RESUMO
La dermatitis herpetiforme es una enfermedad autoinmune que se caracteriza por la presencia de lesiones vesiculares y prurito en la superficie extensora de las extremidades, nalgas y parte baja de la espalda. Se presenta el caso clínico de una mujer de 21 años, natural y procedente de Iquitos, que presentó múltiples vesículas dolorosas, pruriginosas, de base eritematosa y purulentas en ambos codos durante un mes. Posteriormente, estas lesiones se diseminaron a ambas rodillas y se agregó prurito intenso. La paciente experimentó períodos alternantes de remisión y exacerbación. La correlación del cuadro clínico, resultados serológicos y de biopsia, junto con respuesta terapéutica a la dapsona confirmaron el diagnóstico de dermatitis herpetiforme, con una evolución favorable y remisión de la enfermedad.
Dermatitis herpetiforme is an autoimmune disease characterized by the presence of vesicular lesions and itching on the extensor surface of the limbs, buttocks, and lower back. The clinical case of a 21-year-old woman, a native of and from Iquitos, is presented. She presented multiple painful, itchy vesicles with an erythematous and purulent base on both elbows for a month. Subsequently, these lesions spread to both knees, and intense itching was added. The patient experienced alternating periods of remission and exacerbation. The correlation of the clinical picture, serological and biopsy results, along with the therapeutic response to dapsona, confirmed the diagnosis of dermatitis herpetiforme, with a favorable evolution and remission of the disease.
RESUMO
INTRODUCTION: The aim of this study was to analyze the associations between perceived social support and sociodemographic variables on coping strategies. METHODS: A prospective, cross-sectional, multicenter study was conducted in 404 women with resected, non-metastatic breast cancer. Participants completed questionnaires: perceived social support (MSPSS), coping strategies (Mini-MAC), and psychological distress (BSI-18). RESULTS: Sociodemographic factors as age, education, and partnership status were associated with coping strategies. As for maladaptive strategies, hopelessness was more frequent in older people and lower educational level; fatalism in older and single people, and cognitive avoidance was associated with lower educational level. Suppor t from family, friends, and partners was associated with a greater fighting spirit. In contrast, high psychological distress (anxiety and depression) was associated with greater use of maladaptive strategies. CONCLUSION: Young people, a high level of education, having a partner, low psychological distress, and seeking social support were associated with the use of adaptive cancer coping strategies.
Assuntos
Adaptação Psicológica , Neoplasias da Mama/psicologia , Determinantes Sociais da Saúde , Apoio Social , Fatores Sociodemográficos , Fatores Etários , Estudos Transversais , Escolaridade , Feminino , Inquéritos Epidemiológicos , Humanos , Estado Civil , Pessoa de Meia-Idade , Estudos Prospectivos , Angústia Psicológica , Análise de Regressão , EspanhaRESUMO
INTRODUCTION: There is sufficient evidence on the usefulness of surgery as a therapeutic alternative for patients with drug-resistant epilepsy; however this treatment is underutilized, especially in developing countries. METHODS: We describe the outcomes of epilepsy surgery in 27 paediatric patients at Hospital Baca Ortiz in Quito, Ecuador. Our analysis considered the following variables: reduction in seizure frequency, surgery outcome according to the Engel classification, improvement in quality of life, and serious complications due to surgery. RESULTS: 21 corpus callosotomies and 6 resective surgeries were performed. The mean seizure frequency decreased from 465 per month before surgery to 37.2 per month thereafter (p<.001); quality of life scale scores increased from 12.6 to 37.2 (p<.001), and quality of life improved in 72.7% of patients. Regarding resective surgery, 2 patients with temporal lobe epilepsy and one with posterior quadrant epilepsy achieved Engel class IA, and one patient undergoing hemispherotomy due to Rasmussen encephalitis achieved Engel class IIA. Two patients underwent surgery for hypothalamic hamartoma: one achieved Engel III and the other, Engel IA; however, the latter patient died in the medium term due to a postoperative complication. The other major complication was a case of hydrocephalus, which led to the death of a patient with refractory infantile spasms who underwent corpus callosotomy. CONCLUSIONS: Favourable outcomes were observed in 92.5% of patients.
