QOL In Patients Research Articles

Assessment of the quality of life of patients with inflammatory bowel diseases depending on the drug therapy performed

This paper details the impact of inflammatory bowel disease (IBD) on patients’ quality of life. In order to assess patients’ quality of life, a number of specific and general tools have been developed to assess quality of life in patients with IBS. According to the data obtained in a number of clinical studies, IBS significantly reduces the quality of life of patients compared to healthy people. Moreover, the quality of life is directly related to the form and degree of ICD activity. Thus, worse quality of life is associated with Crohn’s disease and active stage of the disease. However, in the remission stage, the quality of life in patients with Crohn’s disease (CD) and ulcerative colitis (UC) do not have statistically significant differences. In addition, diet and lifestyle are of great importance for the QOL of patients with UC. Conservative therapy is an extremely important link that allows to significantly improve the life quality of patients, in which targeting pre-drugs play an important role. The latter significantly improve the QOL of patients with ICD, contributing to the transition of ICD from the active form to remission.

Quality of life and survival in patients with uterine carcinosarcoma: A tertiary center observational study.

This study aimed to assess the QoL in patients with uterine carcinosarcoma (UCS) and identify factors influencing survival. A prospective cohort study was conducted of patients with UCS who were treated between 2016 and 2022 in a Dutch academic hospital. QoL was evaluated using the EORTC QLQ-C30 and QLQ-EN24 questionnaires at baseline, end of treatment, and at one, two, and five years after treatment. Outcomes were described as mean scores in functioning and symptom domains. The mean scores of the QLQ-C30 were compared to those of a matched group from the general Dutch population. Clinical data were collected. Factors influencing survival were assessed via Cox proportional hazards models. The study included 64 patients, 56 of them participated in the QoL questionnaires. The median progression-free survival was 13months, and overall survival was 20months. QoL was significantly lower in all functional domains at one year after treatment compared to members of the general population. The most affected functioning domains were physical, role, cognitive, and social functioning and symptoms like fatigue, pain, and lymphedema. Long-term QoL remained compromised, with global health and insomnia notably impaired even five years after treatment. Significant prognostic factors for better overall survival included lower FIGO stage, surgery, and chemotherapy. Patients with UCS experience significant deterioration in QoL. Despite extensive treatment, QoL remains poor, emphasizing the need for integrating QoL considerations into treatment decisions to balance the benefits of treatment with potential QoL impairments.

The long-term outcome of children with VP shunt and hydrocephalus: motor developmental outcome and QOL of patients with hydrocephalus is associated with the number of revisional procedures but is not impacted by the type of the valve

PurposeDespite constant advances in ventriculo-peritoneal shunt systems, pediatric patients with hydrocephalus may present with neurodevelopmental delay. Therefore, we performed a study including a questionnaire, which aimed to analyze parameters that may have an impact on the cognitive function and quality of life of the pediatric patient with hydrocephalus.MethodsIn this retrospective study, we included 81 patients aged 0–17 with hydrocephalus who were treated with a ventriculo-peritoneal shunt at a single institution. Demographic data, etiology of the hydrocephalus, type of valve implanted, any revision procedures and any complications were analyzed and the neurodevelopmental outcome, epilepsy and quality of life were assessed using a questionnaire sent to these patients. Statistical analysis was performed using SPSS. The significance level was set at p ≤ 0.05.ResultsQuestionnaires were sent to 81 patients who were treated at our institution over a mean retrospective study period of 18 years. Of these, 30 questionnaires were completed by the patients themselves or with the support of their families and included in the study. The etiology of the hydrocephalus as a non-controllable parameter did not affect the cognitive and motor development as well as the occurrence of epilepsy, cephalalgia and the quality of life. However, the number of revisions had a significant (p = 0.041) impact on the motor development of the child. The mean Wellbeing Five score was better with 19.63 in the group with no revisions whereas the score was 12.2 in the group with more than two revisional procedures. The type of the valve (adjustable or not adjustable) as a controllable parameter did not change any of the tested parameters (p > 0.05).ConclusionThe number of revisional procedures significantly affected the motor development of pediatric patients with a ventriculo-peritoneal (VP) shunt calling for further research to improve VP shunt systems as well as surgical procedures like endoscopic third ventriculo-cisternostomy (ETV) in the future.

