Higher Quality Of Life Scores Research Articles

An Assessment of Quality-of-Life Following Tissue Expansion in Pediatric Patients

Introduction: There is limited data on the effects of tissue expansion (TE) surgery on quality-of-life (QOL) in pediatric patients. Evidence-based information may help clinicians, patients, and their families with treatment decision-making and post-operative expectations. This study explores QOL following TE in pediatric patients. Methods: A post-intervention QOL survey and retrospective chart review was performed. Patients who underwent TE at a pediatric tertiary hospital between October 2004 and March 2020 completed the Glasgow Children's Benefit Inventory or the Glasgow Benefit Inventory. Total scores range from −100(worsened QOL) to +100(improved QOL). Participants were also asked if they would recommend TE to other patients with the same indication. Results: The response rate was 38% (n = 20; 14 females, 6 males). The median QOL score was +17[−2,+49]. Higher QOL scores were found for TE indications of scar (+49) and alopecia (+40), compared to giant congenital melanocytic nevus (−2). Higher scores were also associated with shorter time in active treatment ( r = −0.65) and fewer complications ( r = −0.56). 18/20 participants would recommend TE. Participants whose QOL improved (n = 11, 55%) reported increased self-confidence, fitting in with peers, and improved function. Participants with unchanged or decreased QOL (n = 9, 45%) described a negative experience with residual scarring. However, 7/9 with unchanged or decreased QOL would still recommend TE. Conclusions: This preliminary descriptive study demonstrated variable QOL following TE. Patient and treatment-related factors impact QOL outcomes. Despite the range in QOL outcomes, the majority of participants would recommend TE. Further research evaluating QOL following TE is necessary to better understand this relationship.

Artículo traducido] Mejora de la calidad de vida relacionada con la salud en niños de mediana edad con parálisis cerebral después de un alargamiento miofascial percutáneo selectivo y fisioterapia funcional

Introduction and objectivesChildren with cerebral palsy (CP) experience decreased health-related quality of life (HRQOL). This study aimed to assess the HRQOL of children with CP before versus after a combined program of minimally invasive selective percutaneous myofascial lengthening (SPML) and functional physiotherapy. Material and methodsA single-group pre–posttest design was used. Twenty-six middle childhood children with spastic CP, aged 5–7 years, with Gross Motor Function Classification System levels II–IV underwent SPML surgery and 9 months of postoperative functional strength training therapy. The proxy version of the DISABKIDS-Smiley questionnaire was completed by one parent of each child. Dependent t-tests were used to compare mean pre- and post-measurement scores. ResultsAfter the 9-month intervention, the children with CP had significantly higher quality of life scores (mean difference, 11.06 ± 9.05; 95% confidence interval [CI], 7.40–14.71; p < 0.001). ConclusionsThis study demonstrated that children with CP had better HRQOL after a combined program of minimally invasive SPML surgery and functional physiotherapy (ACTRN12618001535268).

The impact of metastatic breast cancer (mBC) treatment on patient reported productivity loss among patients with HER2+ mBC in the U.S.

