Treatment-induced mucositis: an old problem with new remedies

Mucositis may be a painful, debilitating, dose-limiting side-effect of both chemotherapy and radiotherapy for which there is no widely accepted prophylaxis or effective treatment. The basis of management is pain relief, prevention of dehydration and adequate nutrition. When tested vigorously, most antiseptic mouthwashes and anti-ulcer agents are ineffective. Simple mechanical cleansing by saline is the most effective traditional measure. A variety of new agents are effective. Granulocyte macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) act outwith the haemopoeitic system and can reduce mucositis, but the best schedule, dosage and method of administration is not known or which is the best growth factor to prevent this side-effect. A placebo-controlled randomized trial of antibiotic pastilles has shown a significant reduction in mucositis and weight loss during radiotherapy for head and neck cancer. Another method to reduce radiation effects in normal tissue is to stimulate cells to divide before radiotherapy by silver nitrate or interleukin 1. These methods may be particularly effective when given along with hyperfractionated radiation treatment such as CHART.     

Hemophilia. A new approach to an old disease

The history of hemophilia diagnosis and therapy has been a turbulent one. We are coming full circle, back to the use of genetics as the main diagnostic tool for this disease. Therapeutically, the retroviruses that ravaged one generation of hemophiliac patients now may participate in the cure for the next generation. The hemophilia community hopes that the future of hemophilia care will follow a course guided by this modified quote from James Russell Lowell: "New times demand new measures, and men [and women]. As the world advances and in time outgrows the laws that in our fathers' [and mothers'] days were the best, doubtless after us some purer scheme will be shaped out by wiser man [and women] than we, made wiser by the steady growth of truth."     

Expandable rings. A new solution to an old problem

A number of solutions are presented for the problem of over-tight rings particularly in patients with deforming arthropathies of the hand. Rings can be adapted by various methods to allow them to be worn on deformed fingers. An illustrative case is reported.     

Post-mastectomy seroma: a new look into the aetiology of an old problem

Postmastectomy seroma (PMS) remains an unresolved quandary as the risk factors for its formation have still not been identified. Sixty-four consecutive female patients undergoing Halsted mastectomy were prospectively studied for this purpose. The risk factors that were studied included age and weight, diabetes, hypertension, tumour (size and location) and nodal (positive or negative) status and the use of perioperative blood transfusion. Additionally, the effect of PMS on total hospital drainage (THD), post-operative hospital stay and other wound-related complications were assessed. The incidence of PMS in this study was 28%, and those patients with PMS were designated as group A while the remaining patients were designated as group B. Group A patients were significantly older (P < 0.02) and heavier (P < 0.05) than group B patients; also, there were significantly (P < 0.0001) greater number of hypertensive patients in group A than in group B. In terms of other risk factors the two groups were statistically similar. Group A patients had significantly greater (P < 0.01) amount of THD than group B patients. Although no septic complications were observed as a result of seroma, its presence significantly (P < 0.0001) lengthened the post-operative hospital stay in group A patients. It is concluded that (1) PMS is a common problem, (2) its occurrence significantly increases the post-operative hospital stay, and (3) hypertension is perhaps the most important risk factor for its causation. Hypertension contributes to seroma formation, probably by way of prolonged oozing from the large mastectomy wound.(ABSTRACT TRUNCATED AT 250 WORDS)     

Infectious diseases in athletes: new interest for an old problem

Interest in infectious disease among athletes has been greatly stimulated over the past decade by the development of modern automated systems that can enumerate specific elements of the immune system. Research has confirmed earlier clinical and animal studies in showing that either a single bout of exhausting exercise or persistent over-training can increase susceptibility to upper respiratory and other viral infections, although resistance to bacterial infections is apparently unaltered. Such findings do not seem a non-specific response to cooling and drying of the tracheal mucosa. Rather, heavy exercise has a depressant effect upon the T cell/interleukin/NK cell system which may persist for a week or more. In contrast, moderate training enhances immune defences. Given the negative impact of acute viral infections upon both competitive performance and morale, plus the occasional incident of sudden death associated with viral myocarditis, it is important that sports physicians minimize the incidence of viral infections in the athletes for whom they are responsible. Potential tactics include maintenance of immunization schedules, minimizing of exposure to infection, avoidance of over-training, maintenance of an adequate diet, and reduction of psychological and environmental stress. In top athletes, the regular monitoring of immune status may also be warranted, with the possible administration of immunoglobulins and prostaglandin inhibitors as required.     

aDNA--a new approach to old questions

aDNA-analyses are presented for ancient bones, teeth, soft tissues and dried body fluids. The implications and perspectives for Historical Anthropology are discussed. Methods are described on examples of molecular sex determination and kinship analysis. Finally, first amplifications of DNA-sequences from pathogenes of tuberculosis and plague from ancient skeletal material are reported.     

Sex differences, androgyny, and approach responses to erotica: A new variation on the old volunteer problem.

In Study 1, 52 male and 41 female college students were ostensibly given a choice between a hard-core, "lustful" film and a soft-core, "loving" film. Consistent with predictions, results indicate relatively less approach of the lustful theme film by females. Study 2 was a field experiment in which 43 female and 41 male college students were contacted by telephone and asked to volunteer for an experiment involving erotica or one involving perception of geometric figures. Females were less likely than males to volunteer for a study involving erotica, regardless of whether it was described as hard- or soft-core in nature. Results for Ss who had completed the Bem Sex-Role Inventory indicated that the effect was obtained only for sex-typed (vs androgynous) Ss. The possible influence of S self-selection on laboratory studies in this area is considered. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Negro-white differences in intelligence test performance: A new look at an old problem.

Negro-white differences on mental tests are evaluated in this paper, which was prepared at the suggestion of the Society for the Psychological Study of Social Issues (Division 9 of the American Psychological Association). "The evidence against the assumption of native differences in intelligence test performance between Negroes and whites still seems to me to be very convincing." There is "no scientifically acceptable evidence for the view that ethnic groups differ in innate abilities. This is not the same as saying that there are no ethnic differences in such abilities… . The science of psychology can offer no support to those who see in the accident of inherited skin color or other physical characteristics any excuse for denying to individuals the right to full participation in American democracy." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cardiovascular nuclear medicine: a new look at an old problem. Noninvasive approaches to the evaluation of coronary heart disease: new horizons for radiologists lecture

Radioactive tracers were first used to investigate cardiovascular physiology in 1927. Since that time, many procedures have been developed to measure perfusion to the myocardium and the function of the heart. The site and extent of both fixed and transient changes in regional perfusion can be detected noninvasively with monovalent cationic tracers. In addition, both the total function of the heart, such as cardiac output, and ejection fraction of both ventricles and the regional function such as wall motion measurements can be readily performed following intravenous administration of tracers. These tests are useful in evaluating patients with suspected or proved coronary artery disease.