Quality Of Life In Patients Research Articles

Emotional intelligence: a novel predictor of quality of life in patients with systemic sclerosis.

Systemic sclerosis (SSc), a chronic systemic autoimmune disease, affects skin and internal organs compromising organ function and leading to significant morbidity and poor health-related quality of life (HrQoL). This cross-sectional study investigated whether HrQoL is influenced by trait emotional intelligence (TEI). Sixty patients with SSc (Female: 86.67%) completed the socio-demographic characteristics form, TEI Questionnaire Short-Form (TEIQue-SF), and Short-Form Health Survey (SF-36). Sixty healthy controls were also completed the TEIQue-SF. A series of multiple linear regression analyses with correlation matrix was used to analyze SF-36 domains as dependent variables with TEI domains (well-being, self-control, emotionality, sociability) as independent variables. The average age of participants was 57.3 ± 12.9 years with a mean disease duration of 7.7 ± 6.7 years. Patients differed from controls in the sociability domain of TEI. TEI global was found to affect the physical and mental component summaries (p < .001), and all 8 dimensions of the HrQoL (p < .001). Age, disease duration, and gastrointestinal manifestations were negatively associated with various components of SF-36. TEI was positively associated with all dimensions of HrQoL. Understanding the relationship between TEI and HrQoL dimensions is important for the support and empowerment of SSc patients, as well as the establishment and implementation of appropriate psychotherapeutic interventions.

What is an impact of hearing aids primarily fitted for presbyacusis on quality of life in patients complaining of tinnitus: a pilot study

ObjectiveTo assess the secondary effect of hearing aids primarily fitted for presbyacusis and their impact on the quality of life of patients complaining of tinnitus. DesignPilot case studyStudy sampleAdults with presbyacusis hearing loss were recruited in the Asker ENT clinic in Norway. Twenty consecutive patients were included in the pilot study.MethodsTwenty patients who were diagnosed with presbyacusis and additional tinnitus by the hearing tests (pure tone audiometry and speech audiometry) and medical interviews were recruited for the study. The level of their tinnitus distress was measured by the Tinnitus Handicap Inventory (THI) before and around 2 months after the hearing aid fitting. The results were afterwards statistically analyzed using paired sampled t-tests in Excel.ResultsThe data showed that hearing aids fitted primarily for presbyacusis can improve the quality of life in individuals suffering from tinnitus (p = 0.001504). In our sample, women showed higher levels of complaints about their tinnitus, compared to men. We found that age was an influencing factor on the outcomes of hearing aid usage for both presbyacusis and tinnitus, as people in this study before the age of 75 benefited less than patients above 75 (p = 0.005). All patients with moderate hearing loss in our sample showed significant improvement in their quality of life in regard to their tinnitus complaint, with a statistical value of p = 0.044. Also, patients with the lower levels of THI (slight and mild) were the groups who had the most clinically significant improvements in tinnitus distress. Finally, while analyzing the answers to all the THI questionnaire questions from the patients who did not show improvements in THI scores, a pattern of having trouble sleeping was detected as the most probable factor.ConclusionsThe results showed that hearing aids fitted primarily for presbycusis can have a positive influence on the perception of tinnitus and their quality of life.

Immediate Versus Delayed Exercise on Health-related Quality of Life in Patients Initiating Androgen Deprivation Therapy: Results from a Year-long Randomised Trial

Background and objectiveAn array of treatment-related toxicities result from androgen deprivation therapy (ADT) in patients with prostate cancer (PCa), compromising function and health-related quality of life (HRQoL). Exercise has been demonstrated to counter a number of these adverse effects including decreased HRQoL; however, when exercise should be initiated is less clear. This study aims to examine whether commencing exercise when ADT is initiated rather than later during treatment is more effective in countering adverse effects on HRQoL. MethodsMen with PCa (48–84 yr) initiating ADT were randomised to immediate exercise (IMEX; n = 54) or delayed exercise (DEL; n = 48) for 12 mo. IMEX consisted of 6 mo of supervised resistance/aerobic/impact exercise commenced at the initiation of ADT with 6 mo of follow-up. DEL consisted of 6 mo of usual care followed by 6 mo of the same exercise programme. HRQoL was assessed using the Short Form-36 at baseline and 6 and 12 mo. Intention to treat was utilised for the analyses that included a group × time repeated-measure analysis of variance using log transformed data. Key findings and limitationsThere were a significant group × time interaction for the physical functioning domain (p = 0.045) and physical component summary score (p = 0.005), and a significant time effect for bodily pain (p < 0.001) and vitality domains (p < 0.001), with HRQoL maintained in IMEX and declining in DEL at 6 mo. Exercise in DEL reversed declines in vitality and in the physical component summary score, with no differences at 12 mo compared with baseline. Limitations include treatment alterations during the intervention. Conclusions and clinical implicationsConcurrently initiating exercise and ADT in patients with PCa preserves HRQoL, whereas exercise initiated while on established ADT regimens reverses declines in some HRQoL domains. Patient summaryTo avoid initial treatment-related adverse effects on health-related quality of life exercise, medicine should be initiated at the start of treatment.

