Nevin Manimala

Clin Radiol. 2024 Dec 4;81:106765. doi: 10.1016/j.crad.2024.106765. Online ahead of print.

ABSTRACT

AIM: To evaluate predictive chest computed tomography (CT) findings associated with the development of adult T-cell leukemia/lymphoma (ATLL) in human T-lymphotropic virus type I (HTLV-1) carriers.

MATERIALS AND METHODS: This retrospective study examined 171 adult T-cell leukemia/lymphoma and 158 HTLV-1 carriers who were treated from November 2004 to April 2021. The radiological features of 888 chest CT scans in total were retrospectively assessed by two chest radiologists who were unaware of the underlying diagnoses and compared between the groups.

RESULTS: In patients with aggressive type ATLL (acute type and lymphoma type), lymph node enlargement was the most frequently observed abnormality (65.2%), followed by ground-glass opacity (33.3%) and pleural effusion (30.4%). In patients with indolent type (chronic type and smoldering type), lymph node enlargement, and bronchiectasis were the most frequently observed abnormalities (5.6% and 5.6%, respectively). In each type, centrilobular nodules were observed in none and in one patient, respectively. In the 158 HTLV-1 carriers, centrilobular nodules (n = 62; 39.2%) were the most frequently observed abnormality. Centrilobular nodules were significantly frequently observed in HTLV-1 carriers compared with ATLL patients. No HTLV-1 carrier with centrilobular nodules on CT developed ATLL during the duration of care. A comparative analysis between CT scans performed before ATLL development in ATLL patients and those of HTLV-1 carriers showed that no centrilobular nodules were observed on the pre-ATLL CT scans, and a statistically-significant difference in centrilobular nodules was found between these two groups.

CONCLUSION: The presence of centrilobular nodules may be an indicative CT finding in HTLV-1 carriers who are less likely to develop ATLL.

PMID:39733476 | DOI:10.1016/j.crad.2024.106765

J Surg Res. 2024 Dec 28;305:349-355. doi: 10.1016/j.jss.2024.12.006. Online ahead of print.

ABSTRACT

INTRODUCTION: Primary hyperparathyroidism (PHPT) is more prevalent in populations with obesity. Obesity-related vitamin D deficiency may affect rates of multigland parathyroid disease, but this relationship is less clear. We aimed to assess the relationship between obesity and the rate of multigland disease in patients with PHPT.

METHODS: Patients who underwent parathyroidectomy from 2015 to 2021 for sporadic PHPT at a tertiary center were retrospectively analyzed. The primary outcome was rates of single-gland versus four-gland parathyroid hyperplasia in relation to obesity. Secondary outcomes included analysis of serum biochemistries [parathyroid hormone (PTH), calcium, 25(OH) vitamin D (25OHD)] before and 6 mo postoperatively based on obesity classification: no obesity (body mass index [BMI] <30 kg/m²), Class 1 (BMI 30-34.9 kg/m²), Class 2 (BMI 35-39.9 kg/m²), Class 3 (BMI ≥40 kg/m²). Statistical analysis was performed using Chi-square, Mann-Whitney U, and Kruskal-Wallis tests where applicable.

RESULTS: Of 2634 patients who underwent parathyroidectomy, a total of 1173 had obesity. Obesity did not confer any differences in the proportion of four-gland versus single-gland hyperplasia (25 versus 26%, P = 0.79). Compared to patients without obesity, preoperative PTH levels were higher in patients with Class 2 [86 (interquartile range [IQR] 66-118) versus 95 (IQR 70-137) pg/mL, P = 0.001] and Class 3 [86 (IQR 66-118) versus 104 (76-150) pg/mL, P < 0.001] obesity. Conversely, 25OHD before surgery was lower across obesity subclasses [no obesity: 36.0 (25.3-49.3), Class 1: 32.5 (24.0-46.0), Class 2: 32.9 (22.0-44.6), Class 3: 31.7 (20.4-45.0) ng/mL, P < 0.001]. Postoperative PTH and 25OHD improved in all cohorts. No calcium-related differences were found among patients based on obesity classification.

