Psychological resilience and active social participation among older adults with incontinence: a qualitative study

Objectives: Incontinence restricts participation in social activities among older adults. However, some older adults participate in social activities despite this condition. This study aimed to describe how older adults with incontinence could be resilient and actively participate in social activities.

Methods: We conducted semi-structured interviews with 11 socially active older adults with incontinence (age 70–90; nine women and two men) at their homes or in private areas of day-service centres in Chiba, Japan. We coded salient narratives by using thematic analysis and extracted themes. Finally, we developed a conceptual model and illustrated the interactions among themes.

Results: We identified seven themes that affected active social participation; five of these pertained to psychological characteristics (‘motivation to be socially active’, ‘psychological stress of incontinence’, ‘desire to interact with others’, ‘willingness to perform physical exercise’, and ‘confidence in managing incontinence’) and the remaining two pertained to supporting environmental factors (‘assistive devices’ and ‘accessible toilet’). Three psychological themes (‘desire to interact with others’, ‘willingness to perform physical exercise’, and ‘confidence in managing incontinence’) were intertwined with supporting environmental factors and increased the participants’ ‘motivation to be socially active’.

Conclusion: Older adults with incontinence can actively participate in the society when they have desire to interact with others, willingness to perform physical exercise, and confidence in managing incontinence. These psychological characteristics are important for being resilient in the face of incontinence and for active social participation.     

In vitro and in vivo activities of T-705 and oseltamivir against influenza virus

T-705 (6-fluoro-3-hydroxy-2-pyrazinecarboxamide) has a potent and selective inhibitory activity against influenza virus. We studied the effects of an infectious dose on the anti-influenza virus activities of T-705 and oseltamivir, a commercially available neuraminidase inhibitor, both in vitro and in vivo. Plaque formation of influenza A/PR/8/34 virus was completely inhibited by 10 microg/ml of T-705 after 72 h incubation, whereas visible plaque formation was detected in the plate treated with GS 4071, the active form of oseltamivir (10 microg/ml). The antiviral activity of T-705 was not influenced by an increase in multiplicity of infection (MOI) from 0.0001 to 1, but that of GS 4071 was influenced in a yield reduction assay. No increase in viral yield was seen in either culture supernatant or cells after removal of T-705 (10 microg/ml) but, in contrast, productive infection recurred in culture supernatant and in cells after removal of GS 4071. In mice infected with a high challenge dose of influenza A/PR/8/34 virus, orally administered T-705 (200 and 400 mg/kg/day) completely prevented the death of mice and the survival rates of mice were significantly higher than those in mice treated with oseltamivir (P<0.01). When the treatment was delayed at 1, 13 and 25 h post infection, oral administration of 200 mg/kg of T-705 significantly prevented the death of mice (P<0.01), and the survival rates of mice treated with T-705 were comparable to those of mice treated with oseltamivir. These results suggest that T-705 has the potential to be a potent inhibitor of human influenza virus infections.     

Can diffusion-weighted magnetic resonance imaging predict tumor recurrence of uterine cervical cancer after concurrent chemoradiotherapy?

Purpose

To retrospectively investigate the utility of diffusion-weighted imaging (DWI) for predicting clinical outcome after concurrent chemoradiotherapy (CCRT) in uterine cervical cancer.

Materials and methods

Seventy-four consecutive patients with biopsy-proven cervical cancer who received CCRT underwent DWI at 3T. All patients had MR examinations before therapy (preTx) and at 4 weeks of initiating therapy (midTx). At each point, ADC (apparent diffusion coefficient) was measured in the tumors and ADC change between preTx and midTx were also calculated. For predicting tumor recurrence, MR variables and clinical variables were evaluated and the results were compared.

Results

During a mean follow-up of 32.1 months, tumor recurrence developed in 15 (20%) patients: local recurrence (n = 7), distant metastasis (n = 5), and both (n = 3). MidTx tumor ADCs and tumor ADC changes between preTx and midTx were significantly different between the recurrence and non-recurrence groups (P < 0.05), while preTx tumor ADCs were not significantly different between the groups (P = 0.892). Univariate analysis revealed that histologic type, stage, preTx tumor size and volume, and tumor ADC change were significantly related to tumor recurrence (all P < 0.05). However, on multivariate analysis, tumor ADC changes [hazard ratio (HR) 0.886; 95% confidence interval (CI) 0.836–0.940; P = 0.001] and histological type (HR 6.063; 95% CI 1.404–26.187; P = 0.016) were the significant independent predictors of tumor recurrence.

Conclusion

Tumor ADC changes between preTx and midTx might be a useful biomarker for the prediction of cervical cancer recurrence after CCRT.

     

Proteomic analysis of phosphotyrosyl proteins in human embryonic stem cell-derived neural stem cells

Phosphorylation can reveal essential cell functions, such as cell differentiation, signal transduction, metabolic maintenance and cell division. The aim of this study was to investigate phosphorylated protein expression changes during neuronal lineage differentiation from hESCs. To measure the phosphorylated protein expression change during neuronal differentiation, we performed a comparative phosphoproteome analysis using 2-DE after MALDI-TOF MS and an MS/MS protein identification method, making a comparison between neural lineage differentiating cells and normal embryoid bodies (EBs) differentiated from human embryonic stem cells (hESCs) and profiling constituent phosphorylated proteins. Of 36 differentially expressed protein spots, 12 spots were shown to be up-regulated in differentiating neural cells. Specifically, the 7 up-regulated proteins of the 12 have potential roles in neuronal differentiation or neuronal damage recovery, including ACTB, heterogeneous nuclear ribonucleoprotein A2B1 (hnRNP A2B1), heterogeneous nuclear ribonucleoprotein L (hnRNP L), SET, chaperonin-containing TCP-1, vimentin and voltage-dependent anion channel protein 1 (VDAC1). These proteins are discussed further below.     

