scholarly journals CT-Guided Percutaneous Femoroplasty for the Treatment of Proximal Femoral Metastases

2016 ◽  
Vol 5;19 (5;19) ◽  
pp. E767-E773
Author(s):  
Yingze Zhang

Background: The spine, pelvis, skull, and femur are the most common sites of bone metastases, and pain is the main symptom of metastatic tumors. Percutaneous femoroplasty (PFP) is becoming increasingly popular for treating proximal femoral metastases. Objectives: To assess the clinical value and feasibility of PFP performed under the guidance of computed tomography (CT). Study Design: A retrospective clinical review comparing pain intensity and the ability to perform activities of daily living before and after treatment with PFP. Setting: Single academic medical center. Methods: Sixteen patients with proximal femoral metastasis were treated with PFP under CT guidance and followed up for 6 – 12 months. Pain intensity was evaluated using the visual analog scale (VAS) and patients’ quality of life was evaluated using the Barthel Index of Activities of Daily Living (BIADL) preoperatively and at both 7 days and 6 months after PFP. Results: The mean VAS score decreased from 7.44 ± 0.81 preoperatively to 2.69 ± 0.79 at 7 days postoperatively and 1.25 ± 0.93 at 6 months postoperatively. The BIADL score increased from 44.06 ± 9.53 preoperatively to 69.06 ± 8.61 at 7 days postoperatively and 83.13 ± 6.55 at 6 months postoperatively. No patients suffered from pulmonary embolism or complications such as pathologic fracture of the proximal femur. The median overall survival was 12 months. One patient experienced cement leakage into the hip, and the injection was immediately stopped. Then dexamethasone was injected intravenously to prevent potential pulmonary fat embolism caused by localized high pressure. Limitations: The study evaluated a single group of patients before and after CT-guided PFP and did not include a comparison with conventional fluoroscopic approaches in a large patient sample. Conclusion: Use of CT-guided PFP was associated with a low risk of complications and improvement in patients’ quality of life. CT guidance made the operation easy and safe, and thus, this approach represents a potential treatment option for proximal femoral metastases if indications are observed closely. Key words: CT guidance, percutaneous femoroplasty, proximal femoral metastasis, pain relief, cementoplasty

2010 ◽  
Vol 100 (1) ◽  
pp. 10-13
Author(s):  
Hiroaki Matsuno ◽  
Tatsuma Utsunomiya

Background: We sought to investigate the clinical efficacy of the Fuß-sole (Kuroda, Osaka, Japan), a newly developed stocking, in patients with severe foot pain attributable to rheumatoid arthritis. Methods: The Fuß-sole stocking incorporates a plantar insole made of breathable fabric. Twenty patients with rheumatoid arthritis and severe foot pain were enrolled in this study. Clinical efficacy was evaluated using the Japanese Orthopaedic Association's foot-scoring system. Outcome measures were evaluated before and after a 1-month trial of the Fuß-sole stocking. Results: Use of the Fuß-sole stocking resulted in significant improvements in foot pain, activities of daily living, and total scores. Conclusions: Use of the Fuß-sole improves the quality of life of patients with rheumatoid arthritis. (J Am Podiatr Med Assoc 100(1): 10–13, 2010)


BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Raquel Luis-Martínez ◽  
Roberto Di Marco ◽  
Luca Weis ◽  
Valeria Cianci ◽  
Francesca Pistonesi ◽  
...  

Abstract Background The consequences of strict COVID-19 mobility restrictions on motor/non-motor features in Parkinson’s disease (PD) have not been systematically studied but worse mobility and quality of life have been reported. To elucidate this question, 12 mild to moderate PD patients were assessed in March 2020 before and after two months of isolation as part of a clinical study that had to be interrupted due to the pandemic and the implementation of COVID19 mobility restrictions. Methods Twelve patients were systematically evaluated before and after the lockdown period as part of a larger cohort that previously underwent thermal water rehabilitation. Clinical outcomes were the Body Mass index, the Mini-Balance Evaluation Systems Test, the MDS-Unified Parkinson’s Disease Rating Scale part III, the 6 Minute Walking Test and the New Freezing of Gait Questionnaire. Global cognition was evaluated with the Montreal Cognitive Assessment scale. The impact of COVID-19 restrictions on quality of life and functional independence was evaluated with The Parkinson’s disease Quality of life (PDQ-39), the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living questionnaires (IADL) and the Parkinson’s disease cognitive functional rating scales (PD-CFRS). Results After two months of isolation the Mini-BESTest score worsened (p=0.005), and four patients reported one or more falls during the lockdown. BMI increased (p=0.031) while the remaining clinical variables including quality of life did not change. Conclusion We observed moderate worsening at Mini-BESTest, greater risk of falls and increased body weight as consequence of prolonged immobility. We believe negative effects were partially softened since patients were in contact with our multidisciplinary team during the lockdown and had previously received training to respond to the needs of this emergency isolation. These findings highligh the importnace of patient-centered interventions in PD management.


