An Exploratory Model of the Relationships Between Cancer-Related Trauma Outcomes on Quality of Life in Non-Hodgkin Lymphoma Survivors

Given that more than one third of some cohorts of cancer survivors exhibit post-traumatic stress disorder (PTSD) symptomatology, this study examines how trauma outcomes might relate to quality of life (QOL). Eight hundred thirty survivors of adult lymphoma were assessed for PTSD, post-traumatic growth (PTG) and QOL. Structural equation modeling revealed that QOL was best explained by the model in which stressors (e.g., co-morbidities) were mediated by PTSD and PTG. Trauma outcomes mediated the relationship between specific stressors and QOL. These findings support using PTSD and PTG as a diagnostic framework in understanding symptomatology in survivors.     

Clinical and microstructural aberrations of enamel of deciduous and permanent teeth in patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy

Objective

Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) causes multiple endocrine deficiencies, oral candidiasis and different forms of ectodermal dystrophy including enamel hypoplasia, documented in permanent teeth. Our purpose was to examine dental aberrations associated with APECED, including possible manifestations in primary teeth.

Design

We studied clinically, radiographically, and by scanning electron microscopy (SEM) teeth of children belonging to two APECED families with different mutations in the AIRE gene.

Results

In addition to enamel defects in the permanent teeth we observed hypoplastic pits and hypomaturated patches in the deciduous teeth with underlying changes in the prismatic ultrastructure. The enamel of the permanent molars exhibited a layered arrangement with included whirl-like formations.

Conclusions

Our findings confirm that APECED causes enamel defects that are individually but chronologically distributed, and can alter enamel development early enough to affect deciduous teeth.     

Clinical and microstructural aberrations of enamel of deciduous and permanent teeth in patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy

Objective

Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) causes multiple endocrine deficiencies, oral candidiasis and different forms of ectodermal dystrophy including enamel hypoplasia, documented in permanent teeth. Our purpose was to examine dental aberrations associated with APECED, including possible manifestations in primary teeth.

Design

We studied clinically, radiographically, and by scanning electron microscopy (SEM) teeth of children belonging to two APECED families with different mutations in the AIRE gene.

Results

In addition to enamel defects in the permanent teeth we observed hypoplastic pits and hypomaturated patches in the deciduous teeth with underlying changes in the prismatic ultrastructure. The enamel of the permanent molars exhibited a layered arrangement with included whirl-like formations.

Conclusions

Our findings confirm that APECED causes enamel defects that are individually but chronologically distributed, and can alter enamel development early enough to affect deciduous teeth.     

Phenotypic heterogeneity of hereditary diffuse gastric cancer: report of a family with early-onset disease

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车祸伤者创伤后成长状况及相关因素研究

目的：研究车祸伤者创伤后成长状况（PTG），并探讨其相关影响因素。方法选取2014年1月—2015年8月116例车祸幸存伤者，利用基础情况调查表及创伤后成长评定量表（PTGI）调查伤者的一般资料及创伤后成长状态，利用多元线性回归分析影响伤者创伤后成长的相关因素。结果116例车祸幸存伤者的创伤后成长总分为（85.55±13.69）分，性别、损伤程度、预计康复结局是其主要的影响因素，差异均有统计学意义（P<0.05）。结论车祸幸存伤者创伤后成长水平较好，不同类别患者评分不同，临床医护人员应针对不同类别伤者进行护理和心理干预，以促进伤者的信心重建和心理康复。     

中国自然灾害幸存者创伤后成长的质性研究——舟曲泥石流后对幸存者的访谈分析

目的:探讨舟曲泥石流幸存者创伤后成长特点,并比较其与西方幸存者表达的创伤后成长的差异.方法:以2010年8月7日舟曲泥石流灾区为例,运用目的性抽样的方法,对63名幸存者进行了个案访谈,收集了他们在灾难后感知到的创伤后成长相关资料.结果:中国自然灾害幸存者创伤后成长发生率高,其内容包含七个维度(积极信念、生活的积极改变和新的计划、利他行为、积极的自我感知、感激、珍惜和人际关系改善),其中利他行为维度未包括在Tedeschi和Calhoun提出的五因素模型中.结论:中国文化背景下创伤后成长有其独特之处,这与其对宗教的认同度和文化因素的差异有关.     

Factors that hinder post-traumatic growth: A systematic review

People who experience major life crises often report post-traumatic stress. However, the literature suggests that traumatic experiences can also be “catalysts” for positive change (i.e., post-traumatic growth; PTG). PTG can include improved relationships, new possibilities for one's life, a greater appreciation for life, a greater sense of personal strength, and spiritual development. Furthermore, it has been suggested that PTG may decrease feelings of distress following exposure to trauma. While a large number of factors may help promote PTG, others may impede the development of growth (e.g., attachment style). These factors constitute key aspects for clinicians working with victims of trauma. Thus, this review aims to present these hindering factors in order to provide guidance for trauma psychologists and future research.     

Idiopathic intracranial hypertension: associations with coagulation disorders and polycystic-ovary syndrome

To better understand potentially reversible causes of idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, and an apparent association of IIH with polycystic-ovary syndrome (PCOS), we assessed associations of IIH with coagulation disorders and with PCOS in 38 women with well-documented IIH. Fifteen women were found to have PCOS; 14 of them were obese, with a body-mass index (BMI) greater than 30 kg/m(2), and 10 were extremely obese (BMI > or = 40). Factor VIII concentration was high (>150%) in 9 of 38 (24%) IIH cases, compared with 0 of 40 healthy adults controls (P(f) =.0009). Familial aggregation of high concentrations of factor VIII, associated with thrombophilia, was documented in all 5 of the 9 high-level factor VIII probands' families who were sampled. Activated partial thromboplastin time (APTT) was prolonged (> or =31.5 seconds) in 10 of 38 (26%) IIH cases, compared with 1 of 32 (3%) controls (P(f) =.009) and, in 4 of these cases, was accompanied by the lupus anticoagulant. Plasminogen activator inhibitor activity (PAI-Fx) was high (>21.1 U/mL) in 9 of 38 cases (24%), compared with 1 of 40 controls (3%) (P(f) =.006). Lipoprotein A was high (> or =35 mg/dL) in 13 of 37 cases (35%), compared with 5 of 40 controls (13%) (P(f) =.03). IIH cases did not differ (P >.05) from controls for homocysteine, proteins C and S, free S, antithrombin III, ACLAs IgG and IgM, dilute Russell's viper venom time, Factor XI, factor V Leiden G1691A, G20210A prothrombin, C677T MTHFR, plasminogen activator inhibitor 4G/5G, or platelet glycoprotein PL A1A2 mutations. Exogenous estrogens (n = 23), clomiphene (n = 1), or pregnancy (n = 4) accompanied the first appearance of IIH in 28 women. PCOS and coagulation disorders, often augmented by exogenous estrogens or pregnancy, are associated with IIH.