A Study on the Compliance of the Patients with Ocular Fundus Diseases

Purpose: To investigate the compliance of the patients with ocular fundus diseases with recommendation for follow-up examination after laser treatment, and the underlying reasons for non-compliance.Methods: 53 patients with ocular fundus disease were asked to fill in a questionnaire which includes the socio-demographic characteristics, fear of the fundus disease, conception of the laser treatment and the motivation for staying healthy. Variables were compared for the compliers group and the non-compliers group by chi-square test. Result; Of the 53 subjects, 35 were classified as non-compliers and 18 were classified as compliers. There was no statistically significant difference between the two groups on all selected socio-demographic factors, conception of the laser treatment and the motivation for staying healthy. Significant difference was found between the two groups on two of those items concerning the fear of the diseases (P<0. 05). About half of the participants showed the lack of knowledge about     

Incidence of analgesic nephropathy among patients undergoing renal replacement therapy in Czech republic and Slovak republic

BACKGROUND.: The occurrence of analgesic nephropathy (AN) among renal replacementtherapy patients in former Czechoslovakia is not known. Previoussurveys were not based on representative samples and lackeduniform criteria for diagnosing the disease. METHODS.: Incidence of AN in former Czechoslovakia was investigated inpatients commencing renal replacement therapy in 24 (1/3 ofall) dialysis centres from 1 January to 31 December 1992. Patientsshowing an unclear renal diagnosis (n=149) were investigatedwith an interview and renal imaging techniques. The diagnosisof AN was withheld or rejected on the base of recently publisheddiagnostic criteria demonstrating that a decreased renal massof both kidneys combined with bumpy contours and/or papillarycalcifications had a high performance for diagnosing AN (NephrolDial Transplant 1992; 7: 479–486). RESULTS.: Based on the renal imaging criteria, AN was diagnosed in 30of 328 registered patients, resulting in an AN incidence of9.1% while the EDTA data only mentioned an incidence of 4.8%(period 1986–1989). The products most commonly abusedwere analgesic mixtures containing two analgesic substancescombined with caffeine and/or codeine. CONCLUSIONS.: AN was found to be a common disease in the Czech and SlovakRepublics. The disease was diagnosed using reliable renal imagingcriteria.     

Adjuvant immunotherapy with BCG in squamous-cell bronchial carcinoma. Immune-reactivity in relation to immunostimulation (preliminary results in a controlled trial).

Jansen, H M, The, T H, de Gast, G C, Esselink, M T, van der Wal, A M, and Orie, N G M (1978).Thorax, 33, 429-438. Adjuvant immunotherapy with BCG in squamous-cell bronchial carcinoma. Immune-reactivity in relation to immunostimulation (preliminary results in a controlled trial). Twenty-nine patients with, at operation, evidence of locally advanced primary squamous-cell bronchial carcinoma (stage II, UICC, Geneva, 1974) had lung resection to remove all the visible tumour. Postoperatively a randomly chosen group of 16 patients received adjuvant BCG immunostimulation by scarifications, while the control group received no adjuvant treatment. Follow-up studies were done from three to 23 months. Immune-reactivity in vivo with PPD and DNCB skin tests, and in vitro with E-rosetting tests and lymphocyte transformation tests with PHA, Con A, diphtheria toxoid, and PPD was monitored in 10 treated and in seven untreated patients. Recurrence rates decreased appreciably in the BCG-stimulated group after a six to 23 months'' follow-up (p<0·005). A pronounced increase in both in-vivo and in-vitro immune-reactivity went in parallel with a more favourable clinical outcome in the BCG-treated group. In these cases there was a significant increase in skin reactivity to PPD three months after surgery (p<0·025) and a statistically significant rise in lymphocyte reactivity to Con A (p<0·05), diphtheria toxoid (p<0·01), and PPD (p<0·05) but not to PHA 12 months after surgery. DNCB skin reactivity increased as well in the BCG-treated group, but the number of individuals was too small for statistical evaluation. Increase in immune responsiveness did not occur in the control group and appeared to be independent of the initial immune state of the patients. No differences were found in the numbers of E-rosetting lymphocytes in relation to immunotherapy. It is concluded that adjuvant BCG immunotherapy used in patients with minimal residual bronchial carcinoma improves the prognosis and a favourable clinical outcome is mirrored by an increase in cellular immune reactivity.     

Patterns of response and relapse in chemotherapy of extensive squamous carcinoma of the lung

Summary In a large study of combination chemotherapy for patients with extensive squamous carcinoma of the lung, 44 of 247 patients (18%) achieved>50% regression of tumor mass. The likelihood of response was significantly (and independently) higher for females and for fully ambulatory patients. Bone and liver were the most commonly involved metastatic sites, with documented involvement pretreatment in 32 and 16% of patients, respectively. Recurrence in the ipsilateral hemithorax after radiation therapy was the only clinical evidence of disease in 24% of the patients. There were no significant differences in response rate by individual metastatic sites, or for single compared to multiple sites. The median time to response was 4 weeks, with response noted by 8 weeks in 74%.Clinically evident relapse has occurred in 39. Among these, the primary site was the only clinical site of failure in 14, of whom 7 never received radiation therapy. The brain was the only site of initial failure in 6, only 1 of whom had preexisting evidence of brain involvement. Failure in a single area of previously evident disease or the brain accounted for 74% of recurrences in the responding group. These observations suggest that sequential, planned radiation therapy to sites of previous clinical involvement, together with prophylactic whole-brain radiation, may be of benefit in the drug-responsive subpopulation of patients with extensive disease.     

Neuroanatomy and pathophysiology of pain related to spinal disorders.

Sensation is achieved through the integration of many neural elements: receptors, afferent and efferent neurons, the spinal cord with its subdivisions, and the higher brain centers. One of the many sensations perceived by the human body is that of pain or nociception. To understand the concept of "back pain" associated with various spinal pathologies, some basic knowledge of the anatomy and physiology of sensation, and more specifically nociception, is necessary. This knowledge is presented herein.     

Combination of dacarbazine and mitomycin in advanced colorectal cancer

Summary Twenty evaluable patients with advanced measurable colorectal cancer received 3-week courses of a combination of IV dacarbazine 300 mg/m²/day from day 1 to day 5 and IV mitomycin 2 mg/m²/day from day 1 to day 5. Fourteen of these patients had had no prior chemotherapy and received two or more courses of this two-drug regimen. None of the patients achieved complete or partial response. Severe to life-threatening myelosuppression, was encountered in patients with prior radiotherapy and or prior chemotherapy, and/or in patients with a Karnofsky score 70. Hematologic toxicity was mild in the other patients. Nonhematologic toxic effects were generally mild to moderate and consisted essentially in nausea and vomiting. It is concluded that in our hands the regimen selected for this trial has no significant antitumor activity in advanced colorectal cancer.