Percutaneous cementoplasty in multiple myeloma: a valuable adjunct for pain control and ambulation maintenance

GOALS OF WORK: Bone pain and functional impairment are major concerns for multiple myeloma (MM) patients. The goal of this study was to better define the role of percutaneous cementoplasty (PC) in improving their quality of life. MATERIALS AND METHODS: This retrospective analysis included 28 consecutive heavily pretreated MM patients managed at our institution between 1996 and 2002. They underwent a total of 34 PC procedures for the treatment of 117 vertebrae and 2 iliac sites and were evaluated at 1 month. MAIN RESULTS: Significant pain reduction of >50% was obtained after 83% of the procedures, with a mean visual analogous score decreasing from 7.48/10 to 2.1/10 (p < 0.001). It resulted in a complete interruption of opiate analgesic consumption after 59.3% of the procedures, with a mean decrease of 70.4% in the opiate dose. Functional impairment was evaluated with the Eastern Cooperative Oncology Group (ECOG) performance status scale, with mean scores improving from 1.9 to 0.86 after the procedures (p = 0.001). There was no major complication. CONCLUSION: PC is a safe, feasible, and efficient approach for the treatment of bone pain and disability in MM patients.     

Inequality in treatment use among elderly patients with acute myocardial infarction: USA, Belgium and Quebec

Background  

Previous research has provided evidence that socioeconomic status has an impact on invasive treatments use after acute myocardial infarction. In this paper, we compare the socioeconomic inequality in the use of high-technology diagnosis and treatment after acute myocardial infarction between the US, Quebec and Belgium paying special attention to financial incentives and regulations as explanatory factors.     

L’intégration des familles aux soins en cancérologie: perspectives et limites

The fight against cancer concerns us all, and significant others who are badly affected by the illness of their loved ones, have a role to play in implementing the cancer care plan. Confronted with new expectations from both patient and significant others in terms of consideration and participation, the current trend is to consider significant others as active players in the care process with a new role to play. But before we can discuss the role of participants in the care process, we must first define what we mean by significant other. A new area of research, known as proximology, invites us to take a new look at the real impact of chronic conditions and their management on a daily basis. Patients and family alike are demanding this integrated approach to care management. What, then, is the role of the significant other? It is also important to emphasise the ethical dimension of this discussion, being careful not to assign the significant other a fixed — and therefore decisive — role, or even to actively encourage the sick person to turn to his or her significant others for support. We must respect the freedom of each individual. These general reflections lead us to look more specifically at the patient/significant other/caregiver relationship, within the context of a cancer diagnosis. To illustrate our remarks, we will draw on research into the place of family participation in care currently being undertaken at Clermont Ferrand University Hospital in partnership with the Centre Anti Cancéreux Jean Perrin (Jean Perrin Anti-Cancer Centre) in Clermont Ferrand. This research, which is of a multidisciplinary nature, raises a number of questions Can family participation in care be beneficial? What are the benefits and risks for patients and their significant others?     

Natural and unnatural ribozymes: Back to the primordial RNA world

We review natural and in vitro selected ribozymes, for which combined studies could provide us with both insight into the functions performed by ancient RNA molecules in a primitive RNA world and a hypothesis about evolutionary steps that led to the contemporary world.     

Experimental validation of coincidence summing corrections computed by the ETNA software.

The ETNA software has been developed to compute efficiency transfer and coincidence summing corrections. Different experiments are combined to test the validity of this last facility. Point sources with multi-gamma emitters are measured at several source-to-detector distances. Experimental correction factors are determined from the variation in the peaks' relative intensities versus the geometrical conditions. The ETNA code is used to compute the corrections due to coincidence summing for the same geometries. The calculated values are compared to the experimental ones.     

Presence of a gene encoding choline sulfatase in Sinorhizobium meliloti bet operon: Choline-O-sulfate is metabolized into glycine betaine

Glycine betaine is a potent osmoprotectant accumulated by Sinorhizobium meliloti to cope with osmotic stress. The biosynthesis of glycine betaine from choline is encoded by an operon of four genes, betICBA, as determined by sequence and mutant analysis. The betI and betC genes are separated by an intergenic region containing a 130-bp mosaic element that also is present between the betB and betA genes. In addition to the genes encoding a presumed regulatory protein (betI), the betaine aldehyde dehydrogenase (betB), and the choline dehydrogenase (betA) enzymes also found in Escherichia coli, a new gene (betC) was identified as encoding a choline sulfatase catalyzing the conversion of choline-O-sulfate and, at a lower rate, phosphorylcholine, into choline. Choline sulfatase activity was absent from betC but not from betB mutants and was shown to be induced indifferently by choline or choline-O-sulfate as were the other enzymes of the pathway. Unlike what has been shown in other bacteria and plants, choline-O-sulfate is not used as an osmoprotectant per se in S. meliloti, but is metabolized into glycine betaine. S. meliloti also can use this compound as the sole carbon, nitrogen, and sulfur source for growth and that depends on a functional bet locus. In conclusion, choline-O-sulfate and phosphorylcholine, which are found in higher plants and fungi, appear to be substrates for glycine betaine biosynthesis in S. meliloti.     

