SF-36 Health Survey Research Articles

Aerobics Exercise in Two Post Parkinson’s Disease Care: Effective Treatment among Group Exercise Versus Individual Supervised Exercise

Objective To compare group supervised exercise (GE) and individual exercise (IE) in a hospital setting, in terms of improvement in quality of life, gait and balance and social interaction. Study Design and Setting This was a prospective cohort study in Jos (Plateau State) Participants Sixty seven patients completed the outcome data. Measures Daily activities were measured by the bartel index, tinetti scale (balance and gait), short form SF-36 health survey to compare quality of life. Results No statically significant differences were found between the two groups regarding the symptoms of PD. After exercise supervised by physiotherapist both group showed significant improvement from each measurement. These improvements were better in individual than group supervised exercise patient with all functionality scales with a smaller margin. Conclusion Individual supervised exercise is more effective than group supervised exercise in term of improvement in quality of life, activities of daily living, gait and balance and social interaction.

THE PECULIARITIES OF PSYCHO-EMOTIONAL CONDITION OF WOMEN WITH INFERTILITY AND INTRAHEPATIC CHOLESTASIS

The adverse impact of the difficult socio-economic situation on the processes of birth and early neonatal morbidity and mortality requires focusing greater attention on the study of the role of psychological factors in solving demographic problems. In recent years, there has been a significant increase in the percentage of women with infertility in anamnesis, who received modern reproductive technologies, and in these patients, pregnancy is not only an obstetric but also a psychological issue. These women present a complex of symptoms of vasomotor and nervous/psychic disorders already at the preconceptive stage.
 In the modern society, pregnancy often goes with chronic stress related to reproductive disorders in anamnesis, which is intensified by social conflicts, environmental and technological disasters. The search for ways to control the body’s reactivity, which are based on the understanding of the mechanisms of development of adaptation and deadaptation processes, opens prospects of working out ways of targeted correction of pathological conditions during gestation. Women with infertility, especially those with a long unfavorable experience of treating it and/or with perinatal losses in anamnesis, present significant psycho-emotional disorders. The aim of this research is to assess the psycho-emotional condition of women with intrahepatic cholestasis who got pregnant owing to assisted reproductive technologies.
 We have conducted a complex research of 80 women ,who got pregnant owing to assisted reproductive technologies: 40 women with manifestations of intrahepatic cholestasis (basic group) and 40 women without such manifestations (comparison group), 50 women with spontaneous pregnancy and its physiological course made up the reference group. We used questionnaires, tests and projective methods (to identify the type of the psychological component of the gestational dominant, the type of self-perception of pregnancy, to measure the level of reactive (situational) and personal anxiety, depression); the SF-36 Health Survey; the calculation of the Kerdo index and
 A.M. Wein’s questionnaire (to assess vegetative homeostasis). The Spielberg-Hanin scale of reactive and personal anxiety (1976) is the only method that makes it possible to measure anxiety in a differentiated way: as a personal quality and a condition.
 Taking into consideration the symptoms of intrahepatic cholestasis, which significantly influence the pregnant women’s general condition, as well as the established vegetative disorders, sleep disorders, high or extremely high anxiety, signs of depressive conditions, one can presume a decrease in the quality of life of these patients.
 Women with intrahepatic cholestasis who got pregnant owing to assisted reproductive technologies, require the assessment of their vegetative and psycho-emotional condition and the correction of the established disorders, in order to normalize the quality of their life and achieve favorable perinatal results.
 The pregnant women’s psycho-emotional condition is a great extent of the result of interaction of two components: the extragenital one, which includes somatic diseases and individual typological peculiarities of a woman’s physical status, and the genital one, i.e. the physiological peculiarities of the reproductive system. The optimization of a woman’s psychic condition contributes to a more favorable course of pregnancy and the birth of a healthy child.