Effects of Probiotics and Diet Management in Patients With Irritable Bowel Syndrome: A Systematic Review and Network Meta-analysis.

The efficacy of probiotics and diet management in irritable bowel syndrome (IBS) is controversial, and their relative effectiveness remains unclear. This study aimed to evaluate the effects of probiotics, diet management, and their combination on IBS. PubMed, Embase, Cochrane, and Web of Science were searched from inception to July 10, 2023, for relevant studies, including symptom relief, IBS-symptom severity score (-SSS), and IBS-quality of life measure (-QOL). Two investigators independently performed the data extraction and quality assessment. A network meta-analysis was performed using a frequentist approach and a random-effects model to estimate the relative risk (RR) and 95% CI. Forty-four articles were eligible for this study. In relieving IBS symptoms, compared with a sham diet, a low-fermentable oligosaccharide, disaccharide, monosaccharide, and polyols (low-FODMAP) diet (RR: 3.22; 95% CI: 1.70-6.26) and low-FODMAP diet combined with probiotics (RR: 17.79; 95% CI: 3.27-112.54) significantly relieved IBS symptoms. The control group showed significantly lower effectiveness than the probiotics group (RR: 0.47; 95% CI: 0.32-0.69). According to the surface under the cumulative rank curve (SUCRA), a low-FODMAP diet combined with probiotics (80.4%) had the best effect in relieving IBS symptoms, followed by a low-FODMAP diet (70.8%), probiotics (65.1%), and a gluten-free diet (54.3%). In reducing the total IBS-SSS, the low-FODMAP diet (90.5%) was the most effective, followed by the low-FODMAP diet combined with probiotics (76.6%), probiotics alone (62.3%), and gluten-free diet (28.3%). In reducing total IBS-QOL, probiotics (72.1%) ranked first, followed by gluten-free (57.0%) and low-FODMAP (56.9%) diets. Probiotics (34.9%) were associated with the lowest risk of adverse effects. A low-FODMAP diet combined with probiotics is most effective in relieving IBS symptoms. A low-FODMAP diet is the most recommended diet for alleviating IBS severity, and probiotics were associated with improving the QOL of patients with IBS, with the fewest adverse events. PROSPERO registration no. CRD42024499113.

Can invasive interventions be avoided with a holistic swallowing therapy program in older patients in intensive care units: percutaneous endoscopic gastrostomy tubes or oral intake?

The use of percutaneous endoscopic gastrostomy (PEG) tubes in older patients did not show any benefits in terms of survival, improvement in quality of life, or reduction in aspiration pneumonia. Significant gaps exist regarding the evidence for the evaluation and management of dysphagia in older patients. This study aimed to diagnose swallowing disorders and highlight the importance of swallowing therapy in older patients in intensive care units (ICUs). Twenty-five older patients (12 men, 13 women, mean age 67.22 ± 24.03 years) hospitalized in the ICUs with complaints of dysphagia were analyzed prospectively. The 12 weeks (14-16 sessions) of swallowing therapy were administered to patients with dysphagia who signed the (voluntary) consent form. The bedside water swallowing test (BWSS), Functional Oral Intake Scale (FOIS) Score, Clinical Swallowing Evaluation, Mini Nutritional Assessment Test (MNAT), Eating Assessment Tool (EAT-10), the Turkish version of the World Health Organisation Quality of Life Scale Elderly Module, and the Swallowing Therapy Programme Protocol were applied. Pretherapy stage (T1) and post-therapy stage (T2) results were compared with videofluoroscopy swallowing study (VFSS) recordings with thin liquids, moderately thick liquids, extremely thick liquids, and crackers (International Dysphagia Diet Standardization Initiative [IDDSI] Levels 0, 3, 4, and 7, respectively). The World Health Organisation Quality of Life Scale Elderly Module (WHOQOL-OLD) raw scores significantly improved from T1 (38.63 ± 7.05) to T2 (73.07 ± 4.82). The bedside water swallowing test results demonstrated statistically significant differences in therapy timings among older patients (p < 0.001). There were significant improvements in swallowing physiology, as represented by the improved oral and pharyngeal composite scores of the Modified Barium Swallow Impairment Profile (MBSImP) and Penetration-Aspiration Scala (PAS) levels. Before therapy, all patients exhibited high rates of oropharyngeal residue with thin liquids and spoon-thick pudding viscosities (MNA ≤ 17). The results reported in the present study show that malnutrition risk is linked to a poorer QoL in older patients on admission to ICUs. Statistical analyses revealed the dominant effects of functional status and eating-related factors on QoL in this group. Early dysphagia diagnosis of older patients and subsequent application of exercise-based swallowing therapy increase the quality of life of patients. In this study, exercise-based swallowing therapy was developed in Turkey and can be used in older patients as part of a holistic cognitive-communication-swallowing intervention program. Results prove the effectiveness of the developed exercise-based swallowing therapy on the cognitive-communication-swallowing skills of older patients. The present findings reinforce the role of nutrition as a priority for improving patients' perceptions of QoL. Further studies are required to investigate and identify the interventions that improve QoL in older patients. More studies with better research designs are required to establish whether nutritional intervention is effective in enhancing QoL in this vulnerable group.