Assuntos
Epilepsia , Criança , Equador , Epilepsia/cirurgia , Feminino , Humanos , Masculino , Qualidade de Vida , Centros de Atenção Terciária , Resultado do TratamentoRESUMO
OBJECTIVE: To identify distinct trajectories of toxicity in colorectal cancer (CRC) patients after adjuvant chemotherapy and its impact on quality of life (QoL) and psychological symptoms. METHODS: A prospective, multicenter study was conducted in 157 patients. A latent class analysis defined the unobserved latent constructs that can be predicted as symptom clusters, considering the intensity of four types of adverse events (AEs). Patients completed EORTC-QLQ-C30, BSI-18, PDRQ-9, and DRS scales. RESULTS: Ninety-six percent had some degree of toxicity, with grades 3-4 being the most common: neurotoxicity (7.2%), hematological (13.1%), digestive (5.2%), and skin toxicity (1.4%). Three distinct latent classes were identified (high [72.5%], mild [16.9%], and low [10.6%] toxicity). Patients with high toxicity had the worst QoL scores and moderately high somatization and psychological distress scores. CONCLUSIONS: Adjuvant chemotherapy for CRC was associated with frequent toxicity that negatively impacted QoL and psychological wellbeing.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias do Colo/tratamento farmacológico , Neoplasias do Colo/psicologia , Análise de Classes Latentes , Qualidade de Vida , Idoso , Antimetabólitos Antineoplásicos/efeitos adversos , Capecitabina/efeitos adversos , Quimioterapia Adjuvante/efeitos adversos , Neoplasias do Colo/mortalidade , Neoplasias do Colo/patologia , Tomada de Decisões , Emoções , Feminino , Fluoruracila/efeitos adversos , Humanos , Leucovorina/efeitos adversos , Masculino , Pessoa de Meia-Idade , Compostos Organoplatínicos/efeitos adversos , Relações Médico-Paciente , Estudos Prospectivos , Piridinas/efeitos adversos , EspanhaRESUMO
INTRODUCTION: Depression in cancer patients is prevalent and negatively impacts their quality of life. Likewise, it correlates with lower overall survival. The aim of this work is to analyze whether different coping strategies, as well as sociodemographic and clinical factors are associated with the presence of depressive symptoms in individuals with a resected, non-metastatic neoplasm about to initiate adjuvant chemotherapy. METHODS: NEOcoping is a cross-sectional, prospective, observational, multicenter study. Clinical (tumor site and stage, time to diagnosis, risk of recurrence, and type of adjuvant treatment) and sociodemographic characteristics (age, gender, marital status, educational level, occupational sector, and employment status), coping strategies (Mini-MAC scale), and depressive symptoms (BSI scale) were collected. A two-block linear regression model was performed to determine the predictive variables of depressive symptoms. RESULTS: 524 adults with resected, non-metastatic cancer were recruited. Twenty-six percent of patients have clinically significant depressive symptoms. Being female, < 40 years of age, having breast and stomach cancer, and > 50% chance of recurrence were associated with increased risk of depression. Likewise, depression was associated with greater helplessness and anxious preoccupation, and less fighting spirit. Age, gender, and risk of recurrence accounted for only 7% of the variance in depressive symptoms. Including coping strategies in the regression analysis significantly increased the variance explained (48.5%). CONCLUSION: Early psychological intervention in patients with maladaptive coping strategies may modulate the onset of depressive symptoms, especially in those at higher risk for depression.
