bluuebunny/crossref_metadata_2025_split huggingface dataset:
Helicobacter pylori: the challenge in therapy
Authors: Bazzoli Franco , Pozzato Paolo , Rokkas Theodore 
Published: March 2003

AbstractFor the therapeutic management of Helicobacter pylori infection, the Maastricht 2–2000 Consensus Report have introduced the concept of the ‘treatment package’ that considers first‐ and second‐line eradication therapies together. According to this consensus statement, the first‐line therapy for H. pylori eradication is a combination of the proton pump inhibitors (PPI) or ranitidine bismuth citrate (RBC) and claritromycin plus either amoxicillin or metronidazole. The second‐line treatment is suggested to be PPI‐quadruple therapy for a minimum of 7 days. If bismuth compounds are not available, PPI‐based triple therapy will have to be used as a second‐line treatment only after susceptibility testing. Since no considerable progress has been made during the past year in treatment regimens, there is still a need for new compounds that are specific for H. pylori, which could constitute future therapies.
Improving Pain Relief in a Rural Cancer Center
Authors: Baltic Tammy E. , Whedon Marie Bakitas , Ahles Tim A. , Fanciullo Gilbert 
Published: March 2003

purpose: The purpose of this article is to describe barriers to cancer pain management and strategies for making improvements in an academic rural cancer center.overview: Rural communities pose unique challenges to cancer pain management because of their unique strengths and burdens. Successful strategies used by a comprehensive cancer center to improve pain management in rural New England are summarized.clinical implications Improving cancer pain management in a rural setting required a recognition of the contrasting characteristics between a sophisticated academic medical center and a rural community. The successful implementation of quality improvement strategies required a combination of leadership support, internal and external funding, and professional and federal recognition of the problem. Using a quality improvement approach rather than a traditional didactic approach, and fostering communication, trust, and collegiality at our outreach sites were pivotal to our success.
Knowledge and Practices Among Korean Americans
Authors: Kim Katherine , Yu Elena S. H. , Chen Edwin H. , Kim JaeKyung , Brintnall Ruth Ann 
Published: March 2003

purpose
: The purpose of this study was to examine knowledge and practices of colorectal cancer screening among Korean Americans. description of study: The sample consisted of 104 Korean American men and 159 women, 40 to 69 years of age, living in the Chicago area. The National Health Interview Survey (NHIS) Cancer Control Supplement Questionnaire, prepared by the National Center for Health Statistics, was used to collect data regarding colorectal cancer screening knowledge and practices. The NHIS questionnaire was translated into Korean with minor modification.
results
: The percentages of male respondents ever having had a digital rectal exam (DRE) and fecal occult blood test (FOBT) were 13.5% and 10.6%, respectively. Only 11.3% of women reported DRE and 8. 8% FOBT. Multiple logistic regression analysis results indicate that gender, education, knowledge of the seven cancer warning signals, and length of residence in the United States were significantly related to having heard of DRE. For those having had DRE, knowledge of the seven cancer warning signals, and length of residence in the United States were the only significant variables. Gender and education were significantly related to having heard of FOBT. None of the variables were found to be significantly related to having had FOBT. The findings indicate that a majority of respondents were unaware of these cancer screening examinations and forego these tests due to an underestimation of their importance.
clinical implications
: The findings of this study underscore the importance of cancer education and further research addressing the cancer screening needs of Korean Americans. Currently, Korean Americans do not see healthcare providers or health brochures as valuable sources of health information. Therefore, healthcare professionals need to target this population by 1) co‐ordinating their efforts with church and other community leaders and 2) developing health brochures that are in the Korean language and sensitive to the Korean culture.
Cost Considerations as Potential Barriers to Cancer Treatment
Authors: Guidry Jeffrey J. , Aday Lu Ann , Zhang Dong , Winn Rodger J. 
Published: March 2003

