Assessment of Quality of Life Following Radiotherapy in Patients With Rectum Cancer

PurposeThe aim of the present study is to investigate the effects of radiotherapy (RT) on quality of life (QoL) and influencing factors.MethodsData of 106 patients who completely filled out the three questionnaires were evaluated in this prospective study. Quality of life was evaluated with cancer-specific QLQ-C30 and colorectal cancer module QLQ-CR29 created by European Organization for Research and Treatment of Cancer (EORTC). All statistical analyses were done with SPSS version 22 software. A p level of <0.05 was accepted as statistically significant.ResultsMedian age was 61 (27-86). Of the patients, 77 (72.6%) were male and 29 (27.4%) were female. When QLQ-C30 questionnaires were evaluated, it was observed that physical, role, cognitive and emotional function scores were impaired following RT however returned to pre-RT levels on control. According to the results of QLQ-CR29 questionnaire, after RT, impairment was observed in urination frequency, urinary incontinence, stool frequency, dysuria, fecal incontinence, embarrassment, sexual interest in males scales however they returned to pre-RT values on control. When evaluated with regard to age, financial difficulty, global health score, mucus in stool, dysuria, dyspareunia and abdominal pain were observed to be poorer in the young; urination frequency and urinary incontinence were observed to be poorer in the elderly. ConclusionAlthough both functional and symptom scales were shown to impair, most of them were detected to be temporal and patients could well tolerate radiotherapy. Additional assessment is required for evaluating the late effects of treatments on QoL.

Sex-Specific Limitations in Physical Health in Primary Adrenal Insufficiency

BackgroundPatients with primary adrenal insufficiency (PAI) suffer reduced quality of life (QoL), but comparisons with large-scale normative data are scarce. The clinical characteristics associated with reduced QoL are largely unknown.MethodsCross-sectional data on clinical characteristics and QoL scores from 494 patients were included. QoL was measured using RAND-36 (generic) and AddiQoL (-30 and -8, disease-specific). RAND-36 is reported as subdomain scores as well as physical (PCS) and metal (MCS) summary scores and compared with normative data.ResultsPerception of physical role was consistently decreased across age groups in patients with PAI compared with normative data [75 (0-100) vs. 100 (50-100), p&lt;0.001]. Men with PAI reported significantly lower scores for social functioning [88 (75-100) vs. 100 (75-100), p&lt;0.001], as well as for vitality and physical role. In women, the greatest impairment was seen in physical role [50 (0-100) vs. 100 (50-100), p&lt;0.001], followed by social functioning, vitality, physical function, general health, mental health, and emotional role. Overall, better QoL was associated with male sex (AddiQoL-30: 89 ± 13 vs. 82 ± 13, p&lt;0.002), younger age (e.g. 20-29 vs. 80-89 years: PCS 59 [50-62] vs. 46 [37-53], p&lt;0.001), autoimmune etiology [PCS: 53 (45-59) vs.. 45 (38-54), p&lt;0.001], and absence of autoimmune comorbidity [PCS: 54 (45-59) vs. 50 (43-58), p&lt;0.001]. There were no significant differences in QoL scores between different doses or dosing regimens of glucocorticoid or mineralocorticoid replacement.ConclusionQoL is reduced in patients with PAI, especially perception of physical role in women and social functioning in men. Among patients with PAI, female sex, higher age, non-autoimmune etiology, and autoimmune comorbidity was associated with lower QoL-scores.

Quality of Life and Self-care Activities in Diabetic Ulcer Patients, Grade 3: Gender Differences

Introduction: Diabetic foot ulcer (DFU) is a common complication of diabetes mellitus associated with increased morbidity and mortality and diminished quality of life (QoL). This study aimed to explore the effect of gender differences on QoL and adherence to self-care activities. Methods: In this cross-sectional study, we enrolled 135 male and 135 female patients with DFU. Data was collected using the Short Form Health Survey (SF-36) and a questionnaire that measured self-care activities (Diet, Exercise, Blood Examination, and Foot Check). Data analysis was performed using SPSS version 20. Results: In terms of QoL, male participants had moderate to high levels in the categories of energy/fatigue, emotional well-being, social functioning, and bodily pain, whereas they had low levels in physical functioning, physical role, and emotional role. Female patients had moderate QoL in the categories of energy/fatigue and social functioning, whereas they had low QoL in physical functioning, physical role, emotional role, emotional well-being, and bodily pain. Finally, regarding general health, male participants had moderate QoL and females had moderate to low QoL. Both males and females had low adherence to exercise and high in blood-examinations. For both genders, adherence to exercise had a statistically significant association with all sub-categories of QoL apart from those of role (physical and emotional). Conclusion: It is essential for health care professionals to provide gender-specific approaches in treatment of ulceration.

