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Sample records for cancer morbidity level

  1. Mortality and cancer morbidity in workers exposed to low levels of vinyl chloride monomer at a polyvinyl chloride processing plant

    Energy Technology Data Exchange (ETDEWEB)

    Hagmar, L.; Akesson, B.; Nielsen, J.; Andersson, C.; Linden, K.; Attewell, R.; Moeller, T. (University Hospital, Lund (Sweden))

    1990-01-01

    To study whether exposure to low levels of vinyl chloride monomer (VCM) causes increased risk for cancer morbidity and death from ischemic heart disease, a cohort study was performed among 2,031 male workers at a polyvinyl chloride (PVC) processing plant who had been employed for at least 3 months during the period 1945-1980. An almost significantly increased total mortality (SMR = 116, 95% CI 99-136) was found. Deaths caused by violence or intoxication were significantly increased (SMR = 153, 95% CI 109-213), but not deaths from ischemic heart disease (SMR = 100, 95% CI 73-135). A significant increase in total cancer morbidity was observed (SMR = 128, 95% CI 101-161). Respiratory cancers were significantly increased (SMR = 213, 95% CI 127-346). Furthermore, six brain tumors (vs. 2.6 expected) were observed. This increase, however, was not significant (SMR = 229, 95% CI 84-498). No liver hemangiosarcoma was observed. Applying a latency period of greater than or equal to 10 years from start of employment did not change the risk patterns. There were no significant exposure-response associations between exposure estimates for VCM, asbestos, and plasticizers and cancer morbidity.

  2. Cancer morbidity in alcohol abusers

    DEFF Research Database (Denmark)

    Tønnesen, H; Møller, Henrik; Andersen, J R

    1994-01-01

    Data on the association between alcohol abuse and cancer morbidity are scarce in large cohorts of non-hospitalised alcoholic men and women. Of 18,368 alcohol abusers who entered an outpatient clinic in Copenhagen during 1954-87, 18,307 were followed and their cancer incidence was compared...... and the liver are confirmed. In addition, this study indicates an increased occurrence of cancer of the prostate gland, pleura and uterine cervix in alcohol abusers....

  3. Psychological morbidity and stress but not social factors influence level of fear of cancer recurrence in young women with early breast cancer: results of a cross-sectional study.

    Science.gov (United States)

    Thewes, B; Bell, M L; Butow, P; Beith, J; Boyle, F; Friedlander, M; McLachlan, S A

    2013-12-01

    Fear of cancer recurrence (FCR) is a common problem amongst survivors. Past research has shown that young women with breast cancer are particularly vulnerable to FCR, yet few previous studies have specifically examined FCR in this subgroup. The aim of the study is to explore the relationship between FCR, psychological morbidity and social factors. A secondary aim was to explore the relationship between clinical levels of FCR and generalised anxiety disorder (GAD) and hypochondriasis. Two hundred eighteen breast cancer survivors (aged 18-45 years at diagnosis) diagnosed at least 1 year prior were recruited through seven metropolitan oncology clinics and two breast cancer consumer groups. Participants completed a web-based questionnaire, which assessed FCR, psychological functioning, generalised anxiety, hypochondriasis and items exploring past cancer-related experiences, attitudes to future childbearing, social support and correlates were identified using linear regression. Psychological morbidity scales measuring anxiety and psychological functioning and stressful life events were significantly associated with FCR in adjusted and unadjusted models (p cancer experiences, children, social support and attitudes to childrearing were not associated with FCR. Among those with clinical levels of FCR (n = 152), 43% met screening criteria for hypochondriasis, and 36% met screening criteria for GAD. This study shows psychological morbidity is associated with FCR, but the majority of women with high levels of FCR do not also meet the criteria for a clinical level of GAD or hypochondriasis. Understanding the factors that make young women vulnerable to FCR is important to help guide the development of FCR-specific interventions for this subgroup. Copyright © 2013 John Wiley & Sons, Ltd.

  4. Fasting levels of high-sensitivity growth hormone predict cardiovascular morbidity and mortality: the Malmö Diet and Cancer study.

    Science.gov (United States)

    Hallengren, Erik; Almgren, Peter; Engström, Gunnar; Hedblad, Bo; Persson, Margaretha; Suhr, Jennifer; Bergmann, Andreas; Melander, Olle

    2014-10-07

    Both pathological excess and deficiency of growth hormone (GH) are associated with cardiovascular mortality. The goal of this study was to test whether fasting levels of growth hormone measured with a high-sensitivity assay (hs-GH) predict cardiovascular morbidity and mortality at the population level. We studied 4,323 participants (age 46 to 68 years; mean age 58 years; 59% women) of the Swedish, population-based Malmö Diet and Cancer study examined in 1991 to 1994. Using multivariate-adjusted Cox proportional hazards models, we related baseline levels of fasting hs-GH to incidence of coronary artery disease, stroke, congestive heart failure, all-cause mortality, and cardiovascular mortality. During a median follow-up of 16.2 years, hs-GH (hazard ratio [HR]/SD increment of natural logarithm of fasting hs-GH) was independently associated with increased risk of coronary artery disease (397 events; HR: 1.11; 95% confidence interval [CI]: 1.01 to 1.23; p = 0.04), stroke (251 events; HR: 1.18; 95% CI: 1.04 to 1.34; p = 0.01), congestive heart failure (107 events; HR: 1.25; 95% CI: 1.03 to 1.52; p = 0.02), all-cause mortality (645 events; HR: 1.17; 95% CI: 1.08 to 1.26; p 0) of 0.542 (95% CI: 0.205 to 0.840) in cardiovascular mortality. Higher values of hs-GH were associated with an increased risk of cardiovascular morbidity and mortality. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  5. Cancer mortality and morbidity among rubber workers.

    Science.gov (United States)

    Monson, R R; Fine, L J

    1978-10-01

    Mortality and morbidity from cancer among a cohort of 13,570 white male rubber workers were examined. Each man worked for at least 5 years at the Akron, Ohio, plant of the B. F. Goodrich Company. The potential period of follow-up was from January 1, 1940 to June 30, 1976. Departmental work histories were based primarily on records maintained by Local no. 5, United Rubber Workers. The occurrence of cancer was measured by death certificates and by a survey of Akron-area hospital tumor registries from 1964 to 1974. Two types of analyses were made: 1) an external comparison of mortality rates of rubber workers versus rates of U.S. white males, and 2) an internal comparison of cancer morbidity rates among persons who were employed in various work areas of the plant. Excess cases of specific cancers (observed/expected numbers) among workers in specific work areas included: stomach and intestine: rubber making (30/14.4); lung: tire curing (31/14.1), fuel cells and/or deicers (46/29.1); bladder: chemical plant (6/2.4), and tire building (16/10.7); skin cancer: tire assembly (12/1.9); brain cancer: tire assembly (8/2.0); lymphatic cancer: tire building (8/3.2); and leukemia: calendering (8/2.2), tire curing (8/2.6), tire building (12/7.5), elevators (4/1.4), tubes (4/1.6), and rubber fabrics (4/1.1). Agents that may be responsible for these excesses were considered.

  6. Cancer morbidity and quartz exposure in Swedish iron foundries.

    Science.gov (United States)

    Westberg, Håkan; Andersson, Lena; Bryngelsson, Ing-Liss; Ngo, Yen; Ohlson, Carl-Göran

    2013-07-01

    The aim of this study was to determine cancer morbidity amongst Swedish iron foundry workers with special reference to quartz exposure. In addition to respirable dust and quartz, phenol, formaldehyde, furfuryl alcohols, polycyclic aromatic hydrocarbons (PAHs), carbon black, isocyanates and asbestos are used or generated by foundry production techniques and exposure to any of these substances could have potentially carcinogenic effects. Cancer morbidity between 1958 and 2004 was evaluated in a cohort of 3,045 male foundry workers employed for >1 year between 1913 and 2005. Standardised incidence ratios (SIRs) with 95 % confidence intervals (95 % CI) were determined by comparing observed numbers of incident cancers with frequencies in the Swedish cancer register. Exposure measures were assessed using information from the personal files of employees and modelling quartz measurement based on a database of 1,667 quartz measurements. Dose responses for lung cancer were determined for duration of employment and cumulative quartz exposure for latency periods >20 years. Overall cancer morbidity was not increased amongst the foundry workers (SIR 1.00; 95 % CI, 0.90-1.11), but the incidence of lung cancer was significantly elevated (SIR 1.61; 95 % CI, 1.20-2.12). A non-significant negative dose response was determined using external comparison with a latency period of >20 years (SIR 2.05, 1.72 1.26 for the low, medium and high exposure groups), supported by internal comparison data (hazard ratios 1, 1.01, 0.78) for the corresponding groups. For cancers at sites with at least five observed cases and a SIR > 1.25, non-significant risks with SIRs > 1.5 were determined for cancers of the liver, larynx, testis, connective muscle tissue, multiple myeloma plasmacytoma and lymphatic leukaemia. A significant overall risk of lung cancer was determined, but using external and internal comparison groups could not confirm any dose response at our cumulative quartz dose levels.

  7. Prostate cancer in Denmark. Incidence, morbidity and mortality

    DEFF Research Database (Denmark)

    Brasso, K; Iversen, Peter

    1999-01-01

    been by deferred hormonal therapy. Morbidity and mortality associated with prostate cancer are analysed in a group of 1459 patients aged 55-74 years, who were diagnosed as having clinically localized prostate cancer in the 5-year period 1983 to 1987. In this group of patients prostate cancer...... is demonstrated to cause significant morbidity. Furthermore, the patients suffered significant excess mortality and loss of life expectancy....

  8. Mortality and cancer morbidity after heavy occupational fluoride exposure

    DEFF Research Database (Denmark)

    Grandjean, P; Juel, K; Jensen, Ole Møller

    1985-01-01

    with specific mortality rates for the Copenhagen area, violent death (and suicide taken alone) remained in significant excess among employees hired before 1940. Cancer morbidity data for the 35-year period 1943-1977 showed 78 cases of malignant neoplasms in the cryolite workers against 53.2 expected for Denmark...... as a whole and 67.9 for Copenhagen. The excess was almost entirely due to an excess number of respiratory cancers. Cancer morbidity showed no apparent correlation with length of employment or time from first exposure. Because detailed information on predictors for respiratory cancer was unavailable...

  9. Morbidity And Quality Of Life Among Head And Neck Cancer ...

    African Journals Online (AJOL)

    Morbidity And Quality Of Life Among Head And Neck Cancer Patients Treated With Radical Radiotherapy. ... East African Medical Journal ... Conclusion: This study provides information that should aid in communicating with the head and neck cancer patients scheduled for radiotherapy and in the design of preventive and ...

  10. Survivors of childhood cancer in the United States: prevalence and burden of morbidity.

    Science.gov (United States)

    Phillips, Siobhan M; Padgett, Lynne S; Leisenring, Wendy M; Stratton, Kayla K; Bishop, Ken; Krull, Kevin R; Alfano, Catherine M; Gibson, Todd M; de Moor, Janet S; Hartigan, Danielle Blanch; Armstrong, Gregory T; Robison, Leslie L; Rowland, Julia H; Oeffinger, Kevin C; Mariotto, Angela B

    2015-04-01

    No studies have estimated the population-level burden of morbidity in individuals diagnosed with cancer as children (ages 0-19 years). We updated prevalence estimates of childhood cancer survivors as of 2011 and burden of morbidity in this population reflected by chronic conditions, neurocognitive dysfunction, compromised health-related quality of life, and health status (general health, mental health, functional impairment, functional limitations, pain, and fear/anxiety). Surveillance, Epidemiology, and End Results (SEER) Program data from 1975 to 2011 were used to update the prevalence of survivors of childhood cancers in the United States. Childhood Cancer Survivor Study data were used to obtain estimates of morbidity burden indicators, which were then extrapolated to SEER data to obtain population-level estimates. There were an estimated 388,501 survivors of childhood cancer in the United States as of January 1, 2011, of whom 83.5% are ≥5 years after diagnosis. The prevalence of any chronic condition among ≥5-year survivors ranged from 66% (ages 5-19) to 88% (ages 40-49). Estimates for specific morbidities ranged from 12% (pain) to 35% (neurocognitive dysfunction). Generally, morbidities increased by age. However, mental health and anxiety remained fairly stable, and neurocognitive dysfunction exhibited initial decline and then remained stable by time since diagnosis. The estimated prevalence of survivors of childhood cancer is increasing, as is the estimated prevalence of morbidity in those ≥5 years after diagnosis. Efforts to understand how to effectively decrease morbidity burden and incorporate effective care coordination and rehabilitation models to optimize longevity and well-being in this population should be a priority. ©2015 American Association for Cancer Research.

  11. Morbidity And Quality Of Life Among Head And Neck Cancer ...

    African Journals Online (AJOL)

    Morbidity And Quality Of Life Among Head And Neck Cancer Patients Treated With Radical Radiotherapy. ... The rest of the tumours were equally divided between the oral cavity and larynx (31.6%). ... The most frequent symptom was dryness of the mouth while the most troublesome symptom was difficulty in tasting foods.

  12. Morbidity of the neck after head and neck cancer therapy

    NARCIS (Netherlands)

    van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

    Background. Studies on morbidity of the neck after head and neck cancer therapy are scarcely described. Methods. Patients who underwent surgery, including neck dissection, with and without radiation therapy at least 1 year before the study were asked to participate. We assessed neck pain, loss of

  13. Survivors of Childhood Cancer in the United States: Prevalence and Burden of Morbidity

    Science.gov (United States)

    Phillips, Siobhan M.; Padgett, Lynne S.; Leisenring, Wendy M.; Stratton, Kayla K.; Bishop, Ken; Krull, Kevin R.; Alfano, Catherine M.; Gibson, Todd M.; de Moor, Janet S.; Hartigan, Danielle Blanch; Armstrong, Gregory T.; Robison, Leslie L.; Rowland, Julia H.; Oeffinger, Kevin C.; Mariotto, Angela B.

    2015-01-01

    Background No studies have estimated the population-level burden of morbidity in individuals diagnosed with cancer as children (ages 0-19 years). We updated prevalence estimates of childhood cancer survivors as of 2011 and burden of morbidity in this population reflected by chronic conditions, neurocognitive dysfunction, compromised health-related quality of life and health status (general health, mental health, functional impairment, functional limitations, pain and fear/anxiety). Methods Surveillance Epidemiology and End Results Program data from 1975 to 2011 were used to update the prevalence of survivors of childhood cancers in the US. Childhood Cancer Survivor Study data were used to obtain estimates of morbidity burden indicators which were then extrapolated to SEER data to obtain population-level estimates. Results There were an estimated 388,501 survivors of childhood cancer in the US as of January 1, 2011, of whom 83.5% are ≥5 years post-diagnosis. The prevalence of any chronic condition among ≥5-year survivors ranged from 66% (ages 5-19) to 88% (ages 40-49). Estimates for specific morbidities ranged from 12% (pain) to 35% (neurocognitive dysfunction). Generally, morbidities increased by age. However, mental health and anxiety remained fairly stable and neurocognitive dysfunction exhibited initial decline and then remained stable by time since diagnosis. Conclusions The estimated prevalence of survivors of childhood cancer is increasing, as is the estimated prevalence of morbidity in those ≥5 years post-diagnosis. Impact Efforts to understand how to effectively decrease morbidity burden and incorporate effective care coordination and rehabilitation models to optimize longevity and well-being in this population should be a priority. PMID:25834148

  14. [Epidemiology, prevention and risk morbidity factors for lung cancer].

    Science.gov (United States)

    Radziszewska, Aneta; Karczmarek-Borowska, Bożenna; Grądalska-Lampart, Monika; Filip, Agata A

    2015-02-01

    Lung cancer incidence kept increasing dynamically in male population until the late 90s and then there was a sudden drop in the cases and this tendency has been maintained up till now. What seems upsetting, however, is the fact that for female population there is a constant growth in the lung cancer morbidity. Needless to say, Poland still belongs to the countries with high lung cancer incidence and lung cancer mortality. In 2011 the standardized morbidity rate in Poland accounted for 50,0/100 000 in male population and 17,3/100 000 in female population. In Podkarpacie Voivodeship it was 43,6/100 000 for males and 11,8/100 000 for females respectively. Lung cancer incidence and lung cancer mortality seem to increase together with age, and for people 65 and more this type of cancer accounts for approximately 50% of all cancer cases and cancer caused deaths. In spite of various research conducted and great medical progress little can be done to cure lung cancer. The percentage of 5-year survivals increased for males from 10,8% in years 2000-2002 to 11,9% in years 2003-2005, and for females from 15,7% to 16,9%. The main cause of lung cancer is certainly active and passive smoking. It is highly possible that environmental factors are also responsible for lung cancer cases. Among the most devastating are such factors as asbestos, arsenic, aromatic hydrocarbons, individual lifestyle and nutrition, genetic predisposition and finally the pollution, particularly of the air. © 2015 MEDPRESS.

  15. Morbidity of curative cancer surgery and suicide risk.

    Science.gov (United States)

    Jayakrishnan, Thejus T; Sekigami, Yurie; Rajeev, Rahul; Gamblin, T Clark; Turaga, Kiran K

    2017-11-01

    Curative cancer operations lead to debility and loss of autonomy in a population vulnerable to suicide death. The extent to which operative intervention impacts suicide risk is not well studied. To examine the effects of morbidity of curative cancer surgeries and prognosis of disease on the risk of suicide in patients with solid tumors. Retrospective cohort study using Surveillance, Epidemiology, and End Results data from 2004 to 2011; multilevel systematic review. General US population. Participants were 482 781 patients diagnosed with malignant neoplasm between 2004 and 2011 who underwent curative cancer surgeries. Death by suicide or self-inflicted injury. Among 482 781 patients that underwent curative cancer surgery, 231 committed suicide (16.58/100 000 person-years [95% confidence interval, CI, 14.54-18.82]). Factors significantly associated with suicide risk included male sex (incidence rate [IR], 27.62; 95% CI, 23.82-31.86) and age >65 years (IR, 22.54; 95% CI, 18.84-26.76). When stratified by 30-day overall postoperative morbidity, a significantly higher incidence of suicide was found for high-morbidity surgeries (IR, 33.30; 95% CI, 26.50-41.33) vs moderate morbidity (IR, 24.27; 95% CI, 18.92-30.69) and low morbidity (IR, 9.81; 95% CI, 7.90-12.04). Unit increase in morbidity was significantly associated with death by suicide (odds ratio, 1.01; 95% CI, 1.00-1.03; P = .02) and decreased suicide-specific survival (hazards ratio, 1.02; 95% CI, 1.00-1.03, P = .01) in prognosis-adjusted models. In this sample of cancer patients in the Surveillance, Epidemiology, and End Results database, patients that undergo high-morbidity surgeries appear most vulnerable to death by suicide. The identification of this high-risk cohort should motivate health care providers and particularly surgeons to adopt screening measures during the postoperative follow-up period for these patients. Copyright © 2016 John Wiley & Sons, Ltd.

  16. Colorectal cancer screening: Systematic review of screen-related morbidity and mortality.

    Science.gov (United States)

    Vermeer, N C A; Snijders, H S; Holman, F A; Liefers, G J; Bastiaannet, E; van de Velde, C J H; Peeters, K C M J

    2017-03-01

    Implementation of mass colorectal cancer screening, using faecal occult blood test or colonoscopy, is recommended by the European Union in order to increase cancer-specific survival by diagnosing disease in an earlier stage. Post-colonoscopy complications have been addressed by previous systematic reviews, but morbidity of colorectal cancer screening on multiple levels has never been evaluated before. To evaluate potential harm as a result of mass colorectal cancer screening in terms of complications after colonoscopy, morbidity and mortality following surgery, psychological distress and inappropriate use of the screening test. A systematic review of all literature on morbidity and mortality attributed to colorectal cancer screening, using faecal occult blood test or colonoscopy, from each databases' inception to August 2016 was performed. A meta-analysis was conducted to examine the pooled incidence of major complications of colonoscopy (major bleedings and perforations). Sixty studies were included. Five out of seven included prospective studies on psychological morbidity reported an association between participation in a colorectal screening program and psychological distress. Serious morbidity from colonoscopy in asymptomatic patients included major bleedings (0.8/1000 procedures, 95% CI 0.18-1.63) and perforations (0.07/1000 procedures, 95% CI 0.006-0.17). Participation in a colorectal cancer screening program is associated with psychological distress and can cause serious adverse events. Nevertheless, the short duration of psychological impact as well as the low colonoscopy complication rate seems reassuring. Because of limited literature on harms other than perforation and bleeding, future research on this topic is greatly needed to contribute to future screening recommendations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. [The morbidity of stomach cancer among the workers of key industries of the Kuznetsk Basin (Kuzbas)].

    Science.gov (United States)

    Mun, S A; Larin, S A; Glushkov, A N; Schastlivtsev, E L; Brailovskiĭ, V V; Chukhrov, Iu S; Baĭbulatov, R A

    2008-01-01

    The data research of the retrospective analysis of the morbidity of stomach cancer in the Kirov oblast (1990-2005) is presented. The dependence of morbidity rate from the volume production and processing of coal is established. The forecasting of morbidity rate of stomach cancer is estimated up to 2013 considering the factual indicators of volume of output in the key industries of Kuzbas.

  18. The impact of obesity on the 30-day morbidity and mortality after surgery for endometrial cancer.

    Science.gov (United States)

    Mahdi, Haider; Jernigan, Amelia M; Aljebori, Qataralnada; Lockhart, David; Moslemi-Kebria, Mehdi

    2015-01-01

    To examine the effect of body mass index (BMI) on postoperative 30-day morbidity and mortality after surgery to treat endometrial cancer. Retrospective cohort study (Canadian Task Force classification II-2). National Surgical Quality Improvement Program. Patients with endometrial cancer who underwent surgery from 2005 to 2011. Women were grouped according to weight, as follows: normal weight (BMI 18 to obese (BMI 30 to obese (BMI ≥ 40). Univariate and multivariable logistic regression models were analyzed. Of 3947 patients, 38% were of normal weight, 38% were obese, and 24% were morbidly obese. Of these, 48% underwent laparoscopy and 52% underwent laparotomy. Overall 30-day morbidity and mortality were 13% and 0.7%, respectively. Obesity and morbid obesity were associated with a higher American Society of Anesthesiologists class, diabetes, and hypertension. Preoperatively, elevated serum creatinine concentration, hypoalbuminemia, and leukocytosis were more common in morbidly obese women than those of normal weight. Laparoscopic surgery was performed less frequently in morbidly obese women than in those of normal weight (42.5% vs 50%; p = .001). Morbidly obese patients were more likely to develop postoperative complications (morbidly obese 16% vs normal weight 13% vs obese 11%; p = .001), in particular surgical (morbidly obese 14% vs normal weight 11% vs obese 9%; p obese 10% vs normal weight 5% vs obese 5%; p = .01). After laparotomy, morbidly obese women demonstrated a higher rate of any complication (normal weight 21%, obese 18%, morbidly obese 25%; p = .002), surgical complications (normal weight 18%, obese 14%, morbidly obese 22%; p = .002) and infectious complications (normal weight 6%, obese 10%, morbidly obese 16%; p obesity and morbid obesity did not independently predict 30-day morbidity or mortality. Morbidly obese patients with endometrial cancer have more preoperative morbidities and postoperative complications, in particular surgical and infectious

  19. Differences in self reported morbidity by educational level: a comparison of 11 western European countries

    NARCIS (Netherlands)

    Cavelaars, A. E.; Kunst, A. E.; Geurts, J. J.; Crialesi, R.; Grötvedt, L.; Helmert, U.; Lahelma, E.; Lundberg, O.; Matheson, J.; Mielck, A.; Mizrahi, A.; Rasmussen, N. K.; Regidor, E.; Spuhler, T.; Mackenbach, J. P.

    1998-01-01

    STUDY OBJECTIVE: To assess whether there are variations between 11 Western European countries with respect to the size of differences in self reported morbidity between people with high and low educational levels. DESIGN AND METHODS: National representative data on morbidity by educational level

  20. Loss, adaptation and new directions: The impact of arm morbidity on leisure activities following breast cancer.

    Science.gov (United States)

    Thomas, Roanne; Hack, Thomas F; Quinlan, Elizabeth; Tatemichi, Sue; Towers, Anna; Kwan, Winkle; Miedema, Baukje; Tilley, Andrea; Hamoline, Rita; Morrison, Tricia

    2015-01-01

    The impact of arm morbidity on leisure and quality of life is an understudied area in cancer survivorship. The purpose of this study was to qualitatively describe the impact of breast cancer-related arm morbidity on leisure participation in Canadian women. A grounded theory approach was used to generate thematic categories and a model. Drawing on participants from a larger cohort study (n = 740), 40 women with arm morbidity symptoms were purposively sampled and interviewed. Three themes emerged: a sense of loss, adapting participation, and new directions. Women with arm morbidity may experience an abrupt loss of previously enjoyed leisure activities and engage in a process of adapting to discover new meanings and directions. Comprehensive, person-centred cancer survivorship programs may assist with adaptation to arm morbidity.

  1. Prostate cancer in Denmark. Incidence, morbidity and mortality

    DEFF Research Database (Denmark)

    Brasso, K; Iversen, Peter

    1999-01-01

    Prostate cancer incidence and mortality rates in Denmark are reviewed for a 50-year period from 1943 to 1992. The prostate cancer incidence rate nearly tripled and prostate cancer mortality rate increased during this period. Until recently in Denmark the routine management of prostate cancer has...

  2. ATM Mutations and the Development of Severe Radiation-Induced Morbidity Following Radiotherapy for Breast Cancer

    National Research Council Canada - National Science Library

    Rosenstein, Barry

    2003-01-01

    ... of this project are to (1) screen 50 breast cancer patients for a ATM mutations who developed radiation-induced grade 3/4 late subcutaneous tissue morbidity as defined by the RTOG/EORTC scoring scheme, (2...

  3. Glycemic changes after gastrectomy in non-morbidly obese patients with gastric cancer and diabetes.

    Science.gov (United States)

    Shen, Zhiyong; Yu, Jiang; Lei, Shangtong; Mou, Tingyu; Hu, Yanfeng; Liu, Hao; Li, Guoxin

    2015-01-01

    To evaluate the glycemic changes after gastrectomy in non-morbidly obese patients with gastric cancer (GC) and type 2 diabetes mellitus (T2DM). Between December 2011 and June 2014, we included 46 patients with gastric cancer and T2DM of a body mass index (BMI) obese patients experienced an improvement of glycemic control. T2DM resolution happened 3 weeks after surgery. FPG decreased significantly after postoperative day 21 compared to preoperative FPG. 32 patients experienced DM improvement after postoperative day 21. The age and relatively lower preoperative TG patients, who underwent total gastrectomy (Pobese patients may also benefit from metabolic surgery for glycemic control, associated with age, extent of gastrectomy, reconstruction type, and preoperative triglyceride level.

  4. Laparoscopic Gastrectomy and Transvaginal Specimen Extraction in a Morbidly Obese Patient with Gastric Cancer.

    Science.gov (United States)

    Sumer, Fatih; Kayaalp, Cuneyt; Karagul, Servet

    2016-03-01

    Laparoscopic gastrectomy for cancer has some significant postoperative benefits over open surgery with similar oncologic outcomes. This procedure is more popular in the Far East countries where obesity is not a serious public health problem. In the Western countries, laparoscopic gastrectomy for cancer is not a common procedure, yet obesity is more common. Herein, we aimed to demonstrate the feasibility of laparoscopic gastrectomy for advanced gastric cancer in a morbidly obese patient. Additionally, we used natural orifice specimen extraction as an option to decrease wound-related complications, which are more prevalent in morbidly obese patients. In this case, we performed a fully laparoscopic subtotal gastrectomy with lymph node dissection and Roux-en-Y gastrojejunostomy with the specimen extracted through the vagina. To the best of our knowledge, this was the first report of a natural orifice surgery in a morbidly obese patient with gastric cancer.

  5. Late urinary morbidity and quality of life after radical prostatectomy and salvage radiotherapy for prostate cancer

    DEFF Research Database (Denmark)

    Ervandian, Maria; Hoyer, Morten; Petersen, Stine Elleberg

    2017-01-01

    OBJECTIVE: There is a paucity of knowledge of long-term urinary morbidity in patients treated for prostate cancer (PCa) with radical prostatectomy (RP) and salvage radiotherapy (SRT). Improved long-term survival calls for heightened awareness of late effects from radiotherapy after RP. The purpose...... of this study was to assess late urinary morbidity and its potential impact on quality of life (QoL) in patients treated with RP plus SRT compared with patients treated with RP alone. MATERIALS AND METHODS: Long-term morbidity and QoL were evaluated using a cross-sectional design with validated questionnaires...... in urinary morbidity [Danish Prostatic Symptom Score (DAN-PSS)] and QoL [European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)]. Included were a total of 227 patients treated with SRT and 192 treated with RP in the periods 2006-2010 and 2005...

  6. The economic impact of surgical care for morbidly obese endometrial cancer patients: a nationwide study.

    Science.gov (United States)

    Brooks, Rebecca A; Blansit, Kevin; Young-Lin, Nichole; Usach, Irina; Chen, Lee May; Yu, Xinhua; Kapp, Daniel S; Chan, John K

    2016-04-01

    Obesity significantly impacts the cost of cancer treatment, yet the impact of morbid obesity on inpatient hospital charges related to endometrial cancer treatment is not well-defined. The purpose of this study was to determine the charges that are associated with inpatient surgery, hospitalization, and postoperative care of morbidly obese patients with endometrial cancer. Data were obtained from the National Inpatient Sample from 2010. Chi-square test, t-test, and linear regression were used for statistical analyses. Six thousand five hundred sixty patients who underwent hysterectomy for endometrial cancer were identified. Mean age was 62 years (range, 22-99 years). The majority were white (78%), and the remainder were black (10%), Hispanic, (8%), Asian (3%), and Native American (1%). Insurance types were private (45%), Medicare (45%), Medicaid (5%), and uninsured (7%). One thousand eighty-eight of these patients (17%) were coded as morbidly obese. The mean postoperative stay for the morbidly obese was 4.0 days (range, 0-46 days) compared with 3.5 days (range, 0-81 days) for the non-morbidly obese patients (P obese patients required more intensive care with mechanical ventilation (5.5% vs 1.6%; P obese patients compared with their counterparts ($46,654 vs $41,164; P obese patient was $5096 per patient (95% confidence interval, $2593-$7598; P endometrial cancer treatment in the morbidly obese patient was significantly higher compared the non-morbidly obese patient. Resources are needed to support the needs of this population, and programs to encourage weight loss and optimize general health should be encouraged. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. The IRS1 rs2943641 variant and risk of future cancer among morbidly obese individuals.

    Science.gov (United States)

    Maglio, Cristina; Ericson, Ulrika; Burza, Maria Antonella; Mancina, Rosellina Margherita; Pirazzi, Carlo; Assarsson, Johanna Andersson; Sjöholm, Kajsa; Baroni, Marco Giorgio; Svensson, Per-Arne; Montalcini, Tiziana; Pujia, Arturo; Sjöström, Lars; Wiklund, Olov; Carlsson, Lena M S; Borén, Jan; Orho-Melander, Marju; Romeo, Stefano

    2013-04-01

    Obesity and insulin resistance are risk factors for cancer development. The IRS1 rs2943641 genetic variant has been widely associated with insulin resistance. The aim of the study was to examine whether the IRS1 rs2943641 associates with cancer incidence in obese individuals. The IRS1 rs2943641 was genotyped in participants from the Swedish Obese Subjects (SOS) study, an intervention trial on the effect of bariatric surgery on mortality and morbidity compared with usual care and in the population-based Malmö Diet and Cancer (MDC) cohort. In both studies, the median follow-up for cancer incidence was about 15 years. Cancer incidence was assessed in both the SOS and the MDC cohorts through national and local registers. The IRS1 T allele was associated with lower insulin resistance in both the SOS and the MDC studies. A lower cancer incidence was found in T allele carriers from the SOS control group (hazard ratio [HR] 0.77, 95% confidence interval [CI] 0.62-0.96; P = .021) and was restricted to morbidly obese individuals (HR 0.67, 95% CI 0.50-0.91; P = .011). No evidence of such association was detected in the surgery group (interaction P = .005). In the MDC cohort, a nonsignificant tendency for lower cancer incidence in T allele carriers was observed only in morbidly obese individuals. A meta-analysis of morbidly obese individuals (body mass index > 40 kg/m(2)) from the two cohorts strengthened the evidence for the association (HR 0.66, 95% CI 0.50-0.87; P = .004). Our results suggest that the T allele of rs2943641 near IRS1 may associate with lower cancer incidence in morbidly obese individuals.

  8. Pre-morbid predictors of psychological adjustment to cancer

    NARCIS (Netherlands)

    Ranchor, AV; Sanderman, R; Steptoe, A; Wardle, J; Miedema, [No Value; Ormel, J; Miedema, I.

    This study examined the potential role of social support, neuroticism, and self-efficacy as predictors of the short-term and long-term adaptation to the diagnosis of cancer. Psychological adjustment was defined in terms of psychological distress. It is argued that these factors may provide insights

  9. The Association between Hospital-level Obstetric Quality Indicators and Maternal and Neonatal Morbidity

    Science.gov (United States)

    Howell, Elizabeth A.; Zeitlin, Jennifer; Hebert, Paul L.; Balbierz, Amy; Egorova, Natalia

    2015-01-01

    Importance In an effort to improve the quality of care, several obstetric-specific quality measures are now monitored and publically reported. The extent to which these measures are associated with maternal and neonatal morbidity is not known. Objective To examine whether 2 Joint Commission obstetric quality indicators are associated with maternal and neonatal morbidity. Design, Setting, and Participants Population-based observational study using linked 2010 New York City discharge and birth certificate datasets. All delivery hospitalizations were identified and two perinatal quality measures were calculated. Published algorithms were used to identify severe maternal morbidity (delivery associated with a life threatening complication or performance of a life-saving procedure) and morbidity in non-anomalous term newborns (births associated with complications such as birth trauma, hypoxia, and prolonged length of stay). Mixed-effects logistic regression models were used to examine the association between maternal morbidity, neonatal morbidity, and hospital-level quality measures while risk-adjusting for patient sociodemographic and clinical characteristics. Exposure Two Joint Commission perinatal quality measures: 1) elective (non-medically indicated) deliveries at >= 37 and morbidity. Results Severe maternal morbidity occurred among 2.4% of 115,742 deliveries and neonatal morbidity occurred among 7.8% of 103,416 non-anomalous term newborns. Rates for elective deliveries performed before 39 weeks of gestation ranged from: 15.5 to 41.9 per 100 deliveries among 41 hospitals. There were 11.7 to 39.3 cesareans per 100 deliveries performed in low-risk mothers. Overall maternal morbidity ranged from 0.9 to 5.7 mothers with complications per 100 deliveries and 3.1 to 21.3 neonates with complications per 100 deliveries. The maternal quality indicators elective delivery before 39 weeks of gestation and cesarean delivery performed in low-risk mothers were not associated with

  10. Are we able to reduce the mortality and morbidity of oral cancer; Some considerations

    Science.gov (United States)

    2013-01-01

    Oral cancer makes up 1%-2% of all cancers that may arise in the body. The majority of oral cancers consists of squamous cell carcinomas. Oral cancer carries a considerable mortality rate, being mainly dependent on the stage of the disease at admission. Worldwide some 50% of the patients with oral cancer present with advanced disease. There are several ways of trying to diagnose oral cancer in a lower tumor stage, being 1) mass screening or screening in selected patients, 2) reduction of patients’ delay, and 3) reduction of doctors’ delay. Oral cancer population-based screening (“mass screening”) programs do not meet the guidelines for a successful outcome. There may be some benefit when focusing on high-risk groups, such as heavy smokers and heavy drinkers. Reported reasons for patients’ delay range from fear of a diagnosis of cancer, limited accessibility of primary health care, to unawareness of the possibility of malignant oral diseases. Apparently, information campaigns in news programs and TV have little effect on patients’ delay. Mouth self-examination may have some value in reducing patients’ delay. Doctors’ delay includes dentists’ delay and diagnostic delay caused by other medical and dental health care professionals. Doctors’ delay may vary from almost zero days up to more than six months. Usually, morbidity of cancer treatment is measured by quality of life (QoL) questionnaires. In the past decades this topic has drawn a lot of attention worldwide. It is a challenge to decrease the morbidity that is associated with the various treatment modalities that are used in oral cancer without substantially compromising the survival rate. Smoking cessation contributes to reducing the risk of oral cancers, with a 50% reduction in risk within five years. Indeed, risk factor reduction seems to be the most effective tool in an attempt to decrease the morbidity and mortality of oral cancer. Key words:Oral cancer, early diagnosis, quality of life

  11. Are we able to reduce the mortality and morbidity of oral cancer; some considerations.

    Science.gov (United States)

    van der Waal, Isaäc

    2013-01-01

    Oral cancer makes up 1%-2% of all cancers that may arise in the body. The majority of oral cancers consists of squamous cell carcinomas. Oral cancer carries a considerable mortality rate, being mainly dependent on the stage of the disease at admission. Worldwide some 50% of the patients with oral cancer present with advanced disease. There are several ways of trying to diagnose oral cancer in a lower tumor stage, being 1) mass screening or screening in selected patients, 2) reduction of patients' delay, and 3) reduction of doctors' delay. Oral cancer population-based screening ("mass screening") programs do not meet the guidelines for a successful outcome. There may be some benefit when focusing on high-risk groups, such as heavy smokers and heavy drinkers. Reported reasons for patients' delay range from fear of a diagnosis of cancer, limited accessibility of primary health care, to unawareness of the possibility of malignant oral diseases. Apparently, information campaigns in news programs and TV have little effect on patients' delay. Mouth self-examination may have some value in reducing patients'delay. Doctors' delay includes dentists' delay and diagnostic delay caused by other medical and dental health care professionals. Doctors' delay may vary from almost zero days up to more than six months. Usually, morbidity of cancer treatment is measured by quality of life (QoL) questionnaires. In the past decades this topic has drawn a lot of attention worldwide. It is a challenge to decrease the morbidity that is associated with the various treatment modalities that are used in oral cancer without substantially compromising the survival rate. Smoking cessation contributes to reducing the risk of oral cancers, with a 50% reduction in risk within five years. Indeed, risk factor reduction seems to be the most effective tool in an attempt to decrease the morbidity and mortality of oral cancer.

  12. Emerging Therapies to Prevent Skeletal Morbidity in Men With Prostate Cancer

    OpenAIRE

    Saylor, Philip J.; Lee, Richard J.; Smith, Matthew R.

    2011-01-01

    Skeletal morbidity is a prominent burden to men with advanced prostate cancer throughout the natural history of the disease. Bone metastases can cause pain and greatly elevate the risk for fractures and other structural complications. Distinct from the problem of metastases, treatment-related osteoporosis and associated fragility fractures are potential complications of androgen-deprivation therapy. Bone-targeted therapies for prostate cancer have therefore been the focus of considerable rese...

  13. Differences in self reported morbidity by educational level: a comparison of 11 western European countries

    NARCIS (Netherlands)

    A.E.J.M. Cavelaars (Adrienne); O. Lundberg; J. Matheson; N.K. Rasmussen; A. Mielck; A. Mizrahi; J.P. Mackenbach (Johan); A.E. Kunst (Anton); J.J.M. Geurts (José); R. Crialesi; T. Spuhler; L. Grotvedt; U. Helmert (Uwe); E. Lahelma; E. Regidor (Enrique)

    1998-01-01

    textabstractSTUDY OBJECTIVE: To assess whether there are variations between 11 Western European countries with respect to the size of differences in self reported morbidity between people with high and low educational levels. DESIGN AND METHODS: National representative data on

  14. Morbidity and quality of life and the moderating effects of level of education in the elderly

    NARCIS (Netherlands)

    Kempen, GIJM; Brilman, EI; Ranchor, AV; Ormel, J

    The moderating effect of level of education (as an indicator of socioeconomic status) on the associations between chronic medical morbidity and six domains of health-related quality of life (physical function, role function, social function, health perceptions, bodily pain and mental health:) is

  15. Efficacy and morbidity of transrectal ultrasound-guided 12-core biopsy for detection of prostate cancer in Japanese men.

    Science.gov (United States)

    Matsumoto, Kazumasa; Satoh, Takefumi; Egawa, Shin; Shimura, Satoru; Kuwao, Sadahito; Baba, Shiro

    2005-04-01

    The objectives of the present study were to determine whether an extensive biopsy scheme contributes to enhanced detection of prostate cancer in Japanese men and to assess the associated pain and morbidity. A total of 147 patients were included in this analysis, with 12 biopsy cores being obtained from each patient. Standard systematic sextant biopsy at the apex, mid-prostate and base of the prostate gland was carried out under local anesthesia and this was followed by the acquisition of additional sextant cores at the same levels from the far lateral peripheral zone. Each patient answered a self-administered questionnaire on pain and morbidity during the 5 days following biopsy. Overall, 39 patients (26.5%) received a diagnosis of prostate cancer. Nine patients (23.1%) were positive only at the standard sextant sites, three patients (7.7%) were positive exclusively at the far lateral sites and the remaining 27 patients (69.2%) were positive at both sites. Cancer was found most frequently in cores obtained from the apex (P = 0.009), with this trend being more evident in patients with abnormal rectal findings, positive sonographic findings, gland volume 0.15 ng/mL/cm(3) (P first 5 days after biopsy (P < 0.0001). Using this 12-core biopsy scheme, we found cancer most frequently in cores taken at the level of the apex. While the extensive procedure only marginally enhanced overall detection of prostate cancer, it was well tolerated with gradually decreasing pain and morbidity over a brief postbiopsy period. Further efforts to optimize biopsy schemes are warranted.

  16. Sexual morbidity associated with poorer psychological adjustment among gynecological cancer survivors.

    Science.gov (United States)

    Levin, Anna O; Carpenter, Kristen M; Fowler, Jeffrey M; Brothers, Brittany M; Andersen, Barbara L; Maxwell, G Larry

    2010-04-01

    Sexual morbidity is a distressing and undertreated problem in gynecological cancer survivorship known to occur early and persist well beyond the period of physical recovery. Although often studied as a separate domain, sexuality represents an integral component of psychological adjustment and quality of life (QoL) that is adversely affected by cancer treatments. The present study tests the association between sexual morbidity, and adverse psychological adjustment and QoL outcomes. A cross-sectional design was used. The participants were gynecological (cervical, endometrial, ovarian, and vulvar) cancer survivors who were partnered (N = 186), whose cancer was diagnosed 2 to 10 years previously, and who were at least 6 months post any cancer therapy. Most had been found to have early-stage disease (70%) and were treated with hysterectomy (77%), chemotherapy (43%), and/or radiotherapy (23%). Sexual morbidity was operationalized as a multidimensional construct including sexual behavior, sexual functioning, and subjective sexual satisfaction, assessed by patient self-report. Outcomes included self-reported depressive symptoms, traumatic stress symptoms, cancer-specific stress, stress about body changes, and QoL. Nurse-rated of performance status and disruptive signs/symptoms of treatment toxicity, as well as relevant sociodemographic and disease variables were collected as potential controls. Hierarchical multiple regression analyses tested sexual morbidity as a predictor of poor outcomes. All statistical models were significant, accounting for 12% to 53% of the variance in psychological adjustment/QoL. Sexual morbidity covaried with worsened depressive symptoms, body change stress, and psychological QoL beyond the negative contributions of (older) age, (poorer) performance status, and (greater) fatigue. Notably, disease and treatment variables were not statistically significant correlates of psychological adjustment or QoL. These findings suggest that prevention or

  17. Individual-level socioeconomic status is associated with worse asthma morbidity in patients with asthma

    Directory of Open Access Journals (Sweden)

    Bouchard Anne

    2009-12-01

    Full Text Available Abstract Background Low socioeconomic status (SES has been linked to higher morbidity in patients with chronic diseases, but may be particularly relevant to asthma, as asthmatics of lower SES may have higher exposures to indoor (e.g., cockroaches, tobacco smoke and outdoor (e.g., urban pollution allergens, thus increasing risk for exacerbations. Methods This study assessed associations between adult SES (measured according to educational level and asthma morbidity, including asthma control; asthma-related emergency health service use; asthma self-efficacy, and asthma-related quality of life, in a Canadian cohort of 781 adult asthmatics. All patients underwent a sociodemographic and medical history interview and pulmonary function testing on the day of their asthma clinic visit, and completed a battery of questionnaires (Asthma Control Questionnaire, Asthma Quality of Life Questionnaire, and Asthma Self-Efficacy Scale. General Linear Models assessed associations between SES and each morbidity measure. Results Lower SES was associated with worse asthma control (F = 11.63, p Conclusions Results suggest that lower SES (measured according to education level, is associated with several indices of worse asthma morbidity, particularly worse asthma control, in adult asthmatics independent of disease severity. Results are consistent with previous studies linking lower SES to worse asthma in children, and add asthma to the list of chronic diseases affected by individual-level SES.

  18. Postoperative morbidity after fast-track laparoscopic resection of rectal cancer

    DEFF Research Database (Denmark)

    Stottmeier, S; Harling, H; Wille-Jørgensen, Peer Anders

    2012-01-01

    cancer surgery were analysed prospectively from the Danish Colorectal Cancer Database supplemented by data from the medical records. We studied in detail the nature and chronological order of postoperative morbidity and reason for prolonged stay (>5 days). Results: Twenty-five patients (25 per cent) had......Aim: Analysis was carried out of the nature and chronological order of early complications after fast-track laparoscopic rectal surgery with a view to optimize the short-time outcome of rectal cancer surgery. Method: 102 consecutive patients who underwent elective fast-track laparoscopic rectal...

  19. Impact of 2-, 4- and 9-valent HPV vaccines on morbidity and mortality from cervical cancer.

    Science.gov (United States)

    Luckett, Rebecca; Feldman, Sarah

    2016-06-02

    Cervical cancer causes significant morbidity and mortality worldwide. Most cervical cancers are associated with oncogenic human papillomavirus (HPV), and vaccination with any of 3 available HPV vaccines is anticipated to greatly reduce the burden of cervical cancer. This review provides an overview of the burden of HPV, the efficacy and clinical effectiveness of the bivalent (HPV 16, 18), quadrivalent (HPV 6, 11, 16, 18) and 9vHPV (HPV 6, 11, 16, 1831, 33, 45, 52, 58) vaccines in order to assess the anticipated impact on cervical cancer. All three vaccines show high efficacy in prevention of vaccine-specific HPV-type infection and associated high-grade cervical dysplasia in HPV-naïve women. Early clinical effectiveness data for the bivalent and quadrivalent vaccine demonstrate reduced rates of HPV 16 and 18 prevalence in vaccinated cohorts; data evaluating cervical dysplasia and cervical procedures as outcomes will shed further light on the clinical effectiveness of both vaccines. The bivalent vaccine has demonstrated cross-protection to non-vaccine HPV types, including the types in the 9vHPV vaccine. No clinical effectiveness data is yet available for the 9vHPV vaccine.  While HPV vaccination has great promise to reduce cervical cancer morbidity and mortality, estimated benefits are largely theoretical at present. Large population-based clinical effectiveness studies will provide long-term immunogenicity and effectiveness, as well as assessment of cervical cancer as an endpoint, particularly as young vaccinated women enter the appropriate age range to initiate screening for cervical cancer. Strengthening screening and treatment programs will likely have the greatest impact in the short-term on cervical cancer morbidity and mortality.

  20. Co-morbid medical conditions and medical complications of prostate cancer in Southern Nigeria.

    Science.gov (United States)

    Sapira, Monday Komene; Onwuchekwa, Arthur Chukwubike; Onwuchekwa, Chinwe Regina

    2012-08-01

    Prostate cancer often co-exists with other diseases. It accounts for 11% of all cancers in Nigerian men, and it is the commonest cause of mortality due to cancer in elderly males in Nigeria. To present co-morbid medical conditions and medical complications of prostate cancer in patients with the disease in Southern Nigeria. The study was carried out prospectively (2002 to 2003) at University of Port Harcourt Teaching Hospital (UPTH), and Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi- both in Southern Nigeria. Using common proforma, patients who presented to the urology units of the two teaching hospitals were evaluated clinically and with relevant investigations for prostate cancer and other diseases. Those with histologically confirmed prostate cancer were included in this study. Data was also collected retrospectively by using the same proforma to obtain information from case files of 37 patients diagnosed with prostate cancer at UPTH. Data from the two institutions were collated and analysed. Of 189 cases analysed, 73.4% had significant medical co-morbid diseases/complications. These included anaemia (69.8%), urinary tract infection (56.1%), chronic renal failure (33.9%), hypertension (41.8%), diabetes mellitus (9.5%), paraplegia (9.5%), congestive cardiac failure (9.0%) and cerebrovascular disease (5.3%). These patients had high disease burden. Improved health education and well coordinated interdisciplinary team work are suggested in managing this malignancy.

  1. Hospital recorded morbidity and breast cancer incidence: a nationwide population-based case-control study.

    Directory of Open Access Journals (Sweden)

    Anne Gulbech Ording

    Full Text Available INTRODUCTION: Chronic diseases and their complications may increase breast cancer risk through known or still unknown mechanisms, or by shared causes. The association between morbidities and breast cancer risk has not been studied in depth. METHODS: Data on all Danish women aged 45 to 85 years, diagnosed with breast cancer between 1994 and 2008 and data on preceding morbidities were retrieved from nationwide medical registries. Odds ratios (OR and 95% confidence intervals (CI were estimated using conditional logistic regression associating the Charlson comorbidity score (measured using both the original and an updated Charlson Comorbidity Index (CCI with incident breast cancer. Furthermore, we estimated associations between 202 morbidity categories and incident breast cancer, adjusting for multiple comparisons using empirical Bayes (EB methods. RESULTS: The study included 46,324 cases and 463,240 population controls. Increasing CCI score, up to a score of six, was associated with slightly increased breast cancer risk. Among the Charlson diseases, preceding moderate to severe renal disease (OR = 1.25, 95% CI: 1.06, 1.48, any tumor (OR = 1.17, 95% CI: 1.10, 1.25, moderate to severe liver disease (OR = 1.86, 95% CI: 1.32, 2.62, and metastatic solid tumors (OR = 1.49, 95% CI: 1.17, 1.89, were most strongly associated with subsequent breast cancer. Preceding myocardial infarction (OR = 0.89, 95% CI: 0.81, 0.99, connective tissue disease (OR = 0.87, 95% CI: 0.80, 0.94, and ulcer disease (OR = 0.91, 95% CI: 0.83, 0.99 were most strongly inversely associated with subsequent breast cancer. A history of breast disorders was associated with breast cancer after EB adjustment. Anemias were inversely associated with breast cancer, but the association was near null after EB adjustment. CONCLUSIONS: There was no substantial association between morbidity measured with the CCI and breast cancer risk.

  2. Morbidity associated with breast cancer therapy and the place of physiotherapy in its management

    Directory of Open Access Journals (Sweden)

    Rodica Păcurar

    2011-06-01

    Full Text Available Incidence of breast cancer continues to grow while modern diagnosis and treatment techniques improve long-term survival rates of the patients. Hence, more women will experience morbidity associated to breast cancer treatment. The aim of this article is to provide a review of the morbidity associated with breast cancer treatment and to emphasize the role of physiotherapist within the rehabilitation team. Pain, pectoralis tightness and axillary web syndrome are the most frequently encountered surgical side effects. They contribute to upper arm dysfunction and reduced range of motion. Radiotherapy may lead to skin and pulmonary morbidity, lymphedema and dysfunction of the muscles caught in the radiation field. Chemotherapy and hormone therapy are associated with osteoporosis and weight gain, the latter representing an important risk factor to lymphedema. Secondary lymphedema is the most frequent complication of breast cancer treatment, mostly related to axillary surgery and radiotherapy. Physiotherapeutic techniques may prevent and control lymphedema, scar adherence and pulmonary complications, reduce pain and improve range of motion, which results in a better quality of life for the patients.

  3. Radical hysterectomy in obese and morbidly obese women with cervical cancer.

    Science.gov (United States)

    Frumovitz, Michael; Sun, Charlotte C; Jhingran, Anuja; Schmeler, Kathleen M; Dos Reis, Ricardo; Milam, Michael R; Soliman, Pamela T; Taylor, Kristal; Ramirez, Pedro T

    2008-10-01

    To compare intraoperative and postoperative outcomes, pathologic findings, cancer recurrence, and death rates in normal-weight, overweight, obese, and morbidly obese women undergoing radical hysterectomy and pelvic lymphadenectomy for early-stage cervical cancer. A review of patients who underwent radical hysterectomy and pelvic lymphadenectomy for invasive cervical cancer between 1990 and 2006 was performed. On the basis of body mass index (BMI) (calculated as weight [kg]/[height (m)](2)), women were categorized as normal weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9), obese (BMI 30.0-34.9), or morbidly obese (BMI at least 35.0). Four hundred eight women met the inclusion criteria. Of these, 155 (38%) were normal weight, 126 (31%) were overweight, 77 (19%) were obese, and 50 (12%) were morbidly obese. There were no statistically significant differences between these four groups in age, Charlson comorbidity score, smoking history, stage, histologic grade or subtype, tumor size, depth of invasion, transfusion rate, operative time, or intraoperative complications. Higher BMI was significantly correlated with higher estimated operative blood loss (P=.001). There were no statistically significant differences between the groups in pathologic findings, length of postoperative hospital stay, postoperative complications, readmission rate, or proportion of women receiving adjuvant radiotherapy. At a median follow-up time of 64 months, there were no differences between groups in rates of recurrence or death from disease. Radical hysterectomy and pelvic lymphadenectomy is feasible for obese and morbidly obese women with cervical cancer. Obesity alone should not be a contraindication to radical hysterectomy in women with cervical cancer.

  4. Non-cancer morbidity among Estonian Chernobyl cleanup workers: a register-based cohort study.

    Science.gov (United States)

    Rahu, Kaja; Bromet, Evelyn J; Hakulinen, Timo; Auvinen, Anssi; Uusküla, Anneli; Rahu, Mati

    2014-05-14

    To examine non-cancer morbidity in the Estonian Chernobyl cleanup workers cohort compared with the population sample with special attention to radiation-related diseases and mental health disorders. Register-based cohort study. Estonia. An exposed cohort of 3680 men (cleanup workers) and an unexposed cohort of 7631 men (population sample) were followed from 2004 to 2012 through the Population Registry and Health Insurance Fund database. Morbidity in the exposed cohort compared with the unexposed controls was estimated in terms of rate ratio (RR) with 95% CIs using Poisson regression models. Elevated morbidity in the exposed cohort was found for diseases of the nervous system, digestive system, musculoskeletal system, ischaemic heart disease and for external causes. The most salient excess risk was observed for thyroid diseases (RR=1.69; 95% CI 1.38 to 2.07), intentional self-harm (RR=1.47; 95% CI 1.04 to 2.09) and selected alcohol-related diagnoses (RR=1.25; 95% CI 1.12 to 1.39). No increase in morbidity for stress reactions, depression, headaches or sleep disorders was detected. No obvious excess morbidity consistent with biological effects of radiation was seen in the exposed cohort, with the possible exception of benign thyroid diseases. Increased alcohol-induced morbidity may reflect alcohol abuse, and could underlie some of the higher morbidity rates. Mental disorders in the exposed cohort were probably under-reported. The future challenge will be to study mental and physical comorbidities in the Chernobyl cleanup workers cohort. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Non-cancer morbidity among Estonian Chernobyl cleanup workers: a register-based cohort study

    Science.gov (United States)

    Rahu, Kaja; Bromet, Evelyn J; Hakulinen, Timo; Auvinen, Anssi; Uusküla, Anneli; Rahu, Mati

    2014-01-01

    Objective To examine non-cancer morbidity in the Estonian Chernobyl cleanup workers cohort compared with the population sample with special attention to radiation-related diseases and mental health disorders. Design Register-based cohort study. Setting Estonia. Participants An exposed cohort of 3680 men (cleanup workers) and an unexposed cohort of 7631 men (population sample) were followed from 2004 to 2012 through the Population Registry and Health Insurance Fund database. Methods Morbidity in the exposed cohort compared with the unexposed controls was estimated in terms of rate ratio (RR) with 95% CIs using Poisson regression models. Results Elevated morbidity in the exposed cohort was found for diseases of the nervous system, digestive system, musculoskeletal system, ischaemic heart disease and for external causes. The most salient excess risk was observed for thyroid diseases (RR=1.69; 95% CI 1.38 to 2.07), intentional self-harm (RR=1.47; 95% CI 1.04 to 2.09) and selected alcohol-related diagnoses (RR=1.25; 95% CI 1.12 to 1.39). No increase in morbidity for stress reactions, depression, headaches or sleep disorders was detected. Conclusions No obvious excess morbidity consistent with biological effects of radiation was seen in the exposed cohort, with the possible exception of benign thyroid diseases. Increased alcohol-induced morbidity may reflect alcohol abuse, and could underlie some of the higher morbidity rates. Mental disorders in the exposed cohort were probably under-reported. The future challenge will be to study mental and physical comorbidities in the Chernobyl cleanup workers cohort. PMID:24833681

  6. The effects of gastric surgery on systemic ghrelin levels in the morbidly obese.

    Science.gov (United States)

    Lin, Edward; Gletsu, Nana; Fugate, Kim; McClusky, David; Gu, Li H; Zhu, Juan-Li; Ramshaw, Bruce J; Papanicolaou, Dimitris A; Ziegler, Thomas R; Smith, C Daniel

    2004-07-01

    Circulating ghrelin, produced primarily in the stomach, is a powerful orexigen. Ghrelin levels are elevated in states of hunger, but rapidly decline postprandially. Early alterations in ghrelin levels in morbidly obese patients undergoing weight reduction surgery may be attributed to gastric partitioning. Thirty-four patients underwent Roux-en-Y gastric bypass with a completely divided gastroplasty to create a 15-mL vertically oriented gastric pouch. Eight other patients underwent other gastric procedures that did not involve complete division of the stomach, including 4 vertical banded gastroplasties and 4 antireflux surgical procedures. Six additional patients undergoing antireflux surgery served as lean control subjects. Plasma samples were obtained before surgery and immediately after surgery. In a substudy, plasma was collected after Roux-en-Y limb formation and after dividing the stomach to identify any changes in plasma ghrelin levels. Tertiary university medical center. Ghrelin levels at different stages of surgical intervention. Mean +/- SEM preoperative and postoperative ghrelin levels in the gastric bypass group were 355 +/- 20 and 246 +/- 13 pg/mL, respectively (Pgastroplasty group and in all patients undergoing antireflux surgery, ghrelin levels were not significantly changed. Compared with morbidly obese humans, lean controls had significantly higher plasma ghrelin levels at baseline. A divided gastroplasty creating a small proximal gastric pouch results in significant early declines in circulating ghrelin levels that are not observed with other gastric procedures. This may explain, in part, the loss of hunger sensation and rapid weight loss observed following gastric bypass surgery.

  7. Pathogenesis of morbidity after fast-track laparoscopic colonic cancer surgery

    DEFF Research Database (Denmark)

    Stottmeier, S; Harling, H; Wille-Jørgensen, P

    2011-01-01

    were analysed prospectively from the Danish Colorectal Cancer Database, supplemented by data from the medical records. We studied in detail the time course of morbidity and reasons for prolonged stay (> 3 days). RESULTS: Seventeen (16.3%) patients had one or more complications. Surgical complications......AIM: Analysis of the nature and time course of early complications after laparoscopic colonic surgery is required to allow rational strategies for their prevention and management. METHOD: One hundred and four consecutive patients who underwent elective fast-track laparoscopic colonic cancer surgery...

  8. Raised serum TSH levels in patients with morbid obesity: is it enough to diagnose subclinical hypothyroidism?

    Science.gov (United States)

    Rotondi, Mario; Leporati, Paola; La Manna, Antonella; Pirali, Barbara; Mondello, Teresa; Fonte, Rodolfo; Magri, Flavia; Chiovato, Luca

    2009-03-01

    Morbid obesity (body mass index (BMI)> or =40 kg/m(2)) is associated with thyroid function disturbances, with a high rate of subclinical hypothyroidism (SH) being the most consistently reported. We evaluated the circulating thyroid function parameters in morbid obese patients and related the results to the presence of circulating thyroid antibodies (Thyr-Ab). Morbid obese patients were consecutively enrolled (n=350). Two control groups were used: control group (CG)1, healthy normo-weight subjects (n=50); CG2, normo-weight patients with SH (n=56) matched for TSH with the obese patients with SH. Serum levels of free triiodothyronine (FT(3)), free thyroxine (FT(4)), TSH, antithyroglobulin antibodies, and antithyroperoxidase antibodies were measured in all patients. i) Compared with CG1, obese patients having thyroid function parameters in the normal range and negative Thyr-Ab showed significantly higher serum TSH and lower free thyroid hormones levels, but a similar FT(4)/FT(3) ratio; ii) SH was recorded in 13.7% obese patients; iii) compared with CG2, obese patients with untreated SH had a significantly lower rate of positive Thyr-Ab (32.1 vs 66.1%; Pobese patients with negative Thyr-Ab; and v) the comparison of the untreated SH patients (obese and normo-weight) with CG1 demonstrated that in SH obese subjects, unlike normo-weight SH patients, the FT(3) levels were significantly lower. This resulted in a normal FT(4)/FT(3) ratio in SH obese patients. Thyroid autoimmunity is not a major cause sustaining the high rate of SH in morbid obese patients. In these patients, the diagnosis of SH itself, as assessed by a raised TSH alone, appears questionable.

  9. Morbid obesity and subsequent pancreatic cancer: pylorus-preserving pancreatoduodenectomy after laparoscopic sleeve gastrectomy.

    Science.gov (United States)

    Küper, Markus A; Königsrainer, Ingmar; Schmidt, Diethard; Kramer, K Michael; Granderath, Frank A; Schneider, Joachim; Löb, Stefan; Zieker, Derek; Hartmann, Jörg T; Zdichavsky, Marty; Königsrainer, Alfred; Brücher, Björn L D M

    2009-03-01

    Morbid obesity is a recognized risk factor for gastrointestinal cancer. Little is known about pancreatic cancer developing after gastric bypass surgery or about surgery for this type of tumor following bariatric surgery. This report describes a case of pancreatic head cancer identified 3 months after laparoscopic sleeve gastrectomy for morbid obesity. During routine follow-up, mild abdominal pain and elevated pancreatic enzymes prompted computed tomography, which revealed mild edematous pancreatitis. Hyperbilirubinemia developed, and magnetic resonance imaging showed a pancreatic head tumor. CA19-9 was elevated. After a pylorus-preserving pancreatic head resection, the postoperative course was uneventful. The patient received adjuvant chemotherapy. Unfortunately, at the time of writing (9 months postoperatively), a local recurrence and hepatic metastases were diagnosed. Patients treated with bariatric surgery who develop new symptoms or report constant mild symptoms should be evaluated using endoscopy and radiomorphological imaging. Interdisciplinary obesity treatment can then offer significant benefits for the patient, particularly in the case of pancreatic cancer, which is still difficult to diagnose. In addition, there is a need for epidemiological studies of patients who undergo bariatric surgery and subsequently develop cancer.

  10. Dynamics of changes in the structure and morbidity level of technical college students

    Directory of Open Access Journals (Sweden)

    Elena Tserkovnaya

    2017-04-01

    Full Text Available Purpose: to conduct a comparative analysis of the dynamics and structure of morbidity technical college students. Material & Methods: analysis of scientific and methodical literature, the study of statistical reports of the city's 20th student polyclinic in Kharkov. Results: it found that students major morbidity factors for noncommunicable diseases are low locomotors activity in combination with a high traffic load, deterioration of socio-economic conditions, and the growth of chronic fatigue, which leads to a reduction of compensatory-adaptation reactions of the organism. It was revealed that the highest level of prevalence have diseases of the respiratory system, vision and diseases of the nervous system. Conclusion: these data suggest about the maximum growth rate of circulatory diseases, endocrine and urogenital systems, infectious and parasitic diseases in the last 10 years. This problem requires the development and implementation of various activities aimed at counteracting the risk factors of diseases among technical college students.

  11. Co-morbidity of depression, anxiety and fatigue in cancer patients receiving psychological care.

    Science.gov (United States)

    Zhu, Lei; Ranchor, Adelita V; van der Lee, Marije; Garssen, Bert; Almansa, Josué; Sanderman, Robbert; Schroevers, Maya J

    2017-04-01

    This study aimed to examine (1) subgroups of cancer patients with distinct co-morbidity patterns of depression, anxiety and fatigue; (2) how individuals transitioned between these patterns; and (3) whether socio-demographic, clinical and psychological care characteristics distinguished patients' transitions. This naturalistic, longitudinal study focused on 241 cancer patients receiving psycho-oncological care in the Netherlands. Data were collected before initiation of psychological care (T1), 3 months (T2), and 9 months thereafter (T3). Latent transition analysis was performed examining research questions. Three distinct co-morbidity patterns were identified: class 1 ('mood disturbances and fatigue'), class 2 ('mood disturbances') and class 3 ('few symptoms of mood disturbances and fatigue'). Half of those in class 1 remained in this group from T1 to T3, a quarter transitioned to class 2 and another quarter to class 3. Baseline physical symptoms distinguished these transitions: those with more physical symptoms tended to remain stable. Half of patients in class 2 remained stable from T1 to T3, 46% moved into class 3 and 8% into class 1. Baseline physical symptoms and years after cancer diagnosis significantly distinguished these transitions: the 8% moving to class 1 had more physical symptoms and were longer after cancer diagnosis. Most patients in class 3 remained stable from T1 to T3, and predictors of transitions could not be examined. Three distinct co-morbidity patterns of depression, anxiety and fatigue were identified and exhibited different symptom courses longitudinally. Those with poor physical health tended to report elevated mood disturbances and fatigue during psychological care. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  12. Factors affecting the postoperative morbidity and survival of patients with liver cirrhosis following colorectal cancer surgery.

    Science.gov (United States)

    Lee, Jun Ho; Yu, Chang Sik; Lee, Jong Lyul; Kim, Chan Wook; Yoon, Yong Sik; Park, In Ja; Lim, Seok-Byung; Kim, Jin Cheon

    2017-04-01

    Data are lacking on the appropriate risk stratification of patients undergoing surgery for colorectal cancer (CRC). This study aimed to evaluate the predictive factors for perioperative morbidity and oncological outcomes in CRC patients with liver cirrhosis (LC). A retrospective analysis of prospectively collected data was conducted. A total of 161 LC patients who underwent surgery for CRC were identified between January 2001 and December 2010. The mean patient age was 60 ± 10 years, and the median follow-up period was 54.0 months (range 0.5-170.0). The proportions of patients with Child-Pugh classifications for LC were as follows: A (n = 118; 73.3%), B (n = 39; 24.2%), and C (n = 4; 2.5%). The median model for end-stage liver disease (MELD) score was 8 (range 6-21). The postoperative morbidity rate was 37.3% (60/161). Hyperbilirubinemia (p = 0.002), prothrombin time (PT) prolongation (p = 0.020), and intraoperative transfusion (p = 0.003) were the significant factors for postoperative morbidity in multivariate analysis. The postoperative mortality rate was 3.1% (5/161), and the 5-year cancer-specific and 5-year overall survival rates were 86.1 and 59.9%, respectively. The significant clinical risk factors by multivariate analysis that influenced overall survival were the TNM stage of CRC (p = 0.035), MELD score (>8 points) (p morbidity in LC patients who undergo surgery for CRC. Additionally, not only advanced TNM stage but also a high MELD score and the coexistence of HCC are associated with poor overall survival in CRC patients with LC.

  13. Bladder cancer mapping in Libya based on standardized morbidity ratio and log-normal model

    Science.gov (United States)

    Alhdiri, Maryam Ahmed; Samat, Nor Azah; Mohamed, Zulkifley

    2017-05-01

    Disease mapping contains a set of statistical techniques that detail maps of rates based on estimated mortality, morbidity, and prevalence. A traditional approach to measure the relative risk of the disease is called Standardized Morbidity Ratio (SMR). It is the ratio of an observed and expected number of accounts in an area, which has the greatest uncertainty if the disease is rare or if geographical area is small. Therefore, Bayesian models or statistical smoothing based on Log-normal model are introduced which might solve SMR problem. This study estimates the relative risk for bladder cancer incidence in Libya from 2006 to 2007 based on the SMR and log-normal model, which were fitted to data using WinBUGS software. This study starts with a brief review of these models, starting with the SMR method and followed by the log-normal model, which is then applied to bladder cancer incidence in Libya. All results are compared using maps and tables. The study concludes that the log-normal model gives better relative risk estimates compared to the classical method. The log-normal model has can overcome the SMR problem when there is no observed bladder cancer in an area.

  14. Heat-related morbidity in brisbane, australia: spatial variation and area-level predictors.

    Science.gov (United States)

    Hondula, David M; Barnett, Adrian G

    2014-08-01

    Extreme heat is a leading weather-related cause of illness and death in many locations across the globe, including subtropical Australia. The possibility of increasingly frequent and severe heat waves warrants continued efforts to reduce this health burden, which could be accomplished by targeting intervention measures toward the most vulnerable communities. We sought to quantify spatial variability in heat-related morbidity in Brisbane, Australia, to highlight regions of the city with the greatest risk. We also aimed to find area-level social and environmental determinants of high risk within Brisbane. We used a series of hierarchical Bayesian models to examine city-wide and intracity associations between temperature and morbidity using a 2007-2011 time series of geographically referenced hospital admissions data. The models accounted for long-term time trends, seasonality, and day of week and holiday effects. On average, a 10°C increase in daily maximum temperature during the summer was associated with a 7.2% increase in hospital admissions (95% CI: 4.7, 9.8%) on the following day. Positive statistically significant relationships between admissions and temperature were found for 16 of the city's 158 areas; negative relationships were found for 5 areas. High-risk areas were associated with a lack of high income earners and higher population density. Geographically targeted public health strategies for extreme heat may be effective in Brisbane, because morbidity risk was found to be spatially variable. Emergency responders, health officials, and city planners could focus on short- and long-term intervention measures that reach communities in the city with lower incomes and higher population densities, including reduction of urban heat island effects.

  15. Factors Affecting Postoperative Morbidity and Mortality in Patients Who Received Neoadjuvant Therapy for Lung Cancer

    Directory of Open Access Journals (Sweden)

    Kemal Karapinar

    2016-01-01

    Full Text Available Aim: The aim of this study was to investigate the factors that affect mortality and morbidity (MM in patients with non-small lung cell cancer (NSCLC who received Neoadjuvant Therapy (NT for mediastinal lymph node invasion (MLNI before the surgery. Material and Method: Twentyfour NSCLC patients who received NT for MLNI before surgery were selected as the study group. Thirty patients who were operated without receving NT were constituted the control group. Major complications (MAC including pneumonia, empyema, chylothorax Minor complications (MIC including prolonged air leak, arrhythmia, anemia, hoarseness, and wound site infection were determined. Patients were evaluated retrospectively. Results: It was found that life threatening postoperative MAC increased significantly after NT (p=0.04, and MIC or factors causing them did%u2019nt affect the morbidity. NT had no effect on survival. Discussion: Surgery for NSCLC after NT for MLNI increases major morbidities. Careful preoperative assessment, experienced surgical team and appropriate intensive care conditions will reduce MM. Therefore the risk of MM should minimized with wider and prospective studies.

  16. Effects of malnutrition on treatment-related morbidity and survival of children with cancer in Nicaragua.

    Science.gov (United States)

    Pribnow, Allison K; Ortiz, Roberta; Báez, Luis Fulgencio; Mendieta, Luvy; Luna-Fineman, Sandra

    2017-11-01

    Most children with cancer live in resource-limited countries where malnutrition is often prevalent. We identified the relationship between malnutrition and treatment-related morbidity (TRM), abandonment of therapy, and survival of children with cancer in Nicaragua to better inform targeted nutritional interventions. We conducted a retrospective review of patients aged 6 months to 18 years with newly diagnosed acute lymphoblastic leukemia, acute myeloid leukemia (AML), Wilms tumor, Hodgkin lymphoma, or Burkitt lymphoma (BL) who were treated between January 1, 2004, and December 31, 2007 at Children's Hospital Manuel de Jesus Rivera in Managua, Nicaragua. Statistical analysis examined the relations among nutritional status and cancer type, risk category, TRM, and event-free survival (EFS). Sixty-seven percent of patients (189/282) were malnourished at diagnosis. Malnutrition was highest among patients with Wilms tumor (85.7%), BL (75%), and AML (74.3%). A total of 92.2% of patients (225/244) experienced morbidity during the first 90 days. Malnutrition was associated with severe infection (P = 0.033). Severely malnourished patients had ≥grade 3 TRM on more days (P = 0.023) and were more likely to experience severe TRM on >50% of days (P = 0.032; OR, 3.27 [95% CI, 1.05-10.16]). Malnourished patients had inferior median EFS (2.25 vs. 5.58 years; P = 0.049), and abandoned therapy more frequently (P = 0.015). In Nicaragua, pediatric oncology patients with malnutrition at diagnosis experienced increased TRM, abandoned therapy more frequently, and had inferior EFS. Standardized nutritional evaluation of patients with newly diagnosed cancer and targeted provision of nutritional support are essential to decrease TRM and improve outcomes. © 2017 Wiley Periodicals, Inc.

  17. New adipokines vaspin and omentin. Circulating levels and gene expression in adipose tissue from morbidly obese women

    Directory of Open Access Journals (Sweden)

    Aguilar Carmen

    2011-04-01

    Full Text Available Abstract Background Vaspin and omentin are recently described molecules that belong to the adipokine family and seem to be related to metabolic risk factors. The objectives of this study were twofold: to evaluate vaspin and omentin circulating levels and mRNA expression in subcutaneous and visceral adipose tissues in non-diabetic morbidly obese women; and to assess the relationship of vaspin and omentin with anthropometric and metabolic parameters, and other adipo/cytokines. Design We analysed vaspin and omentin circulating levels in 71 women of European descent (40 morbidly obese [BMI ≥ 40 kg/m2] and 31 lean [BMI ≤ 25]. We assessed vaspin and omentin gene expression in paired samples of visceral and subcutaneous abdominal adipose tissue from 46 women: 40 morbidly obese and 6 lean. We determined serum vaspin and plasma omentin levels with an Enzyme-Linked Immunosorbent Assay and adipose tissue mRNA expression by real time RT-PCR. Results Serum vaspin levels in the morbidly obese were not significantly different from those in controls. They correlated inversely with levels of lipocalin 2 and interleukin 6. Vaspin mRNA expression was significantly higher in the morbidly obese, in both subcutaneous and visceral adipose tissue. Plasma omentin levels were significantly lower in the morbidly obese and they correlated inversely with glucidic metabolism parameters. Omentin circulating levels, then, correlated inversely with the metabolic syndrome (MS. Omentin expression in visceral adipose tissue was significantly lower in morbidly obese women than in controls. Conclusions The present study indicates that vaspin may have a compensatory role in the underlying inflammation of obesity. Decreased omentin circulating levels have a close association with MS in morbidly obese women.

