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Study Objectives: The aim of this study was to validate the automatically scored results of an esophageal probe-based polygraph system (ApneaGraph® Spiro) against manually scored polysomnography (Nox A1, PSG) results. We compared the apnea-hypopnea index, oxygen saturation index, and respiratory disturbance index of the devices., Methods: Consenting patients, referred for obstructive sleep apnea workup, were tested simultaneously with the ApneaGraph® Spiro and Nox A1® polysomnograph. Each participant made one set of simultaneous registrations for one night. PSG results were scored independently. Apnea-hypopnea index, oxygen desaturation index, and respiratory disturbance index were compared using Pearson's correlation and scatter plots. Sensitivity, specificity, and positive likelihood ratio of all indices at 5, 15, and 30 were calculated., Results: A total of 83 participants had successful registrations. The apnea-hypopnea index showed sensitivity of 0.83, specificity of 0.95, and a positive likelihood ratio of 5.11 at an index cutoff of 15. At a cutoff of 30, the positive likelihood ratio rose to 31.43. The respiratory disturbance index showed high sensitivity (> 0.9) at all cutoffs, but specificity was below 0.5 at all cutoffs. Scatterplots revealed overestimation in mild OSA and underestimation in severe OSA for all three indices., Conclusions: The ApneaGraph® Spiro performed acceptably when OSA was defined by an AHI of 15. The equipment overestimated mild OSA and underestimated severe OSA, compared to the PSG., (© 2021. The Author(s).)

Background: Nasal septoplasty is a common surgical procedure, but a significant number of patients report equal, or some even worsened, symptom load postoperatively. Rhinologists struggle to find objective tests that adequately reflects disease burden. This study aimed to evaluate the correlation between the PNIF measurement of the most obstructed side with patient reported outcomes., Methods: Bilateral and unilateral PNIF measurements were performed before and after topical decongestion in 528 patients scheduled for surgery due to nasal obstruction. Subjective outcomes were measured using Nasal Obstruction VAS and SNOT-22 with subdomains. Correlations between subjective and objective measurements were calculated and further explored using multivariate regression analyses., Results: Significant negative correlations between PNIF and patient reported outcomes were found. Both bilateral and minimal unilateral PNIF correlations with NO-VAS were equal and stronger than correlations with SNOT-22 including subdomains concerning problems with nasal obstruction. Minimal unilateral PNIF did not show statistically significant gender difference. Topical decongestion decreased statistical correlations., Conclusions: The minimal unilateral PNIF shows a statistically significant but weak negative correlation with preoperative patient reported nasal obstruction, and values do not differ between genders. Clinical evaluation of patients presenting complaints of nasal obstruction could be supported by minimal unilateral PNIF.

Mobile health technology is emerging to take a prominent position in the management of chronic diseases. These technologies aim at enhancing patient empowerment via education and self-management. To date, of all the different apps available for patients with sinus disease, none were developed by medical experts dealing with chronic rhinosinusitis (CRS). The European Forum for Research and Education in Allergy and Airway diseases (EUFOREA) has undertaken a multi-stakeholder approach for designing, developing and implementing a tool to support CRS patients in monitoring their symptoms and to provide patients with a digital support platform containing reliable medical information about their disease and treatment options. mySinusitisCoach has been developed by medical experts dealing with CRS in close collaboration with patients, primary care physicians and community pharmacists, meeting the needs of both patients and health care providers. From a research perspective, the generation of real life data will help to validate clinical studies, patient stratification and improve understanding of the socio-economic impact of CRS, thereby paving the way for better treatment strategies.

The first European Rhinology Research Forum organized by the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) was held in the Royal Academy of Medicine in Brussels on 17th and 18th November 2016, in collaboration with the European Rhinologic Society (ERS) and the Global Allergy and Asthma European Network (GA2LEN). One hundred and thirty participants (medical doctors from different specialties, researchers, as well as patients and industry representatives) from 27 countries took part in the multiple perspective discussions including brainstorming sessions on care pathways and research needs in rhinitis and rhinosinusitis. The debates started with an overview of the current state of the art, including weaknesses and strengths of the current practices, followed by the identification of essential research needs, thoroughly integrated in the context of Precision Medicine (PM), with personalized care, prediction of success of treatment, participation of the patient and prevention of disease as key principles for improving current clinical practices. This report provides a concise summary of the outcomes of the brainstorming sessions of the European Rhinology Research Forum 2016.

