Does quality of life of prostate cancer patients differ by stage and treatment?

BACKGROUND: The lack of consensus amongst experts delineate how important it is for patients diagnosed with prostate cancer (PCa) to make an informed decision on available treatment options through an objective discussion of the risks and benefits. One of important benefits could be seen as patient's quality of life (QoL) after treatment. We aimed to assess QoL differences in prostate cancer patients by stage and treatment for a population-based sample. METHODS: The cross-sectional PCa patient population-based national level study for a prostate cancer patient population was performed. QoL was investigated with EORTC QLQ-C30. The analysis includes descriptive statistics and evaluation of differences in functional and symptom scales by stage and treatment group by predictors in the model. RESULTS: Response rate was 79.1% (N=514). The highest QoL scores were observed in localised PCa, active surveillance treatment group. The lowest scores were observed in advanced stages, chemotherapy treatment group. Between cancer stages, statistically significant differences were observed only in scales of emotional functioning (p<0.001) and social functioning (p<0.001). Between treatment groups, statistically significant differences were observed in scales of physical functioning (p<0.001), role functioning (p<0.001), emotional functioning (p<0.001), and social functioning (p<0.001). CONCLUSIONS: Our study highlighted statistically significant differences in QoL between cancer stages and treatment. Understanding how the QoL changes in relation with the selected treatment option can be important to the urologist and individual patient to have realistic expectations as well as to optimise treatment decisions for the prostate cancer patient when exist several alternatives.

Does illness perception explain quality of life of patients with prostate cancer?

BACKGROUND: It is licely that illness perceptions can explain variations in quality of life of patients with prostate cancer across different treatment methods and stages. Therefore, the aim of this study was to determine if illness perception can explain variations in quality of life of patients with prostate cancer. MATERIAL AND METHODS: The cross-sectional national-level study was carried out. Quality of life was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the Visual Analogue Scale. Illness perceptions were measured by the revised Illness Perception Questionnaire. RESULTS: The response rate was 77.1% (N=501). The variation in global quality of life was explained (32.0%) by levels of emotional representation (ß=-0.126; P=0.023) and consequences (ß=-0.209; P<0.01); physical functioning (27.0%), by consequences (ß=-0.203; P<0.01) and chemotherapy (ß=-2.911; P=0.007); role functioning (37.0%), by emotional representations (ß=-0.198; P<0.01), timeline cyclical (ß=-0.209; P=0.014), and stage of the disease (ß=-0.779; P=0.007); emotional functioning (43.0%), by emotional representations (ß=-0.361; P<0.01) and education level (ß=-0.566; P=0.025); cognitive functioning (34.0%), by educational level (ß=0.714; P=0.005), emotional representations (ß=-0.118; P=0.019), illness coherence (ß=-0.167; P=0.030), consequences (ß=-0.187; P=0.001), and hormonal therapy (ß=-0.778; P=0.049); and social functioning (39.0%), by consequences (ß=-0.320; P<0.01) and combined treatment (ß=-1.492; P=0.016). CONCLUSIONS: Illness perceptions may be important while investigating quality of life in patients with prostate cancer. It may underlie quality-of-life differences in this group of patients and could inform decision makers about the importance of the provision of psychosocial services to patients with prostate cancer.

Factors affecting health-related quality of life in prostate cancer patients.

OBJECTIVE: Prostate cancer is the most common cancer among men in Lithuania. Quality of life (QoL) assessment plays a key role in the evaluation and treatment of cancer patients. The aim of this study was to evaluate factors affecting the QoL of patients with prostate cancer in Lithuania. MATERIAL AND METHODS: A cross-sectional national-level study was performed. QoL was investigated with the EORTC QLQ-C30 questionnaire. Statistical analysis included descriptive statistics, interrelationship analysis between characteristics and multivariate logistic regression to estimate predictors and odds ratios (ORs) for each of the independent variables in the model. RESULTS: The response rate was 74.8% (N = 486). One-quarter of respondents with prostate cancer indicated high QoL scores. Higher QoL scores were given for prostate cancer patients with lower education level [OR = 3.092, 95% confidence interval (CI) 1.007-9.491, p = 0.049], having lower monthly expenses for treatment (OR = 3.653, CI 1.318-10.128, p = 0.013), disease stage II (by patient conveyance) (OR = 10.053, CI 1.015-99.534, p = 0.048), disease stage I (by medical record) (OR = 2.19E + 08, CI 218514200.17-218514200.17, p < 0.001) and in those with undisclosed disease stage (OR = 9.220, CI 1.251-67.965, p = 0.029). CONCLUSIONS: Significant predictors for higher QoL scores were education level, own monthly expenses for treatment and disease stage. Patients with undisclosed disease stage more often had higher QoL scores.

Cost-effectiveness and cost-utility of the treatment of chronic hepatitis B with peginterferon alfa-2a, interferon alfa, and lamivudine in Lithuania.

