Review of testing and use of adjuvant trastuzumab across a cancer network--are we treating the right patients?

This review of practice assessed all early breast cancer patients diagnosed over 12 months to determine the frequency of human epidermal growth factor receptor 2 (HER2) positivity and trastuzumab use. The frequency of HER2 positivity in routine practice (185/1319; 14%) was less than expected. A significant proportion of patients (56/185; 30%) did not receive trastuzumab, largely due to concerns about chemotherapy tolerability.

The effect of physical restraints on fall rates in older adults who are institutionalized.

Since the Omnibus Budget Reconciliation Act (OBRA) of 1987, there has been a significant reduction in the use of physical restraints to prevent falls in older adults who are institutionalized because of the developing awareness of the physical and psychological problems associated with them. The purpose of this ex post facto descriptive study was to determine if there is a difference in falls when physical restraints are allowed or prohibited in one older adult population. Data from incident reports from a purposive sample of 97 older adults in one long-term care facility were analyzed before and after the implementation of a restraint-free policy. The results indicated no significant difference in the number of falls before and after the policy change. However, there was a significantly lower number of falls with injuries and a significantly higher number of falls without injuries. These findings suggest older adults will continue to fall with or without the use of physical restraints because of changes associated with the aging process and risk factors. Removing physical barriers from older adults and allowing freedom of movement may decrease the severity of injury sustained in a fall.

The prevalence of prayer as a spiritual self-care modality in elders.

The purpose of this cross-sectional, descriptive study was to (a) investigate whether elders report using prayer as a coping strategy, (b) examine the frequency and type of spiritual treatment modalities used by elders, and (c) determine if there is a relationship between spiritual treatment modalities and coping in this population. The sample consisted of 50 community-dwelling elders with a mean age of 74 years. Descriptive findings indicate that 96% of elders use prayer to cope with stress based on the Jalowiec Coping Scale. Women and Blacks used prayer to cope with stress significantly more often than did men and Whites. The most frequently reported alternative treatment modality was prayer (84%). The total number of spiritual treatment modalities reported was significantly correlated with the frequent use of more positive coping styles.

Undergraduate medical teaching in departments of oncology in the United Kingdom: a questionnaire survey.

A questionnaire survey has been conducted to assess the nature and extent of teaching given to undergraduate medical students in departments of Oncology within the United Kingdom. Postal questionnaires were sent to 58 departments of Radiotherapy/Oncology and 30 departments of Medical Oncology. This included both teaching and nonteaching departments. Response rates were 84.5% (49 replies) and 90% (27 replies), respectively. Of the responders, 26 Radiotherapy/Oncology departments (53%) and 21 Medical Oncology departments (78%) have a regular commitment to undergraduate medical teaching, the majority being units affiliated to teaching hospitals. The time spent in teaching, methods of teaching, the teaching curriculum, and other details have been documented and are summarised. The information obtained leads us to conclude that there is a considerable variation between departments with regard to teaching commitments and the curriculum. Such variations appear to be primarily centre oriented rather than specialty biased. The survey also raises a number of issues regarding undergraduate medical teaching with reference to oncology, which are discussed.

Metastatic teratoma associated with an intra-abdominal abscess.

A case of metastatic testicular teratoma is reported where histological evidence of metastatic disease was obtained 12 years after orchidectomy. The patient had presented again 2 years earlier but the presence of a large intra-abdominal abscess delayed the diagnosis of recurrence. At no time were the serum levels of alpha-fetoprotein or beta human chorionic gonadotrophin elevated.