Assuntos
Adaptação Psicológica , Depressão/psicologia , Neoplasias/psicologia , Idoso , Escalas de Graduação Psiquiátrica Breve , Quimioterapia Adjuvante , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Neoplasias/patologia , Neoplasias/cirurgia , Prevalência , Estudos Prospectivos , Fatores de RiscoRESUMO
Transmissible venereal tumor (TVT) is a contagious neoplasm of round cells that occurs naturally and that affects mostly the genitalia. The TVT has been classified according to the predominant cell type as follows: linfocytoid, plasmacytoid and mixed. Various degrees of aggressiveness with wide range of biological behavior have been described based on this cell morphology. The present study aimed to evaluate the rate of cell proliferation, by cytochemical AgNOR method, and response to chemotherapy correlated with the cytomorphological classification of TVT. The results of the 22 cases showed that TVT was identified more frequently in female, adults and mixed-breed dogs. Plasmocytoid-classified tumors required a greater number of vincristine sulfate sessions, have higher cell proliferation and were the most resistant to chemotherapy, requiring additional treatment with doxorubicin. Based on these results, we can infer that the plasmacytoid pattern might have a more aggressive behavior compared to other cell types.(AU)
O tumor venéreo transmissível (TVT) é uma neoplasia contagiosa de células redondas que ocorre naturalmente e afeta principalmente a genitália. O TVT é classificado de acordo com o tipo celular predominante da seguinte forma: linfocitóide, plasmocitóide e misto. Vários graus de agressividade com ampla gama de comportamento biológico foram descritos com base nessa morfologia celular. O presente estudo teve como objetivo avaliar a taxa de proliferação celular, pelo método AgNOR citoquímico, e a resposta à quimioterapia correlacionada com a classificação citomorfológica do TVT. Os resultados dos 22 casos mostraram que o TVT foi identificado com maior frequência em cães do sexo feminino, adultos e mestiços. Os tumores classificados como plasmocitóides necessitaram de um maior número de sessões de sulfato de vincristina, apresentaram maior proliferação celular e foram os mais resistentes à quimioterapia, necessitando de tratamento adicional com doxorrubicina. Com base nesses resultados, podemos inferir que o padrão plasmocitoide pode ter um comportamento mais agressivo comparado a outros tipos de células.(AU)
Assuntos
Animais , Cães , Tumores Venéreos Veterinários/tratamento farmacológico , Proliferação de Células , Doenças do Cão , Neoplasias Urogenitais/veterináriaRESUMO
Transmissible venereal tumor (TVT) is a contagious neoplasm of round cells that occurs naturally and that affects mostly the genitalia. The TVT has been classified according to the predominant cell type as follows: linfocytoid, plasmacytoid and mixed. Various degrees of aggressiveness with wide range of biological behavior have been described based on this cell morphology. The present study aimed to evaluate the rate of cell proliferation, by cytochemical AgNOR method, and response to chemotherapy correlated with the cytomorphological classification of TVT. The results of the 22 cases showed that TVT was identified more frequently in female, adults and mixed-breed dogs. Plasmocytoid-classified tumors required a greater number of vincristine sulfate sessions, have higher cell proliferation and were the most resistant to chemotherapy, requiring additional treatment with doxorubicin. Based on these results, we can infer that the plasmacytoid pattern might have a more aggressive behavior compared to other cell types.
O tumor venéreo transmissível (TVT) é uma neoplasia contagiosa de células redondas que ocorre naturalmente e afeta principalmente a genitália. O TVT é classificado de acordo com o tipo celular predominante da seguinte forma: linfocitóide, plasmocitóide e misto. Vários graus de agressividade com ampla gama de comportamento biológico foram descritos com base nessa morfologia celular. O presente estudo teve como objetivo avaliar a taxa de proliferação celular, pelo método AgNOR citoquímico, e a resposta à quimioterapia correlacionada com a classificação citomorfológica do TVT. Os resultados dos 22 casos mostraram que o TVT foi identificado com maior frequência em cães do sexo feminino, adultos e mestiços. Os tumores classificados como plasmocitóides necessitaram de um maior número de sessões de sulfato de vincristina, apresentaram maior proliferação celular e foram os mais resistentes à quimioterapia, necessitando de tratamento adicional com doxorrubicina. Com base nesses resultados, podemos inferir que o padrão plasmocitoide pode ter um comportamento mais agressivo comparado a outros tipos de células.
Assuntos
Animais , Cães , Doenças do Cão , Neoplasias Urogenitais/veterinária , Proliferação de Células , Tumores Venéreos Veterinários/tratamento farmacológicoRESUMO
TITLE: Valoracion de la atrofia cerebral en la esclerosis multiple mediante el indice de cuerpo calloso.
