Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures.

Information on bone loss in treated non-Hodgkin's lymphoma patients is limited. In this study, we used CT to analyze bone loss as well as prevalent and incident fractures. We found severe bone loss, a high rate of fractures, and a novel association between bone loss and the international prognostic index. INTRODUCTION: To investigate bone loss and fracture risk in non-Hodgkin-lymphoma (NHL) patients by (i) comparing treatment-related vertebral density (VD) loss in NHL patients with control subjects and (ii) investigating associations of VD loss versus fracture risk. Further, associations of VD loss and clinical parameters were investigated. METHODS: VD of 123 NHL patients was measured pre- and post-treatment in the L1, L2, and L3 vertebrae in routine computed tomography (CT) scans, performed between Jan 2016 and Mar 2017. Control measurements (n = 52) were obtained from CT colonographies between Sept 2003 and Sept 2017 and their subsequent follow-up-exams (10-137 months). Prevalent and incident (between baseline and follow-up) fractures were assessed in all subjects, and VD loss per year was calculated. Linear regression models were used to (i) compare VD loss between patients and controls and (ii) identify associations between VD loss and clinical parameters. Using logistic regression models, ORs for fractures per SD change in VD were assessed in patients. Analyses were adjusted for age, sex, and contrast application. RESULTS: NHL patients experienced significantly greater VDL1-3 loss than controls (P = 0.003), and greater VDL1-3 loss was associated with a greater likelihood of incident fractures (OR, [95%-CI], P 1.90, [1.03, 3.51], 0.04). Patients with an initial international prognostic index (IPI) of 5 suffered significantly greater VD loss compared with an IPI of 0 (P = 0.01). CONCLUSION: Using VD measurements in routine CT scans, substantial vertebral bone loss in NHL patients could be documented with a high incidence of fractures.

Engagement in breast cancer screening behaviors.

PURPOSE/OBJECTIVES: To distinguish women who engaged in recommended breast cancer screening from those who did not. DESIGN: Descriptive design, with quantitative measures. SETTING: Urban, county hospital serving many low-income clients. SAMPLE: 119 women, age 51 to 80, who had not had mammograms in the last 13 months. METHOD: Nurse-conducted telephone interviews that incorporated a modified Profile of Mood States, Attitudes Towards Mammography Scale, Barriers Scale, and reports of engagement in mammography and clinical breast exam (CBE) in the last 13 months and breast self-exam (BSE) practice in the last 3 months. MAIN RESEARCH VARIABLES: Affect, beliefs, facilitators, and knowledge regarding screening; engagement in mammography, CBE, and BSE. FINDINGS: In discriminant analyses of engagement in mammography and CBE, affect, barriers, prior history of breast problems, and race were significant variables. In discriminant analysis of BSE, history of breast biopsy, family history of breast cancer, beliefs about screening and cancer, prior instruction in BSE, and being single were significant variables. CONCLUSIONS: Variables that discriminated between use and non-use of professional screening were different from those that discriminated between use and non-use of BSE. IMPLICATIONS FOR NURSING PRACTICE: Nurses can promote professional breast screening by addressing women's negative affect, prior breast concerns, and barriers, especially among Caucasians. Nurses can promote monthly BSE by supporting realistic beliefs about screening and cancer as well as by demonstrating BSE, especially among married women.

Accessing state-bound memories in the treatment of phobias: two case studies.

Two cases of simple phobia demonstrate the inadequacies of both behavioral and psychodynamic theories. These cases and their treatment outcomes provide support for the state-dependent memory and learning theory. Hypnosis and ideomotor signaling proved to be not only effective treatments but also useful means of illuminating the role and nature of symptom function. Issues of symptom removal and substitution are also discussed in relation to these cases.

Asymptomatic bacteriuria in healthy preterm babies.

