Ingestão Alimentar de Mulheres com Tumores Ginecológicos em Tratamento Oncológico: Revisão Integrativa da Literatura / Food Intake of Women with Gynecological Tumors Undergoing Cancer Treatment: Integrative Literature Review / Ingestión de Alimentos de Mujeres con Tumores Ginecológicos en Tratamiento Oncológico: Revisión Integradora de la Literatura

Introdução: Pacientes com câncer apresentam uma tendência à perda ponderal e à desnutrição energético-proteica. Isso ocorre em razão das modificações que o organismo sofre pelo desenvolvimento da doença e pelos efeitos adversos do tratamento oncológico que contribuem para a redução da ingestão alimentar. Objetivo: Identificar evidências disponíveis na literatura científica sobre a ingestão alimentar de mulheres com tumores ginecológicos em tratamento oncológico. Método: Revisão integrativa da literatura cujas buscas foram realizadas nas bases de dados Embase, MEDLINE e LILACS por meio da associação de termos descritores e palavras livres. Foram incluídos nas análises estudos observacionais que avaliaram a ingestão alimentar de mulheres adultas com tumores ginecológicos durante o tratamento oncológico, redigidos em português, inglês e espanhol. Resultados: Esta revisão analisou seis estudos que investigaram a mudança na ingestão alimentar dessa população. Identificou-se uma redução da ingestão em até 31% de energia, 39,9% de proteínas, 33,7% de lipídeos, 28,7% de carboidratos e uma inadequação da ingestão de determinados micronutrientes. Conclusão: Mulheres com tumores ginecológicos durante o tratamento oncológico apresentam redução significativa da ingestão de energia, proteínas, lipídeos, carboidratos e micronutrientes. Considerando que a perda de peso e a desnutrição em pacientes com câncer está associada a desfechos clínicos negativos, a avaliação e a análise da ingestão alimentar desses indivíduos são fundamentais para possibilitar uma intervenção nutricional precoce, boa resposta ao tratamento e consequente melhoria da qualidade de vida

Introduction: Cancer patients tend to lose weight and energy-protein malnutrition because of the changes the organism undergoes caused by the progression of the disease and treatment-related adverse effects that contribute for the reduction of food intake. Objective: To identify scientific literature-based evidences on food intake of women with gynecological tumors undergoing cancer treatment. Method: Integrative literature review through searches at the Embase, MEDLINE and LILACS databases with the association of descriptive terms and free words. Observational studies in Portuguese, English and Spanish that evaluated the food intake of this population were included in the analyzes. Results: This review identified 6 studies that investigated the change in food intake of women with gynecological cancer undergoing cancer treatment. A reduction in intake was identified in until 31% of energy, 39.9% of proteins, 33.7% of lipids, 28.7% of carbohydrates and inadequate intake of certain micronutrients. Conclusion: Women with gynecological tumors during cancer treatment present significant reduction of energy, proteins, lipids, carbohydrates and micronutrients intake. Considering that weight loss and malnutrition in cancer patients are associated with negative clinical outcomes, the evaluation and analysis of the food intake of this population individuals is essential for early nutritional intervention, good response to treatment and improvement of the quality of life

Introducción: Los pacientes con cáncer tienen tendencia a la pérdida de peso y a la desnutrición calórico-proteica. Esto ocurre debido a los cambios que sufre el organismo debido al desarrollo de la enfermedad y los efectos adversos del tratamiento del cáncer que contribuyen a la reducción de la ingesta alimentaria. Objetivo: Identificar la evidencia disponible en la literatura científica sobre la ingesta alimentaria de mujeres con tumores ginecológicos en tratamiento oncológico. Método: Revisión integrativa de la literatura cuyas búsquedas se realizaron en las bases de datos Embase, MEDLINE y LILACS mediante la asociación de términos descriptivos y palabras libres. Se incluyeron en los análisis estudios observacionales que evaluaron la ingesta de alimentos de mujeres adultas con tumores ginecológicos durante el tratamiento del cáncer, escritos en portugués, inglés y español. Resultados: Esta revisión analizó seis estudios que investigaron el cambio en la ingesta de alimentos en esta población. Cuantificamos una reducción de la ingesta de hasta un 31% en energía, 39,9% en proteínas, 33,7% en lípidos, 28,7% en carbohidratos y una ingesta inadecuada de determinados micronutrientes. Conclusión: Las mujeres con tumores ginecológicos durante el tratamiento del cáncer tienen una reducción significativa en la ingesta de energía, proteínas, lípidos, carbohidratos y micronutrientes. Teniendo en cuenta que la pérdida de peso en pacientes con cáncer se asocia con resultados clínicos negativos, la evaluación de la ingesta alimentaria de estos individuos es fundamental para permitir una intervención nutricional precoz, una buena respuesta al tratamiento y la consecuente mejora de la calidad de vida

