Resilience and unmet supportive care needs in patients with cancer during early treatment: A descriptive study.

PURPOSE: The concept of resilience is gaining increasing importance as a key component of supportive care but to date has rarely been addressed in studies with adult cancer patients. The purpose of our study was to describe resilience and its potential predictors and supportive care needs in cancer patients during early treatment and to explore associations between both concepts. METHODS: This descriptive study included adult cancer patients under treatment in ambulatory cancer services of a Swiss hospital. Subjects completed the 25-item Connor-Davidson-Resilience Scale and the 34-item Supportive Care Needs Survey. Descriptive, correlational and regression analysis were performed. RESULTS: 68 patients with cancer were included in the study. Compared to general population, resilience scores were significantly lower (74.4 ± 12.6 vs. 80.4 ± 12.8, p = .0002). Multiple regression analysis showed predictors ("age", "metastasis", "recurrence" and "living alone") of resilience (adjusted R2 = .19, p < .001). Highest unmet needs were observed in the domain of psychological needs. Lower resilience scores were significantly and strongly associated with higher levels of unmet psychological needs (Rho = -.68, p < .001), supportive care needs (Rho = -.49, p < .001) and information needs (Rho = -.42, p = .001). CONCLUSION: Ambulatory patients with higher levels of resilience express fewer unmet needs. Further work is needed to elucidate the mechanism of the observed relationships and if interventions facilitating resilience have a positive effect on unmet needs.

Corrección de la incontinencia urinaria de esfuerzo mediante cinta libre de tensión (TVT). Resultados a corto plazo / Correction of urinary stress incontinence through tension-free vaginal tape (TVT). Short term results

Objetivo: Analizar los resultados a corto plazo de la aplicación de la cinta libre de tensión (tensión free vaginal tape [TVT]) para la corrección de la incontinencia urinaria de esfuerzo en mujeres sin patología del suelo pelviano asociada. Material y métodos: Se ha realizado un estudio observacional analítico sobre 56 pacientes con diagnóstico clínico y evaluación urodinámica de incontinencia urinaria de esfuerzo genuina y sin afección del suelo pelviano. A todas ellas se les implantó el dispositivo TVT. Se analizaron los resultados de la técnica, las características de la intervención y las complicaciones perioperatorias. Resultados: El porcentaje de curación total de la incontinencia urinaria de esfuerzo fue del 96,4 per cent (54/56). Una paciente presentó mejoría (1,8 per cent) y otra paciente (1,8 per cent) solicitó la retirada de la cinta por retención urinaria. Conclusiones: La aplicación de banda TVT demuestra ser un método útil a corto plazo para la corrección de la incontinencia urinaria de esfuerzo en nuestro medio (AU)

A new perspective on the natural history of vesicoureteric reflux.

Vesicoureteric reflux is most commonly recognized in girls after urinary tract infection. Increasing recognition of vesicoureteric reflux in neonates, detected after an abnormal prenatal sonogram, shows a marked male predominance: 80% boys. Vesicoureteric reflux in children may be both a congenital abnormality, more common in boys, and an acquired abnormality, more common in girls with voiding dysfunction.

Renal abscess in children.

Three cases of renal abscesses in children are described to illustrate the variable presenting features. An additional 23 pediatric cases, reported over the past ten years, were reviewed for clinical features and therapy. Fever, loin pain, and leukocytosis were common presenting features, but less than half of all abscesses were associated with either an abnormal urinalysis or a positive urine culture. The presenting features were sometimes confused with appendicitis, peritonitis, or a Wilms tumor. An organism was identified in 17 cases--Escherichia coli in 9 children and Staphylococcus aureus in 8 children. The majority of E. coli infections occurred in girls and the majority of S. aureus infections occurred in boys. Reflux was documented in 5 patients, and 2 children had a possible extrarenal source of infection. Antibiotics alone produced a cure in 10 children (38%), but 16 children (62%) required a surgical procedure.

Neonatal outcome of fetuses with urinary tract abnormalities diagnosed by prenatal ultrasonography.

Between 1979 and 1986 an abnormality of the urinary tract was diagnosed by prenatal ultrasound examination in 93 fetuses. Postnatal investigation at a large teaching hospital showed a definite abnormality in 85 infants, 66 of whom were boys. An obstructed urinary tract, usually requiring surgery, was present in 46 infants. Other abnormalities included a multicystic kidney (in 15 infants), vesicoureteric reflux (in 9), prune-belly syndrome (in 5) and polycystic kidneys (in 5). Early recognition and treatment of urinary tract disorders in infants should be accompanied by informed prenatal counselling to minimize parents' anxiety.