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Korhonen J, Siiskonen H, Haimakainen S, Harvima RJ, Harvima IT. Expression of mast cell tryptase and immunoglobulin E is increased in cutaneous photodamage: implications for carcinogenesis. J DERMATOL TREAT 2024; 35:2307488. [PMID: 38291602 DOI: 10.1080/09546634.2024.2307488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/15/2024] [Indexed: 02/01/2024]
Abstract
Purpose: Mast cells, their serine proteinase tryptase, and immunoglobulin E (IgE) can be involved in cutaneous carcinogenesis.Materials and methods: To study the association of tryptase+ and IgE+ cells with photodamage and skin cancers 385 adult patients (201 males, 184 females, 75 with immunosuppression) at risk of any type of skin cancer were examined. Skin biopsies were taken from the sun-protected medial arm and from the photodamaged dorsal forearm skin followed by immunohistochemical staining for tryptase and IgE.Results: The results show that tryptase+ and IgE+ cells are significantly higher in number in the photodamaged than sun-protected skin, both in immunocompetent and -compromised subjects, and there is a strong correlation between tryptase+ and IgE+ cells. The numbers of forearm tryptase+ and especially IgE+ cells associated significantly with the forearm photodamage severity. In the logistic regression analysis, the forearm to upper arm ratio of IgE+ cells produced a univariate odds ratio of 1.521 (p = .010) and a multivariate one of 3.875 (p = .047) for the history of squamous cell carcinoma. The serum level of total IgE correlated significantly to the IgE to tryptase ratio in both skin sites.Conclusions: Therefore, IgE+ mast cells participate in photodamage and carcinogenesis, though it is unclear whether they are tumor-protective or -causative.
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Affiliation(s)
- Jenni Korhonen
- Department of Dermatology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Hanna Siiskonen
- Department of Dermatology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Salla Haimakainen
- Department of Dermatology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Rauno J Harvima
- Department of Dermatology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Ilkka T Harvima
- Department of Dermatology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
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Thote V, Dinesh S, Sharma S. Prediction of deleterious non-synonymous SNPs of human MDC1 gene: an in silico approach. Syst Biol Reprod Med 2024; 70:101-112. [PMID: 38630598 DOI: 10.1080/19396368.2024.2325699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/24/2024] [Indexed: 04/19/2024]
Abstract
MDC1 (Mediator of DNA damage Checkpoint protein 1) functions to facilitate the localization of numerous DNA damage response (DDR) components to DNA double-strand break sites. MDC1 is an integral component in preserving genomic stability and appropriate DDR regulation. There haven't been systematic investigations of MDC1 mutations that induce cancer and genomic instability. Variations in nsSNPs have the potential to modify the protein chemistry and their function. Describing functional SNPs in disease-associated genes presents a significant conundrum for investigators, it is possible to assess potential functional SNPs before conducting larger population examinations. Multiple sequences and structure-based bioinformatics strategies were implemented in the current in-silico investigation to discern potential nsSNPs of the MDC1 genes. The nsSNPs were identified with SIFT, SNAP2, Align GVGD, PolyPhen-2, and PANTHER, and their stability was determined with MUpro. The conservation, solvent accessibility, and structural effects of the mutations were identified with ConSurf, NetSurfP-2.0, and SAAFEC-SEQ respectively. Cancer-related analysis of the nsSNPs was conducted using cBioPortal and TCGA web servers. The present study appraised five nsSNPs (P1426T, P69S, P194R, P203L, and H131Y) as probably mutilating due to their existence in highly conserved regions and propensity to deplete protein stability. The nsSNPs P194R, P203L, and H131Y were concluded as deleterious and possibly damaging from the 5 prediction tools. The functional nsSNP P194R mutation is associated with skin cutaneous melanoma while no significant records were found for other nsSNPs. The present study concludes that the highly deleterious P194R mutations can potentially induce genomic instability and contribute to various cancers' pathogenesis. Developing drugs targeting these mutations can undoubtedly be advantageous in large population-based studies, particularly in the development of precision medicine.
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Affiliation(s)
| | - Susha Dinesh
- Department of Bioinformatics, BioNome, Bengaluru, India
| | - Sameer Sharma
- Department of Bioinformatics, BioNome, Bengaluru, India
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Sakellakis M, Yoon SM, Reet J, Chalkias A. Novel insights into voltage-gated ion channels: Translational breakthroughs in medical oncology. Channels (Austin) 2024; 18:2297605. [PMID: 38154047 PMCID: PMC10761148 DOI: 10.1080/19336950.2023.2297605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/05/2023] [Indexed: 12/30/2023] Open
Abstract
Preclinical evidence suggests that voltage gradients can act as a kind of top-down master regulator during embryogenesis and orchestrate downstream molecular-genetic pathways during organ regeneration or repair. Moreover, electrical stimulation shifts response to injury toward regeneration instead of healing or scarring. Cancer and embryogenesis not only share common phenotypical features but also commonly upregulated molecular pathways. Voltage-gated ion channel activity is directly or indirectly linked to the pathogenesis of cancer hallmarks, while experimental and clinical studies suggest that their modulation, e.g., by anesthetic agents, may exert antitumor effects. A large recent clinical trial served as a proof-of-principle for the benefit of preoperative use of topical sodium channel blockade as a potential anticancer strategy against early human breast cancers. Regardless of whether ion channel aberrations are primary or secondary cancer drivers, understanding the functional consequences of these events may guide us toward the development of novel therapeutic approaches.
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Affiliation(s)
- Minas Sakellakis
- Department of Medicine, Jacobi North Central Bronx Hospital, Bronx, USA
| | - Sung Mi Yoon
- Department of Medicine, Jacobi North Central Bronx Hospital, Bronx, USA
| | - Jashan Reet
- Department of Medicine, Jacobi North Central Bronx Hospital, Bronx, USA
| | - Athanasios Chalkias
- Institute for Translational Medicine and Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Outcomes Research Consortium, Cleveland, OH, USA
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Olszewski M, Maciejewska N, Kallingal A, Chylewska A, Dąbrowska AM, Biedulska M, Makowski M, Padrón JM, Baginski M. Palindromic carbazole derivatives: unveiling their antiproliferative effect via topoisomerase II catalytic inhibition and apoptosis induction. J Enzyme Inhib Med Chem 2024; 39:2302920. [PMID: 38221785 PMCID: PMC10791108 DOI: 10.1080/14756366.2024.2302920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 12/24/2023] [Indexed: 01/16/2024] Open
Abstract
Human DNA topoisomerases are essential for crucial cellular processes, including DNA replication, transcription, chromatin condensation, and maintenance of its structure. One of the significant strategies employed in cancer treatment involves the inhibition of a specific type of topoisomerase, known as topoisomerase II (Topo II). Carbazole derivatives, recognised for their varied biological activities, have recently become a significant focus in oncological research. This study assesses the efficacy of three symmetrically substituted carbazole derivatives: 2,7-Di(2-furyl)-9H-carbazole (27a), 3,6-Di(2-furyl)-9H-carbazole (36a), and 3,6-Di(2-thienyl)-9H-carbazole (36b) - as anticancer agents. Among investigated carbazole derivatives, compound 3,6-di(2-furyl)-9H-carbazole bearing two furan moieties emerged as a novel catalytic inhibitor of Topo II. Notably, 3,6-di(2-furyl)-9H-carbazole effectively selectively inhibited the relaxation and decatenation activities of Topo IIα, with minimal effects on the IIβ isoform. These findings underscore the potential of compound 3,6-Di(2-furyl)-9H-carbazole as a promising lead candidate warranting further investigation in the realm of anticancer drug development.
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Affiliation(s)
- Mateusz Olszewski
- Department of Pharmaceutical Technology and Biochemistry, Faculty of Chemistry, Gdansk University of Technology, Gdansk, Poland
| | - Natalia Maciejewska
- Department of Pharmaceutical Technology and Biochemistry, Faculty of Chemistry, Gdansk University of Technology, Gdansk, Poland
| | - Anoop Kallingal
- Department of Pharmaceutical Technology and Biochemistry, Faculty of Chemistry, Gdansk University of Technology, Gdansk, Poland
| | - Agnieszka Chylewska
- Department of Bioinorganic Chemistry, Faculty of Chemistry, University of Gdansk, Gdansk, Poland
| | - Aleksandra M. Dąbrowska
- Department of Bioinorganic Chemistry, Faculty of Chemistry, University of Gdansk, Gdansk, Poland
| | - Małgorzata Biedulska
- Department of Bioinorganic Chemistry, Faculty of Chemistry, University of Gdansk, Gdansk, Poland
| | - Mariusz Makowski
- Department of Bioinorganic Chemistry, Faculty of Chemistry, University of Gdansk, Gdansk, Poland
| | - José M. Padrón
- BioLab, Instituto Universitario de Bio-Orgánica “Antonio González”, Universidad de La Laguna, La Laguna, Spain
| | - Maciej Baginski
- Department of Pharmaceutical Technology and Biochemistry, Faculty of Chemistry, Gdansk University of Technology, Gdansk, Poland
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Fang XL, Cao XP, Xiao J, Hu Y, Chen M, Raza HK, Wang HY, He X, Gu JF, Zhang KJ. Overview of role of survivin in cancer: expression, regulation, functions, and its potential as a therapeutic target. J Drug Target 2024; 32:223-240. [PMID: 38252514 DOI: 10.1080/1061186x.2024.2309563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/11/2023] [Indexed: 01/24/2024]
Abstract
Survivin holds significant importance as a member of the inhibitor of apoptosis protein (IAP) family due to its predominant expression in tumours rather than normal terminally differentiated adult tissues. The high expression level of survivin in tumours is closely linked to chemotherapy resistance, heightened tumour recurrence, and increased tumour aggressiveness and serves as a negative prognostic factor for cancer patients. Consequently, survivin has emerged as a promising therapeutic target for cancer treatment. In this review, we delve into the various biological characteristics of survivin in cancers and its pivotal role in maintaining immune system homeostasis. Additionally, we explore different therapeutic strategies aimed at targeting survivin.
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Affiliation(s)
- Xian-Long Fang
- Academician Expert Workstation of Fengxian District, Shanghai Yuansong Biotechnology Limited Company, Shanghai, China
| | - Xue-Ping Cao
- Academician Expert Workstation of Fengxian District, Shanghai Yuansong Biotechnology Limited Company, Shanghai, China
| | - Jun Xiao
- State Key Laboratory of Cell Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai, China
| | - Yun Hu
- Academician Expert Workstation of Fengxian District, Shanghai Yuansong Biotechnology Limited Company, Shanghai, China
| | - Mian Chen
- Academician Expert Workstation of Fengxian District, Shanghai Yuansong Biotechnology Limited Company, Shanghai, China
| | - Hafiz Khuram Raza
- Academician Expert Workstation of Fengxian District, Shanghai Yuansong Biotechnology Limited Company, Shanghai, China
| | - Huai-Yuan Wang
- Institute of Smart Biomedical Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, China
| | - Xu He
- Department of Stomatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jin-Fa Gu
- Academician Expert Workstation of Fengxian District, Shanghai Yuansong Biotechnology Limited Company, Shanghai, China
| | - Kang-Jian Zhang
- Academician Expert Workstation of Fengxian District, Shanghai Yuansong Biotechnology Limited Company, Shanghai, China
- State Key Laboratory of Cell Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai, China
- Institute of Smart Biomedical Materials, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, China
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Dwivedi M, Jindal D, Jose S, Hasan S, Nayak P. Elements in trace amount with a significant role in human physiology: a tumor pathophysiological and diagnostic aspects. J Drug Target 2024; 32:270-286. [PMID: 38251986 DOI: 10.1080/1061186x.2024.2309572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024]
Abstract
Cancer has a devastating impact globally regardless of gender, age, and community, which continues its severity to the population due to the lack of efficient strategy for the cancer diagnosis and treatment. According to the World Health Organisation report, one out of six people dies due to this deadly cancer and we need effective strategies to regulate it. In this context, trace element has a very hidden and unexplored role and require more attention from investigators. The variation in concentration of trace elements was observed during comparative studies on a cancer patient and a healthy person making them an effective target for cancer regulation. The percentage of trace elements present in the human body depends on environmental exposure, food habits, and habitats and could be instrumental in the early diagnosis of cancer. In this review, we have conducted inclusive analytics on trace elements associated with the various types of cancers and explored the several methods involved in their analysis. Further, intricacies in the correlation of trace elements with prominent cancers like prostate cancer, breast cancer, and leukaemia are represented in this review. This comprehensive information on trace elements proposes their role during cancer and as biomarkers in cancer diagnosis.
