Effect of written outcome information on attitude of perinatal healthcare professionals at the limit of viability: a randomized study.

BACKGROUND: Differences in perception and potential disagreements between parents and professionals regarding the attitude for resuscitation at the limit of viability are common. This study evaluated in healthcare professionals whether the decision to resuscitate at the limit of viability (intensive care versus comfort care) are influenced by the way information on incurred risks is given or received. METHODS: This is a prospective randomized controlled study. This study evaluated the attitude of healthcare professionals by testing the effect of information given through graphic fact sheets formulated either optimistically or pessimistically. The written educational fact sheet included three graphical presentations of survival and complication/morbidity by gestational age. The questionnaire was submitted over a period of 4 months to 5 and 6-year medical students from the Geneva University as well as physicians and nurses of the neonatal unit at the University Hospitals of Geneva. Our sample included 102 healthcare professionals. RESULTS: Forty-nine responders (48%) were students (response rate of 33.1%), 32 (31%) paediatricians (response rate of 91.4%) and 21 (20%) nurses in NICU (response rate of 50%). The received risk tended to be more severe in both groups compared to the graphically presented facts and current guidelines, although optimistic representation favoured the perception of "survival without disability" at 23 to 25 weeks. Therapeutic attitudes did not differ between groups, but healthcare professionals with children were more restrained and students more aggressive at very low gestational ages. CONCLUSION: Written information on mortality and morbidity given to healthcare professionals in graphic form encourages them to overestimate the risk. However, perception in healthcare staff may not be directly transferable to parental perception during counselling as the later are usually naïve to the data received. This parental information are always communicated in ways that subtly shape the decisions that follow.

3D capillary stop valves for versatile patterning inside microfluidic chips.

The patterning of antibodies in microfluidics chips is always a delicate process that is usually done in an open chip before bonding. Typical bonding techniques such as plasma treatment can harm the antibodies with as result that they are removed from our fabrication toolbox. Here we propose a method, based on capillary phenomena using 3D capillary valves, that autonomously and conveniently allows us to pattern liquids inside closed chips. We theoretically analyse the system and demonstrate how our analysis can be used as a design tool for various applications. Chips patterned with the method were used for simple immunodetection of a cardiac biomarker which demonstrates its suitability for antibody patterning.

Homeopathy for infertility treatment: a case series.

Homeopathy has been used in the past for treating a broad aspect of diseases. In gynecology, its use remains limited. Taking under consideration its clinical aspects, the authors attempted to use it for treating female sub fertility problems. With this study, the authors present five cases of female infertility treated successfully with the use of homeopathic treatment in a large obstetrics-gynecology Hospital in Athens.

Unusual case of multilocular cystic renal cell carcinoma treated with nephron-sparing technique.

INTRODUCTION: The spectrum of cystic renal neoplasms includes both benign and malignant tumors and the order is as follows: benign multilocular cyst, multilocular cystic renal cell cancer and cystic renal cell cancer. Gross similarities among multicystic tumors of the kidney may cause conflict in the diagnosis and treatment of these lesions. CASE REPORT: We report a 37-year-old male who presented with a mild persistent left flank pain and a painful left renal mass. After a series of examinations including abdominal ultrasound, intravenous pyelography and computed tomography, he underwent surgical exploration despite the benign appearance on radiological evaluation. A partial nephrectomy has been finally performed. The pathologic examination showed multilocular cysts lined by flattened to cuboidal epithelium, separated by cellular spindle cell stroma. Few scattered foci of lining cells showing the typical features of clear cell carcinoma of the kidney have been revealed also. CONCLUSION: According to the current literature, prognosis of multilocular renal clear cell carcinoma is excellent in most of the cases. Indeed, metastases development is rare while local recurrence is related to inadequate local excision. Despite the relatively benign nature, urologist should be always aware of such complex renal masses since both the non specific clinical findings and poor contribution of imaging examinations make the preoperative distinction of benign from malignant cystic renal neoplasias difficult.

Prevalence of urolithiasis in rural Thebes, Greece.

INTRODUCTION: Worldwide, urolithiasis is the third most common urological disease affecting both males and females. Both genetic and environmental factors contribute to stone formation. The recurrence rate is approximately 50%, rising to 70% within 10 years and this condition represents a significant healthcare cost burden. An unusually frequent history of urolithiasis has been observed among patients from the rural area of Thebes, Viotia, Greece. OBJECTIVE: To determine the prevalence of urolithiasis in Thebes. METHODS: A representative sample of persons from the rural area of Thebes was questioned about the occurrence of urinary stones during their lifetime, and acute urolithiasis in 2005. A logistic regression model was used to contrast individuals with lithiasis to those without lithiasis. RESULTS: A total of 422 subjects participated in the study. We found a 15% prevalence of urolithiasis in the rural population of Thebes. The rate was slightly higher in men than in women in almost all age groups questioned, although this was not statistically significant. No case of urolithiasis was found in subjects under the age of 17 years. The prevalence of urolithiasis appeared to increase with age in both men and women. Those drinking bottled water were less likely to have lithiasis. CONCLUSION: The life time prevalence rate of urolithiasis observed in the rural area of Thebes was higher to that reported in other studies performed among males and females in the general population of Europe.

Oxidative stability and radical scavenging activity of extra virgin olive oils: an electron paramagnetic resonance spectroscopy study.

