The experience of therapeutic support groups by siblings of children with cancer

When a child is diagnosed with cancer, the whole family, including siblings, lives in fear of how the cancer will affect the sick child and how it will influence other family members. The aim of this article is to describe the experiences expressed by the siblings in a support group environment when their families have or have had a child diagnosed with cancer. Fifteen siblings 8 to 19 years of age with a brother or sister who was receiving treatment for or had died from cancer were interviewed after participating in therapeutic support groups. These interviews were conducted two weeks after the last group interaction and were analyzed using qualitative content analysis. Regardless of gender and age, the siblings felt a sense of belonging and comfort by being in a group, which they appreciated. They were able to share their experiences and help each other with advice and encouragement. They all drew strength from each other. A therapeutic support group for siblings of children with cancer is beneficial. Follow-up interviews with the siblings indicated they found the groups helpful in coping with their situation.     

Gene expression of PMP22 is an independent prognostic factor for disease-free and overall survival in breast cancer patients

Background  

Gene expression of peripheral myelin protein 22 (PMP22) and the epithelial membrane proteins (EMPs) was found to be differentially expressed in invasive and non-invasive breast cell lines in a previous study. We want to evaluate the prognostic impact of the expression of these genes on breast cancer.     

COX-2 inhibition improves immunotherapy and is associated with decreased numbers of myeloid-derived suppressor cells in mesothelioma. Celecoxib influences MDSC function

Background  

Myeloid-derived suppressor cells (MDSC) are a heterogeneous population of immature cells that accumulates in tumour-bearing hosts. These cells are induced by tumour-derived factors (e.g. prostaglandins) and have a critical role in immune suppression. MDSC suppress T and NK cell function via increased expression of arginase I and production of reactive oxygen species (ROS) and nitric oxide (NO). Immune suppression by MDSC was found to be one of the main factors for immunotherapy insufficiency. Here we investigate if the in vivo immunoregulatory function of MDSC can be reversed by inhibiting prostaglandin synthesis by specific COX-2 inhibition focussing on ROS production by MDSC subtypes. In addition, we determined if dietary celecoxib treatment leads to refinement of immunotherapeutic strategies.     

Injuries occurring in hospital staff attending medical emergency team (MET) calls—A prospective,observational study

Background

Clinical emergency response systems such as medical emergency teams (MET) have been implemented in many hospitals worldwide, but the effect that these systems have on injuries to hospital staff is unknown. The objective of this study was to determine the rate and nature of injuries occurring in hospital staff attending MET calls.

Methods

This study was a prospective, observational study, using a structured interview, of 1265 MET call participants, in a 650 bed urban, teaching hospital. Data was collected on the number and the nature of injuries occurring in hospital staff attending MET calls.

Results

Over 131 days, 248 MET calls were made. An average of 8.1 staff participated in each MET call. The overall injury rate was 13 (95% confidence interval (CI) 7–20) per 1000 MET participant attendances, and 70 (95% CI 38–102) per 1000 MET calls. One injured participant required time off-work, an injury requiring time off-work rate of 1 (95% CI 0–4) per 1000 MET participant attendances, or 4 (95% CI 0–27) per 1000 MET calls. The relative risk of sustaining an injury if the MET participant performed chest compressions, contacted patient body fluids on clothing or protective equipment, without direct contact to skin or mucosa, or lifted the patient or a patient body part was 11.0 (95% CI 4.2–28.6), 8.7 (95% CI 3.4–22.0) and 5.5 (95% CI 2.1–14.2), respectively.

Conclusion

The rate of injuries occurring to hospital staff attending MET calls is relatively low, and many injuries could be considered relatively minor.     

Adenoidectomy for otitis media with effusion in 2-3-year-old children

Objective

To compare the efficacy of three surgical treatment combinations - myringotomy and tympanostomy tube insertion (M&T), adenoidectomy with M&T (A-M&T), and adenoidectomy with myringotomy (A-M) - in reducing middle-ear disease in young children with chronic OME.

