Personal contact from friends to increase mammography usage.

To increase the use of mammography among women 40 years of age and older, the American Cancer Society (ACS) designed a telephone intervention strategy (the "Tell A Friend" program) that relied on ACS volunteers. During a half-day training session, each volunteer provided a list of 10 women she was willing to contact over a 6-month period and encourage to have a mammogram. Each list was randomized, and five names were returned to each volunteer for inclusion in the intervention. The other women served as controls and were not contacted by the volunteers. All women were subsequently interviewed at the end of the intervention period. Forty-nine percent of the women in the intervention group (n = 289) had received their most recent mammogram since the start of the intervention period, whereas 34% of control women (n = 305) received mammograms during the same time period (p < or = .001, rate ratio = 1.4, 95% confidence interval = 1.2, 1.7). The effectiveness of the intervention remained after controlling for demographic characteristics. The strategy was effective for both black and white women of all ages, but principally among women with annual household incomes of less than $40,000. We conclude that a telephone intervention strategy of personal contacts between acquainted women can significantly increase mammography use, particularly among women with low-to-moderate income.

Synthesis and characterization of some chromogenic crown ethers as potential optical sensors for potassium ions.

The complexing abilities of a series of chromogenic crown ethers for potassium and sodium ions have been investigated, by spectrophotometry for the reactions in solution, and by diffuse reflectance spectroscopy when the crown ethers were immobilized. The binding coefficients of the reagents increased with increasing negative charge in the cation-binding site and with increasing extent of chelation. Centimolar K(+) concentrations could be determined with the immobilized reagents, with a K(+)/Na(+) selectivity ratio of approximately 10.

Career paths of physicians who received an American Cancer Society Regular Clinical Fellowship.

The authors conducted a survey of American Cancer Society Regular Clinical Fellowship recipients from 1975 to 1976 and 1985 to 1986 and directors whose programs were awarded fellowships in 1985 to 1986. The survey ascertained the career paths taken or planned by the surveyed fellows, program directors' estimates of the career paths chosen by their programs' fellows from the last 5 years, and to elicit opinions on the role of the fellowship program. Response rates exceeded 70% across the three groups. The survey found that there has been a shift toward full-time academic oncologic practice and away from community oncologic practice by fellows. Program directors indicated the fellowship program afforded more benefits to fellows than fellows perceived, with the exception of the contribution to fellows' salaries. Program directors and fellows agreed on the most important aspects of a fellowship program (support a year of otherwise unavailable training and require exposure to research) but were in less agreement on other characteristics.

Intravenous aminophylline in the treatment of acute bronchospastic exacerbations of chronic obstructive pulmonary disease.

Often chronic obstructive pulmonary disease (COPD) patients treated for acute exacerbations receive intravenous (IV) aminophylline in addition to inhaled bronchodilators that may raise serum levels of theophylline into the toxic range. A double-blind, randomized study of 52 men with COPD who came to the emergency department for treatment of exacerbations was initiated to establish the efficacy and safety of this common practice. After history and physical examination, patients were treated with 28% oxygen by Venturi mask and 0.3 cc metaproterenol sulfate in 2.5 cc saline by nebulizer; an IV line was started and patients received either aminophylline or D5W. Measurements included baseline and two-hour serum theophylline levels, pulmonary function tests, and symptom questionnaires. Mean values from the entire group showed decreases in respiratory rate, cardiac rate, and pulsus paradoxus, and increases in forced expiratory volume in one second (FEV1) and vital capacity (VC) over a two-hour treatment period (P less than .01). Despite the increase in serum theophylline in the treatment group, the demographic, clinical, pulmonary function, and outcome data were found to have no statistically significant differences when compared to control patients. The data were then analyzed according to serum theophylline levels. Theophylline level greater than 20 micrograms/mL occurred in 15 patients with no untoward effects; premature ventricular contractions (PVCs) were no more frequent in this group than in those with lower serum theophylline levels. A theophylline level greater than 10 micrograms/mL after two hours of treatment resulted in the following differences, which were not statistically significant: mean FEV1 response less than or equal to 10 micrograms/mL vs greater than 10 micrograms/mL, 20% vs 28%; mean VC change, 17% vs 30%; or mean emergency department returns in one week, 0.1 vs 0.26. In our experience, oxygen and inhaled metaproterenol are effective treatment for exacerbations of COPD.