Development and validation of an instrument to measure the effects of a mistletoe preparation on quality of life of cancer patients: The Life Quality Lectin-53 (LQL-53) Questionnaire

Mistletoe preparations standardised to the content of mistletoe lectin are supposed to improve quality of life (QoL) in patients with cancer. To obtain a validated and sensitive research instrument, the Life Quality Lectin-53 (LQL-53) Questionnaire was developed in three phases: item generation via interviews with 42 patients, item selection by means of a study with 109 cancer patients, and psychometric testing. The LQL-53 includes 46 items assigned to the subscales 'General well-being', 'Emotional well-being', 'Vitality' 'Hope', 'Locus of control', Social relationships', and 'Physical complaints', plus seven items dealing with possible adverse effects of mistletoe treatment. Psychometric testing was carried out in a study with 112 patients with solid tumours who were treated with a mistletoe preparation standardised to mistletoe lectins for 12 weeks. Internal consistency (Cronbach's alpha) was between 0.72 and 0.94. Test-retest reliability was > or = r of 0.72. Subscales correlated highly with external criteria. Construct validity, as determined by Multitrait Scaling Analysis, resulted in an optimal assignment of items to subscales (scaling success) for four of the subscales. During the course of the therapy, significant improvement in QoL was found in all subscales. In two of the subscales, effect size was high (>0.80), and in five other subscales it varied between 0.53 and 0.78.     

Improved surface coil imaging in MR: decoupling of the excitation and receiver coils

We obtained magnetic resonance images with good sensitivity and radio frequency (RF) uniformity using separate transmitter and receiver coils. The excitation, namely, the rotation of the magnetization vector into a plane perpendicular to the magnetic field, was done by applying a homogeneous RF magnetic field produced by a large saddle-shaped coil. Surface coils were used for detection only. Because two coils that operated on the same resonance frequency were used, a coupling problem developed. This problem, which involved inhomogeneity of the RF magnetic field caused by the large current induced in the surface coil during excitation, could only be solved by minimizing the mutual inductance or maximizing the impedance of the surface coil resonance circuit during excitation. We were able to solve this problem using an electronic detuning method.     

Understanding and addressing cognitive bias in medical education

Cognitive biases can impede the utilization of logical/statistical strategies in clinical decision-making. This paper reports on research and educational findings using the Inventory of Cognitive Biases in Medicine (ICBM). The ICBM was administered to groups of medical students before their clinical years and to practicing physicians to determine (a) the extent of cognitive bias in medical decision-making and whether experienced physicians differed from novices, (b) whether cognitive bias varied by medical speciality and (c) whether awareness of cognitive bias in medical decision-making could be taught. Preclinical medical students' mean score (41 %) was near the chance level (42%). While practicing physicians scored higher (49%), they also demonstrated considerable susceptibility to cognitive bias. Cognitive bias varied by medical speciality with internal medicine physicians (57%) scoring best on the ICBM. A controlled educational research study with preclinical medical students showed that learners exposed to a seminar on cognitive bias in medical decision-making scored better on the ICBM than their peers (55% vs. 41%, p < 0.001). Susceptibility to cognitive bias was found to be present substantially among both novices and experts in medicine, but carefully crafted educational strategies in both classroom and clinical settings may lessen the problem.     

Morphological and Morphometrical Description of Trichostrongylus Species Isolated from Domestic Ruminants in Khuzestan Province,Southwest Iran

Backgrounds

Genus Trichostrongylus (Nematoda: Trichostrongylidae) is one of the most important zoonotic nematodes with wide geographic distribution in the world. The purpose of the present study was to describe morphological and morphometrical characteristics of male Trichostrongylus species, currently prevalent in domestic ruminants of Khuzestan Province, southwest Iran.

Methods

Gastro-intestinal organs of 1600 sheep, goats, cattle, and buffalos, slaughtered in Khuzestan Province, southwest Iran, were examined for infectivity with Trichostrongylus species. For examination and measurements of helminthes, Azo-carmine staining was performed, followed by camera lucida drawings of morphological characters and measurements of morphometrical criteria with a calibrated microscope. Using valid nematodes systematic keys, almost all the parasites were identified at the level of species.

