Quality Of Life In Patients Research Articles

Online training program maintains motor functions and quality of life in patients with Parkinson's disease

ObjectiveSeveral systematic reviews have shown that physical exercise positively affects motor function (MF) and quality of life (QoL) in patients with Parkinson's disease (PD). After the coronavirus disease (COVID-19) pandemic, numerous studies were conducted to reveal the effects of telerehabilitation for patients with PD. However, only a few empirical results of online programs for PD patients have been reported. Therefore, this study aimed to determine the effects of an online physical and cognitive training program on MF and QoL in patients with PD.MethodsWe evaluated the impact of our online program on the QoL and MF of patients with PD by comparing data at baseline and after six months of intervention. For the QoL assessment, we used the Schwab and England Activities of Daily Living scale and Parkinson's Disease Questionnaire (PDQ-39), whereas, for MF, we measured movement status using the modified 20-m walk test and timed up-and-go (TUG) test.ResultsWe enrolled 20 patients for QoL and 19 for MF in this study. For PDQ-39, social support (p = 0.046, δ = 0.320) and cognitions (p = 0.028, δ = 0.268) significantly improved. Additionally, cadence (p = 0.032, g = −0.377) in the modified 20-m walk and exam duration (p = 0.003, δ = 0.296) and forward gait (p = 0.003, δ = 0.341) in the TUG test showed significant differences before and after the intervention.ConclusionOur results suggest that online physical and cognitive training programs positively affect MF and QoL in individuals with PD.

Effectiveness of a tertiary specialist obsessive–compulsive disorder (OCD) service in improving clinical outcomes for patients with treatment-resistant/complex OCD

Abstract Introduction: Obsessive-compulsive disorder (OCD) is a chronic condition that can result in significant distress and impaired quality of life (QoL). This retrospective cohort study investigates the effectiveness of individually tailored pharmacotherapy, exposure and response prevention (ERP), and socioeconomic and family interventions on clinical outcomes at a specialist clinic focused on treatment-resistant/complex OCD. Methods: Patients with treatment-resistant/complex OCD treated at the Institute of Mental Health OCD clinic, Singapore, between January 2015 and March 2019 were invited. The interventions included pharmacotherapy and 12–60 intensive cognitive behavioural therapy/ERP sessions. Interventions also targeted socio-occupational dysfunction and family accommodation. Y-BOCS and Q-LES-Q-SF scales were administered pre- and post-treatment. Linear regression and one-way analysis of variance were used for data analysis. Results: Overall, there was a significant reduction in Y-BOCS score of 9.2 (P = 0.000) and an improvement in Q-LES-Q-SF score of 11.6 (P = 0.000). Of 70 participants, 35 (50%), 12 (17%), and 23 (33%) achieved full, partial, and no treatment response, respectively. Improvement in OCD symptoms was associated with lower baseline Y-BOCS scores and being married. Improvement in QoL was associated with higher baseline Q-LES-Q-SF scores. Conclusion: Interventions at the clinic improved OCD symptoms and QoL in patients with treatment-resistant/complex OCD, likely due to the simultaneous socio-occupational support services available.

Tumor-associated macrophages in bladder cancer: roles and targeted therapeutic strategies

Bladder cancer (BC) is the ninth most common and “expensive” cancer in the world. Despite the availability of various treatment modalities such as chemotherapy, immunotherapy and surgery, the overall survival rate of patients with advanced bladder cancer remains low. As one of the most abundant infiltrating immune cells in bladder cancer, tumor-associated macrophages (TAMs) play an important role in the development of BC and in the standard regimen of intravesical BCG therapy. Targeting TAMs have achieved excellent results in clinical trials for a variety of other cancers, but few studies have been conducted for bladder cancer. Further exploration is still needed to develop TAM-related therapeutic strategies for BC treatment, which are expected to improve the therapeutic efficacy and life quality of patients. This review summarizes the relationship between TAMs in bladder cancer and disease staging, evolution, patient prognosis, and treatment outcome. Several potential TAM targets in BC are also pointed, which may help to inhibit tumor-promoting TAMs and provide new therapeutic approaches for advanced BC.

