RESUMEN
BACKGROUND: Retroperitoneal sarcoma represents 15% of sarcomas. The mainstay of treatment is surgery where a majority of patients require multi-visceral resections that may significantly impact their quality of life (QOL) following surgery. Studies in other cancers have shown that QOL may not be significantly impacted after radical or extensive surgery. However, there are limited studies examining the QOL specifically in patients with retroperitoneal sarcoma. In this pilot study, we retrospectively evaluated the QOL of patients with retroperitoneal sarcoma. METHODS: 32 out of 90 patients who underwent surgical intervention for retroperitoneal sarcoma in National Cancer Centre Singapore from January 1999 to August 2018 who were alive and on follow-up were included in this study. EORTC-QLQ-C30 was administered to the patients. RESULTS: The median age of our patients was 59 years (range, 35-84), and median time from surgery to the implementation of questionnaire was 2.5 years (range, 0.05-9.6). Younger patients had significantly better differences in global health, physical and role functioning scores as compared to older individuals. Female patients reported higher global health, physical, emotional and social functioning scores than males. Patients who were more than 2 years post-surgery exhibited better QOL scores as compared to those who had more recent surgery. Our patients had comparable global health and functioning scores compared to a reference group of outpatient cancer patients at our institution. CONCLUSIONS: Our pilot study investigating the QOL of patients with retroperitoneal sarcoma has shown that patients need to be followed up for at least 2 years following surgery to evaluate their QOL. In general, they achieved better functioning scores when compared with other cancer patients. These findings support the need for larger-scale prospective studies to further evaluate the QOL of these patients.
Asunto(s)
Calidad de Vida , Neoplasias Retroperitoneales/psicología , Sarcoma/psicología , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Neoplasias Retroperitoneales/cirugía , Estudios Retrospectivos , Sarcoma/cirugía , Singapur , Encuestas y CuestionariosAsunto(s)
Ansiedad , Liposarcoma , Recurrencia Local de Neoplasia , Neoplasias Retroperitoneales , Gastos en Salud , Humanos , Liposarcoma/patología , Liposarcoma/psicología , Liposarcoma/cirugía , Recurrencia Local de Neoplasia/diagnóstico , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/psicología , Recurrencia Local de Neoplasia/cirugía , Neoplasias Retroperitoneales/patología , Neoplasias Retroperitoneales/psicología , Neoplasias Retroperitoneales/cirugíaRESUMEN
OBJECTIVE: To determine the frequency and range of neurological manifestations of phaeochromocytomas and secretory paragangliomas. METHODS: A retrospective review of case notes of patients admitted to Auckland Hospital from 1985 to 2011 with a discharge diagnosis of phaeochromocytoma or secretory paraganglioma. RESULTS: Ninety-three patients were admitted with a phaeochromocytoma or secretory paraganglioma. Sixty-eight patients (73%) had neurological symptoms, but only 15 patients (16%) received a neurological consultation. Neurological manifestations occurred in three main clinical contexts. First, paroxysmal symptoms occurred in 66 of 93 patients (71%). Neurological symptoms were common features of these attacks and included headache (47 patients), anxiety (24 patients), tremulousness (15 patients) and dizziness (12 patients). The headaches typically had an explosive onset. Delay in diagnosis was common. Second, 28 patients (30%) had an acute crisis, which was associated with neurological symptoms in 11 (39%) of the episodes: headache (10 patients); seizures (five patients); strokes (three patients); delirium (three patients) and subarachnoid haemorrhage (one patient). Third, five of six patients with a head and neck secretory paraganglioma had neurological symptoms related to infiltration of the middle ear or compression of cranial nerves. Reversible cerebral vasoconstriction syndrome (RCVS) was documented in three patients. CONCLUSIONS: Neurological manifestations of phaeochromocytomas and secretory paragangliomas were common, and these tumours can present with various neurological manifestations. The paroxysmal symptoms can be incorrectly attributed to other headache syndromes, panic attacks or cerebral vasculitis. RCVS may play a role in the pathogenesis of the neurological symptoms associated with acute crises and paroxysmal attacks.
