PURPOSE: There is no established treatment of choice for low anterior resection syndrome (LARS). To evaluate the efficacy of biofeedback therapy for objective improvement of pelvic function in LARS, we performed the present study. METHODS: The primary endpoint was the change of Wexner score. Consenting patients between 20 and 80 years old with major LARS at least 2 months after sphincter preserving proctectomy for rectal cancer were enrolled. After recommendation of biofeedback therapy, patients who accept it were enrolled in the biofeedback group and patients who refuse were enrolled in the control group. Initial and follow-up evaluations were performed and analyzed. RESULTS: Fifteen and sixteen patients were evaluated in the control group and the biofeedback group, respectively. There was no statistically significant difference of LARS score between both groups. Decrease in Wexner score and increase in rectal capacity were significantly higher in the biofeedback group (odds ratio [OR], 5.386; 95% confidence interval [CI], 1.194–24.287; P = 0.028 and OR, 1.061; 95% CI, 1.002–1.123; P = 0.042). CONCLUSION: Biofeedback therapy was superior for objective improvement of pelvic function to observation in LARS. It can be considered to induce more rapid improvement of major LARS.
Biofeedback, Psychology ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Manometry ; Postoperative Complications ; Rectal Neoplasms ; Rehabilitation

PURPOSE: Intraabdominal abscess is one of the most common reasons for re-hospitalization after gastrectomy. This study aimed to develop a model for estimating the probability of intraabdominal abscesses that can be used during the postoperative period. MATERIALS AND METHODS: We retrospectively reviewed the clinicopathological data of 1,564 patients who underwent gastrectomy for gastric cancer between 2010 and 2012. Twenty-six related markers were analyzed, and multivariate logistic regression analysis was used to develop the probability estimation model for intraabdominal abscess. Internal validation using a bootstrap approach was employed to correct for bias, and the model was then validated using an independent dataset comprising of patients who underwent gastrectomy between January 2008 and March 2010. Discrimination and calibration abilities were checked in both datasets. RESULTS: The incidence of intraabdominal abscess in the development set was 7.80% (122/1,564). The surgical approach, operating time, pathologic N classification, body temperature, white blood cell count, C-reactive protein level, glucose level, and change in the hemoglobin level were significant predictors of intraabdominal abscess in the multivariate analysis. The probability estimation model that was developed on the basis of these results showed good discrimination and calibration abilities (concordance index=0.828, Hosmer-Lemeshow chi-statistic P=0.274). Finally, we combined both datasets to produce a nomogram that estimates the probability of intraabdominal abscess. CONCLUSIONS: This nomogram can be useful for identifying patients at a high risk of intraabdominal abscess. Patients at a high risk may benefit from further evaluation or treatment before discharge.
Abdominal Abscess ; Abscess* ; Bias (Epidemiology) ; Body Temperature ; C-Reactive Protein ; Calibration ; Classification ; Dataset ; Discrimination (Psychology) ; Gastrectomy* ; Glucose ; Humans ; Incidence ; Leukocyte Count ; Logistic Models ; Multivariate Analysis ; Nomograms* ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms*

OBJECTIVE: To investigate factors influencing commitment to human papilloma virus (HPV) vaccination and prior vaccination among female college students in northern Taiwan. METHODS: A quota sample of 400 female college students was recruited from nine colleges in northern Taiwan during March 2013. Of these, 398 completed the self administered questionnaire which was designed based on the health promotion model. RESULTS: The results showed that factors associated with prior vaccination behavior were family history of gynecologic malignancy, ever being advised to get HPV vaccination, perceived barriers of action and perceived self-efficacy. Predictors for commitment to HPV vaccination in the next 6 months were the cost of vaccination, ever being advised to get HPV vaccination, perceived self-efficacy and situational influences. Perceived self-efficacy was significantly influenced by relationship status, past receipt of a recommendation for HPV vaccination and level of knowledge about HPV. CONCLUSION: When formulating vaccination policies, governmental or medical institutions should include these factors to promote vaccination.
Cross-Sectional Studies ; Female ; *Health Knowledge, Attitudes, Practice ; Health Promotion/methods ; Humans ; Papillomavirus Infections/complications/*prevention & control ; *Papillomavirus Vaccines ; Self Efficacy ; Socioeconomic Factors ; Students/*psychology ; Taiwan ; Uterine Cervical Neoplasms/*prevention & control/virology ; Vaccination/psychology/statistics & numerical data ; Young Adult

