Polymorphous low-grade adenocarcinoma of the parotid gland : case report and review of the literature

Polymorphous low-grade adenocarcinoma (PLGA) is difficult to diagnose both clinically and histologically due to its indolent presentation, and because of its morphological diversity that includes several microscopic patterns. The aggressive biologic behavior seen in minor salivary glands as compared to major glands is apparently associated histologically to a predominance of the papillary pattern in the former. Biologic behavior of PLGA in the major salivary glands is uncertain, as some cases have developed recurrences and metastases independently of the presence of a papillary pattern. A case of PLGA originated de novo in parotid gland is presented a 60 year-old male, treatment was surgically excised through superficial parotidectomy and to postoperative radiotherapy (46 Gy). Forty-eight months later the patient is alive with no signs of recurrence, as well as a review of the literature, with particular emphasis in its differential diagnosis and biological behavior

Tumor fibroso solitario de la region parotidea: Reporte de un caso y revisión de la literatura

El tumor fibroso solitario es una entidad bien establecida, comúnmente localizada en la pleura, aunque recientemente se ha descrito en otras localizaciones, incluyendo la región de cabeza y cuello, en donde se presenta como una lesión bien circunscrita y de crecimiento lento. Debido a su baja frecuencia se puede confundir con otras neoplasias de esta área, por lo que las características microscópicas, ultraestructurales y de inmunohistoquímica ayudan a establecer su diagnóstico. El pronóstico esta relacionado con la localización y el tamaño del tumor. Se presenta un caso en una mujer de 20 años de edad, localizado en la región parotidea con protrusión a cavidad oral, de crecimiento rápido y con un tamaño de 10x8.5x5.5cm, bien circunscrita, y con características histológicas benignas e inmunoreactividad para CD34.Solitary fibrous tumor is a well-recognized entity that most commonly involves the pleura; however, it has been recently described in other locations including the head and neck region, where it occurs as a slowly growing and well-circumscribed lesion. Due to its low frequency it may be confused with other neoplasms, and for this reason microscopic, ultrastructural and immunohistochemical features are necessary to establish its diagnosis. Prognosis of this tumor depends on its location and size. We present a 20-year-old woman with a well circumscribed, rapidly enlarging solitary fibrous tumor located in the parotid region, which protruded into the oral cavity, measured 10 x 8.5 x 5.5 cm and exhibited benign histological features and positive immunoreactivity to CD34

Escala Hospitalaria de Ansiedad y Depresión (HADS) en cuidadores primarios informales de pacientes con cáncer: propiedades psicométricas.

Introduction: Symptoms of anxiety and depression are some of the major mental health problems in caregivers affecting quality of life. Valid and reliable screening instruments such as the Hospital Anxiety and Depression Scale (HADS) has made possible the detection of possible cases of depression and anxiety. However, the psychometric properties of this instrument have not been documented in caregivers in the Mexican population. Objetives: Determine the psychometric properties of the HADS in a sample of caregivers in the Mexican population. Materials and Methods: 200 caregivers from the National Cancer Institute participated, of which 65.5% were women and 34.5% men, with a mean age of 47.4 ± 14.1 years. Participants completed concurrently the HADS and Zarit Burden Interview. Results: A factor analysis to two factors explained 42.05% of the variance with 14 items on two factors. The internal consistency of the overall scale was satisfactory (α=0.83). Cronbach’s alphas for each subscale were .78 and .82. The concurrent validity assessed by way of correlations with concurrent measures showed significant associations (Pearson r=0.41-0.64, p<0.05). Conclusions: The HADS has adequate cons­truct validity, internal consistency and concu­rrent validity for use in caregivers of cancer patients from the Mexican population. The relevance of the results is that this is a popu­lation that can require mental health care in stages of care for patients with cancer.Introducción: la sintomatología ansiosa y depresiva son parte de los principales problemas de salud mental en cuidadores primarios informales afectando su calidad de vida. A través de instrumentos de tamizaje válidos y confiables como la Escala Hospitalaria de Ansiedad y Depresión (HADS) ha sido posible detectar posibles casos. Sin embargo, hasta ahora no se habían caracterizado las propiedades psicométricas en cuidadores primarios informales de pacientes con cáncer en población mexicana. Objetivo: determinar las propiedades psicométricas de la HADS en una muestra de cuidadores primarios informales. Material y Método: Participaron 200 pacientes del Instituto Nacional de Cancerología, de los cuales 65,5% eran mujeres y 34,5% hombres; la edad promedio fue de 47,4 ± 14,1 años. Los participantes contestaron además del HADS la escala de carga de Zarit. Resultados: El análisis factorial presentó dos factores con los 14 reactivos originales. La consistencia interna de la escala global mostró un índice satisfactorio (α=0,83). Los alfas de Cronbach de cada subescala tuvieron un valor de 0,82 y 0,78 que explican el 42,58% de la varianza. La validez por medio de correlación con las medidas concurrentes mostraron resul­tados significativos (r de Pearson de 0,41-0,64, p<0,05). Conclusiones: La HADS en cuidadores pri­marios de pacientes con cáncer en población mexicana presentó adecuadas características psicométricas. La relevancia de los resultados obtenidos radica en que se trata de una po­blación que puede llegar a requerir atención oportuna en salud mental en diferentes etapas del cuidado de pacientes con cáncer

