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Objective: Major depressive disorder (MDD) is the most common psychiatric disorder among breast cancer patients and is associated with substantial functional impairment. Although several outcome studies have explored the utility of psychotherapy for breast cancer patients with subsyndromal depression symptoms, only a few clinical trials have explored the efficacy of behavior therapy for patients with well-diagnosed MDD. An additional limitation of this research is that little is known about factors that best predict treatment outcome. Method: In the context of a recent randomized trial of behavior activation and problem-solving therapy for depressed breast cancer patients (n = 80; Hopko et al., 2011), this study explored predictors of treatment outcome with selected demographic (age, education, marital status, occupational status), psychosocial (pretreatment depression and environmental reward, coexistent anxiety disorders, social support, history of psychotherapy) and cancer-related variables (cancer stage, duration of cancer diagnosis, and cancer treatment). Results: Positive treatment outcome as defined by Beck Depression Inventory-II (Beck et ah, 1996) response and remission criteria was associated with being married, increased social support, not actively undergoing cancer treatment during psychotherapy, and having a history of psychotherapy. Conclusions: The efficacy of behavior therapy for depressed breast cancer patients may depend on several patient variables. Implications for the provision of behavior therapy for breast cancer patients are discussed. [ABSTRACT FROM AUTHOR]

We conducted an epidemiological investigation of musculoskeletal disorders (MSD) among a complete cohort of 222 female nursing students in Yamanashi prefecture, central Japan. This study involved a retrospective analysis of data gathered by means of a self-reported, anonymous questionnaire. Symptom descriptions and evaluation criteria were drawn from previously validated studies. Slightly more than one-third of all nursing students (36.9%) reported a current MSD at some body site. By location, shoulder MSD was the most common condition; affecting 14.9% of them. This was followed by MSD of the lower back (13.5%), neck (9.5%), knee (5.0%), forearm (2.7%), legs (2.3%) and feet (1.8%). Headache was also reported by 4.5%. There were no statistically significant differences between MSD prevalence and year of study in the nursing course (P for trend=0.9534). However, previous hospital work was found to increase the risk of shoulder MSD by a factor of 4.4 (OR 4.4, 95%CI 1.3–13.3, P=0.0107) among the students within this study. Overall, our investigation showed that MSD was less common among a Japanese cohort than in previous reports of nursing students and working nurses. [Copyright &y& Elsevier]

Abstract Background Continuing advances in medical care and nutrition have prolonged the lifespan and expanded the elderly demographic world-wide. Despite increasing elderly populations within Taiwanese nursing homes, there has been a lack of dermatologic surveys, and the prevalence of skin conditions within this group is unknown. Methods To establish the prevalence of skin disease within nursing homes in southern Taiwan, we undertook a dermatologic and epidemiologic investigation of 398 patients in Tainan City, southern Taiwan, between November 1999 and February 2000. Results This study revealed that more than half of all nursing home patients suffered from fungus (61.6%) and xerosis (58.3%), while other pruritic skin diseases, such as dermatitis and scabies, were less prevalent at 7.3% and 3.3%, respectively. Risk factors for fungal infection included bedridden status (risk ratio (RR), 1.2; 95% confidence interval (CI), 1.1–1.4) and male gender (RR, 1.2; 95% CI, 1.0–1.3). Xerosis was statistically correlated with an age range of 80–90 years (RR, 1.2; 95% CI, 1.0–1.4) when compared to other age ranges. Current scabies diagnosis was strongly associated with a previous history of scabies (RR, 8.9; 95% CI, 1.7–21.1). Conclusions Our study provides clinically relevant data regarding the prevalence of skin diseases in institutionalized Taiwanese patients for the first time. The results suggest that scabies persists within some nursing homes despite treatment, and that some patients remain undiagnosed. The dermatologic needs of these Taiwanese patients are not currently being satisfied. [ABSTRACT FROM AUTHOR]

Although hand dermatitis (HD) is a frequent occurrence for many health professionals, little is known about the prevalence of HD among medical students, particularly in Australia. A questionnaire-based survey of HD was administered to 261 students at a medical school in tropical northern Australia during 2004 (98.9% response rate). The prevalence of HD varied by year of study, ranging from 9.7% to 20.4% ( P=0.322), with an overall prevalence of 17.4%. HD prevalence was significantly higher in those with current allergic disease ( P=0.012). Some students (13.8%) reported a reaction immediately after exposure to latex products, a finding which was associated with higher prevalence of HD ( P=0.001). HD may be more prevalent among students of a tropical Australian medical school than among their counterparts studied elsewhere. The identification of allergy as a significant correlate again stresses the importance of allergic disease and its relationship with skin conditions. [ABSTRACT FROM AUTHOR]

The article focuses on the introduction of the Case-Based Reviews, a new series of biannual articles that will provide timely reviews regarding key clinical scenarios within the field of clinical practice. It will present cohesive and multidisciplinary discussions regarding tumor treatment that will prove useful to every health care provider encountering a patient with a brain tumor. Every series will cover a single tumor type or family of related tumors.

