Anticipatory nausea and vomiting among cancer patients: A Review

Abstract

Anticipatory nausea and vomiting (ANV), as a side-effect of cancer chemotherapy, is a well recognized phenomenon. The literature is reviewed for data on: prevalence rates, factors contributing to onset and psychological treatments used to attempt a remission in the symptoms. From the available evidence it appears that ANV is a substantial problem with one major review indicating an average combined prevalence of 32%. Although explicable using a conditioning model it has a complex aetiology with emotional and cognitive elements, as well as specific pharmacological factors, playing a role in onset. ANV appears to be responsive to psychologically-based treatment methods, with a good outcome overall. However, more process evaluation is needed in order to understand aetiologic and treatment mechanisms and to determine how best to treat cases of ANV with different aetiologies. It is considered that procedures for identifying and referring patients with ANV should be routinely incorporated into the care of cancer patients receiving repeated cycles of chemotherapy.     

Coping with adverse drug events in patients with heart failure: Exploring the role of medication beliefs and perceptions

This study describes coping strategies that patients with heart failure (HF) use to manage adverse drug events (ADEs). The included coping strategies were social support seeking, information seeking, non-adherence and taking alleviating medication. The role of beliefs about medication and ADE perceptions in explaining these coping strategies was assessed using the Self-Regulation Model. We performed a cross-sectional study including 250 HF patients who experienced an ADE. Patients completed validated questionnaires assessing their coping strategies, ADE perceptions and medication beliefs. Social support (60%) and information seeking (32%) were the most commonly used strategies to cope with ADEs. Non-adherence was reported by 7% of the patients. Multivariate linear regression analysis showed that demographics, clinical factors and medication beliefs explained only a small amount of the variance in coping strategies, whereas ADE perceptions explained a substantial amount of variance. Path analysis showed that patients’ perceptions about the timeline, consequences and controllability of ADEs by the health care provider were directly related to their coping behaviour. The effect of patients’ medication beliefs on their coping strategies was consistent with mediation through their ADE perceptions. Our results support the value of the Self-Regulation Model in understanding patients’ coping behaviour with regard to ADEs.     

重组人粒细胞集落刺激因子预防肿瘤化疗后Ⅲ度以上骨髓抑制的疗效分析

探讨重组人粒细胞集落刺激因子(rhG-CSF)对初诊晚期肿瘤患者化疗后骨髓抑制的合理预防用药时机.采用前瞻性随机方法,筛选首次化疗后出现Ⅲ度～Ⅳ度骨髓抑制的肿瘤患者,以化疗前24h内给予rhG-CSF的为预防治疗组;以化疗前未预防性给药为对照组,采用组间对照法,比较两组化疗后骨髓抑制的发生情况.结果发现两组的骨髓抑制发生率,预防组明显低于对照组,且Ⅲ度以上骨髓抑制发生率也明显降低.首次化疗后出现Ⅲ度～Ⅳ度骨髓抑制的肿瘤患者,下次化疗前24h内预防性给予rhG-CSF,能有效控制肿瘤化疗后骨髓抑制的发生,降低感染的风险,值得推广.     

心力衰竭的药物及非药物治疗

神经内分泌激活、心室重构是收缩性心力衰竭进展的关键机制,针对上述机制的生物学治疗包括血管紧张素转换酶抑制剂、β受体阻滞剂、盐皮质激素受体拮抗剂等可显著改善心力衰竭患者预后,利尿剂、洋地黄等常规药物治疗可改善心力衰竭症状、降低心力衰竭住院风险,为神经内分泌拮抗剂的应用奠定基础;近年来,从阻断心力衰竭发生机制方面研发了很多新药,但尚没有一种能对长期生存率有显著改善.器械治疗(植入型心脏复律除颤器、心室再同步和心室再同步心脏复律除颤器)可降低特定心力衰竭患者病死风险,预防猝死发生,显著改善预后;心室辅助装置及干细胞治疗则为心力衰竭治疗带来新的曙光.     

On anxiety-specific actions of tranquilizers

Abstract

This study examined the role of social support in the relationship between work demand and psychological distress (GHQ 12) in correctional officers (N=419), a high stress occupational group. Work demands were positively associated with strain. There was no evidence that social support buffered the negative impact of work demands. Rather, consistent with most previous research findings, support showed direct benefits and these were discussed in the context of worker participation and control. The hypothesis that officers high in negative affectivity, as measured by trait anxiety would show greater reactivity to work demands was not supported. However, trait anxiety appeared to inflate the relationship between work stressors (work demand and work support) and psychological distress supporting recent suggestions that the role of trait anxiety in occupational stress should not be disregarded. Trait anxiety combined additively with work demand to predict individual differences in psychological distress, however social support moderated the impact of trait anxiety on strain.     