Paeoniae radix overcomes resistance to EGFR-TKIs via aurora B pathway suppression in lung adenocarcinoma

Targeted therapies using epidermal growth factor receptor (EGFR) inhibitors have markedly improved survival rates and quality of life for patients with EGFR-mutant lung adenocarcinoma (LUAD). Despite these advancements, resistance to EGFR inhibitors remains a significant challenge, limiting the overall effectiveness of the treatment. This study explored the synergistic effects of combining Paeoniae Radix (PR) with first-generation EGFR-tyrosine kinase inhibitors (TKIs), erlotinib and gefitinib, to overcome this resistance. Transcriptomic analysis of EGFR-mutant LUAD cell lines revealed that PR treatment could potentially reverse the gene signatures associated with resistance to EGFR-TKIs, primarily through the suppression of the Aurora B pathway. Experimental validation demonstrated that combining PR with erlotinib and gefitinib enhanced drug responsiveness by inhibiting Aurora kinase activity and inducing apoptosis in LUAD cells. Additionally, gene expression changes confirmed these combined effects, with the suppression of the Aurora B pathway and upregulation of the apoptotic pathway, which was accompanied by increased expression of multiple pro-apoptotic genes. Our findings contribute to the development of natural product-based therapeutic strategies to mitigate drug resistance in LUAD.

Predictors of symptom improvement in patients with chronic coronary syndrome after percutaneous coronary intervention.

Decreases in symptom load and improvements in quality of life are important goals in the invasive treatment of symptomatic chronic coronary syndrome (CCS). To date, it is not known which patients profit most from the invasive treatment. This sub-analysis of the prospective, multi-centre PLA-pCi-EBO trial includes 145 patients with symptomatic CCS and successful PCI. The prespecified endpoints angina pectoris and quality of life (Seattle Angina Questionnaire-SAQ) were assessed 1 and 6months after PCI. Predictors of symptom improvement were analyzed by logistic regression analysis. Quality of life, physical limitation, and angina frequency markedly improved 6months after PCI. Worse baseline health status (i.e., low SAQ subscales) was the best predictor of highly clinically relevant improvements (≥ 20 points in SAQ subscales) in symptom load and quality of life. Demographic factors (age, sex, body-mass index) and cardiovascular disease severity (number of involved vessels, ejection fraction) did not predict relevant improvements after PCI. The influence of psychologic traits has not previously been assessed. We found that neither optimism nor pessimism had a relevant effect on symptomatic outcome. However, patients who exercised more after PCI had a much larger improvement in quality of life despite no differences in physical limitation or angina frequency. PCI effectively reduces symptom load and improves quality of life in patients with symptomatic CCS. Reduced baseline health status (symptom load, quality of life) are the only relevant predictors for improvements after PCI. Physical activity after PCI is associated with greater benefits for quality of life. The German Clinical Trials Register registration number is DRKS0001752.

Early palliative care involvement in gastrointestinal malignancies: A community cancer center perspective.