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Affiliation(s)
- Manish Dwivedi
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Lucknow, India
- Research Cell, Amity University Uttar Pradesh, Lucknow, India
| | - Divya Jindal
- Department of Biotechnology, Center for Emerging Diseases, Jaypee Institute of Information Technology, Noida, India
| | - Sandra Jose
- MET's School of Engineering, Thrissur, India
| | - Saba Hasan
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Lucknow, India
| | - Pradeep Nayak
- Department of Physics, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
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7
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Liu YH, Chen J, Chen X, Liu H. Factors of faecal microbiota transplantation applied to cancer management. J Drug Target 2024; 32:101-114. [PMID: 38174845 DOI: 10.1080/1061186x.2023.2299724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/25/2023] [Indexed: 01/05/2024]
Abstract
The homeostasis of the microbiota is essential for human health. In particular, the gut microbiota plays a critical role in the regulation of the immune system. Thus, faecal microbiota transplantation (FMT), a technology that has rapidly developed in the last decade, has specifically been utilised for the treatment of intestinal inflammation and has recently been found to be able to treat tumours in combination with immunotherapy. FMT has become a breakthrough in enhancing the response rate to immunotherapy in cancer patients by altering the composition of the patient's gut microbiota. This review discusses the mechanisms of faecal microorganism effects on tumour development, drug treatment efficacy, and adverse effects and describes the recent clinical research trials on FMT. Moreover, the factors influencing the efficacy and safety of FMT are described. We summarise the possibilities of faecal transplantation in the treatment of tumours and its complications and propose directions to explore the development of FMT.
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Affiliation(s)
- Yi-Huang Liu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, Hunan, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China
- Xiangya Clinical Research Center for Cancer Immunotherapy, Central South University, Changsha, Hunan, China
- Research Center of Molecular Metabolomics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Juan Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, Hunan, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China
- Xiangya Clinical Research Center for Cancer Immunotherapy, Central South University, Changsha, Hunan, China
- Research Center of Molecular Metabolomics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, Hunan, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China
- Xiangya Clinical Research Center for Cancer Immunotherapy, Central South University, Changsha, Hunan, China
- Research Center of Molecular Metabolomics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hong Liu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, Hunan, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, Hunan, China
- Xiangya Clinical Research Center for Cancer Immunotherapy, Central South University, Changsha, Hunan, China
- Research Center of Molecular Metabolomics, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Aadithi MG, Divya B, Nandhini G, Rajkumar K, Ramesh Kumar A, Sarangarajan R. Evaluation of ABCB5 immunostained epithelial stem cells in oral squamous cell carcinoma, inflammatory gingival hyperplasia and normal mucosa. Biotech Histochem 2024; 99:44-48. [PMID: 38073314 DOI: 10.1080/10520295.2023.2292062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024] Open
Abstract
Oral cancer is the most prevalent head and neck cancer. Although tumor markers have been investigated for detecting the progression and prognosis of oral cancer, no reliable marker has been identified. We investigated the expression of ATP binding cassette subfamily B member 5 (ABCB5) positive stem cells in oral squamous cell carcinoma (OSCC) and in inflammatory gingival hyperplasia. We used tissue samples from normal subjects, patients with inflammatory gingival hyperplasia, and patients with OSCC. Samples were investigated using anti-ABCB5 monoclonal antibody immunohistochemistry to detect epithelial stem cells. Staining density, intensity, and immunoreactive scores of ABCB5 were analyzed for the three study groups. We found ABCB5 immunostaining in all three study groups, but different distributions of ABCB5 expression in different layers of the epithelium. We found no significant difference in staining intensity between inflammatory hyperplasia and normal mucosa, but we found significantly stronger expression in OSCC compared to normal and inflammatory hyperplasia individually. Elevated expression of ABCB5 in OSCC suggests an increased subpopulation of tumor cells with an undifferentiated stem cell phenotype, which facilitates cancer initiation and progression.
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Affiliation(s)
- M G Aadithi
- Department of Oral Pathology & Microbiology, Sri Ramaswamy Memorial (SRM) Dental College, Chennai, India
| | - Bose Divya
- Department of Oral Pathology & Microbiology, Sri Ramaswamy Memorial (SRM) Dental College, Chennai, India
| | - G Nandhini
- Department of Oral Pathology & Microbiology, Sri Ramaswamy Memorial (SRM) Dental College, Chennai, India
| | - Krishnan Rajkumar
- Department of Oral Pathology & Microbiology, Sri Ramaswamy Memorial (SRM) Dental College, Chennai, India
| | - A Ramesh Kumar
- Department of Oral Pathology & Microbiology, Sri Ramaswamy Memorial (SRM) Dental College, Chennai, India
| | - R Sarangarajan
- Department of Oral Pathology, Madha Dental College and Hospital, Chennai, India
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Pathania AS, Chava H, Balusu R, Pasupulati AK, Coulter DW, Challagundla KB. The crosstalk between non-coding RNAs and cell-cycle events: A new frontier in cancer therapy. Mol Ther Oncol 2024; 32:200785. [PMID: 38595981 PMCID: PMC10973673 DOI: 10.1016/j.omton.2024.200785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
The cell cycle comprises sequential events during which a cell duplicates its genome and divides it into two daughter cells. This process is tightly regulated to ensure that the daughter cell receives identical copied chromosomal DNA and that any errors in the DNA during replication are correctly repaired. Cyclins and their enzyme partners, cyclin-dependent kinases (CDKs), are critical regulators of G- to M-phase transitions during the cell cycle. Mitogenic signals induce the formation of the cyclin/CDK complexes, resulting in phosphorylation and activation of the CDKs. Once activated, cyclin/CDK complexes phosphorylate specific substrates that drive the cell cycle forward. The sequential activation and inactivation of cyclin-CDK complexes are tightly controlled by activating and inactivating phosphorylation events induced by cell-cycle proteins. The non-coding RNAs (ncRNAs), which do not code for proteins, regulate cell-cycle proteins at the transcriptional and translational levels, thereby controlling their expression at different cell-cycle phases. Deregulation of ncRNAs can cause abnormal expression patterns of cell-cycle-regulating proteins, resulting in abnormalities in cell-cycle regulation and cancer development. This review explores how ncRNA dysregulation can disrupt cell division balance and discusses potential therapeutic approaches targeting these ncRNAs to control cell-cycle events in cancer treatment.
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Affiliation(s)
- Anup S. Pathania
- Department of Biochemistry and Molecular Biology & The Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Haritha Chava
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Ramesh Balusu
- Department of Hematologic Malignancies and Cellular Therapeutics, Kansas University Medical Center, Kansas City, KS 66160, USA
| | - Anil K. Pasupulati
- Department of Biochemistry, University of Hyderabad, Hyderabad, Telangana 500046, India
| | - Don W. Coulter
- Department of Pediatrics, Division of Hematology/Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Kishore B. Challagundla
- Department of Biochemistry and Molecular Biology & The Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE 68198, USA
- The Child Health Research Institute, University of Nebraska Medical Center, Omaha, NE 68198, USA
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Sapir-Pichhadze R, Laprise C, Beauchamp ME, Kaouache M, Zhang X, Della Vecchia A, Azoulay L, Franco EL, Abrahamowicz M, Nicolau B. Immunosuppression and cancer risk in kidney transplant recipients: A retrospective cohort study. Int J Cancer 2024; 154:2043-2053. [PMID: 38345158 DOI: 10.1002/ijc.34875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 04/14/2024]
Abstract
We assessed whether contemporary immunosuppression agents were associated with cancer among kidney transplant recipients (KTR), and if this association varied by age and sex. We studied a retrospective province-wide cohort of primary KTR (1997-2016). Employing multivariable Cox models, we estimated associations of cumulative doses of prednisone, mycophenolate and tacrolimus administered over the past 10 years, lagged by 2 years, with the incidence of primary malignant neoplasms (PMN). We assessed interactions with age and sex. To assess the impact of exposure recency, we used weighted cumulative exposure (WCE) modeling. Among 1064 KTR, 108 (10.2%) developed PMN over median follow-up of 73 months (interquartile range: 32-120). Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of 0.96 (0.64-1.43), 1.34 (0.96-1.86), and 1.06 (0.88-1.29) were estimated for cumulative daily doses of prednisone (5 mg), mycophenolate (1000 mg), and tacrolimus (2 mg) administered continuously over the past 10 years, respectively. PMN risk associated with cumulative tacrolimus exposure was modified by age (interaction p = .035) and was more pronounced in 15-year and 30-year-old KTR (aHRs of 1.57 [1.08-2.28] and 1.31 [1.03-1.66], respectively) in comparison to older KTR. PMN risk increase associated with higher cumulative mycophenolate dose was more pronounced in females (aHR = 1.86 [1.15-3.00]) than in males (aHR = 1.16 [0.74-1.81]; interaction p = .131). WCE analyses suggested increased PMN risk the higher the mycophenolate doses taken 5-10 years ago. A trend toward increased PMN risk with long-term mycophenolate exposure, particularly in females, and more pronounced risk with long-term tacrolimus exposure in younger KTR, identify opportunities for tailored immunosuppression to mitigate cancer risk.
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Affiliation(s)
- Ruth Sapir-Pichhadze
- Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, Occupational Health, McGill University, Montreal, Quebec, Canada
- Division of Nephrology, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Claudie Laprise
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
| | - Marie-Eve Beauchamp
- Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
| | - Mohammed Kaouache
- Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
| | - Xun Zhang
- Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
| | - Alexia Della Vecchia
- Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
| | - Laurent Azoulay
- Department of Epidemiology, Biostatistics, Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Eduardo L Franco
- Department of Epidemiology, Biostatistics, Occupational Health, McGill University, Montreal, Quebec, Canada
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
| | - Michal Abrahamowicz
- Centre for Outcomes Research and Evaluation, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Belinda Nicolau
- Department of Epidemiology, Biostatistics, Occupational Health, McGill University, Montreal, Quebec, Canada
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
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Yang CY, Smith TJ, Knowlton AR. Cancer Patient Perspectives on the Meaning of Healing and the Clinician as a Healer. Am J Hosp Palliat Care 2024; 41:658-663. [PMID: 37487577 DOI: 10.1177/10499091231191697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND The experience of living with cancer is marked by suffering and loss, which creates a need for healing. Understanding what healing means to patients and how clinicians can play a role in the healing process is essential to holistic cancer care. OBJECTIVE The aim of this study was to explore the perspectives of cancer patients on the meaning and experiences of healing and the qualities of a clinician and the clinician-patient relationship that are healing. METHODS A qualitative study was conducted using semi-structured interviews with 14 cancer patients. Participants were asked about their illness experience, definition of healing, qualities of a healer, and relationships with clinicians that were healing. Interview transcripts were coded, and qualitative analysis was conducted to identify major themes. RESULTS Participants defined the nature of healing as comprising aspects of physical, mental, emotional, and spiritual well-being. Participants described healing as alleviating pain and symptoms; promoting mental strength, emotional comfort, and spiritual connection; restoring and adapting to losses; and improving quality of life. The qualities of a clinician that contributed to a healing relationship included listening, empathy and compassion, understanding patients' values and goals, and caring for the patient as a whole person. CONCLUSION Participants viewed healing as physical, psychosocial, and spiritual in nature and an important part of their cancer experience with an emphasis on quality of life. Clinicians played an important role beyond treating the cancer by helping in the healing process through their humanistic qualities and holistic approach to patient care.
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Affiliation(s)
- Cindy Y Yang
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Thomas J Smith
- Departments of Oncology and Internal Medicine, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Amy R Knowlton
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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12
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Tang T, Yu H, Xu S, Zhong Y, Ma J, Zhao T. Causal effects of endometriosis on cancer risk: A Mendelian randomization study. Int J Cancer 2024; 154:1948-1954. [PMID: 38323658 DOI: 10.1002/ijc.34876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/14/2023] [Accepted: 01/19/2024] [Indexed: 02/08/2024]
Abstract
Endometriosis has been reported in epidemiological studies to be associated with certain types of cancer. However, the presence of reverse causality and residual confounding due to common risk factors introduces uncertainty regarding the extent to which endometriosis itself contributes to the development of cancer. We performed the Mendelian randomization (MR) to investigate the causal associations between endometriosis and 34 different types of cancers. The results of the inverse-variance-weighted (IVW) model suggested that genetic predisposition to endometriosis was causally associated with an increased risk for ovarian cancer (OR = 3.2913; p-value = .0320). The genetic liabilities to endometriosis had causal associations with the decreased risk for skin cancer (OR = 0.9973; p-value = .0219), hematological cancer (OR = 0.9953; p-value = .0175) and ER- breast cancer (OR = 0.6960; p-value = .0381). The causal association of the above combinations were robust by test of heterogeneity and pleiotropy. Together, our study suggests that endometriosis had causal effect on cancer risk.
