Cancer
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In the study by Derogatis et al., which included patients with all stages of cancer, 47% of the patients met the DSM-III criteria for a psychiatric disorder, with adjustment disorders being the most common. Although the cancer stage is one factor that influences the nature and incidence of psychiatric disorders, no study has demonstrated the extensive range of psychiatric disorders in terminally ill cancer patients. ⋯ This preliminary investigation of the prevalence of psychiatric disorders in terminally ill cancer patients showed that more than half of the patients met the criteria for a DSM-III-R psychiatric disorder; delirium was the most common type of psychiatric disturbance. Further prospective trials are critically important to establishing treatment modalities that promote the psychiatric well-being of patients with terminal illnesses.
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Clinical Trial Controlled Clinical Trial
Self-assessed sexual function after pelvic irradiation for prostate carcinoma. Comparison with an age-matched control group.
Treatment of localized prostate carcinoma is often accompanied by disturbances in sexual function. The patient's own opinion and experience with these problems can be of great importance for his quality of life. In men older than 50 years, disturbances in sexual function are common. Treatment such as radiotherapy (RT), which can induce sexual dysfunction, should be evaluated in relation to the problems in an age-matched population without prostate carcinoma. ⋯ Patients with prostate carcinoma treated with RT only indicated higher levels of sexual dysfunction than age-matched controls. This was most obvious in patients younger than 70 years, although their sexual activity was comparable to age-matched controls. The addition of castration to RT tended to increase sexual problems, especially in patients < 70 years. In men between 70 and 74 years, the maintenance of sexual function seems to be very susceptible to disturbances. For patients older than 74 years, decreased sexual function was not perceived as such a significant problem, despite abolished desire and erection.
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A reduction in the risk of lung carcinoma and a lower death rate among former smokers (FS) compared with current smokers (CS) have been documented in numerous U.S. and international studies. The main objective of our study was to compare the differences in demographic and clinical characteristics in groups stratified by smoking status and gender to evaluate the effect of smoking history and cessation on age at lung carcinoma diagnosis and on specific histologic type. ⋯ These results indicate that smoking cessation or less life-time smoking exposure affects the distribution of specific histologic subtypes of lung cancer, especially for women, and that smoking cessation may postpone the age at which lung cancer occurs.
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Comparative Study
Opioid rotation in patients with cancer pain. A retrospective comparison of dose ratios between methadone, hydromorphone, and morphine.
When a change of opioid is considered, equianalgesic dose tables are used. These tables generally propose a dose ratio of 5:1 between morphine and hydromorphone. In the case of a change from subcutaneous hydromorphone to methadone, dose ratios ranging from 1:6 to 1:10 are proposed. The purpose of this study was to review the analgesic dose ratios for methadone compared with hydromorphone. ⋯ These results suggest that only partial tolerance develops between methadone and hydromorphone. Methadone is much more potent than previously described and any change should start at a lower equivalent dose.
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Comparative Study
The effect of calcium and vitamin supplements on the incidence and recurrence of colorectal adenomatous polyps.
Recent attention has focused on calcium and certain vitamins as potential protective agents against colorectal neoplasia. ⋯ More studies are necessary to confirm these findings. It may be necessary to develop other chemopreventive agents, such as aspirin, for colorectal neoplasia.