Becoming an older caregiver: A study of gender differences in family caregiving at the end of life.

Objectives: Older people are not traditionally expected to become caregivers. For this reason, the experience of caregiving in older persons has not been explored adequately in the research on gender differences. The objective of this study was to assess the caregiver burden among older family members who care for cancer patients facing the end of their lives, in order to compare their differences according to gender (male vs.

Does Family Caregiver Burden Differ Between Elderly and Younger Caregivers in Supporting Dying Patients With Cancer? An Italian Study.

Context: The aging of the world's population increasingly calls on older people to care for their cancer relatives. This scenario confronts clinicians involved with end-of-life care with an imposing challenge: elderly family caregivers could have a different perception of the burdens associated with assistance compared to their younger counterparts. Palliativists need to know what limits and resources of these new age categories of caregivers could be for a global management of dying patients with cancer and their family.

Exploring the associations between spiritual well-being, burden, and quality of life in family caregivers of cancer patients.

Objective: The spiritual dimension is important in the process of coping with stress and may be of special relevance for those caring for cancer patients in the various phases of caregivership, although current attention is most prevalent at the end of life. This study explores the associations among spiritual well-being (SWB), caregiver burden, and quality of life (QoL) in family caregivers of patients with cancer during the course of the disease.

Method: This is a cross-sectional study.

A Comprehensive Response: The Role of Nonstate Actors in the Global Plan.

Nonstate actors-especially faith-based organizations, other nongovernmental organizations, groups of people living with HIV and AIDS, and private sector organizations-have been deeply committed to supporting governments reach the goals of the Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (Global Plan). This article highlights the role and contributions of select faith-based organizations and some private sector and philanthropic partners, as well as the work of other organizations. The success and impact of the Global Plan was in no small part a result of large-scale country-led collaboration in the provision of health care and implementation of programs.

Quality of life and burden in family caregivers of patients with advanced cancer in active treatment settings and hospice care: A comparative study.

The aim of this study was to evaluate caregiver burden and quality of life (QoL) in active treatment settings and hospice care for 76 family caregivers of advanced cancer patients, using the Medical Outcomes Study Short Form and the Caregiver Burden Inventory. Compared to the active group, the hospice group reported significantly lower QoL scores in mental component summary score and higher scores in general health subscale and in physical component summary score. Future research needs to further investigate the complexities of caregivers' needs, especially in the emotional and mental domains, and offer effective, clinically proven interventions.

Evaluation of Social Support, Quality of Life, and Body Image in Women with Breast Cancer.

Background: This study was aimed at comparing the quality of life, body image, and perceived social support in women with breast cancer surgery.

Patients And Methods: Patients receiving breast-conserving surgery (BCS) (n = 72), mastectomy alone (n = 44), and mastectomy with breast reconstruction (n = 41) were evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the EORTC Breast Cancer Module (QLQ-BR23), the Body Image Scale (BIS) and the Multidimensional Scale of Perceived Social Support (MSPSS).

Results: The results indicated that the BCS group had a better body image compared with the other 2 groups and better role functioning compared with the mastectomy-alone group.

Non-invasive ventilation as a first-line treatment for acute respiratory failure: "real life" experience in the emergency department.

Objective: To describe our experience with non-invasive ventilation (NIV) for patients with acute respiratory failure (ARF) in the emergency department (ED).

Methods: A prospective/retrospective, observational study on 190 patients with ARF (mean +/-SD age 72.2+/-12.

High prevalence of autoimmune phenomena in hepatitis C virus antibody positive patients with lymphoproliferative and connective tissue disorders.

The aim of this study was to investigate whether hepatitis C virus (HCV) may perturb the immune system towards autoreactivity. We studied the relationship between the prevalence of anti-HCV and the presence of laboratory and/or clinical autoimmune features in 300 patients: lymphoid malignancies (167) and autoimmune disorders (connective tissue diseases 100; idiopathic thrombocytopenic purpura (ITP) 33). As a control, hepatitis B surface antigen (HBV) and anti-hepatitis B core antigen (anti-HBc) were related to the same parameters.

Characterization of bone marrow stromal cells from multiple myeloma.

We have cultured multiple myeloma (MM) bone marrow (BM) stromal cells that are able to sustain the in vitro growth of monoclonal B-cells. Our aim was to evaluate which adhesion molecules are expressed and which extracellular matrix proteins are produced by these cells and whether they differ from the stromal cells that can be grown under the same experimental conditions from the BM of monoclonal gammopathies of undetermined significance (MGUS) and of normal donors. MM BM stromal cells that support malignant B-cell development have a striking proliferative ability that is absent in MGUS and normal donors of the same age group and are formed by four major different cell populations.

Cytokines involved in the progression of multiple myeloma.

We have investigated which of the cytokines that are relevant in the in vitro growth of multiple myeloma (MM) malignant plasma cells are actually produced in vivo by MM patients. To this end, we have measured the levels of IL-1 beta, IL-3, IL-4, IL-6, IL-7, IL-8 and tumour necrosis factor-alpha (TNF-alpha) both in sera and in the supernatant of bone marrow (BM) stromal cell cultures from patients with MM and monoclonal gammopathy of undetermined significance (MGUS). The significance of our findings is three-fold.

Bone marrow microenvironment and the progression of multiple myeloma.

The BM microenvironment in MM, in terms of adhesive features, is well organized to entrap circulating precursors with BM-seeking properties and is able to produce cytokines that offer them the optimal conditions for local growth and final differentiation. Likewise, the malignant B cell clone is equipped with adhesion molecules which enable the cell to establish close contacts with BM stromal cells. Furthermore a number of cytokines are released including IL-1 beta and M-CSF activating BM stromal cells to produce other cytokines, such as IL-6, that stimulate the proliferation of plasma cells.

Circulating malignant precursors in monoclonal gammopathies.

Peripheral blood mononuclear cells (PBMC) from 14 patients with multiple myeloma (MM), 3 patients with benign monoclonal gammopathy, 3 patients with Waldenstrom's macroglobulinaemia (WM) and 2 patients with B-cell chronic lymphocytic leukemia (B-CLL) were cultured in vitro in the presence of IL-3 and IL-6. After 3 days, actively proliferating immunoblast-like B cells were apparent in 12/14 cases of MM, 0/3 BMG, 3/3 WM and 0/2 B-CLL. After 6 d, B blasts had evolved into morphologically evident plasma cells expressing the specific monoclonal light and heavy chains.