54 research outputs found
Clinical chronobiology: a timely consideration in critical care medicine
A fundamental aspect of human physiology is its cyclical nature over a 24-h period, a feature conserved across most life on Earth. Organisms compartmentalise processes with respect to time in order to promote survival, in a manner that mirrors the rotation of the planet and accompanying diurnal cycles of light and darkness. The influence of circadian rhythms can no longer be overlooked in clinical settings; this review provides intensivists with an up-to-date understanding of the burgeoning field of chronobiology, and suggests ways to incorporate these concepts into daily practice to improve patient outcomes. We outline the function of molecular clocks in remote tissues, which adjust cellular and global physiological function according to the time of day, and the potential clinical advantages to keeping in time with them. We highlight the consequences of "chronopathology", when this harmony is lost, and the risk factors for this condition in critically ill patients. We introduce the concept of "chronofitness" as a new target in the treatment of critical illness: preserving the internal synchronisation of clocks in different tissues, as well as external synchronisation with the environment. We describe methods for monitoring circadian rhythms in a clinical setting, and how this technology may be used for identifying optimal time windows for interventions, or to alert the physician to a critical deterioration of circadian rhythmicity. We suggest a chronobiological approach to critical illness, involving multicomponent strategies to promote chronofitness (chronobundles), and further investment in the development of personalised, time-based treatment for critically ill patients
Tumour brain: preâtreatment cognitive and affective disorders caused by peripheral cancers
People that develop extracranial cancers often display co-morbid neurological disorders, such as anxiety, depression and cognitive impairment, even before commencement of chemotherapy. This suggests bidirectional crosstalk between non-CNS tumours and the brain, which can regulate peripheral tumour growth. However, the reciprocal neurological effects of tumour progression on brain homeostasis are not well understood. Here, we review brain regions involved in regulating peripheral tumour development and how they, in turn, are adversely affected by advancing tumour burden. Tumour-induced activation of the immune system, bloodâbrain barrier breakdown and chronic neuroinflammation can lead to circadian rhythm dysfunction, sleep disturbances, aberrant glucocorticoid production, decreased hippocampal neurogenesis and dysregulation of neural network activity, resulting in depression and memory impairments. Given that cancer-related cognitive impairment diminishes patient quality of life, reduces adherence to chemotherapy and worsens cancer prognosis, it is essential that more research is focused at understanding how peripheral tumours affect brain homeostasis
Cancer-Related fatigue interferes with activities of daily living among 753 patients receiving chemotherapy: A URCC CCOP study
Cancer-related self-efficacy in African American prostate cancer patients compared to whites
Patterns of social media use and associations with psychosocial outcomes among breast and gynecologic cancer survivors.
PURPOSE: We sought to characterize the use of social media (SM) among breast and gynecologic cancer survivors, as well as associations between patterns of SM use and psychosocial outcomes.
METHODS: Two hundred seventy-three breast and gynecologic cancer survivors recruited at the Stanford Women\u27s Cancer Center completed the study. Participants completed questionnaires to measure quality of life (FACT-G), functional social support (Duke-UNC FSSQ), distress (PHQ-4), decision regret (DRS), and SM use.
RESULTS: In total, 75.8% of the sample reported using SM. There was no difference in quality of life (QOL), functional social support (FSS), distress, or decision regret between SM users and non-users. SM users indicated using SM for social support (34.3%) and loneliness (24.6%) more than for information-seeking (15.9%), coping (18.8%), or self-disclosure (14%). SM use for coping was associated with lower QOL (p \u3câ.001), lower FSS (p \u3câ.001), and higher decision regret (p =â.029). Use for social support was associated with lower FSS (p =â.029). Use for information seeking was associated with lower QOL (p =â.012). Use of SM when lonely was associated with lower QOL (p \u3câ.001), higher distress (p =â.007), lower FSS (p \u3câ.001), and higher decision regret (p =â.020).
CONCLUSIONS: Associations between SM use and psychosocial outcomes are nuanced and dependent on motivation for use. Further research is needed to better characterize SM use and associations with psychosocial outcomes among cancer survivors.
IMPLICATIONS FOR CANCER SURVIVORS: SM is an important potential avenue for understanding and addressing the psychosocial effects associated with cancer survivorship
Cytokine-mediated changes associated with improvements in cancer-related fatigue induced by exercise: Results from a randomized pilot study of cancer patients receiving radiotherapy
Differential effects of chemotherapy regimens and menopausal status on IL-6 levels in breast cancer (BC) patients during two cycles of treatment: Implications for âchemo brain.â
A phase III randomized prospective trial of the effect of psychotherapy on distress in 287 prostate cancer patients: A URCC CCOP Study
Relationship between subjective and actigraphy-measured sleep in 237 patients with metastatic colorectal cancer
The effect of tai chi chuan on bone remodeling and cytokines among breast cancer survivors: A feasibility trial
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