Alcoholism: independent predictor of survival in patients with head and neck cancer

BACKGROUND: Despite recognition of the high prevalence of alcoholism among patients with head and neck cancer, the prognostic importance of alcoholism has not been evaluated adequately. Previous investigators have speculated that alcoholic patients may have a poorer prognosis than nonalcoholic patients because of more advanced stage of cancer, the immunosuppressive effects of alcohol, and an increased rate of death due to other alcohol-related diseases. PURPOSE: The goal of this population-based study was to identify the features of alcoholism that are associated with survival for patients with head and neck cancer and to develop an alcoholic severity staging system from a composite of the independent features of alcoholism. METHODS: This prospective study included 649 patients who were diagnosed with cancer of the oral cavity, oropharynx, hypopharynx, or larynx during the period from September 1, 1983, through February 28, 1987, in a three-county area of western Washington state that participates in the Surveillance, Epidemiology, and End Results Program of the U.S. National Cancer Institute. Details on lifetime alcohol consumption, treatment for alcoholism, abstinence from alcohol prior to the diagnosis of cancer, and alcohol-related health problems were ascertained through in-person interviews near the time of diagnosis. Patients were classified as either nonalcoholics or alcoholics according to their responses to questions from the Michigan Alcoholism Screening Test. The measures of alcohol consumption and abuse that were found to be independently associated with 5-year survival by logistic regression analysis were combined using conjunctive consolidation to create a final composite variable, called an alcoholic severity stage. Cox proportional hazards regression analysis was done to estimate the relative risk (R) of death within 5 years due to specific causes of death for each of the alcoholic severity stages. RESULTS: Alcoholism (RR = 2.06; 95% confidence interval [CI] = 1.43-2.98) and a history of alcohol-related systemic health problems (i.e., liver disease, pancreatitis, delirium tremens, or seizures) (RR = 2.76; 95% CI = 1.69-4.49) were associated with an increased risk of death, whereas abstinence (i.e., the consumption of fewer than one drink per week at 1 year prior to the diagnosis of cancer) (RR = 0.62; 95% CI = 0.39-0.97) was associated with a decreased risk of death. These associations were independent of age, site of cancer, anatomical stage, histopathologic grade, smoking, and type of antineoplastic treatment. Patients in the two worst alcoholic severity stages had an increased risk of dying not only of head and neck cancer but also of cardiovascular disease, pulmonary disease, and other alcohol-related causes. CONCLUSIONS: Alcohol abuse, measured by alcohol consumption, functional impairment, a history of alcohol-related health problems, or abstinence, can provide important prognostic information for patients with head and neck cancer. Our results suggest that sobriety among alcoholic patients can lead to prolonged survival.     

Gelling of alginate fibres

Equipment was developed to measure the time for complete gelling of sodium alginate fibres in calcium chloride solution, taken as the time to achieve maximum tensile strength. The effects of fibre diameter, alginate concentration, alginate composition and calcium chloride concentration on gelling time were investigated. A diffusional model, developed to predict the gelling time, agreed with experimental results except for the effect of calcium ion concentration which was modelled empirically.     

Appearance of homogeneous smectic multilamellar microenvironments in biomembranes undergoing superoxide-initiated lipid peroxidation: lipid-dienyl radical accumulation and fluidity management in lipid bilayers

Erythrocyte ghosts were exposed to various levels of oxyradical shock in order to identify the extent of accumulation of peroxidative intermediates. Malondialdehyde reacting end products were the same in all different models. But, the accumulation of dienyl radical species increased with higher intensity of oxyradical shock. These dienyl radicals may rearrange to create a homogeneous smectic multilamellar microenvironment which may be more fluid in terms of the molecular dynamics.     

Scattering from coated targets using a frequency-dependent, surfaceimpedance boundary condition in FDTD

One method for reducing the radar cross section of objects such as aircraft and missiles is the application of a lossy coating. Computing scattering from targets coated with dielectric/magnetic materials is challenging due to the reduced wavelengths of an incident field inside the coating. These smaller wavelengths require finer sampling of the fields. A technique for implementing this calculation without greatly increased memory requirements or computation times has previously been developed using a finite-difference time-domain (FDTD) code which has been tested in one, two, and three dimensions. The method requires knowledge of the frequency behaviour of the complex permittivity and permeability, and the thickness of the dielectric coating and is applicable to thin coatings when one or more reflections from the conducting surface are significant. The impedance at the surface of the coating is computed based on the given information and then approximated using a summation of causal functions. The approximated impedance is Z-transformed and added to the FDTD code in special update equations for the fields at the surface of the coating. No computations are required inside the coatings so the FDTD grid can be sized based on the free-space wavelength. The result obtained is valid over the entire frequency range of interest, assuming that the approximated surface impedance is a good match over the entire range. Comparisons with measurements of a scale model coated missile show good agreement and almost no increase in resource requirements over a standard FDTD calculation for an uncoated metal target     

The relationship between attachment, psychopathology, and childhood disability.

Analyzes the literature on 3 aspects of attachment—neurobiological influences, interpersonal and intrapersonal factors, and societal factors—in the psychological development of chronically disabled children. Evidence suggests that neurochemical substances such as cortisol and brain biogenic amine systems reciprocally interact with psychological and psychosocial factors to influence attachment. Interpersonal and intrapersonal factors such as temperamental characteristics of children, severity and type of disability, and family influences interact in the process of attachment. Social perceptions and prejudices about the disabled individual increase parental stress, and diminish parental involvement and resources, which are necessary for attachment. These 3 processes are powerful and interrelated forces in child development, with potential to modify social competence, neurological development, and psychosocial adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of child and maternal processes in the psychological adjustment of children with sickle cell disease.

In this study, 64% of children aged 7–12 yrs with sickle cell disease were found to have a parent-reported behavior problem, and 50% met the criteria for a Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) diagnosis based on a structured clinical interview of the child. Internalizing types of behavior problems and diagnoses were the most frequent. Support was provided for a transactional stress and coping model in delineating the processes associated with child adjustment. In particular, maternal anxiety accounted for 16–33% of the variance in mother-reported internalizing and externalizing behavior problems, respectively, and child pain-coping strategies accounted for 21% of the variance in child-reported adjustment problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)