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PubMed2002

PaSent--the patient's personal health adviser.

We have attempted to automate the search for medical information that is relevant to a patient s electronic record. We used anonymous medical reports sent from the University Hospital of Tromsø to general practitioners as input data. The medical reports were matched against the NEL, a Web-based medical dictionary and document collection service for general practitioners. We evaluated only the three top-scoring documents automatically selected by the system. A medical professional evaluated whether a selected document from the NEL was very relevant to the contents of the input report, relevant or irrelevant. Initial tests showed that 60% of the top three selected documents found by the PaSent system were very relevant or relevant to the contents of the medical report used as input data. Our preliminary conclusion is that automatic location of relevant information is possible using medical reports as input data.

Humans↗
PubMedDate not supplied

[Private and public self-awareness changes in psychotherapy of alcohol-addicted felons].

AIM: Testing effectiveness of psychotherapy by evaluating changes in private and public self-consciousness of alcohol addicted persons and imprisoned felons. METHOD: The questionnaire known as Self-Consiousness Scale Fenigstein, Scheier, Buss's was applied. The tool is based on the theory of Duval and Wicklund and that of Carver and Scheier. Treatment curriculum--was based on two models of alcohol addiction. the psychological one and the other derived of assumptions defined in the Alcoholics Anonymous movement. RESULTS: In the course of the psychotherapeutic treatment--discordantly with prior research expectations--neither the so-called private nor the public self-consciousness changed. In turn, as hypothesised, social anxiety decreased significantly. CONCLUSIONS: 1. Decrease of social anxiety shows effectiveness of the therapeutic approach, which is higher than that of the sole Alcoholics Anonymous programme. 2. Further research should be focused on refinement of both the tool measuring self-consciousness changes and some elements of the therapeutic agenda.

Adult↗
PubMedDate not supplied

Orthopedic surgeons' attitudes and practices concerning treatment of patients with HIV infection.

Concern regarding an occupational risk of acquiring human immunodeficiency virus (HIV) infection may influence surgeons' willingness to operate. A questionnaire survey of all orthopedists in the five cities with the most cases of acquired immunodeficiency syndrome (AIDS) was conducted to assess attitudes and practices. Questionnaires were completed anonymously by 325 of 510 orthopedists. In the previous year, 43 percent had examined or operated on an HIV-infected patient, and at least 90 percent who had had an opportunity to operate on an HIV-infected patient had chosen to do so. Decisions to operate did not appear to be based on hospital requirements, perceived ethical obligations, or knowledge of HIV transmissibility. Most orthopedists (85 percent) claimed the right to order preoperative HIV testing of high-risk patients, but such testing was ordered infrequently. Although most orthopedists believed they could not be compelled to operate and that ethically they could refuse when their health was threatened, they almost always were willing to treat HIV-infected patients.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Diagnostic screening of NEUROD1 (MODY6) in subjects with MODY or gestational diabetes mellitus.

AIMS: Diagnostic screening of NEUROD1 in patients with maturity-onset diabetes of the young (MODY) without mutations in the known MODY-genes (MODYX) and in subjects diagnosed with gestational diabetes mellitus. METHODS: Direct sequencing of NEUROD1 was performed in (i) 73 probands with clinical MODY without mutations in hepatocyte nuclear factor (HNF)-4alpha (MODY1), glucokinase (MODY2) and hepatocyte nuclear factor (HNF)-1alpha (MODY3), and (ii) 51 subjects diagnosed with gestational diabetes. Control material consisted of 105 anonymous blood donors. RESULTS: Mean age at diagnosis of diabetes was 22 and 30 years in the MODYX patients and gestational diabetes mellitus subjects, respectively. Mean fasting blood glucose (9.6 +/- 4.3 vs. 5.7 +/- 1.0 mml/l) as well as glycosylated haemoglobin (8.2 +/- 2.4 vs. 6.0 +/- 0.6%) were higher in the MODYX patients than subjects with gestational diabetes. NEUROD1 mutations were not detected in our two study groups. Three previously reported polymorphisms were found: Ala45Thr, Pro197His and IVS1 -32 nt C>T. The amino acid substitution serine to cysteine in codon 29 (designated Ser29Cys) was detected in one out of 105 control subjects. As the control material consisted of anonymous blood donors, we were prevented from investigation of possible co-segregation between the sequence variant Ser29Cys and diabetes mellitus. CONCLUSIONS: As we found no NEUROD1 mutations, diagnostic screening for this gene is not warranted in Norwegian MODYX patients. Our study also suggests that NEUROD1 is not a candidate gene in gestational diabetes mellitus (GDM). The sequence variant Ser29Cys was identified in one anonymous DNA sample, but we were prevented from studying possible co-segregation with diabetes mellitus.

