Intervención cognitivo-conductual para el control de ansiedad ante la biopsia insicional en pacientes con cáncer de mama

Oncological patients are submitted to invasive exams in order to obtain an accurate diagnosis; these procedures may cause maladaptative reactions (fear, anxiety and pain). Particularly in breast cancer, the most common diagnose technique is the incisional biopsy. Most of the patients are unaware about the procedure and for that reason they may focus their thoughts on possible events such as pain, bleeding, the anesthesia, or the later surgical wound care. Anxiety and pain may provoke physiological, behavioral and emotional complications, and because of this reason, the Behavioral Medicine trained psychologist takes an active role before and after the biopsy. The aim of this study was to evaluate the effect of a cognitive-behavioral program to reduce anxiety in women submitted to incisional biopsy for the first time. There were 10 participants from the Hospital Juárez de México, Oncology service; all of them were treated as external patients. The intervention program focused in psycho-education and passive relaxation training using videos, tape-recorded instructions and pamphlets. Anxiety measures were performed using the IDARE-State inventory, and a visual-analogue scale of anxiety (EEF-A), and the measurement of blood pressure and heart rate). Data were analyzed both intrasubject and intersubject using the Wilcoxon test (p≤0.05). The results show a reduction in anxiety (as in punctuation as in ranges) besides, a reduction in the EEF-A.

Bienestar psicológico, optimismo y resiliencia en mujeres con cáncer de mama

Objective: To evaluate the relationship between Perceived Psychological well-being, Optimism and Resilience in women survivors of breast cancer.Method: The sample was composed of 30 women diagnosed with breast cancer who were undergoing adjuvant treatment in Oncology Units General Hospital of Jerez de la Frontera and the University Hospital Puerta del Mar (Cadiz). The average age was 47.47 years (SD = 6,356) and the average of months from diagnosis of the disease was 9.93 (SD = 8,541). Scale of Psychological Well-being administered Perceived Ryff (1989), the Life Orientation Test Revised (LOT-R) Scheier, Carver and Bridges (1994) and the Scale of Resilience Wagnild and Young (1993) to assess psychological well-being the dispositional optimism and resilience respectivelyResults: Descriptive analyzes show that women diagnosed with breast cancer have levels of psychological well-being, dispositional optimism and higher than the average values provided by Resilience scales. On the other hand, regression analyses revealed that only some of the dimensions of resilience allowed to explain and predict some dimensions of psychological wellbeing, not dispositional optimism.Conclusions: The results seem to confirm the idea that if the capacity of women with breast moderate negative affect generated by the diagnosis itself and the consequences of their cancer treatment works and to promote their adaptation to the new situation we can contribute to increasing psychological well-being.

Experiencias de danzaterapia de mujeres que han sufrido cáncer de mama. Un estudio fenomenológico

Objective: This essay aims at identifying, describing and analyzing possible changes both in the experience of the body and in interpersonal relations of women with breast cancer, which result from their participation in Dance Therapy group meetings.Method: This is a phenomenologically oriented qualitative research using Maria Fux´s dance therapy method for group experiences. Eight meetings are described here, and an analysis of descriptions based primarily on Merleau-Ponty and María Fux is provided.Results: The participants have been able to express pain and sorrow over the circumstances that breast cancer and its relational environments have brought to their lives. They have been able to go through moments of creation and surrender to the rhythmic body sensations and experiential environment with different emotions lived separately and jointly. They have revived memories and sensations of their childhood and adolescence, and finally, they have rediscovered their sensitive body through body resignifications marked by the absence of the breast, and by means of feelings of greater acceptance and integration of lived experiences in new gestalts.Conclusions: This project is still under way, but it is already possible to conclude that the life experiences provided in dance therapy have allowed these women to improve their integration and welfare. Likewise, they have felt positive changes in the perception of their corporality and in their way of being in the world and with other subjects, thus experiencing the body in a new and different way.

