A psychosocial assessment interview of candidates for hematopoietic stem cell transplantation

There is evidence that psychosocial issues are associated with poorer compliance and higher mortality in the post-transplant period. Thus, psychosocial assessment of candidates for transplantation is an important way of detecting early those patients who are susceptible to developing psychiatric symptoms and psychosocial difficulties during treatment. We developed a psychosocial structured interview to assess candidates for hematopoietic stem cell transplantation. The interview is a short and comprehensible instrument, requiring an average of 50 minutes to be completed.     

MR cholangiography with manganese dipyridoxyl diphosphate in the evaluation of biliary-enteric anastomoses: preliminary experience

OBJECTIVE: The purpose of our study was to assess the usefulness of manganese dipyridoxyl diphosphate (Mn-DPDP)-enhanced T1-weighted MR cholangiography for evaluating patients with biliary-enteric anastomoses. CONCLUSION: Mn-DPDP-enhanced T1-weighted MR cholangiography may provide useful functional information and may aid in the assessment of the patency of biliary-enteric anastomoses.     

Organs transplanted from intoxicated donors

PURPOSE: The purpose of our study was to evaluate short- and long-term results of transplants from cadaver donors who have died of poisoning by various substances. MATERIALS AND METHODS: The actuarial survival rate of organs from intoxicated donors was calculated using the Kaplan-Meier method. RESULTS: Among the 507 donors between January 1998 and December 2002, 5 (0.98%) had a cause of brain death of poisoning, namely, organo-phosphates (n = 2), methanol (n = 1), cyanide (n = 1) and acetylsalicilic acid(n = 1), from whom were procured 10 kidneys, 1 liver, 2 corneas, and 1 set of bones. The follow up for patients receiving solid organs was 15.2 months (range, 0-48 months). At 3 months, 90% of kidneys had normal function. No delayed graft function rejection episodes or major complications were reported in any recipient. None showed evidence of acute or chronic poisoning. Two died, 1 early mortality was due to anesthetic complications and the other at 17 months to an unknown cause. Actuarial kidney survival rates were 90% and 80% at 12 and 24 months, respectively. The liver recipient was well at the end of follow up. CONCLUSION: Using organs of poisoned donors is feasible with comparable graft survival rates to other recipient.     

Medication administration: acquisition of knowledge and abilities required for a group of nurses

Nowadays, it is known that medication administration is a multidisciplinary process and requires constant updating from the professionals in charge. However, lack of knowledge, updating and in-service education permeate this theme area. Goals: analyze the educational needs of nurses working at a university hospital in the interior of S?o Paulo State, Brazil with regard to medication administration, as well as discuss about the need for this group of nurses to obtain the required knowledge and abilities. The Nominal Group Technique was used by means of the following question: "What else do you need to know in order to complete your knowledge on medication administration?" Eight categories of educational needs emerged: medication effect mechanisms, medication preparation and administration, information and knowledge acquisition, medication interactions, medication stability, specific and chemotherapeutic medication, side effects of medication and other aspects of medication administration. An updating course was proposed on the basis of the identified educational needs.     

Effect of pupillary dilation on retinal nerve fiber layer thickness measurements using optical coherence tomography

PURPOSE: To evaluate the effect of pupillary dilation on retinal nerve fiber layer thickness (RNFL) measurements using optical coherence tomography (OCT-3). METHODS: Randomly chosen eyes of healthy individuals were scanned before and after pupillary dilation by two trained operators (R.G.O., R.V.) using OCT-3 (Carl Zeiss Meditec, Inc., Dublin, CA). Fast and regular RNFL (256 A-scans) OCT-3 protocols (software version A1.1) were used in each scanning session. RNFL thickness measurements before and after dilation were compared. RESULTS: Ten eyes of 10 subjects (6 females, 4 males) were enrolled. Mean age was 32.0 +/- 11.2 years (range, 21 to 52 years). Mean pupillary diameter before and after dilation was 2.9 +/- 0.6 mm and 7.6 +/- 0.8 mm, respectively (P < 0.0001, paired t-test). There was no significant difference in RNFL thickness measurements before and after dilation using both fast and regular RNFL protocols (P > or = 0.05 for all comparisons, paired t-test). Mean coefficients of variation for mean RNFL thickness measurements were 15.3% before and 13.7% after dilation for operator 1; and 10.8% before and 12.7% after dilation for operator 2 for the fast RNFL protocol and 11.3% versus 10.4% and 12.9 versus 11.1%, respectively, for the regular RNFL protocol. CONCLUSION: Pupillary dilation is not necessary in all subjects to obtain reproducible RNFL thickness measurements using OCT-3.     

Molecular mechanisms of action and prediction of response to oxaliplatin in colorectal cancer cells

The platinum compound oxaliplatin has been shown to be an effective chemotherapeutic agent for the treatment of colorectal cancer. In this study, we investigate the molecular mechanisms of action of oxaliplatin to identify means of predicting response to this agent. Exposure of colon cancer cells to oxaliplatin resulted in G2/M arrest and apoptosis. Immunofluorescent staining demonstrated that the apoptotic cascade initiated by oxaliplatin is characterised by translocation of Bax to the mitochondria and cytochrome c release into the cytosol. Oxaliplatin treatment resulted in caspase 3 activation and oxaliplatin-induced apoptosis was abrogated by inhibition of caspase activity with z-VAD-fmk, but was independent of Fas/FasL association. Targeted inactivation of Bax or p53 in HCT116 cells resulted in significantly increased resistance to oxaliplatin. However, the mutational status of p53 was unable to predict response to oxaliplatin in a panel of 30 different colorectal cancer cell lines. In contrast, the expression profile of these 30 cell lines, assessed using a 9216-sequence cDNA microarray, successfully predicted the apoptotic response to oxaliplatin. A leave-one-out cross-validation approach was used to demonstrate a significant correlation between experimentally observed and expression profile predicted apoptosis in response to clinically achievable doses of oxaliplatin (R=0.53; P=0.002). In addition, these microarray experiments identified several genes involved in control of apoptosis and DNA damage repair that were significantly correlated with response to oxaliplatin.