Impact of Covid-19 Infection on Incidence and Exacerbation of Overactive Bladder Symptoms: A Systematic Review

Background The COVID-19 pandemic continues to be a major global health concern. A key factor is the presence of angiotensin-converting enzyme 2 (ACE2) receptors in various organs, including the lungs, heart, bladder, and testicles. These receptors allow the SARS-CoV-2 virus to enter cells, making these organs vulnerable to damage. This vulnerability may explain why some patients experience non-respiratory symptoms. Notably, overactive bladder (OAB) symptoms and a condition called COVID-associated cystitis (CAC) have been reported to negatively affect the quality of life of COVID-19 patients. A systematic review is needed to summarize the current understanding of these urological aspects of SARS-CoV-2 infection, considering both short- and long-term effects. Methods We conducted a systematic review in accordance with PRISMA guidelines to investigate urological complications of COVID-19, with a specific focus on OAB symptoms and CAC (characterized by frequent urination, urgency, and nocturia). We searched databases, including Medline (PubMed), Embase, and Scopus. Two reviewers independently screened the studies, and the quality of each study was assessed using the Newcastle-Ottawa Scale (NOS). Results Our search identified 343 articles published up to March 2024, of which 12 were included in this review. Many of the studies utilized scoring systems such as the International Prostate Symptom Score (IPSS) and OAB symptom scores. The evidence suggests that COVID-19 may trigger or worsen lower urinary tract symptoms, OAB, and cystitis in some patients, regardless of gender or age. However, these effects appear to be uncommon. Several studies reported an increase in IPSS scores, though it remains unclear whether this increase is temporary or long-lasting. A few studies found that symptoms resolved over several months. Conclusion This systematic review suggests that COVID-19 may affect the urinary system, leading to symptoms such as frequent urination, urgency, and nocturia. These symptoms can negatively impact the quality of life in COVID-19 patients.

Hematological Response to Particle Debris Generated During Wear–Corrosion Processes of CoCr Surfaces Modified with Graphene Oxide and Hyaluronic Acid for Joint Prostheses

Various surface modifications to increase the lifespan of cobalt–chromium (CoCr) joint prostheses are being studied to reduce the wear rate in bone joint applications. One recently proposed modification involves depositing graphene oxide functionalized with hyaluronic acid (a compound present in joints) on CoCr surfaces, which can act as a solid lubricant. This paper analyzes the biological alterations caused by wear–corrosion phenomena that occur in joints, both from the perspective of the worn surface (in vitro model) and the particles generated during the wear processes (in vivo model). The analysis of the inflammatory response of macrophage was performed on CoCr surfaces modified with graphene oxide and functionalized with hyaluronic acid (CoCr-GO-HA), before and after wear–corrosion processes. The wear particles released during the wear–corrosion tests of the CoCr-GO-HA/CoCr ball pair immersed in 3 g/L hyaluronic acid were intra-articularly injected into the experimental animals. The hematological analysis in vivo was made considering a murine model of intra-articular injection into the left knee in male adult Wistar rats, at increasing concentrations of the collected wear particles dispersed in 0.9% NaCl. Non-significant differences in the inflammatory response to unworn CoCr-GO-HA surfaces and control (polystyrene) were obtained. The wear–corrosion of the CoCr-GO-HA disk increased the inflammatory response at both 72 and 96 h of material exposure compared to the unworn CoCr-GO-HA surfaces, although the differences were not statistically significant. The pro-inflammatory response of the macrophages was reduced on the worn surfaces of the CoCr modified and functionalized with graphene oxide (GO) and hyaluronic acid (HA), compared to the worn surfaces of the unmodified CoCr. The hematological analysis and tissue reactions after intra-articular injection did not reveal pathological damage, with average hematological values recorded, although slight reductions in creatinine and protein within non-pathological ranges were found. Some traces of biomaterial particles in the knee at the highest concentration of injected particles were only found but without inflammatory signs. The results show the potential benefits of using graphene in intra-articular prostheses, which could improve the quality of life for numerous patients.

Management of Carcinoma of Esophagus in Old Patient with Panchagavya Therapy as a Palliative Care-A Case Report

ABSTRACT Esophageal cancer is a male-dominant, aggressive malignancy with a five-year survival rate of 15%-20%, predominantly affecting developed nations. Esophageal squamous cell carcinoma (ESCC) is the most common subtype. This case study involves a 70-year-old man with ESCC, who was suffering from difficulty swallowing, inability to burp, constant nausea, and occasional trouble swallowing water for two months. He was successfully treated with Panchagavya Chikitsa, which included Panchagavya Ghrita, Gomutra Arka, Kwath of Amla-Yashtimadhu-Shatpushpa, Haritaki Churna, Haridra Ghanvati, and Vibhitaki Avaleha, along with Nasya, Nabhipurana with Panchagavya Ghrita, and Matra Vasti with Tila Taila over six months. Significant symptom improvement was observed, attributed to the Rasayana (rejuvenative), Balya (strengthening), and Jeevaniya (vitality-enhancing) properties of the treatments. These properties inhibit cancer growth, nourish tissues, and restore balance due to their antioxidant effects. Panchagavya formulations showed promising results without adverse effects, highlighting their efficacy in improving the quality of life for this geriatric patient with ESCC.

