ABSTRACT
Antecedentes: La evaluación de la calidad de vida es un elemento clave en el tratamiento curativo y paliativo de pacientes con cáncer. El tratamiento del cáncer de cuello uterino tiene secuelas importantes que dificultan la calidad de vida de las pacientes. Objetivo: Evaluar la calidad de vida a pacientes tratadas por cáncer de cuello uterino en la Fundación Arturo López Pérez (FALP), utilizando las encuestas para cáncer en general (QOL-C30) y específica para cáncer de cuello (QOL-CX24) de la European Organizaron for Research and Treatment of Cancer (EORTC). Resultados: Evaluamos la calidad de vida a 72 pacientes. Fueron relevantes los problemas emocionales y económicos, el cansancio, la imagen corporal, los síntomas menopáusicos y todo lo relacionado con la actividad sexual. Conclusión: La evaluación de la calidad de vida debe ser parte del enfoque integral, para una adecuada toma de decisiones y detección de problemas ocultos.
Background: Evaluating quality of Life is a key element in the curative treatment and palliative treatment of cancer patients. Cervical cancer treatment has important sequels that are an obstacle to patients' quality of life. Objective: To evaluate the quality of life to cervical cancer patients treated in the Fundación Arturo López Pérez (FALP), using surveys for cancer in general (QOL-C30) and specific to cervical cancer (QOL-CX24) from the European Organization for Research and Treatment of Cancer (EORTC). Results: We evaluated quality of life of 72 patients. Emotional and economical problems, tiredness, body image, menopausical symptoms and everything related to sexual activity were found to be relevant. Conclusion: To evaluate the quality of life, must be part of general approach of this patients, to take good decisions and early detection of hidden problems.
Subject(s)
Humans , Female , Adult , Middle Aged , Cancer Care Facilities , Uterine Cervical Neoplasms/psychology , Uterine Cervical Neoplasms/therapy , Quality of Life , Chile , Health Care Surveys , Surveys and Questionnaires , Sexuality , Socioeconomic FactorsABSTRACT
Caracterizar la función tiroidea y la respuesta a test de TRH (thyroid releasing hormone), en niños con enfermedad renal crónica (ERC) leve (L), moderada (M), peritoneodiálisis (PD), hemodiálisis (HD) y trasplantados renales (TX).
Subject(s)
Immunoglobulins, Thyroid-Stimulating , Thyroid Function TestsABSTRACT
Objective: To characterize the thyroid function in mild (L), moderate (M), hemodialysis (HD), peritoneal dialysis (PD), chronic renal failure (CRE) and post kidney transplant (TX). Method: 46 children between 9.3 +/- 3.7 years-old with CRF (10 mild (L), 10 moderate (M), 10 peritoneodialysis (PD), 6 hemodialysis (HD), 10 transplants (TX)) were evaluated. Basal total T4 and free T3, TRH test (TSH at 0-30-60 min), creatinine, BUN, creatinine clearance and anthropometric parameters were measured. The statistics analysis included Anova Test to compare group results and correlation coefficients for studied variables. Results: Basal thyroid hormone levéis were normal in all groups and no differences between groups (except higher TSH in L (p < 0.01)) were found. TRH test response was prolonged on L, M, PD and HD and deficient in TX, except 3 TX patients who had normal TRH response, all using Tacrolimus, Micofenolate and Prednisone on altérnate day treatment versus the remaining TX who where on Cyclosporine or Azathioprine, Micofenolate and continuous corticoid régimen. Prolonged TRH response correlates with creatinine (p < 0.001) and creatinine clearance (p < 0,01). Conclusions: Basal thyroid hormones were normal in all groups. TRH test response was predominantly prolonged in L, M, PD and HD, suggesting adaptative phenomena at tertiary level, and correlates with renal function. TX patients had deficient TRH response, suggesting hypofisial dysfunction.
