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Physiological and Psychological Effects of Delivering Medical News Using a Simulated Physician–Patient Scenario 总被引:1,自引:0,他引:1
Cohen L Baile WF Henninger E Agarwal SK Kudelka AP Lenzi R Sterner J Marshall GD 《Journal of behavioral medicine》2003,26(5):459-471
We examined the acute stress response associated with having to deliver either bad or good medical news using a simulated physician–patient scenario. Twenty-five healthy medical students were randomly assigned to a bad medical news (BN), a good medical news (GN), or a control group that read magazines during the session. Self-report measures were obtained before and after the task. Blood pressure and heart rate were measured throughout the task period. Four blood samples were obtained across the task period. The BN and GN tasks produced significant increases in self-reported distress and cardiovascular responses compared with the control group. There was also a significant increase in natural killer cell function 10 min into the task in the BN group compared with the control group. The BN task was also somewhat more stressful than the GN task, as shown by the self-report and cardiovascular data. These findings suggest that a simulated physician–patient scenario produces an acute stress response in the physician, with the delivery of bad medical news more stressful than the delivery of good medical news. 相似文献
83.
Melanin pigmentation in mammalian skin and its hormonal regulation 总被引:37,自引:0,他引:37
Cutaneous melanin pigment plays a critical role in camouflage, mimicry, social communication, and protection against harmful effects of solar radiation. Melanogenesis is under complex regulatory control by multiple agents interacting via pathways activated by receptor-dependent and -independent mechanisms, in hormonal, auto-, para-, or intracrine fashion. Because of the multidirectional nature and heterogeneous character of the melanogenesis modifying agents, its controlling factors are not organized into simple linear sequences, but they interphase instead in a multidimensional network, with extensive functional overlapping with connections arranged both in series and in parallel. The most important positive regulator of melanogenesis is the MC1 receptor with its ligands melanocortins and ACTH, whereas among the negative regulators agouti protein stands out, determining intensity of melanogenesis and also the type of melanin synthesized. Within the context of the skin as a stress organ, melanogenic activity serves as a unique molecular sensor and transducer of noxious signals and as regulator of local homeostasis. In keeping with these multiple roles, melanogenesis is controlled by a highly structured system, active since early embryogenesis and capable of superselective functional regulation that may reach down to the cellular level represented by single melanocytes. Indeed, the significance of melanogenesis extends beyond the mere assignment of a color trait. 相似文献
84.
Prokopowicz M Banecki B Lukasiak J Przyjazny A 《Journal of biomaterials science. Polymer edition》2003,14(2):103-118
The paper investigates the conformational stability of bovine serum albumin (BSA) and fibrinogen during 24-h incubation in turn with a linear silicone polymer (polydimethylsiloxane (PDMS)), with linear silicone oligomers (hexamethyldisiloxane and octamethyltrisiloxane) and with cyclic silicone oligomers (octamethylcyclotetrasiloxane (D4) and decamethylcyclopentasiloxane (D5)). Ten-fold and 100-fold excesses of siloxanes with respect to the proteins were used. Using fluorescence spectroscopy of tryptophan located in the domain of proteins and fluorescence of 8-anilino-1-naphthalenesulfonic acid (1,8-ANS), which interacts with hydrophobic domains of proteins, changes in the tertiary structure of the protein were recorded. The results demonstrated that BSA does not change its native form during 24-h incubation with siloxanes. In contrast, the tertiary structure of fibrinogen was found to be altered by both short-chain linear siloxanes: (hexamethyldisiloxane and octamethyltrisiloxane) and long-chain PDMS. The changes can be observed only at a 100-fold excess of siloxanes with respect to the protein. No conformational changes in fibrinogen exposed to cyclic siloxanes were observed. 相似文献
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van Leth F Huisamen CB Badaro R Vandercam B de Wet J Montaner JS Hall DB Wit FW Lange JM;NN Study Group 《Journal of acquired immune deficiency syndromes (1999)》2005,38(3):296-300
BACKGROUND: The initial rate of plasma HIV-1 RNA (pVL) decline has been proposed as a marker of early efficacy of antiretroviral therapy (ART) and a possible predictor of late efficacy. We compared the rate of pVL decline in patients starting ART with nevirapine (NVP), efavirenz (EFV), or both drugs combined in addition to lamivudine (3TC) and stavudine (d4T). METHODS: Analysis of the viral decay constant (VDc) during the first 2 weeks of treatment in patients enrolled in the 2NN study who remained on allocated treatment. RESULTS: The median VDc (log10 copies per day, [interquartile range]) was similar for NVP (0.30 [0.25-0.36], EFV (0.31 [0.27-0.37]), and NVP + EFV (0.30 [0.27-0.36]). Patients with a baseline pVL >100,000 copies/mL were 8.7 (95% confidence interval [CI]: 6.2-12.3) times more likely to have a VDc >75th percentile. A high VDc was not associated with plasma drug concentration or with a decreased risk of virologic failure at week 48 after the start of therapy (hazard ratio = 0.8, 95% CI: 0.6-1.2). CONCLUSION: NVP, EFV, or NVP + EFV in combination with 3TC and d4T show similar rates of pVL decline during the first 2 weeks of treatment. The VDc with these regimens is not predictive of late virologic efficacy. 相似文献
88.
Another synovial sarcoma with t(X;18) 总被引:3,自引:0,他引:3
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