Assuntos
Encefalopatias , Esclerose Múltipla , Doenças Neurodegenerativas , Atrofia , Corpo Caloso , HumanosRESUMO
BACKGROUND: Our study analyzes the incidence of sleep problems and their mediating role on depression and anxious preoccupation in patients with resected, non-advanced cancer. METHODS: A multi-institutional, prospective, observational study was conducted with 750 participants of 14 hospitals in Spain. Participants' socio-demographic and clinical characteristics were collected using a standardized self-report form and using EORTC QoL-QLQ-C30, BSI, Mini-MAC questionnaires. RESULTS: In women, sleep problems, depression and anxious preoccupation were observed in 65, 41 and 21%, respectively. In men, sleep problems, depression and anxious preoccupation were reported in 51, 29 and 61%, respectively. More sleep problems, depression and anxious preoccupation were found among women than males. Depression was a significant predictor of anxious preoccupation. In males, sleep problems partially mediated this association. This was not confirmed in women. CONCLUSION: Our findings point toward the importance of developing interventions that decrease depression and sleep problems in cancer.
Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Neoplasias , Qualidade de Vida , Transtornos do Sono-Vigília/epidemiologia , Adaptação Psicológica , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias/cirurgia , Prevalência , Prognóstico , Estudos Prospectivos , Psicometria , Espanha/epidemiologia , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: This study analyzes the prevalence of malnutrition, depression, anxiety, and somatization and which factor has the biggest effect on quality of life (QoL) in individuals with resected cancer. METHODS: A prospective study was conducted among 747 participants. Participants completed the EORTC-QLQ30, MST, and BSI-18 questionnaires. RESULTS: Prevalence for risk of malnutrition, depression, anxiety, and somatization were 36.4%, 35.5%, 35.2%, and 48.8%, respectively. Hierarchical multiple regression analyses revealed that malnutrition risk, somatization, depression, and anxiety accounted for 50.8% of the variance in functional scale, 45.3% in symptom scale, and 52.2% in global health. Malnutrition, somatization, depression, and anxiety displayed high explanatory power on all health-related QoL (HRQoL) scales. CONCLUSION: The risk of malnutrition and psychological symptoms is strongly associated with HRQoL in cancer patients; thus, medical oncologists should develop effective interventions that contribute to lowering the risk of malnutrition and psychological distress, thereby improving subjects' HRQoL before initiating adjuvant chemotherapy.
Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Desnutrição/epidemiologia , Neoplasias/cirurgia , Qualidade de Vida , Estresse Psicológico/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/etiologia , Estudos Transversais , Depressão/etiologia , Feminino , Seguimentos , Humanos , Masculino , Desnutrição/etiologia , Pessoa de Meia-Idade , Prevalência , Prognóstico , Estudos Prospectivos , Fatores de Risco , Espanha/epidemiologia , Estresse Psicológico/etiologia , Inquéritos e QuestionáriosRESUMO
Resumen Objetivo: Evaluar la utilidad del V-EEG en el diagnóstico diferencial de la epilepsia en un hospital pediátrico de nivel terciario durante el año 2015 Materiales y Métodos: Se realizó un estudio descriptivo sobre 90 pacientes evaluados en esta unidad durante el año 2015. Se recogieron datos de variables relacionadas con la indicación y los resultados del V-EEG, los cuales fueron analizados usando medidas de estadística descriptiva. Resultados: El 53,3% de los pacientes fueron masculinos. El promedio de edad es de 7,7 años con una desviación estándar de 4,7 años. El tiempo que transcurre desde la primera crisis hasta que el paciente acude a realizarse el V-EEG presenta una media de 4,3 años. 72 pacientes (80%) presentaron crisis epilépticas, 12 pacientes (13,3%) presentaron trastornos paroxísticos no epilépticos, mientras 6 niños (6,7%) no presentaron crisis durante el monitoreo. En el 93,3% de los casos el estudio fue exitoso. Conclusiones: Se demuestra la utilidad del monitoreo V-EEG para el diagnóstico diferencial de epilepsia.
Summary Objective: The aim was to evaluate the V-EEG usefulness in the differential diagnosis of epilepsy in a Third Level Children's Hospital during 2015. Materials and Methods: A descriptive study was performed over 90 patients in this unit during 2015. The data was obtained from variables related to indications and results of V-EEG, which were analyzed using descriptive statistics. Results: Fifty three percent of the patients were male. The mean age was 7.7 years (SD ± 4.7 years). The time measured between the first seizure and the V-EEG recording was 4,3 years. Seventy two patients (80%) had epileptic seizures, 12 patients (13,3%) had nonepileptic seizures, while six children (6.7%) had no seizures during the V-EEG monitoring. Ninety three percent of all recordings were successful. Conclusions: It was demonstrated the usefulness of V-EEG monitoring for the differential diagnosis of epilepsy.
