1.Predictors of Decreased Quality of Life in Breast Cancer Survivors Five Years After Diagnosis
Saskia-Laureen HERBERT ; Felix FLOCK ; Ricardo FELBERBAUM ; Wolfgang JANNI ; Sanja LÖB ; Matthias KIESEL ; Tanja SCHLAISS ; Joachim DIESSNER ; Carolin CURTAZ ; Ralf JOUKHADAR ; Davut DAYAN ; Lukas SCHWENTNER ; Susanne SINGER ; Achim WÖCKEL ;
Journal of Breast Cancer 2023;26(3):243-253
Purpose:
Due to improved therapy, early diagnosis, and growing incidence rates, the number of long-term breast cancer survivors is increasing. Survivors can still be affected by aftercare, resulting in reduced quality of life (QoL). Thus, in this study, we investigated possible predictors of decreased physical and social functioning in breast cancer survivors.
Methods:
In a German multicenter prospective study, we enrolled 759 female patients with breast cancer before surgery (t1), and contacted them again 5 years after surgery (t4). Data on QoL were assessed at t4 using the European Organization for Research and Treatment of Cancer QoL Core Questionnaire (EORTC QLQ-C30) and its breast cancer module EORTC QLQ-BR23.Predictors of decreased physical and social functioning were analyzed using logistic regression with odds ratios as effect estimates and 95% confidence intervals. Thresholds for the clinical importance of detrimental effects on QoL were defined according to Giesinger.
Results:
Questionnaires from 759 patients were retrieved at t1. Of these, 456 participated in the study at t4. Poor QoL 5 years after diagnosis was reported by 20%–50% of the participants. Age, mastectomy, chemotherapy, education, employment, cohabitation, psychiatric comorbidities at t1, anxiety, depression, and intensity of physical activity emerged as predictors of decreased physical and social functioning 5 years after diagnosis.
Conclusion
Relief of symptoms and improvement in the QoL should be priorities in aftercare. Detecting patients with a decreased QoL is a rising challenge. Healthcare providers should take special care of patients aged 50–59 years, patients with psychiatric comorbidities and depression, and patients who have undergone mastectomy.
2.Sex and Gender Influence Urinary Symptoms and Management in Multiple System Atrophy
Elke Schipani BAILEY ; Sara J. HOOSHMAND ; Negin BADIHIAN ; Paola SANDRONI ; Eduardo E. BENARROCH ; James H. BOWER ; Phillip A. LOW ; Wolfgang SINGER ; Elizabeth A. COON
Journal of Movement Disorders 2023;16(2):196-201
Objective:
Multiple system atrophy (MSA) is characterized by urinary dysfunction, yet the influence of sex and gender on urinary symptoms and treatment is unclear. We sought to characterize sex and gender differences in the symptomatology, evaluation, and management of urinary dysfunction in patients with MSA.
Methods:
Patients with MSA evaluated at our institution were reviewed and stratified by sex.
Results:
While the prevalence of urinary symptoms was similar in male and female patients, incontinence was more common in females. Despite this, males and females underwent postvoid residual (PVR) measurement at similar rates. While catheterization rates were similar when PVR was measured, males were more than twice as likely to be catheterized than females in the absence of PVR measurement.
Conclusion
Urinary symptoms are common in MSA, but their presentation differs between males and females. The difference in catheterization rates may be driven by a gender disparity in referrals for PVR, which can guide treatment.