OBJECTIVETo study the risk environmental and psycho-social factors associated to prostate cancer (PCa) in Chinese population.

METHODS250 PCa patients and 500 controls were enrolled in this case-control study. Information was collected and logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI) for relationship between lifestyle, eating habits and psycho-social factors with PCa risk.

RESULTSGreen vegetables and green tea were associated with a decreased risk of PCa (OR=0.39, 95% CI: 0.28-0.53; OR=0.59, 95% CI: 0.40-0.87, respectively). Family history of PCa (OR=7.16, 95% CI: 2.01-25.49), history of prostate diseases (OR=2.28, 95% CI: 1.53-3.41), alcohol consumption (OR=1.97, 95% CI: 1.33-2.90), red meat consumption (OR=1.74, 95% CI: 1.20-2.52), barbecued (OR=2.29, 95% CI: 1.11-4.73) or fried (OR=2.35, 95% CI: 1.24-4.43) foods were related with increased PCa risk. Negative psycho-social factors including occupational setbacks (OR=1.61, 95% CI: 1.00-2.59), marital separation (OR=1.94, 95% CI: 1.29-2.91), self-contained suffering (OR=2.37, 95% CI: 1.58-3.55), and high sensitivity to the personal comments (OR=1.73, 95% CI: 1.18-2.54) were related to PCa.

CONCLUSIONRegular consumption of green vegetables and green tea may suggest protective effects on PCa. Alcohol consumption, red meat consumption and barbecued or fried foods were associated with PCa. Negative psycho-social factors may also play a role in the incidence of PCa in Chinese population.

Aged ; Aged, 80 and over ; Animals ; Case-Control Studies ; China ; epidemiology ; Food ; statistics & numerical data ; Humans ; Life Style ; Male ; Middle Aged ; Prostatic Neoplasms ; epidemiology ; etiology ; psychology ; Stress, Psychological ; complications

PURPOSE: The purpose of this study was to investigate the effects of psychosocial interventions on pain in cancer patients. METHODS: Eight studies published between 1980 and 2012 in Korean and ten studies published between 2002 and 2012 in English met the inclusion criteria with a total of 1539 participants. Methodological quality assessed by Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. The data were analyzed by the RevMan 5.2 program of Cochrane library. RESULTS: Overall, study quality was moderate to high. Effect sizes were heterogeneous and subgroup analysis was done. Cognitive behavioral therapy (CBT) were effective for pain (ES= -0.35; 95% CI= -0.56, -0.13). Pain education studies measured with NRS and VAS were effective for pain (ES= -0.77; 95% CI= -1.01, -0.52). Publication bias was not detected. CONCLUSION: This study support the use of psychosocial interventions administered to cancer patients for their pain management. However, more well-designed studies are needed.
Clinical Trials as Topic ; Cognitive Therapy ; Databases, Factual ; Humans ; Neoplasms/*complications/*psychology ; Pain/*etiology ; *Pain Management ; Questionnaires