  18. The treatment outcomes and the use of adjuvant therapies in breast cancer patients with severe co-morbidities.

    Science.gov (United States)

    Han, Jaihong; Lee, Han-Byoel; Lee, Eun-Shin; Kang, Young Joon; Kim, Yumi; Choi, Jihye; Rhu, Jiyoung; Shin, Hee-Chul; Han, Wonshik; Noh, Dong-Young; Moon, Hyeong-Gon

    2017-01-01

    Studies have suggested a potential role of patient's co-morbidity in determining the survival outcomes of breast cancer. In this study, we examined the long-term oncologic outcomes in breast cancer patients who underwent curative surgery according to their pre-existing comorbid conditions and analyzed the association between the co-morbidity and the use of adjuvant therapies. The medical records of 2,501 patients who underwent surgery for primary breast cancer from June 2006 to June 2010 were reviewed retrospectively. The patients were classified into three groups according to preoperative ASA status determined by the anesthesiologists. Clinico-pathologic characteristics and survival outcomes of the patients were compared among the different co-morbidity groups. There were 1,792 (71.6%), 665 (26.6%), and 44 (1.8%) patients in ASA I, II, and III, respectively. Total 95 (3.8%) deaths and 269 (10.8%) recurrences (loco-regional and distant) occurred during the median follow-up period of 71 months. Patients with high comorbidity showed significantly higher rate of deaths (51 (2.8%), 38 (5.7%) and 6 (13.6%) deaths in ASA I, II and III group, respectively, pco-morbidity group received adjuvant therapies (77 (4.3%), 44 (6.6%) and 8 (18.2%) in ASA I, II, and III, respectively, pco-morbidity conditions. In this study, high comorbidity was related to increased risk of death and recurrence in breast cancer. The increased risk of recurrence in high co-morbidity group was mostly seen in patients who did not receive adjuvant therapies. Considering the relatively low rates of serious adverse effects in high co-morbidity patients who received adjuvant therapies, active use of adjuvant therapies in selected patients may improve survival outcomes in breast cancer patients with severe co-morbidities.

  19. Emerging therapies to prevent skeletal morbidity in men with prostate cancer.

    Science.gov (United States)

    Saylor, Philip J; Lee, Richard J; Smith, Matthew R

    2011-09-20

    Skeletal morbidity is a prominent burden to men with advanced prostate cancer throughout the natural history of the disease. Bone metastases can cause pain and greatly elevate the risk for fractures and other structural complications. Distinct from the problem of metastases, treatment-related osteoporosis and associated fragility fractures are potential complications of androgen-deprivation therapy. Bone-targeted therapies for prostate cancer have therefore been the focus of considerable research and drug development efforts. The osteoclast is a validated therapeutic target in the management of prostate cancer. Osteoclast inhibition with zoledronic acid (a bisphosphonate) or with denosumab (a monoclonal antibody to RANK ligand) reduces risk for skeletal events in men with castration-resistant prostate cancer metastatic to bone. Osteoclast inhibition with any of several bisphosphonates improves bone mineral density, a surrogate for osteoporotic fracture risk. Denosumab and toremifene (a selective estrogen receptor modulator) have each been shown to reduce osteoporotic fracture risk among men receiving androgen-deprivation therapy. Beta-emitting radiopharmaceuticals reduce pain due to metastatic disease. Investigations involving alpha-emitting radium-223, endothelin-A receptor antagonists atrasentan and zibotentan, proto-oncogene tyrosine-protein kinase (SRC) inhibitor dasatinib, and tyrosine kinase inhibitor cabozantinib (XL184) are ongoing in clinical trials and are also discussed.

  20. The morbidity and associated risk factors of cancer in chronic liver disease patients with diabetes mellitus: a multicenter field survey.

    Science.gov (United States)

    Kawaguchi, Takumi; Kohjima, Motoyuki; Ichikawa, Tatsuki; Seike, Masataka; Ide, Yasushi; Mizuta, Toshihiko; Honda, Koichi; Nakao, Kazuhiko; Nakamuta, Makoto; Sata, Michio

    2015-03-01

    Diabetes mellitus is associated with various cancers; however, little is known of the relationship between cancer and diabetes in chronic liver disease (CLD) patients. The aim of this study is to investigate the morbidity and associated factors of cancer, including the use of anti-diabetics, in CLD patients with diabetes. We performed a multicenter survey in 2012 and 478 CLD patients with diabetes were enrolled (age 64.3 ± 12.1 years, female/male 187/291). A frequency analysis of cancer and antidiabetic use was performed. Independent factors for cancer were analyzed using logistic regression and decision-tree analysis. The morbidity of cancer was 33.3%. Hepatocellular carcinoma (HCC) and extra-hepatic cancer were diagnosed in 24.7 and 11.3% of enrolled patients, respectively. The frequency of antidiabetic use was 66.5%. Of prescribed antidiabetics, 39% were dipeptidyl-peptidase 4 inhibitors; however, their use was not significantly associated with cancer. In contrast, the use of exogenous insulin (OR 2.21; 95% CI 1.16-4.21, P = 0.0165) and sulfonylurea (OR 2.08; 95% CI 1.05-3.97, P = 0.0353) were independently associated with HCC and extra-hepatic cancer, respectively. In decision-tree analysis, exogenous insulin and sulfonylurea were also identified as a divergence factor for HCC and extra-hepatic cancer, respectively. We found a high morbidity of not only HCC, but also extra-hepatic cancer in CLD patients with diabetes. We also showed a possible association between the use of antidiabetics and the morbidity of cancer. Thus, a large-scale cohort study is needed to establish a therapeutic strategy for diabetes to suppress carcinogenesis in CLD patients.

  1. Late-preterm birth in a level III hospital: incidence and associated morbidity

    Directory of Open Access Journals (Sweden)

    Carla Garcez

    2016-03-01

    Full Text Available Introduction: Late-preterm infants are physiologically and metabolically immature and have important risk of morbidity and mortality.Aim: To analyze the incidence of late prematurity and its associated morbidity and mortality at a level III hospital between 2011 and 2013.Methods: This was a descriptive and retrospective study of infants born between 34 + 0/7 and 36 + 6/7 weeks’ gestation and its associated morbidity and mortality. Medical records were reviewed.Results: In a 3-year period there were 8,458 births of witch 513 (6.1% were late-preterm infants. Of these, 99/513 (19.3% had 34 weeks’ gestation, 145/513 (28.3% had 35 weeks’ gestation and 269/513 (52.4% had 36 weeks’ gestation. Late-preterm birth rate was 5.7% in 2011, 6.9% in 2012 and 5.6% in 2013 (p = 0.08. In relation to birth weight, 269 (52.4% of late-preterm infants had low birth weight. There was an association between gestational age and birth weight (p = 0.002.Of the 513 late-preterm infants, 177 (34.5% were admitted to the Neonatal Intensive Care Unit (NICU and more often at 34 weeks’ gestation (69/99, 69.7% than at 35 (57/145, 39.3% and 36 (51/269, 19.0% weeks’ gestation (p < 0.001. Most frequent clinical diagnoses were hyperbilirubinemia (112/177, 63.3%, feeding difficulties (111/177, 62.7%, transient tachypnea of the newborn (71/177, 40.1%, hypoglycemia (38/177, 21.5%, intrauterine growth restriction (33/177, 18.6%. Average length of hospitalization was 12 days. Newborns of 34 weeks’ gestation were longer admitted than newborns of 35 and 36 weeks’ gestation (15.3 vs 9.8 vs 10.8 days; p = 0.002. There was one death due to sepsis after surgical correction of gastroschisis.Conclusion: The incidence of late-preterm birth remained stable between 2011 and 2013. Late-preterm hospitalization rate in the NICU was 34.5%. Hyperbilirubinemia, feeding difficulties and respiratory disease were the main diagnosis. Late-preterm of 34 weeks’ gestation were admitted more

  2. Cancer morbidity of residents living near an oil refinery plant in North-West Italy.

    Science.gov (United States)

    Salerno, Christian; Berchialla, Paola; Palin, Lucio Antonio; Vanhaecht, Kris; Panella, Massimiliano

    2013-01-01

    Cerano is a municipality of the Province of Novara (North-West Italy). To assess the morbidity associated to its proximity to a petrochemical plant, standardized incidence ratios (SIRs) of oncological pathologies in the period 2003-2009 were calculated based on age-sex specific rates for the district of the Local Health Authority of Novara (ASL13) and the main regional city of Turin. For all cancers combined, men showed a significant higher risk (SIR: 1.21; 95% CI: 1.02-1.40) compared to the ASL13 population; significantly lower risks for both men and women were observed in comparison to the Turin population. Among women, a significant excess of mesothelioma cancers was reported; a significantly higher risk for lympho-haematopoietic pathologies was also observed compared to the Turin population only. Several other cancers have significantly lower rates in Cerano for both men and women. Despite some studies' limitations, these findings could suggest potential chemical risk factors and need further investigation.

  3. Opportunities for reducing morbidity and mortality due to leading cancers in a developing country.

    Science.gov (United States)

    Duncan, J P; Weir, P; Strachan, S; Tulloch-Reid, M

    2015-12-01

    Malignancies are a leading cause of chronic non-communicable disease deaths in Jamaica. However, little or no data is available on integration of cancer screening guidelines in clinics. A cross-sectional survey of 88 consecutive patients with diabetes mellitus (DM) and/or hypertension (HTN) was conducted at major health centers in Jamaica between September and December 2011. Eighty percent respondents were women; 20% were men. The mean age was 57 years old. Forty persons (45.5%) had high cholesterol, 62 (71%) had DM and 62 (71%) had HTN. Of 66 women, 27% reported never having a pap smear and 66% had no pap smear within the last 12 months. 49% women over 40 years never had a mammogram and 74% did not have a mammogram in the last 12 months. Among men over 40 years old, at least 25% never had a prostate examination and 19% never had a prostate-specific antigen blood test. Most participants (>90%) received counseling about diet and exercise, but self-reported compliance with recommendations was low. Cancer screening among chronic disease patients is suboptimal in our population. Improved implementation of guidelines for cancer in chronic disease clinics have the potential to impact on morbidity and mortality. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. A morbidity/mortality analysis of a tertiary level upper gastrointestinal/hepatopancreaticobiliary surgical unit.

    Science.gov (United States)

    Wickremesekera, Susrutha K; Seo, Ho Beom Sean; Trimber, Mary Anne; Bann, Simon; Tse, Katherine

    2016-10-28

    Internationally, regionalisation of major upper gastrointestinal/hepatopancreaticobiliary (UGI/HPB) surgery to a selected number of expert hospital centres has demonstrated that high hospital volume is associated with lower mortality and morbidity. The Wellington UGI/HPB unit compared to international institutions is a low volume unit, however within New Zealand we perform a high number of Upper GI/HPB cases. The aim of this study was to evaluate the quality measures of morbidity and mortality of major upper gastrointestinal and hepatopancreatobiliary surgeries performed at the Wellington UGI/HPB unit. An analysis was conducted to evaluate the major UGI/HBP surgeries performed at Wellington over a six-year period. Patient demographics, and morbidity and mortality were stratified using the Clavien-Dindo classification of surgical complications. Three hundred and twenty-nine major elective cases were performed at the Wellington UGI/HPB unit over the six-year period. Sixty-five percent of patients experienced no morbidity, 19% of patients experienced mild morbidity, which had little effect on recovery, 14% of patients experienced major morbidity and 0.6% (two cases) progressed to mortality. When major UGI/HPB resections were specifically analysed, there were a total of 184 patients with 42 major morbidity (22.8%) and two mortalities (1.1%). Compared with international standards, the Wellington UGI/HPB unit is a low volume centre but has delivered an acceptable quality of care with a low major morbidity and mortality for this type of surgery.

  5. Is it possible to prevent morbidity on post cardiovascular surgery applying low level laser therapy?

    Science.gov (United States)

    Pinto, Nathali C.; Baptista, Ivany Machado d. C.; Pereira, Mara Helena C.; Serrão, Nelson F.; Pomerantzeff, Pablo M. A.; Chavantes, Maria Cristina

    2014-03-01

    Background and Objective: Complications following cardiovascular surgery incision are common in mediastinitis and wound dehiscence form, a 47% mortality rate remaining. Low Level Laser Therapy (LLLT) has been employed mainly to its effectiveness analgesic and anti-inflammatory actions, aiding the tissue repair process. The aim of this study was to evaluate infrared LLLT onto surgical incision in patients submitted to cardiovascular surgery. Materials and Methods: 40 patients were divided in two groups: Placebo Group (G1) - conventional therapy + "Laser pointer" and Laser Group (G2) - conventional therapy + Infrared Laser irradiation on surgical incision. Diode Laser was employed, C.W. mode, around the surgical wound bed, on immediate Post Operative (PO), 1st PO and 3rd PO with the following parameters: wavelength (λ): 830nm, P=35mW, E=0,75J. Results: G2 didn't present any complication and 5% of patients in G1 developed incision dehiscence and infection. On 7thPO, still a large amount of G1 patients showed pain and unquestionable inflammatory signs surrounding the surgical wound, when compared to G2. Besides, hospital stay in Laser Group was 2 times shorter than in Placebo Group (p-value=0.001). Conclusion: Infrared Laser denoted to be safe and exceptionally valuable tools in preventing morbidities on post cardiovascular surgeries.

  6. Analysis of postoperative morbidity and mortality following surgery for gastric cancer. Surgeon volume as the most significant prognostic factor

    Directory of Open Access Journals (Sweden)

    Maciej Ciesielski

    2017-09-01

    Full Text Available Introduction : Surgical resection is the only potentially curative modality for gastric cancer and it is associated with substantial morbidity and mortality. Aim: To determine risk factors for postoperative morbidity and mortality following major surgery for gastric cancer. Material and methods : Between 1.08.2006 and 30.11.2014 in the Department of Oncological Surgery of Gdynia Oncology Centre 162 patients underwent gastric resection for adenocarcinoma. All procedures were performed by 13 surgeons. Five of them performed at least two gastrectomies per year (n = 106. The remaining 56 resections were done by eight surgeons with annual volume lower than two. Perioperative mortality was defined as every in-hospital death and death within 30 days after surgery. Causes of perioperative deaths were the matter of in-depth analysis. Results: Overall morbidity was 23.5%, including 4.3% rate of proximal anastomosis leak. Mortality rate was 4.3%. Morbidity and mortality were not dependent on: age, gender, body mass index, tumour location, extent of surgery, splenectomy performance, or pTNM stage. The rates of morbidity (50% vs. 21.3% and mortality (16.7% vs. 3.3% were significantly higher in cases of tumour infiltration to adjacent organs (pT4b. Perioperative morbidity and mortality were 37.5% and 8.9% for surgeons performing less than two gastrectomies per year and 16% and 0.9% for surgeons performing more than two resections annually. The differences were statistically significant (p = 0.002, p = 0.003. Conclusions : Annual surgeon case load and adjacent organ infiltration (pT4b were significant risk factors for morbidity and mortality following major surgery for gastric cancer. The most common complications leading to perioperative death were cardiac failure and proximal anastomosis leak.

  7. C-reactive protein level in morbidly obese patients before and after bariatric surgery.

    Science.gov (United States)

    Rojano-Rodríguez, M E; Valenzuela-Salazar, C; Cárdenas-Lailson, L E; Romero Loera, L S; Torres-Olalde, M; Moreno-Portillo, M

    2014-01-01

    Human obesity is associated with a proinflammatory state and an elevated level of mediators, such as C-reactive protein (CRP). To establish CRP levels as baseline preoperative values and then at 6 months after bariatric surgery, as well as to determine the changes in weight, body mass index (BMI), leukocytes, and glycemia. An observational, analytical, retrospective, longitudinal, and open study was conducted. Serum CRP values were measured in 36 adults presenting with morbid obesity, and their baseline relation to weight, BMI, leukocytes, and glycemia was determined; the relation to the same parameters was established again, 6 months after bariatric surgery. The mean and standard deviation of preoperative and postoperative CRP (mg/L) was 1.15±0.86 and 0.34±0.28, respectively with p<0.0001; weight (kg) 112.10±22.91 and 84.82±17.11, p=0.0443; BMI (kg/m(2)) 42.48±5.97 and 32.2±4.79, p=0.0988; glucose (mg/dL) 100.58±17.82 and 87.11±8.49, p<0.0001, and leukocytes (× 10(3)/mm(3)) 8.62±1.69 and 6.99±1.56, p=0.3192. Baseline CRP only correlated with weight and BMI (p=0.047 and p=0.027 respectively) and there was no correlation between postoperative CRP and the evaluated parameters. Preoperative CRP had a significant lineal relation to weight and body mass index. Patients who underwent bariatric surgery had a significant decrease in CRP, weight, and fasting glucose at 6 months after surgery. Copyright © 2013 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  8. Mortality and cancer morbidity of production workers in the UK flexible polyurethane foam industry: updated findings, 1958–98

    OpenAIRE

    Sorahan, T.; Nichols, L

    2002-01-01

    Aims: To describe cause specific mortality and site specific cancer morbidity among workers employed in factories that produce polyurethane foams, and to determine if any part of the experience may be caused by occupation, in particular to investigate any association between respiratory disease (malignant and non-malignant) and exposure to diisocyanates.

  9. The impact of co-morbidity on health-related quality of life in breast cancer survivors and controls

    NARCIS (Netherlands)

    Schoormans, D.; Czene, K.; Hall, P.; Brandberg, Y.

    2015-01-01

    Background. The objective of this study was: 1) to compare health-related quality of life (HRQoL) scores of breast cancer survivors to matched controls; and 2) to examine the relative impact (explained variance) of the type and number of co-morbidities on HRQoL. Material and methods. Data from the

  10. Increased Circulating Levels of Alpha-Ketoglutarate in Morbidly Obese Women with Non-Alcoholic Fatty Liver Disease.

    Directory of Open Access Journals (Sweden)

    Gemma Aragonès

    Full Text Available Non-alcoholic fatty liver disease (NAFLD causes a wide spectrum of liver damage, ranging from simple steatosis to cirrhosis. However, simple steatosis (SS and steatohepatitis (NASH cannot yet be distinguished by clinical or laboratory features. The aim of this study was to assess the relationship between alpha-ketoglutarate and the degrees of NAFLD in morbidly obese patients.We used a gas chromatography-quadruple time-of-flight-mass spectrometry analysis to quantify alpha-ketoglutarate in serum from normal-weight subjects (n = 30 and morbidly obese women (n = 97 with or without NAFLD.We found that serum levels of alpha-ketoglutarate were significantly higher in morbidly obese women than in normal-weight women. We showed that circulating levels of alpha-ketoglutarate were lower in lean controls and morbidly obese patients without NAFLD. We also found that alpha-ketoglutarate serum levels were higher in both SS and NASH than in normal liver of morbidly obese patients. However, there was no difference between SS and NASH. Moreover, we observed that circulating levels of alpha-ketoglutarate were associated with glucose metabolism parameters, lipid profile, hepatic enzymes and steatosis degree. In addition, diagnostic performance of alpha-ketoglutarate has been analyzed in NAFLD patients. The AUROC curves from patients with liver steatosis exhibited an acceptable clinical utility. Finally, we showed that the combination of biomarkers (AST, ALT and alpha-ketoglutarate had the highest accuracy in diagnosing liver steatosis.These findings suggest that alpha-ketoglutarate can determine the presence of non-alcoholic fatty liver in morbidly obese patients but it is not valid a biomarker for NASH.

  11. Quality of life, urogynecological morbidity, and lymphedema after radical vaginal trachelectomy for early-stage cervical cancer

    DEFF Research Database (Denmark)

    Frøding, Ligita Paskeviciute; Ottosen, Christian; Mosgaard, Berit Jul

    2015-01-01

    OBJECTIVE: Radical vaginal trachelectomy (RVT) offers a possibility for future childbearing for young women with early-stage cervical cancer. However, the literature on quality of life and self-reported morbidity in patients undergoing RVT is scarce. The aim of this study was to prospectively...... assess quality of life after RVT with focus on urogynecological morbidity and lymphedema. Furthermore, the aim of this study was to compare results with those in women treated with radical abdominal hysterectomy (RAH) and with age-matched control women from the general population. METHODS AND MATERIALS...... severe lymphedema of the legs as assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Cervical Cancer Module. The Global Health Status scores of the RVT patients improved over time but were significantly lower than in the healthy controls during...

  12. Arm and shoulder morbidity in breast cancer patients after breast-conserving therapy versus mastectomy

    Energy Technology Data Exchange (ETDEWEB)

    Nesvold, Inger-Lise (Dept. of Cancer Rehabilitation-Physiotherapy, Rikshospitalet, Univ. of Oslo, Div. The Norwegian Radium Hospital, Montebello, Oslo (Norway)); Dahl, Alv A.; Fossaa, Sophie D. (Dept. of Clinical Cancer Research, Rikshospitalet, Univ. of Oslo: Division The Norwegian Radiumhospital, Montebello, Oslo (Norway)); Loekkevik, Erik (Dept. of Oncology, Rikshospitalet, Montebello, Oslo (Norway)); Marit Mengshoel, Anne (Inst. of Nursing and Health Sciences, Univ. of Oslo: Medical Faculty, Oslo (Norway))

    2008-06-15

    Introduction. The objective of this study was to compare the prevalence of late effects in the arm and shoulder in patients with breast cancer stage II who had radical modified mastectomy (RM) or breast-conserving therapy (BCT) followed by loco-regional adjuvant radiotherapy with or without chemotherapy/anti-oestrogen. Material and methods. All patients had axillary lymph node dissection. At a median of 47 months (range 32-87) post-surgery, 263 women (RM: n=186, BCT: n=77) were seen during an outpatient visit and had their arm and shoulder function and the presence of lymphedema assessed by a clinical examination, interview and self-rating. Volume calculation was used to measure lymphedema. Results. In the RM group 20% had developed arm lymphedema versus 8% in the BCT group (p=0.02). In multivariate analysis lymphedema was associated with a higher number of metastatic axillary lymph nodes [OR1.14, p=0.02], RM [OR 2.75, p=0.04] and increasing body mass index (BMI) [OR 1.11, p<0.01]. In the RM group 24% had a restricted range of motion in shoulder flexion compared to 7% in the BCT group (p<0.01). Shoulder pain was reported by 32% in the RM group and by 12% in the BCT group (p=0.001). Increasing observation time, RM, and increasing BMI were significantly associated with impaired arm/shoulder function. Discussion. Arm/shoulder problems including lymphedema were significantly more common after RM compared to BCT in irradiated breast cancer patients who have undergone axillary lymph node dissection. The performance of BCT should be encouraged when appropriate, to ensure a low prevalence of arm/shoulder morbidity including lymphedema

  13. Arm morbidity after breast cancer treatments and analysis of related factors

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Mi Son; Chung, Yong Sik; Kang, Seung Hee [College of Medicine, Ajou University, Seoul (Korea, Republic of); Moon, Seong Mi [Ajou University Hospital, Seoul (Korea, Republic of); Lee, Eun Hyun [Ajou University, Seoul (Korea, Republic of); Lee, Hye Jin; Song, Yeoung Suk [Yonsei University, Seoul (Korea, Republic of); Park, Hee Bung [Hee Bung Park Breast Clinic, Seoul (Korea, Republic of)

    2005-03-15

    To evaluate the incidence of arm morbidity following breast cancer surgery including axillary dissection and to identify related factors. One hundred and fifty nine patients were studied using a self-report questionnaire and a clinical examination. Lymphedema, reduction of range of motion in shoulder joint and subjective symptoms (pain, impaired arm movement, numbness, stiffness) were evaluated. As related factors, demographic, oncologic characteristics and types of treatment were analysed. The incidence of lymphedema ({>=} 2 cm difference comparing to unaffected arm) was 6.3%, 10.7%, 22.6% and 23.3% at each 10 cm, 20 cm, 30 cm, and 40 cm from wrist. Reduction of range of motion in shoulder joint ({>=} 20 degree difference comparing to unaffected arm) was noted in more than 1/3 patients for flexion, abduction and internal rotation. Especially the reduction of range of motion in internal rotation was severe (> 50% reduction) in 1/3 patients. Approximately 50 to 60% of patients complained impaired arm movement, numbness, stiffness and pain. Body mass index (BMI) was the significant risk factor for lymphedema. Lymphedema was present in 1/3 of patients and the common sites of edema were 30 cm 40 cm proximal from the wrist. Also most severe reduction of range of motion in shoulder joint was with internal rotation. There needs weight control for lymphedema because BMI was the significant risk factor for lymphedema. Also rehabilitation program for range of motion especially internal rotation in shoulder joint should be developed.

  14. Safety and morbidity of first and repeat transrectal ultrasound guided prostate needle biopsies: results of a prospective European prostate cancer detection study.

    Science.gov (United States)

    Djavan, B; Waldert, M; Zlotta, A; Dobronski, P; Seitz, C; Remzi, M; Borkowski, A; Schulman, C; Marberger, M

    2001-09-01

    We prospectively evaluate the safety, morbidity and complication rates for first and repeat transrectal ultrasound guided prostate needle biopsies. In this prospective European Prostate Cancer Detection Study 1,051 men, with total prostate specific antigen between 4 and 10 ng./ml., underwent transrectal ultrasound guided sextant biopsy plus 2 additional transition zone biopsies. Biopsy samples were also obtained from suspicious areas identified during transrectal ultrasound and digital rectal examination. All 820 patients with biopsy samples negative for prostate cancer underwent re-biopsy after 6 weeks. Immediate and delayed (range 1 to 7 days) morbidity, patient satisfaction and complication rates were recorded. Of the 1,051 subjects the initial biopsy was positive for prostate cancer in 231 and negative, including benign prostatic hyperplasia or benign tissue, in 820. Of these 820 patients prostate cancer was detected in 10% (83) on re-biopsy. Minor or no discomfort was observed in 92% and 89% of patients at first and re-biopsy, respectively (p = 0.29). Immediate morbidity was minor and included rectal bleeding (2.1% versus 2.4%, p = 0.13), mild hematuria (62% versus 57%, p = 0.06), severe hematuria (0.7% versus 0.5%, p = 0.09) and moderate to severe vasovagal episodes (2.8% versus 1.4%, respectively, p = 0.03). Delayed morbidity of first and re-biopsy was comprised of fever (2.9% versus 2.3%, p = 0.08), hematospermia (9.8% versus 10.2%, p = 0.1), recurrent mild hematuria (15.9% versus 16.6%, p = 0.06), persistent dysuria (7.2% versus 6.8%, p = 0.12) and urinary tract infection (10.9% versus 11.3%, respectively, p = 0.07). Major complications were rare and included urosepsis (0.1% versus 0%) and rectal bleeding that required intervention (0% versus 0.1%, respectively). Furthermore, an age dependent pattern of pain apprehension during biopsy was observed with the highest scores in patients younger than 60 years. Transrectal ultrasound guided biopsy is generally

  15. PSA testing anxiety, psychological morbidity, and PSA utility in the management of prostate cancer.

    OpenAIRE

    Micsunescu, Anamaria Elia

    2017-01-01

    Anecdotal reports from urologists and medical oncologists have suggested that patients with prostate cancer (PCa) often present with anxiety related to ongoing monitoring of their PSA levels as part of their disease management. The purpose of the current study, therefore, was to determine the prevalence and severity of prostate specific antigen (PSA) testing anxiety in a population of patients with either localised or metastatic PCa living in Australia. Other aspects of psychological morbidit...

  16. Morbidity in patients with clinically localized prostate cancer managed with non-curative intent. A population-based case-control study

    DEFF Research Database (Denmark)

    Brasso, K; Friis, S; Juel, K

    1999-01-01

    To compare the morbidity in patients with newly diagnosed clinically localized prostate cancer managed conservatively with the morbidity in a randomly selected age-matched background population with no history of prostate cancer. Patients younger than 75 y at diagnosis with newly diagnosed......-matched controls by approximately US$88 million, equivalent to an average extra cost per patient of approximately US$18,500. Patients with clinically localized prostate cancer managed conservatively had a significantly higher morbidity than age-matched controls due to admissions associated with prostate cancer...... clinically localized prostate cancer reported to the Danish Cancer Registry in the period 1977-1992. Morbidity in patients and age-matched controls was extracted from The Danish Hospital Discharge Registry. Admissions were stratified by discharge diagnosis. Overall 4744 patients were hospitalized for 251...

  17. MBL2 Genotypes and Their Associations with MBL Levels and NICU Morbidity in a Cohort of Greek Neonates

    Directory of Open Access Journals (Sweden)

    Matthaios Speletas

    2015-01-01

    Full Text Available The objective of this study was to assess the frequency of MBL2 genotypes and their associations with MBL levels and various morbidities of a neonatal intensive care unit (NICU. One hundred and thirty-four (134 NICU (83 term and 51 preterm and 150 healthy neonates were enrolled in the study. MBL2 genotype and MBL serum levels at birth were determined prospectively by PCR-RFLP-sequencing and enzyme-linked immunosorbent assay, respectively. NICU neonates displayed significantly lower MBL serum levels compared to healthy ones. MBL deficiency, defined as the low MBL2 expression group (XA/O and O/O, was significantly associated with an increased risk of respiratory morbidity, especially transient tachypnea of the newborn and respiratory distress syndrome (RDS. Moreover, an increase of 100 ng/mL of serum MBL levels decreases by 5% the risk of total respiratory morbidity and by 7% the risk of RDS, after correction for prematurity and sex and regardless of the presence of infections. Our study further supports the notion that neonates with MBL deficiency and low MBL serum levels at birth may be at higher risk of developing severe respiratory complications.

  18. Early morbidity after radiotherapy with or without chemotherapy in advanced head and neck cancer. Experience from four nonrandomized studies

    Energy Technology Data Exchange (ETDEWEB)

    Bieri, S. [Dept. of Radiation Oncology, Regional Hospital of Sion (Switzerland); Bentzen, S.M. [Gray Lab. Cancer Research Trust, Mount Vernon Hospital, Northwood (United Kingdom); Huguenin, P. [Dept. of Radiation Oncology, Univ. Hospital of Zurich (Switzerland); Allal, A.S. [Dept. of Radiation Oncology, Univ. Hospital of Geneva (Switzerland); Cozzi, L.; Bernier, J. [Dept. of Radiation Oncology, Inst. of Oncology of Southern Switzerland, Bellinzona (Switzerland); Landmann, C. [Dept. of Radiation Oncology, Univ. Hospital of Basel (Switzerland); Monney, M. [Dept. of Radiation Oncology, Univ. Hospital of Lausanne (Switzerland)

    2003-06-01

    Background: Data on early treatment-related morbidity after radiotherapy alone (RT; 217 patients) or combined with chemotherapy (RT + CT; 182 patients) of head and neck squamous cell carcinoma are analyzed. Patients and Methods: The patients were treated between November 1985 and November 1996 in four Swiss centers that independently introduced combined-modality therapy in selected cases of head and neck cancer. RT schedules varied among the four centers, but within each institution all patients received the same dose-fractionation schedule irrespective of whether they had CT or not. The following early morbidity items were evaluated: skin, mucosa, larynx, salivary glands, dysphagia, weight loss, and toxic death. Toxicity was scored using the EORTC/RTOG scale. Results: Although considerable variation was noted among the treatment schedules/centers, the main findings are as follows: (1) early morbidity was significantly enhanced after all five RT + CT schedules compared with RT alone; (2) typically, a third of the patients lost > 10% of their body weight during concurrent RT + CT as compared with 10% of the patients receiving RT alone; (3) at 12 weeks, the prevalence of grade 2 morbidity was 25-60% after RT + CT as compared with 4-20% after RT alone. Conclusion: A number of early morbidity items were found to be more prevalent and/or more severe after RT + CT than after RT alone. (orig.)

  19. Morbidity of rectosigmoid resection in patients undergoing cytoreductive surgery for epithelial ovarian cancer. Risk factors for complication

    OpenAIRE

    Fournier, Marie

    2015-01-01

    Background and aims: Complete cytoreduction is the goal of cytoreductive surgery in advanced epithelial ovarian cancer and rectosigmoid resection is a frequent component of this surgery. The aim of this study was to evaluate the morbidity of rectosigmoid resection at the time of cytoreductive surgery and identify risk factors for complications.Methods: We analysed individual data from all patients undergoing rectosigmoid resection as a part of complete cytoreduction between 2005 and 2013. Pre...

  20. Morbid obesity as an independent risk factor for disease-specific mortality in women with cervical cancer.

    Science.gov (United States)

    Frumovitz, Michael; Jhingran, Anuja; Soliman, Pamela T; Klopp, Ann H; Schmeler, Kathleen M; Eifel, Patricia J

    2014-12-01

    To assess whether obesity is an independent predictor of mortality in women with cervical cancer. This retrospective cohort study of patients with stages IB1-IVA cervical cancer treated with curative intent at MD Anderson Cancer Center from 1980 through 2007 categorized these women as underweight, normal weight, overweight, obese, or morbidly obese according to National Institutes of Health definitions. In addition to weight category, known prognostic factors for survival after a diagnosis of cervical cancer were included in a multivariate model. These known prognostic factors included age, smoking status, race or ethnicity (self-reported), socioeconomic status, comorbidities, tumor histologic subtype, tumor stage, tumor size, presence or absence of hydronephrosis, radiologic evidence of nodal metastasis, and the addition of concurrent chemotherapy with definitive radiation. A total of 3,086 patients met the inclusion criteria. The median survival for the entire cohort was 81 months (range 0-365 months). The presence of lymph node spread and advancing stage were the most significant predictors of survival. Compared with normal-weight women, morbidly obese women had a significantly higher hazard ratio for both all-cause death (hazard ratio 1.26, 95% confidence interval [CI] 1.10-1.45) and disease-specific death (hazard ratio 1.24, 95% CI 1.06-1.47). Underweight, overweight, and obese women did not have an increased risk for death compared with normal-weight women. After controlling for all previously known prognostic factors, morbid obesity remains an independent risk factor for death from cervical cancer. Overweight and obese women have the same prognosis as normal-weight women.

  1. MORBIDITY OF SENTINEL LYMPH NODE BIOPSY (SLNB ALONE VERSUS SLNB AND COMPLETION AXILLARY LYMPH NODE DISSECTION AFTER BREAST CANCER SURGERY- A PROSPECTIVE SINGLE CENTRE STUDY

    Directory of Open Access Journals (Sweden)

    Mythilidevi Sappa

    2017-11-01

    Full Text Available BACKGROUND ALND after breast cancer surgery is associated with considerable morbidity. We hypothesised- 1 The morbidity in patients undergoing SLN biopsy only is significantly lower compared with those after SLN and completion ALND level I and II; and 2 The intermediate survival rates, local and axillary recurrence rates were significantly equivalent in both the groups. MATERIALS AND METHODS Patients with early stage breast cancer (pT1 and pT2 ≤3 cm, cN0 were included between April 2010 and April 2016 in this prospective single centre study. All patients underwent SLN biopsy. In all patients with SLN macrometastases and most patients with SLN micrometastases (43 of 68 or isolated tumour cells (11 of 19, a completion ALND was performed. Postoperative morbidity was assessed based on a standardised protocol. RESULTS SLN biopsy alone was performed in 449 patients, whereas 210 patients underwent SLN and completion ALND. The median follow-ups were 31.0 and 29.5 months for the SLN and SLN and completion ALND groups, respectively. Intermediate-term follow-up information was available from 635 of 659 patients (96.4% of enrolled patients. The following results were found in the SLN versus SLN and completion ALND group- Presence of lymphoedema (3.5% vs. 19.1%, P <0.0001, impaired shoulder range of motion (3.5% vs. 11.3%, P <0.0001, shoulder/arm pain (8.1% vs. 21.1%, P <0.0001 and numbness (10.9% vs. 37.7%, P <0.0001. CONCLUSION The morbidity after SLN biopsy alone is not negligible, but significantly lower compared with ALND. The intermediate survival rates, local and axillary recurrence rates were equivalent in SLNB only and SLNB plus completion ALND groups.

  2. Combined effect of lung function level and decline increases morbidity and mortality risks

    DEFF Research Database (Denmark)

    Baughman, Penelope; Marott, Jacob Louis; Lange, Peter

    2012-01-01

    by combinations of baseline predicted FEV1 and quartiles of slope. Hazard ratios (HR) and 95 % con¿dence intervals (CI) were estimated using strati¿ed analysis by gender, smoking status, and baseline age (B45 and [45). For COPD morbidity, quartiles of increasing FEV1 decline increased HRs (95 % CI......) for individuals with FEV1 at or above the lower limit of normal (LLN) but below 100 % predicted, reaching 5.11 (2.58–10.13) for males, 11.63 (4.75–28.46) for females, and 3.09 (0.88–10.86) for never smokers in the quartile of steepest decline. Signi¿cant increasing trends were also observed for mortality...

  3. Effect of testing for cancer on cancer- and venous thromboembolism (VTE)-related mortality and morbidity in patients with unprovoked VTE.

    Science.gov (United States)

    Robertson, Lindsay; Yeoh, Su Ern; Stansby, Gerard; Agarwal, Roshan

    2015-03-06

    Venous thromboembolism (VTE) is a collective term for two conditions: deep vein thrombosis (DVT) and pulmonary embolism (PE). A proportion of patients with VTE have no underlying or immediately predisposing risk factors and the VTE is referred to as unprovoked. Unprovoked VTE can often be the first clinical manifestation of an underlying malignancy. This has raised the question of whether patients with an unprovoked VTE should be investigated for an underlying cancer. Treatment for VTE is different in cancer and non-cancer patients and a correct diagnosis would ensure that patients received the optimal treatment for VTE to prevent recurrence and further morbidity. Furthermore, an appropriate cancer diagnosis at an earlier, potentially curative stage could avoid the risk of cancer progression and thus lead to improvements in cancer-related mortality and morbidity. To determine whether testing for undiagnosed cancer in patients with a first episode of unprovoked VTE (DVT or PE) is effective in reducing cancer and VTE-related mortality and morbidity and to establish which tests for cancer are most useful. The Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last searched January 2015) and the Cochrane Register of Studies (CRS) (2014, Issue 12). Clinical trials databases were searched. The reference lists of relevant articles were also checked. Randomised and quasi-randomised trials in which patients with an unprovoked VTE were allocated to receive specific tests for cancer or clinically indicated tests only were eligible for inclusion in this review. Primary outcomes included all-cause mortality, cancer-related mortality and VTE-related mortality. Selection of the studies, quality assessment and data extraction were completed independently by two review authors. Any disagreements were resolved by discussion. Two studies with a combined total of 396 patients met the inclusion criteria for this review. Both

  4. Preoperative Nutritional Assessment by Controlling Nutritional Status (CONUT) is Useful to estimate Postoperative Morbidity After Esophagectomy for Esophageal Cancer.

    Science.gov (United States)

    Yoshida, Naoya; Baba, Yoshifumi; Shigaki, Hironobu; Harada, Kazuto; Iwatsuki, Masaaki; Kurashige, Junji; Sakamoto, Yasuo; Miyamoto, Yuji; Ishimoto, Takatsugu; Kosumi, Keisuke; Tokunaga, Ryuma; Imamura, Yu; Ida, Satoshi; Hiyoshi, Yukiharu; Watanabe, Masayuki; Baba, Hideo

    2016-08-01

    A nutritional indicator suitable for predicting complications after esophagectomy has not been confirmed. The nutritional screening tool CONUT is a potential candidate. We retrospectively analyzed 352 patients who underwent elective esophagectomy with lymphadenectomy for esophageal cancer between April 2005 and December 2014. Patients were divided into three groups according to the malnutrition degree in controlling nutritional status (CONUT): normal, light malnutrition, moderate or severe malnutrition. The numbers of patients assigned to the normal, light malnutrition, and moderate or severe malnutrition groups were 205, 126, and 21, respectively. One hundred forty-seven (41.8 %) patients were considered malnourished. Patients with moderate or severe malnutrition had a significantly high incidence of any morbidity, severe morbidities, and surgical site infection. Hospital stay in patients with moderate or severe malnutrition was significantly longer. Logistic regression analysis suggested that moderate or severe malnutrition was an independent risk factor for any morbidity [hazard ratio (HR) 2.75, 95 % confidence interval (CI) 1.081-7.020; p = 0.034] and severe morbidities (HR 3.07, 95 % CI 1.002-9.432; p = 0.049). CONUT was a convenient and useful tool to assess nutritional status before esophagectomy. Patients with moderate or severe malnutrition according to CONUT are at high risk for postoperative complications.

  5. Are we able to reduce the mortality and morbidity of oral cancer; Some considerations

    NARCIS (Netherlands)

    van der Waal, I.

    2013-01-01

    Oral cancer makes up 1%-2% of all cancers that may arise in the body. The majority of oral cancers consists of squamous cell carcinomas. Oral cancer carries a considerable mortality rate, being mainly dependent on the stage of the disease at admission. Worldwide some 50% of the patients with oral

  6. Morbidity of local therapy for locally advanced metastatic breast cancer: an analysis of the Surveillance, Epidemiology, and End Results (SEER)-Medicare Registry.

    Science.gov (United States)

    Fairweather, Mark; Jiang, Wei; Keating, Nancy L; Freedman, Rachel A; King, Tari A; Nakhlis, Faina

    2018-01-27

    Limited data exist to guide the management of in-breast tumors that can produce physical and emotional discomfort in the setting of metastatic disease. We evaluated the morbidity of local therapy (LT) among patients with locally advanced metastatic breast cancer. Patients with de novo T4M1 breast cancer diagnosed between 2005 and 2011 were identified from the SEER-Medicare database. We assessed receipt of care for loco-regional morbidity before and after LT. Among 3660 patients with T4M1 disease, 1558 (43%) underwent LT [surgery (19%), radiation (15%), both (9%)]. Before LT, few patients were reported to have loco-regional morbidity (7.9% vs. 6.7% for no LT, P = 0.17). Following LT, patients were reported to have more loco-regional morbidity than patients who did not have LT (22.6% vs. 7.9%). More patients without baseline loco-regional morbidity were reported to have received care for loco-regional morbidity documented after LT compared to baseline loco-regional morbidity reported in patients without LT (19.9% vs. 6.3%, P morbidity is relatively infrequent among patients with T4M1 disease who do not undergo LT. Receipt of care for loco-regional morbidity was higher following LT. For patients without existing loco-regional morbidity, risks of LT may outweigh potential benefits.

  7. Evaluation of the POSSUM, p-POSSUM, o-POSSUM, and APACHE II scoring systems in predicting postoperative mortality and morbidity in gastric cancer patients

    Directory of Open Access Journals (Sweden)

    Shikai Hong

    2017-03-01

    Conclusion: The POSSUM scoring system performed well with respect to predicting morbidity risk following gastric cancer resection. For predicting postoperative mortality, p-POSSUM and o-POSSUM exhibited superior performance relative to POSSUM and APACHE II.

  8. Cancer incidence, morbidity, and survival in Canadian first nation children: a Manitoba population-based study from the cancer in young people in Canada (CYP-C) registry.

    Science.gov (United States)

    Stammers, David M; Israels, Sara J; Lambert, Pascal J; Cuvelier, Geoff D E

    2014-12-01

    Health disparities between Canadian First Nation (FN) people and the rest of the national population exist. No studies have specifically documented cancer-related health outcomes in Canadian FN children. The purpose of this study was to describe the incidence of pediatric malignancies in Manitoba FN children, and to compare morbidity patterns and survival between FN and non-FN children with cancer in the Canadian province of Manitoba. A retrospective, population-based review of all children (0-14.99 years) diagnosed with malignancy (2001-2008) in Manitoba, Canada was undertaken using the Cancer in Young People in Canada registry. FN children were compared to the non-FN population for markers of morbidity and survival. The average annual age-standardized incidence rate for all childhood cancers in FN children was 132 per 1,000,000 per year. 240 children were included in the morbidity and survival analyses (38 FN; 202 non-FN). No differences were found between FN and non-FN children in time from first presentation of symptoms to consultation with an oncology specialist or diagnosis, or number of hospital admissions / total days of admission for treatment complications. Overall survival was inferior for FN children in univariable analysis (P = 0.048) but not when risk group was included in a multivariable analysis (P = 0.15). No difference in event free survival or cumulative incidence of relapse was identified. The estimated incidence of childhood cancers in the Manitoba FN population is similar to provincial incidence rates. No differences in morbidity patterns or survival were found between Manitoba FN and non-FN children with cancer. © 2014 Wiley Periodicals, Inc.

  9. Relation between severe malaria morbidity in children and level of Plasmodium falciparum transmission in Africa.

    Science.gov (United States)

    Snow, R W; Omumbo, J A; Lowe, B; Molyneux, C S; Obiero, J O; Palmer, A; Weber, M W; Pinder, M; Nahlen, B; Obonyo, C; Newbold, C; Gupta, S; Marsh, K

    1997-06-07

    Malaria remains a major cause of mortality and morbidity in Africa. Many approaches to malaria control involve reducing the chances of infection but little is known of the relations between parasite exposure and the development of effective clinical immunity so the long-term effect of such approaches to control on the pattern and frequency of malaria cannot be predicted. We have prospectively recorded paediatric admissions with severe malaria over three to five years from five discrete communities in The Gambia and Kenya. Demographic analysis of the communities exposed to disease risk allowed the estimation of age-specific rates for severe malaria. Within each community the exposure to Plasmodium falciparum infection was determined through repeated parasitological and serological surveys among children and infants. We used acute respiratory-tract infections (ARI) as a comparison. 3556 malaria admissions were recorded for the five sites. Marked differences were observed in age, clinical spectrum and rates of severe malaria between the five sites. Paradoxically, the risks of severe disease in childhood were lowest among populations with the highest transmission intensities, and the highest disease risks were observed among populations exposed to low-to-moderate intensities of transmission. For severe malaria, for example, admission rates (per 1000 per year) for children up to their 10th birthday were estimated as 3.9, 25.8, 25.9, 16.7, and 18.0 in the five communities; the forces of infection estimated for those communities (new infections per infant per month) were 0.001, 0.034, 0.050, 0.093, and 0.176, respectively. Similar trends were noted for cerebral malaria and for severe malaria anaemia but not for ARI. Mean age of disease decreased with increasing transmission intensity. We propose that a critical determinant of life-time disease risk is the ability to develop clinical immunity early in life during a period when other protective mechanisms may operate. In

  10. Increased Soluble Leptin Receptor Levels in Morbidly Obese Patients With Insulin Resistance and Nonalcoholic Fatty Liver disease

    Science.gov (United States)

    Medici, Valentina; Ali, Mohamed R.; Seo, Suk; Aoki, Christopher A.; Rossaro, Lorenzo; Kim, Kyoungmi; Fuller, Will D.; Vidovszky, Tamas J.; Smith, William; Jiang, Joy X.; Maganti, Kalyani; Havel, Peter J.; Kamboj, Amit; Ramsamooj, Rajendra; Török, Natalie J.

    2016-01-01

    The adipocyte hormone, leptin has been demonstrated to have profibrogenic actions in vitro and in animal models. However, no correlation was found between plasma leptin levels and fibrosis stage in humans. Thus, our aim was to study whether soluble leptin receptor (SLR) or free leptin index (FLI; calculated as the ratio of leptin to SLR), may correlate better with the features of metabolic syndrome and with the histological grade and stage of nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH). We studied a population (n = 104) of morbidly obese patients undergoing bariatric surgery. Data including BMI, type 2 diabetes mellitus, hypertension, and hyperlipidemia were obtained. Plasma fasting leptin and SLR, fasting glucose and insulin were measured, and homeostasis model of assessment insulin resistance (HOMAIR) index and FLI were calculated. All patients had intraoperative liver biopsies. Leptin levels correlated with the BMI. The multiple regression analysis indicated that increasing HOMA and decreasing FLI were predictors of steatosis in the liver (P < 0.0003). SLR levels were positively correlated with the presence of diabetes mellitus and the stage of fibrosis. In conclusion, increased SLR levels in morbidly obese patients with diabetes are correlated with the stage of liver fibrosis, and may reflect progressive liver disease. PMID:20448542

  11. MORBIDITY AND MORTALITY DUE TO AIDS: A STUDY OF BURDEN OF DISEASE AT A MUNICIPAL LEVEL

    Directory of Open Access Journals (Sweden)

    Jane DA SILVA

    2015-10-01

    Full Text Available Introduction: The purpose of measuring the burden of disease involves aggregating morbidity and mortality components into a single indicator, the disability-adjusted life year (DALY, to measure how much and how people live and suffer the impact of a disease. Objective: To estimate the global burden of disease due to AIDS in a municipality of southern Brazil. Methods: An ecological study was conducted in 2009 to examine the incidence and AIDS-related deaths among the population residing in the city of Tubarao, Santa Catarina State, Brazil. Data from the Mortality Information System in the National Health System was used to calculate the years of life lost (YLL due to premature mortality. The calculation was based on the difference between a standardized life expectancy and age at death, with a discount rate of 3% per year. Data from the Information System for Notifiable Diseases were used to calculate the years lived with disability (YLD. The DALY was estimated by the sum of YLL and YLD. Indicator rates were estimated per 100,000 inhabitants, distributed by age and gender. Results: A total of 131 records were examined, and a 572.5 DALYs were estimated, which generated a rate of 593.1 DALYs/100,000 inhabitants. The rate among men amounted to 780.7 DALYs/100,000, whereas among women the rate was 417.1 DALYs/100,000. The most affected age groups were 30-44 years for men and 60-69 years for women. Conclusion: The burden of disease due to AIDS in the city of Tubarao was relatively high when considering the global trend. The mortality component accounted for more than 90% of the burden of disease.

  12. Shoulder and neck morbidity in quality of life after surgery for head and neck cancer

    NARCIS (Netherlands)

    van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

    2004-01-01

    Background. Quality of life has become a major issue in determining the outcome of treatment in head and neck surgery with curative intent. The aim of our study was to determine which factors in the postoperative care, especially shoulder and neck morbidity, are related to quality of life and how

  13. Calf management practices and associations with herd-level morbidity and mortality on beef cow-calf operations.

    Science.gov (United States)

    Murray, C F; Fick, L J; Pajor, E A; Barkema, H W; Jelinski, M D; Windeyer, M C

    2016-03-01

    The objective of this study was to investigate calf management practices on beef cow-calf operations and determine associations with herd-level morbidity and mortality of pre-weaned calves. A 40-question survey about management practices, morbidity and mortality was administered to cow-calf producers by distributing paper surveys and by circulating an online link through various media. A total of 267 producers completed the survey. Data were analyzed with descriptive statistics and multivariable linear regression models. Average herd-level treatment risk for pre-weaning calf diarrhea (PCD) and bovine respiratory disease (BRD) were 4.9% and 3.0%, respectively. Average herd-level mortality within the first 24 h of life (stillbirth), from 1 to 7 days and 7 days to weaning were 2.3%, 1.1%, and 1.4%, respectively. Operations that never intervened at parturition had 4.7% higher PCD than those that occasionally did. On operations using small elastrator bands for castration, PCD was 1.9% higher than those using other methods. For every increase of 100 cows in herd size, BRD decreased by 1.1%. The association between BRD and PCD varied by when calving season began. Operations that used off-farm, frozen colostrum had a 1.1% increase in stillbirths. Operations that verified a calf had suckled had 0.7% lower mortality from 1 to 7 days of age. Those that intervened when colostrum was abnormal or that used small elastrator bands for castration had 1.9% and 1.4% higher mortality during the 1st week of life, respectively, compared with other operations. Mortality from 7 days to weaning was lower by 0.7% when calving season started in April compared with January or February and was higher by 1.0% for each additional week of calving season. Operations that intervened with colostrum consumption for assisted calvings had lower mortality from 7 days to weaning by 0.8% compared with those that did not. For every 1.0% increase in BRD, mortality from 7 days to weaning increased by 1

  14. [Correlation and association of income and educational level with health and nutritional conditions among the morbidly obese].

    Science.gov (United States)

    Rodrigues, Ana Paula Dos Santos; Da Silveira, Erika Aparecida

    2015-01-01

    This article seeks to investigate the relationship between income and educational level and health and nutritional conditions among the morbidly obese. A cross-sectional study was conducted with 79 patients at first appointment, with Body Mass Index (BMI) ≥ 35 kg/m2 and age ≥ 20 years. The following data was collected: demographic, socioeconomic, anthropometric, lifestyle, biochemical and food intake data. Average BMI was 48.3 ± 6.9 kg/m2. There was a significant negative correlation between education level and the variables of weight (r = -0.234) and BMI (r = -0.364) and per capita family income with daily consumption of leafy vegetables (r = -0.263). After multivariate analysis, higher per capita family income was associated with the absence of heart disease (PR: 0.51, CI95%: 0.32-0.81), higher daily consumption of leafy vegetables (PR: 1.79, CI95%: 1.16-2.75) and candy (PR: 3.12, CI95%: 1.21-8.04). In the morbidly obese, per capita household income was associated with absence of heart disease and higher consumption of leafy vegetables and candy. On the other hand, education level was not associated with health and nutrition conditions.

  15. Measuring morbidity associated with urinary schistosomiasis: assessing levels of excreted urine albumin and urinary tract pathologies.

    Science.gov (United States)

    Sousa-Figueiredo, José C; Basáñez, María-Gloria; Khamis, I Simba; Garba, Amadou; Rollinson, David; Stothard, J Russell

    2009-10-06

    Urinary schistosomiasis is responsible for a variety of debilitating conditions; foremost perhaps are urinary tract pathologies (UTPs). Although portable ultrasonography can be used to detect UTPs visually, there is still a need for rapid morbidity assessment (henceforth referred to as RaMA) tools that can be deployed in the field during implementation, monitoring and evaluation of control programmes. We therefore aimed to determine associations between excreted urine-albumin, as measured using a HemoCue photometer, and UTPs, as detected by ultrasonography, in children and adults from an urinary schistosomiasis endemic area in Zanzibar. In a survey of 140 school-children of both sexes (aged 9 to 15 yr) and 47 adult males (> or =16 yr) on the island of Unguja, the prevalence of egg-patent urinary schistosomiasis was 36.4% (CI(95) 28.5-45.0%) and 46.8% (CI(95) 32.1-61.9%) (P = 0.14), and that of UTPs was 39.4% (CI(95) 31.0-48.3%) and 64.4% (CI(95) 48.8-78.1%) (P = 0.006), respectively. In school-children, raised urine-albumin concentrations (>40 mg/L) were associated, albeit non-significantly, with prevalence of infection (OR = 3.1, P = 0.070), but more specifically and significantly with the prevalence of micro-haematuria (OR = 76.7, Palbumin excretion was associated with UTPs, particularly lesions of the bladder wall (OR = 8.4, P = 0.013). Albuminuria showed promising diagnostic performance, especially in school-aged children with sensitivity of 63.3% and specificity of 83.1% at detecting lower UTPs, i.e. bladder-wall lesions (ultrasonography as 'gold standard'). This study indicates that albuminuria assays could be used as a RaMA tool for monitoring UTP prevalence during control programmes, as well as a tool for selecting those with more chronic bladder-wall lesions without resorting to ultrasonography.

  16. Measuring morbidity associated with urinary schistosomiasis: assessing levels of excreted urine albumin and urinary tract pathologies.

    Directory of Open Access Journals (Sweden)

    José C Sousa-Figueiredo

    2009-10-01

    Full Text Available Urinary schistosomiasis is responsible for a variety of debilitating conditions; foremost perhaps are urinary tract pathologies (UTPs. Although portable ultrasonography can be used to detect UTPs visually, there is still a need for rapid morbidity assessment (henceforth referred to as RaMA tools that can be deployed in the field during implementation, monitoring and evaluation of control programmes. We therefore aimed to determine associations between excreted urine-albumin, as measured using a HemoCue photometer, and UTPs, as detected by ultrasonography, in children and adults from an urinary schistosomiasis endemic area in Zanzibar.In a survey of 140 school-children of both sexes (aged 9 to 15 yr and 47 adult males (> or =16 yr on the island of Unguja, the prevalence of egg-patent urinary schistosomiasis was 36.4% (CI(95 28.5-45.0% and 46.8% (CI(95 32.1-61.9% (P = 0.14, and that of UTPs was 39.4% (CI(95 31.0-48.3% and 64.4% (CI(95 48.8-78.1% (P = 0.006, respectively. In school-children, raised urine-albumin concentrations (>40 mg/L were associated, albeit non-significantly, with prevalence of infection (OR = 3.1, P = 0.070, but more specifically and significantly with the prevalence of micro-haematuria (OR = 76.7, P<0.0001. In adults, elevated urine-albumin excretion was associated with UTPs, particularly lesions of the bladder wall (OR = 8.4, P = 0.013. Albuminuria showed promising diagnostic performance, especially in school-aged children with sensitivity of 63.3% and specificity of 83.1% at detecting lower UTPs, i.e. bladder-wall lesions (ultrasonography as 'gold standard'.This study indicates that albuminuria assays could be used as a RaMA tool for monitoring UTP prevalence during control programmes, as well as a tool for selecting those with more chronic bladder-wall lesions without resorting to ultrasonography.

  17. Measuring Morbidity Associated with Urinary Schistosomiasis: Assessing Levels of Excreted Urine Albumin and Urinary Tract Pathologies

    Science.gov (United States)

    Sousa-Figueiredo, José C.; Basáñez, María-Gloria; Khamis, I. Simba; Garba, Amadou; Rollinson, David; Stothard, J. Russell

    2009-01-01

    Background Urinary schistosomiasis is responsible for a variety of debilitating conditions; foremost perhaps are urinary tract pathologies (UTPs). Although portable ultrasonography can be used to detect UTPs visually, there is still a need for rapid morbidity assessment (henceforth referred to as RaMA) tools that can be deployed in the field during implementation, monitoring and evaluation of control programmes. We therefore aimed to determine associations between excreted urine-albumin, as measured using a HemoCue photometer, and UTPs, as detected by ultrasonography, in children and adults from an urinary schistosomiasis endemic area in Zanzibar. Methodology/Principal Findings In a survey of 140 school-children of both sexes (aged 9 to 15 yr) and 47 adult males (≥16 yr) on the island of Unguja, the prevalence of egg-patent urinary schistosomiasis was 36.4% (CI95 28.5–45.0%) and 46.8% (CI95 32.1–61.9%) (P = 0.14), and that of UTPs was 39.4% (CI95 31.0–48.3%) and 64.4% (CI95 48.8–78.1%) (P = 0.006), respectively. In school-children, raised urine-albumin concentrations (>40 mg/L) were associated, albeit non-significantly, with prevalence of infection (OR = 3.1, P = 0.070), but more specifically and significantly with the prevalence of micro-haematuria (OR = 76.7, P<0.0001). In adults, elevated urine-albumin excretion was associated with UTPs, particularly lesions of the bladder wall (OR = 8.4, P = 0.013). Albuminuria showed promising diagnostic performance, especially in school-aged children with sensitivity of 63.3% and specificity of 83.1% at detecting lower UTPs, i.e. bladder-wall lesions (ultrasonography as ‘gold standard’). Conclusion/Significance This study indicates that albuminuria assays could be used as a RaMA tool for monitoring UTP prevalence during control programmes, as well as a tool for selecting those with more chronic bladder-wall lesions without resorting to ultrasonography. PMID:19806223

  18. Application of data mining techniques and data analysis methods to measure cancer morbidity and mortality data in a regional cancer registry: The case of the island of Crete, Greece.

    Science.gov (United States)

    Varlamis, Iraklis; Apostolakis, Ioannis; Sifaki-Pistolla, Dimitra; Dey, Nilanjan; Georgoulias, Vassilios; Lionis, Christos

    2017-07-01

    Micro or macro-level mapping of cancer statistics is a challenging task that requires long-term planning, prospective studies and continuous monitoring of all cancer cases. The objective of the current study is to present how cancer registry data could be processed using data mining techniques in order to improve the statistical analysis outcomes. Data were collected from the Cancer Registry of Crete in Greece (counties of Rethymno and Lasithi) for the period 1998-2004. Data collection was performed on paper forms and manually transcribed to a single data file, thus introducing errors and noise (e.g. missing and erroneous values, duplicate entries etc.). Data were pre-processed and prepared for analysis using data mining tools and algorithms. Feature selection was applied to evaluate the contribution of each collected feature in predicting patients' survival. Several classifiers were trained and evaluated for their ability to predict survival of patients. Finally, statistical analysis of cancer morbidity and mortality rates in the two regions was performed in order to validate the initial findings. Several critical points in the process of data collection, preprocessing and analysis of cancer data were derived from the results, while a road-map for future population data studies was developed. In addition, increased morbidity rates were observed in the counties of Crete (Age Standardized Morbidity/Incidence Rates ASIR= 396.45 ± 2.89 and 274.77 ±2.48 for men and women, respectively) compared to European and world averages (ASIR= 281.6 and 207.3 for men and women in Europe and 203.8 and 165.1 in world level). Significant variation in cancer types between sexes and age groups (the ratio between deaths and reported cases for young patients, less than 34 years old, is at 0.055 when the respective ratio for patients over 75 years old is 0.366) was also observed. This study introduced a methodology for preprocessing and analyzing cancer data, using a

  19. Sexual Self-Schema and Sexual Morbidity Among Gynecologic Cancer Survivors

    OpenAIRE

    Andersen, Barbara L.; Woods, Xichel A.; Copeland, Larry J

    1997-01-01

    Longitudinal research indicates that approximately 50% of women treated for gynecologic cancer have sexual dysfunctions as they recover and become cancer survivors. This outcome occurs in the context of satisfactory quality of life in other domains. This study, comparing gynecologic cancer survivors (n = 61) and gynecologically healthy women (n = 74), documents the reliability of the latter observations with measures of quality of life (general, depressive symptoms, social contacts, and stres...

  20. Morbidity and mortality due to cervical cancer in Poland after introduction of the Act--National Programme for Control of Cancerous Diseases.

    Science.gov (United States)

    Bojar, Iwona; Cvejić, Radunka; Głowacka, Maria Danuta; Koprowicz, Anna; Humeniuk, Ewa; Owoc, Alfred

    2012-01-01

    In 2005 in Poland, referring to the recommendations by the National Health Programme and recommendations by the European Union, the National Programme for Control of Cancerous Diseases was implemented by virtue of the Act, one of its basic assumptions being an improvement of oncologic awareness among the Polish population. It is expected that the result of actions in this respect will be an increase in reporting rates for prophylactic examinations and a decrease in the number of deaths due to cancerous diseases. The objective of the study was presentation of the analysis of morbidity and mortality due to cervical cancer in Poland and in individual regions, after the implementation of the National Programme for Control of Cancerous Diseases. The data was obtained from the Oncology Centre and from the computer Information System for Prophylaxis Monitoring (SIMP). In the analysis of obtained results, qualitative variables distribution was defined by means of the following values: number of instances (n) and frequency (%) with which they occur in a given category. The frequencies with which these categories of variables occur were compared by means of the chi-squared test with Yates' correction. The permissible error probability of the first type (p-value) is assumed to equal 0.05. The statistical assessment of results was performed by means of STATISTICA PL statistical software, version 9.0. In Poland in 2010, as many as 3,078 female patients suffered from with cervical cancer, compared with 3,263 in 2005, i.e. prior to implementation of The National Cancer Prevention Programme Act. Therefore, it can be concluded that there was a decline in cervical cancer incidence of 5.7%. As regards the mortality rate, there was a decline of 3.4%. A comparison of the cervical cancer morbidity and mortality rate for Poland and its provinces between 2005-2010 showed statistically significant differences only for morbidity rate - a decline in frequency in the entire Polish territory

  1. [Prospective study of gluco-lipidic hormone and peptide levels in morbidly obese patients after sleeve gastrectomy].

    Science.gov (United States)

    Bruna, Marcos; Gumbau, Verónica; Guaita, Marcos; Canelles, Enrique; Mulas, Claudia; Basés, Carla; Celma, Isabel; Puche, José; Marcaida, Goitzane; Oviedo, Miguel; Vázquez, Antonio

    2014-03-01

    Different hormones and peptides involved in lipid and carbohydrate metabolism have been studied in relation to morbid obesity and its variation after bariatric surgery. The aim of this study is toevaluate variations in different molecules related to glico-lipidic metabolism during the first year after sleeve gastrectomy in morbidly obese patients. Prospective study in patients undergoing sleeve gastrectomy between November 2009 and January 2011. We analyzed changes in different clinical, anthropometric and analytic parameters related with glico-lipidic metabolism in all patients in the preoperative period, first postoperative day, fifth day, one month, 6 months and one year after surgery. Statistical analysis was performed using SPSS 20.0. We included 20 patients, 60% were women with a median of age of 45 years. Median of body mass index (IMC) was 48,5 kg/m(2) and 70% had obstructive sleep apnea syndrome (SAOS), 65% arterial hypertension (HTA), 45% dyslipidemia and 40% diabetes mellitus. One year after surgery, the percentage of excess of BMI loss was 72% and the rate of cure or improvement of dyslipidemia was 100%, diabetes 87,5%, HTA 84,6% and SAOS 57,1%. At this time, glycemia levels decreased significantly (P<.001), and levels of IGF-1 and HDL-cholesterol increased significantly. Levels of adiponectine increased and leptine (P=.003), insulin (P=.004) and triglycerides (P=.016) decreased significantly one year after the surgery. ACTH levels (that decreased during first 6 months after surgery), glycosilated hemoglobin, total cholesterol and LDL-cholesterol had no changes one year after surgery. Sleeve gastrectomy is a surgical technique with good results of weight loss and cure of comorbidities. This procedure induces significant modifications in blood levels of glico-lipidic metabolism related peptides and hormones, such as glucose, IGF-1, insulin, leptin, triglycerides and HDL-cholesterol. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  2. Voxel-based analysis unveils regional dose differences associated with radiation-induced morbidity in head and neck cancer patients.

    Science.gov (United States)

    Monti, Serena; Palma, Giuseppe; D'Avino, Vittoria; Gerardi, Marianna; Marvaso, Giulia; Ciardo, Delia; Pacelli, Roberto; Jereczek-Fossa, Barbara A; Alterio, Daniela; Cella, Laura

    2017-08-03

    The risk of radiation-induced toxicity in patients treated for head and neck (HN) cancer with radiation therapy (RT) is traditionally estimated by condensing the 3D dose distribution into a monodimensional cumulative dose-volume histogram which disregards information on dose localization. We hypothesized that a voxel-based approach would identify correlations between radiation-induced morbidity and local dose release, thus providing a new insight into spatial signature of radiation sensitivity in composite regions like the HN district. This methodology was applied to a cohort of HN cancer patients treated with RT at risk of radiation-induced acute dysphagia (RIAD). We implemented an inter-patient elastic image registration framework that proved robust enough to match even the most elusive HN structures and to provide accurate dose warping. A voxel-based statistical analysis was then performed to test regional dosimetric differences between patients with and without RIAD. We identified a significantly higher dose delivered to RIAD patients in two voxel clusters in correspondence of the cricopharyngeus muscle and cervical esophagus. Our study goes beyond the well-established organ-based philosophy exploring the relationship between radiation-induced morbidity and local dose differences in the HN region. This approach is generally applicable to different HN toxicity endpoints and is not specific to RIAD.

  3. Surgical safety and personal costs in morbidly obese, multimorbid patients diagnosed with early-stage endometrial cancer having a hysterectomy.

    Science.gov (United States)

    Obermair, Andreas; Brennan, Donal J; Baxter, Eva; Armes, Jane E; Gebski, Val; Janda, Monika

    2016-01-01

    Many women who develop endometrial cancer (EC) or endometrial hyperplasia with atypia are obese and therefore at high risk of surgical complications. Recently clinical trials have been initiated offering non-surgical treatment to these women, but not all may agree to participate in such trials. This paper aims to describe the patient characteristics, and surgical outcomes of women with suspected early stage endometrial cancer and body mass index (BMI) of 30 or greater, who declined enrolment in the feMMe trial, which offers non-surgical hormonal treatment, hormonal plus metformin or hormonal plus weight loss as primary treatment. Consecutive case series from a tertiary gynaecological oncology unit. Over the course of the first 2 years of the feMMe trial, 27 patients met the initial eligibility screening, but declined enrolment in the feMMe trial and opted for upfront surgery. The main surgical outcome measures were type of surgical approach, need for conversion from laparoscopic to open approach, length of stay in hospital and adverse events. Patients' median age was 63 years (range 40 to 86); median BMI was 37.3 kg/m2 (range 30.7 to 54.7); median medical co-morbidities were six (range 3-10). Of the 26/27 surgeries planned to be undertaken laparoscopically, 2/26 patients had to be converted (7 %). Overall, the average hospital stay was 4.5 days, and 11/27 (41 %) of the patients developed one or more adverse events grade 2+ rated according to the Common Toxicity Criteria Version 3. Adverse surgical outcomes are common in multi-morbid, obese or morbidly obese patients diagnosed with early stage EC or endometrial hyperplasia with atypia and who have a hysterectomy.

  4. Lymphohematopoietic Cancer Mortality and Morbidity of Workers in a Refinery/Petrochemical Complex in Korea

    Directory of Open Access Journals (Sweden)

    Dong-Hee Koh

    2011-03-01

    Conclusion: The results showed a potential relationship between leukemia and lymphohematopoietic cancers and exposure to benzene in refinery/petrochemical complex workers. This study yielded limited results due to a short observational period; therefore, a follow-up study must be performed to elucidate the relationship between petrochemical exposure and cancer rates.

  5. Immigration policies and mental health morbidity among Latinos: A state-level analysis.

    Science.gov (United States)

    Hatzenbuehler, Mark L; Prins, Seth J; Flake, Morgan; Philbin, Morgan; Frazer, M Somjen; Hagen, Daniel; Hirsch, Jennifer

    2017-02-01

    Despite abundant state-level policy activity in the U.S. related to immigration, no research has examined the mental health impact of the overall policy climate for Latinos, taking into account both inclusionary and exclusionary legislation. To examine associations between the state-level policy climate related to immigration and mental health outcomes among Latinos. We created a multi-sectoral policy climate index that included 14 policies in four domains (immigration, race/ethnicity, language, and agricultural worker protections). We then examined the relation of this policy climate index to two mental health outcomes (days of poor mental health and psychological distress) among Latinos from 31 states in the 2012 Behavioral Risk Factor Surveillance System (BRFSS), a population-based health survey of non-institutionalized individuals aged 18 years or older. Individuals in states with a more exclusionary immigration policy climate had higher rates of poor mental health days than participants in states with a less exclusionary policy climate (RR: 1.05, 95% CI: 1.00, 1.10). The association between state policies and the rate of poor mental health days was significantly higher among Latinos versus non-Latinos (RR for interaction term: 1.03, 95% CI: 1.01, 1.06). Furthermore, Latinos in states with a more exclusionary policy climate had 1.14 (95% CI: 1.04, 1.25) times the rate of poor mental health days than Latinos in states with a less exclusionary policy climate. Results were robust to individual- and state-level confounders. Sensitivity analyses indicated that results were specific to immigration policies, and not indicators of state political climate or of residential segregation. No relationship was observed between the immigration policy index and psychological distress. These results suggest that restrictive immigration policies may be detrimental to the mental health of Latinos in the United States. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Vaspin mRNA levels in the liver of morbidly obese women with nonalcoholic fatty liver disease.

    Science.gov (United States)

    Waluga, Marek; Kukla, Michał; Żorniak, Michał; Grabiec, Marta; Kajor, Maciej; Dyaczyński, Michał; Kowalski, Grzegorz; Żądło, Dominika; Berdowska, Agnieszka; Kotulski, Rafał; Bułdak, Rafał J; Sawczyn, Tomasz; Waluga, Ewa; Olczyk, Paweł; Hartleb, Marek

    The aim of this study was to evaluate hepatic vaspin mRNA in morbidly obese women with nonalcoholic fatty liver disease (NAFLD) and to look for its relationships with metabolic and histopathological features. The study included 56 severely obese women who underwent intraoperative wedge liver biopsy during bariatric surgery. Hepatic vaspin mRNA was assessed by quantitative real-time PCR. Vaspin mRNA found in all included patients was markedly higher in patients with body mass index (BMI) ≥ 40 kg/m2 (4.59 ±3.09 vs. 0.44 ±0.33; p = 0.05). An evident but statistically insignificant difference in vaspin mRNA levels was observed between patients with and without hepatocyte ballooning (4.77 ±4.23 vs. 0.45 ±0.29, respectively), with and without steatosis (4.80 ±4.20 vs. 0.41 ±0.29, respectively), without and with fibrosis (0.25 ±0.80 vs. 6.23 ±7.2, respectively), and those without and with lobular inflammation (0.27 ±1.0 vs. 5.55 ±10.1, respectively). There was marked difference in vaspin mRNA between patients with simple steatosis/borderline nonalcoholic steatohepatitis (NASH) compared to those with definite NASH (0.24 ±0.96 vs. 10.5 ±10.4). Adiposity is an undoubted confounding factor influencing vaspin levels. Hepatic vaspin mRNA seems to be markedly elevated in morbidly obese patients with more advanced NAFLD and when hallmarks of NASH were observed. Pointing to non-linear mRNA levels within the NAFLD spectrum and an evident increase in patients with fibrosis and definite NASH, the detrimental action of vaspin cannot be excluded.

  7. The morbidity of treatment for patients with stage I endometrial cancer : Results from a randomized trial

    NARCIS (Netherlands)

    Creutzberg, CL; van Putten, WLJ; Koper, PC; Lybeert, MLM; Jobsen, JJ; Warlam-Rodenhuis, CC; De Winter, KAJ; Lutgens, LCHW; van den Bergh, ACM; van der Steen-Banasik, E; Beerman, H; van Lent, M

    2001-01-01

    Purpose: To compare the treatment complications for patients with Stage I endometrial cancer treated with surgery and pelvic radiotherapy (RT) or surgery alone in a multicenter randomized trial. Methods and Materials: The Postoperative Radiation Therapy in Endometrial Carcinoma (PORTEC) trial

  8. Perioperative morbidity and outcome of secondary cytoreduction for recurrent epithelial ovarian cancer

    NARCIS (Netherlands)

    Woelber, L.; Jung, S.; Eulenburg, C.; Mueller, V.; Schwarz, J.; Jaenicke, F.; Mahner, S.

    Background: Despite radical surgical and chemotherapeutic treatment of ovarian cancer, the majority of patients develop recurrent disease. Secondary cytoreductive surgery can result in favourable outcome in selected patients, but information regarding feasibility, safety and perioperative outcome of

  9. Influence of body mass index on clinicopathologic features, surgical morbidity and outcome in patients with endometrial cancer.

    Science.gov (United States)

    Akbayır, Ozgur; Corbacıoglu Esmer, Aytul; Numanoglu, Ceyhun; Cılesız Goksedef, B Pinar; Akca, Aysu; Bakır, Lale Vuslat; Kuru, Oguzhan

    2012-11-01

    differences in tumor grade, surgical technique, surgical morbidity or adjuvant radiotherapy between the BMI groups. Recurrence and cancer-related mortality rates were not affected by the BMI.

  10. Primary and secondary prevention in the reduction of cancer morbidity and mortality.

    Science.gov (United States)

    Adami, H O; Day, N E; Trichopoulos, D; Willett, W C

    2001-10-01

    Overall, cancer is a highly preventable disease. Indeed, modifiable external factors, discovered by epidemiological studies during the last 50 years, account for a majority of all cancer deaths. In this review, we discuss briefly these factors and their contribution to the current burden of cancer with an emphasis on the developed countries. Needless to say, tobacco smoking remains the largest contributor to the cancer landscape, whilst the contribution of poor diet and obesity may be equally important, but much more difficult to quantify. Our main goal was to assess what prevention of cancer has accomplished and might accomplish in the next two decades. Based on (necessarily crude) estimates, age-adjusted mortality rates from cancer in year 2000 had been reduced by approximately 13% due to primary prevention and an additional 6% due to the combined effect of early diagnosis and screening (secondary prevention). According to a realistic goal for the year 2020, a further 29% reduction might be achieved by primary, and 4% by secondary prevention. The main contribution to such accomplishments would be a reduction in tobacco smoking, improvements in diet--including reduced alcohol intake--and arrest of the obesity epidemic, in part through increased physical exercise. Rather than being granted, these goals require great effort and major commitment from all those who share responsibility for public health.

  11. Nurse staffing levels and the incidence of mortality and morbidity in the adult intensive care unit: a literature review.