Adult↗
PubMed2006

[Identity and dissociation in cyberspace. A case of dissociative identity disorder associated with internet role playing].

OBJECTIVE: By mediating dissociative experiences, the Internet can challenge the boundaries of people's sense of identity. To illustrate this hypothesis, a case of dissociative identity disorder (DID) is presented. CLINICAL PICTURE: A young unemployed woman created and frequently played several characters in an online game. For more than 2 years she spent up to 12 h a day in the Internet, assuming various personalities, which in return intruded upon her neglected real life. TREATMENT AND OUTCOME: During the course of an inpatient psychotherapeutic treatment, the clinical diagnosis of DID was confirmed by psychometric testing. After 12 weeks of psychotherapy, the patient had managed to identify her fragmented identities as character traits and integrated them into her core personality. She rearranged her real everyday life, found a new job, and reduced her online activities. DISCUSSION: Even though the patient's psychopathology stems from a disposition in terms of a personality disorder with histrionic and narcissistic features, excessive internet role play obviously functioned as a trigger to develop DIS. Conclusively, cyberspace's anonymous interactivity may offer the possibility to explore one's identity while also putting at risk its coherence.

Adult↗
PubMed2002

Human histamine N-methyltransferase pharmacogenetics: gene resequencing, promoter characterization, and functional studies of a common 5'-flanking region single nucleotide polymorphism (SNP).

Histamine N-methyltransferase (HNMT) catalyzes one of two major metabolic pathways for histamine. The levels of HNMT activity and immunoreactive protein in human tissues are regulated primarily by inheritance. Previous studies of HNMT identified two common single nucleotide polymorphisms (SNPs), including a functionally significant nonsynonymous coding SNP (cSNP), (C314T, Thr105Ile), but that polymorphism did not explain all of the phenotypic variation. In the present study, a genotype-to-phenotype strategy was used to search for additional genetic factors that might contribute to the regulation of human HNMT activity. Specifically, we began by resequencing the human HNMT gene using 90 ethnically anonymous DNA samples from the Coriell Cell Repository and identified a total of eight SNPs, including the two that had been reported previously. No new nonsynonymous cSNPs were observed, but three of the six novel SNPs were located in the 5'-flanking region (5'-FR) of the gene-including a third common polymorphism with a frequency of 0.367 (36.7%). That observation directed our attention to possible genetic effects on HNMT transcription. As a first step in testing that possibility, we created and studied a series of reporter gene constructs for the initial 1kb of the HNMT 5'-FR. The core promoter and possible regulatory regions were identified and verified by electrophoresis mobility shift assays. We then studied the possible functional implications of the new common HNMT 5'-FR SNP. However, on the basis of reporter gene studies, that SNP appeared to have little effect on transcription. Phenotype-genotype correlation analysis performed with 112 human kidney biopsy samples that had been phenotyped for their level of HNMT activity confirmed that the common 5'-FR SNP was not associated with the level of HNMT activity in vivo. In summary, this series of experiments resulted in the identification of several novel HNMT polymorphisms, identification of the HNMT core promoter, and a comprehensive functional genomic study of a common HNMT 5'-FR SNP. These results represent an additional step in the definition of molecular genetic mechanisms involved in the regulation of this important autacoid-metabolizing enzyme in humans.

5' Flanking Region↗
PubMed1998

The rise and fall of levonorgestrel implants: 1992-1996.

OBJECTIVE: To assess shifts over a 4-year period in attitudes of low-income US women regarding use of levonorgestrel implants. METHODS: An anonymous questionnaire was administered at two different points in time to English-speaking women of reproductive age seeking gynecologic or obstetric care in southeast Texas. The first survey, administered to 762 women in 1992, elicited information on demographic and reproductive characteristics, as well as exposure to information on implants and attitudes regarding use of this method. This same survey was administered again in 1995-1996 to 502 women. chi2, Student t, or Kruskal-Wallis nonparametric tests were used to evaluate shifts in attitudes and perceived barriers to use across the 4-year period. RESULTS: Women portrayed less positive attitudes about levonorgestrel implants when surveyed in 1995-1996 as compared with 1992. Most notably, they appeared less appreciative of the convenience associated with implant use and more concerned with potential side effects. Nulliparous and parous women surveyed in 1995-1996 were significantly less likely than those surveyed in 1992 to state that they would consider using this method for birth control (P < .001) and were more likely to state that their partner, friends, and family would object to their use of levonorgestrel implants. CONCLUSION: This study documents the decline in popular perceptions of levonorgestrel implants among low-income English-speaking women over the 4-year period following the introduction of this contraceptive method to the US market.

