A new and simple scoring system to predict overall survival after irradiation for metastatic spinal cord compression.

PURPOSE: To develop a model that predicts survival in patients irradiated for metastatic spinal cord compression (MSCC), hence assisting in the decision between a short and a long-course radiotherapy (RT) regimen. METHODS: 138 patients diagnosed with MSCC and treated with RT alone were included. Based on a multivariate analysis, a scoring system was developed. It included four prognostic variables: age, number of vertebrae, ECOG and histology. Total scores ranged between 14 and 24 points and patients were divided into two groups. RESULTS: The 6-month survival rate was 22% for patients with a score of 14-18 points; and 69% for patients with a score of 19-24 points (P < 0.001). The system exhibits a high specificity and positive predictive value and an appropriate discriminative ability. CONCLUSIONS: Patients with scores between 19 and 24 points were found to survive longer, thus a long-course RT appears to be more appropriate.

Computer simulations of the mechanical response of brushes on the surface of cancerous epithelial cells.

We report a model for atomic force microscopy by means of computer simulations of molecular brushes on surfaces of biological interest such as normal and cancerous cervical epithelial cells. Our model predicts that the force needed to produce a given indentation on brushes that can move on the surface of the cell (called "liquid" brushes) is the same as that required for brushes whose ends are fixed on the cell's surface (called "solid" brushes), as long as the tip of the microscope covers the entire area of the brush. Additionally, we find that cancerous cells are softer than normal ones, in agreement with various experiments. Moreover, soft brushes are found to display larger resistance to compression than stiff ones. This phenomenon is the consequence of the larger equilibrium length of the soft brushes and the cooperative association of solvent molecules trapped within the brushes, which leads to an increase in the osmotic pressure. Our results show that a careful characterization of the brushes on epithelial cells is indispensable when determining the mechanical response of cancerous cells.

Sex education and AIDS education in the schools: what states and large school districts are doing.

Four-fifths of the states either require or encourage the teaching of sex education in the public schools, and nearly nine in 10 large school districts across the United States support such instruction. All but four states and virtually every large school district support the provision of AIDS education, and backing for instruction about sexually transmitted diseases and about abstinence is nearly as widespread. Fewer states and districts (two-thirds and four-fifths, respectively) require or encourage the schools to teach about pregnancy prevention. Examination of state and district curricula indicates that large school districts tend to be bolder than the states in the range of sex-related topics covered, especially in the area of pregnancy prevention. Districts also offer local educators more support (through curricula, training and other activities) than do the states. Finally, AIDS education appears to be receiving more attention and funding from both the states and the local school districts than is sex education.

Public funding of family planning, sterilization and abortion services, 1987.

In FY 1987, the federal and state governments spent +386 million to provide family planning services. Medicaid was the leading source of public funding, accounting for 36 percent of all public monies spent on family planning. Title X of the Public Health Service Act provided 34 percent of total public funds, and two block-grant programs--Social Services and Maternal and Child Health--together were responsible for 17 percent of public support in this area. State governments, which spent a total of +50 million of their own revenues for family planning services, accounted for the remaining 13 percent of public funding. The federal and state governments together spent +65 million to subsidize contraceptive sterilization services in FY 1987. The federal government provided 97 percent of the funding, 88 percent through the Medicaid program. In addition, the federal and state governments spent +64 million to provide 189,000 abortions to poor women; less than one percent of these funds were contributed by the federal government. These data come from a survey of state health, welfare and Medicaid agencies carried out by The Alan Guttmacher Institute and should be viewed as approximations rather than as precise figures.