Background: Health-related quality of life (HR-QoL) is a critical consideration in glioma surgery,alongside improving patient survival. Current evidence highlights maximal surgical resection as a key independent prognostic factor for enhancing HR-QoL and survivability. This study aimed to compare the impact on HR-QoL and survival rates in glioma patients before and after surgery with varying degrees of tumor resection (<10%, 10%–90%, >90%) and residual tumor volumes (≤2 cm 3 , >2 cm 3 ). Methods: This single-institution prospective study analyzed 117 patients with newly diagnosedgliomas (2009–2015). HR-QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) (global quality of life status [GQLS], physical, emotional, role, cognitive, and social function, as well as insomnia and fatigue).We compared survival rates and HR-QoL outcomes based on extent of resection and residual tumor volume. Clinically meaningful thresholds and statistical significance were used to evaluate HR-QoL changes. Results: In grade 4 gliomas, resections >90% and residual tumor volumes ≤2 cm 3 significantlyimproved median survival compared to lesser resections. For HR-QoL, resections >90% led to clinically and statistically significant improvements in GQLS, emotional, role, and cognitive function, as well as insomnia. Residual volumes ≤2 cm 3 significantly enhanced emotional and role function, with statistical improvements in GQLS, cognitive function, social function, insomnia, and fatigue. Lower resection rates and higher residual volumes resulted in significant HR-QoL declines. When stratified by tumor grade, high- and low-grade gliomas showed clinically significant improvements in different HR-QoL domains. Conclusion Resections greater than 90% and residual volumes ≤2 cm 3 significantly improve HR-QoL and overall survival. Conversely, partial resections and larger residual tumor volumes are associated with worse HR-QoL outcomes.

PURPOSE: Non-classical actions of vitamin D as a cytokine are related to the immunopathology of asthma. Few studies have examined vitamin D levels and asthma severity in adults. The aim of this research was to assess the relationship between vitamin D levels, atopy markers, pulmonary function, and asthma severity. METHODS: We analyzed 25-hydroxyvitamin D levels in serum collected from 121 asthmatic adults from Costa Rica to investigate the association between vitamin D levels (categorized as sufficient, > or =30 ng/mL, or insufficient, <30 ng/mL), allergic rhinitis, total IgE and peripheral blood eosinophils (as markers of atopy), asthma severity, baseline forced expiratory volume in 1 second (FEV1), and forced vital capacity (FVC). Univariate and multivariate analyses were performed to assess these relationships. RESULTS: When the population was stratified by vitamin D status, 91% of asthmatic patients with vitamin D levels below 20 ng/mL (n=36) and 74% of patients with vitamin D levels between 20 and 30 ng/mL (n=73) had severe asthma versus 50% of those with vitamin D sufficiency (n=12; P=0.02). Vitamin D insufficiency was associated with a higher risk of severe asthma (odds ratio [OR], 5.04; 95% Confidence interval [CI], 1.23-20.72; P=0.02). High vitamin D levels were associated with a lower risk of hospitalization or emergency department visit during the last year (OR, 0.90; 95% CI, 0.84-0.98; P=0.04). Although there appeared to be a direct relationship between vitamin D levels and FEV1 (regression coefficient=0.48; r2=0.03), it did not reach statistical significance (P=0.07). CONCLUSIONS: Our findings suggest that vitamin D insufficiency is common among our cohort of asthmatic adults. Lower vitamin D levels are associated with asthma severity.
Adult ; Asthma ; Cohort Studies ; Costa Rica ; Emergencies ; Eosinophils ; Forced Expiratory Volume ; Hospitalization ; Humans ; Immunoglobulin E ; Multivariate Analysis ; Rhinitis ; Rhinitis, Allergic, Perennial ; Vital Capacity ; Vitamin D ; Vitamins