Significant Improvement In Quality Of Life Research Articles

Effects of sodium-glucose co-transporter inhibitors on individual clinical endpoints and quality of life.

Sodium-glucose co-transporter inhibitors (SGLTis) have cardiovascular protective effects. We aimed to assess the effects of SGLTis on individual hard clinical endpoints and quality of life (QoL) in patients with cardiovascular risk factors. Data was searched in PubMed, Embase, Cochrane Library and clinicaltrials.gov databases up to February 2024. Randomized controlled trials (RCTs) comparing SGLTis with placebo were included. The primary outcomes were individual hard clinical endpoints (Subset A) and QoL (Subset B). For Subset A, 13 RCTs including 90413 patients were enrolled (age 66±10.1years, 35.7% female, follow-up 2.4±0.3years); as compared with placebo, SGLTis were associated with significantly lower risk of all-cause mortality [risk ratio (RR): 0.90, 95% confidence interval (CI): 0.86-0.94, P<0.01], cardiovascular mortality (RR: 0.87, 95% CI: 0.82-0.92, P<0.01), hospitalization for heart failure (HF) (RR: 0.72, 95% CI: 0.68-0.76, P<0.01), HF events (RR: 0.72, 95% CI: 0.68-0.75, P<0.01), hospitalization for any cause (RR: 0.91, 95% CI: 0.88-0.93, P<0.01) and myocardial infarction (MI) (RR: 0.92, 95% CI: 0.85-0.99, P=0.03). Notably, the favourable effect of SGLTis on all-cause mortality was more pronounced in younger (<65years) patients (RR: 0.86, 95% CI: 0.81-0.92) and in studies with less female (RR: 0.84, 95% CI: 0.79-0.90). The favourable effect of SGLTis on MI was only observed in patients who received sotagliflozin (RR: 0.47, 95% CI: 0.31-0.73). For Subset B, nine RCTs including 2552 HF patients were enrolled (age 67.8±12.4years, 36.4% female, follow-up 3.4±1.9months); SGLTis were associated with significant improvement in QoL as compared with placebo. In patients with a broad spectrum of cardiovascular risk factors, SGLTis substantially improve individual hard clinical outcomes and QoL.

Self-Induced Nasal Septal Perforation: Rhinotillexomania-A Different Entity From Nose Picking.

Nose picking is a common habit that rarely leads to mutilating self-injury. It is important to distinguish between rhinotillexomania (compulsive nose picking) as a disease and nose picking that results in or contributes to nasal septal perforation (NSP). The aim of this study is to investigate the impact of rhinotillexomania and NSP repair on sinonasal symptoms and quality of life (QoL). Patients with symptomatic NSP due to rhinotillexomania and candidates for surgical repair were included. Sinonasal symptoms and QoL were measured using a visual analogue scale (VAS), Sinus CT scan, Barcelona Smell Test 24 (BAST-24), Sinonasal outcome test (SNOT-22), Nasal Obstruction Symptom Evaluation (NOSE), NOSE-Perf, and Medical Outcome Study Short Form (SF-36). Healthy volunteers without sinonasal disorders (n = 43) were also included. A total of 37 patients with Rhinotillexomania (20 male [54.1%]; mean age, 49.2 years [SD 15.4]) were recruited. Totally 32 patients (86.5%) had NSP with the posterior border anterior to the incisive canal. Follow-up data were registered for 29 patients with a mean follow-up duration of 22.1 months (standard deviation, SD 16.7). The overall success rate of NSP repair was 96.6%. Patients experienced significant improvement in sinonasal symptoms and QoL after surgery. Rhinotillexomania is a distinct entity from nose picking. Multidisciplinary approach including behavior therapy and NSP repair are considered the best approaches to relieve sinonasal symptoms. Placing nasal silicone sheets is recommended when the diagnosis of rhinotillexomania is confirmed. The greater palatine artery flap combined with inverted edges appears to be the most effective approach. Level 3 Laryngoscope, 2024.

Effectiveness of Cannabis Oil as an Adjuvant Therapy in Patients with Severe Knee Osteoarthritis: A Randomized, Double-Blind Study

