Childhood cancer: its impact and financial costs for Australian families

This study evaluated the impact and financial costs of childhood cancer for Australian families by means of a nonrandomized retrospective cross-sectional survey at the oncology department of a large metropolitan pediatric hospital. The Family Impact Scale (a standardized questionnaire) and the self-reported economic burden (a questionnaire on expenses and lifestyle changes) were utilized. Results of the family impact score were compared to a previously published cohort of children with insulin-dependent diabetes mellitus. The participants were 56 parents of children newly diagnosed with cancer in the year 2002. In addition to the expected high social and emotional impacts, the majority of families reported suffering from great or moderate economic hardship. Factors predictive for families at risk included single parenthood, lower household income, and greater distance from the hospital. The results show that the distribution of resources is not equitable and is currently failing to negate significant financial stresses for many Australian families.     

Effects of three‐month streptozotocin‐induced diabetes in mice on blood platelet reactivity,COX‐1 expression and adhesion potential

Diabetes is associated with an increased risk of cardiovascular disease. This is partially attributed to an altered activation status of blood platelets in this disease. Previously, alterations have been shown in COX‐1 and protease activated receptor (PAR)‐3 receptor expression in platelets in two animal models of diabetes, there have not been studies which address expression of these proteins in mice with long‐term streptozotocin (STZ)‐induced diabetes. We have also addressed the effect of diabetes on platelet adhesion under flow conditions. With the use of flow cytometry, we have shown that certain markers of platelet basal activation, such as active form of α_IIbβ₃ and of CD40L were increased in STZ‐induced diabetic mice. Platelets from STZ‐induced diabetic mice were also more reactive when stimulated with PAR‐4 activating peptide as revealed by higher expression of active form of α_IIbβ₃, membrane‐bound on vWillebrand Factor and binding of exogenous fluorescein isothyanate‐labelled fibrinogen. Expression of COX‐1 and production of thromboxane A₂ in platelets of STZ‐induced diabetic mice were higher than in control animals. We observed no effect of diabetes on ability of platelets to form stable adhesions with fibrinogen in flow conditions. We conclude that although certain similarities exist between patterns of activation of platelets in animal models of diabetes, the differences should also be taken into account.     

Depletion of alveolar macrophages decreases the dissemination of a glucosylceramide-deficient mutant of Cryptococcus neoformans in immunodeficient mice

In previous studies we showed that a Cryptococcus neoformans mutant lacking glucosylceramide (Deltagcs1) is avirulent and unable to reach the brain when it is administered intranasally into an immunocompetent mouse and is contained in a lung granuloma. To determine whether granuloma formation is key for containment of C. neoformans Deltagcs1, we studied the role of C. neoformans glucosylceramide in a T- and NK-cell-immunodeficient mouse model (Tgepsilon26) in which alveolar macrophages (AMs) are not activated and granuloma formation is not expected. The results show that Tgepsilon26 mice infected with Deltagcs1 do not produce a lung granuloma and that the Deltagcs1 mutant proliferates in the lungs and does disseminate to the brain, although its virulence phenotype is dramatically reduced. Since Deltagcs1 can grow only in acidic niches, such as the phagolysosome of AMs, and not in neutral or alkaline environments, such as the extracellular spaces, we hypothesize that in immunodeficient mice Deltagcs1 proliferates inside AMs. Indeed, we found that depletion of AMs significantly improved Tgepsilon26 mouse survival and decreased the dissemination of Deltagcs1 cells to the central nervous system. Thus, these results suggest that the growth of Deltagcs1 in immunodeficient mice is maintained within AMs. This study highlights the hypothesis that AMs may exacerbate C. neoformans infection in conditions in which there is severe host immunodeficiency.     

The analgesic effectiveness of laser therapy in patients with gonarthrosis: an evaluation

Background. Osteoarthrosis is a very common disease of the musculo-skeletal system. Laser therapy can be used to alleviate the pain associated with this syndrome, which markedly impinge the patients physical comfort and limit physical activity. Material and methods. The research involved 32 patients (26 women and 6 men, average age 57.3 A+/-12.1 years) with pain complaints in one knee joint and radiologically confirmed degenerative changes. The control group consisted of 32 matched patients awaiting treatment. Laser biostimulation was applied with a semiconductor laser (400 mW, wave length 810 nm). Contact (point) irradiation was applied, with a surface energy density of 12.7 J/cm2. One series of 10 procedures was performed on one knee joint, 5 days a week. Pain intensity was evaluated with the Visual Analogue Scale (VAS) and a modified version of the Laitinen questionnaire. Results. In 29 patients (91%) there was a statistically significant reduction in pain complaints in the affected knee measured by VAS. In 19 patients (59%) there was a statistically significant reduction in the frequency and intensity of pain complaints on the Laitinen questionnaire. The improvement in daily motor activity and the reduced use of antalgesic drugs were not statistically significant. Conclusions. Laser biostimulation in patients with knee pain reduces symptoms on the VAS, and significantly reduces the intensity and frequency of pain as assessed by the Laitinen questionnaire. One series of laser treatments has no significant effect on motor activity and use of painkillers in patients with chronic knee pain due to osteoarthrosis.     

Risk of preeclampsia in HIV-positive pregnant women receiving HAART: a matched cohort study

Objective: We sought to determine whether HIV-positive women receiving highly active anti-retroviral therapy (HAART) are at higher risk for preeclampsia than HIV-negative women. Secondary outcomes included comparing the risks of preterm birth, low birth weight, and small for gestational age birth in these women. Methods: In this retrospective matched cohort study, we compared the pregnancy outcomes of HIV-positive women treated with HAART with those of HIV-negative women who gave birth at Mount Sinai Hospital, Toronto, Ontario. Data were ascertained through chart review. Univariate and multivariate logistic regression models were used to compare pregnancy outcomes between the two groups. Results: Ninety-one HIV-positive pregnant women receiving HAART and 273 HIV-negative pregnant women were identified. After adjusting for confounding factors, there was no difference between HIV-positive and HIV-negative women in the odds of preeclampsia (3.3% vs. 5.1%; adjusted odds ratio [aOR] 0.59; 95% CI 0.11 to 3.08), preterm birth (15.6% vs. 11.4%; aOR 1.70, 95% CI 0.79 to 3.66) or small for gestational age infants (20.2% vs. 8.8%; aOR 2.08, 95% CI 0.89 to 5.24). HIV-positive women treated with HAART had increased odds of giving birth to a low birth weight infant compared to HIV-negative women (20.2% vs. 9.9%; aOR 2.91; 95% CI 1.47 to 5.78). Conclusion: In this cohort, HIV-positive women on HAART did not demonstrate a higher risk of preeclampsia, preterm birth, or small for gestational age infants; however, they did have a higher risk of having low birth weight infants.