Values of activities of daily living. A survey of stroke patients and their home therapists

People's values influence their actions and efforts. Based on the assumption that a patient's values can be a guide to successful rehabilitation, the values of 15 activities of daily living as perceived by stroke patients and their home therapists were studied. Twenty-six stroke patients living at home and their 10 visiting occupational and physical therapists participated in the study. The study results indicated that the relative importance of each activity of daily living perceived by the patient group and by the therapist group was similar. Among the 29 therapist-patient pairs, however, only 1 pair showed significantly similar views regarding the values of these activities to the patient. Patients' age, gender, income level, duration since onset of stroke, impaired body side, and independence level in activities were significantly related to their values of certain activities of daily living. The relative value stroke patients living at home place on each activity of daily living could serve as a guide for sequencing learning steps during activities of daily living training in a hospital or rehabilitation setting. Determining patient rehabilitation goals as influenced by personal values may shorten rehabilitation time, be more cost-effective, and aid in the retention of gains made in the rehabilitation setting.     

Genetic polymorphisms influence the steroid treatment of children with idiopathic nephrotic syndrome

Background

Idiopathic nephrotic syndrome (INS) is the most frequent type of nephrotic syndrome that occurs in children. Its response to treatment with steroids varies. The aim of this study was to analyze the correlation between steroid metabolism-related genes and the response to steroid treatment.

Methods

The patient cohort comprised 74 children with INS, of whom were 58 steroid-sensitive (SS) cases and 16 steroid-resistant (SR) cases. The genetic polymorphisms analyzed were those of the CYP3A5 gene (A6986G) and ABCB1 gene (C1236T, G2677T/A, and C3435T), and the polymorphisms between SS and SR children were compared.

Results

C1236T in ABCB1 was associated with steroid resistance in INS children [odds ratio (OR) 2.65, 95?% confidence interval (CI) 1.01–6.94; p?=?0.042] The frequency of the T allele was significantly higher in SR subjects than in SS subjects (0.81 vs. 0.62, respectively). A6986G in CYP3A5 showed a trend of association, but this association did not reach statistical significance (OR 2.63, 95?% CI 0.94–7.37; p?=?0.059). No significant correlation was found between treatment response and G2677T/A or C3435T in ABCB1.

Conclusions

Our results indicate that among our pediatric patients with INS the C1236T polymorphism in the ABCB1 gene was associated with steroid resistance, while the A6986G polymorphism in the CYP3A5 gene showed a trend of association, but did not reach statistical significance, requiring further analysis.     

Increased expression of enolase α in human breast cancer confers tamoxifen resistance in human breast cancer cells

Enolase-α (ENO-1) is a key glycolytic enzyme that has been used as a diagnostic marker to identify human lung cancers. To investigate the role of ENO-1 in breast cancer diagnosis and therapy, the mRNA levels of ENO-1 in 244 tumor and normal paired tissue samples and 20 laser capture-microdissected cell clusters were examined by quantitative real-time PCR analysis. Increased ENO-1 mRNA expression was preferentially detected in estrogen receptor-positive (ER+) tumors (tumor/normal ratio >90-fold) when compared to ER-negative (tumor/normal ratio >20-fold) tumor tissues. The data presented here demonstrate that those patients whose tumors highly expressed ENO-1 had a poor prognosis with greater tumor size (>2 cm, *P = .017), poor nodal status (N > 3, *P = .018), and a shorter disease-free interval (≦1 year, *P < .009). We also found that higher-expressing ENO-1 tumors confer longer distance relapse (tumor/normal ratio = 82.8–92.4-fold) when compared to locoregional relapse (tumor/normal ratio = 43.4-fold) in postsurgical 4-hydroxy-tamoxifen (4-OHT)-treated ER+ patients (*P = .014). These data imply that changes in tumor ENO-1 levels are related to clinical 4-OHT therapeutic outcome. In vitro studies demonstrated that decreasing ENO-1 expression using small interfering RNA (siRNA) significantly augmented 4-OHT (100 nM)-induced cytotoxicity in tamoxifen-resistant (Tam-R) breast cancer cells. These results suggest that downregulation of ENO-1 could be utilized as a novel pharmacological approach for overcoming 4-OHT resistance in breast cancer therapy.     

Identification of the tumor factor of abnormal cancer methylation enzymes as the catalytic subunit of telomerase

Objective  

The objective was to study the relationship between the tumor factor of cancer MAT^LT and the catalytic subunit of telomerase. The function of telomerase in the blockade of cell differentiation and in the protection of DNA MT resembles closely the function of the tumor factor of cancer MAT^LT. Because of this close similarity we made an attempt to examine the possibility that the tumor factor of MAT^LT might be the catalytic subunit of telomerase.     

Dichotomous versus semi-quantitative scoring of ultrasound joint inflammation in rheumatoid arthritis using novel individualized joint selection methods

The aim of the study is to compare the responsiveness of two joint inflammation scoring systems (dichotomous scoring (DS) versus semi-quantitative scoring (SQS)) using novel individualized ultrasound joint selection methods and existing ultrasound joint selection methods. Responsiveness measured by the standardized response means (SRMs) using the DS and the SQS system (for both the novel and existing ultrasound joint selection methods) was derived using the baseline and the 3-month total inflammatory scores from 20 rheumatoid arthritis patients. The relative SRM gain ratios (SRM-Gains) for both scoring system (DS and SQS) comparing the novel to the existing methods were computed. Both scoring systems (DS and SQS) demonstrated substantial SRM-Gains (ranged from 3.31 to 5.67 for the DS system and ranged from 1.82 to 3.26 for the SQS system). The SRMs using the novel methods ranged from 0.94 to 1.36 for the DS system and ranged from 0.89 to 1.11 for the SQS system. The SRMs using the existing methods ranged from 0.24 to 0.32 for the DS system and ranged from 0.34 to 0.49 for the SQS system. The DS system appears to achieve high responsiveness comparable to SQS for the novel individualized ultrasound joint selection methods.