Weather-Related Factors and Patient-Reported Outcomes (PROs) in Cancer Patients: Results from the ExPRO Study

Objective The ExPRO (External factors influencing patient reported outcomes of patients with malignant diseases) study explored associations between QoL data and environmental factors on the day of questionnaire completion: mean temperature, sunshine hours, season, and lunar phase. Methods We undertook a cross-sectional analysis of baseline data in the prospective cohort study at two cancer centers in eastern Germany. From December 2020 to December 2021, cancer patients completed the EORTC QLQ-C30 questionnaire upon admission. Statistical analysis was performed to explore associations between QoL data and environmental factors, including temperature, sunshine hours, season, and lunar phases. Results We received 5040 responses (54% male). QoL scores were highest at 25-30 °C and lowest at 5-10 °C (mean 61.3 vs. 52.6, p <0.001). Insomnia was highest at ≤0 °C and lowest at 25-30 °C (mean 39.3 vs. 29.5, p <0.001). QoL was highest with 8 hours of sunshine and lowest with 0 hours (mean 56.9 vs. 50.9, p = 0.003). Conclusion Higher temperatures, more sunshine, and summer seasons are associated with higher QoL in cancer patients, while lower temperatures and reduced sunlight are associated with poorer QoL. These findings highlight the need to consider environmental factors in PRO assessments.

Quality of life in cutaneous leishmaniasis patients in Khyber Pakhtunkhwa, Pakistan.

To determine the impact of leishmaniasis on the quality of life of patients visiting the district headquarter hospital in District Khyber, Khyber Pakhtunkhwa, Pakistan. A cross-sectional exploratory study was conducted in District Headquarter Hospital of Khyber District, Khyber Pakhtunkhwa from November 2019 to April 2020. In this study, 349 participants who consented were included by using a non-probability consecutive sampling technique. A validated questionnaire "Dermatology Life Quality Index" (DLQI) was used for data collection. Independent sample t-test and one-way ANOVA were used for mean scores comparison. The mean DLQI score of cutaneous leishmania patients was 11.83 ± 3.94. Cutaneous leishmaniasis (CL) patients experienced a huge impact on their quality of life. The highest effect was observed for symptoms and feelings while the least impact was for the treatment. Statistically, no significant difference in mean DLQI score was found for gender, age, marital status, lesion activity, lesion appearance, and treatment history (p > 0.05). However, statistically, a significant difference was observed for the education, occupation, lesion location, and lesion type (p < 0.05). CL had a significant impact on the patient's quality of life and mental health. Further research is required to assess the impact of the treatment on QOL in CL patients. and for a better understanding of the issue and its mechanistic basis.

The Clinical Characteristics, Patterns of Recurrence, and Long-Term Survival Outcomes of Dual-Phenotype Hepatocellular Carcinoma After Curative Liver Resection.

