Survival of patients with carcinoma of the esophagus treated with combined-modality therapy

Since 1985, 229 cases of carcinoma of the esophagus have been considered for entry into a protocol with the use of preoperative chemotherapy and radiation therapy followed by surgical intervention as the primary element of treatment. One hundred sixty-five patients (93 with adenocarcinoma and 72 with squamous cell carcinoma) had esophagogastrectomy. The 5-year survival of the protocol patients who underwent resection was 25% for both groups--squamous cell carcinoma and adenocarcinoma. Of the protocol patients with squamous cell carcinoma who underwent resection, 40% had a sterilized specimen, whereas of those with adenocarcinoma, 20% had a sterilized specimen. If the patient had a sterilized specimen, the 5-year survival was approximately 60% for adenocarcinoma and 40% for squamous cell carcinoma. Those patients with adenocarcinoma and Barrett's esophagus had a 5-year survival of 55%. Of the patients who underwent only esophagectomy and esophagogastrectomy and had not been entered into the protocol, none lived beyond 3 years. The operative mortality rate for those who had esophagogastrectomy was 5%. Sixty-four patients completed the radiation therapy and chemotherapy but did not undergo surgical procedures because of progressive disease or refusal. Of those patients who completed chemotherapy and radiation therapy without surgical intervention, 5-year survival was 18% in patients with squamous cell carcinoma, whereas no patients with adenocarcinoma survived beyond 3 years. The finding of a sterilized specimen after esophagectomy is a favorable prognostic factor in patients with adenocarcinoma or squamous cell carcinoma. The finding that patients with Barrett's esophagus and adenocarcinoma have an improved chance for survival is perhaps related to an earlier diagnosis. It is clear that some patients with squamous cell carcinoma who did not undergo surgical procedures did have a sterilized specimen, because the survival in this group approached 20% at 5 years.     

Social justice in the training of professional psychologists: Moving forward.

The Special Section for Social Justice in Training of the journal for Training and Education in Professional Psychology adds to the growing social justice literature and offers advances in training. This article reflects on the main themes presented in the Special Section including the prevalent role of developmental perspectives, multiculturalism, implementation of learning through action, and organizational recommendations. Further, we highlight areas for additional consideration including the importance of examining values and assumptions of the profession, issues of power within training programs, the need to provide training in navigating and negotiating in systems, benefits of interdisciplinary collaboration, pragmatic and ethical issues in shifting to a social justice framework, and professional development needs of faculty and supervisors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Sleep Heart Health Study: design, rationale, and methods

The Sleep Heart Health Study (SHHS) is a prospective cohort study designed to investigate obstructive sleep apnea (OSA) and other sleep-disordered breathing (SDB) as risk factors for the development of cardiovascular disease. The study is designed to enroll 6,600 adult participants aged 40 years and older who will undergo a home polysomnogram to assess the presence of OSA and other SDB. Participants in SHHS have been recruited from cohort studies in progress. Therefore, SHHS adds the assessment of OSA to the protocols of these studies and will use already collected data on the principal risk factors for cardiovascular disease as well as follow-up and outcome information pertaining to cardiovascular disease. Parent cohort studies and recruitment targets for these cohorts are the following: Atherosclerosis Risk in Communities Study (1,750 participants), Cardiovascular Health Study (1,350 participants), Framingham Heart Study (1,000 participants), Strong Heart Study (600 participants), New York Hypertension Cohorts (1,000 participants), and Tucson Epidemiologic Study of Airways Obstructive Diseases and the Health and Environment Study (900 participants). As part of the parent study follow-up procedures, participants will be surveyed at periodic intervals for the incidence and recurrence of cardiovascular disease events. The study provides sufficient statistical power for assessing OSA and other SDB as risk factors for major cardiovascular events, including myocardial infarction and stroke.     

"Attribution and expressed emotion in the relatives of patients with schizophrenia": Correction to Brewin, MacCarthy, Duda, and Vaughn (1991).

Reports an error in "Attribution and expressed emotion in the relatives of patients with schizophrenia" by Chris R. Brewin, Brigid MacCarthy, Karin Duda and Christine E. Vaughn (Journal of Abnormal Psychology, 1991[Nov], Vol 100[4], 546-554). An incorrect sentence was published. The sentence that ends the fourth paragraph on p. 547 ought to read: A more recent onset of illness would be expected to produce more unstable attributions, and more disturbed behavior (particularly involving violence toward the relative) would be expected to produce attributions that were more internal and personal to the patient but more external and uncontrollable as regards the relative. (The following abstract of the original article appeared in record 1992-12907-001.) Indexes of expressed emotion (EE) in 58 relatives of patients with schizophrenia were related to those relatives' spontaneously expressed causal beliefs about the illness and about related symptoms and behaviors. Relatives made attributions predominantly to factors external, universal, and uncontrollable from their own perspective, and to factors internal, universal, and uncontrollable from the patient's perspective. Low-EE relatives were similar in their attributions to emotionally overinvolved relatives. Compared with these 2 groups, critical and/or hostile relatives made more attributions to factors personal to and controllable by the patient. Subsequent analyses suggested that hostile relatives were further characterized by making more attributions to factors internal to the patient and by making attributions with fewer causal elements. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of varying dietary n-6 to n-3 fatty acid ratios on platelet reactivity, coagulation screening assays, and antithrombin III activity in dogs

Thirty beagles were placed on diets containing ratios of n-6 to n-3 fatty acids ranging from 5:1 to 100:1 for 12 weeks to determine the effects of these diets on platelet reactivity, coagulation screening assays, and antithrombin III activity. Although small changes were observed in adenosine diphosphate (ADP)-, collagen-, and arachidonic acid-induced platelet aggregation and 14C-serotonin release, fibrinogen concentrations, and antithrombin III activities during the 12-week study, these changes were not of clinical significance and did not correlate with the varying ratios of n-6 to n-3 fatty acids.     

Volatile Allelochemicals Released by Crucifer Green Manures

Several members of the crucifer family (Brassicaceae), including white mustard (Brassica hirta Moench), brown mustard [B. juncea (L.) Coss], black mustard [B. nigra (L.) Koch], leafy turnip (B. campestris L.), rapeseed (B. napus L.), and garden cress (Lepidium sativum L.) were examined for their potential as allelopathic green manure crops. Hemp sesbania [Sesbania exaltata (Raf.) Rydb. Ex A. W. Hill] germination and fresh weight was inhibited by chopped leaf tissues of all green manures tested, including wheat (Triticum aestivum L.), when added to a sandy loam soil. Wheat seed germination was inhibited only by B. nigra, B. hirta, and L. sativum, although none of the treatments reduced fresh weight of germinated seedlings. The major volatiles released by chopped plants were determined by solid-phase microextraction sampling and identified by gas chromatography–mass spectrometry (GC-MS). Volatiles included allyl isothiocyanate (allyl-ITC), 3-butenyl isothiocyanate, benzyl isothiocyanate (benzyl-ITC), cis-3-hexen-1-ol, and trans-2-hexenal. These compounds, together with methyl-ITC (methyl-ITC), β-phenylethyl-ITC, benzaldehyde, β-ocimene, and α-farnesene were tested for inhibition of seed germination of several crop and weed species when applied as volatiles. Of these, allyl-ITC and methyl-ITC were the most inhibitory, completely inhibiting the germination of all species at a headspace gas concentration of 1 ppm in airtight glass containers. Selecting mustard green manures that release high levels of allyl-ITC would appear to be optimal for allelopathic activity, and plants that produce high levels of benzyl-ITC also appear promising.