BN SO22 - Magnetic sphincter augmentation in the management of gastro-esophageal reflux disease: A systematic review and meta-analysis

Abstract Background Magnetic sphincter augmentation (MSA) through placement of the LINX device is an alternative to fundoplication in the management of gastro-esophageal reflux disease (GERD). This systematic review and meta-analysis aimed to assess efficacy, quality of life and safety in patients that underwent MSA, with a comparison to fundoplication. Method A literature search of MEDLINE, Embase, Emcare, Scopus, Web of Science and Cochrane library databases was performed for studies that reported data on outcomes of MSA, with or without a comparison group undergoing fundoplication, for GERD from January 2000 to January 2023. Meta-analysis was performed using random-effect models and between-study Results Thirty-nine studies with 8,075 patients were included: 6,983 patients underwent MSA and 1,092 a fundoplication procedure. More individuals discontinued proton-pump inhibitors (P<0.001; WMD 0.83) and had higher rates of satisfaction (P<0.001; WMD 0.85) following MSA compared to fundoplication. Functional outcomes including ability to belch (P<0.001; WMD 0.96) and emesis (P<0.001; WMD 0.92), and bloating (P=0.003; WMD 0.20) were better after MSA than after fundoplication, although MSA had higher rates of dysphagia (P=0.001; WMD 0.41). The overall erosion and removal rate following MSA was 0.24% and 3.9% respectively, indicating no difference in re-intervention rates between MSA and fundoplication (P=0.446; WMD 0.001). Conclusion MSA is a safe and effective procedure at reducing symptom burden of GERD and can potentially improve patient satisfaction and functional outcomes. However, randomized controlled trials directly comparing MSA with fundoplication are necessary to determine where MSA precisely fits in the management pathway of GERD.

Abstract 4118122: Effect of Beta Blockers on Exercise Capacity, Diastolic Function, and Quality of Life in Patients with Heart Failure with Preserved Ejection Fraction

Introduction: In recent landmark HFpEF trials, 75-80% of patients are taking beta blockers (BB) without clear evidence of clinical or symptomatic benefit. Patients with HFpEF commonly have comorbidities that have been classically managed with BB (AF, CAD, HTN), though the utility of this medication class for these conditions is being reconsidered. It remains unclear what impact BB use, in patients with HFpEF, has on exercise capacity, diastolic function, and quality of life. Hypothesis: We hypothesized that BB use is associated with worse exercise capacity, diastolic function, and quality of life in HFpEF patients. Methods: This retrospective cohort study was completed using deidentified patient data from the INDIE-HFpEF and RELAX clinical trials (two trials of HFpEF patients). Patients were divided into two groups based on BB use at trial enrollment. The primary outcomes were exercise capacity, diastolic function, and quality of life at baseline evaluation. A multivariate logistic regression model was used to assess for statistically significant differences after controlling for potentially confounding variables including age, sex, BMI, AF, prior MI, COPD, DM, HTN, serum creatinine, and NYHA functional class. Results: A total of 320 patients were included in this analysis, with 230 on BB (72%). Baseline demographics are shown in Table 1. Patients studied were older (68 years old), white (90%), obese (average BMI 34 kg/m 2 ) individuals with an average LVEF of 61%. Outcomes and multivariate linear regression results are shown in Table 2. After controlling for potential confounding variables, there were no differences in baseline exercise capacity [peak VO2 (mL/kg/min): 12.1 vs 13.2, P=0.233], diastolic function [average E/e’: 14 vs 12, P=0.125; LAVI (mL/m 2 ): 42 vs 37, P = 0.665; peak TR velocity (m/s): 2.8 vs 2.7, P = 0.165; PASP (mmHg): 41 vs 36, P = 0.357], quality of life [KCCQ: 54 vs 58, P = 0.206; MLHFQ 43 vs 46, P = 0.762], or NT-proBNP (633 vs 342; pg/mL, P = 0.208) in HFpEF patients on BB compared to those not on BB. Conclusion: There was no association with BB use and worse exercise capacity, diastolic function, or quality of life in HFpEF patients. This may be due to heterogenous treatment effects, with differing impact of BB based upon the underlying pathophysiology of unique HFpEF phenotypes. To definitively determine the impact of BB use in patients with HFpEF, both on clinical outcomes and symptoms, randomized controlled trials are necessary.

