Factors influencing life satisfaction in acute myeloid leukemia survivors following allogeneic stem cell transplantation: a cross-sectional study

Background: Allogeneic stem cell transplantation (alloSCT) is the preferred option of postremission therapy for high-risk patients suffering from acute myeloid leukemia (AML). Therefore, monitoring life satisfaction (LS) of long-term survivors following alloSCT is becoming increasingly important for oncologists. The aim of the study was to evaluate individual survivor priority of various general and health-related domains of life and their satisfaction with these domains. Furthermore, we investigated the impact of general and health-related LS on resilience, anxiety, depression and quality of life in AML survivors following alloSCT. Methods: Forty-one AML survivors (median age at time of assessment = 49.0 years) who had undergone alloSCT (median time since transplantation = 3.1 years) were enrolled in the study. Psychosocial parameters were assessed using the following instruments: FLZM (Questions on Life Satisfaction), EORTC QLQ-C30, HADS (Hospital Anxiety and Depression Scale) and the RS-25 (Resilience Scale-25 items). Correlation analyses were computed to reveal the associations between the different questionnaires. Results: Independence from help or care, well-regulated living conditions and financial security contributed positively to LS, whereas being off work due to health-reasons and dissatisfaction with physical aspects were negatively associated to the subjective feelings of overall satisfaction. Moreover, a high quality of life was strongly positively correlated with LS (Spearman’s rho general LS: 0.643 and health-related LS: 0.726, both p < 0.001). A high degree of resilience was also strongly positively correlated with better LS (general LS: 0.700, health-related LS: 0.675, both p < 0.001). Symptoms of anxiety and depression were associated with an impaired general LS (anxiety: −0.674, depression: −0.698, both p < 0.001). Conclusions: Our results indicate that LS should be considered an important key contributor to the survivors’ well-being following alloSCT. Thus, identifying protective psychological and physical factors that relieve stressors is of high importance in order to support long-term AML survivors with their special needs.<br

Securing the appendiceal stump in laparoscopic appendectomy: Evidence for routine stapling?

Background: This metaanalysis aimed to compare endoscopic linear stapling and loop ligatures used to secure the base of the appendix. Methods: Randomized controlled trials on appendix stump closure during laparoscopic appendectomy were systematically searched and critically appraised. The results in terms of complication rates, operating time, and hospital stay were pooled by standard metaanalytic techniques. Results: Data on 427 patients from four studies were included. The operative time was 9 min longer when loops were used (p = 0.04). Superficial wound infections (odds ratio [OR], 0.21; 95% confidence interval (CI), 0.06-0.71; p = 0.01) and postoperative ileus (OR, 0.36; 95% CI, 0.14-0.89; p = 0.03) were significantly less frequent when the appendix stump was secured with staples instead of loops. Of 10 intraoperative ruptures of the appendix, 7 occurred in loop-treated patients (p = 0.46). Hospital stay and frequency of postoperative intraabdominal abscess also were comparable in loop-treated and staple-treated patients. Conclusions: The clinical evidence on stump closure methods in laparoscopic appendectomy favors the routine use of endoscopic staplers

A 4-gene expression score associated with high levels of Wilms Tumor-1 (WT1) expression is an adverse prognostic factor in acute myeloid leukaemia

Wilms Tumor-1 (WT1) expression level is implicated in the prognosis of acute myeloid leukaemia (AML). We hypothesized that a gene expression profile associated with WT1 expression levels might be a good surrogate marker. We identified high WT1 gene sets by comparing the gene expression profiles in the highest and lowest quartiles of WT1 expression in two large AML studies. Two high WT1 gene sets were found to be highly correlated in terms of the altered genes and expression profiles. We identified a 17-probe set signature of the high WT1 set as the optimal prognostic predictor in the first AML set, and showed that it was able to predict prognosis in the second AML series after adjustment for Europe

Sucking behaviour using feeding teats with and without an anticolic system: a randomized controlled clinical trial

BACKGROUND: This study aimed to investigate differences in sucking behavior of infants bottle-fed with vented (so-called anticolic) teats (VTs) and nonvented teats (NVTs). METHODS: Trial design: Prospective, randomized clinical trial. Ninety-six term, healthy infants (aged 1–8 months) were assessed for eligibility. Seventy-three infants remained for intention-to-treat (ITT) and 65 infants (vented group: n = 31; nonvented group: n = 34) for the per-protocol (PP) analysis. During bottle-feeding, sucks/min, pauses/min, amount of formula intake (mL), feeding time (min), heart rate (bpm), respiratory rate (bpm), and oxygen saturation (%) were recorded. In addition, a parental survey was carried out to reveal possible symptoms of infantile colic. Sample-size calculation and confirmatory and exploratory analyses were performed using the Mann-Whitney U test and Fisher’s exact test. RESULTS: Except for the parameter sucking pauses per minute (NVTs > VTs, p = .03), no differences between groups were found with the ITT and PP analysis. After excluding infants with a disproportionately complementary diet (subgroup analysis, infants aged 1–6 months, n = 54) the primary outcome (sucks per minute) showed significant differences (NVTs > VTs, p = .01). The amount of formula intake, feeding time, and cardiorespiratory parameters were similar in both groups. The parental survey did not show any relation between types of feeding teats and possible symptoms of infantile colic. CONCLUSIONS: Compared with an NVT group, infants aged 1–6 months need fewer sucks and pauses when fed with VTs. In both groups, equal amounts of feeding medium and feeding time were observed. With NVT feeding, disruption occurs when the bottle vacuum is released by air from the oral cavity. Therefore, higher sucking frequency is needed to rebuild the oral vacuum for bottle milk flow, which implies higher risk of aerophagia. Overall, we suggest that the VTs provided a more coordinated drinking pattern than did the NVTs, which may have a positive effect on gastric distress