Expression of the metalloproteases MMP-1, MMP-2, MMP-3, MMP-9, MMP-11, TIMP-1 and TIMP-2 in angiocentric midfacial lymphomas

<p>Abstract</p> <p>Background</p> <p>Extranodal T/NK cell lymphomas possess distinctive clinico-pathological characteristics: they are angiocentric, exhibit extensive necrosis. Prognosis is poor in the short term. The objective is to explore the expression of different MMPs in the cells and stroma which are around of the blood vessels damaged and their correlation with clinico-pathological parameters.</p> <p>Patients and methods</p> <p>Twenty cases of this type of lymphomas were studied and collected patient clinical data. The expressions of MMP-1, 2, 3, 9, 11, 13 and TIMP-1, 2 were studied by immunohistochemistry. Ultrastructural studies were performed in two cases. Statistical analysis was done with Fisher's exact test, Chi²test.</p> <p>Results</p> <p>Of the 20 patients, 13 were men with median age of 43 years. In 13 patients the primary tumor was localized in the nasal cavity. Treatment was combined chemotherapy and radiotherapy in 60%. The 55% advanced clinical stages, 70% died from the disease. There were neoplastic cell and peritumoral fibroblasts positivity to MMP-1 and MMP-11 in most of the cases. The MMPs-2, 3 and 9 were expressed in neoplastic cell between 30 to 65%of the cases. TIMP-1 was presented mainly in the epithelium and TIMP-2 was poor expressed of the all cases.</p> <p>Conclusion</p> <p>There were no statistical significance between the different enzymes used and the clinical parameters, besides status and survival of the patients. It is necessary to study more enzymes and focus them to quantify and determine their activity, in order to have a better correlation with histological features in this type of neoplasm.</p

Preocupações sobre a recorrência do câncer em mulheres mexicanas sobreviventes do câncer de mama. Propriedades psicométricas da escala CARS

Fear of recurrence is one of the main affectations of cancer survivors. In Latin-American exist a lack of evidence on the subject and of valid instruments to measure it. The objective of this study was to determine the psychometric properties of the Concerns About Recurrence Scale in Mexican breast cancer survivors. An instrumental study was carried out with 200 women breast cancer survivors with a mean age of 53 years old and a mean survival of 52.5 months. A confirmatory factor analysis of the original version of the scale identified four factors that explained 77 % of the variance and satisfactory goodness of fit indicators: CFI = .967, TLI = .957, SRMR = .035, RMSEA = .071 as well as high internal consistency α = .945. Significant associations were also identified between general fear subscale, anxiety subscale of the HADS and total HADS score (r = .638 and r = .607; p = .01). The CARS presented adequate validity, reliability and factorial structure. It is recommended for usage in clinical care and research with Mexican breast cancer survivors.El miedo a la recurrencia es una de las principales afectaciones de los supervivientes de cáncer. En América Latina existe una falta de evidencia en el tema y de instrumentos válidos para medirlo. El objetivo del presente estudio fue determinar las propiedades psicométricas de la Escala de Preocupaciones Acerca del Cáncer (CARS, por su sigla en inglés) en supervivientes de cáncer de mama mexicanas. Se llevó a cabo un estudio instrumental con 200 mujeres supervivientes de cáncer mamario con una edad promedio de 53 años y una sobrevida promedio de 52.5 meses. Un análisis factorial confirmatorio de la versión original del instrumento identificó cuatro factores que explicaron el 77 % de la varianza de la escala e indicadores de bondad de ajuste satisfactorios: CFI = .967, TLI = .957, SRMR = .035, RMSEA = .071, así como una elevada consistencia interna α = .945. Asimismo, se identificaron asociaciones significativas entre las subescalas de miedo general, ansiedad de la HADS y puntaje total de la HADS (r = .638 y r = .607; p = .01). La escala CARS presentó adecuada validez, confiabilidad y estructura factorial. Es recomendable su uso en escenarios clínicos y de investigación con supervivientes de cáncer de mama mexicanas.O medo da recorrência é uma das principais sequelas dos sobreviventes do câncer. Na América Latina há uma falta de evidências sobre o assunto e uma falta de instrumentos válidos para medi-lo. O objetivo do presente estudo foi determinar as propriedades psicométricas da Escala Preocupações sobre o Câncer (CARS) em sobreviventes do câncer de mama mexicanas. Foi realizado um estudo instrumental com 200 mulheres sobreviventes de câncer de mama com uma média de idade de 53 anos e uma sobrevivência média de 52,5 meses. Uma análise fatorial confirmatória da versão original do instrumento identificou quatro fatores que explicaram 77 % da variação da escala e indicadores satisfatórios de bondade de ajuste: CFI = 0,967, TLI = 0,957, SRMR = 0,035, RMSEA = 0,071, assim como alta consistência interna α = 0,945. Associações significativas também foram identificadas entre as subescalas de medo geral, ansiedade HADS e pontuação total HADS (r = 0,638 e r = 0,607; p = 0,01). A escala CARS mostrou adequada validade, confiabilidade e estrutura de fatores. É recomendado seu uso em ambientes clínicos e de pesquisa com sobreviventes do câncer de mama mexicanas

