Role of sex on psychological distress, quality of life, and coping of patients with advanced colorectal and non-colorectal cancer

Patients with advanced gastrointestinal cancer must cope with the negative effects of cancer and complications. However, data on psychological distress, quality of life, and coping strategies in patients with advanced colorectal cancer compared to non-colorectal cancer based on sex is lacking. This was a multicenter study conducted in 203 patients that completed questionnaires evaluating psychological distress, quality of life, and coping strategies before starting systemic cancer treatment. Based on these data, the degree of disease acceptance in gastrointestinal malignancies may depend on sex and location of the primary digestive neoplasm

Final results from the PERUSE study of first-line pertuzumab plus trastuzumab plus a taxane for HER2-positive locally recurrent or metastatic breast cancer, with a multivariable approach to guide prognostication

Background: The phase III CLinical Evaluation Of Pertuzumab And TRAstuzumab (CLEOPATRA) trial established the combination of pertuzumab, trastuzumab and docetaxel as standard first-line therapy for human epidermal growth factor receptor 2 (HER2)-positive locally recurrent/metastatic breast cancer (LR/mBC). The multicentre single-arm PERtUzumab global SafEty (PERUSE) study assessed the safety and efficacy of pertuzumab and trastuzumab combined with investigator-selected taxane in this setting. Patients and methods: Eligible patients with inoperable HER2-positive LR/mBC and no prior systemic therapy for LR/mBC (except endocrine therapy) received docetaxel, paclitaxel or nab-paclitaxel with trastuzumab and pertuzumab until disease progression or unacceptable toxicity. The primary endpoint was safety. Secondary endpoints included progression-free survival (PFS) and overall survival (OS). Prespecified subgroup analyses included subgroups according to taxane, hormone receptor (HR) status and prior trastuzumab. Exploratory univariable analyses identified potential prognostic factors; those that remained significant in multivariable analysis were used to analyse PFS and OS in subgroups with all, some or none of these factors. Results: Of 1436 treated patients, 588 (41%) initially received paclitaxel and 918 (64%) had HR-positive disease. The most common grade 653 adverse events were neutropenia (10%, mainly with docetaxel) and diarrhoea (8%). At the final analysis (median follow-up: 5.7 years), median PFS was 20.7 [95% confidence interval (CI) 18.9-23.1] months overall and was similar irrespective of HR status or taxane. Median OS was 65.3 (95% CI 60.9-70.9) months overall. OS was similar regardless of taxane backbone but was more favourable in patients with HR-positive than HR-negative LR/mBC. In exploratory analyses, trastuzumab-pretreated patients with visceral disease had the shortest median PFS (13.1 months) and OS (46.3 months). Conclusions: Mature results from PERUSE show a safety and efficacy profile consistent with results from CLEOPATRA and median OS exceeding 5 years. Results suggest that paclitaxel is a valid alternative to docetaxel as backbone chemotherapy. Exploratory analyses suggest risk factors that could guide future trial design

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

ETHOS 1: a high-latitude planetary nebula with jets forged by a post-common-envelope binary central star

The definitive version can be found at: http://onlinelibrary.wiley.com/ Copyright Royal Astronomical SocietyWe report on the discovery of ETHOS 1 (PN G068.1+11.0), the first spectroscopically confirmed planetary nebula (PN) from a survey of the SuperCOSMOS Science Archive for high-latitude PNe. ETHOS 1 stands out as one of the few PNe to have both polar outflows (jets) travelling at 120 +/- 10 km s-1 and a close binary central star. The light curve observed with the Mercator Telescope reveals an orbital period of 0.535 d and an extremely large amplitude (0.816 mag) due to irradiation of the companion by a very hot pre-white dwarf. ETHOS 1 further strengthens the long-suspected link between binary central stars of PNe (CSPN) and jets. The Isaac Newton Telescope/Intermediate Dispersion Spectrograph and Very Large Telescope (VLT) FORS spectroscopy of the CSPN reveals weak N iii, C iii and C iv emission lines seen in other close binary CSPN and suggests that many CSPN with these weak emission lines are misclassified close binaries. We present VLT FORS imaging and Manchester Echelle Spectrometer long-slit observations from which a kinematic model of the nebula is built. An unusual combination of bipolar outflows and a spherical nebula conspires to produce an X-shaped appearance. The kinematic age of the jets (1750 +/- 250 yr kpc-1) is found to be more than that of the inner nebula (900 +/- 100 yr kpc-1), consistent with previous studies of similar PNe. Emission-line ratios of the jets are found to be consistent with that of reverse-shock models for fast low-ionization emitting regions (FLIERs) in PNe. Further large-scale surveys for close binary CSPN will be required to securely establish whether FLIERs are launched by close binaries.Peer reviewe

Discovery of close binary central stars in the planetary nebulae NGC 6326 and NGC 6778

