We examined which adaptive coping strategies, referring to the concept of 'locus of disease control', were of relevance for patients with chronic pain conditions, and how they were interconnected with patients' life satisfaction and interpretation of disease.

Circulating tumor cells (CTCs) are detectable in peripheral blood of metastatic breast cancer patients (MBC). In this paper we evaluate a new CTC separation method based on a combination of anti-EpCAM- and anti-cytokeratin magnetic cell separation with the aim to improve CTC detection with low target antigen densities.

Personalised (or individualised) medicine in the days of genetic researchrefers to molecular biologic specifications in individuals and not to aresponse to individual patient needs in the sense of person-centredmedicine. Studies suggest that patients often wish for authenticallyperson-centred care and personal physician-patient interactions, and thatthey therefore choose Complementary and Alternative medicine (CAM) as apossibility to complement standard care and ensure a patient-centredapproach. Therefore, to build on the findings documented in thesequalitative studies, we investigated the various concepts of individualisedmedicine inherent in patients’ reasons for using CAM. We used the technique of meta-ethnography, following a three-stage approach:(1) A comprehensive systematic literature search of 67 electronic databasesand appraisal of eligible qualitative studies related to patients’reasons for seeking CAM was carried out. Eligibility for inclusion wasdetermined using defined criteria. (2) A meta-ethnographic study wasconducted according to Noblit and Hare's method for translating key themesin patients’ reasons for using CAM. (3) A line-of-argument approachwas used to synthesize and interpret key concepts associated withpatients’ reasoning regarding individualized medicine. (1) Of a total of 9,578 citations screened, 38 studies were appraised with aquality assessment checklist and a total of 30 publications were included inthe study. (2) Reasons for CAM use evolved following a reciprocaltranslation. (3) The line-of-argument interpretations of patients’concepts of individualised medicine that emerged based on the findings ofour multidisciplinary research team were “personal growth”,“holism”, “alliance”, “integrativecare”, “self-activation” and “wellbeing”. The results of this meta-ethnographic study demonstrate that patients’notions of individualised medicine differ from the current idea ofpersonalised genetic medicine. Our study shows that the“personal” patients’ needs are not identified with aspecific high-risk group or with a unique genetic profile in the sense ofgenome-based “personalised” or “individualised”medicine. Thus, the concept of individualised medicine should include thehumanistic approach of individualisation as expressed in concepts such as“personal growth”, “holistic” or “integrativecare”, doctor-patient “alliance”,“self-activation” and “wellbeing” needs. This shouldalso be considered in research projects and the allocation of healthcareresources.

Macrophages are highly versatile cells that play an important role in tumour microenvironment. Tumour associated macrophages (TAMs) have been linked to both, good or bad prognosis of several cancer types depending on their number, composition and polarization. Viscum album lipophilic extract (VALE) contains several pentacyclic triterpenes known to modulate the activity of monocytes and other immune cells and to exhibit anticancer properties. In our in vitro study, we investigated the effect of tumour cell lines on macrophage polarization and monocyte chemotactic transmigration and examined the modulatory potential of VALE and its predominant triterpene oleanolic acid (OA). Human peripheral blood monocytes were differentiated into monocyte derived macrophages (MDM) using M-CSF and polarized into M1 by IFN-γ and LPS and into M2 macrophages by IL-4 and IL-13 or by co-culture with two different tumour cell lines. Polarized macrophages were subsequently treated with VALE or OA. Phenotypic markers and cytokines were assessed by flow cytometry and immunoanalysis. Migration of human peripheral blood monocytes induced by monocyte chemotactic protein-1 (MCP-1) or supernatants of different tumour cell lines under the influence of VALE or OA was measured in a chemotaxis transmigration assay. In vitro polarized M1 and M2 type macrophages revealed specific phenotypic patterns and tumour cell co-cultured MDM displayed ambiguous phenotypes with M1 as well as M2 associated markers. VALE and OA showed modest influence on cell surface marker profile and cytokine expression of tumour cell co-cultured macrophages. All tumour cell supernatants markedly enhanced the migratory activity of monocytes. VALE and OA significantly inhibited MCP-1 induced monocyte transmigration, whereas monocyte migration initiated by tumour cell derived supernatants was not affected. In our study we reconfirmed that co-culture with different tumour cell lines can result in a mixed macrophage phenotype with M1 as well as M2 patterns, a finding that is important for a better understanding of tumour microenvironment functions. Moreover, we demonstrated that VALE shows slight immunomodulatory effects on tumour cell co-cultured macrophages and modulates monocyte chemotactic transmigration in vitro, indicating promising possibilities of triterpenes from Viscum album L. to contribute in a multimodal concept of anti-cancer therapy in future. Our data contribute to an understanding of monocyte function and macrophage polarization in vitro and of the possibility to influence their behaviour by triterpene containing mistletoe extracts.

Experimental research on the effects of homeopathic treatments on impaired plants was last reviewed in 1990. To compile a systematic review of the existing literature on basic research in homeopathy with abiotically stressed plants using predefined criteria. The literature search was carried out on publications that reported experiments on homeopathy using abiotically stressed whole plants, seeds, plant parts and cells from 1920 to 2010. Outcomes had to be measured by established procedures and statistically evaluated. Using of a Manuscript Information Score (MIS) we identified those publications that provided sufficient information for proper interpretation (MIS≥5). A further evaluation was based on the use of adequate controls to investigate specific effects of homeopathic preparations and on the use of systematic negative control experiments. A total of 34 publications with abiotically stressed plants was identified, published between 1965 and 2010. The 34 publications described a total of 37 experimental studies. Twenty-two studies included statistics, 13 had a MIS≥5, 8 were identified with adequate controls and 4 with negative control experiments. Significant and reproducible effects with decimal and centesimal potencies were found, including dilution levels beyond Avogadro's number. One experimental model was independently assessed by another research team and yielded inverted results compared to the original trial. Abiotically stressed plant models seem to be a useful approach to investigate homeopathic basic research questions, but more experimentation and especially more independent replication trials are needed. Systematic negative control experiments should be implemented on a routine basis to exclude false-positive results.

Decision-making during pregnancy regarding different options of care can be difficult, particularly when risks of intervention versus no intervention for mother and baby are unclear. Unbiased information and support for decision making may be beneficial in these situations. The management of normal pregnancies at and beyond term is an example of such a situation. In order to determine the need to develop an evidence-based decision aid this paper searches, analyses and appraises patient decision aids and patient information leaflets regarding care options in cases of late term and post-term pregnancies, including complementary and alternative medicine (CAM). A literature search was carried out in a variety of lay and medical databases. Inclusion criteria: written information related to uncomplicated singleton pregnancies and targeted at lay people. Analysis and appraisal of included material by means of quality criteria was set up based on the International Patient Decision Aid Standards accounting for evidence-basing of CAM options. Inclusion of two decision aids and eleven leaflets from four decision aids and sixteen leaflets. One decision aid met the quality criteria almost completely, the other one only insufficiently despite providing some helpful information. Only one leaflet is of good quality, but cannot substitute a decision aid. There is an urgent need for the design of an evidence-based decision aid of good quality for late-term or post-term pregnancy, particularly in German language.