BARRIERS TO CANCER SCREENING AMONGST WOMEN WITH MENTAL HEALTH PROBLEMS

The involvement of women with mental health problems in cancer screening was examined in order to explore service delivery options among this particular group. Structured interviews were used to identify the utilization of cancer screening and barriers experienced in accessing such screening among this group. The sample of women reported similar utilization rates of cancer screening as the general female population of the same Australian state. However, they identified a number of barriers to effective access to cancer screening. In response to the interview finding that consumers valued screening services from a well-known provider in a familiar environment, a series of women's health clinics were offered within a mental health service. This experience is described and was used to try to better understand barriers to cancer screening experienced by women with mental health problems. The women's health clinics were most efficiently offered in conjunction with hospital-based psychiatric services.     

Histological effects of fibrin glue on nervous tissue: a safety study in rats

BACKGROUND

Little is known of the histologic effects of fibrin glue on normal nervous tissue. To verify the safety of intracranial application of fibrin glue, we investigated the histologic effects of fibrin glue on brain tissue and intracranial nerves of rats.

METHODS

In Group I (n = 12), bifrontal craniotomy with opening of the dura and arachnoid was performed, and on one side one droplet of fibrin glue was applied into the subarachnoid space. In Group II (n = 12), a unilateral temporal craniotomy was performed, the cavernous sinus was opened, and one drop of fibrin glue was applied to the trigeminal nerve. The controls for Group II (n = 8) were operated in the same way but without application of the fibrin glue. Rats were sacrificed at 1, 3, 7, and 28 days after surgery. The brains and nerves were processed for histologic examination and were semi-quantitatively scored for neuronal damage, gliosis, edema, fibroplasia, inflammatory reaction, axonal damage, and myelin damage.

RESULTS

No differences were found in the occurrence of neuronal damage, gliosis, edema, fibroplasia, axonal damage, or myelin damage between rats with and without fibrin glue application. In Group I the inflammatory reaction seen at Day 7 was more severe on the fibrin glue side when compared to the control side. At Day 28, however, this difference had resolved.

CONCLUSIONS

In this morphological safety study, intracranial application of fibrin glue in a rat model does not induce extra brain damage, intracranial nerve damage, or scar tissue formation.     

Neck Pain and Disability Scale and the Neck Disability Index: reproducibility of the Dutch Language Versions

The first aim of this study was to translate the Neck Pain and Disability Scale (NPAD) from English into Dutch producing the NPAD–Dutch Language Version (DLV). The second aim was to analyze test–retest reliability and agreement of the NPAD–DLV and the Neck Disability Index (NDI)–DLV. The NPAD was translated according to established guidelines. Thirty-four patients (mean age 37.5 years, 68% female) with chronic neck pain (CNP), within an outpatient rehabilitation setting, participated in this study. The NPAD–DLV and the NDI–DLV were filled out twice with a mean test–retest interval of 18 days. The intraclass correlation coefficient of the NPAD–DLV was 0.76 (95% confidence interval (CI) 0.57–0.87) and of the NDI–DLV 0.84 (95% CI 0.69–0.92). The limits of agreement of the NPAD–DLV and the NDI–DLV were, respectively, ±20.9 (scale 0–100) and ±6.5 (scale 0–50). The reliability of the NPAD–DLV and the NDI–DLV was acceptable for patients with CNP. The variation (‘instability’) in the NPAD–DLV total scores was relatively large and larger than the variation of the NDI–DLV.     

A Longitudinal Comparison of Arm Morbidity in Stage I–II Breast Cancer Patients Treated with Sentinel Lymph Node Biopsy,Sentinel Lymph Node Biopsy Followed by Completion Lymph Node Dissection,or Axillary Lymph Node Dissection

Background  

Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and ALND in stage I/II breast cancer patients.     

Superior mesenteric artery stent fracture leading to recurrent mesenteric ischemia

We report 2 cases of patients with recurrent symptoms of mesenteric ischemic disease after percutaneous transluminal angioplasty (PTA) and stenting due to superior mesenteric artery stent fracture. Both patients were treated by redo PTA and stenting successfully. Stent fractures, their complications, and management are discussed.     

Which constructs can predict emotional exhaustion in a working population? A study into its determinants

The main objective of this study was to examine the psychosocial stress model developed by Taylor and Aspinwall with emotional exhaustion as the outcome variable. Respondents, 409 men and 346 women, who had a paid job for at least 20 hours per week, completed questionnaires concerning demographic variables, personality, temperament, work pressure, workload, perceived social support, appraisal, coping, and emotional exhaustion. Structural equation analyses provided only partial support for the validity of the model. First, on theoretical and statistical grounds, one more path linking external resources to social support was added. Second, contrary to expectations, coping styles did not predict emotional exhaustion. To conclude, when coping is measured retrospectively, it does not add to our understanding of emotional exhaustion. It is suggested that future studies should be longitudinal and include objective measures of stressors and psychosocial health outcomes in addition to self‐reports. Copyright © 2007 John Wiley & Sons, Ltd.     

Venous thromboembolism and cyproterone acetate in men with prostate cancer: a study using the General Practice Research Database

OBJECTIVE: To evaluate the risk of venous thromboembolism (VTE) associated with the use of cyproterone acetate (CPA) amongst men with prostate cancer. PATIENTS AND METHODS: Using data from the General Practice Research Database, cases of VTE were identified amongst men with prostate cancer. Four controls with no evidence of a VTE were selected for each case. The time from diagnosis of prostate cancer to first hormonal treatment, and from first hormonal treatment to VTE, was compared for different treatments. Adjusted risk estimates for VTE were derived from further analysis using a nested case-control study design amongst all men with advanced prostate cancer, qualified by evidence of hormonal treatment. RESULTS: The time between diagnosis and first treatment was significantly shorter for men first treated with CPA than for men first treated with a luteinizing hormone releasing hormone (LHRH) analogue (adjusted hazard ratio 1.33, 95% confidence interval, CI, 1.06-1.67). When the first treatment was CPA, the treatment-free period after diagnosis was significantly shorter for men who later had a VTE than for those who did not. The case-control study yielded an adjusted risk estimate for VTE amongst CPA users that was significantly higher than amongst men who were prescribed an LHRH analogue or who had had an orchidectomy (adjusted odds ratio 5.23, 95% CI 3.12-8.79). CONCLUSION: There was a greater risk of VTE associated with CPA, which might be due to differences in disease severity between users of different products. The clinical significance of this finding is unclear.     

Pediatric heart allocation and transplantation in Eurotransplant

Pediatric heart allocation in Eurotransplant (ET) has evolved over the past decades to better serve patients and improve utilization. Pediatric heart transplants (HT) account for 6% of the annual transplant volume in ET. Death rates on the pediatric heart transplant waiting list have decreased over the years, from 25% in 1997 to 18% in 2011. Within the first year after listing, 32% of all infants (<12 months), 20% of all children aged 1–10 years, and 15% of all children aged 11–15 years died without having received a heart transplant. Survival after transplantation improved over the years, and in almost a decade, the 1‐year survival went from 83% to 89%, and the 3‐year rates increased from 81% to 85%. Improved medical management of heart failure patients and the availability of mechanical support for children have significantly improved the prospects for children on the heart transplant waiting list.