The relationship between nursing students' compassion competencies and perceptions of spirituality and spiritual care

OBJECTIVES

The present study was conducted to examine the relationship between nursing students' compassion competencies and their perceptions of spirituality and spiritual care.

METHODS

The population of the study consisted of nursing students over the age of 18 years who were educated at the nursing faculty of a state university in Turkey between May and June 2022. The study was completed with 263 student nurses. The "Sociodemographic Characteristics Form," "Compassion Competency Scale," and "Spirituality and Spiritual Care Rating Scale" were used to collect the data. Frequencies, percentages, mean values, standard deviations, and Pearson Correlation Analysis were used to evaluate the data.

RESULTS

The nursing students were found to have a high level of compassion competency (4.04 ± 0.57). It was also found that the students had moderate (54.76 ± 5.35) perceptions of spirituality and spiritual care. On the other hand, there was a moderate and positive relationship between the total mean scores of "Compassion Competency" and "Perceptions of Spirituality and Spiritual Care" (p > 0.05).

SIGNIFICANCE OF RESULTS

It was concluded that as nursing students' compassion competencies increased, their perceptions of spirituality and spiritual care also increased.

Silently Proliferating: Cancer

Cancer is a health problem that has existed for years and frequently affects tissues and organs. Although some standards have been set for its treatment, different treatments and approaches are used for each type of cancer. The treatment process and having to live with cancer drag the individual to a difficult process that affects the individual negatively. Problems such as the severe course of the disease, taking longer than expected treatment, and having many side effects reduce the individual's physical performance and activities of daily living. Therefore, this situation reduces the quality of life and causes the general well-being of the individual to be negatively affected at the psycho-social level. In order to cope with the problems that cancer patients experience, it is important to support them physically, mentally, emotionally, socio-culturally, and spiritually. The decrease in the quality of life of the caregiver also affects the quality of care and therefore the quality of life of the patient. For this reason, it is necessary to determine how patients and caregivers perceive the disease, reduce their psychological anxiety and pain, as well as the factors affecting this perception, and ensure their compliance with treatment.

The association between perineural invasion in mpMRI-targeted and/or systematic prostate biopsy and adverse pathological outcomes in robot-assisted radical prostatectomy

INTRODUCTION AND OBJECTIVES

This study aims to investigate the relationship between perineural invasion (PNI) in targeted (TBx) and/or systematic (SBx) prostate needle biopsy and adverse pathological features of prostate cancer (PCa) in prostatectomy specimens.

MATERIALS AND METHODS

A total of 95 male patients who underwent transperineal TBx and/or concomitant SBx subsequently treated with robot-assisted radical prostatectomy for PCa between October 2015 and June 2020 were included. The performance of PNI as a classification test (sensitivity, specificity, positive and negative predictive values) and its correlation with clinically significant PCa, surgical margin positivity, extraprostatic extension, and seminal vesicle invasion in prostatectomy were computed.

RESULTS

The median age of the patients was 65 (60-70) years. TBx and concomitant SBx were performed in 78 (82.1%) patients, while 16 (16.8%) patients underwent SBx alone and one (1.1%) patient underwent TBx alone. The frequency of PNI in TBx and SBx was 17 (21.5%) and 32 (34.0%), respectively. The specificity/negative predictive values of PNI for surgical margin positivity, extraprostatic extension, and seminal vesicle invasion were 79.7/88.7%, 92.5/79.0%, and 83.3/96.8%, in TBx, and 71.1/87.1%, 80.7/74.2%, and 69.5/91.9%, in SBx, respectively. There was also a statistically significant correlation between PNI in biopsy and surgical margin positivity, extraprostatic extension, and seminal vesicle invasion in prostatectomy as well as the ISUP grade group and pT stage.

CONCLUSIONS

The absence of PNI in prostate needle biopsy may predict localized PCa with a pT stage ≤ 2c and negative surgical margins in contrast to its presence which appears to be an indicator of unfavorable factors in final pathology.