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Affiliation(s)
- Tianyou Tang
- The College of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Huilin Yu
- The Second Medicine College, Chongqing Medical University, Chongqing, China
| | - Sipei Xu
- The First Medicine College, Chongqing Medical University, Chongqing, China
| | - Yi Zhong
- The College of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Jie Ma
- Department of Pharmacology, Pharmaceutical Engineering College, Chongqing Chemical Industry Vocational College, Chongqing, China
| | - Tingting Zhao
- Laboratory of Human Function Experimental Teaching and Management Center of Chongqing Medical University, Chongqing, China
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13
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Hassan H, Oloyede S, Villanueva G, Zahra S, Joseph-Frederick Z, Green G, Schechter T, Zupanec S, Dupuis LL, Sung L. Brochure intervention to manage bothersome taste changes in pediatric patients receiving cancer therapy. Pediatr Blood Cancer 2024; 71:e30965. [PMID: 38514496 DOI: 10.1002/pbc.30965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Primary objective was to determine if a patient informational brochure describing potentially useful strategies could help manage specific taste changes. Secondary objective was to describe the specific strategies used and whether the strategies were perceived as being helpful. PROCEDURE This single-center study included pediatric patients with cancer or hematopoietic cell transplant recipients receiving active treatment who experienced bothersome taste changes in the last month. Participants participated in baseline and follow-up interviews conducted 14-21 days apart. A brochure that listed 16 potentially helpful strategies was provided at baseline. At follow-up, we asked about brochure use and whether it helped. At both interviews, we asked about experienced taste changes, strategies used, and whether strategy helped. RESULTS Of 100 enrolled participants, different (87%) and bad (72%) taste were most common at baseline. Following the brochure intervention, statistically significant reductions were observed in food tasting different, bad, bland, bitter, sour, and metallic. For most strategies, the proportion of patients who used specific strategies or found them helpful was not significantly different between baseline and follow-up. However, "eating foods you like" was considered helpful in significantly more participants who used the strategy in follow-up (72 out of 89, 80.9%) compared with baseline (55 out of 95, 57.9%; p = .008). Between visits, 81.2% looked at the brochure. Among participants, 53.1% found the brochure helpful, very helpful, or extremely helpful. CONCLUSIONS A brochure that offered strategies to manage changes in taste helped participants cope with them. Further research should evaluate the brochure using randomized and multicenter trials.
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Affiliation(s)
- Hadeel Hassan
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
- Department of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Seye Oloyede
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Gillian Villanueva
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Serena Zahra
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Zakia Joseph-Frederick
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Gloria Green
- Department of Clinical Dietetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tal Schechter
- Department of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sue Zupanec
- Department of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - L Lee Dupuis
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
- Department of Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto
| | - Lillian Sung
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
- Department of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Tedesco G, Santarosa M, Maestro R. Beyond self‑eating: Emerging autophagy‑independent functions for the autophagy molecules in cancer (Review). Int J Oncol 2024; 64:57. [PMID: 38606507 DOI: 10.3892/ijo.2024.5645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/21/2024] [Indexed: 04/13/2024] Open
Abstract
Autophagy is a conserved catabolic process that controls organelle quality, removes misfolded or abnormally aggregated proteins and is part of the defense mechanisms against intracellular pathogens. Autophagy contributes to the suppression of tumor initiation by promoting genome stability, cellular integrity, redox balance and proteostasis. On the other hand, once a tumor is established, autophagy can support cancer cell survival and promote epithelial‑to‑mesenchymal transition. A growing number of molecules involved in autophagy have been identified. In addition to their key canonical activity, several of these molecules, such as ATG5, ATG12 and Beclin‑1, also exert autophagy‑independent functions in a variety of biological processes. The present review aimed to summarize autophagy‑independent functions of molecules of the autophagy machinery and how the activity of these molecules can influence signaling pathways that are deregulated in cancer progression.
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Affiliation(s)
- Giulia Tedesco
- Unit of Oncogenetics and Functional Oncogenomics, CRO Aviano, National Cancer Institute, IRCCS, I‑33081 Aviano, Italy
| | - Manuela Santarosa
- Unit of Oncogenetics and Functional Oncogenomics, CRO Aviano, National Cancer Institute, IRCCS, I‑33081 Aviano, Italy
| | - Roberta Maestro
- Unit of Oncogenetics and Functional Oncogenomics, CRO Aviano, National Cancer Institute, IRCCS, I‑33081 Aviano, Italy
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15
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Lohi P, Auvinen A, Niskanen L, Partonen T, Haukka J. Does the duration of diabetes increase the risk of cancer? A nationwide population-based cohort of patients with new-onset diabetes and a matched reference cohort. Int J Cancer 2024; 154:1940-1947. [PMID: 38450737 DOI: 10.1002/ijc.34858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/05/2023] [Accepted: 12/29/2023] [Indexed: 03/08/2024]
Abstract
Diabetes mellitus and cancer are both common health issues, but the correlation between these two diseases remains unclear. We investigated the association of cumulative exposure of diabetes mellitus as an indication of hyperglycemia in terms of disease duration on multiple cancer types. We hypothesized that the risk of cancer would increase over time after the onset of diabetes. The study population consisted of a population-based cohort of 398,708 people and it was constructed from the Finnish CARING project. The Diabetes group consisted of 185,258 individuals, and the non-diabetic reference group comprised 187,921 individuals. Over 4.1 million person-years were accumulated, and the median follow-up time was 10.55 years. In the diabetes group, 25,899 cancer cases were observed compared with 23,900 cancers in the non-diabetic group. We did not find a clear relationship between the duration of diabetes mellitus and most cancer types examined. However, for cancers of the pancreas, prostate gland, bronchus, and lungs, a temporal relationship was found. Furthermore, even within the cancer types where the relationship was detected, it did not change over time. These findings indicate that diabetes does not independently increase the risk of cancer. Instead, the development of diabetes may be attributed to shared risk factors with cancer, such as obesity and/or insulin resistance accompanied by hyperinsulinemia. Thus, it is likely that the clock for increased cancer risk starts ticking already before onset of diabetes and hyperglycemia.
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Affiliation(s)
- Petrus Lohi
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Anssi Auvinen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Leo Niskanen
- Department of Endocrinology, Päijät-Häme Central Hospital, Lahti, Finland
- University of Eastern Finland, Kuopio, Finland
| | - Timo Partonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Jari Haukka
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
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16
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Bennett D, Murray I, Mitchell H, Gavin A, Donnelly D. Impact of COVID-19 on cancer incidence, presentation, diagnosis, treatment and survival in Northern Ireland. Int J Cancer 2024; 154:1731-1744. [PMID: 38268160 DOI: 10.1002/ijc.34847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/26/2024]
Abstract
The COVID-19 pandemic had a major impact on cancer patients and services but has been difficult to quantify. We examined how the entire cancer pathway-from incidence, presentation, diagnosis, stage, treatment and survival-was affected in Northern Ireland during April-December 2020 compared to equivalent 2018-2019 periods using retrospective, observational cancer registry data from the Northern Ireland Cancer Registry (NICR). There were 6748 cancer cases in April-December 2020 and an average 7724 patients in April-December 2018-2019. Incident cases decreased by 13% (almost 1000). Significant differences were found across age cohorts and deprivation quintiles, with reductions greatest for younger people (<55 years; 19% decrease) and less deprived (22% decrease). A higher proportion had emergency admission (16%-to-20%) with lower proportions diagnosed pathologically (85%-to-83%). There was a significant stage shift, with lower proportions of early stage (29%-to-25%) and higher late-stage (21%-to-23%). Lower proportions received surgery (41%-to-38%) and radiotherapy (24%-to-22%) with a higher proportion not receiving treatment (29%-to-33%). One-year observed-survival decreased from 73.7% to 69.8% and 1-year net-survival decreased from 76.1% to 72.9%, with differences driven by five tumours; Lung (40.3%-to-35.0%), Head-and-Neck (77.4%-to-68.4%), Oesophageal (53.5%-to-42.3%), Lymphoma (81.1%-to-75.2%) and Uterine cancer (87.4%-to-80.4%). Our study reveals profound adverse impact of COVID-19 on the entire cancer patient pathway, with 13% fewer cases, greater emergency admissions and significant stage-shift from early to more advanced-stage disease. There was major treatment impact with lower rates of surgery and radiotherapy and higher proportions receiving no treatment. There were significant reductions in 1-year survival. Our study will support service recovery and protect cancer services in future pandemics or disruptions.
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Affiliation(s)
- Damien Bennett
- Northern Ireland Cancer Registry, Centre for Public Health, Belfast, Northern Ireland
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Inez Murray
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Helen Mitchell
- Northern Ireland Cancer Registry, Centre for Public Health, Belfast, Northern Ireland
| | - Anna Gavin
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - David Donnelly
- Northern Ireland Cancer Registry, Centre for Public Health, Belfast, Northern Ireland
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17
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Singh N, Giannitrapani KF, Gamboa RC, O’Hanlon CE, Fereydooni S, Holdsworth LM, Lindvall C, Walling AM, Lorenz KA. What Patients Facing Cancer and Caregivers Want From Communication in Times of Crisis: A Qualitative Study in the Early Months of the COVID-19 Pandemic. Am J Hosp Palliat Care 2024; 41:558-567. [PMID: 37390466 PMCID: PMC10315453 DOI: 10.1177/10499091231187351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Interpersonal communication is a cornerstone of patient-centered care. We aimed to identify what patients with cancer and caregivers may want from communication during a public health crisis. METHODS We interviewed 15 patients (8 Veteran, 7 non-Veteran) and caregivers from regionally, racially, and ethnically diverse backgrounds across the US about serious illness care and quality of care during the COVID-19 pandemic Using an iterative, inductive and deductive process, 2 coders analyzed content associated with the code "Communication," which appeared 71 times, and identified 5 themes. RESULTS Participants identified as White (10), Latino/a (3), Asian (1), and Black (1). (1) Help patients and caregivers prepare for care during crisis by communicating medical information directly and proactively. (2) Explain how a crisis might influence medical recommendations and impact on recovery from illness. (3) Use key messengers to improve communication between primary teams, patients, and caregivers. (4) Include caregivers and families in communication when they cannot be physically present. (5) Foster bidirectional communication with patients and families to engage them in shared decision-making during a vulnerable time. CONCLUSION Communication is critical during a public health crisis yet overwhelmed clinicians may not be able to communicate effectively. Communicating with caregivers and family, transparent and timely communication, ensuring diverse providers are on the same page, and effective listening are known gaps even before the COVID-19 pandemic. Clinicians may need quick interventions, like education about goals of care, to remind them about what seriously ill patients and their caregivers want from communication and offer patient-centered care during crises.
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Affiliation(s)
- Nainwant Singh
- Stanford University School of Medicine, Palo Alto, CA, USA
- VA HSR&D Center for Innovation to Implementation (Ci2i), Menlo Park, CA, USA
| | - Karleen F. Giannitrapani
- Stanford University School of Medicine, Palo Alto, CA, USA
- VA HSR&D Center for Innovation to Implementation (Ci2i), Menlo Park, CA, USA
| | - Raziel C. Gamboa
- Stanford University School of Medicine, Palo Alto, CA, USA
- VA HSR&D Center for Innovation to Implementation (Ci2i), Menlo Park, CA, USA
| | | | | | | | - Charlotta Lindvall
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Anne M. Walling
- Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare Center, Los Angeles, CA, USA
| | - Karl A. Lorenz
- Stanford University School of Medicine, Palo Alto, CA, USA
- VA HSR&D Center for Innovation to Implementation (Ci2i), Menlo Park, CA, USA
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18
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Phillips MC, Thotathil Z, Dass PH, Ziad F, Moon BG. Ketogenic metabolic therapy in conjunction with standard treatment for glioblastoma: A case report. Oncol Lett 2024; 27:230. [PMID: 38586213 PMCID: PMC10996027 DOI: 10.3892/ol.2024.14363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/06/2024] [Indexed: 04/09/2024] Open
Abstract
Glioblastoma (GBM) is the most common primary malignant brain tumour in adults. The standard of care consists of surgical resection and concurrent chemoradiation, followed by adjuvant temozolomide chemotherapy. This protocol is associated with a median survival of 12-15 months, and <5% of patients survive >3 years. Ketogenic metabolic therapy (KMT) targets cancer cell metabolism by restricting glucose availability and evoking differential stress resistance and sensitization, which may augment the standard treatments and lead to therapeutic benefit. The present study reports the case of a 64-year-old woman with isocitrate dehydrogenase (IDH)-wildtype GBM who pursued the standard treatment protocol in conjunction with an intensive, multimodal KMT program for 3 years. The KMT program consisted of a series of prolonged (7-day, fluid-only) fasts, which were specifically timed to maximize the tolerability and efficacy of the standard treatments, combined with a time-restricted ketogenic diet on all other days. During the first and second treatment years the patient sustained a glucose ketone index (GKI) of 1.65 and 2.02, respectively, which coincided with complete clinical improvement, a healthy body-mass index and a high quality of life, with no visible progressive tumour detected on imaging at the end of the second year. In the setting of the death of an immediate family member leading to increased life stress, slightly relaxed KMT adherence, and a higher GKI of 3.20, slow cancer progression occurred during the third year. The adverse effects attributed to KMT were mild. Despite the limitations of this case report, it highlights the feasibility of implementing the standard treatment protocol for GBM in conjunction with an intensive, long-term, multimodal and specifically timed KMT program, the potential therapeutic efficacy of which may depend upon achieving as low a GKI as possible.
