Rehab Centers: Quality of Life in Patients With Muscle Invasive and Non-Muscle Invasive Bladder Cancer.

Quality of life in patients with muscle invasive and non-muscle invasive bladder cancer.

Filed under: Rehab Centers

Support Care Cancer. 2012 Dec 14;
Singer S, Ziegler C, Schwalenberg T, Hinz A, Götze H, Schulte T

PURPOSE: Compared to the literature on other malignancies, data on quality of life (QoL) in bladder cancer are sparse. This study sought answers to the following questions: In what QoL domains do patients with bladder cancer differ from the general population? Do patients with radical cystectomy differ in QoL compared to those who received conservative treatment? Do patients with neobladder generally have better QoL compared to patients with other diversion methods? METHODS: At the beginning of inpatient rehabilitation, N?=?823 patients with bladder cancer were assessed. Data of a representative community sample (N?=?2037) were used for comparison. The questionnaire EORTC QLQ-C30 was used to measure QoL. Multivariate linear regression models were computed to investigate differences between groups. RESULTS: Patients with both non-muscle invasive and muscle invasive bladder cancer reported significantly more problems and worse functioning than the general population. Radiotherapy is associated with clinically relevant more pain, dyspnoea, constipation, appetite loss and decreased social functioning while chemotherapy is associated more with dyspnoea. Cystectomy patients reported more fatigue, appetite loss and decreased role functioning. Male patients ?70 years with conduit experienced more sleep and emotional problems. These effects of urinary diversion were not observed in women and younger patients. CONCLUSIONS: Patients with bladder cancer experience various QoL concerns at the beginning of inpatient rehabilitation. These problems can partly be explained by the type of treatment the patients receive. Type of urinary diversion is relevant for QoL in subgroups of patients.
HubMed – rehab


Physician Involvement in Torture: An Ethical Perspective.

Filed under: Rehab Centers

J Med Humanit. 2012 Dec 14;
Siddiqui NA, Civaner M, Elci OC

Evidence proves that physician involvement in torture is widely practiced in society. Despite its status as an illegal act as established by multiple international organizations, mandates are routinely unheeded and feebly enforced. Philosophies condemning and condoning torture are examined as well as physicians’ professional responsibilities and the manner in which such varying allegiances can be persuasive. Physician involvement in torture has proven detrimental to the core values of medicine and has tainted the field’s commitment to individuals’ health and well-being. Only when this complex issue is addressed using a multilevel approach will the moral rehabilitation of medicine begin.
HubMed – rehab


Preoperative predictors for good postoperative satisfaction and functional outcome in lumbar spinal stenosis surgery – a prospective observational study with a two-year follow-up.

Filed under: Rehab Centers

Scand J Surg. 2012; 101(4): 255-60
Aalto T, Sinikallio S, Kröger H, Viinamäki H, Herno A, Leinonen V, Turunen V, Savolainen S, Airaksinen O

Background and Aims: Lumbar spinal stenosis (LSS) is the most frequent indication for back surgery in adults aged over 65 years, but about one-third of operated patients have less than good/excellent results from the operation. Awareness of outcome predictors and their predictive values may help clinicians in their assessment of the prognosis of patients when considering surgical treatment. Our aim was to study the preoperative predictors in LSS for a good postoperative outcome (satisfaction with surgery and functional improvement) with a two-year follow-up.Material and Methods: LSS patients (n = 102) completed a questionnaire preoperatively and on two-year follow-up. Preoperative patient-related predictors, self-rated health, comor-bidities and preoperative treatment were assessed. Satisfaction with the surgical outcome was assessed with a seven-category scale; satisfaction was determined to be good if the patient response was “condition has considerably improved” or “totally cured”. Other responses (“con-dition has slightly improved” or worse) represented poorer satisfaction. A good functional outcome was determined as >30% relative improvement compared to the presurgery score in the Oswestry Disability Index (ODI).Results: The predictors for good satisfaction were age < 75 years at operation (OR 4.03; 95% CI 1.35-12.02; p = 0.012) and no previous lumbar operation (OR 3.65; 95% CI 1.13-11.79; p = 0.031). Predictors for a good improvement in the ODI score were regular preoperative analgesic use < 12 months (OR 3.40; 95% CI 1.21-9.53; p = 0.020), non-smoking (OR 3.47; 95% CI 1.09-11.03; p = 0.035) and good (above average) self-rated health (OR 3.27; 95% CI 1.06-10.12; p = 0.039).Conclusions: In LSS, regular analgesic treatment preoperatively for 12 months or less, self-rated health above average and non-smoking predicted a good postoperative functional improvement. An age under 75 years and no previous lumbar operation predicted good post-operative satisfaction with the surgery. HubMed – rehab


Coordination of spinal motion in the transverse and frontal planes during walking in people with and without recurrent low back pain.

Filed under: Rehab Centers

Spine (Phila Pa 1976). 2012 Dec 12;
Crosbie J, de Faria Negrão Filho R, Nascimento DP, Ferreira P

ABSTRACT: Study Design. Observational cohort study.Objective. To investigate spinal coordination during preferred and fast speed walking in pain-free subjects with and without a history of recurrent LBP.Summary of Background Data. Dynamic motion of the spine during walking is compromised in the presence of back pain (LBP), but its analysis often presents some challenges. The coexistence of significant symptoms may change gait because of pain or adaptation of the musculoskeletal structures or both. A history of LBP without the overlay of a current symptomatic episode allows a better model in which to explore the impact on spinal coordination during walking.Methods. Spinal and lower limb segmental motions were tracked using electromagnetic sensors. Analyses were conducted to explore the synchrony and spatial coordination of the segments and to compare the control and LBP subjects.Results. We found no apparent differences between the groups for either overall amplitude of motion nor for most indicators of coordination in the lumbar region, however there were significant postural differences in the mid-stance phase and other indicators of less phase locking in controls compared to LBP subjects. The lower thoracic spinal segment was more affected by the history of back pain than the lumbar.Conclusion. Although small, there were indicators that alterations in spinal movement and coordination in subjects with recurrent LBP were due to adaptive changes rather than the presence of pain.
HubMed – rehab



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