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Background and purpose: There is a consensus within the medical community regarding the perioperative treatment of locally advanced gastric cancer (LAGC), yet the selection of an efficient and safe treatment strategy remains a contentious issue. Previous studies have validated the effectiveness of chemotherapy in conjunction with immune checkpoint inhibitor (ICI) and anti-angiogenic agents in the perioperative treatment of LAGC. This study aimed to investigate the perioperative treatment regimen combining ICI, anti-angiogenic drugs and chemotherapy, in order to provide additional references for the selection of perioperative treatment strategies for patients with LAGC. Methods: This was a prospective, single-arm exploratory study designed to assess the efficacy and safety of perioperative treatment with penpulimab combined with anlotinib and chemotherapy for potentially resectable stage T3-4N+M0 LAGC. Patients diagnosed with LAGC at the Inner Mongolia Autonomous Region People’s Hospital from January 2022 to December 2023 were enrolled in the study. The primary endpoints were pathological complete response (pCR) rate and major pathological remission (MPR) rate, while secondary endpoints included surgical conversion rate, objective response rate (ORR), disease-free survival (DFS), progression-free survival (PFS) and adverse reactions. Quality of life before and after treatment was evaluated using the European Organization for Research on Treatment of Cancer (EORTC) QLQ-STO22 Chinese version questionnaire. This study was reviewed and approved by the Ethics Committee of Inner Mongolia Autonomous Region People’s Hospital (number: 202404604L). Results: A total of 32 patients participated in the study, with an ORR of 78.1% (25/32). Of these, 18 patients underwent surgical treatment, achieving a pCR rate of 22.2% (4/18) and a MPR rate of 38.9% (7/18). The median PFS for patients who did not undergo surgery was 9.8 months (95% CI: 7.6-13.1), and the median follow-up duration was 16.4 months (95% CI: 11.7-22.5). For patients who received radical surgical resection, the median DFS was not reached, and the 1-year DFS rate was 88.8% (16/18). Common adverse reactions following the treatment included myelosuppression, liver function abnormalities, diarrhea and neurotoxicity, with most adverse events being grade 1-2, a few grade 3 adverse events, and no grade 4 or 5 adverse events. According to the EORTC QLQ-STO22 Chinese version questionnaire, significant improvements were observed in the domains of difficulty swallowing, pain and eating restrictions. Additionally, improvements were noted in anxiety and reflux symptoms, while changes in body image were less pronounced. Conclusion: In the perioperative treatment of LAGC, the combination therapy of oxaliplatin, tegafur, anlotinib and penpulimab can improve the efficacy while ensuring safety, and is expected to become a new treatment for LAGC.

Background and purpose: There is a consensus within the medical community regarding the perioperative treatment of locally advanced gastric cancer (LAGC), yet the selection of an efficient and safe treatment strategy remains a contentious issue. Previous studies have validated the effectiveness of chemotherapy in conjunction with immune checkpoint inhibitor (ICI) and antiangiogenic agents in the perioperative treatment of LAGC. This study aimed to investigate the perioperative treatment regimen combining ICI, anti-angiogenic drugs and chemotherapy, in order to provide additional references for the selection of perioperative treatment strategies for patients with LAGC. Methods: This was a prospective, single-arm exploratory study designed to assess the efficacy and safety of perioperative treatment with penpulimab combined with anlotinib and chemotherapy for potentially resectable stage T3-4N+M0 LAGC. Patients diagnosed with LAGC at the Inner Mongolia Autonomous Region People’s Hospital from January 2022 to December 2023 were enrolled in the study. The primary endpoints were pathological complete response (pCR) rate and major pathological remission (MPR) rate, while secondary endpoints included surgical conversion rate, objective response rate (ORR), disease-free survival (DFS), progression-free survival (PFS) and adverse reactions. Quality of life before and after treatment was evaluated using the European Organization for Research on Treatment of Cancer (EORTC) QLQ-STO22 Chinese version questionnaire. This study was reviewed and approved by the Ethics Committee of Inner Mongolia Autonomous Region People’s Hospital (number: 202404604L). Results: A total of 32 patients participated in the study, with an ORR of 78.1% (25/32). Of these, 18 patients underwent surgical treatment, achieving a pCR rate of 22.2% (4/18) and a MPR rate of 38.9% (7/18). The median PFS for patients who did not undergo surgery was 9.8 months (95% CI: 7.6-13.1), and the median follow-up duration was 16.4 months (95% CI: 11.7-22.5). For patients who received radical surgical resection, the median DFS was not reached, and the 1-year DFS rate was 88.8% (16/18). Common adverse reactions following the treatment included myelosuppression, liver function abnormalities, diarrhea and neurotoxicity, with most adverse events being grade 1-2, a few grade 3 adverse events, and no grade 4 or 5 adverse events. According to the EORTC QLQ-STO22 Chinese version questionnaire, significant improvements were observed in the domains of difficulty swallowing, pain and eating restrictions. Additionally, improvements were noted in anxiety and reflux symptoms, while changes in body image were less pronounced. Conclusion: In the perioperative treatment of LAGC, the combination therapy of oxaliplatin, tegafur, anlotinib and penpulimab can improve the efficacy while ensuring safety, and is expected to become a new treatment for LAGC. [ABSTRACT FROM AUTHOR]

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Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder. With the emergence of disease-modifying therapies, the prognosis of SMA has significantly improved, drawing increased attention to the importance of home rehabilitation and nursing management. Long-term, standardized home rehabilitation and nursing can delay the progression of SMA, enhance the psychological well-being, and improve the quality of life of both patients and caregivers. This article provides an overview of the goals of home rehabilitation, basic functional training methods, respiratory management, and nutritional management for SMA patients, as well as psychological health issues, emphasizing the significance of obtaining appropriate home rehabilitation and support during the care process. [ABSTRACT FROM AUTHOR]

Objectives: Comorbidities associated with venous origin chronic pelvic pain (VO-CPP) were evaluated pre and post venous treatment to assess change. Materials and methods: 45 women with VO-CPP were treated with venous stenting and/or embolization. Four surveys assessed symptoms pre- and post-treatment: IPPS (chronic pelvic pain), PUF (interstitial cystitis), OHQ (dysautonomia), and modified ROME III (IBS). Prevalence of joint hypermobility was investigated. Results: Ages were 18–65. Pretreatment, 64% and 49% of women were in the severe range for PUF and OHQ, respectively. 40% and 56% met criteria for IBS and Ehlers-Danlos syndrome/Hypermobility Spectrum Disorder (EDS/HSD), respectively. 17eceived an iliac stent, 5 pelvic embolization, and 23 both. Post-treatment, average scores improved: IPPS (by 55%), PUF (34%), and OHQ (49%). Rome III improved only slightly. Conclusion: Pelvic pain, interstitial cystitis, and dysautonomia were frequently found with VO-CPP and improved after venous treatment. EDS/HSD and IBS were common in these women. [ABSTRACT FROM AUTHOR]

