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The Potential of Expression of Cyclin-D1 on Neoadjuvant Chemotherapy in Invasive Breast Carcinoma

Asian Pac J Cancer Prev. 2023 Apr 1;24(4):1131-1136. doi: 10.31557/APJCP.2023.24.4.1131.

ABSTRACT

BACKGROUND: Patients undergoing neoadjuvant chemotherapy (NC) for invasive breast cancer (IBC) need indicators to track their progress during treatment. The goal of this research is to learn how cyclin D1 works in conjunction with taxane and non-taxane therapy for people with IBC.

METHODS: There were 31 examples divided into two groups, based on: those using a different type of NC (taxane- or non-taxane-based), and NC administration time (before or after). Tumor grade, age, PR, ER, Ki-67, HER2, and Cyclin D1 expression were among the factors considered. Using immunohistochemical labeling, we were able to categorize cyclin D1 levels according to a threshold value, and we supplemented this with data we found in our databases. To analyze the data, we used a modified linear model.

RESULTS: The expression of Cyclin D1 decreased after NC delivery (p=0.086). Cyclin D1 expression was reduced in the taxane group (p=0.792). The non-taxane group also saw no differences in outcomes (p = 0.065). There was a larger decrease in Cyclin D1 expression in the non-taxane group compared to the taxane group, but the difference was not statistically significant (p=0.200).

CONCLUSION: Cyclin D1 expression, even if the differences are not statistically significant, may be a prognostic indicator of NC reaction in IBC. The involvement of Cyclin D1 in NC warrants more research with bigger IBC sample sizes.

PMID:37116133 | DOI:10.31557/APJCP.2023.24.4.1131

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Comparing the Effects of Sesame Oil vs. Nitroglycerin Ointment on the Incidence of Chemotherapy-Induced Phlebitis: A Single Blind Clinical Trial

Asian Pac J Cancer Prev. 2023 Apr 1;24(4):1113-1117. doi: 10.31557/APJCP.2023.24.4.1113.

ABSTRACT

BACKGROUND: Phlebitis is a severe inflammatory response in patients undergoing chemotherapy that can lead to complications and increased length of hospitalization.

OBJECTIVE: This study was conducted to examine the effects of sesame oil and nitroglycerin ointment on the incidence of chemotherapy-induced phlebitis in patients with cancer. Methods: This clinical trial study involved 138 cancer patients who were randomly assigned into three groups. The three groups received nitroglycerin ointment, sesame oil, or betadine alcoholic solution that were applied on the distal catheter area at a length of 1.5 centimeters and width of 2 × 4 cm using graded paper. The site was then dressed and fixed with anti-allergenic adhesives. The research samples were examined for 72 hours for the incidence of phlebitis.

RESULTS: No statistically significant difference was observed between the incidence of phlebitis in the sesame oil, nitroglycerin ointment and alcohol-betadine groups in the first 24 hours (p=0.2), the second 24 hours (p=0.13) and the third 24 hours (p=0.13).

CONCLUSION: External use of both sesame oil and nitroglycerin is effective in reducing chemotherapy-induced phlebitis. Due to its anti-inflammatory effect and low cost, however, using sesame oil is recommended.

PMID:37116130 | DOI:10.31557/APJCP.2023.24.4.1113

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Risk Factors Associated with Nasopharyngeal Cancer Incidences in Indonesia: A Systematic Review and Meta-Analysis

Asian Pac J Cancer Prev. 2023 Apr 1;24(4):1105-1111. doi: 10.31557/APJCP.2023.24.4.1105.

ABSTRACT

OBJECTIVE: To determine the risk factors associated the incidence of NPC, particularly in Indonesia.

METHODS: This systematic review and meta-analysis was conducted according to PRISMA statement. Database including PubMed, Scopus, Science Direct, Web of Science, and GARUDA were retrieved. Newcastle-Ottawa scale was used to assess the quality of published study and analyse the risk of bias of included study. Random-effect model and reported pooled Odds Ratio (OR) with 95%CI was carried out in our meta-analysis.

RESULTS: A pooled of 7 studies were included in our study which included 764 participants. We found that female gender was not associated with the incidences of NPC (OR 1.45, 95% CI: 0.61-3.45, p=0.40), and smoking was highly increased the incidence of NPC (OR 4.39 95% CI (0.79-24.40), but not statistically significant (p=0.09). Furthermore, salted fish consumption and some HLA alleles were associated with increased risk.

CONCLUSION: The incidence of NPC is not associated with female gender nor smoking habits. However, the risk of NPC is higher for those who consume salted fish and have some susceptible HLA alleles. Further investigations in larger studies are needed to confirm these findings.