Deciphering H3K4me3 broad domains associated with gene-regulatory networks and conserved epigenomic landscapes in the human brain

Regulators of the histone H3-trimethyl lysine-4 (H3K4me3) mark are significantly associated with the genetic risk architecture of common neurodevelopmental disease, including schizophrenia and autism. Typical H3K4me3 is primarily localized in the form of sharp peaks, extending in neuronal chromatin on average only across 500-1500 base pairs mostly in close proximity to annotated transcription start sites. Here, through integrative computational analysis of epigenomic and transcriptomic data based on next-generation sequencing, we investigated H3K4me3 landscapes of sorted neuronal and non-neuronal nuclei in human postmortem, non-human primate and mouse prefrontal cortex (PFC), and blood. To explore whether H3K4me3 peak signals could also extend across much broader domains, we examined broadest domain cell-type-specific H3K4me3 peaks in an unbiased manner with an innovative approach on 41+12 ChIP-seq and RNA-seq data sets. In PFC neurons, broadest H3K4me3 distribution ranged from 3.9 to 12 kb, with extremely broad peaks (~10 kb or broader) related to synaptic function and GABAergic signaling (DLX1, ELFN1, GAD1, IGSF9B and LINC00966). Broadest neuronal peaks showed distinct motif signatures and were centrally positioned in prefrontal gene-regulatory Bayesian networks and sensitive to defective neurodevelopment. Approximately 120 of the broadest H3K4me3 peaks in human PFC neurons, including many genes related to glutamatergic and dopaminergic signaling, were fully conserved in chimpanzee, macaque and mouse cortical neurons. Exploration of spread and breadth of lysine methylation markings could provide novel insights into epigenetic mechanism involved in neuropsychiatric disease and neuronal genome evolution.

Two cases with progressive cystic leukoencephalopathy

Leukoencephalopathies with cystic changes in the white matter on magnetic resonance imaging are aetiologically heterogeneous neurological disorders seen in children. A group of leukoencephalopathies characterised by white matter lesions progressing to multifocal cystic degeneration has been reported in various disorders, including mitochondrial enzyme deficiencies, leukodystrophies, and infectious processes. We report two patients with leukoencephalopathy showing progressive cystic changes on serial MRI, and magnetic resonance spectroscopy resembling progressive cavitating leukoencephalopathy.

Extrapontine Myelinolysis in a Child: a Rare Case with MRI, DWI and MRS Follow-up

We describe a case of extrapontine myelinolysis in a child presenting with chorea and parkinsonian symptoms after treatment for hyponatremic dehydration. Although both extrapontine myelinolysis (EPM) in childhood and extrapyramidal presentation of EPM are very rare in children, the patient presented with pure extrapyramidal symptoms. Besides basal ganglia involvement and sparing brain stem, MRI demonstrated involvement of the amygdala bilaterally hitherto never reported in EPM patients. While single voxel proton spectroscopy (MRS) of the basal ganglia at the beginning was normal, the follow-up MRS showed moderate to severe NAA and mI decrease. Diffusion-weighted imaging abnormalities appeared relatively late during the disease course, also an unexpected finding. In addition, there were apparent increases in apparent diffusion coefficient (ADC) values of the affected basal ganglia instead of diffusion restriction.

Coagulation markers D-dimer and prothrombin fragment 1.2 compared to disease and treatment status in prostate cancer patients

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Background: Activation of the coagulation cascade is a hallmark of advanced prostate cancer (PC). In patients (pts) with advanced PC, the D-dimer and prostate specific antigen (PSA) are frequently elevated; neither is an established predictive marker for response to treatment. We hypothesized that chemotherapy refractory (CRefrac) PC is associated with active thrombin generation, and that D- dimer and prothrombin fragment 1.2 (PF1.2) as activation markers of coagulation could be markers of CRefrac PC. Methods: We analyzed PSA, D-dimer and PF1.2 from a cross section of 29 PC pts. PSA values were measured by the Bayer/Centaur method (Bayer Healthcare, Tarrytown, NY). D-dimer assay was performed using quantitative latex-agglutination (Diagnostica Stago, Asnieres, France), and PF 1.2 levels were determined by enzyme-immunoassay (Dade Behring, Marburg, Germany). Values were analyzed with respect to disease and treatment status. Results: The median age was 66. Twenty pts had metastatic PC, while 9 pts had stable or rising PSA but no evidence of metastatic disease. Among the 20 metastatic pts, 10 were CRefrac, 3 were hormone refractory and 7 were responding to or stable on hormone therapy. Median PSA was 36 ng/ml (range 0.1–1170). Median D-dimer was 372 ng/ml [range 110–13,300; normal (<256 ng/ml)]. Median PF 1.2 was 402 ng/ml (range 100–853; normal 87–325 ng/ml). Only 19 pts had sufficient sample for PF1.2 values. Stratification by disease and treatment status showed significantly higher D-dimer values in CRefrac pts compared to all other pts (median 1144 vs 317, p=0.014, rank-transformed analysis). Eight of 11 CRefrac specimens had elevated D-dimer values; 2 of the 3 exceptions were pts receiving warfarin therapy. Only 3 of 20 non-CRefrac specimens had elevated D-dimer values. Five of 8 CRefrac pts and 8 of 12 non-CRefrac pts had elevated PF1.2 values. Conclusions: D-dimer values are substantially elevated in CRefrac PC. However, the clinical significance of these findings and of the apparent suppression of D-dimer by warfarin therapy is unknown. Longitudinal studies of D-dimer and PF1.2 in PC pts undergoing chemotherapy are needed.