Socioeconomic position and quality of life among Colombian hypertensive patients: The mediating effect of perceived stress

This study aimed to assess the relationships between socioeconomic position, perceived stress and Health Related Quality of Life (HRQoL) of patients with hypertension. Data were obtained using the baseline survey of 258 patients from the Social Determinants and Inequities in the Control of Blood Hypertension Program (ProDSICHA). HRQoL was measured with SF-8 Health Survey. Socioeconomic position was measured using education, and the MacArthur Scale. Stress was measured with Perceived Stress Scale. A higher educational level was associated with a higher perception of stress (Coeff = 0.78, p = 0.019). Also, a lower position in the community was associated with a higher perception of stress (Coeff = −0.56, p = 0.027). A higher level of perceived stress was associated with a higher level of mental health (Coeff = 0.64, p = 0.000). No statistical differences were found in the relations between socioeconomic position and physical HRQoL. These findings warrant further research to understand the role of socioeconomic position in physical HRQoL.

A Survey of Male Sexual Functioning in the General Population in the Northern Netherlands

Aim. To describe age-related male sexual functioning in a representative Dutch general population using internationally accepted and validated questionnaires. Material and Methods. A random selection of 1404 men from the general populations in the Netherlands were asked to participate. Men primarily completed the International Index of Erectile Function (IIEF), but also provide medical history, details of daily activities, the Body Image Scale, the SF-36 Health Survey, the Hospital Anxiety and Depression Scale, and the Multidimensional Fatigue Inventory. Participants’ representativeness was assessed by comparison with data from the Dutch Central Agency for Statistics and the Dutch Health Monitor. Main outcome measurements were the age-related domain scores of the IIEF. Results. Responses were obtained from 333 of 1404 men (24%). Participant characteristics were broadly comparable to those of the Dutch population, except for underreporting homosexuals, immigrants, age <40 years and mid-level educations. Overall, 39% of respondents were sexually inactive, and inactivity increased significantly with advancing age. All IIEF domain scores decreased markedly with increasing age, except for overall satisfaction. The prevalence rates of mild and severe erectile dysfunction were 22% and 5%, respectively, and both increased significantly with advancing age. Conclusion. Four of the IIEF domain scores (i.e., erectile function, orgasmic function, sexual desire, and intercourse satisfaction) decrease with increasing age, whereas the overall satisfaction domain scores remain stable throughout life.

Reliability and Validity of the Turkish Version of SF-12 Health Survey.

The aim of this study is to determine the psychometric properties of the Turkish version of the SF-12 Health - a widely used scale that assesses health - related quality of life - and to assess whether its psychometric properties are as good as with the 36 items long version (SF-36). The study included a total of 190 participants including 138 young adults aged from 18 to 29 years (22.04±2.35) and 52 older adults aged from 60 to 80 years (67.27±5.22). The relationships between EQ-5D-3L, CES-D and SF-12 scales were investigated for content, convergent and divergent, criterion-related and the known-groups construct validity. In order to assess reliability, internal consistency and item-total correlation coefficients were calculated and test re-test analyses were conducted. The internal consistency coefficients of the scale were found to be satisfactory (for the components α=0.73 and 0.72). Consistent with the original study, physical and mental components of the SF-12-TR were found to be strongly correlated with the components of the SF- 36 and explained, respectively, 86.6% and 92.4% of the variance. The components of the SF-12-TR were found to be moderately or strongly correlated to the sub-dimensions of the EQ-5D-3L and CES-D, which measure the same structures, while they were unrelated or weakly correlated with the sub-dimensions measuring different structures. The findings indicated that the psychometric properties of the Turkish form of SF-12-TR are similar to the original version, and the SF-12-TR can be used as an alternative to the SF-36-TR in clinical and research settings in our country.

The Impact of the Covid-19 Pandemic in Boccia Players with Cerebral Palsy in Brazil, Applying the Sf-36 Health Survey Questionnaire

The Impact of the Covid-19 Pandemic in Boccia Players with Cerebral Palsy in Brazil, Applying the Sf-36 Health Survey Questionnaire

Variable clinical features of patients with Fabry disease and outcome of enzyme replacement therapy