ObjectiveAssuming that the difference exist in the manifestation of psychological suffering among genders, the purpose of this review is to summarize the current knowledge on gender differences in vitiligo quality of life and psychological assessment.MethodsWe searched in PubMed, Scopus, and Web of Science databases for original articles in English language. Results were screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA checklist).ResultsThe study yielded 107 results; 12 articles have been evaluated as eligible. Each eligible study has been screened and analyzed. The study’s qualitative evaluation revealed that 8 papers were classifiable as satisfactory, 4 were classifiable as unsatisfactory. The agreement between the coders was high (% agreement = 84.6%; Cohen’s kappa = 0.79). All considered researches (100%) were cross-sectional studies, based on self-report questionnaires. From our analysis, women with vitiligo had a higher risk to experience lower quality of life, and worse mental health in a wide range of psychopathology symptoms than men. A wide heterogeneity of tools is used to investigate the quality of life and psychological symptoms among these patients.ConclusionUnfortunately, there are few explanatory models proposed in the literature to rationalize these findings. It will be important to investigate in further researches the specific influence of known risk factors for psychopathology in this population to better explore these phenomena.

Background: Breast cancer is most common female cancer in the world and it is also the principle cause of death from cancer among women globally. Women living with and beyond breast cancer have special needs that have to be considered by society and health care system. Due to emergence of physical, psychological and social effects after diagnosis, the quality of life (QOL) of women is highly affected, which leads to change in attitude and expectations towards life. The majority of clinical studies on breast cancer focuses on treatment and survival. However, with a greater life expectancy promoted by advances in therapeutics and early diagnosis, interest has shifted to the assessment of quality of life (QOL). The purpose of this study is to understand, evaluate and assessment of quality of life in female breast cancer survivors and factors that could influence quality of life and the main life areas where the women are more affected when they receive their diagnosis. Method: A total of 100 patients with breast cancer were studied in department of surgery at Guru Nanak Dev Hospital Amritsar Punjab after applying exclusion and inclusion criteria and after proper consent. The survey in this study contained a total of 26 questions from WHOQOL-BREF which provides a fast profile of 4 areas (domains). Result: The results of the study show that there was a significant variability of general QOL, physical domain, psychosocial domain, social domain, and environmental domain in relation to age group, marital status, employment, education of the patient, education of the head of the family, occupation of the head of the family, socio-economic status Conclusion: The outcomes in this study shows that sociodemographic variables are highly influenced by psychological domain and least with the environmental and social domain. [ABSTRACT FROM AUTHOR]

Background: Most patients with lung cancer are diagnosed at advanced stages of the disease, where chemotherapy plays an important role. This prospective study was conducted to determine the impact of palliative chemotherapy on quality of life (QOL) in advanced-stage lung cancer patients. Methods: QOL in lung cancer out-patients was assessed at diagnosis and end of treatment using the EORTC QLQ-C30 questionnaire. Changes in mean QOL scores were calculated. The correlation between patients' tumor response and change in QOL scores was also studied. Scoring was done according to the EORTC manual and results were analyzed using SPSS statistical package. Results: Out of 52 patients, 46 (88.46%) were men and six (11.54%) were women. After chemotherapy, patients' overall QOL score improved significantly (P = 0.005). Cognitive functioning significantly worsened (P = 0.01). Physical functioning (PF) and emotional functioning (EF) scores improved, while role functioning (RF) and social functioning (SF) scores worsened. Pain, dyspnea, and sleep significantly improved (P = 0.001, P = 0.001, and P = 0.005 respectively). On the other hand, nausea, vomiting (P = 0.000), diarrhea (P = 0.004), and financial difficulties (P = 0.009) worsened. Overall QOL improved in patients with partial tumor response (PR) and stable disease (SD) (P = 0.044 and P = 0.000, respectively), but worsened in progressive disease group (PD) (P = 0.648). Symptom scores improved markedly in PR and SD groups. Chemotherapy toxicity was maximum in PD group (P = 0.028). Conclusion: Global quality of life and symptom control significantly improved in lung cancer patients after chemotherapy. Deterioration of cognitive functioning, increased financial burden, and chemotherapy-related toxicity were noteworthy. Changes in QOL were coherent with patients' tumor response. [ABSTRACT FROM AUTHOR]

Being a hereditary bleeding disorder, hemophilia is characterized by spontaneous bleeding, especially joint bleeding. The treatment outcome is a comprehensive evaluation system of the following three aspects: bleeding, musculoskeletal structure (imaging), and function-activity participation. Multidisciplinary testing and corresponding scales are needed in the assessment. Among them, the quality of life assessment of hemophilia patients is particularly important, through general questionnaires and hemophilia-specific questionnaires. Canadian hemophilia outcomes-Kids' life assessment tool(CHO-KLAT), a special quality of life assessment tool for children with hemophilia, is the most widely used. This paper briefly describes the development and application of comprehensive evaluation system of the children with the disease.

Chronic venous ulcer (CVU) is an ulcer on gaiter area persisting for more than six weeks and difficult to heal even after three months of treatment. The prevalence of CVU ranges from 0.18% and 1% and Standard therapy for CVU is multilayered bandages and treatment of incompetent veins to prevent recurrence. All adult patients having CVU, due to primary varicose veins were randomly allocated to two intervention groups (Group A-comprising of use of compression bandages along with treatment of varicose veins by Endovenous Laser ablation and Group B-Non usage of compression bandages after the aforesaid surgical intervention). Out of 60, total 30 (50%) cases were in each group. Quality of life and therapeutic outcomes were noted, and patients were followed for 6 months. Quality of life outcomes compared based on SF-36 questionnaire showed more improvement in group A in all 8 domains. Other parameters like use of analgesics, itching, eczema, and increased leisure activities were better with use of compression bandages. Healing of ulcer was faster in Group A. Charing Cross varicose vein questionnaire also showed more improvement in group A (p value<0.001, <0.001, 0.003 at 1 month, 3 month and 6 month, respectively). In chronic venous ulcer, four-layer compressive bandaging after surgery enhances the healing rate of venous ulcer with better quality of life outcomes. [ABSTRACT FROM AUTHOR]

Cancer, in Europe, is the second cause of death. In addition, there is an unacceptable variability in terms of access to innovation, quality of care, and outcomes, within and between countries. The European Union has activated an unprecedented initiative to fight cancer by launching Europe's Beating Cancer Plan and the Cancer Mission. The goals are to reduce mortality, increase survival, and ameliorate quality of life by increasing knowledge, improving quality of care, and reducing inequalities through interventions on actionable determinants of variability. A competitive call was launched with the objective to develop and validate a set of quality of life and patient preference measures for cancer patients and survivors, to be used for routine data collection all over Europe. A consortium, the EUonQoL, was funded, including partners from 41 countries with 55 participants. It will start the activities on January 2023 and rresults are expected by December 2024. [ABSTRACT FROM AUTHOR]

