Prevalence of anxiety in patients awaiting diagnostic procedures in an oncology center in Brazil.

OBJECTIVE: Anxiety disorders have been shown to undermine the quality of life of cancer patients. Unfortunately, medical professionals often neglect to screen for anxiety in their patients. The aim of the present study was to describe the prevalence of anxiety in patients awaiting diagnostic procedures in an oncology center waiting room, and to investigate possible relationships between anxiety and demographic and clinical variables. METHODS: A cross-sectional study was performed with 398 patients who completed a self-administered questionnaire containing the Hospital Anxiety and Depression Scale (HADS) and the State-Trait Anxiety Inventory (STAI). RESULTS: Results of the HADS indicated that 38% of participants had anxiety, while data from the STAI showed that 46% had either high state or trait anxiety. The most frequently cited source of anxiety was concern over test results. Age, gender, employment status, and education level were correlated with anxiety. CONCLUSIONS: The prevalence of anxiety is high among patients awaiting diagnostic procedures. Patients in the waiting room should be routinely screened for anxiety. Careful assessment and treatment of anxiety are important components in the care of patients with cancer.

Chance of psychiatric morbidity amongst recently diagnosed cancer outpatients attending a chemotherapy unit.

The prevalent rate of psychiatry morbidity amongst patients with cancer reported in various studies ranges from 5 to 50%, a variation that can be attributed to differences in sample size, the disease itself and treatment factors. The objectives of the present study were to determine the frequency of psychiatric morbidity amongst recently diagnosed cancer outpatients and try to identify which factors might be related to further psychological distress. Two hundred and eleven (70.9%) female patients and 87 (29.1%) male patients from the chemotherapy unit of the Cancer Hospital A.C. Camargo (São Paulo) completed a questionnaire that featured data on demographic, medical and treatment details. The Self Reporting Questionnaire (SRQ-20) was administered to the patients to determine their personal psychiatric morbidity. Seventy-two patients (25.8%) scored > or = 8 in the SRQ-20, the cut-off point for a patient to be considered a psychiatric case. When the low and high scoring groups were compared no differences were detected regarding age, marital status, tumor site, sex, or previous treatment. Nonetheless, patients in the lowest social class and those who were bedridden less than 50% of the time had a significantly higher probability of being a psychiatric case. Regarding help-seeking behavior in situations in which they had doubts or were frightened, about 64% of the total sample did not seek any type of support and did not talk to anyone. This frequency of psychiatric morbidity agrees with data from the cancer literature. According to many investigators, the early detection of a comorbid psychiatric disorder is crucial to relieve a patient's suffering.

Chance of psychiatric morbidity amongst recently diagnosed cancer outpatients attending a chemotherapy unit

The prevalent rate of psychiatry morbidity amongst patients with cancer reported in various studies ranges from 5 to 50 percent, a variation that can be attributed to differences in sample size, the disease itself and treatment factors. The objectives of the present study were to determine the frequency of psychiatric morbidity amongst recently diagnosed cancer outpatients and try to identify which factors might be related to further psychological distress. Two hundred and eleven (70.9 percent) female patients and 87 (29.1 percent) male patients from the chemotherapy unit of the Cancer Hospital A.C. Camargo (São Paulo) completed a questionnaire that featured data on demographic, medical and treatment details. The Self Reporting Questionnaire (SRQ-20) was administered to the patients to determine their personal psychiatric morbidity. Seventy-two patients (25.8 percent) scored > or = 8 in the SRQ-20, the cut-off point for a patient to be considered a psychiatric case. When the low and high scoring groups were compared no differences were detected regarding age, marital status, tumor site, sex, or previous treatment. Nonetheless, patients in the lowest social class and those who were bedridden less than 50 percent of the time had a significantly higher probability of being a psychiatric case. Regarding help-seeking behavior in situations in which they had doubts or were frightened, about 64 percent of the total sample did not seek any type of support and did not talk to anyone. This frequency of psychiatric morbidity agrees with data from the cancer literature. According to many investigators, the early detection of a comorbid psychiatric disorder is crucial to relieve a patient's suffering.

The deletions of 22q11--the Portuguese experience.

The patients with a chromosome 22q11 deletion have a variable phenotype which includes DiGeorge (DG) and Velocardiofacial (VCF) syndromes. The aim of the present study is to characterize the phenotype of DG and VCF using facial biometry in 12 portuguese patients. We found 4/12 patients with the DG phenotype: 3/4 had telecanthus, small mouth and retrognathia; 1/4 had telecanthus, short nose with bulbous tip and a normal mouth. These patients had major cardiac defects associated with hypoplastic or absent thymus and monosomy 22q11. We did not find velopharyngeal insufficiency in patients with the so called DG phenotype 8/12 patients had the VCF phenotype: typical facies with variable features. Four of these had velopharyngeal insufficiency and learning disabilities. Four patients had cardiac defects and 5/8 had monosomy 22q11. Probably this clinical variability is due to mutations in critical genes involved in embryonic development.

The "Y" sign of lateral dislocation of the incus.

This report presents a new sign of ossicular dislocation utilizing high resolution computed tomography of the temporal bone. In the case of lateral dislocation of the incus, a "Y" shaped configuration (Y sign) of the malleoincudal complex is seen in the coronal views even though the axial views present a normal "ice cream cone" configurations.

Radiologia do tórax em crianças com asma aguda grave / Radiology the thorax in infants with acute asthma severe

Vinte e seis crianças (15F, 11M), com idade média de 28,5 meses, em crise aguda grave de asma brônquica, foram hospitalizadas na Unidade de Emergência, foram hospitalizadas na Unidade de Emergência do PS Infantil do Hospital Municipal Carmino Carichio-SP, durante os meses de setembro, outubro e novembro de 1986. Todos os pacientes, ao momento da internaçäo, foram submetidos a radiologia do tórax (PA e P) e a esquema terapêutico com Aminofilina e Corticosteróides I.V.; inalaçäo com beta-agonista + O2 (5 l/min) e mantidos nesse setor até melhora dos sintomas. A interpretaçäo do RX foi realizada pelo médico atendente e por dois radiologistas em momentos diferentes. Segundo o médico atendente, em 19 (73%) foi feito o diagnóstico de broncopneumonia e em 7 (27%) o de alteraçöes compatíveis com asma. Na avaliaçäo pelos radiologistas, houve concordôncia quanto a: hiperinsuflaçäo pulmonar em todos, infiltrado intersticial peribrônquico para hilar em 19 (73%) e imagem de consolidaçäo em 13 (50%). Quanto ao provável diagnóstico das imagens de consolidaçäo, em dois casos (15%) foi de atelectasia e em 6 (46%) de broncopneumonia, näo havendo concordância nos demais. Durante a internaçäo os pacientes foram mantidos sem antibioticoterapia, e a duraçäo média de internaçäo foi de 38,8 horas. Apenas um paciente necessitou internaçäo em enfermaria. A duraçäo média da crise atual foi igual (2,8 dias) para os grupos, de acordo com a presença ou näo de imagem de consolidaçäo ao RX. A avaliaçäo clínica ...

A mucocele etmoidal como causa de exoftalmo unilateral / Ethmoidal mucocele as cause of unilateral exophthalmos

As mucoceles säo lesöes císticas, crônicas e expansivas dos seios paranasais. A sintomatologia ocular é muito freqüente, com exoftalmo inferior e lateral. Em nossa experiência, o sinal de massa cística, näo homogênea, extra-conal com alteraçäo da tábua óssea, ao exame ultrassonográfico, é altamente significativo, quase característico do diagnóstico de mucocele