[Prostate cancer microenvironment: Its structure, functions and therapeutic applications]. / Microenvironnement du cancer de la prostate : structure, fonctions et applications thérapeutiques.

INTRODUCTION: In the field of prostate cancer there is a growing tendency for more and more studies to emphasise the predominant role of the zone situated between the tumour and the host: the tumour microenvironment. The aim of this article is to describe the structure and the functions of the prostate cancer microenvironment as well as the principal treatments that are being applied to it. MATERIAL AND METHODS: PubMed and ScienceDirect databases have been interrogated using the association of keywords "tumour microenvironment" and "neoplasm therapy" along with "microenvironnement tumoral" and "traitements". Of the 593 articles initially found, 50 were finally included. RESULTS: The tumour microenvironment principally includes host elements that are diverted from their primary functions and encourage the development of the tumour. In it we find immunity cells, support tissue as well as vascular and lymphatic neovascularization. Highlighting the major role played by this microenvironment has led to the development of specific treatments, notably antiangiogenic therapy and immunotherapy. CONCLUSION: The tumour microenvironment, the tumour and the host influence themselves mutually and create a variable situation over time. Improvement of the knowledge of the prostate cancer microenvironment gradually enables us to pass from an approach centred on the tumour to a broader approach to the whole tumoral ecosystem. This enabled the emergence of new treatments whose place in the therapeutic arsenal still need to be found.

[Longitudinal follow-up of the IPSS within the 5 years following treatment of a localized prostate cancer: overall analysis and by type of treatment]. / Suivi longitudinal de l'IPSS dans les cinq ans suivant un traitement d'un cancer de prostate localisé: analyse globale et par type de traitement.

OBJECTIVES: The International Prostate Score Symptom (IPSS) and the question of quality of life (QOL-Q) associated were used in this study for monitoring patients treated for localized prostate cancer (P-Ca). PATIENTS AND METHODS: Three groups treated with radical prostatectomy (RP), external beam radiotherapy (RT) or brachytherapy (BRACHY) completed the self-administered questionnaire IPSS and Q-QOL before treatment (bef-TT), after 3 months and once a year for 5 years. RESULTS: The study included 40 PR, 40 RT and 40 BRACHY. There was no difference between the three groups in bef-TT for the IPSS and Q-QOL or in the patients' characteristics, and P-Ca except for age and a higher PSA in the RT group (70.6 years old and 10.0 ng/mL vs. 66.5/66.2 and 7.1/6.2 for RP and CURIE respectively). The impact, no matter what treatment they received, was significant after the third month and then went back to the pre-AN1 at TT. The analysis by group treatment showed no significant difference between groups at 3months and during the first 4 years of follow-up. In the fifth year the RT group had a greater IPSS than BRACHY and PR groups (P<0.04). CONCLUSION: This study showed no degradation of the IPSS or Q-QOL remote treatment of localized prostate cancer. Urinary incontinence has been partially exploring. His study would have allowed a better urinary quality of life analysis in these patients.

Applying our medicine to the psychopharmacology debate.

Reasonable arguments can and should be made in favor of and in opposition to psychologists seeking prescription privileges. The debate presents psychology with the opportunity to converge rather than fractionate. An APA Task Force established in 1991 recognized that a number of preliminary issues would have to be addressed before the question of prescription privileges could be answered, and made recommendations for the types of training various psychologists would need. This article describes that training and discusses how psychologists in training may be affected by the current debate.

Psychologic adjustment of human immunodeficiency virus-infected school-age children.

We investigated the psychosocial adjustment of school-aged, human immunodeficiency virus-positive children and factors associated with level of adjustment. Participants were primarily transfusion-infected children living in middle-class families. We administered measures of depression, anxiety, and self-concept to children, and measures of behavior problems, social functioning, personality characteristics, and life events to parents. An index of disease stage was also collected. Children reported experiencing low levels of depressive and anxious affect and generally felt positively about themselves. By contrast, parents saw their children as more anxious and less socially active than respective standardization samples. A greater than expected proportion of these children, as reported by their parents, scored in the maladaptive range on measures of social functioning, anxiety, and conduct problems. Experience of adversive life events and progression of the disease were associated with more behavioral and social problems. Findings are discussed in terms of their generalizability and implications for future research.

Counting the stitches that count: preventive intervention promises and public health.