Characterization and functional capacity in women with breast cancer, gynaecological cancer and gestational trophoblastic disease / Caracterización y capacidad funcional de mujeres con cáncer mamario, cáncer ginecológico y enfermedad trofoblástica gestacional / Caracterização e capacidade funcional de mulheres com câncer ginecológico, câncer mamário e doença trofoblástica gestacional

Objective: to describe the social, demographic and clinical profile, and functional capacity of women diagnosed with gynecological cancer, breast cancer and gestational trophoblastic disease during chemotherapy. Method: longitudinal retrospective study that evaluated the records of women treated in hospital clinics from January 2000 to December 2012. Results: they evaluated the records of 438 women. The analysis showed that were not able to perform their daily activities, limited to the activities of self-care. Older patients had greater functional impairment during therapy. Conclusions: the sample was women 41 to 50 years, diagnosed with breast cancer (50.9%) and made use of anthracycline based protocols (47%); the scores of the functional capacity of the sample fell from 78.22 to 73.57. It is evident that nursing care should focus on the control of signs and symptoms that impact the functional capacity of women under chemotherapy.

Objetivo: describir el perfil socio demográfico, clínico y capacidad funcional de mujeres diagnosticadas con cáncer ginecológico, mamario y enfermedad trofoblástica gestacional en tratamiento quimioterápico. Método: estudio longitudinal retrospectivo, que evaluó los registros de mujeres en tratamiento en un hospital de clínicas en el período de enero/2000-diciembre/2012. Resultados: fueron evaluados los registros de 438 mujeres. El análisis mostró que las pacientes no eran capaces de realizar sus actividades cotidianas, limitándose a las actividades del autocuidado. Las pacientes mayores sufrieron más comprometimiento funcional durante la terapéutica. Conclusiones: la muestra estudiada era de mujeres con 41-50 años, diagnosticadas con cáncer de mama (50,9%) y hacían uso de protocolos basados en antracíclicos (47%); los escores de la capacidad funcional de la muestra decayeron de 78,22 para 73,57. Se evidencia que los cuidados de enfermería deben centrarse en el control de señales y síntomas que causan impacto en la capacidad funcional de las mujeres en quimioterapia.

Objetivo: descrever o perfil sociodemográfico e clínico e a capacidade funcional de mulheres diagnosticadas com câncer ginecológico, câncer mamário e doença trofoblástica gestacional em tratamento quimioterápico. Método: estudo longitudinal retrospectivo, que avaliou os registros de mulheres em tratamento em um hospital de clínicas no período de janeiro de 2000 a dezembro de 2012. Resultados: foram avaliados os registros de 438 mulheres. A análise mostrou que as pacientes não eram capazes de realizar suas atividades cotidianas, limitando-se àquelas do autocuidado. As pacientes idosas sofreram maior comprometimento funcional durante a terapêutica. Conclusões: a amostra estudada era de mulheres com 41 a 50 anos, diagnosticadas com câncer de mama (50,9%), que faziam uso de protocolos baseados em antracíclicos (47%); os escores da capacidade funcional da amostra decaíram de 78,22 para 73,57. Evidencia-se que os cuidados de enfermagem devem centrar-se no controle de sinais e sintomas que causam impacto na capacidade funcional das mulheres sob quimioterapia.

Conhecimento da equipe de enfermagem acerca de eventos adversos do tratamento quimioterápico / Knowledge of a nursing team about chemotherapy adverse effects

Este estudo teve como objetivo identificar o conhecimento dos profissionais da equipe de enfermagem acerca dos eventos adversos decorrentes do tratamento quimioterápico. Estudo descritivo e transversal realizado entre março e maio de 2013 com 28 profissionais da equipe de enfermagem que trabalham no Ambulatório, na Unidade de Internação e na Central de Quimioterapia de um hospital universitário. Para a coleta dos dados foi utilizado um instrumento elaborado pelas autoras e validado por enfermeiras especialistas na área. Entre os participantes, 82,1% não possuem nenhum tipo de especialização na área de oncologia. As profissionais apresentaram dificuldades em classificar os eventos adversos em relação ao tempo de aparecimento, bem como ao manejo dos mesmos. Os eventos adversos relatados coincidem com os mais evidenciados na prática clínica. Diante da complexidade do tratamento quimioterápico, torna-se indiscutível a necessidade de capacitação dos profissionais de saúde que atuam na área quando consideramos uma prática assistencial em oncologia de qualidade.

