Support group participation among persons with HIV: demographic characteristics and perceived barriers.

Support groups are widely available for persons living with HIV and some evidence supports their efficacy. However, limited information exists regarding characteristics of those who utilize HIV support groups. The present study examined demographic characteristics and perceived barriers of attenders and non-attenders of HIV support groups via a mail survey. The 35 respondents were predominantly white (71.4%), male (65.7%), homosexual/bisexual (57.1%) and diagnosed with HIV within the last five years (62.8%). Results suggested that HIV support group attenders had higher educational attainment and a longer time since diagnosis than non-attenders. Respondents who expressed interest in HIV support group participation were diagnosed more recently than those who did not express interest. Respondents who had attended other types of support groups reported fewer perceived barriers to participation in HIV support groups. Overall, findings suggest that the perception of barriers may be related to interest and participation in support groups for HIV and other problems.

The effect of peat components on endocrine and immunological parameters and on trace elements--results of two pilot studies.

Peat and different peat preparations are successfully used in clinical therapies for different indications (as, for instance, in the field of gynecology). New studies show the biochemical effects of peat components which they have aside from their physical-thermal effects. This is of extraordinary interest with regard to the medical use of peat, because considerable concentrations of trace elements and heavy metals have been found in different kinds of peat. By means of atomic spectrometry it was investigated in 17 female patients with irritable bladder whether and how variations of the concentration of special trace elements and heavy metals (lead, cadmium, copper, manganese) could be measured within 24-hour urine after vaginal peat-mush treatments had been applied serially. Additionally, the effect of peat-mush baths compared to the effect of water baths (n=6) - both of which were applied to 17 female patients with degenerative diseases - was examined with regard to their special endocrinological parameters. The results concerning safety did not show any changes of the concentration of the trace-elements or heavy metals within the 24-hour urine. These results can be explained by the chelating features of the peat components, which are the reason for the absorption of the trace elements. Examinations done to compare the effects of peat-mush baths and water baths have shown that peat components - independent from their thermal effects - are the reason for the occurrence of special effects. This applies in particular to the parameter soluble interleukin-2-receptor. As regards estradiol, a significant increase could be measured after peat-mush baths had been applied to 17 postmenopausal female patients (n=11). Comparing these results with those of the group of patients treated with water baths, we noticed that the increase of estradiol was remarkably lower and not significant. The effect of the peat components is thought to be the reason for this.

Effects of cholestyramine on vitamin E levels in patients treated with statins.

The aim of this study was to investigate the effects of cholestyramine in combination with statins on vitamin E levels and their concentration related to LDL-cholesterol (LDL-C) in patients with hyperlipidemia. In an open-label, randomized study of 25 patients with elevated LDL-C, 12 received cholestyramine (12 g/d) in addition to chronic statin therapy, which had been started at least 8 weeks prior to the study in all patients. At the start and end of the 12-week study period, vitamin E concentrations were measured by high-performance liquid chromatography and cholesterol and triglycerides enzymatically in all patients. Vitamin E levels remained virtually unchanged within normal range before (11.90 +/- 0.71 mg/l) and after 12 weeks (11.69 +/- 0.82 mg/l) of concomitant therapy with cholestyramine. However, the ratio of vitamin E/LDL-C increased from 7.48 +/- 0.56 to 8.58 +/- 0.75 (x 10(-2)) (p < 0.09) in the cholestyramine group but not in the control group. LDL-C concentrations decreased from 162.00 +/- 5.98 to 144.33 +/- 12.48 mg/dl. The authors conclude that cholestyramine 12 g/d given for 12 weeks in addition to chronic statin therapy did not lower vitamin E levels in hyperlipemic patients. However, antioxidant status (vitamin E/LDL-C ratio) seems to be improved by a cholestyramine-associated LDL-C decrease.

Massage therapy for patients undergoing autologous bone marrow transplantation.

The purpose of the current study was to examine the impact of massage therapy on psychological, physical, and psychophysiological measures in patients undergoing autologous bone marrow transplantation (BMT). Patients scheduled to undergo BMT were randomly assigned to receive either (a) massage therapy, consisting of 20-minute sessions of shoulder, neck, head, and facial massage, or (b) standard treatment. Overall effects of massage therapy on anxiety, depression, and mood were assessed pretreatment, midtreatment, and prior to discharge using the State-Trait Anxiety Inventory, Beck Depression Inventory, and Brief Profile of Mood States, respectively. The immediate effects of massage were measured via the State Anxiety Inventory, Numerical Scales of Distress, Fatigue, Nausea, and Pain and indices of psychophysiological arousal (heart rate, blood pressure, and respiration rate), collected prior to and following patients' first, fifth, and final massage (on Days--7, midtreatment, and predischarge). Analysis of the data evaluating the immediate effects of massage showed that patients in the massage therapy group demonstrated significantly larger reductions in distress, fatigue, nausea, and State Anxiety than the standard treatment group at Day-7, in State Anxiety at midtreatment, and in fatigue at the predischarge assessment. The overall measures of psychological symptoms measured at pretreatment, midtreatment, and prior to discharge showed no overall group differences, although the massage group scored significantly lower on the State Anxiety Inventory than the standard care group at the midtreatment assessment. The two groups together showed significant declines through time on scores from the Profile of Mood States and State and Trait Anxiety Inventories.

The benefits of group music at the 1996 music weekend for women with cancer.