No significant financial relationships to disclose.

Clinical trial accrual rates in prostate cancer: Prospective experience from a single institution

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Background: Clinical trial (CT) participation is a key to better cancer therapy. The Nevada Cancer Institute (NVCI), the official cancer center of NV, is committed to CT participation. We hypothesized that CT accrual at the NVCI should exceed the national average of 3–5%. Methods: Patient (pt) visits began in 3/05 and by 12/31/07 1363 pts had been seen. Prostate cancer (PC) was the largest group (N=270; 50 with 1 visit only). All records are electronic and entered into a cancer registry. A relatively robust portfolio of PC CTs has been available, thus the cancer registry data base was compared to the CT data base for the 16 PC CTs (8 phase III, 1 phase II, 7 phase I) that accrued pts. The data base records all accruals, screen failures, consent withdrawals, and subsequent treatments (on or off CT). Results: 101 consents were signed by 68 PC pts (25 consented to 2 or more CTs). 31 consents lead to screen failures/consent withdrawal (5 pts were screen failures for 2 CTs while 1 pt was a screen failure for 3 CTs). Screen failure was less common in phase II/III CTs (18/74 =24%) than in phase I CTs (10/27=37%). Most of the phase I screen failures were due to rapid decreases in performance status or organ function dysfunction. Among the 68 unique pts who consented, 35 pts were treated on 1 CT and 16 pts were treated on 2 or more CTs resulting in a total of 51 PC pts being treated on at least 1 CT. Conclusions: CT accrual at the NVCI of PC pts (51/270=19%) exceeds the national average. Reports of CT activity should specify the denominator and include both consent and accrual rates. Screen failure/consent withdrawal was common in this older male population with advanced disease. This analysis has limitations; Phase I CTs were activated only after 10/05, only 1 phase II CT was open during this period and CTs for radiation and surgery alone for PC pts were not open. Thus, the percent of pts on CT should rise as more CTs are activated.

No significant financial relationships to disclose.

Baló's concentric sclerosis: clinical and radiologic features of five cases

Baló's concentric sclerosis (BCS) is a rare demyelinating disease considered to be a variant of multiple sclerosis. Five BCS cases were diagnosed antemortem based on their typical concentric mass patterns on MR images and based on clinical and CSF findings. Histopathologic investigation was also performed in one case. Our case report supports the concept that BCS may be a self-limited disease that is not always fatal. Characteristic MR imaging findings may allow antemortem diagnosis of BCS when performed at the onset of the disease.

Spinal ganglioneuroma presenting as a highly vascular lesion with hypertrophic venous drainage

We present the case of a 33-year-old man with a highly vascular spinal ganglioneuroma associated with hypertrophic draining veins mimicking arteriovenous malformation. Ganglioneuromas are classically known as avascular and association with hypertrohic venous drainage has not been previously reported. The magnetic resonance imaging and digital subtraction angiography features of this benign tumor were strongly suspicious for malignancy because of the high vascularity caused by intratumoral arteriovenous shunts. This case emphasizes the importance of including ganglioneuroma in the differential diagnosis of vascular spinal tumors and recalls that hypertrophic draining veins may be associated with spinal tumors.

