It is well established that brief psychoeducational programs for cancer patients will significantly improve mean quality of life. As this kind of adjunctive treatment becomes integrated into general cancer management, it will be necessary to devise cost-effective and efficacious programs that can be offered to relatively large numbers of patients. We have developed a very brief 4-session program that provides this service to 40-80 patients and family members per month (and seems capable of serving much larger numbers, depending on the capacity of the facility in which they assemble). Patients meet in a hospital auditorium for a large group, lecture-style program that offers training in basic coping skills: stress management, relaxation training, thought monitoring and changing, mental imagery and goal setting. Over the first year we have treated 363 patients and 150 family members. Improvements were assessed by changes in the POMS-Short Form, and both patients and family members were found to improve significantly over the course of the program. While this is not a randomized comparison, it suggests that the benefits gained from a large group in a classroom are not substantially less than the improvements that have been documented in the usual small group format, where more interactive discussions are possible.

Adaptation, Psychological↗

PubMedDate not supplied

The effect of vinblastine on CFU-E in normal and W anaemic mice.

Using a plasma clot technique, we studied the comparative levels of in vitro erythroid colony forming units (CFU-E) of normal and W anaemic mice following intravenous (IV) injection of 6.25 mg/kg of vinblastine (VBL). Mice used in this study were C57Bl/6J, WBB6F1, (+/+,Wv/+ and W/Wv). CFU-E content was looked at on day 0, 1, 3, 5, 7 and 10 following IV VBL. The CFU-E content of bone marrow (BM) and spleen was adequate prior to VBL treatment in all four mouse strains tested. We found IV VBL resulted in a significant rebound of CFU-E production in spleens of all four mouse strains. Most CFU-E production occurred on days 7 and 10 post VBL. The total CFU-E content of BM was not significantly affected by VBL in C57Bl/6J, WBB6F1, +/+ and Wv/+ mice. However, a significant reduction of total CFU-E was seen in the BM of WBB6F1, W/Wv mice. This plus the fact that increased CFU-E is seen in the spleen of all mouse strains including W/Wv suggests that there may be differing cellular or environmental factor(s) in different hematological organs controlling CFU-E of the W/Wv mouse.

Anemia↗

PubMedDate not supplied

Effect of acute and chronic hyponatremia on blood-brain barrier function in the rat.

To study whether acute or chronic hyponatremia alters blood-brain barrier (BBB) permeability, rats made hyponatremic by constant desmopressin acetate infusion were studied by NMR spectroscopy and imaging. On constant volume ventilation and nitrous oxide, acute (1- and 2-day) and chronic (7- and 14-day) hyponatremic and normonatremic controls were infused with 0.25 M HCl. Despite reducing blood pH by at least 0.35 in < 50 min, brain pH, measured by 31P NMR, was unaffected in any group. As a second test of BBB function, gadolinium-DTPA (Gd-DTPA) was injected intravenously in these five groups. Coronal slice 1H NMR images obtained before and after Gd-DTPA showed image intensity changes in multiple areas outside brain, but neither control nor hyponatremic rats showed any differences in cortex, white matter or cerebellum. To ascertain whether the threshold for BBB disruption was altered, hypertonic mannitol (1.5, 2.0 or 3.0 mL) was injected rapidly into one internal carotid artery and pre- and post-Gd-DTPA images obtained. In both control and hyponatremic rats only the largest dose caused detectable Gd-DTPA leakage into brain. Thus, BBB function appears intact in both acute and chronic hyponatremia since neither H+ nor GD-DTPA penetrated the barrier and resistance to mannitol disruption was unaffected by hyponatremia.

Acute Disease↗

PubMedDate not supplied

Underreporting of adverse drug reactions: attitudes of Irish doctors.

Despite the fundamental importance of reporting of suspected adverse drug reactions, less than 10 per cent of serious adverse drug reactions are reported. To further enhance our understanding of doctors' knowledge and attitudes to the current Adverse Drug Reaction (ADR) reporting scheme we surveyed 158 doctors, including some 106 general practitioners and 23 hospital-based doctors. The response rate was 39.5 per cent. The majority had experience of reporting an ADR. Seriousness of the ADR appears to be the most important reason for reporting. Uncertainty that the adverse drug reaction was definitely caused by the medicine, that the adverse drug reaction was too trivial to report or that it was too well known a reaction to report are common reasons for not reporting. Of concern 84 per cent of doctors are unaware of the criteria of the National Drug Regulatory Agency indicating the need for additional education and information in this regard. We also found considerable disagreements in doctors' understanding of the meaning of common, occasional, rare, or very rare as applied to ADRs.

Adverse Drug Reaction Reporting Systems↗

PubMedDate not supplied

A model of sustained activation of the sympathetic nervous system (SNS) using anterior hypothalamic cooling in the baboon.

Explore the source record for details and available documents.

Animals↗

PubMedDate not supplied

Age related changes in NADPH cytochrome c reductase activity in mouse skin and liver microsomes.

In this study, the effect of ageing on the activity of cutaneous and hepatic NADPH cytochrome c reductase, a component of the mixed function mono-oxygenase system, was studied in young adult and senescent male C57B1/6J mice. Horse heart cytochrome c was used as substrate and its reduction by skin and liver microsomes was measured spectrophotometrically. Statistical analysis of our results show a significant decrease in cutaneous enzyme activity with age. This, however, was not the case in liver where no significant difference was seen, consistent with previous studies on mixed function mono-oxygenase activity in mouse liver. This suggests that the ageing process may have a tissue specific effect on the monooxygenase system in the C57B1/6J strain of mouse. However, further work in other rodent species and humans is required to fully characterize the effect of ageing on the drug metabolizing capacity of skin as compared to liver.

Journal Article↗

PubMedDate not supplied

Accuracy of blood ethanol determination using serum osmolality.

A retrospective review of 81 emergency department patients was performed to determine the accuracy of blood ethanol levels (BEL) calculated from serum osmolality. The osmolar gap (measured-calculated serum osmolality) was used to determine the calculated BEL. The mean difference between calculated and measured BEL was 49.2 mg/dL. Calculated BEL overestimated measured BEL in 83% of patients. Adding a correction factor for unmeasured osmoles to the equation for calculated serum osmolality will reduce this error.

Alcoholic Intoxication↗

PubMedDate not supplied

Hazards associated with the use of benzodiazepines in alcohol detoxification.

While benzodiazepines possess many positive attributes for the treatment of alcohol withdrawal, they are not ideal drugs. The occurrence of toxic effects is not infrequent, and unless recognized promptly, toxicity may significantly impact treatment and length of stay. Use of shorter acting benzodiazepines may result in seizure activity under certain conditions of withdrawal.

Adult↗