Translation and linguistic validation of the EORTC QLQ-PAN26 questionnaire for assessment of health-related quality of life in patients with pancreatic cancer and chronic pancreatitis into isiXhosa and Afrikaans.

BACKGROUND: Health-related quality of life (HRQOL) parameters have become important components in the holistic management of pancreatic ductal adenocarcinoma (PDAC) and are now increasingly incorporated in treatment protocols. The European Organisation for Research and Treatment of Cancer (EORTC) pancreatic cancer specific questionnaire (QLQ-PAN26) has also been validated for chronic pancreatitis (CP). The objective was to translate the EORTC QLQPAN26 questionnaire into and validate it for isiXhosa and Afrikaans. METHODS: Following the EORTC translation procedure, two forward translations of the English version into isiXhosa and Afrikaans were performed independently by two language practitioners for each language, followed by reconciliation of disagreements. A back translation of the reconciled version into English by a second pair of language practitioners was done. The results of all the steps were summarised with comments in a report for review by the EORTC translation unit. After proofreading by an external proof-reader chosen by the translation unit, pilot testing was performed on a cohort of ten isiXhosa patients and ten Afrikaans patients with PDAC or chronic pancreatitis. Results were summarised in a pilottesting report, and the final version approved by the translation unit. RESULTS: Thirteen patients diagnosed with PDAC and seven with CP were included in the study. The questionnaire was completed electronically (n = 12) or on paper (n = 8). Median age in the isiXhosa group was 53.7 (range 41-63) and in the Afrikaans group 60.9 (range 35-79). Questions 31-54 had a 100% completion rate, while 35% of respondents did not complete Q55 and Q56. Internal consistency was satisfactory in isiXhosa (alpha = 0.88) and Afrikaans (alpha = 0.89). CONCLUSION: The EORTC QLQ-PAN26 used in patients with PDAC and CP has been translated and linguistic validation performed in isiXhosa and Afrikaans. Availability of a questionnaire in patients' mother tongue should increase the validity of results.

Microbiological evaluation of environmental cleanliness in haematopoietic cell transplant patient rooms: implementing JACIE standards.

BACKGROUND: Environmental hygiene is one of the most important strategies to prevent hospital-acquired infections by reducing pathogens in haematopoietic cell transplant (HCT) patient rooms. This study was designed in response to JACIE requirements for microbiological monitoring, and aimed to assess environmental hygiene in protective isolation rooms. METHODS: Environmental cleanliness was assessed by measuring microbial loads in at-rest and operational conditions sampled from target surfaces, and in passive and active air from rooms occupied by patients with different grades of neutropenia. The study also evaluated whether microbial loads were influenced by isolation precautions. RESULTS: The failure rate of cleanliness on target surfaces in at-rest conditions was 0% compared with 37% for surfaces and 13% for passive and active air samples in operational conditions. Differences in failure rates were observed in the rooms of patients with different levels of neutropenia (P=0.036 for surfaces, 0.028% for passive air). No relationship was found between infections and microbial loads. CONCLUSIONS: Microbiological assessment integrated with an enhanced monitoring programme for hospital hygiene provides invaluable information to drive infection control policies in HCT patients. These results highlight the need to set and validate strict standards for the assessment of cleanliness in a clinical setting.

Fusion between homologous cells, modified epigenetic environment and possible cell cancerization.

For a long time now we have been putting forwards the hypothesis that, when two cells belonging to different tissues of the same organism fuse, the nucleous/nuclei of the resulting "fused" cell could lay into a cytoplasm possibly containing factors influencing the activation or deactivation of genes able to interfere with the differentiation "iter" proper of the parent cells. As a consequence, the fused cells could undergo neoplastic transformation. In order to give an experimental support to such an hypothesis, mononuclear cells and granulocytes were isolated from the white blood cells of the same individual, mixed (at 1/1 ratio) and fused, using polyethylen glycol (PEG). The fused cells were then cultured into a suitable medium, supplemented with phytohemoagglutinin (PHE), a lectin which is able to stimulate at least one of the nuclei. Samples from these cultures were withdrawn at progressive time-intervals and stained with May Grümwald-Giemsa. Microscopic examination showed the appearance of cells morphologically resembling Hodgkin's and Reed Sternberg cells, or leukemic cells. A crown of mononucleated cells was often surrounding such anomalous cells, as happens in the early stage of killer cells action against target cells. In two out of fifty cultures, cells grew without need for serum supply, suggesting the onset of an autocrine system.