Course and predictors of excellent response to therapy in patients with differentiated thyroid cancer at long-term follow-up.

OBJECTIVES: To investigate the long-term outcomes of differentiated thyroid cancer (DTC) and the predictive factors for excellent and incomplete responses to therapy on long-term follow-up of patients. METHODS: A retrospective chart review and analysis was carried out at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Demographic, histological, and therapeutic data were collected from patients older than 13 years at the time of diagnosis, with a minimum follow-up of 18 months. Outcomes were divided into excellent, indeterminate, biochemically incomplete, and structurally incomplete responses. Odds ratios (ORs) for predictors of incomplete response at the last visit were determined. We first tested associations univariately with incomplete responses, and then variables with significant associations were included in a multivariable logistic model. RESULTS: Among 230 patients with DTC, 61.7% had excellent responses to therapy on long-term follow-up, and 24.3% had incomplete biochemical and structural responses. The median follow-up was 4.6 years. Factors significantly associated with incomplete response to therapy in the multivariate analysis (p<0.05) were age >55 years (OR=5) and lymph node (OR=3.4) and distant metastases (OR=29). Older age did not affect the outcome in low-risk patients with DTC but was significantly associated with incomplete responses in those with intermediate risk (p=0.04) and high risk (p=0.003). CONCLUSION: We strongly advocate incorporating age into recurrence risk assessment for patients with DTC.

Quality of life among adults with beta-thalassemia major in western Saudi Arabia.

OBJECTIVES: To assess the quality of life in the thalassemia adult patients and clarify how effective the management is of these patients and whether a change in care is warranted. METHODS: In this cross-sectional study, adult thalassemia patients (>18 years) of both genders, attending the day care unit in King Abdulaziz University Hospital, Jeedah, Saudi Arabia were surveyed using SF-36 questionnaire. Data were collected between October 2012 and December 2012. The questions highlighted 3 health status scales; physical functioning (PF), emotional functioning (EF), and social functioning (SF). Scores were analyzed using SPSS. RESULTS: Forty-eight adults were surveyed (mean+/-SD: 26.02+/-5.56). These were made up of 60.4% males and 41.7% were Saudis. The frequency of blood transfusion was every 3 weeks in 81.3% of patients, but 18.8% were having transfusions less frequently. Half of our sampled patients were splenectomized (54.2%). The PF score for the total sample was 61.4 (SD=22.7), the SF score was 75 (SD=26.4) and the EF score was 69.7 (SD= 21.6); the SF and EF scores were lower in females and non-Saudis compared to male Saudis. CONCLUSION: The PF score in our sample was low compared to other regional studies; the SF and EF scores were low in females and non-Saudis. 

Quality of life among children with beta-thalassemia major treated in Western Saudi Arabia.

OBJECTIVE: To assess the quality of life among children and adolescents with thalassemia major. METHODS: This cross-sectional study used the Pediatric Quality of Life Inventory (PedsQL). Children and adolescents with beta-thalassemia major who attended the Day Care Unit at King Abdulaziz University Hospital, Jeddah, Saudi Arabia from October 2012 to February 2013 were surveyed. The questions highlighted 4 health status scales, namely physical functioning (PF), emotional functioning (EF), school performance (SC), and social functioning (SF). Scores were calculated for each patient and data were analyzed using the Statistical Package for Social Sciences. RESULTS: We recruited 46 children (60.9% males). The median age of the sample was 12 years (range, 2-18 years). Most patients (84.8%) had 3 weekly blood transfusions. The mean+/-SD physical functioning (PF) score was 57.2+/-25.9; the EF score was 74.1+/-20.3, SF score was 78.5+/-24, and SC score was 54.3+/-24.2. The PF score was significantly lower in patients with a family history of thalassemia (p=0.003), and in those whose families had low incomes (p=0.049). Conversely, the SF score was significantly higher in school-educated patients (p=0.01). CONCLUSION: The quality of life of thalassemic children is affected by multiple factors, such as family income and a family history of thalassemia. Education appeared to increase patient functionality. Supportive measures could improve the quality of life in thalassemic patients.