Dual-phenotype hepatocellular carcinoma (DPHCC) is discernible from classical HCC (CHCC) in its morphology and is characterized by the co-expression of both CHCC and cholangiocyte markers. This study aimed to clarify the difference between DPHCC and CHCC after surgery. Patients with HCC after surgery were collected. The clinical characteristics, patterns of recurrence, and survival outcomes of patients with DPHCC and CHCC were compared. Multivariate analyses were used to determine the independent risk factors that influence the prognosis of patients. Patients with DPHCC (n = 141) account for 26% of the total patients (n = 541). Compared to patients with CHCC, patients with DPHCC are significantly associated with incomplete capsules, microvascular invasion, and poor differentiation (all P < 0.05). Compared to patients with CHCC, the 5-year overall survival (OS) (56% vs 43%) and recurrence-free survival (RFS) (35% vs 28%) are lower in patients with DPHCC. Meanwhile, among patients with tumor recurrence after surgery, patients with DPHCC have a higher proportion of advanced-stage tumors, and extrahepatic metastasis (all P < 0.05). Moreover, multivariate analysis showed that DPHCC is an independent risk factor for both OS (HR 1.399, 95% CI 1.061-1.845, P = 0.017) and RFS (HR 1.313, 95% CI 1.033-1.669, P = 0.026). DPHCC, an aggressive HCC subtype with poor differentiation and high invasiveness, shows inferior RFS and OS post-liver resection compared to CHCC. Clinicians' recognition and addressing of its unique challenges can improve DPHCC patients' prognosis and QoL.

Optimizing Drug Adherence and QoL of Pulmonary Tuberculosis Patients through Structured Health Education Based on Peer Group Support

Background: Patients with pulmonary tuberculosis frequently experience issues like non-compliance with treatment, boredom from prolonged therapy, and stopping treatment due to lack of recovery. This non-compliance can lead to drug resistance, therapy failure, reduced quality of life, and a higher risk of death. This study aimed to investigate the effects of Structured Health Education combined with Peer Group Support on medication adherence and quality of life among pulmonary tuberculosis patients. Methods: This quantitative study employed an actual experimental research design with a pretest-posttest control group approach. The research included 38 respondents as the sample. The independent variable was Structured Health Education with Peer Group Support, while the dependent variables were Medication Compliance and Quality of Life. The research instruments used included the Morisky Medication Adherence Scale-8 (MMAS-8) to measure medication compliance and the WHOQOL-BREF to assess quality of life. The Mann-Whitney Test was applied to test the study's hypotheses. Results: Structured Health Education based on peer group support is efficacious in improving patients' medication adherence and quality of life with pulmonary tuberculosis. Conclusion: Nurses in the outpatient room of the health centre can apply the results of this study in providing nursing interventions and structured health education based on peer group support to improve medication adherence and the quality of life of patients with pulmonary tuberculosis.

Long term inguinal pain comparing TEP to Lichtenstein repair: the TEPLICH RCT 8 years follow-up

PurposeTo investigate long-term chronic postoperative inguinal pain (CPIP), QoL and recurrence in patients with a primary inguinal hernia comparing TEP to Lichtenstein.Material and methodsA questionnaire-based follow-up containing the Inguinal Pain Questionnaire (IPQ), the Cunningham Pain Scale and SF-36 was done 8 years after the TEPLICH RCT. The main objective was non-ignorable pain last week according to IPQ. A phone interview was performed with patients reporting new non-ignorable pain and those having a suspected recurrence. Records were scanned for long-term CPIP and recurrences. A lost to follow-up analysis was performed.ResultsA total of 322 of 366 patients (88%) completed the follow-up of mean 7.94 years (5–10.75 years). Non-ignorable pain last week was reported by 7.6% in TEP and 6.7% in Lichtenstein (p < 0.73). New non-ignorable pain was reported by 5 patients. No difference in non-ignorable pain over time (1–8 years) was observed within groups. Moderate to severe pain, according to Cunningham, was reported by 3.8% in TEP and 5.5% in Lichtenstein (p < 0.48). QoL remained above the Swedish norm. No recurrences occurred after 3 years follow-up. The lost to follow-up analysis showed no difference in non-ignorable pain.ConclusionsRCTs, comparing TEP to Lichtenstein repair with follow-up ≥ 5 years regarding CPIP are sparse with conflicting data. In this study, low frequencies of CPIP present at 3 years seem to persist at 8 years. Recurrences occured within the first 3 years. Patients need to be informed of the risk of long-term CPIP.

