Mechanisms of cisplatin-induced muscle atrophy

Fatigue is the most common side effect of chemotherapy. However, the mechanisms of “muscle fatigue” induced by anti-cancer drugs are not fully understood. We therefore investigated the muscle-atrophic effect of cisplatin, a platinum-based anti-cancer drug, in mice. C57BL/6J mice were treated with cisplatin (3 mg/kg, i.p.) or saline for 4 consecutive days. On Day 5, hindlimb and quadriceps muscles were isolated from mice. The loss of body weight and food intake under the administration of cisplatin was the same as those in a dietary restriction (DR) group. Under the present conditions, the administration of cisplatin significantly decreased not only the muscle mass of the hindlimb and quadriceps but also the myofiber diameter, compared to those in the DR group. The mRNA expression levels of muscle atrophy F-box (MAFbx), muscle RING finger-1 (MuRF1) and forkhead box O3 (FOXO3) were significantly and further increased by cisplatin treated group, compared to DR. Furthermore, the mRNA levels of myostatin and p21 were significantly upregulated by the administration of cisplatin, compared to DR. On the other hand, the phosphorylation of Akt and FOXO3a, which leads to the blockade of the upregulation of MuRF1 and MAFbx, was significantly and dramatically decreased by cisplatin. These findings suggest that the administration of cisplatin increases atrophic gene expression, and may lead to an imbalance between protein synthesis and protein degradation pathways, which would lead to muscle atrophy. This phenomenon could, at least in part, explain the mechanism of cisplatin-induced muscle fatigue.     

正念干预在护士共情疲劳中应用的范围综述

目的 对正念干预在护士共情疲劳中应用的研究进行范围审查,归纳和总结正念干预的基本内容和应用现状,为临床医护人员开展正念干预及相关研究提供参考依据。方法 根据范围综述的研究方法,计算机检索中国知网、万方数据库、中国生物医学文献数据库、PubMed、Embase、CINAHL、Web of Science、Scopus、ProQuest、Cochrane Library等国内外数据库。检索时限为建库至2022年6月15日。对纳入文献进行汇总和分析。结果 共纳入26篇文献。正念干预的培训内容主要包括理论课程培训、正念技能训练、同情训练、应对压力指导和正念承诺实践;正念干预的形式主要为线下培训、线上培训及混合方式培训;正念干预理论课程培训的频率和时长多为每周1次,1.0~2.0 h/次;正念技能训练的频率和时长多为每周2~4次,<30 min/次;结局指标包括应用效果、可行性评价及应用体验。结论 正念干预对改善护士共情疲劳具有积极作用。未来需进一步探索个性化正念干预方案,结合互联网、人工智能技术不断优化正念干预的内容和策略,开展更多高质量的随机对照研究,以验证其长期干预效果。     

Predictors of Subjective Cognitive Complaint in Postacute Older Adult Stroke Patients

Objective

To investigate the impact of objective cognitive impairment, negative affect, and fatigue on cognitive complaint in a postacute (mean=6.64±1.32mo) sample of patients with ischemic stroke.

Design

Cross-sectional study.

Setting

Specialized stroke units at major metropolitan hospitals.

Participants

Patients with first-ever ischemic stroke (N=25) aged between 50 and 85 years with relatively good neurologic recovery (National Institutes of Health Stroke Scale score ≤7) during the postacute period. Participants were excluded from the study if there was a documented history of psychiatric illness, neurologic disease, dementia, or a moderate or severe aphasia.

Interventions

Not applicable.

Main Outcome Measures

Cognitive complaint as measured by the A-B Neuropsychological Assessment Schedule.

Results

Ninety percent of the patients reported some level of cognitive difficulty in everyday life. Fatigue, cognitive slowing, memory difficulties, and poor concentration were the most frequently reported complaints. More than half of all participants had significant impairment in at least 1 cognitive domain after their stroke. A standard multiple regression was performed to evaluate the relative impact of negative affect, fatigue, and objective cognitive functioning on subjective cognitive complaint. This model accounted for 61% of the variance in total subjective cognitive complaint (R=.78, F_3,21=10.96, P<.001), with depression being the only variable to make a significant independent contribution to the prediction of subjective cognitive complaint.

Conclusions

Cognitive complaints are reported by almost all patients after a stroke. Although 50% of the participants had objective evidence of a cognitive impairment, neither objective cognitive impairment nor fatigue predicted cognitive complaint independently of negative affect. Clinicians who receive reports of cognitive complaints in the postacute period after stroke should be alert to the possibility of psychological distress in their patient.     

Gene expression profiles of fatigued fibromyalgia patients with different categories of pain and catastrophizing: A preliminary report

Background

Fibromyalgia (FM) is a chronic condition characterized by diffused musculoskeletal pain and overwhelming fatigue.

Purpose

To compare the gene expression profiles of fatigued FM women with different levels of pain and catastrophizing.

