A quantitative analysis of microcirculation in sore-prone pressure areas on conventional and pressure relief hospital mattresses using laser Doppler flowmetry and tissue spectrophotometry

BACKGROUND Pressure ulcers are associated with severe impairment for the patients and high economic load. With this study we wanted to gain more insight to the skin perfusion dynamics due to external loading. Furthermore, we evaluated the effect of different types of pressure relief mattresses. METHODS A total of 25 healthy volunteers were enrolled in the study. Perfusion dynamics of the sacral and the heel area were assessed using the O2C-device, which combines a laser light, to determine blood flow, and white light to determine the relative amount of hemoglobin. Three mattresses were evaluated compared to a hard surface: a standard hospital foam mattress bed, a visco-elastic foam mattress, and an air-fluidized bed. RESULTS In the heel area, only the air-fluidized bed was able to maintain the blood circulation (mean blood flow of 13.6 ± 6 versus 3.9 ± 3 AU and mean relative amount of hemoglobin of 44.0 ± 14 versus 32.7 ± 12 AU.) In the sacral area, all used mattresses revealed an improvement of blood circulation compared to the hard surface. CONCLUSION The results of this study form a more precise pattern of perfusion changes due to external loading on various pressure relief mattresses. This knowledge may reduce the incidence of pressure ulcers and may be an influencing factor in pressure relief mattress selection.

High expression of gastrin-releasing peptide receptors in the vascular bed of urinary tract cancers: promising candidates for vascular targeting applications

Tumoral gastrin-releasing peptide (GRP) receptors are potential targets for diagnosis and therapy using radiolabeled or cytotoxic GRP analogs. GRP-receptor overexpression has been detected in endocrine-related cancer cells and, more recently, also in the vascular bed of selected tumors. More information on vascular GRP-receptors in cancer is required to asses their potential for vascular targeting applications. Therefore, frequent human cancers (n = 368) were analyzed using in vitro GRP-receptor autoradiography on tissue sections with the (125)I-[Tyr(4)]-bombesin radioligand and/or the universal radioligand (125)I-[d-Tyr(6), beta-Ala(11), Phe(13), Nle(14)]-bombesin(6-14). GRP-receptor expressing vessels were evaluated in each tumor group for prevalence, quantity (vascular score), and GRP-receptor density. Prevalence of vascular GRP-receptors was variable, ranging from 12% (prostate cancer) to 92% (urinary tract cancer). Different tumor types within a given site had divergent prevalence of vascular GRP-receptors (e.g. lung: small cell cancer: 0%; adenocarcinoma: 59%; squamous carcinoma: 83%). Also the vascular score varied widely, with the highest score in urinary tract cancer (1.69), moderate scores in lung (0.91), colon (0.88), kidney (0.84), and biliary tract (0.69) cancers and low scores in breast (0.39) and prostate (0.14) cancers. Vascular GRP-receptors were expressed in the muscular vessel wall in moderate to high densities. Normal non-neoplastic control tissues from these organs lacked vascular GRP-receptors. In conclusion, tumoral vessels in all evaluated sites express GRP-receptors, suggesting a major biological function of GRP-receptors in neovasculature. Vascular GRP-receptor expression varies between the tumor types indicating tumor-specific mechanisms in their regulation. Urinary tract cancers express vascular GRP-receptors so abundantly, that they are promising candidates for vascular targeting applications.

The Getting-Out-of-Bed (GoB) scale: a measure of motivation and life outlook in older adults with cancer