CONCLUSIONS: Obesity is not associated with an increased rate of four-gland hyperplasia in patients with PHPT, and therefore should not alter surgical management. The levels of 25OHD in patients with obesity should be monitored for vitamin deficiency preoperatively and postoperatively.

PMID:39733472 | DOI:10.1016/j.jss.2024.12.006

Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4397-4406. doi: 10.31557/APJCP.2024.25.12.4397.

ABSTRACT

OBJECTIVE: The purpose of this research intended to determine the impact of an multi-component exercise program on body composition and physical, emotional and social well being (PWB, EWB,SWB) in breast cancer survivors (BCS). Methods: One hundred and thirty two eight women with BC were enrolled in this research based on inclusion and exclusion criteria and were randomized into group A and B. Group A received breast cancer (BC) support group therapy whereas group B received multi-component exercise program. Waist Hip ratio (WHR), Body Mass Index (BMI), Circumference measurement and Functional Assessment of Cancer Therapy Breast (FACT-B) scale were employed as outcome measures. To validate the outcomes, pre- and post-assessments of the mentioned measures were conducted. Statistical evaluation was conducted with SPSS statistical software (version 26.0).

RESULTS: The findings revealed considerable improvement among the group for homolateral and contralateral arm and forearm, right and left thigh and right and left leg circumference (p=0.0087,0.0162, 0.0061, 0.0048, 0.0266,0.0142,0.0364, 0.0021), FACT-B (p=0.008, 0.002, 0.007,0.01,0.001,<0.0001), conversely no significant enhancement was observed for BMI (p=0.743) and WHR (p=0.6614) of patients undergoing multi-component exercise as compared to other group. Also, significant improvement between the groups was observed for circumference(0.0478,0.0305,0.0279,0.0240,0.0374,0.0293,0.0420,0.0334,0.0449,0.0260,0.0412 ,0.0160,0.0454,0.0324,0.0375,0.0214), FACT-B (0.51, 0.045, 0.313, 0.238, 0.593, 0.049, 0.405, <0.0001, 0.190, 0.015,0.131,0.176,0.006,<0.0001), conversely no significant enhancement was observed for BMI (p=0.9634, 0.364), WHR (p=0.988, 0.915) at post treatment 6 month and 1 year.

CONCLUSION: The study concluded that multi-component exercise program had shown a significant effect on body composition and PWB, EWB, SWB among BCS.

PMID:39733433 | DOI:10.31557/APJCP.2024.25.12.4397

Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4391-4396. doi: 10.31557/APJCP.2024.25.12.4391.

ABSTRACT

OBJECTIVE: Aim of the study was to evaluate and compare the prevalence female sexual dysfunction (FSD) in cervical cancer (CC) survivors to a healthy female population.

MATERIALS AND METHODS: This observational prospective trial was conducted at Thammasat University Hospital, Thailand, between April 2023 and February 2024. Participants were CC survival who attended an outpatient cancer clinic. Subject with age between 30 and 60 years old and engaged in sexual intercourse at least once within the last 4 weeks were recruited. The control group was women who attended outpatient gynecologic clinic for routine pelvic examination with no serious medical diseases and no malignancy. The female sexual function index (FSFI) was applied to all the participants during the survey. Other demographic data of the participants were collected.

RESULTS: A total of 116 cases were enrolled in the study. Participants were equally divided into the study and control groups. The mean age and BMI of participants were 49.4 years and 24.7 kg/m², respectively without statistical significance. The FSD’s prevalence of the CC survival was significantly higher than control group (34.5 and 10.4 percent, respectively). CC survivors reported significantly poorer outcomes in the domains of lubrication, sexual satisfaction, and pain compared to the control group.

CONCLUSION: The prevalence rates of CC survival and control group was 34.5 and 10.4 percent, respectively. Three out of six FSFI domains namely lubrication, satisfaction, and pain showed more problematic for CC survivors compared to control group.

