Mujeres con cáncer de mama: evaluación del afecto positivo y negativo y valoración de un programa de Intervención psicológica en el ámbito hospitalario

[email protected] la actualidad hay numerosos estudios que demuestran que la intervención psicológica es benefi ciosa para los pacientes con cáncer. Nuestro objetivo es investigar el efecto intra- sujetos de la intervención psicológica sobre el afecto positivo y negativo durante los ciclos de tratamiento de quimioterapia adyuvante en mujeres con cáncer de mama. Además estudiamos el efecto de la interacción entre la psicoterapia y la resistencia/vulnerabilidad psicológica de las pacientes en las mismas variables dependientes. Método: La muestra está formada por 119 pacientes diagnosticadas de un cáncer de mama localizado que recibieron tratamiento adyuvante con quimioterapia. Todas las pacientes fueron evaluadas y recibieron intervención psicológica a lo largo del tratamiento. Las variables dependientes: el afecto positivo y negativo fueron evaluadas en cinco intervalos: previamente al tratamiento quimioterápico, 2º, 4º, 6º ciclo de quimioterapia y a los dos meses post-tratamiento. El factor entresujetos resistencia/vulnerabilidad psicológica se derivó de un Análisis de Cluster a partir de cuatro medidas, pre y post, de ansiedad y depresión. Los instrumentos de evaluación utilizados fueron la Escala de Afecto Positivo y Negativo (Sánchez-Cánovas, 1994), y la Escala Hospitalaria de Ansiedad y Depresión (HADS) de Zigmond y Snaith (1983). Se realizó análisis descriptivo de los datos, Análisis Múltiple de la Varianza (MANOVA) de medias repetidas para la comparación intra-sujetos y el diseño factorial mixto para la comparación entre-sujetos (resistentes /vulnerables) Resultados: muestran el efecto principal intra-sujetos de la intervención psicológica en el afecto positivo (p<0.05), no existiendo efecto de la interacción entre la intervención psicológica y la resistencia/vulnerabilidad psicológica. Respecto del afecto negativo, el efecto de la intervención psicológica intra-sujetos y la interacción de ésta con los grupos de pacientes resistentes/vulnerables es signifi cativo en ambos casos (p<0.05). Los contrastes intrasujetos entre los 5 intervalos muestran diferencias signifi cativas entre el intervalo del pretratamiento (1ª evaluación) y el 2º ciclo de quimioterapia (2ª evaluación) en el afecto positivo y negativo. Conclusiones: La ganancia más importante se obtiene en la primera intervención psicológica y ésta es crucial para el mantenimiento del estado de ánimo positivo y la disminución del afecto negativo de las pacientes. Hay ganancia en los dos grupos, las pacientes vulnerables son las que más mejoría experimentan. Es importante señalar la importancia de esta primera intervención y la repercusión que tiene frente a las contingencias aversivas que supone los sucesivos ciclos de quimioterapia.Currently there are numerous publications demonstrating that psychological intervention in patients with cancer is benefi cial. Our objective is to study the within-subjects effect of the psychological intervention on the positive and negative affect during adjuvant chemotherapy cycles in women with breast cancer. In addition, we study the effect of the interaction between psychotherapy and psychological resistance/ vulnerability of patients on the same dependent variables. Method: The sample consists of 119 patients diagnosed with a localized breast cancer that received adjuvant chemotherapy treatment. All the patients were evaluated and received psychological intervention throughout the treatment. Dependent variables: positive and negative affect were evaluated in fi ve intervals: chemotherapy pre-treatment, second, fourth, sixth cycle of chemotherapy and two month post-treatment. The two groups of resistant and vulnerable patients were divided by Cluster Analysis of two measures of anxiety and depression before and after of chemotherapy. Measures used were the Positive and Negative Affect Scale (Sánchez- Cánovas, 1994) and the Hospital Anxiety and Depression Scale (HADS) of Zigmond and Snaith (1983). Descriptive analysis of data and a multivariate analysis of variance with repeated-measures (MANOVA-RM) were performed to compare within-subjects and the mixed factorial design to compare betweensubjects (resistant/vulnerable). Results: demonstrate the main within-subjects effect of the psychological intervention in the positive affect (p<0.05), existing no effect between psychological intervention and psychological resistance /vulnerability interaction. In relation to the negative affect, the effect of the within-subjects psychological intervention and its interaction with the resistant/vulnerable group of patients is signifi cant in both cases (p<0.05). Within-subjects contrasts among the fi ve intervals show signifi cant differences between the pre-treatment interval (fi rst evaluation) and the second cycle of chemotherapy (second evaluation) in the negative and positive affect. Conclusions: The most important benefi t is obtained in the fi rst psychological intervention which is crucial to maintain a positive mood state and diminish the negative affect of patients. There is benefi t in both groups; however, the vulnerable patients present more improvement. Moreover, it is worth mentioning the importance of this fi rst intervention and its repercussion in response to aversive contingencies of chemotherapy cycles

