Nevin Manimala

J BUON. 2021 Jul-Aug;26(4):1398-1404.

ABSTRACT

PURPOSE: Recently, neoadjuvant treatment approach has gained importance in locally advanced HER-2 positive breast cancer. Adding pertuzumab increases pathological complete response (pCR). In this study, we aimed to examine the clinicopathologic features that predict the pCR in patients receiving neoadjuvant pertuzumab, trastuzumab, and chemotherapy in locally advanced HER2 positive breast cancer.

METHODS: Locally advanced HER2 positive breast cancer patients who were followed up in 4 different oncology centers and received 4 cycles of pertuzumab, trastuzumab and taxane were retrospectively evaluated. A total of 58 (92%) patients received anthracycline chemotherapy before combination of dual her-2 blockade and taxanes. Fisher’s and chi-square tests were used for nominal variables and numeric data analyses.

RESULTS: A total of 63 female patients were included in the study. Their median age was 46 years (21-75) and 40 (63.5%) patients were premenopausal. Median tumor size was 25 mm (2-70) and there were 22 (34.9%) patients with Stage 3a. pCR was 66% and 75% in the whole group and in the hormone negative group, respectively. Statistically significant increase was found in pCR in patients with grade 3 tumors and cerbB2 with 3+ immunohistochemical staining. No relationship was found between pCR and age at diagnosis, menopausal status, tumor infiltrating lymphocyte, dose-dense anthracycline, Ki67≥40, body mass index (BMI) ≥ 30 kg/m2 and accompanying DCIS.

CONCLUSION: Four cycles of pertuzumab, trastuzumab and taxane after neoadjuvant anthracycline for locally advanced HER2 breast cancer are associated with increased pCR in patients with grade 3 tumors and high cerbB2 expression.

PMID:34564997

J BUON. 2021 Jul-Aug;26(4):1373-1378.

ABSTRACT

PURPOSE: The objective of this study was to investigate the therapeutic effect and safety of three-dimensional digital subtraction angiography (3D-DSA) in interventional therapy for hepatocellular carcinoma (HCC) patients.

METHODS: A total of 62 HCC patients who underwent interventional therapy were selected and divided into control group (n=31, receiving ordinary two-dimensional DSA) and observation group (n=31, undergoing 3D-DSA). The dosage of contrast agent, operation time and exposure dose were compared between the two groups. Besides, the effective rate, success rate of superselective arterial catheterization, lipiodol deposition rate and the incidence rate of complications of the two groups were observed and recorded.

RESULTS: Compared with those in control group, the dose of contrast agent and exposure dose were lower in observation group, and the operation time in the former was significantly shorter than that in the latter. The effective rate was 74.19% in observation group and 48.39% in control group. Moreover, in comparison with control group, operation group exhibited a higher effective rate, a higher success rate of superselective arterial catheterization and a higher lipiodol deposition rate, showing statistically significant differences (p<0.05). Besides, the incidence rate of complications (including myelosuppression, gastrointestinal discomfort and infection, 4.88%) in observation group was markedly lower than that in control group (25.81%) (p<0.05).

CONCLUSION: 3D-DSA under contrast guidance during interventional treatment of patients with HCC can significantly improve the therapeutic effect, and it is of great importance to reduce the incidence rate of complications and enhance the safety of interventional treatment.

PMID:34564994

J BUON. 2021 Jul-Aug;26(4):1298-1305.

ABSTRACT

PURPOSE: We aimed to evaluate the efficacy and safety of helical tomotherapy (HT) combined with computed tomography (CT)-guided three-dimensional intracavitary brachytherapy (CT-ICBT) in the treatment of locally advanced cervical cancer.

