Profile of undergraduate nursing students' attitudes towards mental disease,before the influence of specific academic education

Students starting the Nursing Course bring with them stereotypes and prejudice in relation to mentally-ill people, thus showing lack of knowledge as to their possibilities of recovery and social living. This study aimed at elaborating a profile of the attitudes presented by these students in relation to such people and at showing aspects that can negatively influence their future professional conduct. To that end, the opinion scale for mental disease was used. The students presented a negative attitude profile, which made it possible to conclude that academic education from courses in this area must be planned so as to favor the change of the attitude profile presented.     

Drug and alcohol-related emergency department visits: results of a pilot survey in two hospitals in Israel

There is no system for reporting drug and alcohol-related emergency department (ED) visits in Israel. This pilot survey was aimed at examining the feasibility of establishing an ED surveillance system in a general hospital and a psychiatric hospital. We describe the design and preliminary results of a pilot-survey conducted in the emergency departments of two hospitals in Northern Israel. Active and passive case identification was conducted in Rambam Hospital and Tirat Carmel Psychiatric Hospital, from August, 1999-January, 2000. A total of 160 ED patients were identified, 64% as drug-related, with heroin being the most common drug. The majority of cases were identified through self-reports. Overdose and IVDU complications accounted for 20% of drug cases identified at Rambam Hospital, and injury and motor vehicle accidents accounted for 12% of all visits at this hospital. We did not attempt to estimate the proportion of all ED visits that are associated with drugs and/or alcohol. Under-ascertainment of cases and incomplete data recording remain major concerns for a survey of this nature. Results of this pilot survey indicate that with proper training of ED nurses a national ED surveillance system can be successfully and efficiently established in general hospitals and psychiatric hospitals in Israel.     

Late lower extremity fractures in patients with paraplegia

We report the result of the treatment of 26 lower limb fractures in patients with established paraplegia. We treated one fracture of the femoral neck, one intertrochanteric, two subtrochanteric, two of the femoral shaft, seven of the supracondylar region, six of the proximal tibia, one of the tibial shaft, and six pilon fractures. Nine fractures were treated non-operatively, and the remaining fractures were treated operatively. Union was achieved in all the patients, but we think that open reduction and internal fixation may improve the level of independence and mobility of these patients during fracture healing.     

Orthomolecular oncology: a mechanistic view of intravenous ascorbate's chemotherapeutic activity

The effect of vitamin C in cancer has been a subject of great controversy; mainly because of the inconsistent results obtained by oral intakes of ascorbate when used as an anticancer agent. We believe the intravenous application of ascorbate will provide more consistent results in cancer patients since Vitamin C blood levels attained are substantially higher in a range proven cytotoxic to malignant cells. In this article we will present and discuss our proposed mechanism on the chemotherapeutic activity exhibited by ascorbate.     

Tumor lysis syndrome in extensive-stage small-cell lung cancer

Tumor lysis syndrome is a constellation of metabolic complications that occurs in the setting of treatment of hematologic malignancies. On occasion, it has been reported to occur after therapy for solid tumors associated with large tumor burdens and aggressive therapy. We herein report the rare occurrence of acute tumor lysis syndrome in a woman with extensive-stage small-cell lung cancer after cytotoxic therapy.     

Raltitrexed (Tomudex): an alternative choice in patients intolerant to 5-fluorouracil

Raltitrexed (Tomudex), a classical folate antagonist, is a selective inhibitor of thymidylate synthase (TS). It has significant single-agent activity in metastatic colorectal cancer. Severe life-threatening toxicity related to the administration of 5-fluorouracil and leucovorin is described in two patients, both of whom were not deficient in dihydropyrimidine dehydrogenase. Raltitrexed was administered to both patients with clinically acceptable side effects and allowed a TS inhibitor to be administered as part of an adjuvant program.     

Results with chemotherapy comprised of cyclophosphamide, doxorubicin, vincristine, and prednisone followed by radiotherapy with or without prechemotherapy surgical debulking for patients with bulky, aggressive lymphoma

BACKGROUND: The authors performed a case-control analysis of local control, progression free survival, and overall survival in patients with Stage I-II aggressive lymphomas measuring > or = 7 cm in greatest dimension who were treated initially with or without surgical debulking: All patients then received cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) based chemotherapy followed by involved field radiotherapy. METHODS: From May 1975 through May 1996, 50 patients were treated with (n = 25 patients) or without (n = 25 patients) resection of > 80% of their bulky lymphomas. Chemotherapy consisted of 3-12 cycles of CHOP. In general, patients who underwent debulking received three cycles of chemotherapy, whereas patients who did not undergo debulking received at least six cycles of chemotherapy. The total radiotherapy dose was 40.8 grays (Gy) +/- 4.2 Gy (mean +/- standard deviation). RESULTS: The median follow-up was 62 months. Patients who underwent debulking were similar prognostically to patients who did not. There was a trend toward improved local control (5 year rates: 96% vs. 80%; P = 0.10) and overall survival (5 year rates: 83% vs. 71%; P = 0.18) in patients who underwent debulking compared with patients who did not, respectively. Progression free survival was significantly better for patients who underwent debulking compared with patients who did not (5 year rates: 88% vs. 62%, respectively; P = 0.04). CONCLUSIONS: Because this study was retrospective, selection bias may account for the observed difference in progression free survival. Because it is unlikely that a trial randomizing patients with bulky, aggressive lymphoma to surgery will be conducted, the authors' current efforts are focused on escalation of the total radiotherapy dose as a possibly less costly and less morbid approach toward improving progression free survival for these patients.