Physical activity of early stage melanoma survivors.

BACKGROUND: Early stage melanoma survivors are typically otherwise healthy adults with a median age of 56.5 years for women at the time of diagnosis. Women have a projected lifespan of 20 to 30 additional years during which they should be able to enjoy and benefit from leisure outdoor physical activities while limiting their risk of a second melanoma from unprotected sun exposure. OBJECTIVE: This study evaluated the physical activity of melanoma survivors before their diagnosis of melanoma as well as 2 to 3 months and 12 months after surgical resection. METHODS: Participants in this observational study were early stage melanoma survivors (Stage 0-1A) who were surgically treated for melanoma within the last 6 months. Participants completed three online surveys (Leisure Time Exercise Questionnaire) that estimated their physical activity 2 to 3 months prior to the diagnosis with melanoma as well as 2 to 3 months and 12 months after surgery. RESULTS: All 75 participants were non-Hispanic white, and 38 of 75 participants (50.6%) were women. The median age of this urban/suburban Midwest population was 52 years. Prior to their diagnosis, all melanoma survivors were active, and 55% of women reported vigorous leisure physical activity. Two to three months after surgery, 11 of 38 women (30%) were inactive and 31% were inactive at 12 months. At 12 months after surgery, inactivity was positively correlated with older age (61-80 + years; F 1050 = 15.38; p < .001) and being a woman (0.05; F 1050 = 11.02; p < .01). CONCLUSION: Dermatologists are in a position to promote a healthy lifestyle for melanoma survivors, especially older women who can be expected to live many more years and may restrict leisure outdoor physical activity to comply with sun protection recommendations. When considering the overall health of older, female melanoma survivors, dermatologists may recommend they walk with a friend at any time of the day while wearing a hat, protective clothing, and sunscreen on exposed skin.

Promoting early detection of melanoma during the mammography experience.

BACKGROUND: Invasive melanoma, a lethal form of skin cancer, is the seventh most common cancer in women. Factors such as a history of indoor tanning or sunburn and a personal or family history of skin cancer increase a woman's risk of developing a melanoma. OBJECTIVE: Because the majority of melanomas occur in patients age 40 years or older, which is the age that is recommended for women to begin screening mammograms, the mammogram experience could be used to promote early detection of melanoma by introducing skin self-examinations (SSE) to a population of women who are already invested in preventive health. METHODS: This was a pilot and feasibility study that was designed to promote the early detection of melanoma among women who undergo a mammogram at the Lynn Sage Breast Center at the Northwestern Medicine/Prentice Women's Hospital in Chicago, Illinois. The study was conducted in three phases: development of the materials, delivery of the program, and assessment of the program effectiveness. RESULTS: Eighty six percent of women with scheduled mammogram appointments participated in the study (n = 560). Among these women, 68% noticed the SSE information in the changing rooms, 78% thought the information applied to them, and 68% identified with at least one of the risk factors for melanoma. Twenty percent of the patients checked their skin in the changing room, 13% noticed a concerning mole, and 60% of those women who noted a concerning lesion stated their intent to see a dermatologist for further evaluation. CONCLUSION: A large proportion of the women in our study had risk factors for developing a melanoma and noticed the SSE information in the screening center. Placing an intervention to encourage methods for the early detection of melanoma in an outpatient mammography environment is an effective strategy to increase awareness in a large proportion of at-risk women.

Efficacy of a sun protection workbook for kidney transplant recipients: a randomized controlled trial of a culturally sensitive educational intervention.

A culturally sensitive educational intervention that encouraged sun protection behaviors among kidney transplant recipients (KTRs) was developed and the short-term efficacy was evaluated. Non-Hispanic White, Hispanic/Latino and non-Hispanic Black patients, who received a transplant 2-24 months prior to the study, were randomized into two study groups: intervention versus standard of care. Electronic reminders tailored to the weather conditions were sent every 2 weeks by text message or email. Self-reported surveys and biologic measurements were obtained prior to the intervention and 6 weeks later. Among the 101 study participants, there was a statistically significant increase in knowledge, recognition of personal risk of developing skin cancer, willingness to change sun protection behavior and self-reported performance of sun protection in participants receiving the intervention in comparison with those receiving standard of care (p < 0.05). The pigment darkening of the sun-exposed forearm and sun damage of the forearm and sunburns/skin irritation from the sun were significantly less in participants receiving the intervention (p < 0.05). Providing sun protection education at the beginning of summer with reminders tailored to weather conditions helped KTRs adopt sun protection practices. This sun protection program for KTRs may be incorporated into the care provided by the nephrologist or transplant surgeon.