198 Background: Early involvement of palliative care (PC) specialists enhances quality of life for patients with advanced gastrointestinal (GI) cancer. Methods: This retrospective study evaluated patients with newly diagnosed stage III and IV GI cancer seen at a large community cancer center between 10/1/22 and 9/30/23. We compared patients seen by a PC provider in clinic at least once to those without an outpatient PC visit within the one-year study period. Results: 283 patients with stage III/IV colorectal (42%), gastroesophageal (23%), pancreatic (16%), hepatobiliary (12%), and other GI cancers (8%) received care within the study period (Table). Of these, 49 (17%) had at least one PC clinic visit, and 234 (83%) had no PC visits. Patients with pancreatic (35% vs 12%) and hepatobiliary cancer (20% vs 10%) were over-represented in the group receiving PC vs those without PC, while patients with colorectal cancer were under-represented (20% vs 47%). Greater percentages of patients in the group receiving PC completed advanced care planning (ACP) documents (63% vs 24%) and died during the study period (65% vs 15%). Conclusions: A minority of patients with GI malignancies at a large community cancer center are seen by an outpatient PC provider during the first year after diagnosis. These patients are more likely to have tumor types associated with worse prognosis, to complete ACPs, and to die within one year. Broader delivery of early PC will require expanded services in community cancer centers and continued development of tools for identifying patients most likely to benefit. The distribution of gastrointestinal cancer between outpatient palliative care visit and no outpatient palliative care visit. Primary cancer PC No PC Total Colorectal 10 (20% | 8%) 110 (47% | 92%) 120 (42% | 100%) Gastroesophageal 10 (20% | 16%) 54 (23% | 84%) 64 (23% | 100%) Pancreatic 17 (35% | 39%) 27 (12% | 61%) 44 (16% | 100%) Hepatobiliary 10 (20% | 30%) 23 (10% | 70%) 33 (12% | 100%) Other GI 2 (4% | 9%) 20 (9% | 91%) 22 (8% | 100%) Total 49 (100% | 17%) 234 (100% | 83%) 283 (100% | 100%) PC: Palliative care.

Effectiveness of a novel finger range-of-motion brace for extensor tendon injury: a report of 10 patients

BackgroundExtensor tendon injuries require surgical repair, followed by rehabilitation to ensure optimal outcomes. Immobilization has been the cornerstone of postoperative management. However, immobilization after surgery frequently makes the finger stiffness, often resulting in reduced functionality and quality of life for patients. Recent studies indicate that early controlled motion can significantly improve outcomes, but safe early range of motion (ROM) exercise is a significant clinical challenge. This article aims to check the efficacy of the novel designed finger ROM brace for preventing finger stiffness for extensor tendon injuries with case series.MethodsA finger ROM brace was designed based on the natural finger movement. Like a real finger, there are two tiny hinge joints and three round-shape body components. The design aimed to be ergonomic dynamic splint assisting controlled motion to promote early motion, thus reducing tendon tension and preventing stiffness. Elastic resistant ROM exercise could be by inserting a silicone band into the groove on the components and free movement could be achieved by removing a silicone band.ResultBetween December 2022 and July 2023, 10 patients who underwent tenorrhaphy because of extensor tendon laceration were involved. Complete extensor tendon laceration was 3 patients, other seven patients had partial laceration of extensor tendons. Surgery was performed within 2 days of injury, and no infection was observed in all patients. After the extensor tendon was confirmed as healed state by ultrasound, the patients were permit the active exercise wearing finger ROM brace with a silicone band. Within 1–2 weeks after elastic resistant exercise, the patients could achieve free full ROM movement without any complication.ConclusionThe novel finger ROM brace combines the advantages of dynamic splinting and under-actuated mechanisms to offer a comprehensive solution for preventing stiffness after extensor tendon suture. Future studies should focus on clinical trials to validate the efficacy and safety of this brace in a larger population.

Prior Knowledge, Acceptance, Adaptation, and Challenges Following Stoma Formation among Colorectal Cancer Patients in Northern Peninsular of Malaysia: A Qualitative Study

INTRODUCTION: Stoma formation affects an individual in various ways, including physical, emotional, social, and cognitive functions. Diverse studies report ways of an individual lives with new stoma formation. However, the comprehensive understanding of the entire process by the patient, which includes knowledge before the surgical procedure, as well as the subsequent acceptance, adaptation, and challenges to living with a stoma is lacking. MATERIALS AND METHODS: In-depth interview session were conducted with 12 colorectal cancer patients who have undergone surgical procedures for intestinal stoma formation. The patterns and themes within the data were identified by thematic analysis, involving data familiarisation and coding followed by themes’ generation and refinement of the themes. RESULTS: Four themes and 9 subthemes were identified, which revealed the sufficiency of stoma-related information and understanding prior to surgery as well as positive acceptance of self and family members reflected through their reactions and support. Nonetheless, the challenges were anticipated which highlights the complications of the stoma itself, obstacles surrounding social life, and financial burdens. CONCLUSION: This study provided valuable insights into the experiences of individuals living with a stoma following colorectal cancer surgery. The themes and subthemes highlight the need to address social stigma as well as financial issues to alleviate the burden of stoma-related expenses. Increasing public awareness and improving financial assistance could be a way to enhance the overall quality of life for patients living with stoma

Editorial Comment: Severity of Lower Urinary Tract Symptoms Predicts Neurologic Quality of Life in Patients With Multiple Sclerosis

Editorial Comment: Severity of Lower Urinary Tract Symptoms Predicts Neurologic Quality of Life in Patients With Multiple Sclerosis

The impact of whole-process visualization collaborative nursing discussions education on perioperative symptoms and emotional well-being in radical prostatectomy patients.

