Integrated psychological care in head and neck cancer: Views from health care providers, patients, and supports.

Objectives/hypothesis: An evaluation by head-and-neck cancer (HNC) staff, patients, and patient support feedback regarding integrated psychological care and perceived benefit based on patient characteristics.

Study Design: Cross-sectional survey of HNC staff, patients, and their primary supports; and retrospective chart review of psychiatric characteristics of HNC patients.

Methods: HNC staff, patients (who were evaluated by the integrated psychologist), and their primary supports were given questionnaires on their perception of benefit of including a psychologist in the evaluation and treatment of HNC patients.

Plastic versus self-expanding metallic stents for malignant hilar biliary obstruction: a prospective multicenter observational cohort study.

Background: There are few comparative data as to whether plastic or self-expanding metallic stents are preferable for palliating malignant hilar biliary obstruction.

Methods: Thirty-day outcomes of consecutive endoscopic retrograde cholangiopancreatographies performed for malignant hilar obstruction at 6 private and 5 university centers were assessed prospectively.

Results: Patients receiving plastic (N=28) and metallic stents (N=34) were similar except that metallic stent recipients more often had: Bismuth III or IV tumors (16/34 vs.

Endoscopic balloon dilation compared with sphincterotomy for extraction of bile duct stones.

Background And Aims: Endoscopic retrograde cholangiopancreatography is commonly performed to remove bile duct stones. The aim of this study was to determine short-term outcomes of endoscopic balloon dilation of the sphincter of Oddi compared with sphincterotomy for stone extraction.

Methods: A randomized, controlled multicenter study of 117 patients assigned to dilation and 120 to sphincterotomy was performed in a spectrum of clinical and academic practices.

New strategies in nonoperative management of meconium ileus.

Purpose: The aim of this study was to develop new nonoperative strategies for the management of meconium ileus in an attempt to improve on the current unacceptable failure rate.

Methods: Mice were constipated with subcutaneous morphine injection. Each then received an enema solution (perflubron, surfactant, Tween-80, Gastrografin, Golytely, DNase, N-Acetylcysteine, Viokase, or normal saline).

Pitfalls in HIV testing.

Preview Inaccurate results on HIV tests are rare, but they do occur. Therefore, it is important that primary care physicians understand the laboratory techniques involved. Which assays are used for detection of the virus? How are results of such tests interpreted? What factors cause false-positive and falsenegative results? Drs Cordes and Ryan answer these questions and clarify the uncertainty surrounding HIV testing.