    Science.gov (United States)

    McGahan, Matthew; Kucharski, Geraldine; Coyer, Fiona

    2012-05-01

    Studies have shown that nurse staffing levels, among many other factors in the hospital setting, contribute to adverse patient outcomes. Concerns about patient safety and quality of care have resulted in numerous studies being conducted to examine the relationship between nurse staffing levels and the incidence of adverse patient events in both general wards and intensive care units. The aim of this paper is to review literature published in the previous 10 years which examines the relationship between nurse staffing levels and the incidence of mortality and morbidity in adult intensive care unit patients. A literature search from 2002 to 2011 using the MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and Australian digital thesis databases was undertaken. The keywords used were: intensive care; critical care; staffing; nurse staffing; understaffing; nurse-patient ratios; adverse outcomes; mortality; ventilator-associated pneumonia; ventilator-acquired pneumonia; infection; length of stay; pressure ulcer/injury; unplanned extubation; medication error; readmission; myocardial infarction; and renal failure. A total of 19 articles were included in the review. Outcomes of interest are patient mortality and morbidity, particularly infection and pressure ulcers. Most of the studies were observational in nature with variables obtained retrospectively from large hospital databases. Nurse staffing measures and patient outcomes varied widely across the studies. While an overall statistical association between increased nurse staffing levels and decreased adverse patient outcomes was not found in this review, most studies concluded that a trend exists between increased nurse staffing levels and decreased adverse events. While an overall statistical association between increased nurse staffing levels and decreased adverse patient outcomes was not found in this review, most studies demonstrated a trend between increased nurse staffing levels

  12. Ferromagnetic thermal ablation of locally recurrent prostate cancer: prostate specific antigen results and immediate/intermediate morbidities.

    Science.gov (United States)

    Master, Viraj A; Shinohara, Katsuto; Carroll, Peter R

    2004-12-01

    Curative options for locally recurrent prostate cancer following external beam radiotherapy are limited due to the significant morbidity associated with surgical therapy. ThermoRods (Ablation Technologies, San Diego, California) are permanently implantable, 14 mm cobalt-palladium alloy rods that produce heat through oscillation of a magnetic field. The rod is designed to self-regulate the temperature to 70C by a temperature dependent magnetic transition (Curie effect). We determined whether patients with prostate cancer and local failure could be treated with thermal ablation of the prostate using this novel technology. A total of 14 men with an average age of 72 years (range 62 to 81) were enrolled in the study. All had biopsy proven prostate cancer with increasing prostate specific antigen (PSA) (1.0 to 10.3 ng/ml). The seminal vesicles were not routinely biopsied. Metastatic disease was assayed in all men with bone scan and in later patients with abdominopelvic computerized tomography. Patients had ThermoRods placed under transrectal ultrasound guidance, similar to brachytherapy. The pre-plan was rigorously followed to produce a 3-dimensional array with rods separated by 1 cm across the short axis. Patients were treated in a magnetic field for 1 hour. Urethral and rectal temperatures were also monitored and cooled appropriately. Serial PSA measurements and 6 month posttreatment biopsies were obtained after the procedure. Average time since radiation was 4.5 years. PSA nadir values after radiation were between 0.3 and 2.2 ng/ml. Prostatic temperatures were homogeneously increased greater than 50C, while rectal and urethral temperatures did not exceed 44C at any point. The urethral catheter was removed 2 weeks postoperatively in all cases. Six months after the procedure 8 of the 14 men (57%) had a PSA decrease to less than 0.1 ng/ml. Complications included urinary retention as well as incontinence. Incontinence was generally temporary and only 1 patient (7%) had

  13. Increased morbidity odds ratio of primary liver cancer and cirrhosis of the liver among vinyl chloride monomer workers.

    Science.gov (United States)

    Du, C L; Wang, J D

    1998-08-01

    To determine if there is an increased risk of admission to hospital for various diseases among vinyl chloride monomer (VCM) workers. 2224 workers with occupational exposure to VCM were identified for occurrence of disease based on a search of hospital computer files on labour insurance. These data were compared with those of workers manufacturing optical equipment and motorcycles from 1 January 1985 to 31 March 1994. Cardiovascular and cerebrovascular diseases were used as reference diseases, and the age adjusted morbidity odds ratio (MOR) was calculated. A significantly increased risk of admission to hospital among VCM workers due to primary liver cancer (MOR 4.5-6.5), cirrhosis of the liver (MOR 1.7-2.1), and other chronic diseases (MOR 1.5-2.0) was found. There were eight cases of primary liver cancer, all with heavy previous exposure to VCM. Another four cases of hepatoma in polyvinyl chloride (PVC) workers were found in the death registry. Ten out of 11 cases of hepatoma, with detailed medical information, were carriers of hepatitis B virus. The average latent period (20 years) was not different from other studies. Alternative agents of primary liver cancer were largely ruled out, suggesting that the combination of hepatitis B and VCM may lead to primary liver cancer. There is an increased risk of primary liver cancer in workers exposed to VCM, although the incomplete coverage of the Labor Insurance Bureau data warrants cautious interpretation of the results. Further study exploring the synergistic effects of VCM and hepatitis B is also indicated.

  14. Effect of testing for cancer on cancer- and venous thromboembolism (VTE)-related mortality and morbidity in people with unprovoked VTE.

    Science.gov (United States)

    Robertson, Lindsay; Yeoh, Su Ern; Stansby, Gerard; Agarwal, Roshan

    2017-08-23

    Venous thromboembolism (VTE) is a collective term for two conditions: deep vein thrombosis (DVT) and pulmonary embolism (PE). A proportion of people with VTE have no underlying or immediately predisposing risk factors and the VTE is referred to as unprovoked. Unprovoked VTE can often be the first clinical manifestation of an underlying malignancy. This has raised the question of whether people with an unprovoked VTE should be investigated for an underlying cancer. Treatment for VTE is different in cancer and non-cancer patients and a correct diagnosis would ensure that people received the optimal treatment for VTE to prevent recurrence and further morbidity. Furthermore, an appropriate cancer diagnosis at an earlier, potentially curative stage could avoid the risk of cancer progression and thus lead to improvements in cancer-related mortality and morbidity. This is an update of a review first published in 2015. To determine whether testing for undiagnosed cancer in people with a first episode of unprovoked VTE (DVT of the lower limb or PE) is effective in reducing cancer and VTE-related mortality and morbidity and to determine which tests for cancer are best at identifying treatable cancers early. For this update, the Cochrane Vascular Information Specialist (CIS) searched the Specialised Register (16 February 2017). In addition, the CIS searched the Cochrane Register of Studies CENTRAL (2017, Issue 1). We searched trials registries (February 2017) and checked the reference lists of relevant articles. Randomised and quasi-randomised trials in which people with an unprovoked VTE were allocated to receive specific tests for cancer or clinically indicated tests only were eligible for inclusion in this review. Primary outcomes included all-cause mortality, cancer-related mortality and VTE-related mortality. Two review authors independently selected studies, assessed quality and extracted data. We resolved any disagreements by discussion. Four studies with 1644

  15. Late treatment-related morbidity in breast cancer patients randomized to postmastectomy radiotherapy and systemic treatment versus systemic treatment alone

    Energy Technology Data Exchange (ETDEWEB)

    Hoejris, I.; Andersen, J.; Overgaard, M.; Overgaard, J. [Aarhus Univ. Hospital (Denmark). Dept. of Oncology

    2000-07-01

    Late treatment-related morbidity after mastectomy and adjuvant systemic treatment with and without postoperative irradiation was assessed in 84 patients randomized in the Danish Breast Cancer Cooperative Group Trials 82b and c. A structured interview and physical examination, using a standardized assessment sheet, constructed on the basis of the late effects normal tissues (LENT) scoring system, was used. The median length of follow-up from mastectomy was 9 years (range 6-13 years). Lymphedema was measured in 14%, of the irradiated patients versus 3% of the non-irradiated patients (NS). Slightly decreased shoulder morbidity was measured in 45% of the irradiated women versus 15% of the non-irradiated patients, but moderate or more severe impairment was seen in only 5% of the irradiated patients and in none of the non-irradiated patients (p = 0.004). Seventeen percent of the irradiated patients and 2% of the non-irradiated patients found that impairment of shoulder movement caused symptoms (p = 0.001)

  16. Video-assisted thoracoscopic surgery lobectomy for lung cancer is associated with a lower 30-day morbidity compared with lobectomy by thoracotomy

    DEFF Research Database (Denmark)

    Laursen, Lykke Østergaard; Petersen, René Horsleben; Hansen, Henrik Jessen

    2016-01-01

    . Consequently, our aim was to compare the 30-day morbidity and mortality for lung cancer patients operated by VATS lobectomy or lobectomy by OT. METHOD: Data were obtained from prospective national and regional databases, including patients who underwent lobectomy for lung cancer in the eastern part of Denmark...... from 1 January 2005 to 31 December 2011. All patients operated before 2009 were re-staged according to the latest International Association for the Study of Lung Cancer lung cancer classification. Patient characteristics, comorbidities, pathology and operative data were assessed using an independent...... samples t-test, Pearson's χ(2), Fisher's exact test and Mann-Whitney test. Morbidity was assessed using multinomial logistic regression adjusted for gender, age, cancer stage, forced expiratory volume in 1 s (FEV1), year of surgery and Charlson comorbidity score. RESULTS: In total, 1379 patients underwent...

  17. Limiting the morbidity of inguinofemoral lymphadenectomy in vulvar cancer patients; a review

    NARCIS (Netherlands)

    Pouwer, Anne-Floor W.; Arts, Henriette J.; van der Velden, Jacobus; de Hullu, Joanne A.

    2017-01-01

    Inguinofemoral lymphadenectomy (IFL) is performed in the treatment for vulvar cancer. One or more complications after IFL is reported in up to 85% of the patients. This review presents an overview of surgical techniques and peri- and post-operative care that has been studied in order to reduce the

  18. Limiting the morbidity of inguinofemoral lymphadenectomy in vulvar cancer patients; a review

    NARCIS (Netherlands)

    Pouwer, A.W.; Arts, H.J.; Velden, J. Van der; Hullu, J.A. de

    2017-01-01

    INTRODUCTION: Inguinofemoral lymphadenectomy (IFL) is performed in the treatment for vulvar cancer. One or more complications after IFL is reported in up to 85% of the patients. This review presents an overview of surgical techniques and peri- and post-operative care that has been studied in order

  19. Dynamics and forecast of morbidity and mortality from prostate cancer in St. Petersburg

    Directory of Open Access Journals (Sweden)

    N. G. Petrova

    2015-01-01

    Full Text Available The paper presents the characteristics of primary disease incidence, prevalence and mortality from prostate cancer among men's population of St. Petersburg (normal and age-standardized rates; analyzed their dynamics for 20 years; shows the calculated trend of these indicators up to 2020.

  20. Barrett's esophagus : high cancer-risk groups, cardiovascular co-morbidity and interaction with Helicobacter pylori

    NARCIS (Netherlands)

    S. Gudlaugsdottir (Sunna)

    2002-01-01

    textabstractBarrett's esophagus (BE) has come to be regarded as an impOliant premalignant condition. In recent years the incidence of adenocarcinoma of the esophagus and of the gastric cardia has risen dramatically. Analyses of cancer incidence data fi'om nine areas of the United States revealed

  1. Loco-regional morbidity after breast conservation and axillary lymph node dissection for early breast cancer with or without regional nodes radiotherapy, perspectives in modern breast cancer treatment: the Skagen Trial 1 is active

    DEFF Research Database (Denmark)

    Nielsen, Hanne Melgaard; Friis, Rasmus Blechingberg; Linnet, Søren

    2017-01-01

    BACKGROUND: Axillary lymph node dissection (ALND) and adjuvant radiotherapy (RT) in early breast cancer are associated with a risk of morbidity, including lymphedema and impaired shoulder mobility. The aim of this study was to evaluate loco-regional morbidity after breast conserving surgery (BCS...

  2. Prognostic factors for postoperative morbidity and tumour response after neoadjuvant chemoradiation followed by resection for rectal cancer.

    Science.gov (United States)

    Berkel, Annefleur E M; Woutersen, Dankert P; van der Palen, Job; Klaase, Joost M

    2014-09-01

    In patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation followed by rectal resection, postoperative morbidity is a significant clinical problem. Pathologic complete tumour response seems to give the best prognosis in the long term. Little is known about the factors that are associated with postoperative complications and pathologic complete response. The aim of this retrospective study was to identify and describe these factors. Ninety-nine consecutive patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiation (50 Gy and capecitabine) followed by surgery at our institute between January 2007 and May 2012 were identified. Postoperative complications were graded according to the Clavien-Dindo classification. Pathologic tumour response was categorized as complete response or no/partial response. Postoperative complications occurred in 68 patients (69%) and grade 3-5 complications in 25 patients (25%). The 30-day and 90-day mortality were 1% (n = 1) and 2% (n = 2), respectively. A young age (p = 0.021) and a preoperative or postoperative blood transfusion (p = 0.015) independently predicted complications. Intraoperative or postoperative blood transfusion (p = 0.007) and ypT0-1 stage (p = 0.037) were independent predictors for grade 3-5 complications. Complete response rate was 22% (n = 22); 4% (n = 4) of patients showed no response. No independent factors predicting complete response were found. Neoadjuvant chemoradiation followed by rectal resection is associated with significant postoperative morbidity but minimal postoperative mortality. A complete response rate of 22% was achieved.

  3. Morbidity and mortality in long-term survivors of Hodgkin lymphoma: a report from the Childhood Cancer Survivor Study

    Science.gov (United States)

    Geiger, Ann M.; Mertens, Ann C.; Leisenring, Wendy M.; Tooze, Janet A.; Goodman, Pam; Stovall, Marilyn; Robison, Leslie L.; Hudson, Melissa M.

    2011-01-01

    The contribution of specific cancer therapies, comorbid medical conditions, and host factors to mortality risk after pediatric Hodgkin lymphoma (HL) is unclear. We assessed leading morbidities, overall and cause-specific mortality, and mortality risks among 2742 survivors of HL in the Childhood Cancer Survivor Study, a multi-institutional retrospective cohort study of survivors diagnosed from 1970 to 1986. Excess absolute risk for leading causes of death and cumulative incidence and standardized incidence ratios of key medical morbidities were calculated. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of risks for overall and cause-specific mortality. Substantial excess absolute risk of mortality per 10 000 person-years was identified: overall 95.5; death due to HL 38.3, second malignant neoplasms 23.9, and cardiovascular disease 13.1. Risks for overall mortality included radiation dose ≥ 3000 rad ( ≥ 30 Gy; supra-diaphragm: HR, 3.8; 95% CI, 1.1-12.6; infradiaphragm + supradiaphragm: HR, 7.8; 95% CI, 2.4-25.1), exposure to anthracycline (HR, 2.6; 95% CI, 1.6-4.3) or alkylating agents (HR, 1.7; 95% CI, 1.2-2.5), non–breast second malignant neoplasm (HR, 2.6; 95% CI 1.4-5.1), or a serious cardiovascular condition (HR, 4.4; 95% CI 2.7-7.3). Excess mortality from second neoplasms and cardiovascular disease vary by sex and persist > 20 years of follow-up in childhood HL survivors. PMID:21037086

  4. The learning curve of laparoscopic treatment of rectal cancer does not increase morbidity.

    Science.gov (United States)

    Luján, Juan; Gonzalez, Antonio; Abrisqueta, Jesús; Hernandez, Quiteria; Valero, Graciela; Abellán, Israel; Frutos, María Dolores; Parrilla, Pascual

    2014-01-01

    The treatment of rectal cancer via laparoscopy is controversial due to its technical complexity. Several randomized prospective studies have demonstrated clear advantages for the patient with similar oncological results to those of open surgery, although during the learning of this surgical technique there may be an increase in complications and a worse prognosis. Our aim is to analyze how the learning curve for rectal cancer via laparoscopy influences intra- and postoperative results and oncological markers. A retrospective review was conducted of the first 120 patients undergoing laparoscopic surgery for rectal neoplasia. The operations were performed by the same surgical team with a wide experience in the treatment of open colorectal cancer and qualified to perform advanced laparoscopic surgery. We analyzed sex, ASA, tumour location, neoadjuvant treatment, surgical technique, operating time, conversion, postoperative complications, length of hospital stay, number of lymph nodes, stage and involvement of margins. Significant differences were observed with regard to surgical time (224 min in the first group, 204 min in the second group), with a higher rate of conversion in the first group (22.5%) than in the second (11.3%). No significant differences were noted for rate of conservative sphincter surgery, length of hospital stay, post-surgical complications, number of affected/isolated lymph nodes or affected circumferential and distal margins. It is possible to learn this complex surgical technique without compromising the patient's safety and oncological outcome. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  5. The Correlation of Increased CRP Levels with NFKB1 and TLR2 Polymorphisms in the Case of Morbid Obesity.

    Science.gov (United States)

    Soydas, T; Karaman, O; Arkan, H; Yenmis, G; Ilhan, M M; Tombulturk, K; Tasan, E; Kanigur Sultuybek, G

    2016-11-01

    Morbid obesity (MO) is associated with an increase in circulating levels of systemic acute phase proteins such as C-reactive protein (CRP). Toll-like receptor is possible candidate for inflammatory responses which is mainly mediated by NFKB1. The aim of this study was to investigate the relationship between NFKB1 and Toll-like receptor (TLR) 2 polymorphisms and the risk of MO in a Turkish population in the context of CRP serum levels which may contribute to susceptibility to the disease. We analysed the distribution of NFKB1-94 ins/del ATTG rs28362491 and TLR2 Arg753Gln rs5743708 polymorphisms using PCR-RFLP method and CRP serum levels using ELISA method in 213 MO and 200 healthy controls. The frequency of the ins/ins genotype and ins allele of rs28362491 was significantly higher in the patients compared to control group (P: 0.0309; P: 0.0421, respectively). Additionally, the frequency of GG genotype and G allele of rs5743708 was found to be statistically higher in the patient group (P: 0.0421; P 20 mg/l) in MO patients with ins/ins genotype were significantly higher than in patients with del/ins genotype (P: 0.0309). Serum CRP levels were also higher in MO patients with GG genotype and G allele (P: 0.0001). According to combined analysis, the wild type of rs28362491 and rs5743708 polymorphisms (ins/ins/GG genotype) was also significantly higher in the patient group versus the control group when compared with the combined ins/ins/GA and del/ins/GA genotype (P < 0.0001). Therefore, our findings suggest that rs28362491 and rs5743708 polymorphisms were significantly associated with MO disease through acting by modulating serum CRP levels. © 2016 The Foundation for the Scandinavian Journal of Immunology.

  6. Effect of Weight Reduction Following Bariatric Surgery on Serum Visfatin and Adiponectin Levels in Morbidly Obese Subjects

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Hosseinzadeh-Attar

    2013-04-01

    Full Text Available Objective: Adipokines are signaling and mediator proteins secreted from adipose tissue. A novel adipokine, visfatin, was reported as a protein which was mainly expressed in visceral adipose tissue. Controversial results have been shown regarding the changes of adipokines following weight reduction. So we investigated the effects of weight reduction on serum concentrations of adiponectin and visfatin in morbidly obese subjects. Methods: 35 severely obese patients (26 females and 9 males, aged 15-58 years, were studied. Anthropometric parameters and biochemical parameters as well as adiponectin and visfatin were analyzed before and 6 weeks after weight reduction. Results: Anthropometric indices decreased significantly. Blood levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride were reduced significantly. The reduction of visfatin and the elevation of adiponectin were significant as well. However, other parameters like fasting glucose and insulin did not change. Moreover, we could not find any significant correlation between the change of serum visfatin and that of adiponectin. Conclusions: 6-week weight reduction after bariatric surgery resulted in decreased serum visfatin and increased adiponectin levels. However, we cannot find any significant correlation between changes of adiponectin, visfatin, BMI, waist circumference, and insulin resistance. Further studies with different design are suggested to clarify these associations.

  7. Treatment outcomes and morbidity following definitive brachytherapy with or without external beam radiation for the treatment of localized prostate cancer: 20-year experience at Mount Sinai Medical Center.

    Science.gov (United States)

    Marshall, Richard A; Buckstein, Michael; Stone, Nelson N; Stock, Richard

    2014-01-01

    To present our treatment algorithm and 20-year experience in treating prostate cancer with brachytherapy since 1990, with focus on cancer-control outcomes and treatment-related morbidity. We selected patients treated for localized prostate cancer with brachytherapy, combination therapy with external beam radiotherapy, and adjuvant androgen deprivation therapy as prescribed by our Mount Sinai risk stratification and treatment algorithm. Outcomes were analyzed with respect to biochemical failure, distant metastases, prostate cancer-specific survival, and overall survival. Morbidity was assessed with respect to urinary, sexual, and rectal outcomes. In total, 2,495 patients met inclusion criteria. The 12-year actuarial freedom from biochemical failure was 83% (low risk: 90%, intermediate risk: 84%, and high risk: 64%); freedom from distant metastasis was 95%; prostate cancer-specific survival was 95%; and overall survival was 70%. On multivariate analysis, significant associations were found between cancer control and risk group, total biologically effective dose, and androgen deprivation therapy. With regard to morbidity, potency was preserved in 61%, and urinary symptoms improved in 35%. The 12-year actuarial freedom from urinary retention events was 90% and from severe rectal bleed was 93%. Brachytherapy, as administered via the Mount Sinai algorithm, remains an efficacious and benign treatment option for patients with localized prostate cancer of all risk groups. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Psychological morbidity and quality of life in women with advanced breast cancer: a cross-sectional survey.

    Science.gov (United States)

    Grabsch, Brenda; Clarke, David M; Love, Anthony; McKenzie, Dean P; Snyder, Raymond D; Bloch, Sidney; Smith, Graeme; Kissane, David W

    2006-03-01

    Our purpose was to determine the frequency of psychiatric morbidity and to assess the quality of life of women with advanced breast cancer. The 227 women in the sample were recruited in Melbourne, Australia, and were interviewed (prior to intervention) for a randomized controlled trial of supportive-expressive group therapy. The main outcome measures were DSM-IV psychiatric diagnoses plus quality of life data based on the EORTC QLQ-C30 (core) and QLQ-BR23 (breast module) instruments. Forty-two percent of the women (97/227) had a psychiatric disorder; 35.7% (81) of these had depression or anxiety or both. Specific diagnoses were minor depression in 58 women (25.6%), major depression in 16 (7%), anxiety disorder in 14 (6.2%), and phobic disorder in 9 (4%). Seventeen (7.5%) women had more than one disorder. In terms of quality of life, one-third felt less attractive, one-quarter were dissatisfied with their body image, and, in most, sexual interest had waned. Menopausal symptoms such as hot flashes affected less than one-third, whereas symptoms of lymphedema were experienced by 26 (11.5%). Women with advanced breast cancer have high rates of psychiatric and psychological disturbance. Quality of life is substantially affected. Clinicians need to be vigilant in monitoring psychological adjustment as part of a comprehensive biopsychosocial approach.

  9. The Relationship between Serum Hemoglobin and Creatinine Levels and Intra-Hospital Mortality and Morbidity in Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Afsoon Fazlinezhad

    2014-09-01

    Full Text Available Background: Studies have shown that Glomerular Filtration Rate (GFR and Hemoglobin (Hb concentrations are two predictive values for ST-elevation Myocardial Infarction (MI mortality.. Objectives: This study aimed to investigate the relationship between GFR and Hb concentrations and intra-hospital mortality and electrocardiographic (ECG and echocardiographic abnormalities in ST-elevation MI patients admitted to a highly equipped hospital in Mashhad. The results will help define some factors to manage these patients more efficiently.. Patients and Methods: This descriptive study aimed to assess the relationship between Hb and GFR concentrations and mortality and morbidity among 294 randomly selected patients with ST-elevation MI. Echocardiography, ECG, and routine laboratory tests, including Hb and creatinine, were performed for all the patients. Then, the data were entered into the SPSS statistical software, version 16 and were analyzed using chi-square, t-test, and ANOVA. P < 0.05 was considered as statistically significant.. Results: Intra-hospital mortality rate was 10.5%. Besides, the results showed higher levels of serum blood sugar (P < 0.001, higher levels of creatinine (P < 0.001, lower levels of GFR (P < 0.001, lower ejection fraction (P < 0.001, higher grades of left ventricular diastolic dysfunction (P = 0.002, and lower mean Hb concentration (P = 0.022 in the dead compared to the alive cases. Besides, the patients with mechanical complications had lower Hb levels (P = 0.008. The results showed no significant relationship between creatinine level and mechanical and electrical complications (P = 0.430 and P = 0.095, respectively. However, ejection fraction was significantly associated with GFR (P = 0.016.. Conclusions: According to the results, low levels of Hb and GFR could predict mortality caused by ST-elevation MI and ECG abnormalities could notify intra-hospital death. Moreover, lower Hb levels were associated with mechanical

  10. Morbidity after neck dissection in head and neck cancer patients : a study describing shoulder and neck complaints, and quality of life

    NARCIS (Netherlands)

    Wilgen, Cornelis Paul van

    2004-01-01

    In this thesis we are aiming at more insight in morbidity after head and neck cancer treatment (resection of the primary tumour, neck dissection and pre-or post-operative radiation therapy). We will study shoulder complaints and the role of the spinal accessory nerve, pain and the underlying pain

  11. Child morbidity of salmonellosis and the level of resistance of clinical isolates of salmonella to antibacterial preparations in saint Petersburg

    Directory of Open Access Journals (Sweden)

    N. V. Gonchar

    2015-01-01

    Full Text Available The aim of the study was to study the dynamics of the incidence of salmonellosis children in St. Petersburg and phenotypic resistance of clinical isolates of S. Enteritidis and S. Typhimurium to antibiotics in recent years. Materials and methods. The incidence of salmonellosis children studied according to the report for the first nine months of Rospotrebnadzor in 2013–2014. Incidence of salmonellosis in the structure of bacterial intestinal infections caused by pathogens in children hospitalized in the Department of intestinal infections in 2013–2014, studied according to annual reports. Antibiotic sensitivity was studied 86 Salmonella isolates (S. Enteritidis strain 64 and strain 22 S. Typhimurium, isolated from patients in children 2010–2014. Used the method of serial microdilution broth. Salmonella isolates were divided into sensitive, resistant, intermediate sensitivity to antibiotics. The Results. Analysis of the incidence of salmonellosis children of St. Petersburg has revealed its decline in 2014 (109.2 compared to 2013 (123,9 but relatively long-term average level was an increase in incidence (107,6. In the structure of salmonellosis in children prevailed salmonellosis Group D. In hospitalized children in the structure of bacterial intestinal infections detected Excess of share of salmonellosis in 2014 (36,9±3,4% compared to 2013 (24,5±2,4%; p <0,01. A reduction in the frequency sensitivity of S. Enteritidis to ampicillin, cefepime, ceftazidime and chloramphenicol. Compared to S. Enteritidis S. Typhimurium isolates were more resistant to ceftazidime and ampicillin, but more sensitive to ciprofloxacin. Conclusion. Morbidity of salmonellosis in recent years characterized by a relatively long-term average increase of the level. In the structure of salmonellosis in children prevailed salmonellosis Group D. There was a reduction of sensitivity S. Enteritidis isolates to cephalosporins new generations, and S. Typhimurium isolates

  12. Long-Term Outcome and Morbidity After Treatment With Accelerated Radiotherapy and Weekly Cisplatin for Locally Advanced Head-and-Neck Cancer: Results of a Multidisciplinary Late Morbidity Clinic

    Energy Technology Data Exchange (ETDEWEB)

    Ruetten, Heidi, E-mail: h.rutten@rther.umcn.nl [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Pop, Lucas A.M.; Janssens, Geert O.R.J. [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Takes, Robert P. [Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Knuijt, Simone [Department of Rehabilitation/Speech Pathology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Rooijakkers, Antoinette F. [Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Berg, Manon van den [Department of Gastroenterology-Dietetics, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Merkx, Matthias A. [Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Herpen, Carla M.L. van [Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Kaanders, Johannes H.A.M. [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)

    2011-11-15

    Purpose: To evaluate the long-term outcome and morbidity after intensified treatment for locally advanced head-and-neck cancer. Methods and Materials: Between May 2003 and December 2007, 77 patients with Stage III to IV head-and-neck cancer were treated with curative intent. Treatment consisted of accelerated radiotherapy to a dose of 68 Gy and concurrent cisplatin. Long-term survivors were invited to a multidisciplinary outpatient clinic for a comprehensive assessment of late morbidity with special emphasis on dysphagia, including radiological evaluation of swallowing function in all patients. Results: Compliance with the treatment protocol was high, with 87% of the patients receiving at least five cycles of cisplatin and all but 1 patient completing the radiotherapy as planned. The 5-year actuarial disease-free survival and overall survival rates were 40% and 47%, respectively. Locoregional recurrence-free survival at 5 years was 61%. The 5-year actuarial rates of overall late Radiation Therapy Oncology Group (RTOG)/European Organization for Research and Treatment of Cancer (EORTC) Grade 3 and Grade 4 toxicity were 52% and 25% respectively. Radiologic evaluation after a median follow-up of 44 months demonstrated impaired swallowing in 57% of the patients, including 23% with silent aspiration. Subjective assessment using a systematic scoring system indicated normalcy of diet in only 15.6% of the patients. Conclusion: This regimen of accelerated radiotherapy with weekly cisplatin produced favorable tumor control rates and survival rates while compliance was high. However, comprehensive assessment by a multidisciplinary team of medical and paramedical specialists revealed significant long-term morbidity in the majority of the patients, with dysphagia being a major concern.

  13. Adult Co-morbidity Evaluation 27 scores of head and neck cancer patients using touch-screen technology: patient satisfaction and clinical verification.

    Science.gov (United States)

    Brammer, C; Dawson, D; Joseph, M; Tipper, J; Jemmet, T; Liew, L; Spinou, C; Grew, N; Pigadas, N; Rehman, K

    2017-05-01

    This study aimed to assess head and neck cancer patient satisfaction with the use of a touch-screen computer patient-completed questionnaire for assessing Adult Co-morbidity Evaluation 27 co-morbidity scores prior to treatment, along with its clinical reliability. A total of 96 head and neck cancer patients were included in the audit. An accurate Adult Co-morbidity Evaluation 27 co-morbidity score was achieved via patient-completed questionnaire assessment for 97 per cent of participants. In all, 96 per cent of patients found the use of a touch-screen computer acceptable and would be willing to use one again, and 62 per cent would be willing to do so without help. Patients were more likely to be willing to use the computer again without help if they were aged 65 years or younger (χ2 test; p = 0.0054) or had a performance status of 0 or 1 (χ2 test; p = 0.00034). Use of a touch-screen computer is an acceptable approach for assessing Adult Co-morbidity Evaluation 27 scores at pre-treatment assessment in a multidisciplinary joint surgical-oncology clinic.

  14. [METHODOLOGY FOR THE ASSESSMENT OF THE IMPACT OF THE ATMOSPHERIC AIR POLLUTION ON THE FORMATION OF THE LEVELS OF OVERALL MORBIDITY RATE OF BRONCHIAL ASTHMA].

    Science.gov (United States)

    Veremchuk, L V; Cherpack, N A; Gvozdenko, T A; Volkova, M V

    2015-01-01

    In large cities with strong air pollution the formation of the levels of morbidity rate of bronchial asthma has a complex causation that requires the search for informative methods for identification of causes and consequences of this dependence. Method for the assessment of the dependence of overall levels of morbidity rate of bronchial asthma on the degree of air pollution allows you to select a "useful information" of the direct impact of air pollution on a background of random processes and latent relationship between human and environment. The use of the method of the information entropy analysis allowed us to estimate the total and the individual contribution of the separate components of air pollution on the formation of levels of total morbidity rate of bronchial asthma in the population of the city of Vladivostok. Levels of total incidence of this pathology were established to differ in various age groups. The adult population is more adapted to air pollution, but retains a high sensitivity to the impact of nitrogen dioxide. Levels of overall l morbidity rate of bronchial asthma in children and adolescents depend on the total air pollution with some dominance of the influence of suspended matter and carbon monoxide.

  15. Psychological morbidity and health-related quality of life in patients with differing awareness of cancer diagnosis: a cross-sectional study.

    Science.gov (United States)

    Wang, Dian Can; Guo, Chuan Bin; Peng, Xin; Su, Yan Jie

    2014-09-01

    Concealment of cancer diagnosis from patients is not rare worldwide and physicians in mainland China are in fact discouraged from disclosing a cancer diagnosis to cancer patients. Preventing worsened psychological morbidity is at the core of the argument for nondisclosure. The purpose of this study was to quantify anxiety, depression, and distress among patients with various degrees of awareness of their cancer diagnosis. Quality of life was also measured. Using a cross-sectional and blinded design, the Hospital Anxiety and Depression Scale questionnaire, the Distress Thermometer, and the SF-36 Health Survey were administered to 287 hospitalized patients with oral and maxillofacial tumors. Independently, the patients' awareness of disease was assessed with semistructured interviews. Hospital Anxiety and Depression Scale, Distress Thermometer, and SF-36 did not identify significant differences in scores among the hospitalized patients with various degrees of awareness of their cancer diagnosis: an awaiting diagnosis group, a concealed diagnosis group, and a disclosed diagnosis group. Before surgery, inpatients who were hospitalized because of oral and maxillofacial tumors with various degrees of awareness of their cancer diagnosis had similar psychological morbidity and quality of life. Informing hospitalized cancer patients of their diagnosis before surgery may not deteriorate their psychiatric condition or their quality of life. Copyright © 2014 John Wiley & Sons, Ltd.

  16. Early Contralateral Shoulder-Arm Morbidity in Breast Cancer Patients Enrolled in a Randomized Trial of Post-Surgery Radiation Therapy

    Directory of Open Access Journals (Sweden)

    Nele Adriaenssens

    2012-01-01

    Full Text Available Introduction Shoulder/arm morbidity is a common complication of breast cancer surgery and radiotherapy (RT, but little is known about acute contralateral morbidity. Methods Patients were 118 women enrolled in a RT trial. Arm volume and shoulder mobility were assessed before and 1–3 months after RT. Correlations and linear regression were used to analyze changes affecting ipsilateral and contralateral arms, and changes affecting relative interlimb differences (RID. Results Changes affecting one limb correlated with changes affecting the other limb. Arm volume between the two limbs correlated (R = 0.57. Risk factors were weight increase and axillary dissection. Contralateral and ipsilateral loss of abduction strongly correlated (R = 0.78. Changes of combined RID exceeding 10% affected the ipsilateral limb in 25% of patients, and the contralateral limb in 18%. Aromatase inhibitor therapy was significantly associated with contralateral loss of abduction. Conclusions High incidence of early contralateral arm morbidity warrants further investigations.

  17. Night-shift work increases morbidity of breast cancer and all-cause mortality: a meta-analysis of 16 prospective cohort studies.

    Science.gov (United States)

    Lin, Xiaoti; Chen, Weiyu; Wei, Fengqin; Ying, Mingang; Wei, Weidong; Xie, Xiaoming

    2015-11-01

    Night-shift work (NSW) has previously been related to incidents of breast cancer and all-cause mortality, but many published studies have reported inconclusive results. The aim of the present study was to quantify a potential dose-effect relationship between NSW and morbidity of breast cancer, and to evaluate the association between NSW and risk of all-cause mortality. The outcomes included NSW, morbidity of breast cancer, cardiovascular mortality, cancer-related mortality, and all-cause mortality. Sixteen investigations were included, involving 2,020,641 participants, 10,004 incident breast cancer cases, 7185 cancer-related deaths, 4820 cardiovascular end points, and 2480 all-cause mortalities. The summary risk ratio (RR) of incident breast cancer for an increase of NSW was 1.057 [95% confidence interval (CI) 1.014-1.102; test for heterogeneity p = 0.358, I(2) = 9.2%]. The combined RR (95% CI) of breast cancer risk for NSW vs daytime work was: 1.029 (0.969-1.093) in the 20-year exposure lengths. The overall RR was 1.089 (95% CI 1.016-1.166) in a fixed-effects model (test for heterogeneity p = 0.838, I(2) = 0%) comparing rotating NSW and day work. Night-shift work was associated with an increased risk of cardiovascular death (RR 1.027, 95% CI 1.001-1.053), and all-cause death 1.253 (95% CI 0.786-1.997). In summary, NSW increased the risk of breast cancer morbidity by: 1.9% for 5 years, 2.5% for 5-10 years, 7.4% for 10-20 years, and 8.8% for >20-years of NSW. Additionally, rotating NSW enhanced the morbidity of breast cancer by 8.9%. Moreover, NSW was associated with a 2.7% increase in cardiovascular death. Copyright © 2015. Published by Elsevier B.V.

  18. Prevalence and impacts of upper limb morbidity after treatment for breast cancer: a cross-sectional study of lymphedema and function.

    OpenAIRE

    Bulley, Catherine; Coutts, Fiona; Blyth, Christine; Jack, W; Chetty, U.; M. Barber; Tan, Chee-Wee

    2013-01-01

    A cross-sectional study screened lymphedema, impaired upper limb function (ULF) and quality of life (QOL) in women post-breast cancer. Women attending review appointments who had completed surgery, chemotherapy and radiotherapy, were without recurrence, and could complete questionnaires in English were invited. Medical records were reviewed and questionnaires completed: the Morbidity Screening Tool (MST), Disability of the Arm, Shoulder and Hand questionnaire (DASH), and Functional Assessment...

  19. Perioperative mortality and morbidity prediction using POSSUM, P-POSSUM and APACHE II in Chinese gastric cancer patients: surgical method is a key independent factor affecting prognosis.

    Science.gov (United States)

    Fang, Yantian; Wu, Chunhsien; Gu, Xiaodong; Li, Zhengyang; Xiang, Jianbin; Chen, Zongyou

    2014-02-01

    Gastric cancer is the fourth most common cancer worldwide. Predicting morbidity and mortality is important in deciding timing of surgery and type of surgery offered. APACHE II, POSSUM, and P-POSSUM are the most reliable scoring methods in use today. This is the first paper to evaluate the utility of all three scoring systems in China. We collected data on 851 patients (583 male and 268 female) who underwent surgery between 1991 and 2011. Physiological and pathological data was entered in spreadsheet format and analyzed using STATA version 11.0 to generate ROC curves for each scoring system. In predicting mortality, P-POSSUM and POSSUM were most effective and APACHE II was ineffective. POSSUM predicted a higher morbidity risk than was actually encountered. Age and type of operation were found to be independent risk factors for mortality. The utility of the APACHE II score in gastric cancer patients is limited. APACHE II is suitable for considering group versus individual effect. The POSSUM score is useful in general surgery, but needs improvement. We found the P-POSSUM score to be superior for morbidity and mortality prediction. P-POSSUM is useful for both the general population and for a specific cohort. The type of surgery is a key decision point for surgeons, and independently affects prognosis. Based upon these findings and clinical scoring systems, clinicians can develop individualized treatment algorithms.

  20. The dark side of the moon: impact of moon phases on long-term survival, mortality and morbidity of surgery for lung cancer.

    Science.gov (United States)

    Kuehnl, A; Herzog, M; Schmidt, M; Hornung, H-M; Jauch, K-W; Hatz, R A; Graeb, C

    2009-04-16

    Superstition is common and causes discomfiture or fear, especially in patients who have to undergo surgery for cancer. One superstition is, that moon phases influence surgical outcome. This study was performed to analyse lunar impact on the outcome following lung cancer surgery. 2411 patients underwent pulmonary resection for lung cancer in the past 30 years at our institution. Intra- and postoperative complications as well as long-term follow-up data were entered in our lung-cancer database. Factors influencing mortality, morbidity and survival were analyzed. Rate of intra-operative complications as well as rate of post-operative morbidity and mortality was not significantly affected by moon phases. Furthermore, there was no significant impact of the lunar cycle on long-term survival. In this study there was no evidence that outcome of surgery for lung cancer is affected by the moon. These results may help the physician to quiet the mind of patients who are somewhat afraid of wrong timing of surgery with respect to the moon phases. However, patients who strongly believe in the impact of moon phase should be taken seriously and correct timing of operations should be conceded to them as long as key-date scheduling doesn't constrict evidence based treatment regimens.

  1. The dark side of the moon: Impact of moon phases on long-term survival, mortality and morbidity of surgery for lung cancer

    Directory of Open Access Journals (Sweden)

    Kuehnl A

    2009-04-01

    Full Text Available Abstract Objective Superstition is common and causes discomfiture or fear, especially in patients who have to undergo surgery for cancer. One superstition is, that moon phases influence surgical outcome. This study was performed to analyse lunar impact on the outcome following lung cancer surgery. Methods 2411 patients underwent pulmonary resection for lung cancer in the past 30 years at our institution. Intra-and postoperative complications as well as long-term follow-up data were entered in our lung-cancer database. Factors influencing mortality, morbidity and survival were analyzed. Results Rate of intra-operative complications as well as rate of post-operative morbidity and mortality was not significantly affected by moon phases. Furthermore, there was no significant impact of the lunar cycle on long-term survial. Conclusion In this study there was no evidence that outcome of surgery for lung cancer is affected by the moon. These results may help the physician to quite the mind of patients who are somewhat afraid of wrong timing of surgery with respect to the moon phases. However, patients who strongly believe in the impact of moon phase should be taken seriously and correct timing of operations should be conceded to them as long as key-date scheduling doesn't constrict evidence based treatment regimens.

  2. Levels of Distress in Women at Risk for Ovarian Cancer

    National Research Council Canada - National Science Library

    Kash, Kathryn M

    2008-01-01

    The overall goal of this study was to determine the levels of distress in women with a family history of ovarian cancer and to identify the mediating factors between risk of developing ovarian cancer and distress...

  3. Evaluation of the POSSUM, p-POSSUM, o-POSSUM, and APACHE II scoring systems in predicting postoperative mortality and morbidity in gastric cancer patients.

    Science.gov (United States)

    Hong, Shikai; Wang, Shengying; Xu, Guozeng; Liu, JinLu

    2017-04-01

    Gastric cancer is the fourth most prevalent cancer worldwide. The ability to accurately predict surgery-related morbidity and mortality is critical in deciding both the timing of surgery and choice of surgical procedure. The aim of this study is to compare the POSSUM, p-POSSUM, o-POSSUM, and APACHE II scoring systems for predicting surgical morbidity and mortality in Chinese gastric cancer patients, as well as to create new scoring systems to achieve better prediction. Data from 612 gastric cancer patients undergoing gastrectomy between January 2007 and December 2011 were included in this study. The predictive abilities of the four scoring systems were compared by examining observed-to-expected (O/E) ratios, the receiver operating characteristic curve, Student t test, and χ2 test results. The observed complication rate of 34% (n = 208) did not differ significantly from the rate of 36.6% (n = 208) predicted by the POSSUM scoring system (O/E ratio = 0.93). The observed mortality rate was 2.9% (n = 18). For predicting mortality, POSSUM had an O/E ratio of 0.34 as compared with p-POSSUM (O/E ratio = 0.91), o-POSSUM (O/E ratio = 1.26), and APACHE II (O/E ratio = 0.28). The POSSUM scoring system performed well with respect to predicting morbidity risk following gastric cancer resection. For predicting postoperative mortality, p-POSSUM and o-POSSUM exhibited superior performance relative to POSSUM and APACHE II. Copyright © 2017. Published by Elsevier Taiwan.

  4. Decreased chronic morbidity but elevated HIV associated cytokine levels in HIV-infected older adults receiving HIV treatment: benefit of enhanced access to care?

    Directory of Open Access Journals (Sweden)

    Portia C Mutevedzi

    Full Text Available The association of HIV with chronic morbidity and inflammatory markers (cytokines in older adults (50+years is potentially relevant for clinical care, but data from African populations is scarce.To examine levels of chronic morbidity by HIV and ART status in older adults (50+years and subsequent associations with selected pro-inflammatory cytokines and body mass index.Ordinary, ordered and generalized ordered logistic regression techniques were employed to compare chronic morbidity (heart disease (angina, arthritis, stroke, hypertension, asthma and diabetes and cytokines (Interleukins-1 and -6, C-Reactive Protein and Tumor Necrosis Factor-alpha by HIV and ART status on a cross-sectional random sample of 422 older adults nested within a defined rural South African population based demographic surveillance.Using a composite measure of all morbidities, controlling for age, gender, BMI, smoking and wealth quintile, HIV-infected individuals on ART had 51% decreased odds (95% CI:0.26-0.92 of current morbidity compared to HIV-uninfected. In adjusted regression, compared to HIV-uninfected, the proportional odds (aPOR of having elevated inflammation markers of IL6 (>1.56 pg/mL was nearly doubled in HIV-infected individuals on (aPOR 1.84; 95%CI: 1.05-3.21 and not on (aPOR 1.94; 95%CI: 1.11-3.41 ART. Compared to HIV-uninfected, HIV-infected individuals on ART had >twice partial proportional odds (apPOR=2.30;p=0.004 of having non-clinically significant raised hsCRP levels(>1 ug/mL; ART-naïve HIV-infected individuals had >double apPOR of having hsCRP levels indicative of increased heart disease risk(>3.9 ug/mL;p=0.008.Although HIV status was associated with increased inflammatory markers, our results highlight reduced morbidity in those receiving ART and underscore the need of pro-actively extending these services to HIV-uninfected older adults, beyond mere provision at fixed clinics. Providing health services through regular community chronic disease

  5. High αv Integrin Level of Cancer Cells Is Associated with Development of Brain Metastasis in Athymic Rats.

    Science.gov (United States)

    Wu, Yingjen Jeffrey; Pagel, Michael A; Muldoon, Leslie L; Fu, Rongwei; Neuwelt, Edward A

    2017-08-01

    Brain metastases commonly occur in patients with malignant skin, lung and breast cancers resulting in high morbidity and poor prognosis. Integrins containing an αv subunit are cell adhesion proteins that contribute to cancer cell migration and cancer progression. We hypothesized that high expression of αv integrin cell adhesion protein promoted metastatic phenotypes in cancer cells. Cancer cells from different origins were used and studied regarding their metastatic ability and intetumumab, anti-αv integrin mAb, sensitivity using in vitro cell migration assay and in vivo brain metastases animal models. The number of brain metastases and the rate of occurrence were positively correlated with cancer cell αv integrin levels. High αv integrin-expressing cancer cells showed significantly faster cell migration rate in vitro than low αv integrin-expressing cells. Intetumumab significantly inhibited cancer cell migration in vitro regardless of αv integrin expression level. Overexpression of αv integrin in cancer cells with low αv integrin level accelerated cell migration in vitro and increased the occurrence of brain metastases in vivo. αv integrin promotes brain metastases in cancer cells and may mediate early steps in the metastatic cascade, such as adhesion to brain vasculature. Targeting αv integrin with intetumumab could provide clinical benefit in treating cancer patients who develop metastases. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  6. Severity of non-alcoholic fatty liver disease is associated with high systemic levels of tumor necrosis factor alpha and low serum interleukin 10 in morbidly obese patients.

    Science.gov (United States)

    Paredes-Turrubiarte, Gabriela; González-Chávez, Antonio; Pérez-Tamayo, Ruy; Salazar-Vázquez, Beatriz Y; Hernández, Vito S; Garibay-Nieto, Nayeli; Fragoso, José Manuel; Escobedo, Galileo

    2016-05-01

    Morbid obesity has been shown to increase the risk to develop hepatic steatosis, also referred to as non-alcoholic fatty liver disease (NAFLD). Emerging evidence suggests that the severity of NAFLD may associate with increased serum levels of inflammatory markers as well as decreased concentration of mediators with anti-inflammatory actions, such as tumor necrosis factor alpha (TNF-α) and interleukin (IL) 10, respectively. We thus examined the serum levels of TNF-α and IL-10 in 102 morbidly obese women and men (body mass index > 40 kg/m(2)), exhibiting different grades of NAFLD. Blood glucose, glycated hemoglobin, insulin, the homeostatic model assessment of insulin resistance (HOMA-IR), total cholesterol, triglycerides, high- and low-density lipoproteins, parameters of liver function, TNF-α, and IL-10 were measured in each subject. The stage of NAFLD was estimated by abdominal ultrasound imaging. In comparison with morbidly obese subjects without steatosis, morbidly obese patients with NAFLD showed increased age (39.23 ± 9.80 years), HOMA-IR (6.74 ± 1.62), total cholesterol (219.7 ± 9.58 mg/dl), aspartate aminotransferase (36.25 ± 3.24 UI/l), gamma-glutamyl transpeptidase (37.12 ± 3.41 UI/l), and TNF-α (37.41 ± 1.72 pg/ml) as well as decreased serum levels of IL-10 (61.05 ± 2.43 pg/ml). Interestingly, the systemic levels of TNF-α increased, while IL-10 decreased in accordance with the severity of NAFLD, which supports a role for systemic inflammatory mediators in promoting steatosis progression. Further clinical prospective studies need to be addressed to elucidate the role of TNF-α and IL-10 in the development of NAFLD while also establishing their clinical utility in the assessment of morbidly obese patients at higher risk to develop severe steatosis.

  7. Impact of Increasing Age on Cause-Specific Mortality and Morbidity in Patients With Stage I Non-Small-Cell Lung Cancer: A Competing Risks Analysis.

    Science.gov (United States)

    Eguchi, Takashi; Bains, Sarina; Lee, Ming-Ching; Tan, Kay See; Hristov, Boris; Buitrago, Daniel H; Bains, Manjit S; Downey, Robert J; Huang, James; Isbell, James M; Park, Bernard J; Rusch, Valerie W; Jones, David R; Adusumilli, Prasad S

    2017-01-20

    Purpose To perform competing risks analysis and determine short- and long-term cancer- and noncancer-specific mortality and morbidity in patients who had undergone resection for stage I non-small-cell lung cancer (NSCLC). Patients and Methods Of 5,371 consecutive patients who had undergone curative-intent resection of primary lung cancer at our institution (2000 to 2011), 2,186 with pathologic stage I NSCLC were included in the analysis. All preoperative clinical variables known to affect outcomes were included in the analysis, specifically, Charlson comorbidity index, predicted postoperative (ppo) diffusing capacity of the lung for carbon monoxide, and ppo forced expiratory volume in 1 second. Cause-specific mortality analysis was performed with competing risks analysis. Results Of 2,186 patients, 1,532 (70.1%) were ≥ 65 years of age, including 638 (29.2%) ≥ 75 years of age. In patients lung cancer-specific cumulative incidence of death (CID) was 7.5%, 10.7%, and 13.2%, respectively (overall, 10.4%); noncancer-specific CID was 1.8%, 4.9%, and 9.0%, respectively (overall, 5.3%). In patients ≥ 65 years of age, for up to 2.5 years after resection, noncancer-specific CID was higher than lung cancer-specific CID; the higher noncancer-specific, early-phase mortality was enhanced in patients ≥ 75 years of age than in those 65 to 74 years of age. Multivariable analysis showed that low ppo diffusing capacity of lung for carbon monoxide was an independent predictor of severe morbidity ( P lung cancer-specific mortality ( P = .002). Conclusion In patients who undergo curative-intent resection of stage I NSCLC, noncancer-specific mortality is a significant competing event, with an increasing impact as patient age increases.

  8. Adjuvant Hypofractionated Versus Conventional Whole Breast Radiation Therapy for Early-Stage Breast Cancer: Long-Term Hospital-Related Morbidity From Cardiac Causes

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Elisa K. [Department of Oncology, Saint John Regional Hospital, Saint John (Canada); Woods, Ryan; McBride, Mary L. [Cancer Control Research Department, BC Cancer Agency, Vancouver (Canada); Virani, Sean [Division of Cardiology, University of British Columbia, Vancouver (Canada); Nichol, Alan [Radiation Therapy Program, BC Cancer Agency, Vancouver (Canada); Speers, Caroline [Breast Cancer Outcomes Unit, BC Cancer Agency, Vancouver (Canada); Wai, Elaine S. [Radiation Therapy Program, BC Cancer Agency, Vancouver (Canada); Tyldesley, Scott, E-mail: styldesl@bccancer.bc.ca [Radiation Therapy Program, BC Cancer Agency, Vancouver (Canada)

    2014-03-15

    Purpose: The risk of cardiac injury with hypofractionated whole-breast/chest wall radiation therapy (HF-WBI) compared with conventional whole-breast/chest wall radiation therapy (CF-WBI) in women with left-sided breast cancer remains a concern. The purpose of this study was to determine if there is an increase in hospital-related morbidity from cardiac causes with HF-WBI relative to CF-WBI. Methods and Materials: Between 1990 and 1998, 5334 women ≤80 years of age with early-stage breast cancer were treated with postoperative radiation therapy to the breast or chest wall alone. A population-based database recorded baseline patient, tumor, and treatment factors. Hospital administrative records identified baseline cardiac risk factors and other comorbidities. Factors between radiation therapy groups were balanced using a propensity-score model. The first event of a hospital admission for cardiac causes after radiation therapy was determined from hospitalization records. Ten- and 15-year cumulative hospital-related cardiac morbidity after radiation therapy was estimated for left- and right-sided cases using a competing risk approach. Results: The median follow-up was 13.2 years. For left-sided cases, 485 women were treated with CF-WBI, and 2221 women were treated with HF-WBI. Mastectomy was more common in the HF-WBI group, whereas boost was more common in the CF-WBI group. The CF-WBI group had a higher prevalence of diabetes. The 15-year cumulative hospital-related morbidity from cardiac causes (95% confidence interval) was not different between the 2 radiation therapy regimens after propensity-score adjustment: 21% (19-22) with HF-WBI and 21% (17-25) with CF-WBI (P=.93). For right-sided cases, the 15-year cumulative hospital-related morbidity from cardiac causes was also similar between the radiation therapy groups (P=.76). Conclusions: There is no difference in morbidity leading to hospitalization from cardiac causes among women with left-sided early-stage breast

  9. Hair iron and other minerals' level in breast cancer patients.

    Science.gov (United States)

    Joo, Nam-Seok; Kim, Sang-Man; Jung, Yong-Sik; Kim, Kwang-Min

    2009-01-01

    Little is known about hair minerals in cancer patients, and serum iron level has been shown to be elevated in breast cancer patients. Therefore, the aim of this study was to evaluate hair iron and hair minerals' level related to hair iron in breast cancer patients compared to controls. We compared hair mineral analysis data of 40 breast cancer subjects with age and body mass index-matched normal control data (n = 144) by cross-sectional analysis. All breast cancer patients were newly diagnosed at one Breast Cancer Center in Ajou University and had their hair cut before anti-cancer chemotherapy, and the normal controls (without breast cancer) also had their hair cut for various reasons in out-patient clinics of the Department of Family Practice and Community Health. Breast cancer patients had low calcium, magnesium, iron, copper, manganese, and zinc, whereas they had high arsenic, sodium, and potassium compared with the normal control. The hair iron level was positively correlated with hair calcium (r = 0.761, P arsenic (r = -0.537, P breast cancer patients compared to normal controls. Especially, hair iron level was significantly reduced and associated with hair calcium and manganese levels.

  10. Recommendations from the EGAPP Working Group: genetic testing strategies in newly diagnosed individuals with colorectal cancer aimed at reducing morbidity and mortality from Lynch syndrome in relatives.

    Science.gov (United States)

    2009-01-01

    The Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Working Group found sufficient evidence to recommend offering genetic testing for Lynch syndrome to individuals with newly diagnosed colorectal cancer to reduce morbidity and mortality in relatives. We found insufficient evidence to recommend a specific genetic testing strategy among the several examined. Genetic testing to detect Lynch syndrome in individuals with newly diagnosed colorectal cancer (CRC) is proposed as a strategy to reduce CRC morbidity and mortality in their relatives (see Clinical Considerations section for definition of Lynch syndrome). The EGAPP Working Group (EWG) constructed a chain of evidence that linked genetic testing for Lynch syndrome in patients with newly diagnosed CRC with improved health outcomes in their relatives. We found that assessing patients who have newly diagnosed CRC with a series of genetic tests could lead to the identification of Lynch syndrome. Relatives of patients with Lynch syndrome could then be offered genetic testing, and, where indicated, colorectal, and possibly endometrial, cancer surveillance, with the expectation of improved health outcome. The EWG concluded that there is moderate certainty that such a testing strategy would provide moderate population benefit. The EWG found adequate evidence to conclude that the analytic sensitivity and specificity for preliminary and diagnostic tests were high. After accounting for the specific technologies and numbers of markers used, the EWG found at least adequate evidence to describe the clinical sensitivity and specificity for three preliminary tests, and for four selected testing strategies. These measures of clinical validity varied with each test and each strategy (see Clinical Considerations section). The EWG found adequate evidence for testing uptake rates, adherence to recommended surveillance activities, number of relatives approachable, harms associated with additional follow-up, and

  11. Heightened circulating levels of antimicrobial peptides in tuberculosis—Diabetes co-morbidity and reversal upon treatment

    Science.gov (United States)

    Kumar, Nathella Pavan; Moideen, Kadar; Viswanathan, Vijay; Sivakumar, Shanmugam; Menon, Pradeep A.; Kornfeld, Hardy

    2017-01-01

    Background The association of antimicrobial peptides (AMPs) with tuberculosis—diabetes comorbidity (PTB-DM) is not well understood. Methods To study the association of AMPs with PTB-DM, we examined the systemic levels of cathelicidin (LL37), human beta defensin– 2 (HBD2), human neutrophil peptides 1–3, (HNP1-3) and granulysin in individuals with either PTB-DM, PTB, latent TB (LTB) or no TB infection (NTB). Results Circulating levels of cathelicidin and HBD2 were significantly higher and granulysin levels were significantly lower in PTB-DM compared to PTB, LTB or NTB, while the levels of HNP1-3 were significantly higher in PTB-DM compared to LTB or NTB individuals. Moreover, the levels of cathelicidin and/or HBD2 were significantly higher in PTB-DM or PTB individuals with bilateral and cavitary disease and also exhibited a significant positive relationship with bacterial burden. Cathelidin, HBD2 and HNP1-3 levels exhibited a positive relationship with HbA1c and/or fasting blood glucose levels. Finally, anti-tuberculosis therapy resulted in significantly diminished levels of cathelicidin, HBD2, granulysin and significantly enhanced levels of HNP1-3 and granulysin in PTB-DM and/or PTB individuals. Conclusion Therefore, our data demonstrate that PTB-DM is associated with markedly enhanced levels of AMPs and diminished levels of granulysin. PMID:28910369

  12. Heightened circulating levels of antimicrobial peptides in tuberculosis-Diabetes co-morbidity and reversal upon treatment.

    Directory of Open Access Journals (Sweden)

    Nathella Pavan Kumar

    Full Text Available The association of antimicrobial peptides (AMPs with tuberculosis-diabetes comorbidity (PTB-DM is not well understood.To study the association of AMPs with PTB-DM, we examined the systemic levels of cathelicidin (LL37, human beta defensin- 2 (HBD2, human neutrophil peptides 1-3, (HNP1-3 and granulysin in individuals with either PTB-DM, PTB, latent TB (LTB or no TB infection (NTB.Circulating levels of cathelicidin and HBD2 were significantly higher and granulysin levels were significantly lower in PTB-DM compared to PTB, LTB or NTB, while the levels of HNP1-3 were significantly higher in PTB-DM compared to LTB or NTB individuals. Moreover, the levels of cathelicidin and/or HBD2 were significantly higher in PTB-DM or PTB individuals with bilateral and cavitary disease and also exhibited a significant positive relationship with bacterial burden. Cathelidin, HBD2 and HNP1-3 levels exhibited a positive relationship with HbA1c and/or fasting blood glucose levels. Finally, anti-tuberculosis therapy resulted in significantly diminished levels of cathelicidin, HBD2, granulysin and significantly enhanced levels of HNP1-3 and granulysin in PTB-DM and/or PTB individuals.Therefore, our data demonstrate that PTB-DM is associated with markedly enhanced levels of AMPs and diminished levels of granulysin.

  13. Relationship Between State-Level Google Online Search Volume and Cancer Incidence in the United States: Retrospective Study.

    Science.gov (United States)

    Phillips, Charles A; Barz Leahy, Allison; Li, Yimei; Schapira, Marilyn M; Bailey, L Charles; Merchant, Raina M

    2018-01-08

    In the United States, cancer is common, with high morbidity and mortality; cancer incidence varies between states. Online searches reflect public awareness, which could be driven by the underlying regional cancer epidemiology. The objective of our study was to characterize the relationship between cancer incidence and online Google search volumes in the United States for 6 common cancers. A secondary objective was to evaluate the association of search activity with cancer-related public events and celebrity news coverage. We performed a population-based, retrospective study of state-level cancer incidence from 2004 through 2013 reported by the Centers for Disease Control and Prevention for breast, prostate, colon, lung, and uterine cancers and leukemia compared to Google Trends (GT) relative search volume (RSV), a metric designed by Google to allow interest in search topics to be compared between regions. Participants included persons in the United States who searched for cancer terms on Google. The primary measures were the correlation between annual state-level cancer incidence and RSV as determined by Spearman correlation and linear regression with RSV and year as independent variables and cancer incidence as the dependent variable. Temporal associations between search activity and events raising public awareness such as cancer awareness months and cancer-related celebrity news were described. At the state level, RSV was significantly correlated to incidence for breast (r=.18, P=.001), prostate (r=-.27, P<.001), lung (r=.33, P<.001), and uterine cancers (r=.39, P<.001) and leukemia (r=.13, P=.003) but not colon cancer (r=-.02, P=.66). After adjusting for time, state-level RSV was positively correlated to cancer incidence for all cancers: breast (P<.001, 95% CI 0.06 to 0.19), prostate (P=.38, 95% CI -0.08 to 0.22), lung (P<.001, 95% CI 0.33 to 0.46), colon (P<.001, 95% CI 0.11 to 0.17), and uterine cancers (P<.001, 95% CI 0.07 to 0.12) and leukemia (P<.001, 95

  14. Reduced Systemic Levels of IL-10 Are Associated with the Severity of Obstructive Sleep Apnea and Insulin Resistance in Morbidly Obese Humans

    Directory of Open Access Journals (Sweden)

    Sonia Leon-Cabrera

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA has been related to elevation of inflammatory cytokines and development of insulin resistance in morbidly obese (MO subjects. However, it is still unclear whether the systemic concentration of anti-inflammatory mediators is also affected in MO subjects directly related to the severity of OSA and level of insulin resistance. Normal weight and MO subjects were subjected to overnight polysomnography in order to establish the severity of OSA, according to the apnea-hypopnea index (AHI. Blood samples were obtained for estimation of total cholesterol and triglycerides, insulin, glucose, insulin resistance, tumor necrosis factor alpha (TNF-α, interleukin 12 (IL12, and interleukin 10 (IL-10. Serum levels of IL-10 were significantly lower in MO subjects with OSA than in MO and control individuals without OSA. Besides being inversely associated with serum TNF-α and IL-12, decreased IL-10 levels were significantly related to increased AHI, hyperinsulinemia, and insulin resistance. Serum IL-10 is significantly reduced in morbidly obese subjects with severe OSA while also showing a clear relationship with a state of hyperinsulinemia and insulin resistance probably regardless of obesity in the present sample. It may be of potential clinical interest to identify the stimulatory mechanisms of IL-10 in obese individuals with OSA.

  15. County-level cumulative environmental quality associated with cancer incidence.

    Science.gov (United States)

    Jagai, Jyotsna S; Messer, Lynne C; Rappazzo, Kristen M; Gray, Christine L; Grabich, Shannon C; Lobdell, Danelle T

    2017-08-01

    Individual environmental exposures are associated with cancer development; however, environmental exposures occur simultaneously. The Environmental Quality Index (EQI) is a county-level measure of cumulative environmental exposures that occur in 5 domains. The EQI was linked to county-level annual age-adjusted cancer incidence rates from the Surveillance, Epidemiology, and End Results (SEER) Program state cancer profiles. All-site cancer and the top 3 site-specific cancers for male and female subjects were considered. Incident rate differences (IRDs; annual rate difference per 100,000 persons) and 95% confidence intervals (CIs) were estimated using fixed-slope, random intercept multilevel linear regression models. Associations were assessed with domain-specific indices and analyses were stratified by rural/urban status. Comparing the highest quintile/poorest environmental quality with the lowest quintile/best environmental quality for overall EQI, all-site county-level cancer incidence rate was positively associated with poor environmental quality overall (IRD, 38.55; 95% CI, 29.57-47.53) and for male (IRD, 32.60; 95% CI, 16.28-48.91) and female (IRD, 30.34; 95% CI, 20.47-40.21) subjects, indicating a potential increase in cancer incidence with decreasing environmental quality. Rural/urban stratified models demonstrated positive associations comparing the highest with the lowest quintiles for all strata, except the thinly populated/rural stratum and in the metropolitan/urbanized stratum. Prostate and breast cancer demonstrated the strongest positive associations with poor environmental quality. We observed strong positive associations between the EQI and all-site cancer incidence rates, and associations differed by rural/urban status and environmental domain. Research focusing on single environmental exposures in cancer development may not address the broader environmental context in which cancers develop, and future research should address cumulative environmental

  16. Plasminogen activator inhibitor type 1 serum levels and 4G/5G gene polymorphism in morbidly obese Hispanic patients with non-alcoholic fatty liver disease.

    Science.gov (United States)

    Espino, Alberto; Villagrán, Andrea; Vollrath, Valeska; Hanckes, Paulina; Salas, Roberto; Farah, Andrea; Solís, Nancy; Pizarro, Margarita; Escalona, Alex; Boza, Camilo; Pérez, Gustavo; Carrasco, Gonzalo; Padilla, Oslando; Miquel, Juan Francisco; Nervi, Flavio; Chavez-Tapia, Norberto C; Arab, Juan Pablo; Alvarez-Lobos, Manuel; Arrese, Marco; Riquelme, Arnoldo

    2011-01-01

    The plasminogen activator inhibitor type-1 (PAI-1) has been implicated in the regulation of fibrinolysis and extracellular matrix components. The single base pair guanine insertion/deletion polymorphism (4G/5G) within the promoter region of the PAI-1 gene influences PAI-1 synthesis and may modulate hepatic fibrogenesis. To evaluate the influence of PAI-1 serum levels and 4G/5G polymorphism on the risk of liver fibrosis associated to non-alcoholic fatty liver disease (NAFLD) in morbidly obese patients. Case-control study of 50 obese patients undergoing bariatric surgery and 71 non-obese subjects matched by age and sex. Anthropometric and biochemical measurements were performed, including PAI-1 serum levels. Genomic DNA was obtained to assess the presence of 4G/5G polymorphism. BMI, insulinemia, triglycerides, HOMA-IR, hypertension and diabetes were significantly higher in obese patients compared to control subjects. PAI-1 serum levels observed in obese patients were significantly lower (10.63 ± 4.82) compared to controls (14.26 ± 11.4; p 5G promoter genotypes frequencies (p = 0.12). No differences were observed in PAI-1 plasma levels among obese patients with liver fibrosis (10.64 ± 4.35) compared to patients without liver fibrosis (10.61 ± 5.2; p = 0.985). PAI-1 4G/5G promoter genotypes frequencies were similar in patients with or without liver fibrosis associated to NASH (p = 0.6). Morbidly obese patients had significantly lower PAI-1 serum levels with similar PAI-1 4G/5G genotypes frequencies compared to non-obese subjects. The frequency of 4G/5G genotypes in Chilean Hispanic healthy subjects was similar to that described in other populations. No association was found between PAI-1 serum levels or 4G/5G genotype with liver fibrosis in obese patients.

  17. Risk Estimation for Lung Cancer in Libya: Analysis Based on Standardized Morbidity Ratio, Poisson-Gamma Model, BYM Model and Mixture Model

    Science.gov (United States)

    Alhdiri, Maryam Ahmed; Samat, Nor Azah; Mohamed, Zulkifley

    2017-03-01

    Cancer is the most rapidly spreading disease in the world, especially in developing countries, including Libya. Cancer represents a significant burden on patients, families, and their societies. This disease can be controlled if detected early. Therefore, disease mapping has recently become an important method in the fields of public health research and disease epidemiology. The correct choice of statistical model is a very important step to producing a good map of a disease. Libya was selected to perform this work and to examine its geographical variation in the incidence of lung cancer. The objective of this paper is to estimate the relative risk for lung cancer. Four statistical models to estimate the relative risk for lung cancer and population censuses of the study area for the time period 2006 to 2011 were used in this work. They are initially known as Standardized Morbidity Ratio, which is the most popular statistic, which used in the field of disease mapping, Poisson-gamma model, which is one of the earliest applications of Bayesian methodology, Besag, York and Mollie (BYM) model and Mixture model. As an initial step, this study begins by providing a review of all proposed models, which we then apply to lung cancer data in Libya. Maps, tables and graph, goodness-of-fit (GOF) were used to compare and present the preliminary results. This GOF is common in statistical modelling to compare fitted models. The main general results presented in this study show that the Poisson-gamma model, BYM model, and Mixture model can overcome the problem of the first model (SMR) when there is no observed lung cancer case in certain districts. Results show that the Mixture model is most robust and provides better relative risk estimates across a range of models. Creative Commons Attribution License

  18. Intratumoral levels of estrogens in breast cancer.

    Science.gov (United States)

    Blankenstein, M A; van de Ven, J; Maitimu-Smeele, I; Donker, G H; de Jong, P C; Daroszewski, J; Szymczak, J; Milewicz, A; Thijssen, J H

    1999-01-01

    Breast cancer tissue is an endocrine organ and particularly the estrogen biosynthetic properties of this tissue have been well studied. The concentration of estradiol in breast cancer tissue from postmenopausal patients is considerably higher than that in the circulation and appears to depend largely on local production. Androgenic precursor steroids are abundantly present, but estrogen storage pools like fatty acid derivatives appear to be less important than initially thought. New, potent and highly specific aromatase inhibitors effectively inhibit peripheral conversion of androgens to estrogens (Cancer Res. 53: 4563, 1993) as well as intratumour aromatase, median aromatase activity being 89% lower in the tissue from patients pretreated with aromatase inhibitor 7 days prior to surgery (P < 0.001). Also the intratissue concentrations of estrogens were decreased (64% and 80% reduction, respectively for estrone and estradiol; P = 0.001 and <0.05; Cancer Res. 57: 2109, 1997). These results illustrate that intratissue estrogen biosynthesis is effectively inhibited by the new generation of aromatase inhibitors. The pathophysiological consequences of this finding are currently under study.

  19. Serum endocan levels in endometrial and ovarian cancers.

    Science.gov (United States)

    Laloglu, Esra; Kumtepe, Yakup; Aksoy, Hulya; Topdagi Yilmaz, Emsal Pınar

    2017-09-01

    Ovarian and endometrial carcinomas are the two most common malignancies of the female reproductive system. Endocan is a proteoglycan that is specific to vascular endothelial cells. Increased serum levels have been reported in some tumors. The aim of this study was to investigate serum endocan levels in cases of endometrial and ovarian cancer. Levels of serum endocan were assessed in 27 patients with endometrial cancer and 20 with ovarian cancer, and in 38 control subjects with benign ovarian or endometrial disorders. Thirty-five healthy subjects were also included. Serum endocan levels were measured using a specific enzyme-linked immunosorbent assay. Serum CA-125 levels were also measured in the patient and control groups. All patients had detectable serum endocan levels among endometrial and ovarian cancer groups except six cases. However, in the benign and healthy control groups, all endocan levels were undetectable except for two cases in the benign group and three in the healthy control group. Serum endocan levels were significantly higher in the entire patient group than in the controls (Pendometrial cancer and ovarian cancer were higher than in both the control groups (Pendometrial disorders do not lead to expression of endocan, malignant cases can result in measurable endocan levels. This may be useful in differentiating benign and malign diseases of the endometrium or ovary. © 2016 Wiley Periodicals, Inc.

  20. Morbidity and mortality after distal pancreatectomy for trauma: a critical appraisal of 107 consecutive patients undergoing resection at a Level 1 Trauma Centre.

    Science.gov (United States)

    Krige, J E J; Kotze, U K; Nicol, A J; Navsaria, P H

    2014-09-01

    This study evaluated 30-day morbidity and mortality and assessed pancreas-specific complications in patients with major pancreatic injuries who underwent a distal pancreatectomy. Records of 107 consecutive patients who underwent a distal pancreatectomy at a Level 1 Trauma Centre in Cape Town between January 1982 and December 2011 were reviewed. Primary endpoints were postoperative morbidity and death. Complications were graded according to the Clavien-Dindo severity classification and the International Study Group of Pancreatic Surgery (ISGPS) definitions. A total of 107 patients [94 men, median age 26, median RTS 7.8, 69 penetrating injuries (63 gunshot wounds, 6 stabs wounds), 38 blunt injuries] underwent distal pancreatectomy. Overall mortality was 12%, 16% for gunshot injuries, 8% for blunt trauma and 0% in patients who had stab wounds. Eighty patients had a post-operative complication. A pancreatic leak (n=26) was the most common pancreatic related complication. Median postoperative stay in 28 patients with no or grade I complications was 9 days; in 11 patients with grade II complications was 18 days; in 14 grade IIIa, 31 days; in 19 grade IIIb, 38 days; in 8 grade IVa, 33 days in 14 grade IVb, and in 13 grade V the duration of postoperative stay was 14±39.4 days. Overall mortality for distal pancreatectomy was 12%. Pancreatic leak was a common cause of morbidity. Length of hospitalisation increased with increasing Clavien-Dindo severity grading. There was a significant difference in the duration of hospitalisation in patients with no or grade I complications compared to those with grade II-IV injuries (p<0.05). Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Detection of serum midkine levels in cancer patients using rabbit ...

    African Journals Online (AJOL)

    Detection of serum midkine levels in cancer patients using rabbit anti-human midkine monoclonal antibodies. ... African Journal of Biotechnology ... The standard curve, precision and recovery rate were tested, respectively, and serum MK concentration of 102 cancers patients and 102 normal individuals were detected using ...

  2. ATM Heterozygosity and the Development of Radiation-Induced Erectile Dysfunction and Urinary Morbidity Following Radiotherapy for Prostate Cancer

    National Research Council Canada - National Science Library

    Cesaretti, Jamie A

    2008-01-01

    The goal of this training grant project is to determine whether the prevalence of ATM carriers among prostate cancer patients treated with radiotherapy that develop erectile dysfunction and urinary...

  3. ATM Heterozygosity and the Development of Radiation-Induced Erectile Dysfunction and Urinary Morbidity Following Radiotherapy for Prostate Cancer

    National Research Council Canada - National Science Library

    Cesaretti, Jamie A

    2007-01-01

    The goal of this training grant project is to determine whether the prevalence of ATM carriers among prostate cancer patients treated with radiotherapy that develop erectile dysfunction and urinary...

  4. ATM Heterozygosity and the Development of Radiation-Induced Erectile Dysfunction and Urinary Morbidity Following Radiotherapy for Prostate Cancer

    National Research Council Canada - National Science Library

    Cesaretti, Jamie A

    2006-01-01

    The goal of this training grant project is to determine whether the prevalence of ATM carriers among prostate cancer patients treated with radiotherapy that develop erectile dysfunction and urinary...

  5. ATM Heterozygosity and the Development of Radiation-Induced Erectile Dysfunction and Urinary Morbidity Following Radiotherapy for Prostate Cancer

    National Research Council Canada - National Science Library

    Cesaretti, Jamie A

    2005-01-01

    The goal of this training grant project is to determine whether the prevalence of ATM carriers among prostate cancer patients treated with radiotherapy that develop erectile dysfunction and urinary...

  6. The obese endometrial cancer patient: how do we effectively improve morbidity and mortality in this patient population?

