Accelerated R-COP: a pilot study for the treatment of advanced low grade lymphomas that has a high complete response rate.

This pilot study tested the hypothesis that dose intensity/dose density treatment may improve the response rate and remission duration in patients with advanced low grade lymphomas. ten patients with low grade lymphomas: follicular lymphoma grades I and II, marginal zone lymphoma, and small cell lymphocytic lymphoma with progressive disease were studied. Patients had an ECOG performance of 0-2, and Stage III and IV disease. Both untreated and previously treated patients with progressive disease were eligible. Patients received a combination of rituximab 375 mg/m(2), cyclophosphamide 1000 mg/m(2), and vincristine 1.4 mg/m(2) (up to a maximal dose of 2 mg), administered by intravenous infusion every two weeks, for ten treatments. Prednisone 50 mg was administered every other day orally for thirty days and then tapered over the next thirty days. Granulocyte colony stimulating factor (G-CSf) was administered on days seven to ten following each cycle of chemotherapy. After 5 and 10 cycles, patients were evaluated for response that included imaging with Ct and pet scans. A total of 10 patients (7 untreated and 3 previously treated) were enrolled into this pilot study between may 2003 and July 2004. Untreated patients received an average of 8.3 cycles of therapy (range 5 to 10 cycles). Seven of 7 untreated patients achieved a complete response (CR), and 5 had not relapsed as of 32-43 months later. Previously treated patients received an average of 9.3 cycles of therapy (range 6 to 12 cycles). One of three previously treated patients achieved a complete response and has no evidence of relapse at 29 months. the other two heavily pretreated patients achieved partial responses, lasting 2 and 5 months. Toxicity was mild consisting mainly of parasthesias requiring attenuation of the vincristine dose. There were no instances of neutropenic fever requiring hospitalization. This program is well tolerated with a high CR rate, and may serve as a basis for future trials.

Social relations across the life span: in search of unified models.

The authors in this collection have addressed topics of great relevance to the study of social relations across the life span, including the application of family systems models, the development of friendship relations, and the consequences of sibling conflict. Issues considered in this discussion are 1) the value of conceptualizing social development as a life-long process, 2) theoretical and methodological implications of a life course perspective on social relations, and 3) how the collaborative efforts represented in these articles contribute to achieving unified models of life span social development. The collaborators are lauded for their progress toward formulating valid and useful models of family and friendship relations across the life span. The social convoy model is suggested as a broader framework for organizing life span developmental research on diverse relationships.

Infant-mother attachment: relationships to maternal responsiveness and infant temperament.

The purpose of this study was to explore the relationships between maternal responsiveness, infant temperament, and infant-mother attachment as measured in Ainsworth's Strange Situation. Discriminant analysis revealed that infant temperament was more strongly related to attachment than maternal responsiveness. Infants rated as Anxious-Avoidant in attachment were perceived by their mothers as significantly easier in temperament. Possible explanations for findings and implications for nurses working with infants and parents are discussed.

Effects of clarification of support expectations in prenatal couples.

The purpose of this study was to test a theoretical model of confirmation of expectations for mutual support after childbirth and to evaluate an intervention given in prenatal classes during which prospective parents clarified their expectations. Results provided support for the proposed model in that parents with greater confirmation of expectations were found to have more positive relationship satisfaction, emotional affect, and parenting attitudes. Differences in men and women emerged that demonstrated that confirmation of support expectations was more important to women, while the level of support actually received was more important to men. The prenatal class intervention did not significantly affect parent outcomes.

Social support and relationship change after childbirth: an expectancy model.

Much has been written about social support, but little is known about the processes that promote continuity or discontinuity in supportive relationships. A proposed model of relationship processes (Levitt, 1991) specifies that changes in the quality of close relationships are likely to occur when expectations for social support are tested and disconfirmed. Relationships are particularly vulnerable to change after major life events, such as childbirth, when increased support needs precipitate the testing of expectations. In a preliminary assessment of this model, 43 mothers were interviewed at 1 month and 13 months after birth. Changes in relationship satisfaction were related strongly to the extent to which mothers perceived that their expectations for support had been disconfirmed. The results are consistent with the proposed model and suggest the value of considering the effects of social support in light of the individual's expectancies.

