HPV Prevalence and Prognostic Value in a Prospective Cohort of 255 Patients with Locally Advanced HNSCC: A Single-Centre Experience.

Background. HPV is a positive prognostic factor in HNSCC. We studied the prevalence and prognostic impact of HPV on survival parameters and treatment toxicity in patients with locally advanced HNSCC treated with concomitant chemoradiation therapy. Methods. Data on efficacy and toxicity were available for 560 patients. HPV was detected by PCR. Analysis was performed using Kaplan-Meier survival curves, Fisher's test for categorical data, and log-rank statistics for failure times. Results. Median follow-up was 4.7 years. DNA extraction was successful in 255 cases. HPV prevalence was 68.6%, and 53.3% for HPV 16. For HPV+ and HPV-, median LRC was 8.9 and 2.2 years (P = 0.0002), median DFS was 8.9 and 2.1 years (P = 0.0014), and median OS was 8.9 and 3.1 years (P = 0.0002). Survival was different based on HPV genotype, stage, treatment period, and chemotherapy regimen. COX adjusted analysis for T, N, age, and treatment remained significant (P = 0.004). Conclusions. Oropharyngeal cancer is increasingly linked to HPV. This study confirms that HPV status is associated with improved prognosis among H&N cancer patients receiving CRT and should be a stratification factor for clinical trials including H&N cases. Toxicity of CRT is not modified for the HPV population.

Mercury distribution in relation to iron and manganese in the waters of the St. Lawrence river.

Waters entering the St. Lawrence River from Lake Ontario and from the Ottawa River have been sampled on a quaternary basis between March 1995 and October 1996. Mercury, iron, manganese, organic carbon and other chemical parameters have been determined in the filtered water (< 0.5 micron) and suspended particles (> 0.5 micron). Average total mercury concentrations (+/- standard deviation, number of determinations) in filtered samples were 1.3 +/- 0.9 pM (39) at the mouth of Lake Ontario and 4.0 +/- 2.3 pM (54) at the outlet of the Ottawa River. The respective average concentrations in suspended particles were 1.1 +/- 0.4 (39) and 0.6 +/- 0.2 (55) nmol g-1. Partial correlation analyses reveal that in the fraction < 0.5 micron--which seems to consist of a significant fraction of colloids--mercury was significantly linked to iron, while in the particulate phase, mercury was related to manganese. Mercury was not correlated with organic carbon. A sorption model on iron and manganese hydroxides is proposed to explain these observations.

[My personal and professional efficacy]. / Mon efficacité personnelle et professionnelle.

Being a nurse means there's little room for error. The work is demanding and often stressful. As a result, suggests the author, nurses are sometimes too hard on themselves, blaming themselves for things that are beyond their control. This can lead to depression, burnout or leaving the profession altogether. The article suggests performance evaluation criteria that are both realistic and achievable. A number of examples are given, using everyday situations that we have all had to confront, at one time or another, in our personal or professional lives. Effective versus ineffective evaluation criteria are presented, as well as several practical suggestions. Nursing will continue to be a stressful, demanding profession, says the author. But following these simple suggestions will go a long way towards mitigating the stress and allowing nurses to take justifiable pride in what they do.

[A bird's-eye view]. / Le point de vue de l'oiseau.

Nurses, because of the nature of their work, often find it difficult to distance themselves emotionally from their patients. Thus, not surprisingly, they are subject to periods of depression. In this article the author presents a series of questions based on the cognitive therapy model to help nurses be more objective in other words, to encourage a bird's-eye view.

[Mental imagery and new behavior]. / Imagerie mentale et comportements nouveaux.

Mental imagery, a technique commonly used by competitive athletes and one often taught to those with chronic pain, is described. The author explains how all of us can use this technique to gain control over our lives. He discusses the use of an interior camera to produce scenarios that permit successful outcomes.

A preliminary report on the fine structure of Tripneustes esculentus eggs.

The fine structure of Tripneustes esculentus eggs was studied with the aid of an electron microscope. Cells obtained from this West Indies sea urchin showed cortical granules, mitochondria forming a rosette around lipid granules, endoplasmic reticula, Golgi apparatus and annulated lamellae. These structures appear identical to those seen in eggs of the Atlantic sea urchin: Arbacia punctulata.