Psychological and relational factors in ESRD hemodialysis treatment in an underserved community

ObjectiveThe researchers investigated the association of depression with treatment adherence, and examined the possible moderating roles of social support and of the physician-patient working alliance (PPWA) on treatment adherence, satisfaction with treatment, and quality of life.MethodsThe current study sampled ninety-five patients with End Stage Renal Disease who were receiving outpatient hemodialysis (HD) treatment.ResultsFindings indicated that higher levels of depression were significantly associated with lower ratings of adherence, quality of life, and social support. In contrast, higher levels of social support and of the PPWA were significantly associated with higher ratings of adherence, satisfaction with treatment, and quality of life. Analyses of moderation showed no effect for PPWA between depression and adherence, satisfaction, or quality of life; however, there was a significant moderation effect for social support.ConclusionThere are mild but significant associations between PPWA and social support. Positive associations between the PPWA and social support on adherence, satisfaction, and quality of life indicate that each one, PPWA and social support, plays its own role on patients’ experiences of and behavior in treatment. Affective social support significantly limits the negative influence of depression on adherence.Practice ImplicationsAssessment of depression and social support is essential in hemodialysis treatment.     

Modulation of flexo-rigid balance in photoresponsive thymine grafted copolymers towards designing smart healable coating

Efficacy and durability of the photovoltaic device mandates its protection against hot, humid weather condition, high energy of UV light and unwanted scratches. Such challenges can be mitigated by smart polymeric coating with inherent properties e.g. hydrophobicity to prevent moisture, optimal viscocity for better processibility and crack-healing. The hydrophobic polymers TP1–TP4 containing pendant photo-crosslinkable thymine moieties are designed that undergo [2 + 2] photocycloaddition upon UV_B irradiation and can be dynamically reverted back upon irradiation with UV_C light. A judicious control of solvent environment, chain length, functionality% and concentration of the polymers regulate the aspects of photodimerization thereby, rendering intra or inter-chain collapse to form diverse nanostructures. Photodimerization of the thymine moieties renders coil to globule transformation in dilute condition whereas irradiation performed at high macromolecular concentration regime exhibits higher order nanostructures. The photoresponsive chain collapse leads to the formation of rigid crosslinked domains within flexible polymer chains akin to the hard–soft phases of thermoplastic elastomers. Such rigidification of the crosslinked segments endows a tool to photomodulate the glass transition temperature (T_g) that can dynamically revert back upon decrosslinking. Further, the structural modulation of the polymers is explored towards autonomic and nonautonomic self-healing behaviour at ambient conditions. Moreover, the self-healing efficacy can be tuned with the film thickness and it remains unaltered upon using solar simulator or direct sunlight. Overall, such hydrophobic low T_g polymers display photo-regulated self-healing mechanism consisting of both autonomic and non-autonomic self-healing and may find applications in designing smart protective coatings for photovoltaic devices.

Photo-crosslinking using [2 + 2] cycloaddition in thymine grafted low viscosity polymer generates flexorigid domain to result self-healing polymer with increased hydrophobicity for potential use as smart coating material.     

Primary chondrosarcoma of the heart.

Primary cardiac chondrosarcoma is extremely rare with very few cases reported in the literature. Most cardiac chondrosarcomas described in the literature are secondary. We report herein a case of 22-year-old man who presented with easy fatigability, which the general practitioner diagnosed as mitral stenosis clinically. Echocardiography showed left atrial mass, possibly myxoma. The histopathology of the excised mass revealed mesenchymal chondrosarcoma, confirmed by immunohistochemistry. Clinical and radiological studies did not reveal any other neoplasm.     