Women with breast cancer: positive and negative affect assessment and psychological intervention program in the hospital area

En la actualidad hay numerosos estudios que demuestran que la intervención psicológica es beneficiosa para los pacientes con cáncer. Nuestro objetivo es investigar el efecto intra-sujetos de la intervención psicológica sobre el afecto positivo y negativo durante los ciclos de tratamiento de quimioterapia adyuvante en mujeres con cáncer de mama. Además estudiamos el efecto de la interacción entre la psicoterapia y la resistencia/vulnerabilidad psicológica de las pacientes en las mismas variables dependientes. Método: La muestra está formada por 119 pacientes diagnosticadas de un cáncer de mama localizado que recibieron tratamiento adyuvante con quimioterapia. Todas las pacientes fueron evaluadas y recibieron intervención psicológica a lo largo del tratamiento. Las variables dependientes: el afecto positivo y negativo fueron evaluadas en cinco intervalos: previamente al tratamiento quimioterápico, 2º, 4º, 6º ciclo de quimioterapia y a los dos meses post-tratamiento. El factor entresujetos resistencia/vulnerabilidad psicológica se derivó de un Análisis de Cluster a partir de cuatro medidas, pre y post, de ansiedad y depresión. Los instrumentos de evaluación utilizados fueron la Escala de Afecto Positivo y Negativo (Sánchez-Cánovas, 1994), y la Escala Hospitalaria de Ansiedad y Depresión (HADS) de Zigmond y Snaith (1983). Se realizó análisis descriptivo de los datos, Análisis Múltiple de la Varianza (MANOVA) de medias repetidas para la comparación intra-sujetos y el diseño factorial mixto para la comparación entre-sujetos (resistentes /vulnerables) Resultados: muestran el efecto principal intra-sujetos de la intervención psicológica en el afecto positivo (p&lt;0.05), no existiendo efecto de la interacción entre la intervención psicológica y la resistencia/vulnerabilidad psicológica. Respecto del afecto negativo, el efecto de la intervención psicológica intra-sujetos y la interacción de ésta con los grupos de pacientes resistentes/vulnerables es significativo en ambos casos (p&lt;0.05). Los contrastes intra-sujetos entre los 5 intervalos muestran diferencias significativas entre el intervalo del pre-tratamiento (1ª evaluación) y el 2º ciclo de quimioterapia (2ª evaluación) en el afecto positivo y negativo. Conclusiones: La ganancia más importante se obtiene en la primera intervención psicológica y ésta es crucial para el mantenimiento del estado de ánimo positivo y la disminución del afecto negativo de las pacientes. Hay ganancia en los dos grupos, las pacientes vulnerables son las que más mejoría experimentan. Es importante señalar la importancia de esta primera intervención y la repercusión que tiene frente a las contingencias aversivas que supone los sucesivos ciclos de quimioterapia.Currently there are numerous publications demonstrating that psychological intervention in patients with cancer is beneficial. Our objective is to study the within-subjects effect of the psychological intervention on the positive and negative affect during adjuvant chemotherapy cycles in women with breast cancer. In addition, we study the effect of the interaction between psychotherapy and psychological resistance/ vulnerability of patients on the same dependent variables. Method: The sample consists of 119 patients diagnosed with a localized breast cancer that received adjuvant chemotherapy treatment. All the patients were evaluated and received psychological intervention throughout the treatment. Dependent variables: positive and negative affect were evaluated in five intervals: chemotherapy pre-treatment, second, fourth, sixth cycle of chemotherapy and two-month post-treatment. The two groups of resistant and vulnerable patients were divided by Cluster Analysis of two measures of anxiety and depression before and after of chemotherapy. Measures used were the Positive and Negative Affect Scale (Sánchez-Cánovas, 1994) and the Hospital Anxiety and Depression Scale (HADS) of Zigmond and Snaith (1983). Descriptive analysis of data and a multivariate analysis of variance with repeated-measures (MANOVA-RM) were performed to compare within-subjects and the mixed factorial design to compare betweensubjects (resistant/vulnerable). Results: demonstrate the main within-subjects effect of the psychological intervention in the positive affect (p&lt;0.05), existing no effect between psychological intervention and psychological resistance /vulnerability interaction. In relation to the negative affect, the effect of the within-subjects psychological intervention and its interaction with the resistant/vulnerable group of patients is significant in both cases (p&lt;0.05). Within-subjects contrasts among the five intervals show significant differences between the pre-treatment interval (first evaluation) and the second cycle of chemotherapy (second evaluation) in the negative and positive affect. Conclusions: The most important benefit is obtained in the first psychological intervention which is crucial to maintain a positive mood state and diminish the negative affect of patients. There is benefit in both groups; however, the vulnerable patients present more improvement. Moreover, it is worth mentioning the importance of this first intervention and its repercussion in response to aversive contingencies of chemotherapy cycles