Practice of cough etiquette and quality of life among MDR-TB patients at a tertiary care hospital

Tuberculosis is a highly contagious disease. When a patient with pulmonary TB coughs/sneezes without appropriate cough etiquette, it may spread to others. Also cough due to TB has significantly impaired quality of life of patient. To find the cough hygiene practices and assess quality of life among multi drug resistant tuberculosis patients. It was a hospital based cross-sectional study conducted at DR-TB centre of Basaveshwara medical college and hospital over a period of six months. All the active MDR-TB cases either attending or admitted at the DR-TB centre were personally interviewed by giving preformed questionnaire to assess the knowledge and practice of respiratory hygiene and Leicester cough questionnaire and Cough specific quality of life questionnaire were given to assess the quality of life.Total of 50 patients were included in our study out of which 28 were males and 22 were females. Majority (64%) were unaware of mode of transmission of TB. 90% were unaware of hygienic sputum disposal. Knowledge and practice of cough etiquette was poor. Our study also showed that total LCQ scores were lower in females as compared to males (10.1±2.8 versus 12.3±2.2). Total CQLQ scores were higher in females as compared to males (78.3±10 versus 69.6±4.9). Both indicating worse QOL in female patients.Majority were unaware of proper knowledge and practice of cough hygiene. Most of the females reported worse QOL. There should be proper interaction between DOTS providers and patient’s, they should educate patients about cough etiquette and its importance. NTEP should also focus on improving QOL of patients.

P43 Correlation of SF-36v2 score with disease burden and patient background in Japanese patients with psoriasis vulgaris

Abstract Psoriasis vulgaris is a chronic inflammatory skin disease that accounts for 0.3–0.4% of the Japanese population and is known to reduce the QoL of affected individuals. However, there are few evaluations of Japanese patients with psoriasis in general health-related quality of life indices such as short form (SF)-36v2. The Western Japan Psoriasis Registry is a prospective cohort conducted by the Western Japan Inflammatory Skin Disease Research Group and currently enrols around 2600 patients. QoL of psoriasis vulgaris patients enrolled in this registry were assessed using a questionnaire including SF36v2. Objective severity of the skin symptom was evaluated by board-certified dermatologists. The study was authorized by the internal review board of each facility and was conducted with the patient’s written consent. A total of 1065 PsV patients (765 males and 300 females) were enrolled. The mean age was 60.3 years; the mean physical component summary (PCS) of SF-36v2 in PsV patients was 47.9, lower than the national average. The scores were significantly lower in items physical functioning and general health. When stratified with demographics, women and those aged over 60 years had lower scores in almost all items. In contrast, habitual drinkers had higher scores on all items. In terms of comorbidities, patients with hypertension and diabetes had lower PCS than those who do not have such comorbidities, while having hyperlipidaemia or hyperuricaemia did not make any difference in scores. Regarding Physical Functioning, scores were higher overall in patients with a current lesion area of &amp;lt;3% and patients with a PGA score of 2 or less. For patients who have lesions on the head/neck and extremities, the scores were lower overall than those who do not have lesions in such areas. In correlation with other patient-reported outcomes, SF-36v2 scores were lower in the group with DLQI &amp;gt;10 than in those with DLQI ≦10. Similar results were found for the patient’s global assessment of severity and Itch NRS. In conclusion, women, older age, non-drinking, concomitant diabetes, objective severity, lesions on the head and neck, extremities, and itching were found to be factors that reduced quality of life in patients with PsV. This study was conducted by the members of the nonprofit organization Western Japan Inflammatory Skin Disease Research Group, and this work is partially supported by Boehringer Ingelheim.