352 Background: Little is known about the impact of treatments and other factors on productivity loss among HER2+ mBC patients. This study aimed to assess the work productivity and activity impairment among employed women with HER2+ mBC. Methods: A cross-sectional survey was completed by the members of two patient advocacy organizations in the U.S. Those who were employed for paid work (≥20 hours/week) and receiving systemic treatments for HER2+ mBC for the past 3-months were recruited. Participants self-reported their sociodemographic, clinical and treatment history, time burden related to disease management, and completed the work productivity and activity impairment (WPAI) and Functional Assessment of Cancer Therapy Breast (FACT-B) quality of life (QoL) questionnaires. Patients were grouped based on their current regimen: (1) Oral only, (2) one parenteral drug (1 IV), (3) 2 IVs, (4) 3+ IVs. Association between WPAI scores and sociodemographic and clinical characteristics was assessed using simple linear regression. Results: A total of 118 HER2+ mBC patients participated [mean (SD) age 47.2 (9.5) years, 69.5% were employed full-time and 30.5% part-time, 89% were White, 13.6% resided in rural area]. Among 118 patients, 38 (32.2%) were on 1 IV, 38 (32.2%) on 2 IVs, 31 (26.6%) on 3+ IVs and 11 (9.3%) on oral only regimen. The median travel time (4 hrs vs. 6 hrs) and time spent at healthcare visits (7.3 hrs vs.13.4 hrs) was numerically higher among those on 3+ IVs than those on 1 IV. The median percent work time missed (7.7% vs. 5.8%), overall work impairment (38.2% vs.31.3%) and activity impairment (40.0% vs. 30.0%) in the past 7 days was numerically higher in patients on 3+ IVs than on 1 IV. Working part-time, residing in rural area, having low household income (&lt;25K vs. &gt;75K) and non-commercial insurance was associated with greater overall work impairment (all p-values &lt;0.05). Longer time since mBC diagnosis, longer time on treatment and higher QoL score were associated with lower overall work impairment (all p-values &lt;0.05). Working part-time, low household income, non-commercial insurance, longer time on treatment and higher QoL score were similarly associated with activity impairment (all p-values &lt;005). Conclusions: Socioeconomic and geographical factors were important determinants of work productivity loss among HER2+ mBC patients. IV treatment is the mainstay of therapy for HER2+ mBC patients and being on a simpler regimen for a longer time is likely to reduce work productivity loss and activity impairment. Improving access to novel monotherapy infusion treatment in rural community oncology practices may offer an opportunity to reduce patient time burden and work productivity loss among HER2+ mBC patients and improve health-related quality of life. Additional research from a larger diverse sample is warranted to further understand health disparities in HER2+ mBC patients.

The effect of yoga on insomnia and quality of life among nursing professionals during COVID-19: A pre-post-test interventional study.

The coronavirus disease 2019 (COVID-19) pandemic has taken a toll on the well-being and quality of life (QoL) of healthcare professionals, especially nurses. Insomnia, a common consequence of the pandemic, adds to the physical and mental strain on healthcare workers. This study aimed to assess the impact of workplace yoga intervention on insomnia severity and QoL among female nursing and healthcare professionals during the pandemic. A pre-post-interventional study was conducted among 173 nursing professionals working in a hospital setting. Baseline assessments collected age, body mass index (BMI), insomnia severity using the Insomnia Severity Index (ISI), and QoL using the World Health Organization Quality-of-Life Brief Version (WHOQOL-BREF). A 6-week workplace yoga intervention was conducted by trained professionals, followed by posttest assessments. Among 173 participants, 57 had insomnia. Participants without significant insomnia had higher QoL scores (P < 0.001). Following the yoga intervention, both subthreshold and moderate clinical insomnia groups experienced reduced insomnia severity (P < 0.001). Quality-of-life scores in the physical, psychological, and environmental domains improved significantly (P < 0.05). Workplace yoga intervention appears to be a promising approach to alleviate insomnia and enhance QoL among female nursing and healthcare professionals during the COVID-19 pandemic. Implementing tailored workplace yoga programs can play a crucial role in promoting the well-being and resilience of healthcare workers, contributing to a positive work environment and improved patient care outcomes.

Quality Of Life and Coping Strategies Among Caregivers of Patient with Cardiovascular Diseases

Caregivers and family members of patients with long-term cardiovascular diseases often experience varying degrees of depression due to the significant changes in life style and the challenges associated with managing the condition. Adapting and modifying coping strategies as needed is crucial for caregivers to effectively decrease or manage stressful situations. The objectives of this study was to assess the quality of life and coping strategies among caregiver of cardiovascular patient. At IMS &amp; SUM Hospital in Bhubaneswar ,Odisha, a descriptive correlational research design was used. Purposive sampling selected 200 participants who completed a socio-demographic questionnaire. Two standardized scale s were employed: the WHOQOL-BREF scale to measure quality of life and the coping inventory for stressful situations to assess coping strategies. The study findings showed a significant negative correlation ( r = -0.338, p &lt; 0.01) between quality of life and coping strategies, as indicated by Karl Pearson’s correlation coefficient. This suggests that as, if the coping strategies is better, the quality of life is also better. Additionally, the study employed ANOVA and t-tests to examine the differences between quality of life and coping strategies. The study findings suggest that the quality of life of young individuals is more impacted by caregiving compared to the elderly. There is a significant negative correlation between quality of life and coping strategies, indicating that higher quality of life scores are associated with lower coping strategy scores. Conversely, better coping strategies are linked to better quality of life. Caregivers employ various coping strategies, and counselling can play a crucial role in providing emotional support, guidance, and practical advice to help caregivers manage challenges and maintain their well-being while caring for cardiovascular patients.