Adult↗
PubMed2005

The public health response to epidemic syphilis, San Francisco, 1999-2004.

In 1999, the Centers for Disease Control and Prevention launched the National Plan to Eliminate Syphilis. From 1999 to 2003 in San Francisco, early syphilis was epidemic, increasing from 44 cases to 522 cases a year. Syphilis cases were more likely to be in gay or bisexual men, those with human immunodeficiency virus (HIV) infection, those who had anonymous partners, and those who met sex partners on the Internet. Increases in sexual activity and sexual risk behavior in men who have sex with men during this period have been attributed to the improved physical health of HIV-infected men on highly active antiretroviral therapy, HIV treatment optimism, increases in methamphetamine use, and the use of Viagra. The San Francisco Department of Public Health's response to the epidemic included enhanced surveillance, expanded clinical and testing services, provider and community mobilization and sexual health education, and risk factor identification and abatement through investigations, public health advocacy, and treatment. Collaborations with community-based organizations and local businesses were key to the successful implementation of disease-control efforts. A multitude of converging risk factors and new environments contributed to the syphilis epidemic, requiring a comprehensive, innovative, and flexible disease-control strategy.

Contact Tracing↗
PubMed1996

Genetics of scnDNA polymorphisms in juvenile oysters (Crassostrea virginica). Part I: Characterizing the inheritance of polymorphisms in controlled crosses.

The amplification of DNA by polymerase chain reaction followed by restriction enzyme digestion was used to examine five anonymous single-copy nuclear DNA polymorphisms in 11 pair crosses for juvenile oysters (Crassostrea virginica). There was an overall 7% frequency of aberrant (non-Mendelian) offspring genotypes among 174 total pair-cross progeny. Strict Mendelian inheritance of alleles was observed for two of the five loci. Possible explanations for the aberrant offspring genotypes include nonamplifiable alleles owing to priming site polymorphism or aneuploidy, or paralogous amplification. Analysis of more pair crosses is needed to test these explanations.

Animals↗
PubMed1997

[Alcohol consumption and adolescence: a descriptive epidemiological study].

OBJECTIVES: To determine the consumption of alcoholic drinks among adolescents in Tres Cantos and its defining characteristics. DESIGN: A descriptive, cross-sectional study. SETTING: State schools in Tres Cantos. PARTICIPANTS: All the students present (994) who had registered for the 1994-95 year. MEASUREMENTS AND RESULTS: A self-filled anonymous questionnaire was answered in the class-rooms of the schools in Tres Cantos during May 1995. The relationship between the variables was worked out using the computer programme EPI-INFO (version 5.01). 73.1% of those polled consumed alcoholic drinks. There were no significant differences for gender. Most consumption was at the weekend. The commonest drink was wine and its combinations, followed by beer, rum or gin and coke, spirits and fizzy drinks. The CAGE test was positive in 14.1% of cases. 59.6% had got drunk on some occasion, 89.3% consumed alcohol for the first time before they were 16, which most did outside the home. There was a significant association between participating in religious activities and less alcohol consumption. CONCLUSIONS: The percentage of alcohol consumers among students is high. It is characterised by being similar in both sexes, starting at an early age and clear predominance of consumption at weekends and outside the home. Wine and its combinations is the commonest drink.

Adolescent↗
PubMed2000

vCJD - predicting the future?

