Poor Treatment Effect Research Articles

Disparities in health care outcomes between immigrants and the majority population in Germany: A trend analysis, 2006-2014.

BackgroundImmigrants often encounter barriers in the health system that may affect their health care outcomes. In order to better cater to the needs of immigrants, many health care institutions have increased their efforts in recent years to provide services which are more sensitive to the needs of an increasingly diverse population. Little is known about whether these efforts are successful. This study examines difference in outcomes of tertiary prevention between immigrants and the autochthonous population in Germany over the period of 2006–2014.MethodsThe analysis is based on a 10% random sample of routine data on completed tertiary preventive treatments in Germany during 2006–2014. Four different indicators of treatment effectiveness were compared between patients with a nationality from Germany, Portugal/Spain/Italy/Greece, Turkey and Former Yugoslavia using logistic regression adjusted for demographic/socioeconomic factors. Interaction terms for year were modeled to examine group differences over time.ResultsDepending on the outcome, Turkish and Former Yugoslavian nationals had an 23%-69% higher chance of a poor treatment effectiveness than Germans (OR = 1.23 [95%-CI = 1.15,1.32] and OR = 1.69 [95%-CI = 1.55,1.83], respectively). Fewer differences were observed between nationals from Portugal/Spain/Italy/Greece and Germans. Disparities did not significantly differ between the years in which services were utilized.ConclusionMeasures implemented by health care institutions did not reduce existing health care disparities between immigrants and the majority population in Germany. One potential reason is that existing approaches are unsystematic and often not properly evaluated. More targeted strategies and a thorough evaluation is needed in order to improve health care for immigrants sustainably.

Colorectal cancer in Taiwan: A case-control retrospective analysis of the impact of a case management programme on refusal and discontinuation of treatment.

The purposes of this study were to identify the impact of a case management programme on the related factors of refusing treatment or discontinuing treatment in Taiwanese colorectal cancer patients. Side effects of anti-cancer treatments are associated with refusing treatment and discontinuing treatment. This case-control study, longitudinal database and secondary analysis of population-based data was conducted from 2009-2012. Logistic regression was used to reveal the factors related to refusing or discontinuing treatment. Of the 68 patients who refused treatment, the top reasons for refusing treatment were patients or their family considered the patients poor physical condition, difficulty in enduring any condition likely to cause physical discomfort from the disease treatment, selected complementary and alternative medicine, patients or their families or friends experienced negative treatment effects and worried about the side effects of treatment, older age, poor family support and lost contact. Of the 278 patients who discontinued treatment, the most common reasons for discontinuing treatment were patients or their families or friends experienced negative treatment effects and worried about the side effects of treatment, inconvenient transportation, patients or their family considered the patients poor physical condition, difficulty in enduring any condition likely to cause physical discomfort from the disease treatment, poor treatment effect and selected complementary and alternative medicine. Case managers can provide positive communication and available resources in relation to cancer treatment. A case management programme can help patients cope with the difficulties encountered during the treatment period.

A Narrative Review of Psychological Cannabis Use Treatments with And Without Pharmaceutical Adjunct.

As policy responses to cannabis use and availability change internationally, levels of cannabis use disorder rise and treatment seeking increases. Diversion to cannabis treatment from the criminal justice system also increases demand in the system. At a time of developing treatment systems in response to this demand, an understanding of the evidence is increasingly important. To provide a narrative review of the developing evidence-base for psycho-social interventions for cannabis use disorder, including adjunctive cannabinoid agonist therapy. Two researchers independently conducted a literature search for articles published prior to February 2016, located through online search of four electronic databases (Google Scholar, CINAHL, Medline, and PsycINFO). Only randomised controlled trials describing treatment(s) for cannabis use or cannabis use disorder with a measure of either cannabis use frequency or cannabis use disorder severity were included. Non-English papers, review papers, posters, opinion pieces, letters or editorials, case studies (N<10) and published abstracts were excluded. The cannabis treatment most likely to be effective for adolescents and adults is based on the combination of Motivational Enhancement Therapy (MET) and Cognitive Behavioural Therapy (CBT) with the inclusion of contingency management and agonist replacement therapy showing promise. A more concrete and robust evidence base is required for these interventions. Replication of treatment studies is needed using standardised interventions, methods and measures to minimise conflicting findings, inconsistent follow-up periods and relatively poor treatment effects over time.

