Time Heals all Wounds- but Scars Remain. Can Personalized Medicine Help?
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ABSTRACT:
SUBMITTER: Amini-Nik S
PROVIDER: S-EPMC6023985 | biostudies-literature | 2018
REPOSITORIES: biostudies-literature
Publications
Time Heals all Wounds- but Scars Remain. Can Personalized Medicine Help?
Frontiers in genetics 20180622
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Project description:BackgroundPatients understandably have concerns about thyroidectomy scars. This study aimed to characterize patients' perceptions of their thyroidectomy scar before and up to 1-y after surgery.MethodsPatients with papillary thyroid cancer (n = 83) completed semi-structured interviews before and at 2-wks, 6-Wk, 6-mo, and 1-y post-thyroidectomy. Interviews probed about scar concerns and appearance. Content analysis was used to identify themes.ResultsThe majority of participants did not express concerns about scar appearance. When expressed, preoperative concerns often stemmed from previous surgery experiences or unease with neck incisions. Postoperatively, concerns about scar appearance decreased over time throughout the healing period with most patients being satisfied with their scar appearance by 6-mo after surgery.ConclusionsPatients with papillary thyroid cancer express few concerns about scar thyroidectomy appearance. Surgeons can reassure patients who have preoperative concerns that most patients are satisfied with their scar appearance by 6-mo after surgery.
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Project description:IN LIFE, EVERYONE GOES THROUGH HURTFUL EVENTS CAUSED BY SIGNIFICANT OTHERS: a deceiving friend, a betraying partner, or an unjustly blaming parent. In response to painful emotions, individuals may react with anger, hostility, and the desire for revenge. As an alternative, they may decide to forgive the wrongdoer and relinquish resentment. In the present study, we examined the brain correlates of forgiveness using functional Magnetic Resonance Imaging (fMRI). Healthy participants were induced to imagine social scenarios that described emotionally hurtful events followed by the indication to either forgive the imagined offenders, or harbor a grudge toward them. Subjects rated their imaginative skills, levels of anger, frustration, and/or relief when imagining negative events as well as following forgiveness. Forgiveness was associated with positive emotional states as compared to unforgiveness. Granting forgiveness was associated with activations in a brain network involved in theory of mind, empathy, and the regulation of affect through cognition, which comprised the precuneus, right inferior parietal regions, and the dorsolateral prefrontal cortex. Our results uncovered the neuronal basis of reappraisal-driven forgiveness, and extend extant data on emotional regulation to the resolution of anger and resentment following negative interpersonal events.
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Project description:Memories of rejection contribute to feeling lonely. However, high-quality listening that conveys well-meaning attention and understanding when speakers discuss social rejection may help them to reconnect. Speakers may experience less loneliness because they feel close and connected (relatedness) to the listener and because listening supports self-congruent expression (autonomy). Five experiments (total N = 1,643) manipulated listening during visualized (Studies 1, 4, 5) and actual (Studies 2, 3) conversations. We used different methods (video vignettes; in-person; computer-mediated; recall; written scenarios) to compare high-quality with regular (all studies) and poor (Study 1) listening. Findings across studies showed that high-quality listening reduced speakers' state loneliness after they shared past experiences of social rejection. Parallel mediation analyses indicated that both feeling related to the listener and autonomy satisfaction (particularly its self-congruence component; Study 5) mediated the effect of listening on loneliness. These results provide novel insights into the hitherto unexplored effect of listening on state loneliness.
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Project description:For the last two decades, it has been hotly debated whether vitamin E-the major lipid-soluble antioxidant, which functions to maintain neurological integrity-is efficacious as a therapy for Alzheimer's disease. Several factors key to the debate, include (1) which of the eight naturally-occurring vitamin E forms should be used; (2) how combination treatments affect vitamin E efficacy; and (3) safety concerns that most-recently resurfaced after the results of the Selenium and vitamin E Cancer prevention trial SELECT prostate cancer trial. However, with the advent of new genetic technologies and identifications of vitamin E-modulating single nucleotide polymorphisms (SNPs), we propose that clinical trials addressing the question "Is vitamin E an effective treatment for Alzheimer's disease" should consider a more focused and personalized medicine approach to designing experiments. An individual's naturally-occurring SNP variants may indeed influence vitamin E's therapeutic effect on Alzheimer's disease.
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Project description:BACKGROUND:Breast cancer is more prevalent among women 60 years or older than among women younger than 60 years. However, we know much more about the breast cancer experiences of younger women than of older women. Such knowledge is important, for example, to guide treatment decisions or to provide psychosocial care. OBJECTIVE:The aim of this study was to gain insight into the experiences of women with breast cancer 70 years or older. METHODS:Semistructured interviews were conducted with 21 older patients with breast cancer in the Netherlands. We used open coding and affinity diagramming to evoke the themes reflecting the experiences of these women. RESULTS:Four themes emerged from the data: living through and coping with breast cancer, information exchange and informed choice, support experiences, and impact on daily life. Getting breast cancer took some women by surprise. However, older women with breast cancer coped fairly well and were satisfied with the support they received, especially from oncology nurses. Disturbing treatment adverse effects and changes in appearance, comorbid diseases, lack of clear information, and/or an unsupportive environment complicated their living with breast cancer. CONCLUSIONS:Even though many older women with breast cancer handle their disease rather well, some women do encounter difficulties. Lack of support, comorbid diseases, and treatment adverse effects warrant extra attention. IMPLICATIONS FOR PRACTICE:Nurses' close attention to women at risk and early intervention could help relieve individual suffering, while taking these womens' strengths into account can enhance self-management.
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Project description:IGNITE: Genomic Medicine Implementation - The Personalized Medicine Program
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Project description:Cancer treatment often lacks individual dose adaptation, contributing to insufficient efficacy and severe side effects. Thus, personalized approaches are highly desired. Although various analytical techniques are established to determine drug levels in preclinical models, they are limited in the automated real-time acquisition of pharmacokinetic profiles. Therefore, an online UHPLC-MS/MS system for quantitation of drug concentrations within 3D tumor oral mucosa models was generated. The integration of sampling ports into the 3D tumor models and their culture inside the autosampler allowed for real-time pharmacokinetic profiling without additional sample preparation. Docetaxel quantitation was validated according to EMA guidelines. The tumor models recapitulated the morphology of head-and-neck cancer and the dose-dependent tumor reduction following docetaxel treatment. The administration of four different docetaxel concentrations resulted in comparable courses of concentration versus time curves for 96 h. In conclusion, this proof-of-concept study demonstrated the feasibility of real-time monitoring of drug levels in 3D tumor models without any sample preparation. The inclusion of patient-derived tumor cells into our models may further optimize the pharmacotherapy of cancer patients by efficiently delivering personalized data of the target tissue.
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