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Palliative Performance Scale (PPS) scores have shown potential for prognosticating survival in Caucasian samples, but have not been studied for prognostic value in cancer patients from minority groups. Using data obtained from a retrospective chart audit of 492 cancer patients admitted over an 18-month period to a minority-serving home-based hospice and palliative care program, we examined the relationship between PPS scores and length of survival (survival days). Patients with PPS scores of 10% to 30% had fewer survival days than those with scores of 40% and those with scores of 50% to 100% (median = 6, 19, and 34 days, respectively; F = 25.02, P < 0.001). A PPS score of 40% serves as a reliable inclusion criterion for a study requiring two weeks for completion, while 50% to 100% is required for a three-week study. Findings from a predominantly minority sample are similar to those from predominantly Caucasian samples. KeywordsPalliative Performance Scale; prognostication; survival; minorities; hospice; palliative carePrognosticating the length of time that a person with terminal cancer will survive is important for implementing feasible research studies that will have generalizable findings and contribute to effective end-of-life care (1,2). Unfortunately, predicting survival is not easy (3), even after admission to hospice or palliative care programs. Palliative Performance Scale (PPS) scores have shown potential for prognosticating survival in predominately Caucasian samples, but have not been studied for prognostic value in cancer patients from racial and ethnic minority groups. From an instrument validity perspective, it is important to establish that the PPS prognosticates survival in racial and ethnic minority groups as well as it does for racial majority groups, but previous research studies included few cancer patients from racial and ethnic minority groups.Address correspondence to: Diana J. Wilkie, PhD, RN, FAAN, Department of Medical-Surgical Nursing (MC 802), College of Nursing, University of Illinois at Chicago, 845 South Damen Avenue, Room 660, Chicago, IL 60612-7350, USA, E-mail: E-mail: diwilkie@uic.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Although many cancer patients die soon after enrollment in hospice, the number of days they survive (survival days) varies greatly. Using Medicare data from 1990 with a sample of 6,451 patients, of whom 92% were Caucasian and 80% were diagnosed with cancer, investigators (4) found that the median survival after hospice enrollment was 36 days but that 16% of patients died within seven days and 15% liv...

Objective-Telomerase plays a major role in the control of replicative capacity, a critical property for successful angiogenesis and maintenance of endothelial integrity. In this study, we examined the relationship between telomerase activity and endothelial cell proliferation as well as the regulation of this enzyme by fibroblast growth factor-2 (FGF-2) and vascular endothelial growth factor-A (VEGF). Methods and Results-Telomerase was repressed in endothelial cells freshly derived from intact endothelium, whereas activity was present during logarithmic growth in culture. In cultured human umbilical vein endothelial cells (HUVECs), mRNA levels of hTERT-the catalytic subunit of telomerase-and enzyme activity decreased reversibly on induction of quiescence. Treatment of quiescent HUVECs with FGF-2 restored telomerase activity in a time-and dose-dependent manner, whereas VEGF had no such effect, although both factors induced comparable mitogenic responses. FGF-2, but not VEGF, upregulated the mRNA levels for hTERT and for the hTERT gene transactivation factor Sp1. Key Words: telomerase Ⅲ fibroblast growth factor-2 Ⅲ endothelial cell Ⅲ Sp1 Ⅲ senescence I nduction of angiogenesis is a novel therapeutic strategy presently being evaluated for the treatment of human ischemic vascular disease. The success of this strategy depends on an adequate proliferative response of vascular endothelial cells at the site of ischemia. 1 Cellular replicative potential is in part limited by the integrity of telomeres, the physical ends of chromosomal DNA. 2 Telomeric DNA shortens by Ϸ50 to 200 base pairs with each round of cell division as a consequence of the inability of conventional DNA polymerases to replicate the 3Ј termini of the template strands. A large body of evidence indicates that critical shortening of one or more telomeres activates a DNA damage checkpoint that blocks additional replication and leads to cell senescence. However, more recently, the integrity of the T-loop-a higher-order structure formed at the end of the telomere by telomeric DNA and specialized proteins-rather than telomere length, per se, has been implicated as a major determinant of senescence. 3,4 In many actively proliferating cells, maintenance of replicative capacity and chromosome stability requires the activity of telomerase, a specialized reverse-transcriptase that adds hexanucleotide repeats of the sequence TTAGGG to the 3Ј ends of nuclear DNA, thus counteracting telomeric erosion. 3 Studies in various immortalized cell lines 5 and normal human lymphocytes 6 have shown that like other enzymes involved in chromosomal DNA synthesis, 7 telomerase activity levels are differentially regulated during periods of proliferation and quiescence. Human telomerase consists of at least 3 subunits. Of these, the RNA component hTR, which provides the template for telomere synthesis, and the telomeraseassociated protein hTEP1 are constitutively expressed. 8,9 The third component, human telomerase reverse transcriptase (hTERT), which contains the catalytic activit...