Trace metal partitioning in Thalassia testudinum and sediments in the Lower Laguna Madre, Texas.

Seagrass communities dominate the Laguna Madre, which accounts for 25% of the coastal region of Texas. Seagrasses are essential to the health of the Laguna Madre (LM) and have experienced an overall decline in coverage in the Lower Laguna Madre (LLM) since 1967. Little is known on the existing environmental status of the LLM.

Vasodilatation vs. immunotherapy to prevent delayed graft function: delayed graft function as an indication of immune activation.

Delayed renal allograft function (DGF) is a factor for acute rejection and chronic allograft nephropathy. Cold ischemia time (CIT) is associated with an increased in DGF. Twenty patients receiving allografts with CIT>12 were enrolled in a double-blinded, randomized (1:1), placebo-controlled study to assess vasodilatation with fenoldopam (Abbott; dopamine-1 receptor agonist) on DGF.

American Society of Clinical Oncology technology assessment on the use of aromatase inhibitors as adjuvant therapy for postmenopausal women with hormone receptor-positive breast cancer: status report 2004.

Purpose: To update the 2003 American Society of Clinical Oncology technology assessment on adjuvant use of aromatase inhibitors.

Recommendations: Based on results from multiple large randomized trials, adjuvant therapy for postmenopausal women with hormone receptor-positive breast cancer should include an aromatase inhibitor in order to lower the risk of tumor recurrence. Neither the optimal timing nor duration of aromatase inhibitor therapy is established.

Self-reported use of shared decision-making among breast cancer specialists and perceived barriers and facilitators to implementing this approach.

Background: Physicians are increasingly urged to practice shared decision-making with their patients. Using a cross-sectional survey, we explored the extent to which Ontario breast cancer specialists report practising shared decision-making with their patients, their comfort level with this approach, and perceived barriers and facilitators to implementation.

Participants And Methods: All Ontario surgeons and oncologists (radiation and medical) treating women with early-stage breast cancer were eligible for this study.

Why cancer patients enter randomized clinical trials: exploring the factors that influence their decision.

Purpose: Few interventions have been designed and tested to improve recruitment to clinical trials in oncology. The multiple factors influencing patients' decisions have made the prioritization of specific interventions challenging. The present study was undertaken to identify the independent predictors of a cancer patient's decision to enter a randomized clinical trial.

Radiotherapy fractionation for the palliation of uncomplicated painful bone metastases - an evidence-based practice guideline.

Background: This practice guideline was developed to provide recommendations to clinicians in Ontario on the preferred standard radiotherapy fractionation schedule for the treatment of painful bone metastases.

Methods: A systematic review and meta-analysis was performed and published elsewhere. The Supportive Care Guidelines Group, a multidisciplinary guideline development panel, formulated clinical recommendations based on their interpretation of the evidence.

Job stress and job satisfaction of cancer care workers.

Background: There is an increasing demand for oncology care as a result of a number of trends. In combination with ongoing changes to the health-care system, these trends have an impact on the workplace environment of systemic therapy personnel.

Methods: A postal survey was sent to major providers of tertiary systemic therapy services in Ontario.

Towards improving the co-ordination of supportive cancer care services in the community.

In this paper an evaluation approach to assess the co-ordination of supportive community cancer care is presented. The aim of the study was to identify current gaps in co-ordination of services in a selected region in the province of Ontario, Canada, determine how consistent these gaps were across the province of Ontario, and develop service design considerations for improving the co-ordination of supportive cancer care services in the province of Ontario. The study addressed services required by two populations -clients who had been recently diagnosed and those in the palliative stages of cancer.

Effect of a decision aid on knowledge and treatment decision making for breast cancer surgery: a randomized trial.

Context: The long-term results of randomized trials have demonstrated equivalent survival rates for mastectomy and breast-conserving therapy for the treatment of early stage breast cancer. Consequently, the choice of treatment should be based on a patient's preferences.

Objective: To evaluate the impact of a decision aid regarding the different surgical treatment options on patient decision making.

The difference between study recommendations, stated policy, and actual practice in a clinical trial.

Background: We determined whether physicians involved in a clinical trial adhere to the study recommendations or the stated policy of their treatment centre with respect to the administration of boost radiation after breast conserving surgery.

Patients And Methods: Boost radiation treatment policy was determined by survey at 25 oncology centres involved in a randomised trial of breast or breast plus nodal radiation in Canada. Actual practice was compared with stated policy and study recommendations.

Invasive pneumococcal infections in adult lung transplant recipients.

An increased risk of invasive pneumococcal infection (IPI) has been described among kidney or heart transplant recipients, but the epidemiology of IPI among lung transplant recipients has not been previously reported. We undertook a single center, retrospective cohort study to define the incidence, timing, clinical, and microbiologic features of IPI in lung transplant patients. Fourteen out of 220 recipients (6.

Accuracy of ultrasound in localization of breast boost field.