Fabrication and evaluation of Wrap Around Neural-Pass to record and stimulate neural activity in the cervical spinal cord

Abstract We have successfully fabricated a Wrap Around Recording Electrode to record neural activity in the Cervical Spinal Cord (CSC) and a Wrap Around Stimulating Electrode to stimulate the CSC. These are used in the Wrap Around Neural-Pass to improve the QOL of patients with CSC injury by restoring motor, sensory, upper limb, and lower limb nerves minimally invasively that invades only the CSC. The fabricated electrodes had sufficient wrapping ability to be wrapped around the CSC of rats and could record neural activity in the rat’s spinal cord. We also clarified the optimal polymerization conditions for PEDOT used as the stimulating electrode material for the Wrap Around Stimulating Electrode, and the electrodes had low impedance, high Cathodal Charge Storage Capacity (CSCC), and Charge Injection Capacity (CIC) suitable for stimulating the CSC nerves.

Quality of life of elderly patients with type 2 diabetes at Thai Binh Provincial General Hospital

Objective: This study aimed to assess the QoL of elderly patients with T2DM at Thai Binh Provincial General Hospital and identify associated factors influencing their QoL. Method: A total of 303 elderly patients aged 60 and above were recruited. QoL was measured using SF-36 questionnaire. Socio-demographic data, nutritional status, and comorbidities were also collected. Statistical analyses were conducted to evaluate associations between these variables and QoL scores. Results: The average QoL score among participants was 48.7 ± 7.4. Significant differences in QoL were observed by age, with patients aged 60-69 reporting the highest scores (50.7 ± 7.2) and those aged 80 and older the lowest (46.0 ± 6.6), p = 0.0002. Comorbidities significantly impacted QoL; patients with neurological disorders had scores of 46.9 ± 7.1 compared to 50.0 ± 7.3 for those without (p = 0.0002). Conclusion: Elderly patients with T2DM at Thai Binh Provincial General Hospital experience a reduced QoL, primarily influenced by age and comorbidities. Comprehensive management strategies addressing these factors are essential for enhancing the QoL of this population. These findings underscore the importance of targeted interventions and resource allocation to improve diabetes care and overall well-being, particularly for elderly patients in resource-limited settings.

A STUDY TO DETERMINE THE SHORT TERM OUTCOME OF INFRAINGUINAL BYPASS FOR CRITICAL LIMB ISCHEMIA

Introduction: Critical limb ischemia is defined as persistent, recurring ischemic rest pain requiring opiate analgesia for at least 2 weeks, or ulceration or gangrene of the foot or toes and ankle systolic pressure lower than 50 mm Hg or toe systolic pressure lower than 30 mm Hg. CLI is a clinical diagnosis and it should be confirmed early and objectively through ABI, toe systolic pressure or transcutaneous partial pressure of oxygen (TcPO2). Once the diagnosis is confirmed, the goals of treating CLI are to relieve ischemic pain, heal ischemic ulcers, prevent limb loss, improve patient function and QOL and prolong survival. Revascularization will help to achieve these goals. The aim of the study is to assess the outcome of infra-inguinal bypass surgery in all PVD patients who presented to our General Surgery department with CLI. Objectives: To assess the following in CLI after infra-inguinal bypass surgery: 1) Wound healing 2) Limb salvage 3) Self assessed degree of ambulation 4) Primary patency of graft-using arterial doppler Methods: This is a single directional cohort study conducted in 48 patients who presented to Amala General Surgery Department with critical limb ischemia, who underwent infra-inguinal bypass surgery with reversed saphenous vein graft. PVD patients with CLI were assessed preoperatively. Periodic assessment was also done during postoperative period at 1 month and 6 months. Primary graft patency was checked at 6 months using arterial doppler. These patients were monitored closely during the pre-operative period, during surgery and postoperative period. They were also followed up at 1 and 6 months. The study duration is 18 months, from January 2018 to June 2019. Results and Discussion: From January 2018 to June 2019, 48 patients (37 males, mean age of 65 years) underwent infrainguinal bypasses (37 femoropopliteal, 11 femorodistal) for CLI (12 Fontaine III and 36 Fontaine IV).There was no perioperative mortality. The mean duration of hospitalization was 10.542 with standard deviation of 3.2809.Wound healing observed at 1 month is 39.58%, which was increased to 77.08 % at the end of 6 months (Mc Nemar Test p value=0.0001).Limb salvage attained at the end of 6 months is 87.5%.Ambulatory status of the patients were assessed at the end of 1 month after surgery and only 2% were ambulatory outdoors, 90 % were ambulating indoors and 8% were non-ambulatory. Total ambulatory status post-surgery (indoor and outdoor combined), came around 92% at 1 month. At 6 months post-surgery, 19 % of patients were ambulating outdoors, 60 % were ambulating indoors and 21 % were non-ambulatory. Total ambulatory status at 6 months (indoor and outdoor combined) post-surgery came around 79 % (Mc Nemar Test p value = 0.001) and primary patency of the graft at 6 months for our cohort is 79.2%. Conclusion: This Study includes 48 patients with CLI who has undergone infrainginal bypass with reversed saphenous vein graft. 87.5% limb salvage, 77.08% wound healing at 6 months, 79% was ambulatory status at 6 months and 79.2% primary graft patency were attained.. 7 out of 8 CLI patients treated surgically has limb salvage and good functional status.

