Upper bound dose values for meson radiation in heavy-ion therapy.

Radiation treatment of cancer has evolved to include massive particle beams, instead of traditional irradiation procedures. Thus, patient doses and worker radiological protection have become issues of constant concern in the use of these new technologies, especially for proton- and heavy-ion-therapy. In the beam energies of interest of heavy-ion-therapy, secondary particle radiation comes from proton, neutron, and neutral and charged pions produced in the nuclear collisions of the beam with human tissue atoms. This work, for the first time, offers the upper bound of meson radiation dose in organic tissues due to secondary meson radiation in heavy-ion therapy. A model based on intranuclear collision has been used to follow in time the nuclear reaction and to determine the secondary radiation due to the meson yield produced in the beam interaction with nuclei in the tissue-equivalent media and water. The multiplicity, energy spectrum, and angular distribution of these pions, as well as their decay products, have been calculated in different scenarios for the nuclear reaction mechanism. The results of the produced secondary meson particles has been used to estimate the energy deposited in tissue using a cylindrical phantom by a transport Monte Carlo simulation and we have concluded that these mesons contribute at most 0.1% of the total prescribed dose.

In vitro and in vivo demonstration of risperidone implants in mice.

BACKGROUND: Non-adherence with medication is a critical limitation in current long-term treatment of schizophrenia and a primary factor in poor quality-of-life outcomes. However, few treatments have addressed this shortcoming using an implantable drug delivery approach. The goal of this study was to provide in vitro and in vivo proof of concept for a long-term implantable risperidone delivery system in mice. METHODS: Implantable formulations of risperidone were created using the biodegradable polymer Poly Lactic co Glycolic Acid (PLGA) combined with various drug loads. Implant bioactivity was tested using in vitro release and stability studies, as well as in vivo pharmacokinetic and behavioral studies in mice. RESULTS: The pattern of risperidone release is influenced by various parameters, including polymer composition and drug load. In vitro measures demonstrate that risperidone is stable in implants under physiological conditions. Behavioral measures demonstrate the bioactivity of risperidone implants delivering 3 mg/kg/day in mice, while pharmacokinetic analyses indicate that reversibility is maintained throughout the delivery interval. CONCLUSIONS: The current report suggests that implantable formulations are a viable approach to providing long-term delivery of antipsychotic medications based on in vivo animal studies and pharmacokinetics. Implantable medications demonstrated here can last two months or longer while maintaining coherence and removability past full release, suggesting a potential paradigm shift in the long-term treatment of schizophrenia.

Explaining retrospective reports of symptoms in patients undergoing chemotherapy: anxiety, initial symptom experience, and posttreatment symptoms.

This study evaluated different perspectives on the relationship of trait anxiety to symptom report. Baseline trait anxiety was related to (a) initial symptoms reported 2 days after beginning chemotherapy, (b) posttreatment symptoms reported 2 days after cessation of medication, and (c) retrospective reports of initial symptoms (made concurrently with posttreatment reports). Associations were significant for vague psychophysiological symptoms but not for concrete visible symptoms. Path models indicated that the relationship of anxiety to retrospective report of vague symptoms was due to both enhanced encoding and facilitated recall of symptoms. Further analyses revealed, however, that this relationship reflects symptoms stability rather than anxiety-related differences in attention. Anxious and nonanxious patients appear to be equally accurate in their retrospective report of symptoms.

Pain and depression experienced by women with interstitial cystitis.

The goal of this study was to better understand the experience of women suffering from interstitial cystitis (IC), a chronic pain condition that has, as of yet, received little attention from psychosocial investigators. Eighty women with IC participated. The results from this study demonstrate that, in addition to frequency of voiding (the hallmark symptom of the disorder), IC sufferers also endure significant pain and depression. Levels of pain experienced by IC patients during their most painful flares exceed levels of pain experienced by other chronic pain patients. Similarly, levels of depression experienced by IC patients exceed those evidenced by the general population and by other populations of chronic pain patients. Furthermore, the pain and depression experienced by IC patients may be predicted by cognitive factors. Severity of pain is associated with self-efficacy for coping with pain. Severity of depression is associated with pain, self-efficacy for coping with pain, and self-stigmatization.

