Practitioners of open dialogue report their personal transformations as a result of conducting network meetings.

As health care providers practicing Open Dialogue, we cleave to the notion that the support we provide to users and their communities will lead to the kind of enduring personal transformation that they would consider an improvement. But what effects do Open Dialogue network meetings have toward instilling enduring personal transformations within the practitioners themselves? This subject is rarely addressed, particularly in academic settings. In this autoethnographic account, an experiencer/occupational therapist, a marriage & family therapist, and a psychiatrist each describe enduring transformations that they attribute to working together as Open Dialogue network meeting facilitators at one stand-alone clinic over 2 years. Our report illustrates the potential of Open Dialogue network meetings, particularly the depth and breadth of transformation that can occur in all who attend them.

Comparison of Resuscitative Protocols for Bupropion Overdose Using Lipid Emulsion in a Swine Model.

AIMS: The aim of this study was to investigate the effects of different treatment combinations on bupropion recovery as well as time to return of spontaneous circulation. METHODS: We conducted an eight group, randomized, experiment to evaluate combinations of epinephrine, vasopressin, and lipids on the restoration of cardiac function in Yorkshire pigs. After tracking the animals' baseline vitals for 10 minutes, we injected the animals with bupropion (35 mg/kg) and initiated a randomized protocol 2 minutes after cardiac arrest. RESULTS: Results demonstrated that animal survival given treatment combinations including epinephrine were statistically superior to any other group (p < 0.001, Fishers' exact test). The odds of survival with use of epinephrine vs. other options were 22:1 (5.47, 88.43). Further, all animals receiving only lipids died. Cox survival analysis with bootstrapped parameter estimates provided evidence that the rapidity of cardiac recovery was maximized with a combination of epinephrine and lipids (p < 0.05). CONCLUSIONS: Lipids may require an additional chemical catalyst in order to be effective in cardiac recovery. Epinephrine and lipids combined shortened recovery time for surviving animals.

A Phase II trial of Denileukin Diftitox in patients with previously treated advanced non-small cell lung cancer.

INTRODUCTION: Denileukin diftitox, a chimeric protein, uses the cytocidal properties of diphtheria toxin to cells expressing interleukin-2 receptors. The aim of this study was to evaluate the efficacy and safety of denileukin diftitox in the treatment of advanced relapsed nonsmall cell lung cancer (NSCLC). PATIENTS AND METHODS: Multicenter phase II trial in patients with NSCLC with Eastern Cooperative Oncology Group PS 0-2, stage IIIB/IV at diagnosis, who had failed at least 1 previous chemotherapy regimen. Denileukin diftitox was infused at 18 microg/kg/d x 5 days, every 21 days for 6 cycles. RESULTS: For the 41 patients enrolled, the median age was 56 years (range, 21-80), 25 were men, and the median number of previous chemotherapy regimens was 2 (range, 1-5). The median number of treatment cycles was 2 (range, 1-6). By RECIST criteria, 18 (44%) had stable disease, 10 (24%) progressive disease, and 13 (32%) were not evaluable for response as they received less than 2 treatment cycles. The median time to disease progression was 1.8 months [range, 0.3-11.3; 95% confidence interval (CI) 1.3-2.6]. Median survival was 5.8 months (range, 0.3-33.6; 95% CI 3.4-11.4). The median follow-up time was 16.1 month. One death from myocarditis verified at autopsy was attributed to treatment. One grade 4 toxicity (vascular leak syndrome) was encountered, and 18 grade 3 toxicities, primarily gastro-intestinal, vascular leak syndrome, and constitutional symptoms. CONCLUSION: Denileukin diftitox at current dose schedule has limited activity in patients with previously treated NSCLC, manifested by disease control without impact on survival.