Purpose: The removal of cannabis from Thailand's narcotic drug list presents both opportunities and challenges for medical use. The effectiveness of cannabis oil in treating severe knee osteoarthritis in patients awaiting total knee arthroplasty was evaluated in this study. Methods: Thirty-two patients with severe knee osteoarthritis, unresponsive to conservative treatment, were enrolled and divided into two equal groups. The control and experimental groups received syrup and cannabis oil, respectively, at night for 30 days. Pain and quality of life (QOL) were assessed using the Numeric Rating Scale (NRS), and the Knee Injury and Osteoarthritis Outcome Score (KOOS), respectively. Liver and kidney functions were also assessed. Results: The experimental group showed a significant reduction in NRS scores compared to the control group (p = 0.00015). Significant improvements were observed in KOOS subscales for pain, activities of daily living (ADL), and QOL (p = 0.01). However, the symptoms subscale improvement was not significant (p = 0.14). When comparing the KOOS subscales, no significant differences were observed between the groups (p &gt; 0.05). Liver and kidney function remained stable in both groups. Despite these improvements, the changes did not reach a minimal clinically important difference (MCID), indicating limited clinical perceptibility to the patients. Conclusions: Cannabis oil was associated with significant improvements in pain, ADL, and QOL in severe knee osteoarthritis. Although improvements did not meet MCID thresholds, observed benefits suggest potential for pain management. Larger controlled studies are recommended to confirm its clinical efficacy in pain management.

Ruxolitinib Cream Monotherapy Improved Symptoms and Quality of Life in Adults and Adolescents with Mild-to-Moderate Atopic Dermatitis: Patient-Reported Outcomes from Two Phase III Studies.

Atopic dermatitis (AD) is associated with itch, skin pain, sleep disturbances, and diminished quality of life (QoL). Ruxolitinib (Janus kinase [JAK] 1/JAK2 inhibitor) cream demonstrated efficacy and safety in adults and adolescents with mild-to-moderate AD in two phase III studies (TRuE-AD1/TRuE-AD2). In TRuE-AD1/TRuE-AD2, significant improvements in itch were observed as early as 12 h following application of ruxolitinib cream. The aim of this paper was to assess additional patient-reported outcomes (PROs) in the vehicle-controlled (VC) and long-term safety (LTS) periods of TRuE-AD1/TRuE-AD2. In the TRuE-AD studies, patients aged ≥12 years with AD were randomized 2:2:1 to apply twice-daily 1.5% ruxolitinib cream, 0.75% ruxolitinib cream, or vehicle cream continuously for 8weeks (VC period). During the LTS period, patients applied the same ruxolitinib cream strength, but on an as-needed basis; patients who initially applied vehicle were re-randomized to apply 0.75% or 1.5% ruxolitinib cream. Pooled data from both study periods were analyzed. PRO assessments included symptoms (itch [Patient-Oriented Eczema Measure, POEM], skin pain [numerical rating scale], and sleep [POEM and Patient-Reported Outcomes Measurement Information System]) and assessments of disease-specific QoL (Dermatology Life Quality Index [DLQI] and the children's version [CDLQI]). A total of 1208 and 1031 patients from the VC and LTS periods, respectively, were included in the analysis. Significant improvements in skin pain were observed within 12h among patients who applied ruxolitinib cream versus vehicle; improvements continued throughout the VC period. Improvements in patient-reported symptoms (including sleep) were observed within 2 weeks (first assessment) of ruxolitinib cream application. At Week 2, significant improvements in symptom burden and overall QoL were observed with ruxolitinib cream (0.75%/1.5%) versus vehicle in POEM (-8.9/-9.8 vs -2.2; both p<0.0001), DLQI (mean changes from baseline, -5.8/-6.1 vs -1.2; both p<0.0001), and CDLQI (-4.3/-5.3 vs -1.3; both p<0.0001). Further symptom burden and QoL improvements were reported during the VC period and were maintained through the end of the LTS period (Week 52). Consistent with the previously reported itch response data, ruxolitinib cream improved skin pain within 12 h of application. Ruxolitinib cream improved patient-reported AD symptom burden and overall QoL by Week 2. Improvements continued or were maintained for 52 weeks. (Graphical abstract and plain language summary available). ClinicalTrials.gov identifiers, NCT03745638 and NCT03745651 (both studies were registered on November 19, 2018).

The Comparison of The Quality of Life Between Conventional Orthognathic Surgery and Surgery-first Orthognathic Surgery in Skeletal Class III Deformity Patients

Objectives: This prospective cohort study aimed to compare the quality of life (QoL) of patients with skeletal Class III deformities undergoing either conventional orthognathic surgery (CS) or surgery-first orthognathic surgery (SF) using the Orthognathic Quality of Life Questionnaire (OQLQ) and the Oral health Impact (OHIP-14) tools. Methods: The OQLQ was translated into Thai. Thirty-four patients were enrolled, with 17 in each group according to their orthodontic treatment plans. Patients completed the OQLQ and OHIP-14 assessments on the day before surgery (T1) and at 1 month (T2), 3 months (T3), and 6 months (T4) post-surgery. Data collection occurred from October 2021 to April 2022. Independent sample T-tests and one-way repeated measures ANOVA were used for statistical analysis (p&lt;0.05). Results: At T1, the QoL was significantly lower in the CS group compared to the SF group. The CS group exhibited significant QoL improvements at T2 (OQLQ) and T3 (OHIP-14) compared to T1. The SF group had a lower QoL at T2 but showed significant improvement at T4 (OQLQ and OHIP-14). Conclusions: There was no significant difference in QoL between the two groups after surgery. Both surgical approaches led to improvements in patients' QoL. Thus, the choice of surgical method should be based on appropriate indications and patient-doctor agreement.

