ABSTRACT
This study developed and validated a questionnaire to measure the sexual health of patients with spinal cord injuries [SCI]. This was a cross-sectional study conducted at the Brain and Spinal Injury Research Center [BASIR], Tehran, Iran. Extensive review of literature, expert opinions, and encounters with SCI patients were used to develop and validate the questionnaires. There were 40 [32 males, 8 females] patients with SCI that presented for treatment at BASIR who enrolled in the study. Participants completed the questionnaires while they were admitted for medical care and during treatment follow-up visits. Participants completed the questionnaires twice, at a 2-4 week interval. Reliability testing for each measure was performed separately. Cronbach's alpha was used for internal consistency and test-retest was used for reliability. An expert committee approved the face and content validities of the questionnaires, Internal consistency of our questionnaires, was acceptable according to Cronbach's alpha that ranged from 0.73 for the sexual activity measure to 0.90 for the sexual adjustment measure. Test-retest reliability was satisfactory. Intraclass Correlation Coefficient [ICC] of measures ranged from 0.65 for sexual function to 0.84 for sexual activity. The sexual health measures has provided a valid assessment of sexuality-related matters in this sample of patients with SCI, which suggests that evaluation of sexual well-being may be useful in clinical trials and practice settings. Overall, the sexual health measures shows good internal consistency and test-retest reliability
ABSTRACT
The aim of this study was to evaluate the outcome in patients with renal cell carcinoma [RCC] and the inferior vena cava [IVC] or the right atrium tumor thrombus that were treated with radical nephrectomy and thrombectomy. Eleven of a total of 105 patients who underwent radical nephrectomy due to RCC had tumor thrombus extended to the IVC and/or the right atrium. We evaluated the surgical techniques used and the perioperative mortality and morbidity in these patients. The median age of the patients was 47 years [range, 16 to 59 years]. They all underwent radical nephrectomy with cavotomy, tumor thrombus removal, and lymphadenectomy. Eight patients underwent extracorporeal circulation and hypothermic circulatory arrest; 2, temporary venovenous bypass by chevron incision and median sternotomy; and 1, only chevron incision with mobilization of the right lobe of the liver and cross-clamping proximal to the tumor thrombus and cavotomy. In 1 case, a solitary liver metastasis was excised and the patient died within 30 days postoperatively because of massive hemorrhage due to liver metastatectomy. Two patients had invasion to the IVC wall and 7 had pathological lymph node involvement. Four patients were tumor free [follow-up range, 9 to 18 months] and 7 died due to multiple metastases during the follow-up. This study supports the role of extensive surgical treatment as the best initial management of patients with renal cancer extended to the IVC only in highly selected cases