Widespread distribution and altered pain processing in head and neck cancer survivors at long‑term after treatment

Funding for open access publishing: Universidad de Granada/CBUAPurposeRadiotherapy (RT) treatment in head and neck cancer (HNC) patients may induce long-term sequels as pain, which nowadays is not fully understand. Therefore, there is a need of characterization of pain features in HNC to enhance after oncology treatment management. Head and neck cancer survivors develop chronic pain after radiotherapy treatment. The purpose of the current study is to evaluate the presence of pain, pain distribution, and pain processing by means of patient reported outcomes and quantitative sensory testing.MethodsPain pressure threshold (PPT), temporal summation (TS), Brief Pain Inventory (BPI), Widespread Pain Index (WPI), The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and EuroQol5D5L were assessed in 20 head and neck cancer survivors (sHNC) and 20 health-related sex and age-matched controls.ResultsThe sHNC present lower PPT values in both the affected and non-affected side than did the healthy controls, especially in the widespread pain in the body, an altered TS in both affected and non-affected side and lower scores in quality of life and arm dysfunction.ConclusionsFollowing radiotherapy treatment after 1 year, sHNC present widespread pain, hypersensitivity in the radiated area, altered pain processing, upper limb affection, and a QoL diminution. These data provide evidence that a peripheral and central sensitization is happening in sHNC. Future efforts should focus on preventing pain after oncologic treatment. The comprehension about pain and its features in sHNC enhance health professional understanding and allows to tailor an optimal patient-targeted pain treatment.Universidad de Granada/CBU

Role of breathing training programs on quality of life in chronic kidney disease patients

Background: Due to its chronic and progressive nature, chronic kidney disease (CKD) affects patients in many spheres including their perception of quality of life (QOL). Breathing training techniques have shown positive effects on health and QOL for different conditions. Objective: The aim of this study was to perform a scoping review to examine the characteristics related to the application of breathing training on patients with CKD, and to identify the relevant outcomes and target group for the application of breathing training. Methods: This scoping review was performed in accordance with PRISMA-SRc guidelines. We systematically searched three electronic databases for articles published before March 2022. The studies included patients with chronic kidney disease that received breathing training programs. The breathing training programs were compared to usual care or no treatment. Results: A total of four studies were included in this scoping review. The four studies had heterogeneous disease stages and breathing training programs. All the studies included reported positive effects of breathing training programs on QOL of CKD patients. Conclusion: The breathing training programs were able to improve the quality of life of patients with CKD undergoing hemodialysis treatment.Spanish Ministry of Education [grant number FPU: 20/0167

Efficacy of Web-Based Supportive Interventions in Quality of Life in COPD Patients, a Systematic Review and Meta-Analysis

This research was funded by Ministerio de Ciencia, Innovacion y Universidades, grant number FPU: 19/02609, FPU: 17/00408 and FPU: 16/01531 and by University of Granada, grant number FPU: PP20/05.Background: Adults living with Chronic Obstructive Pulmonary Disease (COPD) often have difficulties when trying to access health care services. Interactive communication technologies are a valuable tool to enable patients to access supportive interventions to cope with their disease. The aim of this revision and meta-analysis is to analyze the content and efficacy of web-based supportive interventions in quality of life in COPD. Methods: Medline (via PubMed), Web of Science, and Scopus were the databases used to select the studies for this systematic review. A screening, analysis, and assessment of the methodological quality was carried out by two independent researchers. A meta-analysis of the extracted data was performed. Results: A total of 9 of the 3089 studies reviewed met the inclusion criteria. Most repeated web content elements were educational and involved communication with healthcare professional content. Finally, seven of the nine studies were included in a quantitative analysis. Web-based supportive interventions significantly improved quality of life when added to usual care (SMD = -1.26, 95% CI = -1.65, -0.86; p < 0.001) but no significant differences were found when compared with an autonomous pedometer walking intervention (p = 0.64) or a face-to-face treatment (p = 0.82). Conclusion: This systematic review and meta-analysis suggests that web-based supportive interventions may complement or accompany treatments in COPD patients due to the advantages of online interventions. The results obtained should be treated with caution due to the limited number of studies in this area and methodological weaknesses.University of Granada FPU: PP20/05Spanish Government FPU: 19/02609 FPU: 17/00408 FPU: 16/0153

