“When you are living and dying at the same time” – a qualitative exploration of living with gastrointestinal motility disorders

alexandrossfakianakis shared this article with you from Inoreader "When you are living and dying at the same time" – a qualitative exploration of living with gastrointestinal motility disorders via Journal of Human Nutrition and Dietetics ABSTRACT Aim An expanding base of evidence indicates that chronic gastrointestinal disorders impact not only physical wellbeing, but also affect many psychosocial aspects of life. However, less is known about gastrointestinal motility disorders. The aim of this study was to explore how individuals experience gastrointestinal motility disorders and its impact on daily living. Methods Eleven people with a gastrointestinal motility disorder participated in semi-structured interviews face-to-face or via telephone. The interviews explored how participants came to be diagnosed, their experiences with health professionals, as well as impact of dysmotility on enjoyment of food, socialising, eating out, and quality of life. Interviews were tape-recorded, transcribed and analysed using an inductive thematic analysis approach. Results Analysis revealed an overarching theme of frustration that stemmed from three subthemes: 1) feeling misunderstood, judged, and dismi ssed by health professionals leading to delayed diagnosis, misdiagnosis and multiple diagnoses, 2) severity and unpredictability of undesirable gastrointestinal symptoms and 3) reduced quality of life due to physical and social limitations, impairing their ability to have normal life experiences including education, work, and social activities. Conclusion Dysmotility is a complex illness that impacts nearly all aspects of a person's life. In addition to managing reported physical symptoms, the social and psychological burden associated with dysmotility needs to be addressed to improve outcomes and quality of life. This article is protected by copyright. All rights reserved. View on Web

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Health‐related quality of life in children and adolescents with pleuropulmonary blastoma: A report from the International PPB/DICER1 Registry

alexandrossfakianakis shared this article with you from Inoreader Health‐related quality of life in children and adolescents with pleuropulmonary blastoma: A report from the International PPB/DICER1 Registry via Pediatric Blood & Cancer Abstract Purpose Pleuropulmonary blastoma (PPB) is the most common lung cancer of infancy and early childhood and is associated with germline DICER1 variants. Type I and Ir PPB are cystic lesions treated surgically, with a subset of children with type I receiving chemotherapy. Type II and III are more aggressive lesions, treated with surgery, intensive chemotherapy and potentially radiation. We sought to assess health-related quality of life (HRQoL) in children with PPB and known germline DICER1 variants. Methods Children with a diagnosis of PPB or germline DICER1 pathogenic variant without history of PPB or other DICER1-related neoplasm (DICER1+ only) were enrolled in the International PPB/DICER1 Registry. Parent reports for participants aged 2–17 years for the PedsQL v.4 and PedsQL Multidimensional Fatigue Scale v.3 were collected. Fatigue, physical, and psychosocial function scores were compared. Results Analysis included 84 participants (PPB type Ir = 20, type I = 15, type II/III = 27, DICER1+ only = 22). Total fatigue scores of participants with type I and II/III PPB were lower compared to DICER1+ only, with effect size larger in type II/III (−0.82 vs. −0.40). Total psychosocial and physical functioning scores were lower in participants with type I and type II/III PPB compared to DICER1+ only, with larger effects noted in type II/III. Female sex was suggestive of worse HRQoL for both type I/Ir and type II/III cohorts. Conclusions These data demonstrate the importance of regular HRQoL assessment in patients with a history of PPB as well as the importance and feasibility of studying HRQoL in children with rare tumors. View on Web

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Salvage treatments for locally recurrent nasopharyngeal cancer: A systematic review and meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader Salvage treatments for locally recurrent nasopharyngeal cancer: A systematic review and meta‐analysis via Head & Neck Abstract The present study aimed to evaluate the effectiveness and safety of various salvage treatments to treat locally recurrent nasopharyngeal carcinoma (IrNPC). A comprehensive search was conducted to gather relevant research publications on salvage treatment for IrNPC. Specifically, 2-, 3-, and 5-year overall survival were the primary outcome. A total of 89 studies with 101 cohorts were collected. Endoscopic nasopharyngectomy was found to be associated with a significantly improved 5-year OS compared with CRT (p = 0.027) and IMRT (p = 0.016). Moreover, based on recurrence T classification, the 2-, 3-, and 5-year OS were similar across different treatments. Endoscopic nasopharyngectomy was associated with a significant reduction in treatment-related complications (grade ≥ 3) compared with IMRT (p < 0.001) and open nasopharyngectomy (p = 0.028). Endoscopic nasopharyngectomy may provide comparable treatment outcomes t o re-irradiation, while offering a better safety profile for selective patients with resectable IrNPC. View on Web