Abstract 4140102: Changes in EQ-5D-5L with Aficamten in Obstructive Hypertrophic Cardiomyopathy (oHCM): the SEQUOIA-HCM Trial

Introduction: In patients with obstructive hypertrophic cardiomyopathy (oHCM), the SEQUOIA-HCM trial demonstrated that aficamten, a next-in-class cardiac myosin inhibitor, improved exercise capacity, heart failure symptoms and hemodynamics compared with placebo. Aficamten’s impact on overall quality-of-life (QoL) in oHCM has not been reported. Hypothesis: Aficamten, compared with placebo, improves QoL as assessed by the EQ-5D-5L. Aims: To describe EQ-5D-5L changes in patients enrolled in SEQUOIA-HCM. Methods: SEQUOIA-HCM (NCT05186818) is a phase III, placebo-controlled trial of adults with symptomatic oHCM randomized to aficamten (n=142) or placebo (n=140) on top of standard-of-care medical therapy. Participants underwent blinded dose escalation over 6 weeks and were treated for 24 weeks followed by a 4-week washout. EQ-5D-5L (ranges from 0 to 1) and overall QoL using the Visual Analogue Scale (VAS; from 0 to 100) was measured at baseline through week 28 with higher scores indicating better QoL. Aficamten treatment effect on EQ-5D-5L was estimated using linear regression (study visits) and mixed effects regression (overall treatment effect) using all follow-up data with model adjustments for baseline EQ-5D-5L score and randomization stratification variables. Results: Mean age (n=282) was 59.1±12.9 years (40.8% women; 79.1% white). Aficamten baseline EQ-5D-5L index and VAS scores were 0.8±0.19 and 71.2±17.9 (placebo: 0.78±0.2; 68.9±18.6), respectively. Aficamten improved the EQ-5D-5L by 0.026 (95% CI: -0.001, 0.052; p=0.056) and the VAS by 2.8 points (95% CI: 0.8, 4.8; p=0.006) versus placebo with significant differences as early as 8 weeks after treatment initiation (p=0.005). After treatment withdrawal at 24 weeks, QoL benefits in aficamten-treated patients decreased compared with placebo (Figure: Index, p&lt;0.001; VAS, p=0.003), with hemodynamic parameters returning to baseline. Conclusions: Aficamten yielded early, sustained and significant improvement in overall QoL compared with placebo. Withdrawal of aficamten was associated with the loss of treatment benefits and perhaps an increased perception of pre-treatment symptoms. These data support a role of aficamten in improving QoL among patients with oHCM.

Effects of Inspiratory Muscle Training in Patients with COPD Exacerbations: A Randomized Controlled Trial

Abstract Objective Pulmonary rehabilitation (PR) is considered for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, the impact of adding inspiratory muscle training (IMT) to PR on inspiratory muscle function is underexplored. This study aimed to evaluate the effects of IMT in addition to PR on inspiratory muscle function, functional exercise capacity (FEC), and quality of life (QoL) in patients with AECOPD. Design 16 patients with AECOPD and a maximal inspiratory pressure (PImax) &lt; 80 cmH2O were randomized into the experimental (PR + IMT) or the control (PR + sham IMT) group for an eight-week intervention. Inspiratory muscle activation was measured using surface electromyography, FEC was examined by six-minute walk distance (6MWD), and QoL was assessed with COPD Assessment Test (CAT). Results The experimental group showed sustained and significant improvements in inspiratory muscle function, 6MWD, and QoL after intervention (all p &lt; 0.05). The experimental group had higher PImax with less diaphragm activation (both p &lt; 0.001) and more improvements in 6MWD and QoL after intervention (both p &lt; 0.05). Conclusions Adding IMT to PR resulted in more improvements in inspiratory muscle function, FEC, and QoL for patients with AECOPD, suggesting IMT as a beneficial addition to PR.