Relationship between Pain Intensity, Physical Factors, Pronociceptive Pain Modulation Profile and Psychological Vulnerability on Upper Limb Disability in Older Patients with Chronic Shoulder Pain

Background: Chronic shoulder pain is a very prevalent condition causing disability and functional impairment. The purpose of the study was to evaluate the relationship between pain intensity, physical variables, psychological vulnerability, pronociceptive pain modulation profile and disability in older people with chronic shoulder pain. Methods: A cross-sectional study was carried out. A total of 56 participants with non-specific chronic shoulder pain of the “Complejo Hospitalario Universitario” (Granada) and 56 healthy controls were included. The outcomes evaluated were pain intensity (visual analogue scale), physical factors (dynamometry for grip strength), psychological vulnerability (Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia), pronociceptive pain modulation profile (pain pressure algometry) and disability (Quick Disability Arm Shoulder Hand questionnaire). Results: Disability showed a positive correlation with pain and psychological vulnerability (p < 0.05) and a negative correlation with pronociceptive pain variables and dynamometry (p < 0.001). Psychological vulnerability also presented a strong negative correlation with proprioceptive pain variables and dynamometry and a positive correlation with pain (p < 0.05). In regard to the pronociceptive pain modulation profile, a strong negative correlation with pain (p < 0.001) and a positive moderate correlation with dynamometry (p < 0.001) were shown. Conclusions: Our results support a strong association between disability, psychological vulnerability and pronociceptive pain modulation profile in older adults with chronic shoulder pain.German Research Foundation (DFG) FPU: 20/2167

Efficacy in urinary symptom burden, psychological distress, and self‑efficacy of education‑enhanced interventions in prostate cancer patients: a systematic review and meta‑analyses

Background Worldwide, prostate cancer is both the second-most diagnosed cancer and most common solid tumor in men. Prostate cancer patients present with a symptom burden that is compounded by the impact of medical oncology treatment, affecting different domains of their perceived health status. Education active techniques are a key role in chronic disease to increase participation in their recovery. Purpose The purpose of the current review was to examine the efficacy of education-enhanced in urinary symptom burden, psychological distress, and self-efficacy in patients diagnosed with prostate cancer. Methods A wide search of the literature was conducted for articles from their inception to June 2022. Only randomized controlled trials were included. Data extraction and methodologic quality assessment of the studies were carried out by two reviewers. We previously registered the protocol of this systematic review on PROSPERO (CRD42022331954). Results A total of six studies were included in the study. After education-enhanced intervention showed significant improvements in any of perceived urinary symptom burden, one in psychological distress, and one in self-efficacy in the experimental group. The meta-analysis showed that education-enhanced interventions have a significant effect on depression. Conclusion Education-enhanced could have positive effects on urinary symptom burden, psychological distress, and selfefficacy in prostate cancer survivors. Our review was unable to demonstrate the best timing to apply education-enhanced strategies.Universidad de Granada/ CBUAFPU (Formación Profesorado Universitario)The Spanish Ministry of Education (Spain) (FPU: 21/00451, FPU 20/01670, and FPU 19/02609)

Post-COVID Patients With New-Onset Chronic Pain 2 Years After Infection: Cross-Sectional Study

Background: Although pain is common in non-hospitalized post-COVID-19 syndrome, only a few studies have provided information on the pain experience of these patients. Aim: To identify the clinical and psychosocial profile associated with pain in non-hospitalized patients with post-COVID-19 syndrome. Method: In this study there were three groups: healthy control group, successfully recovered group, and post-COVID syndrome group. Pain-related clinical profile and pain-related psychosocial variables were collected. Pain-related clinical profile included: pain intensity and interference (Brief Pain Inventory), central sensitization (Central Sensitization Scale), insomnia severity (Insomnia Severity Index), and pain treatment. Pain-related psychosocial variables were: fear of movement and (re)injury (Tampa Scale for Kinesiophobia), catastrophizing (Pain Catastrophizing Scale), depression, anxiety and stress (Depression, Anxiety and Stress Scale), and fear-avoidance beliefs (Fear Avoidance Beliefs Questionnaire). Results: In all, 170 participants were included in the study (healthy control group n = 58, successfully recovered group n = 57, and post-COVID syndrome group n = 55). Post-COVID syndrome group obtained significantly worse punctuation in pain-related clinical profile and psychosocial variables than the other two groups (p < .05). Conclusions: In conclusion, patients with post-COVID-19 syndrome have experienced high pain intensity and interference, central sensitization, increased insomnia severity, fear of movement, catastrophizing, fear-avoidance beliefs, depression, anxiety, and stres

