Asking questions during breast cancer consultations: does being alone or being accompanied make a difference?

PURPOSE: Companions often accompany patients to cancer consultations. The number of questions asked by patients and companions is an indicator of their active participation. The present study aims to provide first descriptive evidence on the characteristics of unaccompanied and accompanied Italian breast cancer patients that attend the first consultation after surgery and to analyse companions contribution to the type and quantity of questions asked during the consultation. METHOD: Seventy consultations of female patients with breast cancer were audio taped. Questions were transcribed and coded by content. Companion's questions were also classified in terms of function. Socio-demographic and clinical data, patients' role preference and confidence in decision making measures were gathered for each patient. Post consultation satisfaction with decision and the perceived level of shared decision making were collected either for the patient and the companion. RESULTS: 69% of patients were accompanied, usually by one close family member, either husband or adult child. Non employed or retired patients and those with a preference for passive role in decision making were more likely to be accompanied. Unaccompanied patients and accompanied patients had comparable levels of anxiety, emotional distress and depression and were equally active in asking questions. These levels were far greater than those reported for other cancer patients in the literature. Companions did not increase significantly the number of questions per consultation. CONCLUSION: Accompanied and non accompanied patients differed more in socio-demographic than clinical characteristics. Companions sustained the patient and shared information without reducing the level of patient involvement.

The 35/50 kDa surface antigen of Trypanosoma cruzi metacyclic trypomastigotes, an adhesion molecule involved in host cell invasion.

We have previously shown that monoclonal antibodies directed to the 90 kDa glycoprotein and the 35/50 kDa glycoconjugate, present on the surface of Trypanosoma cruzi metacyclic trypomastigotes, inhibited host cell invasion. Here we investigated whether these molecules could be the ligands for the target cell receptor. Binding assays were performed by incubating Vero cells with sonicated parasite extract. Detection of bound parasite components was carried out by using monoclonal antibodies (MoAbs) IG7 and 10D8, which recognize the 90 kDa and the 35/50 kDa antigens respectively. These experiments revealed that the 35/50 kDa glycoconjugate of metacyclic forms, but not the 1G7-reactive antigen, binds to Vero cells. The purified 35/50 kDa antigen bound to Vero cells and inhibited the entry of metacyclic forms in a dose-dependent manner. Although to a lesser extent, an immunologically related 35/50 kDa antigen of non-infective epimastigotes also bound to Vero cells but it was unable to inhibit parasite penetration at a concentration (100 micrograms/ml) in which metacyclic antigen exhibited more than 60% inhibition. All these data suggest that the metacyclic 35/50 kDa surface glycoconjugate is a ligand to the host cell in the process of T. cruzi invasion.