Bleeding and Thrombosis in Multiple Myeloma: Platelets as Key Players during Cell Interactions and Potential Use as Drug Delivery Systems.

Multiple myeloma (MM) is a hematological malignancy originated in the bone marrow and characterized by unhindered plasma cell proliferation that results in several clinical manifestations. Although the main role of blood platelets lies in hemostasis and thrombosis, platelets also play a pivotal role in a number of other pathological conditions. Platelets are the less-explored components from the tumor microenvironment in MM. Although some studies have recently revealed that MM cells have the ability to activate platelets even in the premalignant stage, this phenomenon has not been widely investigated in MM. Moreover, thrombocytopenia, along with bleeding, is commonly observed in those patients. In this review, we discuss the hemostatic disturbances observed in MM patients and the dynamic interaction between platelets and myeloma cells, along with present and future potential avenues for the use of platelets for diagnostic and therapeutic purposes.

Journeying Apart: Exploring Informal Caregiver Experiences and Unmet Closures in Caring for COVID-19 Deceased.

The current study investigates the experiences and expectations of informal caregivers who lost their loved ones to the COVID-19 virus. The unusual circumstances of the deaths including physical isolation from their loved ones during the final hours before death significantly impacted their grieving process. In this interpretative phenomenological study, caregivers' experiences are explored through the lens of grief models and Gestalt perspectives. By thematic coding, seven superordinate themes emerged: Inability to accept death, Unfair nature of death, Helplessness, Regret and self-blame, Shattering of assumptive world, Using work as a distraction and Lack of government facilities. The findings of this study suggest that a significant number of informal caregivers continue suffering through the distress caused by the death of their loved ones in the pandemic, highlighting the need for grief counselling interventions for such bereaved informal caregivers.