Physical Function and Quality of Life After Resection of Mobile Spine Chondrosarcoma.

Study Design:Retrospective cohort study. Objectives:(1) To assess patient-reported outcomes-physical function, pain, and quality of life-in patients who underwent resection of a mobile spine chondrosarcoma. (2) To assess complications (90 days), readmissions, reoperations, oncological outcomes, and neurologic status. Methods:Thirty-three patients with spinal conventional chondrosarcoma resection between 1984 and 2014 at one hospital were included. The primary outcome measures were-minimally 6 months after surgery-the EuroQol 5 Dimensions (EQ5D), PROMIS-Physical Function, PROMIS-Pain Intensity, and Oswestry (ODI) Disability Index, or Neck (NDI) Disability established in 14 out of 20 alive (70.0%) patients. Complications, readmission, reoperations, oncological outcomes, and neurological status were reported for the complete cohort of 33 patients. Results:After spine chondrosarcoma resection, patients (n = 14) reported worse physical function (median 43, range 22-61, P = .026), worse quality of life (median EQ5D 0.70, range 0.04-1, P = .022), and comparable pain intensity (median 47, range 31-56, P = .362) when compared with US general population values. The median NDI/ODI was 25 (range 0-72) indicating mild to moderate disability. Patients undergoing reoperation had worse patient-reported outcomes than those who did not. Eighteen (55.5%) out of 33 patients suffered complications (90 days), 14 (42.4%) had unplanned readmission, and 13 (39.4%) underwent reoperation. Intralesional resection was associated with increased readmission, reoperation, and recurrence rate. Conclusions:Chondrosarcoma affects quality of life and physical function and its treatment frequently results in complications and reoperations. Our findings can be used to inform future patients about expected outcomes

Increased amino acid turnover and myofibrillar protein breakdown in advanced cancer are associated with muscle weakness and impaired physical function

Muscle wasting in cancer negatively affects physical function and quality of life. This study investigates amino acid metabolism and the association with muscle mass and function in patients with cancer.In 16 patients with advanced cancer undergoing chemotherapy and 16 healthy controls, we administered an intravenous pulse and prime of stable amino acid tracers. We took blood samples to measure the Rate of appearance (Ra), whole body production (WBP), clearance (Cl), and post absorptive whole body net protein breakdown (WBnetPB). Plasma amino acid concentrations and enrichments were analysed by LC-MS/MS. We assessed muscle mass, handgrip/leg/respiratory muscle strength and reported physical activity, quality of life, and physical function.Muscle strength was lower in cancer patients than in healthy controls. Total and limb muscle mass, reported physical activity and WBnetPB were comparable. WBP and Cl of tau-methylhistidine, leucine, glutamine and taurine were higher in cancer patients as well as glycine Cl. Amino acid metabolism was correlated with low muscle mass, strength, physical function and quality of life.Myofibrillar protein breakdown and production of amino acids involved in muscle contractility are up regulated in patients with cancer undergoing chemotherapy and related to muscle weakness and reduced physical outcomes

Measurement of trap density in dielectric film

Method uses basic circuit to examine quality and trap density of film used in insulated gate field effect transistors. Data are measured as function of performance and life expectancy

Associations between health-related quality of life, physical function and fear of falling in older fallers receiving home care

Falls and injuries in older adults have significant consequences and costs, both personal and to society. Although having a high incidence of falls, high prevalence of fear of falling and a lower quality of life, older adults receiving home care are underrepresented in research on older fallers. The objective of this study is to determine the associations between health-related quality of life (HRQOL), fear of falling and physical function in older fallers receiving home care

Do flexible goal adjustment and acceptance help preserve quality of life in patients with Multiple Sclerosis?

Background Goal regulation strategies such as flexible goal adjustment and acceptance are believed to be protective factors in persons with chronic illness, but research on their relative contributions to quality of life in multiple sclerosis (MS) is lacking. Purpose We aimed to test the idea that acceptance and flexible goal adjustment (in contrast to tenacious goal pursuit) may help preserve the quality of life in persons with MS. Method A sample of 117 patients with MS was recruited. They completed questionnaires measuring quality of life (physical functioning, psychological distress), acceptance, flexible goal adjustment, and tenacious goal pursuit. Results Acceptance significantly accounted for variance in all three indexes of quality of life, beyond the effects of demographic and illness characteristics. The role of goal regulation style was less clear. Flexible goal adjustment significantly accounted for psychological well-being only. Surprisingly, tenacious goal pursuit predicted better psychological functioning and less psychological distress. No support was found for the hypothesis that acceptance and flexible goal adjustment would moderate the relation between illness severity and quality of life. Conclusion The findings suggest the potential importance of acceptance in understanding MS patients' quality of life, although its hypothesized protective function could not be confirmed. Further conceptual work on acceptance and goal regulation style is needed, as well as prospective work investigating their causal status