Sex differences in patient-reported outcomes and perception of ascites burden amongst outpatients with decompensated cirrhosis and ascites.: Sex Differences in Ascites Burden Perception.

Perception of the ascites burden and its effects on quality of life may be different between sexes. This study assessed sex differences in perception of ascites burden and its impact on health related QoL (HRQoL) in patients with recurrent or refractory ascites. The North American Consortium for the Study of End-stage Liver Disease prospectively enrolled outpatients with cirrhosis and large ascites requiring repeat large volume paracenteses. Demographics, laboratory results, co-morbidities, medications, frailty measurements, self-reported questionnaires related to functional status, physical activities, and HRQoL (generic = SF36 & ascites specific = ascites Q) were compared between sexes. 392 men (59.6±10.7yrs) and 184 women (59.5±11.1yrs) with predominantly alcohol related liver disease 51% and 43% respectively), median MELD-Na: 13, were enrolled. Both groups had similar co-morbidities and cirrhosis complications, ascites duration and severity, and frailty scores (p=0.94). Women had more symptoms related to their ascites (Ascites Q score =66±21 vs. 60±21 in men, p=0.001) (higher value = feeling worse). 35% of women felt depressed versus 22% of men (p=0.0009), with lower mental but not physical functioning components of SF36 (p=0.019). Women continued to conduct their daily activities as adequately as men as indicated by Duke Status Activity index (p=0.27) and Godin Leisure Activity Index (p=0.47). Women with cirrhosis and ascites experienced worse emotional HRQoL than men without difference in daily function. Our analyses underscore the differences in the lived experience of women versus men with cirrhosis and highlight the need for patient-reported metrics to provide patient-centered care.

Prospects for the use of perampanel in the treatment of epilepsy in patients with malignant gliomas of the brain

Epilepsy occurs in 35–95% of patients with low-grade malignant cerebral gliomas and in 29–71% of patients with high-grade gliomas. Seizures can be the first manifestation of a malignant cerebral glioma or may develop in the postoperative period and during chemoradiation therapy. This necessitates the use of antiepileptic drugs that can control seizures, ensure seizure prevention, and provide secondary seizure prophylaxis without reducing the effectiveness of anticancer therapy or the patient’s quality of life. The processes of epileptogenesis and oncogenesis are closely interrelated through common developmental mechanisms, with glutamate playing a key role. Increased glutamate secretion is accompanied by elevated expression and activation of its receptors, which raises seizure susceptibility. This is associated with increased levels of brain-derived neurotrophic factor, the number of synapses between peritumoral neurons and glioma cells, and the expression of various growth factors, all of which contribute to tumor progression. In this context, special attention is given to perampanel, a glutamate receptor antagonist and third-generation antiepileptic drug, in the treatment of epilepsy in patients with malignant cerebral gliomas. It has been shown that perampanel not only effectively controls seizures in patients with malignant cerebral gliomas but also suppresses tumor progression. Perampanel can dose-dependently enhance apoptosis and disrupt cell migration in malignant glioma cell lines. A synergistic effect of perampanel in combination with temozolamide has been identified. During chemoradiation therapy, perampanel exerts a protective effect on healthy peritumoral tissues. Adverse drug reactions associated with perampanel use are infrequent and mild. Further research is needed to investigate the anticonvulsant and antitumor efficacy of perampanel for the treatment of epilepsy in patients with malignant brain tumors.

