The EORTC Quality of Life Study Group has developed a questionnaire for evaluating Quality of Life in international clinical trials: QLQ-C30. The purpose of the present work is to validate the third version of this questionnaire (3.0) for use in Spain. Two hundred and one head and neck cancer patients completed the QLQ-C30 at one or two time points during the treatment and follow-up periods, and a subsample completed the questionnaire on three occasions. Psychometric evaluation of the structure, reliability and validity of the questionnaire was undertaken. The data support the structure and the reliability of the scales. Validity was confirmed in three ways: the interscale correlations are statistically significant and moderate, several scales and items discriminate among groups of patients with different scores on the clinical variables, and some scales reflect significant changes during treatment and the follow-up period. The EORTC QLQ-C30 (version 3.0) is a reliable and valid questionnaire when applied to a sample of Spanish head and neck cancer patients. These results are in line with previous studies.
Rat RBCs loaded with 125I-CA by hypotonic dialysis and isotonic resealing were evaluated as a carrier system. Loaded RBCs stored at 4 degrees C remained unlysed (90% survival) allowing release of encapsulated 125I-CA for up to 4 days. Thereafter, cellular lysis increased significantly. IP-injected loaded RBCs reached the maximum level (50%) in circulation at 24 h post-injection. Circulating loaded RBCs showed a half-life of 8-10 days, which was advantageous for carrier function. In contrast to IP-injected free CA, which remained in circulation for only a short time, encapsulated CA showed significant levels in circulation up to 10 days post-injection. The profile of organ uptake with time is essentially not altered for loaded with respect to native cells, being higher the removal of loaded cells and mainly localized in spleen. Nevertheless, liver is the organ with highest elimination capacity for both native and loaded cells, showing its maximum at 24 h post-injection. Concomitantly, the concentration of 125I-CA in all organs studied was highest at this time. These data demonstrate that rat loaded RBCs can potentially be used as a carrier system for long-term dissemination of drug into the organism, with specially increased delivery to the spleen. They also support the use of the rat as an experimental model for biochemical and pharmacological studies in these therapeutic systems.
On screening tools for emotional distress, the terms ''depression'' and ''anxiety'' are commonly used for patients with advanced cancer. However, these terms could have negative connotations in Spanish such that cultural and unexpected differences in perception may invalidate or skew the results of the screening if the best terms are not chosen. The goal of this study was to determine the best expression that can be used to explore anxiety and depression in Spanish. A prospective study of 100 Spanish-speaking patients was performed. Spanish patients with cancer completed the Hospital Anxiety and Depression Scale (HADS) and six Verbal Numerical Scales (VNS) exploring the level of anxiety using the terms ansioso (anxious), nervioso (nervous), or intranquilo (uneasy= disquiet), and the level of depression using the terms deprimido (depressed), desanimado (discouraged), or triste (sad). The correlation, sensitivity, and specificity for all the VNS and HADS (8 and 11 cutoff points) were analyzed. The correlation (Spearman r) between HADS and the anxiety VNS was r ¼ 0.557 using ''anxious''; r ¼ 0.603 using ''nervous''; and r ¼ 0.594 using ''uneasy.'' The correlation for the depression VNS was r ¼ 0.662 using ''depression''; r ¼ 0.759 using ''discouraged'' and r ¼ 0.596 using ''sad''; a < 0.001 was used in all VNS. A cutoff point of 4 of 10 for any term used to explore anxiety achieved the best levels for sensitivity (0.80) and specificity (0.70). The term ''discouraged'' with a cutoff point of 4 of 10 shows a sensitivity of 0.89, a specificity of 0.84, as well as a predictive positive value of 0.77 and a negative value of 0.93. In Spanish, the term desanimado seems to be more suitable in screening for depression. Alternate terms could be used to explore anxiety in Spanish. Exploring depression with simple questions in Spanish achieves greater accuracy than the same approach to exploring anxiety.
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