Changes in quality of life after a diagnosis of cancer: a 2-year study comparing breast cancer and melanoma patients.

PURPOSE: Longitudinal studies addressing change in health-related quality of life (HRQoL) following a diagnosis of cancer have mainly focused on a single cancer type, and little is known about the differences in HRQoL over time according to the type of tumor. The current study aims to compare the change in HRQoL over 2 years following breast cancer or melanoma diagnosis and socio-demographic variables associated with HRQoL over time. METHODS: Patients recently diagnosed with breast cancer (n = 215) or melanoma (n = 78) completed surveys within 1 month of diagnosis and 6, 12, and 24 months later. Multilevel modeling analyses were used to compare the evolution over time of HRQoL dimensions, as measured by the EORTC QLQ-C30, in both cancers. Longitudinal effect of socio-demographic variables on HRQoL was also assessed. RESULTS: Consistent with the literature, both cancer patients experienced decreased HRQoL scores following the diagnosis before improving over time. However, our analyses revealed that this rebound effect may occur at diverse times over the course of the illness according to the type of cancer. In addition, HRQoL over time was positively associated with age and negatively related to living with a partner regardless of the type of cancer. CONCLUSIONS: The results of the present study suggest that support in hospital units should be specific and depend on the cancer type.

Power analysis on the time effect for the longitudinal Rasch model.

Statistics literature in the social, behavioral, and biomedical sciences typically stress the importance of power analysis. Patient Reported Outcomes (PRO) such as quality of life and other perceived health measures (pain, fatigue, stress,...) are increasingly used as important health outcomes in clinical trials or in epidemiological studies. They cannot be directly observed nor measured as other clinical or biological data and they are often collected through questionnaires with binary or polytomous items. The Rasch model is the well known model in the item response theory (IRT) for binary data. The article proposes an approach to evaluate the statistical power of the time effect for the longitudinal Rasch model with two time points. The performance of this method is compared to the one obtained by simulation study. Finally, the proposed approach is illustrated on one subscale of the SF-36 questionnaire.

From synthetic to natural nanoparticles: monitoring the biodegradation of SPIO (P904) into ferritin by electron microscopy.

A strong focus on Superparamagnetic Iron Oxide Nanoparticles (SPIOs) has been appreciated recently especially for their use in Magnetic Resonance Imaging (MRI). However, some questions are being raised over these particles due to their long-term toxicity related to the production of toxic free iron during their biodegradation. Here we show by Electron Microscopy how SPIOs (P904) (Guerbet, Paris) are degraded after they are taken up by macrophages, so that iron from the SPIO core is progressively incorporated into the iron-storing protein ferritin (a nontoxic form of iron).

Study of magnetic nanovectors by Wet-STEM, a new ESEM mode in transmission.

Many nanovectors used for therapy (drug targeting, radiation therapy) or diagnostic such as Magnetic Resonance Imaging (MRI) have a composite structure consisting of an organic core or organic coverage encapsulating magnetic nanoparticles and they are commonly dispersed in liquid suspensions for intravenous injection. Here is presented the application of a new Environmental Scanning Electron Microscopy (ESEM) mode in transmission, so called Wet-STEM, for transmission imaging of droplets of such suspensions. This is illustrated by Wet-STEM images from PLLA/Re nanospheres (about 100-300 nm in diameter) loaded with magnetite nanoparticles (about 10 nm in diameter) and from iron oxide core (about 5 nm in size) MRI contrast agents, both examples in aqueous suspensions. It is shown that the Wet-STEM mode allows both the collective behavior of such nanovectors in suspension to be characterized and the inner composite structure of individual vectors to be revealed. Such experimental results are discussed by comparison with Monte Carlo computer simulations of the distribution of the electrons scattered through the samples in rather large solid angles (between 20° and 47°) corresponding to the detection conditions.

Electrochemical oxidation of CBS-113 A, a new anti-inflammatory drug: applicability to liquid chromatography-electrochemical detection.

The electrochemical properties of a new non-steroidal anti-inflammatory drug (2-hydroxy-4-methylphenyl-2-aminothiazole hydrochloride; CBS-113 A) have been studied using voltammetry in direct current and cyclic modes at glassy carbon disk electrodes. The results show an oxidative process with a diffusion-controlled and a reversible mechanism; these data agree with those obtained in a reversed-phase high-performance liquid chromatography (HPLC) system coupled either with amperometric (single glassy carbon electrode) or coulometric detection (two porous graphite electrodes in series) set at potentials of +0.65 V (vs. Ag/AgCl) and +0.4 V (vs. Pd/H2), respectively. Similar electrochemical properties were found for 2-hydroxyphenyl-2-amino-5'-methylthiazole hydrochloride (RD-1546) which is a potential internal standard. An HPLC system coupled with a UV detector (lambda = 272 nm) and an amperometric detector (+0.65 V) showed a gain in sensitivity of about 10 using electrochemical detection (ED) for the determination of CBS-113 A in human plasma. Linearity range, precision and accuracy were calculated and showed the potential application of HPLC-ED to pharmacokinetic studies of CBS-113 A in plasma.

[Use of octreotide in the treatment of digestive endocrine tumors. A French multicenter study]. / Utilisation de l'octréotide dans les tumeurs endocrines digestives. Etude française multicentrique.

