RESUMO
A 67-year-old man with a history of alcohol and hepatitis C-associated cirrhosis is diagnosed with incidental metastatic liver cancer during hospitalization for hepatic encephalopathy. He had 2 LI-RADS-3 (indeterminant) lesions on liver magnetic resonance imaging 3 months prior but had no history of hepatocellular carcinoma and was listed for liver transplant. During inpatient paracentesis, the ascites fluid was bloody, so the abdominal and pelvic computed tomography was performed showing a lytic lesion in the left posterior inferior pubic rami. Alpha fetoprotein was within normal limits. His liver was imaged on several occasions without definite evidence of malignancy. Bone biopsy revealed metastatic hepatocellular carcinoma. On return to baseline mental status, patient endorsed no bony pain.
RESUMO
BACKGROUND: This study analysed the relationship between social support and psychological distress in Latina women in Miami-Dade County. Acculturation was examined as a modifying factor. METHODS: A 2005 data set from interviews of 155 Latina mothers in Miami-Dade County, from mother-daughter dyads, was analysed. Social support was measured using the Interpersonal Support Evaluation List (ISEL) score. Psychological distress was based on self-reporting symptoms of depression, anxiety, or suicidality. Acculturation was based on English proficiency and length of U.S. residency. RESULTS: Compared to those with high social support, women with low social support had greater odds of reporting psychological distress (odds ratio = 7.8 [95% CI 2.70-22.10]). Acculturation did not modify the association (p=0.74). CONCLUSIONS: Social support was inversely associated with psychological distress among Latina women. Acculturation was not an effect modifier, likely due to inadequate power. The study has clinical implications for mental illness prevention in this population.
