scholarly journals Malignant Bowel Obstruction in Advanced Gynecologic Cancers: An Updated Review from a Multidisciplinary Perspective

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Yeh Chen Lee ◽  
Nazlin Jivraj ◽  
Catherine O’Brien ◽  
Tanya Chawla ◽  
Eran Shlomovitz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bowel Obstruction ◽  
Treatment Guidelines ◽  
Clinical Trial Design ◽  
Major Complication ◽  
Evidence Based ◽  
Malignant Bowel Obstruction ◽  
Gynecologic Cancers ◽  
The Impact

Malignant bowel obstruction (MBO) is a major complication in women with advanced gynecologic cancers which imposes a significant burden on patients, caregivers, and healthcare systems. Symptoms of MBO are challenging to palliate and result in progressive decompensation of already vulnerable patients with limited therapeutic options and a short prognosis. However, there is a paucity of guidelines or innovative approaches to improve the care of women who develop MBO. MBO is a complex clinical situation that requires a multidisciplinary approach to ensure the appropriate treatment modality and interprofessional care to optimally manage these patients. This review summarizes the current literature on the different approaches targeting MBO management including surgical intervention, chemotherapy, total parenteral nutrition, and pharmacological treatment. In addition, the impact of MBO management on patients’ quality of life (QOL) is examined. This article focuses on the challenges in developing evidence-based treatment guidelines for MBO and barriers in clinical trial design for MBO and proposes strategies to advance the MBO management. Collaboration is essential to design studies that may improve the overall care and quality of life for these patients. Prospective data are needed to inform clinical practice, establish a new benchmark for evidence-based MBO management, and better understand the biology of MBO.

Influence of pain on daily life of people with venous ulcers: evidence-based practice

2011 ◽  
Vol 5 (2) ◽  
pp. 514
Author(s):  
Isabelle Katherinne Fernandes Costa ◽  
Gabriela De Sousa Martins Melo ◽  
Thalyne Yuri de Araújo Farias Dias ◽  
Francis Solange Vieira Tourinho ◽  
Bertha Cruz Enders ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Daily Life ◽  
Evidence Based ◽  
Calidad De Vida ◽  
Venous Ulcers ◽  
Physical Mobility ◽  
Huge Impact ◽  
Web Of Knowledge ◽  
The Impact

ABSTRACT Objective: to evaluate the available evidence on the impact of pain on daily life of people with venous ulcers. Method: this is a study of integrative review followed the following steps: establishing the hypothesis and objectives, establishing criteria for inclusion or exclusion of articles, defining the information to be extracted from the selected items, results analysis, discussion and presentation of results. To select the articles we used three databases, Medline, Cinahl and ISI Web of Knowledge and the sample consisted of 18 articles. Results: in the works that were analyzed showed evidence that the pain of venous ulcers influences the patient's daily life. Among people with venous ulcers, we found that the pain is a major aggravating to decreased quality of life, especially as regards the loss of mood, sleep disturbance, social isolation and loss of physical mobility. Conclusion: The pain of the wound can lead to a huge impact on the daily life of a person and, as such, the need of each patient must be acknowledged and considered in a holistic manner. Descriptors: venous ulcers; quality of life; pain; nursing.      RESUMOObjetivo: avaliar as evidências disponíveis sobre a influência da dor na vida diária da pessoa com úlcera venosa. Método: trata-se de um estudo de revisão integrativa obedeceu às seguintes etapas: estabelecimento da hipótese e objetivos; estabelecimento de critérios de inclusão e exclusão de artigos; definição das informações a serem extraídas dos artigos selecionados; análise dos resultados; discussão e apresentação dos resultados. Para a seleção dos artigos utilizou-se três bases de dados, Medline, Cinahl e Isi Web Of Knowledge e a amostra constituiu-se de 18 artigos. Resultados: nos trabalhos que foram analisados evidenciamos que a dor da úlcera venosa influencia na vida diária do paciente. Dentre as pessoas com úlcera venosa, verificamos que a dor é um dos grandes agravantes para a diminuição da qualidade de vida, principalmente no que diz respeito a perda do humor, distúrbios do sono, isolamento social e perda da mobilidade física. Conclusão: a dor da ferida pode levar a um enorme impacto na vida de uma pessoa diariamente e, como tal, a necessidade de cada paciente deve ser reconhecida e considerada de maneira holística. Descritores: úlcera venosa; qualidade de vida; dor; enfermagem.RESUMENObjetivo: evaluar la evidencia disponible sobre el impacto del dolor en la vida cotidiana de las personas con úlceras venosas. Método: se trata de un estudio de revisión integradora seguido los siguientes pasos: el establecimiento de la hipótesis y objetivos, el establecimiento de los criterios para su inclusión o exclusión de los artículos, la definición de la información que se extrae de los elementos seleccionados, la análisis de resultados, discusión y presentación de resultados. Para seleccionar los artículos que utilizaron tres bases de datos, Medline, CINAHL y el ISI Web of Knowledge y la muestra estuvo constituida por 18 artículos. Resultados: en las obras que fueron analizados mostraron evidencia de que el dolor de las úlceras venosas influye en la vida diaria del paciente. Entre las personas con úlceras venosas, se encontró que el dolor es una de las principales agravantes de disminución de la calidad de vida, especialmente en lo que respecta a la pérdida del estado de ánimo, trastornos del sueño, aislamiento social y pérdida de movilidad física. Conclusión: el dolor de la herida puede causar un gran impacto en la vida cotidiana de una persona y, como tal, la necesidad de cada paciente debe ser reconocida y considerada en forma integral. Descriptores: úlceras venosas; calidad de vida; dolor; enfermería.

