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Siracusano S, Zaka A, Zaffuto E, Porcaro AB, Colombo R, Talamini R, Romantini F, Montorsi F, Lonardi C. Predicting global QoL after orthotopic neobladder or ileal conduit diversion: nomogram development. Front Oncol 2023; 13:1055140. [PMID: 37234982 PMCID: PMC10206116 DOI: 10.3389/fonc.2023.1055140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/14/2023] [Indexed: 05/28/2023] Open
Abstract
Introduction Quality of life (QoL) outcomes in patients undergoing radical cystectomy (RC) with orthotopic neobladder (ONB) or ileal conduit (IC) have been extensively investigated. However, a general lack of consensus on QoL's predictive factors exists. The aim of the study was to develop a nomogram using preoperative parameters to predict global QoL outcome in patients with localized muscle-invasive bladder cancer (MIBC) undergoing RC with ONB or IC urinary diversion (UD). Methods A cohort of 319 patients who underwent RC and ONB or IC were retrospectively enrolled. Multivariable linear regression analyses were used to predict the global QoL score of the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), according to the patient characteristics and UD. A nomogram was developed and internally validated. Results Patients' data in the two study groups significantly differed with regard to comorbidity profiles (chronic cardiac failure, p < 0.001; chronic kidney disease, p < 0.01; hypertension, p < 0.03; diabetic disease, p = 0.02; chronic arthritis, p = 0.02). A multivariable model that included patient age at surgery, UD, chronic cardiac disease, and peripheral vascular disease represented the basis for the nomogram. The calibration plot of the prediction model showed a systematic overestimation of the predicted global QoL score over the observed scores, with a slight underestimation for observed global QoL scores between 57 and 72. After performing leave-one-out cross-validation, the root mean square error (RMSE) emerged as 24.0. Discussion/conclusion A novel nomogram based completely on known preoperative factors was developed for patients with MIBC undergoing RC to predict a mid-term QoL outcome.
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Affiliation(s)
| | - Agustina Zaka
- Department of Urology, University of Verona, Verona, Italy
| | - Emanuele Zaffuto
- Department of Urology, Vita e Salute San Raffaele University, Milan, Italy
| | | | - Renzo Colombo
- Department of Urology, Vita e Salute San Raffaele University, Milan, Italy
| | - Renato Talamini
- Epidemiologist Freelance Consultant in Epidemiological Studies and Clinical Trials, Aviano, Italy
| | | | - Francesco Montorsi
- Department of Urology, Vita e Salute San Raffaele University, Milan, Italy
| | - Cristina Lonardi
- Department of Human Sciences, University of Verona, Verona, Italy
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Siracusano S, Zaka A, Bassi P, Gontero P, Mearini E, Imbimbo C, Simonato A, Dal Moro F, Giannarini G, Valotto C, Montorsi F, Colombo R, Porpiglia F, Bartoletti R, Vella M, Minervini A, Rossanese M, Porcaro B, Romantini F, Vicentini C, Talamini R, Ficarra V, Racioppi M, Lonardi C. Short-term effects of bowel function on global health quality of life after radical cystectomy. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01118-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Siracusano S, Zaka A, Bassi P, Gontero P, Mearini E, Imbimbo C, Simonato A, Dal Moro F, Giannarini G, Valotto C, Montorsi F, Colombo R, Porpiglia F, Bartoletti R, Vella M, Minervini A, Porcaro AB, Romantini F, Vicentini C, Talamini R, Ficarra V, Lonardi C. Quality-of-Life Outcomes in Female Patients With Ileal Conduit or Orthotopic Neobladder Urinary Diversion: 6-Month Results of a Multicenter Prospective Study. Front Oncol 2022; 12:855546. [PMID: 35515136 PMCID: PMC9067240 DOI: 10.3389/fonc.2022.855546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Radical cystectomy (RC) often affects patients’ life as this surgery is a traumatic and invasive event for the patients, with drawbacks on their daily, social, working, and sex life. Such changes in the quality of life (QoL) of patients are commonly studied through retrospective clinical evaluations and rarely with longitudinal studies. To date, studies focusing on functional outcomes, sexual function, and health-related QoL for female patients are lacking. We evaluated 37 patients using EORTC QLQ-C30 (QLQ-30) and Short-Form 36 (SF-36) questionnaires, before and after surgery, at 3 and 6 months of follow-up. The mean values for the emotional functioning in QLQ-C30 as well as the mental health in SF-36 were significantly higher in the ONB group compared to the IC group at 3 months of follow-up. These differences were not significant at 6 months of follow-up. At 6 months of follow-up, the ONB group showed a higher mean score in the physical and role functioning than the IC group. Although there was a statistically significant age difference at baseline of the two groups, none of the results are correlated with age, as demonstrated by Spearman’s analysis. The ONB seems to represent the most advantageous solution compared to the IC in terms of QOL at the 6-month follow-up.