Methods

Children 24-47 months of age, with a history of bilateral middle-ear effusion (MEE) for at least 3 months, unilateral for 6 months or longer or unilateral for 3 months after extrusion of a tympanostomy tube, unresponsive to recent antibiotic, were randomly assigned to either M&T, A-M&T, or A-M. Treatment assignment was stratified by age (24-35 months, 36-47 months), nasal obstruction (no, yes) and previous history of M&T (no, yes). Subjects were followed monthly and with any signs or symptoms of ear disease for up to 36 months.

Results

Ninety-eight subjects were randomly assigned to the three treatment groups. Fifty-six subjects (57%) were 24-35 months of age; 63% had nasal obstruction, and 36% had previously undergone M&T. During the 36 months after entry, subjects were noted to have MEE for the following percentages of time: 18.6% in the M&T group, 20.6% in the A-M&T group, and 31.1% in the A-M group (M&T vs. A-M&T, p = 0.87; M&T vs. A-M, p = 0.01). By 36 months, there were no differences in the number of further surgical procedures for ear disease needed among the groups.

Conclusions

Adenoidectomy with or without tube insertion provided no advantage to young children with chronic OME in regard to time with effusion compared to tube insertion alone. Fewer tympanostomy tubes were placed in children undergoing A-M as their initial procedure, but this should be balanced by the performance of the more invasive surgical procedure and their increased time with effusion.     

Nutrient and food group intakes of women with and without bulimia nervosa and binge eating disorder during pregnancy

BACKGROUND: Little is known concerning the dietary habits during pregnancy of women with eating disorders that may lie in the causal pathway of adverse birth outcomes. OBJECTIVE: We examined the nutrient and food group intakes of women with bulimia nervosa and binge-eating disorder during pregnancy and compared these with intakes of women with no eating disorders. DESIGN: Data on 30,040 mother-child pairs from the prospective Norwegian Mother and Child Cohort Study were used in cross-sectional analyses. Dietary information was collected by using a food-frequency questionnaire during the first half of pregnancy. Statistical testing by eating disorder categories with the non-eating-disorder category as the referent group was conducted by using log means adjusted for confounding and multiple comparisons. Food group differences were analyzed by using a Wilcoxon's two-sided normal approximation test that was also adjusted for multiple comparisons. RESULTS: Women with binge-eating disorder before and during pregnancy had higher intakes of total energy, total fat, monounsaturated fat, and saturated fat, and lower intakes of folate, potassium, and vitamin C than the referent (P < 0.02). Women with incident binge-eating disorder during pregnancy had higher intakes of total energy and saturated fat than the referent (P = 0.01). Several differences emerged in food group consumption between women with and without eating disorders, including intakes of artificial sweeteners, sweets, juice, fruit, and fats. CONCLUSION: Women with bulimia nervosa before and during pregnancy and those with binge-eating disorder before pregnancy exhibit dietary patterns that differ from those in women without eating disorders, that are reflective of their symptomatology, and that may influence pregnancy outcomes.     

Using NMR metabolomics to identify responses of an environmental estrogen in blood plasma of fish

Nuclear magnetic resonance (NMR) based metabolomics in combination with multivariate data analysis may become valuable tools to study environmental effects of pharmaceuticals and other chemicals in aquatic organisms. To explore the usefulness of this approach in fish, we have used 1H NMR metabolomics to compare blood plasma and plasma lipid extracts from rainbow trout exposed to the synthetic contraceptive estrogen ethinylestradiol (EE2) with plasma from control fish. The plasma metabolite profile was affected in fish exposed to 10 ng/L but not 0.87 ng/L of EE2, which was in agreement with an induced vitellogenin synthesis in the high dose group only, as measured by ELISA. The main affected metabolites were vitellogenin, alanine, phospholipids and cholesterol. The responses identified by this discovery-driven method could be put in context with previous knowledge of the effects of estrogens on fish. This adds confidence to the approach of using NMR metabolomics to identify environmental effects of pharmaceuticals and other contaminants.