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Months Posttreatment (month + posttreatment)
Selected AbstractsImpact of demographics, tumor characteristics, and treatment factors on swallowing after (chemo)radiotherapy for head and neck cancerHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 4 2010Jacqui Frowen BSpPath (Hons) Abstract Background This prospective study evaluated the impact of patient demographics, tumor characteristics, and radiotherapy treatment on swallowing before and after radiotherapy or chemoradiotherapy. Methods Eighty-one patients with head and neck cancer were examined using videofluoroscopy swallowing studies (VFSS) before treatment and again at 3 and 6 months after treatment. Results Swallowing was best at baseline, significantly worse 3 months posttreatment, and improved by 6 months posttreatment. Worse swallowing was associated with: living in rural areas; ex-heavy alcohol consumption; hypopharyngeal tumor site; large (particularly T4) tumors; nonconformal radiotherapy; bilateral radiation to the pharynx; and longer radiotherapy fields. Through the use of multiple regression analysis, previous swallowing was determined to be the most common predictor of swallowing outcomes, followed by T classification, alcohol history, and radiotherapy technique. Conclusions The pretreatment and treatment factors that influenced swallowing in this cohort should be considered when planning treatment, in discussing potential side effects with patients, and when developing and testing future treatment techniques. © 2009 Wiley Periodicals, Inc. Head Neck, 2010 [source] Swallowing disorders in the first year after radiation and chemoradiationHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 2 2008Jeri A. Logemann PhD Abstract Background Radiation alone or concurrent chemoradiation can result in severe swallowing disorders. This manuscript defines the swallowing disorders occurring at pretreatment and 3 and 12 months after completion of radiation or chemoradiation. Methods Forty-eight patients (10 women and 38 men) participated in this study involving videofluorographic evaluation of oropharyngeal swallow at the 3 time points. Results At baseline, patients had some swallow disorders, probably related to presence of their tumor. At 3 months posttreatment, frequency of reduced tongue base retraction, slow or delayed laryngeal vestibule closure, and reduced laryngeal elevation increased from baseline. Some disorders continued at 12 months posttreatment. Functional swallow decreased over time in patients treated with chemoradiation, but not those treated with radiation alone. Discussion Chemoradiation results in fewer functional swallowers than radiation alone at 12 months posttreatment completion. © 2007 Wiley Periodicals, Inc. Head Neck, 2008 [source] Randomized, placebo-controlled, double-blind clinical trial evaluating the treatment of plantar fasciitis with an extracoporeal shockwave therapy (ESWT) device: A North American confirmatory studyJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 2 2006Patricia Kudo Abstract Despite numerous publications and clinical trials, the results of treatment of recalcitrant chronic plantar fasciitis with extracorporeal shockwave therapy (ESWT) still remain equivocal as to whether or not this treatment provides relief from the pain associated with this condition. The objective of this study was to determine whether extracorporeal shock wave therapy can safely and effectively relieve the pain associated with chronic plantar fasciitis compared to placebo treatment, as demonstrated by pain with walking in the morning. This was set in a multicenter, randomized, placebo-controlled, double-blind, confirmatory clinical study undertaken in four outpatient orthopedic clinics. The patients, 114 adult subjects with chronic plantar fasciitis, recalcitrant to conservative therapies for at least 6 months, were randomized to two groups. Treatment consisted of approximately 3,800 total shock waves (±10) reaching an approximated total energy delivery of 1,300 mJ/mm2 (ED+) in a single session versus placebo treatment. This study demonstrated a statistically significant difference between treatment groups in the change from baseline to 3 months in the primary efficacy outcome of pain during the first few minutes of walking measured by a visual analog scale. There was also a statistically significant difference between treatments in the number of participants whose changes in Visual Analog Scale scores met the study definition of success at both 6 weeks and 3 months posttreatment; and between treatment groups in the change from baseline to 3 months posttreatment in the Roles and Maudsley Score. The results of this study confirm that ESWT administered with the Dornier Epos Ultra is a safe and effective treatment for recalcitrant plantar fasciitis. © 2005 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res [source] The Impact of Depressive Symptoms on Alcohol and Cigarette Consumption Following Treatment for Alcohol and Nicotine DependenceALCOHOLISM, Issue 1 2008Molly M. Kodl Background:, Although depression is common among alcohol and tobacco dependent patients, its impact on treatment outcomes is not well established. The purpose of this study was to examine the impact of depressive symptoms on abstinence from tobacco and alcohol after treatment for alcohol dependence and nicotine dependence. Methods:, The Timing of Alcohol and Smoking Cessation Study (TASC) randomized adults receiving intensive alcohol dependence treatment, who were also smokers, to concurrent or delayed smoking cessation treatment. The sample consisted of 462 adults who completed depression and substance use (alcohol and smoking) assessments at treatment entry and 6, 12, and 18 months posttreatment. Longitudinal regression models were used to examine the relationships between depression and subsequent abstinence from alcohol and tobacco after baseline characteristics, including alcohol and smoking histories, were considered. Results:, Depressive symptoms were prospectively related to nonabstinence from alcohol. Depressive symptoms at the previous assessment increased the odds of