Effects of mindfulness-based cognitive therapy on breast cancer survivors with insomnia: A randomised controlled trial.

OBJECTIVE: We investigated the effects of mindfulness-based cognitive therapy on insomnia (MBCT-I) in breast cancer survivors. METHODS: In total, 136 participants were allocated randomly to a MBCT-I group or a waitlist control (WLC) group. Indicators of insomnia and mindfulness were evaluated using the Insomnia Severity Index, actigraphy and the Five Facet Mindfulness Questionnaire. Data were collected at baseline (T1), post-intervention (T2), 3-month follow-up (T3) and 6-month follow-up (T4) time points. RESULTS: Insomnia severity decreased significantly in the MBCT-I group, compared with the WLC group, at T2, T3 and T4 (all p < .001). We found that 59.6% of the MBCT-I group with moderate and severe insomnia improved to no insomnia and subclinical insomnia at T4 relative to T1, accounting for 7.9% and 55.3%, respectively. Compared with the WLC group, the MBCT-I group improved on actigraphy measures of sleep; they exhibited a pattern of decreased sleep onset latency and waking after sleep onset, as well as increased total sleep time and sleep efficiency. Mindfulness also increased more in the MBCT-I group than in the WLC group at T2, T3 and T4 (all p < .001). CONCLUSIONS: MBCT-I may be an efficacious non-pharmacologic intervention to improve sleep quality in breast cancer survivors.

Illness cognitions and the associated socio-demographic and clinical factors in Chinese women with breast cancer.

PURPOSE: Illness cognitions are important mediators between disease and psychological adjustment. Evidence related to illness cognitions among patients with breast cancer remains limited. The purpose of this study was to examine illness cognitions among Chinese women with breast cancer and associations with socio-demographic and clinical factors. METHODS: A cross-sectional study was carried out involving 313 women with breast cancer recruited from a general hospital and a social cancer support club in Beijing from October 2016 to May 2017. Data were collected using the Illness Cognition Questionnaire. RESULTS: Participants reported positive overall cognition regarding breast cancer (helplessness, 13.70 ± 4.24; acceptance, 16.86 ± 4.30; perceived benefits, 17.93 ± 3.86). A multiple regression model indicated that six factors were associated with illness cognitions: treatment phase of disease, having no children, not returning to work (positive associations with helplessness, negative associations with acceptance; age (negative associations with helplessness, positive associations with acceptance); treatment phase of disease, having no medical insurance (negative associations with perceived benefit); and disease duration (positive associations with acceptance). CONCLUSIONS: This study reports on the presence of different illness cognitions in Chinese women with breast cancer and the associated factors, and the results could help oncology medical and nursing staff identify risk factors for poor emotional adjustment to breast cancer and the patients who may benefit from interventions aimed at improving the presence of positive illness cognitions.

Calcifying fibrous tumor of stomach: A case report.

RATIONALE: Calcifying fibrous tumor (CFT) is a rare benign soft tissue mesenchymal neoplasm. Although the gastrointestinal (GI) tract is the most common predilection site of CFT, the clinicians, even including pathologist, generally consider it as GI stromal tumor (GIST) or other submucosal tumors such as schwannoma and leiomyoma. PATIENT CONCERNS: A 55-year-old man presented with complaints of epigastric discomfort and abdominal distention for more than 1 year. DIAGNOSES: On the basis of endoscopic and computed tomography examination, preliminary diagnosis was GIST. INTERVENTIONS: Endoscopic submucosal dissection (ESD) surgery was performed to remove the gastric mass. OUTCOMES: The histopathological examination revealed a gastric CFT. LESSONS: We present a case of gastric CFT, which was misdiagnosed as GIST based on endoscopic and radiologic findings.

Lamina osteotomy and replantation with miniplate fixation for thoracic myelopathy due to ossification of the ligamentum flavum.

Lamina osteotomy and replantation with miniplate fixation is often used to treat benign intradural tumors, effectively preventing nerve entrapment and postoperative spinal deformities. However, no studies report using this technique to treat thoracic myelopathy due to ossification of the ligamentum flavum (OLF). This article reports the clinical outcome of a series of 18 cases of contiguous multilevel OLF treated by lamina osteotomy and replantation with miniplate fixation.Eighteen consecutive patients at the authors' institution were treated between 2008 and 2010 for contiguous multilevel OLF. Clinical efficacy, operative time, blood loss, sagittal alignment, and complications were investigated. Japanese Orthopaedic Association scale scores improved from 4.7±1.4 preoperatively to 7.9±1.3 three months postoperatively and 8.8±1.3 at final follow-up (P<.01), with a mean recovery rate of 67.8%±13.1%. No significant kyphotic deformity occurred postoperatively, and local kyphosis in the treated area increased by a mean of only 1.9°±1.0° at final follow-up. No patient required additional surgery due to spinal canal reobstruction and progressive spinal deformity. Cerebrospinal fluid leakage occurred in 4 patients and resolved after repair. Pulmonary infection and deep venous thrombosis occurred in 1 patient who was discharged with no complications after routine treatment.Lamina osteotomy and replantation with miniplate fixation is an effective therapeutic option for thoracic myelopathy due to contiguous multilevel OLF compression. The technique provides adequate decompression and stabilized sagittal alignment and avoids invasion of the spinal canal by scar tissue.

[A clinical study of fungal infection in burn patients].

OBJECTIVE: To address the features of the fungal infection after burn injury in clinic. METHODS: Three thousand nine hundred and nine burn patients admitted to our institute from Jan. 2003 to Dec. 2006 were involved in this study. Two thousand two hundred and seventy-one samples were harvested for fungal detection by culture from 467 patients suspected to be infected by fungi based on their clinic manifestations. The collected samples included wound tissue, blood, urine, stool, sputum, catheters and others. The antibiotic sensitivity of the identified fungi were determined by routine method. When same kind of fungus was found from different samples taken from one patient, it was recorded as one positive sample. The samples were ranked in an ascending order as wound secretion, stool, urine, sputum and bronchial alveolar lavage fluid, arteriovenous catheter or urinary catheter, blood. Only the positive sample of the highest rank source was recorded as the positive strain of fungus from this particular patient. RESULTS: It was found 61 fungal positive samples from the 2271 samples collected. Out of 467 patients, 38 strains of fungi were detected from 36 burn patients during the investigated period, the incidence was 0.92% (36/3909). The most three commonest types among the identified 38 strains of fungi were Candida tropicalis (42.1%), Candida albicans (31.6%) and Candida famata (T. Famata, 10.5%). The drug sensitivity tests demonstrated that most of the strains detected in this investigation, with the exception of candida glabrata, were sensitive to most of the routine antimycotics agents such as Amphotericin B, Fluconazole, and Itraconazole etc. Among the 36 fungus positive patients, in 18 patients the burn area exceeded 80% TBSA, 12 patients with 50%-79% TBSA, 4 patients with 30%-49% TBSA, and in 2 patients the burn area was smaller than 30% TBSA. It was found most of the fungal infections (77.78%) occurred 2 weeks after burn injury, and 8 of the 36 fungus-infected patients died (the mortality was 22.22%). Conclusions Further examinations are necessary to confirm the diagnosis in burn patients suspected to have fungal infection. Once fungal infections are confirmed, antimycotic therapy must be started immediately.