Polymeric prodrugs of mitomycin C designed for tumour tropism and sustained activation

Prodrugs of mitomycin C (MMC) based on soluble poly-[N-(2-hydroxyethyl)-L-glutamine] (pHEG) polymers have been evaluated as tumour-targeted drugs. These materials are designed to exploit the enhanced permeability of tumour vasculature, combining a passive tumour tropism with decreased systemic liberation of free MMC. A tri- or tetrapeptide linkage (e.g. Gly-Phe-Ala-Leu) between pHEG and the aziridine nitrogen of MMC can combine good hydrolytic stability with rapid cleavage by lysosomal enzymes, releasing free MMC. The conjugates showed decreased systemic toxicity and could be administered to mice at a total MMC dose of 15 mg/kg i.v., compared with just 6 mg/kg for free MMC. Conjugates also showed better activity against animal models of established tumours, achieving up to 77% increased life span (ILS) against solid P388 leukaemia, compared with only 23% for free MMC, and up to 121% ILS against solid C26 colorectal carcinoma, compared with no activity for the free drug. Improving the therapeutic index of anticancer drugs by combining tumour tropism with decreased systemic toxicity is a versatile approach that should produce a new generation of improved anticancer agents.     

Blood pressure estimation and beliefs among normotensives and hypertensives.

14 medicated hypertensive, 15 nonmedicated mild hypertensive, 39 normotensive, and 13 hypotensive adults participated in a 1–2 hr laboratory experiment that assessed each S's symptoms, moods, and estimates of systolic blood pressure (SBP) relative to actual SBP levels. Several self-reports and autonomic measures were collected during and after each of 22 tasks. Within-S correlations indicated that all Ss could estimate SBP at levels greater than chance. Further, 68% of the Ss evidenced at least 1 significant symptom–SBP correlation. Although medicated hypertensives believed they could estimate their BP more accurately than other groups, they were actually no more accurate than the other Ss. They also evidenced far fewer empirically derived symptom–SBP and emotion–SBP correlations than any other group. Overall, blood pressure (BP) beliefs were largely inaccurate. If these erroneous beliefs can be eliminated, Ss may be able to estimate BP fluctuations more accurately. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer consultation groups for psychologists in private practice: A national survey.

We report the results of the first national survey of psychologists in private practice regarding their participation in peer consultation groups. The sample (71% return) was drawn from 800 randomly selected psychologists listed in the National Register of Health Service Providers in Psychology. We found that 23% of the sample currently belonged to peer consultation groups, and 24% had belonged in the past. Of those not currently in groups, 61% expressed the desire to belong if one were available. There were virtually no significant demographic differences between current members and nonmembers. We examined the following group characteristics: formation, length of existence, size, membership, leadership, theoretical orientation, range of experience, time and place, content, and group process. Groups tended to be small, informal, and leaderless; however, we found great variation among groups on all dimensions. Findings also showed a high degree of satisfaction with membership. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Robust crossfeed design for hovering rotorcraft

Control law design for rotorcraft fly-by-wire systems normally attempts to decouple the angular responses using fixed-gain crossfeeds. This approach can lead to poor decoupling over the frequency range of pilot inputs and increase the load on the feedback loops. In order to improve the decoupling performance, dynamic crossfeeds should be adopted. Moreover, because of the large changes that occur in the aircraft dynamics due to small changes about the nominal design condition, especially for near-hovering flight, the crossfeed design must be ‘robust’. A new low-order matching method is presented here to design robust crossfeed compensators for multi-input, multi-output (MIMO) systems. The technique minimizes cross-coupling given an anticipated set of parameter variations for the range of flight conditions of concern. Results are presented in this paper of an analysis of the pitch/roll coupling of the UH-60 Black Hawk helicopter in near-hovering flight. A robust crossfeed is designed that shows significant improvement in decoupling perfomance and robustness over the fixed-gain or single point dynamic compensators. The design method and results are presented in an easily used graphical format that lends significant physical insight to the design procedure. This plant precompensation technique is an appropriate preliminary step to the design of robust feedback control laws for rotorcraft.     

Percutaneous endoscopic gastrostomy (PEG) in upper gastrointestinal tract occlusion in gynecologic oncology

BACKGROUND AND AIMS: Intestinal obstruction is a frequent cause of death in patients suffering from gynecological cancer, who have undergone multiple treatment in the form of surgery and/or chemotherapy and/or radiotherapy. The usual form of rescue treatment consists in the use of a nasogastric tube to administer support and analgesic treatment. Surgical gastrostomy is not a viable proposition in these extremely weak patients with large masses compressing and displacing the stomach. Percutaneous endoscopic gastrostomy (PEG), a technique first introduced for nutritional purposes, can be beneficially used to achieve decompression in these patients. METHODS: PEG was performed in a total of 67 patients who had already undergone multiple treatment for abdominal-pelvic neoplasia with upper gastrointestinal obstruction, who could no longer be operated and who had a life expectancy of less than sixty days. In three cases positioning was not possible owing to the lack of transillumination of the gastric and abdominal wall. 54/64 patients had previously undergone at least two operations. RESULTS: Esophagogastric lesions were found in 29% of patients, some of which were attributed to the nasogastric tube. Symptomatic wellbeing was obtained in 76.5% a few days after PEG. PEG remained in situ from 4 to 472 days. Slight peristomal infection was observed in 9% of cases. In seven cases it was necessary to add octreotide owing to the reappearance of symptoms. CONCLUSIONS: PEG is relatively easy to use and allows obstructive symptoms to be resolved in the majority of patients. Special medical skills are not required and the patient may be easily managed at home together with support therapy and pain management. Once PEG has been performed, it is possible to take fluids and semi-liquid foods, offering the patient a chance to taste flavours which have often been forgotten. PEG enables neoadjuvant chemotherapy to be performed in patients with previously untreated intestinal obstruction.     

The effects of growth hormone in children with a GH deficiency: a report of 5 cases

The authors describe 5 cases, 3 boys and 2 girls, with idiopathic growth hormone deficiency in prepubertal age, treated with human growth hormone. In four of five cases the response to treatment with GH was relevant. Only in one case (F1) the response was negative. The results of this study confirm that rhGH is a safe and effective therapy in children with GHD.