Urine was cultured from 51 healthy preterm babies. If the initial bag specimen grew more than 50 000 organisms/ml, a second bag specimen was cultured. After two positive bag specimens a suprapubic urine was cultured. Significant bacteriuria was excluded on the basis of one or two bag specimens in 90% of the babies. Suprapubic urine was sterile in a further 11 babies. Four babies with positive bag specimens were unfortunately not completely investigated: 2 had mixed growths and 2 had pure growths of 100 000 organisms/ml. As we and others consider that bacteriuria can only be diagnosed on a suprapubic sample of urine the incidence of proved infection in our series was zero. If both the babies with a pure growth of 100 000 organisms/ml had true bacteriuria, the incidence would rise to 1.3%. In view of the difficulties in obtaining clean urine samples in preterm babies and as the incidence of bacteriuria is so low, we do not recommend that healthy preterm babies be screened for bacteriuria.

A simple procedure for the radioimmunoassay of 17 alpha-hydroxyprogesterone in serum: comparison with an immunological purification technique.

A simple radioimmunoassay for the measurement of 17 alpha-hydroxyprogesterone in 0.1-0.25 ml serum is described. An antibody prepared against 17 alpha-hydroxyprogesterone 3(O-carboxymethyl)-oxime-BSA as immunogen was used. A correlation of the 17 alpha-hydroxyprogesterone concentration found in the serum of normal subjects and of patients with that obtained by a more complex immunological purification method was good (r=0.924, P less than 0.001). Accuracy, precision, and specificity were acceptable with the simple method. Normal values for infants, children, and adults have been established, and the individual concentrations of 17 alpha-hydroxyprogesterone in the serum of patients withcongenital adrenal hyperplasia were well separated from normal values.

Perioperative cephalosporin prophylaxis in cesarean section: effect on endometritis in the high-risk patient.

A total of 120 patients who were to be delivered by cesarean section and who were at high risk of postoperative infection received three doses of either cefamandole, cephalothin or placebo perioperatively. Maternal serum levels for both antibiotics were in the therapeutic range. Although both drugs reduced the incidence of febrile morbidity and endometritis, only cefamandole significantly reduced the fever index. Risk factors for postoperative infections were the presence of ruptured membranes, labor, and internal fetal monitoring. Cefamandole beneficially influenced all risk factors while cephalothin was able to reduce only the risk of ruptured membranes. When a new method for obtaining endometrial tissue was utilized, 50% of cultures were negative. There was no difference in the organisms isolated from patients with and without endometritis.

An assessment of the production and performance of F1 hybrid wheats based on Triticum timopheevi cytoplasm.

This work reports on the production and yield assessment of F1 wheat hybrids from crosses between cytoplasmic male sterile lines, with Triticum timopheevi cytoplasm, and cultivars with fertility restoring genes.In four years of trials conducted between 1974 and 1977, only three F1 hybrids out of a total of 168 yielded significantly more than the control variety 'Maris Huntsman', which currently occupies a substantial proportion of the area planted with winter wheat in the UK. Because of the rapid increase in yield of conventional wheat varieties, which has already led to varieties which outyielded 'Maris Huntsman', the yield advantage of these F1 hybrids is insufficient for them to be developed as commercial varieties.The efficient production of uncontaminated male sterile and F1 seed presents problems of isolation and a difficult biological problem in increasing the cross breeding potential of maintainer and restorer lines. These together with selection for other parental characters such as restoration, short straw and resistance to sprouting make the development of F1 hybrids more difficult and expensive than that of conventional varieties.

Single gene restoration of cytoplasmic male sterility in wheat and its implications in the breeding of restorer lines.

Cultivars of T. aestivum crossed onto two lines with male sterility induced by the cytoplasm of T. timopheevi gave a high level of restoration in the F1 generation. The ratio of fertile to sterile plants segregating in the F2 generation was consistent with that expected for a single dominant restorer gene. The possible association between this gene and mildew resistance or some other desirable character derived from 'CI 12633', a common ancestor of the cultivars used, is discussed.