Intrusive thoughts about cancer, often identified as 'cancer-specific worries' or 'cancer-specific distress', have been postulated to be associated with dysfunction in women at increased risk of developing breast or ovarian cancer. The current study discusses the development and validation of a measure designed to assess women's perceptions of the interference such worries create in their daily functioning. Analyses revealed that approximately two-thirds of a high-risk breast cancer clinic sample perceived worries about breast cancer as interfering with their functioning across a variety of life domains. Multiple regression analyses indicated that worry interference scores predicted Profile of Mood States (POMS) Anxiety and Confusion, and Short Form-36 (SF-36) Role-Emotional and Mental Health scores after the effects of other variables such as frequency of worry about breast cancer, and having a family history of cancer had been considered. Women who perceived their worries as interfering with their functioning reported higher levels of anxiety and confusion, and diminished mental health and role functioning. The results add to the expanding area of anxiety/distress in at-risk populations by providing (1) a direct measure of the perceived interference associated with breast cancer-specific thoughts, (2) a validation of the measure via its associations with standard measures of emotional distress and health functioning, and (3) evidence of the measure's incremental predictive value in explaining distress and quality of life, after consideration of background variables, such as having a family history of cancer.

Activities of Daily Living↗

PubMedDate not supplied

A bcl-x(S) adenovirus demonstrates therapeutic efficacy in an ascites model of human breast cancer.

OBJECTIVES: To determine whether a Bcl-x(S) adenoviral vector has therapeutic potential in an ascites model of human breast cancer in nude mice. METHODS: Advanced ascites were developed by injecting mice intraperitoneally (IP) with MDA-MB-231 human breast carcinoma cells. Mice received sequential IP injections of the Bcl-x(S) virus or a control lac-Z adenovirus. A third group of mice received no virus. Tumor burden and survival were monitored. Histopathology and necropsies were performed on mice. RESULTS: A single injection of the Bcl-x(S) adenovirus produced no systemic or local toxicity and no abnormal histopathology in normal mice. However, abdominal organs within these mice were transduced with the Bcl-x(S) vector. Adenoviral gene transduction efficiency in MDA-MB-231 ascites was 36+/-6.40% (n = 3). Percent weight change differences revealed that ascites bearing mice injected three times with the Bcl-x(S) vector showed a statistically significant decrease in tumor burden compared with lac-Z-injected mice (n = 7; P = .012 on days 10-15 after the first injection). Mice injected with the Bcl-x(S) vector had significantly greater survival relative to lac-Z-injected mice (n = 7; P = .0004). Bcl-x(S) protein expression was detected in aspirates of mice injected with the Bcl-x(S) vector but not the lac-Z vector. Necropsies revealed that ascites bearing mice injected with Bcl-x(S) vector lacked carcinoma in the peritoneal cavity compared with control mice. CONCLUSION: The Bcl-x(S) adenovirus can reduce tumor burden and increase survival in an ascites model of advanced stage breast cancer.

Adenoviridae↗

PubMedDate not supplied

Studies on 1,2,3,6-tetrahydropyridine derivatives as potential monoamine oxidase inactivators.

The Parkinsonian-inducing neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and close structural analogs are the only known cyclic tertiary amines with good monoamine oxidase substrate properties. In addition to its excellent substrate properties, MPTP is a mechanism-based inactivator of monoamine oxidase B (MAO-B). In an attempt to exploit the special interactions between this cyclic tertiary allylamine and MAO-B, we have initiated studies to evaluate the enzymatic and biological properties of MPTP analogs bearing functional groups which are known to mediate the metabolism-dependent inactivation of this enzyme. This paper describes the synthesis, enzyme substrate/inhibitor properties, and neurotoxic/neuroprotective properties of 1-cyclopropyl-4-phenyl-1,2,3,6-tetrahydropyridine, the corresponding acyclic secondary amine (E)-4-cyclopropyl-2-phenyl-2-butene, and 4-cyclopropyl-1-methyl-1,2,3,6-tetrahydropyridine.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗

PubMedDate not supplied

Meperidine attenuates the secretion but not the transcription of interleukin 1 beta in human mononuclear leukocytes.

