Program characteristics of home-delivered meals programs for persons with HIV and AIDS

The nutritional status of persons with HIV and AIDS [PWAs] is constantly challenged throughout the progression of the illness. Home-delivered meals programs for PWAs are rapidly developing across the country to address this problem among the growing population of people with HIV infection and AIDS. This study examined client socio-demographic characteristics (sex, age, ethnicity), types of services offered by these programs, organizational and financial criteria, and characteristics of survey respondents.Data for this study was obtained from 15 of the 17 known home-delivered meals programs for PWAs in the United States through an original, cross-sectional survey instrument conducted by telephone interview between March 1994 and May 1994.Results from this study show an increase in the number of minority populations who participate in these programs (36% African-American and 12% Hispanic vs. 51% Caucasian), as well as women (17.2%) and children (7%). Geographic location was an important determinant for program eligibility. The number of meals served weekly varied greatly (from 510 to 12,600 per week). Other significant services included nutrition counselling, newsletters, and holiday-basket programs. Enhancing service-delivery systems was one of the more prevalent high-priority concerns cited, especially with regard to food quality and safety.These results show that these programs are catering increasingly to minority populations, women and children, and that they are expanding their services to meet the growing needs of their client populations. These findings suggest that there is a greater need for meals and other home-based services for persons living with HIV and AIDS.This research was supported by the Massachusetts Department of Public Health.He formerly was Director of Elder Health at the Massachusetts Department of Public Health, Boston, MA; he is a founder and serves on the Board of Directors of Community Servings     

Anti-tumour activity of bisphosphonates in human myeloma cells

Multiple myeloma is a haematological malignancy characterized by an expansion of malignant plasma cells within the bone marrow and is frequently associated with bone disease involving the development of osteolytic bone lesions, pathological fractures, osteoporosis and hypercalcaemia. A class of anti-resorptive drugs known as bisphosphonates have been in use to treat osteoclast-mediated bone diseases for the past 3 decades, and are currently proving effective in the treatment of the bone disease associated with multiple myeloma. Recent studies have suggested that bisphosphonate treatment may also result in an improvement in survival in some patients with multiple myeloma. These effects on survival may reflect an indirect effect of the bisphosphonates on tumour growth, via inhibition of osteoclast activity and hence a reduction in the release of tumour growth factors. However, it is also possible that bisphosphonates may have a direct effect on myeloma cells. In support of this we have demonstrated that bisphosphonates can decrease cell proliferation and induce apoptosis in human myeloma cells in vitro, and this review discusses the possibility that bisphosphonates may have not only an anti-resorptive action, but may also have a direct anti-tumour activity.     

The trough line: a radiographic sign of posterior shoulder dislocation.

Over 50% of posterior dislocations of the shoulder are not recognized initially because of failure to appreciate the subtle clues available on the standard frontal projection. In 15 of 20 cases of posterior dislocation, two parallel lines of cortical bone were identified on the medial aspect of the humeral head. One line represents the medial cortex of the humeral head. The other was found to represent the margin of a troughlike impaction fracture. This is designated the "trough line". This line proved to be an important clue in the recognition of posterior dislocations of the shoulder.     

RTOG Phase I study on fast neutron teletherapy for squamous cell carcinoma of the esophagus

From August, 1977, through January, 1981, the Radiation Therapy Oncology Group sponsored a Phase I study (RTOG 77-09) on the use of fast neutrons for treating inoperable squamous cell carcinomas of the esophagus. A total of 39 evaluable patients were treated with curative intent using either fast neutrons alone or in combination with low LET irradiation as part of a mixed beam fractionation scheme. Actuarial survival curves are presented for both the "neutrons alone" and the "mixed beam" treatment groups. There was no significant survival difference between these groups of patients. The projected survival at two years is less than 10%, which is comparable with megavoltage photon results for an unselected series of patients. The size of the primary lesion and the initial Karnofsky performance status were found to be the most important prognostic indications for prolonged survival. Sixteen of 39 patients were felt to have achieved local clearance of their tumor at some time during their follow-up with the median time until a local recurrence being 17 months. Treatment related complications and patterns of metastatic spread are discussed. In general, it appeared that the response of large tumors to neutron irradiation resulted in necrosis and fistula formation. In many cases this was accompanied by persistent/recurrent tumor within the high dose radiation volume.     

X-Ray Structure and Crystal Lattice Interactions of the Taxol Side-Chain Methyl Ester

A colorless, parallelepiped crystal of methyl (2R,3S)-N-benzoyl-3-phenylisoserinate belonging to the space group P2_l with a = 5.414(4), b = 7.813(1), c = 17.802(7) , = 90.87(4)°, Z = 2, V = 752.9 ³, D _calc = 1.32 g cm^–3, and µ_calc = 1.02 cm^–1 was selected and the structure solved using direct methods. Refinement led to a final R = 0.079 for 819 [F _o 5(F_o)] reflections. Intermolecular hydrogen-bonding interactions are prevalent in the crystal lattice of this compound.