Association of plant and animal protein intake with sleep quality and quality of life in hemodialysis patients: a multicenter cross-sectional study

BackgroundThe current study aimed to evaluate the association between the intake of plant-based protein, animal-based protein, total protein, and the ratio of plant to animal protein with sleep quality and quality of life in patients undergoing hemodialysis.MethodsIn this cross-sectional study, 479 adult patients undergoing dialysis for a minimum of 3 months were included. The dietary intake was calculated using information from a validated 168-item semi-quantitative food frequency questionnaire. Quality of life (QOL) was assessed using the Kidney Disease Quality of Life Short Form (KDQOL-SF 1.3). and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality.ResultsIn this study, the mean age of the participants was 58.18 years (± 14.25 years), with the majority being male (58.2%). After adjusting for potential confounders, significant positive associations were observed between total protein intake (β = 0.12, p = 0.03) and quality of life (QOL). Conversely, there were significant negative associations between the ratio of plant to animal protein intake (β = −0.94, p < 0.01) and QOL. Furthermore, significant negative associations were found between total protein intake (β = −0.02, p < 0.05) and animal protein intake (β = −0.19, p < 0.05) with poor sleep quality. Additionally, there were significant positive associations between the ratio of plant to animal protein intake (β = 0.188, p < 0.05) and poor sleep quality.ConclusionIncreased consumption of animal protein is associated with improved sleep quality and Quality of Life (QOL) in patients undergoing hemodialysis (HD). Further research, especially prospective studies, is required to confirm these associations.

An assessment of quality of life in ESRD patients undergoing hemodialysis

Abstract Background and aim Assessment of quality of life in ESRD patients. The quality of life of the patients may be greatly reduced because it necessitates lifelong treatment in the form of renal replacement therapy or hemodialysis. Therefore, the main goal of the study is to evaluate the QOL (quality of life) of patients receiving hemodialysis using WHO QOL criteria. Methods At the Dr. B. R. AMCH dialysis unit, a cross-sectional descriptive study involving (n = 134) patients (of whom n = 34 gave negative consent) was carried out over the course of 3 years, from September 10, 2018, to September 10, 2021. Conclusion WHO QOL is a trustworthy tool for assessing QOL in ESRD patients. The research indicates that the progression of the illness has a negative impact on both mental and physical health, as well as causing financial strain and strained relationships with others.

Comprehensive analysis of psychological symptoms and quality of life in early patients with IBD: a multicenter study from China.

To investigate the prevalence and risk factors of psychological symptoms and quality of life (QoL) in early patients with inflammatory bowel disease (IBD). From September 2021 to May 2022, a unified questionnaire was developed to collect clinical data from early patients with IBD from 42 tertiary care hospitals. The influencing factors of psychological symptoms and poor QoL are screened by logistic regression analysis for constructing model in predicting poor QoL. The consistency index, receiver operating characteristic (ROC) curve, area under the ROC curve (AUC), net reclassification improvement (NRI), integrated discrimination improvement (IDI), calibration curve, and decision curve analysis (DCA) were used to evaluate the performance of the model. A total of 939 early patients with IBD were surveyed, Among them, 20.3% exhibited anxiety, 21.7% had depression, 57.3% experienced sleep disturbance, and 41.9% reported poor QoL. The factors influencing psychological symptoms varied between ulcerative colitis (UC) and Crohn's disease (CD) patients. The QoL was primarily affected by disease activity, income level and depression. The AUC value of the model in the training group was 0.781 (95% CI: 0.748-0.814). The calibration diagram of the model closely matched the ideal curve. Compared to other prediction models, our model showed superior predictive capability, with NRI and IDI values of 0.324 (95%CI:0.196-0.4513) and 0.026 (95%CI:0.014-0.038), respectively. DCA indicated that the nomogram model could provide clinical benefits. Early patients with IBD exhibit a high prevalence of psychological symptoms and poor QoL. The nomogram prediction model we constructed demonstrates high accuracy and performance in predicting QoL in early patients with IBD.

