Showing papers by "David Spiegel published in 2015"
TL;DR: The history, rationale, and guidelines for developing a new definition of hypnosis are described, as well as definitions of the following related terms: hypnotic induction, hypnotizability, and hypnotherapy.
Abstract: This article describes the history, rationale, and guidelines for developing a new definition of hypnosis by the Society of Psychological Hypnosis, Division 30 of the American Psychological Association. The definition was developed with the aim of being concise, heuristic, and allowing for alternative theories of the mechanisms (to be determined in empirical scientific study). The definition of hypnosis is presented as well as definitions of the following related terms: hypnotic induction, hypnotizability, and hypnotherapy. The implications for advancing research and practice are discussed. The definitions are presented within the article.
273 citations
TL;DR: Long-term treatment with cinacalcet substantially reduced PTH, diminished the elevated bone formation rate/tissue area, lowered several biochemical markers of high-turnover bone disease toward normal, and generally improved bone histology.
138 citations
TL;DR: The history, rationale, and guidelines for developing a new definition of hypnosis are described as well as definitions of the following related terms: hypnotic induction, hypnotizability, and hypnotherapy.
Abstract: This article describes the history, rationale, and guidelines for developing a new definition of hypnosis by the Society of Psychological Hypnosis, Division 30 of the American Psychological Association. The definition was developed with the aim of being concise, being heuristic, and allowing for alternative theories of the mechanisms (to be determined in empirical scientific study). The definition of hypnosis is presented as well as definitions of the following related terms: hypnotic induction, hypnotizability, and hypnotherapy. The implications for advancing research and practice are discussed. The definitions are presented within the article.
102 citations
TL;DR: Vagal activity of patients with MRBC strongly predicted their survival, extending the known predictive window of HF-HRV in cancer beyond palliative care.
Abstract: ObjectiveHigh levels of high‐frequency heart rate variability (HF-HRV), related to parasympathetic-nervous-system functioning, have been associated with longer survival in patients with myocardial infarction and acute trauma and in patients undergoing palliative care. From animal studies lin
71 citations
Patrick S. Parfrey, Tilman B. Drüeke1, Geoffrey A. Block, Ricardo Correa-Rotter +583 more•Institutions (8)
TL;DR: In the EVOLVE trial as mentioned in this paper, a global, multicenter, randomized placebo-controlled trial in 3883 prevalent patients on hemodialysis, whose outcomes included death, major CV events, and development of severe unremitting secondary hyperparathyroidism (HPT).
Abstract: Background andobjectivesThecalcimimeticcinacalcet reduced therisk of death or cardiovascular (CV) events in older, but not younger, patients with moderate to severe secondary hyperparathyroidism (HPT) who were receiving hemodialysis. To determine whether the lower risk in younger patients might be due to lower baseline CV risk and more frequent use of cointerventions that reduce parathyroid hormone (kidney transplantation, parathyroidectomy, and commercial cinacalcet use), this study examined the effects of cinacalcet in older ($65 years, n=1005) and younger (,65 years, n=2878) patients. Design, setting, participants, & measurements Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) was a global, multicenter, randomized placebo-controlled trial in 3883 prevalent patients on hemodialysis, whose outcomes included death, major CV events, and development of severe unremitting HPT. The age subgroup analysis was prespecified. ResultsOlderpatients hadhigher baselineprevalenceof diabetesmellitusandCV comorbidity. Annualizedrates of kidney transplantation and parathyroidectomy were .3-fold higher in younger relative to older patients and were more frequent in patients randomized to placebo. In older patients, the adjusted relative hazard (95% confidence interval) for the primary composite (CV) end point (cinacalcet versus placebo) was 0.70 (0.60 to 0.81); in younger patients, the relative hazard was 0.97 (0.86 to 1.09). Corresponding adjusted relative hazards for mortality were 0.68 (0.51 to 0.81) and 0.99 (0.86 to 1.13). Reduction in the risk of severe unremitting HPT was similar in both groups. Conclusions In the EVOLVE trial, cinacalcet decreased the risk of death and of major CV events in older, but not younger, patients with moderate to severe HPT who were receiving hemodialysis. Effect modification by age may be partly explained by differences in underlying CV risk and differential application of cointerventions that reduce parathyroid hormone. Clin J Am Soc Nephrol 10: ccc–ccc, 2015. doi: 10.2215/CJN.07730814
70 citations
TL;DR: It is highlighted the importance of assessing both partner support and marital status when evaluating a survivor’s psychosocial functioning and support network and could lead to interventions to bolster support and reduce distress.
