Henriksenhenningsen6778
Older patients with cancer constitute a heterogeneous group with varying degrees of frailty; therefore, geriatric assessment with initial geriatric oncology screening is recommended. The Geriatric 8 (G8) and the modified Geriatric 8 (mG8) are promising screening tools with high accuracy and an association with survival. However, evidence is sparse regarding patient-centered outcomes. This protocol describes a study, which aims to address the predictive and prognostic value of the G8 and mG8, with quality of life (QoL) as the primary outcome.
In this single-center prospective cohort study, patients, age ≥70 years with solid malignancies, will be screened with the G8 and mG8 prior to receiving 1st line antineoplastic treatment. Patients will contribute medical record data including; cancer type, Charlson comorbidity index score, performance status, and treatment intent, type, and dosage, at baseline. Patients will complete QoL questionnaires (EORTC QLQ-C30 and ELD-14) at baseline, 3, 6, 9, and 12-months folionNCT04644874.
Geriatric oncology screening may identify a subgroup of older patients with frailty, at risk of experiencing diminishing QoL and poor treatment adherence. With the proposed screening program, patients who require treatment modification and additional support to maintain their QoL may be identified. It is our hope, that these insights may facilitate the formation of national guidelines for the treatment of older patients with cancer. RegistrationNCT04644874.
Daytime urinary incontinence (UI) can have an enormous impact on a child's life, lowering both self-esteem and quality of life. Although most children start therapy after their first visit to our outpatient clinic, no studies have reported on parents' or patients' expectations of care for daytime UI in this setting.
We aimed to explore the expectations of the parents of children referred to an outpatient clinic for daytime UI.
This was a qualitative study that involved performing semi-structured interviews with the parents of children who had been referred for daytime UI (with or without nocturnal enuresis). Interviews took place between July 2018 and October 2018 and continued until saturation was reached. The results were transcribed verbatim and analyzed according to Giorgi's strategy of phenomenological data analysis.
Nine parents of children, aged 5-12 years old, were interviewed, revealing "(Experienced) Health," Self-management," and "Social Impact" as the main themes that influenced parental eut the need to start treatment.
Given the rarity of giant hydronephrosis (GH), ideal surgical approach, assessment of drainage after surgery, expected improvement in renal function and morphological changes in the kidney on follow up have not been studied extensively. https://www.selleckchem.com/products/trolox.html The aim of this study was to investigate the role of ureterocalicostomy (UC) in unilateral GH with respect to its current indications, outcomes and the challenges associated with it.
We retrospectively analysed data of 25 children (up to the age of 18 years) who underwent UC between January 2008 and January 2019 using open, laparoscopic or robotic-assisted approach. Preoperative workup included ultrasonography for pelvic anteroposterior diameter (APD) and cortical thickness (CT), and diuretic scan for split renal function (SRF) and drainage. Patients were followed with ultrasonography and diuretic renal scan at 3 months, after further 6 month and then annually.
The median age was 7 years and median follow-up was 22 months. Eight children underwent UC as salvage procedureetic scan parameters were useful for follow up and for detection of failure. The success rate in our study was 92%. Chief limitations of our study were retrospective nature and lack of comparison with pyeloplasty. Moreover, some cases were performed with minimal invasive techniques, so the study group was heterogenous.
UC offers excellent outcome in children with GH due to primary as well as secondary UPJO. Isolated ultrasonographic or diuretic renogram parameters are not sufficient to predict failure and a combination of them should be used for follow up after UC.
UC offers excellent outcome in children with GH due to primary as well as secondary UPJO. Isolated ultrasonographic or diuretic renogram parameters are not sufficient to predict failure and a combination of them should be used for follow up after UC.
Nowadays there is still no ideal treatment for paediatric overactive bladder. Initial management measures (urotherapy and constipation control), resolve 40% of cases. The second line of treatment in overactive bladder is anticholinergic drugs, above all oxybutynin. Although most patients improve with these therapies, the complete resolution rate is around 30-40%. Sacral transcutaneous electrical nerve stimulation has recently emerged as a new alternative in the management of patients with refractory paediatric overactive bladder. However, only a few studies have been done to compare the effectiveness of this therapy versus conventional drugs.
The objective of the present study is to compare, in children with overactive bladder, the efficacy of the sacral transcutaneous electrical nerve stimulation versus oxybutynin therapy.
We performed a prospective and randomized study of patients with diagnosis of overactive bladder treated with sacral transcutaneous electrical nerve stimulation versus oxybutynin, durate of adverse effects secondary to electrotherapy is significantly lower than those treated with oxybutynin.
Oxybutynin and sacral transcutaneous electrical nerve stimulation are both effective therapies in the management of paediatric overactive bladder. However, electrotherapy has been shown to be a more effective therapy with a complete clinical resolution rate in a larger number of patients. link2 Furthermore, the rate of adverse effects secondary to electrotherapy is significantly lower than those treated with oxybutynin.
