Differences Between Emergency Nurse Perception and Patient Reported Experience With an ED HIV and Hepatitis C Virus Screening Program.

Introduction: Nontargeted human immunodeficiency virus (HIV) screening and targeted hepatitis C virus (HCV) screening for selected high-risk patients (those born between 1945 and 1965 and those who report injection drug use) was integrated into our ED triage process and carried out by nurses. Determining whether emergency nurses accurately perceive what patients experience is important to know because staff misperceptions may pose a barrier to program adherence and sustainability.

Methods: We performed a cross-sectional survey study of emergency nurses and patients to assess the accuracy of emergency nurses' perception of patient experience with the HIV/HCV screening program.

Phenobarbital for acute alcohol withdrawal: a prospective randomized double-blind placebo-controlled study.

Background: Acute alcohol withdrawal syndrome (AAWS) is encountered in patients presenting acutely to the Emergency Department (ED) and often requires pharmacologic management.

Objective: We investigated whether a single dose of intravenous (i.v.

Sector resection with or without postoperative radiotherapy for stage I breast cancer: five-year results of a randomized trial. Uppsala-Orebro Breast Cancer Study Group.

Background: The effectiveness of routine postoperative irradiation following breast-conserving treatment of breast cancer has not previously been assessed in randomized clinical trials that have taken place in settings where mammography has been a major pathway to diagnosis or that have followed patients treated surgically by sector resection.

Purpose: The aim of this study was to determine if treatment of stage I breast cancer by strictly standardized surgical technique with meticulous confirmation of a complete excision can reduce the local recurrence rate to an acceptable level without routine adjuvant radiotherapy.

Methods: In this trial conducted in Sweden, 381 women with stage I breast cancer were surgically treated by sector resection plus axillary dissection; then 184 women were randomly selected to receive postoperative radiotherapy to the breast (XRT group), and 197 women received no further treatment (non-XRT group).

Factors that influence the incidence of brachial oedema after treatment of breast cancer.

Six factors that may increase the likelihood of swelling of the arm after treatment of breast cancer were investigated in 136 patients who had undergone treatment. The highest incidence of oedema was among patients who had received radiotherapy in high doses with few fractions to the axilla (60%), and in patients with a history of one or more infections in the arm on the operated side (89%). Overweight, oblique surgical incision, infection in the arm, and radiotherapy correlated with arm swelling.

The narrow proton beam therapy unit at the the Svedberg Laboratory in Uppsala.

The synchrocyclotron at the The Svedberg Laboratory (TSL) in Uppsala is now reconstructed and can presently operate with fixed frequency and proton energies up to 100 MeV. A first treatment room with a narrow proton beam unit for therapy of eye tumours is now in operation. Therapy of eye melanomas started in April, 1989 and during 1989 and 1990, 19 patients were treated with 72 MeV protons.

Computed tomography in early diagnosis of local recurrence of rectal carcinoma.

Local recurrence is a common problem among patients treated surgically for adenocarcinoma of the rectum and rectosigmoid. When a local recurrence has become clinically manifest, curative therapy is virtually impossible. Asymptomatic local recurrences are difficult to find clinically, especially in patients treated with an abdominoperineal resection.

Local anaesthetics modifying the dermal response of irradiation. An experimental study.

In a series of experiments in rabbits the dermal reaction, provoked by a single dose or intermittent doses of irradiation, was prevented or modified by topical or parenteral administration of local anaesthetics, compared to irradiated control animals. The topical application of a eutectic lidocaine/prilocaine cream, EMLA 5%, was found to be more effective than intravenously injected lidocaine (Xylocain 1%).

Sequential methotrexate--5-FU--leucovorin (MFL) in advanced colorectal cancer.

Methotrexate (MTX) (250 mg/m2) was given as an i.v. infusion over 2 hr.

Pre- versus postoperative radiotherapy in rectal carcinoma: an interim report from a randomized multicentre trial.

Since October 1980 a randomized multicentre trial has been in progress among patients with rectal carcinoma, in whom high-dose fractionated pre-operative irradiation (total dose 25.5 Gy in 5-7 days) is being tested against postoperative irradiation to a high dose level using a conventional fractionation scheme (totally 60 Gy in 8 weeks) delivered only to a high-risk group of patients (Dukes' stages B and C). The primary aim of the trial is to investigate whether local recurrence rate differs between the two groups, and a secondary aim is to see whether 5-year survival will differ between the two groups of patients.

Proton radiotherapy with the Uppsala cyclotron. Experience and plans.

From 1957 to 1968, the 230-cm synchrocyclotron at the Gustaf Werner Institute was used for clinical tests with a 185 MeV proton beam. The radiotherapeutic research was part of an extensive research programme in physics, chemistry, biology and medicine. Only a small series of patients were treated.