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Hepatic Artery Infusion Pumps: A Surgical Toolkit for Intraoperative Decision-Making and Management of Hepatic Artery Infusion-Specific Complications

alexandrossfakianakis shared this article with you from Inoreader Hepatic Artery Infusion Pumps: A Surgical Toolkit for Intraoperative Decision-Making and Management of Hepatic Artery Infusion-Specific Complications via Annals of Surgery - Most Popular Articles Background: Hepatic artery infusion (HAI) is a liver-directed therapy that delivers high-dose chemotherapy to the liver through the hepatic arterial system for colorectal liver metastases and intrahepatic cholangiocarcinoma. Utilization of HAI is rapidly expanding worldwide. Objective and Methods: This review describes the conduct of HAI pump implantation, with focus on common technical pitfalls and their associated solutions. Perioperative identification and management of common postoperative complications is also described. Results: HAI therapy is most commonly performed with the surgical implantation of a subcutaneous pump, and placement of its catheter into the hepatic arterial system for inline flow of pump chemotherapy directly to the liver. Intraoperative challenges and abnormal hepatic perfusion can arise due to aberrant anatomy, vascular disease, technical or patient factors. However, solutions to prevent or overcome technical pitfalls are present for the majority of cases. Postoperative HAI-specific complications arise in 22% to 28% of patients in the form of pump pocket (8%–18%), catheter (10%–26%), vascular (5%–10%), or biliary (2%–8%) complications. The majority of patients can be rescued from these complications with early identification and aggressive intervention to continue to deliver safe and effective HAI therapy. Conclusions: This HAI toolkit provides the HAI team a reference to manage commonly encountered HAI-specific perioperative obstacles and complications. Overcoming these challenges is critical to ensure safe and effective pump implantation and delivery of HAI therapy, and key to successful implementation of new programs and expansion of HAI to patients who may benefit from such a highly specialized treatment strategy. View on Web

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Enteral nutrition support and treatment toxicities in patients with head and neck cancer receiving definitive or adjuvant helical intensity‐modulated radiotherapy with concurrent chemotherapy

alexandrossfakianakis shared this article with you from Inoreader Enteral nutrition support and treatment toxicities in patients with head and neck cancer receiving definitive or adjuvant helical intensity‐modulated radiotherapy with concurrent chemotherapy via Head & Neck Abstract Background Enteral nutrition (EN) is often required in patients with head and neck cancer (HNSCC); however, initiation criteria is limited or inconsistent. This study aimed to describe the relationship of treatment toxicities and requirement for EN and investigate toxicity and baseline characteristics association with EN duration. Methods Acute toxicities and baseline characteristics were collected from patients with HNSCC (n = 110) undergoing H-IMRT. Percentage EN contributing to estimated requirements and EN duration were measured. Results The threshold for patients needing ≥50% of estimated requirements via EN increased from week 3 to 4 for grade ≥2 oral/pharyngeal mucositis, dysgeusia, thick saliva and nausea, and for grade 3 dysphagia. Patients with grade 2–3 dysphagia had a reduced risk of ceasing EN compared to those with grade 0–1 dysphagia. Conclusions Using acute toxicities in clinical practice may be a useful tool to inform prompt initiation of EN prior to decline in nutritional status and anticipate EN duration. View on Web

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Preferential looking to eyes versus mouth in early infancy: heritability and link to concurrent and later development

alexandrossfakianakis shared this article with you from Inoreader Preferential looking to eyes versus mouth in early infancy: heritability and link to concurrent and later development via Journal of Child Psychology and Psychiatry Background From birth, infants orient preferentially to faces, and when looking at the face, they attend primarily to eyes and mouth. These areas convey different types of information, and earlier research suggests that genetic factors influence the preference for one or the other in young children. Methods In a sample of 535 5-month-old infant twins, we assessed eye (relative to mouth) preference in early infancy, i.e., before neural systems for social communication and language are fully developed. We investigated the contribution of genetic and environmental factors to the preference for looking at eyes, and the association with concurrent traits and follow-up measures. Results Eye preference was independent from all other concurrent traits measured, and had a moderate-to-high contribution from genetic influences (A = 0.57; 95% CI: 0.45, 0.66). Preference for eyes at 5 months was associated with higher parent ratings of receptive vocabulary at 14 months. No statistically significant association with later autistic traits was found. Preference for eyes was strikingly stable across different stimulus types (e.g., dynamic vs. still), suggesting that infants' preference at this age does not reflect sensitivity to low-level visual cues. Conclusions These results suggest that individual differences in infants' preferential looking to eyes versus mouth to a substantial degree reflect genetic variation. The findings provide new leads on both the perceptual basis and the developmental consequences of these attentional biases. View on Web

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Three‐dimensional evaluation of sleep bruxism‐related splint wear using a dental laboratory scanner: a preliminary clinical study

alexandrossfakianakis shared this article with you from Inoreader Three‐dimensional evaluation of sleep bruxism‐related splint wear using a dental laboratory scanner: a preliminary clinical study via Journal of Oral Rehabilitation Abstract Background: The wear depth on the occlusal splint (OS) is reportedly associated with the sleep bruxism (SB) level, as evaluated using portable polysomnography (PSG) recordings. However, the OS is deformed owing to SB forces, possibly preventing the accurate quantification of the wear facets. Objectives: To introduce a newly developed system to quantify the wear facets on the OS using a dental laboratory scanner (D810) and investigate the association between the wear facets, as evaluated with this system, and the SB level. Methods: Ten healthy individuals who were diagnosed with SB based on portable PSG recordings participated in this study. They were asked to wear the OS for 2 months. The first day after a 2-week adaptation period was defined as the reference day, and sequential scanning of the OS surface was performed on days 15, 30, and 45. Changes in the OS surface from the reference day allowed dimensional evaluation of the wear facets in terms of the maximum wear depth, wear area, and wear volume. Multiple regression analyses were conducted to test whether each of these variables could be predicted by any of the SB-related variables. Results: The total duration of SB episodes per hour of sleep and the maximum muscle activity were significantly associated with the wear area, as measured with our system (adjusted R-squared was 0.78, p < 0.01). Conclusion: Our system allows dimensional analysis of the wear facets on the OS surface in association with the SB level. View on Web

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