Summary
Background
The physical appearance of psoriasis can be cosmetically disfiguring, resulting in a substantial social burden for patients. An important aspect of this burden is the experience of ...stigmatization. While stigmatization is known to be disabling and stressful for patients, little is known about its correlates, and effective interventions are lacking.
Objectives
To examine predictor variables for perceived stigmatization in psoriasis.
Methods
Questionnaires were administered to 514 patients with psoriasis in a cross‐sectional study. Zero‐order correlation and multiple‐regression analyses were conducted including sociodemographic, disease‐related, personality, illness cognitions and social support predictor variables.
Results
Stigmatization was experienced by 73% of patients to some degree, and correlated with all five categories of predictor variables. In multiple‐regression analyses, stigmatization was associated with higher impact on daily life; lower education; higher disease visibility, severity and duration; higher levels of social inhibition; having a type D personality; and not having a partner.
Conclusions
The results indicate that perceived stigmatization is common in psoriasis, and can be predicted by sociodemographic, disease‐related and personality variables. These predictor variables provide indications of which patients are especially vulnerable regarding perceived stigmatization, which might be used in treatment.
What's already known about this topic?
Perceived stigmatization is common and distressing in patients with psoriasis.
Some of its predictors have been examined in small samples.
What does this study add?
This large study of 514 patients with psoriasis examined a combination of potential predictor variables, both previously examined and never before studied.
Sociodemographic, disease‐related and previously unstudied type D personality variables were found to be predictive of perceived stigmatization.
What are the clinical implications of this work?
These results provide an understanding of which patients may be especially vulnerable to stigmatization‐related problems, which may warrant special attention during treatment.
Opioid drugs, such as morphine, are among the most effective analgesics available. However, their utility for the treatment of chronic pain is limited by side effects including tolerance and ...dependence. Morphine acts primarily through the mu-opioid receptor (MOP-R)
1, which is also a target of endogenous opioids. However, unlike endogenous ligands, morphine fails to promote substantial receptor endocytosis both in vitro
2–5 and in vivo
6–11. Receptor endocytosis serves at least two important functions in signal transduction. First, desensitization and endocytosis act as an “
off” switch by uncoupling receptors from G protein. Second, endocytosis functions as an “
on” switch, resensitizing receptors by recycling them to the plasma membrane. Thus, both the
off and
on function of the MOP-R are altered in response to morphine compared to endogenous ligands. To examine whether the low degree of endocytosis induced by morphine contributes to tolerance and dependence, we generated a knockin mouse that expresses a mutant MOP-R that undergoes morphine-induced endocytosis. Morphine remains an excellent antinociceptive agent in these mice. Importantly, these mice display substantially reduced antinociceptive tolerance and physical dependence. These data suggest that opioid drugs with a pharmacological profile similar to morphine but the ability to promote endocytosis could provide analgesia while having a reduced liability for promoting tolerance and dependence.
Chronic somatic conditions, such as psoriasis, arthritis psoriatica and rheumatoid arthritis, have a large impact on patients' lives. Tailored therapist-guided internet-based cognitive-behavioural ...therapy (ICBT) has been shown to be effective in improving physical and psychological well-being in these patients. Two cases are presented here, in order to provide an in-depth illustration of the course and content of this novel treatment and to investigate the therapeutic alliance in an online treatment. After face-to-face intakes, both patients received therapist-guided ICBT tailored to their specific problems and treatment goals. The treatment resulted in improved physical and psychological well-being and these clinically significant improvements were maintained at 6-month follow-up. In addition, the therapeutic relationship was evaluated positively by both patients and increased further during treatment, indicating an adequate therapeutic working alliance in this online treatment. These case reports show that tailored ICBT may contribute to improved care for patients with chronic somatic conditions.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Chronic treatment of pain with opiate drugs can lead to analgesic tolerance and drug dependence. Although all opiate drugs can promote tolerance and dependence in practice, the severity of those ...unwanted side effects differs depending on the drug used. Although each opiate drug has its own unique set of pharmacological profiles, methadone is the only clinically used opioid drug that produces substantial receptor endocytosis at analgesic doses. Here, we examined whether moderate doses of methadone carry any benefits over chronic use of equianalgesic morphine, the prototypical opioid. Our data show that chronic administration of methadone produces significantly less analgesic tolerance than morphine. Furthermore, we found significantly reduced precipitated withdrawal symptoms after chronic methadone treatment than after chronic morphine treatment. Finally, using a novel animal model with a degrading μ-opioid receptor we showed that, although endocytosis seems to protect against tolerance development, endocytosis followed by receptor degradation produces a rapid onset of analgesic tolerance to methadone. Together, these data indicated that opioid drugs that promote receptor endocytosis and recycling, such as methadone, may be a better choice for chronic pain treatment than morphine and its derivatives that do not.
