Quality of life after free flap reconstruction for the cancer of the head and neck: Comparison between five-year survivors and non-survivors.

BACKGROUND: Free flap surgery due to the cancer of the head and neck includes high risk of postoperative complications and a five-year mortality up to 50%. We aimed to study the relation between the quality of life (QoL) reported two years after the operation and the mortality during a next three-year follow-up. We aimed to study the relation between the quality of life (QoL) reported two years after the operation and the mortality during a next three-year follow-up. METHODS: The QoL of 53 patients was assessed using RAND-36, UW-QOL, EORTC-C30 and H&N-35 tools two years after the operation. The assessed QoL was compared between the five-year survivors and the non-survivors. RESULTS: A total of 14 (26.4%) patients died during the follow-up. The RAND-36 scores of the deceased were lower in domains "general health", "energy", "emotional role functioning" and "emotional well-being". In UW-QOL tool, the domains "swallowing" and "mood", as well as experienced QoL were lower in the non-survivors. In EORTC QLQ assessment the non-survivors reported lower QoL in domains "global health status", "physical functioning", "role functioning", "swallowing", and "felt ill". CONCLUSION: Based on our results, poor long-term survival is related to poor QoL reported two years after surgery. The difference was found in general domains of QoL tools indicating that poor QoL is a surrogate of chronic health problems having an impact on the long-term survival.

Quality of life in head and neck cancer patients at 5 years after free flap reconstruction: a significant decline during the follow-up.

PURPOSE: Free flap reconstructions following head and neck tumor resection are known to involve more than 50% rate of complications and other adverse events and up to 50% mortality during a 5-year follow-up. We aimed to examine the difference in the long-term quality of life (QoL) between the 2-year and 5-year assessments after free flap surgery for cancer of the head and neck. METHODS: A total of 28 of the 39 eligible patients responded to the survey. QoL was assessed at 5 years after operation and compared with the assessment performed at 2 years after the operation using RAND-36, EORTC-C30 and H&N-35, and SWAL-QOL tools. RESULTS: The criteria for poor QoL using RAND-36 tool was met in 11 (39.3%) patients in contrast to 4 (14.3%, P = 0.003) patients in the 2-year assessment. EORTC-C30 global score was decreased from 83.9 (SD16.4) to 64.6 (SD 24.0, P < 0.001) during the follow-up. In both RAND-36 and EORTC-C30 surveys, decline was found in physical and role functioning together with energy and emotional well-being domains. SWAL-QOL showed poor swallowing-related QoL in both assessments. CONCLUSION: We found a significant decline in QoL during a 5-year follow-up after free flap surgery for cancer of the head and neck.

Pre-Harvest Modelling and Mitigation of Aflatoxins in Maize in a Changing Climatic Environment-A Review.

Aflatoxins (AFs) are harmful secondary metabolites produced by various moulds, among which Aspergillus flavus is the major AF-producer fungus. These mycotoxins have carcinogenic or acute toxigenic effects on both humans and food producing animals and, therefore, the health risks and also the potential economic damages mounted by them have led to legal restrictions, and several countries have set maximum allowable limits for AF contaminations in food and feed. While colonization of food and feed and AF production by A. flavus are highly supported by the climatic conditions in tropical and subtropical geographic regions, countries in the temperate climate zones are also increasingly exposed to AF-derived health risks due to climate change. In the present study, we have reviewed the available mathematical models as risk assessment tools to predict the possibility of A. flavus infection and levels of AF contaminations in maize in a changing climatic environment. After highlighting the benefits and possible future improvements of these models, we summarize the current agricultural practices used to prevent or, at least, mitigate the deleterious consequences of AF contaminations.