Chitosan and Its Carboxymethyl-Based Membranes Produced by Crosslinking with Magnesium Phytate.

Membranes produced by crosslinking chitosan with magnesium phytate were prepared using highly deacetylated chitosan and its N-carboxymethyl, O-carboxymethyl and N,O-carboxymethyl derivatives. The conditions of the membrane production were described. IR, Raman, electron absorption and emission spectra were measured and analyzed for all the substrates. It was found that O-carboxymethyl chitosan derivative is the most effectively crosslinked by magnesium phytate, and the films formed on this substrate exhibit good mechanical parameters of strength, resistance and stability. Strong O-H···O hydrogen bonds proved to be responsible for an effective crosslinking process. Newly discovered membrane types produced from chitosan and magnesium phytate were characterized as morphologically homogenous and uniform by scanning electron microscopy (SEM) and IR measurements. Due to their good covering properties, they do not have pores or channels and are proposed as packaging materials.

Non-inferiority randomised phase 3 trial comparing two radiation schedules (single vs. five fractions) in malignant spinal cord compression.

BACKGROUND: The optimal EBRT schedule for MSCC is undetermined. Our aim was to determine whether a single fraction (SF) was non-inferior to five daily fractions (5Fx), for functional motor outcome. METHODS: Patients not proceeding with surgical decompression in this multicentre non-inferiority, Phase 3 trial were randomised to 10 Gy/SF or 20 Gy/5Fx. A change in mobility from baseline to 5 weeks for each patient, was evaluated by a Modified Tomita score: 1 = 'Walk unaided', 2 = 'With walking aid' and 3 = 'Bed-bound'. The margin used to establish non-inferiority was a detrimental change of -0.4 in the mean difference between arms. RESULTS: One-hundred and twelve eligible patients were enrolled. Seventy-three patients aged 30-87 were evaluated for the primary analysis. The 95% CI for the difference in the mean change in mobility scores between arms was -0.12 to 0.6. Since -0.4 is not included in the interval, there is evidence that 10 Gy/SF is non-inferior to 20 Gy/5Fx. One grade 3 AE was reported in the 5Fx arm. Twelve (26%) patients in the 5Fx arm had a Grade 2-3 AE compared with six (11%) patients in the SF arm (p = 0.093). CONCLUSION: For mobility preservation, one 10-Gy fraction is non-inferior to 20 Gy in five fractions, in patients with MSCC not proceeding with surgical decompression. CLINICAL TRIAL REGISTRATION: Cancer Trials Ireland ICORG 05-03; NCT00968643; EU-20952.

Nursing implications: symptom presentation and quality of life in rectal cancer patients.

AIMS AND OBJECTIVES: To determine the changes in symptoms experienced by rectal cancer patients during preoperative chemoradiotherapy, with a specific focus on fatigue and to explore how symptoms impact the quality of life. BACKGROUND: Rectal cancer continues to be a healthcare issue internationally, despite advances in management strategies, which includes the administration of preoperative chemoradiotherapy to improve locoregional control. It is known that this treatment may cause adverse effects; however, there is a paucity of literature that specifically examines fatigue, symptoms and quality of life in this patient cohort. DESIGN: A prospective, quantitative correlational design using purposive sampling was adopted. METHODS: Symptoms and quality of life were measured with validated questionnaires in 35 patients at four time points. RESULTS: Symptoms that changed significantly over time as examined using rm-anova include fatigue, bowel function issues, nutritional issues, pain, dermatological issues and urinary function issues. Findings indicate that fatigue leads to poorer quality of life, with constipation, bloating, stool frequency, appetite loss, weight worry, nausea and vomiting, dry mouth and pain also identified as influencing factors on quality of life. CONCLUSION: Findings have highlighted the importance of thorough symptom assessment and management of patients receiving preoperative chemoradiotherapy, particularly midway through treatment, in order to optimise quality of life and minimise interruptions to treatment. RELEVANCE TO CLINICAL PRACTICE: Close monitoring of symptoms during preoperative chemoradiotherapy, particularly at week 4, will enable the implementation of timely interventions so that interruptions to treatment are prevented and the quality of life is optimised, which may hasten postoperative recovery times.

