Clinical incidence of lymphoedema in breast cancer patients in Jönköping County, Sweden

The clinical incidence of lymphoedema of the arm in breast cancer patients was studied before and after general mammography screening in the country of jönköping, Sweden. There was a significant decrease of incidence of lymphoedema from 15% in 1983 to 8% in 1988. Clinical and pathological therapy data have been analysed in relation to lymphoedema. Significant factors contributing to lymphoedema were the number of lymph nodes examined and the number of pathologically positive lymph nodes. A higher proportion of patients receiving post-operative radiotherapy to the axilla developed lymphoedema, compared with those with surgery alone.
A comparison between the two groups is impossible due to the fact that post-operative radiotherapy was prescribed only to patients with pathologically positive lymph nodes.     

Onycholysis and subungual haemorrhages secondary to systemic chemotherapy (paclitaxel)

Paclitaxel is a chemotherapic agent of the taxane family used in treatment of malignant solid tumory. We report here the case of a 40-year old woman referred to our clinic for nail changes involving all 20 digits and developed after 5 months of paclitaxel intake, due to a breast carcinoma. Clinical examination revealed red-brown discoloration of the nails associated with hematomas and onycholysis. The nail changes were very painful and the patient complained of discharge of bad-smelling yellow brown opaque fluid from underneath the nail plate. Hemorrhagic onycholysis and subungual abscesses are a possible side effect of taxane treatment that should be early recognized to prevent serious complications.     

The patient''s experience of diabetes and its treatment: construction of an attitude scale by a semantic differential technique

An instrument for measuring attitudes towards diabetes and self-care was constructed by a semantic differential technique. The instrument contained nine adjective pairs. Factor analysis classified these into four factors: self-esteem/autonomy, object evaluation, quality of life supporting factor and self-strength/vulnerability. The reliability coefficient of test-retest by 28 nurses/nurse tutors was 0.93. Fifty diabetic patients completed the attitude scale for testing the validity of the instrument. Male patients had a more positive attitude towards diabetes than females. Those who had had diabetes for less than 10 years were more positive than those with a longer duration of the disease. A higher degree of education, well-performed self-monitoring of blood glucose and achievement of good metabolic control were all associated with a more negative attitude towards diabetes. A group of nurses/nurse tutors who also completed the attitude scale had a more negative attitude towards diabetes than the investigated groups of patients.     

Increased number of substitutions in the D-loop of mitochondrial DNA in the sudden infant death syndrome

The purpose of the present study was to investigate substitutions in the D-loop of mitochondrial DNA (mtDNA) in sudden infant death syndrome (SIDS) and controls, since several observations indicate the involvement of mtDNA mutations in SIDS. These include elevated levels of vitreous humour hypoxanthine in SIDS victims, familial clustering without mendelian traits, and observations of increased sleepiness and a lower activity score in infants who later succumbed to SIDS. Eighty-two cases of SIDS and 133 controls were investigated and the D-loop sequences were recorded in the base-pair range 16 055-16 500 in the mtDNA sequence. The sequencing was carried out using the Applied Biosystems Sequenase dye terminator method and a ABD373A sequencer. The recorded D-loop sequences were compared with the Cambridge sequence and differences were recorded as substitutions. The SIDS cases had a tendency towards a higher substitution rate in the D-loop than the controls ( p = 0.088). This observation makes it interesting to search for deleterious mutations in other locations in the mtDNA.