The recent emergence of variant Creutzfeldt-Jakob disease (vCJD) in the UK, and demonstration that vCJD is caused by the same prion strain that causes bovine spongiform encephalopathy, have led to concerns about the possibility of a human epidemic. Although only 79 cases of vCJD have occurred to date, it is likely that hundreds of thousands of infected cattle entered the human food chain in the late 1980s and early 1990s, and the average incubation period of vCJD is unknown. Mathematical models have not yet been able to give useful predictions of future numbers of cases, and in the absence of a blood test for vCJD, current attempts to reduce uncertainties about future numbers of cases are based on the accumulation of PrPSc in lymphoreticular tissues. Extensive lymphoreticular PrPSc accumulation has been seen in all cases of symptomatic vCJD so far examined, and in one case 8 months prior to the onset of symptoms. Animal models of prion disease suggest that lymphoreticular involvement occurs early in the incubation period and reliably predicts future neurological disease. Based on these data, large scale anonymous studies looking for PrP accumulation in surgically removed tonsillectomy and appendicectomy specimens are underway. Examination of the first 3000 specimens has not revealed any positive samples, but at the moment the significance of negative findings is uncertain. It is anticipated that by the time these studies are complete more data will be available on how early PrP can be demonstrated in lymphoreticular tissue in vCJD, which together with the results from examination of further samples, will allow some comment as to the likelihood of a large human vCJD epidemic.

Creutzfeldt-Jakob Syndrome↗
PubMed1998

Mental health, absenteeism and earnings at a large manufacturing worksite.

BACKGROUND: A few recent studies have examined the relationship between mental illness and labor market variables. The findings are inconsistent, however, and leave unanswered many questions concerning both the nature and magnitude of the relationship. AIMS OF THE STUDY: A recently available worksite-based data set is analyzed to explore the relationship between symptoms of emotional and psychological problems and employee absenteeism and earnings among employees at a large US worksite. METHODS: The analysis was based on data collected through a random and anonymous survey of workers at a large US manufacturing worksite. Two measures of absenteeism are combined - days absent during the past 30 days due to sickness or injury and days absent during the past 30 days because the employee did not want to be at work - to create both a dichotomous (i.e., ever absent) and a continuous (i.e., number of days absent) absenteeism variable. Annual earnings were measured as personal earnings from the primary job. Various statistical models were tested to determine the independent and joint (with alcohol and illicit drug use) relationship between symptoms of emotional problems and labor market variables. RESULTS: The analysis consistently finds that workers who report symptoms of emotional/psychological problems have higher absenteeism and lower earnings than otherwise similar coworkers. This finding is robust to model specification and to the inclusion of comorbid conditions such as alcohol and illicit drug use. DISCUSSION: This study contributes new information to the literature in this area by estimating the effects of emotional/psychological symptoms on two important labor market variables: absenteeism and earnings. Several specifications of the absenteeism and earnings equations were estimated to test the independent effect of emotional symptoms and the joint effects of emotional symptoms and other comorbid conditions. The results suggest that employers should consider the productivity losses associated with workers' mental health when designing worksite-based programs such as employee assistance programs (EAPs). LIMITATIONS: Unlike national surveys of households or individuals, the sample does not include unemployed individuals or those outside the labor force. Therefore, the decision to participate in the labor market can not be modeled. In addition, the study relies on voluntary self-reported survey data that may suffer from underreporting of substance use and emotional symptoms. Although respondents were repeatedly assured about confidentiality, if underreporting does exist, it may be more acute than in household surveys because respondents may be more worried about job loss if they self-report drug or alcohol use at the worksite. CONCLUSIONS: All four measures of emotional symptoms had a positive and statistically significant relationship with absenteeism and a negative and statistically significant relationship with personal earnings. These findings were robust across all specifications, even when the effects of other potentially confounding factors (i.e., alcohol and drug use variables) are included. In addition, the number of days intoxicated and cigarette use in the past year appear to be significantly related to earnings even after controlling for emotional symptoms. Finally, the explanatory power of the models is relatively high for cross-sectional data, especially for the earnings regressions. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: The findings from this worksite suggest that employers might do well to reassess the priorities of their EAPs and consider directing more of their resources to diagnosing and assisting employees with emotional and psychological distress. IMPLICATIONS FOR HEALTH POLICY FORMULATION: It is strongly suggestive that mental health status is related to absenteeism and earnings for employees at this worksite. However, most employer-based programs and policies are designed to dissuade the use of alcohol and illicit drugs by workers (e.g., employee drug and alcohol testing) rather than addressing other employee behaviors and problems. IMPLICATIONS FOR FURTHER RESEARCH: Numerous opportunities are present to collect similar data from other worksites and settings to determine whether these models and results are robust.

Journal Article↗
PubMed1989

Gene diagnosis in X-linked ichthyosis.