Neoplasia papilar cística do pâncreas

Papyllary cystic tumor of the pancreas, so-called Frantz’s tumor, is rare. Clinical presentation of this disease is usually a slowly growing abdominal mass with or without abdominal pain, affecting predominantly young females. Its pathogenesis is still unknown . Surgical resection is usually curative, and prognosis is excellent. The authors report two pancreatic tumor cases(Frantz’s tumor) in women aged 26 and 31 years old. Pre operative assessment showed a solid-cystic tumor of the tail and body of the pancreas. An extended distal pancreatectomy was performed without splenic preservation

Faulkner revisited : narrating property, race, gender and history in William Faulkner's Go Down, Moses, Toni Morrison's Song of Solomon and Gloria Naylor's Mama Day

My thesis explores the formation of the subject in the novels of Faulkner’s Go Down, Moses, Toni Morrison’s Song of Solomon, and Gloria Naylor’s Mama Day. I attach the concept of property in terms of how male protagonists are obsessed with materialistic ownership and with the subordination of women who, as properties, consolidate their manhood. The three novelists despite their racial, gendered, and literary differences share the view that identity and truth are mere social and cultural constructs. I incorporate the work of Judith Butler and other poststructuralist figures, who see identity as a matter of performance rather than a natural entity. My thesis explores the theme of freedom, which I attached to the ways characters use their bodies either to confine or to emancipate themselves from the restricting world of race, class, and gender. The three novelists deconstruct any system of belief that promulgates the objectivity of truth in historical documents. History in the three novels, as with the protagonists, perception of identity, remains a social construct laden with distortions to serve particular political or ideological agendas. My thesis gives voice to African American female characters who are associated with love and racial and gender resistance. They become the reservoirs of the African American legacy in terms of their association with the oral and intuitionist mode of knowing, which subverts the male characters’ obsession with property and with the mainstream empiricist world. In this dissertation, I use the concept of hybridity as a literary and theoretical devise that African-American writers employ. In effect, I embark on the postcolonial studies of Henry Louise Gates, Paul Gilroy, W. E. B Du Bois, James Clifford, and Arjun Appadurai in order to reflect upon the fluidity of Morrison’s and Naylor’s works. I show how these two novelists subvert Faulkner’s essentialist perception of truth, and of racial and gendered identity. They associate the myth of the Flying African with the notion of hybridity by making their male protagonists criss-cross Northern and Southern regions. I refer to Mae Gwendolyn Henderson’s article on “Speaking in Tongues” in my analysis of how Naylor subverts the patriarchal text of both Faulkner and Morrison in embarking on a more feminine version of the flying African, which she relates to an ex-slave, Sapphira Wade, a volatile female character who resists fixed claim over her story and identity. In dealing with the concept of hybridity, I show that Naylor rewrites both authors’ South by making Willow Springs a more fluid space, an assumption that unsettles the scores of critics who associate the island with authenticity and exclusive rootedness.

Avaliação da qualidade de vida e da autopercepção corporal em mulheres com câncer de mama submetidas à reconstrução mamária

O câncer de mama compõe-se de 22% dos casos novos verificados a cada ano, configurando o segundo tipo de doença mais frequente entre as mulheres. O tratamento para esse tipo de enfermidade, bem como os sintomas apresentados, provocam alterações psicológicas nas mulheres, afetando a dimensão da auto-imagem do dado existencial do ser. Logo, a escolha pela reconstrução mamária tem mostrado uma adaptação da imagem que cada mulher produz de si, e isso concorre para restabelecer o equilíbrio psicológico que é afetado, diante do diagnóstico e da perda da mama. A fisioterapia é essencial tanto na preparação, quanto após a intervenção cirúrgica das pacientes, tendo como premissa a recuperação das suas funções e também, no restabelecimento da sua autoimagem corporal, podendo minimizar os efeitos adversos da reconstrução mamária. Nesse ínterim, em uma forma transversal prospectiva, este estudo teve como objetivo, avaliar a qualidade de vida e da autopercepção corporal em pacientes com câncer de mama submetidas à reconstrução mamária, relacionando a qualidade de vida com a realização ou não da fisioterapia, após o processo da intervenção cirúrgica. Como resultados, observou-se a existência de correlações entre a IC - Imagem Corporal e os domínios da qualidade de vida, com uma correlação moderada significativa apenas no domínio psicológico e que correspondeu à melhor imagem corporal da paciente. Quanto à imagem corporal, todas as pacientes demonstraram um índice satisfatório na escala corporal. Quando comparado à execução ou não da fisioterapia apresentaram igual comportamento para quem fez e para aquelas que não realizaram fisioterapia. Na verificação de quem fez ou não fisioterapia, a satisfação foi superior no grupo que fez, e a insatisfação foi menor nesse grupo do que naquele que não realizou fisioterapia.