PMID:39733432 | DOI:10.31557/APJCP.2024.25.12.4391

Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4371-4380. doi: 10.31557/APJCP.2024.25.12.4371.

ABSTRACT

BACKGROUND: Cancer screening is a crucial component in the fight to reduce cancer incidence and mortality. Currently, the WHO recommends highly effective cancer screening programs, including screening for cervical cancer (CC), breast cancer (BC), and colorectal cancer (CRC). Despite the implementation of a cancer screening program since 2014, an evaluation of the effectiveness of BC, CC, and CRC screening in the Kazakhstan has not yet been conducted. Study aimed to assess the effectiveness and coverage of BC, CC, and CRC screening in the Republic of Kazakhstan during the period from 2021 to 2023.

METHODS: Data for the retrospective analysis were extracted from the “Healthcare Statistics” database. Data on participants eligible for screening (n=8,167,184) for BC, CC, and CRC were included in the analysis.

RESULTS: In 2023, there was a noticeable decrease in the number of detected cases of CC (1.7) compared to previous years. The detection rates for BC (14) and CRC (around 1) per 100,000 population in 2023 remained almost at the same level as in previous years. The detection rate for BC was 0.74% in 2021, followed by a decline to 0.59% in 2022. In 2023, there was an increase to 1.69%. As for CC, the detection rate was 0.70% in 2021, it increased to 0.77% in 2022, but then decreased again to 0.53% in 2023. CRC shows a steady decline in detection rates. In 2021, the detection rate was 4.23%, then it dropped to 3.64% in 2022, and continued to decrease to 3.28% in 2023.

CONCLUSIONS: The data for 2021-2023 underscore the necessity for continuous monitoring, analysis, and adaptation of screening strategies, taking into account regional peculiarities and new challenges, such as the pandemic. Ensuring high screening coverage for BC, CC, and CRC is a key factor for the early detection and effective treatment of these diseases.

PMID:39733430 | DOI:10.31557/APJCP.2024.25.12.4371

Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4359-4369. doi: 10.31557/APJCP.2024.25.12.4359.

ABSTRACT

BACKGROUND: Cancer is a major cause of morbidity and mortality in Tunisia. The objectives of our study were to estimate the incidence level of the main cancer sites in Northern Tunisia in 2023 and to dress projections till 2040.

METHODS: The population based cancer registry database of northern Tunisia was the source of cases of this study. This registry uses the active method to collect data from all health services that cover cancer patients of both public and private sectors. Incidence rate projections were established using the age-period-cohort model.

RESULTS: In 2023, according to our estimations, age standardized incidence rate (ASR) including skin cancers other than melanoma was of 165.9 /100,000 in males and 141.4/100,000 in females. In men, the five most common cancer locations (apart from the skin) were: lung with an ASR of 37.6/100,000 habitant, colorectal (29.4/100,000), bladder (24.1/100,000), prostate (15.2/100,000) and stomach (6.0/100,000). Concerning females, the top five locations (apart from the skin) were: breast (55.4/100,000), colorectal (23.0/100,000), corpus uteri (9.3/100,000), thyroid (9.0/100,000) and lung (5.8/100,000). By 2040, the incidence rates of colorectal cancer would reach more than the double in both genders. The ASR of lung and bladder cancers in males would be increasing; however, that of stomach cancer would be stable next decades. In females, while incidence rates of breast, thyroid and corpus uteri cancers would reach more than the double in 2040, cervical cancer incidence is expected to be stable next decades.

CONCLUSION: Cancer incidence level in Northern Tunisia place the country in an intermediate level and projections seem to be worrying. Strengthening prevention, screening and early diagnosis are strongly recommended.

PMID:39733429 | DOI:10.31557/APJCP.2024.25.12.4359

Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4339-4349. doi: 10.31557/APJCP.2024.25.12.4339.