Psychosocial Factors in Patients Indicated for Lumbar Spinal Stenosis Surgery.

In the context of the interdisciplinary care of patients with chronic back pain, surgery is an option for those who do not benefit from conservative treatment. Psychological assessment prior to back surgery aims to identify suitable candidates for surgery and predict possible complications or poor treatment effects. The literature suggests that psychosocial factors are important outcome predictors of lumbar spinal surgery; however, there is not enough empirical evidence to show that early identification and treatment of these factors help improve surgical outcome. This review discusses the possible psychosocial risk factors in patients with lumbar spinal stenosis who are undergoing decompression or stabilization surgery, shows the association between presurgical psychological parameters and surgical treatment outcome, and describes the characteristics of our pilot study to implement presurgical psychological assessment in routine clinical practice.

Effect of ATRA on the expression of HOXA5 gene in K562 cells and its relationship with cell cycle and apoptosis.

Leukemia is the most common malignant disease in children with high incidence and mortality rates, and a poor treatment effect. The aim of the present study was to examine the changes in the expression of homeobox (Hox) A5 gene and its relationship with cell cycle and apoptosis through the intervention of human K562 myeloid leukemia cell line by all-trans retinoic acid (ATRA), to analyze the role of HOXA5 in the pathogenesis and development process of myeloid leukemia. The optimal concentration of ATRA to be used with K562 cells was determined using a cell counting kit-8 (CCK-8). After 24, 72 and 48 h following treatment of K562 cells with 10 µmol/l ATRA, cell cycle events and apoptosis were measured using flow cytometry. HOXA5 mRNA and protein expression in K562 cells was assessed by RT-PCR and western blot analysis, and the relationship between HOXA5 expression and cell cycle and apoptosis was analyzed. The HOXA5 mRNA and protein expression levels were increased following treatment with ATRA in K562 cells. Apoptosis was increased significantly. The cell cycle was inhibited in G0/G1 phase. Cell proliferation was also inhibited. HOXA5 mRNA and protein expression rates positively correlated with cell apoptosis and the increased percentage and cell cycle of the G0/G1 phase. However, HOXA5 negatively correlated with the reduced percentage of S stage. In conclusion, the expression of HOXA5 in cells was increased following treatment with ATRA in K562 cells, in a time-dependent manner. Additionally, ATRA may inhibit the proliferation of K562 cells and promote apoptosis by upregulating the HOXA5 mRNA and protein expression.