This study aimed to identify the knowledge of the professional nursing team about the adverse events resulting from chemotherapy treatment. Descriptive cross-sectional study conducted between March and May 2013 with 28 professional nursing team working at the outpatient clinic, the inpatient unit and Chemotherapy Center of a university hospital. To collected data were used an instrument developed by the authors and validated by expertise nurses in this area. Among the participants, 82,1 % did not have any expertise in the area ofoncology. The professionals had difficulties in classifying adverse events in relation to time of onset, and their management. Reported adverse events coincide with the most evident in clinical practice. Given the complexity of chemotherapy becomes the indisputable need for training of health professionals working in the area when considering a care in oncology quality.

Câncer ginecológico e gravidez: uma revisão sistematizada direcionada para obstetras / Gynecological cancer and pregnancy: a systematic review aimed to obstetricians

A estimativa de incidência de câncer em grávidas é baixa. Entretanto, com a procriação ocorrendo em idades mais avançadas nas últimas décadas, observou-se um aumento na incidência dos cânceres diagnosticados durante a gravidez. Neste artigo, foi realizada uma revisão sistemática sobre a ocorrência do câncer ginecológico concomitante à gravidez. O objetivo foi apresentar as evidências disponíveis sobre a triagem, diagnóstico, acompanhamento do tratamento oncológico, bem como a possibilidade de preservação da fertilidade nessas mulheres. A revisão de literatura foi realizada na base de dados Pubmed, de 2010 a 2014. Dos 352 artigos encontrados, 26 foram selecionados para leitura completa. Devido à baixa incidência de cânceres ginecológicos associado à gravidez a condução destas pacientes tem como base os relatos e séries de casos e poucas coortes históricas. Os cânceres ginecológicos mais frequentemente associados à gravidez são o câncer do colo do útero e o de ovário. Nestes grupos de pacientes, o obstetra desempenha papel fundamental na triagem, diagnóstico, avaliação inicial, e coordenação da equipe multidisciplinar de assistência. O tratamento deve ser individualizado, com o objetivo de alcançar as maiores taxas de cura. Entretanto, deve também vislumbrar a possibilidade de manter a gravidez, com mínimos danos ao feto e de preservar a fertilidade, se possível, o que é incentivado pela tendência de início tardio da vida reprodutiva.(AU)

Cancer incidence estimates during pregnancy are low. However, with procreation occurring at older ages in recent decades, an increased incidence of cancers diagnosed during pregnancy has been observed. In this article a systematic review on the occurrence of concomitant gynecological cancer to pregnancy was performed. The objective was to provide the available evidence on screening, diagnosis and monitoring of cancer treatment and preservation of pregnancy and fertility in these group of women. The literature review was performed in PubMed database from 2010 to 2014. Of the 352 reviewed articles, 26 were selected to complete reading. Due to the low incidence of gynecological cancers associated with pregnancy, the management of these patients is based on reports, case series, and a few historical cohorts. Gynecologic cancers most often associated with pregnancy are cervical cancer and the ovarian cancer. In these group, the obstetrician composes an important role in screening, diagnosis, initial evaluation, and coordination of the multidisciplinary team care. Treatment should be individualized in order to achieve the highest cure rates. However, it should also envisage the possibility to maintain the pregnancy, with minimal damage to the fetus and to preserve fertility, if possible, which is encouraged by the tendency of the late reproductive years.(AU)

Palonosetron versus granisetron in combination with aprepitant for the prevention of chemotherapy-induced nausea and vomiting in patients with gynecologic cancer / 부인종양

OBJECTIVE: There is no research regarding the appropriate antiemetic agents for female patients, especially those receiving moderately emetogenic chemotherapy (MEC). We evaluated the antiemetic efficacy of a combination of 5-HT3 receptor with/without aprepitant in patients with gynecological cancer treated with the TC (paclitaxel and carboplatin) regimen of MEC. METHODS: We enrolled 38 patients diagnosed with gynecologic cancer and scheduled to receive the TC regimen. The patients were randomly assigned to receive a 5-HT3 receptor antagonist, either palonosetron in the first cycle followed by granisetron in the second cycle or vice versa. In the third cycle, all patients received a combination of the 5-HT3 receptor and dexamethasone with/without aprepitant. RESULTS: When three drugs were administered, palonosetron consistently produced an equivalent complete response (CR) rate to granisetron in the acute phase (89.5% vs. 86.8%, p=0.87) and delayed phase (60.5% vs. 65.8%, p=0.79). With regard to the change in dietary intake, palonosetron exhibited similar efficacy to granisetron in the acute phase (92.1% vs. 89.4%, p=0.19) and delayed phase (65.7% vs. 68.4%, p=0.14). However, in the delayed phase, the addition of aprepitant therapy with a 5-HT3 receptor antagonist and dexamethasone produced a higher CR rate than a 5-HT3 receptor antagonist with dexamethasone (93.3% vs. 47.8%, p<0.001) and allowed the patients to maintain a higher level of dietary intake (93.3% vs. 56.5%, p<0.001). CONCLUSION: The addition of aprepitant therapy was more effective than the control therapy of a 5-HT3 receptor antagonist, and dexamethasone in gynecological cancer patients treated with the TC regimen.