Methods

Nine women with FM enrolled in an active Medstar Research Institute protocol were included in the gene expression analyses of peripheral blood RNA via Affymetrix GeneChip Human Genome U133 Plus 2.0 array (Santa Clara, CA). Scores from Brief Pain Inventory, Pain Catastrophizing Scale, and Multidimensional Fatigue Inventory categorized the nine participants into pain (high, n = 3; low, n = 6) and catastrophizing groups (high, n = 5; low, n = 4).

Discussion

Differential expression of 107 genes between the high and low pain groups and 139 genes between the high and low catastrophizing groups (over 2.0-fold change, p < .05) were observed. Network analyses showed interferon signaling and interferon regulatory activation factor pathways distinguished between the pain groups whereas dendritic cell maturation delineated between the catastrophizing groups.

Conclusion

Findings provide preliminary evidence that specific physiological pathways may possibly delineate pain and catastrophizing mechanisms. Further investigation via the use of a larger and more homogenous sample is warranted.     

Reliability and validity of Short Form 36 Version 2 to measure health perceptions in a sub-group of individuals with fatigue

Purpose.?To determine the validity and reliability of Short Form 36 Version 2 (SF36v2) in sub-groups of individuals with fatigue.

Method.?Thirty subjects participated in this study, including n == 16 subjects who met case definition criteria for chronic fatigue syndrome (CFS) and n == 14 non-disabled sedentary matched control subjects. SF36v2 and Multidimensional Fatigue Inventory (MFI-20) were administered before two maximal cardiopulmonary exercise tests (CPETs) administered 24?h apart and an open-ended recovery questionnaire was administered 7 days after CPET challenge. The main outcome measures were self-reported time to recover to pre-challenge functional and symptom status, frequency of post-exertional symptoms and SF36v2 sub-scale scores.

Results.?Individuals with CFS demonstrated significantly lower SF36v2 and MFI-20 sub-scale scores prior to CPET. Between-group differences remained significant post-CPET, however, there were no significant group by test interaction effects. Subjects with CFS reported significantly more total symptoms (p < 0.001), as well as reports of fatigue (p < 0.001), neuroendocrine (p < 0.001), immune (p < 0.01), pain (p < 0.01) and sleep disturbance (p < 0.01) symptoms than control subjects as a result of CPET. Many symptom counts demonstrated significant relationships with SF36v2 sub-scale scores (p < 0.05). SF36v2 and MFI-20 sub-scale scores demonstrated significant correlations (p < 0.05). Various SF36v2 sub-scale scores demonstrated significant predictive validity to identify subjects who recovered from CPET challenge within 1 day and 7 days (p < 0.05). Potential floor effects were observed for both questionnaires for individuals with CFS.

Conclusion.?Various sub-scales of SF36v2 demonstrated adequate reliability and validity for clinical and research applications. Adequacy of sensitivity to change of SF36v2 as a result of a fatiguing stressor should be the subject of additional study.     

飞行(学)员人格因素与职业倦怠及工作压力相关研究

目的 通过研究飞行(学)员群体人格因素与职业倦怠、工作压力的相关关系,为飞行职业应激干预提供指导. 方法 采用Maslach职业倦怠问卷通用版(Maslach burnout inventorygeneral survey,MBI-GS)、工作压力感问卷、艾森克人格问卷简式量表中国版、航空安全控制点问卷及坚韧人格问卷,调查飞行(学)员167人(歼击机飞行员67人,直升机飞行员37人、直升机学员44人和运输机飞行员19人).按飞行机种分为歼击机飞行员组、运输机飞行员组、直升机飞行员组和直升机学员组.利用SPSS 16.0统计软件,通过单因素方差分析比较不同组受试者的职业倦怠、工作压力感的特点.采用Pearson相关分析分析职业倦怠、工作压力感与人格特征之间的关系. 结果 本组问卷回收率100％,有效率100％.MBI-GS的内部一致性系数为0.710.职业倦怠情感耗竭和玩世不恭维度在4组受试之间存在差异(F=5.864、3.726,P＜0.01、0.05);其与艾森克人格问卷内外向维度、与安全控制点总分、坚韧人格总分呈负相关(r=-0.380～-0.278,P＜0.01),与艾森克人格问卷神经质维度、安全控制点外控维度呈正相关(r=0.229～0.526,P＜0.01). 结论 人格因素对职业倦怠有预测作用,外控和情绪不稳定的飞行员职业倦怠感强,内控和人格坚韧的倦怠感低.航空安全控制点结果说明对安全控制感低的飞行(学)员职业倦怠感强,符合飞行工作是高度危险职业的特点.     

某高校大学生疲劳性亚健康状况及影响因素分析

目的 了解大学生疲劳性亚健康状况并探讨其影响因素. 方法 采取分层随机整群抽样方法,用自行编制的疲劳性亚健康量表对长沙市某高校761名不同年级在校大学生进行问卷调查. 结果 大学生疲劳性亚健康发生率为35.35％,不同年级大学生疲劳性亚健康比较差异有统计学意义（P＜0.05）,农村学生比城市学生疲劳得分高差异有统计学意义（P＜0.05）.Logistic回归结果显示,锻炼时间少、恋爱、经济压力大、睡眠时间少、月消费水平低等因素均是大学生疲劳性亚健康发生的重要影响因素（P＜0.05）. 结论 长沙市某高校大学生疲劳性亚健康状况发生率较高,各高校应加大对大学生进行健康教育干预力度,引导大学生正确预防和消除疲劳性亚健康.     

