Recall of emotional and neutral words and paragraphs in traumatic brain injury

Background: Traumatic brain injury (TBI) results in verbal recall deficits and impaired processing of emotion encoded in facial appearance, prosody and the linguistic content of messages. Emotion facilitates memory (emotional memory advantage) for non-brain injured (NBI) individuals but the impact of emotion on verbal recall for linguistically encoded stimuli in TBI has not been explored.

Aims: The purpose of this study was to determine the effects of stimulus emotional content on verbal recall of words and paragraphs in TBI compared to NBI individuals.

Methods and procedures: Six 10-item lists, each with five emotional and five neutral words, and six paragraphs (three emotional, three neutral) were counterbalanced and presented in random order to 20 individuals with TBI and 44 NBI. The number of words from lists and the number of content units from paragraphs were compared for the two groups.

Outcomes and results: The NBI participants recalled more words from the lists and content units from the paragraphs than the individuals with TBI. Both groups recalled significantly more emotional than neutral words. NBI but not TBI participants had significantly greater recall for information in paragraphs with emotional content.

Conclusions: Participants with TBI showed impaired recall of words and paragraph content. Emotion facilitated word and paragraph content recall for neurotypical individuals but emotional memory advantage was limited to words for the TBI participants.     

Depression embodied: an ambiguous striving against fading

Although depression is associated to physical discomfort, meanings of the body in depression are rarely addressed in clinical research. Drawing on the concept of the lived body, this study explores depression as an embodied phenomenon. Using a hermeneutic phenomenological approach, the analysis of narrative‐based interviews with 11 depressed adults discloses a thematic structure of an embodied process of an ambiguous striving against fading. Five subthemes elicit different dimensions of this process, interpreted as disabling or enabling: feeling estranged, feeling confined, feeling burdensome, sensing life and seeking belongingness. In relation to clinical practice, we suggest that the interdisciplinary team can focus on enhancing the enabling dimensions, for example through guided physical activities to support the patient to feel more alive, capable and connected. Moreover, we suggest that the treatment process benefits from an increased awareness of the ambiguity in the patient's struggle, acknowledging both destructive and recharging elements of the withdrawing, and the perceived conflict in‐between.     

Sacituzumab govitecan: breakthrough targeted therapy for triple-negative breast cancer

Introduction: Triple negative breast cancer (TNBC) is an aggressive breast cancer subtype associated with an increased risk of recurrence and cancer-related death. Unlike hormone receptor-positive or HER2-positive breast cancers, there are limited targeted therapies available to treat TNBC and cytotoxic chemotherapy remains the mainstay of treatment. Sacituzumab govitecan (IMMU-132) is an antibody-drug conjugate targeting Trop-2 expressing cells and selectively delivering SN-38, an active metabolite of irinotecan.

Areas covered: This review covers the mechanism of action, safety and efficacy of sacituzumab govitecan in patients with previously treated, metastatic TNBC. Additionally, efficacy data in other epithelial malignancies is included based on a PubMed search for ‘sacituzumab govitecan’ and ‘clinical trial’.

Expert opinion: Sacituzumab govitecan has promising anti-cancer activity in patients with metastatic TNBC previously treated with at least two prior lines of systemic therapy based on a single arm Phase I/II clinical trial. A confirmatory Phase III randomized clinical trial is ongoing. Sacituzumab govitecan has a manageable side effect profile, with the most common adverse events being nausea, neutropenia, and diarrhea. The activity of sacituzumab govitecan likely extends beyond TNBC with promising early efficacy data in many other epithelial cancers, including hormone receptor-positive breast cancer.     

Is routine extubation overnight safe in cardiac surgery patients?

Objectives

Expedient extubation after cardiac surgery has been associated with improved outcomes, leading to postoperative extubation frequently during overnight hours. However, recent evidence in a mixed medical-surgical intensive care unit population demonstrated worse outcomes with overnight extubation. This study investigated the impact of overnight extubation in a statewide, multicenter Society of Thoracic Surgeons database.