Convoys of social support: an intergenerational analysis.

Within the Convoy Model, social networks are viewed as dynamic hierarchic structures surrounding the individual throughout life. As a step toward empirical definition of convoy structure and function across the life span, a bicultural sample (N = 159) of young adult women, their mothers, and their grandmothers were queried. Comparable results were obtained across generations and cultures with regard to network size, the amount of support provided by the network, and the nomination of close family members as primary sources of support. However, there was a marked shift across generations in the balance of familial versus friendship relations. Younger persons included fewer family members and more friends in their networks, and they received more support from friends. These cross-sectional results are consistent with the Convoy Model and suggest that longitudinal research is warranted.

Mothers' stress and close relationships: correlates with infant health status.

This descriptive follow-up study focuses on changes in maternal stress and close relationships over the infant's first year and explores the association of these maternal variables with infant health status. After initial interviews at 1 month, mothers of 43 infants completed a follow-up questionnaire when their infants were 13 months old. Women tended to select their husbands or mothers as their closest relations, and 9 women noted that their closest person at 13 months was a different person than at 1 month. Infant hospitalization, but not risk status or major illness in the infant, was significantly related to maternal stress and relationship change. The association among infant hospitalization, greater maternal stress, and less closeness in relationships support the importance of focusing on the whole family in the hospital setting.

Temperament and interactive effects: mothers and infants in a teaching situation.

Temperament is a theoretical concept used to understand individual's behavioral styles. In this study, temperament was measured in 13-month-old infants (N = 51) and their mothers, who were also observed together in a teaching situation. The purpose of the study was to determine the relationships between maternal and infant temperaments and interactive behaviors in the teaching situation. Mothers were given 10 minutes to teach infants four tasks designed to assess qualitative aspects of the interaction. In general, the interaction between mother and infant had a synchronous quality that was influenced by, but largely independent of, the temperamental characteristics of mother and infant. Responsive maternal teaching behaviors were significantly related to positive infant affect during teaching. Weak relationships were found between the temperament variables and interactive behaviors in the teaching situation. When mothers and infants were matched on temperament characteristics, no effects of matching temperaments on interactive behaviors in the teaching situation were found. These findings suggest that mothers are able to adjust their behaviors to compensate for their infant's temperament. Based on these data, nurses can focus on the dynamics of the interactions themselves and avoid making judgments based on temperament alone when evaluating mother-infant relationships.

Personal and professional support for mothers of NICU and healthy newborns.

Personal support provided by close social network members and professional support provided by nurses were studied in 83 postpartum mothers and newborns in neonatal intensive care units and newborn nurseries. Mothers perceived each type of support differently in terms of outcomes. Only personal support was significantly related to emotional affect and life satisfaction outcomes. Both personal and professional support were related to relationship satisfaction outcomes. Findings suggest that personal support and professional support be treated as separate concepts.

Food effects on the nighttime pharmacokinetics of Theo-Dur tablets.

A randomized crossover study demonstrated major food effects on the pharmacokinetics of Theo-Dur, two 200-mg theophylline anhydrous sustained-release tablets, as an evening dose. These effects included a higher maximum serum theophylline level and relatively prolonged delay in drug absorption, both significant. The findings, which showed marked individual variation, could be clinically important for patients receiving evening medication.

Social support, perceived control, and well-being: a study of an environmentally stressed population.

Interviews were conducted with elderly residents of an area targeted for massive redevelopment. Social support was considered simultaneously with health and personal control beliefs in relation to well-being, and the unresolved issue of the sufficiency of one support figure was explored. Health, control, and support each emerged as independent predictors of after and life satisfaction, and affect was significantly lower for those with no close support figure than for those with one close relationship. The results suggest that one close support figure may be sufficient to promote well-being, but alternative interpretations are possible.

Social support and well-being: preliminary indicators based on two samples of the elderly.