Objectives: In patients with prostate cancer, evaluation of quality of care requires the inclusion of patient-reported outcomes measures assessed by validated and reliable instruments. Basic psychometric tests of the Norwegian version of the Expanded Prostate Cancer Index Composite with 26 items (EPIC-26) were performed in this study., Material and Methods: Translation of the original questionnaire (University of California, Los Angeles Prostate Cancer Index Composite), field testing and retranslation were done according to published guidelines. The final EPIC-26 items were subsequently selected from the Norwegian version of the EPIC-50 with slight verbal adjustments to comply with the English version of the EPIC-26. Reliability and validity were tested among 471 patients who, between 2009 and 2010, had been included in a prospective Norwegian multicenter study assessing adverse effects after radical prostatectomy or prostatic radiotherapy, usually combined with (neo)adjuvant hormone treatment. All patients completed the EPIC-26 before treatment and 3 and 12 months afterwards., Results: Internal consistency was documented by Cronbach's alpha coefficients ranging from 0.64 to 0.91 for the five domains/subdomains. Item-to-scale correlation coefficients ranged from 0.20 to 0.88, with the lowest value (0.20) for overall sexual problem. Criterion validity was proven by significant correlations between individual responses to the International Prostate Symptom Score and sum scores of the irritative/obstructive subdomain score of the EPIC-26. Satisfactory sensitivity and responsiveness reflected clinical utility for assessing between-group differences and treatment-related changes., Conclusions: Based on basic psychometric tests, the Norwegian version of the EPIC-26 showed acceptable reliability and validity for assessment of adverse effects after treatment of non-metastatic prostate cancer.

Background: In men with PCa, large variations of PROs after RP or high-dose RAD might be related to between-country differences of medical and sociodemographic variables, and differences in PROs before treatment in the sexual and urinary domains., Patients and Methods: In 1908 patients with localized PCa from Norway, the United States, or Spain, the relation between medical (prostate-specific antigen, Gleason score, cT-category) and sociodemographic variables (age, education, marital status) before treatment was investigated. Using the Expanded Prostate Cancer Index Composite questionnaire, PROs before treatment within the sexual and urinary domains were also considered., Results: Compared with the European patients, American patients were younger, fewer had comorbid conditions, and more had a high education level. Fifty-three percent of the US men eligible for RP had low-risk tumors compared with 42% and 31% among the Norwegian and the Spanish patients, respectively. Among the Spanish RAD patients, 54% had had low-risk tumors compared with 34% of the American and 21% of the Norwegian men planned for RAD, respectively. Compared with the European patients, significantly fewer US patients reported moderate or severe sexual dysfunction and related problems. In most subgroups, the number of patients with sexual or urinary dysfunction exceeded that of patients with bother related to the reported dysfunction., Conclusion: Statistically significant between-country differences were observed in medical and sociodemographic variables, and in PROs before treatment within the sexual and urinary domains. Large differences between reported dysfunction and related problems within the sexual and urinary domains indicate that dysfunction and bother should be reported separately in addition to calculation of summary scores. The documented differences, not at least regarding PROs, might in part explain the large variation of side effects after treatment evident in the medical literature., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: To evaluate work status at three months after radical prostatectomy (RP) in patients with prostate cancer (PCa) in relation to socio-demographics, urinary incontinence and bother, medical complications health-related quality of life (HRQOL) and surgical methods. To identify pre-RP available factors that can predict the duration of immediate post-RP sick leave., Material and Methods: This prospective questionnaire-based study included 264 men with PCa<65 years, who were active in the work force before RP. Urinary incontinence and bother were assessed using the Expanded Prostate Cancer Index Composite-50 (EPIC-50). HRQOL was measured using SF-12. Medical complications comprised self- reported new morbidities and re-hospitalizations within three months after RP. Patients' work status was defined as either "stable/improved" or "declined" at three months compared to work status at baseline. Duration of immediate post-RP sick leave was considered as prolonged when lasting >6 weeks. Associations were analyzed using logistic regression analyses., Results: Almost 30% of the patients had declined work status three months after RP. Change of physical HRQOL was the only factor remaining significantly associated with declined work status in the multivariate analysis. Half of the patients had prolonged immediate sick leave. Having physically strenuous work was the strongest predictor for this outcome., Conclusions: Long periods of sick leave and reduced workforce participation after RP should be considered potential adverse effects of this treatment.

