Performance of serial CT ASPECTS for predicting stroke outcomes in patients with thrombolyzed acute ischemic stroke.

Objectives: The objective of this study was to compare the sensitivity and specificity of serial ASPECTS for predicting IHM and unfavorable outcome defined by a modified Rankin Scale score ≥3 at the time of discharge from the hospital in thrombolyzed AACIS patients. Materials and Methods: This retrospective study examined thrombolyzed AACIS patients admitted at Saraburi Hospital, a regional health-care facility in Thailand. The study was conducted between January 2015 and July 2022. The comparative predictive performance of the baseline ASPECTS, 24-h ASPECTS, and change in ASPECTS for IHM and unfavorable outcome was examined using the receiver operating characteristic (ROC) curves. The optimal cutoff values were identified based on Youden's index and the nonparametric method to compare the area under the ROC curve (AuROC) among the three scales. The potential confounders adjusted by multivariable logistic regression were reported odds ratio (OR) and 95% confidence interval (CI). Results: Three hundred and forty-five patients with thrombolyzed AACIS were analyzed; the median age was 61.8 ± 15.2 years. 53.0% were male, and the median National Institutes of Health Stroke Scale score was 11 points (interquartile range: 8-17). The AuROC for predicting IHM was 0.823 for the baseline ASPECTS, 0.955 for 24-h ASPECTS, and 0.920 for the change in ASPECTS. For predicting unfavorable outcome, the AuROC was 0.744 for the baseline ASPECTS, 0.853 for 24-h ASPECTS, and 0.800 for the change in ASPECTS. After adjusting for other factors, the OR for predicting IHM was 14.38 (95% CI: 1.69-122.57) for 24-h ASPECTS and 16.7 (95% CI: 4.36-64.01) for the change in ASPECTS. Regarding unfavorable outcome, the adjusted OR was 5.58 (95% CI: 1.83-17.01) for 24-h ASPECTS and 4.85 (95% CI: 2.45-9.60) for the change in ASPECTS. Conclusion: The 24-h ASPECTS and change in ASPECTS could be more precise predictors for predicting IHM and unfavorable outcome in patients with thrombolyzed AACIS.

Self-Management Energy Conservation for Cancer-Related Fatigue in Thai Women With Breast Cancer Receiving Chemotherapy: A Pilot Study.

OBJECTIVES: To examine the adherence to and the usefulness, satisfaction, and preliminary efficacy of a 12-week self-management energy conservation and active management intervention on fatigue. SAMPLE & SETTING: A total of 19 Thai women diagnosed with stage I-III breast cancer receiving adjuvant chemotherapy were enrolled from a local hospital in the central region of Thailand. METHODS & VARIABLES: A randomized controlled trial design was used. Fatigue was measured using the Piper Fatigue Scale-Revised and was collected at baseline and 12 weeks. Descriptive statistics and Student's t tests were used to analyze the data. RESULTS: Participants completed four interventional sessions. Of participants in the experimental group, nine were satisfied with the intervention, seven were satisfied with its effects on fatigue, and seven were very satisfied with the telephone delivery. Participants in the experimental group reported significantly less fatigue at 12 weeks compared to the attention control group (p = 0.008). IMPLICATIONS FOR NURSING: Teaching energy conservation principles and strategies to women with breast cancer undergoing chemotherapy is an intervention oncology nurses can easily deliver.

Exercise intervention for fatigue-related symptoms in Thai women with breast cancer: A pilot study.

The purpose of this pilot study was to preliminarily examine the effects of an exercise program on the symptoms of fatigue, sleep disturbance, mood disturbance, symptom distress, and physical fitness for Thai women with breast cancer. Twenty-three eligible women were randomly assigned to either an experimental group (n = 11) or to a control group (n = 12). Data were collected and analyzed at baseline and again at 4, 7, and 10 weeks. At each time point, fatigue was measured at an expected high point during treatment. Participants in the exercise group demonstrated a trend toward improving the symptoms with mean score changes. Using generalized estimating equations analysis, a significant decrease in mood disturbance was found in the exercise group compared with control at 10 weeks (ß = 0.03, P = 0.04). The participants exhibited significantly longer 12-minute walk distance at 10 weeks than those in the control group (t = 2.28, P = 0.04). These results indicate that exercise during adjuvant chemotherapy may be beneficial for Thai women with breast cancer.