The effectiveness of lifestyle interventions to reduce side effects of androgen deprivation therapy for men with prostate cancer: a systematic review.

PURPOSE: The aim of this review is to systematically review randomized controlled trials on lifestyle interventions on PCa patients undergoing androgen deprivation therapy. METHODS: A literature search was conducted using the electronic databases Medline and PubMed. To be eligible, studies had to be randomized controlled trials (RCTs) that focused on side effects of ADT and lifestyle interventions to reduce side effects for men undergoing ADT with PCa. Lifestyle interventions were defined as interventions that included any dietary or behavioral components. RESULTS: Twenty-nine trials were included. Most of them focused on exercise interventions, while some investigated the effect of dietary or behavioral interventions. The effect of different lifestyle influencing modalities aimed to improve on the adverse effects of ADT varied greatly. CONCLUSIONS: It is not possible to draw one conclusion on the effect of exercise-based interventions, but noted on several adverse effects of ADT improvement. Further studies are necessary to develop personalized lifestyle interventions in order to mitigate the adverse effects.

[Rib fixation for flail chest after resuscitation]. / Ribfixatie bij fladderthorax na reanimatie.

BACKGROUND: Rib fractures are a common complication caused by chest compressions during resuscitation. Flail chest may occur as a consequence, leading to respiratory failure. CASE DESCRIPTION: We present two cases in which surgical rib fixation was performed to treat flail chest after resuscitation. CONCLUSION: Based on a literature search, surgical rib fixation may be considered for flail chest after resuscitation in carefully selected patients.

Cervix removal at the time of hysterectomy: factors affecting patients' choice and effect on subsequent sexual function.

OBJECTIVES: To identify factors that influence the decision-making process on the type of hysterectomy (total or supracervical) and the impact of surgery of subsequent sexual function. STUDY DESIGN: A cross-sectional survey was undertaken on 212 women who underwent total laparoscopic hysterectomy (TLH) or laparoscopic supracervical hysterectomy (LSH) for benign conditions at the Division of Minimally Invasive Gynecology at Brigham and Women's Hospital in Boston, MA, USA. We analyzed the factors that patients considered in their decision-making process, their sexual function after surgery and their satisfaction with the surgery overall. Demographic and perioperative outcomes were also collected. RESULTS: A total of 115 women answered the survey, for a response rate of 54.24%. The patients who underwent LSH (n=54) and TLH (n=61) were overall similar in terms of baseline factors and perioperative outcomes. Patients reported that the physician was the main source of information regarding decision to remove or retain the cervix (79.13%). The physicians' recommendation was viewed as very or extremely important (83.68%) to the decision-making process, followed by concerns regarding their future sex life (51.09%). Almost half of the women reported that hysterectomy had no impact on sexual function. No statistically significant differences were seen between groups regarding satisfaction with sexual function (p=.822), impact on sexual function (p=.753) or recommendation of this surgery to other women (p=.505). CONCLUSION: Concerns about sexual health were important to women when considering the type of hysterectomy to undergo. Cervix removal or retention at the time of hysterectomy did not impact women's sexual function after mean follow-up of 15.2 months.