    Science.gov (United States)

    Papatla, K; Huang, M; Slomovitz, B

    2016-11-01

    The relationship between obesity, metabolic syndrome, and endometrial cancer has been established and accepted for decades. However, despite this understanding, endometrial cancer patients continue to die of their obesity-related comorbidities such as cardiovascular disease and diabetes. Furthermore, studies show that gynecologic oncologists, general obstetrician/gynecologists, and bariatric specialists do not appropriately address obesity as a risk factor for cancer and also do not provide appropriate counseling on weight loss and lifestyle modification during screening, diagnosis, and follow-up for endometrial cancer. Given the increasing numbers of obese women both in the United States as well as globally, it is imperative that this risk be addressed and mitigated during patient interactions. Therefore, this article reviews the literature on obesity, metabolic syndrome, and endometrial cancer, as well as the literature on causes of death in endometrial cancer patients. Given the increased cardiovascular and all-cause mortality, we provide a number of methods to address obesity as a risk factor for cancer during patient visits. These methods include self-directed diet and exercise, supervised diet and exercise programs, medical management with insulin-sensitizing agents and statins, as well as bariatric surgery in extreme cases. Furthermore, we also encourage collaboration between general obstetrician/gynecologists, gynecologic oncologists, and bariatric specialists in the care of obese endometrial cancer patients to ensure that they not only survive their diagnosis, but also go on to live long, healthy lives. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  7. Combination of dose escalation with technological advances (intensity-modulated and image-guided radiotherapy) is not associated with increased morbidity for patients with prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pinkawa, Michael; Piroth, Marc D.; Holy, Richard; Djukic, Victoria; Klotz, Jens; Krenkel, Barbara; Eble, Michael J. [RWTH Aachen (Germany). Klinik fuer Strahlentherapie

    2011-08-15

    The aim was to evaluate treatment-related morbidity after intensity-modulated (IMRT) and image-guided (IGRT) radiotherapy with a total dose of 76 Gy in comparison to conventional conformal radiotherapy (3DCRT) up to 70.2-72 Gy for patients with prostate cancer. All patients were prospectively surveyed prior to, on the last day, as well as after a median time of 2 and 16 months after RT using a validated questionnaire (Expanded Prostate Cancer Index Composite). Criteria for the 78 matched pairs after IMRT vs. 3DCRT were patient age, use of antiandrogens, treatment volume ({+-} whole pelvis), prognostic risk group, and urinary/bowel/sexual quality of life (QoL) before treatment. QoL changes after dose-escalated IMRT were found to be similar to QoL changes after 3DCRT in all domains. Only sexual function scores more than 1 year after RT decreased slightly more after 3DCRT in comparison to IMRT (mean 9 vs. 6 points; p = 0.04), with erections firm enough for intercourse in 14% vs. 30% (p = 0.03). Painful bowel movements were reported more frequently after 3DCRT vs. IMRT 2 months after treatment ({>=} once a day in 10% vs. 1%; p = 0.03), but a tendency for higher rectal bleeding rates was found after IMRT vs. 3DCRT more than 1 year after RT ({>=} rarely in 20% vs. 9%; p = 0.06). Combination of dose escalation with technological advances (IMRT and IGRT) is not associated with increased morbidity for patients with prostate cancer. (orig.)

  8. Morbidity at elementary school entry differs by sex and level of residence urbanization: a comparative cross-sectional study

    Directory of Open Access Journals (Sweden)

    Lin Kuan-Chia

    2007-12-01

    Full Text Available Abstract Background Health is vital to a child's learning in school and success in life. Therefore, early physical examination, and follow-up if necessary, would bring parents' attention to their child's health and would likely improve outcomes. The purposes of this study are twofold: to assess the health status of first-graders and to examine the health status differences between sexes, levels of residence urbanization, and quantity of available medical resources. Methods This is a comparative descriptive study. Data from the 2002 Student Entry Physical Examination (SEPE and Student Medical History Inventory (SMHI were obtained from 203 public and private elementary schools in northern Taiwan where a population of 53,053 students was included. Frequencies, independent sample t test, one-way ANOVA along with Scheff's post hoc test, and Pearson's correlation were conducted using SPSS. Results This study showed that 13.7% of students had at least one diagnosed disease from the SMHI reported by parents. Moreover, the SEPE indicated that 79.5% students had at least one health concern. Dental caries, myopia, and obesity were the most prevalent health problems among the first-graders (69.6%, 27.1%, and 9.5%, respectively. Research results show that there were significant differences in the prevalence of dental caries, myopia, and obesity between different sexes and among levels of urbanization. However, the quantity of available medical resources made no significant difference. Conclusion Elementary school entry physical examination is an important way to detect students' health problems. It is suggested that school health interventions consider students' health profiles along with their sex and level of urbanization in planning. More research is needed to find the risk factors of the health problems. Additionally, the creation of a school health committee is suggested to implement and evaluate the entry health examination program.

  9. Evolution of subclinical hypothyroidism and its relation with glucose and triglycerides levels in morbidly obese patients after undergoing sleeve gastrectomy as bariatric procedure.

    Science.gov (United States)

    Ruiz-Tovar, Jaime; Boix, Evangelina; Galindo, Isabel; Zubiaga, Lorea; Diez, María; Arroyo, Antonio; Calpena, Rafael

    2014-05-01

    There is an increased prevalence of subclinical hypothyroidism (SCH) in patients with obesity. It is unclear if this biochemical abnormality may be a secondary phenomenon of obesity or a real hypothyroid state. A retrospective study of all the morbidly obese patients undergoing laparoscopic sleeve gastrectomy as bariatric procedure between October 2007 and November 2012 was performed. Weight loss, body mass index (BMI) and excess weight loss, baseline glucose, lipid profiles, and TSH levels were obtained before operation and postoperative determinations at 3, 6, and 12 months after surgery. Sixty patients were included. Prevalence of subclinical hypothyroidism was 16.7% preoperatively, 10% at 3 months, 3.3% at 6 months, and 1.7% at 12 months. A significant correlation could be established between TSH decrease and weight loss at 12 months (Pearson 0.603; p = 0.007). TSH decrease showed a significant correlation with glucose and glycated hemoglobin decrease from 6th month onwards. Referring to lipid profile, an association of TSH decrease with total cholesterol, LDL cholesterol, or HDL cholesterol could not be determined. A significant association between TSH decrease and triglycerides and cardiovascular risk index triglycerides/HDL cholesterol reductions could also be established 12 months after surgery. SCH is usually corrected after bariatric surgery, while there are no significant changes in total or LDL cholesterol. This suggests that, in morbidly obese subjects, SCH is, in most patients, just a consequence of the abnormal fat accumulation and not a real hypothyroid state.

  10. Linking CHHiP prostate cancer RCT with GP records: A study proposal to investigate the effect of co-morbidities and medications on long-term symptoms and radiotherapy-related toxicity

    Directory of Open Access Journals (Sweden)

    Agnieszka Lemanska

    2017-06-01

    Full Text Available Background: Patients receiving cancer treatment often have one or more co-morbid conditions that are treated pharmacologically. Co-morbidities are recorded in clinical trials usually only at baseline. However, co-morbidities evolve and new ones emerge during cancer treatment. The interaction between multi-morbidity and cancer recovery is significant but poorly understood. Purpose: To investigate the effect of co-morbidities (e.g. cardiovascular and diabetes and medications (e.g. statins, antihypertensives, metformin on radiotherapy-related toxicity and long-term symptoms in order to identify potential risk factors. The possible protective effect of medications such as statins or antihypertensives in reducing radiotherapy-related toxicity will also be explored. Methods: Two datasets will be linked. (1 CHHiP (Conventional or Hypofractionated High Dose Intensity Modulated Radiotherapy for Prostate Cancer randomised control trial. CHHiP contains pelvic symptoms and radiation-related toxicity reported by patients and clinicians. (2 GP (General Practice data from RCGP RSC (Royal College of General Practitioners Research and Surveillance Centre. The GP records of CHHiP patients will be extracted, including cardiovascular co-morbidities, diabetes and prescription medications. Statistical analysis of the combined dataset will be performed in order to investigate the effect. Conclusions: Linking two sources of healthcare data is an exciting area of big healthcare data research. With limited data in clinical trials (not all clinical trials collect information on co-morbidities or medications and limited lengths of follow-up, linking different sources of information is increasingly needed to investigate long-term outcomes. With increasing pressures to collect detailed information in clinical trials (e.g. co-morbidities, medications, linkage to routinely collected data offers the potential to support efficient conduct of clinical trials. Keywords: Data

  11. THE EFFECTIVENESS OF MIXED JUICE MUNG BEAN AND GUAVA FOR INCREASING HEMOGLOBIN LEVEL IN CANCER PATIENT WITH CHEMOTHERAPY

    Directory of Open Access Journals (Sweden)

    Nurul Huda

    2016-09-01

    Full Text Available Cancer is a chronic disease with high morbidity and mortality rate in a year. One of therapy in curing cancer is chemotherapy. But unfortunately chemotherapy has some negative effects such as decreasing the level of hemoglobin (Hb. Mung bean that contain a lot of iron and Guava which is rich of vitamin C for iron absorption are useful in cancer patient with chemotherapy. Therefore, a mixture of both is believed in increasing hemoglobin level significantly. The purpose of this study was to determine the effectiveness of mixed juice mung bean and guava for increasing hemoglobin level in experiment and control group of cancer patient with chemotherapy.This research used Quasi Experiment design with pretest-posttest design control group approach. The total number of respondent was 30 chosen by purposive sampling method. Results of this study showed hemoglobin level in experiment group 14.07 and 10.42 in control group with p value (0,000 < α (0,05. It can be concluded that a mixture juice mung beans and guava effective for increasing hemoglobin level in cancer patient with chemotherapy. This research suggests that this mixture can be an option for nursing intervention in increasing hemoglobin level for cancer patient after receiving chemotherapy.

  12. Psychological morbidity and autonomic reactivity to emotional stimulus in parental cancer: a study with adult children caregivers.

    Science.gov (United States)

    Teixeira, R J; Pereira, M G

    2014-01-01

    Literature suggests that parental cancer can provoke aversive emotional arousal in adult children, who may perceive caregiving as a traumatic experience. Limited research has been conducted on emotional and physiological impact of family caregiving for cancer patients undergoing chemotherapy. The aim of the present study was to examine psychological and physiological responses in parental cancer's caregivers. Two matched groups of adult children, with 78 participants each (parental cancer vs. control), completed psychological measures of distress, post-traumatic stress disorder (PTSD) symptoms, and burden. Additionally, each participant visualised standardised pictures with different emotional valences, while cardiovascular (heart rate) and electrodermal responses (skin conductance) were recorded. Between-group analysis showed significant differences on all psychological variables, and on skin conductance for all types of pictures. However, for the heart rate responses, differences were found only for pictures with unpleasant emotional arousal. In the parental cancer group, the heart rate peak response stood out as a predictor of PTSD symptoms, after controlling for distress and burden. This study highlights the important role of psychophysiological measures of family caregiving in oncology. Physiological responses may explain a higher prevalence of PTSD symptoms. Therefore, biofeedback combined with targeted psychosocial interventions for relaxation could be of great clinical value for this population. © 2013 John Wiley & Sons Ltd.

  13. Arsenic and chromium topsoil levels and cancer mortality in Spain.

    Science.gov (United States)

    Núñez, Olivier; Fernández-Navarro, Pablo; Martín-Méndez, Iván; Bel-Lan, Alejandro; Locutura, Juan F; López-Abente, Gonzalo

    2016-09-01

    Spatio-temporal cancer mortality studies in Spain have revealed patterns for some tumours which display a distribution that is similar across the sexes and persists over time. Such characteristics would be common to tumours that shared risk factors, including the chemical soil composition. The objective of the present study is to assess the association between levels of chromium and arsenic in soil and the cancer mortality. This is an ecological cancer mortality study at municipal level, covering 861,440 cancer deaths in 7917 Spanish mainland towns from 1999 to 2008. Chromium and arsenic topsoil levels (partial extraction) were determined by ICP-MS at 13,317 sampling points. To estimate the effect of these concentrations on mortality, we fitted Besag, York and Mollié models, which included, as explanatory variables, each town's chromium and arsenic soil levels, estimated by kriging. In addition, we also fitted geostatistical-spatial models including sample locations and town centroids (non-aligned data), using the integrated nested Laplace approximation (INLA) and stochastic partial differential equations (SPDE). All results were adjusted for socio-demographic variables and proximity to industrial emissions. The results showed a statistical association in men and women alike, between arsenic soil levels and mortality due to cancers of the stomach, pancreas, lung and brain and non-Hodgkin's lymphomas (NHL). Among men, an association was observed with cancers of the prostate, buccal cavity and pharynx, oesophagus, colorectal and kidney. Chromium topsoil levels were associated with mortality among women alone, in cancers of the upper gastrointestinal tract, breast and NHL. Our results suggest that chronic exposure arising from low levels of arsenic and chromium in topsoil could be a potential risk factor for developing cancer.

  14. EVALUATION OF THE INFLUENCE OF THE STATE OF ENVIRONMENTAL SECURITY OF THE POPULATION OF KYIV ON THE LEVEL OF MORBIDITY

    Directory of Open Access Journals (Sweden)

    Maryna Kirova

    2017-08-01

    Full Text Available The influence of atmospheric air pollution on the health status of the city of Kiev has been monitored. A direct relationship between the increase in the concentration of harmful substances in the atmospheric air of the contaminated area and the increase in the incidence of the population, including diseases of the respiratory system, circulatory systems, blood and blood-forming organs, endocrine, nervous systems is established. Problems of ensuring environmental safety are traditionally among the priority areas of state-legal regulation. National environmental policy is aimed at achieving the strategic goals: preservation of natural objects and complexes, ecosystems, maintenance of their integrity and life support functions, sustainable development of society, improvement of the quality of environment and life, improvement of population health and demographic situation, provision of environmental safety state. And this is possible only in carrying out the assessment and consistent reduction of environmental risks for human health. There is a high risk of emergencies of natural and man-made nature in Ukraine. In Ukraine there are 23,767 potentially dangerous enterprises and other objects, the accidents on each of which can lead to emergencies of anthropogenic and natural state, regional, local and object level. Each year, up to 300 emergencies of natural and man-made nature are recorded, resulting in death of people, causing significant economic losses. Environmental policy in modern conditions is considered as an integrated factor of social and economic development of Ukraine, which helps to ensure the transition to sustainable development of the economy and the introduction of an environmentally balanced system of nature use. Provision of environmentally and technogenically safe living conditions of citizens and society, preservation of the natural environment and rational use of natural resources is assigned by the Law of Ukraine "On the

  15. Pre- and postoperative esophageal and gastric pH levels in morbidly obese patients undergoing vertical gastroplasty.

    Science.gov (United States)

    Papavramidis, Theodossis S; Papavramidis, Spiros T; Sapalidis, Konstantinos G; Kessisoglou, Isaac I; Gamvros, Orestis I

    2004-02-01

    The aim of this study was to determine whether the anatomicofunctional changes induced by vertical gastroplasty lead to pH alterations in the esophagus and body and antrum of the stomach. 23 non-smoking volunteers (3 men, 20 women) mean age 35.29 +/- SD 6.85 years, mean weight 163.17 +/- 52.11 kg and mean BMI 56.06 +/- 14.01 kg/m2 were studied. The pH of the esophagus, body and antrum of the stomach were measured preoperatively and 18 months postoperatively (after excess weight loss). Data was analyzed statistically using paired student t-test. The pH values before (pH(1)) and after (pH(2)) the operation were: for the esophagus pH(1e) +/- SD = 6.12 +/- 0.31 and pH(2e) +/- SD = 5.92 +/- 0.37 (P =0.38), for the body of the stomach pH(1b) +/- SD = 2.2 +/- 0.30 and pH(2b) +/- SD = 2.56 +/- 0.34 (P =0.30), and for the antrum pH(1a) +/- SD = 1.78 +/- 0.28, and pH(2a) +/- SD = 1.65 +/- 0.36 (P =0.011). Vertical gastroplasty does not affect the pH levels in the esophagus and in the body of the stomach. However, there is acidification in the antrum, which could lead to pH-related diseases.

  16. [Social inequality in morbidity and mortality from oral and oropharyngeal cancer in the city of São Paulo, Brazil: 1997-2008].

    Science.gov (United States)

    Ferreira, Maria Angela Fernandes; Gomes, Murilo Novaes; Michels, Fernanda Alessandra Silva; Dantas, Aldo Aluísio; Latorre, Maria do Rosário Dias de Oliveira

    2012-09-01

    Occupation of geographical space is historically determined by the socioeconomic model and the dynamism of its social, political, and ideological relations. This study aimed to evaluate the spatial distribution of morbidity and mortality from cancer of the mouth and oropharynx and related socioeconomic variables in the city of São Paulo, Brazil, from 1997 to 2008. Data were collected from the Population-Based Cancer Registry and the Program for Improvement of Mortality Data (PRO-AIM) and were georeferenced using Terraview and GeoDa. The theoretical framework for evaluating the results was the work of Milton Santos. The incidence rates showed spatial autocorrelation with a Global Moran index of 0.226 and mortality rates of 0.337. Incidence of cancer of the mouth and oropharynx did not show a well-defined spatial pattern in the city of São Paulo, but mortality rates were highly unequal, concentrating the lowest rates in the central area of the city, which is wealthier and economically less unequal.

  17. Testosterone levels in benign prostatic hypertrophy and prostate cancer.

    Science.gov (United States)

    Mearini, Luigi; Costantini, Elisabetta; Zucchi, Alessandro; Mearini, Ettore; Bini, Vittorio; Cottini, Emanuele; Porena, Massimo

    2008-01-01

    Although hormones play fundamental roles in prostate growth, their clinical significance is not completely clear. In the present study we assessed whether serum hormone levels are markers of prostate disease. In 128 patients with benign prostatic hypertrophy or prostate cancer, testosterone, follicle-stimulating hormone, luteinizing hormone, and prolactin levels were correlated with disease. In patients with prostate cancer, the hormone levels were also correlated with prognostic factors. Predictive values were assessed for prostate-specific antigen and testosterone levels only, using multiple logistic regression analysis and receiver operating characteristic curves. The testosterone concentrations were significantly lower in patients with prostate cancer than in those with benign prostatic hypertrophy and were also significantly lower in patients with advanced-stage disease than in patients with organ-confined disease. Testosterone appears to be an independent predictor of disease and enhances the predictive accuracy for benign prostatic hypertrophy and prostate cancer. This study supports experimental findings that prostate cancer is frequently associated with low testosterone concentrations. In the diagnostic workup for prostate cancer, associating prostate-specific antigen and testosterone levels may improve the predictive accuracy of prostate disease tests.

  18. RANDOMIZED COMPARISON OF MORBIDITY AFTER D1 AND D2 DISSECTION FOR GASTRIC-CANCER IN 996 DUTCH PATIENTS

    NARCIS (Netherlands)

    BONENKAMP, JJ; SONGUN, [No Value; HERMANS, J; SASAKO, M; WELVAART, K; PLUKKER, JTM; VANELK, P; OBERTOP, H; GOUMA, DJ; TAAT, CW; VANLANSCHOT, J; DEGRAAF, PW; VONMEYENFELDT, MF; TILANUS, H; VANDEVELDE, CJH

    1995-01-01

    For patients with gastric cancer deemed curable the only treatment option is surgery, but there is disagreement about whether accompanying lymph-node dissection should be limited to the perigastric nodes (D1) or should extend to regional lymph nodes outside the perigastric area (D2). We carried out

  19. Randomised comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients

    NARCIS (Netherlands)

    Bonenkamp, J. J.; Songun, I.; Hermans, J.; Sasako, M.; Welvaart, K.; Plukker, J. T.; van Elk, P.; Obertop, H.; Gouma, D. J.; Taat, C. W.

    1995-01-01

    For patients with gastric cancer deemed curable the only treatment option is surgery, but there is disagreement about whether accompanying lymph-node dissection should be limited to the perigastric nodes (D1) or should extend to regional lymph nodes outside the perigastric area (D2). We carried out

  20. Circulatory Estrogen Level Protects Against Breast Cancer in Obese Women

    Science.gov (United States)

    Suba, Zsuzsanna

    2013-01-01

    Literary data suggest apparently ambiguous interaction between menopausal status and obesity-associated breast cancer risk based on the principle of the carcinogenic capacity of estrogen. Before menopause, breast cancer incidence is relatively low and adiposity is erroneously regarded as a protective factor against this tumor conferred by the obesity associated defective estrogen-synthesis. By contrast, in postmenopausal cases, obesity presents a strong risk factor for breast cancer being mistakenly attributed to the presumed excessive estrogen-production of their adipose-tissue mass. Obesity is associated with dysmetabolism and endangers the healthy equilibrium of sexual hormone-production and regular menstrual cycles in women, which are the prerequisites not only for reproductive capacity but also for somatic health. At the same time, literary data support that anovulatory infertility is a very strong risk for breast cancer in young women either with or without obesity. In the majority of premenopausal women, obesity associated insulin resistance is moderate and may be counteracted by their preserved circulatory estrogen level. Consequently, it is not obesity but rather the still sufficient estrogen-level, which may be protective against breast cancer in young adult females. In obese older women, never using hormone replacement therapy (HRT) the breast cancer risk is high, which is associated with their continuous estrogen loss and increasing insulin-resistance. By contrast, obese postmenopausal women using HRT, have a decreased risk for breast cancer as the protective effect of estrogen-substitution may counteract to their obesity associated systemic alterations. The revealed inverse correlation between circulatory estrogen-level and breast cancer risk in obese women should advance our understanding of breast cancer etiology and promotes primary prevention measures. New patents recommend various methods for the prevention and treatment of obesity

  1. Role of Increased n-acetylaspartate Levels in Cancer.

    Science.gov (United States)

    Zand, Behrouz; Previs, Rebecca A; Zacharias, Niki M; Rupaimoole, Rajesha; Mitamura, Takashi; Nagaraja, Archana Sidalaghatta; Guindani, Michele; Dalton, Heather J; Yang, Lifeng; Baddour, Joelle; Achreja, Abhinav; Hu, Wei; Pecot, Chad V; Ivan, Cristina; Wu, Sherry Y; McCullough, Christopher R; Gharpure, Kshipra M; Shoshan, Einav; Pradeep, Sunila; Mangala, Lingegowda S; Rodriguez-Aguayo, Cristian; Wang, Ying; Nick, Alpa M; Davies, Michael A; Armaiz-Pena, Guillermo; Liu, Jinsong; Lutgendorf, Susan K; Baggerly, Keith A; Eli, Menashe Bar; Lopez-Berestein, Gabriel; Nagrath, Deepak; Bhattacharya, Pratip K; Sood, Anil K

    2016-01-26

    The clinical and biological effects of metabolic alterations in cancer are not fully understood. In high-grade serous ovarian cancer (HGSOC) samples (n = 101), over 170 metabolites were profiled and compared with normal ovarian tissues (n = 15). To determine NAT8L gene expression across different cancer types, we analyzed the RNA expression of cancer types using RNASeqV2 data available from the open access The Cancer Genome Atlas (TCGA) website (http://www.cbioportal.org/public-portal/). Using NAT8L siRNA, molecular techniques and histological analysis, we determined cancer cell viability, proliferation, apoptosis, and tumor growth in in vitro and in vivo (n = 6-10 mice/group) settings. Data were analyzed with the Student's t test and Kaplan-Meier analysis. Statistical tests were two-sided. Patients with high levels of tumoral NAA and its biosynthetic enzyme, aspartate N-acetyltransferase (NAT8L), had worse overall survival than patients with low levels of NAA and NAT8L. The overall survival duration of patients with higher-than-median NAA levels (3.6 years) was lower than that of patients with lower-than-median NAA levels (5.1 years, P = .03). High NAT8L gene expression in other cancers (melanoma, renal cell, breast, colon, and uterine cancers) was associated with worse overall survival. NAT8L silencing reduced cancer cell viability (HEYA8: control siRNA 90.61% ± 2.53, NAT8L siRNA 39.43% ± 3.00, P proliferation (HEYA8: control siRNA 74.83% ± 0.92, NAT8L siRNA 55.70% ± 1.54, P Proliferating cancer cells have much greater metabolic requirements than nonproliferating differentiated cells (2,3). Moreover, altered cancer metabolism elevates unique metabolic intermediates, which can promote cancer survival and progression (4,5). Furthermore, emerging evidence suggests that proliferating cancer cells exploit alternative metabolic pathways to meet their high demand for energy and to accumulate biomass (6-8). © The Author 2016. Published by Oxford University Press

  2. Suboptimal Vitamin D levels among adult survivors of childhood cancers

    Directory of Open Access Journals (Sweden)

    Denise A. Rokitka

    2016-07-01

    Full Text Available Purpose: Vitamin D plays an important role in many bodily systems, with increasing evidence suggesting its importance for the prevention of chronic diseases and cancer. The identification of vitamin D levels in childhood cancer survivors becomes, therefore, particularly relevant, given that optimizing levels may contribute to the prevention of secondary malignancies and chronic diseases.Methods: A cross - sectional analysis of serum 25 - hydroxyvitamin D levels among adult survivors of childhood cancers living in New York State and surrounding areas (n = 139 was performed. Independent variables included gender, race/ethnicity, cancer site, year of diagnosis, past medical and surgical history, prior radiation therapy; prior chemotherapy, age at diagnosis, age at last clinic visit, year of last clinic visit, height, weight, body mass index, and vitamin D supplementation.Results: Overall, 34% of survivors were vitamin D deficient (< 20 ng/ml, 39% were classified as insufficient (20 - 29 ng/ml and 27% (≥ 30 ng/ml were classified as having sufficient levels. Despite vitamin D supplementation among 41 patients, 68.3% continued to have insufficient or deficient levels. Participants with a BMI > 25 demonstrated lower levels of vitamin D (p < 0.05. Vitamin D levels did not vary by age group, race, ethnicity, diagnosis, or years since diagnosis.Conclusion: Given the growing awareness of the role of vitamin D and the documented late effects of treatment for childhood cancers, the high prevalence of vitamin D deficiency within the childhood cancer survivor population is of concern. Vitamin D represents an important target for surveillance and intervention to help improve long - term outcomes of childhood cancer survivors.

  3. Acute Urinary Morbidity Following Stereotactic Body Radiation Therapy for Prostate Cancer with Prophylactic Alpha-Adrenergic Antagonist and Urethral Dose Reduction.

    Science.gov (United States)

    Repka, Michael C; Guleria, Shan; Cyr, Robyn A; Yung, Thomas M; Koneru, Harsha; Chen, Leonard N; Lei, Siyuan; Collins, Brian T; Krishnan, Pranay; Suy, Simeng; Dritschilo, Anatoly; Lynch, John; Collins, Sean P

    2016-01-01

    Stereotactic body radiation therapy (SBRT) delivers high doses of radiation to the prostate while minimizing radiation to the adjacent critical organs. Large fraction sizes may increase urinary morbidity due to unavoidable treatment of the prostatic urethra. This study reports rates of acute urinary morbidity following SBRT for localized prostate cancer with prophylactic alpha-adrenergic antagonist utilization and urethral dose reduction (UDR). From April 2013 to September 2014, 102 patients with clinically localized prostate cancer were treated with robotic SBRT to a total dose of 35-36.25 Gy in five fractions. UDR was employed to limit the maximum point dose of the prostatic urethra to 40 Gy. Prophylactic alpha-adrenergic antagonists were initiated 5 days prior to SBRT and continued until resolution of urinary symptoms. Quality of life (QoL) was assessed before and after treatment using the American Urological Association Symptom Score (AUA) and the Expanded Prostate Cancer Index Composite-26 (EPIC-26). Clinical significance was assessed using a minimally important difference (MID) of one half SD change from baseline. One hundred two patients underwent definitive prostate SBRT with UDR and were followed for 3 months. No patient experienced acute urinary retention requiring catheterization. A mean baseline AUA symptom score of 9.06 significantly increased to 11.83 1-week post-SBRT (p = 0.0024) and 11.84 1-month post-SBRT (p = 0.0023) but returned to baseline by 3 months. A mean baseline EPIC-26 irritative/obstructive score of 87.7 decreased to 74.1 1-week post-SBRT (p big problem, and that proportion increased to 37.6% 1 week following completion of SBRT before returning to baseline by 3 months. Stereotactic body radiation therapy for localized prostate cancer with utilization of prophylactic alpha-adrenergic antagonist and UDR was well tolerated as determined by acute urinary function and bother, and symptoms were comparable to those

  4. Acute Urinary Morbidity Following Stereotactic Body Radiation Therapy for Prostate Cancer with Prophylactic Alpha-Adrenergic Antagonist and Urethral Dose Reduction

    Directory of Open Access Journals (Sweden)

    Michael Charles Repka

    2016-05-01

    Full Text Available Background: Stereotactic body radiation therapy (SBRT delivers high doses of radiation to the prostate while minimizing radiation to adjacent critical organs. Large fraction sizes may increase urinary morbidity due to unavoidable treatment of the prostatic urethra. This study reports rates of acute urinary morbidity following SBRT for localized prostate cancer with prophylactic alpha-adrenergic antagonist utilization and urethral dose reduction (UDR.Methods: From April 2013 to September 2014, 102 patients with clinically localized prostate cancer were treated with robotic SBRT to a total dose of 35-36.25 Gy in 5 fractions. UDR was employed to limit the maximum point dose of the prostatic urethra to 40 Gy. Prophylactic alpha-adrenergic antagonists were initiated five days prior to SBRT and continued until resolution of urinary symptoms. Quality of life (QoL was assessed before and after treatment using the American Urological Association Symptom Score (AUA and the Expanded Prostate Cancer Index Composite-26 (EPIC-26. Clinical significance was assessed using a minimally important difference (MID of one half standard deviation change from baseline.Results: 102 patients underwent definitive prostate SBRT with UDR and were followed for 3 months. No patient experienced acute urinary retention requiring catheterization. A mean baseline AUA symptom score of 9.06 significantly increased to 11.83 one-week post-SBRT (p = 0.0024 and 11.84 one-month post-SBRT (p = 0.0023 but returned to baseline by 3 months. A mean baseline EPIC-26 irritative/obstructive score of 87.7 decreased to 74.1 one-week post-SBRT (p < 0.0001 and 77.8 one-month post-SBRT (p < 0.0001 but returned to baseline at 3 months. EPIC-26 irritative/obstructive score changes were clinically significant, exceeding the MID of 6.0. At baseline, 8.9% of men described their urinary function as a moderate to big problem, and that proportion increased to 37.6% one week following completion of SBRT

  5. Systems-level modeling of cancer-fibroblast interaction.

    Directory of Open Access Journals (Sweden)

    Raymond C Wadlow

    2009-09-01

    Full Text Available Cancer cells interact with surrounding stromal fibroblasts during tumorigenesis, but the complex molecular rules that govern these interactions remain poorly understood thus hindering the development of therapeutic strategies to target cancer stroma. We have taken a mathematical approach to begin defining these rules by performing the first large-scale quantitative analysis of fibroblast effects on cancer cell proliferation across more than four hundred heterotypic cell line pairings. Systems-level modeling of this complex dataset using singular value decomposition revealed that normal tissue fibroblasts variably express at least two functionally distinct activities, one which reflects transcriptional programs associated with activated mesenchymal cells, that act either coordinately or at cross-purposes to modulate cancer cell proliferation. These findings suggest that quantitative approaches may prove useful for identifying organizational principles that govern complex heterotypic cell-cell interactions in cancer and other contexts.

  6. Collagen mRNA levels changes during colorectal cancer carcinogenesis

    DEFF Research Database (Denmark)

    Skovbjerg, Hanne; Anthonsen, Dorit; Lothe, Inger M B

    2009-01-01

    . In addition, corresponding tissue was examined from healthy volunteers (n = 20). mRNA levels were normalized to beta-actin. Immunohistochemical analysis of the distributions of type IV and type VII collagens were performed on normal and affected tissues from colorectal cancer patients. RESULTS: The alpha1(IV......). The level of alpha 6(IV) was 5-fold lower in colorectal cancer tissue as compared to healthy individuals (p alpha 6(IV) mRNA coincides...... zone of stratified epithelia. Immunohistochemical studies have previously reported changes in steady-state levels of different alpha(IV) chains in several epithelial cancer types. In the present study we aimed to quantitatively determine the mRNA levels of type IV collagen (alpha1/alpha 4/alpha 6...

  7. Baldness, benign prostate hyperplasia, prostate cancer and androgen levels.

    Science.gov (United States)

    Faydaci, Gökhan; Bilal, Eryildirim; Necmettin, Penpegül; Fatih, Tarhan; Asuman, Orçun; Uğur, Kuyumcuoğlu

    2008-12-01

    We evaluated the pattern of baldness and serum androgen levels in patients with benign prostate hyperplasia (BPH) and prostate cancer. BPH, prostate cancer and androgenic alopecia (AA) were somehow androgen dependent and affect large population of elderly men. A total of 152 patients, 108 patients with BPH and 44 patients with prostate cancer were included in the study. We measured serum total, free and bioavailable testosterone, FSH, LH, prolactin, estradiol, albumin and SHBG levels. Baldness classification was based on Norwood's classification and we categorised baldness as vertex and frontal baldness. The frequency of AA in BPH and prostate cancer groups were not different. We looked for some correlation between the two groups with respect to AA and hormone levels. We did not find any correlation between AA and total testosterone, free testosterone, bioavailable testosterone or SHBG levels in both groups. This prospective study with selected small group of patients showed that there is no difference of male pattern baldness in BPH and prostate cancer patients and also there is no correlation between pattern of baldness and serum androgen levels.

  8. Objectively assessed physical activity levels in Spanish cancer survivors.

    Science.gov (United States)

    Ruiz-Casado, Ana; Verdugo, Ana Soria; Solano, María J Ortega; Aldazabal, Itziar Pagola; Fiuza-Luces, Carmen; Alejo, Lidia Brea; del Hierro, Julio R Padilla; Palomo, Isabel; Aguado-Arroyo, Oscar; Garatachea, Nuria; Cebolla, Héctor; Lucia, Alejandro

    2014-01-01

    To objectively assess physical activity (PA) levels in a cohort of Spanish cancer survivors. Descriptive, cross-sectional. The Hospital Universitario de Fuenlabrada and two healthcare centers in Madrid, Spain. 204 cancer survivors and 115 adults with no history of cancer. Participants wore a triaxial accelerometer for seven or more consecutive days to assess PA levels. Body mass index (BMI), indirect indicators of adiposity (waist circumference, waist-to-hip ratio), and cardiorespiratory fitness also were determined. Light, moderate, vigorous, and total PA (sum of the former). Most (94%) of the cancer survivors met international recommendations for moderate PA, but very few (3%) fulfilled those (75 minutes or more per week) for vigorous PA. Except for lower total (minute per day, p=0.048) and vigorous PA levels (p0.05). A high percentage of the survivors (33%) were obese (BMI greater than 30 kg/m2), and many also showed poor cardiorespiratory fitness (45% were below the 8 metabolic equivalent threshold). Although cancer survivors overall met international PA recommendations for a healthy lifestyle, their BMI and cardiorespiratory profiles were not within the healthy range. Cancer survivors need to be informed about healthy lifestyle habits and should be regularly monitored.

  9. Apelin levels are higher in obese patients with endometrial cancer.

    Science.gov (United States)

    Altinkaya, S Ozlem; Nergiz, Sümeyra; Küçük, Mert; Yüksel, Hasan

    2015-02-01

    The aim of the present study was to evaluate serum concentrations of apelin, a newly discovered adipocytokine, in relation with tumor markers, metabolic profile and clinicopathologic features of patients with endometrial cancer. A total of 46 women with endometrial cancer and 44 controls were eligible for the study. Clinicopathologic features and metabolic profile as well as apelin-36 levels were evaluated in each subject. Women with endometrial cancer exhibited higher serum concentrations of apelin levels than controls (215.1 ± 59.8 pg/mL vs 177.3 ± 55.2 pg/mL, P = 0.002). Apelin levels were significantly correlated positively with body mass index, fasting insulin levels and homeostasis model assessment index (P obese (body mass index ≥ 30) and non-obese women, apelin levels remained higher in women with endometrial cancer in the obese group (P = 0.006, 243.5 ± 49.2 pg/mL vs 200.5 ± 52.7 pg/mL, respectively); whereas these levels were similar in the non-obese group (P = 0.879, 161.9 ± 37.5 pg/mL vs 159.6 ± 51.3, respectively). After adjustment for all possible confounding factors, age, apelin levels > 160 pg/mL, and diabetes mellitus were found to be associated with risk of endometrial cancer. The data of the present study suggest that higher levels of circulating apelin are associated with an increased risk of developing endometrial cancer in obese women. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  10. Neither high-dose nor low-dose brachytherapy increases flap morbidity in salvage treatment of recurrent head and neck cancer

    Directory of Open Access Journals (Sweden)

    Peter W. Henderson

    2016-08-01

    Full Text Available Purpose: While brachytherapy is often used concurrently with flap reconstruction following surgical ablation for head and neck cancer, it remains unclear whether it increases morbidity in the particularly high risk subset of patients undergoing salvage treatment for recurrent head and neck cancer (RH&NC. Material and methods : A retrospective chart review was undertaken that evaluated patients with RH&NC who underwent flap coverage after surgical re-resection and concomitant brachytherapy. The primary endpoint was flap viability, and the secondary endpoints were flap and recipient site complications. Results : In the 23 subjects included in series, flap viability and skin graft take was 100%. Overall recipient site complication rate was 34.8%, high-dose radiation (HDR group 50%, and low-dose radiation (LDR group 29.4%. There was no statistically significant difference between these groups. Conclusions : In patients who undergo flap reconstruction and immediate postoperative radiotherapy following salvage procedures for RH&NC, flap coverage of defects in combination with brachytherapy remains a safe and effective means of providing stable soft tissue coverage.

  11. Adjuvant chemoradiation after laparoscopically assisted radical vaginal hysterectomy (LARVH) in patients with cervical cancer. Oncologic outcome and morbidity

    Energy Technology Data Exchange (ETDEWEB)

    Gruen, Arne; Musik, Thabea; Stromberger, Carmen; Budach, Volker; Marnitz, Simone [Charite Univ. Medicine Berlin, Campus Virchow-Klinikum, Berlin (Germany). Dept. of Radiooncology; Koehler, Christhardt; Schneider, Achim [Charite Univ. Medicine Berlin, Campus Mitte- und Benjamim Franklin, Berlin (Germany). Dept. of Gynaecology; Fueller, Juergen; Wendt, Thomas [Jena Univ. Hospital (Germany). Dept. of Radiooncology

    2011-06-15

    Compared to laparotomic surgery, laparoscopically assisted radical vaginal hysterectomy (LARVH) offers decreased blood loss during surgery and faster convalescence of the patient postoperatively, while at the same time delivering similar oncologic results. However, there is no data on outcome and toxicity of LARVH followed by (chemo)radiation. A total of 55 patients (range 28-78 years) with cervical cancer on FIGO stages IB1-IIIA (Tables 1 and 2) with risk factors were submitted to either external beam radiotherapy alone [EBRT, n = 8 (14%), including paraaortic irradiation, n = 4 (2.2%); EBRT and brachytherapy (BT), n = 33 (60%); BT alone, n = 14 (25.5%)] or chemoradiation after LARVH. At a median follow-up of 4.4 years, the 5-year disease-free survival (DFS) was 81.8% with 84.5% overall survival (OS). Acute grade 3 side effects were seen in 4 patients. These were mainly gastrointestinal (GI) and genitourinary (GU) symptoms. Grade 4 side effects were not observed. With similar oncologic outcome data and mostly mild side effects, LARVH followed by (chemo)radiation is a valid alternative in the treatment of cervical cancer patients. (orig.)

  12. Adjuvant chemoradiation after laparoscopically assisted vaginal radical hysterectomy (LARVH) in patients with cervical cancer: oncologic outcome and morbidity.

    Science.gov (United States)

    Gruen, Arne; Musik, Thabea; Köhler, Christhardt; Füller, Jürgen; Wendt, Thomas; Stromberger, Carmen; Budach, Volker; Schneider, Achim; Marnitz, Simone

    2011-06-01

    Compared to laparotomic surgery, laparoscopically assisted radical vaginal hysterectomy (LARVH) offers decreased blood loss during surgery and faster convalescence of the patient postoperatively, while at the same time delivering similar oncologic results. However, there is no data on outcome and toxicity of LARVH followed by (chemo)radiation. A total of 55 patients (range 28-78 years) with cervical cancer on FIGO stages IB1-IIIA (Tables 1 and 2) with risk factors were submitted to either external beam radiotherapy alone [EBRT, n = 8 (14%), including paraaortic irradiation, n = 4 (2.2%); EBRT and brachytherapy (BT), n = 33 (60%); BT alone, n = 14 (25.5%)] or chemoradiation after LARVH. At a median follow-up of 4.4 years, the 5-year disease-free survival (DFS) was 81.8% with 84.5% overall survival (OS). Acute grade 3 side effects were seen in 4 patients. These were mainly gastrointestinal (GI) and genitourinary (GU) symptoms. Grade 4 side effects were not observed. With similar oncologic outcome data and mostly mild side effects, LARVH followed by (chemo)radiation is a valid alternative in the treatment of cervical cancer patients.

  13. Relatives' level of satisfaction with advanced cancer care in Greenland

    DEFF Research Database (Denmark)

    Augustussen, Mikaela; Hounsgaard, Lise; Pedersen, Michael Lynge

    2017-01-01

    Palliative cancer care in Greenland is provided by health professionals at local level, the national Queen Ingrid's Hospital and at Rigshospitalet in Denmark. To improve and develop care for relatives of patients with advanced cancer, we conducted a mixed method study examining relatives' level...... from health professionals. They experienced a lack of security, worries about the future and a lack of support at home. The study showed a substantial level of dissatisfaction among relatives of patients with advanced cancer. We strongly recommend a focus on psychosocial care, more access...... to information and to include relatives in decision making and in the future planning of palliative care services. An assessment of relatives' needs is essential to develop an adequate palliative care in a range of settings....

  14. No differences in short-term morbidity and mortality after robot-assisted laparoscopic versus laparoscopic resection for colonic cancer

    DEFF Research Database (Denmark)

    Helvind, Neel Maria; Eriksen, Jens Ravn; Mogensen, Anders Skibsted

    2013-01-01

    . There was a significantly longer setup time for RC (77.1 vs. 69.7 min, P = 0.000), but surgical time was significantly shorter for RC (165.8 vs. 183.4 min, P = 0.006) and there was no difference in the overall procedure time (254.0 vs. 243.6 min, P = 0.086). CONCLUSION: We found RC to be a safe and feasible alternative...... to LC for colonic cancer. We found that for RC surgical time was shorter and overall procedure time was comparable to that for LC; however, these results should be confirmed in future randomized clinical trials....

  15. No association between educational level and pancreatic cancer incidence in the European Prospective Investigation into Cancer and Nutrition

    NARCIS (Netherlands)

    van Boeckel, Petra G. A.; Boshuizen, Hendriek C.; Siersema, Peter D.; Vrieling, Alina; Kunst, Anton E.; Ye, Weimin; Sund, Malin; Michaud, Dominique S.; Gallo, Valentina; Spencer, Elizabeth A.; Trichopoulou, Antonia; Benetou, Vasiliki; Orfanos, Philippos; Cirera, Lluis; Duell, Eric J.; Rohrmann, Sabine; Hemann, Silke; Masala, Giovanni; Manjer, Jonas; Mattiello, Amalia; Lindkvist, Bjorn; Sánchez, María-José; Pala, Valeria; Peeters, Petra H. M.; Braaten, Tonje; Tjonneland, Anne; Dalton, Susanne Oksbjerg; Larranaga, Nerea; Dorronsoro, Miren; Overvad, Kim; Illner, Anne-Kathrin; Ardanaz, Eva; Marron, M.; Straif, K.; Riboli, E.; Bueno-de-Mesquita, B.

    2010-01-01

    Until now, studies examining the relationship between socioeconomic status and pancreatic cancer incidence have been inconclusive. To prospectively investigate to what extent pancreatic cancer incidence varies according to educational level within the European Prospective Investigation into Cancer

  16. Burden of psychiatric morbidity among attendees of a secondary level hospital in Northern India: Implications for integration of mental health care at subdistrict level.

    Science.gov (United States)

    Haldar, Partha; Sagar, Rajesh; Malhotra, Sumit; Kant, Shashi

    2017-01-01

    There is little information available on the type, pattern, trend, and demographic differentials of psychiatric cases attending a subdistrict level facility in India. Our objectives were to describe the sociodemographic profile of the patients availing the psychiatric outpatient department services and document the diagnosis. This study is based on a retrospective analysis of routinely recorded administrative data collected during psychiatry consultations that took place between January 2010 and June 2014, at the subdistrict level hospital, Ballabgarh, Faridabad district, Haryana, Northern India. The data were abstracted in Microsoft Excel, scrutinized for duplicates, and cleaned in terms of the International Classification of Diseases 10th Revision coding. Descriptive analysis was done for dependent variables and continuous variables were compared using independent t-test. A total of 2806 people (new registrations) were provided psychiatric consultations between January 2010 and June 2014. The mean age of males was 33.7 years (95% confidence interval [CI], 32.9, 34.5) and of females was 35.6 years (95% CI, 34.9, 36.3). Neurotic, stress-related, and somatoform disorders (F40-F48) comprised the major category of diagnoses with 661 cases (24%), followed by unspecified mental disorders (F99) with 528 cases (19%), mood (affective) disorders (F30-F39) with 448 cases (16%), and episodic and paroxysmal disorders (G40-G47) with 334 cases (12%). We reported an increase in level and trend in the monthly attendance of patients who required psychiatric at a secondary care hospital in Northern India. We suggest that setting up of mental health units only at district hospital might not be a sufficient health system's approach as has been envisaged under the District Mental Health Program.

  17. Relationship between Arm Morbidity and Patient-Reported Outcomes Following Surgery in Women with Node-Negative Breast Cancer: NSABP Protocol B-32

    Science.gov (United States)

    Kopec, Jacek A.; Colangelo, Linda H.; Land, Stephanie R.; Julian, Thomas B.; Brown, Ann M.; Anderson, Stewart J.; Krag, David N.; Ashikaga, Takamaru; Costantino, Joseph P.; Wolmark, Norman; Ganz, Patricia A.

    2012-01-01

    Background The impact of arm morbidity following breast cancer surgery on patient-observed changes in daily functioning and health-related quality of life (HRQoL) have not been well-studied. Objective To examine the association of objective measures such as range of motion (ROM) and lymphedema, with patient-reported outcomes (PROs) in the arm and breast, upper extremity function, activities, and HRQoL. Methods The National Surgical Adjuvant Breast and Bowel Project Protocol B-32 was a randomized trial comparing sentinel node resection (SNR) with axillary dissection (AD) in women with node-negative breast cancer. ROM and arm volume were measured objectively. PROs included symptoms; arm function; limitations in social, recreational, occupational, and other regular activities; and a global index of HRQoL. Statistical methods included cross-tabulations and multivariable linear regression models. Results In all, 744 women provided at least 1 postsurgery assessment. About one-third of the patients experienced arm mobility restrictions. A similar number of patients avoided the use of the arm 6 months after surgery. Limitations in work and other regular activities were reported by about a quarter of the patients. In this multivariable analysis, arm mobility and sensory neuropathy were predictors of patient-reported arm function and overall HRQoL. Predictors for activity limitations also included side of surgery (dominant vs nondominant). Edema was not significant after adjustment for sensory neuropathy and ROM. Limitations Arm mobility and edema were measured simultaneously only once during the follow-up (6 months). Conclusion Clinical measures of sensory neuropathy and restrictions in arm mobility following breast cancer surgery are associated with self-reported limitations in activity and reductions in overall HRQoL. PMID:22951047

  18. Increased cancer cell proliferation in prostate cancer patients with high levels of serum folate

    Science.gov (United States)

    Introduction: A recent clinical trial revealed that folic acid supplementation is associated with an increased incidence of prostate cancer (1). The present study evaluates serum and prostate tissue folate levels in men with prostate cancer, compared to histologically normal prostate glands from can...

  19. Morbidity analysis in minimally invasive esophagectomy for oesophageal cancer versus conventional over the last 10 years, a single institution experience

    Directory of Open Access Journals (Sweden)

    Misbah Khan

    2017-01-01

    Full Text Available Background: There has been an increasing inclination towards minimally invasive esophagectomies (MIEs at our institute recently for resectable oesophageal cancer. Objectives: The purpose of the present study is to report peri-operative and long-term procedure specific outcomes of the two groups and analyse their changing pattern at our institute. Methods: All adult patients with a diagnosis of oesophageal cancer managed at our institute from 2005 to 2015 were included in this retrospective study. Patients' demographic and clinical characteristics were recorded through our hospital information system. The cohort of esophagectomies was allocated into two groups, conventional open esophagectomy (OE or total laparoscopic MIE; hybrid esophagectomies were taken as a separate group. The short-term outcome measures are an operative time in minutes, length of hospital and Intensive Care Unit (ICU stay in days, post-operative complications and 30 days in-hospital mortality. Complications are graded according to the Clavien-Dindo classification system. Long-term outcomes are long-term procedure related complications over a minimum follow-up of 1 year. Trends were analysed by visually inspecting the graphic plots for mean number of events in each group each year. Results: Our results showed no difference in mortality, length of hospital and ICU stays and incidence of major complications between three groups on uni- and multi-variate analysis (P > 0.05. The operative time was significantly longer in MIE group (odds ratio [OR]: 1.66, confidence interval [CI]: 2.4–11.5. The incidence of long-term complication was low for MIE (OR: 1.0, CI: 133–1.017. However, all post-operative surgical outcomes trended to improve in both groups over the course of this study and stayed better for MIE group except for the operative time. Conclusion: MIE has overall comparable surgical outcomes to its conventional counterpart. Furthermore, the peri-operative outcomes tend to

  20. Community level morbidity control of lymphoedema using self care and integrative treatment in two lymphatic filariasis endemic districts of South India: a non randomized interventional study.

    Science.gov (United States)

    Narahari, Saravu R; Bose, Kuthaje S; Aggithaya, Madhur G; Swamy, Gaddam Kumara; Ryan, Terence J; Unnikrishnan, Bhaskaran; Washington, Reynold G; Rao, Balu Palicheralu Sreenivasa; Rajagopala, Shrikrishna; Manjula, Kadengodlu; Vandana, Usha; Sreemol, Thaivalath Anandan; Rojith, Mathew; Salimani, Shanappa Y; Shefuvan, Mohammed

    2013-09-01

    Currently there is no global program to manage lymphoedema as a result of lymphatic filariasis (LF). The primary aim of this study was to determine the efficacy of a previously proposed integrative treatment protocol, using locally available resources to address the morbidity, in a community village setting. Two LF endemic districts of south India, Gulbarga in Karnataka (GK) and Alleppey in Kerala (AK), were selected for the study. All known patients were invited to an LF camp. Patients with grade two late or three lymphoedema were enrolled. All patients were given training in the integrative procedure which involved patient education and the domiciliary protocol. A total of 730 patients (851 limbs) completed the three and half month follow up. There was a statistically significant (1%) reduction up to mid thigh level volume measurement for both small (0.7-1.1 liters) and large (1.8-5.0 liters) limbs, p yoga interventions before integrative treatment is considered for national health programmes in developing countries.

  1. Does the level of prostate cancer risk affect cancer prevention with finasteride?

    Science.gov (United States)

    Thompson, Ian M.; Tangen, Catherine M.; Parnes, Howard L.; Lippman, Scott M.; Coltman, Charles A.

    2009-01-01

    Objectives Finasteride reduced the risk of prostate cancer by 24.8% in the Prostate Cancer Prevention Trial; whether this represents treatment or prevention and who is most likely to benefit are unknown. We sought to clarify these issues by this investigation. Methods We fit a logistic regression model to men in the placebo group of the PCPT using risk factors for prostate cancer at entry to predict prostate cancer during the subsequent 7 years of study. Men in the two treatment groups were categorized into quintiles of risk of prostate cancer based on the predictive logistic model. A second model was fit evaluating finasteride’s effect on prostate cancer for each subgroup defined by quartiles of baseline PSA. The magnitude of the prevention effect of finasteride on prostate cancer was then evaluated across risk and PSA strata. Results Finasteride significantly reduced prostate cancer risk for all risk quintiles. For quintiles 1 through 5, odds ratios were 0.72, 0.52, 0.64, 0.66, and 0.71, respectively (all p≤0.05). For quartiles of risk of entry PSA (Finasteride significantly reduced prostate cancer risk, regardless of the level of this risk, estimated either by multivariable risk or by PSA stratum; this suggests that finasteride exerts both treatment and preventive effects. All men undergoing PSA screening should be informed of the potential for finasteride to reduce their risk of prostate cancer. PMID:18455628

  2. Awareness and knowledge level of cervical cancer among women ...

    African Journals Online (AJOL)

    This study assessed the awareness and knowledge level of cervical cancer among reproductive women in the Bolgatanga Municipality of the Upper East Region of Ghana. A structured question-naires was used to gather data from one hundred and fifty (150) women. The participants were re-cruited using the convenient ...

  3. Prospective Study of Sex Hormone Levels Among Prostate Cancer ...

    African Journals Online (AJOL)

    experiments have sought to determine the independent effect on risk as well as the interrelationship between these hormones. In this study, we investigated the variations in testosterone and oestradiol levels among prostate cancer patients attending UPTH clinics with the objective of determining the role played by sex ...

  4. County-level environmental quality and associations with cancer incidence

    Science.gov (United States)

    Cancer has been associated with individual ambient environmental exposures such as PM2.5 and arsenic. However, the role of the overall ambient environment is not well-understood. A novel county-level Environmental Quality Index (EQI) was developed for all U.S. counties (n=3,141)...

  5. Pedigree and BRCA gene analysis in breast cancer patients to identify hereditary breast and ovarian cancer syndrome to prevent morbidity and mortality of disease in Indian population.

    Science.gov (United States)

    Darooei, Mina; Poornima, Subhadra; Salma, Bibi Umae; Iyer, Gayatri R; Pujar, Akhilesh N; Annapurna, Srirambhatla; Shah, Ashwin; Maddali, Srinivas; Hasan, Qurratulain

    2017-02-01

    Global burden of breast cancer is expected to increase to >2 million new cases every year by 2030 and 10% of these are likely to have hereditary breast and ovarian cancer syndrome. Identifying these individuals by pedigree and BRCA1/2 mutation analyses will enable us to offer targeted mutation testing and appropriate counseling. This study from a tertiary care hospital showed that of the 127 breast cancer patients on treatment during 2014-2015, 24 of them fulfilled the criteria of hereditary breast and ovarian cancer syndrome after detailed verbal autopsy and pedigree analysis, and BRCA1 and 2 next-generation sequencing done after pre-test counseling revealed mutations in 13 cases (54%), these included 9 BRCA1 mutations (69%) and 4 BRCA2 mutation (31%). Subsequent post-test counseling recommended targeted mutation analysis for 64 high-risk members in these 13 families with pathogenic mutations, which will help in surveillance for early detection, appropriate management, and prevention of the disease by decreasing the burden to both family and nation. Results from this preliminary study highlight the importance of genetic counseling, pedigree analysis, and genetic testing. It can be recommended that all oncology units should have a genetic counseling service for providing appropriate support to oncologists, patients, and families to prevent unnecessary testing; however, breast cancer screening program is incomplete without evaluating for hereditary breast and ovarian cancer syndrome.

  6. Loco-regional morbidity after breast conservation and axillary lymph node dissection for early breast cancer with or without regional nodes radiotherapy, perspectives in modern breast cancer treatment: the Skagen Trial 1 is active.

    Science.gov (United States)

    Nielsen, Hanne Melgaard; Friis, Rasmus Blechingberg; Linnet, Søren; Offersen, Birgitte Vrou

    2017-05-01

    Axillary lymph node dissection (ALND) and adjuvant radiotherapy (RT) in early breast cancer are associated with a risk of morbidity, including lymphedema and impaired shoulder mobility. The aim of this study was to evaluate loco-regional morbidity after breast conserving surgery (BCS), ALND, taxane-based chemotherapy and whole breast irradiation (WBI) with or without regional nodes RT. Eligible patients had BCS and ALND from 2007 to 2012 followed by adjuvant taxane-based chemotherapy and if indicated, trastuzumab and endocrine treatment. The RT consisted of WBI and regional nodes RT in case of ≥ pN1 disease (group 1) and WBI only in case of pN0-1(mic) disease (group 2). The dose was 50 Gy in 25 fractions. The patients were invited to participate in a cross-sectional study evaluating morbidity. Of the 347 eligible patients, 277 patients (79%) accepted the invitation. Of these, 185 patients (67%) belonged to group 1 and 92 patients (33%) to group 2. The median time from RT to evaluation of morbidity was 3.3 years (group 1) and 4.3 years (group 2). In group 1, 34 patients (18%) and in group 2, 15 patients (16%) had ≥2 cm enlargement in circumference of ipsilateral upper or lower arm (p = .67). The frequence of impairment of ipsilateral shoulder abduction to ≤120° was 3% in both groups and of shoulder flexion to ≤120° was 1% and 2% (group 1 versus 2). No difference in patient reported outcome measure (PROM) data regarding heaviness or enlargement of ipsilateral upper and lower arm or mobility and sensory disturbances. The risk of lymphedema was low in patients after ALND and not related to use of regional nodes RT. Impairment of shoulder function was rare, and no differences in PROM were detected regarding use or not of regional nodes RT.

  7. Manifestation pattern of early-late vaginal morbidity after definitive radiation (chemo)therapy and image-guided adaptive brachytherapy for locally advanced cervical cancer: an analysis from the EMBRACE study.

    Science.gov (United States)

    Kirchheiner, Kathrin; Nout, Remi A; Tanderup, Kari; Lindegaard, Jacob C; Westerveld, Henrike; Haie-Meder, Christine; Petrič, Primož; Mahantshetty, Umesh; Dörr, Wolfgang; Pötter, Richard

    2014-05-01

    Brachytherapy in the treatment of locally advanced cervical cancer has changed substantially because of the introduction of combined intracavitary/interstitial applicators and an adaptive target concept, which is the focus of the prospective, multi-institutional EMBRACE study (www.embracestudy.dk) on image-guided adaptive brachytherapy (IGABT). So far, little has been reported about the development of early to late vaginal morbidity in the frame of IGABT. Therefore, the aim of the present EMBRACE analysis was to evaluate the manifestation pattern of vaginal morbidity during the first 2 years of follow-up. In total, 588 patients with a median follow-up time of 15 months and information on vaginal morbidity were included. Morbidity was prospectively assessed at baseline, every 3 months during the first year, and every 6 months in the second year according to the Common Terminology Criteria for Adverse Events, version 3, regarding vaginal stenosis, dryness, mucositis, bleeding, fistula, and other symptoms. Crude incidence rates, actuarial probabilities, and prevalence rates were analyzed. At 2 years, the actuarial probability of severe vaginal morbidity (grade ≥3) was 3.6%. However, mild and moderate vaginal symptoms were still pronounced (grade ≥1, 89%; grade ≥2, 29%), of which the majority developed within 6 months. Stenosis was most frequently observed, followed by vaginal dryness. Vaginal bleeding and mucositis were mainly mild and infrequently reported. Severe vaginal morbidity within the first 2 years after definitive radiation (chemo)therapy including IGABT with intracavitary/interstitial techniques for locally advanced cervical cancer is limited and is significantly less than has been reported from earlier studies. Thus, the new adaptive target concept seems to be a safe treatment with regard to the vagina being an organ at risk. However, mild to moderate vaginal morbidity is still pronounced with currently applied IGABT, and it needs further attention

  8. Basal and postprandial plasma levels of PYY, ghrelin, cholecystokinin, gastrin and insulin in women with moderate and morbid obesity and metabolic syndrome.

    Science.gov (United States)

    Zwirska-Korczala, K; Konturek, S J; Sodowski, M; Wylezol, M; Kuka, D; Sowa, P; Adamczyk-Sowa, M; Kukla, M; Berdowska, A; Rehfeld, J F; Bielanski, W; Brzozowski, T

    2007-03-01

    Metabolic syndrome (MS), defined as central obesity, hyperinsulinemia, insulin resistance, hypertension, dyslipidemia and glucose intolerance, has been associated with inflammatory biomarkers and cardiovascular diseases. This study was carried out on three groups of women; lean controls, moderately obese with MS (OB-MS) and morbidly obese with MS (MOB-MS). The main objectives were: 1. to analyze the plasma levels of total and acylated ghrelin, peptide YY(3-36) (PYY(3-36)), cholecystokinin (CCK), gastrin and insulin levels under basal conditions and in response to a standard mixed meal, and 2. to elucidate the relationship between the plasma levels of these gut peptides and metabolic syndrome parameters. Plasma levels of the gut hormones were measured by radioimmunoassays at time 0 just before the meal and at 30, 60 and 120 min after a meal ingestion. Traditional lipid profile and high-sensitivity C reactive protein (hs-CRP), the strongest biomarker of inflammation were also determined in OB-MS and MOB-MS. When compared to OB-MS, MOB-MS exhibited much higher anthropometric parameters such as waist circumference, higher fat mass and higher plasma levels of low density lipoprotein-cholesterol (LDL-C) and hs-CRP. Both these obese groups revealed significantly higher values of body mass index (BMI), fat mass, total cholesterol (TC), LDL-C, fasting glucose, fasting insulin, insulin resistance (IR) calculated from homeostatic model assessment (HOMA) and hs-CRP compared to the values recorded in lean subjects. Fasting PYY(3-36) level was lower, while fasting acylated ghrelin was higher in MOB-MS than in OB-MS. Plasma total and acylated ghrelin levels were significantly lower in OB-MS compared to lean women. In MOB-MS women the fasting PYY(3-36) levels were lower compared to lean controls and OB-MS, whilst postprandially in both OB-MS and MOB-MS, it was much lower than in lean women. The fasting plasma levels of total and acylated ghrelin and their postprandial decrease

  9. Prostate cancer outcome and tissue levels of metal ions

    Science.gov (United States)

    Sarafanov, A.G.; Todorov, T.I.; Centeno, J.A.; MacIas, V.; Gao, W.; Liang, W.-M.; Beam, C.; Gray, Marion A.; Kajdacsy-Balla, A.

    2011-01-01

    BACKGROUNDThere are several studies examining prostate cancer and exposure to cadmium, iron, selenium, and zinc. Less data are available on the possible influence of these metal ions on prostate cancer outcome. This study measured levels of these ions in prostatectomy samples in order to examine possible associations between metal concentrations and disease outcome.METHODSWe obtained formalin fixed paraffin embedded tissue blocks of prostatectomy samples of 40 patients with PSA recurrence, matched 1:1 (for year of surgery, race, age, Gleason grading, and pathology TNM classification) with tissue blocks from 40 patients without recurrence (n = 80). Case–control pairs were compared for the levels of metals in areas adjacent to tumors. Inductively coupled plasma-mass spectrometry (ICP-MS) was used for quantification of Cd, Fe, Zn, and Se.RESULTSPatients with biochemical (PSA) recurrence of disease had 12% lower median iron (95 µg/g vs. 111 µg/g; P = 0.04) and 21% lower zinc (279 µg/g vs. 346 µg/g; P = 0.04) concentrations in the normal-appearing tissue immediately adjacent to cancer areas. Differences in cadmium (0.489 µg/g vs. 0.439 µg/g; 4% higher) and selenium (1.68 µg/g vs. 1.58 µg/g; 5% higher) levels were not statistically significant in recurrence cases, when compared to non-recurrences (P = 0.40 and 0.21, respectively).CONCLUSIONSThere is an association between low zinc and low iron prostate tissue levels and biochemical recurrence in prostate cancer. Whether these novel findings are a cause or effect of more aggressive tumors, or whether low zinc and iron prostatic levels raise implications for therapy, remains to be investigated. 

  10. Plasma Kisspeptin-54 levels in gastric cancer patients.

    Science.gov (United States)

    Ergen, Arzu; Canbay, Emel; Bugra, Dursun; Zeybek, Umit; Yamaner, Sumer; Bulut, Turker

    2012-01-01

    Kisspeptin (Kisspeptin-54; KP-54) is a 54-amino acid peptide was originally known as metastin that was implicated in suppression of tumor metastasis and circulating kisspeptin has been proposed as a tumor marker for numerous cancers in humans. However, the plasma level of KP-54 in gastric cancer (GC) remains undetermined. We aimed to investigate the plasma levels of KP-54 in patients with GC. Plasma KP-54 levels were quantified with enzyme-immunoassay from blood samples of 40 patients with GC at their initial staging and 59 age-matched controls. Plasma KP-54 levels were significantly higher in GC patients (63.3±17.9) than in controls (49.0±12.7) (p=0.000). Cut-off value for KP-54 was determined as 44 ng/ml and sensitivity, specificity, positive predictive value and negative predictive value, were 60%, 78%, 63%, and 74% respectively. Plasma KP-54 levels were not correlated with any clinicopathological features of GC patients (p>0.05). Result of our preliminary study suggest that plasma KP-54 levels might be a useful parameter in diagnosis of GC. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  11. Postoperative radiotherapy-induced morbidity in rectal cancer Morbilidad de la radioterapia postoperatoria en el cáncer de recto

    Directory of Open Access Journals (Sweden)

    M. Garay Burdeos

    2004-11-01

    Full Text Available Objectives: we analyzed long-term morbidity and bowel function alteration after postoperative radiotherapy for rectal cancer following resection with anastomosis. Patients and methods: thirty-seven patients who underwent surgery with intention to cure and a minimal follow-up period of 3 years were included. These patients were divided into two groups: in the first group, 14 patients received postoperative chemo-radiotherapy, 5-fluorouracil plus folinic acid, and 45 Gy plus 5 Gy boost. In the second group, there were 23 patients regarded as controls. We designed a questionnaire about their bowel function and analyzed the morbidity detected in their follow-up. Results: the group that was treated with postoperative chemo-radiotherapy had more daily bowel movements (p = 0.03 and night-time movements (p = 0.04; incontinence (69.2 versus 17.4% in the control group; p = 0.002, and perianal skin irritation (p = 0.04 versus the control group. Although without meaningful differences, the group under treatment wore a pad more often, had more defecatory urgency, could distinguish worse gas from stool, and needed more frequently antidiarrheal measures. Major complications were present in 28.6% of the under-treatment group: three intestinal resections were performed due to actinic stenosis; one patient had a residual stercoral fistula; another had several occlusive crises solved with medical treatment. Conclusions: postoperative chemo-radiotherapy had a high morbidity rate, which determined a significant alteration in quality of life. Accuracy in indication is therefore necessary, as well as a consideration of other alternatives for treatment, such as preoperative chemo-radiotherapy and total mesorectal excision.Objetivos: analizar la morbilidad y alteración del funcionalismo rectal a largo plazo de la radioterapia postoperatoria tras resección con anastomosis en el cáncer de recto. Material y métodos: se incluyen 37 pacientes intervenidos con intenci

  12. Serum selenium level and risk of lung cancer mortality

    DEFF Research Database (Denmark)

    Suadicani, P; Hein, H O; Gyntelberg, F

    2011-01-01

    Serum selenium has been implicated as a risk factor for lung cancer, but the issue remains unsettled. We tested in a cohort of 3,333 males aged 53 to 74 years the hypothesis that a low serum selenium would be associated with an increased risk of lung cancer mortality.During 16 years, 167 subjects(5.......1%) died from lung cancer; 48 males (5.0%) among males with low serum selenium, 0.4-1.0 μmol·l(-1), n=965, 57 males (5.1%) among males with medium serum selenium, 1.1-1.2 μmol·l(-1), n=1,141, and 62 males (5.1%) among males with high serum selenium, 1.3-3.0 μmol·l(-1), n=1,227. After adjustment for age...... (chronic bronchitis and peak flow), referencing the lowest level of serum selenium HRs were 1.17(0.79-1.75), and 1.43(0.96-2.14), respectively. Among heavy smokers a high serum selenium was associated with a significantly increased risk of lung cancer mortality after taking into account all potential...

  13. Level of activity in children undergoing cancer treatment.

    Science.gov (United States)

    Winter, Corinna; Müller, Carsten; Brandes, Mirko; Brinkmann, Anja; Hoffmann, Christiane; Hardes, Jendrik; Gosheger, Georg; Boos, Joachim; Rosenbaum, Dieter

    2009-09-01

    The diagnosis of cancer bears severe implications for pediatric patients. One immense restriction consists in a reduced level of activity due to different factors. Physical activity affects various aspects of development and can be regarded as an essential part of a child's life. In the present study physical activity in patients undergoing cancer therapy was quantified in order to determine the extent of the restriction and to provide baseline information for the assessment of possible interventions. Physical activity in 80 patients and 45 healthy children matched for age and gender was measured using the StepWatch 3 Activity Monitor (SAM, OrthoCare Innovations). Pediatric cancer patients, at 2,787 gait cycles (gcs) per day, were significantly less active than their healthy counterparts (8,096 gcs). Patients were significantly more active at home than during inpatient stays (3,185 gcs compared to 1,830 gcs), and patients with bone tumors were less active than those with leukemia regarding both, the amount (1,849 gcs vs. 2,992 gcs) and the intensity of activity. The present study quantified an often observed but so far hardly assessable problem. Activity in cancer patients is considerably reduced and patients with bone tumors are at increased risk from the detrimental effects of prolonged inactivity. Both our findings and the accepted fact that activity is an essential element of child development confirm the need for interventions tailored to a patient's needs and abilities during the course of treatment. (c) 2009 Wiley-Liss, Inc.

  14. Serum adipocytokine levels in patients with colorectal cancer

    Directory of Open Access Journals (Sweden)

    Sema Uslu

    2010-12-01

    Full Text Available Objectives: Adipose tissue, besides its main function as an energy storage depot, is currently considered an endocrine organ that secretes several self-produced cytokines. Leptin and resistin play an important role in energy homeostasis, glucose, lipid metabolism and regulation of body weight. The aim of the current study was to determine the concentration of leptin and resistin in pre-operational and post-operational periods of patients diagnosed as colorectal cancer.Materials and methods: The body mass index (BMI and values of leptin and resistin in blood at diagnosis were measured in 12 colorectal cancer patients in pre- and post-operational periods and in 12 age- and sex-matched controls. Serum leptin and resistin concentrations were measured by ELISA method.Results: Decreased leptin (1.95±0.62 ng/ml and resistin (4.32±1.83 ng/ml levels were found in pre-operational group compared with the control group (leptin: 6.12±0.82 ng/ml; resistin: 10.75±1.46 ng/ml (p0.05.Conclusion: We conclude that serum concentration of leptin and resistin may have a role in patients with colorectal cancers. Further studies are needed to investigate the possible prognostic value of leptin and resistin in clinical practice of patients with colorectal cancers.

  15. Raised plasma endostatin levels correlate inversely with breast cancer angiogenesis.

    Science.gov (United States)

    Teh, Swee H; Hill, Arnold D K; Lee, Adriana W S; Foley, Deirdre; Kennedy, Susan; Young, Leonie; McDermott, Enda; O'Higgins, Niall

    2004-01-01

    Angiogenesis is essential for solid tumors, such as breast cancer, to grow. The effect of surgical removal of breast tumors on plasma endostatin and vascular endothelial growth factor (VEGF) levels was evaluated. Tumor tissues were analyzed for expression of Intratumoral microvessel density (IMVD) and endostatin. The effect of VEGF and endostatin in inducing apoptosis on human liver microvascular endothelial cells (HLMVEC) was investigated. Plasma from healthy volunteers, patients with fibroadenomas and breast cancer patients were assayed for endostatin and VEGF via immunoassay, pre-operatively and four weeks post-operatively. Expression of endostatin in tumor tissue was determined by Western blotting. IMVD was assessed following immunohistochemical staining with anti-CD34 antibody. Plasma endostatin levels, in breast cancer patients, were significantly elevated (P = 0.015) in the post-operative (60.59 +/- 7.70 etag/ml) compared with the pre-operative group (30.62 +/- 4.54 etag/ml) and with normal age-matched controls (34.97 +/- 3.76 etag/ml). In patients with high pre-operative plasma endostatin value, IMVD was decreased to 20.1 +/- 3.2 counts compared with 41.9 +/- 5.4 counts in those with low pre-operative endostatin value (P = 0.006). Neither plasma endostatin nor VEGF levels correlated with routine clinico-pathological parameters. Endostatin induced endothelial cell apoptosis and modulated the cytoprotective effect of VEGF in HLMVEC survival. Plasma endostatin levels are increased in patients following surgical removal of the primary tumor. The decreased IMVD seen in patients with higher endostatin levels may be due to the apoptosis-inducing effect of endostatin on microvascular endothelial cells.

  16. The effect of low level laser on anaplastic thyroid cancer

    Science.gov (United States)

    Rhee, Yun-Hee; Moon, Jeon-Hwan; Ahn, Jin-Chul; Chung, Phil-Sang

    2015-02-01

    Low-level laser therapy (LLLT) is a non-thermal phototherapy used in several medical applications, including wound healing, reduction of pain and amelioration of oral mucositis. Nevertheless, the effects of LLLT upon cancer or dysplastic cells have been so far poorly studied. Here we report that the effects of laser irradiation on anaplastic thyroid cancer cells leads to hyperplasia. 650nm of laser diode was performed with a different time interval (0, 15, 30, 60J/cm2 , 25mW) on anaplastic thyroid cancer cell line FRO in vivo. FRO was orthotopically injected into the thyroid gland of nude mice and the irradiation was performed with the same method described previously. After irradiation, the xenograft evaluation was followed for one month. The thyroid tissues from sacrificed mice were undergone to H&E staining and immunohistochemical staining with HIF-1α, Akt, TGF-β1. We found the aggressive proliferation of FRO on thyroid gland with dose dependent. In case of 60 J/ cm2 of energy density, the necrotic bodies were found in a center of the thyroid. The phosphorylation of HIF-1α and Akt was detected in the thyroid gland, which explained the survival signaling of anaplastic cancer cell was turned on the thyroid gland. Furthermore, TGF-β1 expression was decreased after irradiation. In this study, we demonstrated that insufficient energy density irradiation occurred the decreasing of TGF-β1 which corresponding to the phosphorylation of Akt/ HIF-1α. This aggressive proliferation resulted to the hypoxic condition of tissue for angiogenesis. We suggest that LLLT may influence to cancer aggressiveness associated with a decrease in TGF-β1 and increase in Akt/HIF-1α.

  17. Arm morbidity following sentinel lymph node biopsy or axillary lymph node dissection: a study from the Danish Breast Cancer Cooperative Group

    DEFF Research Database (Denmark)

    Husted, Madsen A.; Haugaard, K.; Soerensen, J.

    2008-01-01

    the impact on shoulder mobility of node positive patients having a secondary axillary dissection because of the findings of metastases postoperatively. AIM: We aimed to investigate the objective and subjective arm morbidity in node negative and node positive patients. METHODS AND MATERIALS: In a prospective...... groups of node negative patients. Highly significant difference was found comparing sensibility. Comparing the morbidity in node positive patients who had a one-step axillary dissection with patients having a two-step procedure (sentinel lymph node biopsy followed by delayed axillary dissection) revealed...... no difference in objective or subjective arm morbidity. CONCLUSION: Node negative patients operated with sentinel lymph node biopsy have less arm morbidity compared with node negative patients operated with axillary lymph node dissection. Node positive patients who had a secondary axillary lymph node dissection...

  18. Dose-volume effect relationships for late rectal morbidity in patients treated with chemoradiation and MRI-guided adaptive brachytherapy for locally advanced cervical cancer: Results from the prospective multicenter EMBRACE study.

