Resumen: Objetivo: Valorar la utilidad de la Activación Conductual para el afrontamiento del cáncer. Método: 18 pacientes con cáncer de mama de reciente diagnóstico siguieron 6 sesiones protocolarizadas dirigidas a recuperar actividades relevantes, eliminar conductas de enfermedad y modificar patrón de evitación experiencial. El análisis funcional determinó objetivos concretos de intervención y la estimación del cambio clínico en cada caso. Se evaluó el cambio pre-post-seguimiento (trimestral). Resultados: Se observa recuperación de las actividades, en particular, domésticas (p = 0,005) y ocio (p = 0,05). Es escasa la presencia de patrones de evitación, aunque se logra su reconocimiento. Las conductas de enfermedad se reconocen y reducen (p = 0,03). No hay casos de ansiedad ni depresión (HAD), pero sí sintomatología que mejora durante la intervención. Conclusiones: La orientación de los pacientes oncológicos hacia el mantenimiento de actividades de la vida cotidiana relevantes durante la quimioterapia, parece mejorar el afrontamiento de la enfermedad. Palabras clave: Terapia de Activación Conductual; cáncer; afrontamiento; funcionalidad; estado emocional.[en] Behavioral Activation Therapy (AC) in women with breast cancer undergoing chemotherapy: case evolution analysis. Abstract: Objective: To assess the utility of Behavioral Activation for coping with cancer. Method: 18 patients with recently diagnosed breast cancer followed 6 protocoled sessions, aimed to recover relevant activities, eliminate illness behavior and to modify experiential avoidance patterns. Functional analysis determined concrete intervention objectives and the estimation of clinically significant change for each case. Pre-post and three months follow up changes were assessed. Results: Activity recovery is observed,
The effectiveness of treatments for substance use disorders is strongly related to retention, since early dropout from treatment is associated with greater likelihood of relapse. The purpose of this prospective, ex post facto study is to analyze the effect of individual variables on retention in a treatment program carried out in a prison drug-free unit. The Addiction Severity Index, motivation and personality profile of fifty inmates were assessed on entry to the prison. Inmates were monitored for a year to identify length of stay. Results: Motivation variables at intake play a vital role in the prediction of retention in a prison drug-free unit; scores on the Aggressive-Sadistic and arcissistic scales are also strong predictors of treatment retention.La eficacia de los tratamientos para los trastornos por uso de sustancias está altamente relacionada con la retention, pues entre otras cosas el abandono del tratamiento se vincula con una mayor probabilidad de recaída. El propósito de este estudio prospectivo ex post facto es analizar el efecto de distintas variables individuales sobre la retención en el tratamiento dispensado en una unidad libre de drogas intrapenitenciaria. Cincuenta internos de este programa fueron evaluados al ingreso en variables relacionadas con el perfil de gravedad de la adicción, la motivación y la personalidad. Resultados: La motivación inicial es una variable fuertemente predictora de la retención en el tratamiento, tanto a los seis meses como al año de estancia. Asimismo, las escalas Narcisista y Agresivo-Sádica evaluadas por el instrumento MCMI-II también tuvieron capacidad pronóstica en la retención.
differences according to treatment received (p ¼ 0.064) or PS (p ¼ 0.345). The median overall survival was 9.7 months (95% CI 6.670-12.740). The median time from the last administration of chemotherapy to death was 6.8 months (95% CI 2240-6288). Conclusion: In our experience, second-line chemotherapy in malignant mesothelioma is feasible, with a clinical benefit and a response rate that allows third-line treatment to be administered to a non-negligible percentage of patients.
575 Background: Currently, endoscopic resection of early colorectal cancer (ECC) defined as carcinoma with invasion limited to the mucosa (Tis), and submucosa (T1) is possible due to advances in instrumentation. However, when tumor invades submucosal layer, lymph node dissemination is present in 16.2% of cases, requiring additional surgery and limfadenectomy. Risk factors for lymph node dissemination and independent for relapse have been previously described in literature. Methods: We performed a retrospective analysis of all patients with colorectal T1 tumors, treated at our center with endoscopic resection and some with additional surgery between 2006 and 2017. Stadistical analysis was perfomed with IBM SPSS Statistics 24.0. Results: 159 patients (p) were treated with endoscopic resection, 56.6% (90p) underwent additional surgery. Mean age was 68.74 years and 69.9% (111p) were male. Endoscopic resection: negative margins 87.6%, vascular 3.1%, lymphatic 2.5% and perineural invasion 3.8%, high degree of histological differentiation 1.3%. Surgical resection: negative margins 100%, lymph node spread 8.8%. In a mean follow-up of 23.36 months since endoscopic treatment, 13 patients had relapsed. Risk of relapse did not differ between patients who received additional surgery and those who only underwent endoscopic resection (p = 0.791). On the other hand, lymph node dissemination (p = 0.007) and a positive margin (p = 0.01) were independent risk factors for risk of relapse. Vascular, lymphatic and perineural invasion, nor degree of histological differentation were stadistically significant. However, there was a positive association between lymph node dissemination and lymphatic (p = 0.07), vascular (p = 0.007) and perineural (p = 0.001) invasion and also degree of histological differentiation (p = 0.000). Conclusions: In our study, relapse rate was under 10% in eleven years. The only independent risk factors for relapse were a positive margin and lymph node dissemination. Perineural, vascular and lymphatic invasion obtained from polypectomy sample, could infer the probability of positive lymph nodes and indirectly be an indicator for risk of relapse.
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