Labial gland biopsy--a simple diagnostic procedure for Sjogren's syndrome.

Sjogren's syndrome is a collagen vascular disorder with multisystem. Its presentation may be similar to other diseases from which it can be differentiated by certain investigations--one of the most important being the labial salivary gland biopsy. A case report of Sjogren's syndrome is presented and the technique of the labial salivary gland biopsy is described.

Treating post traumatic stress disorder couples: a psychoeducational program.

The effects of veterans' war-related emotional disorders on wives has received little attention in the literature on families and family therapy. Clinical evidence shows devastating effects of combat-related psychopathology on the marriage relationship. Post-traumatic stress disorder can result in chronic marital distress, in addition to veteran disabilities. It is contended here that a clinical couples' therapy model fails to address the specific needs of this population of couples. A cognitive-behavioral analysis of the effects of post-traumatic stress disorder (PTSD) on couple functioning is presented as well as a rationale for treatment based on psychoeducational, cognitive-behavioral, and self-help principles. This paper reviews an experimental program carried out in Israel designed to reach and treat the PTSD couple.

Cognitive and behavioral determinants of compliance in diabetics.

The interaction between patient and medical team is especially stressful in cases of diabetes, because of the high potential for critical behaviors by the team and for avoidance or aggressive behaviors by the patient. This study examined some cognitive and behavioral correlates of compliance behaviors in 70 insulin-dependent diabetics. A special scale was developed to evaluate specific cognitions, behaviors, and anxiety during confrontations with the physician, dietitian, nurse, and secretary. Another special scale was developed to evaluate compliance with self-care behaviors in diabetes. Cognitive and behavioral coping skills specific to patient-medical team encounters were found to be significant correlates of various compliance variables in the following order: maintenance of positive self-esteem and efficacy during criticism, positive acceptance of criticism, avoidance of conflict by offering compromise solutions, and assertive request for follow-up with a specific doctor. Each was found to be a significant predictor of compliance behaviors. The findings indicate the importance of positive cognitive and assertive coping skills in specific stressful situations involving the patient and medical team.

Compliance and control: issues in group training for diabetics.

When patients in treatment do not comply with medical directives, the most competent health care may go for naught and patients' well-being may be jeopardized. By focusing on the links between assertiveness and coping skills and compliant behavior, the group program described here increased compliance as well as self-confidence in diabetic group members.

Epilepsy and the inner city schools: a school-based program that makes a difference.

A program was developed within the Baltimore City School System to comply with U.S. Public Laws 94-142 and 94-484. The program provided assessment, appropriate placement, counseling, work experience, and epilepsy education. Self-identified students were primarily black and poor, more likely to be either 1 year behind in reading or in special education. Seventy percent had psychosocial problems but for less than half were the problems directly related to seizures. The program decreased the nonpromotion rate and the dropout rate to less than half of that for the school system as a whole, and cut in half the percentage of youths who were unemployed or not in school or training 1 and 2 years after graduation. The per pupil cost was 10% greater than current expenditures for the system as a whole.

The single-case design in family therapy evaluation research.

This paper discusses the need for the development of new research designs for family therapy evaluation, and a manner for meeting that need. The single-case research design has gained acceptance as bona fide experimental designs for evaluating the effectiveness of intervention techniques in drug and psychotherapy outcome research. Although the need for more outcome studies on the effectiveness of family therapy has been frequently noted, there has been virtually no use of the single-case design in family therapy outside of the behavior modification literature on families. This paper presents potential benefits of the application of single case-design for the practice of family therapy. Preliminary guidelines are suggested for the application of these designs.