QOL-11. GBM PATIENTS CONTINUE TO FACE BARRIERS TO PERSONALIZED AND COMPREHENSIVE CARE THAT MAY IMPACT LONGEVITY AND QUALITY-OF-LIFE

Abstract We assessed the quality and accessibility of healthcare services provided to Glioblastoma (GBM) patients across the United States through an online survey distributed among the OurBrainBank community and partners and promoted on social media. A total of 297 patients or caregivers completed the survey (85% caregivers; 15% GBM patients). Median age at diagnosis was 57, lower than the national average of 64. 78% of our respondents described having some college education, and 69% had commercial insurance. Preliminary results revealed that 69% were informed about tumor testing. Among those informed, 64% did not have any molecular testing beyond initial diagnostic tests. For all respondents, 65% were not informed about storing tissue for future testing, and 79% reported not having their tissue stored for possible treatments or clinical trial qualification. Additionally, 52% reported no discussion of seeking a second opinion, and 64% reported not being offered enrollment in any clinical trial. Overall, people living with GBM face significant barriers to achieving comprehensive and personalized care. Lack of tumor testing and storage present missed opportunities for future access to emerging therapies that could improve individual outcomes. Over half of patients had no discussion about seeking a second opinion and were not offered enrollment in clinical trials, highlighting significant barriers to accessing life-extending or quality-of-life (QOL) improving treatments. Compared to the general population affected by GBM, survey respondents represented a disproportionately young and urban population, suggesting potential bias in who is able to respond to the survey. This may underestimate the challenges faced by patients with additional barriers. We are implementing strategies to reach a more geographically diverse participant group, particularly in rural areas. Ongoing targeted recruitment will further elucidate barriers to patient-centered care in GBM, with the potential for significant improvements in survival and QOL.

Effect of Weight Loss Interventions on the Symptomatic Burden and Biomarkers of Polycystic Ovary Syndrome : A Systematic Review of Randomized Controlled Trials.

Polycystic ovary syndrome (PCOS) is common in women of reproductive age and is associated with obesity. Clinical guidelines recommend weight loss, but the impact on the clinical manifestations of PCOS is unclear. To quantify the effect of weight loss interventions on clinical features of PCOS, compared with usual care. MEDLINE, Embase, PsycINFO, CINAHL, Cochrane, Web of Science, and trial registries were searched from inception through June 2024. Randomized controlled trials comparing interventions aiming to reduce weight against usual care, including lower-intensity weight loss interventions in people with PCOS. Conversations with people with PCOS informed the outcomes. Pairs of independent reviewers screened studies, extracted data, and assessed risk of bias (RoB). Outcomes included glycemic control (Homeostasis Model Assessment for Insulin Resistance [HOMA-IR], fasting insulin and glucose), hormonal markers (free androgen index [FAI] and other sex hormones), menstrual frequency, hirsutism, and PCOS-related quality of life (QoL). Pooled mean differences were obtained from random-effects meta-analysis with Knapp-Hartung adjustment. Primary analyses included 29 comparisons with 1529 participants: 13, 12, and 4 comparisons were judged as high, some, or low RoB, respectively. Twelve used behavioral interventions, 9 used glucagon-like peptide-1 (GLP1) agonists, and 8 used other weight loss medications. Weight loss interventions were associated with significantly greater improvements in HOMA-IR (mean difference, -0.45 [-0.75 to -0.15]; I 2 = 24%), FAI (mean difference, -2.03 [-3.0 to -1.07]; I 2 = 48%), and menstrual frequency (mean difference, 2.64 [0.65 to 4.63]; I2 = 43%). There was no evidence that weight loss interventions were associated with clinically or statistically significant improvements in hirsutism, QoL, or other sex hormones, which may be due to the limited power of the available data. There was high statistical heterogeneity in the interventions, comparators, and outcomes, largely unexplained by sensitivity and subgroup analyses. Weight loss interventions were associated with improvements in some important features of PCOS and should be considered as a routine treatment option for people with PCOS. National Institute for Health and Care Research School for Primary Care Research. (PROSPERO: CRD42022367488).

Person Profile Dementia Intervention in Long-Term Care: A Stepped-Wedge Cluster-Randomized Trial

ObjectivesWe aimed to assess the efficacy of a person-centered care intervention in improving quality of life (QoL) for people with dementia in long-term care facilities. DesignThis study was a stepped-wedge cluster-randomized clinical trial of monthly person-centered outcome measurements, followed by collaborative nurse-led person profile interventions involving nursing staff and family members, compared with monthly person-centered outcome measurements alone. Setting and ParticipantsWe included people with a medical diagnosis of Alzheimer's disease or vascular dementia or with clinical symptoms of dementia from 23 long-term care facilities in the German-speaking part of Switzerland. MethodsThe primary outcome was QoL, as assessed using the QUALIDEM. Secondary outcomes were the QUALIDEM subscales and the Integrated Palliative Care Outcome Scale for People with Dementia subscales. The study duration was 15 months, and linear mixed-effect models were used for the analysis. ResultsWe recruited 240 people with dementia from 23 long-term care facilities. Modeling 1143 observations, we found a statistically significant positive intervention effect of 2.6 points according to the QUALIDEM (95% CI, 1.34–3.86; P < .001; total QUALIDEM intervention: 67; 95% CI, 64.8–69.1 vs 64.4; 95% CI, 62.3–66.4 for the control). We also found positive effects of the intervention on all secondary outcomes. Conclusions and ImplicationsOnce-a-month person profile interventions based on person-centered outcome measurements provided a small but significant improvement in QoL. Thus, our findings suggest a potential benefit to the broader implementation of person profiles involving nursing staff and family members in long-term care facilities.