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Affiliation(s)
| | - Ziad Thotathil
- Department of Radiation Oncology, Waikato Hospital, Hamilton 3204, New Zealand
| | | | - Fouzia Ziad
- Department of Pathology, Waikato Hospital, Hamilton 3204, New Zealand
| | - Ben G. Moon
- Midland MRI, Waikato Hospital, Hamilton 3204, New Zealand
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Xiao T, Yan A, Tan L, Zhu H, Gao W. LncRNA HOXA‑AS2 is a prognostic and clinicopathological predictor in patients with cancer: A meta‑analysis. Oncol Lett 2024; 27:226. [PMID: 38586205 PMCID: PMC10996033 DOI: 10.3892/ol.2024.14359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/23/2024] [Indexed: 04/09/2024] Open
Abstract
Elevated expression of long non-coding RNA homeobox A cluster antisense RNA 2 (lncRNA HOXA-AS2) is known to have prognostic value in various solid tumors. The present meta-analysis aimed to comprehensively quantify its prognostic significance across a wider spectrum of malignancies and to provide an updated synthesis of evidence that could refine prognostic models. To achieve this aim, multiple databases were carefully searched for lncRNA HOXA-AS2-related articles published in the past 10 years. Hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to demonstrate the prognostic value of lncRNA HOXA-AS2 using Stata 15.0 software. The function of lncRNA HOXA-AS2 was inferred from its associations with key clinical outcomes such as lymph node metastasis, distant metastasis, tumor stage and tumor size, which may reflect its role in tumor biology. In the present systematic review and meta-analysis of 454 patients across 7 studies, it was found that high lncRNA HOXA-AS2 expression was significantly associated with a shorter overall survival (OS) time in patients with cancer (HR=2.14; 95% CI, 1.40-3.27; P<0.001). High lncRNA HOXA-AS2 expression was also associated with lymph node metastasis [odds ratio (OR)=2.06; 95% CI, 1.07-3.99; P=0.032], distant metastasis (OR=2.11; 95% CI, 1.15-3.88; P=0.016), advanced tumor stage (OR=2.71; 95% CI, 1.50-4.89; P=0.001) and larger tumor size (OR=2.02; 95% CI, 0.86-4.78; P=0.006). However, no significant association was observed with age (OR=1.00; 95% CI, 0.63-1.59; P=0.991) or sex (OR=1.55; 95% CI, 0.72-3.34; P=0.258). In conclusion, elevated expression of lncRNA HOXA-AS2 was significantly related to poor clinical outcomes in various cancer types, such as osteosarcoma, non-small cell lung cancer and papillary thyroid carcinoma, a finding that was further confirmed by the present study. Specifically, the potential of lncRNAHOXA-AS2 as a biomarker in assessing tumor stage, metastasis risk and OS in patients was demonstrated. However, the results of the present study also indicated that the expression of lncRNA HOXA-AS2 was not significantly associated with age or sex, suggesting its role in cancer progression might be independent of these factors. This insight may direct future research to place more focus on the relationship between lncRNA HOXA-AS2 and specific cancer types and clinical characteristics.
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Affiliation(s)
- Tijun Xiao
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Shaoyang University, Shaoyang, Hunan 422000, P.R. China
| | - An Yan
- Department of Hepatopancreatobiliary Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, P.R. China
| | - Lifang Tan
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Shaoyang University, Shaoyang, Hunan 422000, P.R. China
| | - Hongwei Zhu
- Department of Hepatopancreatobiliary Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, P.R. China
| | - Wenzhe Gao
- Department of Hepatopancreatobiliary Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, P.R. China
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20
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Lee JJ, Rapoport NA, Pipkorn P, Puram SV, Jackson RS. Airway protection and outcomes after staged versus concurrent bilateral neck dissections with transoral base of tongue cancer resection. Head Neck 2024; 46:1020-1027. [PMID: 38414192 DOI: 10.1002/hed.27696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 12/30/2023] [Accepted: 02/08/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVES To assess airway, safety, and resource utilization outcomes between transoral base of tongue (BOT) surgery with staged versus concurrent bilateral neck dissections (BND). METHODS A retrospective cohort study of patients with human papilloma virus (HPV)-related BOT cancer who underwent transoral surgery and BND from January 2015 through June 2022 was conducted. Free flap patients were excluded. RESULTS Of 126 patients (46 [37%] staged and 80 [63%] concurrent BND), there were no significant differences in rates of postoperative intubation, tracheostomy, intensive care admission, operative takebacks, gastrostomy, and 30-day readmission. Total operative time (median difference 1.4 [95% CI 0.9-1.8] hours), length of stay (1.0 [1.0-1.0] day), and time between primary surgery and adjuvant therapy initiation (4.0 [0.0-8.0] days) were lower in the concurrent BND cohort. CONCLUSION Concurrent BND alongside transoral BOT resection is safe with similar airway outcomes and lower total operative time, length of stay, and time to adjuvant therapy initiation compared to staged BND.
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Affiliation(s)
- Jake J Lee
- Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | | | - Patrik Pipkorn
- Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sidharth V Puram
- Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ryan S Jackson
- Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
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21
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Soleimani M, Harooni A, Erfani N, Khan AR, Saba T, Bahaj SA. Classification of cancer types based on microRNA expression using a hybrid radial basis function and particle swarm optimization algorithm. Microsc Res Tech 2024; 87:1052-1062. [PMID: 38230557 DOI: 10.1002/jemt.24492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/27/2023] [Accepted: 12/25/2023] [Indexed: 01/18/2024]
Abstract
The diagnosis and treatment of cancer is one of the most challenging aspects of the medical profession, despite advances in disease diagnosis. MicroRNAs are small noncoding RNA molecules involved in regulating gene expression and are associated with several cancer types. Therefore, the analysis of microRNA data has become one of the most important areas of cancer research in recent years. This paper presents an improved method for cancer-type classification based on microRNA expression data using a hybrid radial basis function (RBF) and particle swarm optimization (PSO) algorithm. Two datasets containing microRNA information were used, and preprocessing and normalization operations were performed on the raw data. Feature selection was carried out by using the PSO algorithm, which can identify the most relevant and informative features in the data along with helping to prioritize them. Using a PSO algorithm for feature selection is an effective approach to microRNA analysis. This enhances the accuracy and reliability of cancer-type classifications based on microRNA expression data. In the proposed method, we, respectively, achieved an accuracy of 0.95% and 0.91% on both datasets, with an average of 0.93%, using an improved RBF neural network classifier. These results demonstrate that the proposed method outperforms previous works. RESEARCH HIGHLIGHTS: To enhance the accuracy of cancer-type classifications based on microRNA expression data. We present a minimal feature selection method using particle swarm optimization to reduce computational load & radial basis function to improve accuracy.
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Affiliation(s)
- Masoumeh Soleimani
- Department of Mathematics and Statistical Sciences, Clemson University, Clemson, South Carolina, USA
| | - Aryan Harooni
- Department of Electrical and Computer Engineering, Isfahan University of Technology, Isfahan, Iran
| | - Nasim Erfani
- Department of Computer Engineering, Dolatabad Branch, Islamic Azad University, Isfahan, Iran
| | - Amjad Rehman Khan
- Artificial Intelligence & Data Analytics Lab CCIS Prince Sultan University, Riyadh, Saudi Arabia
| | - Tanzila Saba
- Artificial Intelligence & Data Analytics Lab CCIS Prince Sultan University, Riyadh, Saudi Arabia
| | - Saeed Ali Bahaj
- MIS Department College of Business Administration, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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22
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Li Y, Dong W, Tang H, Guo X, Wu S, Lu G, Li X, Chen C. Correlates of death anxiety for patients with cancer: A systematic review and meta-analysis. J Clin Nurs 2024; 33:1933-1947. [PMID: 38284499 DOI: 10.1111/jocn.17021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/24/2023] [Accepted: 01/07/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE A systematic review and meta-analysis was performed to identify the factors related to cancer death anxiety based on available evidence. DESIGN This systematic review and meta-analysis followed the PRISMA 2020 guidelines. METHODS Seven databases were searched to identify studies on the relationships of cancer death anxiety with demographic characteristics, disease factors and psychosocial factors from inception to May 2023. The Agency for Medical Research and Quality (AHRQ) scale was used to evaluate the quality of the included studies. After two researchers independently completed the literature search, data extraction and quality evaluation, meta-analysis was conducted by using RevMan5.3 and Stata 17.0 software. RESULTS In total, 52 studies were included in this review. The results revealed that there were positive correlations of death anxiety with female sex, the symptom burden, anxiety levels, depression levels, fear of recurrence, attachment avoidance, psychological distress, resignation and confrontation coping. Death anxiety was negatively correlated with age, education level, ability to perform daily activities, self-esteem, spiritual well-being, sense of meaning in life, resilience, quality of life, social support and religious beliefs. CONCLUSIONS Our results can inform the design of interventions to address death anxiety and improve the overall quality of life of cancer patients. Healthcare professionals should promptly identify and focus on death anxiety in high-risk populations of cancer patients. RELEVANCE TO CLINICAL PRACTICE Cancer patients commonly experience death anxiety, and this anxiety has a nonnegligible impact on patients' mental health and overall quality of life. This study can inform the development of interventions by clinical healthcare professionals. NO PATIENT OR PUBLIC CONTRIBUTION This was a meta-analysis based on data from previous studies.
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Affiliation(s)
- Yuanyuan Li
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China
| | - Wanglin Dong
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China
| | - Haishan Tang
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China
| | - Xiajun Guo
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China
| | - Sijia Wu
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China
| | - Guangli Lu
- Institute of Business Administration, School of Business, Henan University, Kaifeng, China
| | - Xia Li
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China
| | - Chaoran Chen
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, China
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23
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Li W, Li L, Ornstein KA, Morrison RS, Liu B. Spatiotemporal Patterns of Hospitalizations Among Older Adults With Co-Presence of Cancer and Dementia in US Counties: 2013-2018. J Appl Gerontol 2024; 43:601-611. [PMID: 37963605 DOI: 10.1177/07334648231213747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Abstract
We assessed the spatiotemporal patterns of hospitalization with comorbid cancer and dementia. Using the 2013-2018 inpatient claims data for Medicare fee-for-service (FFS) beneficiaries, we calculated hospitalization rates by dividing the total admissions from individuals with the co-presence of a major cancer (breast, prostate, lung, and colorectal) and dementia diagnoses with the total counts of FFS beneficiaries aged 65 or older. We identified 22 hotspots with high hospitalization rates that showed heterogeneous spatial and temporal utilization patterns. The odds of a county being a hotspot increased significantly with the county-level percentage of dual Medicare-Medicaid beneficiaries (aOR 1.05; 95% CI: 1.04-1.07) and the prevalence of cancer (aOR 1.73; 95% CI: 1.59-1.89), while decreased significantly with increasing degree of rurality (aOR .82; 95% CI: .79-.85) and decreased yearly over time (aOR .72; 95% CI: .68-.75). The identified hotspots and factors at the county-level may help understand healthcare utilization patterns and assess resource allocation for this unique patient group.
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Affiliation(s)
- Weixin Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Lihua Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, USA
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Katherine A Ornstein
- Center for Equity in Aging, Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - R Sean Morrison
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bian Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, USA
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24
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Cohen O, Tzelnick S, Randolph G, Rinaldo A, Álvarez F, Rodrigo JP, Saba NF, Nuyts S, Corry J, Mäkitie AA, Vander Poorten V, Nathan CA, Piazza C, Ferlito A. Initial surgical management of sporadic medullary thyroid cancer: Guidelines based optimal care - A systematic review. Clin Endocrinol (Oxf) 2024; 100:468-476. [PMID: 38472743 DOI: 10.1111/cen.15041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/02/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor from parafollicular cells that produce calcitonin (Ct). Despite several existing guidelines for the surgical management of sporadic MTC (sMTC), optimal initial surgical management of the thyroid, the central and the lateral neck remains a matter of debate. METHODS A systematic review in PubMed and Scopus for current guidelines addressing the surgical management of sMTC and its referenced citations was conducted as per the PRISMA guidelines. RESULTS Two-hundred and one articles were identified, of which 7 met the inclusion criteria. Overall, guidelines vary significantly in their recommendations for the surgical management of sMTC. Only one guideline recommended partial thyroidectomy for limited disease, but the possibility to avoid completion thyroidectomy in selected cases is acknowledged in 42% (3/7) of the remaining guidelines. The majority of guidelines (71.4%; 5/7) recommended prophylactic central neck dissection (CND) for all patients while the remaining two guidelines recommended CND based on Ct level and tumor size. The role of prophylactic lateral neck dissection based on preoperative Ct levels was recommended by 42% (3/7) of guidelines. Overall, these guidelines are based on low-quality evidence, mostly single-center retrospective series, some of which are over 20 years old. CONCLUSION Current surgical management guidelines of sMTC should be revised, and ought to be based on updated data challenging current recommendations, which are based on historic, low-quality evidence. Partial thyroidectomy may become a viable option for small, limited tumors. Prospective, multi-center studies may be useful to conclude whether prophylactic ND is necessary in all sMTC patients.