METHODS: A total of 96 patients with locally advanced cervical cancer (IIB-IIIB) treated were retrospectively analyzed. They underwent concurrent radiochemotherapy, and the chemotherapy regimen paclitaxel + cisplatin was given for 3 weeks. The patients were divided into HT+CT-ICBT group (n=48) and intensity-modulated radiotherapy (IMRT) + two-dimensional ICBT (IMRT+ICBT group, n=48) according to the different extracorporeal and intracavitary radiotherapies. The short-term clinical efficacy, and short- and long-term adverse reactions were compared between the two groups, the tumor recurrence and survival status were recorded through follow-up, and the overall survival (OS) and progression-free survival (PFS) rates were compared between the two groups.

RESULTS: The patient general clinical characteristics were comparable in both groups. The short-term clinical effective rate was 91.7% (44/48) and 87.5% (42/48), respectively, in HT+CT-ICBT group and IMRT+ICBT group. In the two groups, the incidence rate of grade 3-4 chronic radiation proctitis was 4.2% (2/48) and 22.9% (11/48), while that of grade 3-4 chronic radiation cystitis was 2.1% (1/48) and 18.7% (9/48), respectively. According to the follow-up results, the 3-year OS was 85.4% (41/48) and 77.1% (37/48), and the 3-year PFS was 81.3% (39/48) and 70.8% (34/48), respectively, in the two groups. Log-rank test showed that the 3-year OS and PFS had no statistically significant differences (p=0.395, p=0.401).

CONCLUSION: HT+CT-ICBT is safe and effective in the treatment of locally advanced cervical cancer, and it has similar short-term clinical efficacy and long-term survival rate compared with IMRT+ICBT, which also significantly reduces the long-term incidence of radiation proctitis and cystitis, so it is worthy of popularization and application.

PMID:34564984

J BUON. 2021 Jul-Aug;26(4):1266-1270.

ABSTRACT

PURPOSE: Never before the preoperative quality of life (QoL) score of colorectal cancer (CRC) patients was analyzed and linked directly to cancer staging according to pathology in specimens and, thereafter, in patients to estimate long-term prognosis. Our study attempted to give answers to these questions.

METHODS: This was a prospective study of 80 elderly patients who underwent major colorectal surgery for cancer in a single University’s surgical department conducted between 01/2018 and 12/2018. All patients aged >65 years, diagnosed with a resectable CRC without metastatic disease undergoing an elective surgery were prospectively included. As exclusion criteria were considered age <65 years, an emergency operation, non-resectable tumor, stage IV CRC and American Society of Anesthesiologists (ASA) score IV. All patients were asked to answer a self-administered questionnaire of the validated Greek version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30.

RESULTS: Comparison of the mean score of EORTC QLQ-C30 showed stage I CRC was 87.62% (11.81%), 77.24% (12.91%) in stage II patients and 78.99% (15.25%) in stage III cancer. The mean difference between the three groups was statistically significant (p=0.002). Moreover, in post-hoc analysis, there was a statistically significant difference in the mean QLQ-C30 score between patients with stage I and stage II cancer (p=0.043) and between patients with stage I and stage III tumor (p=0.01), but this difference was not observed when comparing patients with stage II and III cancer (p=0.319).

CONCLUSION: Our study demonstrated a significant association between preoperative QoL and tumor staging as shown in the specimen’s examination in elderly patients with CRC. More prospective studies are needed to elucidate how QoL and its fluctuations during the postoperative period can be correlated with long-term survival and disease progression in elderly CRC patients.

PMID:34564980

J BUON. 2021 Jul-Aug;26(4):1226-1230.

ABSTRACT

PURPOSE: The purpose of this study was to explore the clinical diagnostic value of combined detection of multiple tumor markers (CEA, CA242, CA19.9 and CA125) and blood lipid indexes in colorectal cancer, and to analyze their predictive effect on adverse reactions after chemotherapy.

METHODS: The clinical data of 35 patients with colorectal adenoma, 64 patients with colorectal cancer I-II and 29 patients with colorectal cancer III-IV were retrospectively analyzed. All the patients were admitted to our hospital from April 2017 to December 2019. The antigen level of tumor markers and the plasma level in patients were detected before surgery to compare the expression difference of different tumor types. The Youden index, sensitivity and specificity of the four tumor markers were compared when used alone or in combination.