scholarly journals Evidence-Based Minireview: Abnormal uterine bleeding in users of rivaroxaban and apixaban

Hematology ◽  
2020 ◽  
Vol 2020 (1) ◽  
pp. 538-541
Author(s):  
Amanda E. Jacobson-Kelly ◽  
Bethany T. Samuelson Bannow
Keyword(s):  
Quality Of Life ◽  
Observational Studies ◽  
Oral Anticoagulants ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Evidence Based ◽  
Substantial Impact ◽  
Menstruating Women ◽  
The Impact

Abstract Up to two-thirds of menstruating women experience abnormal uterine bleeding (AUB) when treated with oral anticoagulants. However, the true prevalence of AUB for specific agents remains uncertain, as many of these episodes, while interfering significantly with quality of life and overall health, are not captured by definitions of major bleeding (MB) or clinically relevant nonmajor bleeding (CRNMB) used in clinical trials. A 2017 systematic review determined that women taking rivaroxaban, but not edoxaban or apixaban, had a twofold higher risk of AUB than women taking warfarin. Since then, new data have become available from extension trials, cancer-associated venous thromboembolism trials, pediatric trials, and a few observational studies specifically examining AUB as an outcome. Reported rates of uterine CRNMB were low (around 1%) and similar for rivaroxaban and apixaban in all these studies, and no episodes of uterine bleeding meeting MB criteria were reported. Rates of AUB not meeting MB or CRNMB criteria were much higher, affecting up to 50% of women on rivaroxaban. Only 1 such study included women on apixaban, and no AUB was reported. In pediatric trials, 19% of girls experienced menorrhagia when treated with rivaroxaban. In conclusion, rates of uterine MB and CRNMB were low in all studies, but rates of other types of AUB not meeting these criteria ranged from 15.8% to 50%. We conclude that AUB is underreported due to the limitations of MB/CRNMB criteria despite its substantial impact on quality of life. We urge future investigators to include broader definitions of AUB to better capture the impact of this outcome in menstruating women treated with oral anticoagulants.

The Impact of Individualized Evidence-Based Decision Support on Aneurysm Patients' Decision Making, Ideals of Autonomy, and Quality of Life

2008 ◽  
Vol 28 (5) ◽  
pp. 751-762 ◽  
Author(s):  
Anne M. Stiggelbout ◽  
Albert C. Molewijk ◽  
Wilma Otten ◽  
J. Hajo Van Bockel ◽  
Cornelis M. A. Bruijninckx ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Decision Support ◽  
Evidence Based ◽  
The Impact

scholarly journals The Impact of Malocclusion/Orthodontic Treatment Need on the Quality of Life

2009 ◽  
Vol 79 (3) ◽  
pp. 585-591 ◽  
Author(s):  
Zhijian Liu ◽  
Colman McGrath ◽  
Urban Hägg
Keyword(s):  
Quality Of Life ◽  
Orthodontic Treatment ◽  
Meta Analysis ◽  
Current Evidence ◽  
Future Research ◽  
Evidence Based ◽  
Treatment Need ◽  
Methodologic Quality ◽  
The Impact