Background And Purpose: To prospectively compare diagnostic ultrasound to the 'gold standard' of surgical clips for localization of the lumpectomy site for electron boost irradiation.

Patients And Methods: Consecutive breast cancer patients referred following lumpectomy underwent diagnostic ultrasound in radiation treatment position 21-100 days post-surgery. All patients had 3-6 surgical clips defining the excision cavity.

Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers.

Background: The vital role played by family caregivers in supporting dying cancer patients is well recognized, but the burden and economic impact on caregivers is poorly understood. We prospectively examined the psychosocial, occupational and economic impact of caring for a person with a terminal illness.

Methods: We studied 89 caregivers of women with advanced breast cancer receiving care at either the Ottawa or Hamilton regional cancer centres in Ontario.

Clinical practice guidelines for the care and treatment of breast cancer: 16. Locoregional post-mastectomy radiotherapy.

Objective: To provide information and recommendations to assist women with breast cancer and their physicians in making decisions regarding the use of locoregional post-mastectomy radiotherapy (PMRT).

Outcomes: Locoregional control, disease-free survival, overall survival and treatment-related toxicities.

Evidence: This guideline is based on a review of all meta-analyses, consensus statements and other guidelines published between 1966 and November 2002.

Clinical practice guidelines for the care and treatment of breast cancer: 15. Treatment for women with stage III or locally advanced breast cancer.

Objective: To define the optimal treatment for women with stage III or locally advanced breast cancer (LABC).

Evidence: Systematic review of English-language literature retrieved from MEDLINE (1984 to June 2002) and CANCERLIT (1983 to June 2002). A nonsystematic review of the literature was continued through December 2003.

Workshop on partial breast irradiation: state of the art and the science, Bethesda, MD, December 8-10, 2002.

Breast conserving surgery followed by radiation therapy has been accepted as an alternative to mastectomy in the management of patients with early-stage breast cancer. Over the past decade there has been increasing interest in a variety of radiation techniques designed to treat only the portion of the breast deemed to be at high risk for local recurrence (partial-breast irradiation [PBI]) and to shorten the duration of treatment (accelerated partial-breast irradiation [APBI]). To consider issues regarding the equivalency of the various radiation therapy approaches and to address future needs for research, quality assurance, and training, the National Cancer Institute, Division of Cancer Treatment and Diagnosis, Radiation Research Program, hosted a Workshop on PBI in December 2002.

A consensus development approach to define national research priorities in bone metastases: proceedings from NCIC CTG workshop.

Aims: A 1-day workshop was conducted to gather interested Canadian radiation oncologists to identify priority research questions that could be answered through clinical trials under the auspices of the National Cancer Institute of Canada--Clinical Trials Group (NCIC-CTG) Symptom Control committee.

Materials And Methods: In preparation for the workshop, a survey of Canadian radiation oncologists resulted in four research areas in symptom control, including radiation-induced mucosal reactions, fatigue, radiotherapy for brain metastases and radiotherapy for bone metastases. The first half of the workshop consisted of plenary sessions where the research setting and perspective was defined for each area.

High-sensitivity photoacoustic leak testing.

The photoacoustic effect may be exploited for the detection and localization of gas leaks from otherwise sealed components. The technique involves filling the test component with a tracer gas, and radiating the component to produce photoacoustic sound from any leak site where tracer gas is present. This paper describes demonstration experiments utilizing 10.

Offering a choice between two adjuvant chemotherapy regimens: a pilot study to develop a decision aid for women with breast cancer.

Background: The primary objective of this study was to develop a decision aid which would encourage and assist patients to become involved in treatment decision making, and help clinicians to objectively educate patients about the benefits and risks of adjuvant chemotherapy for breast cancer. A secondary objective was to investigate the factors influencing this treatment decision-making process for women when choosing between adriamycin and cyclophosphamide (AC) versus cyclophosphamide, methotrexate and 5-fluorouracil (CMF) chemotherapy.

Methods: An educational visual instrument called a Decision Board was developed consisting of written and graphical material.

The Initial Health Assessment: an intervention to identify the supportive care needs of cancer patients.

Background: The first step in effective supportive care delivery is an assessment of patient needs. The Initial Health Assessment Form (IHA) was developed to aid clinicians in recognition and documentation of a patient's supportive care needs during their first visit to a comprehensive cancer centre. The purpose of this study was to determine the relative effectiveness of this instrument as compared to routine practice.

A Phase I-II study in the use of acupuncture-like transcutaneous nerve stimulation in the treatment of radiation-induced xerostomia in head-and-neck cancer patients treated with radical radiotherapy.

Purpose: Recent studies have suggested that acupuncture may improve radiation-induced xerostomia with an increase in the median salivary flow rate and sustained symptom relief. An acupuncture-like transcutaneous nerve stimulation method (Codetron) without invasive needles was developed to mimic acupuncture treatment. This Phase I-II study examined the effectiveness of Codetron in treating radiation-induced xerostomia.