Effect of supervised exercise on physical function and balance in patients with intermittent claudication

Background The aim of the study was to identify whether a standard supervised exercise programme (SEP) for patients with intermittent claudication improved specific measures of functional performance including balance. Methods A prospective observational study was performed at a single tertiary vascular centre. Patients with symptomatic intermittent claudication (Rutherford grades 1–3) were recruited to the study. Participants were assessed at baseline (before SEP) and 3, 6 and 12 months afterwards for markers of lower-limb ischaemia (treadmill walking distance and ankle : brachial pressure index), physical function (6-min walk, Timed Up and Go test, and Short Physical Performance Battery (SPPB) score), balance impairment using computerized dynamic posturography with the Sensory Organization Test (SOT), and quality of life (VascuQoL and Short Form 36). Results Fifty-one participants underwent SEP, which significantly improved initial treadmill walking distance (P = 0·001). Enrolment in a SEP also resulted in improvements in physical function as determined by 6-min maximum walking distance (P = 0·006), SPPB score (P < 0·001), and some domains of both generic (bodily pain, P = 0·025) and disease-specific (social domain, P = 0·039) quality of life. Significant improvements were also noted in balance, as determined by the SOT (P < 0·001). Conclusion Supervised exercise improves both physical function and balance impairment

Quality of Life Following Massive Weight Loss and Body Contouring Surgery: an Exploratory Study.

Reconstructive surgery is a major growth intervention for body improvement, enhancing appearance and psychological well-being following massive weight loss. The psychosocial benefits include greater capacity for social networking, lower scores of body uneasiness, body image satisfaction, improved mental well-being and physical function. However little collective evidence exists regarding the impact of body contouring on patients Quality of Life (QoL) and there is a lack of systematic review and randomised controlled trials (RCTs) with a scarcity of high level evidence. The purpose of this exploratory study was to explore the QoL perceptions, experiences and outcomes of patients who have undergone body contouring following significant weight loss and to explore the relevance and potential utility of the Obesity Psychosocial State Questionnaire (OPSQ) as a valuable QoL outcomes measuring tool for use in clinical research. Data were collected in a community setting in the south of England via digitally recorded semi-structured interviews with twenty participants (18 women and 2 men), who also self-completed the Obesity Psychosocial State Questionnaire (OBSQ). Medical notes were reviewed retrospectively to gather data about body mass index (BMI), co-morbidities, eating profiles/lifestyle, uptake of bariatric surgery and type/number of body contouring procedures undergone. A thematic approach was adopted to analyse the interviews and medical record data, supported by Nvivo7 qualitative software, and a statistical approach to analyse the questionnaire data, supported by Statistical Analysis Software. The results provide unique glimpses of the body contouring interventions for empowering and facilitating a ‘transformation’, a ‘new identity’, a ‘new start’ in life, improved physical function, greater body image satisfaction, a stronger sense of well-being and an improved quality of life. A few of the participants who reported that their weight gain was powered by childhood traumas (abuse, neglect, abandonment) continued to struggle for ‘normality’, with fragile eating control and addictive traits. Eating disordered trauma survivors mentioned post traumatic flashbacks and underlying conflicts that triggered powerlessness and emotional eating. The emotional flooding with psychological and body related memories did not appear to be fully processed or released, despite counselling and binge eating programmes. The participants also confirmed the value of the OBSQ, whilst highlighting its limited set of three questions on feelings of self-efficacy towards eating habits. The study findings show that body contouring optimises quality of life with significant improvement in physical function, body image, mental health and psychosocial function. Further research is warranted to extent the scope of the findings within a sample drawn from multiple treatment centres. This would valuably: • Explore gender, ethnic and cultural variables, important to optimising quality of life. • Clarify distinguishing features between short and long-term QoL outcomes. • Lead to the development of national policy and guidelines on reconstructive ‘body contouring’ surgery following massive weight loss, in line with the call from the British Association for Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) A future multi-centre collaborative study could employ the OBSQ, supplemented by an additional tool to explore factors that influence eating habits such as the three factor eating questionnaire (such as the TFEQ-R1 21 Scale). Such research could enhance understanding of quality of life and long-term weight management