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Affiliation(s)
- Oded Cohen
- Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Sharon Tzelnick
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Gregory Randolph
- Division of Otolaryngology-Endocrine Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard University, Boston, Massachusetts, USA
| | | | - Fernando Álvarez
- Department of Otolaryngology, Hospital Universitario Central Asturias, Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Asturias, Spain
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central Asturias, Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, Oviedo, Asturias, Spain
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Sandra Nuyts
- Laboratory of Experimental Radiotherapy, Department of Oncology, Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - June Corry
- Department Radiation Oncology, GenesisCare St Vincent's Hospital, Melbourne, Australia
| | - Antti A Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, Research Program in Systems Oncology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Vincent Vander Poorten
- Section Head and Neck Oncology, Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, University Hospitals Leuven, KU Leuven, Louvain, Belgium
| | - Cherie-Ann Nathan
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University-Health Shreveport, Shreveport, Louisiana, USA
| | - Cesare Piazza
- Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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25
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Myers AM, Barlow RC, Baldini G, Campbell AM, Carli F, Carr EJ, Collyer T, Danjoux G, Davis JF, Denehy L, Durrand J, Gillis C, Greenfield DM, Griffiths SP, Grocott M, Humphreys L, Jack S, Keen C, Levett DZH, Merchant Z, Moore J, Moug S, Ricketts W, Santa Mina D, Saxton JM, Shaw CE, Tew GA, Thelwell M, West MA, Copeland RJ. International consensus is needed on a core outcome set to advance the evidence of best practice in cancer prehabilitation services and research. Br J Anaesth 2024; 132:851-856. [PMID: 38522964 DOI: 10.1016/j.bja.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/31/2024] [Accepted: 02/23/2024] [Indexed: 03/26/2024] Open
Abstract
Prehabilitation aims to optimise patients' physical and psychological status before treatment. The types of outcomes measured to assess the impact of prehabilitation interventions vary across clinical research and service evaluation, limiting the ability to compare between studies and services and to pool data. An international workshop involving academic and clinical experts in cancer prehabilitation was convened in May 2022 at Sheffield Hallam University's Advanced Wellbeing Research Centre, England. The workshop substantiated calls for a core outcome set to advance knowledge and understanding of best practice in cancer prehabilitation and to develop national and international databases to assess outcomes at a population level.
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Affiliation(s)
- Anna M Myers
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK.
| | - Rachael C Barlow
- Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - Gabriele Baldini
- Anaesthesiology and Intensive Care Department of Health Sciences, Section of Anaesthesiology, Intensive Care and Pain Medicine, University of Florence, Florence, Italy
| | | | - Franco Carli
- Department of Anaesthesia, McGill University Health Center, Glen Site, Royal Victoria Hospital, Montreal, QC, Canada
| | - Esther J Carr
- South Tees NHS Foundation Trust, James Cook University Hospital, Middlesbrough, UK
| | - Tom Collyer
- Anaesthetic Department, Harrogate and District NHS Foundation Trust, Harrogate, UK
| | - Gerard Danjoux
- North Yorkshire Academic Alliance of Perioperative Medicine, James Cook University Hospital, Middlesbrough, UK
| | - June F Davis
- Macmillan Cancer Support, London, UK; Allied Health Solutions, Hadlow, Kent, UK
| | - Linda Denehy
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia; Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - James Durrand
- Department of Anaesthesia and Perioperative Medicine, James Cook University Hospital, Middlesbrough, UK
| | - Chelsia Gillis
- School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Diana M Greenfield
- Weston Park Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | | | - Mike Grocott
- Faculty of Medicine, University of Southampton, Southampton, UK; Acute Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Trust, University of Southampton, Southampton, UK
| | - Liam Humphreys
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Sandy Jack
- Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Biomedical Research Centre, University Hospital Southampton NHS Trusts, Southampton, UK
| | - Carol Keen
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Denny Z H Levett
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Trust, University of Southampton, Southampton, UK; Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Zoe Merchant
- Greater Manchester Cancer Alliance, Manchester, UK
| | - John Moore
- Department of Anaesthesia and Peri-operative Medicine, Manchester University NHS Foundation Trust, Manchester, UK
| | - Susan Moug
- Departments of Colorectal Surgery, Royal Alexandra Hospital, Paisley, Scotland, UK
| | - William Ricketts
- Respiratory Medicine, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada; Department of Anaesthesiology and Pain Management, University Health Network, Toronto, ON, Canada
| | - John M Saxton
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull, UK
| | - Clare E Shaw
- NIHR Biomedical Research Centre at The Royal Marsden and the Institute of Cancer Research, London, UK
| | | | - Michael Thelwell
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Malcolm A West
- University of Southampton, Faculty of Medicine, Cancer Sciences, University Surgery, Southampton University Hospital NHS Foundation Trust, Southampton, UK
| | - Robert J Copeland
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
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26
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Bader M, Steckelings UM, Alenina N, Santos RA, Ferrario CM. Alternative Renin-Angiotensin System. Hypertension 2024; 81:964-976. [PMID: 38362781 PMCID: PMC11023806 DOI: 10.1161/hypertensionaha.123.21364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
The renin-angiotensin system is the most important peptide hormone system in the regulation of cardiovascular homeostasis. Its classical arm consists of the enzymes, renin, and angiotensin-converting enzyme, generating angiotensin II from angiotensinogen, which activates its AT1 receptor, thereby increasing blood pressure, retaining salt and water, and inducing cardiovascular hypertrophy and fibrosis. However, angiotensin II can also activate a second receptor, the AT2 receptor. Moreover, the removal of the C-terminal phenylalanine from angiotensin II by ACE2 (angiotensin-converting enzyme 2) yields angiotensin-(1-7), and this peptide interacts with its receptor Mas. When the aminoterminal Asp of angiotensin-(1-7) is decarboxylated, alamandine is generated, which activates the Mas-related G-protein-coupled receptor D, MrgD (Mas-related G-protein-coupled receptor type D). Since Mas, MrgD, and the AT2 receptor have opposing effects to the classical AT1 receptor, they and the enzymes and peptides activating them are called the alternative or protective arm of the renin-angiotensin system. This review will cover the historical aspects and the current standing of this recent addition to the biology of the renin-angiotensin system.
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Affiliation(s)
- Michael Bader
- Max-Delbrück-Center for Molecular Medicine (MDC), Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
- Charité - University Medicine, Berlin, Germany
- Institute for Biology, University of Lübeck, Lübeck, Germany
| | - U. Muscha Steckelings
- Institute for Molecular Medicine, Dept. of Cardiovascular & Renal Research, University of Southern Denmark, Odense, Denmark
| | - Natalia Alenina
- Max-Delbrück-Center for Molecular Medicine (MDC), Berlin, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Robson A.S. Santos
- National Institute of Science and Technology in Nanobiopharmaceutics (Nanobiofar) - Department of Physiology and Biophysics, Institute of Biological Sciences - Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Carlos M. Ferrario
- Laboratory of Translational Hypertension, Department of Surgery, Wake Forest School of Medicine, Winston Salem, NC 27157, USA
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27
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Faraj KS, Kaufman SR, Herrel LA, Maganty A, Oerline MK, Caram MEV, Shahinian VB, Hollenbeck BK. Urologist practice divestment from radiation vault ownership and treatment patterns for prostate cancer. Cancer 2024; 130:1609-1617. [PMID: 38146764 PMCID: PMC11009074 DOI: 10.1002/cncr.35168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/23/2023] [Accepted: 11/27/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Urologists practicing in single-specialty groups with ownership in radiation vaults are more likely to treat men with prostate cancer. The effect of divestment of vault ownership on treatment patterns is unclear. METHODS A 20% sample of national Medicare claims was used to perform a retrospective cohort study of men with prostate cancer diagnosed between 2010 and 2019. Urology practices were categorized by radiation vault ownership as nonowners, continuous owners, and divested owners. The primary outcome was use of local treatment, and the secondary outcome was use of intensity-modulated radiation therapy (IMRT). A difference-in-differences framework was used to measure the effect of divestment on outcomes compared to continuous owners. Subgroup analyses assessed outcomes by noncancer mortality risk (high [>50%] vs. low [≤50%]). RESULTS Among 72 urology practices that owned radiation vaults, six divested during the study. Divestment led to a decrease in treatment compared with those managed at continuously owning practices (difference-in-differences estimate, -13%; p = .03). The use of IMRT decreased, but this was not statistically significant (difference-in-differences estimate, -10%; p = .13). In men with a high noncancer mortality risk, treatment (difference-in-differences estimate, -28%; p < .001) and use of IMRT (difference-in-differences estimate, -27%; p < .001) decreased after divestment. CONCLUSIONS Urology group divestment from radiation vault ownership led to a decrease in prostate cancer treatment. This decrease was most pronounced in men who had a high noncancer mortality risk. This has important implications for health care reform by suggesting that payment programs that encourage constraints on utilization, when appropriate, may be effective in reducing overtreatment.
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Affiliation(s)
- Kassem S Faraj
- Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI
| | - Samuel R Kaufman
- Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI
| | - Lindsey A Herrel
- Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI
| | - Avinash Maganty
- Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI
| | - Mary K Oerline
- Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI
| | - Megan E. V. Caram
- VA Health Services Research & Development, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Vahakn B Shahinian
- Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
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28
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Tabaksert A, James T, Rusius C, Walters H, Lester S. Drainless, day-case lateral neck dissection with Artiss™ fibrin sealant: A prospective cohort study. Head Neck 2024; 46:1146-1151. [PMID: 38465445 DOI: 10.1002/hed.27715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/29/2024] [Accepted: 02/13/2024] [Indexed: 03/12/2024] Open
Abstract
OBJECTIVE Lateral neck dissection (LND) is performed for staging/treatment of head and neck lesions. This traditionally includes placement of a drain and inpatient admission. Drainless, day-case head and neck surgery is attractive due to cost-effectiveness and reduced length of stay, but evidence is lacking in LND. We aim to investigate Artiss™ as an alternative to drain placement, facilitating day-case LND. METHODS A prospective review was conducted of patients who underwent LND in a UK hospital over a 22-month period. RESULTS Thirty-nine patients were identified (27 Artiss™ only; 12 Artiss™ with a drain). Eight Artiss™ only patients were day-case. All drains were removed by post-operative day 2. There was no statistically significant difference in the number of complications between the two groups. CONCLUSION This observational study demonstrates that for selected patients, Artiss™ could facilitate drainless, day-case LND. Further controlled studies with matched groups and larger numbers are required to validate this.
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Affiliation(s)
- Ayla Tabaksert
- Department of Ear, Nose and Throat, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Tobias James
- Department of Ear, Nose and Throat, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Christopher Rusius
- Department of Ear, Nose and Throat, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Holt Walters
- Department of Ear, Nose and Throat, James Cook University Hospital, Middlesbrough, United Kingdom
| | - Shane Lester
- Department of Ear, Nose and Throat, James Cook University Hospital, Middlesbrough, United Kingdom
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29
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Papakonstantinou PE, Kalogera V, Charitos D, Polyzos D, Benia D, Batsouli A, Lampropoulos K, Xydonas S, Gupta D, Lip GYH. When anticoagulation management in atrial fibrillation becomes difficult: Focus on chronic kidney disease, coagulation disorders, and cancer. Blood Rev 2024; 65:101171. [PMID: 38310007 DOI: 10.1016/j.blre.2024.101171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 02/05/2024]
Abstract
Anticoagulation therapy (AT) is fundamental in atrial fibrillation (AF) treatment but poses challenges in implementation, especially in AF populations with elevated thromboembolic and bleeding risks. Current guidelines emphasize the need to estimate and balance thrombosis and bleeding risks for all potential candidates of antithrombotic therapy. However, administering oral AT raises concerns in specific populations, such as those with chronic kidney disease (CKD), coagulation disorders, and cancer due to lack of robust data. These groups, excluded from large direct oral anticoagulants trials, rely on observational studies, prompting physicians to adopt individualized management strategies based on case-specific evaluations. The scarcity of evidence and specific guidelines underline the need for a tailored approach, emphasizing regular reassessment of risk factors and anticoagulation drug doses. This narrative review aims to summarize evidence and recommendations for challenging AF clinical scenarios, particularly in the long-term management of AT for patients with CKD, coagulation disorders, and cancer.
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Affiliation(s)
| | - Vasiliki Kalogera
- Third Cardiology Department, School of Medicine, National and Kapodistrian University of Athens, "Sotiria" Chest Hospital, Mesogeion Ave 152, 11527 Athens, Greece
| | - Dimitrios Charitos
- First Cardiology Department, Evangelismos Hospital, Ipsilantou 45-47, 106 76 Athens, Greece
| | - Dimitrios Polyzos
- Second Cardiology Department, Evangelismos Hospital, Ipsilantou 45-47, 106 76 Athens, Greece
| | - Dimitra Benia
- Cardiology Department, General Hospital-Health Center of Kithira, Aroniadika, 80200 Kithira Island, Greece
| | - Athina Batsouli
- Second Cardiology Department, Evangelismos Hospital, Ipsilantou 45-47, 106 76 Athens, Greece
| | - Konstantinos Lampropoulos
- Second Cardiology Department, Evangelismos Hospital, Ipsilantou 45-47, 106 76 Athens, Greece; School of Medicine, European University of Cyprus, Diogenous 6, 2404 Egkomi, Cyprus
| | - Sotirios Xydonas
- Second Cardiology Department, Evangelismos Hospital, Ipsilantou 45-47, 106 76 Athens, Greece
| | - Dhiraj Gupta
- Department of Cardiology, Liverpool Heart and Chest Hospital, L14 3PE Liverpool, United Kingdom.
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Thomas Dr., L14 3PE Liverpool, United Kingdom; Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Selma Lagerløfs Vej 249, 9260 Gistrup, Aalborg, Denmark.