Original article can be found at : http://www.aanda.org/ Copyright The European Southern ObservatoryWe present observations proving the close binary nature of the central stars belonging to the planetary nebulae (PNe) NGC 6326 and NGC 6778. Photometric monitoring reveals irradiated lightcurves with orbital periods of 0.372 and 0.1534 days, respectively, constituting firm evidence that they passed through a common-envelope (CE) phase. Unlike most surveys for close binary central stars (CSPN) however, the binary nature of NGC 6326 was first revealed spectroscopically and only later did photometry obtain an orbital period. Gemini South observations revealed a large 160 km/s shift between the nebula and emission lines of C III and N III well known to originate from irradiated atmospheres of main-sequence companions. These so-called weak emission lines are fairly common in PNe and measurement of their radial velocity shifts in spectroscopic surveys could facilitate the construction of a statistically significant sample of post-CE nebulae. There is growing evidence that this process can be further accelerated by preselecting nebulae with traits of known post-CE nebulae. Both NGC 6326 and NGC 6778 were selected for their rich attribution of low-ionisation filaments and collimated outflows, thereby strengthening the connection between these traits and post-CE CSPN.Peer reviewe

Perceived Dignity of Advanced Cancer Patients and Its Relationship to Sociodemographic, Clinical, and Psychological Factors.

Objective: Loss of dignity is one of the main reasons for wishing for an early death in patients with incurable diseases such as cancer and is strongly associated with psychological distress and loss of quality of life. The present study aims to analyze the perceived dignity of patients with advanced cancer undergoing systemic treatment and their relationship with sociodemographic, clinical, and psychological factors

Rigorous Investigation of RF Breakdown Effects in High Power Microstrip Passive Circuits

This work presents a new rigorous investigation of corona effects in microstrip components. To carry out the investigation, a new software tool has been developed. The new tool first calculates the electromagnetic fields in complex microstrip structures using a Volume Integral Equation (VIE) formulation. Novel numerical techniques have been incorporated in the VIE to increase the accuracy during the computation of the electromagnetic fields. This includes novel techniques introduced to treat the singularities of the Green's functions. Once the electromagnetic fields are computed accurately, corona effects in the relevant structures are investigated. For this, a numerical solution of the free electron density continuity equation has been implemented.The new software developed has been used, for the first time,in the study of corona effects in the neighborhood of coaxial to microstrip transitions, containing flat ribbons. Numerical results are validated through measurements, showing the accuracy of the developed models

Fibrinogen nitrotyrosination after ischemic stroke impairs thrombolysis and promotes neuronal death

Ischemic stroke is an acute vascular event that compromises neuronal viability, and identification of the pathophysiological mechanisms is critical for its correct management. Ischemia produces increased nitric oxide synthesis to recover blood flow but also induces a free radical burst. Nitric oxide and superoxide anion react to generate peroxynitrite that nitrates tyrosines. We found that fibrinogen nitrotyrosination was detected in plasma after the initiation of ischemic stroke in human patients. Electron microscopy and protein intrinsic fluorescence showed that in vitro nitrotyrosination of fibrinogen affected its structure. Thromboelastography showed that initially fibrinogen nitrotyrosination retarded clot formation but later made the clot more resistant to fibrinolysis. This result was independent of any effect on thrombin production. Immunofluorescence analysis of affected human brain areas also showed that both fibrinogen and nitrotyrosinated fibrinogen spread into the brain parenchyma after ischemic stroke. Therefore, we assayed the toxicity of fibrinogen and nitrotyrosinated fibrinogen in a human neuroblastoma cell line. For that purpose we measured the activity of caspase-3, a key enzyme in the apoptotic pathway, and cell survival. We found that nitrotyrosinated fibrinogen induced higher activation of caspase 3. Accordingly, cell survival assays showed a more neurotoxic effect of nitrotyrosinated fibrinogen at all concentrations tested. In summary, nitrotyrosinated fibrinogen would be of pathophysiological interest in ischemic stroke due to both its impact on hemostasis - it impairs thrombolysis, the main target in stroke treatments - and its neurotoxicity that would contribute to the death of the brain tissue surrounding the infarcted area.This work was supported by the Spanish Ministry of Science and Innovation (SAF2012-38140; SAF 2009-10365); Fondo de Investigación Sanitaria (FIS PI13/00408, FIS PI13/00864, CP04-00112, PS09/00664 and Red HERACLESRD12/0042/0014, RD12/0042/0016 and RD12/0042/0020); FEDER Funds; Generalitat de Catalunya (SGR09-1369); and Fundació la Marató de TV3 (100310). Dr. A.M. Galán belongs to the Miguel Servet stabilization program of the Spanish Government's ISCIII research institute and “Direcció d'Estratègia i Coordinació del Departament de Salut” of the Generalitat de Catalunya