Author(s):  
Wei Yu ◽  
Jie Tong ◽  
Xirong Sun ◽  
Fazhan Chen ◽  
Jie Zhang ◽  
...  

Background: Factors related to medication adherence in patients with schizophrenia have always been key to the treatment and rehabilitation of these patients. However, the treatment modes in different countries are not the same, and there is no research on the factors influencing medication adherence under different mental health service modes. Objectives: The purpose of this study was to explore medication adherence and its influencing factors in patients with schizophrenia in the Chinese institutional environment. Methods: We conducted a cross-sectional study of hospitalized persons living with schizophrenia from November 2018 to January 2019. A systematic sampling method was used to select 217 hospitalized persons living with schizophrenia. The Medication Adherence Rating Scale (MARS), Positive and Negative Syndrome Scale (PANSS), General Self-Efficacy Scale (GSES), Schizophrenia Quality of Life Scale (SQLS), and Scale of Social Skills for Psychiatric Inpatients (SSPI) were used to explore medication compliance and its influencing factors in the Chinese institutional environment. Results: The descriptive analysis and ANOVA showed that there were no significant differences in medication adherence when assessed by demographic characteristics such as sex, marital status, and education level (p > 0.05). A correlation analysis showed that there was no significant correlation between medication adherence and mental symptoms (p > 0.05) but that there was a positive correlation with self-efficacy, quality of life, and activities of daily living (p < 0.01). The linear regression analysis showed that self-efficacy, psychosocial factors, symptoms/side effects, and activities of daily living had significant effects on medication adherence (F = 30.210, p < 0.001). Conclusions: Our findings show that the self-efficacy, quality of life, and social function of patients with schizophrenia are important self-factors influencing medication adherence in the Chinese institutional environment.


2021 ◽  
pp. 026921552199517
Author(s):  
Runze Li ◽  
Yanran Zhang ◽  
Yunxia Jiang ◽  
Mengyao Wang ◽  
Wei How Darryl Ang ◽  
...  

Objective: To examine the effectiveness of rehabilitation training based on virtual reality in improving balance, quality of life, activities of daily living, and depressive symptoms of patients with Parkinson’s disease. Data sources: PubMed, EMBASE, CINAHL, Scopus, Cochrane Library, PsycINFO, ProQuest, Physiotherapy Evidence Database, IEEE Xplore, China National Knowledge Infrastructure, Wanfang, and VIP Information databases were searched from their inception to October 15, 2020. Trial registries, gray literature, and target journals were also searched. Methods: Eligible randomized controlled trials included studies with patients with Parkinson’s disease in rehabilitation training based on virtual reality. Comprehensive Meta-Analysis 3.0 software was used. Physiotherapy Evidence Database Scale and the Grading of Recommendation, Assessment, Development, and Evaluation system were used to assess the methodological quality of individual trials and the overall quality of the evidence, respectively. Results: A total of 22 randomized controlled trials with 836 patients were included. Meta-analysis revealed that training significantly improved balance ( g = 0.66, P < 0.001), quality of life ( g = 0.28, P = 0.015), activities of daily living ( g = 0.62, P < 0.001), and depressive symptoms ( g = 0.67, P = 0.021) compared to the control group. Subgroup analysis indicated that training should utilize video game consoles. Meta-regression analyses showed that age, sessions, and frequency of training had statistically significant impacts on balance scores. Quality of individual trials was high and overall evidence ranged from very low to low. Conclusion: Virtual rehabilitation training could be adopted in healthcare institutions as supplementary training for patients with Parkinson’s disease.


2014 ◽  
Vol 51 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Denis PAJECKI ◽  
Marco Aurélio SANTO ◽  
Ana Lumi KANAGI ◽  
Daniel RICCIOPPO ◽  
Roberto de CLEVA ◽  
...  

