Causes of initial remission induction failure in acute myelogenous leukemia

One-hundred and sixty-one of 378 previously untreated patients with acute myelogenous leukemia (AML) failed to enter complete remission with a combination of anthracycline, cytosine arabinoside, vincristine, and prednisone between 1973 and 1979. Thirty-six of the failing patients (22%) were considered chemotherapy failures. As in the past, the remainder failed largely because of death from infection. However, despite the routine use of prophylactic platelet transfusions, hemorrhage was a major cause of death in 33%. Thirty-seven percent of the fatal infections were due to fungi and the incidence of fungal infection was as high during the second week of treatment as later. Age greater than 50 yr predisposed to fatal infection but not chemotherapy failure, while the presence of an antecedent hematologic disorder increased the risk of both fatal fungal infection and resistance to chemotherapy. Patients with an initial white blood cell count of greater than or equal to 25000/microliter were more likely to die of hemorrhage at all times during treatment. Improvement in supportive care remains crucial if improved complete rates are to be forthcoming in previously untreated patients.     

A national survey of practice nurse involvement in mental health interventions

BACKGROUND: The move in the United Kingdom (UK) from institutional to community care has led to an inevitable increase in the involvement of practice nurses (PNs) in mental health care. Around 20 000 PNs are currently working in the United Kingdom (UK). However, the extent and nature of PN involvement in delivering mental health interventions has not been adequately explored. AIM: This study aimed to quantify practice nurses' involvement in delivering mental health interventions in primary care settings. METHOD: A questionnaire was sent to a random sample of 1500 practice nurses registered with the Practice Nurse Forum at the Royal College of Nursing. Sixty per cent of questionnaires were returned; however, once non-eligible respondents were removed an adjusted response rate of 54% was achieved. RESULTS: Practice nurses play a significant role in the assessment and treatment of mental health problems, most frequently via the administration of depot antipsychotics and the screening for depression. However, antipsychotic side-effects were infrequently monitored and PNs' understanding of treatment issues in depression is poor. These findings may be associated with the reported lack of mental health training that PNs have received. CONCLUSIONS: The findings of this study have important implications for the training of practice nurses in mental health, specifically in the areas of medication management and the detection of mental disorders.     

Synthesis and Cytotoxic Evaluation of 1,2,3-Trisubstituted 2-(2-Oxoalkyl)-2,3-dihydrobenzimidazoles

A new series of 1,2,3-trisubstituted 2-(2-oxoalkyl)-2,3-dihydrobezimidazoles have been synthesized and evaluated for their cytotoxic activity using one normal (FL) and two cancer (RD and A2058) cell lines. Among the nine compounds tested, 5h showed the best selective antiproliferative properties in vitro, being especially active against the human metastatic melanoma cells - inhibition by 93% after 96 h treatment at 10^-4 M concentration.     

榆耳发酵液中新倍半萜——榆耳三醇的结构

从榆耳(Gloeostereum incarnatum S.Ito et Imai)的液体发酵物中经层析分离得一新倍半萜榆耳三醇(gloeosteretriol),根据红外光谱、核磁共振谱和质谱数据推定其结构为Ⅰ,并用X-射线晶体衍射进一步确证其结构和立体构型。