Bone marrow microenvironment (BMM) has been proven to have benefits for both normal hematopoietic stem cell niche and pathological leukemic stem cell niche. In fact, the pathological leukemia microenvironment reprograms bone marrow niche cells, especially mesenchymal stem cells for leukemia progression, chemoresistance and relapse. The growth and differentiation of MSCs are modulated by leukemia stem cells. Moreover, chromatin abnormality of mesenchymal stem cells is sufficient for leukemia initiation. Here, we summarize the detailed relationship between MSC and leukemia. MSCs can actively and passively regulate the progression of myelogenous leukemia through cell-to-cell contact, cytokine-receptor interaction, and exosome communication. These behaviors benefit LSCs proliferation and survival and inhibit physiological hematopoiesis. Finally, we describe the recent advances in therapy targeting MSC hoping to provide new perspectives and therapeutic strategies for leukemia.
Background: Food insecurity (FI), the limited access to healthy and affordable food, is a social determinant of health that hinders blood pressure (BP) control in individuals with hypertension. Cross-sectional studies that examine this relationship do not allow for observations over time. We used longitudinal data on CARDIA Study participants with hypertension to examine the association between FI and BP control over 15 years. Methods: Generalized estimating equations were used to examine the association between FI and BP control across repeated observations on 605 participants with physician diagnosed and self-reported hypertension. Participants had some FI if they endorsed any of the following statements: “We have enough food to eat, but not always the kinds of food we want to eat”; “Sometimes we don’t have enough food to eat”; “Often we don’t have enough food to eat.” We estimated odds ratios (OR) and 95% confidence interval (CI) for control of systolic blood pressure (SBP) <140 mmHg, diastolic blood pressure (DBP) < 90 mmHg and combined measures of SBP and DBP. We calculated sequentially adjusted models and interaction terms based on previous research. Model 1 was adjusted for age, gender, race and field center. Model 2 was additionally adjusted for antihypertensive medication use, maximum education, marital status and household income. Model 3 was additionally adjusted for BMI, physical activity, smoking status and alcohol intake. Results: FI was reported by 21.7% of study participants (N=131). FI was reported in Black participants (N=106), and women (N=89) most. Gender modified the association of FI with BP control, whereby food insecure women were less likely to control BP Table 1. Other interactions were not significant. Conclusions: Food insecure women had more difficulty with BP control than food insecure men. Explanations for the differential influence of FI on men and women should be studied so that targeted interventions can be developed.
Introduction: The WHO Physical Activity Guidelines recommend at least 2 days of resistance training (RT) per week. RCTs have shown a dose-response between RT volume and improving blood pressure, lipids, and markers of glycemia. There is discordance between the Guidelines recommending a frequency while empirical evidence supports a volume. Our objective was to test whether RT Guidelines and volume were associated with lower mortality. Methods: Data are from the 1999–2006 NHANES cycles. Participants self-reported past 30 days of physical activity including type, which was used to assign METs, number of sessions, and average session duration in minutes. Those who reported engaging in RT (push-ups, sit-ups, and weightlifting) with no missing data were included ( N =1,391). RT volume was measured in monthly MET-minutes, calculated as the product of the number of sessions, mean session duration, and intensity. Mortality was ascertained from the linked National Death Index through the end of 2019. Covariates included monthly aerobic physical activity volume, sex, age, and education. Cox proportional hazards regression was used to estimate hazard ratios for all-cause mortality by RT Guideline adherence and RT volume. Results: Participants had a mean age of 41.3±16.3 years and were mostly male (62.7%). Most participants met the Guidelines ( n =1,041, 74.8%). The mean monthly RT volume was 2,210±2,550 MET-minutes. Mortality incidence was 11.4% with a mean follow-up time of 189±41.6 months (159 events, 263,585 total person-months). Neither meeting the Guidelines nor monthly RT volume was associated with all-cause mortality (Table 1.). There was no evidence of effect modification by sex or age. Conclusions: According to these findings, current Guidelines promoting RT for health benefits are not supported by empirical data. However, the absence of an association between monthly RT volume and all-cause mortality warrants further investigation using better instrumentation for assessing RT volume.
Objective: We review the pathophysiology and possible prevention measures of complications after extracorporeal shock wave lithotripsy (ESWL).Methods: A literature search was performed with the Medline database on ESWL between 1980 and 2004. Results: ESWL application has been intuitively connected to complications. These are related mostly to residual stone fragments, infections, and effects on tissues such as urinary, gastrointestinal, cardiovascular, genital, and reproductive systems. Recognition of ESWL limitations, use of alternative therapies, correction of pre-existing renal or systemic disease, treatment of urinary tract infection, use of prophylactic antibiotics, and improvement of ESWL efficacy are the most important measures of prevention. Decrease of shock wave number, rate and energy, use of two shock-wave tubes simultaneously, and delivery of two shock waves at carefully timed close intervals improve ESWL efficacy and safety.Conclusion: ESWL is a safe method to treat stones when proper indications are followed. The need for well-designed prospective randomised trials on aetiology and prevention of its complications arises through the literature review.
The National Institute for Health and Clinical Excellence (NICE) (2004) has identified that dyspepsia management can be standardized, structured and categorized, which means that an integrated care pathway (ICP) can be developed and implemented in local hospitals. Mandy Wong outlines how an ICP can be used in a nurse-led dyspepsia clinic to provide patients with sufficient contact time while allowing nurse specialists to advise on drug use, diet and lifestyle and identify alarming symptoms that require fast-track investigations.
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