Continued public support for the design, implementation, and dissemination of preventive interventions depends on achievement of four major criteria: (a) Reductions in the incidence or prevalence rates of diagnosable emotional and behavioral disorders, (b) reductions in the need for mental health services through effective primary and secondary interventions, (c) enhancement of the effectiveness of obtained services as screening and early detection efforts are implemented, and (d) reductions in the nation's health care costs associated with emotional and behavioral dysfunctions. Strategies including risk reduction, risk avoidance, health promotion, empowerment, and resource development are preventive insofar as they contribute to achievement of the aforementioned outcomes.

Children's exposure to community violence: following a path from concern to research to action.

This paper discusses the antecedents and current progress of an ongoing program of research on the nature, extent, and consequences of children's direct and indirect exposure to violent events and settings. Involvement in such research has sensitized the authors to difficult ethical and methodological challenges that, we believe, merit consideration by mental health scientists and policy markers. Resolution of those challenges has substantive implications for both subsequent research and the application of resultant findings.

Targeting preventive interventions: enhancing risk estimates through theory.

Incorporation of mediational screening procedures within targeted preventive interventions must be grounded in a substantial theoretical and epidemiological knowledge base. Essential information includes an etiological model of the disorder(s) to be prevented and epidemiological confirmation that risk factors used for the selection of intervention recipients have been prospectively confirmed. Targeting these recipients using a combination of indicated and selective criteria is expected to increase the base rate at which the disorder(s) to be prevented occurs in the intervention population and thus the power of the evaluation design used to confirm reductions in proximal and distal indices of disorder(s). Caution is urged, however, to consider the potential iatrogenic effects of overly focused targeting and the potential reductions in intervention effectiveness resulting from application to homogeneous vs. heterogeneous populations. Mediational screening's heuristic contribution to theory is discussed.

Prevention and public health. Psychology's response to the nation's health care crisis.

Psychology as a scientific and applied discipline has a unique responsibility to participate in the pursuit of strategies that reduce the nation's health care needs. As a social and behavioral science, psychology can contribute to unraveling the processes underlying conditions of health and disorder. As an applied discipline, psychology can work to design effective interventions to promote human health and to avoid disease and dysfunction. Insofar as these endeavors are unsuccessful, psychology can help reduce significant contributors to the nation's morbidity and mortality. Achieving such success, however, challenges psychologists to collaborate effectively, to combine science with practice and policy, and to address complex philosophical and ethical issues concerned with individual freedom and public responsibility.

The search for effective prevention programs: what we learned along the way.

Efforts by an American Psychological Association task force to identify model prevention programs for high-risk groups throughout the life span are summarized. Criteria for selection and program content are described, and implications for the construction, implementation, and evaluation of effective programs are discussed.

Multivariate approaches to the identification of delinquency proneness in adolescent males.

A sample of 337 adolescent male students were surveyed for demographic, individual, school, and familial functioning and delinquency status to investigate two questions relevant to prediction of adolescent delinquency proneness. First, three methods of scoring a delinquency self-report measure (frequency, variety, and seriousness) were compared to assess their differential relevance to the prediction of delinquency proneness. Second, a multivariate model was examined to assess its explanatory ability for identification of delinquency proneness. Findings, replicated through a series of regression analyses, demonstrate that age of onset is the best predictor. Other than family functioning, psychosocial indicators add little to the predictive model. Third, a specific factor model was preferable to a "risk count" method. Finally, the advantage of self-reports of delinquent behavior over official records is discussed as is the comparability of self-report scoring procedures. How self-reported delinquency is scored is not as critical as previously thought.

Correlates of death anxiety in elderly persons.

Studied the variables related to death anxiety in the elderly. The population consisted of 122 elderly persons who resided in the community and in institutions. Questionnaires that measured demographics, support systems, health, personality, and death anxiety were administered. Multiple regression analyses with death anxiety as the criterion were performed on five subsamples of the population. The results showed very little consistency in predictors of death anxiety among the subsamples. It was concluded that death anxiety response patterns are a function of the population examined, rather than existing as general characteristics of the elderly, which explains the inconsistency of previous literature on death anxiety in elderly persons.

Referral to a school mental health project: a screening note.

The screening efficiency of two measures of school-adjustment is considered by assessing the proportion of children referred to a school mental health program whose scores fall at or above the 85th centile on one or both measures. The study's findings demonstrate that 60-90% of referred children were identifiable by a screening cutoff score procedure. The implications for using a cutoff score approach in selecting children for the intervention are discussed.