PMID:37116129 | DOI:10.31557/APJCP.2023.24.4.1105

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Effect of multi-month antiretroviral dispensing on HIV clinic attendance at 68 Nigerian Army Reference Hospital, Yaba, Nigeria

Afr J AIDS Res. 2023 Apr;22(1):63-68. doi: 10.2989/16085906.2023.2188232.

ABSTRACT

Background: Multi-month dispensing (MMD) of antiretroviral therapy has demonstrated benefits for HIV patients and health service delivery systems, including reduced frequency of hospital visits and improved retention. We evaluated the effect of 6-monthly dispensing (MMD6) on patient clinic attendance at a single military facility in the one-year pre- and post-policy change.Methods: This was a descriptive, retrospective, cross-sectional study, exploring the relationship between MMD6 and clinic attendance numbers. We reviewed aggregate clinic attendance records for clients on ART and documented monthly trends in clinic attendance numbers, number of clients current on ART, and amount of ART dispensed.Results: In the pre-MMD6 group, 4 150 patients were included, and 4 190 in the post-MMD6 group. Clinic attendance was 30 407 visits (16 111 pre-MMD6 and 14 296 post-MMD6). An overall mean increase of 326.58 ± 861.81 (95% CI = -874.15 ± 220.98) drugs were dispensed per month; t(11) = -1.31, p = 0.22; mean monthly clinic attendance declined from 1342.8 ± 220.10 visits pre-MMD6 to 1191.33 ± 309.10 post-MMD6 with t(11) = 1.601, p = 0.14, but was not statistically significant.Conclusion: Six-monthly dispensing can be an important tool to reduce HIV clinic volumes and improve antiretroviral access. It is particularly important for care continuity in military facilities where service members may be deployed or transferred to other bases along with their dependents.

PMID:37116113 | DOI:10.2989/16085906.2023.2188232

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Symptoms of depression, anxiety, and thoughts of suicide/self-injury in adolescents and young adults living with HIV in Botswana

Afr J AIDS Res. 2023 Apr;22(1):54-62. doi: 10.2989/16085906.2023.2186252.

ABSTRACT

Globally, mental health problems have been reported to be more common in youth living with HIV (YLWH) than in the general population, but routine mental health screening is rarely done in high-volume HIV clinics. In 2019, YLWH in a large HIV clinic in Botswana were screened using the Generalized Anxiety Scale-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) in a pilot standard-of-care screening programme. Two-way ANOVA was used to describe the effects of age group (12-<16, 16-<20 and 20-25 years old) and sex on GAD-7 and PHQ-9 scores. Chi-square statistics were used to compare characteristics of YLWH with and without potential suicidality/self-harm symptoms based on question 9 in the PHQ-9. Among 1 469 YLWH, 33.1%, 44.3% and 15.0% had anxiety, depression and potential suicidality/self-harm symptoms respectively. YLWH of 20-25 years old and 16-<20 years old had higher GAD-7 scores compared to 12-<16-year-olds (p = 0.014 and p = <0.001 respectively). Female YLWH of 20-25 years old had higher PHQ-9 scores compared to 12-<16-year-olds (p = 0.002). There were no other sex-age dynamics that were statistically significant. Female YLWH endorsed more thoughts of suicidality/self-harm than males (17% versus 13%, p = 0.03 respectively). Given the proportion of YLWH with mental health symptoms, Botswana should enhance investments in mental health services for YLWH, especially for young female adults who bear a disproportionate burden.

PMID:37116112 | DOI:10.2989/16085906.2023.2186252

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Quantitative Paramagnetic NMR-Based Analysis of Protein Orientational Dynamics on Membranes: Dissecting the KRas4B-Membrane Interactions

J Am Chem Soc. 2023 Apr 28. doi: 10.1021/jacs.3c01597. Online ahead of print.

ABSTRACT

Peripheral membrane proteins can adopt distinct orientations on the surfaces of lipid bilayers that are often short-lived and challenging to characterize by conventional experimental methods. Here we describe a robust approach for mapping protein orientational landscapes through quantitative interpretation of paramagnetic relaxation enhancement (PRE) data arising from membrane mimetics with spin-labeled lipids. Theoretical analysis, followed by experimental verification, reveals insights into the distinct properties of the PRE observables that are generally distorted in the case of stably membrane-anchored proteins. To suppress the artifacts, we demonstrate that undistorted Γ2 values can be obtained via transient membrane anchoring, based on which a computational framework is established for deriving accurate orientational ensembles obeying Boltzmann statistics. Application of the approach to KRas4B, a classical peripheral membrane protein whose orientations are critical for its functions and drug design, reveals four distinct orientational states that are close but not identical to those reported previously. Similar orientations are also found for a truncated KRas4B without the hypervariable region (HVR) that can sample a broader range of orientations, suggesting a confinement role of the HVR geometrically prohibiting severe tilting. Comparison of the KRas4B Γ2 rates measured using nanodiscs containing different types of anionic lipids reveals identical Γ2 patterns for the G-domain but different ones for the HVR, indicating only the latter is able to selectively interact with anionic lipids.