MR imaging findings of recurrent tumoral calcinosis

Tumoral calcinosis is an uncommon disorder and characterized by development of calcified masses within the soft tissues near the large joints. We present a recurrent tumoral calcinosis case with radiographic and magnetic resonance (MR) imaging findings.

Percutaneous treatment of abdominal hydatid cysts with hypertonic saline and alcohol. An experimental study in sheep

RATIONALE AND OBJECTIVES

Seven naturally infected sheep with proper hepatic and peritoneal hydatid cysts were studied to assess a new percutaneous approach for cystic hydatid disease.

METHODS

A needle was inserted into the cyst cavity of sheep under sonographic guidance. Immediately after instillation of hypertonic saline to inactivate protoscolices, ultrasound demonstrated that germinal and laminated membranes of the hydatid cysts were separated completely from the pericyst in all sheep. Later, a catheter was inserted into the cyst cavity using Seldinger technique. Alcohol was used as a sclerosing agent.

RESULTS

Ultrasound showed reduction in cyst size and progressive solidification. No anaphylactic reaction was observed. After sonographic follow-up that lasted from 1 to 26 weeks, the sheep were killed to evaluate macroscopic and histologic changes. At autopsy, no secondary cyst formation was seen. The appearance of treated cysts was different from the others, and there were signs of involution. The histologic sections did not show any viable protoscolices or daughter cysts. The authors observed pericyst hyalinization, inflammatory cells in the cyst wall, cyst wall necrosis, calcification of cyst wall, degeneration of laminated membrane, severe degeneration or absence of germinal membrane, and inflammatory cells and necrotic material in the cyst cavity.

CONCLUSIONS

Percutaneous treatment of hydatid disease was effective in the animal model. Ultrasound was useful in evaluating the intervention.

Detection of deep vein thrombosis: combined flow and blood pool radionuclide venography vs contrast venography

This study was performed to validate the combined study of flow radionuclide venography (FRV) with subsequent 99mTc-red blood cell(RBC) blood pool radionuclide venography(BRV) for the detection of deep vein thrombosis (DVT). Findings in 32 patients with suspected DVT of lower extremities (n = 52) were compared with those of corresponding contrast venograms (CV) serving as a reference method. FRV was performed by using three separate doses of a large 99mTc04-bolus (10-12 cc) injection. The findings were as follows: concerning the detection of DVT in calf veins, agreement between FRV and CV, FRV+BRV and CV, and BRV and CV were 67%, 73% and 60%, respectively. For femoral veins, agreement between FRV and CV was 96%, while it was 87% between BRV and CV. When FRV and BRV of femoral veins were evaluated in combination, 100% agreement between radionuclide and radiologic method was observed. For iliac veins there was no disagreement in comparison of the methods either singly or in combination. In 7.6% of the extremities, collaterals not demonstrated by CV and BRV were visualized only by FRV. Although the radioactive agent was injected in a relatively large volume, all of the calf veins could not be filled even when they were completely patent. It was concluded that a combined study of FRV with BRV improved the diagnostic value of radionuclide venography for the detection of DVT in calf and femoral veins.

Heparin-Coated Surfaces that bind Antithrombin have Reduced Platelet Reactivity

Surfaces with heparin bound by covalent linkage react with platelets but are passivated by prior exposure to platelet free plasma (PFP), provided they are capable of adsorbing antithrombin III (AT). For example, heparin-agarose beads induce platelet adhesion and aggregation, which are reduced by preincubation of the beads with PFP, but PFP depleted of AT is not effective. The degree of passivation of the beads parallels their removal of AT from PFP. The beads are also passivated by a solution of purified AT.

Furthermore heparin-polymethyl acrylate copolymers made by radical polymerization initiated by Ce4+ bind AT, as demonstrated by measurement of AT remaining in solution after adsorption or eluted from the surface after plasma incubation. On such a surface, AT is activated just as by heparin in solution, measured by the ability of heparinized beads to inactivate thrombin (S-2160 chromogenic tripeptide substrate assay) in the presence of AT and by lack of inactivation of thrombin with AT-poor plasma and return of inactivating effect when AT is added back.

Aggregation of platelets by specific heparin fractions in solution appears to be an analogous phenomenon, which is inhibited by antithrombin.