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Affiliation(s)
- Salvatore Siracusano
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Agustina Zaka
- Department of Surgery, Dentistry, Pediatrics and Gynaecology, University of Verona, Verona, Italy
| | | | - Paolo Gontero
- Department of Surgical Science, Turin University, Turin, Italy
| | - Ettore Mearini
- Department of Medicine and Surgery, Perugia University, Perugia, Italy
| | - Ciro Imbimbo
- Department of Urology, Federico II Naples University, Naples, Italy
| | | | | | | | | | - Francesco Montorsi
- Department of Urology, San Raffaele Hospital, Vita e Salute University, Milan, Italy
| | - Renzo Colombo
- Department of Urology, San Raffaele Hospital, Vita e Salute University, Milan, Italy
| | | | | | - Marco Vella
- Department of Urology, Palermo University, Palermo, Italy
| | | | | | - Federico Romantini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Carlo Vicentini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Renato Talamini
- Department of Epidemiology, Aviano Oncology Center, Aviano, Italy
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Siracusano S, Zaka A, Romantini F, Porcaro AB, Vicentini C, Lonardi C. Quality of Life in Female Patients Following Ileal Neobladder and Ileal Conduit: Where Are We? J Clin Med 2021; 10:jcm10143042. [PMID: 34300207 PMCID: PMC8304698 DOI: 10.3390/jcm10143042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/30/2021] [Accepted: 07/05/2021] [Indexed: 11/16/2022] Open
Abstract
Women undergoing a radical cystectomy (RC) followed by a urinary diversion (UD) for bladder cancer (BC), experience a substantial reduction in health-related quality of life (HRQOL). At present, studies comparing long-term QOL outcomes for different UD methods in female patients are lacking. We summarize the current state of the QoL assessment in female patients after an RC.
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Affiliation(s)
- Salvatore Siracusano
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (F.R.); (C.V.)
- Correspondence:
| | - Agustina Zaka
- Department of Urology, University of Verona, 37129 Verona, Italy; (A.Z.); (A.B.P.)
| | - Federico Romantini
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (F.R.); (C.V.)
| | | | - Carlo Vicentini
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (F.R.); (C.V.)
| | - Cristina Lonardi
- Department of Human Science, University of Verona, 37129 Verona, Italy;
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Hashmi K, Khalid S, Raja K, Zaka A, Easterbrook J. 892 Emergency General Surgical Practice at a District General Hospital during COVID-19 Pandemic: Implementing Royal College of Surgeons Guidance. Br J Surg 2021. [PMCID: PMC8135695 DOI: 10.1093/bjs/znab134.502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction COVID-19 pandemic had a significant impact on surgical practice across NHS. RCS released guidance on altering surgical practise during the pandemic to deliver safe surgical care in March, 2020. We present an audit conducted at a DGH comparing practice of emergency general surgery (EGS) with RCS guidance at the peak of COVID-19 pandemic. Method Consecutive patients undergoing EGS from 1st April to 15th May,2020. Data of demographics, ASA grade, comorbidities, type of surgery, hospital stay, informed COVID-19 pneumonia consent, complications and 30-day mortality were collected. Pre- and post-operative COVID-19 status was determined. Results Forty-four (n = 44) patients, mean age 47.5 and IQR (26-69). Male (55.8%) and females (44.2%). Preoperative COVID19 status was confirmed in around 79.1% patients. All (100%) patients who underwent CT imaging preoperatively had CT chest performed. Informed consent for COVID19 pneumonia was taken in 4.7% patients. 30-day mortality risk was 7% and complications risk was 4.7%. RR of 30-day mortality in preoperative COVID19 status positive patients was RR = 0.92 (CI 0.85-1.01) and for complications was RR = 0.95 (CI 0.88-1.02). Conclusions RCS guidance on managing and altering practice in EGS during COVID-19 pandemic is reliable, implementable, and measurable in a DGH setting. Simple improvements in consent process can achieve full compliance with RCS guidelines.