Purpose Our main objective is to evaluate the psychometric properties of the Spanish version of the EHP-30 questionnaire. The secondary aim is to evaluate the differences in the scores of the core EHP-30 scales between patients with either surgical treatment or conservative management of endometriosis. Methods Cross-sectional study conducted into a tertiary hospital endometriosis reference unit. All patients (n = 223) pre-surgically completed the core EHP-30 questionnaire, the EQ-5D questionnaire (n = 184) and a visual analogue scale (n = 210) for endometriosis-related pain. Demographical and clinical data were recorded. Results Psychometric characteristics of the Spanish core EHP-30 questionnaire were investigated. Statistical analyses confirmed the five-structure factor, a high degree of internal consistency and of item-total correlation for all the assessed items. Convergent validity between EQ-5D and EHP-30 items and between VAS and EHP-30 subscale pain was observed. Additionally, patients with surgical management rendered significantly higher scores in the core EHP-30 subscales “pain” and “control and powerlessness”. Conclusions We present the reliability, validity and acceptability of the Spanish core EHP-30 questionnaire, providing clinicians and researchers with an improved tool to assess the endometriosis-related quality of life. Additionally, we show that patients subsidiaries of surgical treatment for endometriosis present with higher pain and powerlessness than those with conservative management.

China’s rapid urbanization has greatly boosted the quality of life of its traditionally impoverished regions. Research into the spatial distribution characteristics, evolution and spatial correlation of the quality of life in impoverished regions can help illuminate the experience of successful development and construct a knowledge base for authorities to devise development strategies. This study focuses its attention on the historically impoverished districts and counties (which are designated as parallel administrative units in China) of Guizhou Province in southwestern China. Extensively citing official statistics on districts and counties released by China’s National Bureau of Statistics and local governments, it assesses the quality of life of those places in the 3 years of 2000, 2010, and 2020 from the four dimensions of economy, society, culture, and environment. The aim is to illustrate the distribution characteristics and the evolution of quality of life in Guizhou’s historically impoverished districts and counties. In order to understand the characteristics of spatial clustering as well as the patterns of evolution of the quality of life of Guizhou’s impoverished districts and counties, the study incorporates spatial autocorrelation analysis into a spatio-temporal analysis of local quality of life. It could presumably help enrich the knowledge base that local authorities draw on to formulate development strategies that are scientific and adapted to local conditions. The study found that while the overall quality of life in all the impoverished districts and counties of Guizhou Province has improved, large gaps in quality of life between eastern and western regions of the province persisted. In addition, the driving force behind the evolution in the overall quality of life of those places changed with time, as did the characteristics of the spatial aggregation in quality of life.

Aims: To highlight the relationship among compression therapy (CT), the autonomic nervous system (ANS) (parasympathetic and sympathetic system), and the heart rate variability (HRV) analysis. Background: Beyond the typical analgesic and anti-inflammatory effects of CT in patients affected by venous and/or lymphatic diseases, some literature about CT influence on wellbeing has been published as well. More specifically, CT influence on the ANS has been elucidated mostly through HRV application, providing useful quali-quantitative data for scientific and clinical purposes. Material and Methods: A literature search was performed through several web-based search engines to investigate the available evidence concerning the possible influence of CT on the ANS and on psychoneuroendocrineimmunology. Moreover, we examined literature data regarding HRV use in the assessment of CT. Lastly, a preliminary cross-over study was performed on 10 patients affected by phlebolymphedema of the lower limbs, undergoing CT with 18–21 mmHg stockings for 10 h and investigated by means of HRV. Results: A CT-based increase of the anti-inflammatory activity of the parasympathetic (vagal) system has been elucidated in most scientific literature. Similarly, CT application has generally resulted in an improvement of HRV, which indicates a beneficial influence on the ANS. In our preliminary experience with compression stockings and HRV, two parasympathetic-based parameters improved by 22.8% and 68.0% after 10 h, whereas they decreased in the same subjects without stockings by 2.7% and 8.2%, during normal breathing. The remaining HRV parameters did not show relevant variations, especially during diaphragmatic breathing. Conclusions: From literature data and based on our very preliminary experience, it is possible to deduce that CT exerts different effects on the psychobiological parameters of the individual, overall improving HRV and parasympathetic activity. Incorporating both HRV/ANS assessment in phlebolymphology and the beneficial neural action of CT in health care may represent viable options in the future biomedical science. [ABSTRACT FROM AUTHOR]

Purpose: Our main objective is to evaluate the psychometric properties of the Spanish version of the EHP-30 questionnaire. The secondary aim is to evaluate the differences in the scores of the core EHP-30 scales between patients with either surgical treatment or conservative management of endometriosis.Methods: Cross-sectional study conducted into a tertiary hospital endometriosis reference unit. All patients (n = 223) pre-surgically completed the core EHP-30 questionnaire, the EQ-5D questionnaire (n = 184) and a visual analogue scale (n = 210) for endometriosis-related pain. Demographical and clinical data were recorded.Results: Psychometric characteristics of the Spanish core EHP-30 questionnaire were investigated. Statistical analyses confirmed the five-structure factor, a high degree of internal consistency and of item-total correlation for all the assessed items. Convergent validity between EQ-5D and EHP-30 items and between VAS and EHP-30 subscale pain was observed. Additionally, patients with surgical management rendered significantly higher scores in the core EHP-30 subscales "pain" and "control and powerlessness".Conclusions: We present the reliability, validity and acceptability of the Spanish core EHP-30 questionnaire, providing clinicians and researchers with an improved tool to assess the endometriosis-related quality of life. Additionally, we show that patients subsidiaries of surgical treatment for endometriosis present with higher pain and powerlessness than those with conservative management. [ABSTRACT FROM AUTHOR]

Background: Study participants and patients often perceive (long) questionnaires as burdensome. In addition, paper-based questionnaires are prone to errors such as (unintentionally) skipping questions or filling in a wrong type of answer. Such errors can be prevented with the emergence of mobile questionnaire apps. Objective: This study aimed to validate an innovative way to measure the quality of life using a mobile app based on the EQ-5D-5L questionnaire. This validation study compared the EQ-5D-5L questionnaire requested by a mobile app with the gold standard paper-based version of the EQ-5D-5L. Methods: This was a randomized, crossover, and open study. The main criteria for participation were participants should be aged =18 years, healthy at their own discretion, in possession of a smartphone with at least Android version 4.1 or higher or iOS version 9 or higher, digitally skilled in downloading the mobile app, and able to read and answer questionnaires in Dutch. Participants were recruited by a market research company that divided them into 2 groups balanced for age, gender, and education. Each participant received a digital version of the EQ-5D-5L questionnaire via a mobile app and the EQ-5D-5L paper-based questionnaire by postal mail. In the mobile app, participants received, for 5 consecutive days, 1 question in the morning and 1 question in the afternoon; as such, all questions were asked twice (at time point 1 [App T1] and time point 2 [App T2]). The primary outcomes were the correlations between the answers (scores) of each EQ-5D-5L question answered via the mobile app compared with the paper-based questionnaire to assess convergent validity. Results: A total of 255 participants (healthy at their own discretion), 117 (45.9%) men and 138 (54.1%) women in the age range of 18 to 64 years, completed the study. To ensure randomization, the measured demographics were checked and compared between groups. To compare the results of the electronic and paper-based questionnaires, polychoric correlation analysis was performed. All questions showed a high correlation (0.64-0.92; P<.001) between the paper-based and the mobile app-based questions at App T1 and App T2. The scores and their variance remained similar over the questionnaires, indicating no clear difference in the answer tendency. In addition, the correlation between the 2 app-based questionnaires was high (>0.73; P<.001), illustrating a high test-retest reliability, indicating it to be a reliable replacement for the paper-based questionnaire. Conclusions: This study indicates that the mobile app is a valid tool for measuring the quality of life and is as reliable as the paper-based version of the EQ-5D-5L, while reducing the response burden. [ABSTRACT FROM AUTHOR]

