Characteristics and correlates of effective and ineffective social supports

The paper examines cohorts of individuals with helpful and unhelpful social supports identified in a longitudinal study of stressful events, social supports and health. Specific features of the quantity and quality of social relationships leading to help and support are examined.

Individuals with helpful social supports describe their social networks as smaller and appear to derive support primarily from spouse and close family relationships. No significant differences in the number of multiplex and reciprocal relationships were found.

Subjects reporting the least helpful social supports also reported significantly more stressful events in the past five years and significantly more childhood events.     

Epidemiology of traumatic cardiac arrest in patients presenting to emergency department at a level 1 trauma center

Introduction:There is a paucity of literature on prehospital care and epidemiology of traumatic cardiac arrest (TCA) in India. This study highlights the profile and characteristics of TCA.Methods:A retrospective cohort study was conducted to study epidemiological profile of TCA patients ≥1 year presenting to a level 1 trauma center of India.Results:One thousand sixty-one patients were recruited in the study. The median age (interquartile range) was 32 (23–45) years (male:female ratio of 5.9:1). Asystole (253), pulseless electrical activity (11), ventricular fibrillation (six), and ventricular tachycardia (five) were initial arrest rhythm. Road traffic crash (RTC) (57.16%), fall from height (18.52%), and assault (10.51%) were modes of injury. Prehospital care was provided by police (36.59%), ambulance (10.54%), relatives (45.40%), and bystanders (7.47% cases). Return of spontaneous circulation was seen in 69 patients, of which only three survived to hospital discharge.Conclusion:RTC in young males was a major cause of TCA. Asystole was the most common arrest rhythm. Police personnel were major prehospital service provider. Prehospital care needs improvement including the development of robust TCA registry.Key words: Cardiopulmonary resuscitation, emergency department, road traffic crash, traumatic cardiac arrest     

Clinical Profile of Scrub Typhus in Pregnancy in Sub-Himalayan Region

Background

Scrub typhus is rare in pregnancy, but it has now become an important cause of febrile illness in pregnancy in sub-Himalayan region of India. Only a few case reports have been published so far, and they show adverse maternal and fetal outcomes. No consensus has been reached till now regarding treatment.

Methodology

All the pregnant patients irrespective of period of gestation admitted with febrile illness with positive IgM ELISA for scrub typhus with or without eschar were included. The clinical profile was observed using a detailed history of symptoms, travel, recreation, agricultural activities, treatment record prior to admission, and a detailed examination, and the treatment outcome was noted. Fever workup including cultures, CXR, CSF analysis, serology for scrub was done. IgM scrub typhus was done by kit method manufactured by InBios Intertational, Inc.

Results

We observed in total 14 pregnant patients out of which eight were in the the second trimester and six were in the third trimester. The clinical features of the disease observed for pregnant females were the same as for nonpregnant females. There was no difference in the severity of scrub typhus between pregnant and nonpregnant women. No mortality was found in these patients. On follow-up, they had normal peripartum and postpartum periods. All were treated with azithromycin 500 mg once a day for 5 days.

Conclusion

Although rare, scrub typhus should be considered in differential diagnosis of fever in pregnant patients especially in scrub season. Azithromycin should be the drug of choice in pregnancy as it has no adverse effect on fetus and pregnancy outcome.

     

Periorbital Hyperpigmentation: A Comprehensive Review

Periorbital hyperpigmentation is a commonly encountered condition. There is very little scientific data available on the clinical profile and pathogenesis of periorbital hyperpigmentation. Periorbital hyperpigmentation is caused by various exogenous and endogenous factors. The causative factors include genetic or heredity, excessive pigmentation, postinflammatory hyperpigmentation secondary to atopic and allergic contact dermatitis, periorbital edema, excessive vascularity, shadowing due to skin laxity and tear trough associated with aging. There are a number of treatment options available for periorbital hyperpigmentation. Among the available alternatives to treat dark circles are topical depigmenting agents, such as hydroquinone, kojic acid, azelaic acid, and topical retinoic acid, and physical therapies, such as chemical peels, surgical corrections, and laser therapy, most of which are tried scientifically for melasma, another common condition of hyperpigmentation that occurs on the face. The aim of treatment should be to identify and treat the primary cause of hyperpigmentation as well as its contributing factors.     

Dermal Drug Delivery for Cutaneous Malignancies: Literature at a Glance

Purpose

Cutaneous malignancies are the most common human cancers, and despite growing public awareness of the harmful effects of sun exposure, incidence and morbidity continue to rise which has generated great interest in unravelling of their aetiology and in the search for new non-invasive treatment strategies.

Methods

A yearly increase in incidence of cutaneous malignancies has been reported since a long time worldwide, suggesting that prevalence of this cancer will soon equal that of all other cancers combined. Grouping of various skin lesions and malignancies under a common umbrella term poses challenges because clear differences exist in their aetiopathogenesis, clinical course and management strategies, suggesting the need of the novel and future therapeutic perspectives for the treatment from nanotechnology to immunotherapy.

Results

Moreover, treatment modalities should comprised of gold standards of the current recommended therapies worldwide and the actual needs of these patients.

Conclusion

The overall goal of this review was to explore the approaches for cutaneous malignancies’ new technological methods instead of new molecules.

     

Biodistribution and Efficacy of Low Temperature-Sensitive Liposome Encapsulated Docetaxel Combined with Mild Hyperthermia in a Mouse Model of Prostate Cancer

Purpose

Low temperature sensitive liposome (LTSL) encapsulated docetaxel were combined with mild hyperthermia (40–42°C) to investigate in vivo biodistribution and efficacy against a castrate resistant prostate cancer.

Method

Female athymic nude mice with human prostate PC-3 M-luciferase cells grown subcutaneously into the right hind leg were randomized into six groups: saline (+/? heat), free docetaxel (+/? heat), and LTSL docetaxel (+/? heat). Treatment (15 mg docetaxel/kg) was administered via tail vein once tumors reached a size of 200-300 mm³. Mice tumor volumes and body weights were recorded for up to 60 days. Docetaxel concentrations of harvested tumor and organ/tissue homogenates were determined by LC-MS. Histological evaluation (Mean vessel density, Ki67 proliferation, Caspase-3 apoptosis) of saline, free Docetaxel and LTSL docetaxel (+/? heat n?=?3–5) was performed to determine molecular mechanism responsible for tumor cell killing.

Result

LTSL/heat resulted in significantly higher tumor docetaxel concentrations (4.7-fold greater compared to free docetaxel). Adding heat to LTSL Docetaxel or free docetaxel treatment resulted in significantly greater survival and growth delay compared to other treatments (p?<?0.05). Differences in body weight between all Docetaxel treatments were not reduced by >10% and were not statistically different from each other. Molecular markers such as caspase-3 were upregulated, and Ki67 expression was significantly decreased in the chemo-hyperthermia group. Vessel density was similar post treatment, but the heated group had reduced vessel area, suggesting thermal enhancement in efficacy by reduction in functional perfusion.

Conclusion

This technique of hyperthermia sensitization and enhanced docetaxel delivery has potential for clinical translation for prostate cancer treatment.