ABSTRACT
PURPOSE: The original Functional Assessment of Anorexia/Cachexia Therapy (FAACT) was designed to measure general aspects of quality of life (QOL) as well as specific anorexia/cachexia-related concerns. Our primary purpose was to reduce the number of anorexia/cachexia subscale items in a manner that either retains or improves reliability, validity and precision. METHODS: The FAACT was administered using an interactive computer program that allowed immediate entry of the data. A total of 213 patients were recruited. RESULTS: A combined empirical and conceptual approach led to the reduction of the anorexia/cachexia subscale (A/CS) from 18 to 12 items. A 26-item trial outcome index (TOI) combining physical well-being (PWB), functional well-being (FWB), and the A/CS-12 was highly reliable and sensitive to change in performance status rating (PSR). We found that PWB, FWB, and A/CS-12 subscales performed differently. Specifically, PWB and FWB scores decreased in patients whose (PSR) worsened. However, although A/CS-12 scores were responsive to change in PSR over time, average A/CS-12 scores of all patients, even those whose PSR worsened, improved over the course of treatment. CONCLUSIONS: Elimination of six items from the anorexia/cachexia subscale of the FAACT was accomplished without loss of internal consistency or sensitivity to change in performance status. The A/CS-12 subscale provides unique, important information not captured by a generic chronic illness questionnaire.
Subject(s)
Activities of Daily Living/classification , Anorexia/drug therapy , Cachexia/drug therapy , Feeding Behavior/drug effects , HIV Infections/complications , Megestrol Acetate/administration & dosage , Neoplasms/complications , Nutritional Status/drug effects , Quality of Life , Sickness Impact Profile , Surveys and Questionnaires , Activities of Daily Living/psychology , Adult , Aged , Anorexia/etiology , Cachexia/etiology , California , Chicago , Cost of Illness , Feeding Behavior/classification , Female , Humans , Male , Middle Aged , Treatment Outcome , Weight LossSubject(s)
Fractures, Bone/surgery , Orbit/injuries , Surgery, Plastic/methods , Adolescent , Adult , Aged , Child , Ectropion/etiology , Entropion/etiology , Female , Humans , Male , Middle Aged , Postoperative ComplicationsABSTRACT
Of 253 consecutive hypospadias repairs by various surgeons, using the Byars technique, 57 (22 percent) had postoperative fistulae; 41 required one operation, 9 required two operations, and 7 required more than two operations for closure of these fistulae. Other complications were infrequent. When performed either by attending or resident physicians, the Byars hypospadias repair produced complete correction of the chordee, a urethra of satisfactory length and caliber, normal penile appearance, and a fistula rate comparable to that reported after other procedures.
Subject(s)
Hypospadias/surgery , Child, Preschool , Humans , Male , Methods , Postoperative Complications , Retrospective Studies , Urethral Diseases/etiology , Urinary Fistula/etiologyABSTRACT
A prospective double-blind study was instituted in a group of 150 general surgical patients to test the effectiveness of mini-dose heparinization in the pre- and postoperative periods. There was a 21 per cent reduction in the incidence of deep venous thrombosis in the heparin treated group. A radiopharmaceutical imaging technique with 99m-technetium macroaggregated albumin was used to evaluate the deep venous system. The procedure proved to be simple, safe, and painless; however, it was difficult to differentiate venous stasis from deep venous thrombosis. A negative study was good evidence that deep venous thrombosis did not exist. An additional benefit of this procedure was that a perfusion lung study could be obtained which provided additional information regarding pulmonary embolism without injecting additional radiopharmaceutical. Again, the negative perfusion lung study provided more information.
