(C) 2010 Wiley Periodicals, Inc. J Appl Polm Sci 117: 3651-3658, 2010″
“The purpose of the study is to (1) estimate the direction, clinical relevance, and duration of health-related quality of life (HRQL) change in the first year following esophageal cancer surgery and (2) to assess the robustness of the estimates by subgroup and sensitivity analyses, and an exploration of publication bias.

A systematic literature search in MEDLINE, EMBASE, CINAHL, PsychINFO, and CENTRAL to identify randomized and non-randomized studies was performed. We compared the baseline HRQL data with 3-, 6-, 9-, or 12-month follow-ups

to estimate the magnitude and duration of HRQL change. These estimates were then classified as trivial, small, medium, or large. Primary outcomes were role functioning, eating, and fatigue. click here Secondary outcomes were physical and social selleck functioning, dysphagia, pain, and coughing problems. We conducted subgroup analysis for open surgery,

open surgery preceded by neo-adjuvant therapy, and minimally invasive surgery. Sensitivity analyses assessed the influence of study design, transformation/imputation of the data, and HRQL questionnaire used.

We included data from 15 studies to estimate the change in 28 HRQL outcomes after esophageal cancer surgery. The main analysis showed that patients’ social functioning deteriorated. Symptoms of fatigue, pain, and coughing problems increased. These changes lasted for 9-12 months, although some symptoms persisted beyond the first year after surgery. For many other HRQL outcomes, estimates were only robust after subgroup or sensitivity analyses (e.g., role and physical functioning), or remained too heterogeneous to interpret (e.g., eating and dysphagia).

Patients will experience a clinically relevant and long-lasting deterioration in HRQL after esophageal cancer surgery. However, for many HRQL outcomes, more and better quality evidence is needed.”
“Meningiomas are extra-axial dural-based tumors. They are the most common intracranial tumors, occur in mid to late life, and have a female predilection. Symptoms are a function

of location. Bcr-Abl inhibitor Meningiomas are usually benign, but atypical and malignant forms exist. Treatment is indicated for symptomatic lesions or when neurologic symptoms may shortly occur. Surgical resection can be curative; however, because of their location, some lesions are amenable only to partial resection. Radiation therapy is used for incompletely removed symptomatic lesions, lesions that are not surgically accessible, and small symptomatic lesions. For higher grade meningiomas, radiation is used after surgery. For lesions that recur or grow despite surgery and radiation, systemic chemotherapy can be tried. There is no optimal agent, but hydroxyurea is used most often with very modest success; hormonal approaches have not been successful.