In a democratic country, every citizen has the right to information about the environment in which he or she lives - therefore, there should be some procedure of conventional, formal evaluation of an urbanized area with reference to its local fragments. Such kind of the procedure has been proposed in this article. The procedure is based on the conventional scoring of local areas, which can be assigned weights representing positive and negative features. The procedure provides for variants of preconditions and continuation of considerations for source data variables. The method of assessing the quality of life in the local area should serve the broad local community, therefore the intermediate and final results of the considerations are presented not only in the form of maps, but also in an illustrative way - in the form of three-dimensional (3D) images, with colors easily associated with positive or negative features. A wide range of tools from the professional GIS package - ArcGIS version 10 was used to perform the task. These tools allow to solve complex spatial problems as well as to visualize the results in an effective way. [ABSTRACT FROM AUTHOR]

The aim was to investigate the views of stakeholders on the practical relevance of a broad quality of life (QoL) outcome tool for care in older adults: the Extended Quality of Life Tool (EQLT). We conducted individual interviews and focus groups with a variety of stakeholders involved in the care for older adults which were analyzed using a framework analysis. Stakeholders considered relevant: focus on the client perspective; perspective on QoL broader than health; the possibility to take diversity into account; and the possibility to determine a minimum level of QoL. Three facilitators for implementation of the tool were mentioned as well as four barriers. The EQLT can support conversations with clients about their needs and wishes, thus enabling decisions about care services based on a broad set of domains of QoL. Implementation of the tool should take into account the facilitators and barriers identified in the current study. [ABSTRACT FROM AUTHOR]

This paper presents methods of assessing patients with juvenile idiopathic arthritis. Functional scales, methods of assessing pain, fatigue, quality of life, and motor skills are important not only for clinicians but also for patients. They enable considering many aspects important for the everyday life of a young person with rheumatic disease and his or her family during the treatment. The recognition of the patient's needs on the basis of the described scales may contribute to the patient becoming more active and involved in the treatment process. The research presented in the paper shows that the scales are widely used in many countries. [ABSTRACT FROM AUTHOR]

The article analyzes the impact of chronic obstructive pulmonary disease (COPD) on the quality of life of patients according to the results of clinical and instrumental examination and ante - testing using the integral CAT-test.Objective. Study of the effect of COPD on the quality of life in outpatient practice based on the results of the integral CAT-test. Materials and methods. The article analyzes the impact of chronic obstructive pulmonary disease (COPD) on the quality of life of patients according to the results of clinical and instrumental examination and ante - testing using the integral CAT-test.Results. The primary treatment of patients with a long history of COPD in stages II and III recorded a greater impact of the respiratory component on the quality of life. Because of complex therapy (inhaled bronchodilators and glucocorticosteroids, antibiotics according to indications, non - pharmacological methods of pulmonary rehabilitation, respiratory gymnastics, and school for patients with COPD) during 1 year of follow - up, there were significant changes in the indicators of quality of life. In patients with the sum of scores on the SAT-test up to 20 showed a decrease in the number and severity of clinical symptoms of respiratory status, and the average value of forced expiratory volume in 1 s (FEV1) remained almost at the same level with a significant improvement in the overall quality of life. In patients with a score of 21 or higher, the FEV1 level after 1 year significantly increased by 12.2%, which is apparently due to a higher level of patient compliance and the effect of pulmonary rehabilitation measures.Conclusion. The results of assessing the impact of different stages of COPD on the quality of life of patients in outpatient practice will improve the monitoring of the course of the disease and optimize the prognosis, state the effectiveness of complex therapy and adjust the dispensary observation plan.

Within the framework of the Carcinologic Speech Severity Index (C2SI) INCa Project, we collected a large database of French speech recordings aiming at validating Disorder Severity Indexes. Such a database will be useful for measuring the impact of oral and pharyngeal cavity cancer on speech production. It will permit to assess patients' quality of life after treatment. The database is composed of audio recordings from 134 sessions and associated metadata. Several intelligibility and comprehensibility levels of speech functions have been evaluated. Acoustics and prosody have been assessed. Perceptual evaluation rates from both naive and expert juries are being produced. Automatic analyzes are being carried out. It is intended to provide speech therapists and physicians with objective tools, which take into account the intelligibility and comprehensibility of patients which received cancer treatment (surgery and/or radiotherapy and/or chemotherapy). The aim of this paper is to justify the necessity of such a corpus and to present its data collection. This C2SI corpus will be available to the scientific community through the Scientific Interest Group Parolothèque. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is a major contributor to global cancer cases and deaths, making it a significant public health concern. As the number of CRC survivors continues to rise, understanding the impact of CRC and its treatment on their quality of life (QoL) has become increasingly important. The determinants of QoL in CRC patients are multifaceted and include physical health, physical fitness, physical activity, healthy eating, psychological health, social support, the availability of high-quality medical care, and QoL at the end of life. These factors interact to shape the overall well-being of CRC survivors. To enhance the QoL of CRC patients, a comprehensive approach is needed. This includes tailoring treatments to individual patient characteristics, providing psychological support and symptom management, promoting post-treatment rehabilitation, organizing support groups, emphasizing early detection, and effectively managing CRC-related symptoms. Addressing these aspects can significantly improve the QOL and well-being of CRC survivors, helping them adapt to life after treatment and thrive in the face of the challenges they may encounter., (Copyright© 2024 Zhabagin et al. Published by Tehran University of Medical Sciences.)

Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder. With the emergence of disease-modifying therapies, the prognosis of SMA has significantly improved, drawing increased attention to the importance of home rehabilitation and nursing management. Long-term, standardized home rehabilitation and nursing can delay the progression of SMA, enhance the psychological well-being, and improve the quality of life of both patients and caregivers. This article provides an overview of the goals of home rehabilitation, basic functional training methods, respiratory management, and nutritional management for SMA patients, as well as psychological health issues, emphasizing the significance of obtaining appropriate home rehabilitation and support during the care process.