purpose
: An analytical cross‐sectional survey was conducted to determine the prevalence of barriers to cancer treatment in Texas as perceived by diagnosed cancer patients. Results reported here address the role of insurance coverage, indirect costs (transportation, lodging, and work days lost), and direct costs of care as barriers to treatment for white, black, and Hispanic cancer patients. Specific objectives of the analyses undertaken here are to examine 1) racial/ethnic differences in insurance coverage; 2) barriers relating to insurance coverage experienced by cancer patients; and 3) role of treatment‐related costs as barriers to cancer treatment.
description of study
: A mail questionnaire was developed to assess the perceived barriers to cancer treatment in Texas for adult cancer patients, 17 years and older, who had been diagnosed with breast, colon, cervical, prostate, or lymphoma during the period of 1989 to 1993. The sampling frame for this study was obtained from a network of cancer treatment facilities throughout the state of Texas within the University of Texas M.D. Anderson Cancer Center Texas Community Oncology Network. A total of 593 cancer patients returned their surveys, yielding a 65.2% response rate. Weighting adjustments were then made to correct for differential sampling and response rates by racial groupings and type of cancer. All of the analyses used adjusted weights.
results
: The findings document the financial considerations (insurance, direct and indirect costs) as they relate to barriers to cancer treatment. Specific insurance premium‐related barriers with regard to maintaining and affording coverage were more prevalent for blacks. Hispanics were less likely to have insurance coverage; however, more blacks reported being denied insurance coverage when they changed jobs compared with whites and Hispanics. Minorities, particularly Hispanics, were more likely to have experienced cost‐related barriers associated with medications, diagnostic tests, and hospitalizations. In addition, Hispanics experienced significant out‐of‐pocket costs in paying for cancer treatment.
clinical implications
: This research shows the need for staff at cancer treatment facilities to be aware that there are nonclinical, financial factors that are important considerations in the treatment of cancer patients. Assessment of cancer patients during the diagnostic and treatment stages, possibly through case management, will provide information on potential barriers to treatment for individual patients. Hospital programs that reimburse out‐of‐pocket costs, transportation costs to obtain services, and lodging accommodations may be available. Additional services may be offered through cancer advocacy groups, such as the American Cancer Society and the National Coalition for Cancer Survivors, to assist patients with managing costs and overcoming barriers to care.
Factors Hindering Patients' Use of Medications for Cancer Pain Factors Hindering Patients' Use of Medications for Cancer Pain
Authors: Ersek Mary , Miller Kraybill Beth , Du Pen Anna 
Published: March 2003

objectives: The purpose of this study was to explore the reasons that cancer patients with pain find it difficult to adhere to analgesic therapy.materials and methods: Twenty‐one patients with advanced cancer with pain were interviewed using a semistructured schedule of questions. Participants were asked to describe their decision making regarding analgesics and the factors that made it difficult for them to take analgesics prescribed for their pain. They also were asked to describe their relationships with their healthcare providers. Themes were identified and refined using qualitative analytic techniques. Two investigators independently coded all data to ensure that findings accurately reflected participants' experiences.results: Findings reveal several factors that hindered analgesic use and the specific ways in which patients evaluated these factors in making decisions about taking pain medication. The provider‐patient factors that impeded analgesic use also were described. Finally, the common use of nonpharmacologic methods of pain control offers insight into the role of these therapeutic strategies in achieving pain relief and decreasing analgesic use.conclusions: The findings underscore the importance of early intervention to address barriers to analgesic use. Some barriers may be overcome through educational efforts. The findings suggest, however, that consistent, repeated patient education often may not be sufficient to subdue patients' negative thoughts about taking the medication. Other approaches, such as changing medications or assisting the patient to use nonpharmacologic pain strategies, may prove more successful.
Body Image and Quality of Life After Head and Neck Cancer Surgery
Authors: Dropkin Mary jo 
Published: March 2003