Coexpression of MYC/Bcl-2 in Diffuse Large B-Cell Lymphoma: A Clinic Research

BackgroudDiffuse large B-cell lymphoma (DLBCL) is the most commonly occurred non-Hodgkin's lymphoma (NHL). With the development of chemotherapy and immunotherapy, some patients get a good prognosis, but still a considerable number of patients suffer from a strongly aggressive DLBCL with poor treatment effects. Due to the discovery of "double hit" of MYC/Bcl-2 genes, the coexpression of these two proteins has attracted more attention. Further investigations will be necessary to investigate the role of MYC/Bcl-2 co-expression in the clinical features of DLBCL as well as its relationship with prognosisto explore the significance of MYC/Bcl-2 protein coexpression in DLBCL.Methods89 confirmed DLBCL cases treated with the chemotherapy regimen of CHOP or R-CHOP between February 2008 and March 2014 were collected. Complete clinical data and paraffin-embedded tissues samples were available from these cases. immunohistochemistry analysis of MYC and Bcl-2 protein expression were carried out. In addition, the relationship between MYC/Bcl-2 protein coexpression and factors such as the age, gender, primary site, Ann Arbor staging, international prognostic index (IPI), immunohistochemical Hans type, and Ki-67 expression rate of patients were statistically analyzed in this paper. Furthermore, we investigated how the abovementioned indicators and whether or not Rituximab or MYC/Bcl-2 coexpression was applied were associated with the progression-free survival (PFS) and overall survival (OS) of patients.Results1. 89 cases with DLBCL were collected. The median age was 65 years with a range of 18-82. 54 cases were over 60 years old. 64 patients had a primary tumor in the lymph nodes .As per the IPI score, there were 30 low-risk cases (IPI<3). There were 27 cases at Ann Arbor stage I-II, 62 cases at stage III-IV, 31 GCB cases, 58 nonGCB cases. For 61 cases, the expression rate of Ki-67 was more than 70%.There were 41 cases treated with the chemotherapy regimen of R-CHOP and 48 cases treated with chemotherapy regimen of CHOP.MYC/Bcl-2 coexpression was associated with high-risk IPI score (P = 0.022).2. 37 cases had high MYC protein expression, accounting for 41.5%. Also, 51cases (57.3%) had high Bcl-2 protein expression. There were 29 cases (32.6%) of MYC/Bcl-2 co-expression Compared with non-coexpression group, the median PFS (16m VS 33m, P<0.001) of the co-expression group decreased significantly.but there was not a significantly difference of the median OS. Moreover, Compared the MYC or Bcl-2 single expression group with the non-expression group, there were no significant differences among them.3. Single factor analysis with other common risk factors indicated that in the high-risk group, including advanced aged (grouping by 60 years old)、treating without rituximab III-IV stages, and high IPI score, both PFS and OS decreased, and the difference was statistically significant (P<0.05); When grouping by immunohistochemical Hans classification, primary site and Ki-67 expression (divided by 70%), OS comparison of the two groups showed no significant difference (P> 0.05).4. In the multivariate regression analysis, It was found that MYC/Bcl-2 coexpression, IPI score, age, and use of rituximab, staging were independent prognostic factors to PFS (P <0.05), while IPI score, staging and age were independent prognostic risk factors to OS (P<0.05). However,MYC/Bcl-2 coexpression temporarily could not be considered as an independent risk factor for OS.ConclusionsBcl-2/MYC protein coexpression is significantly associated with IPI score of high-risk patients. Patients with MYC/Bcl-2 coexpression had a poorer prognosis than non-coexpression, with shortened PFS. They had a prognosis poorer than single high expressions of MYC or Bcl-2. The influence of MYC/Bcl-2 coexpression to the OS of DLBCL needs a longer follow-up time to study.MYC/Bcl-2 coexpression, IPI score, age, and use of rituximab, staging were independent prognostic factors to prognosis. DisclosuresNo relevant conflicts of interest to declare.

Perioperative nursing of huge malignant lobulated breast tumor

Objective To summarize the perioperative nursing of huge malignant lobulated breast tumor, so as to promote the recovery of patients. Methods A total of 11 patients with huge malignant lobulated breast tumor patients were selected, assessed the preoperative status,finished breast tumor site nursing, strengthen psychological nutritional assessment, the adjustment of the respiratory system for the operation, prevent falls. In addition to do a good job in general nursing and postoperative pain management, but should also focus on the observation of the chest wall flap, drainage tube care, to prevent bleeding and infection, etc. Results By implementing the nursing plan, 1 case of breathing difficulties preoperative patients with respiratory function improved, 1 case of refuse treatment of patients accepted surgical treatment after psychological intervention, 2 cases of postoperative patients with skin flap necrosis, local treatment, after compression bandage, 1 case of good recovery, 1 case of poor treatment effect for the wound recovered well after back surgery graft; 1 case of patients with subcutaneous effusion, to adjust the drainage tube, suction fluid, after compression bandage, partial treatment, recovering well. Patients were good recovery, discharged smoothly. Conclusions By constantly sum up experience, through positive assessment of patients after preoperative mental and physical health and attaches importance to patients' skin flap, bleeding, pain, completes the drainage tube nursing and prevention of infection, can effectively promote the recovery of patients. Key words: Breast neoplasms; Perioperative nursing