Variability of quality-of-life measurements and reporting in randomised controlled trials of pancreatic cancer: a systematic review

ObjectivesThis systematic review aims to evaluate the methodology used in pancreatic cancer (PC) randomised controlled trials (RCTs) measuring quality of life (QOL) and focuses on the type, frequency, survey compliance...

Effectiveness of Schroth Therapy in Improving Self-Perception, Body Image, and Quality of Life in Patients with Adolescent Idiopathic Scoliosis: A Systematic Review

Introduction: Adolescent idiopathic scoliosis is a structural spinal deformity that not only affects physical health but also has significant psychosocial consequences, such as body image disturbances, reduced self-perception, and diminished quality of life (QoL). Schroth therapy, a physiotherapeutic intervention designed to address scoliosis through three-dimensional exercises, has shown promise in managing these outcomes. This systematic review aims to evaluate the effectiveness of Schroth therapy in improving self-perception, body image, and QoL in adolescents with AIS. Methods: A systematic review was conducted following PRISMA guidelines. Studies published between 2015 and 2024 were identified using PubMed, Embase, and Cochrane Library databases. Randomised controlled trials (RCTs) involving adolescents aged 10-18 years with AIS, receiving Schroth therapy as the primary intervention, were included. Outcomes measured were self-perception, body image, and QoL, assessed using tools like the SRS-22/23 and WRVAS. The risk of bias was evaluated using the Pedro scale. Results: Six studies, with sample sizes ranging from 28 to 60 participants, were included in this review. The Schroth therapy group demonstrated significant improvements in self-perception, as measured by the Walter Reed Visual Assessment Scale (WRVAS), with a between-group difference of 6.5 points (95% CI: 3.2 to 9.9, p &lt; 0.01, F = 169.5) reported by Buyukturan et al. (2024). Additionally, improvements in the self-image domain of the SRS-22 questionnaire were observed, with a mean change of 0.149 (95% CI: 0.001 to 0.297, p = 0.049) noted by Zhang et al. (2024). In terms of quality of life (QoL), one study by Kocaman et al. (2021) found a 15% increase in overall SRS-22 scores (p = 0.02), while the combined SE + ASSE group exhibited significant improvements in QoL compared to the SE-only group (p = 0.019) as shown by Khaledi et al. (2024). While other measures, such as Cobb angle and back muscle endurance, showed significant results, the focus of this review highlights the notable benefits of Schroth therapy on self-perception and QoL. Conclusions: Schroth therapy appears effective in enhancing self-perception, body image, and quality of life in adolescents with AIS. While current evidence supports its psychosocial benefits, further long-term studies with larger sample sizes and more sensitive assessment tools are needed to validate these findings.

Effectiveness of hybrid comprehensive telerehabilitation in women with heart failure - subanalysis of the TELEREH-HF RCT

Abstract Background Despite the known benefits of cardiac rehabilitation, it remains underutilized among women. In particular, little is known about the effectiveness of hybrid comprehensive telerehabilitation (HCTR) in women with heart failure (HF). Purpose: The purpose of this study was to assess effectiveness and safety of HCTR in women with HF. Methods: The present analysis formed part of TELEREH-HF multicenter, randomized trial that enrolled 850 HF patients (NYHA I-III, LVEF ≤ 40%). Patients were randomized 1:1 to HCTR plus usual care (UC) or UC alone. Patients underwent either an HCTR (1 week in hospital and 8 weeks at home, five times weekly) or UC with observation. The effectiveness of HCTR was assessed by changes in peak oxygen consumption (VO2 peak), workload duration (t) in cardiopulmonary exercise test and quality of life (QoL) based on Medical Outcome Survey Short Form 36 Questionnaire (SF-36). Measurements were made before and after intervention/observation. Results: Women constituted 11.5 % of population in the TELEREH-HF study. Forty women in HCTR group and 44 women in UC group completed HCTR and observation respectively. HCTR resulted in significant improvement in VO2peak, workload duration and QoL. We did not observe these favorable results in the UC group except for an increase workload duration. In the HCTR group, there was a significantly greater improvement in physical component of QoL than in the UC group. All results are presented in Table 1. In neither group were there deaths nor major adverse events related to exercise training. Conclusion In women with HF, hybrid comprehensive telerehabilitation is safe and resulted in a significant improvement in physical capacity and QoL.

