RESUMEN
With increased patient survival, the psychosocial consequences of amputation in cancer patients has become increasingly important. The following study examined the psychosocial correlates of amputation in 16 male and 17 female Brazilian adolescent patients aged 10-20 years who had lost a limb to cancer. Interviews were conducted within 12 months of amputation. Eighty-two percent indicated that they were involved in preoperative decision making, but only 58% understood the limitations in functioning after undergoing an amputation. Before surgery, the most frequently chosen confidante was the mother, followed by a sibling, staff member, and a friend. The major postoperative problems in these patients were walking, pain, and social issues. Overall, 75% of the amputees felt they were independent in and out of the home. Most individuals (66.6%) had, but fewer (58%) wore, their prosthesis. Prior to amputation, 30 patients were enrolled in school and 13 had a job. Of 15 who returned to school, 67% could not keep up with the school work and 93% had problems getting along with their classmates. Of five patients who returned to their jobs, no one reported discrimination in hiring or promotion; however, four workers felt they had lost a job because of their amputation, and two reproted having to change jobs. Many had altered their lifestyles to suit their disability, but the social and educational adjustment of these patients appears promising. Proper education of school faculty, classmates, and medical staff may enhance the adjustment of adolescent cancer amputees.
Asunto(s)
Amputación Quirúrgica/psicología , Neoplasias/cirugía , Psicología del Adolescente , Ajuste Social , Adaptación Psicológica , Adolescente , Adulto , Brasil , Niño , Educación , Empleo , Femenino , Humanos , Masculino , Neoplasias/psicología , Prótesis e Implantes , Encuestas y CuestionariosRESUMEN
The role of eosinophils in granulopoiesis is unclear. In a variety of conditions, the level of eosinophils is inversely related to the level of neutrophils. The present report describes two patients with eosinophilia and neutropenia and examines the in vitro effects of eosinophils on the colony formation of their bone marrow in semisolid culture medium. The addition of autologous eosinophils to bone marrow cultures from these patients resulted in a decrease in the number of colonies; in contrast, antieosinophilic serum increased the number of colony-forming units. Indomethacin, an inhibitor of prostaglandin, was capable of reversing the effects of added eosinophils. The findings suggest that eosinophils have an inhibitory effect on in vitro granulopoiesis. The suppressive effects may be due to the high content of prostaglandin E found in eosinophils. A schematic diagram based on the current knowledge of the mechanism of granulopoiesis is presented.