A certain level of attention to bodily signals may be adaptive in the management of chronic skin conditions, as a lack of attention may lead to inadequate self-care behaviour and, consequently, may ...affect functioning and treatment outcomes. The purpose of this study was to develop a body awareness questionnaire and to investigate its psychometric properties and physical and psychological correlates in a cross-sectional study in patients with psoriasis (n = 475). The 16-item Body Attention, Ignorance and Awareness Scale demonstrated a 3-factor structure that could be interpreted as body ignorance, body attention, and body awareness (Cronbach's α of 0.73, 0.74, and 0.68, respectively). Higher body ignorance was significantly related to more physical symptoms and worse psychological functioning. Body attention and body awareness showed small significant correlations with coping and personality. Given the negative influence of impaired psychological functioning on treatment outcomes, it may be clinically important to screen for theses constructs of body awareness in chronic skin conditions.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The fungal AAL-toxin triggers programmed cell death (PCD) through perturbations of sphingolipid metabolism in AAL-toxin-sensitive plants. While
Arabidopsis is relatively insensitive to the toxin, the
...loh2 mutant exhibits increased susceptibility to AAL-toxin due to the knockout of a gene involved in sphingolipid metabolism. Genetic screening of mutagenized
loh2 seeds resulted in the isolation of AAL-toxin-resistant mutant
atr1.
Atr1 displays a wild type phenotype when grown on soil but it develops less biomass than
loh2 on media supplemented with 2% and 3% sucrose.
Atr1 was also more tolerant to the reactive oxygen species-generating herbicides aminotriazole (AT) and paraquat. Microarray analyses of
atr1 and
loh2 under AT-treatment conditions that trigger cell death in
loh2 and no visible damage in
atr1 revealed genes specifically regulated in
atr1 or
loh2. In addition, most of the genes strongly downregulated in both mutants were related to cell wall extension and cell growth, consistent with the apparent and similar AT-induced cessation of growth in both mutants. This indicates that two different pathways, a first controlling growth inhibition and a second triggering cell death, are associated with AT-induced oxidative stress.
Somatic hybrid plants of various ploidy levels obtained after chemical fusion between two dihaploid clones of potato Solanum tuberosum L. have been analysed by cytological, morphological and ...molecular methods. The hybrid nature of tetraploid and hexaploid plants and the genome dosage in hexaploid hybrids were confirmed by Giemsa C-banding. Tetraploid and hexaploid hybrids showed numerical as well as structural chromosome mutations. The latter occurred mainly in the nuclear organizing chromosome. The tetraploid hybrids were more vigorous than the dihaploid parents as demonstrated by an increase in height, enlargement of leaves, increase in the number of internodes, restored potential for flowering and increased tuber yield. The grouping of tetraploid somatic hybrids into various classes on the basis of leaf morphology revealed that plants with a full chromosome complement were more uniform than aneuploids. Many hexaploid somatic hybrids were also more vigorous than the dihaploid parents and could be grouped into two different classes on the basis of floral colour and tuber characteristics, the differences being due to their different dosage of parental genomes. Most of the tetraploid somatic hybrids showed pollen development halted at the tetrad stage as one of the parental clones contained a S. stoloniferum cytoplasm. However, one tetraploid plant produced pollen grains with high viability. The chloroplast genome in the hybrid plants was determined by RFLP analysis. All of the hybrids had a cpDNA pattern identical to one parent, which contained either S. tuberosum or S. stoloniferum cpDNA. A slight preference for S. tuberosum plastids was observed in hybrid plants. No correlation between pollen development and plastid type could be detected.
Immature embryos of Triticum aestivum (ten cultivars and lines), Triticum durum, Triticum dicoccum and Triticum monococcum were cultured in vitro on MS medium supplemented with 1 or 2 mg/l of 2,4-D ...and 20 or 30g/l of sucrose for 3 days and processed to score sister chromatid exchanges (SCEs) per chromosome. Media components affect DNA replication from the start of the culture. The SCE frequencies were dependent on the genotype and were not correlated with the degree of ploidy. They increased after doubling of the concentration of 2,4-D and/or sucrose, except in one cultivar of T. aestivum. The mean numbers were lower than observed in root meristems of T. aestivum (two cultivars) and T. dicoccum. Immature embryos of regenerants of T. aestivum (one cultivar) and T. durum demonstrated variable SCE frequencies, which may have been caused by mutations in the parental cell cultures. In the T. aestivum embryos the lowest frequencies were found in regenerants obtained from explants with the highest frequencies.
PDF