Small bowel mesentery solitary fibrous tumor. A rare neoplasia in a young male

Extrapleural Solitary Fibrous Tumors (SFT), in particular small bowel mesentery SFTs, are extremely rare neoplasms. We describe the case of a young male hospitalized for unspecific abdominal symptoms and evidence of a well-circumscribed mass arising from the small bowel mesentery. Histopathological and immunohistochemical analysis on the surgical specimen confirmed the diagnosis of SFT. A Pubmed search revealed only another case of small bowel mesentery SFT, confirming the extremely rarity of this tumor.

Multiple endocrine neoplasia, the old and the new: a mini review

Multiple endocrine neoplasia syndromes have since been classified as types 1 and 2, each with specific phenotypic patterns. MEN1 is usually associated with pituitary, parathyroid and paraneoplastic neuroendocrine tumours. The hallmark of MEN2 is a very high lifetime risk of developing medullary thyroid carcinoma (MTC) more than 95% in untreated patients. Three clinical subtypesdMEN2A, MEN2B, and familial MTC (FMTC) have been defined based on the risk of pheochromocytoma, hyperparathyroidism, and the presence or absence of characteristic physical features). MEN2 occurs as a result of germline activating missense mutations of the RET (REarranged during Transfection) proto-oncogene. MEN2-associated mutations are almost always located in exons 10, 11, or 13 through 16. Strong genotype-phenotype correlations exist with respect to clinical subtype, age at onset, and aggressiveness of MTC in MEN2. These are used to determine the age at which prophylactic thyroidectomy should occur and whether screening for pheochromocytoma or hyperparathyroidism is necessary. Specific RET mutations can also impact management in patients presenting with apparently sporadic MTC. Therefore, genetic testing should be performed before surgical intervention in all patients diagnosed with MTC. Recently, Pellegata et al. have reported that germline mutations in CDKN1B can predispose to the development of multiple endocrine tumours in both rats and humans and this new MEN syndrome is named MENX and MEN4, respectively. CDKN1B. A recent report showed that in sporadic MTC, CDKN1B V109G polymorphism correlates with a more favorable disease progression than the wild-type allele and might be considered a new promising prognostic marker. New insights on MEN syndrome pathogenesis and related inherited endocrine disorders are of particular interest for an adequate surgical and therapeutic approach.

Dosimetria in vivo em tumores de mama: comparação entre a dose medida e calculada

Introdução – A dosimetria in vivo é útil na medição da dose administrada aos doentes durante o tratamento, avaliando diferenças significativas entre a dose prescrita e a dose administrada no volume alvo, bem como nos órgãos de risco. Objetivo – Comparar a dose medida com a dose calculada em doentes com tumores de mama com e sem filtro físico. Métodos – Realizaram-se medições da dose na pele, utilizando díodos tipo–p, para os campos tangenciais e respetivos field-in-field em 38 doentes. Resultados – Verificaram-se diferenças estatisticamente significativas nos campos tangenciais open (ρ=0,000). Discussão – Estudos reportam desvios sistemáticos significativos entre a dose calculada e a dose medida. Conclusão – Com este estudo conclui-se que não existe influência nas doses devido à presença do filtro físico.

Patrones de reducción luego de quimioterapia neoadyuvante por cáncer de mama: implicancias en la cirugía conservadora

Introducción: existen dos formas de respuesta tumoral a la quimioterapia neoadyuvante: concéntrica o dispersa. Los pacientes con respuesta dispersa no son buenos candidatos a cirugía conservadora porque sus microfocos tumorales pueden pasar desapercibidos en el tejido que rodea el tumor residual principal. Este tipo de respuesta se ha identificado como marcador de recurrencia ipsilateral luego de cirugía conservadora. Objetivo: el objetivo de este estudio es evaluar el porcentaje de respuesta de cada patrón y la suficiencia del margen obtenido en los casos de cirugía conservadora. Material y método: se analizaron los registros médicos de pacientes sometidos a cirugía luego de quimioterapia neoadyuvante entre mayo de 2004 y diciembre de 2013. Se efectuó un análisis detallado del tipo de quimioterapia recibida y de los informes patológicos para determinar el patrón de respuesta así como la de los fenotipos moleculares y el grado tumoral en cada caso. Resultados: 14 de los 55 casos (25%) presentaron un patrón de respuesta dispersa (diez con microfocos distantes de cáncer invasor y cuatro con microfocos distantes de cáncer in situ). El porcentaje de respuesta patológica completa fue de 15,4%. No hubo diferencias significativas en el tipo de respuesta entre los diferentes inmunofenotipos ni entre diferentes grados tumorales, ni entre las pacientes que recibieron taxanos y las que no los recibieron. Conclusiones: un cuarto de las pacientes de nuestra serie presentó un patrón de respuesta dispersa luego de quimioterapia neoadyuvante. Este es un signo de advertencia para aquellos que abogan por la cirugía conservadora luego de neoadyuvancia, ya que la respuesta difusa aumenta el riesgo de márgenes insuficientes y recurrencia ipsilateral.