BACKGROUND: Chronic hepatitis B infection is an important health care problem worldwide. According to the World Health Organization, 10% to 15% of population is infected with hepatitis B virus. Nearly 100 new cases of acute hepatitis B are annually registered in Lithuania, but official statistics covers only 8-25% of all disease incidence. The aim of this study was to evaluate the cost-effectiveness of the treatment of chronic hepatitis B with peginterferon alfa-2a and compare it to treatment with interferon alfa and lamivudine in Lithuania. MATERIAL AND METHODS: A Markov model was used to evaluate long-term cost-effectiveness of the treatment with peginterferon alfa-2a and to compare it with treatment with interferon alfa and lamivudine. Peginterferon alfa-2a was administered by subcutaneous injections at a dosage of 180 µg every week for 48 weeks; interferon alfa, 6 million IU three times a week for 24 weeks; and lamivudine, 100 mg per day from 48 weeks to 5 years for HBeAg-positive chronic hepatitis B and 100 mg per day up to 5 years in HBeAg-negative chronic hepatitis B. RESULTS: Treatment with peginterferon alfa-2a gained 1.179 life years as compared to 0.658 life years gained with treatment with interferon alfa; incremental costs per incremental life-year gained (LYG) were 51,256.92 Lt (14,845.03 €). Treatment with peginterferon alfa-2a gained 0.545 quality-adjusted life-years (QALYs) with incremental costs per incremental QALY of 48,980.08 Lt (14,185.61 €). Treatment with peginterferon alfa-2a had twice higher cost-effectiveness than treatment with interferon alfa: 50,4167.00 Lt (146,016.85 €) vs. 954,020.08 Lt (276,303.31 €), respectively. Costs for a complete response were also twice lower. Treatment with peginterferon alfa-2a gained 0.757 incremental LYG more compared to lamivudine (48-week course). Comparing incremental cost-effectiveness using peginterferon alfa-2a for treatment, incremental costs per incremental LYG were 41,993.67 Lt (12,162.21 €); additionally there was a gain of 0.792 incremental QALYs, while incremental costs for incremental QALY were 40,096.19 Lt (11,612.66 €). Complete response costs were 83,515.98 Lt (24,187.89 €) less compared to lamivudine (48-week course). CONCLUSIONS: Treatment of chronic hepatitis B prolongs patients' overall survival and quality-adjusted life. Peginterferon alfa-2a was the most effective drug registered in Lithuania for CHB treatment.

Influence of temporary filling material on dental cracks and fractures during endodontic treatment: A systematic review.

INTRODUCTION: A significant loss of dental structures during endodontic treatment increases the probability of tooth cracks, fractures or even tooth loss. The objective of this systematic review was to assess the influence of temporary filling material on dental cracks and fractures during endodontic treatment. MATERIALS AND METHODS: The literature was digitally searched for in vivo and in vitro studies using Pubmed, ScienceDirect and Wiley Online Library databases. A total of 38 potentially relevant records were identified in the literature search after duplicates were removed. After screening, full-text analysis of selected studies was done. Two reviewers independently selected the studies, extracted the data which was structured and summarized. RESULTS: Five publications met the selection criteria. Ten temporary filling materials were evaluated in this review. The analysis demonstrated that non-eugenol chemically hardening temporary filling materials significantly increase filling and dental fractures and have the lowest fracture and tooth fracture resistance. Glass ionomer cements (GIC) presented the higher hermetic, tightness and fracture resistance features. CONCLUSIONS: A temporary filling material during endodontic treatment may influence dental cracks and fractures. Highest impact for dental cracks and fractures has ready-to-use, eugenol-free temporary filling materials, whereas the least impact has GIC.

Illicit Tobacco in Lithuania: A Cross-Sectional Survey.

Taxation policies are the most cost-effective measure to reduce overall tobacco consumption. However, cigarettes in Lithuania are among the cheapest in the European Union. The threat of the illicit trade is often used to compromise evidence-based policies, pricing policies particularly. The aim of this study was to determine the extent of illicit cigarette consumption in Lithuania and identify the main characteristics of illicit cigarette smokers. The national cross-sectional survey with direct observation of the latest purchased pack of cigarettes was conducted between August and September 2019. In total, 1050 smokers aged ≥18 were interviewed face-to-face. The illicit share of the total consumption of cigarettes per year was 10.7% with 9.7% of smokers showing or describing illicit cigarette packs compared to 17% reported by industry-funded studies. Older smokers, smokers with lower education and heavy smokers were more likely to regularly purchase illicit cigarettes. The average price of an illicit pack was almost two times lower than licit. Although the illicit trade of tobacco products is a serious policy challenge, the threat of an increase in illicit trade should not delay tobacco taxation improvements.

Associations between parental skills and their attitudes toward importance to develop good oral hygiene skills in their children.

BACKGROUND: For many years, poor oral hygiene and frequent consumption of sugars is known as key behavioral risk factors for oral diseases, such as dental caries and periodontal disease. Parental attitudes toward children's oral health could be associated with their own oral health skills. We aimed to analyze associations between parental skills and attitudes toward caries development and possibilities to control positive oral health behavior in their children. MATERIAL AND METHODS: A cross-sectional study involved 550 parents of 3- to 4-year-old children. A 40-item questionnaire was developed from the Theory of Planned Behavior, Health Belief Model and the Health Locus of Control model, and parental attitudes toward dental caries in their children were analyzed. RESULTS: A total of 397 filled-in questionnaires were collected; the response rate was 72%. Parents with good own oral hygiene skills significantly more often understood the importance of brushing their children's teeth (chi(2)=29.8; df=1; P<0.001). Study results highlighted also significant differences in importance to prevent tooth decay (chi(2)=3.1; df=1; P=0.051), importance to control sugar snacking (chi(2)=10.6; df=1; P=0.001), and parental perceived seriousness of tooth decay in children (chi(2)=9.2; df=1; P=0.002) comparing parents with poor and good oral hygiene skills. Differences in parental efficacy to control proper toothbrushing and parental efficacy to control sugar snacking in children were not significant comparing both groups. CONCLUSIONS: More than half (61%) of the parents have reported appropriate own oral hygiene skills. Parental attitudes toward children's oral health were significantly associated with their own oral health behavior and understanding the importance of development of oral hygiene skills in their children.