Recurrence of Breast Cancer After Primary Treatment: A Matched Comparison Study of Disease-Free Survival in Women Who Do and Do Not Receive Adjunctive Naturopathic Oncology Care.

PURPOSE: To compare disease free survival experienced by women who received usual oncologic care compared to a cohort of women who received naturopathic oncology care in addition to usual care. METHODS: Women with breast cancer who received naturopathic oncology (NO) care in Western Washington State (WA) (N = 176) were recruited to a prospective study of clinical health-related quality of life outcomes and then matched to women who received usual care (UC) only (N = 334). RESULTS: Among 510 women with breast cancer stages 1 to 3, a total of 50 women (10%) experienced a disease-free survival (DFS) ending event within the observation period; 23 (6.8% of those in the UC cohort, and 27 (15.3% of those in the NO cohort (P < .05). Although, women in the 2 cohorts received similar surgical, chemotherapy, and radiation treatment, women with breast cancer who received naturopathic oncology adjunctive care were less likely to use anti-estrogen therapy, and experienced poorer DFS (logrank test, P < .05). However, differences in DFS could not be shown to be due to cohort differences in anti-estrogen therapy, baseline HRQOL, or naturopathic oncology therapies prescribed. The stage 3 women in the naturopathic oncology group had more advanced disease at diagnosis. They were more likely to have 5 or more metastatic lymph nodes at baseline (18.5%) compared to their usual care matched control group (13%). Women in the naturopathic oncology group also had higher grade tumors at diagnosis. CONCLUSIONS: Results show that recurrence of breast cancer was associated with more advanced malignant lymph node involvement; and that naturopathic oncology services provided in 2009-2015 did not improve disease-free survival in these high-risk breast cancer patients.

Design of selective and soluble inhibitors of tumor necrosis factor-alpha converting enzyme (TACE).

A program to improve upon the in vitro, in vivo, and physicochemical properties of N-hydroxyformamide TACE inhibitor GW 3333 (1) is described. Using the primary structure of pro-TNF-alpha, along with a homology model of the catalytic domain of TACE based on the X-ray diffraction coordinates of adamalysin, we synthesized N-hydroxyformamide TACE inhibitors containing a P2' arginine side chain. Introduction of nitro and sulfonyl electron-withdrawing groups covalently bound to the P2' guanidine moiety rendered the inhibitors electronically neutral at cellular pH and led to potent inhibition of TNF-alpha release from stimulated macrophages. Inhibitors containing these arginine mimetics were found to have increased solubility in simulated gastric fluid (SGF) relative to 1, allowing for the incorporation of lipophilic P1' side chains which had the effect of retaining potent TACE inhibition, but reducing potency against matrix metalloproteases (MMPs) thus increasing overall selectivity against MMP1, MMP3, and MMP9. Selected compounds showed good to excellent in vivo TNF inhibition when administered via subcutaneous injection. One inhibitor, 28a, with roughly 10x selectivity over MMP1 and MMP3 and high solubility in SGF, was evaluated in the rat zymosan-induced pleuisy model of inflammation and found to inhibit zymosan-stimulated pleural TNF-alpha elevation by 30%.

N-hydroxyformamide peptidomimetics as TACE/matrix metalloprotease inhibitors: oral activity via P1' isobutyl substitution.

N-Hydroxyformamide-class metalloprotease inhibitors were designed and synthesized, which have potent broad-spectrum activity versus matrix metalloproteases and TNF-alpha converting enzyme (TACE). Compound 13c possesses good oral and intravenous pharmacokinetics in the rat and dog.

Teacher training as a behavior change process: principles and results from a longitudinal study.

For students to realize the benefits of behavior change curricula for disease prevention, programs must be implemented effectively. However, implementation failure is a common problem documented in the literature. In this article, teacher training is conceptualized as a behavior change process with explicit teacher motivation components included to help effect the intended behavior (i.e., implementation). Using this method, the Hutchinson Smoking Prevention Project, a randomized controlled trial in school-based smoking prevention, conducted 65 in-service programs, training nearly 500 teachers (Grades 3-10) from 72 schools. Implementation was monitored by teacher self-report and classroom observations by project staff. The results were favorable. All eligible teachers received training, virtually all trained teachers implemented the research curriculum, and 89% of observed lessons worked as intended. It is concluded that teacher training conceptualized as a behavior change process and including explicit teacher motivation components can promote effective implementation of behavior change curricula in public school classrooms.

[Personality characteristics in students at risk of alcoholism]. / Cechy osobowosci studentów zagrozonych uzaleznieniem sie od alkoholu.