Atrial tachyarrhythmia prevention by Shensong Yangxin after catheter ablation for persistent atrial fibrillation: the SS-AFRF trial.

Despite advances in technology and techniques, the recurrence rate of persistent atrial fibrillation (AF) following catheter ablation remains high. The Shensong Yangxin (SSYX) capsule, a renowned traditional Chinese medicine formula, is used in the treatment of cardiac arrhythmias. This trial aimed to investigate whether the SSYX can improve clinical outcomes in patients who have undergone catheter ablation for persistent AF. A multi-centre, randomized, double-blind, placebo-controlled clinical trial was conducted at 66 centres in China among 920 patients with persistent AF undergoing first ablation. Participants were randomized to oral SSYX, 1.6 g (.4 g/granule) thrice daily (n = 460), or matched placebo (n = 460) for 12 months. The primary endpoint was recurrent atrial tachyarrhythmias lasting for ≥30 s following a blanking period of 3 months. Secondary endpoints included time to first documented atrial tachyarrhythmias, AF burden, cardioversion, stroke/systemic embolism, changes in echocardiographic parameters, and quality-of-life (QoL) score. Analyses were performed according to the intention-to-treat principle. A total of 920 patients underwent randomization (460 assigned to SSYX group and 460 assigned to placebo group). During the follow-up of 12 months, patients assigned to SSYX had a higher event-free rate from recurrent atrial tachyarrhythmias when compared with the placebo group (12-month Kaplan-Meier event-free rate estimates, 85.5% and 77.7%, respectively; hazard ratio, .6; 95% confidence interval .4-.8; P = .001). Patients assigned to receive SSYX had a better QoL score at 12 months compared to those randomized to placebo. There was no significant difference in the incidence of serious adverse events between the two groups. Treatment with SSYX following radiofrequency catheter ablation for persistent AF reduced the incidence of recurrent atrial tachyarrhythmias and led to clinically significant improvements in QoL during a 12-month follow-up in a Chinese population.

Quality of Life of Breast Cancer Women under Treatment at a Tertiary Care Center of Western Maharashtra

Background: ‘Breast cancer’ the most common cancer amongst females in India. Having good Quality of life (QoL) among the patients undergoing treatment is one of the vital and significant factors for ensuring holistic approach to treatment and well-being of cancer patients. The present study was conducted to assess the QoL and its determinants among breast cancer patients undergoing treatment at a tertiary care institute in western Maharashtra. Material and Methodology: 300 histopathologically confirmed breast cancer patients undergoing treatment at a tertiary care centre were divided into three groups to include 100 patients in each group. Group 1 (patients with duration of treatment 1 to 2 years) Group 2 (patients with duration of treatment 2 to 5 years) and Group 3 (more than 5 years). Validated tool Function Assessment of Cancer Therapy Breast specific (FACT-B) questionnaire was used to collect information on QoL and analysed using appropriate statistical tests. Results: Mean age of patients was 53.2 + 10.08 years, 136 (45.33%) were from age group 51 to 65 years. Majority of the patients 106 (35.33%) were educated till secondary schooling and 172 (57.33 %) were belonging to the middle-upper class. Lump in breast was most common presenting symptom in 235 (78.33%) cases followed by nipple retraction. 275 (91.67 %) cases had infiltrating ductal Carcinoma and 144 (48%) patents were in Stage II cancer. Over all mean FACT-B score for QoL was 104.02 + 18.65 out of 141. Mean FACT-B score for Group 1, Group 2 and Group 3 was 88.18 +17.20, 105.89 + 11.78 and 118.28 + 12.45 respectively with (p&lt; 0.05), suggests significant improvement in QoL with increase in time elapsed since treatment. Conclusion: Socio-demographic factors, type of surgery and duration of treatment had significant effect on QoL among breast cancer patients. Apropos physicians, paramedic staff and domestic care givers need to be sensitised on importance of QoL for collective and deliberate efforts to achieve holistic care. QoL can be made integral part of breast cancer treatment and management policy or programme.

Parametric Analysis of Mobile Money Adoption and Women Financial Inclusion in Kogi State - Nigeria