ABSTRACT

OBJECTIVE: Of this study was to analyse the correlation of gene polymorphisms with clinical and laboratory data of paediatric patients with B-lineage acute lymphoblastic leukaemia with prognostically unfavourable features.

METHODS: A study of 200 children with B-lineage acute lymphoblastic leukaemia (B-ALL) treated with polychemotherapy programmes was conducted. Analysis by sex revealed a statistically insignificant predominance of the group of boys over girls (54%). The mean age of the subjects was 9.3±0.2 years. Genotyping of polymorphic loci was performed using TaqMan method of single site-specific amplification and genotyping. The data of patients with initial prognostically unfavourable clinical and laboratory data in the form of initial leukocytosis from 50 to 99 thousand – 10 (5%), over 100 thousand – 16 (8%), initial CNS lesion in the form of neuroleukaemia – 5 (2.5%), initial splenomegaly more than 6 cm – 12 (6%); patients with poor response to therapy, having absolute number of blast cells in peripheral blood over 1,000 on day 8 of treatment according to the protocol (response to prednisolone prophase) – 13 (7%), with unsatisfactory response to treatment on Day 15 – 40 patients (20%) and on Day 33 – 4 children (2%); also patients who developed relapse of the disease – 17 (9%).

RESULTS: According to the findings, of all 24 gene variants, 13 variants (54%), namely, HLA – rs6457327, TNF – rs1800630 and rs2229094, GATA3 – rs3824662, TP53 – rs1042522, CASP9 – rs4661636, CASP8 – rs10505477, CEBPE – rs2239633; PIP4K2A – rs7088318, CASC8 – rs10505477, IRF4 – rs87207, CYP1A1 – rs4646903 and rs7089424 of ARID5B gene were found to be associated with B-ALL and unfavourable prognostic features.

CONCLUSIONS: The findings of this study revealed significant associations of polymorphic genetic variants, which may serve as a basis for the development of effective methods for predicting the risk of relapse development and the timeliness of intensification of B-ALL treatment. Prompt genetic counselling of children with identified unfavourable genotypes of the investigated gene polymorphisms will make it possible to predict the development of relapse, resistance and/or poor response to B-ALL treatment, and to propose an individual strategy for monitoring children’s health in the short and long term.

PMID:39733427 | DOI:10.31557/APJCP.2024.25.12.4339

Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4333-4338. doi: 10.31557/APJCP.2024.25.12.4333.

ABSTRACT

OBJECTIVE: This study aims to evaluate the efficacy of premedication protocols in preventing immediate hypersensitivity reactions (HSRs) to taxane chemotherapy by comparing protocols that omit H2 antagonists with those that include famotidine.

METHODS: This was an open-label, single-center, randomized clinical trial. Randomization was 1:1 to two groups. The experimental arm omitted H2 antagonists from the premedication protocol, while the control arm included famotidine. The efficacy of the premedication protocol for preventing HSRs in the experimental group was compared with that of the control group using a multilevel regression analysis with a random intercept and random effect model.

RESULTS: Between September 2022 and December 2023, 150 patients enrolled. The group without H2 antagonists had 331 cycles, averaging 3.15 per patient. The famotidine group had 327 cycles, averaging 3.39 per patient. The total number of cycles was not significantly different (p = 0.951). There were six HSRs (1.81%) in the group without H2 antagonists and five (1.53%) in the famotidine group. The HSRs risk difference between groups was 0.28% (95% CI -0.02 to 0.02, p = 1.000). A multilevel regression analysis with a random intercept and effect model compared the efficacy of premedication protocols for preventing HSRs between the experimental and control groups. The risk ratio for HSRs in the group without H2 antagonists was 1.00, which was not statistically significant compared to the famotidine group (95% CI 0.98 to 1.04, p = 0.528).

CONCLUSION: The clinical trial demonstrated that omitting the H2 antagonists premedication protocol for taxane chemotherapy is as effective in preventing HSRs as using famotidine. These findings suggest that this protocol can be implemented in clinical practice.