Associations between the Severity of Sarcopenia and Health-Related Quality of Life in Community-Dwelling Middle-Aged and Older Adults

(1) Background: The aim of this study was to analyze the associations between severity of sarcopenia and health-related quality of life (HRQoL) among community-dwelling middle-aged and older adults. (2) Methods: A cross-sectional study involving 304 older-adult participants was used to assess the severity of sarcopenia by measuring muscle strength (handgrip dynamometer), muscle mass (bioelectrical impedance analysis), and physical performance (Timed Up-and-Go test). The generic 36-item Short-Form Health Survey (SF-36) was used to evaluate HRQoL. Anxiety and depression (Hospital Anxiety and Depression Scale) as well as age were considered as possible confounders. Probable sarcopenia was determined by low muscle strength; confirmed sarcopenia was defined by the presence of both low muscle strength and muscle mass; and severe sarcopenia was defined by low muscle strength and mass along with poor physical performance. (3) Results: The linear regression analysis showed that the presence of probable sarcopenia was associated with the SF-36 domains physical role (adjusted R2 = 0.183), general health (adjusted R2 = 0.290), and social functioning (adjusted R2 = 0.299). As for the SF-36 mental (MCS) and physical (PCS) component summary scores, probable sarcopenia, as well as depression and anxiety, remained associated with MCS (adjusted R2 = 0.518), and these three variables, together with age, were linked to PCS (adjusted R2 = 0.340). (4) Conclusion: Probable sarcopenia, but not confirmed or severe sarcopenia, was independently associated with poor HRQoL. More precisely, it was related to PCS and MCS, as well as to the physical role, general health, and social functioning of SF-36 domains.

Invariant quantities of scalar–tensor theories for stellar structure

We present the relativistic hydrostatic equilibrium equations for a wide class of gravitational theories possessing a scalar–tensor representation. It turns out that the stellar structure equations can be written with respect to the scalar–tensor invariants, allowing to interpret their physical role.

Correlation between work productivity loss (WPL) and European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) domains from the MONALEESA-7 (ML-7) trial of premenopausal women with HR+/HER2- advanced breast cancer (ABC).

1051 Background: The international, randomized, double-blind, placebo-controlled, Phase III ML-7 trial (NCT02278120) assessed ribociclib + endocrine therapy (ET) vs ET alone in premenopausal women with HR+/HER2– ABC. To our knowledge, the relationship between WPL and domains of the EORTC QLQ-C30 and the tumor-specific module for breast cancer (QLQ-BR23) has not been explored in ABC. In this post hoc analysis (data cutoff, November 30, 2018) of all patients (pts) enrolled in ML-7, we assessed the correlation between the WPL component of the Work Productivity and Activity Impairment: General Health (WPAI:GH) questionnaire and domains of the EORTC QLQ-C30/BR23. Methods: We analyzed EORTC and WPAI:GH data from all pts enrolled in ML-7 who were employed at any point during the trial (N = 329 of 672 total pts). Domains of the EORTC QLQ-C30 and QLQ-BR23 that had the greatest correlation (pairwise Pearson correlation) with WPL were prioritized for analysis. Separate univariable mixed-model repeated-measures regression models were fitted for each domain, with WPL as the dependent variable and each EORTC domain as a single fixed-effect covariate. Linear and quadratic relationships were considered. Model selection was based on the Akaike information criterion (AIC). Results: Linear models were favored over quadratic models. WPL was negatively correlated with global health status (GHS) and the physical, role, social, and emotional functioning domains and was positively correlated with the fatigue and pain domains of the QLQ-C30 ( P <.001; Table). The coefficients indicated the estimated mean change in WPL was associated with a 1-unit increase in each QLQ-C30 domain. For example, a 10-point increase in GHS was associated with an estimated mean decrease of 7.8% (95% CI, 7.1%-8.5%) in WPL. Conclusions: Greater WPL was associated with higher levels of fatigue and pain and with lower levels of overall quality of life and physical, role, social, and emotional functioning among pts with HR+/HER2− ABC in ML-7. Further investigation of the correlation with QLQ-BR23 and multivariable analysis could determine which EORTC domains and items independently drive these findings. Clinical trial information: NCT02278120 .[Table: see text]

Gravitational breathing memory and dual symmetries

Brans-Dicke theory contains an additional propagating mode which causes homogeneous expansion and contraction of test bodies in transverse directions. This “breathing” mode is associated with novel memory effects in addition to those of general relativity. Standard tensor mode memories are related to a symmetry principle: they are determined by the balance equations corresponding to the BMS symmetries. In this paper, we show that the leading and subleading breathing memory effects are determined by the balance equations associated with the leading and “overleading” asymptotic symmetries of a dual formulation of the scalar field in terms of a two-form gauge field. The memory effect causes a transition in the vacuum of the dual gauge theory. These results highlight the significance of dual charges and the physical role of overleading asymptotic symmetries.

