Wilkersonkeegan1920

CONCLUSIONS KRD regimen, in our clinical case, showed some activity being well tolerated in a very poor prognosis disease such as PCL. Probably, right use and maybe sooner use of new drugs such as bortezomib or carfilzomib, in combination regimens, may be useful in better treating such disease.INTRODUCTION Narrative medicine makes explicit the experience of disease and enhances the subjective view in the cure. In addition, the narrative approach involves personal experience and emotional resonances of the health care professional leading him to redefine the values in terms of health and disease. check details The IMPERO study aims to explore the personal "life experience" of health care professionals involved in studies exploring a new methodological clinical approach the use of a digital narrative diary in collecting and integrating theme-oriented narration in clinical practice. METHODS Qualitative study based on the interviews of three health care professionals (two oncologists and one nurse) involved in the AMENO study. The main topic of the interviews was the "perceived" and the intimate experience of each health care professional, particularly on the meaning and the role regarding their personal and professional experience while coping with patients narration. The analysis of data focuses on three aspects areorganizing the criteria that contribute in defining the quality of patient care by focusing on the patient-health care professional relationship. DISCUSSION The approach of narrative medicine must be reviewed in the light of the relational systemic theory which allows us to understand several aspects the training in narrative medicine itself, the acquisition of professional skills by practitioners, and the organizational development of the institutions (the organizational structures but also the values and professional culture of work).Increased life expectancy rates in people with a stoma prompt the need to gain a better understanding of what are the concerns and the strategies of adaptation in this population in the long term to provide appropriate guidance and ongoing care. Therefore, the aim of this study is to explore the experiences and perceptions of people living with a colostomy for at least 20 years with regard to body changes and how these influence stoma care. This is phenomenological study. Five main themes were identified following data analyses 1) accepting the stoma and living one's life almost fully; 2) changes; 3) practices to which I owe the recovery of my autonomy; 4) we are in need before, during and after; 5) most people don't know. After many years, interviewees did not report significant changes in the way they had to manage their stoma and activities of daily living. Participants underlined how their healthcare needs continue throughout their lives, thus outlining the key role they attribute to nurses, stoma therapy services and associations of people with a stoma.Communicating unexpected and bad news is a stressful yet unavoidable aspect of clinical practice. However, there is a lack of educational models to train clinicians for difficult conversations. This study aims to describe the main characteristics of the Program to Enhance Relational and Communication Skills (PERCS); present PERCS efficacy at 10 years since its inception in Italy; and illustrate a specific PERCS on organ donation as an example. PERCS is an educational model based on principles of experiential learning, developed at Children's Hospital Boston. PERCS has been offered as a continuing medical education program in an academic hospital in Milan. PERCS workshops last 5 hours and enroll a maximum of 13-15 interdisciplinary participants across levels of experience. The workshops are geared around the simulation and debriefing of difficult conversations. Before and after the workshops, participants rated their perceived preparation, communication and relational skills, confidence, and anxiety on 5-point Likert scales. Pre-post data were analyzed with paired sample t-tests. Between 2008 and 2018, 52 workshops have been offered, involving a total of 602 participants. Participants reported better preparation, confidence, communication and relational skills, and lower anxiety (for all dimensions, p less then 0.001) after the workshops. The strengths of the PERCS model includes the integration between teaching specific skills and promoting relational attitudes, the learner-centered method, and its efficacy. Major challenges relate to the assessment of actual behavioral change of participants and long-lasting effect of the program at follow-ups.Cutaneous adverse effects are often associated to cancer therapies. Modifications of the aspect represent one of the factors responsible for quality of life decrese, particularly visible in women. It must be underlined also that in many female tumors the cutaneous adverse effects are often enhanced by the hormonal levels inducing skin damage and photoinduced reactions. In this scenario the cosmetic oncology plays a very important role. In fact, it is a branch of cosmetic, having high social and ethical value born to support oncological patients by physical appearance improvement. The skin and cutaneous annexes of the oncological patient are different in comparison to that of health people requiring particular attention. In first instance a high skin protection and hydration is necessary for such patients. For this reason, the cosmetic oncology supports the oncological patients in the improvement of their appearance by means of specific products and skin care procedures. Projects of cosmetic oncology, involving many territorial pharmacies, raised with the idea that the attenuation of the external signs therapy-induced can contribute to the improvement of the patient quality of life.Radiomics is a new frontier of medicine based on the extraction of quantitative data from radiological