Protocadherin PCDH10, involved in tumor progression,is a frequent and early target of promoter hypermethylation in cervical cancer

Cervical cancer (CC) is the second most common cancer in women. Currently, no tractable molecular‐based therapeutic targets exist for patients with invasive CC and no predictive markers of risk assessment for progression of precancerous lesions are identified. New molecular insights into CC pathogenesis are urgently needed. Towards this goal, we first determined the copy number alterations of chromosome 4 and then examined the role of PCDH10 mapped to 4q28 as a candidate tumor suppressor gene. We identified monosomy 4 in 47% of 81 invasive CC studied by SNP array and found that 91% of 130 invasive CC harboring methylation in the promoter region of the PCDH10 gene. We then showed that aberrant promoter hypermethylation of PCDH10 is associated with downregulation of gene expression and cell lines exposed to demethylating agent resulted in profound reactivated gene expression. We also showed that the promoter methylation in the PCDH10 gene occurs at an earliest identifiable stage of low‐grade squamous intraepithelial lesion. Our studies demonstrate that inactivation of PCDH10 may be a critical event in CC progression and form a potentially useful therapeutic target for CC. © 2009 Wiley‐Liss, Inc.     

Four-rooted maxillary first molar having C-shaped palatal root canal morphology evaluated using cone-beam computerized tomography: a case report

The aim of this article was to present an endodontically managed maxillary first molar with unusual C-shaped palatal root morphology confirmed by cone-beam computerized tomography (CBCT) images. CBCT axial images showed the presence of C-shaped palatal root canal anatomy with a palatal root bifurcation at the apical third. The evaluation of CBCT images can result in better understanding of root canal anatomy, which enables the clinician to investigate the root canal system and to clean, shape, and obturate it more effectively.     

Neuroendocrine tumor of vulva: a case report and review of literature

Neuroendocrine tumor (Merkel cell carcinoma-MCC) of the vulva is a very rare entity with less than 15 cases reported in the English literature. It is known for its aggressive behaviour and propensity for early dissemination. The actual cell of origin and etiology of this disease is controversial. In absence of any definite guidelines for management (due to its rarity), extrapolation of data from extra-vulvar MCC seems logical. We present a case of vulvar neuroendocrine tumor who presented at a locally advanced stage.     

Pathophysiology of low back pain during exposure to microgravity

Astronauts exposed to microgravity frequently report low back pain. This pain is described as moderate to severe in intensity. This condition warrants investigation as low back pain may hinder an astronaut's ability to perform challenging tasks by virtue of disruption of sleep and, subsequently, mental concentration. It is reported by astronauts that a "fetal tuck position" described as knees to chest position relieves back pain. It is possible that the pathogenesis of back pain in microgravity is discogenic (or mechanical) and somatic, referred from the sinuvertebral nerves due to excessive expansion of the lumbar intervertebral discs associated with reduction of gravitational compressive loads in space. The fetal tuck position may increase lumbar intervertebral disc hydrostatic pressure by flexion and transfer of spinal compressive forces toward the anterior region of the lumbar discs, subsequently reducing disc volume. Moreover, this position may reduce Type IV mechanoreceptor facilitation and nerve impulse propagation from the sinuvertebral nerves of the annulus fibrosus, and thus diminish low back pain perception. Elongated posterior soft tissues (apophyseal joint capsules and ligaments) with spinal flexion may potentially stimulate Type I and II mechanoreceptors. This neutralizes substance P in the spinal cord dorsal horn by increasing naturally occurring opioids such as enkephalins. Separately, other investigators have reported a higher incidence of herniated discs (HNP) in astronauts postflight. Further studies of countermeasures are recommended to prevent excessive spinal elongation and disc expansion, reduce low back pain in microgravity, and simulate 1-G disc homeostasis, which may also help prevent HNPs postflight.     

Worldwide Analyses of Maxillary First Molar Second Mesiobuccal Prevalence: A Multicenter Cone-beam Computed Tomographic Study

Introduction

Maxillary first molar second mesiobuccal (MB2) root canal prevalence may change among different populations. The aim of this study was to analyze the worldwide prevalence of the MB2 root canal and understand its possible relation with sex, age, side, and root configuration using in vivo cone-beam computed tomographic (CBCT) assessment.