Spectroscopic Evidence of Thermal Changes in Plant Oils during Deep-Frying-Chemical and Infrared Studies.

For this study, the thermal degradation of palm, coconut, rice bran, and rapeseed (canola) oils was studied. Products formed during deep-frying were identified using chemical methods and these results were verified with those derived from FT-IR (Fourier-transform infrared spectroscopy) studies. Mathematically processed spectral data were analyzed in terms of the breaking of double bonds, the decomposition of the carotenoids, and the reduction of the C=O carbonyl group. Clearly visible changes in the position and intensity of some bands were used for explaining the structural changes in the studied oils. These changes prove that during the heating of the oils, decomposition of the plant fat into fatty acids appears, together with the reduction of the number of certain bonds (e.g., C=C, =C-H, and C=O) and cracking of the acylglycerol chains. The iodine values of the heated oils, determined from the FT-IR spectra measurements, show a significant decrease in their degree of unsaturation level. These effects, visible in the FT-IR spectra, confirm the chemical and structural changes derived from the chemical and physicochemical studies of the plant oils. The influence of heating time on the band intensity of proteins was also studied.

[Efficacy of primary and combined radiotherapy in locally advanced cancer of oropharynx and nasopharynx in III and IV stage]. / Ocena skutecznosci radioterapii i leczenia skojarzonego u chorych na raka czesci nosowej i ustnej gardla w stopniu III i IV klinicznego zaawansowania.

Aim of the study is evaluation of radiotherapy treatment in cancer of oropharynx and nasopharynx. Retrospective analysis was based on 283 patients in III and IV clinical stage of disease without distant metastases who were treated between 1989-2001. 201 patients were treated radiotherapy alone and 82 by combined modality: radiotherapy and chemotherapy. Induction chemotherapy and radiotherapy was used in 34 cases, concomitant chemoradiotherapy--25 and adjuvant chemotherapy and radiotherapy in 23 cases. Following methods of radiotherapy fractionation were used: accelerated in 35 cases, conventional--26, hyperfractionation--21. Accelerated treatment mainly was used in concomitant combined modality. Log-rank statistical analysis revealed better results of treatment for combined modality: radiotherapy and chemotherapy. Most effectiveness method of combined modality was concomitant radiochemotherapy. Locoregional control in 3 years observation interval was better for concomitant mode about 18% comparing to induction chemotherapy and radiotherapy and 30% to adjuvant chemotherapy and radiotherapy. Based on this data, the optimal mode of treatment in III and IV stage of oropharyngeal and nasopharyngeal cancer, especially with extensive nodal disease and extranodal involvement is concomitant treatment with accelerated fractionation dose of radiotherapy.

[Peritoneal metastasis from regionally advanced hypopharyngeal cancer]. / Przerzut do otrzewnej w przebiegu zaawansowanego miejscowo raka plaskonablonkowego czesci krtaniowej gardla.

A very rare case of patient with locally advanced hypopharyngeal cancer with solitary, large peritoneal metastasis was presented. Diagnostic imaging excluded other organs metastases (lungs, liver, bones). At 62-old patient with advanced hypopharyngeal cancer (T4N2b) a dynamical nodal progression (within 1.5 months) without primary tumour progression was observed, and number of metastatic nodes was increased from 2 to 9. Simultaneously, a solitary peritoneal metastasis was detected and other metastases were excluded. Stage of disease was determined as T4N2cM1 and patient was qualified to palliative treatment.

Predicting radiotherapy-related clinical toxicities in cancer: a literature review.

Assessment of patients receiving radiotherapy for cancer is essential, with the ability to identify those who may be more likely to experience radiotherapy-related side effects noted as an important issue for nurses. Body mass, age, and radiation dose may be predictive factors for the development of such side effects. This review considers these factors and how nurses can use this evidence to inform their care, with results indicating that the dose of radiation, the site treated, and body mass index are predictive of toxicities that may develop. Increased awareness of these predictive factors will aid nurses in identifying patients at greater risk of developing radiation-related side effects. This will assist in guiding nursing interventions, as well as enabling the individualization of patient education, by placing greater emphasis on preventive measures for patients who are more vulnerable to the development of radiation-related toxicities.