PMID:37116086 | DOI:10.1021/jacs.3c01597

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Correlation between Severity of Thrombocytopenia and Portal Hypertensive Gastropathy in Patients with Chronic Liver Disease

J Assoc Physicians India. 2023 Jan;71(1):1.

ABSTRACT

INTRODUCTION: Portal hypertensive gastropathy (PHG) is known but under detected complication of cirrhosis of liver. Patients with stable liver disease are more prone to internal bleeding due to portal hypertension. Thrombocytopenia is a common complication associated with chronic liver disease and it is associated with poor prognosis. The aim of this study is to find out the association between correlation between severity of thrombocytopenia and portal hypertensive gastropathy in patients with chronic liver disease.

MATERIALS: This cross-sectional analytical study was conducted in a tertiary care centre at Saveetha Medical College Hospital and Research Centre. A total of 80 consecutive subjects were included in this study. All adult patients admitted with diagnosis chronic liver disease underwent upper GI endoscopy; those with portal hypertensive gastropathy were included in this study. The patient with liver disease with only varices but not gastropathy was excluded. Patient less than 18 years and with poor preparation were excluded from this study. Platelet count was estimated and severity of gastropathy was classified. Correlation of thrombocytopenia and severity of gastropathy was studied.

RESULT: Patients with mild portal hypertensive gastropathy category had normal platelet count between 1.5-4.5 lakhs/mm3 . But in patients with severe PHG, almost 80% of patients had thrombocytopenia, in which 8% had severe thrombocytopenia &lt;50,000 cells/mm3 . The inverse relationship between the platelet count and the severity of PHG was statistically significant.

CONCLUSION: The severity of thrombocytopenia increased with increasing grade of portal hypertensive gastropathy. Hence platelet count can serve as the prognostic marker of chronic liver disease induced portal hypertensive gastropathy References Chung WJ. Management of portal hypertensive gastropathy and other bleeding. Clin Mol Hepatol 2014;20(1):1-5. Madhwani R, Hanif FM, Ul Haque MM, et al. Noninvasive clinical predictors of portal hypertensive gastropathy in patients with liver cirrhosis. J Transpl Int Med 2017;5(3):169-173.

PMID:37116043

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Conversational Agent Interventions for Mental Health Problems: Systematic Review and Meta-analysis of Randomized Controlled Trials

J Med Internet Res. 2023 Apr 28;25:e43862. doi: 10.2196/43862.

ABSTRACT

BACKGROUND: Mental health problems are a crucial global public health concern. Owing to their cost-effectiveness and accessibility, conversational agent interventions (CAIs) are promising in the field of mental health care.

OBJECTIVE: This study aims to present a thorough summary of the traits of CAIs available for a range of mental health problems, find evidence of efficacy, and analyze the statistically significant moderators of efficacy via a meta-analysis of randomized controlled trial.

METHODS: Web-based databases (Embase, MEDLINE, PsycINFO, CINAHL, Web of Science, and Cochrane) were systematically searched dated from the establishment of the database to October 30, 2021, and updated to May 1, 2022. Randomized controlled trials comparing CAIs with any other type of control condition in improving depressive symptoms, generalized anxiety symptoms, specific anxiety symptoms, quality of life or well-being, general distress, stress, mental disorder symptoms, psychosomatic disease symptoms, and positive and negative affect were considered eligible. This study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Data were extracted by 2 independent reviewers, checked by a third reviewer, and pooled using both random effect models and fixed effects models. Hedges g was chosen as the effect size.

RESULTS: Of the 6900 identified records, a total of 32 studies were included, involving 6089 participants. CAIs showed statistically significant short-term effects compared with control conditions in improving depressive symptoms (g=0.29, 95% CI 0.20-0.38), generalized anxiety symptoms (g=0.29, 95% CI 0.21-0.36), specific anxiety symptoms (g=0.47, 95% CI 0.07-0.86), quality of life or well-being (g=0.27, 95% CI 0.16-0.39), general distress (g=0.33, 95% CI 0.20-0.45), stress (g=0.24, 95% CI 0.08-0.41), mental disorder symptoms (g=0.36, 95% CI 0.17-0.54), psychosomatic disease symptoms (g=0.62, 95% CI 0.14-1.11), and negative affect (g=0.28, 95% CI 0.05-0.51). However, the long-term effects of CAIs for the most mental health outcomes were not statistically significant (g=-0.04 to 0.39). Personalization and empathic response were 2 critical facilitators of efficacy. The longer duration of interaction with conversational agents was associated with the larger pooled effect sizes.

