The aim of this study was to validate the Mexican-Spanish version of The European Organization for Research and Treatment of Cancer (EORTC) QLQ-BR23 questionnaire. The translation procedure followed EORTC guidelines. QLQ-C30 and QLQ-BR23 instruments were completed by Mexican women with breast cancer, attending a teaching referral cancer centre from February 2009 to January 2010. Patients were divided in two groups: (1) Patients with early stage of breast cancer; and (2) Patients with locally advanced breast cancer (LABC). Reliability and validity tests were performed, and validity over time (responsiveness) was conducted in a subset of patients. Two hundred and thirty-four women (mean age, 52.3 years) completed both questionnaires. Convergent and divergent validity was adequate. Cronbach's alpha of all multi-item scales showed values ≥0.7 except for Cognitive and Breast symptoms scales (0.52 and 0.65 respectively). Patients with early stages (n= 77) showed better functional scores and lower symptoms scores than patients with LABC (n= 157). Score means variation after responsiveness analysis demonstrated high sensitivity to change after breast cancer surgery. The Mexican-Spanish version of the EORTC QLQ-BR23 questionnaire is a valid and suitable instrument to estimate HRQL in patients with breast cancer.
The molecular mechanisms implicated in pronounced weight loss and metabolic benefits after bariatric surgery are still unknown. Adipocyte phenotype and metabolism have not been entirely explored. However, some features of adipocyte function have been studied, such as adipocyte size and inflammation, which are both reduced after bariatric surgery. Adipocyte fat metabolism, which is partly regulated by leptin, is likely modified, since adipocyte area is decreased. Here, we show that leptin receptor expression is increased, while adipocyte size is decreased 8 months after Roux-en-Y gastric bypass. Thus, adipocyte function is possibly modified by improved leptin signaling after bariatric surgery.
Pancreatic pseudocysts are defined as homogeneous pancreatic or peripancreatic collections that are not associated with necrotic tissue and are surrounded by granulated or fibrous tissue with no epithelium. Management has been classified as surgical (conventional and laparoscopic) and nonsurgical (endoscopic and radiologic). The aim of this report is to describe our initial experience in the management of a pancreatic pseudocyst by means of laparoscopic posterior cyst-gastrostomy anastomosis, performed at the Pancreas Clinic of the Hospital General "Dr. Manuel Gea González" in Mexico City. New techniques and instrumentation have contributed to the relatively recent development of laparoscopic pancreatic surgery. Our technique has practical advantages that have been confirmed by other authors, such as simple hemostasis, a wide viewing angle enabling adequate necrosectomy, anastomosis that does not require the use of staples, and the possibility of resolving other associated intra-abdominal pathologies, as in this case.
Background: Surgical site complications (infection, dehiscence, necrosis) continue to be an important cause of morbidity in patients undergoing breast cancer surgery. It seems to have a negative impact in quality of life and an increase in health-care costs in comparison with patients with a satisfying outcome.Meterial and Methods:Using two questionnaires to evaluate quality of life from the European Organization for the Research and Treatment of Cancer (EORTC), QLQ-C30 and BR-23, we analyzed 90 breast cancer patients after surgery. We obtained information about direct costs (gloves, gauze, antibiotics, wound dressing, hospital admission) and indirect costs (travel time, transport, day off at work) related to post-surgery consults. We analyzed dissimilarities concerning self-perception of quality of life between patients with and without surgical complications and differences in health-care treatment costs.Results: Twelve (11.76%) patients developed surgical site infection (SSI), 6 (5.88%) necrosis and 9 (8.8%) dehiscence.Self-perception of quality of life was decreased in patients with surgical site complications.The crude median costs of complicated patients was $1,368 US dollars compared to $992 US dollars in non-complicated patients. After adjusting costs according to type of complications only statistical significance was found in patients with SSI and dehiscence (95% confidence interval, $203-$301 and $94-$170 respectively) and the direct costs showed the most important difference.Discussion: The direct and indirect costs was superior in complicated than in non-complicated patients and there was a decrease in self-percieved quality of life, which is consistant with other findings. This should awaken interest in applying new methods to reduce risk of surgical site complications. There is an important lack of evidence regarding quality of life and costs related to post-surgery complications in any health care facilities in our country, which wil make this the first study to do it, specially in breast cancer patients. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3110.
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