Shoulder arthrodesis with a reconstruction plate

From 1995 to 2005, arthrodesis with a reconstruction plate was performed for eight shoulders. The average follow-up period was 44 months. The indications for shoulder arthrodesis were joint destruction as a sequel of tuberculous arthritis, malignant bone tumour, pyogenic arthritis, failed arthrodesis and paralysis of the brachial plexus. The evaluation criteria included bony union and pain. Two cases of malignant tumour required an homologous bone graft due to severe bone deficit—a fracture that occurred in the distal part of the arthrodesed shoulder after removing the plate. With the exception of these two cases, severe pain or other complications did not occur in any other case. Shoulder arthrodesis with a reconstruction plate was judged to be a useful method for glenohumeral salvage in cases without severe bone deficit. Further, additional treatment methods should be considered to prevent fracture that may occur as a result of severe bone deficit.

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Résumé  De 1995 à 2005, nous avons réalisé huit arthrodèses d’épaule avec une plaque de reconstruction. Le suivi moyen a été de 44 mois. Les indications ont été les suivantes: destruction articulaire d’origine tuberculeuse, tumeurs malignes, arthrite, échec d’arthrodèse et paralysie du plexus brachial. Les critères d’évaluation ont été les suivants: fusion osseuse articulaire et douleur. Deux cas de tumeurs malignes ont nécessité la réalisation d’une greffe secondaire à une fracture de la partie distale de l’arthrodèse après ablation de matériel. En dehors de ces deux cas, nous n’avons pas observé de douleurs importantes ou d’autres complications. L’arthrodèse avec plaques de reconstruction spéciale est une technique que nous avons trouvé relativement facile dans le cas où il n’y avait pas de pertes de substance osseuse majeure. De plus, il est nécessaire d’envisager un traitement complémentaire pour prévenir les fractures qui peuvent survenir en cas de defect osseux important.

     

Endometrial Osteopontin mRNA Expression and Plasma Osteopontin Levels are Increased in Patients with Endometriosis

Problem  The aim of this study was to evaluate osteopontin (OPN) mRNA expression in eutopic endometrium and plasma OPN levels in patients with endometriosis.
Method of study  A total of 79 patients with histologically confirmed endometriosis and 43 patients without endometriosis participated in this study. OPN mRNA expression in endometrial tissues was measured by real-time quantitative polymerase chain reaction (PCR) and plasma concentrations of OPN were quantified using a specific commercial sandwich enzyme-linked immunosorbent assays (ELISA).
Results  Osteopontin mRNA expression in endometrial tissue was significantly higher in women with endometriosis than in controls ( P =  0.010). The mean plasma levels of OPN (mean ± S.E.M.) in patients with endometriosis and controls were 407.31 ± 37.80 ng/mL and 165.84 ± 19.29 ng/mL, respectively ( P  < 0.001). Receiver operating characteristic (ROC) analysis for plasma OPN revealed an area under the curve (AUC) of 0.894, with a sensitivity of 93.0%, specificity of 72.4%, positive likelihood ratio of 3.37, and negative likelihood ratio of 0.1 using a cut-off value of 167.68 ng/mL.
Conclusion  Osteopontin may be involved in the pathogenesis of endometriosis and plasma OPN may be a useful non-invasive marker for the diagnosis of endometriosis.     

Ictal hyperperfusion patterns in relation to ictal scalp EEG patterns in patients with unilateral hippocampal sclerosis: a SPECT study

PURPOSE: The aims of the present study were to explore the relation between ictal scalp EEG patterns and ictal hyperperfusion patterns in patients with unilateral hippocampal sclerosis-associated mesial temporal lobe epilepsy (HS-MTLE) by using semiquantitative single-photon emission computed tomography (SPECT) analysis and to assess clinical significance of ictal hyperperfusion patterns. METHODS: We studied retrospectively 39 consecutive patients with surgically proven HS-MTLE. All had both interictal and ictal SPECTs with the tracer injection during a complex partial seizure (CPS) typical of MTLE semiology. According to initial ictal discharge (IID) frequency on scalp EEG, two lateralizing patterns were identified: (a) a sustained regular 5- to 9-Hz rhythm with a restricted temporal or subtemporal distribution (group 1); and (b) an irregular 2- to 5-Hz rhythm with a widespread distribution (group 2). We performed group analysis by using statistical parametric mapping (SPM) of paired ictal-interictal SPECTs to identify regions of significant ictal hyperperfusion and compared clinical characteristics, tracer-injection time, semiology, pathologic HS grade, and surgical outcome between two groups. RESULTS: Of the 39 patients, 19 patients (10 males, nine right HS) were designated as group 1, and the remaining 20 patients (eight males, seven right HS), group 2. Group 1 showed hyperperfusion mainly confined to the ipsilateral temporal lobe, whereas group 2 showed widespread hyperperfusion in the extratemporal structures such as ipsilateral basal ganglia, brainstem, and bilateral thalamus, in addition to the ipsilateral temporal lobe. No significant difference was found between two groups in clinical characteristics, injection time, pathologic HS grade, and surgical outcome. Among semiologic features, dystonic limb posturing was more frequently observed in group 2 (p = 0.006). CONCLUSIONS: Scalp EEG IID frequency in HS-MTLE can be an important determining factor of ictal hyperperfusion patterns. The lack of difference in surgical outcome between two groups implies that different hyperperfusion patterns, according to their IID frequencies, reflect only preferential pathways of ictal propagation rather than intrinsic epileptogenic region.