Fabry disease (FD) is an X-linked lysosomal storage disorder caused by a deficiency in the enzyme α-galactosidase A due to mutations in the GLA gene. This leads to an accumulation of globotriaosylceramide (GL-3) in many tissues, which results in progressive damage to the kidneys, heart, and nervous system. We present the molecular and clinical characteristics and long-term outcomes of FD patients from a multidisciplinary clinic at the University of California, Irvine treated with agalsidase beta enzyme replacement therapy (ERT) for 2–20 years. This cohort comprised 24 adults (11 males, 13 females) and two male children (median age 45; range 10–68 years). Of the 26 patients in this cohort, 20 were on ERT (12 males, 8 females). We describe one novel variant not previously reported in the literature in a patient with features of ‘classic’ FD. The vast majority of patients in this cohort presented with symptoms of ‘classic’ FD including peripheral neuropathic pain, some form of cardiac involvement, angiokeratomas, corneal verticillata, hypohidrosis, tinnitus, and gastrointestinal symptoms, primarily abdominal pain. The majority of males had clinically evident renal involvement. An annual eGFR reduction of −1.88 mL/min/1.73 m2/yr during the course of ERT was seen in this cohort. The most common renal presentation was proteinuria, and one individual required a renal transplant. Other common findings were pulmonary involvement, lymphedema, hearing loss, and significantly, three patients had strokes. Notably, there was a high prevalence of endocrine dysfunction and low bone mineral density, including several with osteoporosis.While enzyme replacement therapy (ERT) cleared plasma GL-3 in this cohort, there was limited improvement in renal function or health-related quality of life based on the patient-reported SF-36 Health Survey. Physical functioning significantly declined over the course of ERT treatment, which may be, in part, due to the late initiation of ERT in several patients. Further delineation of the phenotypic and genotypic spectrum in patients with FD and the long-term outcome of ERT will help improve management and treatment options for this disease.

Aerobics Exercise in Two Post Parkinson’s Disease Care: Effective Treatment among Group Exercise Versus Individual Supervised Exercise

Objective: To compare group supervised exercise (GE) and individual exercise (IE) in a hospital setting, in terms of improvement in quality of life, gait and balance and social interaction. Study Design and Setting: This was a prospective cohort study in Jos (Plateau State). Participants: Sixty seven patients completed the outcome data. Measures: Daily activities were measured by the bartel index, tinetti scale (balance and gait), and short form SF-36 health survey to compare quality of life. Results: No statically significant differences were found between the two groups regarding the symptoms of PD. After exercise supervised by physiotherapist both group showed significant improvement from each measurement. These improvements were better in individual than group supervised exercise patient with all functionality scales with a smaller margin. Conclusion: Individual supervised exercise is more effective than group supervised exercise in term of improvement in quality of life, activities of daily living, gait and balance and social interaction.

Sleep-disordered breathing and quality of life in patients with chronic cerebrovascular diseas

Introduction. Chronic cerebrovascular disease (CeVD) is usually accompanied by a decrease in the quality of life (QoL). A possible cause of decreased QoL is sleep-disordered breathing. Aim: to assess the frequency of sleep-related breathing disorders and QoL in patients with chronic CeVD. Materials and methods. The study included 100 patients (50 men and 50 women), with an average age of 65 (58; 74.5) years. Cognitive (MoCA-test) and affective disturbances (HADS), severity of daytime sleepiness and fatigue (the Berlin questionnaire to identify patients at risk for the sleep apnea syndrome) were assessed. QoL was evaluated using the SF-36 health survey. Sleep-disordered breathing (SDB) was verified using cardiorespiratory monitoring. The apnoea/hypopnoea index was also calculated. Results. On average, the cognitive impairment score was 25 (23, 27) points; the anxiety level was 6 (4; 9), depression level was 6 (3.5; 8), daytime sleepiness and fatigue were 4 (1.5; 7). QoL was reduced in the majority of patients. SDB was registered in 82% of patients. Multiple comparisons found no differences in QoL scores depending on the presence and severity of sleep-related breathing disorders. Patients with a history of stroke had higher scores for general health ( p = 0.06), mental health ( p = 0.01), and overall psychological health ( p = 0.04). The stroke patients were younger ( p = 0.02) and experienced less daytime sleepiness and fatigue ( p = 0.007). Women had lower QoL scores compared to men. At the same time, the women were older than the men ( p = 0.006) and had higher levels of anxiety ( p = 0.0008). Statistically significant correlations were found between the various QoL components and age, anxiety and depression levels, severity of daytime sleepiness and fatigue, and cognitive dysfunction, but not the apnoea/hypopnoea index. Conclusion. Patients with chronic ischaemic CeVD and SDB had reduced QoL; however, the mental health component remained slightly higher than the physical component. The main factors associated with a decrease in QoL were age, female gender, anxiety and depression levels, and excessive daytime sleepiness/fatigueo.