Relationship between three dietary indices and health-related quality of life among rural elderly in China: a cross-sectional study.

This study aimed to explore the association between health-related quality of life (HRQOL) and diet quality using three evidence-based dietary indices among older people in rural China. This cross-sectional study included 1,258 rural older people (mean age 72.32 years; 55.6% female). HRQOL was assessed using the European Five Dimension Health Scale (EQ-5D), and dietary intake was assessed using a Food Frequency Questionnaire. Three dietary scoring indices, including the Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension, and Dietary Diversity Score (DDS), were calculated to assess and analyze the relationship between these dietary indices and quality of life. The EQ-5D score was 0.95 ± 0.10, and the EQ-Visual Analog Scale (VAS) score was 76.76 ± 14.44. All three groups with higher dietary indices had higher quality of life scores. After controlling for covariates in multivariate adjusted binary logistic regression analyzes, participants in the top tertile of DDS had higher quality of life scores than those in the bottom tertile. DDS was consistently associated with EQ-5D (Model 2: OR = 1.567, p = 0.001; Model3: OR = 1.351, p = 0.044) and EQ-VAS (Model 2: OR = 1.830, p < 0.001; Model 3: OR = 1.383, p = 0.047), significantly different from the other groups. Older people in rural China who adhere to various foods experience a better quality of healthy life.

Assessment of Quality of Life Before and After Ileostomy Reversal After Low Anterior Resection for Rectal Cancer

Aim: Low Anterior Resection Syndrome negatively affects patients’ quality of life after surgery for rectal cancer. Temporary loop leostomy is preferred to avoid anastomosis leakage related problems. Aim of this study is to evaluate Patients’ quality of life before and after ileostomy reversal. &#x0D; Material and Methods: Patients with laparoscopic low anterior resection with protective loop ileostomy were included in the study. Before and after the reversal of the ileostomy quality of life assessment was done by EORTC QLQ-C30 scale. &#x0D; Results: Sixty two patients with temporary loop ileostomy after laparoscopic low anterior resection for rectal cancer were included in the study. Our study population showed better results in General health scale and social function scale after ileostomy reversal. However; there is no significant difference in general function and general symptom scale. &#x0D; Conclusion: Temporary ileostomy can negatively affect patients’ quality of life and patients have higher quality of life scores after ileostomy reversal.

Characteristics of participants in the first fully online National Diabetes Prevention Programme: A quantitative survey

Background Diabetes prevention programmes (DPPs) are being implemented around the world to tackle the rise in type 2 diabetes. In 2021/22, the Health Service Executive(HSE) in Ireland piloted a fully online national diabetes prevention programme(NDPP). Characteristics and factors affecting participation may be different among people attending online DPPs compared to face-to-face programmes. The aim of this study was to describe the demographic, psychosocial and health characteristics of participants in the pilot of the online NDPP in Ireland. Methods A survey from the evaluation of the English NDPP was adapted for the Irish context with Patient and Public Involvement(PPI) input. The survey was sent (between April and June 2022) to all individuals who attended the initial assessment of the pilot NDPP (n=73). It contained questions on health status, co-morbidities, motivation to improve health, quality of life, self-efficacy, beliefs about the risk of diabetes, participation(e.g. recollection and understanding of invite, number of sessions attended), as well as demographic information. Results Response rate was 30.5% (n=22). Mean age of responders was 62 years (range 36–82 years) and over half were men (57.1%, n=12). The majority (81%, n=17) had attended 6 or more of the 14 sessions. Most (90.5% n=19) reported having family members or acquaintances with diabetes, had positive views of their current health status and high quality of life scores (71.4%, n= 15). Mental health scores were slightly higher than the national average. Over half (57.2%, n=12) were confident or very confident about participating in an online DPP. Almost all (95.2%, n=20) believed it was important to manage their risk of type 2 diabetes. Conclusions Participants in the online pilot NDPP had positive views of their general health and positive psychosocial characteristics affecting their decision to participate. These beliefs may be modifiable intervention targets to encourage participation among non-attenders in future programmes.