PURPOSE: Our study aimed to examine the relationship between intelligence and health-related quality of life (HRQOL) in children (6-13 years old) diagnosed as having a brain tumor. MATERIALS AND METHODS: We administered a Korean version of the Wechsler Intelligence Scale for Children-III, the Pediatric Quality of Life Inventory, version 4.0 (PedsQL), the Korean version of the Parenting Stress Index-Short Form, and the Korean Version of the Parenting Sense of Competence (K-PSOC) scale before or after initial radiotherapy (T1) and after treatment termination (T2). In total, 13 patients completed both the T1 and T2 interviews. RESULTS: Scores significantly declined between T1 and T2 on the full-scale intelligence quotients (FIQ), verbal intelligence quotients (VIQ), performance intelligence quotients (PIQ), similarity and coding tests, as well as the K-PSOC, which measures parental anxiety. FIQ scores at T1 were correlated with the self-reported PedsQL total scores (r=0.739) and the parent proxy-report PedsQL scores for school functioning (r=0.706) at T2. Also, the FIQ scores at T2 were correlated with the self-reported PedsQL total scores (r=0.748) and scores for physical health (r=0.728) at T2. CONCLUSION: The cognitive ability and intelligence level of the patients significantly declined between on and off treatment periods, and higher intelligence functioning at both on and off treatment was correlated with long-term higher HRQOL. Further investigations that monitor intelligence, HRQOL and parenting stress over a longer period, using a greater number of participants, are needed.
Adolescent ; Anxiety ; Brain Neoplasms/complications/physiopathology/*psychology ; Child ; *Cognition ; Female ; Humans ; Intelligence Tests ; Longitudinal Studies ; Male ; Parenting ; Parents/psychology ; Prospective Studies ; *Quality of Life ; Stress, Psychological/*diagnosis ; Time Factors

One of the annoying complications of radical prostatectomy is urinary incontinence. Post-prostatectomy incontinence (PPI) causes a significant impact on the patient's health-related quality of life. Although PPI is stress urinary incontinence caused by intrinsic sphincter deficiency in most cases, bladder dysfunction and vesicourethral anastomotic stenosis can induce urine leakage also. Exact clinical assessments, such as a voiding diary, incontinence questionnaire, pad test, urodynamic study, and urethrocystoscopy, are necessary to determine adequate treatment. The initial management of PPI is conservative treatment including lifestyle interventions, pelvic floor muscle training with or without biofeedback, and bladder training. An early start of conservative treatment is recommended during the first year. If the conservative treatment fails, surgical treatment is recommended. Surgical treatment of stress urinary incontinence after radical prostatectomy can be divided into minimally invasive and invasive treatments. Minimally invasive treatment includes injection of urethral bulking agents, male suburethral sling, and adjustable continence balloons. Invasive treatment includes artificial urinary sphincter implantation, which is still the gold standard and the most effective treatment of PPI. However, the demand for minimally invasive treatment is increasing, and many urologists consider male suburethral slings to be an acceptable treatment for PPI. The male sling is usually recommended for patients with persistent mild or moderate incontinence. It is necessary to improve our understanding of the pathophysiologic mechanisms of PPI and to compare different procedures for the development of new and potentially better treatment options.
Biofeedback, Psychology ; Constriction, Pathologic ; Humans ; Life Style ; Male ; Muscles ; Pelvic Floor ; Postoperative Complications ; Prostatectomy ; Prostatic Neoplasms ; Quality of Life ; Suburethral Slings ; Urinary Bladder ; Urinary Incontinence ; Urinary Sphincter, Artificial ; Urodynamics

OBJECTIVE: To explore the association between the cancer related fatigue and social support in breast cancer patients after chemotherapy. METHODS: According to the uniform inclusive and exclusive criteria, 396 breast cancer patients after chemotherapy were sampled randomly from 4 hospitals in Changsha and investigated on the spot by cancer fatigue scale and social support scale. RESULTS: The levels of social support, subjective support, Objective support, and utilization of support of the breast cancer patients after chemotherapy were 36.63±7.80, 21.05±4.67, 8.45±3.06, and 7.13±2.10, respectively, which were lower than the normal level, with significant difference(P<0.001). There was a negative correlation between each fatigue dimension and social support, subjective support, Objective support, and utilization of support (P<0.05 or P<0.001). CONCLUSION The social support system in patients with breast cancer after chemotherapy is poor. There is a negative correlation between the social support system and cancer related fatigue.
Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Breast Neoplasms ; complications ; drug therapy ; Carcinoma, Ductal, Breast ; drug therapy ; psychology ; China ; Fatigue ; etiology ; psychology ; Female ; Humans ; Middle Aged ; Social Support