Dosha status distribution of Thyropro39 scale derived data for Quality of life in hypothyroidism patients- A cross-sectional study

Thyropro 39 scale is widely used to assess quality of life in hypothyroid patients treated with Ayurvedic system of medicine. Dosha assessment is fundamental to Ayurveda at all stages of treatment. Research is conducted to detect the distribution of Dosha oriented features in a QoL study using Thyropro 39 scale. This hospital based cross sectional study was conducted between June 2021 to June 2022, where 47 (50%) of 94 patients recruited were on regular Levothyroxine supplement. The participants were interviewed and the distribution of features collected in various domains of Thyropro 39 was analysed for Dosha related features. The results showed predominantly the features of Vata dosha in both intensity and distribution, while the features of both Pitta and Kapha doshas were not noticable with the Thyropro39 scale. Domain of symptoms, related to functions of different units of Vata like Udana, Prana, Vyana and Samaana and to the functions of Pachaka, Alochaka & Bhrajaka pitta had affected 3.19% of the group, in quiet a bit intensity. The domains of tiredness (57.44%), nervousness & tension (61.69%), psychological well being (57.45%), mood swings (59.59%) reported quiet and bit and very much intensity showing Vata aggravated status. The domains of vitality (37.23%), memory & concentration (66.44%), relationships (87.22%), daily activities (85.09%) reported not at all or some intensity, Vata showing its depleted status.

A Novel RNS Hardware Architecture of FRM Filter Banks for Digital Hearing Aids

This paper presents a novel hardware architecture for Frequency Response Masking (FRM) Filter Bank based on Residue Number System (RNS) arithmetic for Digital Hearing Aids (DHA). FRM is a computationally efficient approach for filter bank design that separates different frequencies based on the Audiograms of a patient. However, filter banks are critical power-hungry elements that require high computational resources. Therefore, the proposed architecture aims to provide an efficient implementation of FRM filter banks, which can improve the value and affordability of DHAs. The proposed architecture employs FIR filters in direct form, linear phase, and poly phase using RNS arithmetic. This approach enables the performance of arithmetic operations in parallel and independently. The concepts are further extended for the efficient implementation of FRM filter bank. The results of the proposed architecture show that direct implementation reduces the delay when the number of taps increases in the FIR filter. However, to reduce computational resources and optimize the area requirement, a Folded RNS architecture is also proposed. The Folded RNS architecture offers hardware savings of 23–27% for a 40-tap FIR filter and 29–31% for a 60-tap FIR filter. Additionally, it improves speed by 13–15% for a 40-tap FIR filter and 16–19% for a 60-tap folded RNS FIR filter. The implementation of FRM filter bank using the folded FIR filter shows the same trend in hardware saving and speed improvement as in the case of FIR filters. These results demonstrate that the proposed hardware architecture has the potential to improve the efficiency and affordability of DHAs while enhancing the listening comfort, which can enhance the quality of life for patients with hearing impairments.

Clinical Control and Quality of Life in Patients With Chronic Rhinosinusitis With Asthma: A Study on the Effects of Endoscopic Sinus Surgery.

To determine the impact of endoscopic sinus surgery (ESS) on chronic rhinosinusitis with asthma (CRSwA) patients' clinical control and quality of life. A randomized controlled trial involving 150 CRSwA patients, equally divided into surgical and control groups. Participants were matched for age, gender, illness duration, and computed tomography (CT) grading of the sinuses. Random allocation was conducted using a computer-generated table. The surgical group exhibited significant symptom score improvements across all metrics (P < .001). Lung function parameters showed substantial gains, with forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratios significantly higher than the control group (P < .001). Quality of life scores, measured by RQLQ and AQLQ, improved significantly in the surgical group (P < .001). At 6 months, correlations between lung function and CT grading of the sinuses were evident, with negative and positive correlations, respectively (P < .05). Inflammatory markers and medication usage were notably reduced (P < .001, P < .05), with low adverse event rates (1%). ESS is effective in enhancing clinical outcomes and quality of life for CRSwA patients, reducing inflammation and medication needs, thus supporting its use as a beneficial treatment.

MRI-guided neurolysis for the treatment of chronic refractory knee pain: a case report.