images which can not be seen by radiologist's naked eye and on the use of these data for the creation of clinical decision support systems. The long-term goal of radiomics is to improve the non-invasive diagnosis of focal and diffuse diseases of different organs by understanding links between extracted quantitative imaging data and the underlying molecular and pathological characteristics of lesions. In the last decade, several studies have highlighted the enormous potential of radiomics in both tumoral and non-tumoral diseases of many organs and systems including brain, lung, breast, gastrointestinal and genitourinary tracts. The enormous potential of radiomics needs to be pursued with the methodological rigor of scientific research and by integrating radiological data with other medical disciplines, in order to improve personalized patient management.Neoplasms that arise during pregnancy or within the first year of childbirth are rare events, the occurrence of which, however, tends to increase due to the advancement of the age of reproduction. The simultaneous manifestation of the two events determines in the woman a deep distress due partly to oncological treatments and partly to the woman's wish to experience the "normality of pregnancy". Anxiety, depressive thoughts and fear of the illness reoccurring are all elements that increase the ambivalences that are normally associated with pregnancy. The dedicated healthcare professionals must guarantee a multidisciplinary and holistic approach, custom-made for the woman specifically, and for her family, during her path through pregnancy and illness.Oral cancer drugs often pose problems with proper intake and adequate compliance with treatment. In the age of electronic devices, it is appropriate to try and use technology to optimize drug intake and, potentially, the outcome.An amendment to this paper has been published and can be accessed via a link at the top of the paper.Tonicity-responsive enhancer-binding protein (TonEBP), which is also known as nuclear factor of activated T cells 5 (NFAT5), was discovered 20 years ago as a transcriptional regulator of the cellular response to hypertonic (hyperosmotic salinity) stress in the renal medulla. link2 Numerous studies since then have revealed that TonEBP is a pleiotropic stress protein that is involved in a range of immunometabolic diseases. Some of the single-nucleotide polymorphisms (SNPs) in TONEBP introns are cis-expression quantitative trait loci that affect TONEBP transcription. These SNPs are associated with increased risk of type 2 diabetes mellitus, diabetic nephropathy, inflammation, high blood pressure and abnormal plasma osmolality, indicating that variation in TONEBP expression might contribute to these phenotypes. In addition, functional studies have shown that TonEBP is involved in the pathogenesis of rheumatoid arthritis, atherosclerosis, diabetic nephropathy, acute kidney injury, hyperlipidaemia and insulin resistance, autoimmune diseases (including type 1 diabetes mellitus and multiple sclerosis), salt-sensitive hypertension and hepatocellular carcinoma. These pathological activities of TonEBP are in contrast to the protective actions of TonEBP in response to hypertonicity, bacterial infection and DNA damage induced by genotoxins. An emerging theme is that TonEBP is a stress protein that mediates the cellular response to a range of pathological insults, including excess caloric intake, inflammation and oxidative stress.OBJECTIVES To assess the efficacy of high-intensity interval training (HIIT) for improving cardiorespiratory fitness (CRF) in patients awaiting resection for urological malignancy within four weeks. SUBJECTS/PATIENTS AND METHODS A randomised control trial of consecutive patients aged (>65 years) scheduled for major urological surgery in a large secondary referral centre in a UK hospital. The primary outcome is change in anaerobic threshold (VO2AT) following HIIT vs. standard care. RESULTS Forty patients were recruited (mean age 72 years, male (39) female (1)) with 34 completing the protocol. Intention to treat analysis showed significant improvements in anaerobic threshold (VO2AT; mean difference (MD) 2.26 ml/kg/min (95% CI 1.25-3.26)) following HIIT. Blood pressure (BP) also significantly reduced in following HIIT (SBP -8.2 mmHg (95% CI -16.09 to -0.29) and DBP -6.47 mmHg (95% CI -12.56 to -0.38)). No reportable adverse safety events occurred during HIIT and all participants achieved >85% predicted maximum heart rate during sessions, with protocol adherence of 84%. CONCLUSIONS HIIT can improve CRF and cardiovascular health, representing clinically meaningful and achievable pre-operative improvements. Larger randomised trials are required to investigate the efficacy of prehabilitation HIIT upon different cancer types, post-operative complications, socio-economic impact and long-term survival.Understanding the targeting and spreading patterns of long non-coding RNAs (lncRNAs) on chromatin requires a technique that can detect both high-intensity binding sites and reveal genome-wide changes in spreading patterns with high precision and confidence. Here we determine lncRNA localization using biotinylated locked nucleic acid (LNA)-containing oligonucleotides with toehold architecture capable of hybridizing to target RNA through strand-exchange reaction. During hybridization, a protecting strand competitively displaces contaminating species, leading to highly specific RNA capture of individual RNAs. Analysis of Drosophila roX2 lncRNA using this approach revealed that heat shock, unlike the unfolded protein response, leads to reduced spreading of roX2 on the X chromosome, but surprisingly also to relocalization to sites on autosomes. link3 Our results demonstrate that this improved hybridization capture approach can reveal previously uncharacterized changes in the targeting and spreading of lncRNAs on chromatin.