RESULTS: After one year of follow-up, the levels of tumor markers in patients with tumor metastasis were significantly higher than those in patients without tumor metastasis, with a statistically significant difference (p<0.001). The combination of four markers was better than single tumor marker in the evaluation indexes of diagnostic effect. The combined detection of multiple tumor markers and blood lipid indexes was correlated with the occurrence of five adverse reactions of chemotherapy (p<0.05).

CONCLUSION: The detection of multiple tumor markers and blood lipid indexes can effectively improve the diagnosis of colorectal cancer and enhance the predictive effect on adverse reactions of chemotherapy. HDL, LDL and ApoAI indexes can be used to diagnose the benign and malignant properties of tumors, and determine the clinical stages.

PMID:34564974

Wound Repair Regen. 2021 Sep 25. doi: 10.1111/wrr.12969. Online ahead of print.

ABSTRACT

To investigate whether the addition of human recombinant epidermal growth factor (h-EGF) to 2% carboxymethyl cellulose gel is more effective in diabetic wound healing than standard treatment, a pilot, double-blind, randomized and controlled clinical trial with therapeutic intervention was performed at a university hospital. The sample consisted of 25 patients (14 in the intervention group that used rh-EGF and 11 in the control group that used 2% carboxymethyl cellulose gel). Data were tabulated in SPSS and analysed by intention to treat, without loss or exclusion of participants. Twenty-five subjects participated with a mean age of 60.6 years, a predominance of males in both groups and 100% prevalence of type-2 diabetes. Within 12 weeks, complete wound healing occurred in three ulcers in the intervention group versus one ulcer in the control group. The percent reduction in the wound area was significantly higher in the intervention group than in the control group (p = 0.049). Concerning the types of tissue, an increase in granulation and epithelial tissue and a reduction in exudate levels were observed in both groups. Decreased slough occurred only in the intervention group. No participant experienced serious or local adverse events during the study period. This study shows that h-EGF is effective, with a statistically significant reduction in wound area, improvement of tissue quality, and safe treatment of chronic wounds. In addition, this study demonstrated that blinding of participants during research using h-EGF is feasible.

PMID:34563097 | DOI:10.1111/wrr.12969

Eur J Investig Health Psychol Educ. 2021 Aug 19;11(3):923-932. doi: 10.3390/ejihpe11030068.

ABSTRACT

Medical students tend to use the internet as a primary resource when seeking health information. This study aims to assess the patterns of internet use, eHL level, and learning outcomes with eHL among medical students at Chiang Mai University. A cross-sectional study was conducted among 88 medical students in the first clinical year. The eHL level was determined using the Thai version of the electronic Health Literacy Scale or eHEALS. The patient case report scores were obtained representing the learning outcome. Linear regression was used to identify factors influencing their eHL level and case report scores. Students recognized the importance and usefulness of the internet. The mean eHEALS score was 33.45. There was a lower degree of agreement on questions regarding internet usage, having skills to evaluate the resources, and confidence in using health information to make health decisions. The eHEALS score had no statistically significant association with most variables and case report scores, but with the longer time of internet use (p-value = 0.014). Although medical students perceived that they have high eHL levels, they report lower confidence in using the information. Including critical thinking skills for electronic health information in the medical curriculum could be useful.

PMID:34563081 | DOI:10.3390/ejihpe11030068

Eur J Investig Health Psychol Educ. 2021 Aug 17;11(3):878-893. doi: 10.3390/ejihpe11030065.