Prostate cancer is one of the most common malignant neoplasms in elderly males, with radical prostatectomy being the established therapeutic approach for localized disease. Patients undergoing this surgical procedure frequently experience increased negative emotions and symptomatology during the perioperative period, likely due to concerns about the illness and its treatment. The present study aims to investigate the effects of a novel educational approach involving a whole-process visualization and collaborative nursing discussions on perioperative symptoms and emotional well-being in radical prostatectomy patients. Data were prospectively collected from 310 patients admitted to the hospital between June 2021 and December 2023, all of whom were scheduled to undergo radical prostatectomy. These patients were randomly assigned to either the intervention group (receiving new model education) or the control group (receiving conventional education), with 155 patients in each group. The study compared basic demographic information, anxiety and depression scores, fear of disease progression scores, quality-of-life scores, main symptom scores, and changes in perioperative vital signs between the two groups. No statistically significant differences were observed between the two groups in terms of age, comorbidities, insurance type, education level, income, and tumor history (P > 0.05). Similarly, there were no significant differences in anxiety and depression scores, proportion of patients with anxiety and depression, vital signs, and fear of disease progression scores between the two groups at Time 1 stage (P > 0.05). During stages Time 2 and Time 3, the intervention group exhibited lower anxiety and depression scores, a lower proportion of anxious and depressed patients, as well as significantly reduced blood pressure and heart rate fluctuations compared to the control group (P < 0.05). Following radical prostatectomy, the main symptoms of patients, such as pain, nausea, and fatigue, were assessed using the MADIS Symptom Assessment Scale on days 1-3 post-surgery. The intervention group exhibited significantly lower scores for three symptoms compared to the control group (P < 0.05); at Time 4 stage, the patients in the intervention group also demonstrated significantly improved quality-of-life scores compared to the control group (P < 0.05). Additionally, blood pressure and heart rate of patients returned to baseline levels at Time 4 stage, with no significant difference between the two groups (P > 0.05). Nevertheless, the anxiety and depression scores in the intervention group at the Time 4 stage remained significantly lower than those in the control group (P < 0.05). Additionally, the fear of disease progression scores in both groups were lower than those at the Time 1 stage, with a more pronounced improvement observed in the intervention group compared to the control group (P < 0.05). Patients diagnosed with malignant tumors often experience fear and anxiety regarding the progression of their disease and upcoming surgery, as well as uncertainty surrounding their treatment and prognosis. This heightened emotional distress can contribute to a greater symptom burden during the perioperative period. Utilizing a whole-process visualization and collaborative nursing discussion approach, as compared to traditional communication methods, has been shown to alleviate patients' fears, reduce anxiety and depression, and ultimately lessen the symptom burden experienced during the perioperative phase. Ultimately, this approach can enhance the overall quality of life for patients facing malignant tumors.

A-160 Pruritus and Quality of Life in Patients with Cutaneous T-cell Lymphoma

A-160 Pruritus and Quality of Life in Patients with Cutaneous T-cell Lymphoma

Targeting ICAM1 to Ameliorate Vaso-Occlusion and Inflammation in Sickle Cell Disease.

Sickle cell disease (SCD) is a hereditary disorder characterized by vaso-occlusion, inflammation, and tissue damage. Intercellular adhesion molecule 1 (ICAM-1) plays a crucial role in the pathophysiology of SCD by promoting the adhesion of sickle cells to the endothelium, contributing to vaso-occlusion and tissue damage. The ICAM-1 gene encodes a glycoprotein that interacts with lymphocyte function-associated antigen 1 (LFA-1) and macrophage 1-antigen (Mac-1) receptors, perpetuating inflammation, and oxidative stress. The NF-κB signaling pathway regulates ICAM-1 expression, which is elevated in patients with SCD, leading to increased endothelial cell activation and damage. Targeting ICAM-1 and its interactions with sickle cells and the endothelium has emerged as a potential therapeutic strategy for managing SCD. This review highlights the complex interplay between ICAM-1, sickle cells, and the endothelium, and discusses the potential of ICAM-1-targeted therapies for mitigating VOC and improving the quality of life for patients with SCD.

