Psychosocial predictors of long-term mortality among women with suspected myocardial ischemia: the NHLBI-sponsored Women’s Ischemia Syndrome Evaluation

This paper evaluated long-term associations between psychosocial factors and premature mortality among women with suspected coronary artery disease (CAD). We tracked total mortality events over a median 9.3 years in a cohort of 517 women [baseline mean age = 58.3 (11.4) years]. Baseline evaluations included coronary angiography, psychosocial testing, and CAD risk factors. Measures included the Spielberger Trait Anxiety Scale, Beck Depression Inventory, self-rated health, and Social Network Index. Cox regression analysis was used to assess relationships. Covariates included age, CAD risk factors, and CAD severity. BDI scores (HR 1.09, 95 % CI 1.02–1.15), STAI scores (HR .86, 95 % CI .78–.93), and very good self-rated health (relative to the poor self-rated health group; HR .33, 95 % CI .12–.96) each independently predicted time to mortality outcomes in the combined model. SNI scores (HR .91, 95 % CI .81–1.06) and other self-rated health categories (i.e., fair, good, and excellent categories) were not significant mortality predictors after adjusting for other psychosocial factors. These results reinforce and extend prior psychosocial research in CAD populations.     

Validation of the Hebrew Birth Satisfaction Scale – Revised (BSS-R) and its relationship to perceived traumatic labour

ABSTRACT

Objective and background: The Birth Satisfaction Scale-Revised (BSS-R) is a multi-dimensional measure which is recommended by international clinical guidelines for global use as the birth satisfaction outcome measure of choice. The current investigation sought to develop a Hebrew version of the BSS-R for use in the Jewish–Israeli context and examine the relationship between BSS-R domains and the perception of the experience of labour as traumatic.

Methods: Following review, translation, and back-translation for linguistic equivalence, a Hebrew version of the BSS-R (H-BSS-R) was prepared and psychometrically evaluated using key indices of validity and reliability. Complete multivariate normal data from 288 first-time Jewish Israeli mothers within two years after childbirth was entered into the analysis.

Results: The H-BSS-R was found to have a good fit to the BSS-R tridimensional measurement model, excellent internal consistency, divergent and known-group discriminant validity. Moreover, women who experienced their labour as traumatic had significantly lower H-BSS-R subscale scores than women who reported that their birth experience was non-traumatic.

Conclusion: The H-BSS-R is a robust and valid measure suitable for use with Jewish–Israeli women, as well as for investigating the relationship between traumatic labour and birth satisfaction.     

Anti-VEGFR2 and anti-IGF-1R-Adnectins inhibit Ewing’s sarcoma A673-xenograft growth and normalize tumor vascular architecture

Increasing experimental evidence suggests that IGF-1 may modulate tumor angiogenesis via activation of the expression of VEGF in Ewing sarcomas and rhabdomyosarcomas. This study investigates the effects of the PEGylated Adnectins? CT-322, a VEGFR2-inhibitor and AT580Peg40, an IGF-1R inhibitor, as monotherapy and in combination in a murine A673 xenograft tumor model. The combination of Adnectins CT-322 and AT580Peg40 revealed a 83?% reduction in tumor growth, a nearly 5 times lower vessel density, less necrotic areas and less appearance of intussusceptive angiogenesis. Monotherapy with IGF-1R or CT-322 revealed equally a significant inhibition of tumor and vessel growth. Combinatory inhibition of IGF-1R and VEGFR2 shows a downregulation of IGF-binding protein 2 and a compensatory upregulation of VEGF levels. Immunohistological analysis showed remodeling vascular effects of CT-322-treatment or combination therapy. The vascular architecture in Adnectin-treated tumors was characterized by a strong normalization of vasculature. 3D-evaluation in microvascular corrosion casts showed significantly higher intervascular and interbranching distances in Adnectin-treated tumors. CT-322-treatment and combinatory inhibition reveal a significant reduction of intussusceptive angiogenesis. These pronounced effects on tumor vasculature suggest potential therapeutic benefit of combinatorial IGF1- and VEGF- pathways inhibition in Ewing’s sarcoma.     

Obstrucción intestinal en un caso de endometriosis extragenital

We present an unsuspected case of acute ileal obstruction due to endometriosis. We analyze the clinical symptoms, the diagnostic clues, and the differential diagnosis of this unusual location of endometriosis     

Disseminated Enteroviral Infection Associated with Obinutuzumab

Two cases of disseminated enteroviral infection occurred in patients who received the CD20 monoclonal antibody obinutuzumab. Clinical features included hepatitis, edema, and a dermatomyositis-like syndrome. These manifestations may be unfamiliar to clinicians and are possibly responsive to intravenous immunoglobulin. Clinicians should remain vigilant for enteroviral infections in patients receiving obinutuzumab.