Effects of Lifestyle Intervention on Fatigue, Nutritional Status and Quality of Life in Patients with Gynecologic Cancer

PURPOSE: The purpose of this study was to examine the effect of lifestyle intervention on the development of fatigue, nutritional status and quality of life of patients with gynecologic cancer. METHODS: A nonequivalent control group quasi-experimental design was used. Participants were 49 patients with gynecologic cancer. They were assigned to the experiment group (n=24) or the control group (n=25). The lifestyle intervention for this study consisted of physical activity, nutritional education, telephone call counseling, health counseling, monitoring for lifestyle, and affective support based on Cox's Interaction Model of Client Health Behavior and was implemented for six weeks. RESULTS: Significant group differences were found for fatigue (p =.037), nutritional status (p =.034) and social/family well-being (p =.035) in these patients with gynecologic cancer. CONCLUSION: Results indicate that this lifestyle intervention is effective in lessening fatigue, and improving nutritional status and social/family well-being. Therefore, nurses in hospitals should develop strategies to expand and provide lifestyle interventions for patients with cancer.

Fibrinogen, bFGF and VEGF levels during antibiotic therapy in gynecologic cancer: A preliminary report.

The role of angiogenesis in the development of neoplasia has been identified and characterized. However, anti-angiogenic therapeutic intervention still requires more evidence to become recognized and successful. The aim of this study was to evaluate levels of selected proangiogenic factors, such as fibrinogen, vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in serum of patients with the gynecologic cancer on the first, third and sixth day of antibiotic therapy, routinely administered as a perioperative treatment. In addition, serum concentrations of γ-γ dimers and α-polymers of cross-linked fibrin structure and the degree of bFGF binding with the fibrin network were investigated. Immunohistochemistry staining of the excised tumor tissue was also performed. We observed higher levels of bFGF, VEGF, as well as fibrinogen in patients with gynecologic malignancy, as compared to healthy women. In cancer patients, the concentration of α-polymers and γ-γ dimers of fibrin network increased. Further only γ-γ dimers fraction of fibrin was found to bind to bFGF. Immunohistochemical analysis indicated the presence of bFGF in an excised tumor tissue. In conclusion, the decrease of proangiogenic bFGF and fibrinogen levels in a clinical trial of gynecologic patients may confirm anti-angiogenic properties of selected antibiotic therapy.

Osteonecrosis maxilar: una problemática onco-odontológica / Maxillary osteonecrosis: an onco-odontologic problematic

Los bifosfonatos fueron sintetizados en el siglo XIX por químicos alemanes, los cuales buscaban prevenir el depósito industrial de carbonato de calcio en sus chimeneas. Más tarde se observó la gran afinidad de la droga con el tejido óseo y que además inhibía la conversión de fosfato de calcio amorfo a hidroxiapatita (HA), lo cual reducía la velocidad de disolución de los cristales óseos. Por lo antedicho, estos compuestos sintéticos son utilizados hace más de tres décadas para el tratamiento de desórdenes esqueletales: osteoporosis, enfermedad de Paget, hipercalcemia asociada a mieloma múltiple y metástasis óseas propias de cáncer de próstata y mama, osteogénesis imperfecta y displasia fibrosa. Recientemente se han descripto algunos casos de osteonecrosis maxilar a causa de tratamiento crónico con bifosfonatos, a altas dosis en la prescripción de dichas drogas utilizadas como terapéutica oncológica.

Biphosphonates, synthesized in the mid 19th century by German chemists, were initially used in industry due to their capacity to prevent the deposits of calcium carbonate, which made them especially useful in avoiding the deposit of calcium salt in pipes. Later it was shown that they had great affinity with osseous tissue, where they inhibitedthe conversion of amorphous calcium phosphate in hydroxyapatite and they reduced the dissolution speed o the later. Biphosphonates are synthetics compounds used in the treatment of various metabolic and malignant bone diseases: Osteoporosis, Paget Disease, Hypercalcemia, Multiple Mieloma, Metastatic breast cancer and Metastatic prostate cancer, Osteogenesis Imperfecta, Fibrous Dysplasia. Recently, have been described some cases of Osteonecrosis of the jaw because of biphosphonate treatment in high doses for oncology administration.