RESUMO
RESUMEN Introducción: La epilepsia es una de las patologías neurológicas crónicas más frecuentes, con una incidencia de 50/100.000/año y una prevalencia entre 0,5 y 2% a nivel mundial. Un tercio de estos pacientes son resistentes al tratamiento con fármacos antiepilépticos, lo que se conoce como epilepsia refractaria. La mayoría de estos pacientes sufren de epilepsias focales secundarias a lesiones epileptogénicas evidenciadas cada vez más frecuentemente en correlación directa con las nuevas técnicas de neuroimagen cerebral. La cirugía de la epilepsia es el único tratamiento que podría curar la epilepsia de los pacientes con epilepsia refractaria. El objetivo de la cirugía de la epilepsia es remover la zona epileptogénica con preservación de las áreas elocuentes, y aquí la experiencia quirúrgica y la tecnología de neuroimagen juegan un papel capital. Objetivos: Demostrar la utilidad de la neuronavegación en la planificación prequirúrgica y en la cirugía de la epilepsia refractaria. Método: Estudio descriptivo transversal y analítico, en base a 47 cirugías realizadas (12 resectivas, 32 paliativas y 3 diagnósticas) en pacientes con epilepsia refractaria y edad media de 9,93 años (SD 4,1). En 27 pacientes (57.44%) se utilizó el neuronavegador. En el grupo de pacientes operados con neuronavegación disminuyó el tiempo quirúrgico en 47.17 minutos (p = 0,022), la cantidad de hemorragia en 111.41 mililitros (p = 0,011) y los días de hospitalización en 6.68 días (p = 0,005), en comparación con el grupo intervenido sin neuronavegación. Las complicaciones en el grupo con neuronavegación fueron del 29,63% en comparación con 65% en el grupo intervenido sin neuronavegación (p = 0,034). Conclusiones: En nuestra serie, el uso del neuronavegador en la planificación y desarrollo de la cirugía tuvo un impacto significativo al reducir la cantidad de hemorragia perdida, el tiempo quirúrgico, los días de hospitalización, y las complicaciones postquirúrgicas.
Abstract Introduction: Epilepsy is one of the more frequent neurologic disorders, with an incidence of 50/100,000/year and prevalence between 0.5 and 2% worldwide. A third of these patients suffer focal epilepsy due to epileptogenic lesions evident by Neuroimaging new techniques. Epilepsy surgery is the only treatment that can cure refractory epilepsy. Its goal is to remove the epileptogenic lesion with preservation of eloquent areas, and in this case both surgical experience and neuroimaging technology play a pivotal role. Objective: To demonstrate utility of neuronavigation in presurgical planning and surgery of refractory epilepsy. Method: Descriptive, cross sectional and analytic study of 47 performed surgeries (12 resective, 12 palliative and 3 diagnostic) in patients with refractory epilepsy with an average age of 9.93 years (SD 4.1). In 27 patients (57.44%) neuronavigation was used. In patients operated with assistance of neuronavigation, surgical time diminished in 47.17 minutes (p=0.022), hemorrhage in 111.41 ml (p=0.011) and days of hospitalization in 6.68 days (p=0.005) comparing with group without neuronavigation. Complications in the group with neuronavigation were 29.63% compared with 65% in the group without it. (P=0,034). Conclusions: In this study, using neuronavigation in planning and performing surgery in reducing the amount of blood loss, surgical time, days of hospitalization and post surgical complications.