BACKGROUND: The infusion of amphotericin-B (AmB) often produces clinically distressing rigors and chills, which promptly abate with intravenous injection of meperidine, although its mechanism of action is unknown. OBJECTIVE: To examine the effects of meperidine on the transcription or secretion of Interleukin 1 beta (IL-1 beta) in human mononuclear leukocytes (MNL) exposed in vitro to the lipopolysaccharide (LPS) contained in Escherichia coli endotoxin or to AmB. METHODS: Blood was drawn from eight healthy adult volunteers. The blood was centrifuged, and the layer containing MNL was separated; incubated with various combinations of medium, meperidine, and AmB; then tested for IL-1 content to determine the effect of meperidine on MNL secretion of IL-1 beta. To determine the effect on MNL transcription of IL-1 beta, the RNA was extracted from cells and the IL-1 beta was measured using one of two different methods. RESULTS: Incubation of human MNL in the presence of LPS or AmB significantly increased transcription of IL-1 beta mRNA and secretion of IL-1 beta. Addition of meperidine to these cultures significantly reduced LPS-induced, but not AmB-induced, secretion of IL-1 beta in vitro. Meperidine did not alter IL-1 beta mRNA levels in MNL exposed to LPS or AmB. CONCLUSIONS: These data suggest that meperidine decreases rigors and chills in part by decreasing MNL secretion of IL-1 beta through a posttranscriptional mechanism.

Adult↗

PubMedDate not supplied

Low molecular weight dextran and matching by enzyme technics.

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Autoantibodies↗

PubMedDate not supplied

Infant nutrition and supplements.

Today, American consumers believe they need more and better nutrients than their diets provide. Consequently, consumers spend approximately three billion dollars each year on vitamin and nutrition products. Vitamin and/or mineral supplements are relatively inexpensive and available without a prescription; therefore, it is understandable that they are used by a substantial portion of the population. However, the last 50 years have witnessed a steadily increasing understanding of vitamins and trace mineral biochemistry and its role in human nutrition and intermediary metabolism. It has not been shown conclusively that normal breastfed infants of well nourished mothers need any specific vitamin and mineral supplements, with the exception of iron and fluoride. The use of vitamin D supplements remains controversial. Preterm infants may require supplements of vitamin E, iron, and folic acid because of their rapid rate of growth and less complete, intestinal absorption.

Breast Feeding↗

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Patellar tendon graft reconstruction for midsubstance anterior cruciate ligament rupture in junior high school athletes. An algorithm for management.

Between 1976 and 1988 we treated 75 junior high athletes who had midsubstance ruptures of the anterior cruciate ligament and open physes. Thirty-eight children were initially treated conservatively and later had an intraarticular patellar tendon graft reconstruction, 2 patients underwent extraarticular reconstruction and then later had a patellar tendon graft intraarticular reconstruction, and 20 children had a patellar tendon graft reconstruction initially. In all 60 patients the tibial and femoral tunnels were drilled through the open physes. Minimum followup was 2 years (mean, 4.2). Fifty-five of the 60 children were able to return to their original sports; 5 were active in less strenuous sports. No incidence of abnormal growth related to the intraarticular reconstructive surgery was recorded. Three children tore their anterior cruciate ligament grafts more than 2 years after surgery. Our records showed that conservative treatment of the active junior high athlete with an anterior cruciate ligament rupture failed in each case because of recurrent giving way or meniscal tears. Definitive treatment with an intraarticular autogenous patellar tendon graft reconstruction yielded good to excellent results and eliminated subsequent instability episodes and meniscal tears in our study group.

Adolescent↗

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Caring for patients undergoing treatment for vascular occlusion.

In the treatment of arterial and graft occlusion, St George's Hospital has moved the emphasis away from long infusions of streptokinase to short, high-dose, pulsed administration of recombinant human tissue-type plasminogen activator (rt-PA). This has led to a change in nursing management.