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30
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Mesquita LA, Spiazzi BF, Piccoli GF, Nogara DA, da Natividade GR, Garbin HI, Wayerbacher LF, Wiercinski VM, Baggio VA, Zingano CP, Schwartsmann G, Lopes G, Petrie JR, Colpani V, Gerchman F. Does metformin reduce the risk of cancer in obesity and diabetes? A systematic review and meta-analysis. Diabetes Obes Metab 2024; 26:1929-1940. [PMID: 38389430 DOI: 10.1111/dom.15509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/28/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024]
Abstract
AIM To evaluate the effect of metformin on cancer incidence in subjects with overweight/obesity and/or prediabetes/diabetes. MATERIALS AND METHODS We searched MEDLINE, Embase and CENTRAL for randomized controlled trials (RCTs) in adults with overweight/obesity and/or prediabetes/diabetes that compared metformin to other interventions for ≥24 weeks. Independent reviewers selected and extracted data including population and intervention characteristics and new diagnoses of cancer. We used the RoB 2.0 risk-of-bias tool and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework to assess risk of bias and certainty of evidence. RESULTS From 14 895 records after removal of duplicates, 27 trials were included, providing a total of 10 717 subjects in the metformin group and 10 003 in the control group, with 170 and 208 new cases of cancer, respectively. Using a random-effects model, the relative risk was 1.07 (95% confidence interval 0.87-1.31), with similar results in subgroup analyses by study duration or effect of control intervention on weight. Risk of bias in most studies was low, and no evidence of publication bias was found. Trial sequential analysis provided evidence that the cumulative sample size was large enough to exclude a significant effect of metformin on cancer incidence. CONCLUSIONS Metformin did not reduce cancer incidence in RCTs involving subjects with overweight/obesity and/or prediabetes/diabetes.
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Affiliation(s)
- Leonardo A Mesquita
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Critical Care Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Bernardo F Spiazzi
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Giovana F Piccoli
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Daniela A Nogara
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gabriella R da Natividade
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Henrique I Garbin
- Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Laura F Wayerbacher
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vanessa M Wiercinski
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Viviane A Baggio
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Carolina P Zingano
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gilberto Schwartsmann
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gilberto Lopes
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida, USA
| | - John R Petrie
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Verônica Colpani
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Gerchman
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Division of Endocrinology and Metabolism, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Gao K, Li X, Luo S, Zhao L. An overview of the regulatory role of annexin A1 in the tumor microenvironment and its prospective clinical application (Review). Int J Oncol 2024; 64:51. [PMID: 38516766 PMCID: PMC10997369 DOI: 10.3892/ijo.2024.5639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/06/2024] [Indexed: 03/23/2024] Open
Abstract
Although annexin A1 (ANXA1), a 37 kDa phospholipid‑binding anti‑inflammatory protein expressed in various tissues and cell types, has been investigated extensively for its regulatory role in cancer biology, studies have mainly focused on its intracellular role. However, cancer cells and stromal cells expressing ANXA1 have the ability to transmit signals within the tumor microenvironment (TME) through autocrine, juxtacrine, or paracrine signaling. This bidirectional crosstalk between cancer cells and their environment is also crucial for cancer progression, contributing to uncontrolled tumor proliferation, invasion, metastasis and resistance to therapy. The present review explored the important role of ANXA1 in regulating the cell‑specific crosstalk between various compartments of the TME and analyzed the guiding significance of the crosstalk effects in promotion or suppressing cancer progression in the development of cancer treatments. The literature shows that ANXA1 is critical for the regulation of the TME, indicating that ANXA1 signaling between cancer cells and the TME is a potential therapeutic target for the development of novel therapeutic approaches for impeding cancer development.
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Affiliation(s)
- Kuan Gao
- Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Xinyang Li
- Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Shuya Luo
- Department of Ion Channel Pharmacology, School of Pharmacy, China Medical University, Shenyang, Liaoning 110122, P.R. China
| | - Limei Zhao
- Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
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32
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Hibler EA, Szymaniak B, Abbass MA. Colorectal Cancer Risk between Mendelian and Non-Mendelian Inheritance. Clin Colon Rectal Surg 2024; 37:140-145. [PMID: 38606051 PMCID: PMC11006447 DOI: 10.1055/s-0043-1770382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Hereditary colorectal cancer has been an area of focus for research and public health practitioners due to our ability to quantify risk and then act based on such results by enrolling patients in surveillance programs. The wide access to genetic testing and whole-genome sequencing has resulted in identifying many low/moderate penetrance genes. Above all, our understanding of the family component of colorectal cancer has been improving. Polygenic scores are becoming part of the risk assessment for many cancers, and the data about polygenic risk scores for colorectal cancer is promising. The challenge is determining how we incorporate this data in clinical care.
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Affiliation(s)
- Elizabeth A. Hibler
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Brittany Szymaniak
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Mohammad Ali Abbass
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Shakeri B, Abdi K, Bagi M, Dalvand S, Shahriari H, Sadeghi S, Ghanei Gheshlagh R. A Systematic Review and Meta-analysis of Death Anxiety Among Iranian Patients With Cancer. Omega (Westport) 2024; 89:247-258. [PMID: 35125024 DOI: 10.1177/00302228211070400] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Death anxiety in cancer patients can cause and exacerbate mental disorders and affect the healing process and survival. In this study, percentage score of death anxiety among Iranian cancer patients was reported. The databases of Scopus, PubMed, ISI, MagIran, and Scientific Information Database were searched and 396 articles were retrieved. Twenty-three eligible studies were included in the analysis considering the inclusion criteria. Heterogeneity among selected studies was assessed through the Cochrane Q test and I2 test. The percentage of death anxiety scores in Iranian patients with cancer was 59.91% (95% confidence interval: 51.57-62.24). The results of subgroup analysis showed that the percentage of death anxiety scores in patients with breast cancer was 67.55% (95% CI: 56.50-78.60) and in patients with other malignancies was 53.78% (95% CI: 50.20-57.36). Death anxiety is high among Iranian patients with cancer and counseling sessions to control and manage this challenge seems necessary.
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Affiliation(s)
- Bahreh Shakeri
- Faculty of Nursing and Midwifery, Kurdistan University of Medical Scieneces, Sanandaj, Iran
| | - Kamel Abdi
- Nursing Department, Faculty of Medicine, Komar University of Science and Technology, Sulimaniya City, Iraq
| | - Majid Bagi
- Spiritual Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Sahar Dalvand
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hosein Shahriari
- Faculty of Para Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sharam Sadeghi
- Spiritual Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Reza Ghanei Gheshlagh
- Spiritual Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Hawwash NK, Sperrin M, Martin GP, Joshu CE, Florido R, Platz EA, Renehan AG. Overweight-years and cancer risk: A prospective study of the association and comparison of predictive performance with body mass index (Atherosclerosis Risk in Communities Study). Int J Cancer 2024; 154:1556-1568. [PMID: 38143298 PMCID: PMC7615716 DOI: 10.1002/ijc.34821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/12/2023] [Accepted: 11/22/2023] [Indexed: 12/26/2023]
Abstract
Excess body mass index (BMI) is associated with a higher risk of at least 13 cancers, but it is usually measured at a single time point. We tested whether the overweight-years metric, which incorporates exposure time to BMI ≥25 kg/m2 , is associated with cancer risk and compared this with a single BMI measure. We used adulthood BMI readings in the Atherosclerosis Risk in Communities (ARIC) study to derive the overweight-years metric. We calculated associations between the metric and BMI and the risk of cancers using Cox proportional hazards models. Models that either included the metric or BMI were compared using Harrell's C-statistic. We included 13,463 participants, with 3,876 first primary cancers over a mean of 19 years (SD 7) of cancer follow-up. Hazard ratios for obesity-related cancers per standard deviation overweight-years were 1.15 (95% CI: 1.05-1.25) in men and 1.14 (95% CI: 1.08-1.20) in women. The difference in the C-statistic between models that incorporated BMI, or the overweight-years metric was non-significant in men and women. Overweight-years was associated with the risk of obesity-related cancers but did not outperform a single BMI measure in association performance characteristics.
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Affiliation(s)
- Nadin K. Hawwash
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Cancer Research UK, Manchester Cancer Research Centre, Manchester, UK
| | - Matthew Sperrin
- Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Glen P. Martin
- Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Corinne E. Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA
| | - Roberta Florido
- Division of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Elizabeth A. Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA
| | - Andrew G. Renehan
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester, UK
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35
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Abbass MA, Poylin V, Strong S. Hereditary Colorectal Cancer Syndromes Registry: What, How, and Why? Clin Colon Rectal Surg 2024; 37:198-202. [PMID: 38606043 PMCID: PMC11006437 DOI: 10.1055/s-0043-1770733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Caring for patients with colorectal cancer inherited cancer syndromes is complex, and it requires a well-thought integration process between a multidisciplinary team, an accessible database, and a registry coordinator. This requires an aligned vision between the administrative business team and the clinical team. Although we can manage most of the cancers that those patients develop according to oncologic guidance, the future risk of patients and their families might add emotional and psychological burdens on them in the absence of a well-qualified and trained team where balancing quality of life and cancer risk are at the essence of decision making.
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Affiliation(s)
- Mohammad Ali Abbass
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Vitaliy Poylin
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Scott Strong
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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36
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Nova P, Gomes AM, Costa-Pinto AR. It comes from the sea: macroalgae-derived bioactive compounds with anti- cancer potential. Crit Rev Biotechnol 2024; 44:462-476. [PMID: 36842998 DOI: 10.1080/07388551.2023.2174068] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/14/2023] [Indexed: 02/28/2023]
Abstract
Nature derived compounds represent a valuable source of bioactive molecules with enormous potential. The sea is one of the richest environments, full of skilled organisms, where algae stand out due to their unique characteristics. Marine macroalgae adapt their phenotypic characteristics, such as chemical composition, depending on the environmental conditions where they live. The compounds produced by these organisms show tremendous potential to be used in the biomedical field, due to their antioxidant, anti-inflammatory, immunomodulatory, and anti-cancer properties.Cancer is one of the deadliest diseases in the world, and the lack of effective treatments highlights the urgent need for the development of new therapeutic strategies. This review provides an overview of the current advances regarding the anti-cancer activity of the three major groups of marine macroalgae, i.e., red algae (Rhodophyta), brown algae (Phaeophyceae), and green algae (Chlorophyta) on pancreatic, lung, breast, cervical, colorectal, liver, and gastric cancers as well as leukemia and melanoma. In addition, future perspectives, and limitations regarding this field of work are also discussed.
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Affiliation(s)
- Paulo Nova
- Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Ana Maria Gomes
- Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Ana R Costa-Pinto
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- IPATIMUP - Instituto de Patologia Molecular e Imunologia da Universidade do Porto, Porto, Portugal
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Ouyang N, Feder SL, Baker JN, Knobf MT. Prognostic Communication Between Parents and Clinicians in Pediatric Oncology: An Integrative Review. Am J Hosp Palliat Care 2024; 41:545-557. [PMID: 37309610 DOI: 10.1177/10499091231183107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
Background: Prognostic communication between clinicians and parents in pediatric oncology is complex. However, no review has exclusively examined research on prognostic communication in pediatric oncology. In this review, we synthesize the evidence on prognostic communication in pediatric oncology and provide recommendations for future research. Methods: We conducted an integrative review searching six databases for studies on prognostic communication in pediatric oncology as of August 2022. We applied descriptive and narrative approaches to data analysis. Results: Fourteen quantitative and five qualitative studies were included. All studies were conducted in Western developed countries. In total, 804 parents of 770 children with cancer were included. Across studies, parents were predominately female, Non-Hispanic White, and had high school or higher levels of education. Most parents reported that prognostic communication was initiated in the first year after their children's diagnosis. High-quality prognostic communication was positively associated with trust and hope and negatively associated with parental distress and decisional regret. In qualitative studies, parents suggested that prognostic communication should be open, ongoing, and delivered with sensitivity. Most studies were of moderate quality. The main gaps included inconsistent definitions of prognostic communication, and a lack of comprehensive and validated measurements, high-quality longitudinal studies, and diverse settings and participants. Conclusions: Clinicians should initiate high-quality prognostic communication early on in clinical practice. Future research should consider conducting high-quality longitudinal studies, developing prognostic communication definitions and measurements, and conducting studies across settings with diverse populations.
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Affiliation(s)
- Na Ouyang
- School of Nursing, Yale University, Orange, CT, USA
| | - Shelli L Feder
- School of Nursing, Yale University, Orange, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Justin N Baker
- Division of Quality of Life and Palliative Care, Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - M Tish Knobf
- School of Nursing, Yale University, Orange, CT, USA
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38
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Handelsman DJ, Idan A, Sleiman S, Bacha F, Long GV, Menzies AM, Vaishnav T, Litkouhi N, Volckmar X, Ledger W, Anazodo A. Testicular function after non-cytotoxic and immunotherapy drug treatment. Andrology 2024; 12:891-898. [PMID: 37889046 DOI: 10.1111/andr.13546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/21/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND The effects of novel non-cytotoxic and immunotherapy drugs for cancer treatment on human testicular function have not been studied systematically. OBJECTIVES The present study aimed to characterize effects of non-cytotoxic and immunotherapy drugs in patients with cancers who had not been previously treated with gonadotoxic chemo- or radiotherapy. MATERIALS AND METHODS This study involved 34 men, not previously treated with gonadotoxic regimens, in a mixed longitudinal (Cohort 1: 19 men about to start and approximately 1 year on non-cytotoxic and immunotherapy treatment) and cross-sectional (Cohort 2: 15 men already on non-cytotoxic and immunotherapy treatment) study using data modeling to estimate within-person time-course changes in testicular exocrine and endocrine functions. Cohort 1 provided 45 paired semen and blood samples (34 prior to and nine during treatment) and Cohort 2 provided 45 sets of samples (15 pre-treatment, 30 on treatment), including six men in Cohort 2 who had pre-treatment spermatozoa cryostorage prior to the study. Men on non-cytotoxic and immunotherapy treatment had undergone a median of 33.5 months long-term treatment. RESULTS Spermatozoa output and concentration were reduced by about 50%, with corresponding increases in serum follicle-stimulating hormone and decreases in serum inhibin B. Serum testosterone, luteinizing hormone, and sex hormone-binding globulin were unaffected by non-cytotoxic and immunotherapy treatment. CONCLUSION Within limits of the present study of sample size and duration of on-non-cytotoxic and immunotherapy treatment, non-cytotoxic and immunotherapy drugs have a modest effects on testicular exocrine function (sperm production) or its hormonal correlates (follicle-stimulating hormone, inhibin B), with minimal impact on testicular endocrine (testosterone, luteinizing hormone) function.