RESUMO
PURPOSE: Despite the burgeoning geriatric population with cancer and the importance of understanding how age may be related to mental adjustment and quality of life so far, differences in coping strategies and psychological harm between the elderly and adults are hardly being taken into account to modify the approach to this population. The aim of this prospective study is to describe the differences in psychological characteristics between older and adult cancer patients and examine dissimilarities in their psychological evolution during adjuvant chemotherapy. METHODS: Adults (18-69 years old) and older patients (≥ 70) with newly diagnosed non-metastatic resected cancer admitted to receive adjuvant chemotherapy were recruited. Patients completed the following questionnaires: mini-mental adjustment to cancer, brief symptom inventory, shared decision-making questionnaire-patient's version, multidimensional scale of perceived social support, EORTC quality-of-life instrument, life orientation test-revised, and satisfaction with life scale. RESULTS: 500 cancer patients (394 adults and 106 older) were evaluated. The impact of the diagnosis was less negative among older patients, with no differences in coping strategies, quality of life, or search for support. Regarding psychological changes from the beginning to the end of the adjuvant treatment, both age groups reported more somatic symptoms, increased psychological difficulty, reduced coping strategies, and a significant decrease in quality of life at the end of postoperative chemotherapy. CONCLUSION: Although there were clear psychological differences between adults and senior cancer patients, their evolution during adjuvant chemotherapy was similar, with deterioration in quality of life and coping. This negative psychological impact of adjuvant chemotherapy should be taken into account when considering interventions.
Assuntos
Adaptação Psicológica , Quimioterapia Adjuvante/psicologia , Neoplasias/tratamento farmacológico , Neoplasias/psicologia , Adolescente , Adulto , Fatores Etários , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Qualidade de Vida/psicologia , Adulto JovemRESUMO
PURPOSE: The aim of this study was to analyze differences in physician and patient satisfaction in shared decision-making (SDM); patients' emotional distress, and coping in subjects with resected, non-metastatic cancer. METHODS: 602 patients from 14 hospitals in Spain were surveyed. Information was collected regarding physician and patient satisfaction with SDM, participants' emotional distress and coping, as well as patient sociodemographic and clinical characteristics by means of specific, validated questionnaires. RESULTS: Overall, 11% of physicians and 19% of patients were dissatisfied with SDM; 22% of patients presented hopelessness or anxious preoccupation as coping strategies, and 56% presented emotional distress. By gender, female patients showed a higher prevalence of dissatisfaction with SDM (23 vs 14%), anxious preoccupation (26 vs 17%), and emotional distress (63 vs 44%) than males. Hopelessness was more prevalent in individuals with stage III disease than those with stages I-II (28 vs 18%). CONCLUSION: Physicians must be mindful of the importance of emotional support and individual characteristics when communicating treatment options, benefits, and adverse effects of each alternative to oncological patients.
Assuntos
Quimioterapia Adjuvante , Tomada de Decisões , Satisfação no Emprego , Neoplasias/tratamento farmacológico , Neoplasias/epidemiologia , Satisfação do Paciente/estatística & dados numéricos , Médicos/psicologia , Adulto , Idoso , Quimioterapia Adjuvante/psicologia , Quimioterapia Adjuvante/estatística & dados numéricos , Feminino , Humanos , Masculino , Oncologia/métodos , Oncologia/normas , Oncologia/estatística & dados numéricos , Pessoa de Meia-Idade , Neoplasias/complicações , Neoplasias/psicologia , Médicos/estatística & dados numéricos , Fatores Socioeconômicos , Espanha/epidemiologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Anxiety and depression affect cancer patients' quality of life. Our objectives were to determine the prevalence of anxiety and depression and analyze the association between positive psychological factors, sociodemographic factors, and clinical factors in oncological patients initiating adjuvant treatment. METHODS: A prospective, multicenter cohort of 600 consecutive patients completed the Brief Symptom Inventory, Mini-Mental Adjustment to Cancer, Life Orientation Scale-Revised, and Multidimensional Scale of Perceived Social Support questionnaires. RESULTS: Prevalence of anxiety and depression was 49.8 and 36.6%, respectively. Women and younger individuals were more anxious and depressed than men and seniors. Employed participants suffered more anxiety than retirees, and singles exhibited more depression than married or partnered subjects. Logistic regression analysis showed that hope, optimism, social support, being male, and older were significantly associated with a lower risk of anxiety and depression (p < 0.001). CONCLUSIONS: The high prevalence of anxiety and depression among Spaniards with cancer starting adjuvant chemotherapy suggests that more attention should be paid to mental health in these individuals. These findings are important for cancer patients because they can benefit from interventions that increase positive psychological factors such as hope, optimism, and social support to reduce anxiety and depression.