Morbidity and mortality in endocrine gastro-enteropancreatic (GEP) tumours are mainly related to the clinical consequences of tumoral peptide hypersecretion. Surgical resection at an early stage is the only curative treatment. However, most tumours are detected only when the hypersecretory state reflects the presence of metastases; surgery and chemotherapy then give only palliative results counterbalanced by serious side-effects. Somatostatin inhibits most endocrine secretions of the GEP tract and thus can alleviate invalidating symptoms. Its use is limited by its short half-life (2 min), the necessity of i.v. infusion and the possibility of a rebound phenomenon. Octreotide, a synthetic somatostatin analogue with a long duration of action, is administered subcutaneously and allows ambulatory treatment. In our series of 78 patients we observed about 80 percent of excellent or good clinical results, enabling the patients to resume normal life. Only minor and transient side-effects were noted. The overall tolerance of the drug was considered excellent or good. Prolonged administration of octreotide is a safe and effective symptomatic treatment in patients without any restriction of anti-tumoral procedures. Furthermore, it prevents the severe carcinoid crises that occur during surgery or embolization in patients with carcinoid syndromes.

[Prognosis of acute pneumococcal respiratory insufficiency requiring mechanical ventilation]. / Pronostic des insuffisances respiratoires aiguës d'origine pneumococcique nécessitant la ventilation mécanique.

A retrospective study was carried out between 1980 and 1988 in an attempt to determine the prognostic factors in pneumococcal pneumonia requiring mechanical ventilation. Thirty-six of the 57 patients studied died (63 per cent). The initial severity of the lung disease, was the same in the patients who died and in those who survived. The risk of death was associated with the severity of the septic syndrome, as evaluated by the presence of septic shock, acute renal failure and disseminated intravascular coagulation.

Individual degradation rate constants for cefotaxime, deacetylation profile.

The individual degradation rate constants for cefotaxime in aqueous solution were calculated within a pH range of 1.6-10.0 at 37 degrees C from high performance liquid chromatography data. This allowed the general degradation profile of cefotaxime to be decomposed into a degradation profile attributed to the opening of the beta-lactam nucleus and a degradation profile attributed to the deacetylation. From the calculations of the individual rate constants, the activity of degraded cefotaxime solutions could be predicted. In the pH range of injectable solutions of cefotaxime 5-7, roughly equivalent amounts of inactive beta-lactam cleavage products and deacetylated compound which has a different spectrum of antibacterial activity are formed.

Determination of aminoglycosides in pharmaceutical formulations--II. High-performance liquid chromatography.

A post-column derivatization procedure using OPA and fluorescence detection has been used for the determination of seven aminoglycosides (dibekacin, framycetin, kanamycin, netilmicin, sisomicin, tobramycin and gentamicin) in commercial pharmaceutical formulations. The linearity, precision and detection limits were satisfactory. Recoveries from eye drops, ointments, injections and capsules were comparable (P = 0.05) to those obtained with TLC or microbiological assays. A ruggedness test showed that the method was not sensitive to minor variations in the mobile phase composition, post-column derivatization system or detection wavelength.

Overlapping ionization constants for cefotaxime.

The attribution of three ionization constants (2.1, 3.4, and 10.9) for cefotaxime has been made, based on potentiometric titration and UV absorption data simultaneously. Two overlapping constants were found (2.1 and 3.4) and attributed to the carboxyl group in the 4 position and to the aminothiazole nucleus, respectively.

Sulpiride pharmacokinetics in humans after intramuscular administration at three dose levels.

Pharmacokinetics of the disinhibitory psychotropic agent sulpiride was investigated in 9 healthy male subjects after intramuscular administrations of 50, 100, and 200 mg in a 3 X 3 Latin square design. Plasma and urine concentrations were measured by HPLC for 36 and 48 h, respectively. The lowest detectable concentration was 10 ng/mL. Plasma concentration versus time and urinary excretion rate versus time curves were consistent with an open two-compartment body model, where mean +/- SD apparent half-lives of the absorption from muscle, lambda 1 distribution, and lambda 2 elimination phases were 6.96 +/- 2.64 min, 0.220 +/- 0.120 h, and 6.74 +/- 2.67 h, respectively. The initial volume of distribution was 0.145 +/- 0.063 L/kg, the steady-state volume of distribution was 0.639 +/- 0.184 L/kg, and the total clearance was 89.8 +/- 22.3 mL/min. The microscopic rate constants were k12 = 2.53 +/- 1.13 h-1, k21 = 0.674 +/- 0.197 h-1, and k10 = 0.635 +/- 0.298 h-1. Comparison of total clearance (89.8 mL/min), renal clearance (83.0 mL/min), and renal clearance of unbound drug (97.6 mL/min, f = 0.15) indicated that sulpiride is mainly excreted unchanged by the renal route, 93.1 +/- 6.6% of the administered dose being recovered unchanged in urine. Statistical evaluation of all the above parameters, determined at the three dosage levels, did not show any variations related to dose; the pharmacokinetics of sulpiride, over the dose range tested, was therefore linear and independent of dose. The two-compartment body model proposed was validated by digital computer simulation on a small digital computer (32K).