Amphiregulin contained in NSCLC-exosomes induces osteoclast differentiation through the activation of EGFR pathway

Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related deaths worldwide. The majority of patients are diagnosed in advanced disease stage. Bone metastasis is the most frequent complication in NSCLC resulting in osteolytic lesions. The perfect balance between bone-resorbing osteoclasts and bone-forming osteoblasts activity is lost in bone metastasis, inducing osteoclastogenesis. In NSCLC, the epidermal growth factor receptor (EGFR) pathway is constitutively activated. EGFR binds Amphiregulin (AREG) that is overexpressed in several cancers such as colon, breast and lung. Its levels in plasma of NSCLC patients correlate with poor prognosis and AREG was recently found as a signaling molecule in exosomes derived from cancer cell lines. Exosomes have a key role in the cell-cell communication and they were recently indicated as important actors in metastatic niche preparation. In the present work, we hypothesize a role of AREG carried by exosomes derived from NSCLC in bone metastasis induction. We observed that NSCLC-exosomes, containing AREG, induce EGFR pathway activation in pre-osteoclasts that in turn causes an increased expression of RANKL. RANKL is able to induce the expression of proteolytic enzymes, well-known markers of osteoclastogenesis, triggering a vicious cycle in osteolytic bone metastasis

The effects of poetry-writing SANTEL on erotic body image in remission of cancer in women: a pilot study

International audienceAbstract Aim: Our pilot study aims to describe the effects ofa new specific and structured protocol focused on poetic/erotic writing (named SANTEL) on the (re)sexualization ofbody image in women, who have experienced cancer.Procedure: The protocol consists of four steps: to choose alist of erotic verses focused on the body parts, to fill a semistructuredpoetic text, to write sentences after target phraseson the body; and in the end, to write a free poem. Mrs V.suffered from breast cancer, and one breast was removed.She and her husband participated in this poetic writing protocol,separately. We analyzed the linguistic metaphors ofthe body by QSR Nvivo10 software.Results: Using this protocol, we showed discourse variationsof metaphors before and after the experience of writing.Patient V used “I feel like an alien” as a starting metaphorto describe her cancer experience and after poetic writingsessions, she used other bodily metaphors like “My body isa flower” and “My sensual and white flesh”.Conclusion: This poetic perspective promises a type of“perceptive-literary surgery”, characterized by a sensualinvestment process after remission: a poetic reconstructionof erotic body image.Les effets d'un protocole d'écriture poétique SANTEL sur l'image érotique du corps dans le traitement du cancer féminin : étude pilote The effects of poetry-writing SANTEL on erotic body image in remission of cancer in women: a pilot study A. Santarpia · J. Tellène · M. Carrier Résumé Objectif : Cette étude pilote de type qualitative et exploratoire vise à décrire les effets d'un nouveau protocole d'écriture poético-érotique (nommée SANTEL) sur la rééro-tisation de l'image du corps chez une femme, ayant vécu un cancer. Matériel et méthodes : Il s'agit d'un protocole composé de quatre étapes : une liste des phrases à caractères poétiques et érotiques à choisir, un texte à trous à remplir, des amorces de phrases ciblées sur le corps et en fin un poème libre. Madame V. a subi un cancer du sein nécessitant une ablation complète. Madame V. et son conjoint exécutent le protocole d'écriture séparément. Nous montrons les variations discursives des métaphores utilisées avant et après l'expérience de l'écriture, à travers le logiciel d'analyse qualitative QSR NVivo10. Résultats : Madame V. passera de la métaphore initiale « je me sens une extraterrestre » vers la plus atténuée « Non. Je me dis qu'extraterrestre c'était peut-être un peu énorme ». En plus, elle utilisera de nouvelles métaphores linguistiques du corps pour raconter son image du corps telles que « ce corps de chair blanche » et « une fleur qui s'ouvre délicatement ». Conclusion : Cet exercice spécifique d'écriture promet un type de « chirurgie perceptive-littéraire » dans le processus d'investissement sensuel et affectif après la rémission, une reconstruction perceptive et poétique de l'image érotique du corps. Mots clés Métaphores perceptives · Image du corps · Cancer féminin · Corps érotique · Écriture poétique · Chirurgie perceptive-littéraire · Logiciel QSR NVivo10. Abstract Aim: Our pilot study aims to describe the effects of a new specific and structured protocol focused on poetic/ erotic writing (named SANTEL) on the (re)sexualization of body image in women, who have experienced cancer. Procedure: The protocol consists of four steps: to choose a list of erotic verses focused on the body parts, to fill a semi-structured poetic text, to write sentences after target phrases on the body; and in the end, to write a free poem. Mrs V. suffered from breast cancer, and one breast was removed. She and her husband participated in this poetic writing protocol , separately. We analyzed the linguistic metaphors of the body by QSR Nvivo10 software. Results: Using this protocol, we showed discourse variations of metaphors before and after the experience of writing. Patient V used " I feel like an alien " as a starting metaphor to describe her cancer experience and after poetic writing sessions, she used other bodily metaphors like " My body is a flower " and " My sensual and white flesh ". Conclusion: This poetic perspective promises a type of " perceptive-literary surgery " , characterized by a sensual investment process after remission: a poetic reconstruction of erotic body image. Keywords Bodily metaphors · Body image · Feminine cancer · Erotic body · Poetry writing · Perceptive-literary surgery · QSR Nvivo10 software

