A survey to investigate the association of pain, foot disability and quality of life with corns

Background Corns are a common foot problem affecting a large proportion of the population. This study describes the characteristics of corns experienced by 201 participants taking part in a randomised controlled trial to investigate associations between demographic and corn parameters on pain, foot related disability and quality of life (QoL). Methods Pain from the main (index) corn was measured using a visual analogue scale (VAS); foot related disability was assessed with the Foot Disability Questionnaire (now known as the Manchester Foot Pain and Disability Index) and quality of life was recorded with the EQ-5D questionnaire. The effect of demographic and corn parameters on the pain and quality of life outcomes was assessed with analysis of variance (ANOVA) methods. The effect of the same factors on a linear combination of the foot-related disability outcome measures was assessed using multivariate ANOVA methods. Pain was also tested for its mediating properties on the causal pathway between the independent variables and quality of life. Results The mean pain score was 5.29 points on a 10 cm VAS, with females reporting substantively higher pain levels than males. Age affected foot-related disability, with lower levels on all domains of the MFPDI reported in older participants; each year of advancing age was associated with falls of: 0.009 points on the Concern about Appearance (CA) domain; 0.047 points on the Functional Limitation (FL) domain and 0.048 points on the Pain Intensity (PI) domain. Sex and corn type also affected disability, with higher scores reported by females and participants with plantar corns. Conclusions The effect of pain was shown to mediate the relationship between sex and foot-related disability. The presence of plantar corns has a more detrimental effect on QoL than dorsal/inter-digital corns

A mathematical modelling tool for predicting survival of individual patients following resection of glioblastoma: a proof of principle

The prediction of the outcome of individual patients with glioblastoma would be of great significance for monitoring responses to therapy. We hypothesise that, although a large number of genetic-metabolic abnormalities occur upstream, there are two ‘final common pathways' dominating glioblastoma growth – net rates of proliferation (ρ) and dispersal (D). These rates can be estimated from features of pretreatment MR images and can be applied in a mathematical model to predict tumour growth, impact of extent of tumour resection and patient survival. Only the pre-operative gadolinium-enhanced T1-weighted (T1-Gd) and T2-weighted (T2) volume data from 70 patients with previously untreated glioblastoma were used to derive a ratio D/ρ for each patient. We developed a ‘virtual control' for each patient with the same size tumour at the time of diagnosis, the same ratio of net invasion to proliferation (D/ρ) and the same extent of resection. The median durations of survival and the shapes of the survival curves of actual and ‘virtual' patients subjected to biopsy or subtotal resection (STR) superimpose exactly. For those actually receiving gross total resection (GTR), as shown by post-operative CT, the actual survival curve lies between the ‘virtual' results predicted for 100 and 125% resection of the T1-Gd volume. The concordance between predicted (virtual) and actual survivals suggests that the mathematical model is realistic enough to allow precise definition of the effectiveness of individualised treatments and their site(s) of action on proliferation (ρ) and/or dispersal (D) of the tumour cells without knowledge of any other clinical or pathological information