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Affiliation(s)
- K Hashmi
- Queen Elizabeth Hospital, Kings Lynn, United Kingdom
| | - S Khalid
- Queen Elizabeth Hospital, Kings Lynn, United Kingdom
| | - K Raja
- Queen Elizabeth Hospital, Kings Lynn, United Kingdom
| | - A Zaka
- Queen Elizabeth Hospital, Kings Lynn, United Kingdom
| | - J Easterbrook
- Queen Elizabeth Hospital, Kings Lynn, United Kingdom
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Trifiletti E, Shamloo SE, Faccini M, Zaka A. Psychological predictors of protective behaviours during the Covid-19 pandemic: Theory of planned behaviour and risk perception. J Community Appl Soc Psychol 2021; 32:382-397. [PMID: 33967569 PMCID: PMC8093925 DOI: 10.1002/casp.2509] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/23/2022]
Abstract
The Covid‐19 outbreak was declared a public health emergency by the World Health Organization in January 2020. As a consequence, several protective measures were urged by national governments in order to limit the spread of the pandemic. Drawing on the literature on health behaviours, in the present study, we investigated the psychological factors (i.e., attitudes, social norms, perceived behavioural control, intentions, and risk perception) that were associated with two highly recommended behaviours: frequent hand washing and social distancing (i.e., staying at home except for essential reasons). The study employed a correlational design with a follow‐up. A questionnaire including measures of psychological predictors was administered via social media to a sample of 403 adults residing in Italy during the lockdown. Self‐reported behaviours were assessed one week later. Findings showed that attitudes, social norms, perceived behavioural control were significantly related to hand washing and social distancing through intentions. Risk perception was a significant predictor of social distancing but not of hand washing. These findings suggest that intervention and communication strategies aimed at encouraging preventive measures during the Covid‐19 pandemic should be organized taking into account multiple factors which partially differ depending on the type of behaviour considered. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.
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Affiliation(s)
| | | | - Martina Faccini
- Department of Human Sciences University of Verona Verona Italy
| | - Agustina Zaka
- Italian Association of Transactional Analysis Turin Italy
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Siracusano S, Zaka A, Zaffuto E, Porcaro A, Talamini R, Colombo R, Lonardi C. Predicting global quality of life outcome in patients undergoing radical cystectomy with orthotopic neobladder or ileal conduit urinary diversion: nomogram development and internal validation. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35619-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Zaka A, Shamloo SE, Fiorente P, Tafuri A. COVID-19 pandemic as a watershed moment: A call for systematic psychological health care for frontline medical staff. J Health Psychol 2020; 25:883-887. [PMID: 32370621 DOI: 10.1177/1359105320925148] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic is producing a huge health care burden with millions of cases and thousands of deaths. The coronavirus' high virulence and contagiousness and the frequent sudden onset of illness is overwhelming critical care and frontline healthcare staff. Frontline professionals are exposed to unprecedented levels of intensive existential threat requiring systematic, specialized psychological intervention and support. New psychological services need to be urgently implemented to manage the mental healthcare needs of frontline medical staff working with patients with COVID-19. The COVID-19 pandemic is a watershed moment: health care systems universally require a step-change to improve our preparedness for future pandemics.
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Affiliation(s)
| | | | | | - Alessandro Tafuri
- Department of Urology, University of Verona, Italy.,Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Italy
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