Evaluation of patients' needs to design and assess a patient education program in cancer pain.

Purpose: Patient education constitutes a relevant strategy to improve pain management. In the field of therapeutic patient education (TPE), we aimed 1) to assess pain impact in cancer patients, 2) to identify patients' educative needs in pain management, and 3) to refine research criteria for its future evaluation. Patients and methods: Pain intensity, relief and interference were assessed in 75 cancer patients with unbalanced background pain. Self-assessment questionnaire evaluated i) patients' pain management and ii) their knowledge and needs in TPE. Results: Most patients experienced pain for more than 6 months and 41.6% reported adequate pain relief. Understanding pain and pain management were major patients' preferences (>58%). Most patients declared they knew their pain treatments, but fewer than half of them were able to name them. However, education concerning pain treatment was considered as essential in <30% of patients. Almost all patients (97.1%) stated pain education as beneficial, with a preference for individualized sessions (41.2%). In addition, the assessment criteria for its future evaluation were refined. Conclusion: Targeted population mainly concerned patients with persistent pain. Only half of patients reported pain relief despite antalgics. Patient education was declared as beneficial for almost all participants. Practice implications: Tailoring a pain TPE on patients' needs has the potential to help them to optimally manage their pain daily.

Nasolacrimal duct office probing in children under the age of 12 months: Cure rate and cost evaluation.

INTRODUCTION: Controversy exists regarding the treatment of infants with symptomatic nasolacrimal duct obstruction. One philosophy advocates "early" nasolacrimal duct probing, generally in the office - a relatively common approach in France, while others prefer to wait until the age of 12 months to offer a procedure under general anesthesia. The goal of this study is to report results of immediate office probing for congenital nasolacrimal duct obstruction (CNLDO) under age 1 year in terms of efficacy and cost. METHODS: A retrospective study was performed on 329 patients (443 eyes) treated by probing for CNLDO under the age of 12 months age. A single probing was performed at the first visit in the office under topical anesthesia without sedation. In order to determine the factors associated with failure of probing, univariate analysis was performed using the Student t-test, Pearson's, homogeneity Chi(2) or Fisher's exact tests. For cost evaluation, hypothetical estimates of spontaneous resolution month by month were used according to data in the literature, along with health insurance reimbursement data. RESULTS: The ages of the patients ranged from 2 to 11 months (mean 7.0 ± SD 2.3). The overall success rate for cure by immediate office probing was 76.7%. Unilateral CNLDO had an 80.4% success rate whereas bilateral CNLDO had a 73.2% success rate for each eye (P=0.09). Discharge during probing was associated with failed probing (P=0.02). The cost for the spontaneous resolution strategy was 1.56 times higher than for the immediate probing strategy. A strategy which would apply the spontaneous resolution strategy for children ≤ 5 months and the probing strategy to children>5 months would be the most cost-effective. CONCLUSIONS: Immediate office probing between the ages of 5 to 12 months is a safe, effective method to relieve CNLDO and is the most cost-effective.

[Can tumor necrosis factor inhibitors induce sclero-uveitis?]. / Les anti-Tnf peuvent-ils induire des scléro-uvéites ?

We report three cases of female patients who presented a first episode of unilateral scleritis or acute anterior uveitis while they were treated for 12-16 months by TNF inhibitor: etanercept (Enbrel((R))) 25mg twice weekly for rheumatologic diseases (rheumatoid arthritis or ankylosing spondylitis). Ocular inflammation was resistant to the usual treatment. Some cases of scleritis and uveitis are known to be drug-induced. TNF inhibitors seem to be part of them. Ocular inflammation is usually the first episode. It appears generally in the first year of the treatment by TNF inhibitors and resists to usual treatment. The general disease is usually well stabilized. In our cases, inflammation decreased only when the etanercept was discontinued.

Electron and ion reactions with hexamethyldisiloxane and pentamethyldisiloxane.

The dissociative recombination of electrons with the hexamethyldisiloxane (HMDSO) cation ((CH(3))(3)Si-O-Si(CH(3))(3))(+) and the pentamethyldisiloxane cation ((CH(3))(3)Si-O-Si(CH(2))(2))(+) as well as the ion-molecule reaction between Ar(+) and HMDSO have been studied at 300 K using a flowing afterglow Langmuir probe-mass spectrometer apparatus. The rate constants for these reactions, measured directly for the first time, are, respectively, alpha(1)=1.8 x 10(-6), alpha(2)=3.6 x 10(-6) cm(3)s, and k=2.0 x 10(-9) cm(3)s with uncertainties of +/-30%. In addition, the electronic attachment to neutral HMDSO was also studied and an upper limit value of the rate constant was determined to be beta=3.3 x 10(-11) cm(3)s.

The reaction of anthracene with OH radicals: an experimental study of the kinetics between 58 and 470 K.

The first direct measurement of the reaction rate constant of a polycyclic aromatic hydrocarbon in the gas phase in the temperature range 58-470 K is reported. The reaction is OH+ anthracene and the experiment has been performed in a continuous flow Cinetique de Reaction en Ecoulement Supersonique Uniforme apparatus, which had to be modified for this purpose. Pulsed laser photolysis of H(2)O(2) has been used to generate OH radicals and laser-induced fluorescence to observe the kinetic decay of the radicals and hence determine the rate coefficients. The reaction is found to be fast, and the rate constant increases monotonically as the temperature is lowered. The rate coefficients match the expression k(cm(3) molecules(-1) s(-1))=1.12 x 10(-10)(T/300)(-0.46).

Electron attachment on HI and DI in a uniform supersonic flow: thermalization of the electrons.

In order to check the electron thermalization in the CRESU technique (Cinetique de Reaction en Ecoulement Supersonique Uniforme, e.g., "reaction kinetics in a uniform supersonic flow"), electron attachment on HI and DI has been studied in the 48-170 K range. Attachment to HI is exothermic and the reaction is expected to be fast and to proceed at a rate close to the capture limit. On the contrary, attachment to DI is slightly endothermic, and a strong positive temperature dependence of the measured rate coefficient is expected if the electrons are thermal. This dependence is not observed, and we conclude that the electrons are not in thermal equilibrium with the neutrals in the afterglow. A model, based on electron heating by superelastic collisions with the buffer gas, is proposed to explain this fact and implications for previously published results are discussed.

[Adjusting the dosage of netilmicin from two measurements. Program validation]. / Adaptation des posologies de la nétilmicine à partir de deux points. Validation d'un programme.

The aim of this study is to give to clinicians a well validated usefull tool allowing an increase of safety in the monitoring of netilmicin. During the first administration of the drug, two plasmatic concentrations are measured, and input in a preprogrammed hand-held calculator. A posology and a rythm of administration are returned by the calculator. After six days of this dosage regiment, the peak and the valley concentrations are compared with those previously given by the computer as values at equilibrium. No significant difference can be observed. There is no change in plasmatic creatinine level from the first to the sixth day of treatment. So, a preprogrammed hand-held computer can be convenient and safe to monitor netilmicin.