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Affiliation(s)
- David J Handelsman
- Andrology Department and Clinical Andrology Laboratory, Concord Hospital, Sydney, New South Wales, Australia
- ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Amanda Idan
- Andrology Department and Clinical Andrology Laboratory, Concord Hospital, Sydney, New South Wales, Australia
| | - Sue Sleiman
- Andrology Department and Clinical Andrology Laboratory, Concord Hospital, Sydney, New South Wales, Australia
| | - Fey Bacha
- Andrology Department and Clinical Andrology Laboratory, Concord Hospital, Sydney, New South Wales, Australia
| | - Georgina V Long
- Melanoma Institute of Australia, University of Sydney, Royal North Shore & Mater Hospitals, Sydney, New South Wales, Australia
| | - Alexander M Menzies
- Melanoma Institute of Australia, University of Sydney, Royal North Shore & Mater Hospitals, Sydney, New South Wales, Australia
| | - Tejnei Vaishnav
- School of Women's and Childrens Health, Royal Hospital for Women, Sydney, New South Wales, Australia
| | - Noosha Litkouhi
- School of Women's and Childrens Health, Royal Hospital for Women, Sydney, New South Wales, Australia
| | - Xanthie Volckmar
- School of Women's and Childrens Health, Royal Hospital for Women, Sydney, New South Wales, Australia
| | - William Ledger
- School of Women's and Childrens Health, Royal Hospital for Women, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Antoinette Anazodo
- School of Women's and Childrens Health, Royal Hospital for Women, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
- Sydney Children's Hospital, Sydney, New South Wales, Australia
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39
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Tamayo SC, Quddus MR, Singh K. Recurrent Primary Paget Disease of Vulva with Paget-Like Epithelial Cells in Papillary Dermis: Displaced or Invasion? Int J Surg Pathol 2024; 32:507-510. [PMID: 37461289 DOI: 10.1177/10668969231188902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
While histological diagnosis of Paget disease of vulva is mostly straightforward, identifying and confirming invasion can be challenging. Often invasion is accompanied by epidermal hyperplasia, marked inflammatory response and desmoplastic reaction. Diagnosis of invasion in Paget disease portends a poor outcome. We report findings from a recurrent primary vulvar Paget disease where overall histomorphology of possible invasive disease is unusual and raises a possibility of displacement of Paget cells in the dermis. We compare histology of the index case with known invasive vulvar Paget disease cases retrieved from our pathology archives. Unique histomorphology in the index case suggests a possibility of previous excision related dermal displacement of Paget cells.
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Affiliation(s)
- Steffanie Charlyne Tamayo
- Department of Pathology and Laboratory Medicine, Women and Infants Hospital of Rhode Island and Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - M Ruhul Quddus
- Department of Pathology and Laboratory Medicine, Women and Infants Hospital of Rhode Island and Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Kamaljeet Singh
- Department of Pathology and Laboratory Medicine, Women and Infants Hospital of Rhode Island and Warren Alpert Medical School of Brown University, Providence, RI, USA
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40
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Stegenga K, Henley AK, Harman E, Robb SL. Shifting perspectives and transformative change: Parent perspectives of an active music engagement intervention for themselves and their child with cancer. Pediatr Blood Cancer 2024; 71:e30913. [PMID: 38337169 PMCID: PMC10959685 DOI: 10.1002/pbc.30913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/23/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Children with cancer (ages 3-8 years) and their parents experience significant, interrelated distress associated with cancer treatment. Active music engagement (AME) uses music-based play and shared music-making to mitigate this distress. To advance our understanding about how AME works and its essential features, we interviewed parents who received the AME intervention as part of a multi-site mechanistic trial. The purpose of this qualitative analysis was to describe parents' experiences of AME for themselves and their child and to better understand how the intervention worked to lower parent-child distress. PROCEDURE We conducted a total of 43 interviews with parents/caregivers, and purposively analyzed all interviews from underrepresented groups based on race/ethnicity and parent role. We used thematic analysis and achieved thematic redundancy after analyzing 28 interviews. RESULTS The following statement summarizes resulting themes: Music therapists skillfully use AME to create a safe and healthy space (Theme 1), where parents/children have transformative experiences (Theme 2) that lead to learning and enactment (Theme 3) of new skills that counteract suffering (Theme 4) through empowerment, connectedness, and sustained relief. CONCLUSIONS This work elucidates how AME works to counteract stressful qualities of cancer treatment. As parents witnessed positive and transformative changes in their child, they experienced relief and reported shifts in their perspective about cancer treatment. This led to learning and use of music as a coping strategy that extended beyond therapist-led sessions. Accessible, music-based interventions, like AME, offer a developmentally appropriate and effective way to support parents and young children during treatment.
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Affiliation(s)
- Kristin Stegenga
- Children’s Mercy, Kansas City, Division of Hematology/Oncology/BMT, Kansas City, MO
| | - Amanda K. Henley
- Indiana University, Herron School of Art and Design, Indianapolis, IN
| | | | - Sheri L. Robb
- Indiana University, School of Nursing, Indianapolis, IN
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41
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Wang Z, Zhang Y, Li K. Nuclear miRNAs as transcriptional regulators in processes related to various cancers (Review). Int J Oncol 2024; 64:56. [PMID: 38606502 PMCID: PMC11015916 DOI: 10.3892/ijo.2024.5644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/29/2024] [Indexed: 04/13/2024] Open
Abstract
MicroRNAs (miRNAs) are noncoding small nucleic acids that contain ~22 nucleotides and are considered to promote the degradation or inhibit the translation of mRNA by targeting its 3'‑untranslated region. However, growing evidence has revealed that nuclear miRNAs, combined with gene promoters or enhancers, are able to directly mediate gene transcription. These miRNAs exert a critical influence on cancer progression by affecting cell growth, migration and invasion. In this review, the direct regulation of gene expression by nuclear miRNAs at the transcriptional level was discussed and summarized, and their mechanisms of action in cancers were highlighted with reference to the various body systems.
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Affiliation(s)
- Ziqiang Wang
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong 250014, P.R. China
- Biomedical Sciences College & Shandong Medicinal Biotechnology Centre, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, P.R. China
| | - Yu Zhang
- Biomedical Sciences College & Shandong Medicinal Biotechnology Centre, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong 250117, P.R. China
| | - Kun Li
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong 250014, P.R. China
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42
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Staedtke V, Sun N, Bai R. Hypoxia-targeting bacteria in cancer therapy. Semin Cancer Biol 2024; 100:39-48. [PMID: 38554791 DOI: 10.1016/j.semcancer.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/10/2024] [Accepted: 03/20/2024] [Indexed: 04/02/2024]
Abstract
Tumor hypoxia plays a crucial role in driving cancer progression and fostering resistance to therapies by contributing significantly to chemoresistance, radioresistance, angiogenesis, invasiveness, metastasis, altered cell metabolism, and genomic instability. Despite the challenges encountered in therapeutically addressing tumor hypoxia with conventional drugs, a noteworthy alternative has emerged through the utilization of anaerobic oncolytic bacteria. These bacteria exhibit a preference for accumulating and proliferating within the hypoxic regions of tumors, where they can initiate robust antitumor effects and immune responses. Through simple genetic manipulation or sophisticated synthetic bioengineering, these bacteria can be further optimized to improve safety and antitumor activities, or they can be combined synergistically with chemotherapies, radiation, or other immunotherapies. In this review, we explore the potential benefits and challenges associated with this innovative anticancer approach, addressing issues related to clinical translation, particularly as several strains have progressed to clinical evaluation.
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Affiliation(s)
- Verena Staedtke
- Department of Neurology, Johns Hopkins University, 600 North Wolfe Street, Meyer 8-149 J, Baltimore, MD 21287, USA.
| | - Nihao Sun
- Kennedy Krieger Institute, Lab 520, 707 N Broadway, Baltimore, MD 21205, USA
| | - Renyuan Bai
- Kennedy Krieger Institute, Lab 520, 707 N Broadway, Baltimore, MD 21205, USA; Department of Neurosurgery, Johns Hopkins University, Lab 520, 707 N Broadway, Baltimore, MD 21205, USA
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Srsich AR, McCurdy MD, Fantozzi PM, Hocking MC. Predicting neuropsychological late effects in pediatric brain tumor survivors using the Neurological Predictor Scale and the Pediatric Neuro-Oncology Rating of Treatment Intensity. J Int Neuropsychol Soc 2024; 30:380-388. [PMID: 37746790 DOI: 10.1017/s1355617723000589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
OBJECTIVE The Neurological Predictor Scale (NPS) quantifies cumulative exposure to tumor- and treatment-related neurological risks. The Pediatric Neuro-Oncology Rating of Treatment Intensity (PNORTI) measures the intensity of different treatment modalities, but research is needed to establish whether it is associated with late effects. This study evaluated the predictive validity of the NPS and PNORTI for neuropsychological outcomes in pediatric brain tumor survivors. METHOD A retrospective chart review was completed of pediatric brain tumor survivors (PBTS) (n = 161, Mage = 13.47, SD = 2.80) who were at least 2 years from the end of tumor-directed treatment. Attention, intellectual functioning, perceptual reasoning, processing speed, verbal reasoning, and working memory were analyzed in relation to the NPS and PNORTI. RESULTS NPS scores ranged from 1 to 11 (M = 5.57, SD = 2.27) and PNORTI scores ranged from 1 (n = 101; 62.7%) to 3 (n = 18; 11.2%). When controlling for age, sex, SES factors, and time since treatment, NPS scores significantly predicted intellectual functioning [F(7,149) = 12.86, p < .001, R2 = .38] and processing speed [F(7,84) = 5.28, p < .001, R2 = .31]. PNORTI scores did not significantly predict neuropsychological outcomes. CONCLUSIONS The findings suggest that the NPS has value in predicting IF and processing speed above-and-beyond demographic variables. The PNORTI was not associated with neuropsychological outcomes. Future research should consider establishing clinical cutoff scores for the NPS to help determine which survivors are most at risk for neuropsychological late effects and warrant additional assessment.
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Affiliation(s)
| | | | | | - Matthew C Hocking
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- The University of Pennsylvania, Philadelphia, PA, USA
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Yahyavi SK, Holt R, Knudsen NK, Andreassen CH, Sejling C, Meddis A, Kjaer SK, Schwarz P, Jensen JEB, Torp-Pedersen C, Juul A, Selmer C, Blomberg Jensen M. Cancer risk in patients treated with denosumab compared with alendronate: A population-based cohort study. Bone 2024; 182:117053. [PMID: 38395247 DOI: 10.1016/j.bone.2024.117053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/17/2024] [Accepted: 02/19/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Antiresorptive treatment is currently used in millions of patients with osteoporosis and cancer worldwide. Early studies of denosumab suggested a small signal in ovarian cancer incidence and emerging data suggest that denosumab stimulates germ cell proliferation in the gonads. This study aims to determine the association between the use of denosumab and the risk of reproductive cancers compared with the use of alendronate. RESEARCH DESIGN AND METHODS Using a cohort study design, we used the Danish nationwide registries to identify a population of subjects ≥50 years of age during 2010-2017 who started denosumab after being on alendronate treatment for at least six months. The cohort was matched 1:2 with patients who had been treated with alendronate alone for at least six months. The risk of reproductive cancers and the risk difference between groups were estimated using the Longitudinal Targeted Maximum Likelihood Estimation (L-TMLE) method. RESULTS We identified 6054 Danish individuals who underwent treatment with denosumab. These individuals were matched with 12,108 receiving alendronate. The absolute risk of reproductive cancer was 1.05 % (95 % CI 0.75-1.34) after three years for denosumab users and was not different 0.03 % (-0.34-0.39) than for alendronate users. In supplemental analyses, there was no increased risk of non-reproductive cancers associated with the use of denosumab (risk difference of 0.54 % (-0.41-1.19). Analysis comparing denosumab users with the general population gave similar results. CONCLUSION There was no difference in the risk of cancer following treatment with denosumab compared to treatment with alendronate assessed after a short follow-up of 3 years.
