Relationship of inflammatory markers and pain in patients with head and neck cancer prior to anticancer therapy.

Pain is a common symptom in patients with cancer, including those with head and neck cancer (HNC). While studies suggest an association between chronic inflammation and pain, levels of inflammatory cytokines, such as C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α), have not been correlated with pain in HNC patients who are not currently undergoing anticancer treatment. The purpose of this study was to examine the relationship between these inflammatory markers and perceived pain in HNC patients prior to anticancer therapy. The study group consisted of 127 HNC patients and 9 healthy controls. Pain was assessed using the Brief Pain Inventory (BPI), and serum levels of CRP and TNF-α were determined using the particle-enhanced turbidimetric immunoassay (PETIA) and ELISA techniques, respectively. Patients experiencing pain had significantly higher levels of CRP (P<0.01) and TNF-α (P<0.05) compared with controls and with patients reporting no pain. There were significantly positive associations between pain, CRP level, and tumor stage. This is the first study to report a positive association between perceived pain and CRP in HNC patients at the time of diagnosis. The current findings suggest important associations between pain and inflammatory processes in HNC patients, with potential implications for future treatment strategies.

Relationship of inflammatory markers and pain in patients with head and neck cancer prior to anticancer therapy

Pain is a common symptom in patients with cancer, including those with head and neck cancer (HNC). While studies suggest an association between chronic inflammation and pain, levels of inflammatory cytokines, such as C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α), have not been correlated with pain in HNC patients who are not currently undergoing anticancer treatment. The purpose of this study was to examine the relationship between these inflammatory markers and perceived pain in HNC patients prior to anticancer therapy. The study group consisted of 127 HNC patients and 9 healthy controls. Pain was assessed using the Brief Pain Inventory (BPI), and serum levels of CRP and TNF-α were determined using the particle-enhanced turbidimetric immunoassay (PETIA) and ELISA techniques, respectively. Patients experiencing pain had significantly higher levels of CRP (P<0.01) and TNF-α (P<0.05) compared with controls and with patients reporting no pain. There were significantly positive associations between pain, CRP level, and tumor stage. This is the first study to report a positive association between perceived pain and CRP in HNC patients at the time of diagnosis. The current findings suggest important associations between pain and inflammatory processes in HNC patients, with potential implications for future treatment strategies.

Breath-ammonia testing of healthy subjects and patients with cirrhosis.

BACKGROUND: Hepatic encephalopathy (HE) is a serious neuropsychiatric complication in both acute and chronic liver disease. AIMS: To establish the utility of a portable noninvasive method to measure ammonia in the breath of healthy subjects and patients with HE. METHODS: The study included 106 subjects: 44 women and 62 men, 51 healthy and 55 cirrhotic. The breath ammonia was measured with an electrochemical sensor and expressed in parts/billion (ppb). RESULTS: The breath ammonia in healthy subjects had an average value of 151.4 ppb (95% confidence interval [CI]: 149.4-153.4) and the average value in cirrhotic patients was 169.9 ppb (95% CI: 163.5-176.2) (P < 0.0001). In cirrhotic patients with and without HE, the corresponding values were 184.1 ppb (95% CI: 167.7-200.6) and 162.9 ppb (95% CI: 158.8-167.0), respectively (P = 0.0011). Ammonia levels ≥ 165 ppb permitted a differentiation between healthy and cirrhotic subjects; the area under the receiver operating characteristic (ROC) curve for the ammonia-level values in cirrhotic versus control patients was 0.86 (95% CI: 0.79-0.93). In cirrhotic patients, ammonia levels ≥ 175 ppb permitted the distinction between patients with and without HE; the area under the ROC curve in cirrhotic patients with versus without HE was 0.83 (95% CI: 0.73-0.94). CONCLUSION: A portable sensor for measuring breath ammonia can be developed. If the results of the present study are confirmed, breath-ammonia determinations could produce a significant impact on the care of patients with cirrhosis and could even include the possibility of self-monitoring.

Electrochemical measurement of trace concentrations of biological hydrogen produced by Enterobacteriaceae.

Accurate measurements of the hydrogen gas produced by Escherichia coli and Hafnia alvei pure cultures during glucose metabolism were performed under different growth conditions: stagnant, with magnetic stirring or with vibrational shaking. These measurements were carried out using an electrochemical hydrogen sensor based on a platinum-coated solid polymer electrolyte membrane (Pt-SPE). The results obtained were dependent on the hydrodynamic conditions of the growth, with greater hydrogen production being associated with the stagnant conditions. These measurements will eventually enable us to elucidate whether the pathway used for glucose metabolism is either strictly or mainly anaerobic and to modify experimental conditions so as to influence the reaction.

A quality assurance review of the patient referral process and user satisfaction of outpatient general anaesthesia services for dental treatment.

In many parts of the United Kingdom the Community Dental Service (CDS) receives a consistently high level of referrals for general anaesthetic (GA) provision from general dental practitioners (GDPs), predominantly for the treatment of pain in young children. To provide a safe and effective service it is essential to have an appropriate and satisfactory referral process. As part of the established quality assurance programme in the East Kent CDS two surveys utilising self-complete postal questionnaires were conducted, the first to assess GDP's opinions and to examine their referral procedure, the second to gauge user satisfaction with the overall care provided by the CDS-GA service. The main findings suggested a lack of effective communication both between health professionals and with their patients. Over 80 per cent of the GDPs considered either the existing CDS referral guidelines needed clarification or did not even know such guidelines existed. Parents of referred children reported a high level of satisfaction with the service provided by the CDS, but some were critical of a lack of immediate access for children in pain. The finding of greatest concern was that 50 per cent of the parents stated their child's GDP did not explain the possible risks of general anaesthesia prior to referral and 70 per cent were offered no alternative form of treatment to a general anaesthetic. The results of this study should be fed into the continuing quality assurance programme to enable the effective and appropriate development of the CDS-GA service.

Electronic mail and privacy: setting your company's policy.

In setting a privacy policy, a company must consider not only its interest and the interests of its employees, but also the interests of third parties, including suppliers, customers, law enforcement agencies, and others who may have a legal right to or interest in accessing company records, including electronic mail.

Isquemia hepatica: consecuencias y pronostico. / Hepatic ischemia: consequences and prognostic

Se presenta una serie de 26 pacientes en los cuales fue necesario ligar la arteria hepatica o sus remas, se citan la condiciones que lo motivaron y los resultados observados. Se comenta el estudio de las modificaciones del flujo vascular hepatico en diversas situaciones y se lo relaciona con la mencionada serie arribando a conclusiones que creemos importantes

Isquemia hepatica: consecuencias y pronostico. / Hepatic ischemia: consequences and prognostic

Se presenta una serie de 26 pacientes en los cuales fue necesario ligar la arteria hepatica o sus remas, se citan la condiciones que lo motivaron y los resultados observados. Se comenta el estudio de las modificaciones del flujo vascular hepatico en diversas situaciones y se lo relaciona con la mencionada serie arribando a conclusiones que creemos importantes

Fistula gastroueyunocolica. / Gastrojejunocolic fistula

Se presenta la experiencia obtenida en el tratamiento quirurgico en 3 pacientes portadores de fistulas gastroyeyunocolicas.Se destacan las ventajas del procedimiento quirurgico en un solo tiempo con hiperalimentacion parenteral previa

Fistula gastroueyunocolica. / Gastrojejunocolic fistula

Se presenta la experiencia obtenida en el tratamiento quirurgico en 3 pacientes portadores de fistulas gastroyeyunocolicas.Se destacan las ventajas del procedimiento quirurgico en un solo tiempo con hiperalimentacion parenteral previa