An Evaluation the Effect of Glycyrrhetinic and Glycyrrhizic Acids Derived from Licorice Extract on Gastric Cancer Cell Lines

BACKGROUND AND OBJECTIVE: Gastric cancer is the second most prevalent carcinogenic disease and surgery, chemotherapy and radiation are its principal treatment modalities. However, in most cases, poor response to treatment and adverse side effects are observed regarding these modalities. Given the lack of response to treatment and growing rates of gastric cancer, researchers are trying to come up with more efficient treatments with fewer side effects. In the traditional medicine, licorice has been suggested as a cancer treatment considering its high antioxidant properties and few side effects. This study aimed to evaluate the effect of licorice extract on gastric cancer cell lines. METHODS: In this experimental study, adenocarcinoma gastric cell lines were prepared from cell bank and were cultured. After passage, the cells were transferred into a 96-well plate. In each well, approximately 2,000 cells in RPMI-1640 culture medium with FBS (10%) were placed. The cells were repeatedly exposed to different concentrations of Glycyrrhetinic acid (0, 1, 10 and100.1 μM) and Glycyrrhizic acid (10, 1, 100 and 0.1 μM) for 24 and 48 hours. Finally, the obtained results of the experimental and control groups were compared with each other. FINDINGS: According to our results, the toxic effect of Glycyrrhetinic and Glycyrrhizic acids is dose and time dependent. In 24 hours, the mean optical density (MOD) in 100 μM concentration of Glycyrrhetinic acid was 0.41±0.02 and 0.79±0.04 in the experimental and control groups, respectively (p=0.0002). After 48 hours, MOD was 0.16±0.004 and 1.749±0.24 in the experimental and control groups, respectively (p=0.0003). Moreover, the MOD of 100 μM concentration of Glycyrrhizic acid was 0.78±0.53 and 2.09±0.49 in the experimental and control groups in 48 hours. There was a significant difference between the experimental and control groups (p=0.035). CONCLUSION: The results of this study demonstrated that the licorice compounds have a toxic effect on carcinogenic cells. Therefore, it is recommended to perform more study on both Glycyrrhizic and Glycyrrhizic acids as effective compounds on gastric cancer treatment

When to adjust therapy in patients with rheumatoid arthritis after initiation of etanercept plus methotrexate or methotrexate alone: findings from a randomized study (COMET).

The objective of these posthoc analyses was to evaluate short-term clinical outcomes as predictors of poor response after 1 year of treatment with combination etanercept/methotrexate (ETN/MTX) therapy versus MTX monotherapy in patients with early rheumatoid arthritis (RA). Participants with moderate to severe RA [28-joint Disease Activity Score-Erythrocyte Sedimentation Rate (DAS28-ESR) ≥ 3.2] of 3-24 months' duration received ETN 50 mg weekly plus MTX or MTX monotherapy for 52 weeks. Regression analyses were performed to evaluate the likelihood of remission (DAS28-ESR < 2.6) after 1 year despite poor clinical short-term treatment effects (e.g., absolute or changes from baseline in DAS28-ESR after 4, 8, 12, 20, and 24 weeks of therapy). The magnitude of disease activity and its improvement and timing influenced remission probability in both treatment groups; remission rate was diminished with higher disease activity levels and lower response levels over time from weeks 4 to 24. The rate of DAS28-ESR remission at 1 year was generally greater with ETN/MTX than with MTX alone at most timepoints from weeks 4 to 24. Despite persistent high disease activity (DAS28-ESR > 5.1) after 4, 8, 12, and 24 weeks of therapy, 35%, 27%, 25%, and 22% of patients, respectively, in the ETN/MTX group achieved DAS28-ESR remission after 1 year of continuous treatment; the respective proportions were 33%, 27%, 8%, and 13% in the MTX group. High disease activity and less improvement with treatment over time in the initial 24 weeks of treatment, particularly after 12 weeks, were predictive of a lower remission rate after 1 year.