BACKGROUND: Music therapy has been proven to benefit cancer patients physically and emotionally. The Music Weekend for Women with Cancer was developed as a novel opportunity for participants to experience the healing powers of music amidst others who had a shared understanding of their illness. MATERIALS AND METHODS: Fourteen female mixed cancer patients, three spouses, and one daughter attended the weekend from Friday evening through Sunday afternoon. Workshops and events centered on the use of music as a vehicle for expression of emotions, reflection, relaxation, communication, and enjoyment. Questionnaires were collected before the weekend to describe our population as well as three months after the weekend to assess any changes in their utilization of music and mood state. RESULTS: Although insufficiency of post-weekend data limited the potential for assessing the effects of the weekend on the participants' utilization of music and mood state, the extremely positive evaluations supported the role music can play in helping patients and families explore their reactions to cancer. CONCLUSIONS: Events such as this answer the call in the literature for more opportunities to use music and the arts in cancer education. The authors hope this weekend will serve as a prototype for future events that aim to offer the benefits of music.

Prevalence of mood disorders and utility of the PRIME-MD in patients undergoing radiation therapy.

PURPOSE: To validate a short, structured interview procedure that allows practicing oncologists to quickly and reliably identify mood disorders in their patients, and to estimate the prevalence and types of mood disorders in a radiation therapy patient setting, noting relationships between mood disorders and patient characteristics. METHODS: Consecutive, eligible adult patients from the practices of two radiation oncologists were administered the Primary Care Evaluation of Mental Disorders (PRIME-MD) by the treating physician. A subset of these patients was also evaluated with the SCID, administered by trained mental health care personnel. Agreement between the two instruments was examined using the kappa statistic. Prevalence of mood disorders was determined from the PRIME-MD. The significance of relationships between patient characteristics and mood disorders was examined by chi-square and ANOVA analysis, and subsequently by multivariate logistic regression analysis. RESULTS: One hundred twenty-two patients were studied. Fifty-three of these were administered the SCID. Agreement between the two instruments was very good (kappa = 0.70). A diagnosis of a depressive or anxiety disorder by the PRIME-MD was made in 59 of the 122 patients (48%, 95% confidence interval = 39%, 58%). Multivariate analysis showed that a diagnosis of a depressive mood disorder was significantly related to pain intensity and prior history of depression. CONCLUSION: We have demonstrated the validity and feasibility of the PRIME-MD administered by oncologists in making diagnoses of mood disorders. The prevalence of mood disorders in our set of patients undergoing a course of RT was nearly 50%. Future studies should describe the natural history of these disorders, and determine optimal intervention strategies.

New bedside test for monitoring anticoagulation during hemodialysis.

Heparin therapy in patients can be monitored bedside during dialysis treatment by activated partial thromboplastin time (APTT) measurements using portable coagulation monitors. We verified the efficacy of the CoaguChek Plus System (Boehringer Mannheim, GmbH, Mannheim, Germany) for this purpose. The first series of results was obtained using CoaguChek Plus APTT controls (Level 1 and Level 2) on 3 instruments. The coefficients of variation (CVs) were found to be in the range of 3.6 to 5.0% based on results per instrument (n = 20) and per control level (n = 60). The second series of results was obtained using whole blood drawn from the arterial lines of patients during dialysis treatment. Three determinations out of 1 ml of fresh whole blood gave an overall mean CV of 4.9% from the 123 samples tested. Samples were taken before the onset of heparin treatment, 2 h after treatment was started, and at the end of treatment. The CoaguChek Plus APTT measurements were compared to measurements made using laboratory routine method STA APTT (Boehringer Mannheim GmbH) with results from 104 whole blood samples. Regression analysis according to Passing and Bablok showed good correlation (r = 0.885) and good agreement (y = 0.997x - 6.6) between both methods. Ease of use, excellent performance, reliability, and rapid availability of results within 3 min make the CoaguChek Plus APTT measurements suitable for monitoring patients during dialysis.

Multicenter evaluation of a homogeneous assay for HDL-cholesterol without sample pretreatment.

We evaluated a new homogeneous assay for the measurement of HDL-cholesterol (HDL-C) in six European laboratories. The assay includes two reagents and is applicable to most autoanalyzers, which allows full automation. The total CVs of the new method ranged between 1.3% and 6.7%. Thereby determined HDL-C values were in good agreement with those obtained by precipitation with phosphotungstic acid/MgCl2 or by a combination of ultracentrifugation and precipitation (0.956 < r < 0.994). The assay was linear up to at least 1500 mg/L HDL-C. Hemoglobin did not interfere, whereas icteric samples with bilirubin > 100 mg/L showed discrepancies between the homogeneous and the precipitation assay. Lipemia up to total triglyceride concentrations of 8000 mg/L did not interfere with the homogeneous HDL-C assay. The homogeneous HDL-C assay was easy to handle and produced similar results in all laboratories participating in this study. This method will significantly facilitate the screening of individuals at increased risk for cardiovascular disease.

Formation of lipoprotein-X. Its relationship to bile compounds.

In this study we have demonstrated that in native bile, lipids are organized in the form of a lipoprotein (bile LP) carrying albumin as apoprotein. The lipid composition of bile LP is almost identical to lipoprotein-X (LP-X, the characteristic lipoprotein of cholestasis). However, it differs from LP-X inits protein/lipid ratio and immunological and electrophoretic characteristics. Bile lipoprotein can be converted into "LP-X-like" material in vitro by adding albumin or serum to native bile. The LP-X-like material formed in vitro has physicochemical and chemical characteristics similar or identical to LP-X isolated from serum. As bile lipoprotein can be converted into LP-X-like material by the addition of albumin to bile, LP-X can be converted into bile-LP-like particles by adding bile salts to a LP-X-positive serum. Furthermore, experimental connection of the common bile duct to the vena cava is followed after a few hours by the appearance of LP-X-like material in the plasma. These facts taken together strongly suggest that bile LP is a precursor lipoprotein for LP-X and that it refluxes into the plasma pool under cholestatic conditions.