Barriers and applied activity, quality of life and self‑efficacy in prostate cancer survivors 1 year after completing radiotherapy

Purpose The aims of the study were to assess self-reported physical activity (PA) levels, barriers to PA, quality of life and self-efficacy to manage chronic disease of prostate cancer survivor 1 year after radiotherapy treatment. Methods A cross-sectional case–control study was performed. Prostate cancer survivor patients treated with radiotherapy were recruited from the Radiation Oncology Service of the “Complejo Hospitalario Universitario” (Granada) and compared with age-matched healthy men. Outcomes included were perception of benefits for physical activity and potential barriers (Exercise Benefits/Barriers Scale), physical activity levels assessed by the International Physical Activity Questionnaire (IPAQ), quality of life (EuroQol five-dimension three-levels) and self-efficacy (Self-Efficacy to Manage Chronic Disease). Results A total of 120 patients were included in our study. Significant differences were found between groups with worse results for the prostate cancer patient group in the variable perception of the benefit of physical activity, potential barriers, and physical activity. Regarding quality of life and self-efficacy, significant differences were also observed between groups with a greater score in the control group. Conclusion In conclusion, the results of this study reveal that self-reported PA levels, as measured using the IPAQ, were low in prostate cancer survivors after treatment. Results also showed worse perception of benefits for PA and potential barriers by the cancer survivors. Similarly, the quality of life and self-efficacy to manage chronic disease of prostate cancer survivors was lower.Universidad de Granada/ CBUAThe Spanish Ministry of Education (Grant numbers FPU:20/ 01670, FPU:19/02609, FPU:17/00408)

Radiotherapy-Related Fatigue Associated Impairments in Lung Cancer Survivors during COVID-19 Voluntary Isolation

The author Alejandro Heredia Ciuro and the author Laura Lopez Lopez have received financial support through a FPU ("Formacion Profesorado Universitario") grant of the Spanish Ministry of Education (Spain), (FPU: 17/00408, and FPU: 20/01670).The main objective of this study was to investigate the impairments presented after COVID-19 voluntary isolation by lung cancer survivors that experienced radiotherapy-related fatigue. In this observational study, data were collected after COVID-19 voluntary isolation. Patients were divided into two groups according to their fatigue severity reported with the Fatigue Severity Scale. Health status was assessed by the EuroQol-5D, anxiety and depression by the Hospital Anxiety and Depression Scale, and disability by theWorld Health Organization Disability Assessment Schedule 2.0. A total of 120 patients were included in the study. Patients with severe fatigue obtained higher impairment results compared to patients without severe fatigue, with significant differences in all the variables (p < 0.05). Lung cancer survivors who experienced severe radiotherapy-related fatigue presented higher impairments after COVID-19 voluntary isolation than lung cancer patients who did not experience severe radiotherapy-related fatigue, and showed high levels of anxiety, depression and disability, and a poor self-perceived health status.FPU ("Formacion Profesorado Universitario") grant of the Spanish Ministry of Education (Spain) FPU: 17/00408 FPU: 20/0167

Role of breathing training programs on quality of life in chronic kidney disease patients

Background: Due to its chronic and progressive nature, chronic kidney disease (CKD) affects patients in many spheres including their perception of quality of life (QOL). Breathing training techniques have shown positive effects on health and QOL for different conditions. Objective: The aim of this study was to perform a scoping review to examine the characteristics related to the application of breathing training on patients with CKD, and to identify the relevant outcomes and target group for the application of breathing training. Methods: This scoping review was performed in accordance with PRISMA-SRc guidelines. We systematically searched three electronic databases for articles published before March 2022. The studies included patients with chronic kidney disease that received breathing training programs. The breathing training programs were compared to usual care or no treatment. Results: A total of four studies were included in this scoping review. The four studies had heterogeneous disease stages and breathing training programs. All the studies included reported positive effects of breathing training programs on QOL of CKD patients. Conclusion: The breathing training programs were able to improve the quality of life of patients with CKD undergoing hemodialysis treatment

