scholarly journals Quality of life can be improved by surgical management of giant hepatic haemangioma with enucleation as the preferred option

HPB ◽  
2015 ◽  
Vol 17 (6) ◽  
pp. 490-494 ◽  
Author(s):  
Jianguo Qiu ◽  
Shuting Chen ◽  
Hong Wu
Keyword(s):  
Quality Of Life ◽  
Surgical Management ◽  
Hepatic Haemangioma

Abstract TP295: Stroke Prevention Surgery > Quality of Life and Cognitive Ability to Drive Are Maintained After Surgical Repair of Unruptured Intracranial Aneurysm

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Joan M ODonnell ◽  
Maurizio Manuguerra ◽  
Jemma L Hodge ◽  
Greg Savage ◽  
Michael K Morgan
Keyword(s):  
Quality Of Life ◽  
Intracranial Aneurysm ◽  
Surgical Management ◽  
Cognitive Abilities ◽  
Short Form ◽  
Unruptured Intracranial Aneurysm ◽  
Significant Difference ◽  
Ability To Drive

Background: Studies have questioned the effectiveness of surgery for the management of unruptured intracranial aneurysm (uIA). Few studies have examined the ability to drive and quality of life (QOL) after surgery for uIA. Objective: This study examined the effectiveness of surgical management of uIA by measuring patients’ perceived quality of life and their cognitive abilities related to driving. Methods: Between January 2011 and January 2016 patients with a uIA were assessed using the Quality Metric Short Form 36 (SF36) and the off-road driver screening instrument DriveSafeDriveAware. Reassessments were conducted at the 6-week post-operative follow-up for surgical patients and at 12-month follow-up for surgical and conservatively managed patients. Results: 175 patients enrolled in the study, of which 112(66%) had surgical management of their aneurysm. For the surgical cases who completed all assessments (N=74), there was a trend for the DriveSafe pre-operative mean score of 108 (SD 10.7) to be lower than the 6-week and 12-month post-operative mean scores (111 SD 9.7 and 112 SD 10.2 respectively)(p=0.05). There were no significant changes in DriveAware scores at any epoch or between patient groups nor in the MCS in the surgical group.. There was a significant decline in PCS scores at 6 weeks post-operatively which recovered at 12 months (52 SD 8.1, 46 SD 6.8 and 52 SD 7.1 respectively)( p <0.01). There was no significant difference in 12-month mRS scores between the surgical cases who completed with cases who did not complete all assessments. Conclusion: Surgery for uIA did not affect cognitive abilities for driving at 6 weeks or 12 months after surgery. There was a decline in the QOL in the first months after surgery, however QOL returned to pre-surgical status 12 months after surgery. If the risk of seizures is low and there are no post-operative complications, returning to driving can be recommended.

Case 43

2020 ◽  
pp. 293-300
Author(s):  
Lucinda Barrett ◽  
Bridget Atkins
Keyword(s):  
Quality Of Life ◽  
Surgical Management ◽  
Chronic Infections ◽  
Joint Replacements ◽  
Preventative Measures ◽  
Acute Infections ◽  
Primary Procedure ◽  
Hip Replacements ◽  
Rich Countries

The number of joint replacements performed in resource-rich countries has increased significantly in the last few decades and has allowed a significant improvement in the quality of life for many patients. Despite preventative measures, a small fraction (around 1% for hip replacements) will become infected. These can present as acute or chronic infections. They can also occur at any time after the primary procedure. Late acute infections are usually via the haematogenous route and often present to the acute medical take or via infection services. A prompt, appropriate medical and surgical management strategy is important.

Surgical management for venous leg ulcers: The role of hope, investment and agency

2016 ◽  
Vol 23 (8) ◽  
pp. 1075-1084
Author(s):  
Philippa Tollow ◽  
Jane Ogden
Keyword(s):  
Quality Of Life ◽  
Surgical Management ◽  
Leg Ulcers ◽  
Structured Interviews ◽  
Traditional Treatment ◽  
Venous Surgery ◽  
Traditional Approaches ◽  
Opening Up

A recent systematic review suggests that minimally invasive venous surgery for the treatment of leg ulcers may have a greater impact on quality of life than traditional approaches. A total of 11 participants who had previously undergone surgical management for leg ulcers took part in semi-structured interviews regarding their experiences. Using thematic analysis, three themes were identified: ‘Living in Flux’, ‘Perceptions of Chronicity’ and ‘Expectations’. Surgical treatment may not only improve patients’ quality of life due to treatment of the condition but also by opening up a sense of hope, investment and agency not associated with traditional treatment approaches.

scholarly journals Improved Health-Related Quality of Life After Surgical Management of Severe Refractory Constipation-Dominant Irritable Bowel Syndrome

2015 ◽  
Vol 100 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Jennifer Y. Lam ◽  
Biniam Kidane ◽  
Farouq Manji ◽  
Brian M. Taylor
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Surgical Management ◽  
Short Form ◽  
Health Related Quality ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
Irritable Bowel

Abstract Irritable bowel syndrome (IBS) is the most common of the functional gastrointestinal disorders (FGIDs). Despite its prevalence and health-care costs, there are few effective therapies for patients with severe symptoms. Our objective was to determine whether surgical management would improve health-related quality of life (HRQOL) in severe refractory constipation-dominant FGIDs. From 2003 to 2005, 6 patients underwent total colectomy with end ileostomy or primary anastomosis. They completed Short Form 36 (SF-36) and IBS-36 questionnaires preoperatively and postoperatively. HRQOL was compared with age- and sex-matched Canadian norms using Welch's unpaired t test. Preoperative SF-36 physical and mental health summary scores were significantly lower than Canadian norms (P &lt; 0.0001), while postoperative scores were not significantly different than Canadian norms (P = 0.50 and P = 0.57, respectively). After surgical management, HRQOL in patients with severe constipation-dominant IBS improved from drastically below that of Canadian norms to a comparable level. This finding questions the convention of avoiding operations in IBS patients and demonstrates that surgical management may be suitable for the appropriately screened patient.

scholarly journals Can surgical management of bone metastases improve quality of life among women with gynecologic cancer?