QOL-20. NATIONAL BRAIN TUMOR SOCIETY BRAIN TUMOR QUALITY OF LIFE RESEARCH AGENDA

Abstract BACKGROUND QoL is a critical aspect of health care outcomes, particularly in the context of brain tumor treatment and survivorship. There are evidence gaps in optimal strategies for improving QoL among brain tumor patients and care partners. Understanding the multifaceted dimensions of QoL and identifying key areas for brain tumor QoL research can significantly enhance patient care and support. Engaging the brain tumor community in defining QoL outcomes and determining research priorities can help orient research resources to community needs and perspectives. OBJECTIVE To summarize the process and outcomes of an NBTS-led collaborative effort to co-design a comprehensive research agenda on QoL for brain tumor patients and care partners, as outlined in the “Brain Tumor QoL Research Agenda.” METHODS The agenda was developed through a collaborative effort involving experts in neuro-oncology, patients, care partners, patient advocacy groups, and healthcare professionals over a two-year period. A review of existing literature, patient experiences, and expert opinions informed the identification of key research priorities. A multistakeholder advisory group held monthly meetings where brain tumor QoL was defined. In 2023, we conducted two “Research Roundtables” for adults and pediatric/AYA. The World Cafe method captured data and a survey consensus process to validate findings. RESULTS The QoL research agenda delineates a multifaceted framework encompassing domains crucial for understanding and improving QoL in brain tumor patients. Key focus areas include symptom management, psychosocial support, care burden, treatment decision-making, survivorship issues, and health care delivery models. An RFP was released by NBTS with input from stakeholder advisors in April 2024. CONCLUSION The Brain Tumor QoL Research Agenda created a roadmap for advancing research efforts aimed at enhancing the QoL of individuals affected by brain tumors. By addressing the identified research priorities, healthcare stakeholders can work towards implementing effective interventions and policies to optimize patient outcomes and well-being. This program was funded through a Patient-Centered Outcomes Research Institute® (PCORI®) Eugene Washington PCORI Engagement Award (EACB-23261).

Proton Beam Therapy &amp; IMRT Offer Similar QoL for Prostate Cancer Patients

Proton Beam Therapy &amp; IMRT Offer Similar QoL for Prostate Cancer Patients

Effects of an anti-inflammatory diet (AID) on maternal and neonatal health outcomes in pregnant Chinese patients with inflammatory bowel disease treated with infliximab (IFX)

Objective This study aimed to evaluate the effects of an anti-inflammatory diet (AID) combined with Infliximab (IFX) therapy on maternal and neonatal health outcomes in pregnant Chinese patients with inflammatory bowel disease (IBD). Methods IBD patients treated with steady IFX maintenance therapy at the time of conception were randomly assigned to either the IBD-AID group (n = 49), which received an anti-inflammatory diet intervention during the third trimester, or the habitual diet group (n = 49). Primary outcomes included assessments of disease activity, inflammatory markers, and neonatal health. Secondary outcomes included health-related quality of life (HRQoL) in patients and functional gastrointestinal disorders (FGIDs) in infants. Results The IBD-AID intervention significantly reduced disease activity scores in IBD patients at 4 weeks post-intervention and 1 month postpartum compared to the habitual diet group, and also improved HRQoL. Serum C-reactive protein (CRP) and fecal calprotectin (FC) levels were significantly lower in the IBD-AID group at these times, with a trend towards lower levels at 6 months postpartum. Birth weight and Apgar scores were higher in the IBD-AID group but did not reach statistical significance. The incidence of at least one FGID in infants was significantly lower in the IBD-AID group (24.5%) compared to the habitual diet group (46.9%, p = 0.034). Conclusion The IBD-AID intervention combined with IFX therapy significantly improved disease activity, inflammatory markers, and QoL in maternal IBD patients, and was associated with a lower incidence of FGIDs in infants, indicating benefits for both maternal and neonatal health.