Psychosocial needs of families with a child with cancer

PURPOSE: The aims of this study were to map the problems and needs of children with cancer and their families with regard to possible psychosocial interventions, and to do an acceptability study of different ways to provide support. METHODS: The authors performed a cross-sectional structured telephone interview with 56 parents of children with cancer and 13 adolescents from these families. On 0 to 10 analog scales, parents and adolescents rated the importance of different needs, how these needs had been met, the acceptability of different ways of providing supportive interventions, how often these ways had been used, and comfort using them. RESULTS: Parents' mean rating of importance of information needs was 9.42, peer social support 7.84, and self-management therapy 9.21. The ratings of how well these needs had been met were 8.05, 5.30, and 7.13, respectively. Both parents and adolescents ranked getting information written on paper highest, preferred to communicate in a face-to-face support group for peer social support, and preferred a therapist for self-management therapy. The comfort ratings for using different ways to provide the interventions were all high, as was access; 89% of families had computers in their homes, 76% had Internet access. CONCLUSIONS: The needs for information, peer social support, and self-management therapy are all high. There is still room to meet these needs better. Using paper-based, telephone, computer CD, or an interactive Web-based intervention package all seem to be acceptable and accessible ways to meet the needs and might reduce the risk of families developing psychosocial problems.     

Bradykinin induces a B2 receptor-mediated calcium signal linked to prostanoid formation in human gingival fibroblastsin vitro

The aim of the study was to determine the effect of bradykinin (BK) on the level of cytoplasmic-free Ca²⁺, [Ca²⁺]_i, in human gingival fibroblasts and its relation to BK-induced prostanoid formation. BK, but not des-Arg⁹-BK, induced a significant rapid (within seconds) and transient increase in [Ca²⁺]_i, that was not dependent on extracellular Ca²⁺. The stimulatory effect of BK was seen in concentrations at or above 10^–8 M, with the most pronounced effect at 10^–6 M.d-Arg⁰–Hyp³–Thi^5,8–dPhe⁷-BK, a BK B2 receptor antagonist, but not des-Arg⁹–Leu⁸-BK, a BK B1 receptor antagonist, blocked BK-induced rise in [Ca²⁺]_i. The BK B2 receptor antagonist also significantly reduced BK-induced PGE₂ formation. When extracellular Ca²⁺ in the incubation medium was depleted, either by addition of EGTA or by omission of Ca²⁺ addition, BK still caused a significant stimulation of PGE₂ formation. The calcium ionophores A23187 and ionomycin, similar to BK, caused a burst of PGE₂ formation. The two phorbol esters phorbol 12,13-dibutyrate and 4--phorbol-didecanoate positively amplified calcium ionophore A23187-induced PGE₂ formation. The results indicate that BK-induced PGE₂ formation in gingival fibroblasts is coupled to an increase in [Ca²⁺]_i mediated by the BK B2 receptor, and which is independent of extracellular Ca²⁺.     

Brain ATP:l-methionine S-adenosyltransferase (MAT), S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH): regional distribution and age-related changes

The distribution of the activity of the enzyme methionine adenosyltransferase (ATP:l-methionine S-adenosyltransferase, EC 2.5.1.6, MAT) was investigated in human postmortem brains of individuals without a known history of neuropsychiatric disorders. The brain regions were the frontal, temporal, parietal and occipital cortices, nucleus caudatus, putamen, globus pallidus, thalamus and white matter. The activities in the nucleus caudatus and putamen were approximately 25% higher than the activities in the seven other brain regions, however, not on a statistically significant level. The apparent values of MAT K_m and V_max in the parietal cortex were 11.41 ± 3.51 μM methionine and 25.72 ± 3.90 nmol/mg protein/h, respectively. In the frontal cortex, a significant positive correlation between age and the activity of MAT was found (r = 0.997, P<0.01). Concerning MAT stability in the rat brain, there was a steady decrease in the activity with postmortem time in the brains kept for 0–72 h at room temperature (23°C), which reached the level of significance at 24 h. The activity did not change significantly when the brains were kept for 120 h at 4°C, or by freezing and thawing the tissue before analysis. In a parallel study in rats of different ages (2–22 months), a homogeneous distribution of SAM and SAH was observed in the cortex, striatum, midbrain, hypothalamus, brainstem and cerebellum. The lowest levels of SAM and the highest levels of SAH observed in the striatum gave the lowest SAM/SAH ratio. The SAH content of rat cerebral cortex was highest in the oldest group. The levels of S-adenosylmethionine (SAM) decreased by 38% and that of S-adenosylhomocysteine (SAH) increased by 200% when the brains were kept for 2 h at 23°C. In the brains kept for 24 h at 4°C, the levels of SAM decreased by 70% while those of SAH increased by 240%.     

