Evaluation of patients' needs to design and assess a patient education program in cancer pain.

Purpose: Patient education constitutes a relevant strategy to improve pain management. In the field of therapeutic patient education (TPE), we aimed 1) to assess pain impact in cancer patients, 2) to identify patients' educative needs in pain management, and 3) to refine research criteria for its future evaluation. Patients and methods: Pain intensity, relief and interference were assessed in 75 cancer patients with unbalanced background pain. Self-assessment questionnaire evaluated i) patients' pain management and ii) their knowledge and needs in TPE. Results: Most patients experienced pain for more than 6 months and 41.6% reported adequate pain relief. Understanding pain and pain management were major patients' preferences (>58%). Most patients declared they knew their pain treatments, but fewer than half of them were able to name them. However, education concerning pain treatment was considered as essential in <30% of patients. Almost all patients (97.1%) stated pain education as beneficial, with a preference for individualized sessions (41.2%). In addition, the assessment criteria for its future evaluation were refined. Conclusion: Targeted population mainly concerned patients with persistent pain. Only half of patients reported pain relief despite antalgics. Patient education was declared as beneficial for almost all participants. Practice implications: Tailoring a pain TPE on patients' needs has the potential to help them to optimally manage their pain daily.

Nasolacrimal duct office probing in children under the age of 12 months: Cure rate and cost evaluation.

INTRODUCTION: Controversy exists regarding the treatment of infants with symptomatic nasolacrimal duct obstruction. One philosophy advocates "early" nasolacrimal duct probing, generally in the office - a relatively common approach in France, while others prefer to wait until the age of 12 months to offer a procedure under general anesthesia. The goal of this study is to report results of immediate office probing for congenital nasolacrimal duct obstruction (CNLDO) under age 1 year in terms of efficacy and cost. METHODS: A retrospective study was performed on 329 patients (443 eyes) treated by probing for CNLDO under the age of 12 months age. A single probing was performed at the first visit in the office under topical anesthesia without sedation. In order to determine the factors associated with failure of probing, univariate analysis was performed using the Student t-test, Pearson's, homogeneity Chi(2) or Fisher's exact tests. For cost evaluation, hypothetical estimates of spontaneous resolution month by month were used according to data in the literature, along with health insurance reimbursement data. RESULTS: The ages of the patients ranged from 2 to 11 months (mean 7.0 ± SD 2.3). The overall success rate for cure by immediate office probing was 76.7%. Unilateral CNLDO had an 80.4% success rate whereas bilateral CNLDO had a 73.2% success rate for each eye (P=0.09). Discharge during probing was associated with failed probing (P=0.02). The cost for the spontaneous resolution strategy was 1.56 times higher than for the immediate probing strategy. A strategy which would apply the spontaneous resolution strategy for children ≤ 5 months and the probing strategy to children>5 months would be the most cost-effective. CONCLUSIONS: Immediate office probing between the ages of 5 to 12 months is a safe, effective method to relieve CNLDO and is the most cost-effective.

Understanding the HIV-1 protease reactivity with DFT: what do we gain from recent functionals?

The modeling of HIV-1 plays a crucial role in the understanding of its reactivity and its interactions with specific drugs. In this work, we propose a medium sized model to test the ability of a variety of quantum chemistry approaches to provide reasonable geometric parameters and energetics for this system. Although our model is large enough to include the main polarizing groups of the active site, it is small enough to be used within full quantum studies up to the second order Møller-Plesset (MP2) level with extrapolations to coupled cluster CCSD(T) level. These high level calculations are used as reference to assess the ability of electronic structure methods (semiempirical and DFT) to provide accurate geometries and energies for the HIV-1 protease reaction. All semiempirical methods fail to describe the geometry of the protease active site. Within DFT, pure generalized gradient approximation (GGA) functionals have difficulty in reproducing the reaction energy and underestimate the barrier. Hybrid and/or meta GGA approaches do not yield a consistent improvement. The best results are obtained with hybrid GGA B3LYP or X3LYP and with hybrid meta GGA functionals with a fraction of exact exchange around 30-40%, such as M06, B1B95, or BMK functionals. On the basis of these results, we propose an accurate and computationally efficient strategy, employing quantum chemistry methods. This is applied here to study the protonation state of the reaction intermediate and could be easily used in further QM/MM studies.