Asunto sociocient?fico: una manera para fortalecer la construcci?n de explicaciones a partir del estudio de casos - cancer de mama

En este trabajo de grado presentado para optar al t?tulo de Licenciada en Educaci?n B?sica con ?nfasis en Ciencias Naturales y Educaci?n Ambiental y realizado en el marco general de la Ense?anza de la Ciencias Naturales con un enfoque de asuntos sociocient?ficos; se propuso analizar la construcci?n de explicaciones y los procesos de indagaci?n que realizan los estudiantes a trav?s de un estudio de casos ?C?ncer de mama? llev?ndome a comprender la importancia que juega la ense?anza (el quehacer pedag?gico y/o las intervenciones en los estudiantes) el cual, permita propiciar espacios de encuentro entre el conocimiento y a partir de ello establecer relaciones entre situaciones cotidianas, la ciencia, la sociedad, la cultura, lo ambiental y hasta la parte pol?tica, permitiendo contextualizar a un problema presente. Para tal efecto, se trabaj? con los aspectos metodol?gicos tales como: La observaci?n, grabaciones y cuestionarios referente al estudio de caso c?ncer de mama, el tipo de estudio de este trabajo es cualitativo con metodolog?a de investigaci?n acci?n. As? mismo, el inter?s por identificar, categorizar y analizar la construcci?n de explicaciones en torno a un problema contextualizado ?c?ncer de mama? y en ello se estableci? rejillas de an?lisis y mapas conceptuales para procesar la informaci?n y as? lograr establecer el an?lisis de resultados a trav?s de categor?as, el cual da como insumo algunas respuestas acerca de lo importante del que hacer pedag?gico y las intervenciones que como educadores llegamos hacer con los estudiantes, permitiendo construir explicaciones significativas o retoricas.

Neoplasia papilar cística do pâncreas

Papyllary cystic tumor of the pancreas, so-called Frantz’s tumor, is rare. Clinical presentation of this disease is usually a slowly growing abdominal mass with or without abdominal pain, affecting predominantly young females. Its pathogenesis is still unknown . Surgical resection is usually curative, and prognosis is excellent. The authors report two pancreatic tumor cases(Frantz’s tumor) in women aged 26 and 31 years old. Pre operative assessment showed a solid-cystic tumor of the tail and body of the pancreas. An extended distal pancreatectomy was performed without splenic preservation

Caracterización clínico epidemiológica del cáncer de mama en el Hospital Nacional Rosales

El cáncer de mama es el más frecuente en mujeres con 1.38 millones de casos nuevos para el 2008 (23%) y el segundo más frecuente en general (10.9%). Es el más frecuente tanto en países desarrollados como en desarrollo (690 000 casos nuevos). En El Salvador es la segunda causa de cáncer y la tercera causa de muerte por cáncer. El riesgo de enfermar es superior en las mujeres de países con nivel socioeconómico alto, pero el riesgo de morir es mayor entre las mujeres que habitan países pobres. Se realiza este estudio para conocer el comportamiento de esta patología en nuestra población. Materiales y métodos: Se realizó un estudio descriptivo de seguimiento de una cohorte con cáncer de mama, tratados en el Hospital Nacional Rosales en un periodo de tiempo. Resultados: Se encontró una muestra de 132 pacientes. La edad media fue 54.61 años (DS +13.61). 55 pacientes (41.7%) provenían del departamento de San Salvador. De 119 pacientes en que se obtuvo datos de paridad se encontró una mediana de 3 hijos. 15.52% tenían antecedentes familiares. El 91.7% consultaron por presencia de tumor, con una mediana de consulta de 6 meses. Biopsia fue el método diagnostico en 84.41% de las pacientes. El tipo Ductal invasor fue el más frecuente (78.8%) y el estadio de presentación más frecuente fue IIb y IIIa correspondiendo al 50% de la población total. 5 pacientes no fueron sometidos a ninguna terapia quirúrgica, 20% recibido neoadyuvancia, 50% adyuvancia y 35.6% tamoxifeno. Hubo una pérdida de vista al año del 31% de pacientes, y en los restantes se obtuvo una sobrevida del 97.8%.