Quality of life in adults with achondroplasia in the United States

Studies examining quality of life (QoL) in adults with achondroplasia are limited. We report on QoL and psychiatric illness diagnoses in a modern cohort of adults with achondroplasia. SF-36 Health Survey scores from adults with achondroplasia were compared to general population scores. Demographics, physical measurements, and psychiatric illness diagnoses were recorded from medical records. The achondroplasia population had lower scores than the general population in all categories. Most people with achondroplasia (56%) had a diagnosed psychiatric illness. Those with a diagnosed psychiatric illness had lower scores in physical functioning, role limitations due to physical and emotional health, and mental health. Pain, energy/fatigue, and general health scale scores were roughly equivalent (<2 points difference). Social functioning was >15 points higher in individuals with psychiatric illness diagnoses. Adults with achondroplasia report significantly lower physical and mental well-being and had nearly 3× the rate of psychiatric illness diagnosis than the general population, highlighting the importance of total care for this population. Healthcare providers must understand the physical and mental comorbidities of achondroplasia, beyond short stature and orthopedic issues, so they can proactively improve QoL across the lifespan for patients and families.

Effectiveness of focused extracorporeal shock wave therapy in the treatment of carpal tunnel syndrome : Arandomized, placebo-controlled pilot study.

SummaryBackgroundThe carpal tunnel syndrome is the most common entrapment neuropathy in the general population. A conservative treatment should be considered in mild to moderate cases. The aim of this study was to assess the effect of a focused extracorporeal shock wave therapy in the treatment of mild to moderate carpal tunnel syndrome.Material and MethodsIn this study 30 patients were randomly assigned into 2 groups. Subjects in the study group received three sessions of focused extracorporeal shock wave therapy, whereas the control group underwent a sham therapy. Patients were evaluated 3 and 12 weeks after treatment. The primary outcome was the visual analogue scale score. Secondary outcome measurements included hand grip strength, Boston Carpal Tunnel Syndrome Questionnaire, SF-36 Health Survey and electrodiagnostic measurements.ResultsA significant improvement of visual analogue scale at week 3 (p = 0.018) and week 12 (p = 0.007) as well as hand grip strength at week 12 (p = 0.019) could be observed in the study group. The study group showed a significantly better sensory nerve conduction velocity at week 12 than the control group, before correcting for multiple testing, and also a significant improvement in distal motor latency of the median nerve at week 12 (p = 0.009) as well as in both questionnaires (SF-36 subscale bodily pain, p = 0.020 and severity symptom scale, p = 0.003). No such improvement was observed in the control group.ConclusionFocused extracorporeal shock wave therapy is an effective and noninvasive treatment method for mild to moderate carpal tunnel syndrome.

Positive Aspects of Caregiving Among Family Caregivers of Individuals With Dementia

Traditionally, caregiving for individuals with dementia has been viewed as a negative experience. Understanding positive aspect of caregiving and related factors is important to improve health among family caregivers. We analyzed baseline data from an ongoing dyadic sleep education trial for individuals with dementia and their caregivers (N=21 dyads; mean age 70.8± 11.1 for caregivers, 80.5± 8.3 for care-recipients). The Positive Aspects of Caregiving (PAC 9-item) was used to assess subjective satisfaction with caregiving. Other measures included Zarit Burden Interview (ZBI), SF-12 Health Survey (SF-12v2), Revised Memory and Behavior Problems Checklist (RMBPC), and Pittsburgh Sleep Quality Index (PSQI). Pearson correlations and t-tests were calculated for analyses. Caregivers most frequently endorsed that caregiving enabled them to appreciate life more (n=16 agreed a lot). Caregivers who began providing care within the first few months of the care-recipient needing care (n=16) had greater positive aspects of caregiving than those who started providing care sometime later (n=5) (36.37±7.33 versus 25.8±8.29, p=0.01). Caregivers with higher PAC scores had lower ZBI score (r=-0.49, p=0.02), better mental health on the SF-12v2 (r=0.53, p=0.01), less distress related to care-recipient behaviors on the RMBPC (r=-0.50, p=0.02), and lower PSQI subscale (perceived sleep quality) score (r= -0.46, p=0.04). Findings suggest that higher positive caregiving experience was associated with better mental health and sleep quality, and less burden and distress from the care-recipients behaviors. More research is needed to better understand this relationship and to determine possible interventions to increase positive aspects of caregiving.