Conditional stimulation by galanin of saccharin and ethanol consumption under free and response contingent access.

Prior research has shown that the neuropeptide galanin strongly stimulates food intake in sated rats when food is made freely available. However, when access to food is made contingent upon lever pressing on a reinforcement schedule, no such stimulation occurs. This dissociation is consistent with the theorized "behavioral energizing" function of the ascending mesolimbic dopamine system, which purports that this ascending dopamine system is involved in only the goal directed effort maintaining (appetitive) and not the hedonic (consummatory) aspects of reward. Further, these results suggest that galanin may play an inhibitory role therein, or itself may be inhibited by mesolimbic dopamine activity underlying instrumental behavior. Prior research into this phenomenon has only utilized caloric foods or water, so the current work assessed the generality of this finding by determining if a similar dissociation also applies to commodities with other properties. For the present experiments, two commodities which varied in the dimensions of palatability and caloric load but which are both known to serve as reinforcers in other settings were chosen. In the first experiment, under the current single commodity free consumption test conditions shown to be sensitive to galanin effects of food and water consumption, galanin did not significantly alter the consumption of caloric laden but poorly palatable 7% alcohol solution. However, in the second experiment, galanin significantly increased free consumption of a highly palatable but non-caloric 0.2% saccharin solution but not when operant responding was required for access to saccharin, extending the basic appetitive-consummatory dissociation observed for food. Taken together, these results suggest that the gustatory properties may be a specific factor involved in galanin stimulation of free consumption, and that there may be a continuum of influence of galanin based on the relative "elasticity" of the commodities as reinforcers.

Chronic activity wheel running reduces the severity of kainic acid-induced seizures in the rat: possible role of galanin.

Studies in both humans and rodents suggest that exercise can be neuroprotective, but the mechanisms by which this occurs are still poorly understood. Three weeks of voluntary, physical activity in rats upregulates prepro-galanin messenger RNA levels in the locus coeruleus. Galanin is a neuropeptide extensively coexisting with norepinephrine that decreases neuronal hyperexcitability both in vivo and in vitro. Thus, exercise may diminish neural hyperexcitability through a galaninergic mechanism. The current experiments tested whether voluntary activity wheel running would protect against kainic acid-evoked seizures and whether galaninergic signaling is a necessary factor in this protection. In experiment 1, rats were given access to running wheels or remained sedentary for three weeks. After this period, rats received an intraperitoneal (i.p.) injection of 0, 7, 10 or 14 mg/kg kainic acid. Exercise decreased the severity of or eliminated seizure behaviors and hippocampal c-fos expression induced by kainic acid. In experiment 2, exercising or sedentary rats were injected intracerebroventricularly (i.c.v.) with 0.2 or 0.4 microg of kainic acid following either an injection of M-40 (a galanin receptor antagonist) or saline. Exercise decreased kainic acid-induced seizures at the 0.2 microg dose, and M-40 (6 nmol) decreased this effect. In contrast, there were no detectable differences between exercising and sedentary rats in behavior at the 0.4 microg dose. The results suggest that the protective effects of exercise against seizures are at least partially mediated by regulation of neural excitability through a process involving galanin.

Localized perineal cutaneous nodules: a case of recurrent systemic anaplastic large-cell lymphoma.

We report an unusual case of localized cutaneous nodules heralding the recurrence of systemic CD30+ anaplastic large-cell lymphoma (ALCL). A 47-year-old woman developed numerous violaceous nodules in the perineal and upper thigh area 3 years after multimodal treatment and complete remission of primary anaplastic large-cell CD30+ lymphoma. Using immunohistochemical and T-cell gene rearrangement analysis, a recurrence of her anaplastic large-cell lymphoma was diagnosed.

