Creating critical care oncology beds.

The emergence of specialized oncology practices such as bone marrow transplantation has resulted in a higher incidence of critical complications and complex needs, which has led many oncology units to develop new strategies to care for the patients in the oncology unit. Designated oncology intensive care unit (ICU) beds and a dedicated trained staff is one method of delivery; other institutions transfer patients to existing ICUs, and some have equipped the entire oncology unit for critical care interventions. It is necessary to evaluate key issues when providing critical care to patients with cancer.

Cancer critical care: past, present, and future.

Utilization of critical care interventions for cancer patients has increased because of new hopes for cure or long-term remission, increased ability to treat certain complications, and consumer demand. Cancer therapies are more aggressive causing increased organ toxicity, prolonged aplasia, and a variety of complications that may be life threatening. Public awareness and knowledge that cancer no longer means death has permitted cancer patients to partake of critical care technology.

Trimetrexate with leucovorin versus trimethoprim-sulfamethoxazole for moderate to severe episodes of Pneumocystis carinii pneumonia in patients with AIDS: a prospective, controlled multicenter investigation of the AIDS Clinical Trials Group Protocol 029/031.

Trimetrexate is a powerful inhibitor of the dihydrofolate reductase of Pneumocystis carinii. AIDS patients (n = 215) with moderate to severe P. carinii pneumonia were enrolled in a double-blind study of trimetrexate plus leucovorin versus trimethoprim-sulfamethoxazole (TMP-SMZ) for 21 days.

Disorders of hemostasis in sepsis.

Sepsis is noted for producing disruptions in hemostasis. The patient-related risk factors, clinical presentation, and management strategies are dependent upon the presiding disorder. Platelet deficiency and dysfunction, hepatic protein disorders, and disseminated intravascular coagulation are the most common clinical problems.

Outbreak of Legionnaire's disease linked to a decorative fountain by molecular epidemiology.

The incubation period of Legionnaires' disease in five patients was traced to attendance at conventions in a hotel in the Orlando, Florida, area between January 6 and February 2, 1992. The five case patients (mean age, 69 years) were older than 55 randomly chosen controls (mean age, 53 years) who had also attended one of the same conventions (p = 0.007).

Phase I trial of m-BACOD and granulocyte macrophage colony stimulating factor in HIV-associated non-Hodgkin's lymphoma.

The use of full-dose intensive regimens of chemotherapy in patients with HIV-associated lymphoma has often resulted in severe toxicity, treatment delay, and reduced subsequent dosing. We conducted a Phase I trial to evaluate the toxicity of the combination of m-BACOD (methotrexate, Bleomycin, doxorubicin, cyclophosphamide, vincristine, dexamethasone) with granulocyte-macrophage colony stimulating factor (GMCSF) in these patients. A total of 17 patients were entered and treated at three dose levels of m-BACOD in combination with a fixed dose of GMCSF.

Inherited p53 gene mutations in breast cancer.

Recent evidence has implicated germ-line mutations of the p53 gene as the cause of cancer susceptibility in the Li-Fraumeni syndrome, associated with the development of breast cancer and other neoplasms. Furthermore, somatic mutations of the p53 gene have been detected in a high percentage of non-familial breast cancers. We therefore sought to identify potential carriers of p53 gene mutations in a cohort of patients with early onset breast cancer.

Counterintuitive reversals in lateralization using rectangularly modulated noise.

Listeners were required to detect an interaural delay of 37.5 microseconds in the modulation envelope of a pulse-modulated noise. The noise carrier had a bandwidth of 1000 Hz and a center frequency (fc) that varied from 550-9600 Hz.

Demographic and dietary determinants of constipation in the US population.

We investigated the association between self-reported constipation and several demographic and dietary variables in 15,014 men and women 12-74 years of age examined between 1971-75 during the first Health and Nutrition Examination Survey. Overall, 12.8 percent reported constipation.

Childbearing in prison: a behavioral analysis.

An ethnographic study of the social and psychological experiences of antepartum and postpartum prisoners was undertaken using semistructured interviews. These data, coupled with chart review data for complications experienced by the mothers and newborns, produced the following outcomes: All subjects perceived the experience as a negative one, 20 of the 26 subjects experienced a total of 72 complications, and four of the 26 newborns experienced complications requiring hospitalization in newborn intensive care units.

Psychophysical tuning curves independent of signal level.

Psychophysical tuning curves were obtained for three subjects in a forward masking paradigm, with signal levels of 21, 30, and 50 dB SPL at 1000 Hz and 30, 40, and 50 dB SPL with a 3000-Hz signal. All tuning curves were measured in quiet and with a background noise adjusted to produce a constant signal-to-noise ratio of E/N0 = 16 dB. The results indicated that the tuning curves obtained in quite change shape with increasing signal level, whereas the shapes of tuning curves measured in noise are the same at all signal levels.