ABSTRACT

Difficulties that junior adolescents (aged 11-13 years old) experience in terms of academic adaptation, which are indicated through school anxiety and academic wellbeing characteristics, often lead to a dramatic decrease in academic performance, behavioral problems, and deterioration of their health. The purpose of this investigation is to determine the structure of characteristics of school wellbeing/ill-being of junior adolescents and their role in variations of school anxiety, which largely define academic adaptation. In this study, based on positive psychology and a systematic approach, the level of distinctiveness of characteristics of school wellbeing is carried out with the help of comparative analysis; the factor structure of these characteristics is identified; the characteristics of wellbeing and their coordinated combinations (factors) are determined as predictors of school anxiety. The sample consisted of 120 students of the 5th-7th grades, aged M = 11.5; SD = 1.04 (49.2% girls, 50.8% boys) who attended Saratov secondary schools. To study the level of school anxiety, we used the Philips’ School Anxiety Scale (SAS), and indicators of school wellbeing were measured with the original scales developed by the authors of the study. Statistical processing of the results was carried out with regression analysis and factor analysis. The results showed that the school wellbeing of junior adolescents forms a complex structure that includes cognitive, personal, emotional, social, and psychophysiological characteristics of school life. It was found that from 16% up to 53% of the deviation of variables characterizing school anxiety is conditioned by the assessment of variables characterizing emotional states, the ability of self-regulation, cognitive capabilities, and interest in learning. The study determined a high level of tension in adolescents in the field of emotions’ self-regulation, unpleasant physical sensations at school, before and after attending school, in the course of planning their school day and reflecting on educational activities. The most powerful factors of school anxiety in junior adolescents are physical distress, low ability to self-regulate and social adaptation, lack of independence in a learning activity, and personal immaturity.

PMID:34563078 | DOI:10.3390/ejihpe11030065

Eur J Investig Health Psychol Educ. 2021 Jul 28;11(3):829-837. doi: 10.3390/ejihpe11030060.

ABSTRACT

(1) Background: The older adult population of society is exposed to multiple stressors daily, such as the loss of loved ones, dysfunctional mobility, financial dependence, and suffering from numerous chronic illnesses. The present study aimed to assess the psychometric properties of the Anxiety about Aging Scale among older adults in Iran. (2) Methods: A sample of 703 community-dwelling older adults was recruited and screened using a standardized tool. The mean age of participants was 69.4 ± 8.1 years. The majority of participants were male (59.2%), married (66.6%), and illiterate (79.7%). A ‘forward-backward’ translation method was used in developing the Iranian version of the AAS for assessing the psychometric properties among older adults. Confirmatory factor analysis (CFA) and the Rasch model were used for construct validity. (3) Results: Applying CFA indicated that the model’s four original factors are the best solution, representing 55% of the total variance. The result of the CFA showed that this four-factor model had a good fit for the data. The findings were also confirmed by Rasch analysis. (4) Conclusions: The Persian version of the AAS is valid and reliable for measuring aging anxiety among Iranian older adults.

PMID:34563073 | DOI:10.3390/ejihpe11030060

Eur J Investig Health Psychol Educ. 2021 Jun 24;11(3):627-638. doi: 10.3390/ejihpe11030045.

ABSTRACT

The restorative justice (RJ) paradigm requires coherence among legal, justice, and educational systems to promote a culture of restorative dialogue with victims of violence and to reintegrate aggressors into the community. The objective of this study, from an evolutionary social perspective, was to examine criminal mediation files in the archives of the Murcia Intrajudicial Criminal Mediation Service (UMIM), Spain, to see which variables are associated with which types of violence and understand the contents and adoption of agreements. In this study the sociodemographic, procedural, and interpersonal variables of 216 people who used criminal mediation were analysed. The results showed statistically significant differences concerning age, the procedural moment of referral, and the participants’ relationship. The main conclusions are that the youngest group had a more significant number of encounters with physical violence; most agreements occurred in the initial phase of a judicial procedure; and the majority of agreements had moral content regardless of the age of the parties involved. These factors are of interest to the establishment of judicial and educational restorative models.

PMID:34563058 | DOI:10.3390/ejihpe11030045