Chronic refractory pain poses a significant challenge in knee joint pathologies, especially after exhaustion of conservative, arthroscopic, and endoprosthetic therapy options. This case report illustrates an innovative approach using MRI-assisted chemical neurolysis of a genicular nerve to manage persistent knee pain after arthroscopy. A 62-year-old male patient with chronic refractory knee pain, primarily localized at the inferomedial part of the knee, underwent high-resolution MRI to visualize the genicular nerves. This allowed for targeted ethanol-based neurolysis of the inferomedial genicular nerve. Following the procedure, the patient experienced substantial pain reduction for the follow-up duration of 4months. The successful use of MRI-assisted chemical neurolysis offers a promising alternative treatment for patients with refractory knee pain, providing long-lasting pain relief without major side effects. This technique has the potential to improve the quality of life for patients suffering from chronic knee pain While these initial results are encouraging, it is important to note that further research, including both short-term and long-term studies, as well as randomized controlled trials, is warranted to establish the efficacy and safety of this treatment method in broader populations before it can be considered for routine incorporation into pain management practices.

Therapeutic Potential of Melatonin: Multifaceted Applications in Muscle Health, Metabolic Disorders and Cardiovascular Disease

Melatonin, a hormone primarily synthesized by the pineal gland, is traditionally associated with the regulation of circadian rhythms. However, recent research has unveiled its broad spectrum of biological effects, positioning it as a valuable therapeutic agent in diverse health contexts. Known for its potent antioxidant and anti-inflammatory properties, melatonin plays a crucial role in maintaining homeostasis and protecting cellular integrity. This review explores melatonin’s therapeutic applications across multiple medical domains, including muscle health, metabolic disorders, chronic pain management, and cardiovascular health. In muscle health, melatonin facilitates muscle hypertrophy and regeneration by mitigating oxidative stress and enhancing the activity of satellite cells responsible for muscle repair. This action is particularly beneficial for individuals undergoing intense physical exertion, recovering from injuries, or combating age-related muscle. In metabolic disorders, such as type 2 diabetes, melatonin improves insulin sensitivity and reduces cellular oxidative damage, which supports beta-cell function and glucose regulation, potentially minimizing diabetes-related complications. Furthermore, in fibromyalgia - a condition marked by widespread pain and sleep disturbances - melatonin has demonstrated efficacy in alleviating pain and improving sleep quality, thus enhancing the overall quality of life for patients. In cardiovascular health, melatonin has shown promise in preventing and managing heart failure by reducing oxidative damage, modulating inflammatory pathways, and supporting endothelial function, which collectively contribute to improved cardiac health and reduced disease progression. This comprehensive review underscores melatonin’s emerging role as an integrative therapeutic agent in modern medicine.

Abstract 4143239: Extracorporeal Shockwave Therapy Improves Physical Outcomes and Quality of Life In Patients With Symptomatic Peripheral Arterial Disease: Results from a Meta-analysis of Randomized Controlled Trials

Introduction: Extracorporeal shockwave therapy (ESWT) is a non-invasive procedure that may be useful to treat symptomatic peripheral arterial disease (PAD). Trials comparing ESWT with control groups have shown promising results. Methods: PubMed, Cochrane, EMBASE, and Google Scholar were searched for randomized controlled trials reporting the efficacy of extracorporeal shockwave therapy versus control in patients with symptomatic PAD. Data from eligible studies was analyzed using the Review Manager 5.4 software. Mean difference (MD) and 95% Confidence intervals (CI) were calculated for continuous outcomes. Inverse variance method and a random effects model were used for pooled estimates. A p-value &lt; 0.05 (Z-test) was considered significant. Results: 5 randomized controlled trials with 264 patients were included in our analysis. A significant increase in the mean walking distance (MD: 54.13, 95% CI 9.34 to 98.92, p=0.02), pain-free walking distance (MD: 54.13, 95% CI 14.19, 57.88, p= 0.001), SF-36 physical component summary (MD: 11.97, 95% CI 0.26 to 23.69, p=0.05), EQ-5D-3L index score (MD; 0.08, 95% CI: 0.00 to 0.15, p=0.05) and VascuQoL index ((MD: 0.48, 95% CI 0.03 to 0.92, p= 0.04) was seen with ESWT. A slightly higher ankle brachial pressure index was seen in the control group (MD: -0.01, 95% CI: -0.02 to -0.00, p=0.04). There was no difference in SF-36 physical functioning domain score (MD: 18.58, 95% CI: -0.29 to 37.45, p=0.05) and SF-36 bodily pain score (MD: 9.17, 95% CI: -2.885 to 21.19, p=0.13). Conclusions: There was significant improvement in walking distances, exertional symptoms, and quality of life with ESWT. However, ESWT did not translate to an increase in post-treatment ankle-brachial index which was slightly higher in the control group. There is a need for larger randomized controlled trials to substantiate the efficacy of ESWT in treating symptomatic PAD.

