Translation, intercultural adaptation, and validation of the Slovak version of AOSpine patient reported outcome for spinal trauma tool.

OBJECTIVES: The implementation of patient-reported outcome measurements has become a standard component of evaluating the effect of treatment. For spine injuries, an evaluation tool AOSpine Patient Reported Outcome for Spinal Trauma (AOSpine PROST) has been developed. The aim of this study was to translate, interculturally adapt and validate the Slovak version of AOSpine PROST. METHODS: Based on methodologies we translated and culturally adapted the AOSpine PROST into Slovak. We then validated it on a representative sample of patients treated at a single level­one trauma center in the Slovak Republic. Content validity was assessed by evaluating the number of inapplicable or missing questions.  Internal consistency was assessed by calculating Cronbach's alpha and Corrected item-total correlations. RESULTS: 37 patients were included in the study.  The questionnaire was understandable to patients. The mean T-score across questions and participants in the questionnaire was 79.6 with a narrow range of 70.4 to 97.3 for all questions, which is relatively high. The internal consistency of total score was excellent with Cronbach´s alpha of 0.92. Total correlation across questions revealed relatively good results ranging from 0.17 to 0.90. CONCLUSIONS: The results indicate that the Slovak version of AOSpine PROST is reliable and valid and can be used in practice (Tab. 2, Ref. 14). Text in PDF www.elis.sk Keywords: AOSpine PROST, patient reported outcome, spinal trauma, translation, intercultural adaptation.

Use of Fludarabine for the Treatment of Indolent Lymphoma with Chylothorax.

BACKGROUND: Although chylothorax is rare in patients with malignant lymphoma, it has been reported in cases with mediastinal lymphadenopathy, a bulky retroperitoneal mass, or thoracic ducts blocked by lymphocytes in chronic lymphocytic leukemia (CLL). The clinical picture is not specific. Patients become more immunocompromised and malnourished after repeated evacuations. Chylothorax is usually diagnosed when the triglyceride level is > 1.24 mmol/l and the cholesterol level is < 5.18 mmol/ l in the effusion. Chemotherapy or radiotherapy of the associated malignant tumors has been used as the first-line treatment of malignant chylothorax. The responses of chylothorax after 3-8 chemotherapy courses have been described. A few cases of indolent lymphoma associated with chylothorax that were treated with fludarabine-based chemotherapies with various outcomes have been published. Total parenteral nutrition or a low-fat diet combined with ingestion of medium-chain triglycerides can accelerate remission of chylothorax. OBSERVATION: This study presents two cases with chylothorax associated with a bulky abdominal mass in relapsed CLL and newly diagnosed follicular lymphoma, respectively. No further evacuations were required after one and three courses of fludarabine plus cyclophosphamide with/without rituximab in the patients with CLL and follicular lymphoma, respectively. Chylothorax disappeared after five courses, and a partial or complete response of malignant lymphoma was achieved. The response lasted for 30 months in the patient with CLL and has persisted throughout maintenance therapy with rituximab in the patient with follicular lymphoma. CONCLUSION: Limited experience indicates that fludarabine-based regimes can result in rapid regression of chylothorax, in addition to treating indolent lymphoma, which prevents patients becoming more malnourished and immunocompromised. Key words: lymphoma - fludarabine - chylothorax The authors declare they have no potential confl icts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 2. 2. 2018 Accepted: 20. 5. 2018.