This article investigates how floor plan layout of a printed circuit board (PCB) influences the reliability of the component’s solder joint connections when operated in a vibrating environment. A random vibration profile as seen in an automotive environment was used in full lifetime tests. An industry-standard FR4 PCB with electroless nickel immersion gold (ENIG) surface finish was manufactured with double-sided component placement including 14 flip chips, eight on the top side and six on the bottom side. Ultrasound scans were used as a nondestructive test to assess the integrity of solder joints from manufacture to failure. This enabled monitoring of the important interface between solder joints and flip chip where failure mostly occurs. The initial failure pattern was found by experiment where 86 cycles of random vibration caused all flip chips to mechanically fail. Failure followed a Weibull probability with a value of $\beta = 1.297$ , indicating that failure rates increase with time. The results show that the reliability of a flip chip varies with its position on a PCB with some marked differences to component lifetimes. The results also show that for two-sided flip-chip placements on a PCB, back-to-back, overlapped, and single-sided orientations have subtle effects on flip-chip lifetimes. Similarly, reliability varied with solder joint positions since joints on the sides of a flip chip nearest the PCB edges were less reliable than those on sides on a flip chip furthest away. Finally, design guidelines are offered to effect the most reliable flip-chip placement on a two-sided PCB when operated in a vibrating environment. [ABSTRACT FROM AUTHOR]

Background/Aims: The oxidative stress sensor transient receptor potential melastatin-2 (TRPM2) ion channel has recently gained attention in many types of cancer. The lung tissue is highly susceptible to oxidative stress-mediated injury and diseases; therefore, we aimed to determine whether TRPM2 plays an essential role in protecting lung cancer cells from oxidative damage while promoting cancer cell survival and metastasis. Methods: We used two non-small cell lung (NSCLC) cell lines A549 and H1299 as a lung cancer model. We investigated the functional expression of TRPM2 using electrophysiology, qRT-PCR and Western blots. CFSE and flow cytometry were used to study TRPM2 role in proliferation, cell cycle and apoptosis. Gap closure chambers and Three-Tiered Chemotaxis Chamber were used to study the role of TRPM2 in metastasis. SCID mice were used to study the role of TRPM2 in lung tumor growth and metastasis. Results: We demonstrate that TRPM2 is functionally expressed in NSCLC cells and that its downregulation significantly inhibits cell proliferation and promotes apoptosis. These results were concomitant with an induction in DNA damage and G2/M cell cycle arrest. TRPM2 silencing inhibits also lung cancer cells invasion ability and alters EMT processes. Mechanistically, TRPM2 downregulation causes an increase in the intracellular levels of reactive oxygen (ROS) and nitrogen (RNS) species, which in turn causes DNA damage and JNK activation leading to G2/M arrest, and an ultimate cell death. Finally, TRPM2 downregulation suppresses the growth of human lung tumour xenograft in SCID mice and TRPM2 depleted tumours exhibited a significant reduction in the mRNA expression level of EMT markers compared to the control tumors. Conclusion: Our data provide new insights on the functional expression of TRPM2 in lung cancer, its essential role in tumour growth and metastasis through the control of JNK signaling pathway, and that TRPM2 could be exploited for targeted lung cancer therapies. [ABSTRACT FROM AUTHOR]

AimsCardiac troponins are measured in acute coronary syndrome (ACS) and other conditions. The authors investigate the prognostic significance of cardiac troponin T (TnT) test and comorbid medical conditions.MethodsConsecutive patients admitted to the Aintree University Hospital, Liverpool, between 2 January 2004 and 29 February 2004 who had TnT measurement were included. Patients were separated into normal (<0.01 μg/l) or raised TnT levels (≥0.01 μg/l), and further categorised into: (1) normal TnT with unstable angina; (2) normal TnT with non-ACS; (3) raised TnT with ACS; and (4) raised TnT with non-ACS. Cox regression was used to identify prognostic variables, and logrank test to compare 7-year survival.ResultsOf 1021 patients, 313 had raised TnT (195 ACS, 118 non-ACS) and 708 normal TnT (80 ACS, 628 non-ACS). Age (HR 1.06; 95% CI 1.05 to 1.07), congestive cardiac failure (HR 1.37; 95% CI 1.11 to 1.69), cerebrovascular disease (HR 1.37; 95% CI 1.10 to 1.71), chronic obstructive airway disease (HR 1.44; 95% CI 1.19 to 1.75), liver disease (HR 4.16; 95% CI 2.37 to 7.31), renal disease (HR 1.83; 95% CI 1.27 to 2.64), tumour (HR 1.39; 95% CI 1.07 to 1.79), lymphoma (HR 4.81; 95% CI 2.07 to 11.16), metastatic cancer (HR 3.55; 95% CI 2.32 to 5.45) and a higher Charlson's comorbidity score (HR 1.20, 95% CI 1.13 to 1.26) were adverse predictors. Both raised TnT with ACS (HR 1.92, 95% CI 1.54 to 2.39) and raised TnT with non-ACS (HR 2.37, 95% CI 1.87 to 3.00) were associated with worse survival. Raised TnT with non-ACS had a worse survival than raised TnT with ACS (p=0.001).ConclusionHospitalised patients with raised TnT levels from any cause predicted a higher mortality than normal TnT, with worst survival in those without an obvious ACS. [ABSTRACT FROM AUTHOR]