An ever-increasing body of research and empirical evidence has demonstrated the positive impact of mobile money on individuals, households and businesses, especially in Sub-Saharan Africa, where there were almost 400 million registered accounts at the end of 2018. Mobile money reduces transaction costs for users and helps households to better manage their cash flows; it allows firms to invest and build capital over time, fostering the creation and expansion of business; and it facilitates faster and more efficient government transfers. These benefits have enabled many mobile money users to realise significant quality of life improvements. However, the impact of mobile money on women financial inclusion has not been fully analysed or investigated. To address this evidence gap, this study assesses the impact of mobile money across twenty-on (21) local governments areas of Kogi state - Nigeria. Something which, to our knowledge no previous study has done. This study explores the parametric effect of mobile money on women financial inclusion using cross-sectional data collected from 400 women across twenty-one LGAs of Kogi state in Nigeria. The probit regression results illustrate that mobile money is significant and positively related to women financial inclusion in Kogi state. In addition, economic activity positively plays a significant role in improving women financial inclusion, while gender discrimination and family financial resilience inversely reduces women financial inclusion in the state. Based on these empirical results, this study recommends the following. First, it is important that government at all level devise means to ensure and broaden usage of mobile money by of provision of communication networking, and internet services, especially in rural areas. This will go a long way in aiding and increasing individuals’ usage of mobile phone and money, hence promotion of financial inclusion among women. Secondly, there is need to enhance women economic engagement, most especially in the rural areas. This will boost their financial transactions, savings, and financial stability, thus stimulate their financial inclusion. Thirdly, while it may be unrealistic for gender equality but there is need to enforce gender discriminating law to give women sense of belonging and full participation to thrive their financial inclusion. Lastly, government at local level are also advised to increase and ensure financial stability and support families in building financial resilience. This can increase women financial inclusion.

Improvement of quality of life in women ≤ 25-years-old with chronic pelvic pain following stenting of nonthrombotic iliac vein compression.

Stenting of nonthrombotic iliac vein compression for chronic pelvic pain (CPP) is controversial, especially in young populations. The current study evaluated the effects of iliac vein stenting on CPP through the assessment of quality-of-life (QoL) and pain scores in female patients ≤25-year-old. A retrospective single site cohort study was conducted for 30 female patients who were treated with left common iliac vein (LCIV) stenting for CPP. QoL was assessed before and after stenting using the following assessments: International Pelvic Pain Society (IPPS), Pelvic Congestion Syndrome (PCS), Pelvic Pain and Urinary Urgency Frequency (PUF), Rome III IBS, ancillary symptoms assessment, and pain scores. Secondary evaluation of the accuracy of radiologic interpretations of iliac vein compression on CT and MRI was also performed. Finally, commonly associated comorbidities within this population were assessed. Patient reported outcomes in 30 iliac vein stent patients demonstrated improvements in QoL post-stenting as demonstrated through significant reductions in IPPS, PCS, and pain scores (p = .0103, .0156, and .0092, respectively). Many of the cross-sectional imaging studies that were read by the interpreting radiologist as normal or mild compression were later identified as moderate or severe by the interventional radiologist clinically evaluating the patient. These patients went on to show significant compression on venography and intravascular ultrasound with associated clinical improvement after stenting. Significant improvements in QoL were identified in young women with CPP after LCIV stenting. Similarities in the clinical presentation of common comorbidities and misinterpretation of cross-sectional imaging studies may make the identification of pelvic venous disease more challenging. Our findings endorse the need for further research on stenting in young women with venous origin CPP through comparative outcomes studies and blinded randomized controlled trials.

Outcomes reported in elective colorectal cancer surgery research for older patients: A scoping review.

Colorectal cancer rates are increasing in older populations, who often have comorbidities and face higher surgical risks and mortality rates. Therefore, surgical outcomes, such as 5-year mortality rates, may not be appropriate, necessitating a focus on postoperative quality of life. However, determining optimal postoperative outcome measures for older colorectal cancer patients poses a challenge. This scoping review aimed to explore currently available data describing postoperative outcomes used to assess older patients undergoing elective colorectal cancer surgery. We conducted a comprehensive literature search of major electronic databases from inception to March 2023. Studies exploring frail or older individuals with colorectal cancer undergoing elective surgical procedures, and which reported postoperative outcomes, were included. Outcomes were categorized as surgery-specific versus person-centred and summarized using narrative synthesis. The type and rate of surgery-specific outcomes were tabulated. Of 1366 identified citations, 16 studies focused on person-centred outcomes and 66 reported exclusively on surgery-specific outcomes. Nine 'person-centred outcome' studies reported discharge destination, primarily home discharge. Postoperative delirium ranged from 8.2% to 18.1% in six studies. Four studies explored geriatric syndromes, three analysed activities of daily living, and three studies reported significant quality of life improvement. The 66 'surgery-specific outcome' studies assessed mortality (N = 61); length of stay (N = 40); postoperative complications (N = 47); readmission (N = 18); reoperation (N = 16); and survival (N = 42). Person-centred outcomes are underreported, but crucial for guiding patient management. Older patients require adequate information about their postoperative recovery period to enhance wellbeing. Future research must address this gap to improve care for older people undergoing elective colorectal cancer surgery.

A nationwide double-blind phase III randomized clinical trial (RCT) of olanzapine vs. prochlorperazine for the treatment of refractory nausea in patients receiving moderately or highly emetogenic chemotherapy among NCI Community Oncology Research Program (NCORP) practices.