    Science.gov (United States)

    Mazeron, Renaud; Fokdal, Lars U; Kirchheiner, Kathrin; Georg, Petra; Jastaniyah, Noha; Šegedin, Barbara; Mahantshetty, Umesh; Hoskin, Peter; Jürgenliemk-Schulz, Ina; Kirisits, Christian; Lindegaard, Jacob C; Dörr, Wolfgang; Haie-Meder, Christine; Tanderup, Kari; Pötter, Richard

    2016-09-01

    To establish dose volume-effect relationships predicting late rectal morbidity in cervix cancer patients treated with concomitant chemoradiation and MRI-guided adaptive brachytherapy (IBABT) within the prospective EMBRACE study. All patients were treated with curative intent according to institutional protocols with chemoradiation and IGABT. Reporting followed the GEC-ESTRO recommendations ( [Formula: see text] , [Formula: see text] ), applying bioeffect modeling (linear quadratic model) with equieffective doses (EQD2 3 ). Morbidity was scored according to the CTC-AE 3.0. Dose-effect relationships were assessed using comparisons of mean doses, the probit model and log rank tests on event-free periods. 960 patients were included. The median follow-up was 25.4months. Twenty point one percent of the patients had grade 1 events, 6.0% grade 2, 1.6% grade 3 and 0.1%, grade 4. The mean D ICRU , [Formula: see text] , and [Formula: see text] were respectively: 66.2±9.1Gy, 72.9±11.9Gy, and 62.8±7.6Gy. Increase of dose was associated with increase in severity of single endpoints and overall rectal morbidity (grade 1-4) (p0.001). A [Formula: see text] <65Gy was associated with a two times lower risk of proctitis than [Formula: see text] ⩾65Gy. Significant correlations were established between late rectal morbidity, overall and single endpoints, and dose-volume ( [Formula: see text] , [Formula: see text] ) and dose-point (D ICRU ) parameters. A [Formula: see text] ⩽65Gy is associated with more minor and less frequent rectal morbidity, whereas a [Formula: see text] ⩾75Gy is associated with more major and more frequent rectal morbidity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Maternal age and child morbidity

    DEFF Research Database (Denmark)

    Hviid, Malene Meisner; Skovlund, Charlotte Wessel; Mørch, Lina Steinrud

    2017-01-01

    the association between maternal age and overall child morbidity according to main diagnosis groups. MATERIAL AND METHODS: We conducted a national cohort study including 352 027 live firstborn singleton children. The children were born between Jan 1994 and Dec 2009 and followed to Dec 2012. Children were divided...... into groups according to maternal age: 15-24, 25-29, 30-34, and 35+ years. Poisson regression analyses calculated adjusted incidence rate ratios (IRR) of child morbidities according to main diagnoses groups A-Q of the International Classification of Disease 10 with adjustment for year of birth, body mass...... index, smoking, and mother's level of education. RESULTS: Average follow-up time was 11 years. Compared to children born to women 25-29 years, firstborn children to mothers aged 35+ had higher child morbidity in 8 of 19 main diagnosis groups and firstborn children to mothers 15-24 years had higher child...

  20. Manifestation Pattern of Early-Late Vaginal Morbidity After Definitive Radiation (Chemo)Therapy and Image-Guided Adaptive Brachytherapy for Locally Advanced Cervical Cancer: An Analysis From the EMBRACE Study

    Energy Technology Data Exchange (ETDEWEB)

    Kirchheiner, Kathrin, E-mail: kathrin.kirchheiner@meduniwien.ac.at [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna (Austria); Nout, Remi A. [Department of Clinical Oncology, Leiden University Medical Center (Netherlands); Tanderup, Kari; Lindegaard, Jacob C. [Department of Oncology, Aarhus University Hospital (Denmark); Westerveld, Henrike [Department of Radiotherapy, Academic Medical Centre, University of Amsterdam (Netherlands); Haie-Meder, Christine [Department of Radiotherapy, Gustave-Roussy, Villejuif (France); Petrič, Primož [Department of Radiotherapy, Institute of Oncology Ljubljana (Slovenia); Department of Radiotherapy, National Center for Cancer Care and Research, Doha (Qatar); Mahantshetty, Umesh [Department of Radiation Oncology, Tata Memorial Hospital, Mumbai (India); Dörr, Wolfgang; Pötter, Richard [Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna/General Hospital of Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna (Austria)

    2014-05-01

    Background and Purpose: Brachytherapy in the treatment of locally advanced cervical cancer has changed substantially because of the introduction of combined intracavitary/interstitial applicators and an adaptive target concept, which is the focus of the prospective, multi-institutional EMBRACE study ( (www.embracestudy.dk)) on image-guided adaptive brachytherapy (IGABT). So far, little has been reported about the development of early to late vaginal morbidity in the frame of IGABT. Therefore, the aim of the present EMBRACE analysis was to evaluate the manifestation pattern of vaginal morbidity during the first 2 years of follow-up. Methods and Materials: In total, 588 patients with a median follow-up time of 15 months and information on vaginal morbidity were included. Morbidity was prospectively assessed at baseline, every 3 months during the first year, and every 6 months in the second year according to the Common Terminology Criteria for Adverse Events, version 3, regarding vaginal stenosis, dryness, mucositis, bleeding, fistula, and other symptoms. Crude incidence rates, actuarial probabilities, and prevalence rates were analyzed. Results: At 2 years, the actuarial probability of severe vaginal morbidity (grade ≥3) was 3.6%. However, mild and moderate vaginal symptoms were still pronounced (grade ≥1, 89%; grade ≥2, 29%), of which the majority developed within 6 months. Stenosis was most frequently observed, followed by vaginal dryness. Vaginal bleeding and mucositis were mainly mild and infrequently reported. Conclusion: Severe vaginal morbidity within the first 2 years after definitive radiation (chemo)therapy including IGABT with intracavitary/interstitial techniques for locally advanced cervical cancer is limited and is significantly less than has been reported from earlier studies. Thus, the new adaptive target concept seems to be a safe treatment with regard to the vagina being an organ at risk. However, mild to moderate vaginal morbidity

  1. Serum Levels of Trace Elements in Patients with Testicular Cancers

    Science.gov (United States)

    Kaba, Mehmet; Pirinççi, Necip; Yüksel, Mehmet Bilgehan; Geçit, İlhan; Güneş, Mustafa; Demir, Murat; Akkoyun, HurremTuran; Demir, Halit

    2015-01-01

    ABSTRACT Introduction: Trace elements are primary components of biological structures; however, they can be toxic when their concentrations are higher than those needed for biological functions. Materials and Methods: In the present study serum levels of trace elements were measured in 30 patients (mean age was 26.9±11.2 years) newly diagnosed with germ cell testicular cancer and 32 healthy volunteers (mean age: 27.4±10.8) by using furnace atomic absorption spectrophotometer. Serum samples were stored at-20°C until assays. Results: In patients with germ cell testicular cancer, the diagnosis was seminoma in 15, mix germ cell tumor in 7, embryonal carcinoma in 4, yolk sac tumor in 2 and teratoma in 2 patients. There was stage I testicular tumor in 19 patients (63.3%) while stage II in 6 patients (20.0%), stage IIIA in 4 patients (13.3%) and stage IIIC in one patient (3.4%). It was found that serum Co, Cu, Mg and Pb levels were increased (ptrace elements. PMID:26742967

  2. Dose-volume effect relationships for late rectal morbidity in patients treated with chemoradiation and MRI-guided adaptive brachytherapy for locally advanced cervical cancer: Results from the prospective multicenter EMBRACE study

    DEFF Research Database (Denmark)

    Mazeron, Renaud; Fokdal, Lars U; Kirchheiner, Kathrin

    2016-01-01

    relationships between the D2cm3, D0.1cm3, and DICRU and the probability of grade 1–4, 2–4, and 3–4 rectal events. The equieffective D2cm3 for a 10% probability for overall rectal grade ⩾ 2 morbidity was 69.5 Gy (p levels, less favorable outcome was observed...

  3. Kisspeptin-54 levels are increased in patients with colorectal cancer.

    Science.gov (United States)

    Canbay, Emel; Ergen, Arzu; Bugra, Dursun; Yamaner, Sumer; Eraltan, Ilhan Yaylim; Buyukuncu, Yilmaz; Bulut, Turker

    2012-09-01

    Recent studies have demonstrated that Kisspeptin, the product of the metastasis suppressor gene KiSS-1, could have a role in tumor progression and invasion. In this pilot study, we investigated the association of plasma Kisspeptin-54 level with colorectal cancer (CRC). Plasma Kisspeptin-54 levels were quantified using enzyme-immunoassay (EIA) kits from blood samples of 81 patients with CRC at their initial staging and 59 age-matched healthy controls. Plasma Kisspeptin-54 levels were significantly higher in CRC patients (86.2 ± 20.5) than in controls (49 ± 12.7; p 54 detection was determined as 46 ng/ml, and area under curve (AUC) value was 0.766 with sensitivity 63 %, specificity 81.4 %, positive predictive value 82.2 %, negative predictive value 61.5 %, positive likelihood ratio 3.38, and negative likelihood ratio 0.46. Increased plasma Kisspeptin-54 levels were significantly correlated with nodal involvement of CRC (Spearman, rs = 0.345, p = 0.002). Kisspeptin-54 was also found to be an independent predictive marker for lymph node metastases of CRC (p = 0; Exp(B): 2.053; 95 % CI, 1.255-2.851). Our results reveal that plasma Kisspeptin-54 measurement could be a useful diagnostic and prognostic parameter for CRC. Further prospective evaluation is needed to validate these findings and to establish the clinical usefulness of Kisspeptin-54 for CRC diagnostics.

  4. Increased plasma soluble uPAR level is a risk marker of respiratory cancer in initially cancer-free individuals

    DEFF Research Database (Denmark)

    Langkilde, Anne A; Ladelund, Steen; Andersen, Ove

    2011-01-01

    codes and suPAR levels were measured using a commercially available ELISA. The association of suPAR levels with incident cancer during follow-up was analyzed using Cox regression, adjusted for established risk factors and the inflammatory markers C-reactive protein (CRP) and leukocyte numbers...... with respiratory, gastrointestinal and other cancer types, respectively.CONCLUSIONS: Elevated suPAR levels were associated with increased risk of incident respiratory cancer and other types of cancer, but not gastrointestinal cancers, independently of established risk factors, CRP and leukocyte numbers. Impact......:These findings suggest that inflammation is involved in cancer development. Risk algorithms based on established risk factors and risk-associated biomarkers should be developed and evaluated in large general population-based studies. We suggest suPAR as a candidate for evaluation in cancer risk algorithms....

  5. A comparison of stress levels, coping styles and psychological morbidity between graduate-entry and traditional undergraduate medical students during the first 2 years at a UK medical school.

    Science.gov (United States)

    Zvauya, R; Oyebode, F; Day, E J; Thomas, C P; Jones, L A

    2017-02-13

    Stress levels and psychological morbidity are high among undergraduate medical students (UGs), but there is a lack of research into the psychological health of UK graduate-entry medical students (GEs). GEs are likely to experience different (perhaps more severe) stressors and to cope with stress differently. We compared stress levels, psychological morbidity and coping styles in GE versus UG medical students studying at the same UK medical school in the same academic year. A cross-sectional self-rated questionnaire study of all first- and second-year GE and UG medical students was conducted. Perceived stress, psychological morbidity, recent adverse life events, stress-related personality traits and coping styles were assessed using standard questionnaires. 75% GEs and 46% UGs responded to the questionnaire. Both groups reported equally high levels, and similar profiles of, perceived stress and psychological morbidity. Levels of recent adverse life events and stress-related personality traits were similar in both groups. Compared to UGs, GEs were more likely to use active coping (p = 0.02) and positive reframing (p = 0.03), but were also more likely to use substances (alcohol and other drugs; p cope. Unlike UGs, second-year GEs showed less perceived stress (p = 0.007) and psychological morbidity (p = 0.006) than first-year GEs although levels of both were still high. Our results show that both GE students and their younger UG counterparts on a traditional medical course have similar profiles of stress symptoms. They do, however, cope with stress differently. GEs are more likely to use active problem-focused coping strategies, and they are also more likely to cope by using substances (alcohol or other drugs). GE students need interventions to prevent maladaptive coping styles and encourage adaptive coping that are tailored to their needs. Such interventions should be targeted at first-year students. It is vital that these students develop positive coping

  6. Multi-Morbidity in Hospitalised Older Patients: Who Are the Complex Elderly?

    Science.gov (United States)

    Ruiz, Milagros; Bottle, Alex; Long, Susannah; Aylin, Paul

    2015-01-01

    Background No formal definition for the “complex elderly” exists; moreover, these older patients with high levels of multi-morbidity are not readily identified as such at point of hospitalisation, thus missing a valuable opportunity to manage the older patient appropriately within the hospital setting. Objectives To empirically identify the complex elderly patient based on degree of multi-morbidity. Design Retrospective observational study using administrative data. Setting English hospitals during the financial year 2012–13. Subjects All admitted patients aged 65 years and over. Methods By using exploratory analysis (correspondence analysis) we identify multi-morbidity groups based on 20 target conditions whose hospital prevalence was ≥ 1%. Results We examined a total of 2788900 hospital admissions. Multi-morbidity was highly prevalent, 62.8% had 2 or more of the targeted conditions while 4.7% had six or more. Multi-morbidity increased with age from 56% (65-69yr age-groups) up to 67% (80-84yr age-group). The average multi-morbidity was 3.2±1.2 (SD). Correspondence analysis revealed 3 distinct groups of older patients. Group 1 (multi-morbidity ≤2), associated with cancer and/or metastasis; Group 2 (multi-morbidity of 3, 4 or 5), associated with chronic pulmonary disease, lung disease, rheumatism and osteoporosis; finally Group 3 with the highest level of multi-morbidity (≥6) and associated with heart failure, cerebrovascular accident, diabetes, hypertension and myocardial infarction. Conclusions By using widely available hospital administrative data, we propose patients in Groups 2 and 3 to be identified as the complex elderly. Identification of multi-morbidity patterns can help to predict the needs of the older patient and improve resource provision. PMID:26716440

  7. Prostate Cancer Progression and Serum Sibling (Small Integrin Binding N-Linked Glycoprotein) Levels

    Science.gov (United States)

    2008-10-01

    Castronovo, V. Expression of bone matrix proteins in human breast cancer : potential roles in microcalcification formation and in the genesis of bone...patients representing 9 distinct cancer types. Significantly elevated expression levels were observed for BSP in cancer of the breast , colon...stomach, rectum, thyroid, prostate and kidney; OPN in cancer of the breast , uterus, colon, ovary, lung, rectum, prostate and thyroid; DMP1 in cancer of the

  8. Effects of Intrinsic and Extrinsic Factors on the Level of Hope and Psychological Health Status of Patients with Cervical Cancer During Radiotherapy.

    Science.gov (United States)

    Li, Li-Rong; Lin, Mei-Guang; Liang, Juan; Hu, Qiong-Yan; Chen, Dan; Lan, Meng-Ying; Liang, Wu-Qing; Zeng, Yu-Ting; Wang, Ting; Fu, Gui-Fen

    2017-07-19

    BACKGROUND This study aimed to explore the factors affecting the level of hope and psychological health status of patients with cervical cancer (CC) during radiotherapy. MATERIAL AND METHODS A total of 480 CC patients were recruited. Psychological distress scale, Herth hope index, functional assessment cancer therapy-cervix, and Jolowiec coping scale were used to conduct surveys on psychological distress, level of hope, quality of life (QOL), and coping style to analyze the factors affecting the level of hope and psychological health status of CC patients. RESULTS The morbidity of significant psychological distress in 480 CC patients during radiotherapy was 68%, and the main factors causing psychological distress were emotional problems and physical problems. During radiotherapy, most patients had middle and high levels of hope, and the psychological distress index of patients was negatively correlated with the level of hope. The QOL of CC patients during radiotherapy were at middle and high levels, and the QOL was positively correlated with confrontment, optimism, appeasement, and self-reliance, but it was negatively correlated with predestination and emotional expression. CONCLUSIONS For CC patients during radiotherapy, the morbidity of psychological distress was high, but they were at middle and high levels of hope.

  9. Predictive value of the age-adjusted Charlston co-morbidity index on peri-operative complications, adjuvant chemotherapy usage and survival in patients undergoing debulking surgery after neo-adjuvant chemotherapy for advanced epithelial ovarian cancer.

    Science.gov (United States)

    Phillips, Andrew; Singh, Kavita; Pounds, Rachel; Sundar, Sudha; Kehoe, Sean; Nevin, James; Elattar, Ahmed; Balega, Janos

    2017-11-01

    The aim of this study was to determine whether the age-adjusted Charlston co-morbidity index (ACCI) can predict post-operative complications, adjuvant chemotherapy usage and overall survival (OS) in patients with advanced epithelial ovarian cancer (AOC) treated with neoadjuvant chemotherapy (NACT). A review was performed of all cytoreductive surgeries performed between 16/8/07-3/2/14 for AOC at a UK Cancer Centre. All surgeries were stratified by ACCI into three groups: Low (0-1), Intermediate (2-3) and High (≥4). Of the 293 cases the ACCI distribution was: 74 (25.26%) low, 164 (55.97%) intermediate and 55 (18.77%) high. Patients with a high ACCI were less likely to receive adjuvant chemotherapy (p = .023), more likely to receive fewer adjuvant cycles (p = .0057) but no more likely to experience complications. Median OS for patients with a low, intermediate and high ACCI was 44.58 (95%CI 36.98-52.19), 34.65 (95%CI 29.48-39.82) and 33.37 (95%CI 17.47-49.27) months. ACCI was associated with OS (p Co-morbidity Index has previously been identified as a predictor of survival in both medical and surgical conditions. Recently it has also been validated in patients undergoing primary cytoreductive surgery for advanced ovarian cancer. This study is the first to validate the Age-Adjusted Charlston Co-morbidity Index in patients undergoing cytoreductive surgery following neoadjuvant chemotherapy. Our findings demonstrate that it can be used to not only predict overall survival in women undergoing debulking surgery after neo-adjuvant chemotherapy but also predicts the uptake and commencement of adjuvant chemotherapy. Such findings are important considerations to enable an informed patient choice regarding interval surgery in the more co-morbid patients. More importantly, although the ACCI can be used as a marker of overall survival, even in the most co-morbid of patients there remains a significant survival advantage following surgery to the extent that it should

  10. A level III sentinel lymph node in breast cancer

    Directory of Open Access Journals (Sweden)

    Ghesani Nasrin

    2006-06-01

    Full Text Available Abstract Background For accurate nodal staging, all blue and radioactive lymph nodes should be sampled during the sentinel lymph node biopsy for breast cancer. We report a case of anomalous drainage in which one of the sentinel lymph nodes was unexpectedly found in the level III axillary space. Case presentation A 40-year-old female underwent mastectomy for extensive high-grade ductal carcinoma in-situ (DCIS with micro-invasion. The index lesion was located in the right upper inner quadrant. Lymphoscintigraphy was performed on the morning of surgery. Two sentinel lymph nodes were identified. At operation, 5 mls of isosulfan blue dye was injected at the same site of the radio-colloid injection. The first sentinel lymph node was found at level I and was blue and radioactive. The second sentinel node was detected in an unexpected anomalous location at level III, medial to the pectoralis minor. Both sentinel nodes were negative. Conclusion Sentinel node staging can lead to unexpected patterns of lymphatic drainage. For accurate staging, it is important to survey all potential sites of nodal metastasis either with preoperative lymphoscintigraphy and/or rigorous examination of regional nodal basins with the intra-operative gamma probe.

  11. Low-risk factor profile, estrogen levels, and breast cancer risk among postmenopausal women

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej; Hansen, Ase Marie; Nielsen, Jens

    2008-01-01

    Obesity, alcohol consumption, physical inactivity and postmenopausal hormone use are known modifiable risk factors for breast cancer. We aim to measure incidence rates of breast cancer for women with favorable levels on all 4 risk factors (BMI......Obesity, alcohol consumption, physical inactivity and postmenopausal hormone use are known modifiable risk factors for breast cancer. We aim to measure incidence rates of breast cancer for women with favorable levels on all 4 risk factors (BMI...

  12. County-level environmental quality and associations with cancer incidence#

    Science.gov (United States)

    Background: Cancer risk is affected by a combination of behavioral, genetic, and environmental factors. Individual environmental exposures have been associated with cancer development; however, a variety of environmental exposures may occur simultaneously. The Environmental Quali...

  13. Association between reduction of plasma adiponectin levels and risk of bacterial infection after gastric cancer surgery.

    Directory of Open Access Journals (Sweden)

    Hiroshi Yamamoto

    Full Text Available BACKGROUND AND PURPOSE: Infections are important causes of postoperative morbidity after gastric surgery; currently, no factors have been identified that can predict postoperative infection. Adiponectin (ADN mediates energy metabolism and functions as an immunomodulator. Perioperative ADN levels and perioperative immune functioning could be mutually related. Here we evaluated a potential biological marker to reliably predict the incidence of postoperative infections to prevent such comorbidities. METHODS: We analyzed 150 consecutive patients who underwent elective gastric cancer surgery at the Shiga University of Medical Science Hospital (Shiga, Japan from 1997 to 2009; of these, most surgeries (n = 100 were performed 2008 onwards. The patient characteristics and surgery-related factors between two groups (with and without infection were compared by the paired t-test and χ(2 test, including preoperative ADN levels, postoperative day 1 ADN levels, and ADN ratio (postoperative ADN levels/preoperative ADN levels as baseline factors. Logistic regression analysis was performed to access the independent association between ADN ratio and postoperative infection. Finally, receiver operating curves (ROCs were constructed to examine its clinical utility. RESULTS: Sixty patients (40% experienced postoperative infections. The baseline values of age, American Society of Anesthesiologists physical status, total operating time, blood loss, surgical procedure, C-reactive protein (CRP levels, preoperative ADN levels, and ADN ratio were significantly different between groups. Logistic regression analysis using these factors indicated that type 2 diabetes mellitus (T2DM and ADN ratio were significantly independent variables (*p<0.05, ** p<0.01, respectively. ROC analysis revealed that the useful cutoff values (sensitivity/specificity for preoperative ADN levels, ADN ratio, blood loss, operating time, and CRP levels were 8.81(0.567/0.568, 0.76 (0

  14. Hyperthyroidism and psychiatric morbidity

    DEFF Research Database (Denmark)

    Brandt, Frans; Thvilum, Marianne; Pedersen, Dorthe Almind

    2014-01-01

    Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity.......Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity....

  15. Comparison of cancer incidence and mortality in three GDP per capita levels in China, 2013.

    Science.gov (United States)

    Yang, Zhixun; Zheng, Rongshou; Zhang, Siwei; Zeng, Hongmei; Xia, Changfa; Li, He; Wang, Li; Wang, Yanhong; Chen, Wanqing

    2017-10-01

    In this research, the patterns of cancer incidence and mortality in areas with different gross domestic product per capita (GDPPC) levels in China were explored, using data from population-based cancer registries in 2013, collected by the National Central Cancer Registry (NCCR). Data from 255 cancer registries were qualified and included in this analysis. Based on the GDPPC data of 2014, cities/counties were divided into 3 levels: high-, middle- and low-GDPPC areas, with 40,000 and 80,000 RMB per year as cut points. We calculated cancer incidences and mortalities in these three levels, stratified by gender and age group. The national population of the Fifth Census in 2000 and Segi's population were applied for age-standardized rates. The crude incidence and mortality rates as well as age-standardized incidence rate (ASIR) showed positive associations with GDPPC level. The age-standardized mortality rate (ASMR) nevertheless showed a negative association with GDPPC level. The ASMR in high-, middle- and low-GDPPC areas was 103.12/100,000, 112.49/100,000 and 117.43/100,000, respectively. Lung cancer was by far the most common cancer in all three GDPPC levels. It was also the leading cause of cancer death, regardless of gender and GDPPC level. Negative associations with GDPPC level were found for the ASIRs of lung, stomach, esophageal and liver cancer, whereas colorectal and breast cancer showed positive associations. Except for breast cancer, the ASMRs of the other five cancers were always higher in middle- and low-GDPPC areas than in high-GDPPC areas. The economic development is one of the main factors of the heavy cancer burden on Chinese population. It would be reasonable to implement cancer control strategies referring to the local GDPPC level.

  16. Lack of exercise of "moderate to vigorous" intensity in people with low levels of physical activity is a major discriminant for sociodemographic factors and morbidity.

    Directory of Open Access Journals (Sweden)

    José A Serrano-Sánchez

    Full Text Available The aim is to examine the differences between participation at low and zero moderate to vigorous physical activity (MVPA in relation to their trends and associations with known socio-demographic and health factors. We hypothesised that the number of people at zero MVPA level could be rising despite a parallel increase in the population meeting the recommended MVPA level. We also hypothesised that graded associations of sociodemographic and health factors exist across MVPA levels.Two independent population-based samples (n = 4320 [2004] and n = 2176 [1997], were recruited with a stratified and random sampling procedure and interviewed at home by professional interviewers. The MVPA was assessed by validated questionnaire. The participants were classified into three MVPA levels: zero, low and recommended MVPA. The trend of each MVPA level was analysed with the standardized prevalence ratios. Correlates of low and zero MVPA levels were examined using multinomial logistic regression.The population at zero and recommended MVPA levels rose between 1997-2004 by 12% (95% CI, 5-20% and 7% (95% CI,-4-19% respectively, while the population at low MVPA level decreased. At zero MVPA level, associative patterns were observed with sociodemographic and health factors which were different when compared to the population at low MVPA level.Despite the slight increase of population meeting the recommended MVPA level, a higher trend of increase was observed at zero MVPA level. Both recommended and low MPVA levels increased their participation by absorbing participants from the low MVPA level. The sociodemographic profile of those with low MVPA was more similar to the population at recommended MVPA than at zero MVPA level. Methodological implications about the combination of light and moderate-intensity PA could be derived. The prevention of decline in actual low MVPA could change the trend of increase in the population at zero MVPA level, particularly among

  17. The effects of individual- and network-level factors on discussion of cancer experiences: Survivors of childhood cancer in Korea.

    Science.gov (United States)

    Kim, Min Ah; Yi, Jaehee; Prince, Kort C; Nagelhout, Elizabeth; Wu, Yelena P

    2018-01-01

    This study aimed to identify young adult Korean cancer survivors' individual- (psychological distress, stigma, sociodemographic variables, and cancer-related variables) and network-level factors (relationship type, social support type) that influence discussion of their cancer experiences. Sixty-eight survivors of childhood cancer who were recruited using snowball sampling nominated 245 individuals from their networks, including family and intimate partners (40%) and friends and acquaintances (60%), as people with whom they most frequently interacted. Results of multilevel modeling analysis indicated that higher levels of internalized shame were a prominent individual-level factor associated with a lack of discussion of cancer experiences. Relationship type and support type at the network-level were also significant correlates of discussion of cancer experiences. Programs for reducing the survivors' shame, improving illness identity, and providing professional training for building social relationships that are intimate and in which they could exchange reciprocal support may help Korean childhood cancer survivors to openly share their cancer experiences with others in their social network and to be successful in the journey of cancer survivorship.

  18. Morbidity and GH deficiency

    DEFF Research Database (Denmark)

    Stochholm, Kirstine; Laursen, Torben; Green, Anders

    2008-01-01

    OBJECTIVE: To estimate morbidity in Denmark in all patients with GH deficiency (GHD). DESIGN: Morbidity was analyzed in 1794 GHD patients and 8014 controls matched on age and gender. All records in the GHD patients were studied and additional morbidity noted. Diagnoses and dates of admissions were...... identified in the National Patient Registry. Lag time until first admission was used as a measure of morbidity. Patients were divided into childhood onset (CO) and adult onset (AO), discriminated by an age cut-off of 18 years at onset of GHD. METHOD: Sex- and cause-specific hazard ratios (HRs) in CO and AO...... GHD compared with controls. RESULTS: Total morbidity was significantly increased in the GHD patients. HR for CO males: 3.1 (95% confidence interval (CI): 2.7-3.7), CO females: 3.2 (95% CI: 2.6-3.9), AO males: 2.9 (95% CI: 2.6-3.2), and AO females: 3.2 (95% CI: 2.8-3.6). In 18 out of 20 chapters from...

  19. Circulating and Tissue Expression Levels of YKL-40 in Renal Cell Cancer.

    Science.gov (United States)

    Vom Dorp, Frank; Tschirdewahn, Stephan; Niedworok, Christian; Reis, Henning; Krause, Hans; Kempkensteffen, Carsten; Busch, Jonas; Kramer, Gero; Shariat, Shahrokh F; Nyirady, Peter; Rübben, Herbert; Szarvas, Tibor

    2016-04-01

    Blood levels of YKL-40 are elevated in various malignancies and other inflammatory diseases. Higher YKL-40 levels have consequently been shown to correlate with poor prognosis in several cancers. We investigated the prognostic value of circulating and tissue levels of YKL-40 in renal cell cancer. Preoperative YKL-40 serum/plasma levels were determined in 222 surgically treated patients with renal cell cancer and in 35 controls. Postoperative serum samples were analyzed in 19 of the 222 renal cell cancer cases. Gene expression levels were assessed in 101 renal cell cancer frozen tissue samples using quantitative real-time reverse transcriptase-polymerase chain reaction. Finally immunohistochemical analysis was done in 37 renal cell cancer cases to assess tissue localization of YKL-40. Results were correlated with clinicopathological and followup data. YKL-40 serum but not tissue gene expression levels were higher in patients with renal cell cancer compared to controls (p = 0.050). Serum YKL-40 levels significantly increased following nephrectomy (p renal cell cancer independently of levels determined in serum or plasma. Tumor cells do not seem to be the main source of increased serum/plasma YKL-40 levels in patients with renal cell cancer. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  20. ASCENDE-RT: An Analysis of Treatment-Related Morbidity for a Randomized Trial Comparing a Low-Dose-Rate Brachytherapy Boost with a Dose-Escalated External Beam Boost for High- and Intermediate-Risk Prostate Cancer.

    Science.gov (United States)

    Rodda, Sree; Tyldesley, Scott; Morris, W James; Keyes, Mira; Halperin, Ross; Pai, Howard; McKenzie, Michael; Duncan, Graeme; Morton, Gerard; Hamm, Jeremy; Murray, Nevin

    2017-06-01

    To report the genitourinary (GU) and gastrointestinal (GI) morbidity and erectile dysfunction in a randomized trial comparing 2 methods of dose escalation for high- and intermediate-risk prostate cancer. ASCENDE-RT (Androgen Suppression Combined with Elective Nodal and Dose Escalated Radiation Therapy) enrolled 398 men, median age 68 years, who were then randomized to either a standard arm that included 12 months of androgen deprivation therapy and pelvic irradiation to 46 Gy followed by a dose-escalated external beam radiation therapy (DE-EBRT) boost to 78 Gy, or an experimental arm that substituted a low-dose-rate prostate brachytherapy (LDR-PB) boost. At clinic visits, investigators recorded GU and GI morbidity and information on urinary continence, catheter use, and erectile function. Exclusion of 15 who received nonprotocol treatment and correction of 14 crossover events left 195 men who actually received a DE-EBRT boost and 188, an LDR-PB boost. Median follow-up was 6.5 years. The LDR-PB boost increased the risk of needing temporary catheterization and/or requiring incontinence pads. At 5 years the cumulative incidence of grade 3 GU events was 18.4% for LDR-PB, versus 5.2% for DE-EBRT (Pversus 3.2% for DE-EBRT (P=.124). The 5-year prevalence of grade 3 GI toxicity was lower than the cumulative incidence for both arms (1.0% vs 2.2%, respectively). Among men reporting adequate baseline erections, 45% of LDR-PB patients reported similar erectile function at 5 years, versus 37% after DE-EBRT (P=.30). The incidence of acute and late GU morbidity was higher after LDR-PB boost, and there was a nonsignificant trend for worse GI morbidity. No differences in the frequency of erectile dysfunction were observed. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. The Effect of National Cancer Screening on Disparity Reduction in Cancer Stage at Diagnosis by Income Level.

    Directory of Open Access Journals (Sweden)

    Hye-Min Jung

    Full Text Available Early detection of cancer is an effective and efficient cancer management strategy. In South Korea, the National Health Insurance administers the National Cancer Screening Program to its beneficiaries. We examined the impact of the National Cancer Screening Program on socioeconomic disparities in cancer stage at diagnosis.Cancer patients registered in the Korean Central Cancer Registry from January 1, 2010 to December 31, 2010 with a diagnosis of gastric cancer (n = 22,470, colon cancer (n = 16,323, breast cancer (n = 10,076, or uterine cervical cancer (n = 2,447 were included. Income level was divided into three groups according to their monthly contribution of National Health Insurance. We employed absolute (age-standardized prevalence rate, slope index of inequality and relative (relative index of inequality measures to separately examine social disparities among participants and non-participants of the National Cancer Screening Program in terms of the early-stage rate.Age-standardized prevalence rates of early-stage by income group were always higher in participants than in non-participants. Furthermore, the age-standardized prevalence rate of early-stage in the low income group of the participants was also higher than that of the high income group of the non-participants. The sizes of disparities (both slope index of inequality and relative index of inequality are smaller in participants compared to non-participants.National Cancer Screening Program participation reduced income disparity in cancer stage at diagnosis. Population-based cancer screening programs can be used as an effective measure to reduce income disparity in cancer care.

  2. The Effect of National Cancer Screening on Disparity Reduction in Cancer Stage at Diagnosis by Income Level.

    Science.gov (United States)

    Jung, Hye-Min; Lee, Jin-Seok; Lairson, David R; Kim, Yoon

    2015-01-01

    Early detection of cancer is an effective and efficient cancer management strategy. In South Korea, the National Health Insurance administers the National Cancer Screening Program to its beneficiaries. We examined the impact of the National Cancer Screening Program on socioeconomic disparities in cancer stage at diagnosis. Cancer patients registered in the Korean Central Cancer Registry from January 1, 2010 to December 31, 2010 with a diagnosis of gastric cancer (n = 22,470), colon cancer (n = 16,323), breast cancer (n = 10,076), or uterine cervical cancer (n = 2,447) were included. Income level was divided into three groups according to their monthly contribution of National Health Insurance. We employed absolute (age-standardized prevalence rate, slope index of inequality) and relative (relative index of inequality) measures to separately examine social disparities among participants and non-participants of the National Cancer Screening Program in terms of the early-stage rate. Age-standardized prevalence rates of early-stage by income group were always higher in participants than in non-participants. Furthermore, the age-standardized prevalence rate of early-stage in the low income group of the participants was also higher than that of the high income group of the non-participants. The sizes of disparities (both slope index of inequality and relative index of inequality) are smaller in participants compared to non-participants. National Cancer Screening Program participation reduced income disparity in cancer stage at diagnosis. Population-based cancer screening programs can be used as an effective measure to reduce income disparity in cancer care.

  3. A longitudinal study of shoulder and arm morbidity in breast cancer survivors 7 years after sentinel lymph node biopsy or axillary lymph node dissection

    NARCIS (Netherlands)

    Kootstra, Jan J.; Dijkstra, Pieter U.; Rietman, Hans; de Vries, Jaap; Baas, Peter; Geertzen, Jan H. B.; Hoekstra, Harald J.; Hoekstra-Weebers, Josette E. H. M.

    Knowledge about long-term consequences of breast cancer treatment on shoulder and arm function and volume in stages I-II breast cancer survivors is limited. The effects of shoulder-arm function shortly after surgery on long-term function are unknown. One hundred and ninety-four women were examined

  4. A longitudinal study of shoulder and arm morbidity in breast cancer survivors 7 years after sentinel lymph node biopsy or axillary lymph node dissection

    NARCIS (Netherlands)

    Kootstra, J.J.; Dijkstra, P.U.; Rietman, Johan Swanik; de Vries, J.; Baas, P.C.; Geertzen, J.H.B.; Hoekstra, H.J.; Hoekstra-Weebers, J.E.

    2013-01-01

    Knowledge about long-term consequences of breast cancer treatment on shoulder and arm function and volume in stages I–II breast cancer survivors is limited. The effects of shoulder–arm function shortly after surgery on long-term function are unknown. One hundred and ninety-four women were examined

  5. EFFECT OF MINDFULLNESS MEDITATION ON STRESS LEVEL AND COPING MECHANISM IN CANCER PATIENTS

    OpenAIRE

    Wahyu Werdani, Yesiana Dwi

    2017-01-01

    Cancer patients have a tendency to experience mental disorders, because the physical changes cause frustration and despair. It impacts on anxiety, depression, and social isolation. The purpose of this study was to analyze the influence of mindfullness meditation to stress levels and coping mechanisms in cancer patients. This study used pre experimental approach with one group pre-test post-test design. Samples were 32 cancer patients with composmentis condition in Indonesian Cancer Foundation...

  6. Correlation of serum and salivary CA15-3 levels in patients with breast cancer.

    Science.gov (United States)

    Agha-Hosseini, Farzaneh; Mirzaii-Dizgah, Iraj; Rahimi, Asieh

    2009-10-01

    The aim of this study was to assess the relationship between serum and saliva levels of cancer antigen (CA) 15-3 and to compare them between women with and without breast cancer. A case-control study was carried out on 61 women aged 28-69 years, including women with and without breast cancer (26 as part of the case study and 35 as part of the control group) conducted at the Emam Khomeini Hospital, Tehran University of Medical Sciences. CA 15-3 levels were assayed in serum and unstimulated whole saliva by EIA. Unpaired t-test, one-way ANOVA and Pearson correlation were used as statistical analysis. The salivary and serological levels of CA 15-3 in the cancer patients were significantly higher (P cancer patients. However, the saliva flow rate was significantly lower in the cancer patients (P cancer in women.

  7. Differential Serum Cytokine Levels and Risk of Lung Cancer Between African and European Americans.

    Science.gov (United States)

    Pine, Sharon R; Mechanic, Leah E; Enewold, Lindsey; Bowman, Elise D; Ryan, Bríd M; Cote, Michele L; Wenzlaff, Angela S; Loffredo, Christopher A; Olivo-Marston, Susan; Chaturvedi, Anil; Caporaso, Neil E; Schwartz, Ann G; Harris, Curtis C

    2016-03-01

    African Americans have a higher risk of developing lung cancer than European Americans. Previous studies suggested that certain circulating cytokines were associated with lung cancer. We hypothesized that variations in serum cytokine levels exist between African Americans and European Americans, and increased circulating cytokine levels contribute to lung cancer differently in the two races. Differences in 10 serum cytokine levels, IL1β, IL4, IL5, IL6, IL8, IL10, IL12, granulocyte macrophage colony-stimulating factor, IFNγ, and TNFα, between 170 African-American and 296 European-American controls from the National Cancer Institute-Maryland (NCI-MD) case-control study were assessed. Associations of the serum cytokine levels with lung cancer were analyzed. Statistically significant results were replicated in the prospective Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial and the Wayne State University Karmanos Cancer Institute case-control study. Six cytokines, IL4, IL5, IL8, IL10, IFNγ, and TNFα, were significantly higher among European-American as compared with African-American controls. Elevated IL6 and IL8 levels were associated with lung cancer among both races in all three studies. Elevated IL1β, IL10, and TNFα levels were associated with lung cancer only among African Americans. The association between elevated TNFα levels and lung cancer among European Americans was significant after adjustment for additional factors. Serum cytokine levels vary by race and might contribute to lung cancer differently between African Americans and European Americans. Future work examining risk prediction models of lung cancer can measure circulating cytokines to accurately characterize risk within racial groups. ©2015 American Association for Cancer Research.

  8. Plasma transforming growth factor beta levels in breast cancer patients

    NARCIS (Netherlands)

    Sminia, P; Barten, AD; Van Waarde, MAWH; Vujaskovic, Z; Van Tienhoven, G

    1998-01-01

    We investigated whether the concentration of circulating transforming growth factor beta (TGF beta) yields diagnostic value in breast cancer. Blood was collected from twenty stage I and II breast cancer patients both prior to treatment and after surgical excision of the tumour. Both latent and

  9. Level of Awareness of Various Aspects of Lung Cancer Among College Teachers in India: Impact of Cancer Awareness Programmes in Prevention and Early Detection.

    Science.gov (United States)

    Shankar, Abhishek; Roy, Shubham; Malik, Abhidha; Rath, G K; Julka, P K; Kamal, Vineet Kumar; Barnwal, Keshav; Upadhyaya, Sneha; Singh, Rajan; Srivastava, Vivek

    2016-12-01

    Lung cancer is one of the most common causes of cancer mortality among men in India and incidence is increasing, but actually, they are largely preventable diseases. In India, advanced stage at the time of presentation is responsible for high mortality and morbidity and early detection is the only way to reduce it. The purpose of this study is to know the level of awareness of various aspects of lung cancer among college teachers and impact of awareness programmes in its prevention and early detection. This assessment was part of Pink Chain Campaign-a campaign on cancer awareness. During the cancer awareness events in 2011-2013 at various women colleges in different parts in India, pre-test related to lung cancer was followed by awareness programme. Post-test using the same questionnaire was conducted at the end of interactive session, at 6 months and 1 year. A total of 872 out of 985 teachers participated in the study (overall response rate was 88.5 %). Mean age of the study population was 41.6 years (range 26-59 years). There was a significant increase in the level of knowledge regarding lung cancer at 6 months, and this was sustained at 1 year. Among teachers who were just asked yes or no question, 117 teachers (13.4 %) were smokers and 241 teachers (27.6 %) were alcoholics. Magazines and newspapers were sources for knowledge in 50-60 % of teachers, whereas approximately 30 % of teachers were educated by TV and Internet regarding various aspects of lung cancer. Post awareness at 6 months and 1 year, Pink Chain Campaign was the major source of knowledge related to lung cancer in more than 90 % of teachers by continuous and timely update on subject. Post awareness at 6 months and 1 year, there was a significant change in alcohol and smoking habits. Major reasons for not going for check-up were ignorance (83.1 %), fear (30.1 %) and lethargic attitude (29.3 %) initially, but over time, lack of time, lethargic attitude and hesitation became

  10. Elevated Plasma Vitamin B12 Levels as a Marker for Cancer

    DEFF Research Database (Denmark)

    Arendt, Johan Frederik Berg; Pedersen, Lars; Nexo, Ebba

    2013-01-01

    BACKGROUND: A substantial proportion of patients referred for plasma vitamin B12 (cobalamin [Cbl]) measurement present with high Cbl levels, which have been reported in patients with different cancer types. However, the cancer risk among patients with newly diagnosed high Cbl levels has not been...... a database of laboratory test results covering the entire population. Data on cancer incidence (follow-up 1998-2010), Cbl treatment, and prior diagnoses were obtained from medical registries. Patients receiving Cbl treatment were excluded. Cancer risks were calculated as standardized incidence ratios (SIRs......) with 95% confidence intervals (CIs), stratified by plasma Cbl levels. All statistical tests were two-sided. RESULTS: We identified 333 667 persons without prevalent cancer and not receiving Cbl treatment. Six percent had Cbl levels greater than the upper reference limit (≥601 pmol/L). Cancer risk...

  11. Treatment-Related Morbidity in Prostate Cancer: A Comparison of 3-Dimensional Conformal Radiation Therapy With and Without Image Guidance Using Implanted Fiducial Markers

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Jasmeet, E-mail: drsingh.j@gmail.com [Calvary Mater Newcastle, Newcastle (Australia); Greer, Peter B. [School of Physical and Mathematical Sciences, University of Newcastle, Newcastle (Australia); White, Martin A. [School of Medicine and Public Health, University of Newcastle, Newcastle (Australia); Parker, Joel; Patterson, Jackie [Calvary Mater Newcastle, Newcastle (Australia); Tang, Colin I.; Capp, Anne; Wratten, Christopher; Denham, James W. [Calvary Mater Newcastle, Newcastle (Australia); School of Medicine and Public Health, University of Newcastle, Newcastle (Australia)

    2013-03-15

    Purpose: To estimate the prevalence of rectal and urinary dysfunctional symptoms using image guided radiation therapy (IGRT) with fiducials and magnetic resonance planning for prostate cancer. Methods and Materials: During the implementation stages of IGRT between September 2008 and March 2010, 367 consecutive patients were treated with prostatic irradiation using 3-dimensional conformal radiation therapy with and without IGRT (non-IGRT). In November 2010, these men were asked to report their bowel and bladder symptoms using a postal questionnaire. The proportions of patients with moderate to severe symptoms in these groups were compared using logistic regression models adjusted for tumor and treatment characteristic variables. Results: Of the 282 respondents, the 154 selected for IGRT had higher stage tumors, received higher prescribed doses, and had larger volumes of rectum receiving high dosage than did the 128 selected for non-IGRT. The follow-up duration was 8 to 26 months. Compared with the non-IGRT group, improvement was noted in all dysfunctional rectal symptoms using IGRT. In multivariable analyses, IGRT improved rectal pain (odds ratio [OR] 0.07 [0.009-0.7], P=.02), urgency (OR 0.27 [0.11-0.63], P=<.01), diarrhea (OR 0.009 [0.02-0.35], P<.01), and change in bowel habits (OR 0.18 [0.06-0.52], P<.010). No correlation was observed between rectal symptom levels and dose-volume histogram data. Urinary dysfunctional symptoms were similar in both treatment groups. Conclusions: In comparison with men selected for non-IGRT, a significant reduction of bowel dysfunctional symptoms was confirmed in men selected for IGRT, even though they had larger volumes of rectum treated to higher doses.

  12. Morbidity from parotid sialography

    NARCIS (Netherlands)

    Kalk, WWI; Vissink, A; Spijkervet, FKL; Moller, JM; Roodenburg, JLN

    2001-01-01

    Objective. Sialography is commonly used for the diagnosis of Sjogren's syndrome, although its invasive nature is often regarded as a serious drawback for routine usage. The aim of this study was to evaluate the morbidity and acceptability of parotid sialography using oil-based contrast fluid. Study

  13. Decreasing asthma morbidity

    African Journals Online (AJOL)

    1994-12-12

    Dec 12, 1994 ... Apart from the optimal use of drugs, various supplementary methods have been tested to decrease asthma morbidity, usually in patients from reiatively affluent socio-economic backgrounds. A study of additional measures taken in a group of moderate to severe adult asthmatics from very poor socio- ...

  14. Significance of pretreatment cardiovascular morbidity as a risk factor during treatment with parenteral oestrogen or combined androgen deprivation of 915 patients with metastasized prostate cancer

    DEFF Research Database (Denmark)

    Johansson, Robert; Damber, Jan Erik; Hagerman, Inger

    2011-01-01

    This study aimed to evaluate prognostic risk factors for cardiovascular events during treatment of metastatic prostate cancer patients with high-dose parenteral polyoestradiol phosphate (PEP, Estradurin®) or combined androgen deprivation (CAD) with special emphasis on pretreatment cardiovascular ...

  15. Changes in soluble CEA and TIMP-1 levels during adjuvant chemotherapy for stage III colon cancer

    DEFF Research Database (Denmark)

    Aldulaymi, Bahir; Christensen, Ib Jarle; Sölétormos, György

    2010-01-01

    Tissue inhibitor of metalloproteinases-1 (TIMP-1) has been suggested to be a valuable marker in colorectal cancer (CRC), but the effects of chemotherapy on TIMP-1 levels are unknown. The present study evaluated the effect of chemotherapy on TIMP-1 levels in comparison with carcinoembryonic antige...... (CEA) levels in patients with stage III colon cancer.......Tissue inhibitor of metalloproteinases-1 (TIMP-1) has been suggested to be a valuable marker in colorectal cancer (CRC), but the effects of chemotherapy on TIMP-1 levels are unknown. The present study evaluated the effect of chemotherapy on TIMP-1 levels in comparison with carcinoembryonic antigen...

  16. Patient income level and cancer clinical trial participation.

    Science.gov (United States)

    Unger, Joseph M; Hershman, Dawn L; Albain, Kathy S; Moinpour, Carol M; Petersen, Judith A; Burg, Kenda; Crowley, John J

    2013-02-10

    Studies have shown an association between socioeconomic status (SES) and quality of oncology care, but less is known about the impact of patient SES on clinical trial participation. We assessed clinical trial participation patterns according to important SES (income, education) and demographic factors in a large sample of patients surveyed via an Internet-based treatment decision tool. Logistic regression, conditioning on type of cancer, was used. Attitudes toward clinical trials were assessed using prespecified items about treatment, treatment tolerability, convenience, and cost. From 2007 to 2011, 5,499 patients were successfully surveyed. Forty percent discussed clinical trials with their physician, 45% of discussions led to physician offers of clinical trial participation, and 51% of offers led to clinical trial participation. The overall clinical trial participation rate was 9%. In univariate models, older patients (P = .002) and patients with lower income (P = .001) and education (P = .02) were less likely to participate in clinical trials. In a multivariable model, income remained a statistically significant predictor of clinical trial participation (odds ratio, 0.73; 95% CI, 0.57 to 0.94; P = .01). Even in patients age ≥ 65 years, who have universal access to Medicare, lower income predicted lower trial participation. Cost concerns were much more evident among lower-income patients (P income patients were less likely to participate in clinical trials, even when considering age group. A better understanding of why income is a barrier may help identify ways to make clinical trials better available to all patients and would increase the generalizability of clinical trial results across all income levels.

  17. ASCENDE-RT: An Analysis of Treatment-Related Morbidity for a Randomized Trial Comparing a Low-Dose-Rate Brachytherapy Boost with a Dose-Escalated External Beam Boost for High- and Intermediate-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Rodda, Sree [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Tyldesley, Scott [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Morris, W. James, E-mail: jmorris@bccancer.bc.ca [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Keyes, Mira [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Halperin, Ross [Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); BC Cancer Agency, Centre for the Southern Interior, Kelowna, British Columbia (Canada); Pai, Howard [Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); BC Cancer Agency, Vancouver Island Centre, Victoria, British Columbia (Canada); McKenzie, Michael; Duncan, Graeme [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, University of British Columbia, Vancouver, British Columbia (Canada); Morton, Gerard [Sunnybrook Health Sciences Centre, Toronto, Ontario (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Hamm, Jeremy [Department of Population Oncology, BC Cancer Agency, Vancouver, British Columbia (Canada); Murray, Nevin [British Columbia (BC) Cancer Agency, Vancouver Centre, Vancouver, British Columbia (Canada); Department of Medicine, University of British Columbia, Vancouver, British Columbia (Canada)

    2017-06-01

    Purpose: To report the genitourinary (GU) and gastrointestinal (GI) morbidity and erectile dysfunction in a randomized trial comparing 2 methods of dose escalation for high- and intermediate-risk prostate cancer. Methods and Materials: ASCENDE-RT (Androgen Suppression Combined with Elective Nodal and Dose Escalated Radiation Therapy) enrolled 398 men, median age 68 years, who were then randomized to either a standard arm that included 12 months of androgen deprivation therapy and pelvic irradiation to 46 Gy followed by a dose-escalated external beam radiation therapy (DE-EBRT) boost to 78 Gy, or an experimental arm that substituted a low-dose-rate prostate brachytherapy (LDR-PB) boost. At clinic visits, investigators recorded GU and GI morbidity and information on urinary continence, catheter use, and erectile function. Exclusion of 15 who received nonprotocol treatment and correction of 14 crossover events left 195 men who actually received a DE-EBRT boost and 188, an LDR-PB boost. Median follow-up was 6.5 years. Results: The LDR-PB boost increased the risk of needing temporary catheterization and/or requiring incontinence pads. At 5 years the cumulative incidence of grade 3 GU events was 18.4% for LDR-PB, versus 5.2% for DE-EBRT (P<.001). Compared with the cumulative incidence, the 5-year prevalence of grade 3 GU morbidity was substantially lower for both arms (8.6% vs 2.2%, P=.058). The 5-year cumulative incidence of grade 3 GI events was 8.1% for LDR-PB, versus 3.2% for DE-EBRT (P=.124). The 5-year prevalence of grade 3 GI toxicity was lower than the cumulative incidence for both arms (1.0% vs 2.2%, respectively). Among men reporting adequate baseline erections, 45% of LDR-PB patients reported similar erectile function at 5 years, versus 37% after DE-EBRT (P=.30). Conclusions: The incidence of acute and late GU morbidity was higher after LDR-PB boost, and there was a nonsignificant trend for worse GI morbidity. No differences in the frequency of

  18. Preoperative Hba1c level in prediction of short-term morbidity and mortality outcomes following coronary artery bypass grafting surgery

    Directory of Open Access Journals (Sweden)

    Ümit Arslan

    2015-05-01

    Conclusion ― We concluded that in those diabetic patients that elective coronart artery bypass graft is applied, highly reactive HbA1c levels (HbA1c ≥7, may indicate morbitity in the early stages of post operation.

  19. Correlation between preoperative serum levels of five biomarkers and relationships between these biomarkers and cancer stage in epithelial overian cancer

    National Research Council Canada - National Science Library

    Hwang, Jongyun; Na, Sunghun; Lee, Hyangah; Lee, Dongheon

    2009-01-01

    To examine the correlation among the preoperative serum levels of five biomarkers presumed to be useful for early detection of epithelial ovarian cancer and evaluate the relationships between serum...

  20. The impact of cancer and its treatment on physical activity levels and behavior in Hong Kong Chinese childhood cancer survivors.

    Science.gov (United States)

    Chung, O K Joyce; Li, Ho Cheung William; Chiu, Sau Ying; Ho, Ka Yan Eva; Lopez, Violeta

    2014-01-01

    Research indicates that regular physical activity is associated with numerous physiological and psychological health benefits for childhood cancer survivors. A review of the literature reveals that no study has so far examined the physical activity levels and behavior of Hong Kong Chinese childhood cancer survivors, and how the cancer and its treatment affect the physical activity and other behavior of these children remains unclear. The aims of this study were to assess the physical activity levels of Hong Kong Chinese childhood cancer survivors and to explore the factors that affect their adherence to and maintenance of regular physical activity. A cross-sectional study was used. A total of 128 childhood cancer survivors (9-16-year-olds) who underwent medical follow-up in the outpatient clinic were invited to participate in the study. There was a significant decline in physical activity levels among childhood cancer survivors. Most of them did not take physical exercise regularly. Concern about academic performance, fatigue, and a decrease in physical strength and endurance after remission prevented them from engaging in regular physical activity. This study indicates that many childhood cancer survivors did not engage in regular physical activity and that they overlooked or underestimated its importance. It is essential for nurses to correct misconceptions about physical activity among childhood cancer survivors and their parents and, most importantly, to advocate the principle of regular physical activity for these children, with the aim of enhancing their physical and psychological well-being.

  1. A correlation of breast cancer and calcium levels in hair analyzed by X-ray fluorescence.

    Science.gov (United States)

    Chikawa, Jun-ichi; Mouri, Yoshitaka; Shima, Hiroki; Yamada, Kousaku; Yamamoto, Hitoshi; Yamamoto, Shingo

    2014-01-01

    Time variations of elemental concentrations and their abnormalities due to breast cancer have been observed along single hair strands by X-ray fluorescence excited by synchrotron radiation. The renal-controlled elements Ca, Sr, S, K, Cl, Br and P have upper and lower levels associated with gating and closing of ion channels in the hair-making cells. The Ca lower level is normal. In cases of Ca deficiency, with a decrease from the normal, store-operated Ca channel gating occurs so as to keep the hair Ca at the normal, and paradoxically high Ca levels near or at the upper level are produced by PTH-operated channel gating of the cells. Chronic Ca deficiency shows a temporal pattern along the hair consisting of a long-term duration of the upper [Ca] level, 10-month long decay to the lower level and abrupt increase to the upper level. The observation for hair from breast-cancer patients also shows the upper Ca level for the time period well before detection, and suggests that cancer is always generated at the long-lasting [Ca] upper level and the hair [Ca] decreases gradually toward the lower level with the cancer growth. This decay of [Ca] is accompanied by those of [Sr] and [K]. Their different decay forms can be explained by parathyroid hormone related peptide (PTHrP) in serum secreted from the cancer having 150 times longer dwell time on the PTH receptors than that of PTH. Patient hair has a memory for the entire cancer process from the state before cancer generation, and the pattern can be distinguished from concentration variation due to the chronic Ca deficiency without cancer, leading to a criterion for cancer detection by the ratio of [Sr]/[Ca]. The hair analysis is useful for early detection of cancer.

  2. Depressed mood in breast cancer survivors: associations with physical activity, cancer-related fatigue, quality of life, and fitness level.

    Science.gov (United States)

    Galiano-Castillo, Noelia; Ariza-García, Angelica; Cantarero-Villanueva, Irene; Fernández-Lao, Carolina; Díaz-Rodríguez, Lourdes; Arroyo-Morales, Manuel

    2014-04-01

    One out of five cancer survivors suffer from depression after oncology treatment. The aim of this study was to examine the relationship between depression and quality of life (QoL), cancer-related symptoms, physical activity level, health-related fitness, and salivary flow rate in breast cancer survivors. 108 breast cancer survivors in the year after the conclusion of treatment were included in this cross-sectional study. Demographic and clinically relevant information, cancer-related fatigue (Piper Fatigue Scale), QoL (QLQ-Br23 module), pain intensity VAS scale, salivary flow rate, physical activity level (Minnesota Leisure Time Physical Activity Questionnaire), and health-related fitness were assessed in all participants. Depressed mood was measured with the Profile of Mood States (POMS) Depression subscale. Significant positive correlations between depressed mood and fatigue, systemic side effects, perceived shoulder pain, and breast-arms symptoms (r ranged between .57 and .28, P depressed mood and body image, future perspective, force handgrip, and physical activity level (r ranged between -.41 and -.19; p body image were significant predictors of depressed mood, and when combined, they explained 39.6% of the variance in depressed mood. Cancer-related fatigue, physical activity level, and QoL partially explain the variability of depressed mood in breast cancer survivors. This paper facilitates a better understanding of the relationship between depressed mood and possible factors associated with it. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Maternal morbid obesity and obstetric outcomes.

    LENUS (Irish Health Repository)

    Farah, Nadine

    2012-02-01

    OBJECTIVE: The purpose of this retrospective cohort study was to review pregnancy outcomes in morbidly obese women who delivered a baby weighing 500 g or more in a large tertiary referral university hospital in Europe. METHODS: Morbid obesity was defined as a BMI > or =40.0 kg\\/m2 (WHO). Only women whose BMI was calculated at their first antenatal visit were included. The obstetric out-comes were obtained from the hospital\\'s computerised database. RESULTS: The incidence of morbid obesity was 0.6% in 5,824 women. Morbidly obese women were older and were more likely to be multigravidas than women with a normal BMI. The pregnancy was complicated by hypertension in 35.8% and diabetes mellitus in 20.0% of women. Obstetric interventions were high, with an induction rate of 42.1% and a caesarean section rate of 45.3%. CONCLUSIONS: Our findings show that maternal morbid obesity is associated with an alarmingly high incidence of medical complications and an increased level of obstetric interventions. Consideration should be given to developing specialised antenatal services for morbidly obese women. The results also highlight the need to evaluate the effectiveness of prepregnancy interventions in morbidly obese women.

  4. Interleukin-18 gene promoter and serum level in women with ovarian cancer.

    Science.gov (United States)

    Samsami Dehaghani, Alamtaj; Shahriary, Khatere; Kashef, Mohammad Amin; Naeimi, Sirous; Fattahi, Mohammad Javad; Mojtahedi, Zahra; Ghaderi, Abbas

    2009-11-01

    IL-18, initially defined as a potent inducer of IFN- gamma production, is a systemic, multifunctional cytokine with both pro-cancerous and anti-cancer activities. The contribution of the IL-18 promoter polymorphisms at positions -607 (C/A) and -137 (G/C) to cancer development has been reported. We sought to examine IL-18 serum level and its polymorphisms in Iranian women with ovarian cancer. Single nucleotide polymorphisms (SNPs) at positions -607 (C/A) and -137 (G/C) were analyzed by allele-specific polymerase chain reaction in 85 women with ovarian cancer and 158 healthy controls. IL-18 serum level was determined using ELISA method. No significant association was found between the allele, genotype, and haplotype distributions of the SNPs and ovarian cancer. Mean IL-18 serum level was significantly higher in patients than in controls (P = 0.008). Comparing IL-18 serum levels with genotypes at positions -607 and -137 revealed no significant difference. No association was also found between IL-18 levels and the disease stage. In conclusion, our results indicate that IL-18 promoter polymorphisms at positions -607 (C/A) and -137 (G/C) appear not to confer susceptibility to ovarian cancer in Iranian population; however, IL-18 serum level increases in ovarian cancer patients.

  5. Comparison of Serum Selenium Levels in Breast Cancer Patients and Healthy People at a Cancer Institute in 2004

    Directory of Open Access Journals (Sweden)

    M Maleki

    2007-01-01

    Full Text Available Introduction: Breast Cancer is one of the most important fatal cancers in women. The mean age of breast cancer in Iran is 48.8 years which is very lower than other countries. Selenium can play an important role in reduction of cancer in several ways, for example selenium increases immunity response and protects cells from oxidation of free radicals and also decreases carcinogenic metabolites. Breast cancer is one of the most important cancers in our country because its incidence is very high and the mean age of patients is very low. Different studies have shown the benefits of selenium in prevention of cancer and since many years selenium has been used as a dietary supplement in advanced countries. Several studies regarding relationship between selenium levels and breast cancer have been done in different countries. We therefore planned a study to evaluate serum selenium levels in breast cancer patients and compare them with a healthy control group. Methods: We selected 45 patients younger than 48 years old and 33 patients older than 48 years old who had not yet received any therapy (surgery, chemotherapy, etc for their cancer as a case group and 46 healthy people who were matched with the patients as a control group and included 23 persons younger and 23 persons older than 48 years old. From each participant, 5cc blood was derived and in several stages, serum selenium levels were evaluated using atomic absorption technology. Data about type of cancer, stage, grade, IHC and cigarette smoking were also collected. Results: The mean Se level was 161.20 μg/l (SD=46.27 μg/l in the patients and 189.13 μg/l (SD=48.75 μg/l in the control group that was statistically significant (P48 years old was 155.39 μg/l (SD=46.68 μg/l that was lower than the control groups. Difference in serum selenium levels between patients and controls in the older group was significant (P=0.007, but in the younger group, it was not statistically significant (P=0

  6. Fasting serum glucose level and cancer risk in Korean men and women.

    Science.gov (United States)

    Jee, Sun Ha; Ohrr, Heechoul; Sull, Jae Woong; Yun, Ji Eun; Ji, Min; Samet, Jonathan M

    2005-01-12

    Diabetes is a serious and costly disease that is becoming increasingly common in many countries. The role of diabetes as a cancer risk factor remains unclear. To examine the relationship between fasting serum glucose and diabetes and risk of all cancers and specific cancers in men and women in Korea. Ten-year prospective cohort study of 1,298,385 Koreans (829,770 men and 468,615 women) aged 30 to 95 years who received health insurance from the National Health Insurance Corp and had a biennial medical evaluation in 1992-1995 (with follow-up for up to 10 years). Death from cancer and registry-documented incident cancer or hospital admission for cancer. During the 10 years of follow-up, there were 20,566 cancer deaths in men and 5907 cancer deaths in women. Using Cox proportional hazards models and controlling for smoking and alcohol use, the stratum with the highest fasting serum glucose (> or =140 mg/dL [> or =7.8 mmol/L]) had higher death rates from all cancers combined (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.22-1.37 in men and HR, 1.23; 95% CI, 1.09-1.39 in women) compared with the stratum with the lowest level (cancer site, the association was strongest for pancreatic cancer, comparing the highest and lowest strata in men (HR, 1.91; 95% CI, 1.52-2.41) and in women (HR, 2.05; 95% CI, 1.43-2.93). Significant associations were also found for cancers of the esophagus, liver, and colon/rectum in men and of the liver and cervix in women, and there were significant trends with glucose level for cancers of the esophagus, colon/rectum, liver, pancreas, and bile duct in men and of the liver and pancreas in women. Of the 26,473 total cancer deaths in men and women, 848 were estimated as attributable to having a fasting serum glucose level of less than 90 mg/dL. For cancer incidence, the general patterns reflected those found for mortality. For persons with a diagnosis of diabetes or a fasting serum glucose level greater than 125 mg/dL (6.9 mmol/L), risks

  7. A global view on cancer incidence and national levels of the human development index.

    Science.gov (United States)

    Fidler, Miranda M; Soerjomataram, Isabelle; Bray, Freddie

    2016-12-01

    Socioeconomic factors are associated with cancer incidence through complex and variable pathways. We assessed cancer incidence for all cancers combined and 27 major types according to national human development levels. Using GLOBOCAN data for 184 countries, age-standardized incidence rates (ASRs) were assessed by four levels (low, medium, high, very high) of the Human Development Index (HDI), a composite index of life expectancy, education, and gross national income. A strong positive relationship between overall cancer incidence and HDI level was observed. When comparing the ASR in very high HDI regions with that in low HDI regions, we observed a positive association ranging from 2 to 14 and 2 to 11 times higher in males and females, respectively, depending on the cancer type. Positive dose-response relationships between the ASR and HDI level were observed in both sexes for the following cancer types: lung, pancreas, leukemia, gallbladder, colorectum, brain/nervous system, kidney, multiple myeloma, and thyroid. Positive associations were also observed for testicular, bladder, lip/oral cavity, and other pharyngeal cancers, Hodgkin lymphoma, and melanoma of the skin in males, and corpus uteri, breast, and ovarian cancers and non-Hodgkin lymphoma in females. A negative dose-response relationship was observed for cervical and other pharyngeal cancers and Kaposi sarcoma in females. Although the relationship between incidence and the HDI remained when assessed at the country-specific level, variations in risk within HDI levels were also observed. We highlight positive and negative associations between incidence and human development for most cancers, which will aid the planning of cancer control priorities among countries undergoing human development transitions. © 2016 UICC.

  8. Comparison of Serum Lipid Levels in Chronic Obstructive Pulmonary Disease and Lung Cancer

    Directory of Open Access Journals (Sweden)

    Mehmet Kos

    2016-01-01

    Full Text Available Aim: Relationship between serum lipid level in chronic obstructive lung disease (COLD and lung cancer was not well documented. In our study we planned to compare serum lipid levels (Total Cholesterol-TC, low density lipoprotein cholesterol-LDL-C, trigliseride-TGL, and high density lipoprotein cholesterol-HDL-C in these common diseases. Material and Method: We evaluated 100 patients and 50 control group retrospectively. We enrolled the lipid parameters before any medical treatment start. Student%u2019s t-test and one-way ANOVA test was used for comparison of the patient characteristics and mean cholesterol level. Results: TC levels were higher in COLD disease than lung cancer group but not statistically significant. TGL levels were higher in lung cancer group than COLD and control group but this was also not statistically significant. Mild-moderate degree COLD patients had lower HDL-C than severe COLD patients (p=0.02. But TC and TGL levels were lower in severe COLD pateints. Small cell lung sancer and non-small lung cancers had statistically significantly lower TC and TGL levels (respectively p=0.04 and p=0.02. Discussion: We estimated that lipid leves of at the beginning of COLD were decreased to provide lipid necessity in cancer tissue due to tumor rapid cell proliferation in cancer, tumor cachexia and increased nutrition problems when developed lung cancer. Larger prospective studies are required to more accurate assessment this issue.

  9. The impact of morbid obesity on solid organ injury in children using the ATOMAC protocol at a pediatric level I trauma center.

    Science.gov (United States)

    Vaughan, Nathan; Tweed, Jeff; Greenwell, Cynthia; Notrica, David M; Langlais, Crystal S; Peter, Shawn D St; Leys, Charles M; Ostlie, Daniel J; Maxson, R Todd; Ponsky, Todd; Tuggle, David W; Eubanks, James W; Bhatia, Amina; Greenwell, Cynthia; Garcia, Nilda M; Lawson, Karla A; Motghare, Prasenjeet; Letton, Robert W; Alder, Adam C

    2017-02-01

    Obesity is an epidemic in the pediatric population. Childhood obesity in trauma has been associated with increased incidence of long-bone fractures, longer ICU stays, and decreased closed head injuries. We investigated for differences in the likelihood of failure of non-operative management (NOM), and injury grade using a subset of a multi-institutional, prospective database of pediatric patients with solid organ injury (SOI). We prospectively collected data on all pediatric patients (Obesity status was derived using CDC definitions; patients were categorized as non-obese (BMI obese (BMI ≥95th percentile). The ISS, injury grade, and NOM failure rate were calculated among other data points. Of 1012 patients enrolled, 117 were identified as having data regarding BMI. Eighty-four percent of patients were non-obese; 16% were obese. The groups did not differ by age, sex, mechanism of injury, or associated injuries. There was no significant difference in the rate of failure of non-operative management (8.2% versus 5.3%). Obesity was associated with higher likelihood of severe (grade 4 or 5) hepatic injury (36.8% versus 15.3%, P=0.048) but not a significant difference in likelihood of severe (grade 4 or 5) splenic injury (15.3% versus 10.5%, P=0.736). Obese patients had a higher mean ISS (22.5 versus 16.1, P=0.021) and mean abdominal AIS (3.5 versus 2.9, P=0.024). Obesity is a risk factor for more severe abdominal injury, specifically liver injury, but without an associated increase in failure of NOM. This may be explained by the presence of hepatic steatosis making the liver more vulnerable to injury. A protocol based upon physiologic parameters was associated with a low rate of failure regardless of the pediatric obesity status. Level II prognosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Circulating DNA and its methylation level in inflammatory bowel disease and related colon cancer.

    Science.gov (United States)

    Bai, Xuming; Zhu, Yaqun; Pu, Wangyang; Xiao, Li; Li, Kai; Xing, Chungen; Jin, Yong

    2015-01-01

    Both of chronic inflammation and abnormal immune in inflammatory bowel disease can induce colon cancer. Previous research showed that cell apoptosis and necrosis become the main source of circulating DNA in the peripheral blood during tumorigenesis that reduced along with methylation degree. However, its role in the process of colitis transforming to colon cancer is not clarified. Drinking 3% DSS was used to establish colitis model, while 3% dextran sodium sulfate (DSS) combined with azo oxidation methane (AOM) intraperitoneal injection was applied to establish colitis related colon cancer model. Circulating DNA and its methylation level in peripheral blood were tested. Morphology observation, HE staining, and p53 and β-catenin expression detection confirmed that drinking 3% DSS and 3% DSS combined with AOM intraperitoneal injection can successfully establish colitis and colitis associated colorectal cancer models. Circulating DNA level in colitis and colon cancer mice increased by gradient compared with control, while significant difference was observed between each other. Circulating DNA methylation level decreased obviously in colitis and colon cancer, and significant difference was observed between each other. Abnormal protein expression, circulating DNA and its methylation level in ulcerative colitis associated colorectal tissues change in gradient, suggesting that circulating DNA and its methylation level can be treated as new markers for colitis cancer transformation that has certain significance to explore the mechanism of human ulcerative colitis canceration.

  11. Awareness level and attitude towards breast cancer screening ...

    African Journals Online (AJOL)

    This study investigated breast cancer screening practices among female health workers in Esanland, Edo State. The study was descriptive and adopted the survey research design. The participants were 750 females from the five local government areas of Esanland, Edo State. The instrument used was a questionnaire, ...

  12. Association of vitamin D levels and risk of ovarian cancer

    DEFF Research Database (Denmark)

    Ong, Jue-Sheng; Cuellar-Partida, Gabriel; Lu, Yi

    2016-01-01

    employed SNPs with well-established associations with 25(OH)D concentration as instrumental variables for MR: rs7944926 (DHCR7), rs12794714 (CYP2R1) and rs2282679 (GC). We included 31 719 women of European ancestry (10 065 cases, 21 654 controls) from the Ovarian Cancer Association Consortium, who were...

  13. Advanced prostate cancer risk in relation to toenail selenium levels

    NARCIS (Netherlands)

    Geybels, M.S.; Verhage, B.A.J.; Schooten, F.J. van; Goldbohm, A.; Brandt, P.A. van den

    2013-01-01

    BACKGROUND: Selenium may prevent advanced prostate cancer (PCa), but most studies on this topic were conducted in populations with moderate to high selenium status. We investigated the association of toenail selenium, reflecting long-term selenium exposure, and advanced PCa risk in a population from

  14. Single Cell “Glucose Nanosensor” Verifies Elevated Glucose Levels in Individual Cancer Cells

    OpenAIRE

    Nascimento, Raphael A. S.; Özel, Rıfat Emrah; Mak, Wai Han; Mulato, Marcelo; Singaram, Bakthan; Pourmand, Nader

    2016-01-01

    Because the transition from oxidative phosphorylation to anaerobic glycolytic metabolism is a hallmark of cancer progression, approaches to identify single living cancer cells by their unique glucose metabolic signature would be useful. Here, we present nanopipettes specifically developed to measure glucose levels in single cells with temporal and spatial resolution, and we use this technology to verify the hypothesis that individual cancer cells can indeed display higher intracellular glucos...

  15. Cardiopulmonary fitness, adiponectin, chemerin associated fasting insulin level in colorectal cancer patients.

    Science.gov (United States)

    Ahn, Ki-Yong; Lee, Mi Kyung; Kim, Dong-Il; Park, Jihye; Min, Jihee; In Yang, Hyuk; Lee, Junga; Oh, Minsuk; An, Joongbae; Lee, Ji-Won; Chu, Sang Hui; Meyerhardt, Jeffrey A; Kim, Nam-Kyu; Jeon, Justin Y

    2016-07-01

    Since circulating level of insulin is associated with colorectal cancer prognosis, it is important to identify factors contributing to fasting insulin level in colorectal cancer patients. The purpose of the current study is to investigate the association of physical fitness, adiponectin, and chemerin levels with circulating level of insulin in colorectal cancer patients. A total of 123 stage II-III colorectal cancer patients who completed standard cancer treatment were recruited. Anthropometric characteristics, fitness measurements, fasting insulin level, homeostasis model assessment of insulin resistance, lipid profiles, and adiponectin and chemerin levels were analyzed. Cardiopulmonary fitness level inversely associated with fasting insulin levels (the least fit (1st tertile): 8.11 ± 0.64, moderately fit (2nd tertile): 6.02 ± 0.63, and highly fit (3rd tertile): 5.58 ± 0.66 μU/ml, unfit vs. moderately fit, p fasting adiponectin and chemerin levels were associated with fasting insulin levels after adjustment for gender, age, stage, and BMI. In our combined analyses, participants with high adiponectin and low chemerin levels showed significantly lower fasting insulin levels (4.92 ± 0.75 vs. 8.07 ± 0.80 μU/ml, p fasting insulin level. Our results suggest that physical fitness and adiponectin and chemerin levels may contribute to circulating levels of insulin. These results suggest that exercise may influence the prognosis of colorectal cancer patients by influencing physical fitness level, circulating levels of adiponectin and chemerin.

  16. Determinants of gastric cancer screening attendance in Korea: a multi-level analysis.

    Science.gov (United States)

    Chang, Yunryong; Cho, Belong; Son, Ki Young; Shin, Dong Wook; Shin, Hosung; Yang, Hyung-Kook; Shin, Aesun; Yoo, Keun-Young

    2015-05-01

    We aimed to assess individual and area-level determinants of gastric cancer screening participation. Data on gastric cancer screening and individual-level characteristics were obtained from the 2007-2009 Fourth Korea National Health and Nutrition Examination Survey. The area-level variables were collected from the 2005 National Population Census, 2008 Korea Medical Association, and 2010 National Health Insurance Corporation. The data were analyzed using multilevel logistic regression models. The estimated participation rate in gastric cancer screening adhered to the Korea National Cancer Screening Program guidelines was 44.0% among 10,658 individuals aged over 40 years who were included in the analysis. Among the individual-level variables, the highest income quartile, a college or higher education level, living with spouse, having a private health insurance, limited general activity, previous history of gastric or duodenal ulcer, and not currently smoking were associated with a higher participation rate in gastric cancer screening. Urbanization showed a significant negative association with gastric cancer screening attendance among the area-level factors (odds ratio (OR) = 0.73; 95% confidence interval (CI) = 0.57-0.93 for the most urbanized quartile vs. least urbanized quartile). There are differences in gastric cancer screening attendance according to both individual and regional area characteristics.

