Reconnaissance of tumor immune microenvironment spatial heterogeneity in metastatic renal cell carcinoma and correlation with immunotherapy response.

A clearer understanding of the tumor immune microenvironment (TIME) in metastatic clear cell renal cell carcinoma (ccRCC) may help to inform precision treatment strategies. We sought to identify clinically meaningful TIME signatures in ccRCC. We studied tumors from 39 patients with metastatic ccRCC using quantitative multiplexed immunofluorescence and relevant immune marker panels. Cell densities were analyzed in three regions of interest (ROIs): tumor core, tumor-stroma interface and stroma. Patients were stratified into low- and high-marker density groups using median values as thresholds. Log-rank and Cox regression analyses while controlling for clinical variables were used to compare survival outcomes to patterns of immune cell distributions. There were significant associations with increased macrophage (CD68+ CD163+ CD206+ ) density and poor outcomes across multiple ROIs in primary and metastatic tumors. In primary tumors, T-bet+ T helper type 1 (Th1) cell density was highest at the tumor-stromal interface (P = 0·0021), and increased co-expression of CD3 and T-bet was associated with improved overall survival (P = 0·015) and survival after immunotherapy (P = 0·014). In metastatic tumor samples, decreased forkhead box protein 3 (FoxP3)+ T regulatory cell density correlated with improved survival after immunotherapy (P = 0·016). Increased macrophage markers and decreased Th1 T cell markers within the TIME correlated with poor overall survival and treatment outcomes. Immune markers such as FoxP3 showed consistent levels across the TIME, whereas others, such as T-bet, demonstrated significant variance across the distinct ROIs. These findings suggest that TIME profiling outside the tumor core may identify clinically relevant associations for patients with metastatic ccRCC.

Prevalence of antibodies against Kilham virus in experimental rat colonies of Argentina.

The Kilham rat virus (KRV) is a parvovirus originally isolated from a rat sarcoma in the late 1950s. The clinical signs associated with a natural KRV infection include foetal resorption in dams, runting, ataxia, cerebellar hypoplasia and jaundice in suckling rats, and sudden death, scrotal cyanosis, abdominal swelling and dehydration in juvenile rats. The ability of this virus to produce persistent infections has resulted in a high frequency of contamination of cell cultures and transplantable-tumor system. In addition, the virus may interfere with research in other ways. The remarkable resistance to environmental conditions determines the importance of the detection and control of this agent, especially in the laboratory animal production. This study determines the seroprevalence of Kilham antibodies from sera of adult rats from conventional facilities, using the haemagglutination inhibition test. The seroprevalence varied between 27.8% and 75%. This result confirms that the virus is circulating in Argentinean conventional facilities and might be interfering with research. The recognized Kilham virus may be prevented from supply sources by implementing a health monitoring schedule including a regular serological surveillance, and by keeping the animals under barrier systems.

Biomechanics of minor automobile accidents: treatment implications for associated chronic spine symptoms.

Biomedical experimental data indicate that automobile accidents with no vehicle damage are unlikely to cause injury to the occupants. Soft tissue injuries heal in a few weeks. Chronic pain has never been produced by experimental injury and is much less common in countries without financial payments for accident victims. Chronic pain after no-damage collisions is probably caused by psychologic factors. Psychologic treatment should be added to conventional nonoperative treatment when no objective explanation for chronic symptoms is found.

Cognitive-behavioral techniques in the treatment of chronic low back pain: preliminary results.

Review of the literature reveals chronic low back pain has not responded well to conventional medical treatment with medication and surgery. The addition of cognitive-behavioral approaches to complement conventional medicine seems to improve the results and lessens pain in this group of patients.

Computer graphics. A tool for decision making in nursing.

The use of computer graphics in nursing has not yet reached its full potential. Graphs or maps can display large amounts of data so that critical elements can be inspected in a minimal amount of time. This article discusses computer graphics in terms of their use in nursing and the need for this electronic modality in nursing curricula.

Torture: a nursing concern.

Survivors of torture report that their tormentors have included physicians and nurses. Such misuse of medical and nursing knowledge to engage in unconscionable acts is unethical, unprofessional and a violation of human rights. Torture and its use, ways in which health professional participate and steps taken by nursing toward its prevention are discussed.

Climate, diffused solar radiation and multiple sclerosis.

Environmental factors implicated as affecting world-wide distribution of multiple sclerosis are reviewed. It is suggested that climate may be involved in the etiology of this disease. Diffused solar radiation effects on multiple sclerosis hospital admission rates are demonstrated.

Influence of weather on osteoarthritics.

This exploratory study examined the effects of selected weather variables on pain and pain-related stress in osteoarthritic subjects. Urban and rural dwelling arthritics who perceived that weather made their symptoms worse and those who did not were surveyed. Some persons with osteoarthritis in urban Chicago were more weather sensitive than their rural counterparts in Grand Forks, North Dakota. Multiple regression analysis showed that precipitation affected degree of pain for urban subjects who identified weather as a pain-generating factor; barometric pressure, relative humidity and sunshine were significant factors influencing pain-related stress. Wind speed correlated with pain and pain-related stress; relative humidity and precipitation correlated with pain-related stress for urban subjects who did not perceive weather as a problem. Specific weather variables were not identified as affecting rural subjects' pain. However, temperature and barometric pressure affected degree of pain-related stress in rural subjects who perceived weather as a problem. Subtle differences between Chicago urban and Grand Forks rural climates are reflected in arthritic subjects' degree of pain and their perception of pain-related stress.

Life satisfaction, health control orientation, and illness-related factors in persons with osteoarthritis.

The purpose of this study was to assess life satisfaction in osteoarthritics and to explore relationships between that variable and health perception, health locus of control, and illness-related factors. The study group consisted of 160 osteoarthritics from four different types of settings. The osteoarthritics rated their present life satisfaction and recent health as relatively good and were externally controlled in terms of their health beliefs. Present life satisfaction was related to better health perception, internal locus of control, and less joint pain.

Comparison of fixation of spinal fractures.

Mechanical failure was induced in cadaver spines by applying flexion, extension, and lateral bending loads with continuous recordings of moment and rotation. Each spine was then stabilized with Harrington distraction rods, compression rods, and titanium mesh in sequence, and tested in a similar manner. The spines stabilized with mesh appeared stronger but less stiff than spines stabilized with Harrington rods.

Satisfaction with life for patients undergoing hemodialysis and patients suffering from osteoarthritis.

Two groups of chronically ill patients, alike in some respects of psychological stress and physical limitations but differing in degrees of physical threat to life because of treatment, were compared in terms of quality of life. Twenty patients undergoing hemodialysis at a satellite center and 20 patients with severe osteoarthritis receiving care at a hospital clinic, ranging in age from 40 to 60 years, were randomly selected and asked to rate themselves on Cantril's self-anchoring scale in relation to pase, present, and future life satisfaction. An ANOVA for simple main effects indicated that patients undergoing hemodialysis viewed present life satisfaction significantly higher, F = 4.81, p less than .05, than did patients with arthritis. Expectation for greater life satisfaction tended to be slightly better for dialysis patients, but not significantly so; past life satisfaction was the same for both groups. Dialysis patients viewed their present life better than past life, whereas arthritis patients had the opposite viewpoint. The increased life satisfaction among dialysis patients may be the result of an increased sense of physical well-being because of the dialysis procedure, and chronic pain may be a factor in the decreased life satisfaction among arthritis patients.