Impact of surgery on quality of life in patients with primary hyperparathyroidism

Impact of surgery on quality of life in patients with primary hyperparathyroidism

Real-World Data on Brodalumab Treatment in Patients with Moderate-to-Severe Plaque Psoriasis: An Observational Study from the Czech Republic BIOREP Registry.

The aim of this observational, multicenter study was to assess the real-world use of brodalumab for the treatment of moderate-to-severe plaque psoriasis in patients in the Czech Republic, using data from the BIOREP registry. The study included 273 patients aged≥18years with moderate-to-severe psoriasis who received brodalumab. Endpoints were drug survival (time from treatment initiation to discontinuation), effectiveness [Psoriasis Area and Severity Index (PASI)], and health-related quality-of-life [Dermatology Life Quality Index (DLQI)]. Predicted drug survival probability was 92.4% [95% confidence interval (CI): 89.1, 95.7%] at 6months and 84.2% (95% CI 79.5, 89.1%) at 12months; this was maintained at 24months [80.4% (95% CI 74.5, 86.8%)]. Younger age, higher body mass index, and no previous biologic treatment were significantly associated with longer drug survival. Absolute PASI≤3 after 3months was achieved by 89.8% of patients; 92.4%, 77.8%, and 59.1% reached PASI 75, PASI 90, and PASI 100, respectively. After 12months, 96.5% of 141 patients had an absolute PASI≤3. The proportion of patients achieving DLQI 0/1 was 87.3% at 12months. This study demonstrated high and sustained drug survival with high rates of skin clearance and improved quality of life in patients with relatively severe disease treated with brodalumab. Improvements were observed as early as 3months post-treatment initiation and were sustained for up to 24months in a real-life setting.

The impact of early cardiac rehabilitation nursing on cardiac function and quality of life in patients after emergency PCI.

The impact of early cardiac rehabilitation nursing on cardiac function and quality of life in patients after emergency PCI.

Sexual Health and Quality of Life in Patients With Low-Risk Early-Stage Cervical Cancer: Results From GCIG/CCTG CX.5/SHAPE Trial Comparing Simple Versus Radical Hysterectomy.

Simple hysterectomy and pelvic node assessment (SHAPE) is a phase III randomized trial (ClinicalTrials.gov identifier: NCT01658930) reporting noninferiority of simple compared with radical hysterectomy for oncologic outcomes in low-risk cervical cancer. This study presents secondary outcomes of sexual health and quality of life (QOL) of the SHAPE trial. Participants were randomly assigned to receive either radical or simple hysterectomy. Sexual health was assessed up to 36 months postoperatively using the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised and QOL using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Cervical Cancer-Specific Module (QLQ-CX24) questionnaires. Among participants with at least one QOL measure, clinical and pathologic characteristics were balanced and with no differences in preoperative baseline scores for sexual health or QOL between groups. FSFI total score met the cutoff for dysfunction up to 6 months (P = .02) in the radical hysterectomy group. Group differences favored simple hysterectomy for FSFI subscales: desire and arousal at 3 months (P ≤ .001) and pain and lubrication up to 12 months (P ≤ .018). Both groups met the cutoff for sexual distress but was higher in radical hysterectomy at 3 months (P = .018). For QLQ-CX24, symptom experience was significantly better up to 24 months (P = .031) and body image better at 3, 24, and 36 months (P ≤ .01) for simple hysterectomy. Sexual-vaginal functioning was significantly better up to 24 months (P ≤ .022) and more sexual activity up to 36 months (P = .024) in the simple hysterectomy arm. Global health status was significantly higher at 36 months for simple hysterectomy (P = .025). Simple hysterectomy was associated with lower rates of sexual dysfunction than radical hysterectomy, with a lower proportion of women having sustained sexual-vaginal dysfunction. These results further support the benefit of surgical de-escalation for low-risk cervical cancer.