[Can tumor necrosis factor inhibitors induce sclero-uveitis?]. / Les anti-Tnf peuvent-ils induire des scléro-uvéites ?

We report three cases of female patients who presented a first episode of unilateral scleritis or acute anterior uveitis while they were treated for 12-16 months by TNF inhibitor: etanercept (Enbrel((R))) 25mg twice weekly for rheumatologic diseases (rheumatoid arthritis or ankylosing spondylitis). Ocular inflammation was resistant to the usual treatment. Some cases of scleritis and uveitis are known to be drug-induced. TNF inhibitors seem to be part of them. Ocular inflammation is usually the first episode. It appears generally in the first year of the treatment by TNF inhibitors and resists to usual treatment. The general disease is usually well stabilized. In our cases, inflammation decreased only when the etanercept was discontinued.

Electron and ion reactions with hexamethyldisiloxane and pentamethyldisiloxane.

The dissociative recombination of electrons with the hexamethyldisiloxane (HMDSO) cation ((CH(3))(3)Si-O-Si(CH(3))(3))(+) and the pentamethyldisiloxane cation ((CH(3))(3)Si-O-Si(CH(2))(2))(+) as well as the ion-molecule reaction between Ar(+) and HMDSO have been studied at 300 K using a flowing afterglow Langmuir probe-mass spectrometer apparatus. The rate constants for these reactions, measured directly for the first time, are, respectively, alpha(1)=1.8 x 10(-6), alpha(2)=3.6 x 10(-6) cm(3)s, and k=2.0 x 10(-9) cm(3)s with uncertainties of +/-30%. In addition, the electronic attachment to neutral HMDSO was also studied and an upper limit value of the rate constant was determined to be beta=3.3 x 10(-11) cm(3)s.

The reaction of anthracene with OH radicals: an experimental study of the kinetics between 58 and 470 K.

The first direct measurement of the reaction rate constant of a polycyclic aromatic hydrocarbon in the gas phase in the temperature range 58-470 K is reported. The reaction is OH+ anthracene and the experiment has been performed in a continuous flow Cinetique de Reaction en Ecoulement Supersonique Uniforme apparatus, which had to be modified for this purpose. Pulsed laser photolysis of H(2)O(2) has been used to generate OH radicals and laser-induced fluorescence to observe the kinetic decay of the radicals and hence determine the rate coefficients. The reaction is found to be fast, and the rate constant increases monotonically as the temperature is lowered. The rate coefficients match the expression k(cm(3) molecules(-1) s(-1))=1.12 x 10(-10)(T/300)(-0.46).

Electron attachment on HI and DI in a uniform supersonic flow: thermalization of the electrons.

In order to check the electron thermalization in the CRESU technique (Cinetique de Reaction en Ecoulement Supersonique Uniforme, e.g., "reaction kinetics in a uniform supersonic flow"), electron attachment on HI and DI has been studied in the 48-170 K range. Attachment to HI is exothermic and the reaction is expected to be fast and to proceed at a rate close to the capture limit. On the contrary, attachment to DI is slightly endothermic, and a strong positive temperature dependence of the measured rate coefficient is expected if the electrons are thermal. This dependence is not observed, and we conclude that the electrons are not in thermal equilibrium with the neutrals in the afterglow. A model, based on electron heating by superelastic collisions with the buffer gas, is proposed to explain this fact and implications for previously published results are discussed.

EuroBionet: a pan-European biomonitoring network for urban air quality assessment.