The structure of social support and its relation to health, affect, and life satisfaction are compared for two samples of the elderly. The first is a national representative sample; the second is a distressed sample from South Miami Beach. Although there are similarities in the structure of social support across the two groups, those in the Miami Beach sample report fewer support figures, and far fewer within geographic proximity, than do those in the national sample. This comparative network impoverishment is particularly marked for male respondents and is accentuated by a high number of isolates in this group. In addition, stronger relationships are found between support network size and affect, and among affect, life satisfaction, and health in the South Miami Beach sample. Older men in poor health and without supportive relationships are targeted as a particularly high risk subgroup. The discussion includes a focus on personal, situational, and life span differences related to variations in support and well-being and a consideration of implications for more recent waves of elderly sun-belt migrants.

Choline magnesium trisalicylate: comparative pharmacokinetic study of once-daily and twice-daily dosages.

This randomized crossover study compared the pharmacokinetics of choline magnesium trisalicylate tablets administered once daily (3000 mg of salicylate) or twice daily (1500 mg of salicylate) for six d. Serum salicylate levels were measured by HPLC. Mean "trough" concentrations fell within the therapeutic range (5-30 mg/dL) with either regimen and were relatively constant, indicating that the steady state had been reached. The 24-h area under the salicylate curve (AUC0-24 h) after the final 3000-mg salicylate dose averaged about twice the mean 12-h AUC after the last 1500-mg dose, indicating that the two dosing regimens were equally bioavailable. Clinical observations and results of laboratory safety studies indicate that both dosage schedules of the drug are well tolerated. The present findings support the once-daily therapeutic use of choline magnesium trisalicylate.

Bioequivalence and metabolism of nitrendipine administered orally to healthy volunteers.

Relative bioavailability of 5-, 10-, and 20-mg nitrendipine tablets was determined in a four-way crossover bioequivalence study involving 22 normal male volunteers. Liquid suspension of nitrendipine was used as a reference. Plasma and urine samples collected during each study period were assayed by high performance liquid chromatographic and capillary gas chromatographic (GC) procedures for nitrendipine and the nitrendipine pyridine metabolite. Four other more polar urinary nitrendipine metabolites were also analyzed in urine by the GC procedure, which involved diazomethane esterification. Although relative bioavailability of the tablets ranged from 58.0 to 69.9%, there was no statistically significant difference in the area under the curve among the doses. Since 35 to 43% of both the liquid and tablet doses was recovered in the urine of volunteers, excretion of urinary metabolites appears to be independent of the dosage form. However, a rank-order correlation between the relative tablet bioavailability and cumulative amounts of excreted metabolites was observed. Nitrendipine, its pyridine metabolite, and the glucuronide conjugates were also detected in the urine, but the amount of nitrendipine and its pyridine metabolite did not exceed 0.1% of dose, whereas the glucuronides accounted for about 8% of the dose.

GLC determination of phendimetrazine in human plasma, serum, or urine.

A sensitive, specific, and quantitative GLC method is described for the determination of phendimetrazine in plasma, serum, or urine. An internal standard was used, which was extracted along with the drug. This mixture then was acetylated to improve the chromatographic separation. A concentration as low as 2 ng/ml of phendimetrazine could be measured from 2 ml of sample using a nitrogen-phosphorous detector. Linearity extended from 2 to 500 ng/ml, and the coefficient of variation was 7%. The method was shown to be applicable to a single-dose bioavailability study.

Effect of oxygen and solute on PGE and PGF production by rat kidney slices.

Increasing oxygen from 5% to 95% resulted in an increases production of both PGE's and PGF's. The release of prostaglandins from slices of rat kidney cortex and outer and inner medulla was measured. Prostaglandin production was observed predominantly in the inner medulla, was close to the lower limit of detection in the outer medulla, and was undetectable in the cortex. Increasing oxygen concentration resulted in a threefold increase in inner medullary prostaglandin production. Synthesis at 95% O2 was less at 2100 mOsm than at 300 mOsm, while synthesis at 5% O2 was not affected by high solute concentration. The implications of these results with respect to kidney function are discussed.