Objectives: To observe the effect and safety of acupuncture on quality of life, pain, and prostate symptoms in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)., Methods: Seventy patients with CP/CPPS were randomly divided into an acupuncture group (35 cases, 1 case was eliminated) and a sham acupuncture group (35 cases, 3 cases dropped out). The patients in the acupuncture group were treated with routine acupuncture at bilateral Zhongliao (BL 33), Huiyang (BL 35), Shenshu (BL 23) and Sanyinjiao (SP 6), while the patients in the sham acupuncture group were treated with shallow needling at non-meridian and non-acupoint points beside bilateral Zhongliao (BL 33), Huiyang (BL 35), Shenshu (BL 23) and Sanyinjiao (SP 6),without manipulation to induce arrival of qi ( deqi ). Both groups retained the needles for 30 min, with one session every other day, three times a week, for a total of 8 weeks (24 sessions). Before and after treatment, and at the follow-up of 24 weeks after treatment completion, the scores of MOS 36-item short-form health survey (SF-36, including 8 dimensions of physical function [PF], role physical function [RP], bodily pain [BP], general health status [GH], vitality [VT], social function [SF], role emotional [RE], and mental health [MH], which can be summarized as physical component summary [PCS] and mental component summary [MCS]), pelvic pain visual analogue scale (VAS), National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), and international prostate symptom score (IPSS) were evaluated, and safety of both groups was assessed., Results: After treatment and at the follow-up, the scores of each dimension and PCS, MCS scores of SF-36 in the acupuncture group were higher than those before treatment ( P <0.05, P <0.01); compared before treatment, the RP, BP, and SF scores and PCS score in the sham acupuncture group were increased after treatment ( P <0.05, P <0.01). After treatment, the acupuncture group had higher scores in RP, BP, GH, MH and PCS, MCS than those in the sham acupuncture group ( P <0.05, P <0.01); at the follow-up, except for PF and RE dimensions, the scores in each dimension and PCS, MCS scores in the acupuncture group were higher than those in the sham acupuncture group ( P <0.05, P <0.01). After treatment and at the follow-up, pelvic pain VAS, NIH-CPSI, IPSS scores in the acupuncture group were lower than those before treatment ( P <0.01); in the sham acupuncture group, pelvic pain VAS, NIH-CPSI scores were lower after treatment, and NIH-CPSI score at the follow-up was lower compared with those before treatment ( P <0.01). After treatment and at the follow-up, pelvic pain VAS, NIH-CPSI, IPSS scores in the acupuncture group were lower than those in the sham acupuncture group ( P <0.01, P <0.05). No significant adverse reactions were observed in both groups, and the incidence rates of adverse reactions had no significant difference ( P >0.05)., Conclusions: Acupuncture could effectively improve the quality of life, reduce pain levels, alleviate prostate symptoms, and shows favorable long-term efficacy in patients with CP/CPPS.

The goal was to evaluate the immediate results of treatment and knee function in patients after total knee replacement. Material and methods. The study included: questioning of patients, analyzing the medical records of inpatients, analyzing the features of surgical intervention and treatment during the postoperative period. We examined 81 patients with grade 3 gonarthrosis according to Ahlbäck. The patients underwent an examination of an orthopedic traumatologist with clinical assessment of their state by the KOOS scale (The Knee injury and Osteoarthritis Outcome Score). Results. A significant reduction in the pain syndrome was observed in the period from 30 to 180 days, ranging from 38.07 (11.1-50.0) points to 86.88 (72.2-97.2) points, respectively, which in turn speeded up the rehabilitation time after endoprosthetics (p

Abstract Background Quality of life (QOL) assessment instruments, including patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs), are increasingly promoted as a means of enabling clinicians to enhance person-centered care. However, integration of these instruments into palliative care clinical practice has been inconsistent. This study focused on the design of an electronic Quality of Life and Practice Support System (QPSS) prototype and its initial use in palliative inpatient and home care settings. Our objectives were to ascertain desired features of a QPSS prototype and the experiences of clinicians, patients, and family caregivers in regard to the initial introduction of a QPSS in palliative care, interpreting them in context. Methods We applied an integrated knowledge translation approach in two stages by engaging a total of 71 clinicians, 18 patients, and 17 family caregivers in palliative inpatient and home care settings. Data for Stage I were collected via 12 focus groups with clinicians to ascertain desirable features of a QPSS. Stage II involved 5 focus groups and 24 interviews with clinicians and 35 interviews with patients or family caregivers during initial implementation of a QPSS. The focus groups and interviews were recorded, transcribed, and analyzed using the qualitative methodology of interpretive description. Results Desirable features focused on hardware (lightweight, durable, and easy to disinfect), software (simple, user-friendly interface, multi-linguistic, integration with e-health systems), and choice of assessment instruments that would facilitate a holistic assessment. Although patient and family caregiver participants were predominantly enthusiastic, clinicians expressed a mixture of enthusiasm, receptivity, and concern regarding the use of a QPSS. The analyses revealed important contextual considerations, including: (a) logistical, technical, and aesthetic considerations regarding the QPSS as a technology, (b) diversity in knowledge, skills, and attitudes of clinicians, patients, and family caregivers regarding the integration of electronic QOL assessments in care, and (c) the need to understand organizational context and priorities in using QOL assessment data. Conclusion The process of designing and integrating a QPSS in palliative care for patients with life-limiting conditions and their family caregivers is complex and requires extensive consultation with clinicians, administrators, patients, and family caregivers to inform successful implementation.

Objective: to carry out a complex assessment of life quality (LQ) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) according to SF-36 questionnaire.Materials and methods. The study included 20 patients who underwent in-patient examination and treatment in City Clinical Hospital № 1 n.a. N.I. Pirogov (Moscow City Healthcare Department) to confirm the diagnosis of CTEPH and for selection of drug therapy. All patients completed a standardized SF-36 questionnaire. The possible association of various parameters of this questionnaire with both clinical and instrumental data of patient’s examination was studied.Results. Statistically significant correlations between the clinical symptoms of the disease, the severity of pulmonary hypertension, and the assessment of the possible physical activity of patients with CTEPH with various scales of mental and physical functioning of SF-36 questionnaire have been obtained.Conclusion. The study of QL parameters increases the possibilities for a comprehensive assessment of health status in patients with CTEPH. Based on this finding, SF-36 questionnaire can be used in routine clinical practice to assess the disease severity. Increasing the patient’s number as well as carrying out a dynamic QL study according to sex and age of patients with SF-36 questionnaire will further allow to develop additional criteria for assessing the effectiveness of therapy.