A 1-year combined weight-bearing training program is beneficial for bone mineral density and neuromuscular function in older women

Forty-eight community living women 66–87 years old volunteered to participate in a 12-month prospective, randomized, controlled, trial. The aim was to determine if a combined weight-bearing training program twice a week would be beneficial to bone mineral density and neuromuscular function. The participants were pairwise age-matched and randomly assigned to either an exercise group (n=24) or a control group (n=24). Twenty-one subjects in the intervention group and 19 in the control group completed the study. The exercise program lasted for 50 min and consisted of a combination of strengthening, aerobic, balance and coordination exercises. The mean percentage of scheduled sessions attended for the exercise group was 67%. At the completion of the study, the intervention group showed significant increments in bone mineral density of the Wards triangle (8.4%, P<0.01) as well as improvement in maximum walking speed (11.4%, P<0.001) and isometric grip strength (9.9%, P<0.05), as compared to the control group. The conclusion was that a combined weight-bearing training program might reduce fracture risk factors by improving bone density as well as muscle strength and walking ability. This program could be suitable for older community living women in general, and might, therefore, have important implications for fracture prevention.     

Fertility after discontinuation of levonorgestrel-releasing intrauterine devices

The conception rate and outcome of pregnancy of twenty-one women who had been using a levonorgestrel-releasing intrauterine contraceptive device and who had had the device removed because of planned pregnancy were studied. Eighteen women (85.7 per cent) conceived during the follow-up period. All but one of the pregnancies ended in the birth of a full-term healthy child.     

Aminooxyacetic acid induced accumulation of GABA in the rat brain

The effect of aminooxyacetic acid (AOAA, 90 mg/kg i.v.) on bicuculline, picrotoxin and 3-mercaptopropionic acid (3-MPA) induced convulsions and on GABA concentrations in cerebellum, whole brain and a synaptosomal fraction of whole brain was investigated. At various intervals after AOAA the rats were either injected with one of the convulsive drugs or sacrificed for analysis of the GABA concentration. AOAA caused a rapid initial (0-30 min) and a later slower increase of GABA in cerebellum and whole brain. In the synaptosomal fraction the GABA accumulation was delayed and less pronounced when compared to the whole brain. The bicuculline induced convulsions were markedly potentiated during the first hour but completely blocked from 2-6 h after AOAA. Picrotoxin showed a somewhat different pattern to bicuculline in the interactions with AOAA. The initial strong potentiation was not observed but the later phase of protection was present. In the interactions with 3-MPA, the effect of AOAA was always protective. The time to onset of convulsions was gradually increased during the first 30 min after AOAA. This protective effect remained practically unchanged up to 6 h after AOAA. However, once started, the convulsions were generally of the same duration and intensity. The results can be interpreted as GABA accumulating after AOAA stimulates GABA receptors to a degree more or less proportional to the whole brain GABA concentration and further that GABA synthetized in neurons is liberated, stimulates inhibitory bicuculline sensitive (predominant) and excitatory bicuculline insensitive receptors and is captured to a large extent by non-neuronal cells.