objectives: The purpose of this paper is to describe the process of body image reintegration as it relates to quality of life in the surgical head and neck cancer patient.materials and methods: To illustrate the course of body image reintegration after head and neck cancer surgery, the results of two major studies are presented. In the first study, a cohort sample of 75 adults about to undergo disfigurative surgery for head and neck cancer was examined to determine levels of anxiety before and after the procedure. The State Trait Anxiety Inventory was administered before and after surgery on postoperative days 4 through 6. In the large study, from which the cohort sample was derived, 117 adults about to undergo disfigurative surgery were investigated to determine the relationship between coping with surgical disfigurement/dysfunction and length of hospital stay. The Ways of Coping Checklist was administered before surgery. Disfigurement/dysfunction, as measured by the Disfigurement/Dysfunction Scale, and postoperative coping behaviors, as measured by the Coping Behaviors Score, were accounted for in both samples. Self‐care and resocialization behaviors were observed and measured on postoperative days 4 through 6.results: In the cohort study, anticipation of disfigurative facial surgery was associated with extremely high levels of anxiety. In the large sample, coping effectiveness was diminished. The degree of surgical deficit ranged from mild to severe disfigurement and dysfunction. Preoperative coping effectiveness predicted postoperative coping behavior. It was concluded that body image reintegration was characterized by self‐care, resocialization, and reduced anxiety. Further, that these components, when taken together, constitute assimilation of the surgical defect into self.conclusions: Body image reintegration is critical to subsequent quality of life after head and neck cancer surgery. When disfigurement/dysfunction is associated with treatment, quality of life may be profoundly and adversely affected. Findings from the studies presented indicate a significant correlation between postoperative self‐care and reduction in level of anxiety. The implications of this finding are important to care during the early period after surgery and to long‐term follow‐up after hospital discharge.
Cognition and The Cancer Experience
Authors: Foster Larry W. , McLellan Linda 
Published: March 2003

Objectives: The authors demonstrate the application of cognitive therapy in oncology care by presenting a brief review of theory and relevant case studies.Materials and methods: In light of the life and death nature of the fears evoked by cancer, it is important for the oncology clinician to recognize the role that cognition plays in patient responses to the diagnosis and treatment of cancer. After presentation of a theory base that creatively links cognition and the cancer experience, key cognitive concepts are defined and discussed. Case material illustrates the application of these concepts and how oncology clinicians can use select interventions adapted from the brief mental health treatment modality of cognitive therapy to promote adjustment to cancer.Results: Patient and family views about cancer have emotional and behavioral consequences, influence ability to cope with diagnosis and treatment, and serve to focus clinical intervention. Cognitive interventions can help patients and families think about cancer in objective, adaptive ways. Focusing on perceptions and questions of meaning, clinicians can be effective using cognitive lines of questioning that expand patient stories and elicit beliefs about cause, control, and responsibility for their cancer.Conclusions: Cognitive interventions are brief and solution‐focused interventions that acknowledge and build on generalist interviewing skills common to each discipline. As such, they are particularly useful in physical health settings where work is fast paced and clinicians are faced with the challenge of dealing in a collaborative manner with patient and family coping responses as they apply to the medical problem and care plan.
Caregiver Responses and Needs
Authors: Grimm Patricia M. , Zawacki Kristin L. , Mock Victoria , Krumm Sharon , Frink Barbara B. 
Published: March 2003