Why Being Physically Active or Inactive Affects Older Women’s Physical Role?

Background. Active aging is aimed at promoting quality of life in older adults. Nevertheless, the relationship between physical role and the practice of physical activity (PA) can be influenced by bodily pain feeling and by a low level of health-related quality of life (HRQoL). Passive and active strategies are susceptible to being modified and constitute an important psychological predictor of adaptation to pain. This cross-sectional study (1) analyzed the differences between inactive/active older adult women in terms of clinical and sociodemographic characteristics, pain coping strategies, and HRQoL; (2) studied the associations between pain coping strategies, the dimensions of the HRQoL questionnaire, and physical role; and (3) determined if passive strategies, bodily pain, physical function, and general health were significant mediators in the link between being inactive/active and physical role. Methods. Participants of the present cross-sectional study completed measures of clinical and sociodemographic characteristics, HRQoL using the Short-Form Health Survey-36, and active and passive strategies using the Vanderbilt Pain Management Inventory (VPMI). Results. A total of 157 inactive ( 69.9 ± 7.1 years ) and 183 active ( 68.8 ± 5.3 years ) women from rural areas were included in the study. Both groups significantly differed in the majority of the clinical and sociodemographic characteristics measured, pain coping strategies, and HRQoL. Bodily pain, physical function, and general health predicted physical role. Moreover, passive strategies, bodily pain, physical function, and general health mediated the link between inactive/active participants and physical role. Conclusions. Being physically active or inactive contributes to a better understanding of the link between PA, pain coping strategies, and physical role in older women.

Subjective sleep disorders and daytime sleepiness in patients with restrictive type anorexia nervosa and effects on quality of life: a case-control study.

Purpose To evaluate sleep disorders and daytime drowsiness in a cohort of patients affected by anorexia nervosa (AN) and their impact on health-related quality of life (HRQoL). Method We evaluated AN patients and healthy controls (C) by the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, Beck Depression Index. We also utilized the Short-Form Health Survey (SF-36) questionnaire to assess HRQoL in both AN and C. Results: Twenty-eight out of 34 AN patients (82.3%) had a pathological PSQI score while 10/34 (29.4%) healthy subjects (p<0.0001). The overall PSQI score was significantly higher in AN than in the controls (p=0.0004). The components sleep quality (p=0.008), sleep duration (p=0.03), sleep efficiency (p=0.004), sleep disturbances (p=0.01) and daytime dysfunction (p=0.002) were higher than C. SF36 showed significantly reduced scores of standardized physical components (p=0.01) and standardized mental components (p<0.0001) in AN, while physical function (p=0.0001), physical role (p=0.0005) and general health (p<0.0001), vitality (p=0.001), social functioning (p=0.0006) emotional role (p=0.002) and mental health (p<0.0001) were significantly decreased in AN. We found a significant correlation between the PSQI score and the physical role (r=-0.35, p=0.03) and education (r=0.38, p=0.02).Conclusion We demonstrated low sleep quality lacking subjective daytime sleepiness in AN. Sleep quality correlated significantly with HRQoL (physical role) and level of education. Level of evidence: level III case-control study

Long-Term Outcome and Quality of Life After Cavernoma Resection: Eloquent vs. Non-Eloquent Areas.

Objective: To analyze the long-term quality of life after surgery of cavernoma.Methods: A monocentric retrospective study was conducted on 69 patients with cavernoma treated microsurgically between 2000 and 2016. The eloquence was adopted from Spetzler-Martin definition. A most recent follow-up was elicited between 2017 and 2019, in which the quality of life (QoL) was evaluated with the Short Form-12 questionnaire (SF12).Results: 41 lesions were in eloquent group (EG), 22 in non-eloquent group (NEG), 3 in orbit and 3 in the spinal cord. Postoperative worsening of the modified Rankin scale (mRS) occurred in 19.5% of cases in EG versus 4.5% in NEG. After a mean follow-up of 6.5 years, the neurological status was better or unchanged compared to baseline in 85.4% of EG and 100% of NEG. 44 patients (EG n =27, NEG n = 14) attended the last follow-up. The EG had mostly comparable QoL results matched to NEG except for the physical role (RP). The study population when compared to the norms, did well on only half of the parameters of SF12. Yet, the general health (GH), vitality, physical (RP) and emotional roles (RE) were significantly inferior.Conclusion: At a late follow-up, the surgical morbidity was transient in the NEG and mostly recovered in the EG. Regarding QoL, Patients after eloquent cavernoma resection reported a non-inferior QoL in most SF12 domains (except for physical role) compared to NEG. However, they reported general health perception inferior to norms, which was affected by the limited physical and emotional roles.