OBJECTIVE: To study the relevance between cancer related fatigue and coping styles in breast cancer patients after chemotherapy. METHODS: A survey was conducted in 396 patients with breast cancer after chemotherapy on cancer related fatigue scale and Jalowiec coping scale, and the relation was analyzed. RESULTS: The rate of overall fatigue in breast cancer patients was 96.97%, mostly moderate fatigue. The rate of fatigue dimensions from high to low was physical fatigue, feeling fatigue and cognitive fatigue, respectively. The score of coping styles in patients with breast cancer after chemotherapy from high to low was optimistic coping, facing bravely, support seeking, self-reliance, emotional catharsis, avoidance, fatalism, and conservation. The most widely used coping style was optimistic coping style, and the least was emotional catharisis. There was a positive correlation between coping style of emotional catharsis and cancer related fatigue of all dimensions (P<0.01). There was a negative correlation between emotional fatigue and optimistic,facing bravely, support seeking, self-reliance, or conservation (P<0.05). There was also a negative correlation between physical fatigue and optimistic or support seeking (P<0.05), but there was a positive correlation between avoidance or fatalism and the dimensions of general fatigue, physical fatigue, and cognitive fatigue (P<0.05). CONCLUSION There is prevalent cancer related fatigue in patients with breast cancer after chemotherapy. We should guide the patients to more active coping styles, to enhance the ability of psychological adaption in patients, reduce cancer related fatigue, and improve the quality of life.
Adaptation, Psychological ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Breast Neoplasms ; complications ; drug therapy ; Chemotherapy, Adjuvant ; Fatigue ; chemically induced ; Female ; Humans ; Middle Aged ; Quality of Life ; psychology ; Sampling Studies ; Surveys and Questionnaires

Gastric cancer is the most common cancer and the third most common cause of cancer deaths in Korea. Gastric resection, especially for the early stages of the disease, results in an excellent survival rate, and has been the mainstay of treatment for gastric cancer patients. Due to increasing use of surveillance endoscopy, the diagnosis of gastric cancer at early stages has increased. The 5-year survival rate for early gastric cancer has now improved to better than 90%, and consequently, the population of long-term survivors after gastrectomy has also increased. Therefore, the quality of life including nutritional support has become an important concern for gastrectomized patients during long-term follow-up. Nutritional capacities after gastrectomy should be evaluated by nutritional assessment and absorption tests. Nutritional deficits are more serious after total gastrectomy than after subtotal gastrectomy. Fat malabsorption has been shown to be a significant concern in patients that have undergone total gastrectomy. Other suggested causes of malnutrition include poor oral intake, relative pancreatic insufficiency, bacterial overgrowth, and shortened intestinal transit time. Food residue and bile reflux are frequently observed in the remnant stomach during surveillance endoscopy after a distal subtotal gastrectomy due to gastric cancer. The bile reflux is often associated with remnant gastritis or esophagitis and has an influence on the quality of life following a distal subtotal gastrectomy. Reconstruction methods have not influenced the food retention phenomenon after a distal gastrectomy over long-term periods. In addition, nutritional status after gastrectomy is significantly associated with postoperative complications. In conclusion, the provision of dietary education and nutritional support is highly recommended in postoperative patients for gastric cancer.
Absorption ; Bile Reflux ; Endoscopy ; Esophagitis ; Exocrine Pancreatic Insufficiency ; Follow-Up Studies ; Gastrectomy ; Gastric Stump ; Gastritis ; Humans ; Korea ; Malnutrition ; Nutrition Assessment ; Nutritional Status ; Nutritional Support ; Postoperative Complications ; Quality of Life ; Retention (Psychology) ; Stomach Neoplasms ; Survival Rate ; Survivors