2014 ◽  
Vol 12 (1) ◽  
pp. 250 ◽  
Author(s):  
Tao Ji ◽  
Ramez Eskander ◽  
Yifei Wang ◽  
Kunkun Sun ◽  
Bang H Hoang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bone Metastases ◽  
Surgical Management ◽  
Gynecologic Cancer ◽  
Improve Quality

scholarly journals Systematic Review of Perioperative and Quality-of-life Outcomes Following Surgical Management of Localised Renal Cancer

2012 ◽  
Vol 62 (6) ◽  
pp. 1097-1117 ◽  
Author(s):  
Steven MacLennan ◽  
Mari Imamura ◽  
Marie C. Lapitan ◽  
Muhammad Imran Omar ◽  
Thomas B.L. Lam ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Surgical Management ◽  
Renal Cancer ◽  
Life Outcomes ◽  
Quality Of Life Outcomes

scholarly journals Management of Persons with Hemophilia A with Inhibitors After Emicizumab Approval

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5020-5020
Author(s):  
Anisha Patel ◽  
Karina Raimundo ◽  
Corey Stepule ◽  
Jennifer Whiteley ◽  
Richard H Ko
Keyword(s):  
Quality Of Life ◽  
Disease Management ◽  
Surgical Management ◽  
Hemophilia A ◽  
Qualitative Interviews ◽  
Years Of Experience ◽  
The Us

Abstract Introduction: Emicizumab, a bispecific antibody to factors IXa/X, was approved by the Food and Drug Administration in 2017 for prophylactic treatment of persons with hemophilia A (PwHA) with inhibitors. Compared with other treatments for PwHA, emicizumab has a novel mechanism of action. It is the first hemophilia A (HA) treatment administered subcutaneously and has a much longer half-life than previous treatments; hence, disease management with emicizumab can be different. This study aimed to evaluate how physicians manage HA in patients treated with emicizumab. Methods: This qualitative analysis is the first phase of a planned mixed-methods approach study and comprised 1-hour, blinded telephone interviews with 5 hematologists in all 4 geographic regions of the US. Physicians were included if they met the following criteria: 1) MD or DO degree; 2) board-certified hematologist; 3) practice in the US; 4) ≥2 years of experience post-residency; and 5) currently treat PwHA. To evaluate experience with emicizumab, physicians were also required to have treated a minimum number of patients receiving emicizumab (5 for physicians in hemophilia treatment centers [HTCs] and 3 for physicians in non-HTCs). A total of 5 qualitative interviews were conducted in May and June 2018 to understand the physicians' perspectives on treating PwHA with emicizumab. Interview topics included general management of PwHA, inhibitor screening and testing, management of PwHA with inhibitors, and physicians' experiences treating patients with emicizumab. We report common themes that descriptively emerged from the qualitative interviews, which will inform survey development for the quantitative phase of the study. Results: Of the 5 physicians, 3 were adult hematologists and 4 physicians reported seeing patients in an HTC. All physicians reported having at least 10 years of experience in practice post-residency. Regarding management of PwHA, physicians indicated disease severity, inhibitor status and annual bleed rate as critical factors in guiding treatment decision making. Patients who develop inhibitors require more medical engagement and frequent monitoring. Physicians reported that, from their experience, emicizumab results in a reduction in bleeds, leading to fewer office visits and less monitoring in PwHA with inhibitors. In addition, physicians reported that the need for disease management, even among patients with a phenotype with more bleeding, is lower as a result of emicizumab treatment due to decreased bleed rate and a reduction in need for additional treatments. Physicians reported that emicizumab's subcutaneous, once-weekly dosing leads to improved patients' quality of life and confidence in performing activities without bleeds. Acute bleed management with emicizumab was reported to be slightly different than before, given the boxed warning around concomitant treatment with activated prothrombin complex concentrate; however, the physicians indicated that they still recommend to treat bleeds as soon as one is suspected. Physicians articulated that some questions remain, including the role of immune therapy induction (ITI), use in low-titer inhibitors, and surgical management in patients treated with emicizumab. Physicians reported that there have been no significant access challenges and none of their patients have discontinued therapy; however, long-term monitoring and safety data are needed. Conclusions: This qualitative study suggests that management of PwHA with inhibitors receiving emicizumab is evolving. The interviewed physicians reported that their patients receiving emicizumab experience fewer bleeds and have an improved quality of life. However, questions regarding the role of ITI, surgical management, and long-term safety of emicizumab remain. Future research will provide additional insights into the current management of PwHA with inhibitors treated with emicizumab among US physicians. Disclosures Patel: Genentech Inc: Employment. Raimundo:Genentech Inc: Employment, Other: Ownership interests PLC. Stepule:MedPanel, Inc.: Employment. Whiteley:Genentech, Inc.: Employment, Other: Ownership interests none PLC. Ko:Genentech Inc: Employment; F. Hoffmann-La Roche Ltd: Other: Ownership interests non-PLC.

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