Incobotulinum toxin type A for treatment of chronic myofascial pain.

This study assessed the effectiveness of incobotulinum toxin type A (IBTx) for chronic myofascial pain affecting the masseter and temporal muscles. Twenty two patients who received a diagnosis of chronic masseter and temporalis myofascial pain were evaluated by using a visual analog pain scale (VAS), digital pressure algometry, and the SF-36 Health Survey at baseline (T0), before IBTx injection. Patients were again evaluated at 2 months (T1) and 7 months (T2) after IBTx injection. VAS scores for pain significantly differed (P = 0.029, Friedman test). Post-hoc tests showed a significant reduction in pain at 2 months (T0-T1) and 7 months (T0-T2) (P = 0.011 and P = 0.028, respectively; Wilcoxon test) but not between 2 and 7 months (P = 0.676; Wilcoxon test). There was no significant difference in pressure algometry values (P = 0.385, Friedman test). Quality of life (QOL) assessment showed a significant difference (P = 0.002, Friedman test). Post-hoc tests showed a significant improvement in QOLat 2 months, but no significant difference at 7 months (P = 0.004 and P = 0.260, Wilcoxon test). IBTx injection resulted in safe, effective short-term pain relief for patients with chronic facial pain affecting the masseter and temporalis muscles.

Predicting the 10-year risk of death from other causes in men with localized prostate cancer using patient-reported factors: Development of a tool.

ObjectiveTo develop a tool for estimating the 10-year risk of death from other causes in men with localized prostate cancer.Subjects and methodsWe identified 2,425 patients from the Surveillance Epidemiology and End Results—Medicare Health Outcomes Survey database, age <80, newly diagnosed with clinical stage T1-T3a prostate cancer from 1/1/1998-12/31/2009, with follow-up through 2/28/2013. We developed a Fine and Gray competing-risks model for 10-year other cause mortality considering age, patient-reported comorbid medical conditions, component scores and items of the SF-36 Health Survey, activities of daily living, and sociodemographic characteristics. Model discrimination and calibration were compared to predictions from Social Security life table mortality risk estimates.ResultsOver a median follow-up of 7.7 years, 76 men died of prostate-specific causes and 465 died of other causes. The strongest predictors of 10-year other cause mortality risk included increasing age at diagnosis, higher approximated Charlson Comorbidity Index score, worse patient-reported general health (fair or poor vs. excellent-good), smoking at diagnosis, and marital status (all other vs. married) (all p<0.05). Model discrimination improved over Social Security life tables (c-index of 0.70 vs. 0.59, respectively). Predictions were more accurate than predictions from the Social Security life tables, which overestimated risk in our population.ConclusionsWe provide a tool for estimating the 10-year risk of dying from other causes when making decisions about treating prostate cancer using pre-treatment patient-reported characteristics.

Impact of a Postoperative Intervention Educational Program on the Quality of Life of Patients with Hip Fracture: A Randomized, Open-Label Controlled Trial.

The objective of this study was to determine the impact of a postoperative educational intervention program on the health-related quality of life (HRQoL) of patients with hip fracture using a controlled clinical trial in a randomized, multicenter study. In total, 102 patients (45.5%) from trauma units at the two University Hospitals of the province of Cáceres received the educational program, whereas 122 (54.5%) did not. Patients were consecutively included in either an intervention or a control group. Patients from the intervention group received an educational program during admission and the postoperative period. Patients from the control group did not receive any educational program. These patients were managed according to routine protocols. The patients were predominantly female (76.3%), aged 84.6 years (SD 6.1). All dimensions in both groups at 12 months showed a significant decrease with respect to baseline, except for bodily pain in both groups (p = 0.447; p = 0.827) and social functioning in the intervention group (p = 0.268). Patients receiving the educational program showed higher levels in the dimensions of the Mental Component Summary (MCS-12) (p = 0.043), vitality (p = 0.010), and social functioning (p < 0.001), as well as in the dimensions of the SF-12 health survey questionnaire of HRQoL 12 months after surgery. In conclusion, our study of the intervention group showed that there were significant improvements in MCS-12, vitality, and social function dimensions compared to the control group.