Purpose: This longitudinal, descriptive outcomes study was conducted to compare the emotional responses and needs of the caregivers of patients who undergo bone marrow transplantation (BMT) for hematologic malignancies, as observed in an inpatient/outpatient (IPOP) setting with those in an inpatient setting.Description of study: A convenience sample of 43 caregivers for patients undergoing either autologous or allogeneic BMT was selected from both the inpatient unit (n = 26) and the IPOP ambulatory setting (n = 17). Emotional responses were measured by the Profile of Mood States. The importance and satisfaction of informational, patient‐care, and psychological needs were assessed with the Caregiver Needs Survey, a modified version of the Home Cancer Caregiver Needs Survey. Data were collected at six points across the BMT trajectory, from before the procedure to 12 months after. Descriptive statistics were used to report sample characteristics, emotional responses, and needs. Nonparametric statistics were used to compare the IPOP and inpatient caregiver groups, and to identify relationships between emotional responses and needs within groups.Results: IPOP caregivers were found to have significantly less mood disturbance at points before discharge. Both groups showed a decrease in mood disturbance 6 and 12 months after BMT. IPOP caregivers had higher levels of satisfaction of their informational and psychological needs at day 21. Significant correlations between total mood disturbance and satisfaction of informational, psychological, and patient‐care needs were found for inpatient caregivers across treatment time points.Clinical implications: These findings support the IPOP model of care as being less emotionally distressing for and better meeting the needs of family caregivers. Specific implications for practice include the importance of caregiver education in the area of patient‐care information and of assessment and intervention to meet caregiver psychological needs. Continued evaluation of the impact of changes in care delivery on family caregivers is essential for the provision of comprehensive cancer care.
Monoclonal Antibody Therapy for Lymphoma
Authors: Dillman Robert O. 
Published: March 2003

Purpose: The purpose of this article is to review the historical development and recent advances in the application of monoclonal antibodies for the treatment of lymphoma.Overview: The history of clinical applications of monoclonal antibodies has been intertwined with that of lymphomas. The first report of a complete remission in 1981 described a patient with follicular lymphoma who was treated with a murine anti‐idiotype antibody. Later that decade there appeared additional encouraging reports of radiolabeled monoclonal antibodies, immunotoxins, and other antibodies with antitumor effects against lymphoma and chronic lymphocytic leukemia. Monoclonal antibodies as a treatment of malignancy became reality in late 1997 when the US Food and Drug Administration approved the anti‐CD20 chimeric monoclonal antibody rituximab for the treatment of B‐cell lymphoma. Since that time an anti‐CD25 monoclonal antibody (dacliximab) and an anti‐CD25 immunotoxin fusion product (denileukin diftitox) have become clinically available. Several radio‐ labeled antibodies, including the murine anti‐CD20 products 131I‐tositumomab and 90Y‐ibritumomab tiuxetan, are in advanced stages of clinical testing as are other unlabeled monoclonal antibodies with antilymphoma activity. Other antilymphoma immunotoxins that react with CD25, CD19, and CD22 also have shown promise.Clinical implications: The therapeutic arsenal against lymphoma has been significantly changed by the addition of these antibody products that are active as single agents, and are synergistic, additive, or both with other antilymphoma treatments.
Identifying Support Issues of Parents of Children with Leukemia
Authors: McGrath Pam 
Published: March 2003

Purpose: One of the important factors in helping both children with acute lymphoblastic leukemia (ALL) and their family members during the difficult treatment period is the support they receive. However, there is a scarcity of research that examines the adaptation to such an experience from the family's perspective. This discussion presents the findings from recent research on accessing support from the perspective of parents with a child undergoing treatment for ALL.Description of study: A longitudinal, qualitative study informed by a phenomenological methodology. The results are taken from parent interviews undertaken during the time period from the end of induction‐remission to the end of the 5‐week period (time period T1), collected over the first year of operation of the study.Results: The need for support was reported as intense, and offers of support tend to lessen over time. Among the sources of support noted were partners, family, friends, employers, hospital staff, and other parents in the same situation. However, community resources appeared to be lacking, underused, or both.Clinical implications: Suggestions for support include the provision of practical assistance through appropriately trained volunteers, the involvement of a liaison person to mentor families through the initial stages of treatment, development of parent support groups, and the opportunity for families to meet children who are successfully off treatment. Such support strategies involve sensitivity to particularly vulnerable families who have limited support available and respectfulness of the variation in individual styles of accessing support.
Telephone‐Linked Care for Cancer Symptom Monitoring
Authors: Mooney Kathi H. , Beck Susan L. , Friedman Robert H. , Farzanfar Ramesh 
Published: March 2003