Effect of systemic family dynamics, egma minnen bardndom on psychological traits and treatment efficacy of the first onset schizophrenia

Objective To explore the effect of systemic family dynamics, egma minnen bardndom on the psychological traits, treatment efficacy of the first onset schizophrenia. Methods 53 schizophrenia patients with first onset were assessed by Self-rating Scale of Systemic Family Dynamics (SSFD), Egma Minnen Bardndom Uppforstran(EMBU), Neurotism Scale(Nf), Psychoticism(PSY), Paranoia Scale (Pa), Psychopathic Deviate Scale(Pd), Tolerance Scale(To)of MMPI-2, and lie Scale (L) was used to control assessment effectiveness.40 normal control cases were assessed by SSFD and EMBU.The scale scores between study group and control groupwere compared, and correlation and regression of study group were analyzed. Results Scores of family atmosphere, individuation, system logic of SSFD were higher in study group than those in control group(t=4.04, 3.295, 2.44, all P<0.05), scores of emotional warmth and understand of EMBU in father and mother were lower in study group than those in control group (t=2.925, 3.45, all P<0.01), scores of refused and deny and punishment and stern of EMBU in father and mother were higher in study group than those in control group((t=4.715, 4.971, 4.331, 4.067, all P<0.01)). And correlation analysis showed that refused and deny of EMBU of father and mother, punishment and stern of EMBU of mother and PSY had significantly positive correlation(r=0.3378, 0.4677, 0.2895, all P<0.05), refused and deny and punishment and stern of EMBU of father and mother and Pa had significantly negative correlation (r= -0.2913, -0.3254, -0.5003, -0.3242, all P<0.05), punishment and stern and excessive interference of EMBU of father and Pd had significant positive correlation (r=0.3417, 0.2958, all P<0.05), PSY of MMPI-2 and treatment effect had significant negative correlation (r= -0.3194, P<0.05). Regression analysis showed that psychoticism to forecast the poor treatment effect the rate was 10.2%, father and mother the refused and deny to forecast psychoticism high mark the rate respectively were 11.41% and 21.87%, mother the severe punishment to forecast the psychoticism high mark the rate was 8.13%, Conclusion Father and mother the refused and deny, mother severe punishment have effects on psychological traits of the first onset schizophrenia, psychoticism of psychological traits has an affect on treatment efficacy, the psychoticism high mark presages the poor treatment efficacy. Key words: First onset schizophrenia; Egma Minnen Bardndom; Systemic family dynamics; Psychological traits; Treatment efficacy

Acute pancreatitis associated with hemorrhagic fever with renal syndrome: clinical analysis of 12 cases

Background: Acute pancreatitis is one of the rare complications of hemorrhagic fever with renal syndrome (HFRS), which easy to be misdiagnosed as acute abdomen, usually critically ill, poor treatment effect, highly mortality. In this study, we retrospectively analyzed to explore the clinical characteristics, 12 cases of hemorrhagic fever with renal syndrome complicated with acute pancreatitis treatment methods and prognosis. Methods: We conducted a retrospective study of HFRS in patients complicated with acute pancreatitis. 12 cases were collected from Ningbo first hospital between January 2001 and December 2012. Clinical information and laboratory parameters were obtained by reviewing literature and records. Results: Twelve from 156 cases (7.69%) HFRS complicated with acute pancreatitis. Men comprised more than half (75%) of the sample population, the mean age was (38 ± 19) years. Abdominal pain was the main clinical manifestations in all the patients, all of their serum amylase and serum lipase were increased, 10 patients were given the total abdomen CT examination, eight cases showed enlargement of the pancreas and surrounding leakage, two cases showed pancreatic necrosis and hemorrhage. Three cases complicated with pulmonary edema. In 12 cases, four of them received hemodialysis treatment, one gives surgical intervention. Eight cases were complete remission, three cases were partial remission and one case was death. Conclusions: Acute pancreatitis is one of rare of the serious complications of HFRS, whereas the correct diagnosis and clear the cause of disease is critical for improve the quality of life of patients and reduce the mortality, timely hemodialysis treatment is effective, early intervention can improve the prognosis.