Objective: This study aimed to assess the prevalence of positive surgical margins (PSM) and urinary incontinence (UI) in relation to surgeons' annual radical prostatectomy (RP) volume., Material and Methods: This national study prospectively assessed 521 preoperatively continent patients with prostate cancer (PCa), scheduled for RP by surgeons with high (>50), medium (20-50) or low annual volume (<20) at 14 urological departments in Norway. Patients responded to UI questions from the Expanded Composite prostate cancer index (EPIC-50) before and 1 year after RP. UI was defined as "use of pad(s)" and/or "a moderate or severe urinary leakage problem (ULP)". Preoperative prediction of PSMs and UI was explored in multivariate regression analyses with the following independent variables: surgeons' annual RP volume, type of hospital (university versus community), patient's health, sociodemographic features and PCa characteristics., Results: Based on histopathological reports, the overall PSM rate was 26%, with differences between the high- (18%), medium- (28%) and low-volume (44%) groups. Increasing PSM rates were predicted by surgeons belonging to the low- and medium-volume categories, prostate-specific antigen> 10 µg/l, Gleason score >7, patient age >65 years and <12 years of education. At 1-year follow-up 40% reported UI, without significant differences between the volume groups. Only 46% of those who used pad(s) experienced ULP. UI was predicted by clinical category ≥T2 and community type of hospital, but not by surgeons' annual RP volume. CONCLUSIONS. Preoperative counselling should take into account the relationship between surgeon's annual RP volume and PSM rate and the current knowledge about UI and ULP.

Unlabelled: What's known on the subject? And what does the study add? Sexual function is often impaired after radical prostatectomy resulting in reduced sexual activity and sexual bother. The main focus in the literature concerning sexual adverse effects has been on erectile dysfunction and impairment of sexual function rather than the actual sexual bother it causes, although the sexual bother is most important to the individual patient's quality of life. The relation between these measures, and in particular preoperative prediction of postoperative sexual bother, has only been studied in a limited way and with varying results. Some studies have found good mental health, low levels of preoperative sexual bother, and higher education to be associated with absence of postoperative sexual bother, but another study could not identify any preoperative predictors of postoperative sexual bother. Severe sexual bother after radical prostatectomy was reported by 64% to 95% of patients 3 years after operation, and the prevalence was associated with the level of pretreatment sexual bother and peroperative nerve preservation. On the other hand, others have reported that only 43% of men have sexual bother 2 years after radical prostatectomy. However, none of these studies stratified patients according to their preoperative sexual activity and most of them were American. It has been shown that American findings concerning sexual bother may not always be valid for non-American patients due to differing sex role expectations, thus warranting the need for more non-American studies. This study has shown that two-thirds of patients experienced sexual bother 1 year after radical prostatectomy. We have identified patients with increased risk of experiencing overall sexual bother postoperatively: those who report preoperative sexual bother, those who are sexually active before radical prostatectomy, and those who display neurotic personality traits. Another important finding is that the proportion of patients who experienced bother relevant to having impaired postoperative sexual function was significantly higher among preoperatively sexually active patients than those who had been inactive. This study adds knowledge that patients' preoperative sexual activity, sexual bother and personality should be taken into account to be able to give individualized information about the risk of experiencing sexual bother after radical prostatectomy. Study Type--Therapy (outcomes research). Level of Evidence 2c., Objective: • To explore the prevalence and prediction of overall sexual bother (SB) 1 year after radical prostatectomy (RP) in relation to preoperative sexual activity and postoperative sexual function., Patients and Methods: • This prospective national study included 453 men who completed the sexual domain of the Expanded Prostate Cancer Index Composite before and 1 year after RP. • Preoperatively the patients were classified as sexually active or inactive based on frequency of intercourse during the previous 4 weeks. • The prevalence of 1-year SB and the proportion of bothered patients with impaired sexual function were calculated. • Preoperative factors significantly associated with postoperative SB on univariate analysis (P < 0.05) were included in multivariate regression analysis, post-prostatectomy SB being the dependent variable., Results: • The prevalence of SB increased from 18% preoperatively to 66% at 1 year after RP with a larger proportion of change in the active than the inactive group (59% vs 25%). • The proportion of men reporting postoperative SB related to their impaired sexual function 1 year after RP was significantly higher in the preoperatively sexually active group (83%) compared with the inactive group (63%). • In multivariate analysis preoperative SB, sexual activity and nervousness (neuroticism) significantly predicted postoperative SB with odds ratios of 3.71, 2.11 and 1.57, respectively., Conclusion: • Sexual activity and SB the last month before prostatectomy and neuroticism identify men at risk of developing SB 1 year postoperatively. Assessment of preoperative sexual activity and SB should be a part of preoperative counselling., (© 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.)

