Health-related Quality of Life During the First 4 Years After Non-Muscle-invasive Bladder Cancer Diagnosis: Results of a Large Multicentre Prospective Cohort.

BACKGROUND: The health-related quality of life (HRQoL) of patients with non-muscle-invasive bladder cancer (NMIBC) may be impaired due to the chronic and burdensome disease course, but longitudinal data are limited. OBJECTIVE: To evaluate HRQoL outcomes during the first 4 yr after NMIBC diagnosis, and to compare HRQoL across patient characteristics and with a normative population. DESIGN, SETTING, AND PARTICIPANTS: Patients with NMIBC (n = 1019) were included from the multicentre prospective cohort UroLife. Data were collected at 6 wk (baseline), and 3, 15, and 51 mo after diagnosis. Longitudinal reference data were obtained from an age- and sex-matched normative population (n = 490). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Cancer- and NMIBC-specific HRQoL outcomes (range 0-100) were evaluated by the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and EORTC QLQ-NMIBC24 questionnaires, respectively. Linear mixed modelling was used to analyse within-group changes and between-group differences. RESULTS AND LIMITATIONS: The majority of HRQoL outcomes remained stable over time. Observed changes were only of small clinical relevance. Improvements were noted in insomnia, social functioning, and three NMIBC-specific symptoms, while minor deteriorations in appetite and diarrhoea lasted until 51 mo. HRQoL in some domains was worse for high-grade NMIBC, high European Association of Urology (EAU) risk group, initial Bacillus Calmette-Guérin (BCG) treatment, being female, and being younger (<65 yr); yet differences were few, small, and temporary. No differences were observed across recurrence status. Compared with a normative population, clinically relevant worse scores were observed for six of 15 outcomes, which mostly recovered at 51 mo, except for minor symptoms of appetite loss and diarrhoea. CONCLUSIONS: No remarkable changes in HRQoL were observed during the first 4 yr after NMIBC diagnosis. Grade, EAU risk group, initial treatment, recurrence, sex, and age did not importantly affect HRQoL. HRQoL was largely comparable with that of the general population, especially after 4 yr. PATIENT SUMMARY: Quality of life is not largely affected during the first 4 yr after non-muscle-invasive bladder cancer diagnosis.

Association of occupational exposures and work characteristics with the occurrence of gastrointestinal disorders.

BACKGROUND: Work is a daily activity with various conditions, exposures, and habits that may affect health either positively or negatively. Aim of this study was to investigate the relationship between occupational factors and conditions, and the occurrence of gastrointestinal disorders. METHODS: We enrolled in this study a sample of 891 consecutive individuals, who were examined by standard colonoscopy and gastroscopy and interviewed regarding their working conditions and exposures. Consecutively, data were statistically analyzed to explore possible associations. RESULTS: Peptic ulcer diagnosis was associated with reports of muscle pain/headache [odds ratio (OR): 3.656, 95 % confidence interval (95% CI): 1.898-7.043], with working in shifts (OR: 2.463, 95% CI: 1.058-5.731), and with the presence of occupational stress (OR: 2.283, 95% CI: 1.162-4.486). Gastritis was associated with muscle pain/headache (OR: 2.258, 95% CI: 1.096-4.652), shift work (OR: 3.535, 95% CI: 1.345-9.29), occupational stress (OR: 2.182, 95% CI: 1.072-4.444), and sedentary work (OR 0.275 lower risk 95% CI: 0.113-0.671). Ulcerative colitis was associated with muscle pain/headache (OR: 6.211, 95% CI: 2.162-17.840) and occupational stress (OR: 6.418, 95% CI: 2.243-18.361), while Crohn's disease diagnosis with muscle pain/headache (OR: 3.554, 95% CI: 1.628-7.759), frequent ordering food at work (OR: 4.928, 95% CI: 2.3-10.559), occupational stress (OR: 3.023, 95% CI: 1.413-6.469), work with intense physical activity (OR: 0.665 lower risk, 95% CI: 0.252-0.758). Colon cancer diagnosis was associated with frequent ordering food at work (OR: 2.739, 95% CI: 1.268-5.916) and occupational stress (OR: 3.175, 95% CI: 1.384-7.286), while stomach cancer diagnosis with ordering food at work (OR: 2.794, 95% CI: 1.154-6.763) and exposure to dust (OR: 5.650, 95% CI: 1.551-20.582). Finally, presence of polyps was associated with ordering food at work (OR: 2.154, 95% CI: 1.135-4.091), and constipation with ordering food at work (OR: 2.869, 95% CI: 1.451-5.672), occupational stress (OR: 2.112, 95% CI: 1.097-4.066), and occupational noise (OR: 0.248, 95% CI: 0.084-0.737). CONCLUSION: The incidence of the gastrointestinal diseases is affected by occupational exposures and related lifestyle habits. HIPPOKRATIA 2017, 21(2): 74-79.

Mean Platelet Volume as a Surrogate Marker for Platelet Activation in Patients With Idiopathic Pulmonary Fibrosis.

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is associated with a prothrombotic state. AIM: To study mean platelet volume (MPV) and Platelet Distribution Width (PDW) as markers of platelet activation and their potential association with lung function in patients with recently diagnosed IPF. MATERIALS AND METHODS: This study included 56 patients with IPF (age 64.9±7.4 years) and 79 controls (age 64.2 ± 5.9 years). RESULTS: An inverse relation was demonstrated between platelet count and MPV in the control group but not among patients with IPF. Platelet count was significantly lower in patients with IPF compared with controls (230 ± 60 vs 256 ± 75 × 10(3)/µL, P = .038). Conversely, MPV was higher in patients versus controls (10.3 ± 1.2 vs 9.8 ± 1.2 fl, P = .024), while there was no difference between the groups in PDW. Respiratory function was, as expected, significantly impaired in patients with IPF versus controls in terms of forced expiratory volume in first second (FEV1; 67.2 ± 23.1 vs 102.6 ± 15.9% of predicted value, P < .001), forced vital capacity (FVC; 65.3 ± 21 vs 95.2 ± 16.1% of predicted value, P < .001), FEV1/FVC (83.1 ± 15 vs 87.5 ± 6.4%, P = .041) and partial pressure of oxygen in arterial blood (PaO2; 67.1 ± 10.3 vs 81.5 ± 15.2 mm Hg, P < .001). No significant correlation was seen between MPV and FVC (r = -.1497, P = .275), MPV and lung diffusion capacity for carbon monoxide (r = .035, P = .798) and total lung capacity (r = .032, P = .820). CONCLUSIONS: Patients with IPF exhibit higher MPV values and lower platelet count. Further studies are needed to assess the clinical implications of these findings.