The role of nursing in managing treatment-associated adverse effects in patients with hepatitis C.

The treatment for chronic hepatitis C with interferon and ribavirin is associated with a large number of untoward side effects ( Cornberg, Wedemeyer &, Manns, 2002). Management of these adverse effects has a great impact on the compliance of affected patients during the course of their treatment. Thus, the influence of the nurse on patient compliance and quality of life improvement during interferon and ribavirin treatment cannot be understated. Anecdotally, from the patient's point of view, the adverse effects of treatment often overshadow the goal of treatment, viral clearance. Nurses, as a result of their role as patient advocates, have the ability to enhance treatment compliance greatly by recognizing and managing treatment-associated side effects.     

Testicular tumors

Germ cell tumors of the testes represent a unique paradigm of diseases which can be cured even in extremely advanced phase. Unfortunately, this makes them unique among adult solid tumors. Seminoma and non seminoma are relatively rare with approximatively 25,000 patients in Europe per year, but numbers are increasing world wide. Different strategies are needed depending on stage and prognostic scores. Seminoma is extremely sensitive to radiation therapy and chemotherapy, while all germ cell tumors show a very good response to chemotherapy. Clinical stage I seminoma is currently treated with radiation, single course carboplatin or surveillance policy. Clinical stage I non seminoma can also be approached with different strategies such as retroperitoneal lymph node dissection, observation or one-two courses of standard chemotherapy. Stage II seminoma may be treated with either radiation or chemotherapy, while for all advanced stages chemotherapy is mandatory. Since the mid-eighties PEB (Cisplatin, Etoposide and Bleomycin) is the regimen of choice and no other schedule has proved superior in terms of efficacy. Surgery on the residual disease is crucial to the whole strategy and should be performed or attempted in all cases. Consequently, the correct treatment strategy for these tumors does not depend only on the ability of a single physician, but on a skilled team specialized in this particular tumor. Second line therapies (VeIP, PEI, TIP) can cure 25%–40% of patients, but improved strategies for resistant tumors are desperately needed. High-dose chemotherapy has shown very good results in some studies while being less impressive in others. In any case, it should remain an option for relapsing patients and could be used in some cases of upfront chemotherapy in patients with slow marker decline, but this should only be considered in referring centers.     

The influence of lycopene on the proliferation of human breast cell line (MCF-7).

Lycopene, a non-provitaminic carotenoid, present in many fruit and vegetables, such as tomatoes and their processed products, has been associated with decreased risk of chronic diseases including cancer. The influence of lycopene on the proliferation of the breast tumour cell line (MCF-7) was tested using MTT and BrdU assays at different time intervals (from 24 to 72h) and dose-response (from 0.125 to 100muM). The induction of Gap Junction Intercellular Communication (GJIC) was evaluated by dye-transfer assay using Lucifer Yellow on monolayer cells treated with different lycopene concentrations (from 0.125 to 5muM) for 6 to 48h. The Minimal Inhibitory Concentration (MIC) of lycopene was of 5muM, after a 24h exposure. A prolonged exposure time (72h) induced a similar inhibitory effect. Lycopene stimulated the functionality of GJIC at concentrations of 1muM after 24h and this effect was dose-dependent. The induction of GJIC by lycopene was confirmed by an increased expression of connexin 43. Collectively, the above data confirm the inhibitor effects of lycopene on MCF-7 cell growth and suggest that lycopene is involved in the modulation of the gap junction intercellular communication in this cell line, as observed for other cancer cell lines.     

Victim Help Seeking: Differences Between Intimate Terrorism and Situational Couple Violence

Abstract: Research indicates that two major forms of partner violence exist, intimate terrorism (IT) and situational couple violence (SCV). The current study (N= 389) used a subgroup of women who responded to the Chicago Women’s Health Risk Study to examine whether type of violence experienced is differentially related to formal (e.g., police, medical agencies, counseling) and informal (e.g., family, friends/neighbors) help seeking. IT victims were more likely to seek each type of formal help but were equally or less likely to seek informal help. Findings can inform both family violence research and the development and implementation of social service programs.     

Biochemical and biological activity of the anthracycline analog, 4-demethyl-6-0-methyl-doxorubicin

Summary The chromophore-modified derivative of doxorubicin, 4-demethyl-6-0-methyl-doxorubicin, has been tested for antitumor activity in a range of experimental murine tumor systems. In contrast to the inactive 6-0-methyl derivative of daunorubicin, 4-demethyl-6-0-methyl-doxorubicin provided antitumor effects comparable to that of the parent compound. In addition, detailed DNA-interaction studies showed that the doxorubicin derivative retains the ability to bind DNA by the intercalation mechanism. However, the binding affinity was appreciably reduced following structural modification in the anthraquinone chromophore. On the basis of the proposed models of intercalation, these results could be rationalized in terms of steric influence of the bulky methoxy group. The results of this study are in agreement with the correlation already observed between DNA binding and relative antitumor activity of anthracyclines.     