Abstract: Up to 38 % of prostate cancer survivors experience significant psychological distress; 6–16 % are diagnosed with depression or anxiety disorders. Support from a relationship partner can ameliorate psychological distress, but many studies treat relationship status as a dichotomous predictor without accounting for level of support provided by the partner. The current study is a secondary analysis of a sample of 292 prostate cancer survivors recruited by nine Community Clinical Oncology Program (CCOP) sites around the USA to a larger randomized controlled trial. Self-reported distress was measured at a baseline visit using the Profile of Mood States (POMS) and partner support was measured using the Social Network and Support Assessment (SNSA). Post hoc groups consisting of unmarried survivors, married survivors with low partner support (SNSA scores below the median), and married survivors with high partner support (SNSA scores above the median) were compared on distress using univariate and analysis of covariance (ANCOVA) analyses. Married prostate cancer survivors with high partner support reported significantly lower levels of psychological distress than the other two groups on the total distress scale (16.20–19.19 points lower, p < 0.001). After adjusting for multiple comparisons, this pattern was also seen for subscales of distress. This study highlights the importance of assessing both partner support and marital status when evaluating a survivor’s psychosocial functioning and support network. Assessing support could improve understanding of the association between partner support and prostate cancer survivors’ psychological distress and could lead to interventions to bolster support and reduce distress.
64 citations
TL;DR: The results suggest that oriented heparin immobilization to decellularized aortas may improve the in vivo blood compatibility of decellularity aorta and vessels.
63 citations
TL;DR: Subjective sleep problems are associated with poor clinical outcomes in metastatic colorectal cancer patients and affect chronotherapy effectiveness, and there is a need for a well-tuned circadian timing system in order to increase chronotherapy activity.
55 citations
TL;DR: The results raise the possibility that, among patients with active breast tumors, disruption of circadian activity rhythms and elevated CAR may facilitate tumor promotion and progression.
Abstract: Psychological distress, which can begin with cancer diagnosis and continue with treatment, is linked with circadian and endocrine disruption. In turn, circadian/endocrine factors are potent modulators of cancer progression. We hypothesized that circadian rest-activity rhythm disruption, distress, and diurnal cortisol rhythms would be associated with biomarkers of tumor progression in the peripheral blood of women awaiting breast cancer surgery. Breast cancer patients (n=43) provided actigraphic data on rest-activity rhythm, cancer-specific distress (IES, POMS), saliva samples for assessment of diurnal cortisol rhythm, cortisol awakening response (CAR), and diurnal mean. Ten potential markers of tumor progression were quantified in serum samples and grouped by exploratory factor analysis. Analyses yielded three factors, which appear to include biomarkers reflecting different aspects of tumor progression. Elevated factor scores indicate both high levels and strong clustering among serum signals. Factor 1 included VEGF, MMP-9, and TGF-β; suggesting tumor invasion/immunosuppression. Factor 2 included IL-1β, TNF-α, IL-6R, MCP-1; suggesting inflammation/chemotaxis. Factor 3 included IL-6, IL-12, IFN-γ; suggesting inflammation/TH1-type immunity. Hierarchical regressions adjusting age, stage and socioeconomic status examined associations of circadian, distress, and endocrine variables with these three factor scores. Patients with poor circadian coordination as measured by rest-activity rhythms had higher Factor 1 scores (R(2)=.160, p=.038). Patients with elevated CAR also had higher Factor 1 scores (R(2)=.293, p=.020). These relationships appeared to be driven largely by VEGF concentrations. Distress was not related to tumor-relevant biomarkers, and no other significant relationships emerged. Women with strong circadian activity rhythms showed less evidence of tumor promotion and/or progression as indicated by peripheral blood biomarkers. The study was not equipped to discern the cause of these associations. Circadian/endocrine aberrations may be a manifestation of systemic effects of aggressive tumors. Alternatively, these results raise the possibility that, among patients with active breast tumors, disruption of circadian activity rhythms and elevated CAR may facilitate tumor promotion and progression.