Evaluation of the Quality of Life of Gynecological Cancer Patients Submitted to Antineoplastic Chemotherapy / Avaliação da qualidade de vida de portadoras de câncer ginecológico, submetidas à quimioterapia antineoplásica / Evaluación de la calidad de vida de portadoras de cáncer ginecológico, sometidas a quimioterapia antineoplásica

This study aimed to evaluate the quality of life of female gynecological cancer patients submitted to antineoplastic chemotherapy Between August 2007 and April 2009, 50 patients who were undergoing chemotherapy at an outpatient chemotherapy unit in Uberaba - MG were interviewed, by applying the instrument of evaluation of Quality of Life of the World Health Organization, WHOQOL-BREF. The results showed that the domain most affected was the Physical and the more preserved, the Social, with the mean of the general quality of life above the means obtained in other studies. All domains correlated significantly with the general quality of life. It was evident then that the quality of life of these women is satisfactory, however it is suggested that the domains with lower scores be the targets of more accurate observations during multi-professional interventions in order to provide a better quality of life during the chemotherapy treatment.

Este estudo teve como objetivo avaliar a qualidade de vida de mulheres portadoras de câncer ginecológico, submetidas à quimioterapia antineoplásica. Foram entrevistadas 50 pacientes, no período de agosto de 2007 a abril de 2009, que estavam em tratamento quimioterápico em um ambulatório de quimioterapia de Uberaba, MG, mediante aplicação do instrumento de avaliação de Qualidade de Vida da Organização Mundial da Saúde-WHOQOL-bref. Os resultados apontaram que o domínio mais comprometido foi o físico e o mais preservado, o social, sendo que a qualidade de vida geral obteve média acima da obtida em outros estudos. Todos os domínios correlacionaram-se significativamente com a qualidade de vida geral. Pode-se evidenciar, então, que a qualidade de vida dessas mulheres é satisfatória; entretanto, sugere-se que os domínios com escores mais baixos sejam alvo de observações mais acuradas, durante as intervenções multiprofissionais, a fim de se proporcionar melhor qualidade de vida durante o tratamento quimioterápico.

Este estudio tuvo como objetivo evaluar la calidad de vida de mujeres portadoras de cáncer ginecológico sometidas a quimioterapia antineoplásica. Fueron entrevistadas 50 pacientes en el período de agosto de 2007 a abril de 2009 que estaban en tratamiento quimioterapéutico en un ambulatorio de quimioterapia de Uberaba-MG, mediante la aplicación del instrumento de evaluación de Calidad de Vida de la Organización Mundial de la Salud-WHOQOL-bref. Los resultados apuntaron que el dominio más comprometido fue el físico y el más preservado, el social, siendo que la calidad de vida general obtuvo un promedio superior al obtenido en otros estudios. Todos los dominios se correlacionaron significativamente con la calidad de vida general. Se puede evidenciar, entonces, que la calidad de vida de esas mujeres fue satisfactoria; sin embargo se sugiere que los dominios con puntajes más bajos sean examinados con observaciones más exactas durante las intervenciones multiprofesionales, a fin de proporcionar una mejor calidad de vida durante el tratamiento quimioterapéutico.

Perfil de pacientes com câncer ginecológico em tratamento quimioterápico / Profile of patients with gynecological cancer under chemotherapy / Perfíl de pacientes con cáncer ginecológico bajo tratamiento quimioterápico

Estudo do perfil sócio-epidemiológico demográfico das pacientes em tratamento quimioterápico por câncer na Enfermaria de Ginecologia e Obstetrícia do HE-UFTM, apresentado no período de 1998 a 2006. Estudo retrospectivo cuja coleta de dados foi realizada a partir de dados existentes no prontuário. Foi construído banco de dados no programa Epi-info, utilizando-se para análise distribuição simples, mediana com valores entre máxima e mínima e desvio padrão. A amostra foi constituída por 321 porntuários. Os dados dos pacientes revelaram faixa etária mais incidente 46 a 50 anos, 45 por cento dos casos de câncer foi de mama, o quimioterápico mais utilizado foi ciclofosfamida em 173 tratamentos. Houve aumento na frequência do câncer de mama. Conclui-se que houve mudança no perfil das pacientes.

A study of socio-epimiological demographic profile of patients in chemotherapy for cancer in the Gynecology and Obstetrical Ward in HE- UFTM, presented in the periodo from 1998 to 2006. Retrospective study whose data collection was obtained from health records It was built a data base using Epi-Info. Data analysis considered simple distribution, mediacy with value between the maximum and the minimum and stand deviation. The sample was constituted of 321 health records; the more incident age group was 46 to 50 years-old; breast cancer was the most noticed cancer (45 percent); the chemotherapy most used was ciclofosfamida, in 173 treatments; had an increase in breast cancer. It was concluded that had a change in the patient's profile.