Long term survival after brain metastases from malignant melanoma

We present the case of a 32-year-old patient with malignant melanoma who relapsed with an unresectable brain metastases (BM). He was managed with whole brain radiotherapy (WBRT) and temozolomide chemotherapy. A metabolic positron emission tomography (PET-scan) complete response was achieved. He is living disease-free more than 6 years after the diagnosis of BM. He is now 51 years old and remains asymptomatic and free of disease since then. However, a pronounced residual image still appears on magnetic resonance imaging (MRI) ant PET-scan

Circulating endothelial cells and microparticles as prognostic markers in advanced non-small cell lung cancer.

BACKGROUND: Circulating endothelial cells and microparticles have prognostic value in cancer, and might be predictors of response to chemotherapy and antiangiogenic treatments. We have investigated the prognostic value of circulating endothelial cells and microparticles in patients treated for advanced non-small cell lung cancer. METHODOLOGY/PRINCIPAL FINDINGS: Peripheral blood samples were obtained from 60 patients before first line, platinum-based chemotherapy +/- bevacizumab, and after the third cycle of treatment. Blood samples from 60 healthy volunteers were also obtained as controls. Circulating endothelial cells were measured by an immunomagnetic technique and immunofluorescence microscopy. Phosphatidylserine-positive microparticles were evaluated by flow cytometry. Microparticle-mediated procoagulant activity was measured by the endogen thrombin generation assay. RESULTS: pre- and posttreatment levels of markers were higher in patients than in controls (p<0.0001). Elevated levels of microparticles were associated with longer survival. Elevated pretreatment levels of circulating endothelial cells were associated with shorter survival. CONCLUSIONS/SIGNIFICANCE: Circulating levels of microparticles and circulating endothelial cells correlate with prognosis, and could be useful as prognostic markers in patients with advanced non-small cell lung cancer

Clinical characteristics of 60 patients with NSCLC and 60 controls.

<p>Age is expressed as mean ± SD.</p

D302H polymorphism delays the age of onset of breast cancer in and carriers

International audienceThe polymorphic genetic differences among individuals may modify the high risk for breast cancer (BC) and/or ovarian cancer (OC) susceptibility conferred by and mutations. In the present study we investigate the relevance of −135C > G, R72P, * and D302H polymorphisms as potential modifiers of BC and/or OC susceptibility conferred by these mutations. The study group encompasses 390 / mutation carriers (182 affected with BC and/or OC and 208 unaffected) of 131 unrelated families studied in the Program of Genetic Counselling on Cancer of Valencia Community. The polymorphisms were detected in genomic DNA by ASRA method or real time PCR using fluorescently labeled probes. We found similar incidence of −135C > G, R72P and * polymorphisms among affected and unaffected individuals considering / mutations together and separately. However, the D302H polymorphism was strongly associated with the absence of BC [OR = 3.41 (95% CI 1.33–8.78,  = 0.01)]. In fact, in the females with D302H polymorphism the BC appeared at a median age of 58 in opposition to the 47 years observed for the wild type subjects ( = 0.03). Furthermore, the D302H positive females showed a 50% probability of being free of BC by the age of 78 versus the 2% of the negative ones. Our results support that the presence of the D302H polymorphism diminishes the high risk of BC conferred by and mutations, making possible that some of the carriers could escape from suffering BC along their life span

Treatment administered to the 60 patients with NSCLC.

<p>(1) Six patients received concomitant radiation therapy (Stage III).</p><p>(2) Six patients received concomitant radiation therapy (Stage III).</p><p>(3) Three patients received concomitant radiation therapy (Stage III).</p