Knowledge and attitudes of health-care providers toward cancer pain management: a comparison of physicians, nurses, and pharmacists in the state of New Hampshire

The knowledge and attitudes toward cancer pain management of physicians, nurses, and pharmacists in the state of New Hampshire were examined through the use of a statewide survey. Many of the providers who completed the survey, and thus indicated that they treated patients with cancer pain on a regular basis, were not pain or oncology specialists. Most of these providers were quite well informed about the fundamentals of cancer pain management. Approximately 90% of providers in all three groups were not concerned about addiction among cancer patients. Yet, there was a small percentage of providers who responded in less than optimal ways to items dealing with opioid pharmacology, pain assessment, and the importance of pain relief. Comparison of responses among provider groups indicated that nurses were the most knowledgeable and pharmacists the least knowledgeable about pain assessment. Physicians were the most knowledgeable regarding opioid pharmacology but seemed the least committed to providing optimal pain relief. Further analysis identified a small group of physicians that included a disproportionately high percentage of family practitioners and surgeons who consistently responded in less than optimal ways to items dealing with the importance of pain relief. The results of this study indicate a continuing need for broad-based educational programs in cancer pain management and for new initiatives focused on practitioners who see relatively few cancer patients and may have difficulty accessing traditional educational programs.     

Use of continuous stacking hybridization in sequencing using modified oligonucleotide matrices

The opportunity of DNA sequencing by hybridization with oligonucleotide matrix (SHOM) with simultaneously use continuous stacking hybridization and gapped-matrices is considered. The analysis of reconstruction efficiency for various combinations matrices and l-oligonucleotides libraries were made. In most cases combine use of continuous stacking hybridization and gapped matrices permits to decrease the number of additional stacking hybridization twice without lost of efficiency.     

Dependence of antibody somatic diversification on gut-associated lymphoid tissue in rabbits

By approximately 4 to 8 wk of age, the IgH VDJ genes of essentially all rabbit B lymphocytes have undergone somatic diversification. Some of this diversification occurs in the appendix, which is a gut-associated lymphoid tissue (GALT). To determine whether GALT is essential for somatic diversification, we surgically removed the appendix, sacculus rotundus, and Peyer's patches from neonatal rabbits (designated GALT-less) and examined the extent to which VDJ genes were somatically diversified. We found that the IgM VDJ genes of peripheral B cells from 2- to 5-mo-old GALT-less rabbits had undergone considerably less somatic diversification than those of control rabbits. Further, the percentage of peripheral B cells in the GALT-less rabbits was generally less than that of controls. Our data suggest that, in rabbits, the primary Ab repertoire develops in GALT, and B cell expansion also occurs there. Hence, GALT may function as a mammalian bursal homologue.     

Demonstration of tank effect on growth indices of juvenile rainbow trout (Oncorhynchus mykiss) during an ad libitum feeding trial

Growth indices were examined in 24 identically managed tanks, each containing 120 diploid juvenile rainbow trout (initial mean body weight, 9.3 g) during a 12-week study to examine tank effects associated with tank location in a multi user research facility. Growth indices included mean body weight, feed intake, feed conversion index, and specific growth rate. The null hypothesis that tank effect had no effect on growth over the 12-week period was rejected (P = 0.038), and mean weight in individual tanks differed by as much as 18.7%). During the study it was determined that the proximity of tanks to common-use walkways in the facility could affect growth indices. This was indicated by significant differences in the mean fish weights among blocks of tanks served by different header tanks after 4 (P = 0.001) and 8 (P = 0.024) week. The block containing tanks of fish with the highest them weight was nearest to the 2 common-use walkways in the facility. Fish in this block of tanks, compared with those in other blocks, had significantly greater feed intake but no significant differences in conversion efficiency. Compensatory growth, a well known growth attribute in fishes, diminished the difference in mean weight be tween these blocks of tanks by the end of the study. Comparison of paired ranks within header tank blocks indicated that fish in those located nearest to walkways had higher feeding rates over the 12-week period (P = 0.048), but less efficient feed conversion (P = 0.040) than did fish in matched tanks located farthest from walkways. However, there were no differences in mean weight of fish. Results of this trial document the risks involved in identifying fish in a tank as the experimental unit when treatments are administered to the tank of fish, the latter being the true experimental unit.     

Sex difference in the mortality trends of acute myocardial infarction in Taiwan, 1974 to 1993

The nutritional status of 75 maintenance hemodialysis (MHD) patients was evaluated according to the dietary intake analysis, anthropometric measurements, biochemical and immunological parameters in this study. Furthermore, some possible factors which would affect nutritional status of hemodialysis patients were discussed. The results showed that hemodialysis patients demonstrated a high incidence of malnutrition. The low intake of protein and calorie, metabolic acidosis and inadequate dialysis would worsen the malnutrition while erythropoietin treatment improve the nutritional status of hemodialysis patients. Based on these results, suggestions were proposed for the improvement of nutritional status of MHD.     

Inductive electron-withdrawal from ammonium ion headgroups of cationic lipids and the influence on DNA transfection

We have prepared a panel of lipidic ammonium tetrafluoroborate salts that contain trifluoromethyl, trichloromethyl, and methyl groups attached to the headgroup. 19F-NMR analyses of the cationic lipid panel revealed that the differences in electron-withdrawal from the ammonium ion headgroup accounted for differences in ion-pairing. Exchange of the tetrafluoroborate counterion by complexation to DNA-phosphate of a reporter gene enabled us to probe the influence of inductive electron-withdrawal in cationic lipid-mediated DNA transfection. We tested the lipid panel for transfection activity in two cell lines. The results indicate that the inductive effects of electron-withdrawing functionality diminish transfection activity in modest (2-4-fold) increments. The present study suggests that the mechanism whereby poly(alcohol)- or poly(ether)-substituted headgroups improve DNA transfection is not based on electronic activation of the ammonium ion.     

Improvements in daily functioning after deep brain stimulation of the thalamus for intractable tremor

Deep brain stimulation (DBS) of the thalamus reduces tremor in patients with essential tremor (ET). However, few studies have determined the degree of improvement in daily functioning associated with DBS. We developed a self-report Tremor Activities of Daily Living Scale (TADLS) to compare daily functioning with the stimulator turned on and off. Patients rated their performance on the 30 items of the TADLS with the stimulator turned off and then on. They also performed 10 activities under the supervision of a clinician who rated their functional ability with stimulation off and then on. There was a 58% improvement in self-rated TADLS scores in patients with DBS with the stimulator on compared with stimulation off. When activities were rated by the clinician, the average improvement in functioning with the stimulator on was 54%. There were reasonably high correlations between patient and clinician ratings of functioning. ET patients have a marked improvement in daily functioning with thalamic DBS.