Efectos de intervenciones psicológicas en sobrevivientes de cáncer: una revisión..

Introduction: During the past decades early detection and effective cancer treatments have produced an increase in the number of cancer survivors. This represents a large group of patients susceptible to psychological, physical and social impairments after cancer treatment.Objective: To review the literature on the effects of psychological therapies in the management of psychological and / or somatic symptoms of cancer survivors. Method: A review of the literature reported in MEDLINE, PsycINFO, CINAHL, and MedicLatina Psychology and Behavioral Sciences Collection in the period January 2009 to December 2013 was conducted. Results: 24 articles were identified. Only 22 met the selection criteria; in 2 cases no access to the full articles was obtained, so only 19 were included. Statistically significant effects were identified in sleep difficulties, emotional symptoms, fatigue, quality of life, and post menopausal symptoms. Effect sizes were mostly small to moderate ranging from 0.00 - 1.40.Conclusions: The effects of most psychological interventions were positive whether independent or in combination with other treatment modalities. Interventions via telephone and online therapeutic modalities also showed positive results.Introducción: Durante las últimas décadas la detección temprana y tratamientos eficaces contra el cáncer han producido un aumento en el número de supervivientes de cáncer. Lo que representa un amplio grupo de pacientes susceptibles de presentar afectaciones psicológicas, físicas y sociales posteriores al tratamiento oncológico.Objetivo: Hacer una revisión de la literatura sobre los efectos de las terapias psicológicas en el manejo de aspectos psicológicos y/o síntomas de los supervivientes de cáncer. Método: Se realizó una revisión de la literatura reportada en MEDLINE, PsycINFO, CINAHL, MedicLatina y Psychology and Behavioral Sciences Collection en el periodo de Enero de 2009 a Diciembre de 2013.Resultados: Se identificaron 24 artículos. Solo 22 cumplieron con los criterios de selección, en 2 casos no se tuvo acceso a los artículos completos, por lo que solo se incluyeron 19. Se identificaron efectos estadísticamente significativos en afectaciones del sueño, bienestar emocional, fatiga, calidad de vida, y síntomas post menopáusicos; y tamaños del efecto entre 0,00 -1,40.Conclusiones: Los efectos de la mayoría de las intervenciones psicológicas fueron positivos tanto en modalidad única como en combinación con otras modalidades de tratamiento así como las intervenciones telefónicas y modalidades terapéuticas en línea

Propriedades psicométricas da Escala de Medida do Estado Atual (MOCS) em pacientes mexicanos com câncer

