Effects of tapentadol on pain, motor symptoms and cognitive functions in Parkinson\u2019s disease

Background: Pain is a common and undertreated non-motor symptom in patients with Parkinson\u2019s disease (PD). Opioids have been seldom used in PD because they could worsen cognitive and motor functions. Objective: We aimed to assess efficacy and tolerability of tapentadol in PD patients. Methods: We retrospectively reviewed 21 PD patients treated with tapentadol extended release (ER) for chronic pain. Patients were evaluated before treatment and at 3 and 6 months during treatment for pain intensity (current, 24-hour average, and minimum and worst) with a 0-10 Numerical Rating Scale and the painDETECT questionnaire; for motor symptom severity with the Unified Parkinson\u2019s Disease Rating Scale part III and the Hoehn and Yahr scale; for cognitive functions with MiniMental Status Examination, Corsi\u2019s Block Tapping test, Digit Span, Digit-Symbol Substitution test, FAS test, Rey\u2019s Auditory Verbal Learning test, Trail Making-A and -B, and the 9 Hole-Peg Test; for anxiety and depression with the Hospital Anxiety and Depression Scale; and for the quality of life with the Short Form-12 for Quality of Life. Data were analyzed by one-way ANOVA and paired t-test, and by Friedman\u2019s and Wilcoxon\u2019s test. Statistical significance was taken in all cases as P < 0,05. Results: Pain intensity decreased over the course of treatment. No differences were found in PD symptom severity and dopaminergic drug dosages between pretreatment and treatment evaluations . No decrement in cognitive neuropsychological performances was found and an improvement was observed in Digit Span, Digit-Symbol Substitution test and FAS test. The levels of anxiety, depression and of quality of life improved. Overall tapentadol ER was well tolerated and most patients reported no or mild and short-lived gastroenterological and neurological side effects. Conclusions: These results indicate the potential efficacy and tolerability of medium-high dose of tapentadol ER for the treatment of pain in PD

Pediatric Oncology: Causes, Treatments, and the Role of Integrated Medicine

Cancer is responsible for approximately 10%-12% of childhood deaths, and is second only to accidents as the leading cause of death in individuals over age 14 (Rape & Bush, 1994). There are various forms of cancer that can afflict a child and numerous ways to combat the disease. While it is important to fight the physical aspects of the disease to increase the child\u27s chance of survival, it is also important to deal with the psychological issues that accompany pediatric oncology. Various psychological treatments are available to help a child endure the emotional and physical stresses associated with chemotherapy and other medical procedures. This review paper assesses various studies that evaluate the effects of many psychological treatments aimed at reducing anticipatory nausea/vomiting and children\u27s emotional reactions to future treatments. The studies found that caring attention and emphasis on relaxing techniques to take the children\u27s minds off the pain cancer treatment is causing help the children cope with the effects that the treatment has on them both physically and emotionally

Neutralizing the EGF receptor in glioblastoma cells stimulates cell migration by activating uPAR-initiated cell signaling.

In glioblastoma (GBM), the EGF receptor (EGFR) and Src family kinases (SFKs) contribute to an aggressive phenotype. EGFR may be targeted therapeutically; however, resistance to EGFR-targeting drugs such as Erlotinib and Gefitinib develops quickly. In many GBMs, a truncated form of the EGFR (EGFRvIII) is expressed. Although EGFRvIII is constitutively active and promotes cancer progression, its activity is attenuated compared with EGF-ligated wild-type EGFR, suggesting that EGFRvIII may function together with other signaling receptors in cancer cells to induce an aggressive phenotype. In this study, we demonstrate that in EGFRvIII-expressing GBM cells, the urokinase receptor (uPAR) functions as a major activator of SFKs, controlling phosphorylation of downstream targets, such as p130Cas and Tyr-845 in the EGFR in vitro and in vivo. When EGFRvIII expression in GBM cells was neutralized, either genetically or by treating the cells with Gefitinib, paradoxically, the cells demonstrated increased cell migration. The increase in cell migration was explained by a compensatory increase in expression of urokinase-type plasminogen activator, which activates uPAR-dependent cell signaling. GBM cells that were selected for their ability to grow in vivo in the absence of EGFRvIII also demonstrated increased cell migration, due to activation of the uPAR signaling system. The increase in GBM cell migration, induced by genetic or pharmacologic targeting of the EGFR, was blocked by Dasatinib, highlighting the central role of SFKs in uPAR-promoted cell migration. These results suggest that compensatory activation of uPAR-dependent cell signaling, in GBM cells treated with targeted therapeutics, may adversely affect the course of the disease by promoting cell migration, which may be associated with tumor progression

Le Dinamiche Temporali della Condivisone di Conoscenza in contesti di lavoro virtuale: uno studio empirico longitudinale

La gestione della conoscenza aziendale viene ormai unanimemente riconosciuta dagli studiosi di economia aziendale come un’importante leva strategica e competitiva per l’impresa. Tuttavia, nonostante lo sforzo di ricerca profuso sul tema in questi anni, sembra che in letteratura non si siano ancora formate opinioni condivise e stabili circa le modalità più efficaci di gestione, misurazione e valutazione delle conoscenze in azienda. Di contro, gli studi in materia sembrano essere spesso divisi da opinioni divergenti e talvolta opposte sul concetto stesso di conoscenza cui fare riferimento e sugli obiettivi analitici da assegnare alla ricerca scientifica sul tema. Si ritiene che le divergenze analitiche ed epistemologiche che fino ad oggi hanno caratterizzato la letteratura aziendale sul Knowledge Management costituiscano un limite più che un’opportunità al fine di favorire un’efficace comprensione e gestione della conoscenza aziendale da parte del mondo manageriale. A nostro parere, infatti, il top management e i principali livelli direzionali aziendali potrebbero beneficiare di una lettura integrata e organica dei diversi contributi offerti sul tema dalla letteratura accademica, con particolare riferimento alle tecniche di misurazione della conoscenza. Al fine di delineare i primi elementi di questa prospettiva integrata, in vista di una sistematizzazione unitaria dei diversi approcci al tema, in questo lavoro discuteremo i risultati di un caso empirico di Knowledge Management aziendale. Per fare questo, il presente lavoro è stato articolato in due momenti, il primo di analisi teorica, il secondo di analisi empirica. Il primo momento consiste in un’analisi dei principali approcci al tema del Knowledge Management emersi nella letteratura aziendale, al fine di metterne in luce limiti e opportunità. Il secondo momento consiste nell’esposizione e discussione delle evidenze empiriche riscontrate sul campo. Nelle conclusioni verranno discusse alcune possibili implicazioni pratiche e teoriche dell’indagine empirica

Brokerage Styles and Interaction Rituals in Creative Projects: Towards an Interactionist Perspective on Brokerage

Despite the importance of brokers in creative projects, limited attention has been devoted to the micro-interactions by which brokers induce others’ collaboration while simultaneously retaining some control over creative production. Building on an interactionist perspective, we develop the concept of brokerage style – i.e., a recognizable pattern in the ways in which a broker interacts with others. By using different brokerage styles in different phases of a creative project, brokers can orient the social interactions among project participants, “charging” those interactions with different types of emotional energy and mutual attention, eventually inducing collective collaboration and limiting participants’ expectations of control. We illustrate our interactionist model of brokerage styles with examples from the music and TV industries