drinking at the subsequent time point by a factor of 1.67 (95% CI 1.14, 2.43), p < 0.01. Depressive symptoms were not significantly related to subsequent abstinence from cigarettes. Conclusions:, Depression is an important negative predictor of the ability to maintain abstinence from alcohol within the context of intensive alcoholism and smoking treatment. It may be important to include depression-specific interventions for alcohol and tobacco dependent individuals to facilitate successful drinking treatment outcomes. [source] The Pain Provocation Technique for Adolescents with Chronic Pain: Preliminary Evidence for Its EffectivenessPAIN MEDICINE, Issue 6 2010Tanja Hechler PhD Abstract Objective., This study aims to investigate the effectiveness of the "pain provocation technique" (PPT),a focused treatment strategy incorporating interoceptive exposure (i.e., imagining increases in pain intensity), bilateral stimulation (tactile stimulation), and implementation of pain-related coping to decrease pain intensity,for adolescents suffering from chronic pain. Design., Prospective observational comparative study. Methods., Adolescents utilizing PPT (19 boys and 21 girls) within multimodal inpatient treatment were compared with adolescents in standard multimodal inpatient treatment matched for age, gender, and diagnosis. Core outcome variables (pain intensity, disability, emotional distress) were assessed at admission and 3 months posttreatment. Results., Adolescents in the PPT group demonstrated a sharper decrease in pain intensity and school aversion. Both groups demonstrated significant reductions in disability and emotional distress. Conclusions., Results are discussed in terms of the importance of focused treatment strategies such as interoceptive exposure for adolescents suffering from disabling chronic pain. Future studies are warranted to carefully investigate the effectiveness and possible process of change during the PPT such as sensory, cognitive, emotional, and memory aspects. [source] Internet-Based Brief Sex Therapy for Heterosexual Men with Sexual Dysfunctions: A Randomized Controlled Pilot TrialTHE JOURNAL OF SEXUAL MEDICINE, Issue 8 2009Jacques J.D.M. Van Lankveld PhD ABSTRACT Introduction., Internet-based sex therapy for men with erectile dysfunction has been advocated as an easily accessible and cost-effective treatment. Aim., To test whether Internet-based sex therapy is superior to waiting list. Methods., Internet-based therapy was administered to heterosexual men with erectile dysfunction or premature ejaculation, without face-to-face contact, in a waiting-list controlled design, with pre-, post-, and follow-up measurements at 3 and 6 months posttreatment. Treatment was based on the sensate-focus model of Masters and Johnson, and supplemented with cognitive restructuring techniques. Main Outcome Measures., Self-reported improvement of sexual functioning, erectile functioning (men with ED), premature ejaculation (men with PE), sexual desire, overall sexual satisfaction, and sexual self-confidence. Results., Ninety-eight men participated (58 ED, 40 PE). Sexual functioning was much or somewhat improved in 40 participants (48%). In participants with ED, a near significant effect of treatment was found (P = 0.065), with higher levels of sexual desire (P < 0.05) and sexual self-confidence (P = 0.05) in treated men, in addition to improved erectile functioning (P = 0.01) and overall sexual satisfaction (P < 0.001) in both groups. In participants with PE, treatment was not superior to waiting list. In participants with ED, erectile functioning (P < 0.05) and overall sexual satisfaction (P = 0.002) improved significantly. In participants with PE, latency to ejaculation (P < 0.001), sexual desire (P < 0.05), and overall sexual satisfaction (P < 0.05) improved significantly from baseline to posttreatment, with no further changes at both follow-ups. Sexual self-confidence in men with PE remained unchanged during treatment until follow-up at 3 months posttreatment, and then was found to be improved at 6-months follow-up (P < 0.05). Conclusion., Internet-based sex therapy for male erectile dysfunction was efficacious for male erectile disorder. For men with premature ejaculation, however, treatment was not superior to waiting list. van Lankveld JJDM, Leusink P, van Diest S, Gijs L, and Slob AK. Internet-based brief sex therapy for heterosexual men with sexual dysfunctions: A randomized controlled pilot trial. J Sex Med 2009;6:2224,2236. [source] Effects of weight training on quality of life in recent breast cancer survivorsCANCER, Issue 9 2006The Weight Training for Breast Cancer Survivors (WTBS) study Abstract BACKGROUND Aerobic exercise training has been shown to have beneficial effects on quality of life (QOL) in breast cancer survivors. However, the effects of weight training on psychological benefits are unknown. We sought to examine the effects of weight training on changes in QOL and depressive symptoms in recent breast cancer survivors. METHODS A convenience sample of 86 survivors (4-36 months posttreatment) was randomized into treatment and control groups. The primary outcomes were changes in QOL (CARES short form) and depressive symptoms (CES-D) between baseline and month 6 in this randomized controlled trial. RESULTS Over 6 months the physical global QOL score improved in the treatment group compared with the control group (Standardized Difference = 0.62, P = .006). The psychosocial global score also improved significantly in the treatment group compared with the control group (Standardized Difference = 0.52, P = .02). There were no changes in CES-D scores. Increases in upper body strength were correlated with improvements in physical global score (r = 0.32; P <.01) and psychosocial global score (r = 0.30; P <.01). Increases in lean mass were also correlated with improvements in physical global score (r = 0.23; P <.05) and psychosocial global score (r = 0.24; P <.05). CONCLUSION Twice-weekly weight training for recent breast cancer survivors may result in improved QOL, in part via changes in body composition and strength. Cancer 2006. © 2006 American Cancer Society. [source] | ||||||||||