CONCLUSIONS: The findings show that CAIs are research-proven interventions that ought to be implemented more widely in mental health care. CAIs are effective and easily acceptable for those with mental health problems. The clinical application of this novel digital technology will conserve human health resources and optimize the allocation of mental health services.

TRIAL REGISTRATION: PROSPERO CRD42022350130; https://tinyurl.com/mvhk6w9p.

PMID:37115595 | DOI:10.2196/43862

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The Syzygy, Reformulation and New Perspectives: Dreams, Anima-Animus and Gender

J Anal Psychol. 2023 Apr;68(2):301-326. doi: 10.1111/1468-5922.12903.

ABSTRACT

The main objective of this qualitative and quantitative research paper is to explore the occurrences and relations of the anima, animus and androgynous in dreams, with particular emphasis on the consideration of the androgynous in the human psyche. The sample consists of 9 series of dreams (141 dreams in total), from 9 dreamers, 7 women (female sex/gender) and 2 men (male sex/gender), aged 25-57, heterosexual, undergoing Jungian psychotherapy, and presenting couple-related themes. Statistical results and qualitative analysis offer new input for the re-vision of the classical anima-animus model, and the addition of in-depth explorations into the androgynous, paving the way for a new model of psychopathology and psychotherapeutic clinical work, in transition.

PMID:37115574 | DOI:10.1111/1468-5922.12903

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Characterization of Hip Fractures Among Adults With Schizophrenia in Ontario, Canada

JAMA Netw Open. 2023 Apr 3;6(4):e2310550. doi: 10.1001/jamanetworkopen.2023.10550.

ABSTRACT

IMPORTANCE: Evidence suggests that individuals with schizophrenia are at an increased risk of hip fractures; however, the sex-specific burden of hip fractures among adults with schizophrenia has not been quantified and compared with the general population.

OBJECTIVE: To describe sociodemographic and clinical characteristics of patients with hip fracture and schizophrenia and to quantify their sex-specific annual hip fracture rates relative to those without schizophrenia.

DESIGN, SETTING, AND PARTICIPANTS: This repeated population-based, cross-sectional study leveraged multiple individually linked health administrative databases for patients in Ontario, Canada. We included patients aged 40 to 105 years with hip fracture-related hospitalization between April 1, 2009, and March 31, 2019. Statistical analysis was performed between November 2021 and February 2023.

EXPOSURE: Schizophrenia diagnosis, ascertained using a validated algorithm.

MAIN OUTCOMES AND MEASURES: The main outcome was sex-specific age-standardized annual hip fracture rate per 10 000 individuals and annual percent change in age-standardized rates. Rates were direct adjusted to the 2011 Ontario population, and joinpoint regression analysis was performed to evaluate annual percent change.

RESULTS: We identified 117 431 hip fracture records; of these, there were 109 908 index events. Among the 109 908 patients with hip fracture, 4251 had schizophrenia and 105 657 did not. Their median age was 83 years (IQR, 75-89 years), and 34 500 (31.4%) were men. Patients with hip fracture and schizophrenia were younger at the index event compared with those without schizophrenia. Men had a median age of 73 vs 81 years (IQR, 62-83 vs 71-87 years; standardized difference, 0.46), and women had a median age of 80 vs 84 years (IQR, 71-87 vs 77-89 years; standardized difference, 0.32). A higher proportion of patients with vs without schizophrenia had frailty (53.7% vs 34.2%; standardized difference, 0.40) and previous fragility fractures (23.5% vs 19.1%; standardized difference, 0.11). The overall age-standardized rate per 10 000 individuals with vs without schizophrenia was 37.5 (95% CI, 36.4 to 38.6) vs 16.0 (95% CI, 15.9 to 16.1). Age-standardized rates were 3-fold higher in men with vs without schizophrenia (31.0 [95% CI, 29.5 to 32.6] vs 10.1 [95% CI, 10.0 to 10.2]) and more than 2-fold higher in women with vs without schizophrenia (43.4 [95% CI, 41.9 to 44.9] vs 21.4 [95% CI, 21.3 to 21.6]). Overall, joinpoint regression analysis identified a steady annual decrease of 0.7% (95% CI, -1.1% to -0.3%) in age-standardized rates for both study groups.

CONCLUSIONS AND RELEVANCE: The findings of this cross-sectional study suggest that individuals with schizophrenia experience an earlier age of onset and considerably higher rate of hip fractures compared with the general population, with implications for targeted fracture prevention and optimization of clinical bone health management over the course of their psychiatric illness.

PMID:37115547 | DOI:10.1001/jamanetworkopen.2023.10550