Aerosol and Surface Contamination of SARS-CoV-2 Observed in Quarantine and Isolation Care

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originated in Wuhan, China in late 2019, and its resulting coronavirus disease, COVID-19, was declared a pandemic by the World Health Organization on March 11, 2020. The rapid global spread of COVID-19 represents perhaps the most significant public health emergency in a century. As the pandemic progressed, a continued paucity of evidence on routes of SARS-CoV-2 transmission has resulted in shifting infection prevention and control guidelines between classically-defined airborne and droplet precautions. During the initial isolation of 13 individuals with COVID-19 at the University of Nebraska Medical Center, we collected air and surface samples to examine viral shedding from isolated individuals. We detected viral contamination among all samples, supporting the use of airborne isolation precautions when caring for COVID-19 patients

Prediction of Renal Acid Load in Adult Patients on Parenteral Nutrition

Metabolic acidosis and metabolic bone disease are frequent complications in patients on parenteral nutrition (PN). A common contributor to these complications could be a daily high renal acid load. This study aims to find a method for predicting the potential total acid load (PTAL) and the pH of the compounded parenteral nutrition mixtures. The pH and titratable acidity (TA) of fifty compounded mixtures were measured. The potential metabolic acid load (PMAL) was calculated by considering the amount of nutrients that are acid producers and consumers. The PTAL of the TPN mixtures was calculated by adding TA to PMAL. Multiple linear regression analyses were used to develop a predictive model for the TA and pH of the compounded mixtures. The predicted TA and pH values of the analyzed mixtures agreed with those measured (Passing-Bablok analysis). The PTAL was >50 mmol/day for 82% of the mixtures, >75 mmol/day for 40% of the mixtures, and >100 mmol/day for 22% of the mixtures. The prediction of the renal acid load in patients on long-term PN could allow more appropriate acid-base balancing. Moreover, predicting the pH of such mixtures could be useful to pharmacists to assess the stability and compatibility of the components in the compounded mixtures

Assessment of body composition in health and disease using bioelectrical impedance analysis (bia) and dual energy x-ray absorptiometry (dxa): A critical overview

The measurement of body composition (BC) represents a valuable tool to assess nutritional status in health and disease. The most used methods to evaluate BC in the clinical practice are based on bicompartment models and measure, directly or indirectly, fat mass (FM) and fat-free mass (FFM). Bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DXA) (nowadays considered as the reference technique in clinical practice) are extensively used in epidemiological (mainly BIA) and clinical (mainly DXA) settings to evaluate BC. DXA is primarily used for the measurements of bone mineral content (BMC) and density to assess bone health and diagnose osteoporosis in defined anatomical regions (femur and spine). However, total body DXA scans are used to derive a three-compartment BC model, including BMC, FM, and FFM. Both these methods feature some limitations: the accuracy of BIA measurements is reduced when specific predictive equations and standardized measurement protocols are not utilized whereas the limitations of DXA are the safety of repeated measurements (no more than two body scans per year are currently advised), cost, and technical expertise. This review aims to provide useful insights mostly into the use of BC methods in prevention and clinical practice (ambulatory or bedridden patients). We believe that it will stimulate a discussion on the topic and reinvigorate the crucial role of BC evaluation in diagnostic and clinical investigation protocols

Nutritional Screening and Anthropometry in Patients Admitted From the Emergency Department

