients were categorized as malnourished or at risk for malnutrition. Loss of appetite (n = 37.6%, p < 0.001) and altered taste sensation (n = 30,3%, p < 0.001) were the symptoms most frequently associated with reduced food intake. Patients with risk of malnutrition scored lower on the global health status (n = 48.15%, p = 0.001). Side effects of cancer treatments lead to a higher risk of malnutrition and as a consequence lower QoL. These side effects should be addressed more efficiently in cancer care.

scholarly journals The cost, survival, and quality‐of‐life implications of guideline‐discordant imaging for prostate cancer

2021 ◽  
Author(s):  
Aaron N. Winn ◽  
Matthew Kelly ◽  
Shannon Ciprut ◽  
Dawn Walter ◽  
Heather T. Gold ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
The Cost

scholarly journals Pilates and dance to patients with breast cancer undergoing treatment: study protocol for a randomized clinical trial – MoveMama study

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Leonessa Boing ◽  
Tatiana do Bem Fretta ◽  
Melissa de Carvalho Souza Vieira ◽  
Gustavo Soares Pereira ◽  
Jéssica Moratelli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Physical Activity ◽  
Body Image ◽  
Side Effects ◽  
Sleep Quality ◽  
Control Group ◽  
Belly Dance ◽  
Belly Dancing

Abstract Background Breast cancer is a global public health issue. The side effects of the clinical treatment can decrease the quality of life of these women. Therefore, a healthy lifestyle is essential to minimize the physical and psychological side effects of treatment. Physical activity has several benefits for women with breast cancer, and Pilates solo and belly dancing can be an enjoyable type of physical activity for women with breast cancer undergoing clinical treatment. The purpose of this study is to provide a Pilates solo and a belly dance protocol (three times per week/16 weeks) for women undergoing breast cancer treatment and compare its effectiveness with that in the control group. Methods The participants will be allocated to either the intervention arm (Pilates solo or belly dance classes three times per week for 16 weeks) or a control group (receipt of a booklet on physical activity for patients with breast cancer and maintenance of habitual physical activity routine). The Pilates solo and belly dance classes will be divided into three stages: warmup and stretching, the main stage, and relaxation. Measurements of the study outcomes will take place at baseline; postintervention; and 6, 12, and 24 months after the end of the intervention (maintenance period). The data collection for both groups will occur with a paper questionnaire and tests covering general and clinical information. The primary outcome will be quality of life (EORT QLQ-C30 and EORT QLQ-BR23), and secondary outcomes will be physical aspects such as cardiorespiratory fitness (6-min walk test and cycle ergometer), lymphedema (sum of arm circumference), physical activity (IPAQ short version), disabilities of the arm (DASH), range of motion (goniometer test), muscular strength (dynamometer test) and flexibility (sit and reach test), and psychological aspects such as depressive symptoms (Beck Depression Inventory), body image (Body Image After Breast Cancer Questionnaire), self-esteem (Rosenberg), fatigue (FACT-F), pain (VAS), sexual function (FSFI), and sleep quality (Pittsburgh Sleep Quality Index). Discussion In view of the high prevalence of breast cancer among women, the implementation of a specific protocol of Pilates solo and belly dancing for patients with breast cancer is important, considering the necessity to improve their physical and psychological quality of life. Pilates solo and belly dancing are two types of physical activity that involve mental and physical concentration, music, upper limb movements, femininity, and social involvement. An intervention with these two physical activities could offer options of supportive care to women with breast cancer undergoing treatment, with the aim being to improve physical and psychological quality of life. Trial registration ClinicalTrials.gov, NCT03194997. Registration date 12 August 2017. Universal Trial Number (World Health Organization), U1111-1195-1623.

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