Disorganized attachment,absorption, and new age spirituality: a mediational model

In this paper, we present a theoretical model and an empirical review linking disorganized attachment with New Age spiritual beliefs and activities via a proposed mediator; the propensity to enter altered states of consciousness (absorption/dissociation). Utilizing a prospective longitudinal design (N = 62), an empirical test of the mediational model is also provided for illustrational purposes. More specifically, we tested if unresolved/disorganized (U/d) attachment scores, as identified via the Adult Attachment Interview at the first assessment point, predicted New Age spirituality 3 years later, and whether this link was mediated by absorption. Results supported the mediational model, although the bivariate relation between U/d attachment and New Age spirituality was of modest strength. The discussion focuses on the general implications, clinical as well as non-clinical, of the proposed model. Finally, we argue that time is now ripe for attachment researchers to address additional non-pathological sequelae of disorganized attachment and the related propensity to experience altered states of consciousness.     

Cardiac toxicity in breast cancer patients treated with dual HER2 blockade

Although dual HER2 blockade shows promising results in patients with HER2‐positive breast cancer it is unclear whether this treatment strategy increases the risk for cardiac adverse events. We conducted a meta‐analysis of randomized trials to investigate the risk of cardiac adverse events when a combination of anti‐HER2 therapies compared to anti‐HER2 monotherapy. We searched Medline, the Cochrane library, as well as the electronic abstract databases of the major international congresses' proceedings to identify randomized trials that evaluated the administration of anti‐HER2 monotherapy (lapatinib or trastuzumab or pertuzumab) versus anti‐HER2 combination (pertuzumab plus trastuzumab or trastuzumab plus lapatinib) therapy in breast cancer. The trials were considered eligible if the only systematic difference between the study arms was the type of anti‐HER2 therapy used. Study outcomes were the congestive heart failure (CHF) grade ≥3 and left ventricular ejection fraction (LVEF) decline <50% or more than 10% from baseline. Six trials were considered eligible. Overall incidence results for CHF in the combined anti‐HER2 therapy and the anti‐HER2 monotherapy were 0.88% (95% CI: 0.47–1.64%) and 1.49% (95% CI: 0.98–2.23%). The incidence of LVEF decline was 3.1% (95% CI: 2.2–4.4%) and 2.9% (95% CI: 2.1–4.1%), respectively. The OR of CHF between anti‐HER2 combination and monotherapy was 0.58 (95% CI: 0.26–1.27, p‐value= 0.17) while the OR of LVEF decline was 0.88 (95% CI: 0.53–1.48, p‐value= 0.64). This meta‐analysis provides evidence supporting comparable cardiac toxicity between anti‐HER2 combination therapy and anti‐HER2 monotherapy.     

Adriamycin cytotoxicity may stimulate growth of hepatocellular tumours in an experimental model for adjuvant systemic chemotherapy in liver transplantation

Adjuvant treatment with adriamycin has been suggested to improve results after liver transplantation for hepatocellular cancer. Here we have applied an animal model for evaluation of treatment with adriamycin and/or cyclosporine A on liver tumour growth. Three chemically induced rat liver tumours with various degree of differentiation were transferred to the spleens of syngenic rats. Each recipient group was divided into four subgroups, treated with adriamycin and/or cyclosporine A or none of the drugs. When the tumour was well differentiated no proliferation was found in any of the subgroups. When the tumour exhibited a more pronounced dysplasia, adriamycin stimulated tumour growth. This effect was further increased by cyclosporine. In the animals transplanted with the most aggressive tumour, adriamycin inhibited tumour growth. When given together with cyclosporine this inhibition was counteracted. These data suggest that adriamycin, especially when given together with cyclosporine, may have a stimulatory effect on liver tumour cell growth.     

Genetic profiling of a chondroblastoma‐like osteosarcoma/malignant phosphaturic mesenchymal tumor of bone reveals a homozygous deletion of CDKN2A,intragenic deletion of DMD,and a targetable FN1‐FGFR1 gene fusion

Conventional osteosarcoma is the most common primary malignancy of bone. This group of neoplasms is subclassified according to specific histological features, but hitherto there has been no correlation between subtype, treatment, and prognosis. By in‐depth genetic analyses of a chondroblastoma‐like osteosarcoma, we detect a genetic profile that is distinct from those previously reported in benign and malignant bone tumors. The overall genomic copy number profile was less complex than that typically associated with conventional osteosarcoma, and there was no activating point mutation in any of H3F3A, H3F3B, IDH1, IDH2, BRAF, or GNAS. Instead, we found a homozygous CDKN2A deletion, a DMD microdeletion and an FN1‐FGFR1 gene fusion. The latter alteration has been described in phosphaturic mesenchymal tumor. This tumor type shares some morphological features with chondroblastoma‐like osteosarcoma and we cannot rule out that the present case actually represents an FN1‐FGFR1 positive malignant phosphaturic mesenchymal tumor of bone without osteomalacia.     

A prognostic model for soft tissue sarcoma of the extremities and trunk wall based on size, vascular invasion, necrosis, and growth pattern

BACKGROUND:

In soft tissue sarcoma, better distinction of high‐risk and low‐risk patients is needed to individualize treatment and improve survival. Prognostic systems used in clinical practice identify high‐risk patients based on various factors, including age, tumor size and depth, histological type, necrosis, and grade.

METHODS:

Whole‐tumor sections from 239 soft tissue sarcomas of the extremities were reviewed for the following prognostic factors: size, vascular invasion, necrosis, and growth pattern. A new prognostic model, referred to as SING (S ize, I nvasion, N ecrosis, G rowth), was established and compared with other clinically applied systems.

RESULTS:

Size, vascular invasion, necrosis, and peripheral tumor growth pattern provided independent prognostic information with hazard ratios of 2.2‐2.6 for development of metastases in multivariate analysis. When these factors were combined into the prognostic model SING, high risk of metastasis was predicted with a sensitivity of 74% and a specificity of 85%. Moreover, the prognostic performance of SING compared favorably with other widely used systems.

CONCLUSIONS:

SING represents a promising prognostic model, and vascular invasion and tumor growth pattern should be considered in soft tissue sarcoma prognostication. Cancer 2011. © 2010 American Cancer Society.     

Lapatinib, trastuzumab or the combination added to preoperative chemotherapy for breast cancer: a meta-analysis of randomized evidence

We compared the efficacy and safety of the addition of lapatinib versus trastuzumab or their combination to neoadjuvant chemotherapy in HER2-positive breast cancer. Potentially eligible trials were located through PubMed and Cochrane Library searches and abstracts of major international conferences. The endpoints that we assessed were pathologic complete response (pCR) rate, and toxicity. Pooled risk ratios (RR) were estimated for each endpoint with fixed or random effects models, depending on between studies heterogeneity. Six trials were identified with 1,494 eligible patients. The probability to achieve pCR was higher for the trastuzumab plus chemotherapy arm versus lapatinib plus chemotherapy (RR 1.25, 95?% confidence interval [CI] 1.08-1.43; p?=?0.003) (6 trials; 1,494 patients). Probability to pCR was significantly higher in the group receiving lapatinib and trastuzumab than in the group with trastuzumab alone (RR 1.39, 95?% CI 1.20-1.63; p?相似文献