Evaluation of Quality of Life in Rheumatological Patients with Post-Tonsillectomy

Aim: The main aim of the study was to determine whether tonsillectomy improves the quality of life in adults suffering from chronic or recurrent tonsillitis and in rheumatologically treated patients.&#x0D; Materials and methods: This study was conducted on seropositive or seronegative patients (n=50) who were followed up with various rheumatological diagnoses (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, etc.) at the physical medicine and rehabilitation clinic of SBU Diyarbakir Gazi Yasargil Education Research Hospital and who were diagnosed with acute or chronic tonsillitis and who applied to the ENT clinic. It was done to follow the pre- and post-operative conditions. In these patients who were decided to undergo surgical treatment, HAQ (Health assessment questionnaire) quality of life scale and VAS (Visual Analog Scala) were applied to evaluate the perception of pain before and at the 6th month after the operation.&#x0D; Results: In this study of 50 adults, mean age was 28.0 years (SD 7.2 years), 38 adults were followed up in the 1st month of diagnosis, while 12 adults were followed up in the 7th month of diagnosis. All patients experienced significant improvements throughout the treatment process. According to the results of the patients' quality of life scale, it was determined that it increased significantly, primarily due to improvements in general and physical areas. 96% (96/100) of participating patients reported benefiting from tonsillectomy. Patients in the postoperative control group had significantly higher quality of life scores than patients in the preoperative case group (p &lt; 0.001).&#x0D; Conclusion: Adult patients who underwent tonsillectomy due to acute tonsillitis reported improvement in their quality of life 6 months after surgery. Based on this, physical examination of rheumatological patients who have rheumatological diseases and have undergone tonsillectomy and it is likely to improve general health, create a sense of well-being in patients, and improve overall quality of life. The social benefits of tonsillectomy appear to be negligible. The effects are likely to be long-lasting and have a greater impact on younger patients. The presence of chronic rheumatological disease due to tonsillar inflammation and infective symptoms are the main factors affecting the severity of the disease.

Prioritizing Toxicities in Automated Outcome-Directed Treatment Plan Optimization

We recently reported on quality of life (QOL)-guided radiotherapy including NTCP-based treatment plan optimization. This method employs NTCP objective functions, prioritized based on their impact on QOL, instead of conventional dose-based objective functions for individual organs at risk (OAR). We recently expanded this method to include simple models for tumor control probability (TCP) and general plan quality (e.g., hotspot reduction, target dose homogeneity), allowing for fully automated planning. The aim of this study was to test the feasibility of this method and to study predicted toxicity profiles of various plans by prioritizing toxicities differently during treatment plan optimization. Thirty patients, representative of our population receiving definitive (chemo)radiotherapy for head and neck cancer, were selected for this study. Fully automated VMAT treatment plans were created using a mix of NTCP and TCP objective functions. TCP objective functions were based on a PTV D98 ≥ 95% of the prescribed dose. Automated plans were created for each patient using different priorities for 20 toxicities including salivary, swallowing and speech problems, pain and general symptoms. Toxicities were prioritized in different ways: 1) minimizing the impact on QOL; 2) minimizing salivary toxicity; 3) minimizing swallowing related toxicity; 4) equal weights for each toxicity. Manually created clinical VMAT plans were used as reference. Toxicity priorities were easily selected prior to optimization and resulting plans did not need any manual post-processing. Fully automated NTCP-TCP-based optimization consistently resulted in superior plans when compared to the clinical reference plans and always in lower NTCPs for swallowing, speech, pain and general toxicities. Dose reductions in OARs depended on which toxicities were prioritized during plan optimization, e.g., the mean dose in the parotid glands was on average 13 Gy lower in salivary sparing plans compared with plans focused on swallowing sparing, and the average NTCP of salivary toxicities in those plans was 7% lower. However, these reductions were at the cost of higher NTCPs for dysphagia and moderate-to-severe general symptoms such as fatigue. Plans optimized based on the QOL model had the highest QOL scores. Automated outcome-directed treatment plan optimization is feasible and consistently outperforms manually generated VMAT plans in terms of NTCP and QOL scores. Predicted toxicity profiles depend on toxicity priority settings prior to planning. The highest QOL score was obtained when toxicities were prioritized according to relative impact on QOL.