Context Obesity in the elderly is associated with exacerbation of functional decline (dependency), that occurs with aging, because of decreased muscle mass and strength, and increased joint dysfunction. Consequently, there is progressive loss of independence, autonomy, chronic pain and impaired quality of life. The weight loss can bring benefits in all these aspects, especially when accompanied by exercises. Elderly patients with morbid obesity may be submitted to surgical treatment, taking into account that the massive weight loss, eventually caused by bariatric surgery, may exacerbate the loss of muscle mass and nutritional complications that may bring harm to the overall health and quality of life of these patients. The functional assessment of elderly patients, candidates for bariatric surgery and the extent to which surgery can bring benefits to the patients, in the field of functionality, has still to be determined. Objective To describe profile functionality in obese elderly referred to a bariatric surgery program. Methods Patients with age ≥60 and BMI ≥35 underwent comprehensive geriatric assessment that evaluates co morbidities, medication use, ability to perform basic activities of daily living and instrumental activities of daily living, and the “Timedupandgo” test to evaluate mobility, whose cut-off point was ≤10 seconds. Statistical analysis was performed in order to see if there is a positive correlation of dependency with BMI and age (over or under 65 years). Results Forty subjects have completed evaluation. The mean age was 64.1 years (60-72) and 75% were women. They had an average weight of 121.1 kg (72.7-204) and a mean BMI of 47.2 kg/m2 (35.8-68.9). 16 patients (40%) have shown dependency for activities of daily living, 19 (47,5%) for instrumental activities of daily living and 20 patients (50%) had a “Timedupandgo” test over 10 seconds. Statistical analysis (t-Student, Mann-Whitney, Binary Logistic Regression) has shown positive correlation of dependency in activities of daily living for BMI >49 kg/m2, dependency in instrumental activities of daily living for BMI >46,5 kg/m2, and “Timedupandgo” test greater than 10 seconds for BMI >51 kg/m2 (P<0,05). No dependency difference was observed for patients over or under 65 years age. Conclusions Functional decline is observed in almost half of the morbid obese patients over 60 years old. It is related to increasing BMI (BMI >46,5 kg/m2) but not related to age (60 to 65 years or over 65 years). Functional decline should be considered a co-morbidity in the elderly obese patients and should be assessed before bariatric surgery in this population.


2014 ◽  
Vol 26 (8) ◽  
pp. 1283-1293 ◽  
Author(s):  
Clarissa M. Giebel ◽  
Caroline Sutcliffe ◽  
Minna Stolt ◽  
Staffan Karlsson ◽  
Anna Renom-Guiteras ◽  
...  

ABSTRACTBackground:Performing basic activities of daily living (ADLs) is one of the major difficulties encountered in dementia, which can have considerable negative impacts on the quality of life (QoL) of people with dementia (PwD). However, the extent to which basic ADL performance deteriorates across mild, moderate, and severe dementia is little examined and its impact, together with depression and neuropsychiatric behavior, upon QoL, is of considerable relevance across European countries.Methods:Data were drawn from people living in the community who were participants in a large-scale European study on transition from community living to care homes of PwD. PwD completed measures on cognitive functioning and QoL, and informal carers reported upon QoL, depressive symptomatology, psychopathology, and functional ability of the PwD.Results:ADL performance deteriorated differently for each activity. In particular, toileting, transfer, and feeding remained relatively intact throughout, whereas performance on bathing and dressing deteriorated to a greater extent from mild to severe dementia. It appears that continence was not affected by the stage of dementia with similar levels of impairment. Basic ADL performance impacted to different degrees on QoL across dementia stages and countries.Conclusions:Interventions aimed at maintaining independence or QoL need to target different ADLs across different dementia stages and perhaps also tailor interventions to the context of different countries. Findings contribute to the development of non-pharmaceutical interventions and governmental pledges to promote independence in dementia.


2019 ◽  
Vol 67 (4) ◽  

After having a stroke the main challenges are reducing the risk of recurrent stroke, improving impaired brain function, quality of life, independence in activities of daily living and reintegration into the community. [1] Lesion-induced impairment of brain function also has, besides its effects on e.g. motor, sensory, visual and speech function, an influence on e.g. cognition and mood, all of which are determinants of post-stroke physical activity. The evidence for a benefit of physical activity in secondary stroke prevention is increasing and treatment strategies aimed at factors which are limiting physical activity are more and more recognized.


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