Primary anaplastic large T cell lymphoma of central nervous system

Background Primary anaplastic large T cell lymphoma (ALCL) of central nervous system (CNS) can occur in people of all ages, and is usually unrelated with immunodeficiency. It is often misdiagnosed as meningitis, especially tuberculous meningitis, on clinical practice and imaging examination. In pathological diagnosis, the morphological changes of primary ALCL of CNS are similar to the systemic ALCL and the anaplastic lymphoma kinase⁃1 (ALK⁃1) can be positive or negative. Being misdiagnosed as meningitis, hormone therapy with glucocorticoid before biopsy is always used, and massive necrosis and a lot of histocyte proliferation and phagocytosis can be found under histological findings. Therefore, when the material is not enough, primary ALCL of CNS is often misdiagnosed as cerebral infarction or malignant histocytosis and so on. This paper reports a case of primary ALCL of CNS and makes a review of relevant literature, so as to summarize the clinical manifestations and elevate the recognition of clinicians and pathologists on this disease. Methods and Results A 12⁃year⁃old boy was admitted because of fever, worsening headache, numbness and weakness of right limbs. MRI showed local gyri swelling and abnormal enhancement of pia mater in the right parietal lobe, expanding to the right temporal lobe, and pia mater enhancement in the left parietal lobe. The right temporo⁃parietal lobe lesion biopsy revealed irregularly shaped tumor cells of large size, rich and eosinophilic cytoplasm and horseshoe⁃shaped or kidney⁃shaped nuclei. Immunohistochemical examination showed tumor cells positive for CD3, CD45RO, CD30, ALK⁃1 and epithelial membrane antigen (EMA), and negative for CD20 and CD79a. Conclusion Primary ALCL of CNS is an extremely rare tumor which is usually misdiagnosed as meningitis according to clinical and imaging examinations. Therefore, for those patients who are considered as meningitis but with poor treatment effect and replase of illness, brain tissue biopsy, which is an important means for diagnosis, or cerebrospinal fluid cytologic examination, should be carried out as soon as possible.

Clinical phenotype and gene diagnostic analysis of Omenn syndrome

Omenn syndrome is a rare autosomal recessive hereditary severe combined immunodeficiency. The purpose of this study was to understand clinical characteristics and genetic mutation type of Omenn syndrome and to improve the recognition of Omenn syndrome among pediatric clinicians. One suspected case of severe combined immunodeficiency was found to have pneumonia repeatedly, intractable diarrhea, poor antibiotic treatment effect, lymphadenopathy, hepatosplenomegaly and erythroderma. The patient was diagnosed as having Omenn syndrome by RT-PCR, and the expression of RAG1/RAG2 and gene analysis of RAG1/RAG2 were performed. The classification of lymphocyte was CD3(+) cells (35.3%), CD19(+) cells (0.4%), CD16(+) cells (57.6%). After stimulation with phytohemagglutinin (PHA), lymphocyte proliferation of the child was extremely low. Genetic studies showed RAG1 homozygous deletion mutation (2302 del T). He had detectable activated T-lymphocytes with low circulating B-lymphocytes and no evidence of maternal T-cell engrafment as indicated by the short tandem repeat (STR) analysis. Omenn syndrome is a severe combined immunodeficiency disease caused by mutations in the RAG1/RAG2 gene. The disease has been reported rarely in China. The clinical manifestations of the disease is early postnatal repeated infections and erythroderma. Mutation analysis of RAG1/RAG2 gene may help to confirm the diagnosis and may be useful in early immune reconstitution and genetic counseling.