Effect of acidic media on flexural strength and fatigue of CAD-CAM dental materials

ObjectiveTo investigate the effect of acidic media, including beverages and gastric fluids on flexural strength and fatigue of CAD-CAM materials.MethodsFour CAD-CAM materials (high-translucency zirconia (Ceramill Zolid HT+), lithium disilicate (IPS e-max CAD), hybrid ceramic (Vita Enamic), and nanohybrid resin composite (Grandio Blocs) were prepared and immersed in one of five media (gastric HCl, white wine, Coca-Cola, orange juice, and artificial saliva) in an incubator (37 ℃, 24 h). Surface topography and roughness were obtained using a scanning electron microscope (SEM) and a stylus contact profilometer, respectively. Initial 3-point flexural strength was measured for half of the bars (n = 20/gp) using a universal testing machine (0.5 mm/min). The other bars underwent 10⁶ cyclic fatigue loadings before measurement of residual 3-point flexural strength. Data were statistically analyzed (two-way and three-way ANOVA, Tukey’s post-hoc, p < 0.05). Weibull distributions were plotted for reliability analysis.ResultsZirconia bars has the highest initial flexural strengths followed by lithium disilicate, while resin composite and hybrid ceramic groups had the lowest strength regardless of the erosive medium. Cyclic fatigue significantly reduced initial flexural strengths for all materials except for hybrid ceramic and resin composite. Weibull moduli were the highest for zirconia, lithium disilicate and resin composite and lowest for hybrid ceramic.SignificanceErosive media significantly changed surface roughness of CAD-CAM materials except for zirconia and resin composite without jeopardizing the flexural strength of the CAD-CAM materials. Despite the higher flexural strengths for zirconia and lithium disilicate, resin composite and hybrid ceramic were more resistant to cyclic fatigue.     

Effects of an educational intervention for managing fatigue in women with early stage breast cancer

PurposeThis randomized controlled trial of outpatients with breast cancer (stage I or II) evaluated the effects of a 3-week educational intervention on patient levels of fatigue.MethodsNorwegian outpatients were randomized into an intervention group (n = 79) and a control group (n = 81). Women with fatigue (>2.5 on a 0–10 numeric rating scale, NRS) completed the Fatigue Questionnaire (FQ) and the Lee Fatigue Scale (LFS) at baseline (after treatment) (T1), immediately after intervention (T2) and 3 months after intervention (T3).ResultsThe mean fatigue score (NRS) at study entry was 6.1 (SD 1.7) and 36% (n = 57) had a score ≥7. There were no statistically significant differences between the fatigue measures of women in the intervention and control group at T2 or T3 in the overall sample after the intervention. Using an NRS cut-off of 5, there was a borderline difference for women who scored <5 for chronic fatigue on FQ (p = 0.062) and a significant difference for energy on LFS (p = 0.042) where the women in the intervention group had less fatigue. Using an NRS cut-off score of 6, there was a borderline difference for women who scored <6 for fatigue on FQ (p = 0.062) and a significant difference for energy on LFS (p = 0.021) where women in the intervention group had more energy than those in the control group.ConclusionsFurther research is needed to identify psycho-educational interventions to reduce levels of fatigue and to tailor an intervention based on the level of fatigue. Fatigue measurements should be chosen more carefully.     

背部按摩对癌症患者化疗后疲劳和焦虑情绪的影响

目的：探讨背部按摩护理干预对癌症患者化疗后疲劳及焦虑情绪的影响。方法选取2013年10月—2014年7月于浙江省衢州市某医院经病理学诊断为癌症的94例化疗患者。将94例患者按随机数表法分为观察组及对照组,每组47例。对照组患者进行一般常规护理,观察组患者在常规护理基础上实施规律背部按摩护理干预。在化疗第三周期第1天对两组患者疲劳自评量表（ FSAS）评分及焦虑自评量表（ SAS ）评分进行比较,并记录用药过程中出现的恶心、呕吐、心脏衰竭等不良反应。结果观察组患者中发生不良反应的例数均较对照组少,差异具有统计学意义（P＜0．05）。治疗前两组患者FSAS及SAS评分差异均无统计学意义（P＞0．05）;干预后观察组患者FSAS、SAS评分分别为（35．2±4．7）,（41．8±4．6）分,对照组分别为（45．3±5．8）,（59．4±7．1）分,两组比较差异均有统计学意义（t值分别为6．267,9．558;P＜0．01）;观察组患者干预后FSAS及SAS评分均低于干预前,干预前后比较差异均有统计学意义（ P ＜0．01）;干预后,对照组患者 SAS 评分升高,差异有统计学意义（ P ＜0．05）。结论经过背部按摩护理干预,患者不良反应发生率减少,舒适感增加而疲劳度降低,焦虑情绪也得到有效改善,应加以临床推广。