The differences between the quality of life of malays and nonmalays breast cancer survivors women from a Teaching Hospital,Kuala Lumpur: a qualitative study

Introduction : The purpose of this study is to explore the differences of quality of life (QOL) of Malay and non-Malay breast cancer survivors using qualitative method. Methods : Data was collected using in-depth face to face interview. List of the patients were obtained from Oncology & Surgery Departments and contact numbers were obtained from the medical record. The interviews were conducted either in their home or in the hospital after the appointment has been made. Results : The majority of the Malays were unable to fulfill the needs of their families. However, the non-Malays were able to fulfill the needs of their families. The majority were satisfied with social interaction and the relationships with their families and friends. In terms of feelings, most survivors felt sad, angry and sometimes they feel like they were going to die early. However the majority coped well with their illness. Regarding sleep, all Malays did not have any sleeping problems, but most of the non-Malays reported serious problems. All survivors were worried about the other female members of the family of getting the same illness. Most survivors did not have any problems with altered body image. Conclusion : Malays did not have any sleeping problems, but most of the non-Malays reported serious problems. However, the majority of survivors coped well with their illnesses

Delirium followed by neuroleptic malignant syndrome in rehabilitation setting. Is it anger reaction before discharge?

Delirium and neuroleptic malignant syndrome (NMS) are two uncommon syndromes that are often unrecognized or misdiagnosed by the primary physicians as functional psychiatric disorders. The infrequency and the heterogeneity of clinical manifestation, progression and outcome with which those diagnoses are encountered (particularly in chronic rehabilitation settings) make them formidable diagnostic challenge. In this report, we present a case in which there was a misdiagnosis of delirium and NMS as functional psychiatric disorders. This report demonstrates the fact that early recognition and intervention in such cases are essential to prevent the grave outcome and potential fatality. The authors believe that there is a key role for the consulting psychiatrist in this area in providing diagnostic clarity and advice regarding management and ongoing staff education.Key words: Neuroleptic Malignant Syndrome, antipsychotics, Saudi Arabi

Contemporary empyema thoracis necessitans in an adult male caused by Staphylococcus aureus: decortication is superior to traditional under water seal intercostal tube in chronic empyema

Empyema thoracis necessitans is a rare clinical finding nowadays. We report 55 years old Saudi male with past history of road traffic accident, poly trauma, chest surgery and paraplegia admitted for rehabilitation in Sultan Bin Abduaziz Humanitarian City (SBAHC), Riyadh, Saudi Arabia and diagnosed with  empyema thoracis necessitans due to Staphylococcus aureus, treated initially with traditional thoracostomy under water seal intercostal intubation and antibiotics but subsequently required decortication