Background: Cancer is a public health problem, and stress is one of the psychosocial variables associated to this disease, which calls for the need to have a reliable scale to measures stress in the Hispanic population with cancer. Objective: To determine the psychometric properties of the Measurement of Current Status (MOCS) Scale in Mexican cancer patients. Method: Study design: Cross-sectional, non-experimental instrumental. A total of 197 patients aged 18-81 years, at any clinical stage, receiving cancer treatment or follow-up were included. Instruments: MOCS and emotional distress thermometer. Statistical analysis: Confirmatory factor analysis was performed to evaluate the fit of the model to the data using the maximum likelihood estimation and cut-off points. Results: Two models were obtained. The first, self-perceived current state, had an alpha of .90 with an explained variance of 74.2 %; the second, non-specific effect, with an alpha of .61 and an explained variance of 74.3 %. The confirmatory factor analysis showed that both models had indexes suggesting stability and acceptable adjustment. Scores are shown by interquartile ranges for each model. Conclusions: The Mexican version of the MOCS is reliable and valid; with a confirmatory factor structure similar to the original version. Therefore, we support its use in the clinical and research setting with cancer patients.Antecedentes: El cáncer es un problema de salud pública, una de las variables psicosociales en relación con esta enfermedad es el estrés, por tanto es necesario tener una escala que mida el estrés en población hispana con cáncer. Objetivo: Determinar las propiedades psicométricas de la Escala de Medida del Estado Actual (MOCS, por sus igla en inglés) en pacientes mexicanos con cáncer. Método: Estudio transversal, instrumental no experimental. Participaron 197 pacientes de 18 a 81 años, de cualquier etapa clínica, en tratamiento o seguimiento del cáncer. Instrumentos: MOCS y termómetro de malestar emocional. Análisis estadísticos: análisis factorial confirmatorio para evaluar el ajuste del modelo a los datos mediante el método de máxima verosimilitud y puntos de corte. Resultados: Se obtuvieron dos modelos, el primero, estado actual autopercibido, con un alfa de .90 varianza explicada de 74.2 %, el segundo, efectos inespecíficos, con un alfa de .61 varianza explicada de 74.3 %. El análisis factorial confirmatorio mostró que ambos modelos tuvieron índices que sugieren estabilidad, ajuste aceptable, se muestran puntajes mediante rangos intercuartílicos para cada modelo. Conclusiones: la versión mexicana del MOCS tiene confiabilidad y validez, su estructura factorial confirmatoria es similar a la versión original. Se recomienda su uso en la práctica clínica e investigación en pacientes con cáncer.Antecedentes: O câncer é um problema de saúde pública, uma das variáveis psicossociais relacionadas a essa doença é o estresse, portanto, é necessário ter uma escala que meça o estresse na população hispânica com câncer. Objetivo: Determinar as propriedades psicométricas da Escala de Medição do Estado Atual (MOCS) em pacientes mexicanos com câncer. Método: Desenho do estudo: transversal, instrumental, não experimental. Participaram 197 pacientes com idades entre 18 e 81 anos, em qualquer estágio clínico, em tratamento ou acompanhamento do câncer. Instrumentos: MOCS e Termômetro de desconforto emocional. Análises estatísticas: análise fatorial confirmatória para avaliar o ajuste do modelo aos dados por meio do método de máxima verossimilhança e pontos de corte. Resultados: Foram obtidos dois modelos, o primeiro estado atual autopercebido com um alfa de 0,90 variância explicada de 74,2 %, o segundo efeito inespecífico com um alfa de 0,61 variância explicada de 74,3 %; a análise fatorial confirmatória mostrou que ambos os modelos tiveram índices que sugerem estabilidade, ajuste aceitável e são demonstradas pontuações por meio de intervalos interquartis para cada modelo. Conclusões: a versão mexicana do MOCS tem confiabilidade e validade; sua estrutura fatorial confirmatória é semelhante à versão original. É recomendado para prática clínica e pesquisa em pacientes com câncer

Propiedades psicométricas do Instrumento de Avaliação de Funcionalidade no Tratamento para Doenças Crónicas (FACT-GP) en población general Mexicana

