BACKGROUND: Epidermal growth factor receptor (EGFR) inhibitors frequently result in dermatologic toxicities, including rash, xerosis, pruritus, and paronychia. Although the frequency and severity of these events have been described, their effect on health-related quality of life (QoL) remains poorly understood. By using a dermatology-specific questionnaire, the authors examined the effect of these toxicities on QoL. METHODS: Patients completed the Skindex-16, a questionnaire that measures the effects on 3 domains of QoL: symptoms, emotions, and functioning. The severity of dermatologic toxicities was assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0 (NCI-CTCAE). Correlations of dermatology QoL scores with NCI-CTCAE grade, skin phototype (SPT), sex, age, type of EGFR inhibitor, and cancer type were investigated. RESULTS: Concordant with greater severity of rash grade, there was an increase in median scores for symptoms (P ¼ .0006), emotions (P < .0001), function (P ¼ .001), and overall score (P < .0001). There was an inverse correlation between age and emotions (r ¼ À0.26; P ¼ .03) and overall score (r ¼ À0.25; P ¼ .04). There was a significant difference between patients aged 50 years and patients aged >50 years with regard to symptoms (P ¼ .02), emotions (P ¼ .03), functioning (P ¼ .04), and overall score (P ¼ .02). There were no significant differences between QoL and SPT, sex, treatment type, or cancer type (P > .05). CONCLUSIONS: Toxicities, including rash, xerosis, paronychia, and pruritus, adversely affected QoL, and rash was associated with a QoL greater decrease. Younger patients reported lower overall QoL than older patients who had the same toxicities. The current results support using the NCI-CTCAE as a correlative tool for measuring the effects of rash on dermatology-specific QoL. Cancer 2010;116:3916-23.
Relevance of melanoma education to ethnic people may be improved by using 'melanoma skin cancer', photographs of early melanoma in people with dark skin, and providing guidance on how to inspect hands and feet for suspicious moles.
Design: Conveniencesurveyof100Chicago,Illinois,beachgoers aged 18 to 30 years who were age-and sex-matched with Chicago-area residents who participated in randomdigit-dialed telephone interviews in 1988 and 1994. Setting: Lakefront beach on weekday afternoons in July 2007. Main Outcome Measures: Knowledge of melanoma/ skin cancer link with tanning, and limiting tanning to help prevent melanoma/skin cancer; attitude about the appearance of tanned people; and knowledge of relevant information sources; and UV indoor tanning use in the past year. Results: Knowledge of the melanoma/skin cancer link with tanning changed from 1988 (42%) to 1994 (38%) to 2007 (87%). Knowledge of limiting tanning to help prevent melanoma increased from 1988 (25%) to 1994 (77%), but decreased from 1994 to 2007 (67%). This decline in knowledge about limiting tanning was concurrent with an increase in the attitude that having a tan looks better (1994, 69%; 2007, 81%). Use of indoor tanning beds increased from 1988 (1%) to 1994 (26%) and remained at the same level in 2007 (27%). Although physicians, especially dermatologists, were sources of information about tanning (1988, 2%; 1994, 18%; 2007, 31%) and were considered the most trusted source, only 14% of respondents in 1994 and 2007 reported ever talking to a doctor about indoor tanning. Conclusion: Because young adults report that physicians are their most trusted source of information about tanning, a potential opportunity exists for physicians to influence indoor tanning behavior by counseling their patients.
Background Calf muscle strain and Achilles tendon injuries are common in many sports. For the treatment of muscular and tendinous injuries, one of the newer approaches in sports medicine is capacitive-resistive electric transfer therapy. Our objective was to analyze this in vitro, using invasive temperature measurements in cadaveric specimens. Methods A cross-sectional study designed with five fresh frozen cadavers (10 legs) were included in this study. Four interventions (capacitive and resistive modes; low- and high-power) was performed for 5 min each by a diathermy “T-Plus” device. Achilles tendon, musculotendinous junction and superficial temperatures were recorded at 1-min intervals and 5 min after treatment. Results With the low-power capacitive protocol, at 5 min, there was a 25.21% increase in superficial temperature, a 17.50% increase in Achilles tendon temperature and an 11.27% increase in musculotendinous junction temperature, with a current flow of 0.039 A ± 0.02. With the low-power resistive protocol, there was a 1.14% increase in superficial temperature, a 28.13% increase in Achilles tendon temperature and an 11.67% increase in musculotendinous junction temperature at 5 min, with a current flow of 0.063 A ± 0.02. With the high-power capacitive protocol there was an 88.52% increase in superficial temperature, a 53.35% increase in Achilles tendon temperature and a 39.30% increase in musculotendinous junction temperature at 5 min, with a current flow of 0.095 A ± 0.03. With the high-power resistive protocol, there was a 21.34% increase in superficial temperature, a 109.70% increase in Achilles tendon temperature and an 81.49% increase in musculotendinous junction temperature at 5 min, with a current flow of 0.120 A ± 0.03. Conclusion The low-power protocols resulted in only a very slight thermal effect at the Achilles tendon and musculotendinous junction, but current flow was observed. The high-power protocols resulted in a greater temperature increase at the Achilles tendon and musculotendinous junction and a greater current flow than the low-power protocols. The high-power resistive protocol gave the greatest increase in Achilles tendon and musculotendinous junction temperature. Capacitive treatments (low- and high-power) achieved a greater increase in superficial temperature.
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