Stem Cell Therapy Post-Angioplasty: A Novel Approach to Counteract Restenosis in Coronary Artery Disease Patients

Introduction: Cardiovascular diseases (CVDs) continue to be a primary global health challenge, responsible for significant morbidity and mortality. Despite the advancements in therapeutic modalities, challenges persist. Angioplasty stands out as a key intervention for coronary artery disease (CAD), but post-procedural complications, particularly restenosis, remain a concern. Stem cells, given their regenerative properties, have garnered attention as a potential therapeutic avenue following angioplasty, but clinical understanding is still emerging. Objective: This study aimed to investigate the therapeutic potential of stem cell administration following angioplasty in reducing restenosis rates and improving vascular repair. Methods: A randomized controlled trial was conducted with 500 CAD patients (aged 45-75) undergoing angioplasty. Participants were randomly allocated to control (standard post-angioplasty care) and experimental groups (standard care + stem cell therapy). Primary outcome was the rate of restenosis at 12 months, with secondary outcomes like intimal hyperplasia and quality of life assessed using EQ-5D. Results: At 12-month follow-up, the restenosis rate was significantly lower in the experimental group (12%) than in the control group (27%) [p&lt;0.001]. Additionally, the experimental group demonstrated a 40% reduction in intimal hyperplasia and reported higher quality of life scores compared to controls. Discussion: Our results signify the potential benefits of stem cell therapy post-angioplasty. The marked reduction in restenosis aligns with prior pre-clinical evidence highlighting stem cells' reparative capacities. Limitations include the study's 12-month duration and the specific age bracket of participants. Conclusions: Stem cell therapy after angioplasty shows promise in reducing restenosis and improving patient outcomes. More long-term studies are essential to solidify these findings and guide clinical applications.

Improving health-related quality of life in middle-age children with cerebral palsy following selective percutaneous myofascial lengthening and functional physiotherapy

Introduction and objectivesChildren with cerebral palsy (CP) experience decreased health-related quality of life (HRQOL). This study aimed to assess the HRQOL of children with CP before versus after a combined program of minimally invasive selective percutaneous myofascial lengthening (SPML) and functional physiotherapy. Material and methodsA single-group pre–posttest design was used. Twenty-six middle childhood children with spastic CP, aged 5–7 years, with Gross Motor Function Classification System levels II–IV underwent SPML surgery and 9 months of postoperative functional strength training therapy. The proxy version of the DISABKIDS-Smiley questionnaire was completed by one parent of each child. Dependent t-tests were used to compare mean pre- and post-measurement scores. ResultsAfter the 9-month intervention, the children with CP had significantly higher quality of life scores (mean difference, 11.06±9.05; 95% confidence interval [CI], 7.40–14.71; p<0.001). ConclusionsThis study demonstrated that children with CP had better HRQOL after a combined program of minimally invasive SPML surgery and functional physiotherapy (ACTRN12618001535268).

Associations of physical activity and quality of life in parapneumonic effusion patients.

Little is known about activity behaviours and quality of life (QoL) of patients with parapneumonic pleural effusions (PPE) after hospital discharge. This study is a secondary analysis of a randomised trial (dexamethasone versus placebo) for hospitalised patients with PPE. We: 1) described the patients' activity behaviour patterns and QoL measured at discharge and at 30 days post-discharge; and 2) examined the association between activity behaviours and QoL scores. Activity behaviour (7-day accelerometry; Actigraph GT3X+) and QoL (Medical Outcomes Study Short-Form 36) were assessed. Repeated measures analysis of covariance controlling for baseline values and a series of linear regression models were undertaken. 36 out of 53 eligible participants completed accelerometry assessments. Despite modest increases in light physical activity (+7.5%) and some domains of QoL (>2 points) from discharge to 30 days post-discharge, patients had persistently high levels of sedentary behaviour (>65% of waking wear time) and poor QoL (≤50 out of 100 points) irrespective of treatment group (p=0.135-0.903). Increasing moderate-to-vigorous physical activity was associated with higher scores on most QoL domains (p=0.006-0.037). Linear regression indicates that a clinically important difference of 5 points in physical composite QoL score can be achieved by reallocating 16.1 min·day-1 of sedentary time to moderate-to-vigorous physical activity. Patients with PPE had low levels of physical activity and QoL at discharge and 30 days post-discharge irrespective of treatment. Moderate-to-vigorous physical activity participation was associated with higher QoL scores. Increasing moderate-to-vigorous physical activity following discharge from the hospital may be associated with improvements in QoL.