Assuntos
Ansiedade/epidemiologia , Quimioterapia Adjuvante/estatística & dados numéricos , Depressão/epidemiologia , Neoplasias/epidemiologia , Neoplasias/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/complicações , Quimioterapia Adjuvante/efeitos adversos , Quimioterapia Adjuvante/psicologia , Terapia Combinada , Estudos Transversais , Depressão/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Prevalência , Qualidade de Vida , Fatores de Risco , Apoio Social , Espanha/epidemiologia , Inquéritos e QuestionáriosRESUMO
Changes in the nutritional plan have been shown to affect oocyte quality, crucial to oocyte donors animals used in cloning. This study aimed to evaluate the impact of diets with increasing nutritional levels (maintenance diet=M; 1.3M; 1.6M; 1.9M) fed to goats for four weeks on follicular fluid composition, gene expression and oocyte competence used to cloning in goats. Donor females were superovulated for the retrieval of matured oocytes and physical measurements reported. After four weeks, groups receiving diets above maintenance increased thickness of subcutaneous adipose tissue and body weight, with higher values in 1.9M Group (P<0.05). Treatments did not affect follicular density, number of aspirated follicles, retrieved and matured oocytes. Animals from 1.3M group had lower (P<0.05) maturation rate (44.0%) and number of viable oocytes (65.3%) than M (68.8%) and 1.9M (76.0%). Follicular fluid glucose concentrations increased with nutritional levels (P=0.010), with a difference (P<0.05) between groups 1.9M (11.4±2.6mg/dL) and M (2.6±0.5mg/dL). The diet did not affect the expression of GDF9, BMP15, and BAX genes in oocytes, but BCL2 and apoptotic index were significantly higher (P<0.05) in the 1.3M and 1.6M groups than the other groups. Following the transfer of cloned embryos, one fetus was born live of a twin pregnancy in the 1.9M Group. The association between energy intake and oocyte quality suggests better nutritional use by oocytes when the maximum flow was used (1.9M), but the optimal feeding level in cloning still needs refinement.
Assuntos
Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Dieta/veterinária , Desenvolvimento Embrionário/fisiologia , Cabras/embriologia , Animais , Clonagem de Organismos , Transferência Embrionária/veterinária , Ingestão de Energia , Feminino , Fertilização in vitro/veterinária , Líquido Folicular/química , Regulação da Expressão Gênica/fisiologia , Cabras/metabolismo , Técnicas de Maturação in Vitro de Oócitos/veterinária , Técnicas de Transferência Nuclear/veterinária , Recuperação de Oócitos , Gravidez , SuperovulaçãoRESUMO
OBJECTIVE: The aim of this study was to analyze the psychometric properties of the Shared Decision-Making Questionnaire-Physician version (SDM-Q-Doc) in a sample of medical oncologists who provide adjuvant treatment to patients with non-metastatic resected cancer and the correlations between the total SDM-Q-Doc score and physician satisfaction with the information provided. METHODS: Prospective, observational and multicenter study in which 32 medical oncologists and 520 patients were recruited. The psychometric properties, dimensionality, and factor structure of the SDM-Q-Doc were assessed. RESULTS: Exploratory factor analyses suggested that the most likely solution was two-dimensional, with two correlated factors: one factor regarding information and another one about treatment. Confirmatory factor analysis based on cross-validation showed that the fitted two-dimensional solution provided the best fit to the data. Reliability analyses revealed good accuracy for the derived scores, both total and sub-scale, with estimates ranging from 0.81 to 0.89. The results revealed significant correlations between the total SDM-Q-Doc score and physician satisfaction with the information provided (p < 0.01); between information sub-scale scores (factor 1) and satisfaction (p < 0.01), and between treatment sub-scale scores (factor 2) and satisfaction (p < 0.01). Medical oncologists of older age and those with more years of experience showed more interest in the patient preferences (p = 0.026 and p = 0.020, respectively). Patient age negatively correlated with SDM information (p < 0.01) and physicians appear to provide more information to young patients. CONCLUSION: SDM-Q-Doc showed good psychometric properties and could be a helpful tool that examines physician's perspective of SDM and as an indicator of quality and satisfaction in patients with cancer.