Three families segregating for X-linked ichthyosis (XLI) were analysed using the full-length STS cDNA probe and an anonymous polymorphic DNA sequence closely linked to the STS gene. In patients from two of the families, submicroscopic chromosomal deletions could be detected using both the STS and the GMGX9 (DXS237 locus) probes. Patients in the third family showed the same hybridization pattern as healthy males following molecular hybridization with either of the probes. The results of DNA analysis (indirect genotype diagnosis) agree well with those based on the arysulfatase C/beta-gal determination and prove the reliability of the biochemical test. Both methods are discussed for carrier detection, prenatal diagnosis, and genetic counseling.

Arylsulfatases↗
PubMed1992

A preliminary linkage map of the chicken genome.

We have used backcross progeny from a cross between two inbred lines of chickens to construct a linkage map of the chicken. The map currently consists of 100 loci, identified using either anonymous cloned fragments of genomic DNA or sequences corresponding to cloned genes. Parent birds were derived from two lines of White Leghorn chickens, which differ in susceptibility to a number of diseases. Restriction fragment length variants were identified by comparison of the DNA of these two parent birds using a panel of seven restriction enzyme digests and the segregation pattern observed in progeny of these two birds. Restriction fragment length variants were detected for approximately 41% of the clones tested, whether these were known genes or random genomic fragments. This high level of variability was also reflected in the presence of variation within the parental lines for some clones. The overall size of the linkage groups and the progressively higher incidence of linkage as further clones were added suggests that the map covers the majority of the genome, although it is unlikely that there are marker loci on all the microchromosomes. The present map will be of use in locating genes affecting disease resistance, but also illustrates the relative ease with which such maps for the chicken can be constructed.

Animals↗
PubMed1999

Carbohydrate-deficient transferrin as compared to other markers of alcoholism: a systematic review.

This is a systematic review of the studies in which carbohydrate-deficient transferrin (CDT) has been compared to other laboratory markers in different experimental conditions, clinical settings, and populations. Only the studies (n = 54) in which CDT was compared either to the conventional or new biological markers of alcoholism, heavy drinking, or alcohol use were selected for further evaluation. Two prospective studies indicate that in men CDT is slightly more sensitive than gamma-GT in reflecting changes in these markers caused by drinking of a moderate and fixed amount of alcohol during three to four weeks. In one prospective study, in which the drinking history of male heavy drinking volunteers was as close the golden standard as possible; that is, obtained by a prospective anonymous drinking diary, CDT was slightly but not significantly better marker than conventional laboratory markers (ASAT, ALAT, gamma-GT and beta-Hex) in the identification of men drinking more than 400 g of alcohol daily. Similar prospective studies concerning women have not been done. Six prospective treatment outcome studies indicate that CDT may be a significantly more sensitive marker than gamma-glutamyltransferase (gamma-GT) in the detection of relapses in male alcoholics. However, these two tests can also be considered to be complementary markers. Furthermore, in the detection of relapses the baseline values of CDT and gamma-GT should be measured and compared on individual basis to the pretreatment values. Comparable data are not available from female alcoholics. In selective materials comprising male alcoholics and heavy drinkers, CDT was found to be a slightly more sensitive marker than gamma-GT in seven retrospective studies. In five studies, gamma-GT was slightly better. However, the differences between CDT and gamma-GT in general were not statistically significant. In three studies, the combined use of CDT and gamma-GT improved the sensitivity but with the expense of specificity. Only four studies included women and in three of these the sensitivity of gamma-GT was better than that of CDT, whereas in one study CDT was better than gamma-GT in the detection of female heavy drinkers. Seven studies performed in primary health care settings and among young populations demonstrate that the performance of CDT in the identification of heavy and problem drinkers in this type of populations is very low, although comparable to the poor performance of the conventional laboratory markers, too. According to seven studies, the sensitivity of gamma-GT is slightly better than that of CDT in the identification of excessive alcohol consumption among hospitalized male and female patients. However, in this type of hospital setting, the specificity of CDT is markedly higher than that of gamma-GT. There is some evidence indicating that the performance of the tests can be improved with the combined use of both tests. Eight studies indicate that both in men and women CDT is a better marker than gamma-GT in the identification of alcohol abuse among patients with alcoholic and nonalcoholic liver diseases. This is mostly due to the higher specificity of CDT as compared to that of gamma-GT.

Alcohol Drinking↗
PubMed1998

Assessment of motivations for return donation among deferred blood donors. American Red Cross ARCNET Study Group.

