Patient Satisfaction Survey on Portable Infusion Pumps for Colorectal Cancer Chemotherapy: Hard-Shelled or Soft-Shelled?

Purpose: Elastomeric infusion pumps are widely used in colorectal cancer chemotherapy. However, no studies to date have investigated patient preferences regarding different infusion pump types. Patients and Methods: Twenty patients with unresectable colorectal cancer undergoing chemotherapy were initially treated with a portable hard-shelled continuous infusion pump, followed by a soft-shelled continuous infusion pump. The respondents used a numerical rating scale (0-10) to rate their comfort when using each pump, their ease of carrying it, the pump size and shape, its weight, their ease of reading its memory, and their overall satisfaction with it. They were then asked to determine which pump they would ultimately prefer. Results: In terms of comfort, significantly higher user satisfaction was reported for the soft-shelled pump during the daytime and when going out (P < 0.001, P < 0.001, respectively). For pump portability, size, shape, and weight, the soft-shelled type also outperformed the hard-shelled one (P < 0.001, P=0.0011, P < 0.001, respectively). However, the hard-shelled pump scored significantly better in terms of ease of viewing memory (P < 0.001). Overall satisfaction was significantly higher for the soft-shelled pump than the hard-shelled type (P=0.0095). Finally, 13 patients (65%) indicated that they would prefer a soft-shelled pump for their next treatment, while only one patient (5%) preferred a hard-shelled alternative. A preference for soft-shelled pump was observed, particularly in female patients and those with a body mass index of < 22 kg/m2. Conclusion: The selection of portable elastomeric infusion pumps should consider the preferences of patients with colorectal cancer, as these devices have the potential to enhance their quality of life.

Self-template-assisted micro-phase segregation in blended liquid-crystalline block copolymers films toward three-dimensional structures.

In-plane mesopatterns derived from block-copolymer (BCP) micro-phase segregation in thin films have attracted much interest in practical applications as well as fundamental research programs. However, phase segregation along the film-normal direction has been less studied. Here, we describe a strategy to concurrently, yet independently, control in-plane micro-phase and out-of-plane macro-phase segregation in multiblended films composed of liquid-crystalline BCPs (LCBCPs), affording spontaneously layered three-dimensional (3D) mesostructures. This strategy relies on sequential liquid crystallization during the cooling process in thermal annealing as follows. The constituent LCBCP with the highest isotropic-transition temperature (Tiso) first liquid-crystallizes and segregates from the other LCBCP mixture remaining in isotropic states to form a noncontaminated layer at the top surface. This preformed LCBCP layer preserves its inherent in-plane pattern and acts as a template guiding the subsequent micro-phase segregations of the other low-Tiso LCBCPs underneath. This self-template-assisted micro-phase segregation (STAMPS) readily provides 3D mesostructures, the potential toward rational material design of which is also demonstrated in water-separation applications.

[Perioperative failure of hemodialysis shunts: analysis of risk factors].

BACKGROUND: Because vascular access dysfunction results in substantial morbidity in patients undergoing chronic hemodialysis, this complication should be avoided. However, we experienced four patients whose hemodialysis shunts failed within 24 hours postoperatively. METHODS: We retrospectively analyzed operations performed under general anesthesia in our hospital for patients receiving hemodialysis shunts between May 2001 and October 2002. Comparisons between cases with and without perioperative shunt failures were performed using Mann-Whitney and Fishers exact tests. RESULTS: Spinal surgery (P<0.01) and surgery placed in prone or knee-chest positions (P<0.05) were significantly more frequent, and the operation times (P<0.01) and blood losses (P<0.05) were significantly greater, in the occluded group (n=4) than in the non-occluded group (n=12). CONCLUSIONS: Prone position might have impaired venous backflow from the shunt, thus promoting thrombogenesis. Additionally, moderate hemorrhage, with or without blood transfusion, may have induced a transient hypercoagulable state during the operation, which thus contributed to the acute shunt failure.