Relationship between the tinnitus frequency and the effects of medication and the prognosis in patients with chronic subjective tinnitus

To investigate the influence of tinnitus frequency on medication and prognosis in patients with chronic subjective tinnitus. Seventy-two patients (Ninety-three ears) diagnosed as chronic subjective tinnitus were studied from October 2010 to March 2011. All cases were divided into low frequency(twenty-three ears), medium frequency(fourteen ears) and high frequency (fifty-six ears) according to tinnitus matching test. All cases were treated with microcirculation promotion and steroid therapy (5% glucose 250 ml + ginkgo biloba extract 87.5 mg + dexamethasone 10 mg intravenous drip). Curative effect was evaluated and the factors of prognosis were analyzed after three weeks. After medication, results were acquired as follows: recovery in 0 ear (0%), excellent in 0 ear (0%), effective in 18 ears (19.4%), invalid in 75 ear (80.6%). The effective percentage was 39.1%, 35.7% and 7.1%, respectively. There was significant difference between these groups, but no significant difference between low frequency and medium frequency. Logistic regression analysis showed that the difference of frequency was significant prognostic factors for medication. Microcirculation promotion and steroid therapy had a poor treatment effect in patients with chronic subjective tinnitus. The prognosis of chronic low-medium frequency tinnitus was better than chronic high frequency tinnitus. The difference of frequency retained significant influence on effects and prognosis of medication.

Powdered Cellulose Poultices in Stone and Wall Painting Conservation - Myths and Realities

Cellulose poultices are frequently used in stone and wall painting conservation for the purposes of soluble salt extraction, consolidation and cleaning. They have the reputation of being easy and pleasant to work with, have a neutral pH, high water absorption and plasticity, exhibit good conformance and adhesion to the substrate, and in most cases leave minimal residues after clearance. The cellulosic materials from which they are composed range from cotton wool, blotting paper or newspaper, to cellulose powders, the latter now by far the most common form of cellulose used today by conservators. Drawbacks of these products include poor water retention when applied to vertical surfaces, a tendency to redistribute salts further into the object substrate, and poor long-term treatment effectiveness for salt extraction. Hence cellulose poultices are used frequently due to good working properties, but apparently are in some situations not very effective. In this paper, existing knowledge of these poultices is outlined, followed by investigations undertaken to fill some of the knowledge gaps. Investigations include characterization of poultice properties such as pore size distribution and workability, and of moisture transport processes within poultice/substrate systems including moisture penetration depth, moisture distribution, and poultice shrinkage during drying. Cellulose powder products known under the trade name Arbocel®, extensively tested and used in conservation over several decades, were a particular focus. Resulting guidelines include counter-intuitive measures such as (when used for salt extraction purposes) the use of thinner poultices to reduce drying shrinkage and salt redistribution further into the substrate. The relatively uniform pore size distribution (around 10 μm) of Arbocel® poultices makes them more appropriate for salt extraction on substrates with a medium-coarse pore size (i.e. 15 μm and above), while on fine porous substrates (10 μm and below), the extraction will not be as efficient.

Diagnosis and treatment of primitive neuroectodermal tumor

Primitive neuroectodermal tumor (PNET) is a kind of malignant tumor, which most often affects children and adolescents. The incidence of PNET has risen recently. PNET has low early diagnosis rate and poor treatment effect. With the application of RT-PCR and FISH in pathological diagnosis, and MRI and PET-CT in imageological diagnosis, as well as the implementation of target treatment and multidisciplinary integrated treatment concept in the treatment, the pathogenesis, diagnosis technology and treatment means of of PNET have made remarkable progress. Key words: Neuroectodermal tumors, primitive; Diagnosis; Therapeutics

An Instrument to Assess Patient Perceptions of Satisfaction With Acute Migraine Treatment (EXPERT Study)

