RESUMEN
TRAIL is a tumor necrosis factor-related ligand that induces apoptosis upon binding to its death domain-containing receptors, DR4 and DR5. Two additional TRAIL receptors, TRID/DcR1 and DcR2, lack functional death domains and function as decoy receptors for TRAIL. We have identified a fifth TRAIL receptor, namely osteoprotegerin (OPG), a secreted tumor necrosis factor receptor homologue that inhibits osteoclastogenesis and increases bone density in vivo. OPG-Fc binds TRAIL with an affinity of 3.0 nM, which is slightly weaker than the interaction of TRID-Fc or DR5-Fc with TRAIL. OPG inhibits TRAIL-induced apoptosis of Jurkat cells. Conversely, TRAIL blocks the anti-osteoclastogenic activity of OPG. These data suggest potential cross-regulatory mechanisms by OPG and TRAIL.
Asunto(s)
Apoptosis/fisiología , Glicoproteínas/fisiología , Glicoproteínas de Membrana/fisiología , Receptores Citoplasmáticos y Nucleares , Receptores del Factor de Necrosis Tumoral/fisiología , Factor de Necrosis Tumoral alfa/fisiología , Animales , Proteínas Reguladoras de la Apoptosis , Unión Competitiva , Proteínas Ligadas a GPI , Humanos , Fragmentos Fc de Inmunoglobulinas/genética , Inmunohistoquímica , Células Jurkat , Ligandos , Ratones , Microscopía Fluorescente , Oligopéptidos , Osteoclastos/citología , Osteoprotegerina , Péptidos/inmunología , Unión Proteica/fisiología , Receptores del Ligando Inductor de Apoptosis Relacionado con TNF , Receptores del Factor de Necrosis Tumoral/clasificación , Receptores del Factor de Necrosis Tumoral/metabolismo , Miembro 10c de Receptores del Factor de Necrosis Tumoral , Miembro 25 de Receptores de Factores de Necrosis Tumoral , Proteínas Recombinantes de Fusión/metabolismo , Ligando Inductor de Apoptosis Relacionado con TNF , Receptores Señuelo del Factor de Necrosis TumoralRESUMEN
PURPOSE/OBJECTIVES: To examine the effects of a comprehensive rehabilitation program on facilitating physical and psychosocial adaptation of women with breast cancer who are receiving adjuvant chemotherapy. DESIGN: Experimental. SETTING: Breast evaluation clinics of two New England medical centers with comprehensive cancer treatment programs. SAMPLE: 14 women (mean age = 44 years) receiving adjuvant chemotherapy for breast cancer (86% stage II) following surgical treatment. METHODS: Subjects were assigned randomly to the experimental group or the usual care group. Experimental group members began a structured exercise program of walking and attended support group meetings. All subjects were tested before beginning chemotherapy, during the course of chemotherapy, and one month following chemotherapy completion. MAIN RESEARCH VARIABLES: Performance status, physical functioning, psychosocial adjustment, self-concept and body image, and 12 symptoms (e.g., fatigue, nausea, anxiety). FINDINGS: Measures of physical performance, psychosocial adjustment, and symptom intensity revealed improved adaptation in subjects who completed the walking/support group program. CONCLUSIONS: Physical and psychosocial benefits from a modest walking exercise program and a support group are possible for patients receiving adjuvant chemotherapy. IMPLICATIONS FOR NURSING PRACTICE: Although more detailed research is necessary to answer some of the questions raised by this study, implementing the walking program and forming a support group are achievable in an outpatient setting.
Asunto(s)
Neoplasias de la Mama/rehabilitación , Neoplasias de la Mama/terapia , Terapia por Ejercicio/organización & administración , Rehabilitación/enfermería , Grupos de Autoayuda/organización & administración , Actividades Cotidianas , Adaptación Psicológica , Adulto , Imagen Corporal , Neoplasias de la Mama/fisiopatología , Neoplasias de la Mama/psicología , Quimioterapia Adyuvante , Femenino , Humanos , Mastectomía , Persona de Mediana Edad , Modelos de Enfermería , Enfermeras Clínicas , Enfermería Oncológica , Evaluación de Programas y Proyectos de SaludAsunto(s)
Fatiga , Neoplasias/complicaciones , Planificación de Atención al Paciente , Atención , Cognición , Terapia por Ejercicio , Fatiga/diagnóstico , Fatiga/epidemiología , Fatiga/etiología , Fatiga/enfermería , Fatiga/fisiopatología , Fatiga/psicología , Humanos , Incidencia , Modelos Biológicos , Modelos Psicológicos , Neoplasias/fisiopatología , Neoplasias/terapia , Evaluación en Enfermería , Educación del Paciente como Asunto , Investigación , Factores de RiesgoRESUMEN
To determine the effects of anger on coronary artery vasoconstriction, 12 patients with symptomatic myocardial ischemia were studied during cardiac catheterization. During catheterization, the patients were asked to recall a recent event that had produced anger. One narrowed and 2 non-narrowed arterial segments were selected using predetermined criteria. Patients also completed various self-report measurements upon entering the catheterization laboratory before any procedures, after completion of the clinical angiogram and after the anger recall stressor. There was a significant increase in subject reports of anger (F[1,6] = 21.94, p < 0.01) and arousal (F [2,6] = 5.49, p < 0.05) during the anger stressor. There were no significant changes in heart rate, systolic or diastolic blood pressure, or heart rate x systolic blood pressure product during the anger stressor. A total of 27 arterial segments (9 narrowed and 18 non-narrowed) were selected and analyzed using quantitative angiographic techniques. Repeated-measures analysis of variance (baseline vs anger stressor) found no significant group differences with regard to changes in arterial diameter between conditions or among segments. Reported anger was significantly correlated with a decrease in both mean (r = -0.76, p < 0.05) and minimal (r = -0.82, p < 0.05) diameter changes in narrowed arteries. Vasoconstriction only occurred with high levels of anger. There were no significant correlations between anger report and diameter change in non-narrowed arteries. Thus, anger may produce coronary vasoconstriction in previously narrowed coronary arteries.