Man to man and side by side, they cope with prostate cancer: self-help and social support

Prostate cancer affects men and their loved ones; consequently, survivors and their wives can gain from social support throughout the illness experience. After observing meetings of a support group for prostate cancer survivors and their partners, the authors used the constant comparison method to draw conclusions about the types of support generated in the men's and women's divisions of the group. The authors concluded that both divisions served as sites of information but not as scenes of practical assistance. The authors also found that the discursive practices of the groups and the structural elements of the group meetings inhibited emotional support through topic turning, comparisons between members, and the role of group facilitators. The authors consider the study's implications for support group leaders and scholars.     

Pyosalpinx developing from a preexisting hydrosalpinx after uterine artery embolization

The authors describe a case of the development of a pyosalpinx from a preexisting hydrosalpinx after uterine artery embolization (UAE) for leiomyomata. The hydrosalpinx preexisted the UAE procedure and did not cause the patient any symptoms or signs of infection. UAE was performed with standard technique and was technically as well as initially clinically successful. However, the patient presented 8 weeks post-UAE with a pyosalpinx and superinfection of the previously simple fluid collection, requiring treatment with hysterectomy and oophorectomy. A mechanism for the occurrence of this superinfection is proposed, and potential strategies to avoid this serious complication in the future are discussed.     

The influence of diagnostic label and degree of abnormality on attitudes toward former mental patients

The proposition was advanced that diagnostic label (i.e., style in which patients' mental illness is described) and severity of illness may both influence vocational, social and psychiatric judgments of exmental patients. Two occupational groups —vocational rehabilitation counselors and businessmen-professionals—rated biographical sketches in which diagnostic label and severity of illness were varied. The results indicated that diagnostic label did not influence attitudes, but that severity of psychiatric condition did. Differences between occupational groups' ratings were negligible. It is suggested that subsequent studies take into account the factor of severity of illness when investigating style of patient presentation.     

Enzyme Activities of the Livers of Mice Infected with Salmonella typhimurium

The activities of the mouse liver enzymes tryptophan oxygenase, tyrosine aminotransferase, and pyruvate kinase were measured after infection with three dose levels of Salmonella typhimurium strain SR-11. Infection occurred in all groups as evidenced by an increase in bacterial numbers and by death of the animals. The activities of the enzymes increased in all groups during the course of the infection. The results obtained during infection are compared with those obtained after endotoxin injection.     

Early intervention of therapy in asthma

PURPOSE OF REVIEW: In addition to the acute manifestations of asthma, researchers now understand that asthma is a chronic inflammatory disease of the airways. Knowing the critical time to intervene in asthma is of utmost importance to clinicians and patients alike. This article reviews recent evidence that early intervention improves long-term outcomes in asthma. RECENT FINDINGS: The recent published literature demonstrates that early in the course of asthma, changes in structure occur, and that even in very young children, measurable abnormalities of lung function have already occurred. Large studies of inhaled corticosteroids given early in the progression of asthma show, at best, only modest effects on long-term lung function. Though a study on inhaled corticosteroids in very young children is ongoing, there is little evidence to suggest that any other commonly used medications have important effects on underlying lung function. Recent studies have also highlighted the lack of clear understanding of the relation between inflammation and remodeling, and parallel the disappointing results from studies of inhaled corticosteroids on lung function. SUMMARY: Current anti-inflammatory medications have modest effects on preventing loss of lung function in asthma. Although inhaled corticosteroids are highly efficacious in controlling the overt clinical manifestations of the disease, their effects on lung function are small. The standard paradigm of inflammation leading to remodeling and remodeling to loss of lung function may be overly simplistic. In the future, novel pharmacologic targets and careful timing of treatments must occur to intervene effectively with remodeling and/or decline in lung function in asthma.     

Information assimilation and distribution challenges and goals for real and virtual journals

The distribution of biomedical information was transfigured over three centuries ago with the introduction of scientific journals. This enabled the widespread dissemination of data to global audiences and greatly facilitated not only the advance of science but amplified the interaction between investigators despite their different locations. This process continued to expand in a linear fashion prior to the emergence of the Internet. The latter system has prompted a phenomenal augmentation of information accessibility, and its ever-expanding use has resulted in an exponential increase in the demand for digital technology and online resources. This technology has achieved unprecedented acceptance in the scientific domain and enabled publishers to expeditiously produce and distribute journal contents online. Such unparalleled access to information has sparked incendiary debate within the scientific community and among journal publishers in regard to numerous issues. It is thus much debated as to who has the right to "own" or control intellectual property, whether information should be made freely available to the online global community, how to gauge the legitimacy and authenticity of published research, and the need to reexamine the feasibility and profitability of paper journals in consideration of the digital, online formats that continue to gain popularity. To assess the current status of the situation, a meeting of journal editors, research scientists, and publishing executives was held in Constance, Germany, on June 26, 2004, to discuss these issues and formulate strategies and recommendations for the future of biomedical publishing. Herewith we provide a summation (manifesto) of the meeting's proceedings and provide a consensus opinion with the aim of illuminating the subject and also proposing some putative solutions for the major challenges that currently confront the scientific and publishing community.     

Current status of gastrointestinal carcinoids

Gastrointestinal (GI) carcinoids are ill-understood, enigmatic malignancies, which, although slow growing compared with adenocarcinomas, can behave aggressively. Carcinoids are classified based on organ site and cell of origin and occur most frequently in the GI (67%) where they are most common in small intestine (25%), appendix (12%), and rectum (14%). Local manifestations--mass, bleeding, obstruction, or perforation--reflect invasion or tumor-induced fibrosis and often result in incidental detection at emergency surgery. Symptoms are protean (flushing, sweating, diarrhea, bronchospasm), usually misdiagnosed, and reflect secretion of diverse amines and peptides. Biochemical diagnosis is established by elevation of plasma chromogranin A (CgA), serotonin, or urinary 5-hydroxyindoleacetic acid (5-HIAA), while topographic localization is by Octreoscan, computerized axial tomography (CAT) scan, or endoscopy/ultrasound. Histological identification is confirmed by CgA and synaptophysin immunohistochemistry. Primary therapy is surgical excision to avert local manifestations and decrease hormone secretion. Hepatic metastases may be amenable to cytoreduction, radiofrequency ablation, embolization alone, or with cytotoxics. Hepatic transplantation may rarely be beneficial. Chemotherapy and radiotherapy have minimal efficacy and substantially decrease quality of life. Intravenously administered receptor-targeted radiolabeled somatostatin analogs are of use in disseminated disease. Local endoscopic excision for gastric (type I and II) and rectal carcinoids may be adequate. Somatostatin analogues provide the most effective symptomatic therapy, although interferon has some utility. Overall 5-year survival for carcinoids of the appendix is 98%, gastric (types I/II) is 81%, rectum is 87%, small intestinal is 60%, colonic carcinoids is 62%, and gastric type III/IV is 33%.