  17. [Morbidity among forestry workers].

    Science.gov (United States)

    Rafalski, H; Bernacki, K

    1981-01-01

    The past and presently diagnosed diseases (excluding vibration disease and occupational hearing impairment) were analysed in 1105 sawers operating combustion drive mechanic saws and in 295 controls. The greatest rate, both in the sawers and controls, was that of the diseases of respiratory tract, circulatory system and osseo -- articulo -- muscular system, nervous system and sense organs. These constituted 86% of all diseases that afflicted sawers and controls. No specific general morbidity accompanying vibration disease or occupational hearing impairment was found in the sawers exposed to noise and vibration.

  18. Potentially estrogenic polychlorinated biphenyls congeners serum levels and its relation with lung cancer.

    Science.gov (United States)

    Recio-Vega, Rogelio; Mendez-Henandez, Alejandra; Gabriel, Antonio Padua Y; Jacobo-Avila, Antonio; Portales-Castanedo, Arnulfo; Hernandez-Gonzalez, Sandra; Gallegos-Arreola, Martha Patricia; Ocampo-Gomez, Guadalupe

    2013-09-01

    Lung cancer is the most common cancer in the world. The main cause of lung cancer is cigarette smoke; however, other important genetic and environmental risk factors play a significant role in the development of lung cancer. Among these factors, occupational and accidental exposure to polychlorinated biphenyls (PCBs) has been associated with an increased risk in lung cancer, suggesting that PCBs could be potent carcinogens. The aim of the present study was to investigate the association between PCB exposure levels, CYP1A1 polymorphisms and the risk of lung cancer. This study enrolled newly diagnosed lung cancer patients. Environmental and occupational information related to the patients studied was collected. Blood samples were taken for the measurement of serum levels of 20 PCB congeners and for CYP1A1 polymorphism analysis. The serum levels of two PCB congeners with potential estrogenic activity were higher in lung cancer patients. The risk of lung cancer was found to correlate with age, gender, smoking history and with agricultural workers, as well as with congener 18. No differences were found in the frequency of CYP1A1 polymorphisms. Furthermore, we did not find a correlation between CYP1A1 polymorphisms and PCB serum levels. The high levels of PCB with estrogenic activity found in our cases, could promote lung cancer inducing cell proliferation in non-neoplastic and neoplastic lung cells via ERβ; inducing the formation of DNA adducts, producing oxidative stress with the subsequent DNA damage and increasing the endogenous catechol levels by catechol-O-methyl transferase (COMT) inhibition. Copyright © 2012 John Wiley & Sons, Ltd.

  19. Screening and comorbidity of clinical levels of fear of cancer recurrence.

    Science.gov (United States)

    Simard, Sébastien; Savard, Josée

    2015-09-01

    The prevalence of clinical levels of fear of cancer recurrence (FCR) in cancer survivors is unknown, which may be partly explained by the lack of an assessment method that would make it possible to distinguish between normal and clinical levels of FCR. Moreover, despite the apparent overlap between FCR and manifestations of some psychiatric disorders, no study has yet evaluated the comorbidity of clinical levels of FCR. The goals of this study were to assess the capacity of the Fear of Cancer Recurrence Inventory severity subscale, to consider a shorter form of the FCRI (FCRI-SF), to screen for clinical levels of FCR, and to assess its psychiatric comorbidity. Sixty French-Canadian cancer survivors (73% of those eligible) who had been treated within the past 4 years for localized breast, prostate, lung, or colorectal cancer were randomly selected. Participants were administered a clinical interview assessing FCR, the Structured Clinical Interview for DSM-IV, and self-report scales. A cutoff score of 13 or higher on the FCRI-SF was associated with optimal sensitivity (88%) and specificity (75%) rates for the screening of clinical levels of FCR. Cancer survivors with clinical levels of FCR were significantly more likely to meet the criteria for a current psychiatric disorder (60%) than patients with nonclinical levels (29%). Anxiety disorders tended to be the most common comorbid disorders. The FCRI-SF allows rapid and effective screening of clinical levels of FCR, a condition associated with significant psychiatric comorbidity.

  20. Plasma levels of trefoil factors are increased in patients with advanced prostate cancer

    DEFF Research Database (Denmark)

    Vestergaard, E.M.; Borregaard, Michael Krabbe; Poulsen, Steen Seier

    2006-01-01

    Through cDNA array analyses and immunohistochemistry on tissue microarrays, trefoil factor 3 (TFF3) was recently shown to be overexpressed in prostate cancer. The purpose of this study was to test the feasibility of using the levels of trefoil factors as a plasma marker for prostate cancer....

  1. Flotillins as regulators of ErbB2 levels in breast cancer

    DEFF Research Database (Denmark)

    Pust, S; Klokk, T I; Musa, N

    2013-01-01

    Amplification and overexpression of the receptor tyrosine kinase ErbB2 occur in up to 30% of human breast cancers, and high ErbB2 levels are correlated with poor prognosis for breast cancer patients. In contrast to the epithelial growth factor receptor (ErbB1), ErbB2 is not downregulated by ligan...

  2. Toenail selenium levels and the subsequent risk of prostate cancer: A prospective cohort study

    NARCIS (Netherlands)

    Brandt, P.A. van den; Zeegers, M.P.A.; Bode, P.; Goldbohm, R.A.

    2003-01-01

    Results of a randomized controlled trial have suggested a protective effect of selenium against prostate cancer. Few other prospective studies have been conducted to confirm or refute this. The association between prostate cancer and baseline toenail selenium level was evaluated in the Netherlands

  3. Regional anaesthesia and surgical morbidity

    DEFF Research Database (Denmark)

    Scott, N B; Kehlet, H

    1988-01-01

    This review assesses the results of studies examining the influence of regional anaesthesia on surgical morbidity. Morbidity appears to be reduced when procedures below the umbilicus are concerned, but evidence is less convincing for upper abdominal and thoracic procedures.......This review assesses the results of studies examining the influence of regional anaesthesia on surgical morbidity. Morbidity appears to be reduced when procedures below the umbilicus are concerned, but evidence is less convincing for upper abdominal and thoracic procedures....

  4. Laryngeal morbidity after tracheal intubation

    DEFF Research Database (Denmark)

    Sørensen, M K; Rasmussen, N; Kristensen, M S

    2013-01-01

    BACKGROUND: Tracheal intubation may cause vocal fold damage. The trial was designed to assess laryngeal morbidity comparing the Endoflex(®) tube with a conventional endotracheal tube with stylet. We hypothesised that laryngeal morbidity within the first 24 h after extubation would be lower...... in the shimmer values in that group implies that the Endoflex may be associated with less laryngeal morbidity....

  5. Low expression levels of hepsin and TMPRSS3 are associated with poor breast cancer survival.

    Science.gov (United States)

    Pelkonen, Mikko; Luostari, Kaisa; Tengström, Maria; Ahonen, Hermanni; Berdel, Bozena; Kataja, Vesa; Soini, Ylermi; Kosma, Veli-Matti; Mannermaa, Arto

    2015-05-27

    Hepsin, (also called TMPRSS1) and TMPRSS3 are type II transmembrane serine proteases (TTSPs) that are involved in cancer progression. TTSPs can remodel extracellular matrix (ECM) and, when dysregulated, promote tumor progression and metastasis by inducing defects in basement membrane and ECM molecules. This study investigated whether the gene and protein expression levels of these TTSPs were associated with breast cancer characteristics or survival. Immunohistochemical staining was used to evaluate hepsin levels in 372 breast cancer samples and TMPRSS3 levels in 373 samples. TMPRSS1 mRNA expression was determined in 125 invasive and 16 benign breast tumor samples, and TMPRSS3 mRNA expression was determined in 167 invasive and 23 benign breast tumor samples. The gene and protein expression levels were analyzed for associations with breast cancer-specific survival and clinicopathological parameters. Low TMPRSS1 and TMPRSS3 mRNA expression levels were independent prognostic factors for poor breast cancer survival during the 20-year follow-up (TMPRSS1, P = 0.023; HR, 2.065; 95 % CI, 1.106-3.856; TMPRSS3, P = 0.013; HR, 2.106; 95 % CI, 1.167-3.800). Low expression of the two genes at the mRNA and protein levels associated with poorer survival compared to high levels (log rank P-values 0.015-0.042). Low TMPRSS1 mRNA expression was also an independent marker of poor breast cancer prognosis in patients treated with radiotherapy (P = 0.034; HR, 2.344; 95 % CI, 1.065-5.160). Grade III tumors, large tumor size, and metastasis were associated with low mRNA and protein expression levels. The results suggest that the TTSPs hepsin and TMPRSS3 may have similar biological functions in the molecular pathology of breast cancer. Low mRNA and protein expression levels of the studied TTSPs were prognostic markers of poor survival in breast cancer.

  6. Association of Serum Level of Vitamin D at Diagnosis With Breast Cancer Survival: A Case-Cohort Analysis in the Pathways Study.

    Science.gov (United States)

    Yao, Song; Kwan, Marilyn L; Ergas, Isaac J; Roh, Janise M; Cheng, Ting-Yuan David; Hong, Chi-Chen; McCann, Susan E; Tang, Li; Davis, Warren; Liu, Song; Quesenberry, Charles P; Lee, Marion M; Ambrosone, Christine B; Kushi, Lawrence H

    2017-03-01

    .21-0.96; breast cancer-specific survival: HR, 0.37; 95% CI, 0.15-0.93; invasive disease-free survival: HR, 0.58; 95% CI, 0.34-1.01; all after full adjustment). Serum 25OHD levels were independently associated with breast cancer prognostic characteristics and patient prognosis, most prominently among premenopausal women. Our findings from a large, well-characterized prospective cohort provide compelling observational evidence on associations of vitamin D with lower risk of breast cancer morbidity and mortality.

  7. Is educational level associated with breast cancer risk in Iranian women?

    Science.gov (United States)

    Hajian-Tilaki, Karimollah; Kaveh-Ahangar, Tina; Hajian-Tilaki, Erfaneh

    2012-01-01

    A high educational level has been found to be a risk factor of breast cancer. However, it is not clear whether such association persists after adjustment for individual risk factors of breast cancer such as parity in Iranian women. We conducted a case-control study of 100 histologically confirmed breast cancer cases and 200 age-matched controls in a genetically homogenous population, in Babol, northern Iran. Demographic, reproductive, and lifestyle data were collected by in-person interviews and clinical examination. Educational level was classified into three levels: (1) illiterate and primary level, (2) elementary level and those who did not finish high school, and (3) high school graduates and those receiving more education. The adjusted odds ratio (OR) was estimated using multiple logistic regression model after controlling for parity and several other potential confounding factors. The unadjusted OR showed a nonsignificant negative association of educational levels with breast cancer risk, but after controlling for several potential confounding factors, higher education level was significantly correlated with a lower breast cancer risk [OR 0.17, 95% confidence interval (CI) 0.06-0.45 for educational level of elementary plus some high school and OR 0.10, 95% CI 0.03-0.34 for educational level of high school or more compared to illiterate and primary level]. The inverse association of educational level with breast cancer risk observed in this study is not in accordance with education inequalities found in breast cancer risk in Western countries. The present findings provide a rationale for earlier screening in Iranian women with low education.

  8. Comparison of Dietary Habits and Serum Nitrate Levels in Patients with Esophageal Cancer and Healthy Individuals

    Directory of Open Access Journals (Sweden)

    Reza Alipanah_Moghadam

    2017-07-01

    Conclusion: Consumption of fast foods, hot tea and saturated fats may be associated with esophageal cancer. Serum nitrate levels were lower in patients than control group, probably indicating the need for further research in this field.

  9. Can the Serum Level of Myostatin be Considered as an Informative Factor for Cachexia Prevention in Patients with Medullary Thyroid Cancer?

    Science.gov (United States)

    Hedayati, Mehdi; Nozhat, Zahra; Hannani, Masoomeh

    2016-01-01

    Thyroid cancer, the most common endocrine neoplasia, consists of four main types of carcinomas: papillary, follicular, and anaplastic, all with thyroid follicular origin, and medullary thyroid cancer (MTC) related to para-follicular cells. Cronic diseases such as diverse cancers may be associated with cachexia, especially at advanced stage. Cancer-induced cachexia is associated with diminished quality of life, functional performance, reduced response to antitumor therapy, and increased morbidity and mortality. Myostatin (Mst) is one of the outstanding molecules in the skeletal muscle loss process in cancer and it may be released by both skeletal muscle and cachexia-inducing tumors. Recently changes in serum levels of Mst have been identified as an important factor of cancer-induced cachexia. The goal of this study was to assessserum Mst levels in MTC patients. In this descriptive and case-control study, 90 participants were selected, comprising 45 MTC patients (20 males, 29±13.9 years, 25 females, 29±14.5 years) and 45 control individuals (25 males, 23.1±11.6 years, 20 females, 31.5±14.4 years). Serum Mst was determined using an ELISA kit and body mass index (BMI) was calculated by weight and height measurements. The Kolmogorov Simonov test showed a normal distribution for log transformed Mst serum levels in both case and control groups. Geometric means were 5.9 and 8.2 ng/ml respectively, and a significant difference was found according to the independent t-test results (Pcachexia in MTC patients, especially in females.

  10. Diagnostic Values of Carcinoembryonic Antigen, Cancer Antigen 15-3 and Cancer Antigen 125 Levels in Nipple Discharge.

    Science.gov (United States)

    Zhao, Song; Gai, Xiaodong; Wang, Yongmei; Liang, Weili; Gao, Haidong; Zhang, Kai; Wang, Huimin; Liu, Yanhong; Wang, Jianli; Ma, Rong

    2015-12-31

    An expedient and cost-effective diagnostic tool is needed to complement galactography and exfoliative cytology for detection of benign or malignant breast diseases with nipple discharge. The aim of this prospective study is to explore the utility of carcinoembryonic antigen, cancer antigen 15-3 and cancer antigen 125 levels in nipple discharge for the diagnosis of various breast diseases. We evaluated the pre-operative tumor marker levels in 153 nipple discharge samples collected from one or both breasts of 142 women undergoing surgery. Patients with nipple discharge underwent auxiliary examination (ultrasonography, exfoliative cytology, ductoscopy and galactography). Statistically higher levels of carcinoembryonic antigen and cancer antigen 15-3 were found in patients in the malignant group as compared to those in the benign group. No statistically significant difference in the level of cancer antigen 125 (P = 0.895). Sensitivities of carcinoembryonic antigen and cancer antigen 15-3 for diagnosing breast cancer were 74.42% and 58.14%, and specificities were 87.27% and 80.00% where as the cutoff values with max-sum of sensitivity and specificity were 224.3 ng/ml and 1368.2 U/ml, respectively. The following sensitivities for telling malignant from benign could be determined: exfoliative cytology 46.67%, ultrasonography 76.74%, galactography 75.00%, and ductoscopy 0%. Exfoliative cytology was found to be a valuable alternative method for differentiating benign from malignancy. Thus, tumor marker analysis of nipple discharge fluid for carcinoembryonic antigen and cancer antigen 15-3 would enhance the accurate assessment and treatment planning for patients with nipple discharge.

  11. [Morbidity and mortality of malignant tumor in Zhejiang province, 2014].

    Science.gov (United States)

    Fei, F R; Hu, R Y; Zhong, J M; Gong, W W; He, Q F; Wang, H; Pan, J; Wu, H B; Wang, M; Yu, M

    2016-05-01

    To analyze the morbidity and mortality of malignant tumor in Zhejiang province in 2014. The data were collected from Zhejiang provincial chronic disease surveillance system in 2014. The crude rate, age-standardized rate, cumulative rate(0-74 years old), cut rate(35-64 years old), age-specific and area-specific morbidity/mortality as well as the constitution of top 10 leading cancers were then calculated and analyzed. The age-standardized rate was calculated according to the standard population in China in 1982 and the Segi' s world standard population. The crude morbidity was 348.80/100 000(370.74/100 000 in males and 326.51/100 000 in females). The age-standardized morbidity according to the standard population in China and according to world standard population were 168.84/100 000 and 217.23/100 000 respectively, the cumulative morbidity was 24.66% and the cut morbidity was 376.40/100 000. Age-specific morbidity in age group 0-34 years remained low; however, the morbidity increased obviously in age group ≥35 years, increased more rapidly in age group ≥50 years and finally reached the peak in age group 80-84 years(1 618.20/100 000). The morbidity of malignant tumor, age-standardized morbidity(China standard)and age-standardized morbidity(world standard)were 381.81/100 000, 185.15/100 000 and 236.27/100 000 respectively in urban area, and 330.23/100 000 , 159.47/100 000 and 206.29/100 000, respectively in rural area. The crude mortality was 189.08/100 000(248.57/100 000 in males, 128.72/100 000 in females), and the age-standardized mortality according to China population and world population were 97.56/100 000 and 135.54/100 000 respectively. The cumulative mortality was 15.08%, and the cut mortality was 162.75/100 000. Age-specific mortality increased in age group 45-49 years(92.29/1000 000)and reached the peak in age group ≥85 years(2 263.70/100 000). The mortality was higher in rural area(190.60/100 000)than in urban area(186.38/100 000). The leading

  12. Serum Selenium Level in Patients with Gastric Non-Cardia Cancer and Functional Dyspepsia

    OpenAIRE

    Zahra Hosseini Nezhad; Sodaif Darvish Moghaddam; Mohammad Javad Zahedi; Mehdi Hayatbakhsh; Fariba Sharififar; Farzane Ebrahimi Meimand; Mahdieh Nazari

    2015-01-01

    Background: Gastric cancer (GC) is the most common gastrointestinal cancer in Iran. Helicobacter pylori (H. pylori) accounts as one of the main risk factors for gastric non-cardia cancer (GNCC). It is suggested that high serum selenium level may have a protective role in GNCC. In this cross-sectional study, we determined the serum Se level and the status of H. pylori infection in two populations with GC and functional dyspepsia (FD). Methods: The enrolled patients were 85 (27 women, 58 men...

  13. Serum levels of vitamin D, parathyroid hormone and calcium in relation to survival following breast cancer.

    Science.gov (United States)

    Huss, Linnea; Butt, Salma; Borgquist, Signe; Almquist, Martin; Malm, Johan; Manjer, Jonas

    2014-09-01

    Vitamin D, parathyroid hormone (PTH) and calcium in blood are correlated with each other. Previous studies have suggested vitamin D to have anti-proliferative effects on tumor cells, whereas PTH may have carcinogenic effects. A cancer disease may influence calcium levels in blood, but less is known about calcium and its potential effect on cancer risk and survival. The aim of this study was to examine pre-diagnostic levels of vitamin D (25OHD), PTH and calcium in relation to survival after breast cancer. The Malmö Diet and Cancer Study enrolled 17,035 women between 1991 and 1996. 672 patients developed incident invasive breast cancer up until 31 December 2006. Serum samples collected at baseline were analyzed for 25OHD, PTH and calcium. All patients were followed until 31 December 2010 using the Swedish Cause of Death Registry. The analytes were divided into tertiles and the risk of death from breast cancer was analyzed using an adjusted Cox proportional hazards analysis, yielding hazard ratios with 95 % confidence intervals. Levels of 25OHD and breast cancer mortality were associated in a u-shaped manner with the highest mortality among patients in the first (2.46: 1.38-4.37) and third tertiles (1.99: 1.14-3.49), as compared to the second. An inverse relation was found between calcium levels and breast cancer mortality, with the lowest mortality in the third tertile, (0.53: 0.30-0.92) as compared to the first. There was no clear association between PTH and breast cancer mortality. This study shows that pre-diagnostic 25OHD and calcium may affect survival following breast cancer.

  14. Parricide: Psychiatric morbidity

    Directory of Open Access Journals (Sweden)

    Dunjić Bojana

    2008-01-01

    Full Text Available INTRODUCTION Parricide is defined as a murder of parents by their children; the patricide is murder of father, while matricide is murder of mother. This entity is classified as homicide, but it differs in the fact that victims are parents and the killers are their children. Mostly, it is associated with psychiatric morbidity. OBJECTIVE To describe sociodemographic and psychopathological characteristics of parricide committers and to analyze circumstances of parricide and psychiatric morbidity in order to achieve better recognition and prevention of risks. METHOD This retrospective study included all homicide autopsy records (1991-2005 performed at the Institute of Forensic Medicine, Medical School, University of Belgrade. For further analyses, all parricide records were selected out. The study analyzed all available parameters, which concerned parricide committers, victims and the act itself. Methods of descriptive statistics were used. RESULTS Between 1991 and 2005, there were 948 cases of homicide; of these, 3.5% were parricides. The committers of parricide were on average 31.2±11.9 years old, 87.8% were males, 60.6% with psychiatric symptoms most commonly with schizophrenia, alcohol dependence, personality disorder etc. Victims were on average 63.7±11.9 years old, 54.5% males, and 21.2% had a diagnosed mental illness. CONCLUSION Parricide is a rare kind of homicide accounting for 3% of all homicides. Committers are mostly unemployed males in early adulthood who have mental disorder. The phenomenon of parricide deserves a detailed analysis of the committer (individual bio-psycho-social profile and the environ- mental factors (family, closely related circumstances to enable a precise prediction of the act and prevention of the fatal outcome, which logically imposes the need of further studies.

  15. Stathmin protein level, a potential predictive marker for taxane treatment response in endometrial cancer.

    Directory of Open Access Journals (Sweden)

    Henrica M J Werner

    Full Text Available Stathmin is a prognostic marker in many cancers, including endometrial cancer. Preclinical studies, predominantly in breast cancer, have suggested that stathmin may additionally be a predictive marker for response to paclitaxel. We first evaluated the response to paclitaxel in endometrial cancer cell lines before and after stathmin knock-down. Subsequently we investigated the clinical response to paclitaxel containing chemotherapy in metastatic endometrial cancer in relation to stathmin protein level in tumors. Stathmin level was also determined in metastatic lesions, analyzing changes in biomarker status on disease progression. Knock-down of stathmin improved sensitivity to paclitaxel in endometrial carcinoma cell lines with both naturally higher and lower sensitivity to paclitaxel. In clinical samples, high stathmin level was demonstrated to be associated with poor response to paclitaxel containing chemotherapy and to reduced disease specific survival only in patients treated with such combination. Stathmin level increased significantly from primary to metastatic lesions. This study suggests, supported by both preclinical and clinical data, that stathmin could be a predictive biomarker for response to paclitaxel treatment in endometrial cancer. Re-assessment of stathmin level in metastatic lesions prior to treatment start may be relevant. Also, validation in a randomized clinical trial will be important.

  16. Interleukin-6 levels and HPA axis activation in breast cancer patients with major depressive disorder.

    Science.gov (United States)

    Soygur, Haldun; Palaoglu, Ozden; Akarsu, Eyüp Sabri; Cankurtaran, Eylem Sahin; Ozalp, Elvan; Turhan, Levent; Ayhan, Ismail Hakki

    2007-08-15

    An association or a casual link has been proposed between the neuroendocrinological and neuroimmunological changes attributed to either depression or cancer. This study investigated whether breast cancer patients with and without major depression exhibit plasma interleukin-6 abnormalities and dexamethasone suppression test results. Four groups, each consisting of 30 women (1--healthy women, 2--patients with major depression, 3--breast cancer patients without major depression, 4--breast cancer patients with major depression), were compared to each other. Psychiatric evaluations were made by structured clinical interview for DSM-IV. Severity of depression was measured with the Hamilton Depression Rating Scale. Plasma levels of interleukin-6 were measured. A dexamethasone suppression test was applied. Breast cancer patients with major depression had markedly higher plasma levels of interleukin-6 than the other group. All breast cancer patients with depression had abnormal dexamethasone suppression test results. These findings suggest a hypothalamo-pituitary-adrenal axis activation and plasma levels of interleukin-6 and plasma interleukin-6 elevation and plasma levels if interleukin-6 and plasma levels of post cortisol concentrations. Evidence for a casual link or association of major depression with immune and endocrinological activation needs to be investigated further.

  17. Estimates of Lung Cancer Mortality at the Province Level in China

    Directory of Open Access Journals (Sweden)

    Yuanqiu LI

    2011-02-01

    Full Text Available Background and objective At present, population-based cancer registries were not well established and epidemiologic data for cancer were limited at the province level in China. Using the available mortality data for cancer, estimation model of lung cancer was established to provide the mortality profile for the population in 31 provincial regions in China in 2008. Methods Based on the population coverage and accuracy of the available mortality for provinces, the methods used to produce mortality estimates fall into 1 of the 3 categories: data were used directly; a model was developed to calculate annual change of mortality rate based on historical and current data; relative frequency data combining with mortality for all sites were used to estimate site-specific mortality. Results The total estimated deaths of lung cancer in 2008 were 493,348 (338,346 in males and 155,002 in females in the whole country. The age-standardized rates were highest in Jilin (52.29 per 100,000 in males and 24.68 per 100,000 in females, and the lowest rates were in Tianjin (24.12 per 100,000 in males and Chongqing (8.72 per 100,000 in females. Conclusion The models for lung cancer mortality at the province level have been established and the data will provide valuable scientific reference for describing the epidemic of lung cancer as well as estimating other site-specific cancer mortality in China.

  18. [Estimates of lung cancer mortality at the province level in China].

    Science.gov (United States)

    Li, Yuanqiu; Dai, Min; Chen, Yuanli; Zhang, Siwei; Chen, Wanqing; Dai, Zhen; Zou, Xiaonong

    2011-02-01

    At present, population-based cancer registries were not well established and epidemiologic data for cancer were limited at the province level in China. Using the available mortality data for cancer, estimation model of lung cancer was established to provide the mortality profile for the population in 31 provincial regions in China in 2008. Based on the population coverage and accuracy of the available mortality for provinces, the methods used to produce mortality estimates fall into 1 of the 3 categories: data were used directly; a model was developed to calculate annual change of mortality rate based on historical and current data; relative frequency data combining with mortality for all sites were used to estimate site-specific mortality. The total estimated deaths of lung cancer in 2008 were 493,348 (338,346 in males and 155,002 in females) in the whole country. The age-standardized rates were highest in Jilin (52.29 per 100,000 in males and 24.68 per 100,000 in females), and the lowest rates were in Tianjin (24.12 per 100,000 in males) and Chongqing (8.72 per 100,000 in females). The models for lung cancer mortality at the province level have been established and the data will provide valuable scientific reference for describing the epidemic of lung cancer as well as estimating other site-specific cancer mortality in China.

  19. Awareness Levels about Breast Cancer Risk Factors, Early Warning Signs, and Screening and Therapeutic Approaches among Iranian Adult Women: A large Population Based Study Using Latent Class Analysis

    Directory of Open Access Journals (Sweden)

    Mahdi Tazhibi

    2014-01-01

    Full Text Available Background and Objective. Breast cancer (BC continues to be a major cause of morbidity and mortality among women throughout the world and in Iran. Lack of awareness and early detection program in developing country is a main reason for escalating the mortality. The present research was conducted to assess the Iranian women’s level of knowledge about breast cancer risk factors, early warning signs, and therapeutic and screening approaches, and their correlated determinants. Methods. In a cross-sectional study, 2250 women before participating at a community based screening and public educational program in an institute of cancer research in Isfahan, Iran, in 2012 were investigated using a self-administered questionnaire about risk factors, early warning signs, and therapeutic and screening approaches of BC. Latent class regression as a comprehensive statistical method was used for evaluating the level of knowledge and its correlated determinants. Results. Only 33.2%, 31.9%, 26.7%, and 35.8% of study participants had high awareness levels about screening approaches, risk factors, early warning signs and therapeutic modalities of breast cancer, respectively, and majority had poor to moderate knowledge levels. Most effective predictors of high level of awareness were higher educational qualifications, attending in screening and public educational programs, personal problem, and family history of BC, respectively. Conclusion. Results of current study indicated that the levels of awareness among study population about key elements of BC are low. These findings reenforce the continuing need for more BC education through conducting public and professional programs that are intended to raise awareness among younger, single women and those with low educational attainments and without family history.

  20. Pancreatic Cancer Risk Associated with Prediagnostic Plasma Levels of Leptin and Leptin Receptor Genetic Polymorphisms.

    Science.gov (United States)

    Babic, Ana; Bao, Ying; Qian, Zhi Rong; Yuan, Chen; Giovannucci, Edward L; Aschard, Hugues; Kraft, Peter; Amundadottir, Laufey T; Stolzenberg-Solomon, Rachael; Morales-Oyarvide, Vicente; Ng, Kimmie; Stampfer, Meir J; Ogino, Shuji; Buring, Julie E; Sesso, Howard D; Gaziano, John Michael; Rifai, Nader; Pollak, Michael N; Anderson, Matthew L; Cochrane, Barbara B; Luo, Juhua; Manson, JoAnn E; Fuchs, Charles S; Wolpin, Brian M

    2016-12-15

    Leptin is an adipokine involved in regulating energy balance, which has been identified as a potential biologic link in the development of obesity-associated cancers, such as pancreatic cancer. In this prospective, nested case-control study of 470 cases and 1,094 controls from five U.S. cohorts, we used conditional logistic regression to evaluate pancreatic cancer risk by prediagnostic plasma leptin, adjusting for race/ethnicity, diabetes, body mass index, physical activity, plasma C-peptide, adiponectin, and 25-hydroxyvitamin D. Because of known differences in leptin levels by gender, analyses were conducted separately for men and women. We also evaluated associations between 32 tagging SNPs in the leptin receptor (LEPR) gene and pancreatic cancer risk. Leptin levels were higher in female versus male control participants (median, 20.8 vs. 6.7 ng/mL; P pancreatic cancer risk and those in the top quintile had a multivariable-adjusted OR of 3.02 [95% confidence interval (CI), 1.27-7.16; Ptrend = 0.02] compared with men in the bottom quintile. Among women, circulating leptin was not associated with pancreatic cancer risk (Ptrend = 0.21). Results were similar across cohorts (Pheterogeneity = 0.88 for two male cohorts and 0.35 for three female cohorts). In genetic analyses, rs10493380 in LEPR was associated with increased pancreatic cancer risk among women, with an OR per minor allele of 1.54 (95% CI, 1.18-2.02; multiple hypothesis-corrected P = 0.03). No SNPs were significantly associated with risk in men. In conclusion, higher prediagnostic levels of plasma leptin were associated with an elevated risk of pancreatic cancer among men, but not among women. Cancer Res; 76(24); 7160-7. ©2016 AACR. ©2016 American Association for Cancer Research.

  1. Ovarian stromal hyperplasia and ovarian vein steroid levels in relation to endometrioid endometrial cancer.

    Science.gov (United States)

    Jongen, V H W M; Hollema, H; van der Zee, A G J; Santema, J G; Heineman, M J

    2003-07-01

    To study the relationship between the presence of endometrioid endometrial cancer, the degree of ovarian stromal hyperplasia and ovarian steroid production in postmenopausal women. Retrospective and prospective study, respectively. Medical Centre Leeuwarden and the University Hospital Groningen, The Netherlands. Postmenopausal women with or without endometrial cancer, undergoing a hysterectomy with bilateral salpingo-oophorectomy. In 112 women with endometrioid endometrial cancer, 47 women with a benign gynaecological condition and 10 women with non-endometrioid endometrial cancer, the degree of ovarian stromal hyperplasia was scored retrospectively on a semi-quantitative scale (atrophy, slight, marked). All women were postmenopausal and had undergone a hysterectomy with bilateral salpingo-oophorectomy. Prospectively, blood sampling from the ovarian veins was performed in a further 60 women. Steroid levels (oestrone, oestradiol, androstenedione, testosterone) were determined and related to the degree of ovarian stromal hyperplasia and the presence (n = 52) or absence (n = 8) of endometrioid endometrial cancer. Degree of ovarian stromal hyperplasia and steroid levels in the utero-ovarian circulation. In the retrospective study, the degree of ovarian stromal hyperplasia was higher in the presence of endometrioid endometrial cancer (P = 0.0001). The prospective study showed that an increasing degree of ovarian stromal hyperplasia was related to higher ovarian levels of both testosterone and androstenedione (P < 0.05 and P < 0.005, respectively), but not to oestrone or oestradiol. A non-significant increase in mean ovarian vein levels of both testosterone and androstenedione was seen in patients with endometrial cancer as compared with patients with benign conditions. In endometrioid endometrial cancer, higher degrees of ovarian stromal hyperplasia were found and with increasing degrees of ovarian stromal hyperplasia, levels of ovarian vein androgens were higher. A

  2. [Fasting serum glucose level and gastric cancer risk in a nested case-control study].

    Science.gov (United States)

    Jun, Jae Kwan; Gwack, Jin; Park, Sue Kyung; Choi, Yun-Hee; Kim, Yeonju; Shin, Aesun; Chang, Soung-Hoon; Shin, Hai-Rim; Yoo, Keun-Young

    2006-11-01

    Diabetes has been reported as a risk factor for several cancers. However, the association between diabetes and gastric cancer has been inconsistent. The aim of this study was to evaluate the association between the fasting serum glucose level and gastric cancer risk in Korea. Among the members of the Korean MultiCenter Cancer Cohort (KMCC) from 1993 to 2004, a total of 100 incident gastric cancer cases were ascertained until December 31, 2002 and 400 controls were matched according to age, sex, and year and area of enrollment. Of the eligible subjects, those without fasting serum glucose level information were excluded, with a total of 64 cases and 236 controls finally selected. On enrollment, all subjects completed a baseline demographic and lifestyle characteristics questionnaire, and had their fasting serum glucose level measured. The Helicobacter pylori infection status was determined by an immunoblot assay using long-term stored serum. The odds ratios (ORs) were estimated using conditional and unconditional logistic regression models adjusted for the H. pylori infection status, smoking, drinking, education, follow-up period and matching variables. The ORs for risk of gastric cancer according to the serum glucose level were 1.33 [95% CI=0.50-3.53] and 1.66 [95% CI=0.55-5.02] for the categories of 100-125 and 126 mg/dL or greater, respectively, compared to the category of less than 100 mg/dL. No increased risk of gastric cancer according to the serum glucose level was found (p-trend=0.337). This study provides no evidence for an association of the serum glucose level with gastric cancer.

  3. Association of Vitamin D Level with Clinicopathological Features in Breast Cancer.

    Science.gov (United States)

    Thanasitthichai, Somchai; Chaiwerawattana, Arkom; Prasitthipayong, Aree

    2015-01-01

    A population-based relationship between low vitamin D status and increased cancer risk is now generally accepted. However there were only few studies reported on prognostic impact. To determine the effect of low vitamin D on progression of breast cancer, we conducted a cross-sectional analysis of vitamin D levels and clinico- pathological characteristics in 200 cases of breast cancer diagnosed during 2011-2012 at the National Cancer Institute of Thailand. Vitamin D levels were measured by high-performance liquid chromatography (HPLC). Clinical and pathological data were accessed to examine prognostic effects of vitamin D. We found that the mean vitamin D level was 23.0±6.61 ng/ml. High vitamin D levels (≥32 ng/ml) were detected in 7% of patients, . low levels (vitamin D levels for stages 1-4 were 26.1±6.35, 22.3±6.34, 22.2±6.46 and 21.3±5.42 ng/ml respectively (P=0.016) and 24.1 and 21.3 ng/ml for lymph node negative and positive cases (P=0.006). Low vitamin D level (vitamin D might correlate with progression and metastasis of breast cancer.

  4. Low-level lasers alter mRNA levels from traditional reference genes used in breast cancer cells

    Science.gov (United States)

    Teixeira, A. F.; Canuto, K. S.; Rodrigues, J. A.; Fonseca, A. S.; Mencalha, A. L.

    2017-07-01

    Cancer is among the leading causes of mortality worldwide, increasing the importance of treatment development. Low-level lasers are used in several diseases, but some concerns remains on cancers. Reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) is a technique used to understand cellular behavior through quantification of mRNA levels. Output data from target genes are commonly relative to a reference that cannot vary according to treatment. This study evaluated reference genes levels from MDA-MB-231 cells exposed to red or infrared lasers at different fluences. Cultures were exposed to red and infrared lasers, incubated (4 h, 37 °C), total RNA was extracted and cDNA synthesis was performed to evaluate mRNA levels from ACTB, GUSB and TRFC genes by RT-qPCR. Specific amplification was verified by melting curves and agarose gel electrophoresis. RefFinder enabled data analysis by geNorm, NormFinder and BestKeeper. Specific amplifications were obtained and, although mRNA levels from ACTB, GUSB or TRFC genes presented no significant variation through traditional statistical analysis, Excel-based tools revealed that the use of these reference genes are dependent of laser characteristics. Our data showed that exposure to low-level red and infrared lasers at different fluences alter the mRNA levels from ACTB, GUSB and TRFC in MDA-MB-231 cells.

  5. Triple negative breast cancer patients presenting with low serum vitamin D levels: a case series

    Science.gov (United States)

    Khan, Yasir; Tisman, Glenn

    2009-01-01

    Introduction Serum vitamin D levels measured as 25-hydroxyvitamin D have been shown to be low in cancer patients, including breast cancer patients. However, the vitamin D status has yet to be studied in different breast cancer phenotypes: luminal A, luminal B, HER2+/ER-, and triple negative comprising the majority of basal-like. Case presentation Fifteen triple-negative breast cancer patients have presented to our medical oncology office in the last five years. Thirteen of these fifteen patients (87%) were found to be vitamin D deficient, defined as serum 25(OH)D less than 80 nmol/L, prior to initiation of adjuvant therapy. Ninety-one breast cancer patients from our office were classified as: luminal A (ER+ &/or PR+ and HER2-), luminal B (ER+ &/or PR+ and HER2+), HER2+/ER- (ER-, PR-, and HER2+), and triple-negative or basal-like (ER-, PR-, and HER2-). A normal mean was found from 78 volunteers. The breast cancer patients were found to be statistically different than the normal population. The triple-negative phenotype was found to be the most statistically different than the normal population. Conclusion The triple-negative breast cancer phenotype has the lowest average vitamin D level and the highest percentage of patients that are vitamin D deficient. These data suggests that low vitamin D levels are characteristic of the triple-negative phenotype. PMID:19830074

  6. Cancer therapy trials employing level-of-evidence-1 disease forecast cancer biomarkers uPA and its inhibitor PAI-1

    DEFF Research Database (Denmark)

    Schmitt, Manfred; Harbeck, Nadia; Brünner, Nils

    2011-01-01

    conducted in early breast cancer to demonstrate the prognostic and predictive value for this malignancy. As a result of these investigations, uPA and PAI-1 have reached the highest level of clinical evidence, level of evidence 1. This article sheds light on the current status of major clinical Phase II......-size synthetic peptide (Å6) is tested in advanced ovarian cancer patients.......Clinical research on cancer biomarkers is essential in understanding recent discoveries in cancer biology and heterogeneity of the cancer disease. However, there are only a few examples of clinically useful studies that have identified cancer biomarkers with clinical benefit. Urokinase...

  7. Morbidity, life style and psychosocial situation in cancer survivors aged 60-69 years: results from the Nord-Trøndelag health study (the HUNT-II study).

    Science.gov (United States)

    Grov, Ellen K; Fosså, Sophie D; Dahl, Alv A

    2011-01-26

    Due to considerable health status differences in the elderly population, research limited to narrow age-spans might be an advantage. In this population-based controlled study we compare short-term (cancer survivors and cancer-free controls aged 60-69 years from two Norwegian health registers; the Health Survey of North-Trøndelag County (HUNT-2 study) and the Cancer Registry of Norway (CRN). We examined possible factors associated with being cancer survivor. Among 9,089 individuals aged 60-69 who participated in HUNT-2, 334 had been diagnosed with invasive primary cancer from 1 month to 42 years before HUNT-2 according to CRN and self-report. An overall random sample of controls without cancer five times larger than the sample of cases (N = 1,670) were drawn from the parent cohort. The cancer sample comprised 128 STS and 206 LTS. For most variables no significant differences were observed between LTS and STS. LTS were significantly more women, and cases with gynaecological cancer, with physical impairment and more thyroid diseases compared to STS. When comparing all the survivors with controls, the survivors showed significantly higher rate of pensioning, decreased self-rated health, more physical impairment and thyroid diseases, daily use of medication and psychotropics and higher level of anxiety and Framingham Risk score. Multivariate logistic regression analysis showed that increasing age, being female, physical impairment and thyroid diseases all were significantly associated with being survivor versus controls. STS and LTS showed mostly similar situation. Compared to controls, the survivors reported somewhat poorer physical and mental health, but these differences were of doubtful clinical significance.

  8. Are serum leptin levels a prognostic factor in advanced lung cancer?

    Science.gov (United States)

    Anar, C; Deniz, D; Erol, S; Batum, O; Bicmen, C; Yilmaz, U

    2017-01-01

    The aim of the present study was to evaluate pre-treatment concentrations of leptin in patients with advanced lung cancer and to investigate possible associations between their levels and clinicopathological variables, response to therapy and overall survival. There are 71 previously untreated patients with cytological or histological evidence of primary lung cancer who were admitted to the oncology department between November 2013 and August 2014. Forty-five healthy individuals with age, sex and BMI matching the lung cancer patients, were recruited to take part in the study as a control group. Leptin levels were measured quantitatively by using a microELISA kit. The serum leptin levels at diagnosis were significantly lower in lung cancer patients than those in control subjects (4.75±4.91 ng/ml, 9.67±8.02 ng/ml; pleptin values related to clinicopathological parameters such as ECOG PS, weight loss, histological type, disease stage and TNM classification. Nevertheless, we demonstrated a significant correlation between serum leptin levels and BMI in lung cancer patients (correlation coefficient: 0.303; p>0.010). The analysis of serum leptin values did not show any association with the overall survival of the patients. Our results showed that the serum leptin level has no prognostic indications in advanced lung cancer patients. Leptin is decreased in lung cancer, and there is lack of correlation with tumour‑related factors including prognosis. Therefore, leptin is not a useful clinical marker in lung cancer (Tab. 2, Fig. 2, Ref. 22).

  9. Circulating adiponectin levels and risk of endometrial cancer: Systematic review and meta-analysis.

    Science.gov (United States)

    Li, Zhi-Jun; Yang, Xue-Ling; Yao, Yan; Han, Wei-Qing; Li, B O

    2016-06-01

    Previous epidemiological studies have presented conflicting results regarding associations between circulating adiponectin (APN) levels and the risk of endometrial cancer. Thus a meta-analysis was performed to investigate the association between these factors. Multiple electronic sources, including PubMed, SpringerLink and Google Scholar databases were searched to identify relevant studies for the present meta-analysis. All of the selected studies examined the correlation between circulating APN levels and endometrial cancer. The standardized mean difference (SMD) and 95% confidence intervals (CIs) were estimated and pooled using meta-analysis methods. Overall, 18 case-control studies met the inclusion criteria. A total of 5,692 participants and 2,337 cases of endometrial cancer were included in this meta-analysis. The SMD of the pooled analysis (95% CI) were -1.96 (-2.60, -1.31), P=0.000. When the cancer grades were compared, the APN values were not significantly different between the grades of endometrial cancer [G1 vs. G3, 1.02 (-0.68, 2.72), P>0.05; G1 vs. G2, 0.34 (-0.86, 1.54), P>0.05]. However, there was a significant association between high APN levels and postmenopausal endometrial cancer cases with an SMD (95% CI) of -2.27 (-4.36, -0.18) and P0.05. The low circulating APN level increases the risk of endometrial cancer, whereas the high APN level decreases this risk in postmenopausal women. Circulating APN as simple biomarkers may be a promising tool for the prevention, early diagnosis and disease monitoring of endometrial cancer.

  10. Arsenic levels in drinking water and mortality of liver cancer in Taiwan.

    Science.gov (United States)

    Lin, Hung-Jung; Sung, Tzu-I; Chen, Chi-Yi; Guo, How-Ran

    2013-11-15

    The carcinogenic effect of arsenic is well documented, but epidemiologic data on liver cancer were limited. To evaluate the dose-response relationship between arsenic in drinking water and mortality of liver cancer, we conducted a study in 138 villages in the southwest coast area of Taiwan. We assessed arsenic levels in drinking water using data from a survey conducted by the government and reviewed death certificates from 1971 to 1990 to identify liver cancer cases. Using village as the unit, we conducted multi-variate regression analyses and then performed post hoc analyses to validate the findings. During the 20-year period, 802 male and 301 female mortality cases of liver cancer were identified. After adjusting for age, arsenic levels above 0.64 mg/L were associated with an increase in the liver cancer mortality in both genders, but no significant effect was observed for lower exposure categories. Post hoc analyses and a review of literature supported these findings. We concluded that exposures to high arsenic levels in drinking water are associated with the occurrence of liver cancer, but such an effect is not prominent at exposure levels lower than 0.64 mg/L. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Low-level arsenic exposure from drinking water is associated with prostate cancer in Iowa.

    Science.gov (United States)

    Roh, Taehyun; Lynch, Charles F; Weyer, Peter; Wang, Kai; Kelly, Kevin M; Ludewig, Gabriele

    2017-11-01

    Inorganic arsenic is a toxic naturally occurring element in soil and water in many regions of the US including the Midwest. Prostate cancer is the second most common type of cancer in men in Iowa, surpassed only by non-melanotic skin cancer. Epidemiology studies have evaluated arsenic exposure from drinking water and prostate cancer, but most have focused on high-level exposures outside the US. As drinking water from groundwater sources is a major source of arsenic exposure, we conducted an ecologic study to evaluate prostate cancer and arsenic in drinking water from public water sources and private wells in Iowa, where exposure levels are low, but duration of exposure can be long. Arsenic data from public water systems were obtained from the Iowa Safe Drinking Water Information System for the years 1994-2003 and for private wells from two Iowa Well Water Studies, the Iowa Community Private Well Study (ICPWS, 2002-2003) and Iowa Statewide Rural Well Water Survey Phase 2 (SWIRL2, 2006-2008) that provided data for 87 Iowa counties. Prostate cancer incidence data from 2009 to 2013 for Iowa were obtained from Surveillance, Epidemiology and End Results' SEER*Stat software. County averages of water arsenic levels varied from 1.08 to 18.6 ppb, with three counties above the current 10 ppb limit. Based on the tertiles of arsenic levels, counties were divided into three groups: low (1.08-2.06 ppb), medium (2.07-2.98 ppb), and high (2.99-18.6 ppb). Spatial Poisson regression modeling was conducted to estimate the risk ratios (RR) of prostate cancer by tertiles of arsenic level at a county level, adjusted for demographic and risk factors. The RR of prostate cancer were 1.23 (95% CI, 1.16-1.30) and 1.28 (95% CI, 1.21-1.35) in the medium and high groups, respectively, compared to the low group after adjusting for risk factors. The RR increased to 1.36 (95% CI, 1.28-1.45) in the high group when analyses were restricted to aggressive prostate cancers (Gleason score ≥ 7). This

  12. Co-morbidity in psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, Ann Sophie; Skov, Lone

    2017-01-01

    INTRODUCTION: Psoriasis is a common, chronic, immune-mediated inflammatory disorder. The disease is associated with several co-morbidities including cardiovascular disease, metabolic syndrome, and psychiatric disorders. It is important to identify and treat these co-morbidities because they have...... a strongly negative effect on the overall health of patients with psoriasis. Unfortunately, these co-morbidities are often overlooked and/or left untreated. Therefore, the aim of this review is to discuss the mechanisms of how co-morbidities are associated with psoriasis as well as implications...... for the clinic to be able to recognize such co-morbidities. Areas covered: This is a review of studies investigating and discussing co-morbidities of psoriasis and screening. Literature was retrieved by searching on the PubMed database using individual and combined search terms related to relevant co...

  13. Circulating Vitamin D Levels and Risk of Colorectal Cancer in Women.

    Science.gov (United States)

    Chandler, Paulette D; Buring, Julie E; Manson, JoAnn E; Giovannucci, Edward L; Moorthy, M V; Zhang, Shumin; Lee, I-Min; Lin, Jennifer H

    2015-08-01

    Observational data on the association between circulating 25(OH)D and colorectal cancer risk are limited in women. To determine whether prediagnostic levels of 25(OH)D were associated with risk of incident colorectal cancer in the Women's Health Study (WHS), we conducted a nested case-control study using 274 colorectal cases and 274 controls. Each case was matched to a control by age, ethnicity, fasting status at the time of blood collection, time of day when blood was drawn, and month of blood draw. Conditional logistic regression was used to estimate the OR and 95% confidence interval (CI) for colorectal cancer by 25(OH)D quartiles. Mean plasma 25(OH)D was lower in cases versus controls (21.9 vs. 23.9 ng/mL, P = 0.01). In multivariable-adjusted logistic regression models, plasma 25(OH)D was significantly and inversely associated with odds of colorectal cancer (quartile 4 [Q4] vs. quartile 1 [Q1]: OR, 0.45; 95% CI, 0.25-0.81; Ptrend 0.02). In addition, we observed a somewhat lower risk of colorectal cancer-related mortality after adjustment for matching variables, randomization treatment and other risk factors (Q4:Q1 OR, 0.40; 95% CI, 0.17-0.97; Ptrend 0.05). In this cohort of healthy women, we found a significant inverse association between prediagnostic 25(OH)D levels and risk of incident colorectal cancer, and a borderline significant inverse association between prediagnostic 25(OH)D levels and colorectal cancer-related mortality. These results support a possible association between plasma 25(OH)D and risk of colorectal cancer in women. ©2015 American Association for Cancer Research.

  14. Morbidity of childhood onset narcolepsy

    DEFF Research Database (Denmark)

    Jennum, Poul; Pickering, Line; Thorstensen, Eva Wiberg

    2017-01-01

    Narcolepsy is associated with significant morbidities. We evaluated the morbidities and mortality in a national group of child and adolescent patients after a first diagnosis of narcolepsy. METHODS: Identified from the Danish National Patient Registry (NPR), 243 patients (128 boys) aged 0-19 years...... children presented significantly more diagnoses of multiple comorbidities than controls before and after diagnosis. CONCLUSION: Before and after a diagnosis of narcolepsy in children, morbidity is more frequent in several domains, including metabolic, psychiatric, neurological and other diseases....

  15. The impact of age on anxiety level and cognitive function in patients with colorectal cancer

    Directory of Open Access Journals (Sweden)

    I. S. Stilidi

    2017-01-01

    Full Text Available Background. Colorectal cancer is highly prevalent in Russia, especially among the elderly patients. We analyzed the influence of age on anxiety level and cognitive function on patients with colorectal cancer.Materials and methods. In the period 2012–2015 we analyzed pre-operatively the level of anxiety (HADS scale and cognitive disfunction (MoCA test in 244 patients who underwent radical colorectal resection.Results. Patients younger than 60 constituted 34 %, 60–74 years – 31 %, 75 years and older – 35 %. We were able to show a correlation between age and anxiety level according to HADS. The same trend was found according to MoCA test.Conclusion. Oncopsychologist shall develop individualized treatment plan according to anxiety and cognitive levels in patients with colorectal cancer.

  16. Maturity Level of the Stigma Concept Associated with Cancer Diagnosis in the Nursing Literature

    Science.gov (United States)

    Ahmad, Muayyad M; Musallam, Ruba; Habeeb Allah, Abla; Al-Daken, Laila; Abu-Snieneh, Hana; Al-Dweik, Ghadeer

    2018-02-26

    Objective: This study aimed to evaluate the maturity level of stigma as a concept in nursing and its relationship to care provided for patients with cancer. Methods: The four principles of Morse and his colleagues were used to evaluate the maturity level of the stigma concept: epistemological, logical, pragmaticl, and linguistic. Analysis was conducted with the literature published between 2006 and 2016. Results: The findings of this study suggest that the concept of stigma in nursing is immature, defined inconsistently, and measured with different instruments. How stigma is defined can influence nurses in their assessment of patients with cancer and identification of their needs. Conclusion: Although extensive studies have been conducted in the field of mental illness, it is only recently that the effect of stigma on treatment of cancer patients has attracted attention. Thus, substantial work yet needs to be done to understand the breadth and scope of stigma impacting on individuals with cancer. Creative Commons Attribution License

  17. Combined Limb-Sparing Surgery and Radiation Therapy to Treat Sarcomas of the Hands and Feet: Long-Term Cancer Outcomes and Morbidity

    Energy Technology Data Exchange (ETDEWEB)

    Bishop, Andrew J.; Zagars, Gunar K. [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); Moon, Bryan S.; Lin, Patrick P.; Lewis, Valerae O. [Department of Orthopedic Oncology, MD Anderson Cancer Center, Houston, Texas (United States); Guadagnolo, B. Ashleigh, E-mail: aguadagn@mdanderson.org [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, MD Anderson Cancer Center, Houston, Texas (United States)

    2015-08-01

    Purpose: The purpose of this study was to investigate local control, survival outcomes, and complication rates of patients treated with limb-sparing surgery and radiation therapy (RT) for soft tissue sarcomas (STS) of the hands and feet. Methods and Materials: We reviewed the medical records of 85 consecutive patients treated for STS of the hands (n=38, 45%) and feet (n=47, 55%) between 1966 and 2012. The median age was 41 years (range, 10-82 years of age). Sixty-seven patients (79%) received postoperative RT after resection of their tumor (median dose, 60 Gy; range, 45-70 Gy). The remaining 18 patients (21%) were treated with preoperative RT followed by tumor resection (median dose, 50 Gy; range, 50-64 Gy). Results: Median follow-up was 140 months (range, 24-442 months). Five-year local control, overall survival, and disease-specific survival rates were 86%, 89%, and 89%, respectively. Positive or uncertain surgical margin status was the only factor adversely associated with local recurrence (19% vs 6% for negative margins, P=.046) but this lost significance on multivariate analysis when adjusting for RT dose ≥64 Gy. Of the 12 patients who had local relapses, 6 (50%) were salvaged, and only 2 of those required salvage amputation. Five patients had grade ≥3 late RT sequelae, with 2 patients (2%) having moderate limitations of limb function and 3 patients (4%) having severe limitations requiring procedures for skin ulceration. Conclusions: Limb-sparing surgery combined with RT provides excellent local control outcomes for sarcomas arising in the hands or feet. In patients who have local recurrence, salvage without amputation is possible. The excellent cancer control outcomes observed, considering the minimal impact on limb function, support use of combined modality, limb-sparing local therapy for STS arising in the hands or feet.

  18. Levels of tissue inhibitor of metalloproteinases 1 in plasma and urine from patients with cancer

    DEFF Research Database (Denmark)

    Holten-Andersen, Mads Nikolaj; Brünner, Nils; Nielsen, Hans Jørgen

    2006-01-01

    AIM: To assess the potential use of plasma and urine levels of tissue inhibitor of metalloproteinases 1 (TIMP-1) in urothelial cancer. METHODS: TIMP-1 levels were determined in urine and plasma from healthy donors (n=26), patients with bacterial bladder infection (n=24), urothelial bladder adenoma...

  19. Levels of tissue inhibitor of metalloproteinases 1 in plasma and urine frompatients with bladder cancer

    DEFF Research Database (Denmark)

    Holten Andersen, MN; Brunner, N; Nielsen, HJ

    2006-01-01

    Aim: To assess the potential use of plasma and urine levels of tissue inhibitor of metalloproteinases 1 (TIMP-1) in urothelial cancer. Methods: TIMP-1 levels were determined in urine and plasma from healthy donors (n=26), patients with bacterial bladder infection (n=24), urothelial bladder adenoma...

  20. Changes in plasma TIMP-1 levels after resection for primary colorectal cancer

    DEFF Research Database (Denmark)

    Frederiksen, C.; Lomholt, A.F.; Davis, G.J.

    2009-01-01

    BACKGROUND: Increased plasma levels of tissue inhibitor of metalloproteinases (TIMP-1) are associated with poor outcome in colorectal cancer (CRC), however postoperative changes in plasma TIMP-1 levels after resections for CRC have not been thoroughly evaluated. MATERIALS AND METHODS: Plasma samp...

  1. Clinical significance of plasma lysophosphatidic acid levels in the differential diagnosis of ovarian cancer

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    Yun-Jie Zhang

    2015-01-01

    Full Text Available Objective: To investigate the value of lysophosphatidic acid (LPA in the diagnosis of ovarian cancer. Materials and Methods: We first performed a hospital-based, case-control study involving 123 ovarian cancer patients and 101 benign ovarian tumor patients, and then conducted a meta-analysis with 19 case-control studies to assess the correlation between ovarian cancer and plasma LPA levels. Results: The case-control study results demonstrated that ovarian cancer patients have increased LPA and cancer antigen (CA-125 levels compared to patients with benign ovarian tumor (LPA: Ovarian cancer vs benign ovarian tumor: 5.28 ± 1.52 vs 1.82 ± 0.77 μmol/L; CA-125: Ovarian cancer vs benign ovarian tumor: 87.17 ± 45.81 vs. 14.03 ± 10.14 U/mL, which showed statistically significant differences (both P < 0.05. LPA with advanced sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate of diagnosis excelled CA-125 in the diagnosis of ovarian cancer (both P < 0.05. The areas under the receiver operating characteristic (ROC curve in the diagnosis of ovarian cancer (LPA: 0.983; CA-125: 0.910 were statistically significant compared with the reference (both P < 0.001 and the difference of the areas of ROC curve between LPA and CA-125 in the diagnosis of ovarian cancer showed statistically significant difference (P < 0.05. The meta-analysis results suggested that plasma LPA levels were higher in ovarian cancer tissues than in benign tissues (standardized mean difference (SMD =2.36, 95% confidence interval (CI: 1.61-3.11, P < 0.001 and normal tissues (SMD = 2.32, 95% CI: 1.77-2.87, P < 0.001. Conclusion: LPA shows greater value in the diagnosis of ovarian cancer compared to CA-125 and may be employed as a biological index to diagnose ovarian cancer.

  2. Primary human ovarian epithelial cancer cells broadly express HER2 at immunologically-detectable levels.

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    Evripidis Lanitis

    Full Text Available The breadth of HER2 expression by primary human ovarian cancers remains controversial, which questions its suitability as a universal antigen in this malignancy. To address these issues, we performed extensive HER2 expression analysis on a wide panel of primary tumors as well as established and short-term human ovarian cancer cell lines. Conventional immunohistochemical (IHC analysis of multiple tumor sites in 50 cases of high-grade ovarian serous carcinomas revealed HER2 overexpression in 29% of evaluated sites. However, more sensitive detection methods including flow cytometry, western blot analysis and q-PCR revealed HER2 expression in all fresh tumor cells derived from primary ascites or solid tumors as well as all established and short-term cultured cancer cell lines. Cancer cells generally expressed HER2 at higher levels than that found in normal ovarian surface epithelial (OSE cells. Accordingly, genetically-engineered human T cells expressing an HER2-specific chimeric antigen receptor (CAR recognized and reacted against all established or primary ovarian cancer cells tested with minimal or no reactivity against normal OSE cells. In conclusion, all human ovarian cancers express immunologically-detectable levels of HER2, indicating that IHC measurement underestimates the true frequency of HER2-expressing ovarian cancers and may limit patient access to otherwise clinically meaningful HER2-targeted therapies.

  3. Enhanced levels of Hsulf-1 interfere with heparin-binding growth factor signaling in pancreatic cancer

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    Giese Nathalia A

    2005-04-01

    Full Text Available Abstract Hsulf-1 is a newly identified enzyme, which has the ability to decrease the growth of hepatocellular, ovarian, and head and neck squamous cell carcinoma cells by interfering with heparin-binding growth factor signaling. Since pancreatic cancers over-express a number of heparin-binding growth factors and their receptors, the expression and function of this enzyme in pancreatic cancer was analyzed. Results Pancreatic cancer samples expressed significantly (22.5-fold increased Hsulf-1 mRNA levels compared to normal controls, and Hsulf-1 mRNA was localized in the cancer cells themselves as well as in peritumoral fibroblasts. 4 out of 8 examined pancreatic cancer cell lines expressed Hsulf-1, whereas its expression was below the level of detection in the other cell lines. Stable transfection of the Hsulf-1 negative Panc-1 pancreatic cancer cell line with a full length Hsulf-1 expression vector resulted in increased sulfatase activity and decreased cell-surface heparan-sulfate proteoglycan (HSPG sulfation. Hsulf-1 expression reduced both anchorage-dependent and -independent cell growth and decreased FGF-2 mediated cell growth and invasion in this cell line. Conclusion High expression of Hsulf-1 occurs in the stromal elements as well as in the tumor cells in pancreatic cancer and interferes with heparin-binding growth factor signaling.

  4. Development of multimedia informational tools for breast cancer patients with low levels of health literacy.

    Science.gov (United States)

    Hart, Tae L; Blacker, Susan; Panjwani, Aliza; Torbit, Lindsey; Evans, Michael

    2015-03-01

    To create informational tools for breast cancer patients with low levels of health literacy. Tools were developed through a three-stage process. (1) Focus groups were conducted with breast cancer survivors and interviews were held with health educators to determine content, source of information, format and medium of the tools. (2) Based on this feedback, a suite of tools was developed. (3) Focus groups were reconvened and health educators re-interviewed to obtain feedback and determine satisfaction. We developed a suite of five informational tools using low health literacy principles, which focused on learning about breast cancer resources and learning about the members of one's healthcare team, understanding the "journey" or trajectory of care beginning at diagnosis, hearing from other breast cancer patients about their own journey, and becoming informed about what to expect pre-and post-surgery for breast cancer. The final products were rated highly by breast cancer survivors. The developed materials, designed for patients who read below an 8th grade level, reflect the informational needs reported by breast cancer patients. Healthcare providers must consider utilizing design principles and theories of adult learning appropriate for those with low health literacy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Low expression levels of hepsin and TMPRSS3 are associated with poor breast cancer survival

    OpenAIRE

    Pelkonen, Mikko; Luostari, Kaisa; Tengstr?m, Maria; Ahonen, Hermanni; Berdel, Bozena; Kataja, Vesa; Soini, Ylermi; Kosma, Veli-Matti; Mannermaa, Arto

    2015-01-01

    Background Hepsin, (also called TMPRSS1) and TMPRSS3 are type II transmembrane serine proteases (TTSPs) that are involved in cancer progression. TTSPs can remodel extracellular matrix (ECM) and, when dysregulated, promote tumor progression and metastasis by inducing defects in basement membrane and ECM molecules. This study investigated whether the gene and protein expression levels of these TTSPs were associated with breast cancer characteristics or survival. Methods Immunohistochemical stai...

  6. High level of serum AFP is an independent negative prognostic factor in gastric cancer.

    Science.gov (United States)

    Chen, Yueguang; Qu, Hui; Jian, Mi; Sun, Guorui; He, Qingsi

    2015-11-11

    Gastric cancer with a high level of serum alpha fetoprotein (AFP) is uncommon and has unique clinicopathological features and a poorer prognosis. The aim of this research was to elucidate the clinicopathological and prognostic features of gastric cancer with a high level of AFP. The sera from 1,286 patients with gastric cancer treated at Qilu Hospital of Shandong University from January 2004 to December 2008 were analyzed preoperatively for AFP, CEA and CA19-9 levels after excluding active or chronic hepatitis, liver cirrhosis and hepatocellular carcinoma as well as preoperative distant metastasis. Patients were divided into 2 groups: 86 serum AFP-positive patients and 1,200 serum AFP-negative patients according to a cutoff of 20 ng/mL. The clinicopathological features and prognostic factors were compared between the groups. A higher incidence of serosal invasion, lymph node metastasis and liver metastasis and poorer prognosis was observed in the AFP-positive group compared with the AFP-negative group (all p<0.05). Serum AFP showed the highest specificity (93.66%) and diagnostic accuracy (92.38%) for predicting liver metastasis among the 3 tumor markers examined. Multivariate survival analysis revealed that AFP positivity was an independent prognostic factor in all 1,286 gastric cancer patients. The prognosis of AFP-positive gastric cancer was poorer than that of AFP-negative gastric cancer (p<0.05). A high level of serum AFP is an independent prognostic factor in gastric cancer and can be used for evaluating the prognosis of gastric cancers whether in the presence or absence of liver metastasis.

  7. Effect of Music Therapy on Pain and Anxiety Levels of Cancer Patients: A Pilot Study

    OpenAIRE

    Priyadharshini Krishnaswamy; Shoba Nair

    2016-01-01

    Background: The pain associated with cancer is highly detrimental to the quality of life of the affected individuals. It also contributes to the anxiety of the patient. There is a need for a nonpharmacological approach in addition to the pharmacological therapy for the management of the pain for a more holistic improvement in the individual. With this study, we wish to achieve this through music. Objective: To assess the effect of music therapy on pain scores and anxiety levels of cancer ...

  8. Lipid Peroxidation and Transforming Growth Factor-β1 Levels in Gastric Cancer at Pathologic Stages

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    Özgür Kemik

    2012-09-01

    Full Text Available Objective: High levels of TGF-β1 and enhanced TGF-β1 receptor signaling are related to the pathology of gastric cancer. This effect is caused by oxidative stress and lipid peroxidation products. The aim of this study was to investigate the levels of TGF-β1 and lipid peroxidation products in gastric cancer patients and their correlation with pathologic stage. Material and Methods: Lipid peroxidation products and TGF-β1 levels were studied in the serum samples of 50 gastric cancer patients and 18 control subjects.Results: HNE-protein adducts and TGF-β1 levels were significantly higher in T2, T3 and T4 gastric cancers than in either the T1 stage or controls (p<0.001. Pathologic stage was correlated with TGF-β1 levels (r=0.702, p<0.05.Conclusion: These markers production may contribute to tumor angiogenesis and aid in the prognosis of the gastric cancer.

  9. Melatonin and cortisol serum levels in lung cancer patients at different stages of disease.

    Science.gov (United States)

    Mazzoccoli, Gianluigi; Carughi, Stefano; De Cata, Angelo; La Viola, Marco; Vendemiale, Gianluigi

    2005-06-01

    Numerous interactions exist among the nervous, endocrine, and immune systems, mediated by neurotransmitters, hormones, and cytokines. Melatonin may modulate the integrated functions of a unique neuro-immune-endocrine system. Neoplastic diseases may be linked to progressive loss of integration among these systems. We investigated whether there are differences among healthy elderly people and elderly people suffering from lung cancer at different stages of disease in 24-hour melatonin and cortisol secretory profiles. In seventeen healthy subjects (mean age +/-S.E.: 68.8+/-1.92 years), seventeen patients with stage I and II lung cancer (mean age: 67.2+/-0.80), seventeen patients with stage III and IV lung cancer (mean age: 69.5+/-2.26), melatonin and cortisol serum levels were measured in blood samples collected every four hours for 24 hours. The area under the curve (AUC) and the presence of circadian rhythmicity were evaluated. The circadian rhythm of melatonin was present in all the groups, but serum levels were decreased in the subjects suffering from lung cancer (Pcortisol serum levels were increased (not in a significant way), with a loss of the circadian rhythm of secretion. The melatonin/cortisol ratio was decreased in stage III and IV cancer patients (Pmelatonin secretion and altered cortisol secretion pattern with advancing stage of neoplastic disease may be an expression of a gradual alteration of the integrated function of the neuro-endocrine system in lung cancer patients.

  10. Oxygen levels do not determine radiation survival of breast cancer stem cells.

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    Chann Lagadec

    Full Text Available For more than a century oxygen has been known to be one of the most powerful radiosensitizers. However, despite decades of preclinical and clinical research aimed at overcoming tumor hypoxia, little clinical progress has been made so far. Ionizing radiation damages DNA through generation of free radicals. In the presence of oxygen these lesions are chemically modified, and thus harder to repair while hypoxia protects cells from radiation (Oxygen enhancement ratio (OER. Breast cancer stem cells (BSCSs are protected from radiation by high levels of free radical scavengers even in the presence of oxygen. This led us to hypothesize that BCSCs exhibit an OER of 1. Using four established breast cancer cell lines (MCF-7, T47D, MDA-MB-231, SUM159PT and primary breast cancer samples, we determined the number of BCSCs using cancer stem cell markers (ALDH1, low proteasome activity, compared radiation clonogenic survival and mammosphere formation under normoxic and hypoxic conditions, and correlated these results to the expression levels of key members of the free radical scavenging systems. The number of BCSCs increased with increased aggressiveness of the cancer. This correlated with increased radioresistance (SF(8Gy, and decreasing OERs. When cultured as mammospheres, breast cancer cell lines and primary samples were highly radioresistant and not further protected by hypoxia (OER∼1.We conclude that because BCSCs are protected from radiation through high expression levels of free radical scavengers, hypoxia does not lead to additional radioprotection of BCSCs.

  11. Single Cell "Glucose Nanosensor" Verifies Elevated Glucose Levels in Individual Cancer Cells.

    Science.gov (United States)

    Nascimento, Raphael A S; Özel, Rıfat Emrah; Mak, Wai Han; Mulato, Marcelo; Singaram, Bakthan; Pourmand, Nader

    2016-02-10

    Because the transition from oxidative phosphorylation to anaerobic glycolytic metabolism is a hallmark of cancer progression, approaches to identify single living cancer cells by their unique glucose metabolic signature would be useful. Here, we present nanopipettes specifically developed to measure glucose levels in single cells with temporal and spatial resolution, and we use this technology to verify the hypothesis that individual cancer cells can indeed display higher intracellular glucose levels. The nanopipettes were functionalized as glucose nanosensors by immobilizing glucose oxidase (GOx) covalently to the tip so that the interaction of glucose with GOx resulted in a catalytic oxidation of β-d-glucose to d-gluconic acid, which was measured as a change in impedance due to drop in pH of the medium at the nanopipette tip. Calibration studies showed a direct relationship between impedance changes at the tip and glucose concentration in solution. The glucose nanosensor quantified single cell intracellular glucose levels in human fibroblasts and the metastatic breast cancer lines MDA-MB-231 and MCF7 and revealed that the cancer cells expressed reproducible and reliable increases in glucose levels compared to the nonmalignant cells. Nanopipettes allow repeated sampling of the same cell, as cells remain viable during and after measurements. Therefore, nanopipette-based glucose sensors provide an approach to compare changes in glucose levels with changes in proliferative or metastatic state. The platform has great promise for mechanistic investigations, as a diagnostic tool to distinguish cancer cells from nonmalignant cells in heterogeneous tissue biopsies, as well as a tool for monitoring cancer progression in situ.

  12. Fasting proinsulin levels are significantly associated with 20 year cancer mortality rates. The Hoorn Study.

    Science.gov (United States)

    Walraven, I; van 't Riet, E; Stehouwer, C D A; Polak, B C P; Moll, A C; Dekker, J M; Nijpels, G

    2013-05-01

    Proinsulin is possibly associated with cancer through activation of insulin receptor isoform A. We sought to investigate the associations between proinsulin and 20 year cancer mortality rates. The study was performed within the Hoorn Study, a population-based study of glucose metabolism in individuals aged 50-75 years in the Dutch population. Fasting proinsulin levels were measured twice by a double-antibody radioimmunoassay. Participants were continuously followed to register mortality; causes of death were derived from medical records. Cox survival analyses were performed to assess the 20 year risk of death from cancer in relation to proinsulin. All analyses were adjusted for age and sex, with additional adjustments for traditional risk factors. The effect modification of glucose metabolism and sex was tested. Proinsulin levels were measured in 438 individuals (41% normal glucose tolerance, 35.7% impaired glucose metabolism, 23.3% type 2 diabetes). Of these participants, 53 died from cancer. After adjustment for age and sex, proinsulin >16.5 pmol/l (the upper tertile) was significantly associated with a twofold risk of cancer mortality (HR 2.01, 95% CI 1.16, 3.46) compared with individuals with lower proinsulin levels. Additional adjustment for glucose metabolism, BMI and smoking did not substantially change the results (HR 1.91, 95% CI 1.04, 3.52). No interaction with glucose metabolism or sex was observed. Individuals with fasting proinsulin levels >16.5 pmol/l have a twofold risk of cancer mortality over a 20 year time span. These findings provide population-based evidence for the independent association between high proinsulin levels and cancer mortality rates.

  13. Fasting blood glucose level and prognosis in non-small cell lung cancer (NSCLC) patients.

    Science.gov (United States)

    Luo, Juhua; Chen, Yea-Jyh; Chang, Li-Jung

    2012-05-01

    Diabetes has been consistently linked to many forms of cancers, such as liver, colorectal, pancreatic, and breast cancer, however, the role of diabetes in outcome among cancer patients remains unclear. In this study, we retrospectively reviewed electronic medical records of 342 inpatients newly diagnosed with NSCLC referred by a teaching hospital cancer center in southern Taiwan between 2005 and 2007 to examine the effects of fasting glucose levels at time of cancer diagnosis on overall survival in patients with non-small cell lung cancer (NSCLC). All patients were followed up until the end of 2010. The Kaplan-Meier method was used to compare survival curves for patients with and without diabetes. The Cox proportional hazards model was used to estimate hazard ratios for the association between diabetes, other prognostic factors and patient survival. We observed that significant prognostic factors for poor overall survival in patients with NSCLC included older age, smoking, poor performance status, advanced stage (stage IIIB or IV), and no cancer-directed surgery treatment. Particularly, we identified that diabetic state defined by fasting blood glucose level ≥126 mg/dl was another independent prognostic factor for these patients. Compared with those who had normal range of fasting glucose level (70-99 mg/dl), patients with high fasting glucose level (≥126 mg/dl) had 69% excess risk of all-cause mortality in patients with NSCLC. Diabetes as indicated by elevated fasting blood glucose was independently associated with a significantly higher risk of all-cause mortality in patients with NSCLC, indicating that diabetes or hyperglycemia effectively controlled may present an opportunity for improving prognosis in NSCLS patients with abnormal glucose level. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  14. Assessment of the level of health literacy among fertile Iranian women with breast cancer.

    Science.gov (United States)

    Haghighi, Soheila Tontab; Lamyian, Minoor; Granpaye, Loabat

    2015-10-01

    Health literacy is one of the main determinants of health promotion. Regarding the influential role of the women in a society, enhancing their critical health literacy would be a prerequisite for the promotion of public health. The aims of this study were to determine the level of health literacy among fertile Iranian women with breast cancer and to determine the relationship between the health literacy level and socio demographic factors, such as age, educational level, occupation, age of marriage, duration of marriage, and several clinical factors, including taking psychiatric medication and the type of breast surgery among breast cancer patients. This cross-sectional study was conducted on 260 fertile patients with breast cancer from screening and monitoring centers and breast cancer clinics in Tehran from August 2014 to August 2015. Data were collected using socio demographic and clinical questionnaires developed by the researchers and the questionnaire for health literacy for Iranian adults (HELIA).The results were analyzed using SPSS-IBM version 20 and the Pearson product-moment correlation coefficient, along with Kido's correlation test. The mean age of the participants was 43.32. Most of the participants (68.5%) had high school diplomas or lower school degrees (based on educational system in Iran). The mean score of health literacy was 75.73. The levels of health literacy among the different groups of participants were as follows: insufficient health literacy (6.9% of patients), barely enough health literacy (18.8% of patients), enough health literacy (38.8% of patients) and excellent health literacy (35.1% of patients). Also, significant relationships were found between the level of health literacy and the participants' age of marriage, duration of marriage, educational level, and occupation (p literacy was high among women with breast cancer. This indicates that their high level of health literacy might be used as a contributor to the promotion of the

  15. Hemoglobin levels as a component of the paraneoplastic syndrome in lung cancer

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    Arslanagić Selma

    2012-01-01

    Full Text Available Recently, some studies indicate that paraneoplastic syndrome may be the first sign of lung cancer and may serve in early detection of cancer. Namely, during the last ten years, an increasing importance is given to hematological paraneoplastic syndrome of lung cancer. The aim of this study was to evaluate whether hemoglobin levels have paraneoplastic nature in patients diagnosed with lung cancer prior to any form of therapy, and to examine its relationships with platelet count. The study included 239 patients with lung cancer who were hospitalized at the Clinic for Pulmonary Diseases, Clinical Center of Sarajevo, during the period from January 2005 to December 2008, and a control group of 60 healthy persons. The study did not include lung cancer patients with evident hemoptysis and patients who were under chemotherapy and/or were undergoing surgery. The results of our study have shown that the average hemoglobin for each histopathological type of lung cancer was significantly lower than the average hemoglobin in control group, except for large cell carcinoma. Lung cancers are classified according to the TNM classification. There were no significant differences in average hemoglobin between different stage of non small cell lung carcinoma as well as in average hemoglobin between limited and extended stage of small cell lung carcinoma. Our results also showed that there was a significant negative correlation between platelet count and hemoglobin levels. On the basis of our results we concluded that low hemoglobin in patients with lung cancer, with no evident hemoptysis, may have the character of paraneoplastic syndrome.