Abstract Background No official German translation exists for the 50-item Expanded Prostate Cancer Index Composite (EPIC), and no minimal important difference (MID) has been established yet. The aim of the study was to translate and validate a German version of the EPIC with cultural adaptation to the different German speaking countries and to establish the MID. Methods We translated and culturally adapted the EPIC into German. For validation, we included a consecutive subsample of 92 patients with localized prostate cancer undergoing radical prostatectomy who participated the Prostate Cancer Outcomes Cohort. Baseline and follow-up assessments took place before and six weeks after prostatectomy in 2010 and 2011. We assessed the EPIC, EORTC QLQ-PR25, Feeling Thermometer, SF-36 and a global rating of health state change variable. We calculated the internal consistency, test-retest reliability, construct validity, responsiveness and MID. Results For most EPIC domains and subscales, our a priori defined criteria for reliability were fulfilled (construct reliability: Cronbach’s alpha 0.7–0.9; test-retest reliability: intraclass-correlation coefficient ≥ 0.7). Cross-sectional and longitudinal correlations between EPIC and EORTC QLQ-PR25 domains ranged from 0.14–0.79, and 0.06–0.5 and 0.08–0.72 for Feeling Thermometer and SF-36, respectively. We established MID values of 10, 4, 12, and 6 for the urinary, bowel, sexual and hormonal domain. Conclusion The German version of the EPIC is reliable, responsive and valid to measure HRQL in prostate cancer patients and is now available in German language. With the suggested MID we provide interpretation to what extent changes in HRQL are clinically relevant for patients. Hence, study results are of interest beyond German speaking countries.

Objective: The role of exercise therapy after acute pulmonary embolism (PE) is unknown. Exercise therapy is safely used after myocardial infarction and chronic obstructive pulmonary disease. The aim of this study was to investigate the safety of exercise therapy after acute PE. Methods: We implemented a 3-month exercise program after acute PE. Outcomes were death, bleeding, readmissions, recurrent events, changes in peak VO2 and quality of life (QoL). Results: A total of 23 patients were enrolled and received anticoagulation; no adverse events were reported during the exercise period. One death, 1 DVT and 5 readmissions were reported due to non-exercise related reasons. Functional capacity improved as evidenced by an increased peak VO2 at 3 months (+3.9 ± 5.6 mL/kg/min; p = 0.05). Improvement in QoL was observed at 6-months on the functional (+17.0 ± 22.6, p = 0.03) and physical health factor scales (+0.9 ± 4.6, p = 0.03). Conclusion: Exercise therapy is feasible and safe in appropriately anticoagulated patients after PE. [ABSTRACT FROM AUTHOR]

Introduction: Most common cause of chronic venous insufficiency (CVI) is Great saphenous vein (GSV) followed by short saphenous vein (SSV) insufficiency. Various modalities for the treatment of CVI are Endovenous thermal (by laser or radiofrequency) ablation, Foam sclerotherapy and Ligation and stripping of GSV. Endovenous thermal therapy is costly for the patients residing in the developing country. Herewith we have compared quality of life and early complications between ligation and stripping (L & S) of GSV and Endovenous laser therapy (EVLT). Method: Patients of CVI were diagnosed clinically and radiologically by duplex doppler USG. Fifteen patients in group 1(L & S) and 22 patients in Group 2 (EVLT) were followed at the 6 weeks, 3 months and 6 months. Early post procedural outcomes were documented at one week. Generic health was assessed by SF 36 tools and Specific health was assessed by Aberdeen varicose vein questionnaires (AVVQ) at baseline (preprocedural), at 6 weeks,3 months and at 6 months. Results: Postoperative pain in group 1 and group 2 patients were in 20.0% and 04.5% patients respectively(p>0.05). Paresthesia was in 26.7% and 9.1% respectively (p >0.05). Skin hyperpigmentation was 00.00% and 4.5% respectively (p 0.403). In both groups, infection was found in 20.0% and 04.5% respectively (p 0.137). Tract haematoma along GSV was in 13.3% and 0.00% respectively in both groups.Physical function, role limitation due to physical problems and emotional problems, emotional well-being, social function, pain, general health at end of 6 weeks and at end of 6 months were slightly better in EVLT patients but was insignificant (p >0.05). DVT and recurrence were absent in both groups. Conclusion: Regarding treatment of CVI, Early post-operative complications, Short term General and disease specific QoL is slightly better in patients having EVLT than L & S, but is statistically insignificant. [ABSTRACT FROM AUTHOR]

Objective To provide further convergent validity on the Personal Impact of Epilepsy Scale (PIES) Spanish version for use in Hispanics with epilepsy. Participants and Method This study included 90 patients (22 Hispanic and Spanish speaking - HSS, 30 Hispanic and English speaking – HES, and 38 non-Hispanic and English speaking – NHES) who were diagnosed with epilepsy and referred by their epileptologist for a comprehensive neuropsychological evaluation that, in addition to cognitive measures, also included the Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), and PIES in English or Spanish- depending on the participant's primary language. The PIES was created with subscales to measure the effect of seizures, adverse effects of treatment, and comorbidities such as mood disorders on quality of life. We compared scores on the PIES subscales in English and Spanish to determine equivalence. We further examined if language of administration moderated the relationship between PIES subscale scores and depression/anxiety through nonparametric bootstrapping. Results There were no significant demographic or clinical differences between the 3 groups examined. ANOVA contrast of mean scores on all PIES subscales between HSS, HES and NHES groups did not reach significance (Seizures F [2,88] =.06 , p = -.93; Medication use F[2,88] = 1.95, p =.14, Comorbidity F[2,88] =.64, p =.52, and total PIES F[2,88] =.19, p =.83). The relationships between PIES and BDI-II/BAI scores were not significantly moderated by language of administration. Conclusions Our data suggest clinical equivalency between the English and Spanish versions of the PIES. Furthermore, the relationships between PIES subscales and the BDI-II/BAI were not significantly changed by language of administration. These findings indicate that the Spanish PIES appears to have good convergent validity with the original English version and can be useful in the assessment of quality of life in HSS patients. [ABSTRACT FROM AUTHOR]

Purpose: Deep venous thrombosis induced by iliac vein compression syndrome often interferes with patients' work or daily living. This study aims to investigate the long-term outcome and quality of life in patients with iliac vein compression syndrome after endovascular treatment. Methods: From October 2011 until June 2016, 28 patients with acute deep venous thrombosis diagnosed as iliac vein compression syndrome by ultrasonography were enrolled in this perspective study. Fifteen patients underwent balloon dilation and stent insertion (group A); 13 patients received anticoagulation treatment, thrombolysis, or balloon dilation without stenting (group B). The Medical Outcomes Study-Short Form-36 was used to assess the quality of life preoperatively and after endovascular treatment. The follow-up of Short Form-36 questionnaire was obtained within 12.13 ± 12.04 months after repair. Results: There was no operative mortality in two groups, and technical success was achieved in 14 (93.3%) patients in group A. Thirteen (86.7%) patients were cured in group A, which was significantly higher than that of group B (46.2%, p = 0.042). Only one patient showed occlusion of stent in group A, with a secondary patency rate of 93.3%. Except for 'Role emotion', all remaining domains were significantly improved in group A when compared with preoperative score (p < 0.01). The scores of 'Physical functioning', 'Role physical', and 'General health' in group A were significantly higher than those of group B (p < 0.05). Conclusions: Endovascular stenting to treat iliac vein compression syndrome shows beneficial clinical outcome, cumulative patency rate, and quality of life, with high technical success and low complications. [ABSTRACT FROM AUTHOR]

