Psychological Flexibility In Migraine Patients: The Role Of Acceptance And Values-Based Action

According to the World Health Report 2001, mental and neurological disorders account for 30.80% of healthy years of life lost to disability; migraine alone accounts for 1.40% of that percentage. In addition to the functional impairment the attacks cause, migraine frequently co-occurs with other psychiatric disorders and is associated with other psychological factors. Related psychological factors include avoidance of negative private events (experiential avoidance) and persistent behaviors that are counterproductive to one\u27s personal values. Recent studies of patients with other forms of chronic pain suggest that these behaviors are associated with poor functioning and that techniques fostering psychological flexibility may enhance functioning and quality of life. However, the roles of psychological flexibility and its component constructs have yet to be explored in migraine specifically. The purpose of this study was to examine the relationship between two components of psychological flexibility (acceptance and values-based action) and headache-related variables in treatment-seeking patients with migraine. One hundred three adult patients participated in the study (mean age = 41.45 years [SD = 11.92]; 88.24% female; 91.17% Caucasian). All participants had a physician diagnosis of migraine: 53.39% with episodic migraine without aura, 18.44% with episodic migraine with aura, and 28.16% with chronic migraine. A series of hierarchical multiple regressions was used to assess relations between acceptance/values-based action and headache variables. As expected, acceptance of pain and engaging in values-based action were significantly associated with lower migraine disability and lower pain severity, although these constructs were not significantly associated with frequency of headache or medical visits. These findings suggest that perhaps psychological flexibility is more strongly linked to functional improvement or pain perception than to pain-related symptoms. Clinical implications of this study include awareness of the benefits of psychological flexibility for migraine patients and potential therapeutic techniques to foster psychological flexibility as an adjunct to medical treatment

Tissue microarray analysis of eIF4E and its downstream effector proteins in human breast cancer

Correction to Kleiner HE, Krishnan P, Tubbs J, Smith M, Meschonat C, Shi R, Lowery-Nordberg M, Adegboyega P, Unger M, Cardelli J et al: Tissue microarray analysis of eIF4E and its downstream effector proteins in human breast cancer. J Exp Clin Cancer Res 2009, 28:5

Functional Genomics Unique to Week 20 Post Wounding in the Deep Cone/Fat Dome of the Duroc/Yorkshire Porcine Model of Fibroproliferative Scarring

Background: Hypertrophic scar was first described over 100 years ago; PubMed has more than 1,000 references on the topic. Nevertheless prevention and treatment remains poor, because 1) there has been no validated animal model; 2) human scar tissue, which is impossible to obtain in a controlled manner, has been the only source for study; 3) tissues typically have been homogenized, mixing cell populations; and 4) gene-by-gene studies are incomplete.Methodology/Principal Findings: We have assembled a system that overcomes these barriers and permits the study of genome-wide gene expression in microanatomical locations, in shallow and deep partial-thickness wounds, and pigmented and non-pigmented skin, using the Duroc( pigmented fibroproliferative)/Yorkshire( non-pigmented non-fibroproliferative) porcine model. We used this system to obtain the differential transcriptome at 1, 2, 3, 12 and 20 weeks post wounding. It is not clear when fibroproliferation begins, but it is fully developed in humans and the Duroc breed at 20 weeks. Therefore we obtained the derivative functional genomics unique to 20 weeks post wounding. We also obtained long-term, forty-six week follow-up with the model.Conclusions/Significance: 1) the scars are still thick at forty-six weeks post wounding further validating the model. 2) the differential transcriptome provides new insights into the fibroproliferative process as several genes thought fundamental to fibroproliferation are absent and others differentially expressed are newly implicated. 3) the findings in the derivative functional genomics support old concepts, which further validates the model, and suggests new avenues for reductionist exploration. in the future, these findings will be searched for directed networks likely involved in cutaneous fibroproliferation. These clues may lead to a better understanding of the systems biology of cutaneous fibroproliferation, and ultimately prevention and treatment of hypertrophic scarring.The National Institute on Disability and Rehabilitation ResearchThe National Institutes of HealthThe Washington State Council of Fire Fighters Burn FoundationThe Northwest Burn FoundationUniv Washington, Dept Surg, Div Plast Surg, Seattle, WA 98195 USAIowa State Univ, Dept Anim Sci, Ames, IA USAUniv Washington, Dept Biostat, Seattle, WA 98195 USAMahidol Univ, Ramathibodi Hosp, Dept Surg, Bangkok 10700, ThailandUniv Washington, Dept Environm & Occupat Hlth Sci, Seattle, WA 98195 USAUniversidade Federal de São Paulo, Div Plast Surg, Dept Surg, São Paulo, BrazilUniversidade Federal de São Paulo, Div Plast Surg, Dept Surg, São Paulo, BrazilThe National Institute on Disability and Rehabilitation Research: H133G050022The National Institutes of Health: 1R21GM074673The National Institutes of Health: 5U54GM062119-09Web of Scienc

The Surgical Treatment Of Peripheral Neuropathies: A Plastic Surgeon\u27S Perspective

While many neuropathies are amenable to medical therapy, progressive compression neuropathies almost invariably require a surgical evaluation. Compression neuropathies are more likely to occur when there is a superimposed polyneuropathy as the affected nerve is less able to compensate for this process. It is important for the referring physician to understand the surgical approach to the treatment of compression neuropathies. This is best visualized by understanding the relevant tunnels commonly encountered with compression neuropathies. There are numerous similarities between the tunnels encountered in the upper extremity and those encountered in the lower extremity. This chapter will address the surgical evaluation and treatment of the most commonly encountered upper and lower extremity entrapment neuropathies based on his extensive clinical experience. Although electrodiagnostic studies are helpful, this technique does not reliably identify each and every instance of a compression neuropathy. Therefore, a surgical referral is in order when the patient presents with symptoms of a compression neuropathy that is confirmed by specific physical examination signs. Many of these patients with normal electrodiagnostic studies prove to have significant nerve compression at the time of their surgical intervention. The author reviews the surgical approach to these patients and concludes his chapter with a discussion of nerve repair techniques