Enophthalmos and upper eyelid retraction following osteoplastic frontal sinusotomy

A 38-year-old man presented with hyperophthalmia, enophthalmos, and upper eyelid retraction 18 months following an osteoplastic flap and frontal sinus obliteration for mucocele. Computerized tomography confirmed the presence of frontal bone absorption in the roof of the orbit with traction and elevation of the orbital contents into the obliterated frontal sinus. A fracture of the orbital roof with penetration of periorbita at the time of original surgery was the suspected precipitating cause of the complication. Surgical management included lysis of the cicatrix between the orbit and frontal sinus and interposition of a silicone sheet between the orbit and sinus, which restored the appropriate anatomic relationships and prevented recurrence.     

Polymerization of α-olefins in the presence of δ-TiCl3/Al(CH3)3: Chain propagation rate constants for ethylene and propene

The chain propagation rate constants for the polymerization of ethylene and propene in the presence of δ-TiCl₃/Al(CH₃)₃ at 22 °C are determined by means of a ¹³C NMR analysis of suitable block copolymers. The numerical values of the rate constants are compared with those previously reported.     

Revisiting the prognostic role of gallium scintigraphy in low-grade Non-Hodgkin’s lymphoma

The purpose of this study was threefold: to evaluate the role of gallium-67 scintigraphy in the staging of low-grade non-Hodgkin’s lymphomas (LGNHL), to assess the relationship between the expression of CD71 on the surface of the neoplastic cells and the ⁶⁷Ga uptake by the tumour, and to establish the contribution of ⁶⁷Ga scan in defining the prognosis of LGNHL. Forty-eight patients with untreated LGNHL diagnosed in a single institution over a decade were reviewed. The end point of the study was survival of the patients according to the scintigraphic ⁶⁷Ga score at diagnosis. In addition to ⁶⁷Ga scan, other prognostic variables were studied, relating to the neoplastic burden, the biology of the tumour and the host. Univariate and multivariate analyses were used. ⁶⁷Ga scan identified only 116/286 (41%) nodes involved by lymphoma that were detected by clinical examination or computed tomography scan. A scintigraphic scoring system with an arbitrary cut-off value of 3 (high scan score) was able to predict patients with a dismal prognosis: with a mean follow-up of 47 months (range: 1–146 months) the median survival time was 28 months in patients with a high scan score and 74 months in patients with a low scan score (P=0.002). CD71 values were 27.4%±14.9% (mean ±SD) in the former and 8.9%±7.2% in the latter (P=0.0001). Only performance status and extranodal sites were significant variables for prognosis in multivariate analysis. It is concluded that ⁶⁷Ga scan is inaccurate in staging but might be very important in defining the prognosis in LGNHL, in association with other prognostic variables. Received 1 May and in revised form 6 August 1997     

Risk factors for asthma in adolescents in a large urban region of Brazil.

BACKGROUND: Identify risk factors for asthma in adolescents from S?o Paulo, Brazil. METHODS: total of 528 adolescents (141 asthmatics, 387 control subjects) from the ISAAC study (phase III) were submitted to a complementary questionnaire to evaluate risk factors, through response to questions regarding personal history, environment, and diet and an agreement to undergo the skin prick test (SPT) for aeroallergens. RESULTS: Positive SPT to at least one allergen occurred in 49.4% adolescents. The risk factors for asthma were: prematurity (OR: 3.84, 95% CI: 1.54-9.64), rhinitis (OR: 3.18, 95% CI: 1.71-5.91), positivity in the SPT (OR: 2.81, 95% CI: 1.48-5.32), eczema in characteristic skin-folds (OR: 2.86, 95% CI: 1.13-7.26), and an allergic mother (OR: 2.01, 95% CI: 1.02-3.93). The consumption of cooked vegetables was a protective factor for asthma (OR: 0.37, 95% CI: 0.18-0.79) CONCLUSIONS: Asthma is a multifatorial disease. An allergic mother, aeroallergen sensitization, rhinitis, eczema and prematurity were considered risk factors and the consumption of cooked vegetables was considered a protective factor for asthma in this population.