No abstract

Liver metastases of neuroendocrine tumors are usually slow-growing, and cytoreductive hepatectomy can help reduce the effects of endocrinopathies and increase life expectancy and symptom-free survival. However, it has yet to be fully investigated how hepatectomy for metastatic neuroendocrine tumors can be performed safely. Here we report the results of 13 patients with neuroendocrine liver metastases operated on in our institution and those of a French multicentric study that included 131 patients. Preoperative patient selection and appropriate surgical technique, sometimes combined with preoperative portal embolization and local tumor destruction (radiofrequency and cryotherapy), may increase the resectability and the safety of the procedure. The mortality rate after hepatectomy was 0% (2.3% in the French study); the 3- and 6-year survival rates were 91% and 68%, respectively, in our institution (the mean survival time was 66 months in the French multicentric survey). Significant prolonged survival with complete palliation of symptoms can be obtained after liver metastases resection with low mortality.

This chapter presents research on altruism and health in the context of people living with AIDS. It begins with a review of the literature on AIDS patients who volunteer to help others with the illness. This literature indicates that, as a result of such helping, the volunteers develop a positive sense of self, increase safer sex behaviours, and feel at greater peace with regard to their own future deaths. It then turns to the chapter's own research on a group of seventy-nine long-term survivors of AIDS (people who have survived twice as long as expected), who were compared with a group who had AIDS with a normal course of the illness. The long survivors were significantly more likely to have engaged in AIDS volunteerism and had significantly less depression, anxiety, and perceived stress. In a subsequent study on the psychological predictors of slower disease progression, the chapter again notes that volunteering, giving to charities, and expressing caring for others are related to better prognosis in AIDS and to less emotional distress.

Vitamin D, also known as calciferol, is a fat-soluble vitamin that is naturally present in very few foods and available as a dietary supplement. The two major forms are vitamin D 2 (ergocalciferol) and vitamin D 3 (cholecalciferol). Vitamin D 2 is largely human-made and is usually added to certain foods. Vitamin D 3 is produced endogenously in the skin of humans when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. It is also available in animal-based foods. Both forms are produced commercially and are available as dietary supplements 1,2. At present, the available scientific data indicate that vitamin D has a key role in skeletal health including bone mineralization and

This chapter tests an ecological and evolutionary hypothesis of the fitness of altruists, using the Sloan Study of Youth and Social Development, which includes information on a large sample of American adolescents gathered through questionnaires and the experience sampling method. The hypothesis places altruism in its ecological context as a human behavioural strategy that will be advantageous in some environments (stable ones where altruism thrives) and that may cause stress in others (where altruism is unreciprocated or unappreciated). Data showed that highly prosocial teens tended to inhabit positive, stable, and encouraging environments while low-prosocial teens experienced events typical of harsh social environments (i.e., fighting and teen pregnancy). Transplanting these altruistic and selfish teens would cause stress to both groups, and this is supported by the fact that the highly prosocial teens are less able to cope with the stresses typical of the low-prosocial environment. The study's hypothesis is further supported by the predominantly male sample of narcissists (low-prosocial teens with high self-esteem and plans for the future) within the study who had extremely good mental health, much like the highly prosocial individuals within supportive environments. Religiousness is highly correlated to prosocial behaviour, and religions appear to be very effective at creating social environments or niches where altruism flourishes.