ABSTRACT
The quality of life of patients treated for brain tumor is, in all cases, deeply altered by the tumor and the treatments. Optimizing the symptomatic management is a key objective for all care givers. We present in this paper a very pragmatic focus concerning the management of intracranial hypertension (and/or neurological deficits), venous thromboembolism, confusion, epilepsy and symptoms more directly associated with the end of life.
Subject(s)
Brain Neoplasms/therapy , Medical Oncology , Anticoagulants/therapeutic use , Brain Neoplasms/complications , Brain Neoplasms/physiopathology , Brain Neoplasms/psychology , Confusion/etiology , Confusion/psychology , Confusion/therapy , Epilepsy/etiology , Epilepsy/psychology , Epilepsy/therapy , Humans , Intracranial Hypertension/etiology , Intracranial Hypertension/therapy , Medical Oncology/ethics , Palliative Care , Quality of Life , Terminal Care , Venous Thrombosis/etiology , Venous Thrombosis/therapyABSTRACT
Further to the Epinal events, Health Ministers P. Bas then R. Bachelot-Narquin have launched a plan of work devoted to radiotherapy; they have also committed the SFRO President, within the framework of a mission, to make proposals taking into account the demography of professionals and their level of competence, valorization of careers, cooperation with medical oncologists, delegations of authorities, mutualisation of human and material resources. Due to the numerous actions of the roadmap managed by the tutelages, the aim of the mission was focused on the modalities of work of the professionals linked to radiotherapy: radiation oncologists, radiographers and physicists.
Subject(s)
Radiation Oncology/organization & administration , Societies, Medical , Career Mobility , Clinical Competence , Continuity of Patient Care , Education, Medical, Continuing , France , Humans , Patient Education as Topic , Personnel Selection , Radiation Protection , WorkforceABSTRACT
Little has been done to study the effectiveness of antidepressants in controlling anxiety/depression in a population of cancer patients. A double-blind placebo-controlled study was therefore designed to assess the effectiveness of 20 mg fluoxetine. Of 115 cancer patients who fulfilled entry criteria for levels of distress, 45 patients were randomized to a fluoxetine treatment group (FA) and 46 patients to a placebo group (PA) after a 1-week placebo period designed to exclude placebo responders. The Montgomery and Asberg Depression Scale (MADRS), the Hamilton Anxiety Scale (HAS), the Hospital Anxiety and Depression Scale (HADS), the Revised Symptom Checklist (SCL90-R) and the Spitzer Quality of Life Index (SQOLI) were used to assess the efficacy of fluoxetine. The response rate, defined by a HADS score lower than 8 after 5 weeks of treatment, was not significantly higher in the FA group (11%) compared to the PA group (7%). Compared to the PA group, patients in the FA group showed a significantly greater decrease in SCL90-R mean total score after 5 weeks, but not a greater decrease in HADS mean score. No difference between the two groups was found in observer-reported assessments (MADRS, HAS and SQOLI). Significantly more drop-outs were observed in the FA group (n = 15) than in the PA group (n = 7), although the frequencies of side-effects were not significantly different.
Subject(s)
Antidepressive Agents, Second-Generation/therapeutic use , Anxiety Disorders/drug therapy , Depressive Disorder/drug therapy , Fluoxetine/therapeutic use , Neoplasms/psychology , Adult , Aged , Antidepressive Agents, Second-Generation/adverse effects , Anxiety Disorders/diagnosis , Anxiety Disorders/psychology , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Double-Blind Method , Female , Fluoxetine/adverse effects , Humans , Male , Middle Aged , Personality Inventory , Treatment OutcomeABSTRACT
The purpose of the present work was to study the correlations between clinical response and plasma concentrations of clomipramine or desmethylclomipramine, using two different methods of dosage: radio-immunoassay and high pressure liquid chromatography, compared with mass spectrometry method. The results vary according to the method used, suggesting that methodological problems might explain, at least partly, the discrepancies observed in the literature.
Subject(s)
Clomipramine/analogs & derivatives , Clomipramine/blood , Depressive Disorder/blood , Chromatography, High Pressure Liquid , Clomipramine/metabolism , Clomipramine/therapeutic use , Depressive Disorder/drug therapy , Female , Humans , Male , Mass Spectrometry , Middle Aged , RadioimmunoassayABSTRACT
Both plasmatic and salivary DST were simultaneously performed on a sample of 37 patients with a diagnosis of major depressive disorder (DMS III criteria): 22 primary depressions and 15 secondary depressions. Salivary DST showed a similar specificity but a decreased sensitivity in comparison with plasmatic DST. Essentially, the simultaneous use of both tests resulted in a better specificity for primary depression.