Abstract 4127664: Influences of Age on Improvement of Health-Related Quality of Life in Patients with Atrial Fibrillation following Initial Treatment

Background: The prevalence of Atrial Fibrillation (AF), the most cardiac common arrhythmia, increases with age. Various treatment strategies are available to improve health-related quality of life (HRQoL) in patients with AF; however, the impact of age on HRQoL treatment benefits is unknown. Aims: To investigate the association of age with HRQoL benefit across different treatment strategies. Methods: Using data from a multicenter registry for outpatients with early recognized AF, HRQoL at enrollment and 1 year later was measured with the Atrial Fibrillation Effect on Quality-of-life quesTionnaire (AFEQT). The association between age and the 1-year changes in AFEQT-overall summary (OS) and subdomain scores with either rate or rhythm control strategies were assessed using generalized additive models (GAM) to address non-linear relationships. To support clinical interpretation, multivariable linear regression models were performed with categories of age ranges. Results: Among 2786 patients (31.7% women, 54.7% rhythm control); 946 were &lt;65 of age, 1019 were ≥65–75, and 821 were ≥75 years old. Rhythm (vs. rate) control was pursued in 76.6%, 58.0%, and 33.6% and mean AFEQT-OS changes were 11.1 (SD 16.6), 8.0 (17.0), and 4.7 (18.2) in those aged &lt;65, 65–74, and ≥75, respectively. The GAM showed improvements in AFEQT-OS attenuated with advancing age with both treatment strategies ( Figure ). Linear regression analyses showed lesser improvements in AFEQT-OS as higher age categories (≥65–75 vs. &lt;65, β -1.12 [95% CI, -2.33 – 0.09]; ≥75 vs. &lt;65, β -3.86 [-5.29 – -2.42]), which were mainly driven by lesser improvement in AFEQT-daily activities scores, without differences in AFEQT scores for symptom or treatment concerns ( Table ). Conclusions: In AF patients, HRQoL benefits after treatment were attenuated by advancing age, primarily driven by less improvement in functional limitations, underscoring the need for further research to identify optimal treatment strategies for older adults.

Construction methods and latest applications of kidney cancer organoids

Renal cell carcinoma (RCC) is one of the deadliest malignant tumors. Despite significant advances in RCC treatment over the past decade, complete remission is rarely achieved. Consequently, there is an urgent need to explore and develop new therapies to improve the survival rates and quality of life for patients. In recent years, the development of tumor organoid technology has attracted widespread attention as it can more accurately simulate the spatial structure and physiological characteristics of tumors within the human body. In this review, we summarize the main methods currently used to construct kidney cancer organoids, as well as their various biological and clinical applications. Furthermore, combining organoids with other technologies, such as co-culture techniques and microfluidic technologies, can further develop organoids and address their limitations, creating more practical models. This approach summarizes the interactions between different tissues or organs during tumor progression. Finally, we also provide an outlook on the construction and application of kidney cancer organoids. These rapidly evolving kidney cancer organoids may soon become a focal point in the development of in vitro clinical models and therapeutic research for kidney cancer.

Summary of Professor HUANG Jinchang's experience of electroacupuncture at Baliao acupoints for low anterior resection syndrome of rectal cancer

This paper introduces Professor HUANG Jinchang's experience in treating low anterior resection syndrome (LARS) of rectal cancer. Based on the clinical experience in treating fecal incontinence after rectal cancer surgery, Professor HUANG Jinchang proposes that the primary pathogenesis of LARS is spleen-kidney yang deficiency with internal obstruction of damp turbidity. The treatment approach should focus on strengthening the spleen, warming the kidney, and eliminating turbidity. The Baliao acupoints are specifically selected to eliminate turbidity, promote yang , facilitate the qi flow of the viscera, and regulate the opening and closing of the anus. Emphasis is placed on deep needling at the Baliao acupoints, with flexible acupoint selection based on accompanying symptoms. Additionally, moxibustion and bloodletting cupping are used to restore regular bowel movements and improve the quality of life for patients who have undergone anus-preserving surgery for rectal cancer.