Clinical Utility of Melatonin in Fibromyalgia Diagnosis

       Fibromyalgia syndrome (FMS) is a chronic disease with an unknown etiology, which is characterized by reduced pain threshold (hyperallgesia) & pain with normally innocuous stimuli (allodynia).This diffuse pain is often disease associated  with wide range of  other symptoms including fatigue, sleep disturbance, stiffness& more.FMS often occur concomitantly  with other rheumatologic disease such as rheumatoid arthritis(RA), systemic lupus erthymatosus(SLE).       The pineal hormone melatonin (MT) exerts a variety of effects on the immune system. MT activates immune cells and enhances inflammatory cytokine and nitric oxide production.Methods: We were studied 75 subjects, 55 of subjects were FMS patients defined by the American Colleague of Rheumatology (ACR 2010) criteria. Patients' mean age was 32.5 ± 13.9 years. They were classified into two groups: Group I of 25  primary FMS patients . Group II of 30 secondary FMS patients with other rheumatologic disease such as RA, SLE. Twenty age and sex matched healthy individuals were included in the study as a control group.Results:Mean Melatonin titers were significantly reduced (p<0.0001) in primary FMs patients compared to the controls (21.32vs. 30.9 pg/ml), but they were significantly elevated (p<0.0001) in secondary FMS compared to controls (138.1vs.30.9 pg/ml). Our data imposed that, in 1ry FMS there were negative correlations of MT titers with tender points (r=-0.848**,p<0.0001), sleep disturbance(r=-0.963**, p< 0.0001**), Fatigue (r= -0.972**, p<0.001**), WPI (r= -0,953 **, p<0.0001) and SS (r=-0.901**, p< 0.0001). Conclusions:In primary FMS patients melatonin level is lower than melatonin level in control, but MT level is high in secondary FMS patients. There was a negative correlation between MT with tender points, sleep disturbance, fatigue, SS & WPI. But there was a positive correlation between MT & cognitive symptoms

Nurses experience of caring for patients with COVID-19 : a phenomenological study

Introduction: COVID-19 has impacted all dimensions of life and imposed serious threat on humankind. Background: In Jordan, understanding how nurses experienced providing care for patients with COVID-19 offers a framework of knowledge about similar situations within the context of Arabic culture. Aim: To explore nurses' experience with providing hands-on care to patients with active COVID-19 infection in an Arabic society. Methods: A descriptive phenomenological study interviewed 10 nurses through a purposive sampling approach until data saturation was reached. The research site was hospital designated to receive patients with active COVID-19 infection. Semi-structured interviews were used to collect the data. Findings: Three themes were generated from the data: the impact of the COVID-19 outbreak on nurses' health; unfamiliar work and social environments; and conforming to professional standards. Discussion: There are specific risks to the physical and mental wellbeing of nurses who provide hands-on care to patients with COVID-19 in an Arabic society. Implication for nursing and health policy: Health care institutions should consider establishing programs that promote nurses' wellbeing and support their productivity in a crisis. A danger pay allowance should be considered for nurses during extraordinary circumstances, such as pandemics

Knowledge of Critical Care Nurses about End-of-Life Care towards Terminal Illnesses: Levels and Correlating Factors

Introduction: The preparedness of nurses in relation to providing palliative care is not always adequate, indeed, it is sometimes unsatisfactory; this may be caused by lack of knowledge and limited experience in end-of-life care (EOLC). Thus, this study purposed to assess the levels of registered nurses’ knowledge about EOLC, examine the relationships between EOLC knowledge and some demographic variables, and explore predictors of EOLC knowledge. Methods: A cross-sectional design survey was conducted with Jordanian registered nurses in critical care units (N = 175) in different heath sectors in Jordan. The End-of Life Professional Caregiver Survey (EPCS) was used. Results: Findings showed that nurses had moderate/quite a lot of knowledge (M (SD) = 2.58 (.48)) about EOLC. The cultural and ethical values was the highest subscale of knowledge about EOLC (M (SD) = 2.74 (.52)), while effective care delivery subscale was the lowest one ((M (SD) = 2.33 (.66). Knowledge about EOLC was correlated with age (r = .145, P < .05), work experience (r = .173, P < .05), and training course in palliative or EOLC (r = .217, P < .01). The main predictor of EPCS was training courses in palliative or EOLC (B = .190, P < .05). Conclusion: The nurses need to enhance their knowledge about EOLC and correlating factors should be taken into consideration when developing any intervention program. Nurses need palliative care training courses; also more attention is required in palliative care education particularly in clinical skills in effective care deliver