185 Background: Despite advances in antiemetics given during chemotherapy, nausea remains a clinically significant issue and greatly impairs quality of life (QOL). Current ASCO guidelines recommend olanzapine or prochlorperazine for refractory chemotherapy-induced nausea. However, there is a lack of direct empirical comparisons to establish their relative efficacy. Methods: The URCC NCORP Research Base and 21 NCORP practices enrolled 1,363 chemotherapy-naïve patients with breast cancer starting a high/moderate emetogenic chemotherapy regimen to this Phase III RCT (NCT03367572). Antiemetics were prescribed per ASCO guidelines. Screening occurred during Cycle 1, followed by randomization for Cycle 2. Those with ≥ moderate nausea (≥3 on a 1-7 scale) in Cycle 1 and willing to continue were randomized (1:1:1 ratio) into 3 arms (n=310): 1) ASCO regimen plus olanzapine (OLZ), 2) ASCO regimen plus prochlorperazine (PC), or 3) ASCO regimen plus placebo. Nausea was evaluated using a four-day home diary (4x daily), with the primary outcomes being changes in average (avg) and maximum (max) nausea. FACT-G measured QOL. Intent-to-treat primary analyses (ANOVA and Cohen’s Δ effect size) evaluated whether OLZ or PC improved nausea, testing between-arm differences in nausea change from Cycle 1 to 2 compared to placebo at a p=0.025 significance level corrected for 3 arms. Results: The median age was 50.7y, with 80.7% White/12.3% Black/5.8% Asian/4.2% Latino, and evenly distributed across groups. The change in avg nausea score was statistically significant for the OLZ (avg change = −1.07: Cohen’s Δ = 0.49) and PC arms (avg change = −0.94: Cohen’s Δ = 0.38) compared to the placebo (avg change = −0.50; p &lt;0.001 vs OLZ, p = 0.01 vs PC). Similar but larger changes were noted for change in max nausea score in the OLZ (max change = −2.57: Cohen’s Δ = 0.86) and PC arms (max change = −2.01: Cohen’s Δ = 0.47) against the placebo (max change = −1.30; p &lt;0.001 vs OLZ, p &lt;0.01 vs PC). The OLZ arm had a clinically significant change in overall QOL from pre-chemo to Cycle 2 vs placebo (FACT-G mean difference = +4.91; p = 0.006) but the PC arm vs placebo did not (FACT-G mean difference = −0.87; p = 0.61). OLZ exhibited superiority over PC in terms of changes in max nausea (mean difference = −0.56; p = 0.023) and QOL (FACT-G mean difference = +5.80; p = 0.006), but not for avg nausea (mean difference = −0.13; p = 0.418). Conclusions: OLZ and PC, when added to ASCO guidelines, each significantly reduces refractory nausea. OLZ demonstrates superior max nausea control with clinically and statistically significant improvements in QOL. This study fills the gap in empirical comparisons and solidifies OLZ's position as a promising intervention for refractory nausea. Clinical trial information: NCT03367572 .

Assessing Long-Term Quality of Life Concerns Through Survivorship Clinic in Head and Neck Cancer Patients.

To characterize the concerns of head and neck cancer (HNC) patients and discern changes in quality-of-life (QoL) during long-term follow-up. Retrospective review. Survivorship clinic at a tertiary academic center. A retrospective review was conducted on HNC patients seen in our survivorship clinic between 1/2020 and 1/2024 using the University of Washington Quality of Life (UW-QOL) Questionnaire. Three hundred and forty-two patients were seen for 914 encounters. Patients were divided into 4 groups: pretreatment (n = 326), 0 to 12 months posttreatment (n = 247), 1 to 3 years posttreatment (n = 248), and more than 3 years posttreatment (n = 64). The average follow-up after treatment was 459 days (range: 0-5.2 years). Multivariable analysis revealed significant improvements in overall QoL, health-related QoL, social-emotional composite scores, activity, anxiety, appearance, chewing, mood, pain, speech, and recreation at more than 1-year posttreatment compared to less than 1-year posttreatment. However, declines were noted in saliva and taste scores. No differences in scores were observed between patients 1 to 3 years posttreatment and those >3 years posttreatment. At all timepoints before and after treatment, top concerns were pain, activity, and swallowing. Patients with oral cancer followed for more than 1-year posttreatment had worse scores in appearance, chewing, pain, and speech compared to those with oropharyngeal cancer. Understanding the evolving concerns of HNC patients is imperative for enhancing care. Most QoL domains improve at 1-year posttreatment except for saliva, taste, swallowing, and shoulder function. QoL scores stabilize after 1-year post-treatment. Pain, activity, and swallowing remain the top concerns at all time points.