Results

Overall, 114 animals were found infected with at least one species of Trichostrongylus. Considering morphological characteristics of male Trichostrongylus, six species were identified including T. colubriformis, T. vitrinus, T. probolorus, T. capricola, T. longispicularis and Trichostrongylus sp.

Conclusion

Although, compared to the previous decades, currently Trichostrongylus is much less prevalent in the domestic ruminants of the study area, but still different species occur in these animals.     

Acute and chronic effects of four commercial herbicide formulations on Ceriodaphnia dubia

Toxicity tests with Ceriodaphnia dubia were conducted to determine acute (48 h) and chronic (7-day survival and reproduction) effects of four commonly used herbicide formulations. The 48-h LC50s in decreasing order of toxicity were 14.36 mg/L (Micro-Tech^®), 15.93 mg/L (Bicep^®), 32.99 mg/L (Extrazine^®), and 35.36 mg/L (Lexone^®). Reduced reproduction was detected at concentrations below 48-h LC50s for three of the formulations. The 7-day chronic values (ChV) based on reproduction were 17.68 mg/L (Micro-Tech^®), 8.84 mg/L (Bicep^®), 17.68 mg/L (Extrazine^®), and 8.84 mg/L (Lexone^®). The acute-to-chronic ratios (ACRs) for Micro-Tech^® (0.81), Bicep^® (1.80), Extrazine^® (1.86), and Lexone^® (4.00) indicate a relatively narrow range between acute and chronic sensitivity in daphnids. A comparison of these response data to environmental concentrations suggests these herbicides are not likely to directly impact invertebrates. Potential impacts on plants and human health should be of primary ecological and regulatory concern.     

Shigellosis in Kentucky, 1986 through 1989

A marked increase in the number of cases of shigellosis was reported in Kentucky in 1988. To examine reasons for this increase, we reviewed the 389 cases of shigellosis reported from 1986 through 1989. Ninety-three percent (285/305) of cases due to known species were due to Shigella sonnei. Sixty-two percent (243/389) of cases occurred in children less than 10 years of age. The annual incidence for blacks (6.8 cases per 100,000) was nearly four times that for whites (1.8 per 100,000). The increased number of cases in 1988 was due to outbreaks in five areas of the state, which accounted for 85% (200/234) of the cases. Three of the five outbreaks involved day-care centers. The primary mode of transmission appeared to be person-to-person; there was no evidence of a common source of infection from food or water. To prevent future outbreaks, cases of shigellosis need to be reported promptly to ensure appropriate investigation and control by local health departments.     

Synapsin I-like immunoreactivity in nerve fibers associated with lingual taste buds of the rat

Immunoreactivity to synapsin I, a neuronal phosphoprotein, was localized in free-floating tissue sections prepared from lingual tissue of rats. Many nerve fibers within the tissue exhibited clear immunoreactivity including motor endplates on striated muscle, autonomic fibers innervating blood vessels or glands, and sensory fibers innervating muscles or the lingual epithelium including taste buds. Numerous immunoreactive fibers occurred within each taste bud, with fewer, fine fibers being dispersed in the epithelium between taste buds. The majority of the intragemmal immunoreactive fibers extended throughout the taste buds most of the distance outward from the basal lamina toward the surface of the epithelium. Fine, perigemmal fibers reached nearly to the epithelial surface. Ultrastructural analysis of the immunoreactive sensory fibers revealed that synapsin I-immunoreactivity occurred diffusely throughout the cytoplasm, and heavily in association with microvesicles. The synaptic vesicles at the taste receptor cell-to-afferent fiber synapse were, however, not immunoreactive for synapsin I, although these vesicles fall into the size class shown to be immunoreactive in other systems. This absence of synapsin I may be a common property of vesicles in axonless short receptor cells.     

Treatment of leg ulcers with an allogeneic cultured-keratinocyte-collagen dressing

A living cellular allogeneic dressing made up of cultured keratinocytes adhering to a collagen film was used to treat 20 leg ulcers of various aetiologies in 16 patients. A reduction in pain was noted in 80% of cases, and promotion of granulation tissue in the ulcer bed in 70% of cases. In 10 patients, epithelialization of 71 +/- 29% of the ulcer was noted at Day 30.