ABSTRACT
Introduction: Breast cancer remains one of the major cancers worldwide. In Asia, breast cancer is leading both incidence and mortality rates. Health-related quality of life (HRQoL) studies play an important role in clinical treatment. This systematic review aimed to summarize the evidence of HRQoL and associated factors among patients with breast cancer in low-and-middle-income countries (LMICs) in Asia. Method: Performed according to PRISMA guidelines for systematic review, the studies were searched from three databases (PubMed, Cochrane, Scopus) up to November 2020. The studies which met the predefined eligibility criteria were selected, extracted, and assessed the quality according to the Newcastle-Ottawa Scale (NOS) tool. Results and Discussion: A total of 2,620 studies were searched on the three databases, of which 28 met the selection criteria, then, were included in the systematic review. The Global Health Status (GHS) score of breast cancer patients based on the EORTC QLQ-C30 questionnaire ranged from 56.32 ± 25.42 to 72.48 ± 15.68. The overall HRQoL scores using the FACT-G and FACT-B instruments ranged from 60.78 ± 13.27 to 82.23 ± 12.55 and from 70.29 ± 13.33 to 108.48 ± 19.82, respectively. Factors affecting HRQoL of patients with breast cancer included age, education level, income, marital status, lifestyle, tumor stage, method, and treatment duration. Patient's income showed a consistent effect on HRQoL while the remaining factors reported inconsistent findings across the studies. In conclusion, the HRQoL of breast cancer patients in LMICs in Asia was low and affected by several sociodemographic factors which should be studied more in future research.
ABSTRACT
BACKGROUND: Hepatectomy is always a challenge to surgeons and requires an appropriate approach for specific tumors to achieve effective complication management. Selective hepatic pedicle clamping is more considerable strategy when comparing with total hepatic pedicle clamping in the balance between reducing blood loss and transfusion with causing the hepatic parenchyma damages (two main complications affecting liver resection result). OBJECTIVES: In this study, we aim to describe the application of selective hepatic inflow vascular occlusion (SHIVO) and anatomical anterior approach in liver resection and evaluate the results, focusing on intraoperative and postoperative complications. METHODS: We enrolled 72 patients who underwent liver resection with SHIVO at Viet Duc University Hospital in 4-year period (2011-2014) and then followed up all of them until June 2020 (in 52.6 ± 33 months; range, 2-105 months) or up to the time of death. All the patients were diagnosed with primary or secondary liver cancer, and their future remnant liver volume measured on 64-slice CT scan (dm3) to body weight (kg) > 0.8% (for right hepatectomy). Perioperative parameters were collected and analyzed. RESULTS: The average operation time was 196.2 ± 62.2 minutes, and blood loss was 261.4 ± 202.9 ml; total blood transfusion proportion during and after surgery was 16.7%. Complications accounted for 44.5% of patients in which pleural effusion was the most common one (41.7%). There were no liver failure and biliary fistula after surgery. No deaths were recorded during 30 days postoperatively. Average hospital stay was 11.4 ± 3.7 days. Blood transfusions during the operation and major liver resection were the factors significantly affecting the percentage of complications after liver surgery in our study. In the last follow-up evaluation, 44 patients were dead and 28 patients were alive, in which 7 with recurrence and 21 without recurrence. The overall survival rate was 38.9%. CONCLUSION: SHIVO in anatomical liver resection is a safe and feasible approach to help resect precisely targeted tumors and manage several complications in liver resection.
ABSTRACT
Introduction: Coronavirus disease 2019 (COVID-19) has significantly affected health care workers (HCWs), including their mental health. However, there has been limited evidence on this topic in the Vietnamese context. Therefore, this study aimed to explore COVID-19-related, psychological stress risk factors among HCWs, their concerns and demands for mental health support during the pandemic period. Methods: We employed a cross-sectional study design with convenience sampling. An online, self-administered questionnaire was used and distributed through social media among medical and non-medical HCWs from April 22 to May 12, 2020. HCWs were categorized either as frontline or non-frontline. We measured the prevalence of psychological stress using the Impact of Event Scale-Revised (IES-R) instrument. Multivariate binary logistic regression analysis was performed to identify risk factors associated with psychological stress among HCWs. Results: Among the 774 enrolled participants, 761 (98.3%) eligible subjects were included in the analysis. Most respondents were females (58.2%), between 31 and 40 years of age (37.1%), lived in areas where confirmed COVID-19 cases had been reported (61.9%), medical HCWs (59.9%) and practiced being at the frontline (46.3%). The prevalence of stress was 34.3%. We identified significant risk factors such as being frontline HCWs (odds ratio [OR] = 1.77 [95% confidence interval [CI]: 1.17-2.67]), perceiving worse well-being as compared to those before the COVID-19 outbreak [OR = 4.06 (95% CI: 2.15-7.67)], and experiencing chronic diseases [OR = 1.67 (95% CI: (1.01-2.77)]. Majority (73.9%) were concerned about testing positive for COVID-19 and exposing the infection to their families. Web-based psychological interventions that could provide knowledge on managing mental distress and consulting services were highly demanded among HCWs. Conclusion: The prevalence of psychological stress among HCWs in Vietnam during the COVID-19 pandemic was high. There were also significant risk factors associated with it. Psychological interventions involving web-based consulting services are highly recommended to provide mental health support among HCWs.