The oxidative stability of extra virgin olive oils (EVOO) from the Greek island of Crete was evaluated by electron paramagnetic resonance (EPR) spectroscopy and the spin trapping technique. The spin trap N-t-butyl-alpha-phenylnitrone (PBN) was added to the olive oil samples and the production of free radicals was monitored during heating at 70 degrees C. Induction time for the accelerated oxidation of virgin olive oils at 70 degrees C was determined. The EPR results were compared with the oxidative stability values provided by the Rancimat method at 110 degrees C and high linear correlations were found (r=0.922). EPR spin trapping provides a sensitive and rapid method for evaluating the oxidative stability of EVOO. The same samples of Greek extra virgin olive oils were also examined for their radical scavenging activity (RSA) toward the stable galvinoxyl radical by EPR spectroscopy. The decrease of the intensity of the EPR signal upon incubation time was followed. Both oxidative stability and radical scavenging activity of EVOO samples were correlated to their content in polyphenols and tocopherols.

Field trials to determine residues of chlozolinate in table grapes.

Chlozolinate (Serinal) is a dicarboximide fungicide used in southern European countries principally on grapes. Maximum residue levels have not yet been set by FAO/WHO and are under evaluation in the EU. Field trials have been carried out in Greece on two varieties of table grapes (Cardinal and Victoria) during two consecutive years to assess residues remaining after application according to good agricultural practice. Analysis using a multiresidue method with gas chromatography (ECD) showed that the parent compound decays with a first-order rate constant of 0.057 +/- 0.011 day(-)(1) and that residues had fallen below the proposed MRL of 5 mg/kg in all samples by 21 days postapplication (the proposed PHI). The contribution of the main metabolite, S1, to the total residue is generally <20%. Washing removes a substantial amount (up to 80%) of chlozolinate, which appears to be nonsystemic on grapes, thus reducing real consumer exposure to this pesticide.

Paclitaxel and carboplatin as first-line chemotherapy for advanced breast cancer.

In a phase II study, 66 patients with advanced breast cancer (median age 56 years; range, 28 to 75 years) were treated with paclitaxel (Taxol), 175 mg/m2 infused over 3 hours, and carboplatin (Paraplatin), dosed to attain an area under the concentration-time curve (AUC) of 6 mg x min/mL; treatment was repeated every 3 weeks. A total of 38 (58%) patients had received prior adjuvant chemotherapy, 21 with a regimen containing an anthracycline or mitoxantrone (Novantrone). As of May 1997, 295 cycles of paclitaxel-carboplatin have been administered, 248 (84%) at full dose. The relative dose intensity of paclitaxel is 0.9 (range, 0.5 to 1.2). Of the 66 patients, 8 (12%) have achieved a complete response and 27 (41%) a partial response, for a total response rate of 53%. Grade 3 to 4 toxicities have included anemia (5%), leukopenia (25%), thrombocytopenia (5%), nausea/vomiting (7%), myalgias/arthralgias (4%), allergic reaction, neurotoxicity, and infection (2% each). Alopecia has been universal. Median time to progression is 8.9 months; median survival has not yet been reached. We conclude that the combination of paclitaxel and carboplatin has significant activity in advanced breast cancer and can easily be administered on an outpatient basis with manageable toxicity.

Lipase catalyzed esterification in AOT reverse micelles: a structural study.

AOT reverse micelles are used to cosolubilize hydrophilic and hydrophobic reactants of lipase catalysed esterification. Depending on the nature of the alcohol, a drastic change of the initial rate of the esterification is observed. A structural study of the micellar system with and without reactant is undertaken to explain the change in the activity with the various alcohols.

Serum antibodies to Chlamydia trachomatis in women with ectopic pregnancy, normal pregnancy or salpingitis.

Serum antichlamydial antibodies were studied in three groups. Group A included 49 women with recent ectopic pregnancy, group B included 56 women with normal first trimester pregnancy, and group C included 20 women with a first episode of acute salpingitis. In the ectopic pregnancy group, a significantly higher percentage of women had IgG antichlamydial antibodies than in the normal pregnancy group (75.5% vs. 46.4%, P less than 0.001). Women with acute salpingitis had the same prevalence of IgG antibodies as patients who had an ectopic pregnancy (60% vs. 75.5%, P less than 0.10). In the ectopic pregnancy group, the women had a significantly higher geometric mean titer (GMT) of antichlamydial IgG antibodies than women with an intra-uterine pregnancy (70.4% vs. 27.3%, P less than 0.001). The results suggest that there is a positive relation between prior Chlamydia trachomatis infection and risk for tubal pregnancy.

Incidence of adenomyosis uteri in a Greek population.

The reported incidence of adenomyosis based on unselected hysterectomies varies so widely that conclusions regarding the influence of any factor on that incidence are difficult to reach, although the relation of adenomyosis uteri to endometrial carcinoma has been the subject of only a few studies. In a 5-year period at the General Hospital of Athens, 646 hysterectomies were performed. All data were retrieved from the surgical pathology laboratory files concerning adenomyosis uteri with either simultaneous endometrial carcinoma or endometrial hyperplasia. A control population was selected from patients operated upon for a variety of benign pelvic diseases. Adenomyosis was found in association with endometrial carcinoma in 17.5% of 40 cases, and in association with endometrial hyperplasia in 21.6% of 60 cases. The control series of 546 patients had a 26% incidence of adenomyosis. The results of our study do not indicate any correlation between adenomyosis uteri and endometrial carcinoma.