斑马鱼模式动物在神经功能环路研究中的应用

斑马鱼是发育、遗传以及药物发现研究中常用的模式动物.作为重要的脊椎动物模式系统之一,斑马鱼与人类基因有高度同源性,中枢神经系统也与哺乳动物相似.近来,斑马鱼在神经科学研究以及生理心理学相关问题的研究中的应用日益广泛.研究者们对斑马鱼幼鱼及成鱼的行为表现及行为发育开展了多方面的研究.基于斑马鱼模式动物的特点及优势,遗传突变和药物筛选在对动物行为表现的分子机制的研究中起到重要的推动作用.     

基于“相关线索-自动化用药行为”联结的成瘾记忆消退

成瘾记忆消退致力于消除成瘾者相关线索与药物奖赏效应的联结,以达到消除心理渴求、戒断成瘾行为的目的,但其效果还十分有限。最近,大量的动物和人类实验研究发现:在相关线索下,成瘾者的激活脑区不仅包括中脑边缘皮层-背内侧纹状体,还延伸到感觉运动脑区-背外侧纹状体。这意味着成瘾记忆中存在相关线索与自动化(习惯性)用药行为的联结。所以,与成瘾相关的记忆可能包含两种不同的成分:一是与药物奖赏效应相关的情绪记忆,另一种是与用药动作、技能有关的动作记忆(程序记忆)。由于在成瘾阶段,药物奖赏效应对药物使用和复发的作用已经相对减少,因此,针对成瘾记忆的消退训练,以相关线索与自动化用药行为的联结为标靶,可能可以取得更好的效果,值得做进一步的深入探索。     

Inhibiting doping in sports: deterrence is necessary,but not sufficient

The use of performance-enhancing drugs is a significant problem in sport. It cheats clean athletes of their hard-earned rewards from perfecting their skills though dedication and hard work. It defrauds fans by substituting a distorted playing field for a true competition. Anti-doping agencies have been charged with enforcing drug policies, primarily through the use of drug testing programs. We propose that drug testing, while important, is not sufficient to achieve deterrence. Engaging the principles of perceptual deterrence and development of a moral community of athletes can greatly enhance compliance with rules.     

Cognitive function of youths born to mothers with opioid and poly-substance abuse problems during pregnancy

Previous research has provided inconclusive evidence regarding the neuropsychological difficulties of children born to mothers partaking in opioid or poly-drug use during pregnancy. Little is known about how these children fare as they get older. The present longitudinal study includes follow-up data on 45 children born to mothers who used heroin and poly-drugs and a group of 48 children without prenatal drug exposure. Most of the drug-exposed youths were placed in permanent foster or adoptive homes before one year of age. The youths (ages 17 to 21) were administered 10 neuropsychological tests. The drug-exposed youths had cognitive and fine motor functions within the normal range compared to population norms but performed significantly worse than the non-exposed group. There were indications of generally lower cognitive functions rather than specific problems with executive functioning. Lower mean birthweight in the risk group (619 grams mean difference, p < .001) only partially mediated the group differences in cognitive functioning. There was a tendency for youths who had few and early changes in their caregivers or who were born to mothers who had used the least number of different drugs during pregnancy to have the best cognitive scores. The study indicates that youths born to mothers who used multiple drugs during pregnancy are vulnerable relative to their peers within a wide range of cognitive functions. The vulnerability seems to be related not only to the mother’s drug use during pregnancy but also to factors such as birthweight and unstable parental care during infancy.     

Drug Use and Self-Harming Behavior Among Incarcerated Men: Does Childhood Abuse,Anger, and Executive Function Make a Difference?

Childhood abuse, anger, drug-related problems, and self-harm are commonly seen among incarcerated individuals. Forty-three young incarcerated males from an Istanbul prison were assessed for childhood abuse, anger, drug use, self-harming behavior, and executive function (EF). Further, 58% of the sample was using drugs, and 60.5% showed self-harming behavior. Performing a backward stepwise binary logistic regression model, it was found that the likelihood of using drugs was determined by EF measured by the Trail Making Test form A, childhood abuse, anger, and self-harm. On the other hand, self-harm was determined by childhood abuse, anger, and drug use.