Scale-dependent effects of summer density on autumn mass in reindeer

The ongoing dispute about reindeer overabundance in the West Finnmark (Norway) herding region has accentuated the need for an in-depth understanding of the density-dependent and -independent processes driving this pastoral system, as well as the spatial and temporal scale(s) they operate on. Using 20 604 records of individual male reindeer yearlings we assessed the spatial and temporal variation in animals’ performance (measured by their autumn carcass mass), and investigated summer density dependent effects on autumn carcass masses at different scales. We defined three spatial scales; a regional scale represented by the whole summer range of West Finnmark, a sub-regional scale represented by the mainland (14) and the island (11) summer districts, and a fine scale represented by eight individual summer districts. We defined two temporal scales; the whole collection phase (13 years) and a temporal dimension based on the three periods of population growth. We found carcass masses to be higher at island than at mainland and to vary among districts. Effect of period was found at the regional, sub-regional and often at the district scale. The autumn carcass masses were sensitive to density at West Finnmark and mainland scales, but not at island scale, the effect being negative. This suggests intra-specific competition for summer forage due to consistent higher density resulting in reduced range quality at mainland as compared to island. On the finest scale the density effect was highly variable. Response of carcass mass to density appeared to be scale dependent both in space and time at regional and sub-regional scales. These findings underline the importance, for skilful management, of site specific biological understanding of (1) the density dependent processes and (2) the spatial and temporal scales these processes are operating on. Adaptive management strategies for sustainable use of the summer forage resources in West Finnmark have therefore to be district specific.Skala-avhengige virkninger av antallet rein på høstslaktevektene i Vest-FinnmarkAbstract in Norwegian / Sammendrag: Den stadig pågående diskusjon omkring reintall og overbelastning av beitene i Vest- Finnmark krever en bedre forståelse av tetthetsavhengige, så vel som tetthetsuavhengige prosesser som påvirker dette beitesystemet og på hvilke skalaer disse opererer. Vi benyttet 20 604 slaktevekter av varit (1,5 års gamle bukker) før brunst for å undersøke variasjonen i tid og rom i disse, og om sommerbeitebelegget på ulike skalaer påvirket vektene. Vi definerte tre romlig skalaer: 1) hele sommerbeiteområdet i Vest-Finnmark, 2) to underregioner: innlandsdistriktene samlet og øy/halvøydistriktene samlet og 3) det enkelte sommerbeitedistrikt. På distriktsnivå ble bare slaktedata fra 8 distrikt benyttet. Videre ble to tidsskalaer definert: 1) hele perioden samlet, 2) tre perioder basert på utviklingen i reintallet i Vest-Finnmark - økning i periode 1 (1983-87) og i periode 3 (2001-2004) og nedgang i periode 2 (1996 -2000). Slaktevektene var høyere for øy/halvøydistriktene sammenlignet med innlandsdistriktene samlet og varierte mellom distrikt. Periode påvirket også slaktevektene regionalt, subregionalt og ofte på distriktsnivå. Vi fant en negativ tetthetsavhengig effekt på slaktevektene for Vest-Finnmark samlet. Det samme gjaldt for innlandsdistriktene samlet, men ikke for øy/halvøydistriktene samlet. Dette forklares ved fødekonkurranse på innlandsdistriktenes sommerbeiter, sannsynligvis på grunn av at vedvarende høye tettheter har forringet beitekvaliteten, sammenlignet med øy/halvøydistriktene samlet. På distriktsnivå varierte effekten av tetthet. Resultatene tyder videre på skala-avhengige tetthetseffekter i tid og rom, i Vest-Finnmark samlet, så vel som på innlands- og øy/halvøynivå. Tetthet er et mangesidig og komplekst begrep som ikke kan sees uavhengig av skala. Det er derfor viktig å analysere slike prosesser på flere skalanivå for bedre å kunne forstå samspillet mellom vegetasjon og beitedyr. Dette innebærer i praksis at hvert sommerdistrikt (siida), som er den funksjonelle enheten i forvaltningssammenheng, må behandles uavhengig og danne grunnenheten i en fornuftig forvaltning

Dissociative experiences and their relationship to mood problems among Arab mothers of disabled children

Introduction: To examine the presence of dissociation among Arab mothers with disabled children in Saudi Arabia, and to explore if this is linked to their mood difficulties, in addition to certain other demographic variables. Methods: We conducted a prospective study during the period of June 2011 to February 2012, on 86 mothers (study group) caring for children with physical, mental or sensory disabilities treated at Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia. Patients' selection was conducted using convenience sampling, non-probability technique. A total of 32 mothers (control group) with healthy children were also included. The Dissociative Experiences Scale (DES-11 Arabic) was used to measure dissociation whereas; the hospital anxiety and depression scale (HADS) was used to measure the mood symptoms of mothers. The demographic data of mothers and children were also collected. Results: The mean age of the children with disability was 5.6.±3.1 and healthy children 6.3±3.7 (range 1-14) years. The mean age of mothers in the study group (n=86) was 33.9±6.1 while the control group was 35.2±7.3 years. Results showed that the study group had higher level (Mean=39.9; SD=24.033) of dissociative experience than control sample (Mean=21.08; SD=14.487) (p=0.0001). Compared to control, mothers of disabled children scored significantly higher HADS-anxiety (p=0.042) and HADS-depression (p=0.021). In addition, results also showed that dissociation had significant correlation with mother's depression and anxiety. However, no significant correlations were found between dissociation and child's and mother's age. Conclusion: Mothers of disabled children in Saudi Arabia showed significantly more dissociative experiences than controls, which is correlated to their anxiety and depression. Clinical implications are discussed.Key words: Dissociation, Mood, Depression, anxiety, mothers of disabled children, Saudi Arabi

Signaling from mTOR to eIF2α mediates cell migration in response to the chemotherapeutic doxorubicin.