EuroBionet, the 'European Network for the Assessment of Air Quality by the Use of Bioindicator Plants', is an EU-funded cooperative project currently consisting of public authorities and scientific institutes from 12 cities in 8 countries. In 2000, the bioindicator plants tobacco (Nicotiana tabacum Bel W3), poplar (Populus nigra 'Brandaris'), spiderwort (Tradescantia sp. clone 4430), Italian rye grass (Lolium multiflorum italicum) and curly kale (Brassica oleracea acephala) were exposed to ambient air at 90 monitoring sites according to standardised methods. Visible injuries and growth parameters were assessed and the accumulation of toxic substances in leaves determined. The exposure of tobacco resulted in a gradient with low levels of ozone-induced foliar injury in N and NW Europe, and medium to high values in the southern and central regions. The results of heavy metal and sulphur analyses in rye grass samples generally showed low to very low sulphur and low to medium heavy metal concentrations in leaves. In some cities, however, local hot spots of heavy metal contamination were detected. Analyses of the PAH contents in curly kale leaves gave low to medium values, with locally elevated levels at traffic-exposed sites.

[Adjusting the dosage of netilmicin from two measurements. Program validation]. / Adaptation des posologies de la nétilmicine à partir de deux points. Validation d'un programme.

The aim of this study is to give to clinicians a well validated usefull tool allowing an increase of safety in the monitoring of netilmicin. During the first administration of the drug, two plasmatic concentrations are measured, and input in a preprogrammed hand-held calculator. A posology and a rythm of administration are returned by the calculator. After six days of this dosage regiment, the peak and the valley concentrations are compared with those previously given by the computer as values at equilibrium. No significant difference can be observed. There is no change in plasmatic creatinine level from the first to the sixth day of treatment. So, a preprogrammed hand-held computer can be convenient and safe to monitor netilmicin.

Fluoride distribution and transport along rivers in the French Alps.

Fluoride concentrations in water, sediments, and plants were determined at 26 locations along five rivers in the French Alps where aluminum factories have been discharging fluoride into the surrounding environment since the end of the last century. Despite a wide range of biological and constructional damages caused by fluoride contamination in the past, there was no alarming level of fluoride found in the water, sediments, or plants. Fluoride concentration in water ranged from 0.11 ppm (considered to be natural background level) to 0.62 ppm (moderate contamination). The highest fluoride concentration was 360 ppm in sediments and 207 ppm in plants. The increase of fluoride concentration along the rivers was gradual from upstream to downstream. This gradual increase suggested that the fluoride pathway was from factory to stack, to air, to the entire valley, and to the river. The amount of fluoride transported from the Maurienne valley by the Arc river was estimated to be 680 tons per year. Of this 97.8% tons (665 tons) was transported by the flowing water and the rest (2.2% or 15 tons) by sediments moving downstream.

[The concentration of fluorine in different dairy products made from contaminated milk]. / Repartition du fluor dans les differents produits laitiers obtenus a partir de lait contamine.

The total fluoride levels in milk from cows grazing in fluoride-contaminated pastures (0.26 microgram g-1) are found to be about twice as high as those in milk from cows on a "normal" grass diet (0.11 microgram g-1). Among dairy products from contaminated milk, the fluoride concentrations in cream and cheese are the highest. During processing, large amounts of fluoride accumulate in these products, and the fluoride concentrations of cream and cheese are about three times (0.80 microgram g-1) those of milk. However, the study demonstrates that not only milk but also dairy products are poor sources of fluoride even in cases in which the fluoride content of the ambient air is notably high.

[Compartmental analysis of 6Li/7Li isotope exchange in equilibrium conditions in mouse plasma]. / Analyse compartimentale de l'échange isotopique 6Li/7Li en conditions stationnaires dans le plasma de la souris.

