Background: To our knowledge, the association between sleep-disordered breathing (SDB) and hypertension has not been evaluated in subjects from the general population with a wide age range while adjusting for the possible confounding factors of age, body mass index, sex, menopause and use of hormone replacement therapy, race, alcohol use, and smoking.

There are currently no effective therapies for metastatic prostate cancer because the molecular mechanisms that underlie the metastatic spread of primary prostate cancer are unclear. Transcription factor Stat3 is constitutively active in malignant prostate epithelium, and its activation is associated with high histological grade and advanced cancer stage. Progression of prostate cancer to metastatic disease is one of the key problems in the clinical management of prostate cancer.1 This is because there are currently no effective therapies for metastatic prostate cancer, and metastatic prostate cancer is the lethal form of the disease. Identification of the molecular changes that lead to formation of distant metastasis is critical for improvement of therapeutic interventions for metastatic prostate cancer and for development of strategies to prevent primary prostate cancer from metastasizing.Transcription factor Stat3 has been implicated in the promotion of growth and progression of prostate cancer. Stat3, which is both a cytoplasmic signaling molecule and a nuclear transcription factor, belongs to the sevenmember Stat gene family of transcription factors.2 Stat3 becomes active by phosphorylation of a specific tyrosine residue in the carboxy-terminal domain by a tyrosine kinase (pY705).3 Activation of Stat3 is supplemented by phosphorylation of a specific serine residue (S727).4 After phosphorylation, Stat3 homodimerizes and translocates to the nucleus where it binds to specific Stat3 response elements of target gene promoters to regulate transcription.3 Transcription factor Stat3 is constitutively active in clinical human prostate cancer, 5-9 and activation of Stat3 has been associated with advanced stage of prostate cancer. 5,9 Moreover, several reports implicate Stat3 in promotion of prostate cancer cell proliferation and inhibition of apoptosis. 5,10,11

Context: Age-related macular degeneration is a prevalent disease of aging that may cause irreversible vision loss, disability, and depression. The latter is rarely recognized or treated in ophthalmologic settings.Objective: To determine whether problem-solving treatment can prevent depressive disorders in patients with recent vision loss.Design: Randomized, controlled trial.Setting: Outpatient ophthalmology offices in Philadelphia, Pennsylvania.Patients: Two hundred six patients aged 65 years or older with recent diagnoses of neovascular age-related macular degeneration in one eye and pre-existing age-related macular degeneration in the fellow eye.Intervention: Patients were randomly assigned to problem-solving treatment (n = 105) or usual care (n=101). Problem-solving treatment therapists delivered 6 sessions during 8 weeks in subjects' homes. Main Outcome Measures:Outcomes were assessed at 2 months for short-term effects and 6 months for maintenance effects. These included DSM-IV-defined diagnoses of depressive disorders, National Eye Institute Vision Function Questionnaire-17 scores, and rates of relinquishing valued activities.Results: The 2-month incidence rate of depressive disorders in problem-solving-treated subjects was significantly lower than controls (11.6% vs 23.2%, respectively; odds ratio, 0.39; 95% confidence interval, 0.17-0.92; P=.03). Problem-solving treatment also reduced the odds of relinquishing a valued activity (odds ratio, 0.48; 95% confidence interval, 0.25-0.96; P =.04). This effect mediated the relationship between treatment group and depression. By 6 months, most earlier observed benefits had diminished, though problem-solving treatment subjects were less likely to suffer persistent depression ( 2 1,3 =8.46; P =.04). Conclusions: Problem-solving treatment prevented depressive disorders and loss of valued activities in patients with age-related macular degeneration as a shortterm treatment, but these benefits were not maintained over time. Booster or rescue treatments may be necessary to sustain problem-solving treatment's preventative effect. This study adds important new information to the emerging field of enhanced-care models to prevent or treat depression in older persons.Trial Registration: clinicaltrials.gov Identifier: NCT00042211 Arch Gen Psychiatry. 2007;64(8):886-892

A progressive postresection walking program significantly improves fatigue and health-related quality of life in pancreas and periampullary cancer patients. Recommended Citation Yeo, Theresa; Burrell, Sherry A; Sauter, Patricia K; Kennedy, Eugene P; Lavu, Harish; Leiby, Benjamin E; and Yeo, Charles, "A progressive postresection walking program significantly improves fatigue and health-related quality of life in pancreas and periampullary cancer patients." (2012 Methods:One hundred and two patients with resected PPC consented to participate in this study and were randomized to either an Intervention Group (IG) or a Usual Care Group (UCG).Subjects completed visual analog scales, the FACIT-Fatigue Scale (FFS) and the Short Form36v2® after surgery and again 3 to 6 months after hospital discharge. Results:Patients in the IG and UCG were comparable with regard to demographics, comorbidities, cancer type and staging, type of resection, pre-op fatigue and pain levels, adjuvant therapy and baseline walking distance. Patients in the IG had significantly improved scores on the FFS at study completion, improved fatigue and pain scores, as well as overall physical functioning and mental health composite scores. At study completion, participants in the IG were walking twice as far and were significantly more likely to have continued walking or another form of exercise as compared to the UCG. Using hierarchical cluster analysis three mutually exclusive symptom groupings were identified in the cohort. Kaplan-Meier survival analysis did not indicate an overall survival benefit for the IG. Conclusion:This is the first prospective, randomized and controlled trial to report that participation in a home walking program confers a significant benefit in resected PPC patients

No abstract