Objetivo: Caracterizar la función tiroidea y la respuesta a test de TRH (thyroid releasing hormone), en niños con enfermedad renal crónica (ERC) leve (L), moderada (M), peritoneodiálisis (PD), hemodiálisis (HD) y trasplantados renales (TX). Pacientes y Método: Se estudiaron 46 pacientes con ERC (10 L, 10 M, 10PD,6HDy 10TX),9,3 +/- 3,7 años. Se midió t4t,t41,t3t, t31,TBGbasalytest de TRH(TSHa 0,30y60min). Se evaluó función renal, antropometría y se consignó tratamiento inmunosupresor (IS) en el grupo TX. Se utilizó anova para comparar los resultados entre los grupos y coeficiente de correlación para las variables estudiadas. Resultados: Los valores basales de hormonas tiroideas fueron normales en todos los grupos, sólo TSH fue significativamente mayor en L aunque dentro del rango normal (p < 0,01). La respuesta al test de TRH fue predominantemente prolongada en L, M, PD y HD y deficiente en TX; los 3 pacientes TX con tacrolimus, micofenolato y prednisona en días alternos tuvieron respuesta normal a diferencia del resto TX que recibían prednisona continua, ciclosporina y micofenolato. La prolongación de respuesta a TRH se correlacionó con creatininemia, BUN y clearance de creatinina (p < 0,01). Conclusiones: Los niveles de hormonas tiroideas basales se encuentran normales en todos los grupos de ERC. La respuesta a TRH fue predominantemente prolongada en L, M, PD y HD, demostrando un fenómeno adaptativo a nivel terciario del eje hipotálamo-hipofisis-tiroides. Los TX presentan una respuesta mayoritoriamente deficiente a TRH, sugerente de disfunción hipofisiaria, la que podría estar relacionada con el tipo de tratamiento inmunosupresor y al uso de corticoides en días continuos.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Thyroid Gland/physiopathology , Thyrotropin-Releasing Hormone/pharmacology , Renal Insufficiency, Chronic/physiopathology , Anthropometry , Dose-Response Relationship, Drug , Thyroid Gland , Thyroid Hormones/blood , Renal Insufficiency, Chronic/blood , Kidney Transplantation , Prospective Studies , Renal Dialysis , Thyroid Function TestsABSTRACT
BACKGROUND: Gastric cancer has a direct relation with chronic atrophic gastritis (AG) and intestinal metaplasia (IM), considered as preneoplastic lesions. Determination of serum pepsinogen llevéis (PGI) and pepsinogen I / pepsinogen II ratio (PGI/PGII) can detect this conditions; achieving 70-90% of gastric cancer detection in early stages. AIM: To determine the cut-off values for serum PGI and PGI/PGII in Chilean subjects, for the detection of gastric preneoplastic lesions, establishing their sensitivity, specificity, positive (PPV) and negative (NPV) predictive values. PATIENTS AND METHODS: Prospective study of patients subjected to upper gastrointestinal endoscopy and determination of serum pepsinogen levels. The presence and severity of preneoplastic lesions were compared with serum levels of PGI and PGI/PGII. RESULTS: A total of 56 men and 44 women were studied, with a mean age of 43 (14-77) years. There was a significant association (p <0.001) of PGI and PGI/PGII with AG and IM. We obtained a cut-off value of 2.3 for PGI/PGII (sensitivity =70%>, specificity =92%>, PPV =60%>, NPV =95%) and 36 ng/ml for PGI (sensitivity =62%o specificity =64%o, PPV =20%o, NPV =91%), for detection of moderate to severe AG. No patient with normal mucosa had a PGI <20 ng/ml. The combined criteria of PGI/II < or = 2.3 and/or PGI < or 20 ng/ml, obtained a sensitivity of 85%o, specificity of 92%>, PPV of 65%o, and NPV of 97%o. CONCLUSIONS: We confirmed a strict relation ofPGIand PGI/PGIIwith the presence of preneoplastic gastric lesions in Chilean patients.
