Patiënten met hematologische kanker die hiervoor een autologe stamceltransplantatie ondergaan, staan voor de moeilijke taak om te gaan met zowel een potentieel levensbedreigende ziekte als een stressvolle behandeling. Een deel van deze patiënten rapporteert psychologische klachten. Behandeling van deze klachten verdient aandacht en zal naar verwachting leiden tot een verbetering van de kwaliteit van leven van deze patiënten. In dit artikel beschrijven we de implementatie van een zorgprogramma gericht op vermindering van psychologische klachten, met als belangrijkste onderdeel het internetzelfhulpprogramma ‘Stress onder controle’
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The early detection of breast-cancer-related lymphedema and referral for therapy has the potential to reduce lymphedema-related morbidity. Although research shows the benefits, a gap is observed between evidence and daily practice. We aimed to determine whether the early detection of lymphedema and referral for treatment is adequate following the current guidelines. Women with primary breast cancer treated with breast-conserving therapy or ablative treatment were included. Demographic-, general health-, tumor-, and treatment-related data were recorded. Bilateral arm volume measurements were performed preoperatively and 3, 6, 12, and 24 months post-surgery. A 5% or greater Relative Volume Change was considered the cutoff point for lymphedema and as an indication for therapy referral. After 24 months post-surgery, the main outcomes show that among the patients with early signs of lymphedema, based on a Relative Volume Change ≥5%, a nonreferral for therapy was noted in 83%. Additionally, we observed a significant improvement of the mean Relative Volume Change at 24 months within this group, which might implicate that nonreferral was an adequate choice and that watchful waiting is appropriate when lymphedema is detected within the first year post-surgery.
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BACKGROUND: The COVID-19 pandemic has led to a national lockdown in the Netherlands, which also affected transcatheter aortic valve implantation (TAVI) patients. The objective of the study was to describe physical activity, dietary intake and quality of life (QoL) in patients on the waiting list for TAVI pre-lockdown and during lockdown.METHODS: Consecutive patients awaiting TAVI at the Amsterdam University Medical Centers, the Netherlands were included. Measurements were self-reported effect of lockdown, physical activity, dietary intake and QoL.RESULTS: In total, 58 patients (median age 80, interquartile range (IQR) 76-84, 45% female) were observed pre-lockdown and 16 patients (median age 78, IQR 76-82, 25% female) during lockdown. Ten of the 16 patients during lockdown reported a decline in physical activity. However, we observed a median number of 5861 steps a day (IQR 4579-7074) pre-lockdown and 8404 steps a day (IQR 7653-10,829) during lockdown. Median daily protein intake was 69 g (IQR 59-82) pre-lockdown and 90 g (IQR 68-107) during lockdown. Self-rated health on a visual analogue scale was 63 points (IQR 51-74) pre-lockdown and 73 points (IQR 65-86) during lockdown.CONCLUSIONS: More than half of the patients during lockdown reported less physical activity, while we observed a higher number of steps a day, a similar dietary intake and a higher QoL. Therefore, patients on the TAVI waiting list appeared to be able to cope with the lockdown measures.
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