Purpose: Previous cross-sectional studies show considerable discrepancies between patient and physician ratings of adverse events after prostate cancer treatment. We used data from a randomized, controlled trial to examine such discrepancies., Material and Methods: The Scandinavian Prostate Cancer Groups Study 7 randomized men with locally advanced prostate cancer to antiandrogen monotherapy or to the same hormone treatment combined with external beam radiotherapy after 3 months of total androgen blockade. We selected a subsample of 333 men with valid ratings at baseline, and at 12 and 24-month followup for this prospective substudy. We also examined a cross-sectional sample of 305 men at the end of radiotherapy. We compared patient and physician ratings of frequency of daytime and nighttime urination, urinary incontinence, erectile dysfunction, bowel problems, nausea/vomiting, breast tenderness and gynecomastia., Results: Perfect agreement between patient and physician ratings was observed in 70% to 100% of cases at baseline, in 73% to 98% at 12 months and in 65% to 97% at 24 months. There were 1% to 20% changes in perfect agreement with time. With patient ratings as the gold standard physicians more often underrated than overrated adverse events, except bowel problems, which were overrated at all posttreatment points., Conclusions: In a randomized, controlled trial of external beam radiotherapy and hormone manipulation physicians recorded pelvis related adverse events in acceptable accordance with their patients with prostate cancer. The oncologist tendency to overestimate bowel problems after radiotherapy needs further investigation. Our positive findings from a formal trial should not be transferred to daily clinical practice without further studies of discrepancies in routine clinical practice., (Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)

Objective: To describe fertility issues, only rarely discussed with patients with prostate cancer, although paternity after treatment might be an important component of quality of life for some, as exemplified by two of our patients., Patients: During pretreatment counselling two patients with newly diagnosed prostate cancer initiated the discussion of paternity after treatment. Patient 1 then opted for radiotherapy as the treatment least likely to damage fertility, whereas patient 2 had semen cryopreservation before external beam radiotherapy combined with 6 months adjuvant hormone treatment., Results: Patient 1 became a father to a healthy child 9 months after starting radiotherapy, with conception two days after he had received one session of brachytherapy with (192)Ir (total dose 10 Gy, testicular dose, 0.1 Gy). Patient 2 fathered a child 36 months after completing external beam radiotherapy (total dose 74 Gy, testicular dose 1.2-2.3 Gy), which was combined with medical castration of 6 months' duration., Conclusion: Fertility issues should be considered in patients before curative treatment of prostate cancer.