M-CSF and IL-34 expression as indicators for growth in sporadic vestibular schwannoma.

Macrophage colony stimulating factor and IL-34 are associated with clinical vestibular schwannoma progression. Investigating the biology behind vestibular schwannoma progression helps understanding tumor growth. Inflammation is important in the microenvironment of neoplasms. Macrophages are major players in the intratumoral infiltrate. These tumor-associated macrophages are known to stimulate angiogenesis and cell growth. M-CSF and IL-34 are cytokines that can regulate tumor-infiltrating macrophages. They are expressed by tumors and form potential targets for therapy. The goal of this study was to investigate these cytokines in vestibular schwannomas and to see if their expression is related to angiogenesis, macrophage numbers, cystic degeneration, and volumetric tumor progression. Immunohistochemical expression of M-CSF and IL-34 was analyzed in ten fast-growing vestibular schwannomas and in ten slow-growing vestibular schwannomas. Expression M-CSF and IL-34 were compared between fast- versus slow-growing and cystic versus non-cystic tumors. Data on macrophage numbers and microvessel density, known from earlier research, was also included. All tumors expressed M-CSF and its expression was higher in fast-growing tumors (p = 0.003) and in cystic tumors (p = 0.035). CD163 expression was higher in tumors with strong M-CSF expression (p = 0.003). All tumors expressed IL-34 as well, but no significant differences were found in relation to clinicopathological characteristics. This study demonstrated the expression of M-CSF and IL-34 in vestibular schwannomas. The results suggest that M-CSF is related to macrophage activity and tumor progression, making it a potential target for therapy. If a similar assumption can be made for IL-34 remains unclear.

[Searching for rest in one's soul: the experience of mental health complaints in older Moroccan immigrants]. / Op zoek naar rust in de ziel Rahat el baal. De beleving van problemen met de geestelijke gezondheid van Marokkaanse ouderen.

The number of Moroccan elderly in the Netherlands is growing. Although many have mental health problems, the mental health services have difficulties in reaching them. This study reports on the experience of mental health problems of elderly Moroccan migrants, their search for help and their view on the role of the mental health services. Twenty-two Moroccan elderly (11 men, 11 women) aged 55-75 were interviewed with a semi-structured questionnaire. From the interviews and observations it appeared that these elderly experience their health as bad. When asked, they deny mental health problems. Stress and dejection are not experienced as relating to mental health but as part of life associated with ageing, living in a foreign country, having physical, social and financial problems. The elderly feel that God sets them these tasks to overcome by themselves. Achieving rest in one's soul is central in this process. There is a taboo on serious mental health problems and people are ashamed of them. Only people who neglect religious prescriptions can to be affected by mental health problems. The elderly Moroccans hardly consult mental health services for these problems because then it would become clear that they cannot overcome their problems by themselves. Furthermore, the mental health services are unknown. Therefore, those services have to pay attention to the specific experience of mental complaints of elderly Moroccans. By offering psycho-education the mental health services may come within reach of those elderly.

Op zoek naar rust in de ziel Rahat el baal : De beleving van problemen met de geestelijke gezondheid van Marokkaanse ouderen.

Searching for rest in one's soul: the experience of mental health complaints in older Moroccan immigrants The number of Moroccan elderly in the Netherlands is growing. Although many have mental health problems, the mental health services have difficulties in reaching them. This study reports on the experience of mental health problems of elderly Moroccan migrants, their search for help and their view on the role of the mental health services. Twenty-two Moroccan elderly (11 men, 11 women) aged 55-75 were interviewed with a semi-structured questionnaire. From the interviews and observations it appeared that these elderly experience their health as bad. When asked, they deny mental health problems. Stress and dejection are not experienced as relating to mental health but as part of life associated with ageing, living in a foreign country, having physical, social and financial problems. The elderly feel that God sets them these tasks to overcome by themselves. Achieving rest in one's soul is central in this process. There is a taboo on serious mental health problems and people are ashamed of them. Only people who neglect religious prescriptions can to be affected by mental health problems. The elderly Moroccans hardly consult mental health services for these problems because then it would become clear that they cannot overcome their problems by themselves. Furthermore, the mental health services are unknown. Therefore, those services have to pay attention to the specific experience of mental complaints of elderly Moroccans. By offering psycho-education the mental health services may come within reach of those elderly.