2-Deoxy-2-[F-18]fluoro-<Emphasis Type="SmallCaps">d</Emphasis>-glucose Positron Emission Tomography/Computed Tomography in the Management of Melanoma

Objectives 2-Deoxy-2-[F-18]fluoro-d-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) is widely available as a powerful imaging modality, combining the ability to detect active metabolic processes and their morphologic features in a single exam. The role of FDG-PET is proven in a variety of cancers, including melanoma, but the estimates of sensitivity and specificity are based in the majority of the published studies on dedicated PET, not PET/CT. Therefore, we were prompted to review our experience with FDG-PET/CT in the management of melanoma. Methods This is a retrospective study on 106 patients with melanoma (20–87 years old; average: 56.8 ± 15.9), who had whole-body FDG-PET/CT at our institution from January 2003 to June 2005. Thirty-eight patients (35.9%) were women and 68 patients (64.1%) were men. Reinterpretation of the imaging studies for accuracy and data analysis from medical records were performed. Results All patients had the study for disease restaging. The primary tumor depth (Breslow’s thickness) at initial diagnosis was available for 76 patients (71.7%) and ranged from 0.4 to 25 mm (average: 3.56 mm). The anatomic level of invasion in the skin (Clark’s level) was determined for 70 patients (66%): 3, level II; 13, level III; 43, level IV; 11, level V. The administered dose of ¹⁸F FDG ranged from 9.8 to 21.6 mCi (average: 15.4 ± 1.8 mCi). FDG-PET/CT had a sensitivity of 89.3% [95% confidence interval (CI): 78.5–95] and a specificity of 88% (95% CI: 76.2–94.4) for melanoma detection. Conclusion This study confirms the good results of FDG-PET/CT for residual/recurrent melanoma detection, as well as for distant metastases localization. PET/CT should be an integral part in evaluation of patients with high-risk melanoma, prior to selection of the most appropriate therapy.     

Inter-university collaboration in the development of a distance education course in community health nursing

Collaboration between faculty members from two university nursing programs has successfully produced an introductory community health nursing course for RN-BScN distance education students. The course has integrated theoretical and clinical components organized into a coherent whole via a detailed course manual. The course is designed to be flexible so that individual units of the course manual can be reorganized as needed to fit the curriculum requirements of the co-authoring university. The process of collaboration was both frustrating and satisfying. The frustrations included unavoidable difficulties as well as problems that, now that they have been identified, could be avoided in future. The greatest satisfaction, of course, was that of actually achieving a worthwhile goal despite the obstacles that presented themselves during the course development process.     

The Anonymous Spectator

In this article, I attempt to illuminate points of similarity between the process of “working through” in psychological treatment, and the ordinary day-to-day developmental potential of college life, suggesting that when students can be helped to make optimal use of the college interpersonal milieu, brief, analytically informed psychotherapy can work in concert with the average, expectable experimentation of late adolescence to facilitate growth and maturation.     

The changing face of long-term care: looking at the past decade

Baby boomers on the verge of retirement who are considering future long-term care needs are searching for options that will promote comfort and quality of life in an environment comparable to the home left behind. Culture change is taking on different faces throughout long-term care, moving from a traditional medical model towards a holistic approach. New models of care address individual needs of the aging population. This article has three aims: (1) to evaluate the current state of culture change throughout long-term care, (2) to describe models of change seen among the long-term care industry, and (3) to report on existing work comparing the Green House Model of Care to two traditional nursing homes in Tupelo, Mississippi.     

Gabapentin reduces the mechanosensitivity of fine afferent nerve fibres in normal and inflamed rat knee joints

The antiepileptic drug gabapentin has been shown to have an antihyperalgesic effect following central administration. This electrophysiological investigation examined whether peripherally administered gabapentin could modulate the mechanosensitivity of primary afferents innervating normal and kaolin/carrageenan inflamed rat knee joints. Close intraarterial injection of gabapentin (0.01, 1 and 100mg/kg) dose-dependently reduced afferent firing rate in both normal and acutely inflamed rat knees in response to normal and hyper-rotation of the joint. Thus, in addition to its central mode of action, peripheral administration of gabapentin reduces nociception locally and this may prove to be beneficial in the treatment of various pain syndromes including inflammatory arthritis.