  16. Somatic cancer variant curation and harmonization through consensus minimum variant level data

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    Deborah I. Ritter

    2016-11-01

    Full Text Available Abstract Background To truly achieve personalized medicine in oncology, it is critical to catalog and curate cancer sequence variants for their clinical relevance. The Somatic Working Group (WG of the Clinical Genome Resource (ClinGen, in cooperation with ClinVar and multiple cancer variant curation stakeholders, has developed a consensus set of minimal variant level data (MVLD. MVLD is a framework of standardized data elements to curate cancer variants for clinical utility. With implementation of MVLD standards, and in a working partnership with ClinVar, we aim to streamline the somatic variant curation efforts in the community and reduce redundancy and time burden for the interpretation of cancer variants in clinical practice. Methods We developed MVLD through a consensus approach by i reviewing clinical actionability interpretations from institutions participating in the WG, ii conducting extensive literature search of clinical somatic interpretation schemas, and iii survey of cancer variant web portals. A forthcoming guideline on cancer variant interpretation, from the Association of Molecular Pathology (AMP, can be incorporated into MVLD. Results Along with harmonizing standardized terminology for allele interpretive and descriptive fields that are collected by many databases, the MVLD includes unique fields for cancer variants such as Biomarker Class, Therapeutic Context and Effect. In addition, MVLD includes recommendations for controlled semantics and ontologies. The Somatic WG is collaborating with ClinVar to evaluate MVLD use for somatic variant submissions. ClinVar is an open and centralized repository where sequencing laboratories can report summary-level variant data with clinical significance, and ClinVar accepts cancer variant data. Conclusions We expect the use of the MVLD to streamline clinical interpretation of cancer variants, enhance interoperability among multiple redundant curation efforts, and increase submission of

  17. Impact of elective resection on plasma TIMP-1 levels in patients with colon cancer

    DEFF Research Database (Denmark)

    Hammer, J. H.; Basse, L.; Svedsen, M. N.

    2006-01-01

    OBJECTIVE: Pre- and post-operative plasma tissue inhibitor of metalloproteinases-1 (TIMP-1) levels have a prognostic impact on patients with colorectal cancer. However, the surgical trauma may play an essential role in regulation of plasma TIMP-1 levels, which in turn may influence subsequent TIMP......-1 measurements. PATIENTS AND METHODS: Consecutively, 48 patients with colon cancer (CC) and 12 patients with nonmalignant colonic disease were randomised to undergo elective laparoscopically assisted or open resection followed by fast track recovery. Plasma samples were collected just before and 1...... to preoperative levels 30 days after surgery. Patients undergoing laparoscopically assisted or open resection had similar TIMP-1 levels at each time point. CONCLUSIONS: Major surgery has considerable impact on plasma TIMP-1 levels. Intra- and post-operative changes of plasma TIMP-1 levels are independent...

  18. Effect of educational level on knowledge and use of breast cancer screening practices in Bangladeshi women.

    Science.gov (United States)

    Rasu, Rafia S; Rianon, Nahid J; Shahidullah, Sheikh M; Faisel, Abu J; Selwyn, Beatrice J

    2011-03-01

    The Breast Health Global Initiative 2007 emphasized education and cultural values for promoting breast cancer screening in developing countries. This cross-sectional study investigated if educational level and cultural beliefs affect breast cancer screening practices in 152 women 40 years or older in Dhaka, Bangladesh. Women with a higher (>12 years) educational level were more likely to know about breast self-examination (BSE; OR(adj), 95%CI = 22, 6.39-76.76), to know about mammograms (6, 2.49-15.70), and to practice BSE (3, 1.27-6.83) compared with those with a lower educational level. Breast cancer screening practices or knowledge was not affected by perceiving barriers to having mammograms.

  19. Tumor LINE-1 Methylation Level in Association with Survival of Patients with Stage II Colon Cancer.

    Science.gov (United States)

    Swets, Marloes; Zaalberg, Anniek; Boot, Arnoud; van Wezel, Tom; Frouws, Martine A; Bastiaannet, Esther; Gelderblom, Hans; van de Velde, Cornelis J H; Kuppen, Peter J K

    2016-12-27

    Genome-wide DNA hypomethylation is associated with a worse prognosis in early-stage colorectal cancer. To measure genome-wide DNA methylation levels, long interspersed nucleotide element (LINE-1) repeats are used as a surrogate marker. Cohort studies on the clinical impact of genome-wide DNA methylation level in patients with only early-stage colon cancer, are currently lacking. This study aimed to investigate the prognostic value of LINE-1 methylation in a stage II colon cancer cohort (n = 164). Manual needle microdissection of tumor areas was performed on formalin-fixed paraffin-embedded tumor tissue sections followed by DNA extraction. Bisulfite converted DNA was used to assess tumor LINE-1 methylation level by qPCR. Patients with LINE-1 hypomethylated tumors had a significantly worse overall survival compared to patients with a higher level of LINE-1 tumor DNA methylation (HR 1.68, 95% CI 1.03-2.75; p = 0.04). This effect was more prominent in patients aged over 65 years (HR 2.00, 95% CI 1.13-3.52; p = 0.02), although the test for age interaction was not significant. No significant effect on recurrence-free survival was observed. Based on these results, tumor LINE-1 hypomethylation is associated with a worse overall survival in stage II colon cancer. Whether the origin of this causation is cancer-specific or age-related can be debated.

  20. Cancer patient and staff ratings of caring behaviors: relationship to level of pain intensity.

    Science.gov (United States)

    Chang, Yuanmay; Lin, Ya-Ping; Chang, Hsiu-Ju; Lin, Chia-Chin

    2005-01-01

    This study explored differences in the perceived importance of nursing caring behaviors between patients with cancer pain and oncology nurses and to explore the relationship between level of pain intensity and the importance of various nursing caring behaviors. The study included 50 matched cancer patient-staff pairs from oncology inpatient units of 3 hospitals in northern Taiwan. The Brief Pain Inventory-Chinese version (BPI-C) and the Caring Assessment Report Evaluation Q-sort (CARE-Q) were used for data collection. Results revealed that cancer pain patients ranked "being accessible," "monitors and follows through," and "anticipates" as being the most important nursing caring behaviors; the nursing staff ranked "being accessible," "explains and facilitates," and "monitors and follows through" as being the most important behaviors. No correlations were found between cancer pain patients and staff rankings of the perceived importance of various caring behaviors. The self-reported level of pain intensity by patients was significantly positively correlated with the patient rating of the "anticipates" behavior. Patient self-reported level of pain interference was significantly positively correlated with the "monitors and follows through" behavior and significantly negatively correlated with the "explains and facilitates" behavior. Staff perception of both a patient's level of pain intensity and pain interference was significantly positively correlated with staff rating of the "being accessible" behavior. Results demonstrated that greater patient-staff communication is needed for staff to more accurately provide caring interventions to make patients with cancer pain feel cared for.

  1. Cellular diamine levels in cancer chemoprevention: modulation by ibuprofen and membrane plasmalogens

    Directory of Open Access Journals (Sweden)

    Wood Paul L

    2011-11-01

    Full Text Available Abstract Background To develop effective strategies in cancer chemoprevention, an increased understanding of endogenous biochemical mediators that block metastatic processes is critically needed. Dietary lipids and non-steroidal anti-inflammatory drugs (NSAIDs have a published track record of providing protection against gastrointestinal malignancies. In this regard, we examined the effects of membrane plasmalogens and ibuprofen on regulation of cellular levels of diamines, polyamine mediators that are augmented in cancer cells. For these studies we utilized Chinese hamster ovary (CHO cells and NRel-4 cells, a CHO cell line with defective plasmalogen synthesis. Results NRel-4 cells, which possess cellular plasmalogen levels that are 10% of control CHO cells, demonstrated 2- to 3-fold increases in cellular diamine levels. These diamine levels were normalized by plasmalogen replacement and significantly reduced by ibuprofen. In both cases the mechanism of action appears to mainly involve increased diamine efflux via the diamine exporter. The actions of ibuprofen were not stereospecific, supporting previous studies that cyclooxygenase (COX inhibition is unlikely to be involved in the ability of NSAIDs to reduce intracellular diamine levels. Conclusions Our data demonstrate that ibuprofen, a drug known to reduce the risk of colorectal cancer, reduces cellular diamine levels via augmentation of diamine efflux. Similarly, augmentation of membrane plasmalogens can increase diamine export from control and plasmalogen-deficient cells. These data support the concept that membrane transporter function may be a therapeutic point of intervention for dietary and pharmacological approaches to cancer chemoprevention.

  2. Changes in fat-soluble vitamin levels after gastrectomy for gastric cancer.

    Science.gov (United States)

    Rino, Yasushi; Oshima, Takashi; Yoshikawa, Takaki

    2017-02-01

    Several authors have reported the relationship between gastric cancer risk and vitamins. However, there are few reports on fat-soluble vitamins after gastrectomy for gastric cancer. Fat malabsorption and suppression of food intake after gastrectomy for gastric cancer have been previously documented. Because of fat malabsorption and suppression of food intake, a potential deficiency in fat-soluble vitamins, such as vitamins A, D, E, and K, has been readily suggested. In about 20 % of patients, the serum vitamin E levels were decreased. Indeed, vitamin E deficiency is a common complication after gastrectomy. Continuous vitamin E deficiency could develop from neurological symptoms, i.e., peripheral neuropathy, limb or truncal ataxia. The total cholesterol level is associated with the vitamin E levels. However, the serum vitamin A levels were decreased in only 1.8 % of patients. In total gastrectomy cases, the serum vitamin A level may readily decrease. In contrast, 1,25(OH)2 vitamin D deficiency, which is the most active vitamin D metabolite, is rare. Additionally, vitamin K deficiency after gastrectomy has not been reported thus far. Evidence that serum fat-soluble vitamin levels may decrease after gastrectomy for gastric cancer has not been established yet. Future research must explore fat-soluble vitamin deficiency after gastrectomy.

  3. Prognostic significance of elevated endothelin-1 levels in patients with colorectal cancer.

    Science.gov (United States)

    Arun, C; London, N J M; Hemingway, D M

    2004-01-01

    Prognostic factors from clinical, laboratory and pathological data of patients with colorectal cancer are essential to identify high-risk groups to whom beneficial adjuvant therapy could be given. Endothelin-1, a growth factor, has been associated with the development and spread of solid tumours. This prospective study was performed to determine whether preoperative plasma big ET-1 levels might be useful as a prognostic indicator in patients with colorectal carcinoma. Sixty-five consecutive patients with colorectal cancer confirmed by biopsy were included prospectively into this study over a 12-month period. Plasma samples from a peripheral vein were obtained prior to surgery. Univariate analysis of survival using age ( 70 years), sex, Dukes' stage (A&B versus C), tumour size ( 50 mm), vascular invasion and plasma big ET-1 levels was performed and significant factors were then analysed with the Cox regression model. Three variables, age, Dukes' tumour stage and plasma big ET-1 levels, were found to have prognostic significance (p70 years (p=0.02), Dukes' C tumours (p=0.04) and plasma big ET-1 levels >4.2 pg/mL (p=0.02). The Cox regression model identified the same three variables as having independent prognostic value for overall survival. Preoperative plasma big ET-1 levels may be useful in predicting overall survival in patients with colorectal cancer. Plasma big ET-1 levels may be useful in the selection of high-risk lymph node-negative patients with colorectal cancer for adjuvant therapy.

  4. Cancer mortality in the United States by education level and race.

    Science.gov (United States)

    Albano, Jessica D; Ward, Elizabeth; Jemal, Ahmedin; Anderson, Robert; Cokkinides, Vilma E; Murray, Taylor; Henley, Jane; Liff, Jonathan; Thun, Michael J

    2007-09-19

    Although both race and socioeconomic status are well known to influence mortality patterns in the United States, few studies have examined the simultaneous influence of these factors on cancer incidence and mortality. We examined relationships among race, education level, and mortality from cancers of the lung, breast, prostate, colon and rectum, and all sites combined in contemporary US vital statistics. Age-adjusted cancer death rates (with 95% confidence intervals [CIs]) were calculated for 137,708 deaths among 119,376,196 individuals aged 25-64 years, using race and education information from death certificates and population denominator data from the US Bureau of the Census, for 47 states and Washington, DC, in 2001. Relative risk (RR) estimates were used to compare cancer death rates in persons with 12 or fewer years of education with those in persons with more than 12 years of education. Educational attainment was strongly and inversely associated with mortality from all cancers combined in black and white men and in white women. The all-cancer death rates were nearly identical for black men and white men with 0-8 years of education (224.2 and 223.6 per 100,000, respectively). The estimated relative risk for all-cancer mortality comparing the three lowest ( 12 years) education categories was 2.38 (95% CI = 2.33 to 2.43) for black men, 2.24 (95% CI = 2.23 to 2.26) for white men, 1.43 (95% CI = 1.41 to 1.46) for black women, and 1.76 (95% CI = 1.75 to 1.78) for white women. For both men and women, the magnitude of the relative risks comparing the three lowest educational levels with the three highest within each race for all cancers combined and for lung and colorectal cancers was higher than the magnitude of the relative risks associated with race within each level of education, whereas for breast and prostate cancer the magnitude of the relative risks associated with race was higher than the magnitude of the relative risks associated with level of education

  5. Level and conditioning of knowledge about breast cancer displayed by women in perimenopausal age.

    Science.gov (United States)

    Bogusz, Renata; Humeniuk, Ewa; Walecka, Irena; Bojar, Iwona

    2016-06-02

    Women aged 50-69 are the most likely to develop breast cancer. Knowledge about breast tumours as well as regular examination are two of the key factors which reduce the risk of the disease, and increase both the success of treatment and chances of survival. The aim of the paper was to assess knowledge about risk factors, symptoms, screening, early diagnosis and breast cancer treatment among women in perimenopausal age. 400 women aged 45-60, residing in the Lublin region of eastern Poland participated in the research. The primary research tool was a questionnaire with 35 questions checking knowledge about symptoms, screening and early diagnosis, as well as breast cancer treatment. Particulars were also part of the questionnaire. Over 50% of women obtained average results with regard to general knowledge, 40% obtained high results and 6% low results. Subjective assessment of the women's knowledge was statistically significantly (pbreast cancer early diagnosis and therapy. Over a half of the women in perimenopausal age had average general knowledge, while only 40% - high. Over half of the women in perimenopausal age had average general knowledge, while only 40% - high. Subjective assessment of knowledge differed statistically significantly from the objective assessment. Women with higher education and living in rural areas displayed a higher level of general knowledge about breast cancer. The study did not identified any relationship between level of knowledge about breast cancer and age, financial situation or health of women in perimenopausal age.

  6. Circulating copper and zinc levels and risk of hepatobiliary cancers in Europeans.

    Science.gov (United States)

    Stepien, Magdalena; Hughes, David J; Hybsier, Sandra; Bamia, Christina; Tjønneland, Anne; Overvad, Kim; Affret, Aurélie; His, Mathilde; Boutron-Ruault, Marie-Christine; Katzke, Verena; Kühn, Tilman; Aleksandrova, Krasimira; Trichopoulou, Antonia; Lagiou, Pagona; Orfanos, Phlippos; Palli, Domenico; Sieri, Sabina; Tumino, Rosario; Ricceri, Fulvio; Panico, Salvatore; Bueno-de-Mesquita, H B As; Peeters, Petra H; Weiderpass, Elisabete; Lasheras, Cristina; Bonet Bonet, Catalina; Molina-Portillo, Elena; Dorronsoro, Miren; Huerta, José María; Barricarte, Aurelio; Ohlsson, Bodil; Sjöberg, Klas; Werner, Mårten; Shungin, Dmitry; Wareham, Nick; Khaw, Kay-Tee; Travis, Ruth C; Freisling, Heinz; Cross, Amanda J; Schomburg, Lutz; Jenab, Mazda

    2017-02-28

    Copper and zinc are essential micronutrients and cofactors of many enzymatic reactions that may be involved in liver-cancer development. We aimed to assess pre-diagnostic circulating levels of copper, zinc and their ratio (Cu/Zn) in relation to hepatocellular carcinoma (HCC), intrahepatic bile duct (IHBD) and gall bladder and biliary tract (GBTC) cancers. A nested case-control study was conducted within the European Prospective Investigation into Cancer and Nutrition cohort. Serum zinc and copper levels were measured in baseline blood samples by total reflection X-ray fluorescence in cancer cases (HCC n=106, IHDB n=34, GBTC n=96) and their matched controls (1:1). The Cu/Zn ratio, an indicator of the balance between the micronutrients, was computed. Multivariable adjusted odds ratios and 95% confidence intervals (OR; 95% CI) were used to estimate cancer risk. For HCC, the highest vs lowest tertile showed a strong inverse association for zinc (OR=0.36; 95% CI: 0.13-0.98, Ptrend=0.0123), but no association for copper (OR=1.06; 95% CI: 0.45-2.46, Ptrend=0.8878) in multivariable models. The calculated Cu/Zn ratio showed a positive association for HCC (OR=4.63; 95% CI: 1.41-15.27, Ptrend=0.0135). For IHBC and GBTC, no significant associations were observed. Zinc may have a role in preventing liver-cancer development, but this finding requires further investigation in other settings.

  7. Impact of elective resection on plasma TIMP-1 levels in patients with colon cancer

    DEFF Research Database (Denmark)

    Hammer, J. H.; Basse, L.; Svedsen, M. N.

    2006-01-01

    -1 measurements. PATIENTS AND METHODS: Consecutively, 48 patients with colon cancer (CC) and 12 patients with nonmalignant colonic disease were randomised to undergo elective laparoscopically assisted or open resection followed by fast track recovery. Plasma samples were collected just before and 1......OBJECTIVE: Pre- and post-operative plasma tissue inhibitor of metalloproteinases-1 (TIMP-1) levels have a prognostic impact on patients with colorectal cancer. However, the surgical trauma may play an essential role in regulation of plasma TIMP-1 levels, which in turn may influence subsequent TIMP...

  8. The relationship between total testosterone levels and prostate cancer: a review of the continuing controversy.

    Science.gov (United States)

    Klap, Julia; Schmid, Marianne; Loughlin, Kevin R

    2015-02-01

    For many years it was believed that higher total testosterone contributed to prostate cancer and caused rapid cancer growth. International guidelines consider that adequate data are not available to determine whether there is additional risk of prostate cancer from testosterone replacement. Numerous studies with multiple designs and contradictory conclusions have investigated the relationship between total testosterone and prostate cancer development. To establish current knowledge in this field we reviewed the literature on total testosterone and the subsequent risk of prostate cancer as well as the safety of exogenous testosterone administration in patients with a history of prostate cancer. We searched the literature to identify articles from 1994 to 2014 related to the relationship between total testosterone and prostate cancer. Emphasis was given to prospective studies, series with observational data and randomized, controlled trials. Case reports were excluded. Articles on testosterone replacement safety were selected by patient population (under active surveillance or with a prostate cancer history). We organized our results according to the relationship between total testosterone and prostate cancer, including 1) the possible link between low total testosterone and prostate cancer, 2) the effect of high levels and 3) the absence of any link. Finally, we summarized studies of the risk of exogenous testosterone administration in patients already diagnosed with prostate cancer, treated or on active surveillance. We selected 45 articles of the relationship between total testosterone and prostate cancer, of which 18 and 17 showed a relationship to low and high total testosterone, respectively, and 10 showed no relation. Total testosterone was defined according to the definition in each article. Contradictory findings have been reported, largely due to the disparate methodologies used in many studies. Most studies did not adhere to professional society guidelines

  9. Clinical importance of serum HE4 and MMP2 levels in endometrial cancer patients

    Directory of Open Access Journals (Sweden)

    Cymbaluk-Ploska A

    2017-06-01

    Full Text Available Aneta Cymbaluk-Płoska,1 Anita Chudecka-Głaz,1 Ewa Pius-Sadowska,2 Agnieszka Sompolska-Rzechuła,3 Bogusław Machaliński,2 Anna Surowiec,1 Janusz Menkiszak1 1Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, 2Department of General Pathology, Pomeranian Medical University, 3Department of Statistics, West Pomeranian University of Technology, Szczecin, Poland Introduction: Endometrial cancer is the one of the most common cancers of the genital organ. HE4 and MMP2 are both proteins whose serum levels increase in endometrial cancer.Aim: To explore the diagnostic potential of the serum levels of HE4 and MMP2 in patients with endometrial cancer and benign endometrial diseases. To assess the relationship between the serum levels of HE4 and MMP2 and the typical prognostic factors in patients with endometrial cancer.Materials and methods: Included in the study was a group of 112 patients presenting with bleeding abnormalities at the Pomeranian Medical University in years 2012–2016. Serum HE4 concentrations were measured using the Elecsys Electrochemiluminescence Immunoassay (ECLIA. MMP2 concentrations were quantified in the serum using multiplex immunoassays.Results: We observed statistically significant differences in mean serum levels of HE4 and MMP2 between the group of endometrial cancer patients and the group of patients with no changes in the endometrium (P=0.002/0.003. The diagnostic potential of HE4 and MMP2 in differentiation of high (International Federation of Gynecology and Obstetrics [FIGO] III and IV vs low (FIGO I and II clinical stage of tumor and prediction of cellular differentiation grade (G1 vs G3 on the basis of the analysis of the area under the curve is, respectively, 0.86 and 0.82 for HE4 and 0.82 and 0.74 for MMP2. The HE4 marker was significantly more specific than MMP2 in every study group and amounted to 93% vs 86% in all patients included in the analysis, 94% vs 84% in pre

  10. MANAGEMENT OF ENDOCRINE DISEASE: Morbidity in polycystic ovary syndrome.

    Science.gov (United States)

    Glintborg, Dorte; Andersen, Marianne

    2017-02-01

    Polycystic ovary syndrome (PCOS) is the most prevalent endocrine condition in premenopausal women. The syndrome is characterized by hyperandrogenism, irregular menses and polycystic ovaries when other etiologies are excluded. Obesity, insulin resistance and low vitamin D levels are present in more than 50% patients with PCOS, these factors along with hyperandrogenism could have adverse effects on long-term health. Hyperinflammation and impaired epithelial function were reported to a larger extent in women with PCOS and could particularly be associated with hyperandrogenism, obesity and insulin resistance. Available data from register-based and data linkage studies support that metabolic-vascular and thyroid diseases, asthma, migraine, depression and cancer are diagnosed more frequently in PCOS, whereas fracture risk is decreased. Drug prescriptions are significantly more common in PCOS than controls within all diagnose categories including antibiotics. The causal relationship between PCOS and autoimmune disease represents an interesting new area of research. PCOS is a lifelong condition and long-term morbidity could be worsened by obesity, sedentary way of life, Western-style diet and smoking, whereas lifestyle intervention including weight loss may partly or fully resolve the symptoms of PCOS and could improve the long-term prognosis. In this review, the possible implications of increased morbidity for the clinical and biochemical evaluation of patients with PCOS at diagnosis and follow-up is further discussed along with possible modifying effects of medical treatment. © 2017 European Society of Endocrinology.

  11. [The morbidity of students and the ways of its decreasing].

    Science.gov (United States)

    Medvedkova, N I; Medvedkov, V D; Ashirova, S V

    2012-01-01

    The lower level of health of youth and unfavorable ecological environment inputs drastically into children morbidity. Hence, the important value has rationalization of life style and decrease of parents 'morbidity. The article presents the main components of the total structure of students' morbidity and outlines the ways of its decreasing. The changes in the education process and health of students, special medical group and students, released of physical exercises are demonstrated. The dynamics of morbidity of students over 20 years in the ecologically relatively clean environment and in industrial megalopolis is analyzed.

  12. Androgen receptors and serum testosterone levels identify different subsets of postmenopausal breast cancers

    Directory of Open Access Journals (Sweden)

    Secreto Giorgio

    2012-12-01

    Full Text Available Abstract Background Androgen receptors (AR are frequently expressed in breast cancers, but their implication in cancer growth is still controversial. In the present study, we further investigated the role of the androgen/AR pathway in breast cancer development. Methods AR expression was evaluated by immunochemistry in a cohort of 528 postmenopausal breast cancer patients previously examined for the association of serum testosterone levels with patient and tumor characteristics. AR expression was classified according to the percentage of stained cells: AR-absent (0% and AR-poorly (1%-30%, AR-moderately (>30%-60%, and AR-highly (>60% positive. Results Statistical analysis was performed in 451 patients who experienced natural menopause. AR-high expression was significantly related with low histologic grade and estrogen receptor (ER- and progesterone receptor (PR-positive status (P trendP=0.022, although a trend across the AR expression categories was not present. When women defined by ER status were analyzed separately, regression analysis in the ER-positive group showed a significant association of high testosterone levels with AR-highly-positive expression (OR 1.86; 95% CI, 1.10-3.16, but the association was essentially due to patients greater than or equal to 65 years (OR 2.42; 95% CI, 1.22-4.82. In ER-positive group, elevated testosterone levels appeared also associated with AR-absent expression, although the small number of patients in this category limited the appearance of significant effects (OR 1.92; 95% CI, 0.73–5.02: the association was present in both age groups ( Conclusions The findings in the present study confirm that testosterone levels are a marker of hormone-dependent breast cancer and suggest that the contemporary evaluation of ER status, AR expression, and circulating testosterone levels may identify different subsets of cancers whose growth may be influenced by androgens.

  13. Impact of stress and levels of corticosterone on the development of breast cancer in rats

    Directory of Open Access Journals (Sweden)

    De la Roca-Chiapas JM

    2016-01-01

    Full Text Available José María De la Roca-Chiapas,1 Gloria Barbosa-Sabanero,2 Jorge Antonio Martínez-García,3 Joel Martínez-Soto,1 Víctor Manuel Ramos-Frausto,1 Leivy Patricia González-Ramírez,1 Ken Nowack4 1Department of Psychology, 2Department of Medical Sciences, Division of Health Sciences, Campus Leon-University of Guanajuato, Guanajuato, 3General Regional Hospital of Leon, Guanajuato, Mexico; 4Envisia Learning, Inc., Santa Monica, CA, USA Abstract: Stress is experienced during cancer, and impairs the immune system's ability to protect the body. Our aim was to investigate if isolation stress has an impact on the development of tumors in rats, and to measure the size and number of tumors and the levels of corticosterone. Breast cancer was induced in two groups of female rats (N=20 by administration of a single dose of N-methyl-N-nitrosourea 50 mg/kg. Rats in the control group (cancer induction condition were allowed to remain together in a large cage, whereas in the second group, rats were also exposed to a stressful condition, that is, isolation (cancer induction and isolation condition, CIIC. The CIIC group displayed anxious behavior after 10 weeks of isolation. In the CIIC group, 16 tumors developed, compared with only eleven tumors in the control cancer induction condition group. In addition, compared with the control group, the volume of tumors in the CIIC group was greater, and more rats had more than one tumor and cells showed greater morphological damage. Levels of corticosterone were also significantly different between the two groups. This study supports the hypothesis that stress can influence the development of cancer, but that stress itself is not a sufficient factor for the development of cancer in rats. The study also provides new information for development of experimental studies and controlled environments. Keywords: breast cancer, corticosterone, isolation condition, psychoneuroimmunology, stress

  14. Mean corpuscular volume levels and all-cause and liver cancer mortality.

    Science.gov (United States)

    Yoon, Hyung-Jin; Kim, Kyaehyung; Nam, You-Seon; Yun, Jae-Moon; Park, Minseon

    2016-07-01

    An elevated mean corpuscular volume (MCV) is associated with aging, nutrition, alcohol abuse and more, and it is known as a survival predictor in chronically ill patients. The aim of this study was to investigate the association between MCV levels and mortality from all-causes, cancer and site-specific cancer in a non-anemic healthy population. A total of 36,260 participants aged 40 years or older who underwent routine check-ups at Seoul National University Hospital Health Promotion Center between 1995 and 2008 were followed-up for mortality until December 31, 2008, retrospectively. During an average follow-up of 8.0 years, 1107 deaths including 547 cancer deaths were observed. The adjusted hazard ratios (aHRs) of the subjects with the highest quartile of MCV ≥95.8 fL in men and MCV ≥94.2 fL in women for all-cause and cancer mortality were 1.44 [95% confidence interval (CI), 1.15-1.80] and 1.51 (95% CI, 1.10-2.07) for men and 1.55 (95% CI, 1.08-2.22) and 1.25 (95% CI, 0.74-2.11) for women, respectively, compared with those in the reference group (90.5 fL≤MC liver cancer mortality in men (aHR, 3.55; 95% CI, 1.75-7.21). This study suggests that the elevated MCV level in non-anemic cancer-free individuals was associated with increased all-cause mortality in both men and women, and with cancer mortality, in particular liver cancer mortality in men. Future prospective studies are required to consolidate our findings.

  15. Synuclein gamma predicts poor clinical outcome in colon cancer with normal levels of carcinoembryonic antigen

    Directory of Open Access Journals (Sweden)

    Xing Xiaofang

    2010-07-01

    Full Text Available Abstract Background Synuclein gamma (SNCG, initially identified as a breast cancer specific gene, is aberrantly expressed in many different malignant tumors but rarely expressed in matched nonneoplastic adjacent tissues. In this study, we investigated the prognostic potential of SNCG in colon cancer particularly in the patients with normal carcinoembryonic antigen (CEA levels. Methods SNCG levels were assessed immunohistochemically in cancer tissues from 229 colon adenocarcinoma patients with a mean follow-up of 44 months. Correlations between SNCG levels and clinicopathologic features, preoperative serum CEA level, and clinical outcome were analyzed statistically using SPSS. Results SNCG levels in colon adenocarcinoma were closely associated with intravascular embolus and tumor recurrence but independent of preoperative serum CEA levels. SNCG expression was an independent prognostic factor of a shorter disease-free survival (DFS and overall survival (OS (P P = 0.001, P = 0.001, 0.002 for 97 patients with normal preoperative serum CEA level. Conclusions Our results suggest for the first time that SNCG is a new independent predicator for poor prognosis in patients with colon adenocarcinoma, including those with normal CEA levels. Combination of CEA with SNCG improves prognostic evaluation for patients with colon adenocarcinoma.

  16. Association between protein C levels and mortality in patients with advanced prostate, lung and pancreatic cancer.

    Science.gov (United States)

    Wilts, I T; Hutten, B A; Meijers, J C M; Spek, C A; Büller, H R; Kamphuisen, P W

    2017-06-01

    Procoagulant factors promote cancer progression and metastasis. Protein C is involved in hemostasis, inflammation and signal transduction, and has a protective effect on the endothelial barrier. In mice, administration of activated protein C reduced experimental metastasis. We assessed the association between protein C and mortality in patients with three types of cancer. The study population consisted of patients with advanced prostate, non-small cell lung or pancreatic cancer, who participated in the INPACT trial (NCT00312013). The trial evaluated the addition of nadroparin to chemotherapy in patients with advanced malignancy. Patients were divided into tertiles based on protein C at baseline. The association between protein C levels and mortality was evaluated with Cox proportional hazard models. We analysed 477 patients (protein C tertiles: C level was 107% (IQR 92-129). In the lowest tertile, 75 patients per 100 patient-years died, as compared to 60 and 54 in the middle and high tertile, respectively. Lower levels of protein C were associated with increased mortality (in tertiles: HR for trend 1.18, 95%CI 1.02-1.36, adjusted for age, sex and nadroparin use; as a continuous variable: HR 1.004, 95%CI 1.00-1.008, p=0.07). Protein C seems inversely associated with mortality in patients with advanced prostate, lung and pancreatic cancer. Further research should validate protein C as a biomarker for mortality, and explore the effects of protein C on progression of cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. [The level of evidence for the use of biomarkers in the early detection of prostate cancer].

    Science.gov (United States)

    Lamy, Pierre-Jean; Gauchez, Anne-Sophie; Salomon, Laurent; Haugh, Margaret; Ceraline, Jocelyn; Fulla, Yvonne; Georges, Agnès; Larré, Stéphane; Loric, Sylvain; Luporsi, Elisabeth; Martin, Pierre-Marie; Mazerolles, Catherine; Molinié, Vincent; Mongiat-Artus, Pierre; Piffret, Jacques; Thuillier, François; Perrin, Paul; Rebillard, Xavier

    2016-01-01

    To systematically review the evidence for the use of PSA and other biomarkers in the early detection of prostate cancer, we searched PubMed for clinical trials and studies assessing PSA and other biomarkers in the early detection of prostate cancer, published between 2000 and May 2013 that included >200 subjects. The level of evidence (LOE) for clinical utility was evaluated using the tumor marker utility grading system. A total of 84 publications, corresponding to 70 trials and studies were selected for inclusion in this review. We attributed a level of evidence (LoE) of IA to PSA for early PCa detection, but we do not recommend its use in mass screening. Emerging biomarkers were assessed in prospective case-control and cohort studies: PCA3 (n=3); kallikreins (n=3); [-2]proPSA (n=5); fusion oncogenes (n=2). These studies used biopsy results for prostate cancer to determine specificity and sensitivity, but they did not assess the effect on PCa mortality. The LoE attributed was III-C. PSA can be used for early prostate cancer detection but mass screening is not recommended. Studies on other biomarkers suggest that they could be used, individually or in combination, to improve the selection of patients with elevated PSA levels for biopsy, but RCTs assessing their impact on prostate cancer management and mortality are needed. A better use of available tests is possible for men at risk in order to maximize the risk-benefit ratio.

  18. The association of serum adiponectin levels with histopathological variables in gastric cancer patients.

    Science.gov (United States)

    Seker, Mesut; Bilici, Ahmet; Sonmez, Berkant; Ustaalioğlu, Bala Basak Oven; Gumus, Mahmut; Gozu, Hulya; Sargin, Mehmet; Orcun, Asuman; Gezen, Cem; Eser, Mehmet; Bildik, Nejdet; Salepci, Taflan

    2010-12-01

    Adiponectin is a peptide hormone secreted from the adipose tissue, affecting the proliferation and insulin sensitivity in different cell types. The levels of adiponectin have been found to be decreased in hyperinsulinemia and insulin resistant states, such as obesity. The previous studies have suggested that plasma adiponectin levels are decreased in patients with endometrial and breast cancer. In our study, the relationship among serum adiponectin levels, demographic features and histopathological variables was evaluated in gastric cancer patients. Forty consecutive patients with gastric cancer who underwent gastrectomy with standard lymph node dissection were included and 43 healthy controls were included in this study. The serum levels of glucose, insulin, C-peptide, HbA1c and adiponectin were measured in both groups. We analyzed the correlation among these parameters and patients' demographic features, such as age, gender, body mass index (BMI) and histopathological variables such as tumor localization, stage, nodal status, histological grade, vascular and lymphatic invasion. The mean age was 60.05+9.72 in patients, while it was 38.6+12.73 in controls. The mean serum adiponectin levels were 12.62+7.9 and 10.07+6.72 ng/ml, respectively, in groups. There was no different in terms of adiponectin, C-peptide, HOMA-R level in both groups. On the other hand, BMI, glucose and insulin levels were significantly different in gastric cancer patients in comparison with the controls. There was no correlation among the levels of adiponectin, BMI, insulin and c-peptide levels in patient group (P>0.05). The adiponectin levels of woman were significantly lower than male patients (P=0.002). No relations were detected among tumor stage, tumor localization, nodal status, lymphatic and vascular invasion, and the levels of serum adiponectin (P>0.05). Interestingly, a positive correlation was found between tumor grade and plasma adiponectin levels (r=0.372; P=0.018). Our results

  19. The Association between Leptin Level and Breast Cancer: A Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Jingping Niu

    Full Text Available Contradictory results have been reported regarding the association between leptin level and breast cancer. Therefore, a meta-analysis was performed to investigate this issue.Published literature from PubMed and the Chinese National Knowledge Infrastructure (CNKI Database was retrieved. This study was performed based on different cases and control groups. The combined effect ([Formula: see text] with 95% confidence interval (CI was calculated using fixed-effects or random-effects model analysis.Overall, the mean serum leptin level of case groups was significantly higher than that of control groups. A For 9 studies comparing breast cancer cases and healthy controls the combined effect [Formula: see text] was 0.58 with 95% CI (0.48, 0.68. B For 4 studies comparing premenopausal breast cancer cases and healthy controls the [Formula: see text] was 0.32 (0.12, 0.52. C For 5 studies comparing postmenopausal cases and healthy controls the [Formula: see text] was 0.65 (0.46, 0.84. D For 4 studies comparing breast cancer cases and breast benign controls the [Formula: see text] was 0.38 (0.17, 0.59. E For 2 studies comparing premenopausal breast cancer cases and breast benign controls the [Formula: see text] was 0.33 (-0.25, 0.91. F For 6 studies comparing postmenopausal breast cancer cases and breast benign controls the [Formula: see text] was 0.39 (0.19, 0.60. G For 4 studies comparing lymph node metastasis positive cases and negative controls the [Formula: see text] was 0.72 (0.45, 1.00. H For 3 studies comparing breast benign cases and healthy controls the [Formula: see text] was 0.71 (0.41, 1.01.This meta-analysis suggests that leptin level plays a role in breast cancer and has potential for development as a diagnostic tool.

  20. Morbidity, life style and psychosocial situation in cancer survivors aged 60-69 years: results from The Nord-Trøndelag Health Study (The HUNT-II Study

    Directory of Open Access Journals (Sweden)

    Fosså Sophie D

    2011-01-01

    Full Text Available Abstract Background Due to considerable health status differences in the elderly population, research limited to narrow age-spans might be an advantage. In this population-based controlled study we compare short-term ( Methods Among 9,089 individuals aged 60-69 who participated in HUNT-2, 334 had been diagnosed with invasive primary cancer from 1 month to 42 years before HUNT-2 according to CRN and self-report. An overall random sample of controls without cancer five times larger than the sample of cases (N = 1,670 were drawn from the parent cohort. Results The cancer sample comprised 128 STS and 206 LTS. For most variables no significant differences were observed between LTS and STS. LTS were significantly more women, and cases with gynaecological cancer, with physical impairment and more thyroid diseases compared to STS. When comparing all the survivors with controls, the survivors showed significantly higher rate of pensioning, decreased self-rated health, more physical impairment and thyroid diseases, daily use of medication and psychotropics and higher level of anxiety and Framingham Risk score. Multivariate logistic regression analysis showed that increasing age, being female, physical impairment and thyroid diseases all were significantly associated with being survivor versus controls. Conclusion STS and LTS showed mostly similar situation. Compared to controls, the survivors reported somewhat poorer physical and mental health, but these differences were of doubtful clinical significance.

  1. Serum antioxidant levels and nutritional status in early and advanced stage lung cancer patients.

    Science.gov (United States)

    Klarod, Kultida; Hongsprabhas, Pranithi; Khampitak, Tueanjit; Wirasorn, Kosin; Kiertiburanakul, Sasisopin; Tangrassameeprasert, Roongpet; Daduang, Jureerut; Yongvanit, Puangrat; Boonsiri, Patcharee

    2011-01-01

    Malnutrition frequently occurs in lung cancer patients. We aimed to determine nutritional status and antioxidant and mineral levels in Thai patients with lung cancer. A prospective study with matched case-control was conducted. Nutritional status was assessed by body mass index (BMI) and subjective global assessment (SGA). Eastern Cooperative Oncology Group (ECOG) performance status was used to assess the performance. The serum antioxidant and mineral levels were determined. Forty-nine patients with a mean age of 58.8 (range, 35-82) who were first diagnosed with lung cancer were enrolled. They were compared with 60 healthy controls, and levels of retinol, α-tocopherol, β-carotene, lycopene, β-cryptoxanthin, selenium, and zinc were lower (P Selenium levels were higher in early stage compared to advanced stage patients (P = 0.041). Overweight patients had higher selenium levels (0.04 mg/L) than normal BMI patients (β = 0.04, P = 0.035). Patients with SGA class C had lower selenium levels (0.03 mg/L) than those with class A (β = -0.03, P = 0.035). The poorer ECOG performance patients had significantly lower β-carotene (β = -0.192, P = 0.003) and selenium (β = -0.031, P = 0.011) levels compared with those with good ECOG performance status. Significantly lower levels of antioxidants and selenium were found in lung cancer patients compared to healthy controls. Levels of some antioxidants and minerals differed among categories of BMI, SGA categories, or ECOG performance status. These findings may be helpful for further studies, such as the effect of nutritional supplementation on clinical outcomes. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. D-dimer levels and cerebral infarction in critically ill cancer patients.

    Science.gov (United States)

    Ryu, Jeong-Am; Bang, Oh Young; Lee, Geun-Ho

    2017-08-30

    D-dimer levels have been used in the diagnosis of a variety of thrombosis-related diseases. In this study, we evaluated whether measuring D-dimer levels can help to diagnose cerebral infarction (CI) in critically ill cancer patients. We retrospectively evaluated all cancer patients who underwent brain magnetic resonance imaging (MRI) between March 2010 and February 2014 at the medical oncology intensive care unit (ICU) of Samsung Medical Center. Brain MRI scanning was performed when CI was suspected due to acute neurological deficits. We compared D-dimer levels between patients ultimately diagnosed as having or not having CI and analyzed diffusion-weighted imaging (DWI) lesion patterns. A total of 88 patients underwent brain MRI scanning due to clinical suspicion of CI; altered mental status and unilateral hemiparesis were the most common neurological deficits. CI was ultimately diagnosed in 43 (49%) patients. According to the DWI patterns, multiple arterial infarctions (40%) were more common than single arterial infarctions (9%). Cryptogenic stroke etiologies were more common (63%) than determined etiologies. There was no significant difference in D-dimer levels between patients with and without CI (P = 0.319). Although D-dimer levels were not helpful in diagnosing CI, D-dimer levels were associated with cryptogenic etiologies in critically ill cancer patients; D-dimer levels were higher in the cryptogenic etiology group than in the determined etiology group or the non-infarction group (P = 0.001). In multivariate analysis, elevated D-dimer levels (> 8.89 μg/mL) were only associated with cryptogenic stroke (adjusted OR 5.46; 95% confidence interval, 1.876-15.857). Abnormal D-dimer levels may support the diagnosis of cryptogenic stroke in critically ill cancer patients.

  3. No association of plasma levels of adiponectin and c-peptide with risk of aggressive prostate cancer in the Cancer Prevention Study II Nutrition Cohort.

    Science.gov (United States)

    Stevens, Victoria L; Jacobs, Eric J; Sun, Juzhong; Gapstur, Susan M

    2014-05-01

    Obesity is associated with a higher risk of aggressive prostate cancer and alters circulating levels of insulin and adiponectin, two hormones that influence biologic processes implicated in carcinogenesis. Results of some studies showed associations of circulating levels of adiponectin, insulin, and c-peptide (a marker of insulin secretion) with aggressive prostate cancer, but the size of these studies was limited. A nested case-control study of 272 aggressive prostate cancer cases [Gleason score ≥ 7 (4+3) or T3-T4] and 272 age- and race-matched controls from the Cancer Prevention Study II Nutrition Cohort was conducted to determine the associations of prediagnostic plasma levels of c-peptide and adiponectin with risk of aggressive prostate cancer. Neither circulating adiponectin nor c-peptide was associated with risk of aggressive prostate cancer. In analyses of the highest-risk aggressive prostate cancer (Gleason score ≥ 8 or T3-T4), the highest quartile of c-peptide, compared with the lowest, was associated with an OR of 1.41 [95% confidence interval (CI), 0.72-2.78]. Our findings provide no support for the hypothesis that adiponectin is associated with risk of aggressive prostate cancer but a possible association of high levels of c-peptide with particularly high-risk prostate cancer cannot be ruled out. These results indicate that changes in circulating levels of adiponectin and c-peptide do not play an important role in risk of aggressive prostate cancer. ©2014 AACR.

  4. Beta-carotene levels in exfoliated cervicovaginal epithelial cells in cervical intraepithelial neoplasia and cervical cancer.

    Science.gov (United States)

    Palan, P R; Mikhail, M S; Basu, J; Romney, S L

    1992-12-01

    The purpose of this study was to measure beta-carotene levels in exfoliated epithelial cervicovaginal cells collected by a lavage technique in normal women and patients with histopathologically diagnosed cervical intraepithelial neoplasia and cervical cancer. In a cross-sectional sampling of women (n = 105), cervicovaginal cells and plasma beta-carotene levels were assayed with high-pressure liquid chromatography. In addition, beta-carotene levels were measured in exfoliated epithelial samples of cervicovaginal cells obtained from women (n = 24) enrolled in an ongoing oral beta-carotene supplementation clinical trial. Cervicovaginal cells and plasma beta-carotene levels were found to be significantly decreased in women with cervical intraepithelial neoplasia and cervical cancer as compared with controls (p < 0.0001, analysis of variance). Retinol levels in cervicovaginal cells were undetectable. The beta-carotene levels in cervicovaginal cells were markedly increased in the majority of patients (79%) after oral supplementation as compared with baseline levels in women enrolled in the beta-carotene clinical trial. The study demonstrates that changes of in situ cellular beta-carotene concentrations are measurable in samples of exfoliated epithelial cells obtained by a noninvasive saline lavage harvesting technique. The current findings further support our previous hypothesis that beta-carotene deficiency may have an etiologic role in the pathogenesis of cervical intraepithelial neoplasia and/or cervical cancer.

  5. Protein expression levels of carcinoembryonic antigen (CEA) in Danish ovarian cancer patients: from the Danish 'MALOVA'ovarian cancer study

    DEFF Research Database (Denmark)

    Hogdall, E.V.; Christensen, L.; Blaakaer, J.

    2008-01-01

    from 189 women diagnosed with low malignant potential ovarian tumours (LMP, borderline ovarian tumours) and 571 women diagnosed with ovarian cancer (OC). RESULTS: Using 30% as the cut-off level for CEA over-expression, 18% of LMPs and 4% of OCs were positive. A higher proportion of mucinous tumours...... (I to IV), the highest CEA expression compared with no expression was found to be a prognostic factor (level 3 versus negative: HR = 2.12, 95%CI 1.11-4.05). FIGO stage, residual tumour after primary surgery, age at diagnosis, other histological types versus serous adenocarcinoma and low versus high...

  6. A pilot study to assess the level of depression and the coping strategies adopted by cancer patients receiving treatment in Mizoram State Cancer Institute, Aizawl

    OpenAIRE

    Gitumoni Konwar; Lalengzami Fanai; Vanrammawia K

    2015-01-01

    Background: Cancer, the second most common cause of death, has become a major health problem. Depression is the most common psychological problem encountered in patients with cancer. The coping skills adopted may affect the mental health of patients. Therefore, this research is undertaken to assess the level of depression and coping strategy adopted by the patients diagnosed with cancer. Materials and methods: A descriptive study to assess the level of depression and coping strategy adopte...

  7. Morbidity of Inguinofemoral Lymphadenectomy in Vulval Cancer

    Directory of Open Access Journals (Sweden)

    A. A. Soliman

    2012-01-01

    Results. Within a total of 64 inguinofemoral lymphadenectomies, 24% of the inguinal wounds were affected with cellulitis, 13% developed a seroma, 10% suffered wound breakdown, 5% showed lower limb edema within a month of the operation, and 21.4% showed lower limb edema during the long-term followup. No significant correlation could be found between saphenous vein ligation and the development of any of the local complications. The 3-year survival rate in our cohort was 89.3%. Conclusions. Local complications after inguino-femoral lymphadenectomy are still very high, with no single pre-, intra-, or postoperative factor that could be incriminated. Saphenous vein sparing provided no significant difference in decreasing the rate of local complications. More trials should be done to study the sentinel lymph node detection technique.

  8. Morbidity after ipsilateral radiotherapy for oropharyngeal cancer

    DEFF Research Database (Denmark)

    Jensen, Kenneth; Overgaard, Marie; Grau, Cai

    2007-01-01

    not negatively influenced by the volume sparring technique. Side effects were reduced, in the ipsilaterally treated group, for all endpoints: xerostomia, dysphagia, hoarseness, atrophy, fibrosis and oedema. The number of patients experiencing moderate to severe toxicity was more than halved with ipsilateral...

  9. Level of awareness and knowledge of breast cancer in Nigeria. A ...

    African Journals Online (AJOL)

    Background: Despite reports of improved awareness of breast cancer entity and seemingly upbeat levels of other awareness subthemes in Nigeria, patients continue to present late when treatment is least rewarding. This paradoxical trend of both rising awareness and late presentation coupled with reports suggesting other ...

  10. Serum Levels of Leptin As Marker For Patients At High Risk of Gastric Cancer

    NARCIS (Netherlands)

    Capelle, Lisette G.; de Vries, Annemarie C.; Haringsma, Jelle; Steyerberg, Ewout W.; Looman, Caspar W. N.; Nagtzaam, Nicole M. A.; van Dekken, Herman; ter Borg, Frank; de Vries, Richard A.; Kuipers, Ernst J.

    2009-01-01

    Background: Serological screening for gastric cancer (GC) may reduce mortality. However, optimal serum markers for advanced gastric precursor lesions are lacking. Aim: To evaluate in a case-control study whether serum leptin levels correlate with intestinal metaplasia (IM) and can serve as a tool to

  11. Educational level and risk of colorectal cancer in EPIC with specific reference to tumor location

    NARCIS (Netherlands)

    Leufkens, A.M.; Duijnhoven, van F.J.B.; Boshuizen, H.C.; Sierseman, P.D.; Kunst, A.E.; Mouw, T.; Tjonneland, A.; Olsen, A.; Overvad, K.; Boutron-Ruault, M.C.; Clavel-Chapelon, F.; Morois, S.; Krogh, V.; Tumino, R.; Panico, S.; Polidoro, S.; Palli, D.; Kaaks, R.; Teucher, B.; Pischon, T.; Trichopoulou, A.; Orfanos, P.; Goufa, I.; Peeters, P.H.; Skeie, G.; Braaten, T.; Rodriguez, L.; Lujan-Barroso, L.; Sanchez-Perez, M.J.; Navarro, C.; Barricarte, A.; Zackrisson, S.; Almquist, M.; Hallmans, G.; Palmqvist, R.; Tsilidis, K.K.; Khaw, K.T.; Wareham, N.; Gallo, V.; Jenab, M.; Riboli, E.; Bueno-de-Mesquita, H.B.

    2012-01-01

    Existing evidence is inconclusive on whether socioeconomic status (SES) and educational inequalities influence colorectal cancer (CRC) risk, and whether low or high SES/educational level is associated with developing CRC. The aim of our study was to investigate the relationship between educational

  12. Serum testosterone level as a predictor of biochemical failure after radical prostatectomy for localized prostate cancer

    DEFF Research Database (Denmark)

    Røder, Martin Andreas; Christensen, Ib Jarle; Berg, Kasper Drimer

    2012-01-01

    Study Type - Aetiology (individual cohort) Level of Evidence 2b What's known on the subject? and What does the study add? The precise relationship between serum testosterone (T) and prostate cancer (PCa) incidence and progression is controversial. Low pre-treatment serum T correlates with higher...

  13. Serum level of interleukin-17 and interleukin-35 as a biomarker for diagnosis of thyroid cancer.

    Science.gov (United States)

    Lu, Yi; Yuan, Ye

    2015-10-01

    The aim of this study was to evaluate the serum level of interleukin-17 (IL-17) and IL-35 in thyroid cancer patients and its diagnostic value as a biomarker. Sixty-one thyroid carcinoma patients were recruited from January 2012 to December 2014 in our hospital. Of the 61 included cases, 42 subjects were pathology confirmed with thyroid cancer and other 19 cases were diagnosed with thyroid adenoma. The serum level of IL-17 and IL-35 were compared between the two groups. The diagnosed sensitivity, specificity, and receiver operating characteristic curve (ROC) for serum IL-17 and IL-35 were evaluated according to Bayes theorem. The serum level of IL-17 were 16.3 ± 4.1 pg/ml and 9.4 ± 3.6 pg/ml for the thyroid cancer and thyroid adenoma patients respectively, with statistical difference (P 8239. The diagnosis sensitivity and specificity for serum IL-35 were 76.8% and 82.4% at the cutoff value of 57.6 pg/ml with the area under the ROC of 0.8722. The serum level of IL-17 and IL-35 was significantly different between thyroid cancer and thyroid adenoma patients, which could be a potential biomarker for the diagnosis of malignant thyroid tumor.

  14. Assessing awareness level about warning signs of cancer and its determinants in an Iranian general population.

    Science.gov (United States)

    Feizi, Awat; Kazemnejad, Anoshirvan; Hosseini, Mohsen; Parsa-Yekta, Zohreh; Jamali, Jamshid

    2011-12-01

    The present study was aimed at investigating the awareness level about warning signs of cancer and its determinants in an Iranian general population. This cross-sectional interview-based survey investigated 2,500 people aged 18 years and over, as a representative sample of Tehran population. Latent class regression was applied for analyzing data. A small (18.8%) proportion of the respondents had high level of knowledge, and 54.5% had moderate awareness, and 26.7% had low level of awareness. Most effective predictors for awareness were educational attainment, sex, and marital status. The findings suggest that the overall level of knowledge about warning signs of cancer among the public is low, particularly about some specific signs. Accordingly, educational and intervention programmes, with special attention placed on particular at-risk populations, to increase awareness about the disease leading to its early diagnosis are needed.

  15. Neoadjuvant chemotherapy induces expression levels of breast cancer resistance protein that predict disease-free survival in breast cancer.

    Directory of Open Access Journals (Sweden)

    Baek Kim

    Full Text Available Three main xenobiotic efflux pumps have been implicated in modulating breast cancer chemotherapy responses. These are P-glycoprotein (Pgp, Multidrug Resistance-associated Protein 1 (MRP1, and Breast Cancer Resistance Protein (BCRP. We investigated expression of these proteins in breast cancers before and after neoadjuvant chemotherapy (NAC to determine whether their levels define response to NAC or subsequent survival. Formalin-fixed paraffin-embedded tissues were collected representing matched pairs of core biopsy (pre-NAC and surgical specimen (post-NAC from 45 patients with invasive ductal carcinomas. NAC regimes were anthracyclines +/- taxanes. Immunohistochemistry was performed for Pgp, MRP1 and BCRP and expression was quantified objectively using computer-aided scoring. Pgp and MRP1 were significantly up-regulated after exposure to NAC (Wilcoxon signed-rank p = 0.0024 and p<0.0001, while BCRP showed more variation in response to NAC, with frequent up- (59% of cases and down-regulation (41% contributing to a lack of significant difference overall. Pre-NAC expression of all markers, and post-NAC expression of Pgp and MRP1 did not correlate with NAC response or with disease-free survival (DFS. Post-NAC expression of BCRP did not correlate with NAC response, but correlated significantly with DFS (Log rank p = 0.007, with longer DFS in patients with low post-NAC BCRP expression. In multivariate Cox regression analyses, post-NAC BCRP expression levels proved to predict DFS independently of standard prognostic factors, with high expression associated with a hazard ratio of 4.04 (95% confidence interval 1.3-12.2; p = 0.013. We conclude that NAC-induced expression levels of BCRP predict survival after NAC for breast cancer, while Pgp and MRP1 expression have little predictive value.

  16. Evaluating the epidemiology and morbidity burden associated with human papillomavirus in Israel: accounting for CIN1 and genital warts in addition to CIN2/3 and cervical cancer.

    Science.gov (United States)

    Shavit, Oren; Raz, Raanan; Stein, Michal; Chodick, Gabriel; Schejter, Eduardo; Ben-David, Yehuda; Cohen, Raanan; Arbel, Daphna; Shalev, Varda

    2012-03-01

    Human papillomavirus (HPV) infection is mostly associated with cervical cancer (CC). However, it can cause other illnesses as well, all of which impact on people's wellbeing and consume healthcare resources. Measures for prevention or early detection of these conditions differ in their effectiveness and cost. An informative evaluation of the projected benefit of these measures depends on understanding the current unmet need, not only limited to CC. To evaluate the burden of HPV-related conditions in Israel, including CC, cervical precancerous lesions and genital warts. A retrospective database analysis was conducted for the second largest health management organization (HMO) in Israel, covering approximately 1.8 million people. Records were drawn following a search for key words indicative of related diagnoses, lab results, medications, or procedures for the time period of 2006-2008. Prevalence, incidence and resource utilization were analysed. Findings were extrapolated to the whole Israeli population using age and gender incidence rates. Incidence of CC was found to be 5 per 100,000 females. Incidences of cervical intraepithelial neoplasia (CIN) grades 1, 2 and 3 were 74, 27 and 36 per 100,000 females, respectively. Incidence of genital warts was 239 and 185 per 100,000 for men and women, respectively. The overall annual economic burden was calculated to be $US48,838,058 (year 2010 values). HPV poses a significant burden in terms of health (clinical and quality of life) and in monetary terms, even for conditions that are sometimes regarded as benign, such as CIN1 or genital warts. Current findings should be used for proper evaluation of measures to reduce HPV-related morbidity and mortality, such as regular screening and vaccination.

  17. Castration Therapy of Prostate Cancer Results in Downregulation of HIF-1{alpha} Levels

    Energy Technology Data Exchange (ETDEWEB)

    Al-Ubaidi, Firas L.T. [Department of Genetics, Microbiology and Toxicology, Stockholm University, Stockholm (Sweden); Department of Urology, Central Hospital, Vaesteras (Sweden); Schultz, Niklas [Department of Genetics, Microbiology and Toxicology, Stockholm University, Stockholm (Sweden); Egevad, Lars [Department of Oncology-Pathology, Karolinska Institutet, Stockholm (Sweden); Granfors, Torvald [Department of Urology, Central Hospital, Vaesteras (Sweden); Helleday, Thomas, E-mail: helleday@gmt.su.se [Department of Genetics, Microbiology and Toxicology, Stockholm University, Stockholm (Sweden); Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford (United Kingdom); Science for Life Laboratory, Stockholm University, Solna (Sweden)

    2012-03-01

    Background and Purpose: Neoadjuvant androgen deprivation in combination with radiotherapy of prostate cancer is used to improve radioresponsiveness and local tumor control. Currently, the underlying mechanism is not well understood. Because hypoxia causes resistance to radiotherapy, we wanted to test whether castration affects the degree of hypoxia in prostate cancer. Methods and Materials: In 14 patients with locally advanced prostate cancer, six to 12 prostatic needle core biopsy specimens were taken prior to castration therapy. Bilateral orchidectomy was performed in 7 patients, and 7 were treated with a GnRH-agonist (leuprorelin). After castrationm two to four prostatic core biopsy specimens were taken, and the level of hypoxia-inducible factor-1{alpha} (HIF-1{alpha}) in cancer was determined by immunofluorescence. Results: Among biopsy specimens taken before castration, strong HIF-1{alpha} expression (mean intensity above 30) was shown in 5 patients, weak expression (mean intensity 10-30) in 3 patients, and background levels of HIF-1{alpha} (mean intensity 0-10) in 6 patients. Downregulation of HIF-1{alpha} expression after castration was observed in all 5 patients with strong HIF-1{alpha} precastration expression. HIF-1{alpha} expression was also reduced in 2 of 3 patients with weak HIF-1{alpha} precastration expression. Conclusions: Our data suggest that neoadjuvant castration decreases tumor cell hypoxia in prostate cancer, which may explain increased radiosensitivity after castration.

  18. Correlation Between Preoperative Serum Carcinoembryonic Antigen Levels and Expression on Pancreatic and Rectal Cancer Tissue

    Directory of Open Access Journals (Sweden)

    LSF Boogerd

    2017-05-01

    Full Text Available Carcinoembryonic antigen (CEA–targeted imaging and therapeutic agents are being tested in clinical trials. If CEA overexpression in malignant tissue corresponds with elevated serum CEA, serum CEA could assist in selecting patients who may benefit from CEA-targeted agents. This study aims to assess the relationship between serum CEA and CEA expression in pancreatic (n = 20 and rectal cancer tissues (n = 35 using histopathology. According to local laboratory standards, a serum CEA >3 ng/mL was considered elevated. In pancreatic cancer patients a significant correlation between serum CEA and percentage of CEA-expressing tumor cells was observed ( P  = .04, ρ = .47. All 6 patients with homogeneous CEA expression in the tumor had a serum CEA >3 ng/mL. Most rectal cancer tissues (32/35 showed homogeneous CEA expression, independent of serum CEA levels. This study suggests that selection of pancreatic cancer patients for CEA-targeted agents via serum CEA appears adequate. For selection of rectal cancer patients, serum CEA levels are not informative.

  19. Wound morbidity after kidney transplant

    NARCIS (Netherlands)

    Fockens, M. Matthijs; Alberts, Victor P.; Bemelman, Frederike J.; van der Pant, Karlijn A. M. I.; Idu, Mirza M.

    2015-01-01

    Wound morbidity is an important surgical complication after kidney transplant. To assess risk factors for postoperative wound complications and the impact of such complications on outcomes of kidney transplant. Retrospectively, 108 consecutive kidney transplant patients between January 2010 and

  20. Effects of live sax music on various physiological parameters, pain level, and mood level in cancer patients: a randomized controlled trial.

    Science.gov (United States)

    Burrai, Francesco; Micheluzzi, Valentina; Bugani, Valentina

    2014-01-01

    Few randomized controlled trial studies have focused on the effect of music in cancer patients, and there are no randomized controlled trials on the effects of live music with saxophone in cancer patients. To determine the effects of live saxophone music on various physiological parameters, pain level, and mood level. A randomized controlled trial study. 52 cancer patients were randomized to a control group (n = 26), an experimental group (n = 26) whose members received 30 minutes of live music therapy with saxophone. Systolic and diastolic blood pressure, pulse rate, glycemia, oxygen saturation, pain level, and mood level were measured before and after the live music performance. There was a statistical difference between the groups for oxygen saturation (0.003) and mood level (0.001). Live music performed with a saxophone could be introduced in oncology care to improve the oxygen saturation and mood in cancer patients.

  1. Preoperative alcoholism and postoperative morbidity

    DEFF Research Database (Denmark)

    Tonnesen, H; Kehlet, H

    1999-01-01

    in alcohol abusers were used to evaluate the evidence. RESULTS: Prospective and retrospective studies demonstrate a twofold to threefold increase in postoperative morbidity in alcohol abusers, the most frequent complications being infections, bleeding and cardiopulmonary insufficiency. Wound complications...... account for about half of the morbidity. The pathogenic mechanisms include preoperative immune incompetence, subclinical cardiac insufficiency and haemostatic imbalance. In addition, surgical trauma and/or postoperative abstinence result in an exaggerated stress response, which may further contribute...

  2. Contribution of health behaviors to the association between area-level socioeconomic status and cancer mortality.

    Science.gov (United States)

    Hastert, Theresa A; Ruterbusch, Julie J; Beresford, Shirley A A; Sheppard, Lianne; White, Emily

    2016-01-01

    Cancer mortality is higher among residents of low-socioeconomic status (SES) areas than those of high-SES areas; however, the contribution of modifiable risk factors to this disparity is not known. We used data from 54,737 participants in the VITamins And Lifestyle (VITAL) Study, aged 50-76 with no history of cancer at baseline (2000-2002). Of these, 1488 died of cancer over an average of 7.7 years of follow-up. Data on modifiable risk factors including body mass index (BMI), physical activity, diet, alcohol, smoking and screening were taken from baseline questionnaires. We constructed a block group-level SES index using data from the 2000 United States Census and fit Cox proportional hazards models estimating the association between area-level SES and total cancer mortality with and without control for modifiable risk factors. All statistical tests are 2-sided. Cancer mortality was 77% (95% CI: 50%, 111%) higher in the lowest-SES areas compared with the highest. Modifiable risk factors accounted for 45% (95% CI: 34%, 62%) of this association. Smoking explained the greatest proportion (29%; 95% CI: 22%, 40%) of the observed association, followed by diet (11%; 95% CI: 7%, 17%), physical activity (10%; 95% CI: 7%, 16%), screening (9%; 6%, 13%), and BMI (5%; 95% CI: 1%, 10%). Results were similar in models controlling for individual education and income. The association between area-level SES and cancer mortality is partially explained by modifiable risk factors, which could suggest the appropriate targets to reduce socioeconomic disparities. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Morbidity and Mortality in Sarcoidosis

    Science.gov (United States)

    Gerke, Alicia K.

    2015-01-01

    Purpose of Review Chronic sarcoidosis is a complex disease with numerous comorbid conditions and can be fatal in some cases. Recognizing causes of morbidity and mortality is important to effectively select treatments, manage symptoms, and improve outcomes. The purpose of this review is to examine emerging knowledge on morbidity and mortality in sarcoidosis. Recent Findings Approximately one to five percent of patients with sarcoidosis die from complications of sarcoidosis. Recent population studies indicate that mortality may be increasing over the past decade. The reasons behind these trends are unclear, but could include increasing incidence, detection rates, severity of disease, or age of the population. Morbidity of sarcoidosis is reflected by a trend of increased hospitalizations over recent years and increased use of healthcare resources. Morbidity can be caused by organ damage from granulomatous inflammation, treatment complications, and psychosocial effects of the disease. Recent studies are focused on morbidity related to cardiopulmonary complications, bone health, and aging within the sarcoidosis population. Last, sarcoidosis is associated with autoimmune diseases, pulmonary embolism, and malignancy; however, the underlying mechanisms linking diseases continue to be debated. Summary Morbidity in sarcoidosis is significant and multifactorial. Mortality is infrequent, but may be increasing over the years. PMID:25029298

  4. Defining the level of evidence for technology adoption in the localized prostate cancer pathway.

    Science.gov (United States)

    Valerio, Massimo; El-Shater Bosaily, Ahmed; Emberton, Mark; Ahmed, Hashim U

    2014-08-01

    New technologies in prostate cancer are attempting to change the current prostate cancer pathway by aiming to reduce harms while maintaining the benefits associated with screening, diagnosis, and treatment. In this article, we discuss the optimal evaluation that new technologies should undergo to provide level 1 evidence typically required to change the practice. With this in mind, we focus on feasible and pragmatic trials that could be delivered in a timely fashion by many centers while retaining primary outcomes that focus on clinically meaningful outcomes. © 2013 Published by Elsevier Inc.

  5. A Perspective Discussion on Rising Pesticide Levels and Colon Cancer Burden in Brazil

    Directory of Open Access Journals (Sweden)

    Sergio Akira Uyemura

    2017-10-01

    Full Text Available Agriculture is a mainstay of many developing countries’ economy, such as Brazil. According to the Food and Agriculture Organization of the United Nations, Brazil is the major global consumer of pesticides. Irrespective of the fact that the International Agency for Research on Cancer suggests that pesticides promote human cancer risk, a prospective study reports that colorectal cancer (CRC burden will increase in developing countries by approximately 60% in the coming decades. Here, we review the literature and public data from the Brazilian Federal Government to explore why pesticides levels and new cases of colon cancer (CC are rising rapidly in the country. CC incidence is the second most common malignancy in men and women in the South and the Southeast of Brazil. However, while these regions have almost doubled their pesticide levels and CC mortality in 14 years, the amount of sold pesticides increased 5.2-fold with a corresponding 6.2-fold increase in CC mortality in Northern and Northeastern states. Interestingly, mortality from endocrine, nutritional, and metabolic diseases are rapidly increasing, in close resemblance with the pesticide detection levels in food. Taken together, we discuss the possibility that pesticides might alter the risk of CC.

  6. The TGFβ pathway stimulates ovarian cancer cell proliferation by increasing IGF1R levels.

    Science.gov (United States)

    Alsina-Sanchis, Elisenda; Figueras, Agnès; Lahiguera, Álvaro; Vidal, August; Casanovas, Oriol; Graupera, Mariona; Villanueva, Alberto; Viñals, Francesc

    2016-10-15

    In a search for new therapeutic targets for treating epithelial ovarian cancer, we analyzed the Transforming Growth Factor Beta (TGFβ) signaling pathway in these tumors. Using a TMA with patient samples we found high Smad2 phosphorylation in ovarian cancer tumoral cells, independently of tumor subtype (high-grade serous or endometrioid). To evaluate the impact of TGFβ receptor inhibition on tumoral growth, we used different models of human ovarian cancer orthotopically grown in nude mice (OVAs). Treatment with a TGFβRI&II dual inhibitor, LY2109761, caused a significant reduction in tumor size in all these models, affecting cell proliferation rate. We identified Insulin Growth Factor (IGF)1 receptor as the signal positively regulated by TGFβ implicated in ovarian tumor cell proliferation. Inhibition of IGF1R activity by treatment with a blocker antibody (IMC-A12) or with a tyrosine kinase inhibitor (linsitinib) inhibited ovarian tumoral growth in vivo. When IGF1R levels were decreased by shRNA treatment, LY2109761 lost its capacity to block tumoral ovarian cell proliferation. At the molecular level TGFβ induced mRNA IGF1R levels. Overall, our results suggest an important role for the TGFβ signaling pathway in ovarian tumor cell growth through the control of IGF1R signaling pathway. Moreover, it identifies anti-TGFβ inhibitors as being of potential use in new therapies for ovarian cancer patients as an alternative to IGF1R inhibition. © 2016 UICC.

  7. Rectal cancer mortality and total hardness levels in Taiwan's drinking water.

    Science.gov (United States)

    Yang, C Y; Tsai, S S; Lai, T C; Hung, C F; Chiu, H F

    1999-05-01

    The possible association between the risk of rectal cancer and hardness levels in drinking water from municipal supplies was investigated in a matched case-control study in Taiwan. All eligible rectal cancer deaths (986 cases) of Taiwan residents from 1990 through 1994 were compared with deaths from other causes (986 controls), and the hardness levels of the drinking water used by these residents were determined. Data on water hardness throughout Taiwan were collected from Taiwan Water Supply Corporation (TWSC). The control group consisted of people who died from other causes and the controls were pair matched to the cases by sex, year of birth, and year of death. The results show a significant negative relationship between drinking water hardness and rectal cancer mortality. Odds ratio and 95% confidence intervals were 1.24 (1.01-1. 55) and 1.38 (1.10-1.73), respectively, for exposure to moderately hard water and soft water compared with the use of hard water. Trend analyses showed an increasing odds ratio for rectal cancer with decreasing levels of hardness in drinking water. This is an important finding for the Taiwan water industry and human health. Copyright 1999 Academic Press.

  8. Analysis of ochratoxin A blood levels in bladder cancer cases and healthy persons from Pakistan.

    Science.gov (United States)

    Aslam, Muhammad; Rivzi, S Abidul Hassan; Beg, Anwer Ejaz; Blaszkewicz, Meinolf; Golka, Klaus; Degen, Gisela H

    2012-01-01

    The mycotoxin ochratoxin A (OTA), a well-known human nephrotoxic and carcinogenic agent, is a public health concern in many countries. Exposure is assessed by means of mycotoxin analysis in food commodities and by human biomonitoring of OTA in blood samples. Data available from several European countries and some studies in Africa, Asia, and the Americas indicate frequent detection of OTA. Thus far, data from developing countries that compare blood levels in healthy and diseased individuals are scarce. Thus, the aim of this investigation was to determine OTA levels in blood samples of bladder cancer patients (n = 96) and healthy controls (n = 31) from Pakistan. OTA in blood plasma was analyzed after extraction by high-performance liquid chromatography (HPLC) with fluorescence detection. Among samples of 87 cancer patients and 30 controls, 92% in total contained quantifiable amounts of OTA. In bladder cancer cases the median OTA concentration was 0.19 ng/ml (mean 0.296; range: 0.03 to 3.41 ng/ml), and in healthy controls the median OTA was 0.19 ng/ml (mean 0.3; range: 0.04 to 1.24 ng/ml). The OTA levels found in the Pakistanian cohorts were comparable to those reported previously for the general population in the European Union. In conclusion, OTA is not likely to play a major role in the etiology of bladder cancer in the Karachi cohort, at least as the sole risk factor.

  9. Cancer and aging

    DEFF Research Database (Denmark)

    Pedersen, Jacob K; Engholm, Gerda; Skytthe, Axel

    2016-01-01

    studies of cancer epidemiology and minimized the challenges often faced in many countries, such as uncertain identification of the study base, age misreporting, and low validity of the cancer diagnoses. However, methodological challenges still remain to be addressed, especially in cancer epidemiology...... studies among the elderly and the oldest-old. For example, a characteristic pattern for many cancer types is that the incidence increases up to a maximum at about ages 75-90 years and is then followed by a decline or a leveling off at the oldest ages. It has been suggested that the oldest individuals may...... be asymptomatic, or even insusceptible to cancer. An alternative interpretation is that this pattern is an artifact due to lower diagnostic intensity among the elderly and oldest-old caused by higher levels of co-morbidities in this age group. Currently, the available cancer epidemiology data are not able...

  10. Employment status and occupational level of adult survivors of childhood cancer in Great Britain: The British childhood cancer survivor study.

    Science.gov (United States)

    Frobisher, Clare; Lancashire, Emma R; Jenkinson, Helen; Winter, David L; Kelly, Julie; Reulen, Raoul C; Hawkins, Michael M

    2017-06-15

    The British Childhood Cancer Survivor Study (BCCSS) provides the first detailed investigation of employment and occupation to be undertaken in a large population-based cohort. Previous studies have been limited by design issues such as using small numbers of survivors with specific diagnoses, and involved limited assessment of employment status and occupational level. The BCCSS includes 17,981 5-year survivors of childhood cancer. Employment status and occupational level were ascertained by questionnaire from eligible survivors (n = 14,836). Multivariate logistic regression was used to explore factors associated with employment and occupation, and to compare survivors to their demographic peers in the general population. Employment status was available for 10,257 survivors. Gender, current age, cancer type, radiotherapy, age at diagnosis and epilepsy were consistently associated with being: employed; unable to work; in managerial or non-manual occupations. Overall, survivors were less likely to be working than expected (OR (99% CI): 0.89 (0.81-0.98)), and this deficit was greatest for irradiated CNS neoplasm survivors (0.34 (0.28-0.41)). Compared to the general population, survivors were fivefold more likely to be unable to work due to illness/disability; the excess was 15-fold among CNS neoplasm survivors treated with radiotherapy. Overall survivors were less likely to be in managerial occupations than expected (0.85 (0.77-0.94)). However, bone sarcoma survivors were more likely to be in these occupations than expected (1.37 (1.01-1.85)) and also similarly for non-manual occupations (1.90 (1.37-2.62)). Survivors of retinoblastoma (1.55 (1.20-2.01)) and 'other' neoplasm group (1.62 (1.30-2.03)) were also more likely to be in non-manual occupations than expected. © 2017 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

  11. Level of Awareness and Knowledge of Breast Cancer in Nigeria. A Systematic Review.

    Science.gov (United States)

    Olayide, Agodirin S; Halimat, Akande J; Samuel, Olatoke A; Ganiyu, Rahman A; Soliu, Oguntola A

    2017-03-01

    Despite reports of improved awareness of breast cancer entity and seemingly upbeat levels of other awareness subthemes in Nigeria, patients continue to present late when treatment is least rewarding. This paradoxical trend of both rising awareness and late presentation coupled with reports suggesting other competing drivers of late presentation question the "theory of poor awareness" as the foremost driver of late presentations. By aggregating available data, we aimed to assess what still constitutes poor breast cancer awareness in Nigeria in order to suggest how to allocate resources to reverse the paradox. Studies conducted on Nigerian populace from 2000 to date were reviewed systematically. Search was made in PROSPERO, PubMed/MEDLINE, AJOL, Cochrane library, GOOGLE, ResearchGate and ACADEMIA. Primary outcome was level of awareness about breast cancer entity. Fifty-one eligible (48 descriptive surveys, 3 interventional ones) studies were reviewed. They included 19,598 respondents (98.5% females; 43% rural dwellers). 17,086(87.2%) were laypersons in various walks of life; 2,512(12.8%) were healthcare professionals. There were high levels of awareness of breast cancer entity, BSE, knowledge of fatality and benefit of early detection (weighted percentages 80.6%, 60.1%, 73.2% and 73.9% respectively). Weighted percentages of knowledge of symptoms/signs was 45.1%. Weighted percentages of sense of susceptibility and performance of BSE were low-26.8% and 22.9% respectively. Generally, rate of performance of screening did not vary with changes in the level of awareness/knowledge of concepts. In general, low awareness of breast cancer may not be the direct and foremost driver of persistent late presentation in Nigeria.

