The Role of the Immune System in Ovarian Cancer and Implications on Therapy

Ovarian cancer is the leading cause of death from gynecologic malignancy in the United States. While the treatment options have improved with conventional cytotoxic chemotherapy and advanced surgical techniques, disease recurrence is common and fatal in nearly all cases. Current evidence suggests that the immune system and its ability to recognize and eliminate microscopic disease is paramount in preventing recurrence. The goal of immunotherapy is to balance the activation of the immune system against cancer while preventing the potential for tremendous toxicity elicited by immune modulation. In this paper we will review the role of immune system in disease pathogenesis and different immunotherapies available for the treatment of ovarian cancer as well as current ongoing studies and potential future directions.     

There's no place like home : an evaluation of early supported discharge for stroke

BACKGROUND AND PURPOSE: Because stroke management is aimed at facilitating community reintegration, it would be logical that the sooner the patient can be discharged home, the sooner reintegration can commence. The purpose of this study was to determine the effectiveness of prompt discharge combined with home rehabilitation on function, community reintegration, and health-related quality of life during the first 3 months after stroke. METHODS: A randomized trial was carried out involving patients who required rehabilitation services and who had a caregiver at home. When medically ready for discharge, persons with stroke were randomized to either the home intervention group (n=58) or the usual care group (n=56). The home group received a 4-week, tailor-made home program of rehabilitation and nursing services; persons randomized to the usual care group received services provided through a variety of mechanisms, depending on institutional, care provider, and personal preference. The main outcome measure was the Physical Health component of the Measuring Outcomes Study Short-Form-36 (SF-36). Associated outcomes measures included the Timed Up & Go (TUG), Barthel Index (BI), the Older Americans Resource Scale for instrumental activities of daily living (OARS-IADL), Reintegration to Normal Living (RNL), and the SF-36 Mental Health component. RESULTS: The total length of stay for the home group was, on average, 10 days, 6 days shorter than that for the usual care group. There were no differences between the 2 groups on the BI or on the TUG at either 1 or 3 months after stroke; however, there was a significantly beneficial impact of the home intervention on IADL and reintegration (RNL). By 3 months after stroke, the home intervention group showed a significantly higher score on the SF-36 Physical Health component than the usual care group. The total number of services received by the home group was actually lower than that received by the usual care group. CONCLUSIONS: Prompt discharge combined with home rehabilitation appeared to translate motor and functional gains that occur through natural recovery and rehabilitation into a greater degree of higher-level function and satisfaction with community reintegration, and these in turn were translated into a better physical health.     

Prospective study of posttreatment changes in the temporomandibular joint.

The purpose of this follow-up prospective longitudinal study was to determine what changes occurred in the condyle/fossa relationship after treatment. Orthodontic posttreatment records, including corrected tomograms of 106 white patients (58 Class I and 48 Class II Division 1), from a pretreatment sample of 232 patients, were analyzed. The average pretreatment age was 13.6 +/- 3.0 years. The average length of treatment was 2.3 +/- 0.6 years for the Class I group and 2.8 +/- 0.9 years for the Class II Division 1 group. With orthodontic treatment, the condyle became more concentrically positioned, and a significant (P <.05) decrease in left and right anterior, posterior, and superior joint spaces was observed in most subjects. There was no statistically significant correlation between changes in the condyle/fossa relationship based on age, gender, skeletal or dental variables, signs or symptoms of temporomandibular disorder, headgear use, type of elastics, or nonextraction vs extraction treatment.     

Changing dentists' knowledge, attitudes, and behaviors relating to AIDS: a controlled educational intervention

The efficacy of an educational intervention designed to improve dentists' knowledge, attitudes, and behaviors about acquired immune deficiency syndrome (AIDS) was tested. The intervention had three components: computerized feedback comparing participants' own knowledge, attitudes, and behaviors with those of fellow participants and with an ideal; periodic bulletins; and telephone conference calls with experts. The group receiving the educational package had better scores than a control group on outcomes of willingness to treat persons with AIDS; identification of human immunodeficiency virus lesions; knowledge of AIDS; and completeness of both intraoral and extraoral examinations. It was concluded that intervention is one approach to increasing dentists' positive response to the AIDS epidemic.     

Integration of global health concepts in nursing curricula: a national study

The concept of global health is evolving with a growing recognition that international social, political, economic, environmental, and cultural issues affect health and health care around the world. Nurse faculty are challenged to find ways to prepare future nurses to provide care in an environment that is increasingly affected by globalization. This article presents results of a national survey of schools of nursing designed to identify a consensus definition for global health, attributes of the concept, and ways in which global health is identified and addressed in nursing curricula. Attributes of global health identified in this study are congruent with the literature. Implications for educators are presented, along with examples of how technology can be used to facilitate global interactions.     

Enantiotropically-related polymorphs of {4-(4-chloro-3-fluorophenyl)-2-[4-(methyloxy)phenyl]-1,3-thiazol-5-yl} acetic acid: crystal structures and multinuclear solid-state NMR

Single crystal X-ray diffraction (SCXRD), powder X-ray diffraction (PXRD), and solid-state NMR (SSNMR) techniques are used to analyze the structures of two nonsolvated polymorphs of {4-(4-chloro-3-fluorophenyl)-2-[4-(methyloxy)phenyl]-1,3-thiazol-5-yl} acetic acid. These polymorphs are enantiotropically-related with a thermodynamic transition temperature of 35 +/- 3 degrees C. The crystal structure of Form 1, which is thermodynamically more stable at lower temperatures, was determined by SCXRD. The crystal structure of Form 2 was determined using PXRD structure solution methods that were assisted using two types of SSNMR experiments, dipolar connectivity experiments and chemical shift measurements. These experiments determined certain aspects of local conformation and intermolecular packing in Form 2 in comparison to Form 1, and provided qualitative knowledge that assisted in obtaining the best possible powder structure solution from the X-ray data. NMR chemical shifts for 1H, 13C, 15N, and 19F nuclei in Forms 1 and 2 are sensitive to hydrogen-bonding behavior, molecular conformation, and aromatic pi-stacking interactions. Density functional theory (DFT) geometry optimizations were used in tandem with Rietveld refinement and NMR chemical shielding calculations to improve and verify the Form 2 structure. The energy balance of the system and other properties relevant to drug development are predicted and discussed.     

Prediction of anxiety disorders using the state-trait anxiety inventory for multiethnic adolescents.

The purpose of this study was to determine the validity of the State-Trait Anxiety Inventory (STAI) in predicting DSM-III-R anxiety disorders based on the Diagnostic Interview Schedule for Children (DISC, Version 2.3) and using Asian/Pacific Islander adolescents. An overall prevalence rate of 9.19% for generalized anxiety disorder, overanxious disorder, or social phobia was consistent with past studies. As hypothesized, STAI negatively worded (i.e., Factor 2) items were better predictors than positively stated (i.e., Factor 1) items. The STAI State mean was a better predictor of concurrent DISC anxiety disorders as compared to STAI State Factors I or 2. In contrast, the STAI Trait Factor 2 (negatively worded) composite was the best predictor for nonconcurrent DISC anxiety disorders as compared to STAI Trait Factor 1 or the overall STAI Trait subscale. Satisfactory predictive-validity values were obtained when using the STAI State mean and Trait Factor 2 composite. Implications of these findings are discussed, including using the STAI as a screening measure for ethnically diverse adolescents.