OBJECTIVE: To develop and evaluate the psychometric properties of a measure of motivation and life outlook (Getting-Out-of-Bed [GoB]). DESIGN: Secondary analysis of baseline and 6-month data from a longitudinal follow-up study of older breast cancer survivors. PARTICIPANTS: Women (N = 660) diagnosed with primary breast cancer stage I-IIIA disease, age >or=65 years, and permission to contact from an attending physician in four geographic regions in the United States (city-based Los Angeles, California; statewide in Minnesota, North Carolina, and Rhode Island). MEASUREMENT: Data were collected over 6-months of follow-up from consenting patients' medical records and telephone interviews with patients. Data collected included the 4-item GoB, health-related quality of life (HRQoL), breast cancer, sociodemographic, and health-related characteristics. RESULTS: Factor analysis produced, as hypothesized, one principal component with eigen values of 2.74(baseline) and 2.91(6-months) which explained 68.6%(baseline) and 72.7%(6-months) of total variance. In further psychometric analyses, GoB exhibited good construct validity (divergent: low nonstatistically significant correlations with unrelated constructs; convergent: moderate statistically significant correlations with related constructs; discriminant: distinguished high HRQoL groups with a high level of significance), excellent internal reliability (Cronbach's alpha 0.84(baseline), 0.87(6-months)), and produced stable measurements over 6-months. Women with GoB scores >or=50 at baseline were more likely at 6-months to have good HRQoL, good self-perceived health, and report regular exercise, indicating good predictive ability. CONCLUSION: GoB demonstrated overall good psychometric properties in this sample of older breast cancer survivors, suggestive of a promising tool for assessing motivation and life outlook in older adults. Nevertheless, because it was developed and initially evaluated in a select sample, using measures with similar but not exact content overlap further evaluation is needed before it can be recommended for widespread use.

Wake up. Back to Bed – Zugang zum nächtlichen Training?

Einleitung Ein Klartraum ist definiert als ein Traum, in dem der Träumende weiß, dass er träumt. In der Fachliteratur finden sich verschiedene Induktionstechniken, um die Klartraum-häufigkeit zu steigern (z.B. Stumbrys, Erlacher, Schädlich & Schredl, 2012). Zudem wurde in einer Pilotstudie gezeigt, dass ein Training im Klartraum zu Verbesserungen in einer Zielwurfaufgabe am nächsten Morgen führt (Erlacher & Schredl, 2010). Um ein regelmäßiges Training im Traum zu ermöglichen, besteht für die Sportpraxis das Problem, Klarträume gezielt zu induzieren. In dieser Studie wurde im Schlaflabor die so genannte Memnotische Induktion von luziden Träumen (MILT) – eine Autosugges-tionstechnik in der die Intention, einen Klartraum zu erleben, an Traumhinweise ge-koppelt wird – im Morgenschlaf überprüft. Methoden Insgesamt wurden 52 Versuchsteilnehmer (32 männlich und 20 weiblich) im Alter von 24 Jahren (± 2.2) im Schlaflabor untersucht. Die Personen waren in 4 Gruppen aufge-teilt. Alle Personen schliefen zunächst für ca. 6 Stunden, wurden dann aus einer REM-Phase geweckt und sollten einen Traum berichten. Im Anschluss blieben die Teilnehmer 30 bzw. 60 Minuten wach und praktizierten entweder MILT oder beschäf-tigten sich mit einer kognitiven oder motorischen Kontrollaufgabe. Im Anschluss durf-ten alle Teilnehmer für max. 4 weitere Stunden schlafen. Das Auftreten eines Klartraums in der morgendlichen Schlafphase diente als abhängige Variable. Ergebnisse und Diskussion Die Ergebnisse zeigen, dass MILT zu einer gesteigerten Klartraumhäufigkeit (33-70%) im Vergleich zur Kontrollbedingung (9-14%) führt. Ein Unterschied zwischen 30 Minuten (50%) zu 60 Minuten MILT (70%) ist marginal. Das Auftreten von Klarträumen kann durch MILT im Morgenschlaf signifikant gestei-gert werden. Die Erfolgsquote schwankt jedoch mit Blick auf die genaue Definition ei-nes Klartraums. Es konnten bei nicht klartraumerfahrenen Versuchsteilnehmerinnen mehr Klarträume induziert werden. Für die Sportpraxis könnten solche Induktions-techniken dem Sportler ermöglichen, im Traum zu trainieren. In weiteren Studien wäre zu untersuchen, ob Athleten ebenfalls Klarträume induziert werden können. Ebenso sollte die Auswirkung eines regelmäßigen Klartraumtrainings in der Sportpraxis wei-ter untersucht werden. Literatur Stumbrys, T., Erlacher, D., Schädlich, M. & Schredl, M. (2012). Induction of lucid dreams: a systematic review of evidence. Consciousness and Cognition, 21(3), 1456-1475. Erlacher, D. & Schredl, M. (2010). Practicing a motor task in a lucid dream enhances subsequent performance: A pilot study. The Sport Psychologist, 24(2), 157-167.