Inflammatory Activation of Astrocytes Facilitates Melanoma Brain Tropism via the CXCL10-CXCR3 Signaling Axis

Melanoma is the deadliest skin cancer due to its high rate of metastasis, frequently to the brain. Brain metastases are incurable; therefore, understanding melanoma brain metastasis is of great clinical importance. We used a mouse model of spontaneous melanoma brain metastasis to study the interactions of melanomas with the brain microenvironment. We find that CXCL10 is upregulated in metastasis-associated astrocytes in mice and humans and is functionally important for the chemoattraction of melanoma cells. Moreover, CXCR3, the receptor for CXCL10, is upregulated in brain-tropic melanoma cells. Targeting melanoma expression of CXCR3 by nanoparticle-mediated siRNA delivery or by shRNA transduction inhibits melanoma cell migration and attenuates brain metastasis in vivo. These findings suggest that the instigation of pro-inflammatory signaling in astrocytes is hijacked by brain-metastasizing tumor cells to promote their metastatic capacity and that the CXCL10-CXCR3 axis may be a potential therapeutic target for the prevention of melanoma brain metastasis

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Investigation of disease mechanisms of Collagen IV variants in stroke and protein secretion in endothelial cells

Abstract not currently available

Depressive symptoms among older Jordanian patients with cancer undergoing treatment

To date, the relationship of socio-demographic, treatment, and psychological factors to depression in older patients with cancer has not been systematically studied in Arabic samples, including Jordanian despite the increasing incidence of cancer (Mosleh, Alja’afreh, Alnajar, & Subih, 2018). This study is of significance because it fills the gap in literature in terms of assessing the psychological reactions of older patients with cancer in Middle Eastern countries. Early assessment of the predictors of depressive symptoms among older patients with cancer is essential to craft individualized health-care plans. Thus, our study seeks to assess the levels of depressive symptoms, anxiety, and hope among older Jordanian patients with cancer who are currently undergoing treatment, and to identify the relationship between selected factors (socio-demographic, treatment, and psychological) and depressive symptoms

Self-esteem, stress, and depressive symptoms among Jordanian pregnant women : social support as a mediating factor

This study purposed to assess the mediating role of social support between stress, depressive symptoms, and self-esteem among Jordanian pregnant women. Across-sectional study recruited a total of 538 pregnant Jordanian women using a cluster stratified random sampling technique, during the period from September 2019 to February 2020. The study used the following measures: The Perceived Stress Scale (PSS), Beck’s Depression Inventory (BDI), Rosenberg Self-Esteem Scale, and Multidimensional Social Support Scale (MSPSS). Descriptive statistics and inferential statistics were used to test the mediating effect of social support in terms of the association between depression and self-esteem. The results were considered significant if p ≤.05. The findings showed that 75.6% of participants had moderate-to-high stress levels. High levels of stress, depressive symptoms, and low self-esteem were highly correlated with low social support (p &lt;.05). Depressive symptoms predict the self-esteem (F(2, 537) = 158.631 p &lt;.05). Social support significantly mediates the relationship between the depressive symptoms and self-esteem with p =.01. Thus, during the antenatal care, administration of screening tools to identify pregnant women with low social support levels and at risk of developing psychological difficulties would allow primary healthcare to promote for positive health outcomes for the mothers and the babies

Psychosocial correlates of work-related fatigue among Jordanian emergency department nurses

Purpose: This study purposed to assess the psychosocial correlates of work-related fatigue among Jordanian emergency department nurses. Design and Methods: A cross-sectional study was conducted among Jordanian emergency nurses (n = 220). Measures included Occupational Fatigue Exhaustion/Recovery Scale (OFER15) and Copenhagen Psychosocial Questionnaire version Two (COPSOQ II). Findings: The psychosocial factors correlated with all types of work-related fatigue (acute, chronic, and inter-shift [recovery]) were quantitative demands, work-family conflict, sexual harassment, threats of violence, physical violence, and bullying. Importantly, quantitative demands and sexual harassment were the main predictors of all types of work-related fatigue. Practice Implications: The psychosocial correlated factors should be considered when developing interventions to minimize work-related fatigue phenomenon. This would lead to a more positive working environment which will promote safe nursing care