Arterial Occlusive Diseases↗

PubMedDate not supplied

A nurse-led clinic for patients with peripheral vascular disease.

Patients with peripheral vascular disease have complex and challenging health needs. This article describes an innovative nurse practitioner role in the provision of care for patients with intermittent claudication in an acute hospital setting. A small-scale evaluative study of patient satisfaction with the nurse consultation revealed high levels of satisfaction with the care received. It is suggested that experienced nurses can make substantial contributions to improving care for patients with chronic disease.

Aged↗

PubMedDate not supplied

Rapid urinalysis assays for the diagnosis of urinary tract infection.

Urinary tract infection (UTI) in premenopausal women is a frequent complaint in general practice. UTI is usually diagnosed on the basis of clinical symptoms and the use of one or more laboratory tests, the most common being rapid urinalysis reagent assays (urine dip) or midstream urine culture. In order to correlate the leucocyte esterase results of a rapid urinalysis assay with direct urine microscopy for pyuria, undiluted non-centrifuged urine samples from 206 volunteer female healthcare professionals were subjected to analysis using direct urine microscopy using a counting chamber and a rapid urinalysis assay. Of the 206 specimens, 74 were positive for leucocyte esterase using the rapid urinalysis assay, and 39 specimens demonstrated significant pyuria (greater than or equal to 10 leucocytes/microl) on direct microscopy. When the leucocyte esterase results were correlated with the direct urine microscopy results, an assay reading of 15 leucocytes/microl ('trace' on the visual scale) had a sensitivity of 91%, specificity of 79%, positive predictive value of 53% and a negative predictive value of 97%. An assay reading of 25 leucocytes/microl ('+' on the visual scale) or greater had a sensitivity of 63%, specificity of 95%, positive predictive value of 75% and a negative predictive value of 91%. In premenopausal, non-pregnant females, a rapid urinalysis assay result of 25 leucocytes/microl or greater will predict significant pyuria on urine microscopy with reasonable confidence, thereby reducing the need for more costly urine cultures.

Adult↗

PubMedDate not supplied

Never too old to vote.

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Aged↗

PubMedDate not supplied

Pressure ulcers: developing a program of care.

The treatment of pressure ulcers has evolved from dry to moist healing techniques. Institutions must therefore develop a method to advance their clinical practices. Such a major change requires a systematic implementation of a comprehensive wound management program. The steps necessary in this program development include review of the current literature, review of current practice, standardization of treatment, assessment of product availability, standardization of documentation, in-service training of staff, and evaluation of program success.

Clinical Protocols↗

PubMedDate not supplied

Sex and strain differences in hepatic debrisoquine 4-hydroxylase activity of the rat.

Debrisoquine 4-hydroxylase activity in microsomal fractions from liver of DA, Fischer, and Lewis rats has been determined. Activity in DA rats is up to 14-fold lower than in animals from the corresponding sex of the other strains. There is also a major sex difference in debrisoquine 4-hydroxylase activity of all three strains. Kinetic analysis revealed at least two components of activity, even in the liver of female DA rats. Thus, the decreased activity in these animals could not be attributed to the absence of a single isozyme of cytochrome P-450. Michaelis-Menten analysis revealed that both components of activity were impaired in these animals. Debrisoquine 4-hydroxylase activity was inducible by both 3-methylcholanthrene and phenobarbital in DA and Fischer rats. However, in the DA rat, activity was inducible only at higher substrate concentrations (greater than 50 microM). It is concluded that the DA rat differs from other strains in at least three different isozymes of cytochrome P-450 that can catalyze the 4-hydroxylation of debrisoquine. At least one of these is male-specific and at least one is inducible. The DA rat might provide a suitable model in which to predict which substrates might show impaired oxidation in the poor metabolizer phenotype, but studies on the molecular mechanism of the polymorphism in this strain would appear to have doubtful validity for the polymorphism in man.

Animals↗

PubMedDate not supplied

The rise of little voice.

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Community Health Nursing↗