ORAI2 is Important for the Development of Early-Stage Post-Irradiation Fibrosis in Salivary Glands

PurposeAlthough post-irradiation hyposalivation significantly impairs patient quality of life, the underlying mechanisms driving radiation-induced salivary gland fibrosis and hyposalivation remain poorly understood. This study aims to explore the role of calcium-mediated signaling pathways in radiation-induced salivary gland fibrosis. Materials and MethodsPrimary human submandibular gland (SG) cells and C57BL/6J female mouse SGs were exposed to irradiation to model fibrosis development. Following 15 Gy irradiation exposure, RNA sequencing and bioinformatic analysis were conducted on mouse SGs. The effects of Store-Operated Calcium Entry (SOCE) inhibition using SKF96365 and YM58483 on fibrosis markers were assessed in vitro and in vivo. Additionally, the involvement of ORAI2 protein and the newly identified JNK/NFAT1/TGF-β1 signaling axis in SG fibrosis was explored. ResultsWe identified that the calcium release-activated calcium modulator ORAI2 was important in promoting early-stage post-irradiation fibrosis in SGs. Calcium channel signaling was activated in both human patients and irradiated C57BL/6J female mice SGs. Inhibition of SOCE signaling effectively blocked fibrosis in an ORAI2-dependent manner 30 days after irradiation. Our mechanistic studies revealed a novel ORAI2/JNK/NFAT1 axis within the SOCE pathway critical in driving TGF-β1-mediated fibrogenesis. Encouragingly, pharmacological inhibition of NFAT1 significantly mitigated radiation-induced SG fibrosis and restored saliva flow to 84.61% of normal levels in treated mice 30 days after irradiation, without detectable side effects. ConclusionsOur findings highlight the significance of the ORAI2-mediated calcium signaling pathway, specifically via the ORAI2/JNK/NFAT1 axis, in promoting TGF-β1 expression and contributing to the development of early-stage salivary gland fibrosis following irradiation exposure. Targeting the ORAI2/JNK/NFAT1 axis emerges as a promising therapeutic strategy to alleviate radiation-induced hyposalivation and fibrosis, potentially improving the quality of life for patients undergoing radiotherapy.

2-Stage and 3-stage restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis show comparable short- and long-term outcomes

Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) represents the standard treatment for therapy-refractory, malignant or complicated ulcerative colitis (UC) and can be performed as a 2-stage or 3-stage procedure. This study aimed to compare the short- and long-term outcomes after 2- and 3-stage IPAA in patients with UC in our department. A retrospective analysis of 176 patients with UC who received 2- or 3-stage restorative proctocolectomy with IPAA at our institution from 2001 to 2021 was performed. Outcomes for short-term (morbidity, longer hospital stay, readmission) and long-term (pouch failure and quality of life) parameters were compared between the 2- and 3-stage procedure. Regarding short-term outcomes for all patients, in-hospital morbidity and readmission rates after any surgical stage were observed in 69% and 24%, respectively. Morbidity and readmission did not differ significantly between the 2- and 3-stage procedure in uni- and multivariate analysis. Median length of hospital stay for all stages was 17 days. The 3-stage procedure was identified as an independent factor for longer hospital stay (OR 3.8 (CI 1.3–10.8), p = 0.014). Pouch failure and failure of improved quality of life during long-term follow-up occurred both in 10% of patients, with no significant differences between the 2- and 3-stage procedure in uni- and multivariate analysis. Our data suggest that both the 2- and 3-stage proctocolectomy with IPAA demonstrate favourable and comparable postoperative short- and long-term outcomes, with a high rate of improved quality of life in patients with UC.

An Insight into the Mechanism, Safety and Efficacy for Photoprotection and Dermatological Conditions of Polypodium leucotomos Extract