Качество жизни пациентов в резидуальном периоде ишемического инсульта и определяющие его факторы

Stroke remains one of the leading causes of disability; therefore, it is important to investigate factors that might affect the quality of life of stroke patients and refine rehabilitation technologies for better functional gains. The aim of this paper was to study possible factors that determine the quality of life in the residual ischemic stroke period. The MOS SF-36 health survey was completed by 210 patients undergoing early rehabilitation at a stroke care unit. The study revealed a significant decline in some quality of life indicators correlated with advancing age and severity of the condition (correlation coefficient –0.5; p &lt; 0.01). Both physical and mental component summary scores were lower in women than in men (p &lt; 0.01 and p &lt; 0.001, respectively). High scores on the majority of the applied subscales were observed in the patients with a vertebrobasilar stroke, as compared with those who had suffered a carotid stroke (p &lt; 0.05). The early rehabilitation regimen complemented with acupuncture in the acute stroke period and the subsequent rehabilitation program at the Rehabilitation Hospital significantly contributed (р &lt; 0.05) to improving the quality of life of stroke patients in the residual stroke period.

Health Problems in Conservatoire Students: A Retrospective Study Focusing on Playing-Related Musculoskeletal Disorders and Mental Health.

To gain insight into the prevalence and characteristics of physical health problems and mental health problems in first-, second- and third-year conservatoire students of the classical music department. Also, differences in mental health and general health were investigated between students with playing-related musculoskeletal disorders (PRMDs) and students without PRMDs. Eighty-nine classical music students of Codarts Rotterdam, University of the Arts, were asked to complete a questionnaire targeting PRMDs (components derived from Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians, MPIIQM), mental health (Mental Health Inventory-5), and self-rated general health (SF-1 from Short Form health survey SF-12). The response rate was 52% (n=46). Of all participants, 17.8% (n=8) had experienced PRMDs in the past 12 months and 45.7% (n=21) of the students reported poor mental health (MHI-5≤60). Students experiencing PRMDs in the past 12 months reported poorer general health compared to students without PRMDs (43.8 vs 67.1 [range 0-100], p=0.012). No significant difference was found between the groups with regard to mental health (62.0 vs 66.5 [range 0-100], p=0.522). The burden of PRMD complaints in this population of conservatoire students seems relatively low. However, the number of students facing mental problems in this population is a cause for concern. Conservatoires should focus on the subject of mental health in their curricula to increase more awareness and prevent mental problems. To investigate possible causality between PRMDs and general health, prospective studies are needed.

16935 Fractional CO2 laser therapy as a treatment for radiation-induced fibrosis: A pilot study

Radiation therapy is an effective cancer treatment; however, significant cutaneous adverse events can occur from the skin’s exposure to ionizing radiation. Chronic radiation dermatitis (CRD) can be a debilitating, disfiguring, and painful condition. Currently there are limited treatment options for CRD, and no criterion standard of care exists. In our clinical study we examine fibrosis, a manifestation of CRD, which can cause pain, functional impairment and decrease patients’ quality of life. Fractional laser therapy (FLT) has been shown to treat fibrosis associated with hypertrophic scars, leading to tissue repair. We hypothesized that FLT can also be used in the treatment of CRD to normalize the fibrotic process and induce normal skin remodeling. In this prospective pilot study (n = 22), each treatment site undergoes CO2 fractionated laser therapy and has an internal control not receiving the intervention. Subjects have a total of 3 laser treatments, and 3 follow-up visits 3-12 months after the last treatment. The SF-36 Health Survey and Skindex16 scales are subjective measures used to assess the impact of CRD on quality of life. Objective measurements include skin compliance, skin thickness, and erythema and pigmentation measured by the Derma Torque Meter, ultrasound, and DermaSpectrometer respectively. Currently, 10 subjects have enrolled in this study. Preliminary results show improved cosmesis, patient satisfaction and skin elasticity. While initial analysis indicates enhanced outcomes, we are conducting further research to determine the utility of fractional laser therapy in the treatment of chronic radiation dermatitis.