Abstract Objective: To assess the current evidence of the relationship between malocclusion/orthodontic treatment need and quality of life (QoL). Materials and Methods: Four electronic databases were searched for articles concerning the impact of malocclusion/orthodontic treatment need on QoL published between January 1960 and December 2007. Electronic searches were supplemented by manual searches and reference linkages. Eligible literature was reviewed and assessed by methodologic quality as well as by analytic results. Results: From 143 reviewed articles, 23 met the inclusion criteria and used standardized health-related QoL (HRQoL) and orthodontic assessment measures. The majority of studies (18/23) were conducted among child/adolescent populations. Seventeen of the papers were categorized as level 1 or 2 evidence based on the criteria of the Oxford Centre for Evidence-Based Medicine. An observed association between HRQoL and malocclusion/orthodontic treatment need was generally detected irrespective of how they were assessed. However, the strength of the association could be described as modest at best. Key findings and future research considerations are described in the review. Conclusions: Findings of this review suggest that there is an association (albeit modest) between malocclusion/orthodontic treatment need and QoL. There is a need for further studies of their relationship, particularly studies that employ standardized assessment methods so that outcomes are uniform and thus amenable to meta-analysis.

Medical Management of Inoperable Malignant Bowel Obstruction

2020 ◽  
pp. 106002802097977
Author(s):  
Xiaoyan Huang ◽  
Jing Xue ◽  
Min Gao ◽  
Qiyuan Qin ◽  
Tenghui Ma ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Effects ◽  
Bowel Obstruction ◽  
Medical Management ◽  
Case Reports ◽  
Somatostatin Analogs ◽  
Clinical Approach ◽  
Malignant Bowel Obstruction ◽  
Anti Inflammatory

Objective: To review medical management of inoperable malignant bowel obstruction. Data Sources: A literature review using PubMed and MEDLINE databases searching malignant bowel obstruction, etiology, types, pathophysiology, medical, antisecretory, anti-inflammatory, antiemetic drugs, analgesics, promotion of emptying, prevention of infection, anticholinergics, somatostatin analogs, gastric antisecretory drugs, prokinetic agents, glucocorticoid, opioid analgesics, antibiotics, enema, and adverse effects. Study Selection and Data Extraction: Randomized or observational studies, cohorts, case reports, or reviews written in English between 1983 and November 2020 were evaluated. Data Synthesis: Malignant bowel obstruction (MBO) commonly occurs in patients with advanced or recurrent malignancies and severely affects the quality of life and survival of patients. Its management remains complex and variable. Medical management is the cornerstone of MBO treatment, with the goal of reducing distressing symptoms and optimizing quality of life. Until now, there has been neither a standard clinical approach nor registered medications to treat patients with inoperable MBO. Relevance to Patient Care and Clinical Practice: This review provides information on the etiology, type and pathophysiology, and medical treatment of MBO and related adverse reactions of the drugs commonly used, which can greatly assist clinicians in making clinical decisions when treating MBO. Conclusions: Published research shows that medical management of MBO mainly consists of antisecretory, anti-inflammatory strategies, controlling vomiting and pain, promoting emptying, preventing infection, and combination therapy. Being knowledgeable about the most current treatment options, the related adverse effects, and the evidence supporting different practices is critical for clinicians to provide individualized medical therapy for MBO patients.

Bowel Management

2019 ◽  
pp. 186-205
Author(s):  
Stefanie N. Mooney ◽  
Purvi Patel ◽  
Sorin Buga
Keyword(s):  
Quality Of Life ◽  
Supportive Care ◽  
Liver Failure ◽  
Bowel Obstruction ◽  
Gastrointestinal Symptoms ◽  
Malignant Bowel Obstruction ◽  
Nursing Assessment ◽  
Bowel Management ◽  
Assessment And Treatment

This chapter reviews palliative considerations for bowel management in a patient with advanced disease such as cancer, liver failure, AIDS, or general debility. In particular, it discusses the definition, prevalence, pathophysiology, assessment, and management of gastrointestinal symptoms common in the palliative population, including constipation and diarrhea. It also reviews malignant bowel obstruction and ascites and how these may impact quality of life for patients with life-limiting illness. The discussion of management includes both pharmacologic approaches and supportive care options. This information is designed to help guide nursing assessment and treatment of bowel management, as well as provide useful insight to any clinical provider encountering these conditions.

Room for improvement? A quality-of-life assessment in patients with malignant bowel obstruction

2009 ◽  
Vol 24 (1) ◽  
pp. 38-45 ◽  
Author(s):  
D. Selby ◽  
F. Wright ◽  
K. Stilos ◽  
P. Daines ◽  
V. Moravan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bowel Obstruction ◽  
Life Assessment ◽  
Malignant Bowel Obstruction ◽  
Quality Of Life Assessment
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