Case-control study of congenital malformations

To determine potentially teratogenic influencies in Belgrade, a group of 113 mothers who gave birth to severely malformed infants and a control group of 195 mothers with normal infants were interviewed using a structured questionnaire.Statistically significant differences between the two groups were found in the mother's family history of congenital malformations (P < 0.05) and the mother's diseases during the pregnancy (P < 0.01). Infections in the first trimester were particularly more prevalent in case mothers (OR = 7.70; P < 0.01). Mothers did not differ significantly according to exposure to organic solvents, supportive therapy during the pregnancy, use of oral contraceptives, or other personal habits.Corresponding author.     

Fast, long-range, reversible conformational fluctuations in nucleosomes revealed by single-pair fluorescence resonance energy transfer

The nucleosome core particle, the basic repeated structure in chromatin fibers, consists of an octamer of eight core histone molecules, organized as dimers (H2A/H2B) and tetramers [(H3/H4)2] around which DNA wraps tightly in almost two left-handed turns. The nucleosome has to undergo certain conformational changes to allow processes that need access to the DNA template to occur. By single-pair fluorescence resonance energy transfer, we demonstrate fast, long-range, reversible conformational fluctuations in nucleosomes between two states: fully folded (closed), with the DNA wrapped around the histone core, or open, with the DNA significantly unraveled from the histone octamer. The brief excursions into an extended open state may create windows of opportunity for protein factors involved in DNA transactions to bind to or translocate along the DNA.     

The pitfalls of a systematic MEDLINE review in palliative medicine: symptom assessment instruments

The Medical Literature Analysis and Retrieval System Online (MEDLINE) database provides many references for reviews, but many relevant articles are missed, especially when the topic is complex. Reported here is the detailed methodology of a PubMed search of MEDLINE augmented by a related articles link search. Of 1181 citations identified, through a PubMed search, 10 articles met the inclusion criteria. Fifty-one were identified through the related articles link; of which 43 were not detected by standard searches using medical subject heading terms. More than 50% were identified using the related articles link. Only 14% of relevant articles were identified using the standard PubMed MEDLINE search. The related articles link is not included in methodologic recommendations for systematic literature reviews but this experience suggests that it is a useful tool in PubMed for reviewing complex evidence. Related links searches are proposed in any systematic PubMed MEDLINE literature review in palliative medicine.     

Combining objective and subjective outcomes in cancer-related fatigue: illustrations from a single case report

Neurophysiologic measurements were made on a patient with multiple lung cancers and severe cancer-related fatigue (CRF) who responded to 5 mg methylphenidate twice daily, titrated to 10 mg twice daily after 2 weeks. She remained at 10 mg twice daily for 8 months. Improvement in severe CRF (Brief Fatigue Inventory score) was associated with normalization of neurophysiologic tests.     

Assembly of single chromatin fibers depends on the tension in the DNA molecule: magnetic tweezers study

We have used magnetic tweezers to study in real time chaperone-mediated chromatin assembly/disassembly at the level of single chromatin fibers. We find a strong dependence of the rate of assembly on the exerted force, with strong inhibition of assembly at forces exceeding 10 pN. During assembly, and especially at higher forces, occasional abrupt increases in the length of the fiber were observed, giving a clear indication of reversibility of the assembly process. This result is a clear demonstration of the dynamic equilibrium between nucleosome assembly and disassembly at the single chromatin fiber level.     

Deep vein thrombosis (DVT) in advanced cancer patients with lower extremity edema referred for assessment

Lower extremity edema is a common complication in advanced cancer patients, and deep vein thrombosis (DVT) is one among many causes. Clinical signs and symptoms are known to be unreliable, and radiographic investigations are often required in diagnosing DVT. A retrospective chart review was conducted on 46 advanced cancer patients with lower extremity edema. Researchers analyzed 52 venous duplex scans to determine the radiographic incidence of DVT the reliability of other clinical signs and symptoms in diagnosing DVT, apart from leg edema, and to assess other potential causes of lower extremity edema and their correlation to DVT. Twenty-three (44 percent) of 52 scans were positive for DVT. The most common presentation of edema in the patients with positive scans was bilateral asymmetric edema (11/23, 48 percent). There was limited documentation of other clinical signs and symptoms suggesting DVT. Other variables such as serum albumin (p = 0.46) and creatinine (p = 0.11) were not statistically different in patients who had positive and negative scans. Of other potential causes of lower extremity edema, such as previous surgery, radiotherapy, tumor, or lymph node compression, a number of patients had a coexisting DVT with bilateral asymmetric edema as the most common presentation. The results of this study suggest that advanced cancer patients with bilateral asymmetric lower extremity edema of potentially multifactorial origin have a high incidence of DVT.     

The relationship between symptom prevalence and severity and cancer primary site in 796 patients with advanced cancer

Knowledge of differences in symptom experience between cancer sites may help better understand symptom pathophysiology. A total of 38 symptoms in 796 consecutive patients with advanced cancer were retrospectively analyzed. Symptom prevalence and severity were compared among the 12 primary site groups (PSGs) by the chi-square test. Pairwise comparisons determined which sites differed. Pain, fatigue, weakness, lack of energy, and anorexia had the highest overall prevalence but did not differ among PSGs. The 3 most common neuropsychological symptoms (insomnia, depression, and anxiety) also did not vary among PSGs. Nineteen (50%) symptoms varied significantly between PSGs, in prevalence (17), severity (14), or both (12). Nine of 17, 6 of 14, and 6 of 12 were gastrointestinal symptoms. Symptoms which varied by PSGs can be included in cancer site-specific symptom assessment instruments.