Patients with suspected breast cancer scheduled for nodulectomy or removal of breast tissue for diagnosis, had higher levels and prevalence of anxiety-state than patients undergoing mammaplasty; the levels and prevalence of anxiety-trait were similar in both groups; no risk factors for anxiety-state and anxiety-trait were identified.
Objective: This study evaluated the relationship between psychological coping mechanisms and symptoms of anxiety and depression in the preoperative and postoperative periods in relation to the intensity of postoperative pain among patients undergoing breast cancer surgery. Methods: Female patients who were scheduled to receive immediate surgical treatment for breast cancer were invited to participate, and answered the following questionnaires: The Hospital Anxiety and Depression Scale (HADS), the Self Report Questionnaire (SRQ-20), the Coping Strategies Questionnaire (CSQ), and the visual analogue scale (VAS). Results: Of the 139 patients, 122 (87.8%) had an aggressive procedure. Eighty-five patients (61.2%) had a history of preoperative pain while 54 (38.7%) had not. There was no difference in VAS scores between patients subjected to aggressive or non-aggressive surgery. Only the CSQ subscale catastrophizing showed correlation with VAS at 24 hours and with HADS/D postoperatively. The HADS scores indicated both anxiety and depression, but did not distinguish patients subjected to aggressive or non-aggressive surgery. Conclusions: The majority of patients did not exhibit depression and anxiety. Coping mechanisms and pain in the preoperative period did not have a strong predictive value for additional postoperative pain, but those with a higher anxiety score had greater pain.
As costelas se desenvolvem pela ossificação endocondral, a partir do processo costal das vértebras torácicas. Nesse momento, as variações congênitas aparecem com relativa frequência, geralmente unilaterais, podendo desenvolver-se randomicamente e envolver qualquer arco costal. No presente trabalho, objetivou-se relatar a variação anatômica encontrada na primeira costela de uma das 18 ossadas provenientes do cemitério de Cascavel-PR, atendendo a Lei nº 8501, de 30 de novembro de 1992, e analisadas no laboratório de anatomia da Universidade Federal do Paraná (UFPR) - campus Toledo. Para tanto, foi utilizada a osteotécnica como metodologia de preparo das peças. Dentre as ossadas examinadas, encontrou-se uma fusão entre a primeira e a segunda costela, com a presença de duas cabeças na extremidade posterior. Essa alteração pode ocorrer de forma completa ou parcial, nas porções anteriores ou posteriores do osso, e possivelmente é consequência de um defeito na segmentação. Além disso, existem outras anormalidades anatômicas que podem estar associadas às costelas, como calcificações fisiológicas costocondrais e pseudoartrose do primeiro arco costal; arco costal cervical; arco costal curto e hipoplásico; arco costal bífido; e disostose espondilocostal. Nesse ínterim, a detecção dessas alterações, ainda que incidentais, além de possibilitar a análise a partir de pontos de vista radiológicos e genéticos, é vantajosa para uma investigação clínica adequada, um diagnóstico completo e uma correta abordagem do quadro.
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