Expectativas ante la reconstrucción mamaria en mujeres mastectomizadas / No disponible

Objetivo: El objetivo de este estudio es valorar las expectativasque las pacientes mastectomizadas tienen sobre elprocedimiento de la reconstrucción mamaria, entendiendopor expectativa la idea o creencia que la paciente tiene sobrelos cambios que la reconstrucción puede facilitar en diversasáreas de la persona. Se trata asimismo de relacionardichas expectativas con las respuestas emocionales y conlos cambios en la imagen corporal.Pacientes y métodos: La muestra consta de 61 mujeresmastectomizadas con una media de edad de 47,1 ± 6,6(rango entre 26 y 66 años), con evolución favorable de laenfermedad y que no reciben tratamientos complementarios.Acudieron a consulta de Cirugía Plástica del HospitalUniversitario La Fe de Valencia para iniciar el proceso dereconstrucción mamaria y fueron entrevistadas habiendotranscurrido un tiempo medio de 3,3 años (DT = 2,2), (rangoentre 9 meses y 10 años) desde la mastectomía. Para laevaluación de las expectativas se creó un cuestionario con31 ítems y 5 áreas: funcional-práctica, personal, sexual, derelación con los demás y una área técnica; además valoramosla satisfacción global esperada. Otros instrumentos utilizados:Escala Hospitalaria de Ansiedad y Depresión(HADS) de Zigmond y Snaith y cuestionario específico sobrecambios en relación con su cuerpo de López Pérez. Serealizaron análisis estadísticos descriptivos, correlación dePearson y ANOVA.Resultados: En conjunto las mujeres presentan mayoresexpectativas en la satisfacción global, el área funcionalprácticay los aspectos técnicos de la reconstrucción. Laspuntuaciones en la subescala de depresión y ansiedad correlacionaronpositivamente con las expectativas del área personal(autoestima y estado de ánimo), la sexualidad y la relacióncon los demás. También se aprecia una relaciónsignificativa entre una menor aceptación del cambio de imageny mayor presencia de síntomas depresivos y de ansiedad...(AU)

Objective: The aim of this study was to assess expectationson breast reconstruction procedure in mastectomisedpatients. The expectation construct means the idea or beliefthe woman has regarding changes that reconstruction canprovide in different personal areas. We also assess the relationbetween these expectations, anxiety and depressionand body image change.Patients and methods: The sample consisted of 61 mastectomisedwomen with a mean age of 47.1 ± 6.6 (age rangebetween 24 and 66 years), favourable disease progressand no additional treatments. Patients referred to PlasticSurgery consultation at the University Hospital La Fe in Valenciato initiate breast reconstruction procedure. The intervalbetween mastectomy and interview varied from 9 monthsto 10 years (mean of 3.3 years and SD = 2.2). A specificquestionnaire was performed to evaluate expectations. Itconsisted of 31 items and 5 areas: functional-practical, personal,sexual and social functioning and technical area.Furthermore, we assessed the expected global satisfaction.Other used instruments were: the Hospital Anxiety and DepressionScale (HADS) from Zigmond and Snaith, and aspecific questionnaire on body image change from LópezPérez. Descriptive, Pearson correlation and ANOVA statisticalanalyses were done.Results: Overall, women showed greater expectations onglobal satisfaction, functional-practical area and technicalaspects of breast reconstruction. Anxiety and depressionsub-scale scores were positively correlated with expectations on the personal area (self-esteem and emotional well-being),sexuality and social functioning. The results also showed astatistical significant correlation between a lower acceptanceof body image changes and a higher level of anxiety anddepression. On the other hand we found a negative correlationbetween body image changes and general satisfactionwith breast reconstruction procedure...(AU)

Nitric oxide and superoxide anions in vascular reactivity of renovascular hypertensive rats.

The present study intends to define the role of the endothelium derived relaxing factor nitric-oxide (EDRF-NO) and the reactive oxygen intermediates in hypersensitivity to 5-hydroxytryptamine (5-HT) observed in abdominal aorta rings of two kidney-two clip hypertensive rats. Methylene Blue (which blocks production of cGMP by EDRF-NO) and Nw-nitro-L-arginine (which inhibits EDRF-NO synthesis), both shifted 5-HT dose-response curves to the left and completely abolished the differences in sensitivity to the agonist. The aortic perfusion with Krebs-Alcohol 20% (v/v) suppressed vascular relaxation to Ach (10(-5) M) and also abolished differences in sensitivity to 5-HT. These results suggest that a lower availability of EDRF-NO accounts for a higher 5-HT sensitivity in vessels of hypertensive rats. On the contrary, ridogrel (inhibitor of tromboxane-synthase and blocker of PGH2 and TxA2 receptors) did not suppress the hypersensitivity to 5-HT. In addition, since the superoxide anion (O2-) inactivates EDRF-NO, the effects of Superoxide dismutase (SOD) and Catalase (CAT) added in the bath were analyzed. Significant changes in sensitivity (P < 0.005) were found only for vessels of hypertensive rats (SOD depressing and CAT increasing sensitivity to 5-HT). Complementary, SOD activity was evaluated in the aorta homogenates and was found to be significantly lower in the hypertensive rats [(differences between hypertensive and sham rats, mU.mg wet weight tissue-1: 7 days after clipping, -183 +/- 67 (n = 11), P < 0.02; 21 days, -160 +/- 70 (n = 9), p < 0.05]. Results would indicate: 1. Lower EDRF-NO availability in vessels of the hypertensive animals which would account for higher sensitivity to 5-HT; 2. Such a lower EDRF-NO might depend, in part, upon its greater inactivation by O2- anions; 3. A greater presence of O2- anions in the vessels of hipertensive rats that might be favored by the lower SOD activity concentration in the vascular wall.