The aim of the study was to establish personality traits differentiating between persons endangered with alcohol habituation and those that did not abuse alcohol. With Engs rating scale 225 men and 73 women in danger of alcohol habituation were found among a group of 1255 students. Significant differences in the adaptation level of the affected group--as compared to the unaffected group--were found using MMPI. The differences concerned mainly the lack of emotional stability, poor self-control, high level of hostility and low tolerance to frustration.

Assessing quality of a diagnostic test evaluation.

OBJECTIVE: To develop a standardized scale for assessing the quality of a diagnostic test evaluation. DESIGN: Fourteen participants with formal and practical experience in evaluating diagnostic tests formed a consensus panel. Panel members identified and weighted questions that should be addressed when assessing the quality of a diagnostic test evaluation. SETTING: General internal medicine division at an academic medical center. RESULTS: A 19-item weighted scale was developed. It prioritizes and addresses issues such as description of the proposed purpose of the test; appropriate selection and description of the study population; appropriate performance and description of the diagnostic test; appropriate selection and performance of the reference standard; and adequate presentation of test characteristics. CONCLUSIONS: The scale is proposed as a useful instrument for readers, investigators, reviewers, and editors, because it represents an updated synthesis of important criteria to consider when evaluating diagnostic tests. It can also be used to rate quantitatively the quality of diagnostic test evaluations.

Captopril-stimulated renin secretion in the diagnosis of renovascular hypertension.

Evidence concerning the clinical utility of single dose captopril in the diagnosis of renovascular hypertension was evaluated. Of 173 identified papers, 16 were specifically selected because they used single dose oral captopril and obtained pre-dose and post-dose peripheral renin levels in at least one patient with renovascular hypertension. These 16 studies were appraised independently by three reviewers using standardized forms for evaluation of diagnostic tests. The 16 studies included 805 patients. All studies involved referred hypertensive populations; detailed demographics and clinical characteristics were not provided. Captopril test procedures varied in all studies. Thirteen of 16 studies used arteriography as a gold standard for the diagnosis of renovascular hypertension, and three of 16 used surgical outcome data. In ten studies, patients with renovascular hypertension clearly had a significantly greater increase in plasma renin activity than patients with essential hypertension. In the remaining six, plasma renin activity was increased in patients with renovascular hypertension but control comparisons were not made adequately. Existing data suggest that the captopril test may be useful in identifying patients with renovascular hypertension. However, specific clinical recommendations regarding its use cannot be made until future research better defines test cutoff points and identifies which patients are most likely to benefit from the test.

[Diagnostic value of the MMPI alcoholism scales in assessing the risk of alcohol dependence among students]. / Diagnostycznosc skal alkoholizmu MMPI w ocenie ryzyka uzaleznienia od alkoholu wsród studentów.

The aim of the work was to establish the usefulness of alcoholism scales enclosed in MMPI for the evaluation of risk of alcohol dependence among college students. The results of 1255 college students from different schools and various years of studium were reviewed. The risk of alcohol dependence was established by analysing the frequency of drinking and the amount of alcohol consumed; this allowed to separate the group with "high" and "low" risk of alcohol dependence. Three patterns of alcohol use were established based on subject's personality: with predominance of extraversion, with neurotism, and with character disorders. The study revealed satisfactionary accuracy of following scales: Al-Hampton, Am-Holmes, MAC-MacAndrews, SAL 1, SAL 2-Paluchowski. Results allowed the elaboration of norms for scales mentioned above.

Determination of extractable mirex in whole blood.

A method for the determination of free mirex in blood has been developed in which whole blood is extracted with acetone-hexane (9+91), passed through Na2SO4, concentrated, and analyzed by electron capture gas-liquid chromatograpohy (GLC). Results were highest for fresh blood. Recoveries were verified by determining 14C-labeled mirex before and after extraction. Little mirex was detected in the samples after extraction. Hydrolysis of residual blood indicates that a metabolite of mirex is released. The possible metabolite has a GLC retention time and mass spectrum which resemble hydroxy metabolites of mirex.

[Effectiveness of a preventive mass examination for cardiac risk factors (author's transl)]. / Effektivität einer Reihen- Vorsorge- Untersuchung auf kardiale Risikofaktoren.

18 months after a mass examination for coronary heart disease risk factors in employees of a large industrial firm, 75% of the subjects examined at that time were re-interviewed and measurements of blood pressure and weight repeated. Despite an altogether inadequate longterm control of the risk factors detected, a part of the subjects examined had drawn consequences regarding their way of life by reducing weight, changing smoking habits and increasing physical activity, thus proving the effectiveness of information and advice received in a screening investigation. In about 40% of the overweight subjects a reduction in weight and in half of the hypertensives a lowering of blood pressure to values below 160/95 mmHg was noted.