Metastasis-associated protein S100A4 induces a network of inflammatory cytokines that activate stromal cells to acquire pro-tumorigenic properties

Tumor cells have the ability to exploit stromal cells to facilitate metastasis. By using malignant melanoma as a model, we show that the stroma adjacent to metastatic lesions is enriched in the known metastasis-promoting protein S100A4. S100A4 stimulates cancer cells to secrete paracrine factors, such as inflammatory cytokines IL8, CCL2 and SAA, which activate stromal cells (endothelial cells and monocytes) so that they acquire tumor-supportive properties. Our data establishes S100A4 as an inducer of a cytokine network enabling tumor cells to engage angiogenic and inflammatory stromal cells, which might contribute to pro-metastatic activity of S100A4.     

Pelvic Floor Muscle Problems Mediate Sexual Problems in Young Adult Rape Victims

IntroductionPrior studies have addressed sexual abuse and sexual function in adult women. No studies have focused on the effect of adolescence rape on sexual functioning.AimTo investigate the effect of rape on sexual problems and on pelvic floor problems, as well as the mediating role of pelvic floor problems on sexual problems, in a homogenous group of victims of adolescence rape without a history of childhood sexual, physical, and/or emotional abuse.Main Outcome MeasuresSexual functioning and pelvic floor functioning were assessed using self‐report questionnaires.MethodsIn this cross‐sectional study, a group of 89 young women aged 18–25 years who were victimized by rape in adolescence was compared with a group of 114 nonvictimized controls. The rape victims were treated for posttraumatic stress disorder (PTSD) 3 years prior to participation in the study.ResultsThree years posttreatment, rape victims were 2.4 times more likely to have a sexual dysfunction (lubrication problems and pain) and 2.7 times more likely to have pelvic floor dysfunction (symptoms of provoked vulvodynia, general stress, lower urinary tract, and irritable bowel syndrome) than nonvictimized controls. The relationship between rape and sexual problems was partially mediated by the presence of pelvic floor problems. Rape victims and controls did not differ with regard to sexual activities.ConclusionsRape victims suffer significantly more from sexual dysfunction and pelvic floor dysfunction when compared with nontraumatized controls, despite the provision of treatment for PTSD. Possibly, physical manifestations of PTSD have been left unaddressed in treatment. Future treatment protocols should consider incorporating (physical or psychological) treatment strategies for sexual dysfunction and/or pelvic floor dysfunction into trauma exposure treatments. Postma R, Bicanic I, van der Vaart H, and Laan E. Pelvic floor muscle problems mediate sexual problems in young adult rape victims. J Sex Med 2013;10:1978–1987.     

A look at chronic pain in dogs

Chronic pain can be found in all mammals that have a nociceptive pathway. It is defined as pain that extends beyond the normal time of healing. This article deals with chronic pain that affects canine patients. Chronic pain and depression have both been shown to occur in mammals. Chronic pain can be divided into inflammatory pain, non-osteoarthritis–non-malignant pain and cancer pain. The pet owner is key in the recognition of chronic pain in dogs. There are validated chronic pain scales available for dogs. The article will discuss various examples of chronic pain that affects dogs and ways to alleviate the effects of this pain in selected disease processes.     

Epidemiology of Confirmed COVID-19 Deaths in Adults,England, March–December 2020

Of the 58,186 coronavirus deaths among adults in England during March–December 2020, 77% occurred in hospitals, 93% were in patients >60 years, and 91% occurred within 28 days of positive specimen. Cumulative mortality rates were highest among persons of Black, Asian, other, or mixed ethnicities and in socioeconomically deprived areas.     

Breathe easy: 5 steps to better breathing with your metered-dose inhaler (MDI)

Proper use of the metered-dose inhaler (MDI) is essential for medications to prevent and treat acute asthma exacerbations. This training video teaches children and clinicians correct technique for MDI use.