Objectives: This study is part of an overarching research initiative on the development and integration of an electronic Quality of Life and Practice Support System (QPSS) that uses patient-reported outcome and experience measures in clinical practice. The current study focused on palliative nurse consultants trialing the QPSS with older hospitalized adults receiving acute care. The primary aim of the study was to better understand consultants' and patients' experiences and perspectives of use.Method: The project involved two nurse specialists within a larger palliative outreach consult team (POCT) and consenting older adult patients (age 55+) in a large tertiary acute care hospital in western Canada. User-centered design of the QPSS was informed by three focus groups with the entire POCT team, and implementation was evaluated by direct observation as well as interviews with the POCT nurses and three patients. Thematic analysis of interviews and field notes was informed by theoretical perspectives from social sciences.Result: Over 9 weeks, the POCT nurses used the QPSS at least once with 20 patients, for a total of 47 administrations. The nurses most often assisted patients in using the QPSS. Participants referenced three primary benefits of relational use: enhanced communication, strengthened therapeutic relations, and cocreation of new insights about quality of life and care experiences. The nurses also reported increased visibility of quality of life concerns and positive development as relational care providers.Significance Of Results: Participants expressed that QPSS use positively influenced relations of care and enhanced practices consistent with person-centered care. Results also indicate that electronic assessment systems may, in some instances, function as actor-objects enabling new knowledge and relations of care rather than merely as a neutral technological platform. This is the first study to examine hospital palliative consult clinicians' use of a tablet-based system for routine collection of patient-reported outcome and experience measures. [ABSTRACT FROM AUTHOR]

This article applies a micro-meso-macro analytical framework to understand clinicians' experiences and perspectives of using patient-reported outcome and experience measures (PROMs and PREMs) in routine hospital-based palliative care. We structure our discussion through qualitative analysis of a design and implementation project for using an electronic tablet-based tool among hospital-based palliative clinicians to assess patients' and their family caregivers' quality of life concerns and experiences of care. Our analysis identified three categories of practice tensions shaping clinicians' use of PROMs and PREMs in routine care: tensions surrounding implementation, tensions in standardization and quantification, and tensions that arose from scope of practice concerns. Our findings highlight that clinicians necessarily work within the confluence of multiple system priorities, that navigating these priorities can result in irreducible practice tensions, and that awareness of these tensions is a critical consideration when integrating PROMs and PREMs into routine practice. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the psychometric qualities of the WHOQOL-BREF(PT) (the questionnaire developed by the World Health Organization Quality of Life Grpup for quality of life assessment), when applied to Portuguese elderly people residing in a community setting. The psychometric qualities were assessed by confirmatory factor analysis. A hierarchical second-order model and a third model were performed, and all three models presented similar and reasonable adjustment indexes. The data analysis showed that the construct failed only regarding discriminant validity because the correlations between the first-order factors were higher, associated with lower values of average variance extracted. The psychometric qualities found in the original translation/validation of the WHOQOL-BREF(PT) were compared with those found in this study; this study found higher correlations between domains but a similar level of factor reliability. The findings of this study lead to three recommendations: (i) to compute each factor score for each participant using the factor score weights obtained from confirmatory analysis models instead of adopting a unitary weight for each item, as proposed by the authors of the original translation/validation of the WHOQOL-BREF(PT); (ii) to compute a QOL score, which is not included in the original translation/validation; and (iii) to analyze differences between individual scores for each participants, which should be done by a group of health experts.

The need for undergraduate teaching of Animal Welfare and Ethics (AWE) in Australian and New Zealand veterinary courses reflects increasing community concerns and expectations about AWE; global pressures regarding food security and sustainability; the demands of veterinary accreditation; and fears that, unless students encounter AWE as part of their formal education, as veterinarians they will be relatively unaware of the discipline of animal welfare science. To address this need we are developing online resources to ensure Australian and New Zealand veterinary graduates have the knowledge, and the research, communication and critical reasoning skills, to fulfill the AWE role demanded of them by contemporary society. To prioritize development of these resources we assembled leaders in the field of AWE education from the eight veterinary schools in Australia and New Zealand and used modified deliberative polling. This paper describes the role of the poll in developing the first shared online curriculum resource for veterinary undergraduate learning and teaching in AWE in Australia and New Zealand. The learning and teaching strategies that ranked highest in the exercise were: scenario-based learning; a quality of animal life assessment tool; the so-called ‘Human Continuum’ discussion platform; and a negotiated curriculum.

The choice of sex in newborns with genital ambiguity is challenging. Information concerning the satisfaction of subjects with disorders of sex development from childhood to adulthood is required in order to address sex attribution policies. This study focuses on the methods that enable clinicians to investigate the alignment of phenotypes with gender identity and quality of life in people with disorders of this kind. These methods are presented as tools for studying a cohort of ten subjects with 45,X/46,XY mosaicism examined between 1985 and 2014 in the Department of Pediatric Endocrinology, Regina Margherita Children's Hospital, Turin: five children and five young adults, four reared as females and six as males. Clinical outcome was assessed by means of a clinical scoring system considering height, genital appearance, gonads and pubertal development. The Gender Identity Questionnaire for Children and the World Health Organization Quality of Life assessment were adopted. The four male children strongly identified with their assigned sex: male attribution was satisfactory until pubertal age. In young adults the clinical scores ranged between 55-65% for both genders. In the young male, the reduced sexual activity and the poor body image perception strongly affected his quality of life. The clinical scores of the two young female adults (60% for both) were not balanced with their quality of life scores (87.5% and 68.75% respectively): individual traits and social-familial context should be investigated in order to explain these differences. Clinical and psychosocial assessment in people with disorders of sex development is mandatory in order to plan care procedures; a detailed analysis requires adequate tools. Clinical scoring system, Gender Identity Questionnaire for Children and World Health Organization Quality of Life assessment can be used to investigate the alignment of physical phenotype with gender identity and quality of life.

Objective: Assuming that the difference exist in the manifestation of psychological suffering among genders, the purpose of this review is to summarize the current knowledge on gender differences in vitiligo quality of life and psychological assessment., Methods: We searched in PubMed, Scopus, and Web of Science databases for original articles in English language. Results were screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA checklist)., Results: The study yielded 107 results; 12 articles have been evaluated as eligible. Each eligible study has been screened and analyzed. The study's qualitative evaluation revealed that 8 papers were classifiable as satisfactory, 4 were classifiable as unsatisfactory. The agreement between the coders was high (% agreement = 84.6%; Cohen's kappa = 0.79). All considered researches (100%) were cross-sectional studies, based on self-report questionnaires. From our analysis, women with vitiligo had a higher risk to experience lower quality of life, and worse mental health in a wide range of psychopathology symptoms than men. A wide heterogeneity of tools is used to investigate the quality of life and psychological symptoms among these patients., Conclusion: Unfortunately, there are few explanatory models proposed in the literature to rationalize these findings. It will be important to investigate in further researches the specific influence of known risk factors for psychopathology in this population to better explore these phenomena., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Samela, Malorni, Matarrese, Mattia, Alfani and Abeni.)