  12. NOTCH1, NOTCH3, NOTCH4, and JAG2 protein levels in human endometrial cancer.

    Science.gov (United States)

    Sasnauskienė, Aušra; Jonušienė, Violeta; Krikštaponienė, Aurelija; Butkytė, Stasė; Dabkevičienė, Daiva; Kanopienė, Daiva; Kazbarienė, Birutė; Didžiapetrienė, Janina

    2014-01-01

    Notch signaling is a conserved developmental pathway, which plays an important role in the regulation of cell proliferation, differentiation and death. Deregulation of Notch pathway has been connected with the carcinogenesis in a variety of cancers. The aim of this study was to investigate the level of the Notch signaling pathway proteins (NOTCH1, 3, 4 and JAG2) in the samples from human endometrial cancer. The amount of the Notch receptors NOTCH1, 3, 4 and ligand JAG2 protein was determined by Western blot analysis in the samples from stage I endometrial cancer and adjacent nontumor endometrial tissue of 22 patients. The level of NOTCH4 receptor was 1.7 times lower in stage I endometrial cancer as compared with the healthy tissue of the same patients (P=0.04). The protein level of ligand JAG2 was significantly reduced by 2.5 times in stage IB endometrial adenocarcinoma samples (P=0.01). It was reduced in the majority of stage IB adenocarcinomas. There were no significant changes in the protein amount of NOTCH1 and NOTCH3 receptors comparing stage I endometrial adenocarcinoma and healthy tissues. The reduced amount of NOTCH4 and JAG2 proteins and the decreased level of mRNA coding Notch proteins, as reported in our previous studies, supports the notion that Notch pathway has rather tumor-suppressive than oncogenic role in human endometrial cancer cells. It suggests that Notch pathway activation is a potential therapeutic target. Copyright © 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  13. Low-level lasers on microRNA and uncoupling protein 2 mRNA levels in human breast cancer cells

    Science.gov (United States)

    Canuto, K. S.; Teixeira, A. F.; Rodrigues, J. A.; Paoli, F.; Nogueira, E. M.; Mencalha, A. L.; Fonseca, A. S.

    2017-06-01

    MicroRNA is short non-coding RNA and is a mediator of post-transcriptional regulation of gene expression. In addition, uncoupling proteins (UCPs) regulate thermogenesis, metabolic and energy balance, and decrease reactive oxygen species production. Both microRNA and UCP2 expression can be altered in cancer cells. At low power, laser wavelength, frequency, fluence and emission mode deternube photobiological responses, which are the basis of low-level laser therapy. There are few studies on miRNA and UCP mRNA levels after low-level laser exposure on cancer cells. In this work, we evaluate the micrRNA (mir-106b and mir-15a) and UCP2 mRNA levels in human breast cancer cells exposed to low-level lasers. MDA-MB-231 human breast cancer cells were exposed to low-level red and infrared lasers, total RNA was extracted for cDNA synthesis and mRNA levels by real time quantitative polymerase chain reaction were evaluated. Data show that mir-106b and mir-15a relative levels are not altered, but UCP2 mRNA relative levels are increased in MDA-MB-231 human breast cancer cells exposed to low-level red and infrared lasers at fluences used in therapeutic protocols.

  14. Associations of serum 25-hydroxyvitamin D level with incidence of lung cancer and histologic types in Norwegian adults

    DEFF Research Database (Denmark)

    Sun, Yi-Qian; Langhammer, Arnulf; Wu, Chunsen

    2018-01-01

    Previous prospective studies have shown inconsistent associations between serum 25-hydroxyvitamin D [25(OH)D] level and lung cancer incidence. The aim of the present study was to explore the associations of serum 25(OH)D levels with incidence of lung cancer overall and different histologic types....

  15. Assessing Awareness Level about Warning Signs of Cancer and its Determinants in an Iranian General Population

    OpenAIRE

    Feizi, Awat; Kazemnejad, Anoshirvan; Hosseini, Mohsen; Parsa-yekta, Zohreh; Jamali, Jamshid

    2011-01-01

    The present study was aimed at investigating the awareness level about warning signs of cancer and its determinants in an Iranian general population. This cross-sectional interview-based survey investigated 2,500 people aged 18 years and over, as a representative sample of Tehran population. Latent class regression was applied for analyzing data. A small (18.8%) proportion of the respondents had high level of knowledge, and 54.5% had moderate awareness, and 26.7% had low level of awareness. M...

  16. TS mRNA levels can predict pemetrexed and raltitrexed sensitivity in colorectal cancer.

    Science.gov (United States)

    Zhang, Qun; Shen, Jie; Wang, Hao; Hu, Jing; Yu, Lixia; Xie, Li; Wei, Jia; Liu, Baorui; Guan, Wenxian; Qian, Xiaoping

    2014-02-01

    The purpose of the study is to analyze the relationship between tumor thymidylate synthase (TS) mRNA expression levels and raltitrexed/pemetrexed/5-FU sensitivity. We collected freshly removed colorectal tumor specimens from 50 patients. Chemosensitivities to anticancer drugs were evaluated by histoculture drug response assay. We adopted quantitative reverse transcription polymerase chain reaction for TS mRNA detection and immunohistochemical staining for assessing TS expression in tumor tissues. There is a significant relationship between TS mRNA expression levels and in vitro chemosensitivity of freshly removed colorectal tumor specimens to pemetrexed (P TS mRNA expression levels can predict pemetrexed and raltitrexed sensitivity in colorectal cancer.

  17. Limited prognostic value of tissue protein expression levels of cyclin E in Danish ovarian cancer patients

    DEFF Research Database (Denmark)

    Heeran, Mel C; Høgdall, Claus K; Kjaer, Susanne K

    2012-01-01

    tissue arrays (TA), we analysed the cyclin E expression levels in tissues from 168 women with borderline ovarian tumours (BOT) (147 stage I, 4 stage II, 17 stage III) and 493 Ovarian cancer (OC) patients (127 stage I, 45 stage II, 276 stage III, 45 stage IV). Using a 10% cut-off level for cyclin E......The primary objective of this study was to assess the expression of cyclin E in tumour tissues from 661 patients with epithelial ovarian tumours. The second was to evaluate whether cyclin E tissue expression levels correlate with clinico-pathological parameters and prognosis of the disease. Using...

  18. Social and psychological determinants of levels of engagement with an online breast cancer support group: posters, lurkers, and nonusers.

    Science.gov (United States)

    Han, Jeong Yeob; Kim, Jung-Hyun; Yoon, Hye Jin; Shim, Minsun; McTavish, Fiona M; Gustafson, David H

    2012-01-01

    Despite the benefits and growing availability of online cancer support groups, many breast cancer patients still do not actively participate in them. To better understand cancer patients' online information- and support-seeking behaviors, this study explores how various social and psychological characteristics predict different levels of engagement with an online breast cancer support group: posters, lurkers, and nonusers. The study sample included 231 recently diagnosed breast cancer patients. Data included baseline survey scores of demographic, disease-related, and psychosocial factors and automatically collected discussion group use data over the 4-month intervention. Patterns of engagement with the cancer support group differed according to the patients' characteristics, suggesting that (a) cancer patients have very different orientations to and engagement with an online support group, and (b) deficits in social and psychological resources may not be barriers to participation in a cancer support group, but rather motivators to interact with other patients. The authors discuss the theoretical and practical implications of their findings.

  19. Prevalence and Levels of Depression Among Parents of Children with Cancer in Basrah, Iraq

    Directory of Open Access Journals (Sweden)

    Shukrya K. Al-Maliki

    2016-08-01

    Full Text Available Objectives: Cancer in a family member can be a major source of psychological disorders, especially for the parents of children diagnosed with cancer. This study aimed to determine the prevalence and levels of depression among parents of children with cancer in Basrah, Iraq. Methods: This cross-sectional study was conducted between November 2014 and April 2015 at the Specialist Paediatric Hospital in Basrah City, Iraq. One parent each of 384 children with cancer admitted to the hospital for treatment or follow-up during the study period were invited to participate in the study. Age, gender, years of education, occupation, monthly income, place of residence and the overall number of children in a family were recorded. The Center for Epidemiologic Studies Depression Scale was used to identify depression and assess levels of depression. Results: A total of 336 parents participated in the study (response rate: 87.5%. Of these, 70.5% were depressed, 54.1% of which had major depression. Depression was significantly more common (77.2% versus 57.1% and more severe (60.7% versus 41.1% among mothers compared to fathers (P = 0.001. Parents with fewer years of education were more likely to be depressed; this association was significant for mothers but not fathers (P = 0.001 and 0.814, respectively. Depression was significantly inversely associated with monthly income (P = 0.001. Conclusion: The prevalence of depression among the parents of children with cancer was high. Depression was significantly more severe among mothers compared to fathers and among mothers who were less educated. Income also had a significant association with levels of depression among parents.

  20. Androgen receptor levels during progression of prostate cancer in the transgenic adenocarcinoma of mouse prostate model

    Directory of Open Access Journals (Sweden)

    Krisna Murti

    2010-02-01

    Full Text Available Aim To construct tissue microarrays (TMAs that consisted of prostate tumours from the transgenic adenocarcinoma of mouse prostate (TRAMP mice and non-transgenic murine prostates and to assess androgen receptor (AR levels during progression of prostate cancer in TRAMP mice by immunohistochemistry.Methods Haematoxylin and eosin (H&E sections from the ventral and dorso-lateral prostate lobes of non-transgenic, intact TRAMP and castrated TRAMP were used to demarcate regions of interest for TMAs construction. The samples on TMAs were used to evaluate AR expression using video image analysis (VIA.Results AR was expressed during cancer progression, but AR levels were reduced or absent in late stage disease. Furthermore, when AR levels were compared in tumours from intact and castrate animals, a significant increase in AR levels was observed following androgen ablation.Conclusion Similar to clinical prostate cancer, in the TRAMP model, prostate tumours evolve mechanisms to maintain AR expression and AR responsive gene pathways following castration to facilitate continued tumour growth. (Med J Indones 2010; 19:5-13Keywords : androgen ablation therapy, tissue microarrays, haematoxylin and eosin, video image analysis

  1. Serum Levels of Resistin, Adiponectin, and Apelin in Gastroesophageal Cancer Patients

    Directory of Open Access Journals (Sweden)

    Dorota Diakowska

    2014-01-01

    Full Text Available The aim of the study was the investigation of relationship between cachexia syndrome and serum resistin, adiponectin, and apelin in patients with gastroesophageal cancer (GEC. Material and Methods. Adipocytokines concentrations were measured in sera of 85 GEC patients and 60 healthy controls. They were also evaluated in tumor tissue and appropriate normal mucosa of 38 operated cancer patients. Results. Resistin and apelin concentrations were significantly higher in GEC patients than in the controls. The highest resistin levels were found in cachectic patients and in patients with distant metastasis. Serum adiponectin significantly decreased in GEC patients with regional and distant metastasis. Serum apelin was significantly higher in cachectic patients than in the controls. Apelin was positively correlated with hsCRP level. Resistin and apelin levels increased significantly in tumor tissues. Weak positive correlations between adipocytokines levels in serum and in tumor tissue were observed. Conclusions. Resistin is associated with cachexia and metastasis processes of GEC. Reduction of serum adiponectin reflects adipose tissue wasting in relation to GEC progression. Correlation of apelin with hsCRP can reflect a presumable role of apelin in systemic inflammatory response in esophageal and gastric cancer.

  2. Decreased beta-carotene tissue levels in uterine leiomyomas and cancers of reproductive and nonreproductive organs.

    Science.gov (United States)

    Palan, P R; Mikhail, M; Romney, S L

    1989-12-01

    The dietary importance of beta-carotene as a factor in health maintenance has recently attracted considerable interest. Previously, total carotene content was estimated in a limited number of human tissues by means of spectrophotometric methods. In this study the levels of beta-carotene were measured by high-pressure liquid chromatography in tissue samples of uterine leiomyomas and adjacent normal myometrium obtained at hysterectomy from uteri of 18 patients. beta-Carotene concentration was significantly (p = 0.0013) lower in fibroid tissue than in normal myometrium. In addition, levels of beta-carotene were assayed in tissue samples of cancers of the cervix, endometrium, ovary, breast, colon, lung, liver, and rectum and were compared with levels of respective adjacent normal sites. The concentrations of beta-carotene were found to be lower in all cancer tissues. The decreased levels of beta-carotene suggest that beta-carotene deficiency may have a role in the cause and/or pathogenesis of leiomyomas and cancers of the organs that were investigated. The mechanism of action, however, remains unknown.

  3. Levels of scientific evidence of the quality of life in patients treated for oral cancer

    Science.gov (United States)

    Barrios, Rocío; Montero, Javier; González-Moles, Miguel A.; Baca, Pilar

    2013-01-01

    Treatments used in cancer of the oral cavity have great impact on the physical, psychological and functional state of patients. There has been increasingly interest in evaluating the health-related quality of life using questionnaires among patients treated FOR oral cancer. Up to our knowledge no review on this theme has incorporated the level of evidence of the single identified studies. The objective of the present study is to determinate results and conclusions about the health-related quality of life of these patients, in view of scientific evidence. In general, the diversity of designs, level of evidence and questionnaires used for their assessment does not affect results, which indicate a decline in the health-related quality of life after treatment. This decline is greater when the tumor is large in size, and when radiotherapy is used, though the situation is seen to improve over the span of a year. Questionnaires on health-related quality of life provide concrete information regarding the impact of cancer treatment on patients. Key words:Quality of life, oral cancer, questionnaire. PMID:23722141

  4. Determining the health beliefs and breast cancer fear levels of women regarding mammography.

    Science.gov (United States)

    Ersin, Fatma; Gözükara, Fatma; Polat, Perihan; Erçetin, Gözde; Bozkurt, Mehmet Ekrem

    2015-01-01

    Women's fears and health beliefs impact their participation in early breast cancer diagnosis approaches. This study was conducted to determine the health beliefs and fear levels of women older than 50 regarding mammography. A cross-sectional study was conducted in Turkey. The study cohort consisted of 300 women selected by cluster sampling who agreed to participate in the study. A health belief model scale and breast cancer fear scale were used in data collection. Descriptive statistics, t-test, chi-square test, and correlation analysis were used in the data analysis. Participants had an age average of 59.88 ± 6.49 years, and 86.3% were illiterate. Only 34.7% of women stated that they had had a mammogram in the past. The women's average scores on the lower dimensions of the health belief model scale were determined as follows: 6.52 ± 2.81 for sensitivity perception, 18.49 ± 5.22 for seriousness perception, 16.80 ± 4.31 for health motivation perception, 15.83 ± 3.89 for mammography benefit perception, and 28.74 ± 8.35 for mammography barrier perception. The score average of the breast cancer fear scale was determined as 23.81 ± 9.71. We observed that women's health beliefs and breast cancer fear levels impacted their participation in mammography.

  5. Blood levels of DDT and breast cancer risk among women living in the north of Vietnam.

    Science.gov (United States)

    Schecter, A; Toniolo, P; Dai, L C; Thuy, L T; Wolff, M S

    1997-11-01

    A positive association has been reported between elevated tissue organochlorines (p,p'-DDT/p,p'-DDE, PCBs, dioxins) and breast cancer in some case-control studies and occupational cohort studies. We previously reported high serum levels of p,p'-DDT and its metabolite p,p'-DDE in women living throughout Vietnam. We report here the results of a small hospital-based case-control study examining the association between blood levels of p,p'-DDT/p,p'-DDE and the risk of invasive breast cancer among residents of the north of Vietnam-an area where insecticides such as p,p'-DDT have been heavily used in the recent past. The study was conducted among patients admitted to a single hospital in the capital city of Hanoi in 1994. Study subjects were 21 women newly diagnosed with invasive adenocarcinoma of the breast, who served as cases, and 21 women of similar age with fibrocystic breast disease, who served as controls. No increase was evident in the relative risk of breast cancer with increasing tertiles of serum concentration of the compounds of interest, even after adjustment for major potential confounders, such as age at menarche, parity, history of lactation, and body weight. These results suggest that recent and past exposure to p,p'-DDT does not play an important role in the etiology of breast cancer among women living in a country with a tropical climate where insecticide use for mosquito control is common.

  6. Airway management and morbid obesity.

    Science.gov (United States)

    Kristensen, Michael S

    2010-11-01

    Morbidly obese patients present with excess fatty tissue externally on the breast, neck, thoracic wall and abdomen and internally in the mouth, pharynx and abdomen. This excess tissue tends to make access (intubation, tracheostomy) to and patency (during sedation or mask ventilation) of the upper airway and the function of the lungs (decreased residual capacity and aggravated ventilation perfusion mismatch) worse than in lean patients. Proper planning and preparation of airway management is essential, including elevation of the patient's upper body, head and neck. Preoxygenation is mandatory in morbidly obese patients and should be followed by actions to counteract atelectasis formation. The decision as to weather to use a rapid sequence induction, an awake intubation or a standard induction with hypnotics should depend on the thorough airway examination and comorbidity and should not be based solely on whether morbid obesity is present or not. It is important to ensure sufficient depth of anaesthesia before initiating manipulation of the airway because inadequate anaesthesia depth predisposes to aspiration if airway management becomes difficult. The intubating laryngeal mask airway is more efficient in the morbidly obese patients than in lean patients and serves as a rescue device for both failed ventilation and failed intubation. In the 24 h following anaesthesia, morbidly obese patients experience frequent oxygen desaturation periods that can be counteracted by continuous positive airway pressure, noninvasive ventilation and physiotherapy.

  7. Roles of Natural Compounds from Medicinal Plants in Cancer Treatment: Structure and Mode of Action at Molecular Level.

    Science.gov (United States)

    Rasool, Mahmood; Malik, Arif; Manan, Abdul; Arooj, Mahwish; Qazi, Mahmood Husain; Kamal, Mohammad Amjad; Sheikh, Ishfaq Ahmed; Gan, Siew Hua; Asif, Muhammad; Naseer, Muhammad Imran

    2015-01-01

    Every year, cancer takes the life of millions of people. Conventional treatments have produced unsatisfactory results for some types of cancer, and the side effects are extensive, leading to a shift in the focus of treatment towards alternative medicines. Indeed, medicinal plants have long been investigated by scientists for their anti-cancer properties. Some phytochemicals that are important active constituents of plants, including catechins, ursolic acid, silymarin, glycyrrhizin, ellagic acid, gallic acid and various types of flavonoids, have shown promise in future cancer management. The current review covers various aspects of cancer treatment based on medicinal plants at molecular level and sheds light on their structures and modes of action.

  8. Low co-morbidity, low levels of malnutrition, and low risk of falls in a community-dwelling sample of 85-year-olds are associated with successful aging: the Octabaix study.

    Science.gov (United States)

    Formiga, Francesc; Ferrer, Assumpta; Megido, Maria Jesus; Chivite, David; Badia, Teresa; Pujol, Ramón

    2011-06-01

    The population is aging throughout the world. Preserving physical and cognitive functions is crucial to successful aging. The aim of this study was to determine the proportion of 85-year-old community-dwelling subjects aging successfully, applying a quantitative approach, and assessing the association of successful aging with sociodemographic data, global geriatric assessment, and co-morbidity. This was a community-based survey of inhabitants aged 85 years, with 328 out of 487 subjects born in 1924 assigned to seven primary health-care teams, representing a participation rate of 67.5%. Sociodemographic variables, Barthel index (BI), the Spanish version of the Mini-Mental State Examination (MEC), Mini Nutritional Assessment (MNA), Charlson Index, Gait Rating Scale, social risk, quality of life (QoL), and prevalent chronic diseases were assessed. Subjects scoring higher than 90 on the BI and higher than 24 on the MEC were compared with the rest. Multiple regression analysis was performed. Using these criteria, successful aging status was defined in 162 (49.3%) subjects. Using multiple logistic regression analysis, successful agers had significantly lower co-morbidity scores (p successful agers had significantly higher values than their unsuccessful aging counterparts (p > 0.0001). Almost half of the individuals presented successful aging. Successful agers had less co-morbidity and a lower risk of falls or malnutrition, and they had higher scores on the QoL scale.

  9. Association between heavy metal and metalloid levels in topsoil and cancer mortality in Spain.

    Science.gov (United States)

    Núñez, Olivier; Fernández-Navarro, Pablo; Martín-Méndez, Iván; Bel-Lan, Alejandro; Locutura Rupérez, Juan F; López-Abente, Gonzalo

    2017-03-01

    Spatio-temporal cancer mortality studies in Spain have revealed patterns for some tumours which display a distribution that is similar across the sexes and persists over time. Such characteristics would be common to tumours that shared risk factors, including the geochemical composition of the soil. The aim of this study was to assess the possible association between heavy metal and metalloid levels in topsoil (upper soil horizon) and cancer mortality in mainland Spain. Ecological cancer mortality study at a municipal level, covering 861,440 cancer deaths (27 different tumour locations) in 7917 Spanish mainland towns, from 1999 to 2008. The elements included in this analysis were Al, As, Cd, Cr, Cu, Fe, Mn, Ni, Pb and Zn. Topsoil levels (partial extraction) were determined by ICP-MS at 13,317 sampling points. For the analysis, the data on the topsoil composition have been transformed by the centred logratio (clr-transformation). Principal factor analysis was performed to obtain independent latent factors for the transformed variables. To estimate the effect of heavy metal levels in topsoil composition on mortality, we fitted Besag, York and Mollié models, which included each town's factor scores as the explanatory variable. Integrated Nested Laplace Approximation (INLA) was used as a tool for Bayesian inference. All results were adjusted for sociodemographic variables. The results showed an association between trace contents of heavy metals and metalloids in topsoil and mortality due to tumours of the digestive system in mainland Spain. This association was observed in both sexes, something that would support the hypothesis that the incorporation of heavy metals into the trophic chain might be playing a role in the aetiology of some types of cancer. Topsoil composition and the presence of potentially toxic elements in trace concentrations might be an additional component in the aetiology of some types of cancer, and go some way to determine the ensuing geographic

  10. Clinical and Prognostic Significance of Preoperative Plasma Fibrinogen Levels in Patients with Operable Breast Cancer.

    Directory of Open Access Journals (Sweden)

    Yu Mei

    Full Text Available Elevated plasma fibrinogen levels are associated with tumor progression and poor outcomes in different cancer patients. The objective of this study was to investigate the clinical and prognostic value of preoperative plasma fibrinogen levels in patients with operable breast cancer.Two hundred and twenty-three patients diagnosed with breast cancer were retrospectively evaluated in this study. Plasma fibrinogen levels were examined before treatment and analyzed along with patient clinicopathological parameters, disease-free survival (DFS and overall survival (OS. Both univariate and multivariate analyses were performed to identify the clinicopathological parameters associated with DFS and OS.Elevated preoperative plasma fibrinogen levels were directly associated with age of diagnose (≤47 vs. >47, p<0.001, menopause (yes vs. no, p<0.001, tumor size (T1&T2 vs. T3&T4, p = 0.033, tumor stage (I vs. II vs. III, p = 0.034 and lymph node involvement (N = 0 vs. 1≤N≤3 vs. N≥4, p<0.001, but not with histological grade, molecular type and other Immunohistochemical parameters (ER, PR, HER2 and Ki-67. In a univariate survival analysis, tumor stage, tumor size, lymph node involvement (p<0.001/p<0.001 and plasma fibrinogen (p<0.001/p<0.001 levels were associated with disease-free and overall survival, but just lymph nodes involvement (p<0.001, hazard ratio [HR] = 2.9, 95% confidence interval [CI] = 1.6-5.3/p = 0.006, HR = 3.2, 95% CI = 1.4-7.3 and plasma fibrinogen levels (p = 0.006, HR = 3.4, 95% CI = 1.4-8.3/p = 0.002, HR = 10.1, 95% CI = 2.3-44.6 were associated with disease-free and overall survival in a multivariate survival analysis, respectively.This study demonstrates that elevated preoperative plasma fibrinogen levels are associated with breast cancer progression and are independently associated with a poor prognosis in patients with operable breast cancer.

  11. Psychiatric morbidity following Hurricane Andrew.

    Science.gov (United States)

    David, D; Mellman, T A; Mendoza, L M; Kulick-Bell, R; Ironson, G; Schneiderman, N

    1996-07-01

    The nature of psychiatric morbidity in previously non-ill subjects from the area most affected by Hurricane Andrew was investigated at 6-12 months posthurricane. Preliminary associations of morbidity with personal and event-related risk factors were also determined. Fifty one percent (31/61) met criteria for a new-onset disorder, including posttraumatic stress disorder (PTSD) in 36%, major depression (MD) in 30%, and other anxiety disorders in 20%. Thirty four subjects (56%) had significant symptoms persisting beyond 6 months. Having sustained "severe damage" was the risk factor most strongly associated with outcome. Our data underscore the range of psychiatric morbidity related to a natural disaster, and suggest a relationship to chronic stressors.

  12. Surgical treatment of morbid obesity

    Directory of Open Access Journals (Sweden)

    Brane Breznikar

    2006-12-01

    Full Text Available Background: In the article we present a morbid obesity and treatment options. We describe instructions for patients before operation and our results for operation with adjustable band.Patients and methods: Between May and December 2005 we operated 10 morbidly obese patients, 7 female and 3 male, aged 23 to 56, body mass index (BMI between 38 and 48.5 (laparoscopically inserted adjustable band. Two had comorbidity (diabetes.Results: We followed the patients’ status between 1 and 8 months. They reduced their body weight from 5 to 28 kg, on average 4.3 kg per month.Conclusions: Bariatric surgery is successful method for morbid obesity treatment. It demands multidisciplinary approach. Beside surgeon, endocrinologist, gastroenterologist, psychologist and others take part in the decision for the operation. During subsequent treatment dietetics and general physician play an important role.

  13. Airway management and morbid obesity

    DEFF Research Database (Denmark)

    Kristensen, Michael S

    2010-01-01

    Morbidly obese patients present with excess fatty tissue externally on the breast, neck, thoracic wall and abdomen and internally in the mouth, pharynx and abdomen. This excess tissue tends to make access (intubation, tracheostomy) to and patency (during sedation or mask ventilation) of the upper...... in morbidly obese patients and should be followed by actions to counteract atelectasis formation. The decision as to weather to use a rapid sequence induction, an awake intubation or a standard induction with hypnotics should depend on the thorough airway examination and comorbidity and should not be based...... solely on whether morbid obesity is present or not. It is important to ensure sufficient depth of anaesthesia before initiating manipulation of the airway because inadequate anaesthesia depth predisposes to aspiration if airway management becomes difficult. The intubating laryngeal mask airway is more...

  14. Alcohol abuse and postoperative morbidity

    DEFF Research Database (Denmark)

    Tønnesen, Hanne

    2003-01-01

    Patients who drink too much have more complications after surgery. The aim of this thesis was to evaluate the evidence, possible mechanisms, and prevention of the increased postoperative morbidity in alcohol abusers, defined by a consumption of at least five drinks per day. The literature could...... be criticised for several methodological flaws. Nevertheless, the results are in agreement showing moderate to strong evidence of increased postoperative morbidity after surgical procedures on alcohol abusers. There is weak to moderate evidence of increased postoperative mortality, hospital stay, and re...... precise identification of alcohol abuse. However, the inability of the questionnaires to detect short-term changes in intake and abuse without dependence, the inconsistent predictive values of the biological markers, and the lack of evidence of an association to postoperative morbidity reduces...

  15. Preoperative alcoholism and postoperative morbidity

    DEFF Research Database (Denmark)

    Tonnesen, H; Kehlet, H

    1999-01-01

    BACKGROUND: Preoperative risk assessment has become part of daily clinical practice, but preoperative alcohol abuse has not received much attention. METHODS: A Medline search was carried out to identify original papers published from 1967 to 1998. Relevant articles on postoperative morbidity...... in alcohol abusers were used to evaluate the evidence. RESULTS: Prospective and retrospective studies demonstrate a twofold to threefold increase in postoperative morbidity in alcohol abusers, the most frequent complications being infections, bleeding and cardiopulmonary insufficiency. Wound complications...... account for about half of the morbidity. The pathogenic mechanisms include preoperative immune incompetence, subclinical cardiac insufficiency and haemostatic imbalance. In addition, surgical trauma and/or postoperative abstinence result in an exaggerated stress response, which may further contribute...

  16. Morbid obesity and asthma : co-morbidity or causal relationship?

    NARCIS (Netherlands)

    Aardenburg-van Huisstede, Astrid

    2015-01-01

    This thesis consists of three parts. Part A describes in chapter 2 the complex diagnosis of asthma in the morbidly obese, and especially focuses on underdiagnosis and overdiagnosis of asthma in this patient group. Part B investigates bronchial and systemic inflammation. It starts in chapter 3 with a

  17. Educational level and risk of colorectal cancer in EPIC with specific reference to tumor location.

    Science.gov (United States)

    Leufkens, Anke M; Van Duijnhoven, Fränzel J B; Boshuizen, Hendriek C; Siersema, Peter D; Kunst, Anton E; Mouw, Traci; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Boutron-Ruault, Marie-Christine; Clavel-Chapelon, Françoise; Morois, Sophie; Krogh, Vittorio; Tumino, Rosario; Panico, Salvatore; Polidoro, Silvia; Palli, Domenico; Kaaks, Rudolf; Teucher, Birgit; Pischon, Tobias; Trichopoulou, Antonia; Orfanos, Philippos; Goufa, Ioulia; Peeters, Petra H M; Skeie, Guri; Braaten, Tonje; Rodríguez, Laudina; Lujan-Barroso, Leila; Sánchez-Pérez, Maria-José; Navarro, Carmen; Barricarte, Aurelio; Zackrisson, Sophia; Almquist, Martin; Hallmans, Goran; Palmqvist, Richard; Tsilidis, Konstantinos K; Khaw, Kay-Tee; Wareham, Nick; Gallo, Valentina; Jenab, Mazda; Riboli, Elio; Bueno-de-Mesquita, H Bas

    2012-02-01

    Existing evidence is inconclusive on whether socioeconomic status (SES) and educational inequalities influence colorectal cancer (CRC) risk, and whether low or high SES/educational level is associated with developing CRC. The aim of our study was to investigate the relationship between educational level and CRC. We studied data from 400,510 participants in the EPIC (European Prospective Investigation into Cancer and Nutrition) study, of whom 2,447 developed CRC (colon: 1,551, rectum: 896, mean follow-up 8.3 years). Cox proportional hazard regression analysis stratified by age, gender and center, and adjusted for potential confounders were used to estimate hazard ratios (HR) and 95% confidence intervals (95%CI). Relative indices of inequality (RII) for education were estimated using Cox regression models. We conducted separate analyses for tumor location, gender and geographical region. Compared with participants with college/university education, participants with vocational secondary education or less had a nonsignificantly lower risk of developing CRC. When further stratified for tumor location, adjusted risk estimates for the proximal colon were statistically significant for primary education or less (HR 0.73, 95%CI 0.57-0.94) and for vocational secondary education (HR 0.76, 95%CI 0.58-0.98). The inverse association between low education and CRC risk was particularly found in women and Southern Europe. These associations were statistically significant for CRC, for colon cancer and for proximal colon cancer. In conclusion, CRC risk, especially in the proximal colon, is lower in subjects with a lower educational level compared to those with a higher educational level. This association is most pronounced in women and Southern Europe. Copyright © 2011 UICC.

  18. Breast Cancer Awareness among Females in a Developing world- A ...

    African Journals Online (AJOL)

    Background: Breast cancer is a major health issue and in developing regions, where the early cancer detection facilities are unavailable awareness about this disease can lead to early detection and thereby potentially decrease the morbidity and mortality. Methods: A self designed questionnaire was used to study the level ...

  19. Relationships of sex steroid hormone levels in benign and cancerous breast tissue and blood: A critical appraisal of current science.

    Science.gov (United States)

    Stanczyk, Frank Z; Mathews, Brett W; Sherman, Mark E

    2015-07-01

    A systematic review of the literature on sex steroid measurement in breast tissue identified only 19 articles meeting the following criteria: menopausal status given; steroids measured in tissue homogenates by conventional RIA with a purification step or by mass spectrometry; and values reported per g tissue or per g protein. Twelve articles were analyzed in detail for: ratios of sex steroid hormone levels in cancerous or benign tissues to blood levels, stratified by menopausal status; ratios between the different hormone levels within tissues or within blood; and difference in these ratios between tissue and blood compartments. Estrogen and androgen concentrations varied greatly in benign and cancerous tissues and in blood between individuals. Postmenopausal, but not premenopausal, estradiol concentrations were significantly higher in cancerous compared to benign breast tissue. The estradiol/estrone ratio was lowest in premenopausal benign tissue, and substantially higher in premenopausal cancerous tissue and postmenopausal benign and cancerous tissues. Estradiol and estrone levels were considerably higher in tissue than in plasma in both premenopausal and postmenopausal women. Androgen levels were generally higher in the benign than the cancerous tissue, and tissue androgen levels were higher than in plasma, suggesting in situ aromatization of androgens to estrogens in breast cancer tissue. Limited available data on levels of hydroxylated estrogens in breast tissue compared to corresponding levels in plasma or urine were reviewed, but due to the paucity of studies no conclusions can presently be drawn regarding the relationship of the 2-hydroxyestrone:16α-hydroxyestrone ratio to breast cancer risk and genotoxic effects of 4-hydroxylated estrogens. Finally, data on hormone levels in breast adipose tissue were analyzed; high levels of androstenedione and testosterone and significant estrone and estradiol levels in breast adipocytes from postmenopausal breast

  20. Symptom Levels in Care-Seeking Bangladeshi and Nepalese Adults With Advanced Cancer

    Directory of Open Access Journals (Sweden)

    Richard Reed Love

    2017-06-01

    Full Text Available Purpose: Three-fourths of patients with advanced cancer are reported to suffer from pain. A primary barrier to provision of adequate symptom treatment is failure to appreciate the intensity of the symptoms patients are experiencing. Because data on Bangladeshi and Nepalese patients’ perceptions of their symptomatic status are limited, we sought such information using a cell phone questionnaire. Methods: At tertiary care centers in Dhaka and Kathmandu, we recruited 640 and 383 adult patients, respectively, with incurable malignancy presenting for outpatient visits and instructed them for that single visit on one-time completion of a cell phone platform 15-item survey of questions about common cancer-associated symptoms and their magnitudes using Likert scales of 0 to 10. The questions were taken from the Edmonton Symptom Assessment System and the Brief Pain Inventory instruments. Results: All but two Bangladeshi patients recruited agreed to study participation. Two-thirds of Bangladeshi patients reported usual pain levels ≥ 5, and 50% of Nepalese patients reported usual pain levels ≥ 4 (population differences significant at P < .001. Conclusion: Bangladeshi and Nepalese adults with advanced cancer are comfortable with cell phone questionnaires about their symptoms and report high levels of pain. Greater attention to the suffering of these patients is warranted.

  1. Dietary and Serum Lycopene Levels in Prostate Cancer Patients Undergoing Intensity-Modulated Radiation Therapy

    Science.gov (United States)

    Taylor, Martha L.; Frizzell, Bart

    2013-01-01

    Abstract Tomato products, good sources of lycopene, may lower the incidence of prostate cancer, but data on the effectiveness of lycopene supplementation during radiation therapy are lacking. This study aimed to evaluate the tolerance and acceptance of three different amounts (4, 8, or 12 oz) of tomato juice (TJ) and their effect on serum lycopene during radiotherapy in 20 men with localized prostate cancer. Participants were randomized into a control group or one of three intervention groups who consumed TJ daily during treatment. Dietary lycopene intake was estimated using the National Cancer Institute (NCI) Diet History Questionnaire, and gastrointestinal tolerance of TJ was evaluated using the NCI Cancer Therapy Evaluation Program: Common Toxicity Criteria v 2.0. Serum and TJ lycopene levels were measured by liquid chromatography-mass spectrometry. TJ was well tolerated without any gastrointestinal side effects, and increased serum lycopene levels were observed in the 8 and 12 oz groups from baseline to endpoint. No correlation between serum and dietary lycopene was detected. Despite no reported change in dietary intake, non-significant weight loss was observed in the control group but not the intervention group participants. A significant positive correlation between serum lycopene, weight, and body mass index, and a negative correlation between serum lycopene and piror nutritional supplement use was detected. Weight change should be monitored and evaluated during treatment. Larger clinical trials are needed to validate the use of TJ to increase serum/dietary lycopene intake and correlate with side effects during radiotherapy in men with prostate cancer. PMID:24180552

  2. Correlation of mammographic density and serum calcium levels in patients with primary breast cancer.

    Science.gov (United States)

    Hack, Carolin C; Stoll, Martin J; Jud, Sebastian M; Heusinger, Katharina; Adler, Werner; Haeberle, Lothar; Ganslandt, Thomas; Heindl, Felix; Schulz-Wendtland, Rüdiger; Cavallaro, Alexander; Uder, Michael; Beckmann, Matthias W; Fasching, Peter A; Bayer, Christian M

    2017-06-01

    Percentage mammographic breast density (PMD) is one of the most important risk factors for breast cancer (BC). Calcium, vitamin D, bisphosphonates, and denosumab have been considered and partly confirmed as factors potentially influencing the risk of BC. This retrospective observational study investigated the association between serum calcium level and PMD. A total of 982 BC patients identified in the research database at the University Breast Center for Franconia with unilateral BC, calcium and albumin values, and mammogram at the time of first diagnosis were included. PMD was assessed, using a semiautomated method by two readers. Linear regression analyses were conducted to investigate the impact on PMD of the parameters of serum calcium level adjusted for albumin level, and well-known clinical predictors such as age, body mass index (BMI), menopausal status and confounder for serum calcium like season in which the BC was diagnosed. Increased calcium levels were associated with reduced PMD (P = 0.024). Furthermore, PMD was inversely associated with BMI (P < 0.001) and age (P < 0.001). There was also an association between PMD and menopausal status (P < 0.001). The goodness-of-fit of the regression model was moderate. This is the first study assessing the association between serum calcium level and PMD. An inverse association with adjusted serum calcium levels was observed. These findings add to previously published data relating to vitamin D, bisphosphonates, denosumab, and the RANK/RANKL signaling pathway in breast cancer risk and prevention. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  3. NecroX-5 prevents breast cancer metastasis by AKT inhibition via reducing intracellular calcium levels.

    Science.gov (United States)

    Park, Jin-Hee; Kim, Hyoung Kyu; Jung, Hana; Kim, Ki Hyang; Kang, Mi Seon; Hong, Jun Hyuk; Yu, Byeng Chul; Park, Sungjae; Seo, Su-Kil; Choi, Il Whan; Kim, Soon Ha; Kim, Nari; Han, Jin; Park, Sae Gwang

    2017-01-01

    A major goal of breast cancer research is to prevent the molecular events that lead to tumour metastasis. It is well-established that both cytoplasmic and mitochondrial reactive oxygen species (ROS) play important roles in cell migration and metastasis. Accordingly, this study examined the molecular mechanisms of the anti-metastatic effects of NecroX-5, a mitochondrial ROS scavenger. NecroX-5 inhibited lung cancer metastasis by ameliorating migration in a mouse model. In human cancer cells, the inhibition of migration by NecroX-5 is cell type-dependent. We observed that the effect of NecroX-5 correlated with a reduction in mitochondrial ROS, but mitochondrial ROS reduction by MitoQ did not inhibit cell migration. NecroX-5 decreased intracellular calcium concentration by blocking Ca2+ influx, which mediated the inhibition of cell migration, AKT downregulation and the reduction of mitochondrial ROS levels. However, the reduction of mitochondrial ROS was not associated with supressed migration and AKT downregulation. Our study demonstrates the potential of NecroX-5 as an inhibitor of breast cancer metastasis.

  4. Household-level disparities in cancer risks from vehicular air pollution in Miami

    Science.gov (United States)

    Collins, Timothy W.; Grineski, Sara E.; Chakraborty, Jayajit

    2015-09-01

    Environmental justice (EJ) research has relied on ecological analyses of socio-demographic data from areal units to determine if particular populations are disproportionately burdened by toxic risks. This article advances quantitative EJ research by (a) examining whether statistical associations found for geographic units translate to relationships at the household level; (b) testing alternative explanations for distributional injustices never before investigated; and (c) applying a novel statistical technique appropriate for geographically-clustered data. Our study makes these advances by using generalized estimating equations to examine distributive environmental inequities in the Miami (Florida) metropolitan area, based on primary household-level survey data and census block-level cancer risk estimates of hazardous air pollutant (HAP) exposure from on-road mobile emission sources. In addition to modeling determinants of on-road HAP cancer risk among all survey participants, two subgroup models are estimated to examine whether determinants of risk differ based on disadvantaged minority (Hispanic and non-Hispanic Black) versus non-Hispanic white racial/ethnic status. Results reveal multiple determinants of risk exposure disparities. In the model including all survey participants, renter-occupancy, Hispanic and non-Hispanic black race/ethnicity, the desire to live close to work/urban services or public transportation, and higher risk perception are associated with greater on-road HAP cancer risk; the desire to live in an amenity-rich environment is associated with less risk. Divergent subgroup model results shed light on the previously unexamined role of racial/ethnic status in shaping determinants of risk exposures. While lower socioeconomic status and higher risk perception predict significantly greater on-road HAP cancer risk among disadvantaged minorities, the desire to live near work/urban services or public transport predict significantly greater risk among

  5. Elevated plasma vitamin B12 levels and cancer prognosis: A population-based cohort study

    DEFF Research Database (Denmark)

    Arendt, Johan Frederik Håkonsen; Farkas, Dora Kormendine; Pedersen, Lars

    2015-01-01

    cohort: 72.6%]. Thirty-day mortality was elevated for patients with Cbl levels of 601-800pmol/L or >800pmol/L, compared to patients with levels of 200-600pmol/L [(MRR (95% confidence interval): 601-800pmol/L vs. 200-600pmol/L: 1.9 (1.6-2.2); >800pmol/L vs. 200-600pmol/L: 2.7 (2.4-3.1)]. This association...... study using data from Danish medical registries during 1998-2014. The study included 25,017 patients with a cancer diagnosis and Cbl levels of 200-600pmol/L (reference/normal range), 601-800pmol/L and >800pmol/L measured up to one year prior to diagnosis, and a comparison cohort of 61,988 cancer...... using the Charlson comorbidity index. RESULTS: Survival probabilities were lower among patients with elevated Cbl levels than among patients with normal levels and among members of the comparison cohort [(1-year survival,%) Cbl: 200-600pmol/L: 69.3%; 601-800pmol/L: 49.6%; >800pmol/L: 35.8%; comparison...

  6. Elevated plasma gastrin, CEA, and CA 19-9 levels decrease after colorectal cancer resection.

    Science.gov (United States)

    Bombski, G; Gasiorowska, A; Orszulak-Michalak, D; Neneman, B; Kotynia, J; Strzelczyk, J; Janiak, A; Malecka-Panas, E

    2003-03-01

    Gastrin stimulates mucosal growth of much of the gastrointestinal tract and has also been implicated in promoting growth of colonic tumors, but its role in colorectal carcinogenesis remains controversial. This study determined fasting serum gastrin levels before and after surgery for colorectal cancer (CRC) and the relationship to the clinical stage of the disease to investigate it possible prognostic role. Fasting radioimmunoassay gastrin, CA 19-9, and CEA levels were measured before and after surgery for CRC. Helicobacter pylori status was also assessed since it causes significant hypergastrinemia. Mean fasting plasma gastrin level was significantly higher in CRC patients than in controls before surgery but not 59 days after surgery. Mean CEA and CA 19-9 levels were significantly higher in patients with CRC before surgery than after tumor resection. There was a significant positive correlation between the plasma gastrin, CEA, and CA 19-9 levels and the CRC stage (Dukes' classification). The significance of gastrin as a marker for diagnosis or prognostic purposes in colorectal cancer needs to be further examined.

  7. Metastatic prostate cancer with elevated serum levels of CEA and CA19-9

    Directory of Open Access Journals (Sweden)

    Guang-Dar Juang

    2014-03-01

    Full Text Available Prostate-specific antigen (PSA is well known as a specific tumor marker for prostate cancer, but carcinoembryonic antigen (CEA- and carbohydrate antigen 19-9 (CA19-9-elevating adenocarcinomas originating in the prostate gland are rare. We report a case of metastatic adenocarcinoma of the prostate gland with a high serum level of CEA and CA19-9 in a 78-year-old man in whom prostate cancer (T3N1M1 had been diagnosed 2 years ago and who was treated with androgen deprivation therapy. He visited the emergency department because of a loss of appetite and abdominal pain. The serum CEA and CA19-9 levels were increased to 218.9 ng/mL (normal, <5 ng/mL and 212 ng/mL (normal, <27 ng/mL, respectively. The serum PSA level was slightly elevated (4.41 ng/mL. Computed tomography demonstrated multiple liver metastases, para-aortic lymph node enlargement, and lung metastases. A liver biopsy was performed and the specimen showed high-grade adenocarcinoma with focal positive staining for PSA. Despite chemotherapy with docetaxel, the patient died 3 months after treatment. Based on this case and a review of the literature, an aggressive variant of prostatic carcinoma with a high serum level of CEA and CA19-9 and a low PSA level was shown to progress rapidly with a poor prognosis.

  8. Foreskin Morbidity in Uncircumcised Males

    DEFF Research Database (Denmark)

    Sneppen, Ida; Thorup, Jørgen

    2016-01-01

    OBJECTIVE: As a consequence of the discussion on whether the health benefits of newborn male circumcision outweigh the risks and the discrepancies in reported figures of complications, we evaluated the incidence and morbidity of foreskin surgery due to medical indications in boys from the Capital...

  9. Original Article : Correlation between preoperative serum Levels of five biomarkers and relationships between these biomarkers and cancer stage in epithelial overian cancer

    National Research Council Canada - National Science Library

    Jong Yun Hwang; ; Sung Hun Na; Hyang Ah Lee; Dong Heon Lee

    2009-01-01

    Objective: To examine the correlation among the preoperative serum levels of five biomarkers presumed to be useful for early detection of epithelial ovarian cancer and evaluate the relationships between serum...

  10. Correlations between plasma endothelin-1 levels and breakthrough pain in patients with cancer

    Directory of Open Access Journals (Sweden)

    Yan XB

    2015-12-01

    Full Text Available Xue-bin Yan, Tuo-chao Peng, Dong Huang Department of Anesthesiologist, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, People’s Republic of China Abstract: Endothelin-1 (ET-1 may be involved in driving pain in patients with advanced cancer. However, a few studies focus on the role of ET-1 in breakthrough pain (BP. The aim of this pivotal study was to explore the correlation between the plasma (ET-1 level and BP intensity. A total of 40 patients were enrolled in the study, and they were divided into two groups: BP group and non-BP group. Moreover, 20 healthy adults were used as the normal control group. Pain intensity was measured using visual analog scale (VAS scores of 1–10. Plasma ET-1 levels were detected by an ET radioimmunoassay kit. Subsequently, the correlation of ET-1 level with the VAS score and cancer types was analyzed by Pearson’s correlation coefficient. The plasma ET-1 level in the BP group (35.31±8.02 pg/mL was higher than that in the non-BP group (29.51±6.78 pg/mL and the normal control group (24.77±10.10 pg/mL, P<0.05. In addition, the VAS score in the BP group (7.45±0.82 was higher than that in the non-BP group (2.80±1.23, P<0.05. The plasma ET-1 level was positively correlated with the VAS score of the BP group (Pearson’s r=0.42. There was no significant correlation between the plasma ET-1 level and VAS score of the non-BP group (Pearson’s r=–0.22 or/and cancer types (P>0.05. The elevated plasma ET-1 levels were positively related to BP, and targeting ET-1 may provide a novel pain-reducing therapeutic treatment in BP. Keywords: visual analog scale, correlation, cancer types, background pain

  11. Pulmonary function in morbid obesity.

    Science.gov (United States)

    Sugerman, H J

    1987-06-01

    Morbid obesity is not infrequently associated with severe respiratory impairment. In our experience approximately 10 per cent of morbidly obese patients who underwent gastric surgery had severe respiratory impairment. Respiratory insufficiency of obesity can be divided into two primary breathing disorders: the obstructive sleep apnea syndrome (SAS) and the obesity hypoventilation syndrome (OHS). In its most severe form, when both SAS and OHS are present, it is called the Pickwickian syndrome. In our series 59 morbidly obese patients with respiratory insufficiency secondary to obesity underwent gastric surgery for weight reduction. Fourteen had OHS, 19 had SAS and 26 had both. Of these, two patients died of postoperative complications and one died at five weeks with an inconclusive autopsy, totalling an operative mortality rate of 3.4 per cent and a total mortality of 5.1 per cent. In our overall experience morbidly obese patients lost 67 per cent of excess weight after gastric procedures. In conclusion, surgically induced weight loss will markedly improve or correct respiratory insufficiency secondary to obesity. It will improve arterial oxygenation, minimize CO2 retention, expand lung volumes, correct polycythemia, and reduce apnea frequency. The magnitude of changes in these variables is clinically significant. Therefore, respiratory insufficiency of obesity should be considered a major indication for an aggressive approach to weight reduction. The jejunoileal bypass and unbanded gastroplasty operations have an unacceptable incidence of complications or failure, respectively. There is a high degree of recidivism following dietary programs. Sweets eaters will not do well with a gastroplasty procedure. Gastric bypass for individuals addicted to sweets or the vertical banded gastroplasty for "gorgers" are currently our procedures of choice and are associated with the average loss of two thirds of excess weight and correction of breathing problems associated with

  12. Changes in urinary Cu, Zn, and Se levels in cancer patients after treatment with Sha Shen Mai Men Dong Tang

    Directory of Open Access Journals (Sweden)

    Tung-Yuan Lai

    2016-04-01

    Full Text Available Sha Shen Mai Men Dong Tang (SMD-2; 沙參麥冬湯 shā shēn mài dōng tāng is a Chinese medicinal herb (CMH; 中草藥 zhōng cǎo yào used to treat symptoms associated with cancer therapy. The objective of this study was to assess the effect of SMD-2 on the levels of urinary copper (Cu, zinc (Zn, and selenium (Se in lung cancer patients and head and neck cancer patients receiving chemoradiotherapy. Forty-two head and neck cancer patients and 10 lung cancer patients participated in our clinical trial. Each patient received chemoradiotherapy for 4 weeks. In addition, each patient was treated with SMD-2 for 8 weeks, including 2 weeks prior to and after the chemoradiotherapy treatment. Comparison of urinary Cu, Zn, and Se levels and the ratios of Zn to Cu and Se to Cu at three time points in the two types of cancer were assessed using the generalized estimating equations (GEEs. After the patients received chemoradiotherapy for 4 weeks, SMD-2 treatment was found to be associated with a significant decrease in urinary Cu levels, whereas urinary Zn and Se levels increased significantly. In addition, the ratios of Zn to Cu and Se to Cu in the urine samples of these patients also increased significantly. Both the urinary Zn levels and the ratio of Zn to Cu in head and neck cancer patients were significantly higher than in lung cancer patients. Urinary Zn and Se levels and the ratios of Zn to Cu and Se to Cu, but not urinary Cu levels, increased significantly during and after treatment when assessed using the GEE model. The SMD-2 treatments significantly increased Zn and Se levels in the urine of head and neck cancer patients. Increased Zn and Se levels in urine strengthened immune system.

  13. Preoperative Serum Human Epididymis Protein 4 Levels in Early Stage Endometrial Cancer: A Prospective Study.

    Science.gov (United States)

    Fanfani, Francesco; Restaino, Stefano; Cicogna, Stefania; Petrillo, Marco; Montico, Marcella; Perrone, Emanuele; Radillo, Oriano; De Leo, Rossella; Ceccarello, Matteo; Scambia, Giovanni; Ricci, Giuseppe

    2017-07-01

    The aim of the study was to evaluate the prognostic value of human epididymis protein 4 (HE4) and cancer antigen 125 markers with pathological prognostic factor to complete the preoperative clinical panel and help the treatment planning. This prospective multicenter study was conducted in 2 gynecologic oncology centers between 2012 and 2014 (Institute for Maternal and Child Health IRCCS Burlo Garofolo in Trieste and Catholic University of the Sacred Heart in Rome, Italy). We enrolled 153 patients diagnosed with clinical early (International Federation of Gynecology and Obstetrics stages I-II) type I endometrial cancer. Human epididymis protein 4 levels seemed to be strictly related to age (P endometrial cancer type I versus type II (P = 0.86), the lymphovascular infiltration (P = 0.12), and the cervical invasion (P = 0.6). We established a new variable, considering 3 high-risk tumor features: MI of greater than 50% and/or histological G3 and/or type II. Human epididymis protein 4 levels significantly increase in high-risk tumors (high risk HE4, 93.6 pmol/L vs low-medium risk, 65.5 pmol/L; P < 0.001). A preoperative HE4 evaluation could help stratify patients with deep invasion and/or metastatic disease and is correlated with other relevant prognostic factors to be considered to tailor an adequate surgical strategy.

  14. The phenotypic equilibrium of cancer cells: From average-level stability to path-wise convergence.

    Science.gov (United States)

    Niu, Yuanling; Wang, Yue; Zhou, Da

    2015-12-07

    The phenotypic equilibrium, i.e. heterogeneous population of cancer cells tending to a fixed equilibrium of phenotypic proportions, has received much attention in cancer biology very recently. In the previous literature, some theoretical models were used to predict the experimental phenomena of the phenotypic equilibrium, which were often explained by different concepts of stabilities of the models. Here we present a stochastic multi-phenotype branching model by integrating conventional cellular hierarchy with phenotypic plasticity mechanisms of cancer cells. Based on our model, it is shown that: (i) our model can serve as a framework to unify the previous models for the phenotypic equilibrium, and then harmonizes the different kinds of average-level stabilities proposed in these models; and (ii) path-wise convergence of our model provides a deeper understanding to the phenotypic equilibrium from stochastic point of view. That is, the emergence of the phenotypic equilibrium is rooted in the stochastic nature of (almost) every sample path, the average-level stability just follows from it by averaging stochastic samples. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Levels of scientific evidence of the quality of life in patients treated for oral cancer.

    Science.gov (United States)

    Barrios, Rocío; Montero, Javier; González-Moles, Miguel-Angel; Baca, Pilar; Bravo, Manuel

    2013-07-01

    Treatments used in cancer of the oral cavity have great impact on the physical, psychological and functional state of patients. There has been increasingly interest in evaluating the health-related quality of life using questionnaires among patients treated with oral cancer. Up to our knowledge no review on this theme has incorporated the level of evidence of the single identified studies. The objective of the present study is to determinate results and conclusions about the health-related quality of life of these patients, in view of scientific evidence. In general, the diversity of designs, level of evidence and questionnaires used for their assessment does not affect results, which indicate a decline in the health related quality of life after treatment. This decline is greater when the tumor is large in size, and when radiotherapy is used, though the situation is seen to improve over the span of a year. Questionnaires on health-related quality of life provide concrete information regarding the impact of cancer treatment on patients.

  16. Symptomatic reduction in free testosterone levels secondary to crizotinib use in male cancer patients.

    Science.gov (United States)

    Weickhardt, Andrew J; Doebele, Robert C; Purcell, W Thomas; Bunn, Paul A; Oton, Ana B; Rothman, Micol S; Wierman, Margaret E; Mok, Tony; Popat, Sanjay; Bauman, Julie; Nieva, Jorge; Novello, Silvia; Ou, Sai-Hong Ignatius; Camidge, D Ross

    2013-07-01

    Crizotinib is a tyrosine kinase inhibitor active against ALK, MET, and ROS1. We previously reported that crizotinib decreases testosterone in male patients. The detailed etiology of the effect, its symptomatic significance, and the effectiveness of subsequent testosterone replacement have not been previously reported. Male cancer patients treated with crizotinib had total testosterone levels measured and results compared with non-crizotinib-treated patients. Albumin, sex hormone-binding globulin (SHBG), follicle-stimulating hormone (FSH), and/or luteinizing hormone (LH) were tracked longitudinally. A subset of patients had free testosterone levels measured and a hypogonadal screening questionnaire administered. Patients receiving subsequent testosterone supplementation were assessed for symptomatic improvement. Mean total testosterone levels were -25% below the lower limit of normal (LLN) in 32 crizotinib-treated patients (27 of 32 patients below LLN, 84%) compared with +29% above LLN in 19 non-crizotinib-treated patients (6 of 19 below LLN, 32%), P = .0012. Levels of albumin and SHBG (which both bind testosterone) declined rapidly with crizotinib, but so did FSH, LH, and free testosterone, suggesting a centrally mediated, true hypogonadal effect. Mean free testosterone levels were -17% below LLN (19 of 25 patients below LLN, 76%). Eighty-four percent (16 of 19) with low free levels, and 79% (19/24) with low total levels had symptoms of androgen deficiency. Five of 9 patients (55%) with low testosterone given testosterone supplementation had improvement in symptoms, coincident with increases in testosterone above LLN. Symptoms of androgen deficiency and free or total/free testosterone levels should be tracked in male patients on crizotinib with consideration of testosterone replacement as appropriate. Copyright © 2013 American Cancer Society.

  17. Alpha-tocopherol and alpha-tocopheryl quinone levels in cervical intraepithelial neoplasia and cervical cancer.

    Science.gov (United States)

    Palan, Prabhudas R; Woodall, Angela L; Anderson, Patrick S; Mikhail, Magdy S

    2004-05-01

    alpha-Tocopherol is a potent antioxidant that protects cell membranes against oxidative damage. Red blood cell alpha-tocopherol levels reflect membrane alpha-tocopherol concentrations, and altered levels may suggest membrane damage. The objective of this study was to determine the levels of alpha-tocopherol and alpha-tocopheryl quinone, the oxidized product of alpha-tocopherol, in plasma and red blood cells that were obtained from control subjects and patients with cervical intraepithelial neoplasia and cervical cancer. In this cross-sectional study, 72 women, (32 African American and 40 Hispanic) were recruited. Among these subjects, 37 women had cervical intraepithelial neoplasia; 14 women had cervical cancer, and 21 women were considered control subjects, who had normal Papanicolaou test results. alpha-Tocopherol and alpha-tocopheryl quinone levels were determined in red blood cell and plasma by high-pressure liquid chromatography. Plasma levels of alpha-tocopherol and alpha-tocopheryl quinone were decreased significantly (P=.012 and=.005, respectively, by Kruskal-Wallis test) in study groups compared with the control group; red blood cell levels of alpha-tocopherol and alpha-tocopheryl quinone were not altered significantly. The lower alpha-tocopherol level that was observed in this study is consistent with our previous reports of decreased antioxidant concentrations and increased oxidative stress in women with cervical intraepithelial neoplasia. Unaltered red blood cell alpha-tocopherol and alpha-tocopheryl quinone levels suggest undamaged cell membrane. Further studies are needed to investigate the potential role of oxidative stress in cervical intraepithelial neoplasia.

  18. Radiation oncology: physics advances that minimize morbidity.

    Science.gov (United States)

    Allison, Ron R; Patel, Rajen M; McLawhorn, Robert A

    2014-12-01

    Radiation therapy has become an ever more successful treatment for many cancer patients. This is due in large part from advances in physics including the expanded use of imaging protocols combined with ever more precise therapy devices such as linear and particle beam accelerators, all contributing to treatments with far fewer side effects. This paper will review current state-of-the-art physics maneuvers that minimize morbidity, such as intensity-modulated radiation therapy, volummetric arc therapy, image-guided radiation, radiosurgery and particle beam treatment. We will also highlight future physics enhancements on the horizon such as MRI during treatment and intensity-modulated hadron therapy, all with the continued goal of improved clinical outcomes.

  19. Prognostic Correlation Between MFG-E8 Expression Level and Colorectal Cancer.

    Science.gov (United States)

    Jia, Min; Yao, Huaning; Chen, Chao; Wang, Yueqin; Wang, Han; Cui, Tianpen; Zhu, Jianhua

    2017-04-01

    Colorectal cancer (CRC) is one of the leading causes of cancer-related death all over the world. Milk fat globule-epidermal growth factor (EGF)-factor VIII (MFG-E8) was found to be highly expressed in a variety of cancers. However its role in CRC is unclear. This study investigates the expression of MFG-E8 in CRC tissues and the correlation with clinicopathological features and prognosis in CRC patients. The expression of MFG-E8 proteins was detected by immunohistochemical staining in 90 samples of CRC. The localization of MFG-E8 in colorectal tumor was examined by immunofluorescence staining. The correlation between MFG-E8 protein expression and the clinical pathological features of CRC were evaluated by χ2 test and Fisher's exact test. The survival rates were analyzed by the Kaplan-Meier method, and the relationship between prognostic factors and patient survival was analyzed by the Cox proportional hazard models. Our results showed that MFG-E8 expression increased significantly in colorectal cancer compared with normal mucosa tissues (p <0.001). We further validated MFG-E8 overexpression in 6 pairs of fresh tumor and adjacent normal mucosa tissues from colorectal cancer patients by Western blot (p <0.05). Immunofluorescence staining showed that MFG-E8 accumulated in close proximity to endothelial cells in human colorectal tumor tissue. In addition, high MFG-E8 protein expression was correlated with lymph node metastasis and some pathological classifications (p <0.05). Furthermore, patients with high protein level of MFG-E8 showed shortened overall survivals (p <0.05). Our results showed that MFG-E8 could be a potential novel prognostic marker for CRC and overexpression of MFG-E8 might be involved in lymph node metastasis and angiogenesis of CRC. Copyright © 2017 IMSS. Published by Elsevier Inc. All rights reserved.

  20. Serum IGF-1, IGFBP-3 levels and circulating tumor cells (CTCs) in early breast cancer patients.

    Science.gov (United States)

    Papadakis, Georgios Z; Mavroudis, Dimitrios; Georgoulias, Vasilios; Souglakos, John; Alegakis, Athanasios K; Samonis, George; Bagci, Ulas; Makrigiannakis, Antonis; Zoras, Odysseas

    2017-04-01

    Insulin-like growth factor (IGF)-axis is involved in human oncogenesis and metastasis development for various solid tumors including breast cancer. Aim of this study was to assess the association between IGF-1, IGF-binding protein-3 (IGFBP-3) serum levels and the presence of circulating tumor cells (CTCs) in the peripheral blood of women diagnosed with early breast cancer (EBC), before and after adjuvant chemotherapy. 171 patients with early-stage breast adenocarcinomas were retrospectively evaluated. Immunoradiometric (IRMA) assays were employed for the in-vitro determination of IGF-1 and IGFBP-3 serum levels in blood samples collected after surgical treatment and before initiation of adjuvant chemotherapy. CTCs' presence was assessed through detection of cytokeratin-19 (CK-19) mRNA transcripts using quantitative real time reverse transcription polymerase chain reaction (RT-PCR). IGF-1, IGFBP-3 serum levels were correlated with CTCs' presence before and after adjuvant chemotherapy as well as with tumor characteristics including tumor size, axillary lymph node status, oestrogen (ER)/progestorene (PR) and human epidermural growth factor receptor 2 (HER2) receptor status. Log-rank test was applied to investigate possible association between IGF-1, IGFBP-3 serum levels and disease-free interval (DFI) and overall survival (OS). Before initiation of adjuvant therapy IGF-1, IGFBP-3 serum levels were moderately associated (Spearman's rho=0.361, p<0.001) with each other, while presenting significant differences across age groups (all p values<0.05). IGF-1 serum levels did not correlate with the presence of CTCs before initiation (p=0.558) or after completion (p=0.474) of adjuvant chemotherapy. Similarly, IGFBP-3 serum levels did not show significant association with detectable CTCs either before (p=0.487) or after (p=0.134) completion of adjuvant chemotherapy. There was no statistically significant association between the clinical outcome of patients in terms of DFI, OS

  1. Using the intraoperative hand held probe without lymphoscintigraphy or using only dye correlates with higher sensory morbidity following sentinel lymph node biopsy in breast cancer: A review of the literature

    Directory of Open Access Journals (Sweden)

    Travis Arlene

    2005-09-01

    Full Text Available Abstract Background There are no studies that have directly investigated the incremental reduction in sensory morbidity that lymphoscintigraphy images (LS and triangulated body marking or other skin marking techniques provide during sentinel lymph node biopsy (SLNB compared to using only the probe without LS and skin marking or using only dye. However, an indirect assessment of this potential for additional sensory morbidity reduction is possible by extracting morbidity data from studies comparing the morbidity of SLNB to that of axillary lymph node dissection. Methods A literature search yielded 13 articles that had data on sensory morbidity at specific time points on pain, numbness or paresthesia from SLNB that used radiotracer and probe or used only dye as a primary method of finding the sentinel node (SN. Of these, 10 utilized LS, while 3 did not utilize LS. By matching the data in studies not employing LS to the studies that did, comparisons regarding the percentage of patients experiencing pain, numbness/paresthesia after SLNB could be reasonably attempted at a cutoff of 9 months. Results In the 7 studies reporting on pain after 9 months (> 9 months that used LS (1347 patients, 13.8% of patients reported these symptoms, while in the one study that did not use LS (143 patients, 28.7% of patients reported these symptoms at > 9 months (P 9 months that used LS (601 patients, 12.5% of patients reported these symptoms, while in the 3 studies that did not use LS (229 patients, 23.1% of patients reported these symptoms at > 9 months (P = 0.0002. Similar trends were also noted for all these symptoms at ≤ 9 months. Conclusion Because of variations in techniques and time of assessing morbidity, direct comparisons between studies are difficult. Nevertheless at a minimum, a clear trend is present: having the LS images and skin markings to assist during SLNB appears to yield more favorable morbidity outcomes for the patients compared to performing

  2. Effect modification by drinking water hardness of the association between nitrate levels and gastric cancer: evidence from an ecological study.

    Science.gov (United States)

    Chiu, Hui-Fen; Kuo, Chao-Hung; Tsai, Shang-Shyue; Chen, Chih-Cheng; Wu, Deng-Chuang; Wu, Trong-Neng; Yang, Chun-Yuh

    2012-01-01

    The objectives of this study were to (1) examine the relationship between nitrate levels in public water supplies and risk of death from gastric cancer and (2) determine whether calcium (Ca) and magnesium (Mg) levels in drinking water might modify the effects of nitrate on the risk of gastric cancer development. A matched cancer case-control study was used to investigate the relationship between the risk of death attributed to gastric cancer and exposure to nitrate in drinking water in Taiwan. All deaths due to gastric cancer in Taiwan residents from 2006 through 2010 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Deaths from other causes served as controls and were pair-matched to cancer cases by gender, year of birth, and year of death. Information on the levels of nitrate-nitrogen (NO(3)-N), Ca, and Mg in drinking water were collected from Taiwan Water Supply Corporation (TWSC). The municipality of residence for cancer cases and controls was presumed to be the source of the subject's NO(3)-N, Ca, and Mg exposure via drinking water. Relative to individuals whose NO(3)-N exposure levels were water with a NO(3)-N exposure ≥ 0.38 ppm. There was apparent evidence of an interaction between drinking water NO(3)-N levels and low Ca and Mg intake via drinking water. Our findings showed that the correlation between NO(3)-N exposure and risk of gastric cancer development was influenced by Ca and Mg levels in drinking water. This is the first study to report effects modification by Ca and Mg intake from drinking water on the relationship between NO(3)-N exposure and risk of gastric cancer occurrence. Increased knowledge of the mechanistic interactions between Ca, Mg, and NO(3)-N in reducing risk of gastric cancer development will aid in public policy decisions and setting threshold standards.

  3. GLUT 1 receptor expression and circulating levels of fasting glucose in high grade serous ovarian cancer.

    Science.gov (United States)

    Pizzuti, Laura; Sergi, Domenico; Mandoj, Chiara; Antoniani, Barbara; Sperati, Francesca; Chirico, Andrea; Di Lauro, Luigi; Valle, Mario; Garofalo, Alfredo; Vizza, Enrico; Corrado, Giacomo; Tomao, Federica; Rinaldi, Massimo; Carpano, Silvia; Maugeri-Saccà, Marcello; Conti, Laura; Digiesi, Giovanna; Marchetti, Paolo; De Maria, Ruggero; Giordano, Antonio; Barba, Maddalena; Carosi, Maria A; Vici, Patrizia

    2018-02-01

    In recent years, the poorly remarkable goals achieved in terms of patients' important outcomes for ovarian cancer have fueled our interest toward the study of its metabolic roots. Within this research pipeline, we assessed the association between the expression of the glucose transporter GLUT1, as expressed at the tumor tissue level, and circulating pre-surgical levels of fasting glucose in a case series including data from 40 patients with high FIGO stage serous ovarian cancer. Patients who provided data to the current analysis were randomly selected from a larger cohort. To our purposes, the procedures related to serum and tissue collection, storage and biomarker assessment were highly standardized and centralized at the institutional laboratories. The GLUT1 antibody SPM498 SPRING (REF. E13810) was used at a 1:500 dilution in 2 µm slides. Staining for GLUT1 was observed at the cell membrane level in all the cases assessed, but strong staining was described in 29 (72.5%) of them. The agreement between the two independent reviewers was 100%. Strong GLUT1 staining was inversely associated with circulating levels of fasting glucose, with a particularly striking difference for patients in the lowest fasting glucose tertile (p = 0.044). These results support the biological plausibility of the association of interest. If confirmed in larger studies, our findings may help clarify the potentials of biomarkers related to energy metabolism in terms of prognosis definition, treatment assignment, and outcome interpretation for patients with high FIGO stage serous ovarian cancer. © 2017 Wiley Periodicals, Inc.

  4. Intracellular Carotenoid Levels Measured by Raman Microspectroscopy: Comparison of Lymphocytes from Lung Cancer Patients and Healthy Individuals

    NARCIS (Netherlands)

    Bakker schut, T.C.; Bakker Schut, Tom C.; Puppels, Gerwin J.; Puppels, G.J.; Kraan, Yvonne M.; Greve, Jan; van der Maas, Louis L.J.; Figdor, Carl

    1997-01-01

    Most studies concerning a possible protective role of carotenoids against cancer focus on serum carotenoid levels. We have used Raman microspectroscopy to study the intracellular amounts of carotenoids in lymphocytes of lung cancer patients and of healthy individuals. Our results indicate a

  5. The Prognostic Value of Adaptive Nuclear Texture Features from Patient Gray Level Entropy Matrices in Early Stage Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Birgitte Nielsen

    2012-01-01

    Full Text Available Background: Nuclear texture analysis gives information about the spatial arrangement of the pixel gray levels in a digitized microscopic nuclear image, providing texture features that may be used as quantitative tools for prognosis of human cancer. The aim of the study was to evaluate the prognostic value of adaptive nuclear texture features in early stage ovarian cancer.

  6. Licochalcone A induces T24 bladder cancer cell apoptosis by increasing intracellular calcium levels.

    Science.gov (United States)

    Yang, Xinhui; Jiang, Jiangtao; Yang, Xinyan; Han, Jichun; Zheng, Qiusheng

    2016-07-01

    Licochalcone A (LCA) has been reported to significantly inhibit cell proliferation, increase reactive oxygen species (ROS) levels, and induce apoptosis of T24 human bladder cancer cells via mitochondria and endoplasmic reticulum (ER) stress-triggered signaling pathways. Based on these findings, the present study aimed to investigate the mechanisms by which LCA induces apoptosis of T24 cells. Cultured T24 cells were treated with LCA, and cell viability was measured using the sulforhodamine B assay. Apoptosis was detected by flow cytometry with Annexin V/propidium iodide staining, and by fluorescent microscopy with Hoechst 33258 staining. The levels of intracellular free calcium ions were determined using Fluo-3 AM dye marker. Intracellular ROS levels were assessed using the 2',7'-dichlorodihydrofluorescein diacetate probe assay. The mitochondrial membrane potential was measured using 5,5',6,6'-tetrachloro-1,1',3,3'-tetraethyl benzimidazole carbocyanine iodide. Furthermore, the mRNA expression levels of B‑cell lymphoma (Bcl)‑extra large, Bcl‑2‑associated X protein, Bcl‑2‑interacting mediator of cell death, apoptotic protease activating factor‑1 (Apaf‑1), calpain 2, cysteinyl aspartate specific proteinase (caspase)‑3, caspase‑4 and caspase‑9 were determined using reverse transcription semiquantitative and quantitative polymerase chain reaction analyses. Treatment with LCA inhibited proliferation and induced apoptosis of T24 cells, and increased intracellular Ca2+ levels and ROS production. Furthermore, LCA induced mitochondrial dysfunction, decreased mitochondrial membrane potential, and increased the mRNA expression levels of Apaf‑1, caspase‑9 and caspase‑3. Exposure of T24 cells to LCA also triggered calpain 2 and caspase‑4 activation, resulting in apoptosis. These findings indicated that LCA increased intracellular Ca2+ levels, which may be associated with mitochondrial dysfunction. In addition, the ER stress pathway may be

  7. Physiological normal levels of androgen inhibit proliferation of prostate cancer cells in vitro

    Directory of Open Access Journals (Sweden)

    Weitao Song

    2014-12-01

    Full Text Available For more than 70 years, it has been believed that a severe reduction of serum androgen levels caused regression of prostate cancer (PCa and that increasing androgen levels enhanced growth of PCa. However, numerous recent studies have questioned this traditional belief. In our study, LNCaP and MDA PCa 2b PCa cells were treated with various levels of androgens for 10 or 20 days, and the cell growth was measured with crystal violet mitogenic assay. The results indicated that the effect of androgens on the proliferation of PCa cells occurs in a biphasic pattern, with the androgen levels promoting optimal cell growth at approximately 0.23 ng ml−1 for LNCaP cells and between 1 and 2 ng ml−1 for MDA PCa 2b cells. Both of the optimal androgen levels are within the adult men's physiological low range (<2.4 ng ml−1 . At lower concentrations than the optimal androgen level, increasing androgen concentration promoted the proliferation of PCa cells. However, at the higher concentrations, increasing androgen concentration resulted in a dose-dependent proliferative inhibition. We conclude that physiologically normal levels of androgen inhibit the proliferation of PCa cells in vitro. However, at very low levels androgens are essential for initial growth of PCa cells.

  8. Educational level, voluntary private health insurance and opportunistic cancer screening among women in Catalonia (Spain).

    Science.gov (United States)

    Borràs, J M; Guillen, M; Sánchez, V; Juncà, S; Vicente, R

    1999-10-01

    Health care services in Catalonia (Spain) are organized in a national health service with universal population coverage and include preventive services such as mammography and Pap tests. In addition to