BACKGROUND: The recent addition of a computerized donor deferral registry to American Red Cross blood donation procedures has enabled blood center staffs to identify, before donation, persons who attempt to donate despite previous deferral. The current study investigated reasons that deferred donors return to donate, despite having been notified that they are ineligible. STUDY DESIGN AND METHOD: Anonymous mail surveys requesting demographic information, details of last donation or attempted donation, and assessments of incentives for donating were sent to 311 donors presenting inappropriately at blood drives and 849 matched controls in three American Red Cross regions between April and July 1996. RESULTS: Responses were received from a total of 113 deferred donors and 388 matched controls. Analysis of the 49 permanently deferred donors indicated that they were more likely than controls to donate blood to receive test results or to be awarded community service credit. Responses also revealed that some deferred donors may return to donate blood because of a misunderstanding of the deferral message or erroneous recruitment by blood center staff. CONCLUSION: There is a need before donation for the provision of educational materials regarding the window period of infection and for careful consideration of the use of incentives to attract donors to blood centers. It is also important to provide to donors a clear and consistent message regarding their test results and deferral status.

Altruism↗
PubMed2002

Diagnostic value of the chest radiograph in asymptomatic neonates with a cardiac murmur.

AIM: To establish the diagnostic accuracy and diagnostic usefulness of the chest radiograph in asymptomatic neonates with cardiac murmurs. PATIENTS AND METHODS: The chest radiographs of 68 asymptomatic neonates with cardiac murmurs were analysed retrospectively. The radiographs were anonymized and then evaluated for the presence or absence of cardiac disease by six radiologists, three who regularly interpret neonatal chest radiographs and three who do so infrequently. The eventual diagnosis for each neonate and the impact of the chest radiograph and original report on patient management were established by review of the clinical case notes. RESULTS: The results for each observer were expressed in 2 x 2 contingency tables and statistical analysis was performed using Fisher's exact test. The radiologists who were experienced in reporting neonatal chest radiographs achieved statistically significant results (P=0.003, P=0.002 and P=0.007) compared with those who were less experienced (P=0.13, P=0.16 and P=0.09). Review of the case notes established that the chest radiograph and original report did not influence clinical management in any of the 68 cases studied. CONCLUSIONS: Radiologists who frequently report neonatal chest radiographs achieve high accuracy in differentiating cardiac from non-cardiac disease. However, inaccuracies are unavoidable as radiological evidence of cardiac disease is often not present. A false-positive result could cause undue anxiety while a false-negative report could result in the omission of further investigations. Furthermore, a chest radiograph is unlikely to provide the definitive diagnosis. Chest radiographs did not appear to influence patient management in this study and cannot be recommended in the initial evaluation of the asymptomatic neonate with a heart murmur.

Diagnostic Errors↗
PubMedDate not supplied

Quality-of-life evaluation in an interferon therapy after radical surgery in cutaneous melanoma patients.

Melanoma is the fastest growing solid tumor in men and women, and despite accounting for only 4% of skin cancer cases, it accounts for more than 79% of skin cancer-related deaths. The present study was designed to evaluate the impact of interferon (IFN) treatment on patients' quality of life (QOL) after radical surgery of cutaneous melanoma. The tests were carried out in a group of patients treated in the Department of Soft Tissue and Bone Cancer, Institute of Oncology, in Warsaw. The present study included 2 groups of the patients, 110 persons each. One group consisted of patients who had been subjected to radical surgery of cutaneous melanoma, and the other one consisted of 110 patients treated with a supplementary interferon alfa-2b (IFN-alpha-2b) therapy. Data were collected by means of an anonymous QLQ-C30 (version 2.0.) questionnaire elaborated and provided by the European Organisation for Research and Treatment of Cancer. The QLQ-C30 questionnaire consisted of 43 questions. The IFN-alpha-2b treatment significantly affected patients' physical condition, mental health, and social life. The emotional state of the patients was more affected during IFN-alpha-2b treatment. Somatic symptoms were also increased in those patients. The IFN-alpha-2b therapy also significantly affected family and social life. In spite of several adverse effects, the patients assessed their QOL as good. The IFN-alpha-2b treatment is troublesome for the melanoma patients. It is important that the treating physician and nurse should be aware of the 4 major categories of IFN-alpha-2b toxicity: constitutional, neuropsychiatric, hepatic, and hematologic. A number of steps can be taken to minimize the morbidity associated with IFN-alpha-2b therapy, resulting in an improvement in both QOL and patient compliance.

Activities of Daily Living↗