Osteoarthritis is a leading cause of chronic pain and disability and one of the most common conditions diagnosed and managed in primary care. Despite the evidence that patients would value ...discussions about the course of osteoarthritis to help them make informed treatment decisions and plan for the future, little is known of GPs’ practice of, or views regarding, discussing prognosis with these patients. A cross-sectional postal survey asked 2500 randomly selected UK GPs their views on discussing prognosis with patients with osteoarthritis and potential barriers or facilitators to such discussions. They were also asked if prognostic discussions were part of their current practice and what indicators they considered important in assessing the prognosis associated with osteoarthritis. Of 768 respondents (response rate 30.7 %), the majority felt it necessary to discuss prognosis with osteoarthritis patients (
n
= 738, 96.1 %), but only two thirds reported that it was part of their routine practice (
n
= 498, 64.8 %). Most respondents found predicting the course of osteoarthritis (
n
= 703, 91.8 %) and determining the prognosis of patients difficult (
n
= 589, 76.7 %). Obesity, level of physical disability and pain severity were considered the most important prognostic indicators in osteoarthritis. Although GPs consider prognostic discussions necessary for patients with osteoarthritis, few prioritise these discussions. Lack of time and perceived difficulties in predicting the disease course and determining prognosis for patients with osteoarthritis may be barriers to engaging in prognostic discussions. Further research is required to identify ways to assist GPs making prognostic predictions for patients with osteoarthritis and facilitate engagement in these discussions.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Objective. To determine whether the report of pain is influenced by meteorological conditions. Methods. A population-based study (Epidemiology of Functional Disorders) was conducted in North West ...England. Subjects were mailed a questionnaire that enquired about pain on the day of completion (‘any pain’) and chronic widespread pain (CWP) as defined by the ACR, as well as about the potential mediating factors, sleep quality, exercise and mood, between the weather and pain. Hourly information on sunshine, precipitation, air temperature and pressure was available from a local weather station. Analysis of relationships was done by Cox regression and described as prevalence ratios (PRs) with 95% CIs. Results. Between January 2005 and December 2006, questionnaires from 2491 subjects were returned: 42% of the subjects reported ‘any pain’ on the day of completion, whereas 15% of the subjects had CWP. For both ‘any pain’ and CWP, the PR was the highest in winter (46.1 and 22.2%, respectively) followed by autumn (45.4 and 17.9%, respectively) and spring (41.9 and 14.7%, respectively) and lowest in summer (35.6 and 9.5%, respectively). Persons were less likely to report pain on days with >5.8 h of sunshine (any pain: PR = 0.87, 95% CI 0.82, 0.93; CWP: PR = 0.56; 95% CI 0.38, 0.84) and with average temperature of >17.5°C (any pain: PR = 0.74, 95% CI 0.66, 0.83; CWP: PR = 0.40; 95% CI 0.34, 0.48). These relationships were partly explained by persons reporting taking more exercise and having better sleep quality and a more positive mood on days with sunshine and higher temperatures. Conclusions. Although a strong relationship between lack of sunshine, lower temperatures and pain reporting has been demonstrated, pain is not an inevitable consequence of such climatic conditions.
Pancreatic cancer is the second most common gastrointestinal cancer in the world, yet the five-year survival outcome rate of less than 5% urges for improvement in medical interventions of pancreatic ...cancer. Currently, high dose radiation therapy (RT) is used as an adjuvant treatment; however, the high level of RT required to treat advanced neoplasms leads to high incidence rates of side effects. In recent years, the utilization of cytokines as radiosensitizing agents has been studied, in order to reduce the amount of radiation required. However, few studies have examined IL-28 regarding its potential as a radiosensitizer. This study is the first to utilize IL-28 as a radiosensitizing agent in pancreatic cancer.
MiaPaCa-2, a widely used pancreatic cancer cell line was used in this study. Clonogenic survival and cell proliferation assays were used to evaluate growth and proliferation of MiaPaCa-2 cells. Caspase-3 activity assay was used to evaluate apoptosis of MiaPaCa-2 cells and RT-PCR was used to study the possible molecular mechanisms.
Our results showed that IL-28/RT enhanced RT-induced inhibition of cell proliferation and promoted apoptosis of MiaPaCa-2 cells. Furthermore, compared to RT alone, we found that IL-28/RT up-regulated the mRNA expression of TRAILR1 and P21, while down-regulating mRNA expression of P18 and survivin in MiaPaCa-2 cells.
IL-28 has the potential to be used as a radiosensitizer for pancreatic cancer and warrants further investigation.
Abstract Purpose Percutaneous endoscopic gastrostomy (PEG) provides durable nutritional access for head and neck (HNC) patients as they undergo treatment. Continuing treatment of HNC may necessitate ...repeat PEG placement. We report our outcomes with repeat PEG compared to first-time PEG in HNC patients. Materials and Methods A retrospective chart review identified morbidity, mortality, and possible risk factors for complications. Results Repeat PEG tubes constituted 17% of PEG procedures. Morbidity was rare and similar complication rates were found between the initial PEG and repeat PEG groups (2% vs. 11%, p = 0.131). There were no mortalities. Conclusions Repeat PEG plays an important role in the care of HNC patients and can be considered a safe means to establish durable enteric feeding access for patients with recurrent cancer or treatment complications.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Ovarian cancer is the leading cause of cancer‑ associated mortality in the female reproductive system. Interleukin (IL)‑33 and its receptor IL 1 receptor like 1 (also termed ST2) are expressed by ...many cell types including epithelial cells. The role of IL‑33 in the pathogenesis of neoplasia remains controversial. The authors previously demonstrated that IL‑33 inhibits the growth of pancreatic cancer cells. The present study was performed to explore if IL‑33 has any direct effects on ovarian cancer cells. A clonogenic survival assay, immunohistochemistry (IHC), proliferation kit and caspase‑3 activity kit were all used to evaluate the direct effects of IL‑33 on cell proliferation and apoptosis of a widely studied ovarian cancer cell line, A2780. The possible molecular mechanisms were further evaluated with reverse transcription‑polymerase chain reaction and IHC. It was demonstrated that the percentage of colonies and the optical density value of cancer cells were all increased in the presence of IL‑33; however, the relative caspase‑3 activity in cancer cells was decreased in the presence of IL‑33. Molecular mechanism studies revealed that the pro‑proliferative effect of IL‑33 on cancer cells was associated with decreased levels of p27, and the anti‑apoptotic effect of IL‑33 was associated with levels of Fas cell surface death receptor (Fas) and tumor necrosis factor‑related apoptosis‑inducing ligand receptor 1 (TRAILR1). Therefore, IL‑33 promoted proliferation and inhibited apoptosis of ovarian cancer cells by downregulation of p27, Fas and TRAILR1. Contrary to previous studies demonstrating an anti‑tumor effort in pancreatic cancer, the results of the present study indicated that IL‑33 exhibited a significant onco‑promoting effect on ovarian cancer. Accordingly, the inhibition of IL‑33 may be a promising therapeutic strategy for ovarian cancer.
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