PubMed Health⌕ Search

Biomedical subjects

T Goodacre

Publications and source records attributed to T Goodacre.

14 recordsLinked to original sources
PubMed2004

Quality of life following resection, free flap reconstruction and postoperative external beam radiotherapy for squamous cell carcinoma of the base of tongue.

This study was conducted to evaluate quality of life in a cohort of patients with squamous cell carcinoma of the tongue base, treated with primary surgery, reconstruction and postoperative radiotherapy. Twelve patients were assessed in a cross-sectional study using the University of Washington Quality of Life Instrument (UW-QOL). All patients underwent external beam irradiation following primary resection of their tumour and reconstruction. Patients on average reported their overall and health related QOL to be good. Functionally they had good pain control, speech intelligibility, activity and recreational levels. There were some limitations in chewing, swallowing and taste. The results suggest that surgical resection can offer good functional and overall QOL results for advanced tumours when combined with reconstruction. The morbidity associated with postoperative radiotherapy includes reduced swallowing, taste, saliva production and difficulty chewing.

Adult↗
PubMed2002

Tumour thickness as a predictor of occult lymph node metastases in patients with stage I and II melanoma undergoing sentinel lymph node biopsy.

BACKGROUND: Sentinel lymph node biopsy (SLNB) is a minimally invasive procedure used accurately to stage nodal basins at risk of occult metastases. There are no data as yet to show a survival benefit from SLNB and its use remains controversial. If Breslow thickness of the tumour correlates well with positive SLNB, it could be used to select patients for SLNB. METHODS: A quantitative systematic review of published studies on SLNB in patients with melanoma available by September 2001 was performed. RESULTS: Twelve studies containing 4218 patients with stage I and II melanoma were identified; 17.8 (95 per cent confidence interval 16.7 to 19.0) per cent of patients had nodal micrometastases detected by SLNB. The incidence of micrometastasis in sentinel nodes correlated directly with Breslow tumour thickness; it was 1.0 per cent for lesions of less than or equal to 0.75 mm, 8.3 per cent for 0.76-1.50 mm, 22.7 per cent for 1.51-4.0 mm and 35.5 per cent for more than 4.0 mm. CONCLUSION: The Breslow thickness of primary melanoma predicts the presence of a sentinel node metastasis. The published data are not sufficient to demonstrate a correlation between other known prognostic indicators and a positive SLNB.

Humans↗
PubMed2002

Management of regional lymph nodes in patients with malignant melanoma: questionnaire survey of UK current practice.

In 2001, a short postal questionnaire regarding the management of regional lymph nodes in patients with cutaneous malignant melanoma was sent to 69 NHS departments of plastic and reconstructive surgery in the UK. Questionnaires were returned by 53 units, giving a response rate of 76.8%. Of these 53 units, 49 reported that they treat patients with primary malignant melanoma. There was considerable variation in the number of melanoma patients managed by each unit. This survey confirmed that elective lymph-node dissection is not routinely practiced in the UK; observation and therapeutic lymph-node dissection for patients who develop regional metastasis is the preferred pattern of care. The majority of centres in the UK do not use sentinel lymph node mapping: only 15 of the 49 units do so (30.6%). The number of sentinel lymph node biopsies performed in each unit varied significantly. There was considerable variation in the materials used and the process of care for sentinel lymph node biopsy. On the basis of this current practice, we recommend the setting up of a prospective clinical melanoma register to record the surgical treatment of melanoma patients.

Humans↗
PubMed1998

Measuring quality of life in cosmetic surgery patients with a condition-specific instrument: the Derriford Scale.

OBJECTIVE: To assess the reliability, validity and sensitivity to change of the Derriford Scale, a quality of life instrument designed to assess the distress and dysfunction experienced by people who are self-conscious about their physical appearance. SUBJECTS AND DESIGN: Postal questionnaire survey of 656 cosmetic surgery patients recruited from new referral letters and plastic surgery waiting list reports. A total of 443 subjects completed and returned the questionnaire. Of these respondents, 203 were sent a second questionnaire to assess reproducibility, of whom 155 subjects responded. MAIN OUTCOME MEASURES: Reliability was assessed in terms of internal consistency and reproducibility. Face, content and construct validity were also investigated. RESULTS: The analyses led to mixed results. There was some evidence of internal consistency, but a number of items had low endorsement levels and there may be scope for reducing the overall size of the instrument. When assessed for reproducibility, the level of agreement between scores of individuals completing the questionnaire on two occasions was high, but an important systematic shift in responses was also detected. Correlations between the other health status measures and the Derriford Scale provided some evidence of construct validity. CONCLUSION: In its present form the Derriford Scale has good descriptive value, but there are some measurement problems identified in this report that need to be addressed before the scale is taken up into general use.

Adult↗
PubMed1996

Should breast reduction surgery be rationed? A comparison of the health status of patients before and after treatment: postal questionnaire survey.

OBJECTIVES: To assess the health status of patients before and after breast reduction surgery and to make comparisons with the health status of women in the general population. DESIGN: Postal questionnaire survey sent to patients before and six months after surgery. SETTING: The three plastic surgery departments in the Oxford Regional Health Authority, during April to August 1993. SUBJECTS: 166 women (over the age of 16 years) referred for breast reduction; scores from the "short form 36" (SF-36) health questionnaire completed by women in the 1991-2 Oxford healthy life survey. MAIN OUTCOME MEASURES: Health status of breast reduction patients before and after surgery as assessed by the SF-36, the 28 item general health questionnaire, and Rosenberg's self esteem scale; comparisons between the health status of breast reduction patients and that of women in the general population; outcome of surgery as assessed retrospectively by patients. RESULTS: Differences between the health status of breast reduction patients and that of women in the general population were detected by the SF-36 both before and after surgery. Breast reduction surgery produced substantial change in patients' physical, social, and psychological function. The proportion of cases of possible psychiatric morbidity according to the general health questionnaire fell from 41% (22/54) before surgery to 11% (6/54) six months after treatment. Eighty six per cent (50/58) of patients expressed great satisfaction with the surgical result postoperatively. CONCLUSION: The study provides empirical evidence that supports the inclusion of breast reduction surgery in NHS purchasing contracts.

Adolescent↗
PubMed1996

Patients' health related quality of life before and after aesthetic surgery.

OBJECTIVES: To assess the health related quality of life of patients before and after aesthetic surgery. DESIGN: A survey by questionnaire of patients before receiving surgery and 6 months after surgery. SAMPLE: 656 patients anticipating surgery were sent a preoperative questionnaire, to which 443 replied. Subsequently 259 of these received a postoperative questionnaire, of which 198 were returned. OUTCOME MEASURES: Health status was assessed using three standardised health status instruments (The Short Form 36 Health Survey Questionnaire (SF-36), the General Health Questionnaire (GHQ-28) and the Rosenberg Self Esteem Scale. Comparisons were made between the health status of the plastic surgery patients and that of a random sample of the general population. RESULTS: Patients receiving breast reduction surgery experienced significant improvements on all three health status measures. Patients in all surgical groups experienced significant improvements in self-esteem. CONCLUSIONS: Patients receiving aesthetic surgery experience a wide range of physical, psychological and social problems. Surgery was shown be effective at addressing these problems. Health status assessment provides a valid and independent method for measuring the effects of such health care interventions.

Abdomen↗