Asunto(s)
Neoplasias de las Glándulas Suprarrenales/patología , Neoplasias de las Glándulas Suprarrenales/psicología , Enfermedades del Sistema Nervioso/patología , Enfermedades del Sistema Nervioso/psicología , Paraganglioma/patología , Paraganglioma/psicología , Feocromocitoma/patología , Feocromocitoma/psicología , Enfermedad Aguda , Adolescente , Neoplasias de las Glándulas Suprarrenales/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/etiología , Angiografía Cerebral , Niño , Epilepsia Tónico-Clónica/etiología , Femenino , Neoplasias de Cabeza y Cuello/complicaciones , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/psicología , Cefalea/etiología , Humanos , Hipertensión/etiología , Angiografía por Resonancia Magnética , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/etiología , Paraganglioma/complicaciones , Feocromocitoma/complicaciones , Embarazo , Complicaciones Neoplásicas del Embarazo/patología , Complicaciones Neoplásicas del Embarazo/prevención & control , Neoplasias Retroperitoneales/complicaciones , Neoplasias Retroperitoneales/patología , Neoplasias Retroperitoneales/psicología , Estudios Retrospectivos , Adulto JovenRESUMEN
Exploratory psychotherapy of patients with chronic intercurrent illness has received little attention by psychoanalysts. A young woman with life-long characterologic problems presented herself for analytic psychotherapy shortly after surgery and radiotherapy for a malignancy. The debility of her illness facilitated a slowdown in an action-prone patient and permitted the necessary introspection and regression. willing One finds in these patients a readiness to reorder priorities and a willingness to examine and make the most of their lives, and psychotherapy can therefore become an opportunity for positive change rather than just support for a medical catastrophe. The therapy must address itself to childhood losses and betrayals symbolically repeated in the current medical state.
Asunto(s)
Neoplasias/psicología , Terapia Psicoanalítica , Rol del Enfermo , Adaptación Psicológica , Adulto , Femenino , Humanos , Linfoma/psicología , Neoplasias Retroperitoneales/psicologíaAsunto(s)
Neoplasias Óseas/secundario , Miedo/psicología , Psicología del Adolescente , Sarcoma de Ewing/secundario , Teratoma/secundario , Neoplasias Testiculares/patología , Neoplasias del Cuello Uterino/patología , Adolescente , Neoplasias Óseas/psicología , Neoplasias Óseas/terapia , Resultado Fatal , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/secundario , Neoplasias Pulmonares/terapia , Metástasis Linfática , Masculino , Aceptación de la Atención de Salud/psicología , Neoplasias Retroperitoneales/tratamiento farmacológico , Neoplasias Retroperitoneales/psicología , Neoplasias Retroperitoneales/secundario , Sarcoma de Ewing/psicología , Sarcoma de Ewing/terapia , Teratoma/tratamiento farmacológico , Teratoma/psicología , Neoplasias Testiculares/tratamiento farmacológico , Neoplasias Testiculares/psicología , Neoplasias del Cuello Uterino/psicología , Neoplasias del Cuello Uterino/terapiaAsunto(s)
Ansiedad , Trastornos Mentales/enfermería , Neoplasias Retroperitoneales/enfermería , Adulto , Familia , Femenino , Humanos , Relaciones Interpersonales , Masculino , Trastornos Mentales/complicaciones , Neoplasias Retroperitoneales/complicaciones , Neoplasias Retroperitoneales/psicología , Cuidado TerminalRESUMEN
Obsessive Compulsive Disorder (OCD) is generally chronic. Episodic OCD with complete remission has been rarely reported. Two cases of brief, episodic obsessions and compulsions that appeared for the first time following psychological stress and in the context of medical illness are reported. The possibility of brief episodes of OCD precipitated by stress is illustrated. Exploration of this phenomenon may help us learn more about OCD in general.