Radioprotection of the kidney with degradable microspheres. A pilot study in the dog with repeated irradiation.

The left kidney of 9 dogs was irradiated daily for three days with 300 kVp X-rays. Radioprotection was attempted in 5 of the kidneys by administration of degradable microspheres in the renal artery, immediately before irradiation. Protected kidneys received 3 X 8 or 3 X 12 Gy in midplane dose, unprotected kidneys 3 X 5.

Prognostic implication of estrogen receptor content in breast cancer.

The cytosolic estrogen receptor (ER) content of the primary tumor was determined by isoelectric focusing in 170 consecutive women with unilateral breast cancer diagnosed in 1977 through 1980. No adjuvant treatment over and above surgery and radiotherapy was given. The overall corrected survival was not significantly (p greater than 0.

Computed tomography in staging of rectal carcinoma.

Computed tomography (CT) was performed on 204 patients with rectal carcinoma in an attempt to determine the tumour stage preoperatively. In 154 patients CT and histopathology could be compared. Correct staging was achieved in 60 to 70 per cent of the patients, but considerable over- and understaging limit the use of CT in preoperative staging of rectal carcinoma.

Preoperative irradiation of primarily non-resectable adenocarcinoma of the rectum and rectosigmoid.

In a series of 328 patients with adenocarcinoma of the rectum and rectosigmoid, 39 had a tumour which was considered locally non-resectable (19 patients) or borderline resectable (20 patients). Twenty-eight of these patients received radiation therapy with a daily target dose of 2 Gy up to a total of 46 Gy. If the tumour was still considered non-resectable 3 weeks later, radiation therapy was usually continued up to a total dose of 64 Gy together with 5-fluorouracil.

Radiation therapy of anal carcinoma.

Between 1978 and 1982, 30 consecutive patients with anal carcinoma were given radiation therapy. Irradiation alone was given to cloacogenic carcinoma and in combination with bleomycin to squamous cell carcinoma. Patients with an early tumour (T1, T2) were treated to 65 Gy (60 Gy + bleomycin) directly, whereas patients with a moderately advanced tumour (T3) were treated to the same radiation dose only if no evidence of residual disease existed after approximately 50 Gy (45 Gy + bleomycin); if a palpable tumour still remained 3 to 4 weeks after the end of the irradiation, surgery was performed.

Preoperative irradiation with high-dose fractionation in adenocarcinoma of the rectum and rectosigmoid.

The incidence of local pelvic recurrence after 'curative' resection for rectal carcinoma is high. Adjuvant irradiation given pre- or postoperatively has led to a decreased incidence of pelvic recurrences. In a series of 58 consecutive patients between 1979 and 1980, those with primarily operable rectal tumours received preoperative irradiation in a total dose of 25.

Computed tomography of recurrent rectal carcinoma.

Computed tomography was performed in 28 patients and gave a correct diagnosis in 21 of 22 cases with abdomino-perineal excision of the rectum and in 5 of 6 with anterior resection. CT is of considerable value in the diagnosis of local recurrence of rectal carcinoma, particularly after rectal excision.

Kidney radioprotection by temporary hypoxia. Experiments with degradable microspheres.

Deep hypoxia protects biological tissue against ionizing radiation. By intra-arterial injection of degradable starch microspheres the renal circulation was temporarily blocked in unilaterally nephrectomized rats. The induced hypoxia was utilized for protection of the kidney against single doses of high-voltage X-rays.

Equivalence of quantitative models for tumour response to ionizing radiation in treatment field optimisation procedures.

Three cell kinetic models of tumour response to ionising radiation were compared with regard to their prediction of variation in curability when the dose to the tumour varied between 54 and 66 Gy given in 30 fractions. It was found that a simple model emulated the results of the more complex ones when the parameters of the simple model were properly adjusted. A comparison of the simple model and the CRE formula gave a similar result.

Bronchial carcinoma. I. A prospective five year study on an unselected carcinoma population in a Swedish county.

No prospective clinical investigations of unselected total materials of bronchial carcinoma have been reported. The clinical profile of 273 patients with histologically verified bronchial carcinoma from a Swedish county during 1971-1976 is presented. The difficulties in making valid comparisons with other literature reports makes it necessary to describe in detail the total material.

Survival and recurrences five years after selective treatment for breast carcinoma.

110 consecutively diagnosed breast-cancer patients in all stages were included in a study to evaluate a selective surgical and radiotherapeutical treatment. The surgical treatment was total mastectomy and exploration of the axilla, with lymphnode biopsy and peroperative cytological examination. Axillary dissection was done only when this examination showed metastases.