Quality of Life Among Geriatric Population Living with Functional Disabilities in Urban Slum Dwellers of Kolkata, India

Introduction: Population aging globally impacts individuals, families, communities, and societies. Longer life spans result in an increasing elderly population, leading to the 21st century being known as the century of the elderly. Disability, stemming from health conditions and surroundings, presents challenges necessitating interventions against environmental and social barriers. This study aims to examine the correlation between disability and quality of life (QOL) among elderly individuals living in Kolkata slums. Methodology: The observational study focused on the 100 geriatric populations in Dhapa slums using systematic random sampling. Data was collected using the Lawton Brody IADL Scale, and QOL assessment using WHOQOL-BREF. Results: Majority of the participants were male (64%) and from the general caste (63%). Disability prevalence was 28%. Better QOL scores were observed in males, younger age groups, married individuals and non-diabetics. The physical health domain had the highest QOL score. Literate individuals and those without hypertension or diabetes had higher QOL. Conclusion: India's aging population poses challenges for society and the economy. The study identified factors impacting disability and QOL in the elderly. Improving psychological care, awareness of government schemes, education, and targeted policies can enhance elderly quality of life.

Physical and psychosocial determinants of quality of life in children with obesity

BackgroundObesity has a negative impact on the physical and psychosocial quality of life of children. As rates of obesity continue to increase, it is important to recognize the widespread effects obesity has on children and their families. MethodsThis clinical investigation evaluated the self-reported quality of life of children with obesity in a weight management program and compared this to a parent/guardian’s perspective of the child’s quality of life using the Pediatric Quality of Life survey 4.0. The quality of life of children with obesity was compared to children with other chronic diseases and healthy children. ResultsAn association was discovered between the guardians’ responses to the Pediatric Quality of Life survey and the child’s age. Guardians with children younger than 11 years reported higher quality of life scores than guardians of children 11 years and older. Race, comorbidities of obesity, insurance type, household structure, and parental education attainment were not significantly associated with a child’s quality of life. Children with obesity had a lower quality of life compared to children who were organ transplant recipients and children with organic gastrointestinal disease. ConclusionsThese results emphasize the need to evaluate and treat the physical and psychosocial components of wellbeing in children with obesity at an early age.

Determinants of socioeconomic factors for quality of life and depressive symptoms in community-dwelling older people: A cross-sectional study in Brazil and Portugal.

Our aim was to analyze the association between socioeconomic status and quality of life (QoL) among older people with depressive symptoms treated through the Primary Health Care (PHC) system in Brazil and Portugal. This was a comparative cross-sectional study with a nonprobability sample of older people in the PHC in Brazil and Portugal conducted between 2017 and 2018. To evaluate the variables of interest, the socioeconomic data questionnaire, the Geriatric Depression Scale and the Medical Outcomes Short-Form Health Survey were used. Descriptive and multivariate analyses were performed to test the study hypothesis. The sample consisted of n = 150 participants (Brazil n = 100 and Portugal n = 50). There was a predominance of woman (76.0%, p = 0.224) and individuals between 65 and 80 years (88.0%, p = 0.594). The multivariate association analysis showed that in the presence of depressive symptoms, the QoL mental health domain was most associated with the socioeconomic variables. Among the prominent variables, woman group (p = 0.027), age group 65-80 years (p = 0.042), marital status "without a partner" (p = 0.029), education up to 5 years (p = 0.011) and earning up to 1 minimum wage (p = 0.037) exhibited higher scores among brazilian participants. The portuguese participants showed an association between the general health status domain and woman group (p = 0.042) and education up to 5 years (p = 0.045). The physical functioning domain was associated with income of up to 1 minimum wage (p = 0.037). In these domains, the portuguese participants exhibited higher scores than the brazilian participants. We verified the association between socioeconomic profile and QoL in the presence of depressive symptoms, which occurred mainly among woman, participants with low levels of education and low income, with QoL aspects related to mental, physical and social health and self-perceived health. The group from Brazil had higher QoL scores than the group from Portugal.

