Bulletin du cancer
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Advanced cancer is likely to be perceived as a non-controllable source of stress for the individual. The patient distress at this stage of the illness and the strategies he uses to cope with it need to be explored so as physical symptoms, since they are correlated with quality of life at the end-of-life. But very few recent studies have considered patient coping and quality of life in the palliative stage of cancer. ⋯ For relatives, get medical information is a key point since uncertainty is often perceived as frightening. Patient coping strategies interact with those of the physician, who has to cope with different sources of stress. Taking into account these strategies among patients with advanced cancer could facilitate a medical communication respectful of the patient's mental state, under the complex context of palliative care in oncology.
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The natural history of breast diseases has changed overtime and successive therapeutic strategies have been adapted accordingly. Recently, biological findings on geno- and phenotypic characteristics of tumor cells offer new basis for the development of treatments that target homogenous and various subtypes of breast cancer. Unfortunately, traditional clinical research tools are not in phase with rapid changes in both biological knowledge of the disease and new targeted agents. New methodological approaches are urgently needed to validate such changes and improvements in prognosis.
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To evaluate the prevalence and the characteristics of use of midazolam among hospitalized patients and to analyze physicians' representation of this medicine. We conducted a retrospective study between 1st May and 22nd May 2011 in Grenoble University Hospital in France. All patients receiving midazolam during the study period were included, excepted if the prescription was performed in intensive care units, operating rooms or in pediatric units. ⋯ The main representations of midazolam were the stop of active treatment (46.5 %) and premature cause of death (46.5 %). Practice of sedation is under-estimated by physicians as they have difficulties to differentiate anxiety relieving and sedation and they have difficulties to initiate a sedation. A guideline to help physicians using midazolam could improve practice.