Although chemoradiotherapy (CRT) has improved disease outcomes in advanced head and neck cancer (aHNC), toxicity remains a major concern. Treatment interruptions and decreased quality of life (QOL) can occur due to malnutrition, secondary to mucositis, dysphagia and odynophagia. Gastrostomy tubes are used in many patients to improve nutrition during CRT. The optimal timing of PEG placement in patients with aHNC undergoing CRT remains controversial. Using the PubMed database, we performed a systematic review of published CRT series in aHNC to guide decision-making regarding optimal timing of percutaneous endoscopic gastrostomy (PEG) placement. We aimed to compare outcomes when patients are treated with prophylactic PEG (pPEG) versus reactive PEG (rPEG). Twenty-two studies examining the role of PEG placement in CRT for aHNC were reviewed. pPEG reduces the number of malnourished patients (defined as >10% of body weight), but average weight loss at various time points following treatment appears similar to patients with rPEG. pPEG is also associated with improved QOL at 6 months, and greater long term PEG dependence. Clinical and dosimetric parameters that correlate with malnutrition in patients without pPEG include advanced age, percent weight loss preceding treatment, and radiation dose to the pharyngeal constrictor muscles. Based on this evidence, our institutional strategy is to encourage pPEG in those patients deemed at greatest risk of becoming malnourished during the course of treatment, and to approach the remainder of patients with rPEG. [ABSTRACT FROM AUTHOR]

Objective We assessed outcomes of open surgical venous thrombectomy with temporary arteriovenous fistula, and the procedure’s effect on health-related quality of life. Method We retrospectively analyzed 48 (26 at long-term) patient medical records. Mortality rates, patency, and risk of post-thrombotic syndrome were analyzed using Kaplan–Meier estimation. The association between risk factors/coagulation disorders and patency/post-thrombotic syndrome along with patient health-related quality of life at long-term was analyzed employing various statistical methods. Results Patient one-year survival rate was 93 ± 4% and primary one-year patency rate was 89 ± 5% (secondary one-year patency rate 97 ± 3%). Freedom from post-thrombotic syndrome after eight years was 80 ± 12% (post-thrombotic syndrome rate 20 ± 12%). Health-related quality of life was impaired vs. normative data in the physical and social subscales, and in the mental component score (p < .05). Conclusions Open surgical venous thrombectomy appears safe compared with literature-reported outcomes in similar patients using alternative approaches. Iliofemoral deep vein thrombosis impairs physical, social, and mental health-related quality of life. [ABSTRACT FROM AUTHOR]

Objectives To translate and evaluate the psychometric properties of the Venous Insufficiency Epidemiological and Economic Studies (VEINES) questionnaire, divided into two subscales; symptoms (VEINES-Sym) and quality of life (VEINES-QOL), in a Swedish cohort of patients with venous disease. Methods The original questionnaire was translated into Swedish with forward–backward translation and administered to 112 patients who were consecutively recruited and had varying degrees of chronic venous disease. Mean age was 54.5 ± 15.2 years (range: 19–83) and 75% of the participants were female. All patients completed the RAND 36-item health survey and the VEINES-QOL/Sym. Results The results showed excellent internal consistency for both VEINES-QOL (Cronbach's alpha (α) = 0.93) and VEINES-Sym (α = 0.89). Both the VEINES-QOL and VEINES-Sym correlated well to all the RAND-36 domains, demonstrating good construct validity. Exploratory factor analysis confirmed both subscales of the VEINES-QOL/Sym. Conclusions The Swedish VEINES-QOL/Sym is a valid health-related quality of life instrument for chronic venous disease, both for research purposes and for clinical evaluation. [ABSTRACT FROM AUTHOR]

Background: Per oral endoscopic myotomy (POEM) has emerged as a promising option for the treatment of achalasia. This study assessed POEM training process, outcomes, and improvement in quality of life after POEM performed by an interventional endoscopist (mentor) with trainees.Methods: We performed a retrospective review of data for patients who underwent POEM with involvement of trainees. Trainees were trained in performing mucosotomy, submucosal dissection, creating submucosal tunnel, identifying gastroesophageal junction, myotomy, and closure of mucosal incision in a step-by-step fashion. Trainees' performance on each step was evaluated by the mentor based on several key points in each step. The short form 36 (SF36) was obtained before and certain times after the primary POEM procedure was performed.Results: Sixty-two patients, 26 males and 36 females with a mean age of 59 years, who underwent POEM were enrolled. A checklist included all related items for each step was established. All trainees obtained competence within 6 cases for each step. 61/62 (98.3%) patients had a significant improvement in the Eckardt's score post POEM: 9.3 ± 1.5 prior to POEM and 2.6 ± 1.2 after the POEM (P = 0.001) and a decrease in mean lower esophageal sphincter pressure (LES): pre- and post-procedure mean LES pressures were 28.5 ± 11.4 and 12.1 ± 4.5 mmHg, respectively (P = 0.001). The SF-36 questionnaire demonstrated a significant improvement in quality of life and comparable with those without trainees in other studies.Conclusion: This preliminary study showed for the first time that training for POEM can be performed in a step-by-step fashion, learning mucosal incision, submucosal dissection, myotomy, and mucosal incision closure from an expert interventional endoscopist without increasing adverse events. The checklist for each step could be used as an important guide in training POEM. The outcomes of POEM in this study were similar to those reported by others without trainees. Further multiple center studies are needed to verify this training process and to establish a formal training protocol. [ABSTRACT FROM AUTHOR]

Purpose Studies on ultrasound-accelerated, catheter-directed thrombolysis of acute deep vein thrombosis emphasize good patency rates and low complication rates. Therefore, we analyzed quality of life besides technical success and patency in our patients after ultrasound-accelerated, catheter-directed thrombolysis. Methods Between 2009 and 2014, 42 patients suffering from iliofemoral deep vein thrombosis received ultrasound-accelerated, catheter-directed thrombolysis. Follow-up included clinical exanimation and ultrasound. Thirty patients (36 interventions), mean age 41.3 years (range 19–71 years), 56.6% women (17/30), completed the surveys. Five different scores were used to assess the quality of life and symptoms of postthrombotic syndrome: SF36, Euro-QOL 5D, PDI, VEINES-QOL/Sym, and the Villalta score. Results Mean therapy duration of ultrasound-accelerated, catheter-directed thrombolysis was 76.4 h and therapeutic success could be reported in 80.5% (29/36). Successful ultrasound-accelerated, catheter-directed thrombolysis was followed by stent angioplasty in 58.3% (21/36) procedures. Overall complication rate was 19.44%, mainly formed by minor bleedings. Mean follow-up was 38.5 months. The primary patency rate was 63.8%, the assisted-primary and the secondary patency rate were 80.5%. We observed an improved quality of life in our patients’ cohort compared to patients suffering from postthrombotic syndrome. Conclusion Although ultrasound-accelerated, catheter-directed thrombolysis is feasible with good patency rates, further prospective randomized trials are necessary to evaluate the value of thrombus removal in iliofemoral deep vein thrombosis in comparison to conservative treatment. [ABSTRACT FROM AUTHOR]