Abordaje terapéutico de supervivientes de cáncer de pulmón tras tratamiento coadyuvante

El cáncer de pulmón se produce como resultado del proceso de carcinogénesis en el epitelio que reviste el árbol respiratorio desde la tráquea hasta los alveolos pulmonares. Esta patología conlleva un proceso de deterioro progresivo que si no es tratado de forma oportuna lleva a la muerte del paciente. Las terapias oncológicas, entre las que destacan la cirugía, quimioterapia y radioterapia, se aplican sobre estos pacientes para erradicar o disminuir el proceso oncológico. Sin embargo, estas terapias llevan asociadas unos efectos secundarios que afectan al estado de salud y la calidad de vida de estos pacientes, lo que repercute en última instancia en la supervivencia de los mismos. El tratamiento radioterápico ha sido especialmente asociado a un amplio abanico de efectos secundarios, y, sin embargo, existe una falta de consenso en cuanto a las secuelas que padecen los supervivientes de cáncer de pulmón tras recibir dicho tratamiento. Teniendo en cuenta la repercusión de estas secuelas en el estado de salud de los supervivientes de cáncer y sus potenciales implicaciones sobre la supervivencia de los mismos, es necesario profundizar en la caracterización del perfil clínico, e implementar programas terapéuticos que mejoren las variables clínicas y su recuperación. El objetivo general de esta tesis fue caracterizar el perfil clínico de los supervivientes de cáncer de pulmón tras radioterapia, y posteriormente, establecer un marco terapéutico de referencia para mejorar su recuperación. Se han llevado a cabo un total de cuatro artículos científicos con distintas metodologías de estudio. El primer estudio tuvo un diseño observacional de cohorte trasversal con el objetivo de evaluar la influencia de la fatiga como síntoma cardinal, sobre el estado de salud general de los supervivientes de cáncer de pulmón que han recibido tratamiento radioterápico. Los resultados de este primer estudio mostraron que la presencia de fatiga relacionada con el tratamiento radioterápico es una variable clínica relevante, con efectos negativos en los supervivientes de cáncer de pulmón. El segundo estudio tuvo como objetivo evaluar el grado de concordancia entre una valoración presencial y una a distancia mediante tecnología E-Health para la discapacidad física presentada por los supervivientes de cáncer de pulmón. Los resultados de este segundo estudio demostraron que existe una buena concordancia entre los resultados mostrados por una valoración presencial y una realizada a distancia con tecnología e-Health. Para el tercer estudio, se llevó a cabo un diseño de revisión sistemática con meta-análisis de ensayos clínicos, sobre la aplicación de intervenciones basadas en HIIT para mejorar la capacidad al ejercicio de los supervivientes de cáncer de pulmón. Dicho estudio evidenció que las intervenciones basadas en HIIT son un buen método para reducir y mejorar las secuelas de la capacidad al ejercicio de los supervivientes de cáncer de pulmón que reciben tratamiento oncológico. Finalmente, el cuarto estudio tuvo un diseño de revisión sistemática y meta-análisis de ensayos clínicos, donde se observaron los efectos de las intervenciones basadas en hábitos de vida saludable en los supervivientes de cáncer de pulmón. En este estudio se evidenció que las intervenciones basadas en hábitos de vida saludables son un método eficaz para mejorar la calidad de vida, el estado psicoemocional, y los síntomas relacionados con el cáncer de los supervivientes de cáncer de pulmón. En conclusión, esta tesis muestra que existen factores clínicos relacionados con la evolución de los pacientes de cáncer de pulmón que reciben tratamiento radioterápico, que pueden ser evaluados con valoraciones a distancia, y que deben de tenerse en cuenta ya que influyen en el estado de salud y calidad de vida de estos pacientes. Además, se evidencia la existencia de programas terapéuticos efectivos para mejorar las variables clínicas de los supervivientes de cáncer de pulmón, lo que sirve de base para futuros diseños de programas terapéuticos específicos que mejoren el abordaje de estos pacientes.Tesis Univ. Granada.University of Granada, Granada, Spain [FPU: PP20/05]The Spanish Ministry of EducaHon, Spain [FPU:19/02609, FPU:17/00408