Early-onset subicular microvascular amyloid and neuroinflammation correlate with behavioral deficits in vasculotropic mutant amyloid beta-protein precursor transgenic mice.

Cerebral microvascular amyloid beta protein (Abeta) deposition and associated neuroinflammation are increasingly recognized as an important component leading to cognitive impairment in Alzheimer's disease and related cerebral amyloid angiopathy (CAA) disorders. Transgenic mice expressing the vasculotropic Dutch/Iowa (E693Q/D694N) mutant human Abeta precursor protein in brain (Tg-SwDI) accumulate abundant cerebral microvascular fibrillar amyloid deposits exhibiting robust neuroinflammation. In the present study, we sought to determine if the unique amyloid pathology of Tg-SwDI mice was associated with deficits in behavioral performance. Behavioral performance tests that assessed a variety of psychological functions, including overall activity, motor ability, balance and strength, anxiety, impulsivity, and learning were conducted on homozygous Tg-SwDI mice and similarly aged wild-type C57Bl/6 mice. Our results indicate that Tg-SwDI mice were impaired in the performance of the Barnes maze learning and memory task at 3, 9, and 12 months of age. While more widespread cerebral microvascular Abeta pathology was evident in older animals, the evaluation of the Abeta pathology in the 3 months old transgenic animals revealed specific accumulation of microvascular amyloid and markedly elevated numbers of reactive astrocytes and activated microglia restricted to the subiculum. These findings indicate that early-onset accumulation of subicular microvascular amyloid and accompanying neuroinflammation correlates with impaired performance in the learning and memory task in Tg-SwDI mice.

Effects of gonadectomy on performance in operant tasks measuring prefrontal cortical function in adult male rats.

Previous studies have shown that gonadectomy in adult male rats influences the acquisition and performance of spatial and other working memory tasks that depend in part on the medial prefrontal cortex and its dopamine innervation. Stimulated by previous findings that gonadectomy alters dopamine axon density in not only medial but several other prefrontal fields, the present studies asked whether gonadectomy might also broadly impact dopamine-dependent prefrontal functions, and whether these effects bore any relation to hormone modulation of mesoprefrontal dopamine afferents. Specifically, control, gonadectomized, and gonadectomized rats given estradiol or testosterone propionate were tested on a series of operant tasks that together measured medial prefrontal functions of spatial working memory, impulsivity and extradimensional set shifting and orbital prefrontal functions of reversal learning/perseveration and motivation. Afterwards, animals were sacrificed, their bulbospongiosus muscles were removed and weighed, their brains were processed for immunocytochemistry for the dopamine-synthesizing enzyme tyrosine hydroxylase, and axon densities were measured in orbital and medial prefrontal fields. Statistical evaluations of group effects on behavior and regression analyses comparing individual performance with muscle weights and axon density measures revealed androgen-reversible effects of gonadectomy on acquisition of spatial working memory and extradimensional set shifting that were correlated with bulbospongiosus weight and medial prefrontal dopamine axon density, estrogen-sensitive influences of gonadectomy on motivation and response withholding that were correlated with bulbospongiosus weight but not with dopamine innervation, and still other prefrontal functions, i.e., impulsivity, reversal learning, that were insensitive to gonadectomy and unrelated to gonadectomy-induced changes in muscle weight or prefrontal dopamine innervation.

Galanin/GALP receptors and CNS homeostatic processes.

Galanin is a 29/30 amino acid peptide neurotransmitter that is widely distributed throughout the central nervous system and periphery. There are three well-characterized G-protein coupled galanin receptors subtypes (GalR1-3). A more recently discovered 60 amino acid galanin-like peptide (GALP) shares amino acid sequence homology with galanin (1-13) in position 9-21 and has high binding affinity for GalR1-3, with highest affinity for GalR3. Considerable evidence has accumulated that implicates both galanin and GALP as playing important roles in regulating food and water intake behavior and related neuroendocrine functions. Pharmacological tools are emerging that will allow dissociation of specific roles for the peptides and their associated receptor subtypes in mediating the homeostatic processes of energy and fluid balance.