Background: Due to the high prevalence of malnutrition among hospitalized patients, screening and assessment of nutritional status should be routinely performed upon hospital admission. The main objective of this observational study was to evaluate the prevalence of and the risk for malnutrition, as identified by using three nutritional screening tests, and to observe whether some anthropometric and functional parameters used for nutritional evaluation were related to these test scores. Methods: This single-center observational study included 207 patients admitted from the emergency department for hospitalization in either the internal medicine or surgery units of our institution from September 2017 to December 2018. The prevalence of malnutrition among this patient sample was evaluated by using the Nutritional Risk Screening (NRS-2002), the Subjective Global Assessment (SGA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Body mass index (BMI), bioimpedance analysis (BIA), handgrip strength (HGS) and calf circumference (CC) assessments were also performed. Results: According to the NRS-2002, 93% of the patients were at no risk or at low nutritional risk (NRS score < 3), and 7% were at a high nutritional risk (NRS score ≥ 3). On the other hand, according to the SGA, 46.3% of the patients were well-nourished (SGA-a), 49.8% were moderately malnourished (SGA-b), and 3.9% were severely malnourished (SGA-c). Finally, according to the GLIM criteria, 18% patients were malnourished. Body weight, body mass index (BMI), phase angle (PhA), CC and HGS were significantly lower in the patients with NRS scores ≥ 3, SGA-c and in patients with stage 1 and stage 2 malnutrition, according to the GLIM criteria. Conclusion: The NRS-2002, the SGA and the GLIM criteria appear to be valuable tools for the screening and assessment of nutritional status. In particular, the lowest NRS-2002, SGA and GLIM scores were associated with the lowest PhA and CC. Nevertheless, a weekly re-evaluation of patients with better screening and assessment scores is recommended to facilitate early detection of changes in nutritional status

Food-Based dietary guidelines around the World: Eastern Mediterranean and Middle Eastern Countries

In Eastern Mediterranean countries, undernutrition and micronutrient deficiencies coexist with overnutrition-related diseases, such as obesity, heart disease, diabetes and cancer. Many Mediterranean countries have produced Food-Based Dietary Guidelines (FBDGs) to provide the general population with indications for healthy nutrition and lifestyles. This narrative review analyses Eastern Mediterranean countries' FBDGs and discusses their pictorial representations, food groupings and associated messages on healthy eating and behaviours. In 2012, both the WHO and the Arab Center for Nutrition developed specific dietary guidelines for Arab countries. In addition, seven countries, representing 29% of the Eastern Mediterranean Region population, designated their national FBDGs. At the moment several of these guidelines are available only in the English language. In summary, Eastern Mediterranean FBDGs mainly focus on food safety, not all are available in the local Arabic language, and they do not provide specific suggestions for the large number of foreign workers and migrants

L’usage de la poésie haïku en psycho-oncologie

International audienceAbstract Aim: Our study aims to describe the discourseeffects of specific and structured protocol focused on severalhaiku poems about one patient, who have experienced cancer.Procedure: The protocol consists of 4 steps: a preliminaryexploratory interview, fifteen haiku proposed without a partof the poem (a creative writing filled in by the patient), a freeform haiku composed by the patient, and finally, a finalinterview.Clinical case: A man, D., aged 25, had tumor.Result: Using this protocol, we showed discourse variationson the illness before and after the experience of poetrywriting, by Tropes V8.4 software.Conclusion: Haiku poetry can be a useful tool in the contextof supportive interventions or as preparatory work for engagementin psychotherapeutic intervention. We believe thatthe formal structure of haikus can create conditions for aspecific poetic work composed of: poetic evocation, synthesis,and mapping of the most intimate experiences in oncologyenvironment.Résumé Objectif : Cette étude qualitative et exploratoirevise à décrire les effets d’un protocole poétique centré surles haïkus en psycho-oncologie sur l’approche de la maladiechez un patient atteint de cancer.Matériel et méthodes : Il s’agit d’un protocole d’écriturepoétique composé de quatre étapes : un entretien préliminaire,la proposition de 15 haïkus (sans le vers du milieu)tirés de grands auteurs japonais, la réalisation d’un poèmecomposé librement par deux patients atteints de cancer, unentretien final sur l’expérience de l’écriture poétique.Cas clinique : Un homme, M. D., âgé de 25 ans, qui est entraitement pour un cancer.Résultats : Nous montrons les variations discursives utiliséesavant et après l’expérience de l’écriture poétique, à travers lelogiciel Tropes V8.4.Conclusion : Le travail poétique avec le haïku peut être unoutil utile, dans un contexte de support clinique en institutionou comme préparation à un travail de psychothérapie. Nouspensons que la structure formelle des haïkus peut inviter à untravail poétique spécifique : évocation poétique, synthèse etschématisation des vécus plus intimes en milieu oncologique