Association of treatment regimens with quality of life and overall survival in patients with metastatic colorectal cancer in Peru.

e15617 Background: Colorectal cancer is a significant public health concern in Peru. Metastatic colorectal cancer patients have limited treatment options, and the prognosis is generally poor. In recent years, treatment regimens for metastatic colorectal cancer have evolved significantly, with the emergence of targeted therapies and immunotherapy. However, little is known about the impact of these treatment regimens on quality of life and overall survival in the Peruvian population. The objective of this study is to investigate the association between treatment regimens and quality of life and overall survival (OS) in Peruvian metastatic colorectal cancer patients. Methods: This retrospective study included patients diagnosed with metastatic colorectal cancer between 2010 and 2020 at the AUNA clinic. Patients were included if they received chemotherapy as first-line treatment and were followed up for at least 6 months. Quality of life was assessed using the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) questionnaire, which includes subscales for physical, social/family, emotional, and functional well-being, as well as colorectal cancer-specific concerns. Treatment regimens considered were: FOLFOX, FOLFIRI and others. Univariate and multivariate analyses were performed to identify factors associated with quality of life and overall survival. Results: A total of 193 patients were included in the study, and the median follow-up time was 14 months. The majority of patients were male (60.6%) and the median age was 57 years. The most common first-line chemotherapy regimens were FOLFOX (52.7%), FOLFIRI (23.5%), and capecitabine plus oxaliplatin (16.4%). The median overall survival was 14 months, and the 1-year overall survival rate was 52.8%. Patients treated with FOLFOX had significantly better quality of life scores than those treated with FOLFIRI or capecitabine plus oxaliplatin (p = 0.012). The difference in quality of life scores was most pronounced in the emotional and social/family well-being subscales. However, there was no significant difference in overall survival among the different treatment regimens (p = 0.344). Multivariate analysis showed that the presence of liver metastases and higher FACT-C scores were independent predictors of OS. Conclusions: Our study has shown that the choice of treatment regimen in Peruvian metastatic colorectal cancer patients can have a significant impact on their quality of life. Patients treated with FOLFOX as first line had better quality of life scores than those treated with FOLFIRI or capecitabine plus oxaliplatin, particularly in emotional and social/family well-being subscales. However, there was no significant difference in OS among the different treatment regimens. The presence of liver metastases and higher quality of life scores were found to be independent predictors of overall survival.

Survey to measure the quality of life of patients with tuberculosis in Alexandria, Egypt: a cross-sectional study

BackgroundAssessment of quality of life (QoL) in patients with tuberculosis (TB) may improve healthcare providers’ understanding of the disease burden. This study aimed to investigate the QoL of patients with TB in Alexandria, Egypt.MethodsThis cross-sectional study was conducted in chest clinics and main chest hospitals in Alexandria, Egypt. A structured interview questionnaire was used to collect data from participants through face-to-face interviews from November 20, 2021, until the June 30, 2022. We included all adult patients aged 18 years or above during the intensive or continuation phase of treatment. The World Health Organization (WHO) WHOQOL-BREF instrument was used to measure QoL, which includes the physical, psychological, social relationships, and environmental health domains. Using propensity score matching, a group of TB free population was recruited from the same setting and completed the questionnaire.ResultsA total of 180 patients participated in the study: 74.4% were males, 54.4% were married, 60.0% were 18–40 years old, 83.3% lived in urban areas, 31.7% were illiterate, 69.5% reported insufficient income, and 10.0% had multidrug-resistant TB. The TB-free population group had higher QoL scores than the TB patients’ group: (65.0 ± 17.5 vs. 42.4 ± 17.8) for the physical domain, (59.2 ± 13.6 vs. 41.9 ± 15.1) for the psychological domain, (61.8 ± 19.9 vs. 50.3 ± 20.6) for the social domain, (56.3 ± 19.3 vs. 44.5 ± 12.8) for the environment domain, (4.0(3.0–4.0) vs. 3.0(2.0–4.0)) for general health, and (4.0(3.0–4.0) vs. 2.0(2.0–3.0)) for the general QoL, P < 0.0001. Patients with TB aged 18–30 years had the highest environmental score compared with the other age groups (P = 0.021).ConclusionsTB had a significant negative impact on QoL, with the physical and psychological domains being the most affected. This finding necessitates strategies to improve QoL of patients with to enhance their compliance to treatment.

