A brief POMS measure of distress for cancer patients

The authors describe an 11-item short form of the Profile of Mood States' 58-item Total Mood Disturbance Score (TMDS). The Brief TMDS was derived from a sample of 619 adults with mixed cancer diagnoses, and replicated on a second sample of 295 lung cancer patients. Internal consistency of the Brief TMDS and the correlations of the Brief TMDS with the full TMDS were highly satisfactory for both samples. Given the difficulty many medically ill people have with lengthy self-report scales, and the increasing importance of measuring distress as an adjunct to patient care, this measure shows promise as a rapid, reliable tool.     

Building a Measure of Fatigue: The Functional Assessment of Chronic Illness Therapy Fatigue Scale

The shared goal of all clinical disciplines is to optimize the well-being of people who become patients and find themselves diminished by illness and recovery. This goal relies on sound tools to evaluate both real and perceived deficits in a way that can be used for a particular patient over time and also across medical disciplines and patient populations. Fatigue is a critical and notoriously subjective aspect of many illnesses. Although the soundness of research is often correlated with the objectivity of data, certain clinical measures must, by definition, be patient centered, with all the complexities and challenges of patient-reported evaluations. Measurement of fatigue has been an important and evolving component of symptom management in the field of oncology. The Functional Assessment of Chronic Illness Therapy Fatigue Scale is a self-administered fatigue-assessment tool that has found wide application across diverse medical fields and that has demonstrated validity and utility across a broad range of populations. The Functional Assessment of Chronic Illness Therapy Fatigue Scale has become one in a repository of tools in the item banks that are accumulating under the auspices of The Patient-Reported Outcomes Measurement Information System, a National Institutes of Health initiative to deploy the most clinically relevant and technologically agile tools that we have to advance research in medicine and patient care. As much as with any other discipline, physical medicine and rehabilitation stands to gain from the collective knowledge and creative horizons in the assessment and treatment of fatigue.     

Self-reported fatigue: one dimension or more? Lessons from the Functional Assessment of Chronic Illness Therapy��Fatigue (FACIT-F) questionnaire

Across two general population (total n?=?1,878) and two cancer (total n?=?3,140) samples, we evaluated the dimensionality of self-reported fatigue as measured by the Functional Assessment of Chronic Illness Therapy??Fatigue (FACIT-F) instrument. After evaluating dimensionality of the FACIT-F, we compared the conceptually distinct fatigue experience versus fatigue impact scores in each sample. Confirmatory factor analysis of the 13-item scale showed very good fit to a single dimension (??unidimensional??) model for each sample (comparative fit index range?=?0.92?C0.97). Using a bifactor model to compare the loading of each item with the general fatigue factor versus the identified sub-domain (experience or impact), we found the item-general loading to be higher than that of the item-sub-domain factor in 52 of 52 comparisons (13 items; four samples). When scored separately, experience and impact scores were correlated highly (range?=?0.80?C0.88), yet their difference relative to one another was significant (p?<?0.001). Consistently across samples, experience scores were systematically higher (more endorsement) than impact scores, by a margin of 0.21?C0.46?SD units. This suggests that the fatigue experience and the impact of fatigue upon function are reported along a single dimensional continuum, but that experience is more likely than impact upon function to be endorsed at lower levels of fatigue. Fatigue as an outcome or trial endpoint can be expressed as a single number, and the experience of the symptom is more likely to be endorsed at mild levels of fatigue, presumably before the symptom exerts an adverse impact upon function.     

Glycosylation of β-1 integrins in B16-F10 mouse melanoma cells as determinant of differential binding and acquisition of biological activity

Studying B16-F10 cells we could identify β-1 integrins as laminin, fibronectin and collagen receptors. Gradient ionic strength elution analysis of affinity chromatography showed differential interactions between laminin-binding β-1 integrins (two β-1 polypeptides of 105 and 120 kDa) and fibronectin and collagen-binding β-1 integrins (elution of one major β-1 polypeptide of 120 kDa) and their respective ligands. To evaluate this diversity we submitted B16-F10 extracts to IEF and SDS-PAGE and found that one β-1 integrin formed acidic and larger isoforms, while another formed basic and smaller isoforms. To study this difference we also submitted material eluted from WGA-Sepharose columns to IEF but now only the acidic β-1 isoform was found. Extracts of B16-F10 treated with neuraminidase showed only the basic β-1 isoform, suggesting that terminal sialic acid residues may be responsible for this acidic pattern, an interpretation supported by the fact that MAA (Maackia ammurensis agglutinin) reacts only with the acidic isoform. Differential glycosylation of β-1 integrin isoforms in B16-F10 was also demonstrated since the smaller lamininbinding β-1 integrin isoform reacted only with GNA (Galanthus nivalis agglutinin), whereas the mature larger form reacted with DSA (Datura stramonium agglutinin) and MAA; thus this heterogeneity of β-1 chains is essentially due to variable glycosylation. Autoradiography and immunoblotting analysis of material separated by 2-dimensional electrophoresis show that only the processed forms of β-1 integrins are expressed at the cell surface. © 1995 Wiley Liss, Inc.     

Breast Augmentation as an Incentive in Recovering from Anorexia

In a survey carried out on 229 subjects who had undergone an augmentative mammaplasty it was possible to verify a postoperative increase in weight in 25 cases, four of which were clearly anorexic. We hypothesized that a change in perception of one's body proportions after the insertion of implants, might have been a determinant in blocking the mechanism leading to anorexia, or at least in the continuation of the recovering process. The aim of this article is obviously not to state that augmentative mammaplasty can be a kind of therapy for anorexia. Instead, we want to underline how a more pleasant contour of some body areas can have a role in solving deeper psychological problems.