The effects of new methods of physiotherapy in patients with haemophilic arthropathy

Advanced arthropathy mainly of the knee, hip or ankle joint occurs even in young adults with haemophilia. It has been proved that physical training increases isometric muscular strength and proprioceptive performance in haemophilia patients. The aim of this study was to present the new methods of physiotherapy process and their effect in patients with haemophilic arthropathy. Five subjects, aged from 32 to 42 years, with severe haemophilia A or B attended physiotherapy in a outpatient ambulatory setting over a 3-month period. The following treatment modalities were performed: walking on AlterG anti-gravity treadmill, deep penetrating electromagnetic stimulation (Salus Talent), manual physical therapy, mobilization and manipulation techniques, active muscle-strengthening exercises, post isometric relaxation (PIR) muscle energy techniques, as well as exercises for improvement of coordination, postural equilibrium and proprioception exercises using sensorimotor discs. The HJHS (Haemophilia Joint Health Score) has been used to assess the effectiveness of the treatment, VAS scale (Visual Analog Scale) to assess level of pain, TUG test (Timed Up and Go) to assess mobility as well as dynamic and static balance. Strength of the muscles acting on the joints improved, swelling of joints diminished and the level of pain decreased. An improvement of the dynamic and static balance was found as well. The range of motion did not change. Physiotherapy process did not provoke bleeding episodes in patients with haemophilic arthropathy included to the study

Diminishing the Gender-Related Disparity in Survival among Chemotherapy Pre-Treated Patients after Radical Cystectomy—A Multicenter Observational Study

There is a well-documented problem of inferior outcome of muscle-invasive bladder cancer (MIBC) after radical cystectomy (RC) in women. However, previous studies were conducted before neoadjuvant chemotherapy (NAC) was widely adopted to multidisciplinary management of MIBC. In our study, we assessed the gender-related difference in survival between patients who received NAC and those who underwent upfront RC, in two academic centers. This non-randomized, clinical follow-up study enrolled 1238 consecutive patients, out of whom 253 received NAC. We analyzed survival outcome of RC according to gender between NAC and non-NAC subgroups. We found that female gender was associated with inferior overall survival (OS), compared to males (HR, 1.234; 95%CI 1.046–1.447; p = 0.013) in the overall cohort and in non-NAC patients with ≥pT2 disease (HR, 1.220 95%CI 1.009–1.477; p = 0.041). However, no gender-specific difference was observed in patients exposed to NAC. The 5-year OS in NAC-exposed women in ≤pT1 and ≥pT2 disease, was 69.333% 95%CI (46.401–92.265) and 36.535% (13.134–59.936) respectively, compared to men 77.727% 95%CI (65.952–89.502) and 39.122% 95%CI (29.162–49.082), respectively. The receipt of NAC not only provides downstaging and prolongs patients’ survival after radical treatment of MIBC but may also help to diminish the gender specific disparity

Diminishing the Gender-Related Disparity in Survival among Chemotherapy Pre-Treated Patients after Radical Cystectomy—A Multicenter Observational Study

There is a well-documented problem of inferior outcome of muscle-invasive bladder cancer (MIBC) after radical cystectomy (RC) in women. However, previous studies were conducted before neoadjuvant chemotherapy (NAC) was widely adopted to multidisciplinary management of MIBC. In our study, we assessed the gender-related difference in survival between patients who received NAC and those who underwent upfront RC, in two academic centers. This non-randomized, clinical follow-up study enrolled 1238 consecutive patients, out of whom 253 received NAC. We analyzed survival outcome of RC according to gender between NAC and non-NAC subgroups. We found that female gender was associated with inferior overall survival (OS), compared to males (HR, 1.234; 95%CI 1.046–1.447; p = 0.013) in the overall cohort and in non-NAC patients with ≥pT2 disease (HR, 1.220 95%CI 1.009–1.477; p = 0.041). However, no gender-specific difference was observed in patients exposed to NAC. The 5-year OS in NAC-exposed women in ≤pT1 and ≥pT2 disease, was 69.333% 95%CI (46.401–92.265) and 36.535% (13.134–59.936) respectively, compared to men 77.727% 95%CI (65.952–89.502) and 39.122% 95%CI (29.162–49.082), respectively. The receipt of NAC not only provides downstaging and prolongs patients’ survival after radical treatment of MIBC but may also help to diminish the gender specific disparity