The objective of the nationwide EXPERT survey carried out in France in 2005 was to compare satisfaction with treatment with treatment effectiveness in migraine patients consulting general practitioners (GPs) for migraine, and to establish an instrument to easily evaluate the adequacy of acute treatment of migraine. Many migraine patients feel satisfied with their current acute treatment of migraine whereas objective evaluation reveals poor treatment effectiveness. A total of 2108 GPs included 11,274 migraine patients. Satisfaction with treatment was evaluated using a 4-point verbal scale and a 10-cm visual analog scale (VAS). Treatment effectiveness was assessed by the 4-item questionnaire designed by the French Medico-Economic Evaluation Service (ANAES) and the French Society for the Study of Migraine Headache (SFEMC). In total, 5224 patients (49.8%) stated that they were satisfied with their treatment. Mean VAS score was 5.1. Only 17% of patients (1789/10,539) gave positive responses at the 4 questions of the ANAES/SFEMC questionnaire. VAS score was high for patients satisfied with their treatment and with good treatment effectiveness. Two VAS thresholds were determined using receiver operating characteristic curves that allowed easy identification, with high sensitivity and specificity, of patients satisfied/dissatisfied with their current treatment and with good/poor treatment effectiveness. Based on EXPERT data, this instrument showed that only 16% of patients using triptans (597/3719) were dissatisfied and reported poor treatment effectiveness, whereas treatment was inadequate for 63% of those using aspirin or nonsteroidal anti-inflammatory drugs (1882/2992), 74% of those using paracetamol or other analgesics (2229/2998), and 53% of those using ergotamine (253/474). The new instrument should allow easy identification in general practice of the patients receiving an effective or ineffective acute treatment of migraine and thus facilitate the implementation of treatment guidelines for migraine.

Riluzole Normalizes Early-Life Stress-Induced Visceral Hypersensitivity in Rats: Role of Spinal Glutamate Reuptake Mechanisms

The molecular basis underlying visceral hypersensitivity in functional irritable bowel syndrome remains elusive, resulting in poor treatment effectiveness. Because alterations in spinal non-neuronal (astrocytic) glutamate reuptake are suspected to participate in chronic pain, we asked whether such processes occur in visceral hypersensitivity. Visceral hypersensitivity was induced in Sprague-Dawley rats by maternal separation. Separated adults were given a systemic administration of riluzole (5 mg/kg), an approved neuroprotective agent activating glutamate reuptake. Visceral hypersensitivity was assessed using colorectal distension (40 mm Hg). Somatic nociception was quantified using Hot Plate, Randall-Sellito, and Hargreaves tests. Spinal proteins were quantified using immunofluorescence and Western blot. The dependence of visceral sensory function upon spinal glutamate transport was evaluated by intrathecal injection of glutamate transport antagonist DL-threo-beta-benzyloxyaspartate (TBOA). For in vitro testing of riluzole and TBOA, primary cultures of astrocytes were used. We show that riluzole counteracts stress-induced visceral hypersensitivity without affecting visceral response in nonseparated rats or altering nociceptive responses to somatic pain stimulation. In addition, maternal separation produces a reduction in glial excitatory amino acid transporter (EAAT)-1 with no change in EAAT-2 or gamma-amino butyric acid transporters. Stress was not associated with changes in glial fibrillary acidic protein or astrocytic morphology per se. Furthermore, visceral normosensitivity relies on spinal EAAT, as intrathecal TBOA is sufficient to induce hypersensitivity in normal rats. We identify spinal EAAT as a therapeutic target, and establish riluzole as a candidate to counteract gastrointestinal hypersensitivity in disorders such as irritable bowel syndrome.

Anxiety, Stress and Coping Behaviours in Primary Care Migraine Patients: Results of the SMILE Study

The objectives of the SMILE study were to assess anxiety, stress, depression, functional impact and coping behaviours in migraine patients consulting in primary care in France. General practitioners (n = 1467) and 83 neurologists included 5417 consulting migraine patients. Of these patients, 67% were found anxious, of whom 59% were also depressive. Patients with both anxiety and depressive dimensions showed a profile similar to that of chronic migraine patients (severe attacks, poor treatment effectiveness and pronounced stress, functional impact and maladaptive behaviours). A quantitative progression in the levels of stress, maladaptive coping behaviours and functional impact was noted from patients with neither dimension to those with both anxious and depressive dimensions. Stress and maladaptive coping strategies were found to be major determinants of anxiety. Anxious and depressive dimensions were associated with elevated consumption of acute treatments for migraine and low treatment effectiveness. Stress and anxiety should be looked for carefully in migraine patients.