Estudio del perfil socio-epidemiológico demográfico de las pacientes en tratamiento quimioterapico por cáncer en la Enfermería de Ginecología y Obstetricia del HE-UFTM, presentado en lo periodo de 1998 al 2006. Estudio retrospectivo cuya recolleción de datos, fue realizada en el prontuario. Fue construido banco de dados en el programa Epi-info, se utilizó para analice distribución simple, mediana con valores entre máxima y mínima y desvío padrón. La muestra fue constituida de 321 prontuarios. La faja de edad los pacientes más incidente fue de 46 a 50 años, 45 por ciento de los casos de cáncer fue el de mama, el quimioterapico mas utilizado fue ciclofosfamida, en 173 tratamientos; hubo aumento en la frecuencia del cáncer de mama. Se concluyó que hubo un cambio en el perfil de las pacientes.

Leucocitúria em pacientes submetidas a quimioterapia e coleta de urina / Leucocituria in patients submitted to chemoteraphy and urine collection / Leucocitúria en pacientes sometidas a quimioterapia y recolección de orina

O objetivo do estudo foi verificar a freqüência de leucocitúria em portadoras de câncer ginecológico em quimioterapia (QT) e avaliar as práticas na coleta de urina para exame. Pesquisa descritiva, transversal realizada com mulheres portadoras de câncer ginecológico, durante seções de QT. Com entrevista semi-estruturada foi identificada técnica da coleta de urina e verificados os resultados dos exames realizados antes das seções de QT. Das 30 entrevistadas, 80 por cento relataram coletar corretamente urina, 100 por cento apresentaram pelo menos um erro durante o processo. A frequência de leucocitúria foi de 30 episódios. Os erros ocorreram principalmente na higienização genital e coleta do jato urinário. Infere-se que a forma errônea na coleta de urina somada a neutropenia sejam responsáveis pela leucocitúria.

The proposal of the study was to verify leucocituria frequency in carriers of gynecological cancer in chemotherapy (CT) and to identify practices in urine collection for exam. Descriptive transversal study carried out with ginecologyc cancer patients during chemotherapy sections. With semi-structured interview, it was identified urine collection technique and verified the results of exams accomplished before chemotherapy sections. Among 30 interviews, 80 percent related to collect urine correctly, 100 percent presented at last a mistake during the process. Leucocituria frenquency was 30 episodes. The mistakes occurred mostly in genital cleaning and collection of the urinary jet. It infers that the erroneous form in the collection in addition to the neutropenia can be responsible for the leucocituria.

El objetivo del estudio fue verificar la frecuencia de leucocitúria en portadoras de cáncer ginecológico en quimioterapia (QT) e identificar las prácticas en la colecta de orina para examen. Pesquisa descriptiva transversal realizada con portadoras de cáncer ginecológico, durante las secciones de QT. Por medio de entrevista semi-estructurada fue identificada técnica de colecta de orina y verificados los resultados de los exámenes realizados antes de las secciones de QT. De las 30 entrevistadas, 80 por ciento relataron colectar correctamente la orina, 100 por ciento presentaron por lo menos un error durante el proceso. La frecuencia de leucocitúria fue de 30 episódios. Los errores ocurrieron principalmente en la higienización genital y colecta del chorro urinario. Se infiere que la forma errada en la colecta de orina sumada a la neutropénia sean responsables por la leucocitúria.

Administração de quimioterápicos: uma proposta de protocolo de enfermagem / Chemotherapics administration: a proposal for a nursing protocol

Pacientes submetidos à quimioterapia necessitam da assistência de enfermagem para auxiliá-los na resolução de suas necessidades básicas, ou então, ajudá-los a adaptar-se às limitações provocadas pelo tratamento. Ressalta-se a importância do planejamento da assistência oncológica adotando um ou mais referenciais teóricos para prestação de uma assistência adequada e, conseqüentemente, melhoria na qualidade de vida destes pacientes. O presente estudo teve por objetivo atualizar o protocolo de assistência de enfermagem na Clínica de Ginecologia e Obstetrícia do Hospital Escola da Universidade Federal do Triângulo Mineiro, para pacientes portadoras de câncer ginecológico submetidas à quimioterapia. Através da revisão de literatura foi possível atualizar o protocolo da clínica o qual é apresentado por este estudo.