Quality of life is a relevant aspect of people's lives, even more so when high comorbidities are present in the general population, so its valid and reliable measurement is necessary. Objective: To determine the psychometric properties of the Instrument for the Evaluation of Functionality in the Treatment of Chronic Diseases (FACT-GP) in the general Mexican population. Method: A cross-sectional design was used, with a non-probabilistic sampling, based on availability. Statistical analysis: A confirmatory factorial model was performed. Results: 254 participants with M = 23.5 years (21-32) were included. Four factors with 18 reagents were identified. The internal consistency of the global scale was 0.81, which explains 58.93 % of the variance. Confirmatory factor analysis present adequate indices (CFI, RMR, RMSEA), that prove a balanced and parsimonious fit of the model structure. Conclusion: The FACT-GP showed a structure similar to the original version with valid and reliable indicators for its use in clinical care and research aimed at the general Mexican population.La calidad de vida es un aspecto relevante en la vida de las personas, más aún cuando se presentan comorbilidades altas en población general, por lo que su medición de forma válida y confiable es necesaria. Objetivo: Determinar las propiedades psicométricas del Instrumento de Evaluación de Funcionalidad en el Tratamiento para Enfermedades Crónicas (FACT-GP) en población general mexicana. Método: Se empleó un diseño transversal, con un muestreo no probabilístico, por disponibilidad. Análisis estadístico: Se realizó un modelo factorial confirmatorio. Resultados: Se incluyeron 254 participantes con M = 23.5 años (21-32). Se identificaron 4 factores con 18 reactivos. La consistencia interna de la escala global fue .81, que explican el 58.93 % de la varianza. El análisis factorial confirmatorio presenta índices adecuados (CFI, RMR, RMSEA), que indican un ajuste equilibrado y parsimonioso de la estructura del modelo. Conclusión: El FACT-GP mostró una estructura similar a la versión original, con indicadores válidos y confiables para su uso en la atención clínica e investigación dirigida a población general mexicana.A qualidade de vida é um aspecto relevante na vida das pessoas, ainda mais quando ocorrem altas comorbidades na população em geral, sendo necessária sua mensuração válida e confiável. Objetivo: Determinar as propriedades psicométricas do Instrumento de Avaliação da Funcionalidade no Tratamento para Doenças Crônicas (FACT-GP) na população mexicana em geral. Método: Utilizou-se o delineamento transversal, com amostragem não probabilística, devido à disponibilidade. Análise estatística: Foi realizado um modelo fatorial confirmatório. Resultados: Foram incluídos 254 participantes com idade M = 23,5 anos (21-32). 4 fatores foram identificados com 18 itens. A consistência interna da escala global foi de 0,81, o que explica 58,93 % da variância. A análise fatorial confirmatória apresenta índices adequados (CFI, RMR, RMSEA), que indicam um ajuste equilibrado e parcimonioso da estrutura do modelo. Conclusão: O FACT-GP apresentou estrutura semelhante à versão original com indicadores válidos e confiáveis para sua utilização na assistência clínica e em pesquisas direcionadas à população em geral

Psychometric properties of the Beck Anxiety Inventory (BAI) for patients with cancer.

La sintomatología ansiosa es uno de los principales problemas psicológicos en pacientes oncológicos. La Escala de Ansiedad de Beck (BAI) ha demostrado ser un instrumento válido y confiable. Sin embargo, hasta ahora no se había documentado su comportamiento psicométrico en población oncológica en México.Objetivo: Determinar las propiedades psicométricas de la Escala de Ansiedad de Beck (BAI) en una muestra de pacientes con cáncer. Material y Método: participaron 250 pacientes del Instituto Nacional de Cancerología, de los cuales 138 eran mujeres (55,2%) y 112 eran hombres (44,8%); la edad promedio fue de 46,6 ± 14,3 años. Los participantes contestaron además del BAI, la Subescala de ansiedad de la Escala de Ansiedad y Depresión (HADS-A). Resultados: El análisis factorial varimax con 21 reactivos presentó una estructura con 4 factores: Subjetivo, Neurofisiológico, Autonómico y Síntomas vasomotores que explicaron el 46,38% de la varianza. La consistencia interna de la escala global mostró un índice satisfactorio (α=0,82). La validez por medio de correlación con el HADS-A mostraron resultados significativos (r de Pearson de 0,58, p &lt;0,05) y el ECOG (r de Pearson de -0,36 p &lt;0,05). Conclusiones: el BAI en pacientes con cáncer en población mexicana presentó adecuadas características psicométricas. La detección de sintomatología ansiosa a través del BAI deriva en beneficios para la población oncológica y en estrategias funcionales de atención adecuada y costo-efectivas.Introduction: Depressive symptomatology is a major mental health problem in cancer patients. The Beck Anxiety Scale (BAI) has proven to be a reliable and valid instrument. However, until now has not been documented it’s psychometric properties in Mexican population with cancer.Objetives: Determine the psychometric properties of the Beck Anxiety Scale BAI in a sample of cancer patients. Material and methods: Involved 250 patients from the National Cancer Institute, of which 112 were women (55.2%) were male and 138 (44.82%); the average age was 46.6 ± 14.3 years. Participants answered the BAI, and also the Anxiety Sub-scale of HADS.Results: A varimax factor analysis with 21 items show a structure of 4 factors: Subjective, Neurophysiological, Autonomic and vasomotor symptoms that explain 46.38% of the variance. The internal consistency of the overall scale was satisfactory (α=0.82). The validity through correlations with the HADS-A showed significant associations (Pearson r=0.58, p &lt;0.05) and ECOG (Pearson -0.36, p &lt;0.05).Conclusions: The BAI in Mexican population with cancer showed adequate psychometric characteristics. Detection of anxiety symp toms through BAI provides benefits to the cancer population and facilitates the development of adequate and cost-effective care strategies