Differential effects of serotonin (5-HT) lesions and synthesis blockade on neuropeptide-Y immunoreactivity and 5-HT1A, 5-HT1B/1D and 5-HT2A/2C receptor binding sites in the rat cerebral cortex

The present study was aimed at comparing the effects of serotonin (5-HT) synthesis blockade using chronic administration of p-chlorophenylalanine (PCPA) and 5,7-dihydroxytryptamine injections of variable volume (3 vs. 6 μl) on the density of NPY immunoreactive (Ir) neurons and binding of [³H]8-OH-DPAT, S-CM-G[¹²⁵I]TNH₂ and [¹²⁵I]DOI to 5-HT_1A, 5-HT_1B/1D, and 5-HT_2A/2C receptors in rat cortical regions. Three weeks after large but partial (89% depletion in 5-HT tissue concentration) lesions of 5-HT neurons no changes in neither NPY immunoreactivity nor 5-HT receptor binding were detected. The complete 5,7-DHT lesions produced increases in the number of NPY-Ir neurons in the upper regions of the cingular (134%), frontal (140%) and parietal cortex (48%) and corresponding decreases in 5-HT_2A/2C binding (16–26%). No changes in 5-HT_1A and 5-HT_1B/1D binding were observed after lesions of this kind. After PCPA treatment, decreases in NPY-Ir neurons density (22–40%) and increases in 5-HT_1A and 5-HT_1B/1D receptor binding sites (20–50%) were distributed in both upper and deeper cortical regions. The lack of effect of the partial lesion suggests that spared 5-HT neurons may exert compensatory mechanisms up to a large extent. The changes in NPY immunoreactivity and 5-HT_2A/2C binding detected in the upper regions of the cortex after complete 5-HT lesions probably result from local cellular rearrangements, whereas blocking 5-HT synthesis has more widespread influence on NPY neurons and on 5-HT_1A and 5-HT_1B/1D receptor subtypes. Moreover, decreases in DOPAC concentrations detected only after complete lesions suggest that the involvement of catecholaminergic transmission may also differentiate 5,7-DHT and PCPA treatments. Altogether, these data suggest that different receptor subtypes might be involved in 5-HT–NPY relationships.     

A new determination of 79Se half-life.

A new value of (79)Se half-life was determined by the means of inductively coupled plasma mass spectrometry (ICP-MS) and liquid scintillation counting (LSC) on a sample source isolated from a nuclear reprocessing solution. The procedure used to extract Se from the complex sample solution consisted in liquid-liquid extraction and ion exchange chromatographic methods. The concentration of (79)Se was measured using ICP-MS coupled with electro-thermal vaporisation to eliminate potential isobaric interferences. The activity was measured using LSC after gamma-ray spectrometry to check the contribution of residual radioactive contaminants. From these results, the half-life of (79)Se was found to be 3.77 (19) x 10(5) a.     

C3/C4 Concentration Ratio Reverses Between Colostrum and Mature Milk in Human Lactation

The levels of complement fractions C3 and C4 were assayed in human milk in a classic nephelometric assay adapted to this secretion. Concentrations of these molecules were measured in 667 milk samples obtained sequentially from 76 volunteer lactating mothers during the first 12 weeks of lactation. Immunonephelometry was performed using skimmed milk samples diluted 10 times and yielded reproducible (coefficients of variation in within- and between-run precision lower than 9% for C3 and than 14% for C4) and accurate (linear recovery in dilution-overloading assay) data. High concentrations (mean ± SE) were found for C3 (199.32 ± 16.35 mg/L) and C4 (113.42 ± 11.16 mg/L) in colostrum samples (n = 159; days 1–5). A significant (P < 0.001) and rapid decrease was observed in transitional milk samples (n = 198; days 6–14), containing 57.71 ± 5.18 and 72.39 ± 4.98 mg/L of C3 and C4, respectively. Stable lower levels were noted in mature milk samples (n = 310; days 15–84) at 30.36 ± 1.57 mg/L for C3 (P < 0.001) and 53.38 ± 3.61 mg/L for C4 (P < 0.05). The decrease rate was different for C3 and C4, yielding a reversal of the C3/C4 ratio between colostrum and more mature milk.