52 citations
TL;DR: The prevalence and treatment of anxiety and depression among patients with breast cancer are reviewed and effects of effective treatment of Anxiety and depression on quality of life and overall survival are reviewed.
Abstract: Here, we review the prevalence and treatment of anxiety and depression among patients with breast cancer. Cancer-related symptoms include similarities to responses to traumatic stress. Well-developed screening devices for identifying and tracking psychiatric comorbidity are discussed. Basic principles of psychopharmacology, and individual and group psychotherapy are presented. Finally, effects of effective treatment of anxiety and depression on quality of life and overall survival are reviewed.
36 citations
TL;DR: The total synthesis of glucosepane is reported, enabled by the development of a one-pot method for preparation of the nonaromatic 4H-imidazole tautomer in the core, which is concise, convergent, high-yielding, and enantioselective.
Abstract: Glucosepane is a structurally complex protein posttranslational modification that is believed to exist in all living organisms. Research in humans suggests that glucosepane plays a critical role in the pathophysiology of both diabetes and human aging, yet comprehensive biological investigations of this metabolite have been hindered by a scarcity of chemically homogeneous material available for study. Here we report the total synthesis of glucosepane, enabled by the development of a one-pot method for preparation of the nonaromatic 4H-imidazole tautomer in the core. Our synthesis is concise (eight steps starting from commercial materials), convergent, high-yielding (12% overall), and enantioselective. We expect that these results will prove useful in the art and practice of heterocyclic chemistry and beneficial for the study of glucosepane and its role in human health and disease.
TL;DR: The data indicate that MGO can act as both a foe and a friend of the glyoxalase and the Trx/TrxR systems and propose that Nrf2 can be the unifying element to explain the observed upregulation of GSH, GCL, HO1, TrxR1, trx2,trxR2, and system xc(-) system activity.
TL;DR: The results challenge the long-held belief that peptidoglycan synthesis is restricted to the septum in spherical bacteria, and instead indicate the presence of two spatiotemporally distinct modes of cross-linking in S. aureus: one at the sePTum during cell division, and another at the peripheral wall between divisions.
Abstract: Staphylococcus aureus is an important human pathogen and a model organism for studying cell wall synthesis in Gram-positive cocci. The prevailing model of cell wall biogenesis in cocci holds that peptidoglycan synthesis (i.e., transglycosylation and cross-linking) is restricted spatially to the septal cross-wall and temporally to cell division. Previously, we developed a method for visualizing cross-linking in S. aureus using fluorescently tagged mimics of the endogenous substrate of penicillin-binding proteins (PBPs). These probes are incorporated into the cell wall of S. aureus specifically by PBP4, allowing localization of the enzyme's cross-linking activity in vivo with precise spatial and temporal resolution. Here, using this methodology, we have discovered that PBP4 is active not only at the septum, but unexpectedly at the peripheral wall as well. These results challenge the long-held belief that peptidoglycan synthesis is restricted to the septum in spherical bacteria, and instead indicate the presence of two spatiotemporally distinct modes of cross-linking in S. aureus: one at the septum during cell division, and another at the peripheral wall between divisions.
TL;DR: In Staphylococcus aureus, it is shown that fluorescent mimics of the natural substrate of PBPs (PG stem peptide) are covalently incorporated into the cell wall, installing fluorophores in place of natural crosslinks.