Abstract: Numerous photoprotective techniques have been employed to successfully shield against the harmful effects of ultraviolet radiation. Current photoprotective techniques have limitations due to the amount of topical application, insufficient physical protection, and adverse responses to topical agents. A newer option that offers a promising defense against solar radiation is systemic agents, the well-researched Polypodium leucotomos is significant in this category, and several studies have found to be effective ―oral sunscreenǁ. Polypodium leucotomos (PL) extract has gained significant attention as a potential therapeutic agent in the field of dermatology, particularly in the photoprotection and management of various dermatological conditions. This abstract provides a comprehensive overview of the mechanism, safety, and efficacy of Polypodium leucotomos extract in relation to photoprotection and dermatological conditions. Our primary aim is to review Polypodium leucotomos' photoprotective results from studies that are currently available, and our secondary goal is to describe Polypodium leucotomos' applications in different dermatological conditions. Articles discussing Polypodium leucotomos uses in photoprotection and dermatologic conditions are searched and downloaded from publicly available databases such as PubMed, JSTOR, PLOS, Science Direct, DOAJ, Google Scholar, and Web of Science and evaluate the outcomes of the Polypodium leucotomos effect. Firstly, we delve into the mechanisms underlying the photoprotective properties of PL extract. Extensive research has demonstrated that PL extract exerts its protective effects through multiple pathways, including antioxidant activity, DNA repair stimulation, immunomodulation, and inhibition of inflammatory mediators. These mechanisms collectively contribute to the prevention of photodamage, such as sunburn, DNA damage, and photoaging. Furthermore, we explore the safety profile of PL extract, emphasizing its remarkable tolerability and minimal adverse effects reported in clinical studies. The absence of systemic absorption and its compatibility with other treatments make PL extract a promising option for long-term use in photoprotection and dermatological care. A promising alternative to traditional photoprotection may be Polypodium leucotomos. Additional thorough clinical trials are necessary to ascertain its role and effectiveness more accurately. The efficacy of PL extract in managing various dermatological conditions is also discussed. Multiple studies have demonstrated its beneficial effects in conditions such as vitiligo, melasma, psoriasis, and atopic dermatitis. The anti-inflammatory and immunomodulatory properties of PL extract have shown promise in reducing disease severity, improving skin symptoms, and enhancing the quality of life for patients. Additionally, the abstract highlights the potential future directions and areas of research for PL extract. Investigating its combination therapy with other photoprotective agents, exploring optimal dosage regimens, and further elucidating the molecular mechanisms are areas that warrant attention. In conclusion, this abstract provides an insightful overview of the mechanisms, safety, and efficacy of PL extract in photoprotection and dermatological conditions. The remarkable properties of PL extract, combined with its favorable safety profile, position it as a promising therapeutic intervention in dermatology. Further research and clinical trials are needed to fully exploit its potential and establish its place in the management of various skin conditions.

Time toxicity faced by patients with advanced cancer across primary cancer sites.

268 Background: Time toxicity, defined as the burden of time for patients interacting with the health care systems, is particularly important for patients with limited life expectancy. Little is known about the relative impact of time toxicity among different cancer types at the end of life. This study examines median contact days for inpatient, outpatient, and home health services among different primary cancer types for patients with advanced cancer with limited prognosis. Methods: A retrospective cohort analysis was performed on patients with advanced (stage 4) cancer who died within one year of diagnosis at Kaiser Permanente Northern California between January 1, 2015, and June 30, 2023. Time toxicity was defined as comprehensive contact days with healthcare system over the course of patients’ survival period between cancer diagnosis and death (i.e., contact days divided by survival or contact %). Types of contact included institutional stay (emergency department visit, hospitalization, skilled nursing facility, rehabilitation); outpatient visits (ambulatory care, labs, imaging); and in-home care (home-health, home hospice, telephone and virtual visit). The study quantified overall median contact % and contact % by specific care settings, stratified by cancer primary site. Results: The study included 10102 patients. The median age at diagnosis was 74 years with 47% female. Patients were predominantly white (65%), followed by Asian (12%), Hispanic (12%), and black (8%). The median Elixhauser comorbidity score was 4. With the exception of head and neck cancers, most cancers had higher contact % near diagnosis and at end of life (U-shaped curve). Head and neck cancers had the highest percent of patients undergoing surgery (36%) and radiation (52%), which may explain its sinuosity-like curve with a rapid increase of weekly contact % after diagnosis (a small peak), followed by rapid decrease and another increase by the end of their life. Survival days were comparatively long for head and neck cancers (158 days, IQR: 84-265) and short for thoracic (80 days, IQR: 35-166) and upper gastrointestinal cancers (80 days, IQR: 38-173). Malignant hematology patients had notably higher comprehensive contact % (74%, IQR: 47-100) which was driven primarily by emergency room department visits and hospital stays (p&lt;0.001 for all contact types). Conclusions: The study highlights the high burden of time toxicity in patients with advanced cancer with limited prognosis. The significant variations in time toxicity among different cancer types, especially in malignant hematology and head and neck patients, emphasize the need to tailor goals of care discussions for patients with cancer at the end of life. By focusing on reducing unwanted time toxicity, healthcare providers can enhance the quality of life for patients with cancer, ensuring more efficient and patient-centered care delivery.