Assuntos
Atitude do Pessoal de Saúde , Tomada de Decisões , Oncologia , Neoplasias/cirurgia , Médicos/psicologia , Inquéritos e Questionários , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/patologia , Estudos ProspectivosRESUMO
INTRODUCTION: Decision-making in cancer-related venous thromboembolism (VTE) is often founded on scant lines of evidence and weak recommendations. The aim of this work is to evaluate the percentage of agreement surrounding a series of statements about complex, clinically relevant, and highly uncertain aspects to formulate explicit action guidelines. MATERIALS AND METHODS: Opinions were based on a structured questionnaire with appropriate scores and were agreed upon using a Delphi method. Questions were selected based on a list of recommendations with low evidence from the Spanish Society of Oncology Clinical Guideline for Thrombosis. The questionnaire was completed in two iterations by a multidisciplinary panel of experts in thrombosis. RESULTS: Of the 123 statements analyzed, the panel concurred on 22 (17%) and another 81 (65%) were agreed on by qualified majority, including important aspects of long-term and prolonged anticoagulation, major bleeding and rethrombosis management, treatment in special situations, catheter-related thrombosis and thromboprophylaxis. Among them, the panelists agreed the incidental events should be equated to symptomatic ones, long-term and extended use of full-dose low-molecular weight heparin, and concluded that the Khorana score is not sensitive enough to uphold an effective thromboprophylaxis strategy. CONCLUSION: Though the level of consensus varied depending on the scenario presented, overall, the iterative process achieved broad agreement as to the general treatment principles of cancer-associated VTE. Clinical validation of these statements in genuine practice conditions would be useful.
Assuntos
Anticoagulantes/uso terapêutico , Neoplasias/complicações , Guias de Prática Clínica como Assunto/normas , Trombose/prevenção & controle , Medicina Baseada em Evidências , Humanos , Oncologia , Prognóstico , Medição de Risco , Trombose/etiologiaRESUMO
The osmotic condition modulates the properties of liposomes, particularly those related to their stability and response to external agents such as membrane-active proteins or peptides. In a previous work, we have demonstrated that an osmotic shock can increase, per se, water influx/efflux and the exit of the fluorophore calcein entrapped in the aqueous pool of dipalmitoylphosphatidylcholine (DPPC) and DPPC:sphingomyelin (SM) large unilamellar vesicles (LUVs), suggesting a loss of integrity of the liposome bilayer. In the present work, we have extended our study in order to assess how an osmotic imbalance prior to or synchronous with the addition of a recombinant variant of the pore-forming toxin sticholysin I (rSt I) modifies its pore forming capacity in DPPC and DPPC:SM (1:1) LUVs. Our results conclusively show the capacity of hypotonic gradients to improve the pore forming capacity of rSt I molecules, even in pure DPPC liposomes, rendering pore-formation less dependent on the presence of sphyngomyelin. In fact, non-active toxins in DPPC liposomes become active by a hypotonic imbalance in a similar way to those containing SM as a second component.
Assuntos
1,2-Dipalmitoilfosfatidilcolina/química , Pressão Osmótica , Proteínas Citotóxicas Formadoras de Poros/química , Compostos Orgânicos/químicaRESUMO
Embryo sexing is a powerful tool for livestock producers because it allows them to manage their breeding stocks more effectively. However, the cost of supplies and reagents, and the need for trained professionals to biopsy embryos by micromanipulation restrict the worldwide use of the technology to a limited number of specialized groups. The aim of this study was to couple a fast and inexpensive DNA extraction protocol with a practical biopsy approach to create a simple, quick, effective, and dependable embryo sexing procedure. From a total of 1847 sheep and cattle whole embryos or embryo biopsies, the sexing efficiency was 100% for embryo biopsies, 98% for sheep embryos, and 90.2% for cattle embryos. We used a primer pair that was common to both species and only 10% of the total extracted DNA. The whole protocol takes only 2 h to perform, which suggests that the proposed procedure can be readily applied to field conditions. Moreover, in addition to embryo sexing, the procedure can be used for further analyses, such as genotyping and molecular diagnosis in preimplantation embryos.