PMID:39733426 | DOI:10.31557/APJCP.2024.25.12.4333

Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4323-4331. doi: 10.31557/APJCP.2024.25.12.4323.

ABSTRACT

BACKGROUND: Breast surgery, radiation, chemotherapy and modified radical mastectomy (MRM) may cause long-term side effects such as decreased muscle strength, pulmonary function, cardio-respiratory fitness (CRF), altered body fat distribution and poor sleep quality. These short- and long-term repercussions have an enormous effect on physical functioning in this population. The goal of this research was to determine the effect of a multi-component exercise program on functional performance in breast cancer survivors.

METHODS: In this research, 132 women with breast cancer were selected based on specific inclusion criteria. Participants were separated in a pair of two groups: the control group, which participated in breast cancer support group therapy, and the experimental group, which engaged in a multi-component exercise program. Each group consisted of 66 participants. The study assessed functional performance using a 12-minute walk test and a sit-to-stand test. Over a year, the breast cancer support group and the multi-component fitness program were implemented. Pre- and post-assessments were used to determine the effectiveness of the multi-component workout program. Statistical evaluation was executed utilizing SPSS statistical software (version 26.0 for Windows; SPSS, Inc., Chicago, USA) to obtain the results.

RESULTS: The study findings indicate significant improvements in functional performance for the experimental group. Specifically, the sit-to-stand test showed extremely significant results (p-value of 0.0002), and the 12-minute walk test also demonstrated significance (p-value of 0.008). These positive outcomes highlight the effect of the multi-component exercise program in enhancing physical performance in breast cancer survivors.

CONCLUSION: The study revealed that both of the control group as well as the experimental group exhibited impaired functional performance in measures of outcome including 12-minute walk tests well as sit-to-stand test before the intervention. However, the multi-component exercise program had a notable positive impact on muscle performance among breast cancer survivors.

PMID:39733425 | DOI:10.31557/APJCP.2024.25.12.4323

Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4305-4311. doi: 10.31557/APJCP.2024.25.12.4305.

ABSTRACT

OBJECTIVE: Despite the Ministry of Public Health’s initiative to involve local governments in waste management through the establishment of sewage treatment ponds aimed at disrupting the life cycle of Opisthorchis viverrini (OV), the majority of areas still lack adequate sewage treatment facilities. This action research sought to develop an environmental management model (EMM) to prevent OV and cholangiocarcinoma (CCA) in a high-risk region of Thailand.

METHODS: The study identified two primary target groups: a process development group comprising 20 participants and an evaluation group comprising 32 participants. Research tools involved structured interviews using questionnaires and focus group discussions. Quantitative data were analyzed using descriptive and inferential statistics, with a paired t-test employed for specific comparisons. Qualitative data were examined through content analysis.

RESULTS: The findings were categorized into three key aspects: (1) The contextual factors and challenges related to OV and CCA were analyzed using an epidemiologic triangle framework. (2) Model development: The Appreciation-Influence-Control (A-I-C) method facilitated several activities, including knowledge dissemination, raising awareness among local administrators, training environmental surveillance volunteer leaders (ESVL), developing public relations materials, conducting food waste management training, and constructing a sewage treatment system. (3) Model evaluation: Significant improvements (p<0.05) were observed in participants’ knowledge, attitudes, behaviors, and health beliefs regarding OV and CCA prevention. The outcome of these efforts led to the creation of a new model, termed the “KALMeFS Model,” which comprises K=Knowledge; A=Authority (raising awareness among administrators); L=Leader (establishing ESVLs); Me=Media development; F=Food waste management; and S=Sewage management.

CONCLUSION: The initial steps toward establishing an effective EMM for OV and CCA prevention involved comprehensive planning, knowledge dissemination, standard-setting, and implementation. Monitoring and evaluation are critical to ensuring the long-term success of CCA prevention efforts in Thailand.

PMID:39733423 | DOI:10.31557/APJCP.2024.25.12.4305