Physical symptoms/side effects during breast cancer treatment predict posttreatment distress

Background: Studies suggest that the period following completion of treatment can be distressing for cancer patients. One potentially important predictor of distress is physical symptoms/side effects during treatment.Purpose: A longitudinal, observational design was used to examine whether the number of physical symptoms/side effects experienced during treatment was a correlate of cancer-related distress and general distress 4 months after treatment completion, as measured by the Impact of Events Scale and the Mental Health subscale of the Short Form-36, respectively.Methods: Participants were 151 women who had completed chemotherapy and/or radiotherapy for ductal carcinoma in situ or stage 1 or 2 breast cancer. Hierarchical multiple regression was conducted with relevant sociodemographic, clinical, and psychiatric variables entered as controls.Results: Greater physical symptoms/side effects predicted greater total cancer-related distress, intrusive thoughts, and general distress. Physical symptoms/side effects did not significantly predict avoidance. Follow-up analyses indicated that the relationship between physical symptoms/side effects and general distress was mediated by both total cancer-related distress and intrusive thoughts.Conclusions: These results suggest that patients who experience greater physical symptoms/side effects during treatment are at greater risk for later cancer-related distress and, in turn, general distress. Future research should evaluate whether early intervention with these patients is effective in preventing or reducing distress in the posttreatment period. This work was supported by a grant from the National Cancer Institute (5R01 CA082822).     

An Integrated Technique for Identification of Differential Genes Expressed in Patients with Cancer

Summary: To develop a method for identification of differential gene expression between different cell populations, several convenient techniques of molecular biology, including subtractive hybridization, suppression PCR, T/A cloning and sequencing, were used to identify genes expressed differentially in CD45^- and CD45^- cells isolated from U266 cell line of multiple myeloma. Our results showed that the levels of abundant genes scale down 20 times through subtractive hybridization.Plasmid DNA from CD45^- cell clones was hybridized with forward or backward cDNA probes synthesized from CD45^- and CD45 cells, respectively. A few of differentially expressed genes reconfirmed by RT-PCR were identified from 500 expressed clones of CD45^- cells. It is concluded that a strategy for gene expression identification developed from conventional molecular biological methods can be used in different laboratories.     

Rapid Progression of Native Renal Artery Fibromuscular Dysplasia Following Kidney Donation

Fibromuscular dysplasia is the second commonest anatomical abnormality apart from multiple renal arteries in the potential live donors. Pretransplant evaluation of the donors may include an angiography to evaluate the renal arteries, and failure to recognize renal arterial stenosis, particularly fibromuscular dysplasia, by noninvasive methods may eventually lead to hypertension and ischemic renal failure. We report a case of fibromuscular dysplasia that was undetected by computed tomographic angiography prior to donation. One year after kidney donation, it rapidly progressed to severe symptomatic stenosis with hypertension and acute renal failure. Following renal artery angioplasty, her blood pressure normalized over a period of 2 weeks without any need for antihypertensive medications and the serum creatinine returned to her baseline. The acceptability of renal donors with fibromuscular dysplasia depends on the age, race and the availability of the other suitable donors. Mild fibromuscular dysplasia in a normotensive potential renal donor cannot be considered a benign condition. Such donors need regular follow-up postdonation for timely detection and treatment.     

Biliopancreatic diversion with duodenal switch vs. gastric bypass for severe obesity

Conclusion In the year 2003 there is no “one best bariatric operation” for every severely obese patient. The choice of operation must be tailored to each individual patient’s needs and wishes. For the superobese patient, the patient diagnosed with intestinal metaplasia of the stomach, and for those patients who do not wish to undergo the severe dietary restrictions imposed by the RNY-GB, the BPD-DS is a valuable surgical option.     

Advances in the treatment of depression in older adults

Depressive symptoms in older adults are common, but the minority of elderly meet criteria for major depressive disorder. This has led to confusion regarding the recognition of diagnosis, approach to treatment, and monitoring of outcomes in this needy population. Few depressed older adults are willing to seek treatment from psychiatrists or mental health specialists. Treatment approaches to the depressive spectrum of disorders in late life, which encompasses major and minor depressive disorder, dysthymic disorder, and mood disorders related to medical conditions, must include evidence-based algorithms that can be delivered in a variety of health care settings. Several recent multisite trials have advanced the use of collaborative care models and the systematic stepwise approach to the treatment of depression and anxiety states in older adults. This offers the ability to provide effective treatment of depression for older adults, consistent with current guidelines, in primary care and specialized health care settings.     

Effects of trichostatins on differentiation of murine erythroleukemia cells

The fungistatic antibiotics trichostatins (TS) A and C were isolated from culture broth of Streptomyces platensis No. 145 and were found to be potent inducers of differentiation in murine erythroleukemia (Friend and RV133) cells at concentrations of 1.5 X 10(-8) M for TSA and 5 X 10(-7) M for TSC. Differentiation induced by TS was cooperatively enhanced by UV irradiation but not by treatment with dimethyl sulfoxide. This enhanced activity was completely inhibited by adding cycloheximide to the culture medium 2 h after exposure to TS, suggesting that TS are dimethyl sulfoxide-type inducers of erythroid differentiation. No inhibitory effect of TS was observed on macromolecular synthesis in cultured cells.     

Probable pre- and postsynaptic modifications by 5-hydroxytryptamine of contractile responses to electrical stimulation of isolated guinea-pig vas deferens

Two kinds of electrical stimulation, low frequency stimulation (5 Hz, 1 msec, 5 pulses, every 20 sec) and high frequency stimulation (30 Hz, 0.05-0.1 msec, 10 pulses, every 20 sec), produced contractions in the isolated guinea-pig vas deferens. These responses were blocked by tetrodotoxin but not hexamethonium. Phentolamine potentiated the contractions produced by low frequency stimulation, while it reduced the contractions produced by high frequency stimulation. Diametrically, 5-hydroxytryptamine reduced the contractions produced by low frequency stimulation, while it potentiated the contractions produced by high frequency stimulation. These inhibitory and potentiating actions of 5-hydroxytryptamine were reversed by cyproheptadine and 2-bromolysergic acid diethylamide. Moreover, that 5-hydroxytryptamine produced a depolarization of the smooth muscle membrane was shown by the sucrose gap technique. The results suggest that a 5-hydroxytryptamine receptor exists pre- and postsynaptically in the neuroeffector transmission of the guinea-pig vas deferens, that the stimulation of the presynaptic receptor by 5-hydroxytryptamine inhibits the release of a transmitter from noradrenergic nerves, and that the stimulation of the postsynaptic receptor by a high concentration of 5-hydroxytryptamine produces a depolarization of the smooth muscle membrane, and this relates to the potentiation of contractile responses.