RESUMO
OBJECTIVE: Bladder cancer is, in Poland, the fourth most common malignancy in men and the eighth most common in women. Radical cystectomy often seems to be the only method of treatment. This mutilating procedure may affect the quality of life of the patient. The aim of our study was to analyze the impact of factors influencing quality of life in patients after a cystectomy. METHODS: From January to August 2015, 50 consecutive patients treated in the Department of Urology of the Wroclaw Medical University in Wroclaw were enrolled into the study. Sixty-three percent of the respondents were men. Fifty-two percent of the respondents lived in urban areas. Patients ranged in age from under 25 to over 51 years. Clinical and demographic data were collected. Quality of life was evaluated with the SF-36 health survey questionnaire. For statistical analysis, Student's t-test, the Mann-Whitney U test and Spearman's rank correlation coefficient were used. Statistical analysis was carried out with IBM SPSS Statistics for Windows Version 21.0. RESULTS: A decrease in quality of life was observed in both genders. The impact of place of residence on the occurrence of pain, health perception, vitality, and levels of physical and mental activity was found to be significant (p<0.05). Pain intensity, health perception, vitality, and levels of physical and mental activity were higher in patients living in urban areas. CONCLUSION: Patients with bladder cancer who underwent a radical cystectomy were more likely to have a reduced quality of life if they lived in a village or small town than if they lived in an urban area.
Assuntos
Cistectomia , Qualidade de Vida , Neoplasias da Bexiga Urinária/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , AutorrelatoRESUMO
BACKGROUND: Acute liver failure (ALF) is a rare but potentially life-threatening condition and liver transplantation (LTX) remains frequently the only effective therapy. Nevertheless, some patients recover without LTX but the individual indication for or against LTX remains difficult. AIM: To evaluate maximal liver function capacity (LiMAx) for predicting the prognosis of ALF. Material and methods. Clinic data of 12 patients was retrospectively analyzed to compare the different liver function test results with the patients' clinical outcome. Patients were assessed by the LiMAx test, a non-invasive breath test determining cytochrome P450 1A2 capacity using intravenous 13C-methacetin. Statistical analysis compared patients with spontaneous recovery versus non-recovery (LTX or death). RESULTS: Twelve patients (6 male, 6 female; 49 [11-72] years) with viral hepatitis (n = 2), toxic liver injury (n = 3), or cryptogenic liver failure (n = 7) were analyzed. Seven patients fully recovered from ALF and were discharged without LTX. Three patients died and two underwent LTX. The King's College Criteria (KCC) was fulfilled in only one out of five patients without recovery. The LiMAx was 19 ± 19 (16-62) for non-recovery vs. 94 ± 119 (39-378) µg/kg/h for recovery (P = 0.018). In contrast, all biochemical parameters [bilirubin (P = 0.106), creatinine (P = 0.343), AST (P = 0.53), ALT (P = 0.876) and INR (P = 0.876) were statistically indistinct. Also the Model for End-Stage Liver Disease (MELD) score did not show a difference [35 ± 4.3 (29-40) vs. 30 ± 11.5 (6-40); P = 0.27]. CONCLUSIONS: Maximal liver function capacity determined by LiMAx test is severely impaired in patients with ALF. The LiMAx test might be effective in predicting the individual prognosis and the need for LTX in ALF.