Factors influencing distress in Indian cancer patients

BACKGROUND: The current study set out to identify distress in cancer patients undergoing curative treatment within India. PATIENTS AND METHODS: This study was carried out to measure distress and contributory factors in 103 cancer patients undergoing treatment with curative intent. The patients were interviewed using the Distress Inventory for Cancer (DI-C). The data on social, demographic, clinical, treatment, and follow-up details was collected from case records. RESULTS AND CONCLUSION: The distress score for individual respondents ranged from 34 to 90 (mean 62.3). Patients with lower income, those who were single/widowed, or divorced, those living between 150 and 350 km (3-6 h commuting distance) from the cancer centre, presence of pain and patients with advanced tumours at presentation showed higher distress. A higher distress score correlated significantly with patients being lost to follow-up.     

Animal models and antibody assays for evaluating candidate SARS vaccines: summary of a technical meeting 25-26 August 2005, London, UK

Severe acute respiratory syndrome (SARS) emerged in the Guangdong province of China in late 2002 and spread to 29 countries. By the end of the outbreak in July 2003, the CDC and WHO reported 8437 cases with a 9.6% case fatality rate. The disease was caused by a previously unrecognized coronavirus, SARS-CoV. Drawing on experience with animal coronavirus vaccines, several vaccine candidates have been developed and evaluated in pre-clinical trials. Available data suggest that vaccines should be based on the the 180kDa viral spike protein, S, the only significant neutralization antigen capable of inducing protective immune responses in animals. In the absence of clinical cases of SARS, candidate vaccines should be evaluated for efficacy in animal models, and although it is uncertain whether the United States Food and Drug Administration's "animal rule" would apply to licensure of a SARS vaccine, it is important to develop standardized animal models and immunological assays in preparation for this eventuality. This report summarizes the recommendations from a WHO Technical Meeting on Animal Models and Antibody Assays for Evaluating Candidate SARS Vaccines held on 25-26 August 2005 in South Mimms, UK, provides guidance on the use of animal models, and outlines the steps to develop standard reagents and assays for immunological evaluation of candidate SARS vaccines.     

Electron microscopic changes in tropical endomyocardial fibrosis

Electron microscopic examination of cardiac tissue from seven patients with tropical endomyocardial fibrosis showed the endocardium to be replaced by maturing granulation tissue containing haphazardly arranged collagen bundles, smooth muscle cells, blood vessels and degranulated mast cells. Mature collagen was present on the luminal aspect of the granulation tissue, Myofibres showed mitochondrial swelling, lamella bodies, focal myocytoplasmic clearing and collapsed intercalated discs. Small calibre blood vessels exhibited endothelial swelling, areas of basement membrane duplication and collections of neutrophilic and eosinophilic leucocytes. Eosinophils showed alteration in granule morphology. These changes are similar to the lesions reported in endomyocardial disease with eosinophilia.     

Evaluation of a cystic fibrosis screening system incorporating a miniature sweat stimulator and disposable chloride sensor

A new sweat test (CF Indicator; Medtronic, Inc.) for cystic fibrosis (CF) features a compact, portable configuration of electrodes that dispense pilocarpine for iontophoresis. A disposable chloride sensor patch absorbs a specified volume of sweat, in which the chloride concentration is immediately determined as less than 40, 40-60, or greater than 60 mmol/L. We assessed the performance of the system in a five-center study, in relation to the clinical diagnosis and to the Gibson-Cooke sweat test (GCST) as a control test. With sweat chloride concentrations of less than or equal to 40 mmol/L defined as normal and greater than 40 mmol/L as indicating persons at risk for CF, the new system showed 91% specificity and 100% sensitivity for CF, as compared with 92.8% and 100%, respectively, for the GCST. When we used sweat chloride concentrations of less than or equal to 60 mmol/L as probably normal and greater than 60 mmol/L as probably indicative of CF, the new system showed a 99.1% specificity and 98.6% sensitivity, vs 97.8% specificity and 97.9% sensitivity for the GCST test. In both procedures, occasionally insufficient sweat was collected, and this appeared related to the age of the subject. We conclude that the new sweat test system is potentially useful in physicians' offices, in clinics, and similar settings.