Patients submitted chemotherapy need of the nursing care for help them on the resolution of their basic needs, or then, help them come to terms the treatment's restrictions. The value of the oncology care is stricken out when it is adopted one or more theorist references for serve a good care and, consequently, better quality of life for this patients. This study was constructed in order to up to date the protocol of nursing care on the Gynecology and Obstetrical clinic of school hospital of Universidade Federal do Triângulo Mineiro for patients with cancer that were submitted chemotherapy by literature review was possible up to date the guideline of clinical which one is showed by this study.

Pacientes sometidos a la quimioterapia necesitan de asistencia de enfermería para ayudarlos en la resolución de sus necesidades básicas, o entonces, ayudarlos a adatarse a las limitaciones provocadas por el tratamiento. Resaltase la importancia del planeamiento de la asistencia oncológica adoptándose un o mas referenciales teóricos para prestación de una asistencia adecuada y, consecuentemente, mejoría de la calidad de vida de estos pacientes. El presente estúdio tuvo por objetivo actualizar el protocolo de asistencia de enfermería en la Clínica de Ginecología y Obstetricia del Hospital Escuela de la Universidad Federal del Triângulo Mineiro, para pacientes portadoras de cáncer ginecológico sometidas a la quimioterapia. Través de la revisión de la literatura fue posible actualizar el protocolo de la clínica el cual es presentado por este estudio.

Effects of Telephone Intervention as Supportive Nursing on Self-Care Practices and Qualify of Life for Gynecological Cancer Patients under Chemotherapy / 간호학회지

PURPOSE: The effects of telephone intervention on self-care practices and quality of life for gynecological cancer patients under chemotherapy was investigated. METHODS: A non-equivalent control group pre-test post-test quasi-experimental design was used. The subjects were women cancer patients who had received less than two chemotherapy sessions at C university hospital of Chonnam province(26 in the experimental group: 25 in the control group). The patient's self-care practices(Na & Lee, 1999; Jang, 2004) and quality of life(Lee & Jo, 1997) were measured three times. using a questionnaire. The data was analyzed by Repeated Measures ANOVA, the Friedman test, and the Mann-Whitney test using the SPSS window version 12.0 program. RESULTS: This study showed that the score of self-care practices and quality of life for the experimental group under telephone counseling were higher than those of the control group. CONCLUSION: This study revealed that a telephone intervention as supportive nursing care for women cancer patients under going chemotherapy was effective for self-care practices and qualify of life during the recovery period. Futhermore, this study also suggests that telephone counseling can serve as a continuing nursing supportive intervention for women cancer patients for the upcoming stages of further chemotherapy.

Antiemetic effect of ondansetron and dexamethasone in gynecologic malignant patients receiving chemotherapy.

OBJECTIVES: To evaluate the antiemetic effect of a single dose of ondansetron and dexamethasone as a prophylaxis for chemotherapy induced acute nausea and emesis and factors associated with the control of acute nausea and emesis. MATERIAL AND METHOD: Patients who received single dose of 8 mg ondansetron and 20 mg dexamethasone as a prophylaxis for chemotherapy induced nausea and emesis at Department of Obstetrics and Gynecology, Bangkok Metropolitan Administration Medical College and Vajira Hospital, between October 2004 and April 2006 were identified. The assessment record of the drug efficacy had been evaluated in the first 24 hours after the start of chemotherapy in terms of control of vomiting, and nausea. Age of the patients, history of alcohol intake, type of cancer, regimen of chemotherapy and course of chemotherapy were analysed as possible factors associated with the control of nausea and emesis. RESULTS: Seventy-eight gynecologic-cancer patients receiving 353 cycles of chemotherapy were evaluated in this study. Completed control of acute vomiting and nausea were 68% and 57.2% respectively. Complete control of acute vomiting and nausea were 56.9% and 45.4% in patients of < or = 45 years compared to 78.8% and 68.7% in those with > 45 years. Complete control of acute vomiting and nausea were 59.2% and 48.7% in those receiving cisplatin-containing regimens compared to 86.7% and 75.2% in non-cisplatin containing regimens. Univariable and multivariable analysis showed that younger patients and those who received cisplatin-containing regimens had significant lower rates of complete control of both nausea and emesis. Patients receiving the first three courses of chemotherapy had significantly higher rate of complete control of nausea but not emesis as compared to those receiving chemotherapy after the third course. CONCLUSION: A single intravenous dose of 8 mg of ondansetron and 20 mg of dexamethasone had good control of acute nausea and vomiting only in those who received non-cisplatin containing regimens and those older than 45 years.