Role of a modified epigastric port in reducing post operative pain and causing early ambulation in a patient undergoing laparoscopic cholecystectomy as compared to a standard four port procedure, a randomized controlled study

Background: Standard four port laparoscopic cholecystectomy is the gold standard in the treatment of gall stones. Modified epigastric port laparoscopic cholecystectomy may be considered an alternative, as this procedure maintains the advantages of four ports and does not require any special set of instruments. In this study we aimed to see whether this procedure is comparable to the standard four port laparoscopic cholecystectomy based on the primary objectives of postoperative pain score, degree of ambulation, time to return to normal activities.Methods: Consecutive patients due to undergo laparoscopic cholecystectomy, meeting all the predefined criteria were recruited into the study. The group A was assigned to receive intervention in the form of modified epigastric port laparoscopic cholecystectomy. The group B was assigned to receive intervention in the form of standard four port laparoscopic cholecystectomy. Patients in group A were compared with patients in group B based on multiple pre-defined parameters.Results: Pain scores were significantly better in group A. Degree of ambulation at was significantly better in group A. In respect to the time to resumption of normal activities there was no significant difference between the two groups. When comparing the quality life at 1 month following surgery with SF-36 health survey, the patients in group A did better than patients in group B with respect to the six scales. Conclusions: Modified epigastric port laparoscopic cholecystectomy appears to be significantly better than the standard four port cholecystectomy in terms of postoperative recovery.

The role of loco-regional treatment in long-term quality of life in de novo stage IV breast cancer patients: protocol MF07-01Q.

Since more solid evidence has emerged supporting the effectiveness of loco-regional treatment (LRT), clinicians consider LRT a treatment option for selected de novo stage IV breast cancer (BC) patients. This is the first report on long-term quality of life (QoL) in a cohort of patients who were randomized to receive either LRT and then systemic treatment (ST) or ST alone in the protocol MF07-01. We aimed to evaluate QoL in patients living at least 3years since randomization using scores from the SF-12 health survey. SF-12 (V2) forms were completed during visits of patients who were living 36months after the randomization. We first calculated PCS-12 (Physical Health Composite Scale) and MCS-12 (Mental Health Composite Scale) scores from de novo stage IV BC patients and compared them with the scores of patients diagnosed with stage I-III BC who lived more than 3years. Further, PCS-12 and MCS-12 scores were compared between the LRT and ST groups with de novo stage IV BC. Additionally, general health, physical functioning, role functioning, bodily pain, vitality, mental health, and social functioning were evaluated and compared between the groups. Considering age-related changes in QoL, we also compared PCS-12 and MCS-12 scores of patients below or above 55 and 65years of age. Responses to four additional questions (compare your physical health, mental health, daily activities, and energy currently vs. at diagnosis of BC) were recorded, considering cultural differences. There were 81 patients in this analysis; 68% of patients (n= 55) had LRT, and 32% (n= 26) received ST. General health was good or very good in 62% (n= 34) in the LRT group and 66% (n= 17) in the ST-only group (p= 0.63). Mean PCS-12 score was 40.8+1.6, and mean MCS-12 score was 43.4+2.0 (p= 0.34 and p= 0.54, respectively). PCS-12 and MCS-12 score difference was lower than that of the general Turkish population (PCS-12 = 49.3+12.8 and MCS-12 = 46.8+13.0) and stage I-III BC patients (PCS-12 = 51.1 ± 0.5, MCS-12 = 45.7 ± 0.6). PCS-12 and MCS-12 scores were similar between the LRT and ST-only groups in patients younger and older than 55 and 65, but QoL scores were much better in stage I-III BC patients younger than 65 when compared to the scores of those with de novo stage IV BC. Although treatment with or without LRT did not affect physical health, mental health, daily activities, and energy at 3years vs. at diagnosis of BC in de novo stage IV BC patients (p> 0.05), these variables were significantly better in stage I-III BC patients (p< 0.001). The current MF07-01Q study demonstrates that patient who had LRT has similar physical and mental health outcomes compared to ST only in a cohort of patients who lived longer than 3years. Trial registration This study is registered on clinicaltrials.gov with identifier number NCT00557986.