The Effect of Standard Compression Adjuvant with a Tailored Exercise Training Program on Health-Related Quality of Life Outcomes in Treating Adults with Venous Leg Ulcer: A Randomized Controlled Trial.

Exercise training adjuvant to standard compression is considered to improve calf muscle pump dysfunction in venous leg ulcer (VLU) and subsequent healing. The objectives of this trial were to assess the effectiveness of a tailored exercise training intervention in addition to standard compression therapy on health-related quality of life and anticipating wound healing. Twenty-four VLU participants were recruited and randomly divided into 2 groups. The control group was prescribed conventional compression, and the intervention group received compression plus progressive tailored exercise training. The 14-item chronic venous disease quality of life questionnaire (CIVIQ-14) was used to assess improvement after treatment over time (0, 6, and 12 weeks). Intervention and control groups achieved wound closure for 11 (92%) and 7 (58%) patients. After adjusting for age, sex, and wound size at baseline, the exercise intervention group had 2 times the probability of complete wound healing in 12 weeks than those in the control group (risk ratio = 1.98, 95% CI= 1.01-3.72, P = .047). The primary outcome was the difference in CIVIQ-14 score in 3 dimensions and global index score per visit. The outcomes were evaluated by independent assessors. Demographic, comorbidities, and wound assessments were collected on enrollment. The overall adherence to exercise protocol was 71%. After adjusting age, sex, size of VLU, and CIVIQ score at baseline, the participants in the intervention group had the average global index scores and psychological scores increase at week 12 than those in the control group (21.2; 95% CI= 7.1-35.2, P = .005, and 13.5; 95% CI = 2.9-24.2, P = .044, respectively). Both groups showed similar improvement in the mean change in physical and pain scores within-group over time. Patients with combined conventional compression therapy with exercise training appeared to have a higher quality of life score in psychological and global scores than those with compression therapy alone.

Integrative medicine in multiple myeloma and plasma cell disorders.

Integrative Medicine (IM) use and efficacy is poorly defined in those with plasma cell disorders (PCD). A 69-question survey on the subject was hosted on HealthTree.org for 3 months. The survey included questions about complementary practice use, PHQ-2 score, quality of life, and more. Mean outcome values were compared between IM users and non-users. Proportions of supplement users and IM patients were compared between patients currently on myeloma specific treatment and patients not currently on treatment. The top 10 IM modalities reported among 178 participants were aerobic exercise (83%), nutrition (67%), natural products (60%), strength exercise (52%), support groups (48%), breathing exercises (44%), meditation (42%), yoga (40%), mindfulness-based stress reduction (38%), and massage (38%). The survey showed most patients participated in IM modalities, though they felt uncomfortable discussing them with their oncologist. Participant characteristics were compared between groups (users and non-users) using two-sample t-tests and chi-square tests. Use of vitamin C (3.6 vs. 2.7; p=0.01), medical marijuana (4.0 vs. 2.9; p=0.03), support groups (3.4 vs. 2.7; p=0.04), and massage (3.5 vs. 2.7; p=0.03) were associated with a higher quality of life scores on MDA-SI MM. There were no other significant associations between supplement use or IM practices and the MDA-SI MM, brief fatigue inventory, or PHQ-2. This study provides a foundation in the understanding of IM use in PCD, but more research is needed to evaluate individual IM interventions and their efficacy.