Clinicians need accurate, reproducible, fast, and cost-effective grading systems to determine facial functions. There is currently no internationally accepted objective method to report the loss of function at the onset of facial paralysis and subsequent recovery. Our study aimed to test a three-dimensional handheld light scanner's efficacy for grading facial paralysis and monitoring recovery.
Sixty-one healthy volunteers (28 men and 33 women) aged between 20 and 75 years (mean 36.4±11.9 years old) and 22 patients with facial palsy (10 male and 12 female patients) aged between 12 and 77 years (mean 47.6±19.7 years old) were included in the study. link3 The healthy individuals' and patients' facial scans were performed with a three-dimensional handheld scanner during different facial expressions at 3-month intervals. The asymmetry and intensity degree of each facial expression were determined in terms of the root mean square.
After facial paralysis, a significant larger asymmetry value (1.2±0.4mm vs. 2.0±0.8mm and p<0.05) was determined as compared to the control group, while a significant smaller intensity value (2.3±1.2mm vs. 1.7±0.9mm and p<0.05) was observed. At the end of 3 months, both parameters showed a tendency to recover.
Our findings suggest that three-dimensional morphological analyses may be an effective method to grade facial palsy. However, our data need to be confirmed by larger cohort size and more extended follow-up periods.
Our findings suggest that three-dimensional morphological analyses may be an effective method to grade facial palsy. However, our data need to be confirmed by larger cohort size and more extended follow-up periods.
Post-operative pancreatic fistula (POPF) is the most significant cause of morbidity following distal pancreatectomy. Hemopatch™ is a thin, bovine collagen-based hemostatic sealant. We hypothesized that application of Hemopatch™ to the pancreatic stump following distal pancreatectomy would decrease the incidence of clinically-significant POPF.
We conducted a prospective, single-arm, multicentre phase II study of application of Hemopatch™ to the pancreatic stump following distal pancreatectomy. The primary outcome was clinically-significant POPF within 90 days of surgery. A sample size of 52 patients was required to demonstrate a 50% relative reduction in Grade B/C POPF from a baseline incidence of 20%, with a type I error of 0.2 and power of 0.75. Secondary outcomes included incidence of POPF (all grades), 90-day mortality, 90-day morbidity, re-interventions, and length of stay.
Adequate fixation Hemopatch™ to the pancreatic stump was successful in all cases. The rate of grade B/C POPF was 25% (95%CI 14.0-39.0%). There was no significant difference in the incidence of grade B/C POPF compared to the historical baseline (p=0.46). The 90-day incidence of Clavien-Dindo grade ≥3 complications was 26.9% (95%CI 15.6-41.0%).
The use of Hemopatch™ was not associated with a decreased incidence of clinically-significant POPF compared to historical rates. (NCT03410914).
The use of Hemopatch™ was not associated with a decreased incidence of clinically-significant POPF compared to historical rates. (NCT03410914).Cardiac surgeons are occasionally faced with ascending aorta graft kinking following ascending aorta replacement. Although it may be difficult to precisely assess the correct length of the graft during aortic clamping, while performing proximal and distal graft anastomoses on an empty heart, the major reason for graft kinking is its excessive length. Haemolytic anaemia, graft thrombosis or even heart failure have been reported as a consequence of unrecognised and uncorrected kinking of the ascending aortic graft. This paper describes a modification and improvement of an old aortic graft non-clamping technique to solve the problem of kinked tubular graft without resuming cardiopulmonary bypass.
There are no data available regarding the association of dietary diabetes risk reduction score (DDRRS) and risk of cardiovascular disease (CVD) worldwide. We aimed to investigate the association of the DDRRS with the risk of CVD outcomes in a prospective population-based study.
Individuals without CVD (n=2,195) were recruited from participants of the Tehran Lipid and Glucose Study (2006-2008) and followed for a mean of 6.7 years. The DDRRS was determined on the basis of eight components using a validated 168-item food frequency questionnaire. Cox proportional hazard regression models, adjusted for potential confounders, were used to estimate the hazard ratios and 95% confidence interval (CI) of CVD across quartiles of DDRRS.
The mean ± standard deviation age of participants (44.8% male) was 38.8±13.0 years at baseline. Median DDRRS for all patients was 23 (intequartile range 20-26). During follow-up, 77 (3.5%) new cases of CVD were identified. After adjustment for confounding variables, including age, sex, body mass index, physical activity, smoking, energy intake, diabetes, and hypertension, no association was found between DDRRS and risk of CVD (odds ratio, 0.70; 95% CI, 0.36-1.37 [p-value for trend=0.351]).
The findings of this study showed that higher DDRRS is not associated with risk of CVD events.
The findings of this study showed that higher DDRRS is not associated with risk of CVD events.
