Jamisonmacgregor8010

CONTEXT Family caregivers encounter many challenges when managing pain for their loved ones. ​​There is a lack of clear recommendations on how to prepare caregivers in pain management. OBJECTIVE To evaluate existing interventions that support family caregivers in providing pain management to patients with all disease types. METHODS Four electronic databases were systematically searched (PubMed, CINAHL, PsycINFO, and Scopus) using index and keyword methods for articles published before December 2019. The Mixed Methods Appraisal Tool was used to assess the quality. RESULTS The search identified 6851 studies, and 25 studies met the inclusion criteria. Only two studies focused on non-cancer populations (8%). Three types of interventions were identified in this review (1) educational interventions, (2) cognitive-behavioral interventions, and (3) technology-based interventions. Both educational and cognitive-behavioral interventions improved family caregiver and patient outcomes but the content and intensity of these interventions in these studies varied widely, and there was a limited number of randomized clinical trials (68%). Hence, it is unclear what strategies are most effective to prepare family caregivers in pain management. Technology-based interventions were feasible to support family caregivers in providing pain management. CONCLUSION Providing adequate pain management training can improve patient and family caregiver outcomes. However, the most effective interventions for family caregivers are still unclear. More rigorous and replicable clinical trials are needed to examine the effects of educational interventions, cognitive-behavioral interventions, and technology-based interventions. Also, more studies are needed in patients with a non-cancer diagnosis or multimorbidity. Nutrition is an important source of exogenous AGEs and thermally processed foods present in western-style diets contain a large amount of these pro-inflammatory AGEs. Additionally, the intake of dietary AGEs could upregulate ovarian gene expression of inflammatory macrophage markers. The objective of this study was to investigate the effect of diet rich in AGEs on estrous cyclicity and ovarian function in a mouse model. Six-week old C57BL/6 J female mice were randomly subjected to either a diet low in AGEs (L-AGE) or a diet high in AGEs (H-AGE) for a total of 13 weeks. Experiments performed included daily vaginal smears to assess estrous cyclicity, ovarian superovulation with gonadotropins to assess the number of oocytes released, whole ovarian tissue mRNA quantification by RT-PCR to quantify genes involved in folliculogenesis, steroidogenesis, and macrophage markers, and ovarian morphology for follicle count. Outcome measures included estrous cyclicity, number of oocytes following superovulation, expression of genes involved in folliculogenesis, steroidogenesis, and macrophage infiltration as well as the number of primordial, primary, secondary, antral follicles and corpus lutea. Compared to mice on L-AGE diet, mice on H-AGE spent significantly longer time in the diestrus phase, had similar number of oocytes released following ovarian superovulation, and showed significant alterations in genes involved in steroidogenesis (increase in Star mRNA expression levels) and folliculogenesis (increase in Gdf-9 and Fshr mRNA expression levels). Mouse macrophage marker F4/80 mRNA expression was upregulated in mice on H-AGE diet compared to mice on L-AGE diet. Finally, mice on H-AGE diet had significantly fewer corpus lutea in their ovaries. These results indicate that the ingestion of high amounts of dietary AGEs could disrupt folliculogenesis and steroidogenesis that might lead to abnormal estrous cyclicity. Intake of dietary AGEs could also upregulate ovarian gene expression of inflammatory macrophage markers. V.BACKGROUND The phase 3 JAVELIN Renal 101 trial (NCT02684006) demonstrated significantly improved progression-free survival (PFS) with first-line avelumab plus axitinib vs sunitinib in advanced renal cell carcinoma (aRCC). We report updated efficacy data from the second interim analysis. Ivarmacitinib inhibitor PATIENTS AND METHODS Treatment-naïve patients with aRCC were randomized (11) to receive avelumab (10 mg/kg) intravenously every 2 weeks plus axitinib (5 mg) orally twice daily or sunitinib (50 mg) orally once daily for 4 weeks (6-week cycle). The two independent primary endpoints were PFS and overall survival (OS) among patients with PD-L1+ tumors. Key secondary endpoints were OS and PFS in the overall population. RESULTS Of 886 patients, 442 were randomized to the avelumab plus axitinib arm and 444 to the sunitinib arm; 270 and 290 had PD-L1+ tumors, respectively. After a minimum follow-up of 13 months (data cutoff Jan 28, 2019), PFS was significantly longer in the avelumab plus axitinib arm than in the sunitinib arm (PD-L1+ population hazard ratio [HR] 0.62 [95% CI, 0.490-0.777]; 1-sided P less then 0.0001; median 13.8 [95% CI, 10.1-20.7] vs 7.0 months [95% CI, 5.7-9.6]; overall population HR 0.69 [95% CI, 0.574-0.825]; 1-sided P less then 0.0001; median 13.3 [95% CI, 11.1-15.3] vs 8.0 months [95% CI, 6.7-9.8]). OS data were immature (PD-L1+ population HR 0.828 [95% CI, 0.596-1.151]; 1-sided P = 0.1301; overall population HR 0.796 [95% CI, 0.616-1.027]; 1-sided P = 0.0392). CONCLUSION Among patients with previously untreated aRCC, treatment with avelumab plus axitinib continued to result in a statistically significant improvement in PFS vs sunitinib; OS data were still immature. BACKGROUND Obesity and osteoporosis are two chronic conditions that have been increasing in prevalence. Menopausal transition years place women at high risk for visceral obesity as well as osteoporosis. This study was carried out to elucidate the effect of visceral adiposity on ovariectomy-induced osteoporosis in rats. METHODS We studied female Wistar rats aged 12-14 months, divided into four groups a) Sham-operated control (SHAM) rats (n = 12), rats were fed a control diet (59% of food intake from carbohydrates, 7% from fat, 21% from protein, 13% from minerals and ash) for 12 weeks, b) High fat diet-fed control (HFD) group (n = 9), rats were fed a high fat diet (49% of food intake from carbohydrates, 17% from fat, 21% from protein, 13% from minerals and ash)for 12 weeks, c) Ovariectomized (OVX) rats (n = 14), rats were fed a control diet as SHAM rats, d) High fat diet- fed ovariectomized (OVX- HFD) rats (n = 13), rats were fed a high fat diet as HFD group. At the end of the experiment, blood samples were collected for calcium, phosphorus, and alkaline phosphatase (ALP) assays.