The compartmental analysis of lithium in the mouse plasma has been performed using the stable isotopes, 6Li and 7Li, as tracers. The animals were kept under stationary conditions (concentration of total lithium in plasma maintained equal to 0.28 mM) during the experiment. The isotopic exchange, 6Li/7Li, was described to a good approximation by combining two first-order processes (characteristic parameters: 89 microM and 2.071 X 10(-3) X min-1 for the first one, and 193 microM and 2.215 X 10(-4) X min-1 for the second one). From these kinetic data, it was estimated that the lithium capacities of the plasma and of the cells were 282 and 454 nmol X ml-1, and that the unidirectional fluxes of lithium between plasma and cells and through the kidneys were 0.259 and 0.227 nmol X ml-1 X mn-1. Since the method makes use only of stable, hence harmless, isotopes, one might think of extending it to direct experimentation in man.

Accidental release of fluoride into experimental pond and accumulation in sediments, plants, algae, molluscs and fish.

The fate of fluoride in a simulated accidental release into an experimental pond was observed for 30 days in Grenoble, France. The components investigated were water, sediments, plants, algae, molluscs, and fish. Twenty-four hours after the release, most (99.8%) of the fluoride was distributed in the physical components (water and sediments), and the biological agents contained only 0.2% of the fluoride released. Despite an exposure to hot spots of 5000 ppm at the beginning of the accidental release, no visible toxic effects were observed on the biological components such as plants, algae, molluscs, and fish. The effects of the physical components in the defluoridation showed a significant role in the control the accidental release of fluoride in the aquatic system.

A tracer method to study unidirectional fluxes of lithium. Application to frog skin.

We describe a new tracer method to measure unidirectional fluxes of Li+ despite the lack of any utilizable radioisotope of lithium. This method uses the purified stable isotopes, 6Li and 7Li, detected with an ion-probe microanalyser. The accuracy is comparable to that obtained for other ions (e.g., Na+) with radiotracers. The method has been applied to frog skin with both faces bathed in a 20% lithium/80% sodium medium. Sodium and lithium unidirectional fluxes have been measured simultaneously. The results are consistent with lithium being actively pumped, the outflux of lithium being, however, much larger than that of sodium.

Cortical Air Spaces (Aerenchyma) in Roots of Corn Subjected to Oxygen Stress: STRUCTURE AND INFLUENCE ON UPTAKE AND TRANSLOCATION OF RUBIDIUM IONS.

When the seminal root system of 14-day-old corn (Zea mays cv. Dekalb 202) was subjected to O(2) stress, nodal roots with well developed cortical air spaces (aerenchyma) grew into the deoxygenated solution. Microscopic examination showed that there was extensive breakdown of cells in the midcortex of these roots, while the stele, endodermis, and inner layer of cortical cells remained complete, as did the outer layers of the cortex and the epidermis. Occasional files of intact cells, and the wall residues of collapsed cells, crossed the space between inner and outer cortex. Experiments with short, intact root segments with and without air spaces showed that in the presence of O(2) the ability to absorb and translocate (86)Rb(+), per unit volume or length of root, was little affected by cortical degeneration. The distribution across root sections of recently supplied strontium and rubidium, determined by electron microprobe analysis, indicated that in roots with air spaces the strands of wall residues bridging the cortex could be involved in maintaining the conduction of ions from the outer cortex up to the endodermis.

[Lithium exchange in from epithelium: determination of unidirectional flux using the stable isotopes 6Li and 7Li in an ionic analyzer]. / Echanges de lithium de l'épithélium de Grenouille: détermination des flux unidirectionnels à l'aide des isotopes STABLES 6Li et 7Li et d'un analyseur ionique.

The use of the stable isotopes 6 and 7 of lithium, and detection with the ionic analyser, allow the measurement of unidirectional transepithelial Li-fluxes, between "external" and "internal" solutions which both contain 80% Na and 20% Li. Efflux was found to be bigger than influx. An important lag-phase on the curve, reveals the interference of a Li-compartment, with a high capacity, in the epithelium itself.