Diagnostic and therapeutic implications of the vascular endothelial growth factor family in cancer.

Cancer progression is attained by uncontrolled cell division and metastasis. Increase in tumor size triggers different vascular channel formation to address cell nutritional demands. These channels are responsible for transferring of nutrients and gaseous to the cancer cells. Cancer vascularization is regulated by numerous factors including vascular endothelial growth factors (VEGFs). These factors play an important role during embryonic development. Members included in this group are VEGFA, VEGFB, VEGFC, PIGF and VEGFD which markedly influence cellular growth and apoptosis. Being freely diffusible these proteins act in both autocrine and paracrine fashions. In this review, genetic characterization these molecules and their putative role in cancer staging has been elaborated. Prognostic significance of these molecules along with different stages of cancer has also been summarized. Brief outline of ongoing efforts to target hot spot target sites against these VEGFs and their cognate limitations for therapeutic implications are also highlighted.

Treatment Recruitment and Retention of Geriatric Participants With Hoarding Disorder.

This study describes the initial contact of 255 potential participants, recruitment of 63 participants, and retention of 57 participants from three geriatric Hoarding Disorder (HD) studies. Patients with HD were easily recruited from the community, primarily through the use of clinician referrals and posted flyers, as evidenced by steady patient flow despite lack of compensation for participation. Contrary to treatment outcomes of late life mood and anxiety disorders, geriatric HD patients are largely retained in clinical research treatment studies. Results demonstrate that older adults with HD can be engaged in treatment. Participants often needed the study staff to provide substantial support, including informal motivational interviewing and problem solving, in scheduling and attending the initial visit.

Validity of the fast scan for diagnosis of intraabdominal injury in blunt abdominal trauma.

BACKGROUND: Blunt abdominal trauma is regularly encountered in the emergency department. The aim of the study is to determine the validity of assessment with sonography for trauma (FAST) scans in the evaluation of BAT in comparison to Computed tomogram/Exploratory laparotomy (CT/FLAP). METHODS: This cross-sectional study was carried out at Ayub Teaching Hospital Abbottabad from January 2010 to December 2011. FAST was performed as part of the primary or secondary survey of the trauma patient in the emergency department in all patients with suspected blunt abdominal trauma. All of them also underwent either CT or ELAP depending on their clinical condition. The validity of FAST scan in comparison to CT/ELAP was documented. RESULTS: Our study included 100 patients with suspected blunt abdominal trauma. The mean age was 3 1.52 ± 16.79 years with 88% males. Road traffic accidents accounted for 80% cases and 20% were due to fall. Seventy percent were hemodynamically stable and 30% were unstable. Haemodynamically unstable patients had significantly more positive FAST scans and more positive CTIELAP (p < 0.05). Of the total, 52% had positive CTIELAP and 54% had positive FAST scan. Majority (28%) had splenic injury. A positive scan had a statistically significant probability of a confirmed blunt abdominal trauma on CT/ELAP; p = O.OO, OR = 8.095, 95% CI = 3.3-19.8. FAST scan had a sensitivity, specificity, positive predictive value and negative predictive value of 76.92%, 70.83%, 74.07% and 73.9% respectively. CONCLUSION: FAST scan had lesser accuracy as compared to previously published local and international data. More work is required before it can be routinely utilized to triage the blunt abdominal trauma patients to laparotomy.

Hoarding severity predicts functional disability in late-life hoarding disorder patients.

OBJECTIVE: Late-life hoarding is a serious psychiatric condition with significant implications in health and functioning. Geriatric hoarding patients show greater impairment in activities of daily living and have a greater number of medical conditions compared with same-aged nonhoarders. This study examined the relationship between geriatric hoarding severity and functional disability severity. METHODS: Sixty-five subjects age 60 or older with hoarding disorder (HD) participated in the current study. Participants were assessed with measures of hoarding severity, psychiatric symptoms, and general disability. Hierarchical regression was used to test the unique association of hoarding symptoms with functional disability beyond the effects of demographic factors, anxiety, and depression. RESULTS: When controlling for demographics (age and gender) and psychiatric symptoms (anxiety and depression), hoarding severity predicts functional disability severity. Analyses also show that clinician-administered measures of hoarding are stronger predictors of disability than patient self-report measures. CONCLUSIONS: When treating older adults with HD, clinicians must consider symptom impact on daily life. A multidisciplinary team must be utilized to address the wide-ranging consequences of hoarding symptoms. Future work should examine how psychiatric treatment of HD affects functional disability.

Medical conditions in geriatric hoarding disorder patients.

UNLABELLED: Hoarding disorder (HD) in late life is associated with increased risk for fire, falling, poor sanitary conditions, disability, and health risks. However, research on the health status of individuals with HD is limited. Hoarding symptoms and the resulting clutter may exacerbate health conditions and lead to improper management of medical illnesses. OBJECTIVE: The purpose of this study is to characterize the health status of older adults with hoarding. The rates of medical conditions will be compared to a non-psychiatric peer group. METHOD: 72 older adults with HD and 25 age matched normal controls, completed a medical conditions checklist, symptom severity measures (i.e., UCLA Hoarding Severity Scale, UHSS; Saving Inventory-Revised, SI-R) and a measure capturing activities of daily living (activities of daily living-hoarding, ADL-H). RESULTS: Older adults with HD (n = 72) reported significantly more health conditions compared to their non-psychiatric peers (n = 25). Hoarding severity significantly predicted the total number of medical conditions. Further, the vast majority of HD patients reported at least one medical condition. CONCLUSION: This is alarming given that hoarding patients utilized health services less than typical for older adults. Given the health status of older adults with HD, interventions should target the prevention and management of medical conditions.

Frequency and prevention of laparoscopic port site infection.

BACKGROUND: The present study was conducted to evaluate the usefulness and safety of the nonpowder surgical glove for extraction of the gallbladder in laparoscopic cholecystectomy. METHODS: The study was carried out in Capital Hospital Islamabad and in a private hospital. The duration of study was from March 2009 to March 2012. This was an observational study carried out in 492 patients who underwent laparoscopic cholecystectomy using the surgical glove for extraction of the gallbladder and compared with the conventional method of gall bladder removal in two hospitals were analyzed. The operative findings, port site infection and co morbid conditions were evaluated. RESULTS: Postoperative wound infection was found in 27 (5.48%) of 492 cases. Umbilical port infection was found in 26 (5.28%) of cases in which gall bladder was removed without endogloves and only one case (0.2%) had infection when gall bladder was removed with the endogloves. Wound infection was more in acute cholecystitis (25.9%) and empyema of Gall Bladder (44.4%). Among the co morbid conditions, diabetes mellitus has got higher frequency of wound infection (44%). CONCLUSION: The use of the surgical glove for extraction of the gallbladder is safe, cheap, simple and potentially reduces significant morbidity. Its routine use at laparoscopic cholecystectomy is mandatory in all cases.