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1.
Palliat Support Care ; 10(4): 255-63, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22583756

RESUMO

OBJECTIVE: Depression is a frequent problem in cancer patients, which is known to reduce quality of life; however, many cancer patients with depression are not treated because of the difficulties in assessing depression in this population. Our aim was to evaluate and improve the depression assessment strategies of palliative care (PC) physicians and oncologists. METHOD: We invited all medical oncologists and PC physicians from three cancer centers to participate in this multicenter prospective study. They were asked to classify 22 symptoms (related and specific to depression in cancer patients, related but not specific, and unrelated) as "very important," "important," "less important," or "not important" for the diagnosis of depression in cancer patients, at three different time points (at baseline, after a video education program, and after 4 weeks). They were also asked to complete a questionnaire exploring physicians' perceptions of depression and of their role in its systematic screening. RESULTS: All 34 eligible physicians participated. Baseline performance was good, with >70% of participants correctly classifying at least seven of nine related and specific symptoms. We found no significant improvement in scores in the immediate and 4-week follow-up tests. Additionally, 24 (83%) and 23 (79%) participants expressed support for systematic depression screening and a role for oncologists in screening, respectively. SIGNIFICANCE OF RESULTS: Oncologists had good baseline knowledge about depression's main symptoms in cancer patients and a positive attitude toward being involved in screening. Underdiagnosis of depression is probably related to problems associated with the oncology working environment rather than the physicians' knowledge.


Assuntos
Atitude do Pessoal de Saúde , Depressão/diagnóstico , Transtorno Depressivo/diagnóstico , Oncologia/métodos , Neoplasias/psicologia , Medicina Paliativa/métodos , Adulto , Depressão/classificação , Depressão/etiologia , Transtorno Depressivo/classificação , Transtorno Depressivo/etiologia , Feminino , França , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Oncologia/estatística & dados numéricos , Neoplasias/complicações , Pacientes Ambulatoriais , Medicina Paliativa/estatística & dados numéricos , Projetos Piloto , Padrões de Prática Médica/estatística & dados numéricos , Estudos Prospectivos , Inquéritos e Questionários
2.
Support Care Cancer ; 20(11): 2795-802, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22350596

RESUMO

PURPOSE: Depression occurs among an estimated 15% of cancer patients (range, 1-77.5%). Our main objective was to identify the frequency of reported depression by using the Brief Edinburgh Depression Scale (BEDS) among cancer outpatients. Our secondary objective was to identify associated symptoms of cancer using the Edmonton Symptom Assessment System (ESAS) and to evaluate the screening performance of depression between ESAS and BEDS. METHODS: In this multicenter prospective study conducted, we used the ESAS to collect information on nine symptoms: pain, fatigue, nausea, depression, anxiety, drowsiness, shortness of breath, lack of appetite, and feeling of well-being (each rated from 0 to 10). The BEDS was used to assess for "probable depression" (score >6). Data were analyzed using a parametric and nonparametric test. RESULTS: A total of 146 patients completed the study. The prevalence of probable depression was 43/146 (29%). Probable depression was associated with increased fatigue (p = 0.008), depression (p < 0.0001), anxiety (p < 0.0001), shortness of breath (p = 0.01), and decreased feeling of well-being (p < 0.001). Among patients with probable depression, 42 (98%) patients were not using antidepressants. Regarding the sensitivity and the specificity, we determined that the optimal cutoff for using the ESAS as a depression screening tool was ≥ 2. CONCLUSION: We found significant associations between probable depression as determined with the BEDS and five symptoms as detected with the ESAS. The vast majority of patients with probable depression were not receiving pharmacological treatment. Depression should be suspected in patients with higher symptom distress as for any one of these 5 ESAS items.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Fadiga/epidemiologia , Neoplasias/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antidepressivos/uso terapêutico , Ansiedade/etiologia , Depressão/tratamento farmacológico , Depressão/etiologia , Dispneia/epidemiologia , Dispneia/etiologia , Fadiga/etiologia , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Neoplasias/patologia , Pacientes Ambulatoriais , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Sensibilidade e Especificidade
4.
Electrophoresis ; 25(20): 3365-77, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15490460

RESUMO

Multiwire proportional chamber is a useful technology to build detectors that supersede the lack of interactivity of autoradiography in molecular biology experiments. Some drawbacks still limited the diffusion of existing instruments in biological laboratories. The major competitors are storage phosphor imaging systems. The simplified description of a radio-chromato-imager prototype (RCI) based on an original ultrathin multiwire proportional chamber is presented. It combines the advantage of the different existing technologies to present competitive properties in terms of efficiency, spatial resolution, robustness, manipulation easiness and production cost. Application of the RCI detector to molecular biology was performed by the analysis of karyotype and restriction display two-dimensional pulsed-field gel electrophoresis (KARD 2-D PFGE) data which are used to describe small eukaryotic genome structures. The comparative analysis with autoradiography was performed with the PDQuest software on Spraguea lophii (Microspora) genome fingerprints. The spot detection procedure applied to the different images leads to a similar conclusion considering the genome structure of S. lophii which appeared to be composed of 15 chromosomes for 13 karyotypic bands (200-880 kbp).


Assuntos
Apansporoblastina/genética , Impressões Digitais de DNA/métodos , Eletroforese em Gel de Campo Pulsado/instrumentação , Genoma de Protozoário , Genômica/métodos , Animais , Apansporoblastina/química , Impressões Digitais de DNA/instrumentação , DNA de Protozoário/análise , Genômica/instrumentação , Cariotipagem/instrumentação , Cariotipagem/métodos
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