After exposure to cytotoxic chemotherapeutics, tumor cells alter their translatome to promote cell survival programs through the regulation of eukaryotic initiation factor 4F (eIF4F) and ternary complex. Compounds that block mTOR signaling and eIF4F complex formation, such as rapamycin and its analogs, have been used in combination therapies to enhance cell killing, although their success has been limited. This is likely because the cross-talk between signaling pathways that coordinate eIF4F regulation with ternary complex formation after treatment with genotoxic therapeutics has not been fully explored. Here, we described a regulatory pathway downstream of p53 in which inhibition of mTOR after DNA damage promoted cross-talk signaling and led to eIF2α phosphorylation. We showed that eIF2α phosphorylation did not inhibit protein synthesis but was instead required for cell migration and that pharmacologically blocking this pathway with either ISRIB or trazodone limited cell migration. These results support the notion that therapeutic targeting of eIF2α signaling could restrict tumor cell metastasis and invasion and could be beneficial to subsets of patients with cancer.R.F.H. was supported by MRC studentship and Wellcome Trust (grant number 110071/Z/15/Z). A.E.W., T.A.A.P., and M.S. were supported by MRC Programme funding (MC_UP_A600_1023

10-Year Mortality Outcome of a Routine Invasive Strategy Versus a Selective Invasive Strategy in Non-ST-Segment Elevation Acute Coronary Syndrome: The British Heart Foundation RITA-3 Randomized Trial.

BACKGROUND: The RITA-3 (Third Randomised Intervention Treatment of Angina) trial compared outcomes of a routine early invasive strategy (coronary arteriography and myocardial revascularization, as clinically indicated) to those of a selective invasive strategy (coronary arteriography for recurrent ischemia only) in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). At a median of 5 years' follow-up, the routine invasive strategy was associated with a 24% reduction in the odds of all-cause mortality. OBJECTIVES: This study reports 10-year follow-up outcomes of the randomized cohort to determine the impact of a routine invasive strategy on longer-term mortality. METHODS: We randomized 1,810 patients with NSTEACS to receive routine invasive or selective invasive strategies. All randomized patients had annual follow-up visits up to 5 years, and mortality was documented thereafter using data from the Office of National Statistics. RESULTS: Over 10 years, there were no differences in mortality between the 2 groups (all-cause deaths in 225 [25.1%] vs. 232 patients [25.4%]: p = 0.94; and cardiovascular deaths in 135 [15.1%] vs. 147 patients [16.1%]: p = 0.65 in the routine invasive and selective invasive groups, respectively). Multivariate analysis identified several independent predictors of 10-year mortality: age, previous myocardial infarction, heart failure, smoking status, diabetes, heart rate, and ST-segment depression. A modified post-discharge Global Registry of Acute Coronary Events (GRACE) score was used to calculate an individual risk score for each patient and to form low-risk, medium-risk, and high-risk groups. Risk of death within 10 years varied markedly from 14.4 % in the low-risk group to 56.2% in the high-risk group. This mortality trend did not depend on the assigned treatment strategy. CONCLUSIONS: The advantage of reduced mortality of routine early invasive strategy seen at 5 years was attenuated during later follow-up, with no evidence of a difference in outcome at 10 years. Further trials of contemporary intervention strategies in patients with NSTEACS are warranted. (Third Randomised Intervention Treatment of Angina trial [RITA-3]; ISRCTN07752711)

New Array Approaches to Explore Single Cells Genomes

Microarray analysis enables the genome-wide detection of copy number variations and the investigation of chromosomal instability. Whereas array techniques have been well established for the analysis of unamplified DNA derived from many cells, it has been more challenging to enable the accurate analysis of single cell genomes. In this review, we provide an overview of single cell DNA amplification techniques, the different array approaches, and discuss their potential applications to study human embryos

Stellar Coronal and Wind Models: Impact on Exoplanets

Surface magnetism is believed to be the main driver of coronal heating and stellar wind acceleration. Coronae are believed to be formed by plasma confined in closed magnetic coronal loops of the stars, with winds mainly originating in open magnetic field line regions. In this Chapter, we review some basic properties of stellar coronae and winds and present some existing models. In the last part of this Chapter, we discuss the effects of coronal winds on exoplanets.Comment: Chapter published in the "Handbook of Exoplanets", Editors in Chief: Juan Antonio Belmonte and Hans Deeg, Section Editor: Nuccio Lanza. Springer Reference Work