Abstract: Penicillin-binding proteins (PBPs) catalyze the crosslinking of peptidoglycan (PG), an essential process for bacterial growth and survival, and a common antibiotic target. Yet, despite its importance, little is known about the spatiotemporal aspects of crosslinking—largely because of a lack of experimental tools for studying the reaction in live bacteria. Here we introduce such a tool: an activity-based probe that enables visualization and relative quantitation of crosslinking in vivo. In Staphylococcus aureus, we show that fluorescent mimics of the natural substrate of PBPs (PG stem peptide) are covalently incorporated into the cell wall, installing fluorophores in place of natural crosslinks. These fluorescent stem peptide mimics (FSPMs) are selectively recognized by a single PBP in S. aureus: PBP4. Thus, we were able to use FSPM pulse-labeling to localize PBP4 activity in live cells, showing that it is recruited to the septum in a manner dependent on wall teichoic acid.
TL;DR: Several ways in which child sexual abuse impacts survivors who are mothers are highlights, areas for further study, and the need for interventions to assist this population in meeting the challenges they face as mothers are highlighted.
Abstract: Child sexual abuse has been associated with a number of problems affecting women over their lifespan, including difficulties with parenting. However, there is a modest number of qualitative studies examining the impact of child sexual abuse on survivors who are mothers. There is a particular need for qualitative investigations that ask survivors who are mothers general questions about the impact of child sexual abuse on their lives rather than those that specifically ask about the impact of child sexual abuse on parenting. The former approach would allow survivors to describe effects that may impact parenting but that survivors do not consciously link to affecting their parenting. Such information may inform interventions to assist this population of survivors. This secondary data analysis examined themes revealed in interviews with 44 survivors of child sexual abuse who were mothers. Participants were seeking treatment for their child sexual abuse and completed an in-person interview in which they were asked open-ended questions about the sexual abuse they experienced as a child and how their abuse affects them now as adults. The interviews were recorded, transcribed, and coded using thematic analysis. The following six themes emerged from the narratives: (a) being a parent, (b) family of origin dysfunction, (c) the impact of abuse, (d) the abuse history and response to abuse, (e) coping, and (f) hopes and desires for the future. This study highlights several ways in which child sexual abuse impacts survivors who are mothers, areas for further study, and the need for interventions to assist this population in meeting the challenges they face as mothers.
TL;DR: The first antibodies capable of recognizing each of the three isomers of the methylglyoxal hydroimidazolones (MG-Hs) by using chemical synthesis to create homogenous immunogens are generated.
TL;DR: AMG416 was well tolerated and appears to be an effective agent for the treatment of SHPT in patients on hemodialysis.
Abstract: Background/Aims: This study evaluated the efficacy and safety of AMG416 (etelcalcitide), a novel peptide agonist of the calcium (Ca)-sensing receptor given intrav
02 Apr 2015
TL;DR: This chapter addresses the surgical aspects of care for traumatic injuries in lowand middle-income countries and presents available epidemiological data, as well as data on systematic approaches to trauma and interventions in specific anatomic areas.
Abstract: The burden of death and disability attributable to lack of access to surgical care for traumatic injuries, as well as of nontraumatic chronic conditions and soft tissue and bone infections, falls most heavily on people in lowand middle-income countries (LMICs) (Ozgediz and others 2008; Spiegel and others 2008). Human and technical capacities are insufficient to address the existing burden of injuries in these countries. Selected surgical interventions for trauma have proven costeffective in these settings, and innovative low-cost programs and interventions have improved trauma care outcomes at individual hospitals. It is critical that LMICs create or strengthen existing trauma systems to improve outcomes. Identifying effective and cost-effective interventions and strategies to inform the future direction of these resource-challenged countries is an essential step in this process. The chapter on surgery in the Disease Control Priorities in Developing Countries, second edition (DCP2) (Jamison and others 2006) exposed the scarcity of relevant evidence on outcomes, effectiveness, and costeffectiveness in the literature from the developing world; unfortunately, this situation has improved only mildly. Although some interventions and strategies have been identified (Tollefson and Larrabee 2012), deficiencies in both the quantity and the quality of data remain glaring (Vos 2009). This chapter addresses the surgical aspects of care for these conditions. It presents available epidemiological data, as well as data on systematic approaches to trauma and interventions in specific anatomic areas.