Knowledge and Learning Needs Related to Cancer Treatment in Gynecological Cancer Patients / 간호학회지

PURPOSE: This study was to investigate the knowledge and learning needs of chemotherapy in gynecological cancer patients. METHOD: The subjects consisted of 103 gynecological cancer patients receiving chemotherapy from April 2005 to August 2005. Data was collected using a questionnaire about knowledge and learning needs of chemotherapy. The data was analyzed by t-test, ANOVA, Scheffe test, and Pearson's correlation coefficient using SAS. RESULT: Average scores of knowledge and learning needs of general treatment and care were 2.74, and 3.30 respectively. Average score of knowledge and learning needs of chemotherapy were 2.54, and 3.23 respectively. Learning needs of general treatment and care and of chemotherapy were significantly different in relation to marital status, educational level, family support, the operation, and the amount of chemotherapy received. Items with the highest level of learning needs were the symptoms of recurring illness of general treatment, and minimizing side effects of chemotherapy. There were a negative correlation between knowledge and learning needs on general treatment and a positive correlation between knowledge and learning needs on chemothearpy but there were not significant statistically. CONCLUSION: The level of learning needs related to cancer treatment was high, whereas, that of knowledge was low. Therefore, when designing an educational program for gynecological cancer patients, understanding of learning needs is necessary. Also, consideration of a patient's characteristics, and a systematic and detailed educational program should be provided.

Adverse affects of paclitaxel and carboplatin combination chemotherapy in epithelial gynecologic cancer.

OBJECTIVE: To evaluate the adverse affects of paclitaxel and carboplatin combination chemotherapy. DESIGN: Descriptive cross sectional study MATERIAL AND METHOD: Patients with epithelial cancer of the ovary, fallopian tube and peritoneum treated with paclitaxel and carboplatin combination chemotherapy at Chiang Mai University Hospital between August 2003 and August 2004. RESULTS: Of 224 evaluable cycles in 63 patients treated with paclitaxel (175 mg/m2) and carboplatin (AUC 5), grade 3 and 4 neutropenia occurred in 37.1% or 41.3% of patients. 4.8% of patients experienced febrile neutropenia. Grade 3 and 4 leukopenia occurred in 8.6% of courses and 12.6% of patients. Grade 3 anemia occurred in 5.2% of courses and 9.5% of patients. Grade 3 thrombocytopenia occurred in 2.8% of courses and 9.6% of patients. The nonhematologic adverse affects were rare, however, some adverse events may be potentially life threatening. CONCLUSION: Adverse affects of paclitaxel and carboplatin combination chemotherapy are acceptable and manageable in the majority of patients.

Comparison of oral versus intravenous ramosetron in prevention of acute cisplatin-induced emesis: a randomized controlled trial.

OBJECTIVE: To compare the antiemetic efficacy of a single oral versus intravenous (i.v.) ramosetron, a new class of selective 5-HT3 receptor antagonists, in gynecologic cancer patients receiving high-dose cisplatin. METHOD: Between February 2003 and July 2003, 109 patients with gynecologic cancer scheduled to receive single agent cisplatin chemotherapy at a dose of 75 mg/m2 were randomized to receive either 0.2 mg oral (51 cases) or 0.3 mg i.v. (58 cases) ramosetron 1 h and 30 min respectively before chemotherapy. Patients were evaluated for 24 h after chemotherapy. The number of nausea and vomiting including adverse events were recorded every 6 h. RESULTS: 51 and 58 patients received oral and i.v. ramosetron respectively. Both groups were similar regarding age, performance status, body mass index and diagnosis of gynecologic cancer. 95 per cent of cases were cervical cancer. Antiemetic effect was significantly higher in the oral group when compared with the i.v. group during the first 6 hours and during the period of 18 to 24 hours after administration of cisplatin chemotherapy. Overall in 24 h, patients receiving oral ramosetron experienced no emesis slightly higher than that of the i.v. group (55% and 36% respectively, p = 0.05). Adverse events were mild and transient and were not significantly different in both groups, except tiredness which was more frequent in the i.v. group. CONCLUSION: Oral ramosetron at a dosage of 0.2 mg is as effective as 0.3 mg of intravenous ramosetron in prevention of acute emesis in patients receiving 75 mg/m2 of cisplatin chemotherapy.

Manutencao da fertilidade na paciente com cancer ginecologico estadio inicial / Maintenance of fertility in patients with gynecologycal cancer early stages

O diagnostico de cancer, em qualquer estadio que se apresente, resulta sempre em inumeros questionamentos sobre seu prognostico, morbidade e sobrevida. Muitas vezes promove a depressao e perda definitiva ou temporaria de inumeros projetos de vida. Quando este diagnostico e feito em mulheres na idade reprodutiva, sem prole constituida, temos mais um fator agravante no universo do manejo do cancer. Apresentamos, neste estudo de revisao, os recentes trabalhos publicados que abordam a...