Osteosynthesis of distal radius fractures by doral plate: advantages and disadvantages]

Distal radius fractures remain a challenge. No one osteosynthesis procedure can solve all the problems. A method of analysis is necessary in order to choose the best tools. Open treatment of the fracture is logical but rarely performed. A review of the literature and the experience of the authors are reported in order to analyse the correct place of dorsal plating in distal radius fracture with dorsal displacement. The learning curve of the operative procedure and the design of the implants can explain the occurrence of several complications. The dorsal plate is effective against secondary dorsal displacement. This demanding procedure must be compared with other reported procedures (pining and external fixator) to define the advantages and disadvantages.     

Two Translocations: a Follicular Variant 2; 18 and a Burkitt 8;14 in a Small Non Cleaved Non Hodgkin's Lymphoma

The t(2;18)(p11;q21) has recently been described in two lymphoma cases as a variant of the t(14;18)(q32;q21) typical chromosome translocation in follicular lymphomas. Molecular investigations of t(2;18) confirmed juxtaposition of the bcl-2 gene to the immunoglobulin kappa (Igk) locus and described a new break point region on 18q21 found also in the recently reported, second follicular variant translocation (18;22)(q21;q11). Thus, cytogenetic and molecular studies established the same mechanism of (onco)gene activation by the heavy or light Ig gene in follicular lymphomas and Burkitt lymphomas.

We describe a case of small non cleaved non Hodgkin's lymphoma in which translocation (2;18) coexisted with a typical (8;14) Burkitt translocation. Absent HLA-DR expression by the tumour cells was noted in this case. The possible implications of the cytogenetic and immunologic findings are discussed.     

Interferon gamma in the treatment of chronic polyarthritis. Long-term therapy in clinical practice

Efficacy and practicability of a defined dosage scheme for interferon gamma was proved during one year's treatment in patients with rheumatoid arthritis. Interferon gamma was well tolerated. It was effective in improving blood sedimentation rate, anemia, leucocytosis and thrombocytosis as well as clinical parameters such as pain, mobility, swollen joints and morning stiffness. Concomitant medication with corticosteroids could be reduced.     

Loss of HLA-A,B,C and de novo expression of HLA-D in colorectal cancer

One hundred primary colorectal carcinomas and 19 metastases were studied for the expression of HLA-A,B,C and HLA-D antigens using monoclonal antibodies (MAbs) against framework determinants and a sensitive immunoperoxidase technique on frozen sections. With MAb W6/32, 65 tumors were intensely stained for HLA-A,B,C; 22 showed a reduced staining intensity, in 5 carcinomas a minor or major subset of the tumor cells lacked HLA-A,B,C, and in 8 cases all tumor cells were unreactive. The loss of HLA-A,B,C was inversely correlated with the degree of differentiation. No relation was found to type, stage and site of the tumor, or to age and sex of the patients. With MAb 2.06, 58 tumors were HLA-D negative, 20 exhibited small positive foci, 19 showed a patchy staining pattern, and 3 were homogeneously HLA-D positive. There was no apparent correlation between HLA-D expression and any of the clinico-pathological features mentioned, nor was it related to the loss of HLA-A,B,C. About half of the metastases displayed the same staining pattern for HLA-A,B,C and -D as the respective primary tumors. The remainder differed from the primary carcinoma by gain or loss of HLA antigens.     

Herpesviruses and the transplanted lung: looking at the air side

Herpesviruses may cause substantial complications after lung transplantation. Especially their interaction with lung tissue cells may result in adverse effects for the transplant patients, and may lead to severe end organ disease or to chronic transplant rejection and to development of bronchiolitis obliterans (BOS). However, the determination of the patients' local virus replication in the lung is still problematic. While the virus load in blood can be easily quantified nowadays, the determination of the virus load in the lung compartment can not be easily achieved, especially due to the individually different and not predictable dilution of virus during sampling of the bronchoalveolar lavage (BAL). In the following a short overview will be given about the different herpesviruses and their possible influence on the transplanted lung as well as about a method to determine the original virus load at the air surface of the lung. The quantitative data achieved by this method underline that some herpesviruses are often present at much higher levels at the air surface of the transplanted lung than in the blood, and that their influence on transplant survival may have been substantially underestimated so far.     

Outcome of radiotherapy in T1 glottic carcinoma: a population-based study

We evaluated the radiation outcome and prognostic factors in a population-based study of early (T1N0M0) glottic carcinoma. Survival parameters and prognostic factors were evaluated by uni- and multivariate analysis in 316 consecutive irradiated patients with T1 glottic carcinoma in the Comprehensive Cancer Center West region of the western Netherlands. Median follow-up was 70 months (range 1–190 months). Five and ten-year local control was 86 and 84%. Disease specific survival was 97% at 5 and 10 years. In multivariate analysis, pre-existent laryngeal hypertrophic laryngitis was the only predictive factor for local control (relative risk = 3.0, P = 0.02). Comorbidity was prognostic for overall survival. No factor was predictive for disease specific survival. Pre-existent laryngeal hypertrophic laryngitis is a new risk factor associated with reduced local control in T1 glottic carcinoma treated with radiotherapy.     

Nurses’ knowledge, attitudes, and practices regarding provision of sexual health care in patients with cancer: critical review of the evidence

Background  The experience of living with cancer is associated with a variety of consequences in several central aspects of a patient’s quality of life, including intimacy, body image, human relationships, sexuality, and fertility. Despite their importance, incidence, and impact on psychosocial well-being, sexual health care (SHC) is a matter not frequently dealt with by nurses in daily practice. Goals of work  The purpose of this study was to gather evidence regarding knowledge, attitudes, and behaviors of oncology nurses toward sexual health issues and to identify salient and latent key factors which influence provision of SHC in the context of cancer. Materials and methods  A critical review of the literature was conducted over a period of three decades and 18 original research articles were retrieved and analyzed. Results  A comprehensive data analysis revealed that, although oncology nurses hold relatively liberal attitudes and recognize provision of sexual health care as an important nursing role, they possess limited sexual knowledge and communication skills, while often avoid or fail to effectively respond to patients’ sexual concerns. Nine possible influential key factors have been studied: incorrect assumptions toward sexual issues, comfort, sexual knowledge, professional nursing role, patient- and nurse-related issues, work environment-related issues, continuing education activities, and society-related factors. Conflicting findings are reported. Conclusions  The findings of the present study propose that there is an evident need of dispelling the myths about sexual health in cancer care. Besides, continuing education activities and availability of education materials could assist nurses to adequately address sexual concerns while caring for patients with cancer. This paper was presented as an oral presentation at the 7th Congress of the Balkan Union of Oncology (BUON) in Kusadasi, Turkey, 15-19 October 2008, and it was awarded as the best nursing oral presentation.