ABSTRACT
A prospective study investigated the psychological wellbeing and quality of life of older rural men after a community-based screening for abdominal aortic aneurysm (AAA). Five hundred and sixteen men aged 65-74 years attended the screening program; 53 had an abnormal aorta detected. These and a subsample of men with a normal aorta were followed up 6 months post-screening. All men completed a pre-screening questionnaire including the Medical Outcomes Short Form 36v 2 (MOSF36) and Hospital Anxiety and Depression Scale (HADS). Six months after screening all 53 men with an abnormal and 130 with a normal aorta were sent a questionnaire including MOSF36 and HADS. Baseline and 6 month scores for both MOSF36 and HADS scores were compared between the two groups and within each group. Baseline scores for both MOSF36 and HADS were not significantly different between men who were subsequently diagnosed with an abnormal aorta and those with a normal aorta. After 6 months there was no difference in HADS scores but a significant increase in the MOSF36 dimension of general health. Those with a normal aorta reported better general health, social functioning and greater freedom from bodily pain. AAA screening appears highly acceptable to men in the target age group and future research should focus on implementation, cost effectiveness and collateral benefits of AAA screening.
Subject(s)
Aortic Aneurysm, Abdominal/diagnostic imaging , Aortic Aneurysm, Abdominal/psychology , Mass Screening/psychology , Quality of Life , Aged , Humans , Male , New South Wales , Prospective Studies , Rural Population , Surveys and Questionnaires , UltrasonographyABSTRACT
OBJECTIVE: To optimise collection of sufficient autologous blood for elective surgery. METHODS: Prospective study of 40 patients referred for donation of autologous blood, who were booked for elective orthopaedic surgery in the period August 1992 - September 1994. Patients received recombinant erythropoietin (r-EPO) to stimulate erythropoiesis, and sufficient iron by injection so that iron deficiency did not limit the bone marrow response to the r-EPO. RESULTS: Thirty-eight of the 40 patients treated with this protocol stored an average of 3.7 units each on a twice-weekly donation schedule. Only one patient required supplemental homologous blood (two units) in subsequent surgery. One patient developed persistent hypotension, and one a late reaction to parenteral iron (which was controlled with corticosteroids). There were no other adverse events. CONCLUSIONS: r-EPO in combination with parenteral iron is a safe and effective method of ensuring the collection of optimal amounts of autologous blood before surgery.
Subject(s)
Blood Transfusion, Autologous , Erythropoietin/therapeutic use , Iron/administration & dosage , Adult , Aged , Aged, 80 and over , Elective Surgical Procedures , Female , Humans , Infusions, Intravenous , Iron/adverse effects , Male , Middle Aged , Orthopedics , Phlebotomy/adverse effects , Pilot Projects , Prospective Studies , Recombinant Proteins/therapeutic useABSTRACT
BACKGROUND: Lengthy remission or cure has remained elusive for patients with many of the common haematological malignancies. Thus high dose chemotherapy followed by autologous haemopoietic stem cell transplantation is being increasingly utilised in these diseases. AIM: To assess the safety of high dose chemotherapy and autologous stem cell transplantation in haematological malignancy. METHODS: Forty-eight patients with haematological malignancy were given high dose chemotherapy followed by an infusion of previously cryopreserved autologous peripheral blood stem cells with (patients with acute myeloid leukaemia [AML]) or without (patients with acute lymphoblastic leukaemia [ALL], chronic myeloid leukaemia, non-Hodgkin's lymphoma, Hodgkin's disease and myeloma) autologous bone marrow. RESULTS: All patients except one had sustained engraftment. The median (range) number of days to attain a neutrophil count of 0.5 x 10(9)/L was 12 (10-42) and a platelet count of 20 x 10(9)/L unsupported by platelet transfusions was 15 (eight to 155). Other than oropharyngeal mucositis and febrile neutropenia, morbidity was low. Two patients had haemorrhagic cystitis, one hepatic veno-occlusive disease and one interstitial pneumonitis; all resolved. The treatment-related mortality was 2%--a single patient with AML died of failure of sustained engraftment. CONCLUSIONS: Autologous blood stem cell transplantation to support high dose chemotherapy is a relatively safe procedure and its efficacy is currently being explored in a wide range of haematological malignancies.
Subject(s)
Hematopoietic Stem Cell Transplantation/mortality , Leukemia/therapy , Acute Disease , Adolescent , Adult , Aged , Female , Humans , Leukemia/mortality , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy , Leukemia, Myeloid/mortality , Leukemia, Myeloid/therapy , Male , Middle Aged , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Survival AnalysisABSTRACT
Small cleaved-cell lymphoma (SCCL) is a non-Hodgkin's lymphoma of low clinical grade, highly responsive to radiation and cytotoxic therapy in its early stages, but ultimately fatal as disease progresses and becomes resistant to therapy. This study reports favourable results using recombinant alpha interferon (alpha IFN) and corticosteroids (CS) in five previously-untreated patients with advanced SCCL. Complete response (CR) was seen in three, excellent partial responses (PR) in the other two, with good patient tolerance. Some possible neurotoxicity was observed. As a strategy to minimise or delay cytotoxic exposure in these patients, it appears to have merit.