purpose: The purpose of this pilot project was to explore the feasibility of using a telephone‐based computerized system to monitor postchemotherapy symptoms and to test the mechanism of generating alert communications to healthcare providers about symptoms that are poorly controlled.description of study: Twenty‐seven patients with cancer participated in the study by calling the telephone‐linked care (TLC) system daily during a single cycle of chemotherapy and reporting on seven common chemotherapy‐related symptoms. Using selected symptom data, symptoms that met a preset threshold for severity generated a fax notification of the patient's symptom pattern to the physician. Patients then were interviewed about their satisfaction with TLC and about suggestions for improvement.results: The study demonstrated that TLC is easy to learn and use and that it captures daily symptom information from patients in their homes. A majority of patients experienced symptoms that were severe enough to generate symptom‐alert faxes. Patient satisfaction with TLC was high. The technique, TLC voice, and the duration of the calls were acceptable to patients. There were few technical problems.clinical implications: The TLC system has the potential to improve dramatically symptom monitoring and symptom care of patients with cancer at home. Further testing is needed, but the TLC chemotherapy monitoring application shows promise for improving supportive‐care service delivery for cancer patients. In its initial test, the TLC chemotherapy monitoring application has been shown to be highly acceptable to patients, able to generate useful symptom data, and able to generate faxed alerts to healthcare providers, thus improving communication about poorly controlled symptoms.
Lixelle Adsorbent to Remove Inflammatory Cytokines
Authors: Tsuchida Kenji , Takemoto Yoshiaki , Nakamura Takahiro , Fu Ontaku , Okada Chikako , Yamagami Seiji , Kishimoto Taketoshi 
Published: March 2003

It is the goal of this section to publish material that provides information regarding specific issues, aspects of artificial organ application, approach, philosophy, suggestions, and/or thoughts for the future.A β2‐microglobulin (β2M) selective adsorbent (Lixelle) for direct hemoperfusion has been used for the treatment of hemodialysis patients with the long‐term complication of dialysis related amyloidosis (DRA), but there is no significant correlation between the serum level of β2M and the occurrence of DRA. Inflammatory cytokines such as interleukin (IL)‐1, IL‐6, and tumor necrosis factor alpha (TNFα) are related to the development of DRA. We studied the adsorptive rates of cytokines in vitro using the Lixelle adsorbent. The adsorptive rates were 98. 5% for IL‐1β, 98.0% for interleukin‐1 receptor antagonist (IL‐1RA), 82.9% for IL‐6, 99.9% for IL‐8, 31.2% for TNF α, and 46.1% for soluble TNF receptor (sTNFr), respectively. As the molecular weights of cytokines increase, the adsorptive rates decrease. The Lixelle column adsorbed β2M and various inflammatory cytokines as well. Therefore, the removal of both β2M and inflammatory cytokines may play an important role in the treatment of DRA.
Outdoor Pollution and Headache
Authors: Nattero Giovanni , Enrico Annalisa 
Published: March 2003

The aim of this study was to clarify a possible relationship between pollution and worsening of headache in the industrial city of Turin.October 1992 to June 1993, we examined a group of 32 patients suffering from various headache types. During these months, they kept a daily record of their headaches and associated isturbances. Changes in pain frequency and severity were recorded every hour of the day and compared hour to hour with the various degrees of pollution recorded in the main streets by a monitoring station. The influence of meteorological parameters was also taken into consideration.During winter, carbon monoxide and nitrogen dioxide showed a simultaneous hyperconcentration on the same days and the same hours. Increased incidence of headache attacks and increase in severity corresponded to the same hours, days, and months. The findings were statistically significant (P=0.008, Student's t‐test). An isolated increase in nitrogen dioxide only (without an increase in carbon monoxide which was only recorded once) induced headache a couple of hours after the peak concentration was reached.Among the meteorological factors, only the highest values in wind velocity were shown to exert a significant influence on worsening headache frequency and severity.