Exploring the relationships between depression, hopelessness, cognitive status, pain, and spirituality in patients with advanced cancer

The growing interest in the psychological morbidity of patients with cancer has been the major reason for conducting this study. The measurements used were the Beck Depression Inventory, the Beck Hopelessness Scale, the Mini Mental State Examination, the Greek Brief Pain Inventory, and the Spiritual Involvement and Beliefs Scale. The analysis was conducted in 82 patients with advanced cancer. Significant associations were found between pain interference in "mood" and in "enjoyment of life" and hopelessness, as well as between worse pain and pain interference items with depression and cognitive status. Significant correlations were found between hopelessness, depression, and cognitive condition. These findings demonstrate the physical, psychological, and cognitive aspects of patients with cancer.     

An emerging role of neutrophils and NETosis in chronic inflammation and fibrosis in systemic lupus erythematosus (SLE) and ANCA-associated vasculitides (AAV): Implications for the pathogenesis and treatment

Neutrophils derive from hematopoietic stem cells (HSCs) with systemic inflammation driving their activation and differentiation to myeloid progenitors to ensure enhanced myelopoiesis. Epigenetic reprograming and re-education of these HSCs produces neutrophils primed towards elimination of pathogens and increased inflammatory response. Neutrophils -an important component of acute inflammation- are not present in chronic inflammatory tissues leading to the false assumption that they may not be as important for the latter. Activated neutrophils may release Neutrophil Extracellular Traps (NETs) during a distinct form of cell death, named NETosis; NETs are rich in bioactive molecules that promote thrombosis (including atherothrombosis), inflammation and fibrosis. Thus, although neutrophils may not be present in chronic inflammatory lesions, their remnants may amplify the inflammatory response beyond their short life-span in the tissues. Herein, we review current evidence supporting a role of neutrophils and NETosis in tissue injury and dysfunction in systemic autoimmunity using as disease paradigms Systemic Lupus Erythematosus (SLE) and the ANCA-associated vasculitides (AAV). We also discuss the mechanisms involved and their potential as targets for novel therapy and drug repositioning.     

The use of think-aloud protocols to identify a decision-making process of community pharmacists aimed at improving CMS Star Ratings scores

Background

The Center for Medicare and Medicaid Services (CMS) created the Star Rating system based on multiple measures that indicate the overall quality of health plans. Community pharmacists can impact certain Star Ratings measure scores through medication adherence and patient safety interventions.

Oligodontia and associated characteristics: assessment in view of prosthodontic rehabilitation

Bibliographic evidence regarding oligodontia was reviewed to extract information necessary for a systematic review for a prosthodontic approach to management. Syndromic oligodontia, appearing as a symptom of many syndromes, was distinguished from isolated, or non-syndromic, which is an independent trait. Although a rare disorder, oligodontia has always been considerably researched, especially concerning its prevalence and genetic background. Non-syndromic oligodontia has been associated with the presence of small and misshapen natural teeth, orofacial clefting and reduced saliva secretion. A typical maxillofacial morphology has also been reported, which seems to result from the lack of dental and functional compensation and not from an altered growth pattern. Syndromic oligodontias also exhibit the above basic features but are complicated by each syndrome's specific characteristics. Prosthodontic treatment of individuals with oligodontia must anticipate the dental and oral clinical characteristics and provide with continuing support and preservation of proper maxillofacial relationships.     

Inhibition of tooth movement by osteoprotegerin vs. pamidronate under conditions of constant orthodontic force

The undesired movement of anchor teeth, and relapse of previously moved teeth, are major clinical problems in orthodontics. Dental implants are increasingly used to preserve anchorage, but these are costly and require invasive surgical procedures. An alternative strategy for maintaining anchorage may be the use of biological inhibitors of osteoclastic bone resorption. In the present study, we investigated the relative efficacy of pamidronate vs. osteoprotegerin (OPG) in inhibiting bone resorption and tooth movement, using a new orthodontic model in mice in which maxillary molars are moved for prolonged periods by near-constant, clinically relevant forces. Osteoclast influx to compression sites was initiated on day 3, was maximal on day 4, and persisted until at least day 12 after force application. Tooth movement paralleled osteoclast numbers. Minimal osteoclast apoptosis was observed, suggesting that recruitment, rather than programmed cell death, is a critical regulatory mechanism under conditions of constant force. Osteoclasts were reduced at compression sites by both OPG (95%) and pamidronate (70%); tooth movement was more dramatically inhibited by OPG (77% vs. 34%). Our findings indicate that constant orthodontic force regulates the recruitment, activation, and viability of osteoclasts, and that OPG could have clinical utility in preventing undesired tooth movement.     

Psychometric evaluation of the Arabic language version of the Profile of Mood States

We estimated the psychometrics of the parent and a short form of the Arabic language version of the Profile of Mood States (POMS). A sample of 537 Arab immigrants completed the POMS and a battery of other measures. Data analyses included confirmatory factor analyses and tests of reliability and concurrent validity. The fit of the proposed factor structure was acceptable if 14 pairs of error terms were allowed to correlate, but a better fit was obtained by creating a short form. The short form demonstrated good reliability and concurrent validity, but some factors were highly correlated. High factor correlations were not explainable by group differences in education or level of distress.     

Acute lymphoblastic leukemia relapse in the breast diagnosed with gray-scale and color Doppler sonography

Extramedullary relapses of acute lymphoblastic leukemia (ALL) in children and young adults are rare and in most cases are localized in the central nervous system, testes, or both. We describe a rare case of extramedullary relapse of ALL in the breast of a 17-year-old girl. The patient, who had been diagnosed with ALL 1 year before and had been in complete remission for 5 months, was admitted to the hospital for investigation of a mass in her left breast. On clinical examination, she had a large, palpable, nontender mass in her left breast. Mammography revealed a very dense mass. On gray-scale and power Doppler sonography, the appearance of the mass was consistent with malignancy. Histopathologic examination of a surgical biopsy specimen permitted accurate diagnosis of ALL.