TL;DR: The presence of circadian disruption was associated with a clinically meaningfully higher severity of fatigue, appetite loss, pain, dyspnea and sleep problems, and Correcting circadian dysfunction with the use of pharmacological and/or behavioural interventions could improve these often difficult-to-manage systemic symptoms.
Abstract: 1 Background: The circadian timing system exerts temporal control over physiology, generating rhythms of about 24 hours. Its alteration in benign conditions has been associated with several systemic symptoms, including fatigue, appetite loss and poor sleep. However, the clinical impact of circadian disruption in cancer patients remains overlooked. We hypothesized that patients with circadian disruption would report more severe symptoms than those with robust circadian function. Methods: Data were available for 237 patients with metastatic colorectal cancer: M/F ratio: 1.66; median age: 60.4 years; range: 20.7-77.6; WHO Performance Status (PS) = 0/1: 59.7%/33.5%. We estimated the occurrence of circadian disruption using a validated parameter (the dichotomy index I < O), derived from wrist-actigraphy for at least 72 consecutive hours. Symptoms were self-reported by the patients using the EORTC QLQ-C30 questionnaire. Mann-Whitney U test was used to compare symptom severity according to the presence or absenc...
TL;DR: The cavovarus foot is a complex deformity involving a spectrum of changes to the hindfoot, midfoot, forefoot, and ankle, while Charcot-Marie-Tooth disease, the most common inherited neuropathy, is the prototypical form.
Abstract: The cavovarus foot is a complex deformity involving a spectrum of changes to the hindfoot, midfoot, forefoot, and ankle. While cavovarus deformity can occur secondary to many congenital, neurological, or posttraumatic causes, the prototypical form is that of Charcot-Marie-Tooth (CMT) disease, the most common inherited neuropathy.
The first known cases of cavovarus foot deformity were reported by Aran in the Archives Generales de Medicine in 18501. Professor Jean Martin Charcot and his student Pierre Marie coined the term “peroneal muscular atrophy” in 1886, with clinical descriptions of distal muscle weakness beginning in the legs and hands2. Howard Henry Tooth, in his Cambridge MD dissertation in the same year, wrote on “the peroneal type of progressive muscular atrophy” and provided illustrations of hindfoot varus and wasting of the peronei and foot extensors (Fig. 1)3. Charcot-Marie-Tooth disease has now become synonymous with the hereditary motor and sensory neuropathies (HMSNs), of which nearly fifty genetic subtypes have been described4. These neuropathies constitute a genetically and phenotypically heterogeneous group of peripheral nerve disorders that are …
01 Jan 2015
TL;DR: Hypnosis has been proven effective in treating pain and anxiety in the medical setting using randomized prospective trial methodology among both adults and children as mentioned in this paper, but despite much clinical and neurobiological evidence, hypnosis is rarely used as an analgesic for adults or children.
Abstract: Hypnosis, begun as a therapeutic discipline in the eighteenth century, was the first Western conception of a psychotherapy. It is a powerful analgesic, and there is compelling clinical documentation of its effectiveness as far back as the mid-nineteenth century. The British surgeon James Esdaile reported that 80 % of subjects obtained anesthesia with hypnosis during major surgical procedures such as amputations. Hypnosis has been proven effective in treating pain and anxiety in the medical setting using randomized prospective trial methodology among both adults and children. Hypnosis is a state of highly focused attention coupled with a suspension of peripheral awareness. This ability to attend intensely while reducing awareness of context allows one to alter the associational network linking perception and cognition. The hypnotic narrowing of the focus of attention is analogous to looking through a telephoto lens rather than a wide-angle lens – one is aware of content more than context. This can also facilitate reduced awareness of unwanted stimuli, such as pain, or of problematic cognitions, such as depressive hopelessness, that can amplify pain. Such a mental state enhances openness to input from others – often called suggestibility – and can increase receptivity to therapeutic instruction. Yet despite much clinical and neurobiological evidence, hypnosis is rarely used as an analgesic for adults or children.
01 Jan 2015