Exploring Symptom Clusters and Their Measurements in Patients With Lung Cancer: A Scoping Review for Practice and Research

PROBLEM IDENTIFICATION

This scoping review aimed to explore symptom clusters (SCs) in patients with lung cancer and how included symptoms and symptom dimensions are measured.

LITERATURE SEARCH

PubMed®, CINAHL®, Scopus®, and Cochrane Library were searched for studies published until December 31, 2021. Fifty-three articles were included.

DATA EVALUATION

Data extracted included descriptive items and SC constellations. Patient-reported outcome instruments and measured symptom dimensions were described according to the middle-range theory of unpleasant symptoms.

SYNTHESIS

13 articles investigated SCs a priori and 40 de novo. Thirty-six instruments were used, mostly measuring intensity alone or in combination with timing. Qualitative articles (n = 6) provided rich descriptions within the distress, timing, and quality dimensions.

IMPLICATIONS FOR RESEARCH

Fatigue was the symptom found to most frequently co-occur with other symptoms in SCs. Fatigue, psychological symptoms, and nutritional aspects are emphasized as important areas for oncology nursing practice and further research to improve SC management for patients with lung cancer.

The impact of age on Health-Related Quality of Life (HRQoL) and symptoms among postmenopausal women with breast cancer receiving adjuvant chemotherapy

BACKGROUND AND PURPOSE

Elderly women with breast cancer are often not given adjuvant chemotherapy (CT). One reason for this is that older women are believed to have more problems in tolerating side-effects of CT. The purpose of this study was to analyze the impact of age on health related quality of life (HRQoL) and symptoms in postmenopausal women with breast cancer undergoing adjuvant CT.

PATIENTS AND METHODS

Eighty consecutive postmenopausal patients planned for CT were invited. Seventy-five agreed to participate (age 55-77 years). The patients completed two cancer-specific HRQoL questionnaires, The European Organisation for Research and Treatment of cancer (EORTC) EORTC-QLQ-C30, the EORTC-QLQ-BR23, and the Hospital Anxiety and Depression Scale (HADS) before, during, and 4 months after completion of treatment. The design was descriptional and longitudinal. Correlations were examined between age and change in HRQoL variables.

RESULTS

No significant correlations were found between age and any of the assessed HRQoL domains or symptom scales, except for dyspnoea and sexual functioning. Age was inversely correlated to change in dyspnoea from baseline through follow-up, whereas older women perceived their sexual functioning significantly lower at baseline.

CONCLUSION

The results indicate that among postmenopausal patients in the age range 55-77 years consecutively selected for adjuvant CT age was not a predictor of decreased HRQoL. This supports the argument that age should not be used in isolation in decisions about adjuvant CT for breast cancer in elderly women.

A methacrylate-based cement used as a root canal sealer

In this study, a methacrylate-based orthopaedic bone cement was modified for use as a root canal sealer by changing the monomer from n-butyl methacrylate to tetrahydrofurfuryl methacrylate. The sealing and bonding capabilities, solubility and handling properties of the resin were evaluated. Seventy-three extracted mature human teeth with single canals were used. The teeth were randomly divided into two experimental groups each of 30 teeth; three control teeth were set aside for the leakage tests. Ten teeth were reserved for the scanning electron microscope studies. All the experimental teeth were root filled with gutta-percha and the resin sealer. The particle size of the polymer was limited in Group 1 to 75 microns or less and in Group 2 to 45 microns or less. The controls were filled with gutta-percha only. Silver nitrate solution was used as the leakage indicator. In Group 1 the mean linear penetration of the indicator was 1.10 mm +/- 1.04; four roots showed no leakage. In Group 2 the mean linear penetration of the indicator was 0.57 mm +/- 0.65; 12 roots showed no leakage. The test bodies showed no weight change after 1 and 3 months' storage in saline at 37 degrees C. The scanning electron microscope examination revealed a bond both between the resin and the dentine and between the resin and the gutta-percha. The working time of the new resin composition was normally about 50 min, and handling was found to be easy.

A comparison of the apical dye penetration patterns shown by methylene blue and india ink in root-filled teeth

This study compared the linear leakage patterns shown by 5% aqueous solution of methylene blue (MB) and India ink (II). One-hundred and twenty-five roots with single canals from extracted human teeth were used. The canals were cleaned and shaped using the step-back technique under copious irrigation. Three groups were arranged to receive root fillings of gutta-percha and one of three proprietary sealers using standard lateral condensation techniques: Sealapex (40 roots), Tubli-Seal (40 roots) and Ketac-Endo (20 roots). The remaining roots were used as controls: positive with gutta-percha and no sealer and negative with the apices sealed with nail varnish. The roots were randomly selected for 7-day immersion in either MB or II, then sectioned longitudinally; dye penetration was assessed using a Wild Leitz stereomicroscope. In all groups MB showed more penetration than II. The results were statistically significant at the P = 0.01 level, with the exception of the positive control groups. Negative controls showed no penetration. It is concluded that MB, which has a low molecular weight penetrated more deeply along root canal fillings than II, which has a large particle size.