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Affiliation(s)
- Sam Kafai Yahyavi
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark
| | - Rune Holt
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark
| | - Nadia Krarup Knudsen
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark
| | - Christine Hjorth Andreassen
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark
| | - Christoffer Sejling
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Alessandra Meddis
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Susanne K Kjaer
- Department of Gynaecology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Danish Cancer Institute, Unit of Virus, Lifestyle and Genes, Copenhagen, Denmark
| | - Peter Schwarz
- Department of Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jens-Erik Beck Jensen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Endocrinology, Hvidovre Hospital, University of Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, Nordsjaellands Hospital, Denmark; Department of Public Health, University of Copenhagen, Denmark
| | - Anders Juul
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Christian Selmer
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Endocrinology, Bispebjerg University Hospital, Copenhagen, Denmark.
| | - Martin Blomberg Jensen
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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Rojas-Saunero LP, van der Willik KD, Schagen SB, Ikram MA, Swanson SA. Towards a Clearer Causal Question Underlying the Association Between Cancer and Dementia. Epidemiology 2024; 35:281-288. [PMID: 38442423 PMCID: PMC11022995 DOI: 10.1097/ede.0000000000001712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 11/30/2023] [Indexed: 03/07/2024]
Abstract
BACKGROUND Several observational studies have described an inverse association between cancer diagnosis and subsequent dementia risk. Multiple biologic mechanisms and potential biases have been proposed in attempts to explain this association. One proposed explanation is the opposite expression of Pin1 in cancer and dementia, and we use this explanation and potential drug target to illustrate the required assumptions and potential sources of bias for inferring an effect of Pin1 on dementia risk from analyses measuring cancer diagnosis as a proxy for Pin1 expression. METHODS We used data from the Rotterdam Study, a population-based cohort. We estimate the association between cancer diagnosis (as a proxy for Pin1) and subsequent dementia diagnosis using two different proxy methods and with confounding and censoring for death addressed with inverse probability weights. We estimate and compare the complements of a weighted Kaplan-Meier survival estimator at 20 years of follow-up. RESULTS Out of 3634 participants, 899 (25%) were diagnosed with cancer, of whom 53 (6%) had dementia, and 567 (63%) died. Among those without cancer, 15% (411) were diagnosed with dementia, and 667 (24%) died over follow-up. Depending on the confounding and selection bias control, and the way in which cancer was used as a time-varying proxy exposure, the risk ratio for dementia diagnosis ranged from 0.71 (95% confidence interval [CI] = 0.49, 0.95) to 1.1 (95% CI = 0.79, 1.3). CONCLUSION Being explicit about the underlying mechanism of interest is key to maximizing what we can learn from this cancer-dementia association given available or readily collected data, and to defining, detecting, and preventing potential biases.
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Affiliation(s)
- L. Paloma Rojas-Saunero
- From the Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA
| | | | - Sanne B. Schagen
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Brain and Cognition, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - M. Arfan Ikram
- From the Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Sonja A. Swanson
- From the Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA
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Raffone A, Raimondo D, Rovero G, Travaglino A, Lopez G, Di Maio CM, Neola D, Raspollini A, Renzulli F, Filippelli A, Casadio P, Seracchioli R, Guida M. Conservative re-treatment of women with atypical endometrial hyperplasia and early endometrial carcinoma: We can hope, at least. Int J Gynaecol Obstet 2024; 165:542-551. [PMID: 37772342 DOI: 10.1002/ijgo.15146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/31/2023] [Accepted: 09/06/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND In women with recurrent disease who were conservatively treated for atypical endometrial hyperplasia (AEH) and early endometrial carcinoma (EEC), the reasons why conservative treatment was chosen persist and outcomes of performing a conservative re-treatment are unclear, as pooled estimates on oncologic outcomes of such a re-treatment are lacking. OBJECTIVES To provide pooled estimates of oncologic outcomes of conservative re-treatment in women with recurrent AEH or EC. SEARCH STRATEGY A systematic review and meta-analysis was performed by searching six electronic databases from their inception to March 2022. SELECTION CRITERIA Studies that allowed extraction of data about oncologic outcomes of conservative re-treatment of women with recurrent AEH and EEC after a conservative treatment. DATA COLLECTION AND ANALYSIS Pooled prevalence of complete response (CR), poor response (PR), and recurrence after conservative re-treatment was calculated. MAIN RESULTS Fifteen studies (12 retrospective and 3 prospective) with 492 women (42.1% AEH and 57.9% EEC) were included in the systematic review, and 10 studies (8 retrospective and 2 prospective) were suitable for the meta-analysis. Pooled prevalence was 85.3% (95% confidence interval [CI] 77.0%-91.0%) for CR, 14.7% (95% CI 9.0%-23.0%) for PR, and 40.4% (95% CI 15.5%-71.4%) for recurrence. CONCLUSIONS Conservative re-treatment in AEH or EC recurrent women has a high CR rate and acceptable recurrence rate that might allow it to be considered a safe and viable option, at least as a first round of conservative treatment. Women with an unsatisfied desire for motherhood or with high surgical risk might avoid hysterectomy and attempt childbearing or spare high-risk surgery.
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Affiliation(s)
- Antonio Raffone
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Division of Gynecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Diego Raimondo
- Division of Gynecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giulia Rovero
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Antonio Travaglino
- Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy
- Gynecopathology and Breast Pathology Unit, Department of Woman's Health Science, Agostino Gemelli University Polyclinic, Rome, Italy
| | - Giovanni Lopez
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Carlo Michele Di Maio
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Daniele Neola
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Arianna Raspollini
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Federica Renzulli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Amelia Filippelli
- Division of Gynecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Paolo Casadio
- Division of Gynecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Renato Seracchioli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Division of Gynecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Maurizio Guida
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
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Fredheim OMS, Torvund SK, Thoresen L, Magelssen M. How should respiratory depression and loss of airway patency be handled during initiation of palliative sedation? Acta Anaesthesiol Scand 2024; 68:675-680. [PMID: 38391048 DOI: 10.1111/aas.14396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Loss of airway patency has been reported during initiation of palliative sedation. In present guidelines the loss of airway patency during initiation of palliative sedation is not addressed. Airway patency can be restored by jaw thrust/chin lift or placing the patient in the recovery position. AIM A structured ethical analysis of how respiratory depression and loss of airway patency during initiation of palliative sedation should be handled. The essence of the dilemma is whether it is appropriate to apply simple non-invasive methods to restore airway patency in order to avoid the patient's immediate death. DESIGN A structured analysis based on the four principles of healthcare ethics and stakeholders' interests. RESULTS Beneficence and autonomy support a decision not to regain airway patency whereas non-maleficence lends weight to a decision to restore airway patency. Whether the proportionality criterion of the principle of double effect is met depends on the features of the individual case. The ethical problem appears to be a genuine dilemma where important values and arguments point to different conclusions. CONCLUSION Whether to restore airway patency when the airway is obstructed during initiation of palliative sedation will ultimately be based on clinical judgment taking into account both any known patient preferences and relevant clinical information. There are strong arguments favoring both options in this clinical and ethical dilemma. The fact that a clear and universal recommendation cannot be made does not imply indifference regarding what is the clinically and ethically best option for each individual patient.
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Affiliation(s)
- Olav Magnus S Fredheim
- Department of Palliative Medicine, Division of Surgery, Akershus University Hospital, Lørenskog, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Solveig K Torvund
- Department of Palliative Medicine, Division of Surgery, Akershus University Hospital, Lørenskog, Norway
| | - Lisbeth Thoresen
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Morten Magelssen
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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Hayes H, Stokes J, Sutton M, Meacock R. How do hospitals respond to payment unbundling for diagnostic imaging of suspected cancer patients? Health Econ 2024; 33:823-843. [PMID: 38233916 DOI: 10.1002/hec.4804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
Payments for some diagnostic scans undertaken in outpatient settings were unbundled from Diagnosis Related Group based payments in England in April 2013 to address under-provision. Unbundled scans attracted additional payments of between £45 and £748 directly following the reform. We examined the effect on utilization of these scans for patients with suspected cancer. We also explored whether any detected effects represented real increases in use of scans or better coding of activity. We applied difference-in-differences regression to patient-level data from Hospital Episodes Statistics for 180 NHS hospital Trusts in England, between April 2010 and March 2018. We also explored heterogeneity in recorded use of scans before and after the unbundling at hospital Trust-level. Use of scans increased by 0.137 scans per patient following unbundling, a 134% relative increase. This increased annual national provider payments by £79.2 million. Over 15% of scans recorded after the unbundling were at providers that previously recorded no scans, suggesting some of the observed increase in activity reflected previous under-coding. Hospitals recorded substantial increases in diagnostic imaging for suspected cancer in response to payment unbundling. Results suggest that the reform also encouraged improvements in recording, so the real increase in testing is likely lower than detected.
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Affiliation(s)
- Helen Hayes
- Office of Health Economics (OHE), London, UK
- Health Organisation, Policy and Economics (HOPE), Centre for Primary Care & Health Services Research, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Jonathan Stokes
- Health Organisation, Policy and Economics (HOPE), Centre for Primary Care & Health Services Research, School of Health Sciences, The University of Manchester, Manchester, UK
- MRC/CSO Social & Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Matt Sutton
- Health Organisation, Policy and Economics (HOPE), Centre for Primary Care & Health Services Research, School of Health Sciences, The University of Manchester, Manchester, UK
- Centre for Health Economics, Monash University, Melbourne, Victoria, Australia
| | - Rachel Meacock
- Health Organisation, Policy and Economics (HOPE), Centre for Primary Care & Health Services Research, School of Health Sciences, The University of Manchester, Manchester, UK
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Pliszka A, Wawrzyniak A, Walocha J, Musiał A, Bonczar M, Ostrowski T, Polguj M, Wysiadecki G, Clarke E, Tubbs RS, Balawender K. Embryological basis of polyorchidism including classification, reproductive potential, and risk of malignancy: A review. Clin Anat 2024; 37:405-412. [PMID: 37493239 DOI: 10.1002/ca.24093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/29/2023] [Accepted: 07/02/2023] [Indexed: 07/27/2023]
Abstract
Polyorchidism, a congenital malformation characterized by supernumerary testes (SNTs), is usually revealed incidentally during ultrasound or open scrotal surgery. In the approximately 200 cases so far published in the literature, the left side is affected more often than the right. Despite the rarity of this anomaly, a surgeon must have basic knowledge of its embryological basis and classifications to implement proper treatment and avoid overlooking it, since the consequences could harm the patient. This review summarizes previous classifications. It can be assumed that determining the risk of malignancy, and the level of reproductive potential based on location, vascularization, ductus deferens drainage, and environmental factors (e.g., temperature) affecting the SNTs, indicates the best approach to management. Therefore, we have created a new classification based on previous ones, addressing the aforementioned issues, which will guide the clinician to select the most appropriate treatment.
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Affiliation(s)
- Anna Pliszka
- Department of Normal and Clinical Anatomy, Institute of Medical Sciences, Rzeszow University Medical College, Rzeszow, Poland
| | - Agata Wawrzyniak
- Department of Histology and Embryology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Agata Musiał
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Michał Bonczar
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Tomasz Ostrowski
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Michał Polguj
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Poland
| | - Grzegorz Wysiadecki
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Poland
| | - Edward Clarke
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Poland
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurosurgery, Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
- Department of Structural and Cellular Biology, Tulane University School of Medicine, Louisiana, USA
| | - Krzysztof Balawender
- Department of Normal and Clinical Anatomy, Institute of Medical Sciences, Rzeszow University Medical College, Rzeszow, Poland
- Department of Clinical Urology and Urological Oncology, Municipal Hospital of Rzeszow, Rzeszow, Poland
- Faculty of Medicine, University Sulkhan-Saba Orbeliani University LLC, Tbilisi, Georgia
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50
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Miller EJ, Rose TL, Maughan BL, Milowsky MI, Bilen MA, Carthon BC, Gao X, Rapisuwon S, Zhao Q, Yu M, Agarwal N, Galsky MD. Phase 2 trial of tremelimumab in patients with metastatic urothelial cancer previously treated with programmed death 1/programmed death ligand 1 blockade. Cancer 2024; 130:1642-1649. [PMID: 38180804 DOI: 10.1002/cncr.35179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 01/07/2024]
Abstract
INTRODUCTION Programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) blockade has changed the landscape of treatment for metastatic urothelial cancer, but single-agent cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) blockade in metastatic urothelial cancer has been underexplored. A prior phase 2 trial of tremelimumab in PD-1/PD-L1-blockade naive patients with metastatic urothelial cancer revealed activity comparable to that observed with PD-1/PD-L1 blockade raising the hypothesis that these classes of immune checkpoint inhibitors might be non-cross-resistant. METHODS The current phase 2 trial treated patients with PD-1/PD-L1 blockade-resistant metastatic urothelial cancer with single-agent tremelimumab (750 mg intravenously every 28 days for up to 7 cycles). The primary end point was objective response rate. RESULTS Twenty-six patients were enrolled and 24 patients were evaluable for response. The objective response rate was 8.3%, composed of a total of two partial responses that lasted 10.9 and 24.0 months. Stable disease was observed in another 20.8% of patients, with a median duration of stable disease of 5.4 months. Diarrhea occurred in 15 patients (58%), elevated hepatic transaminases occurred in seven patients (27%), and adrenal insufficiency occurred in two patients (8%); one patient died after experiencing immune-related hepatitis. CONCLUSIONS High dose CTLA-4 blockade in patients with PD-1/PD-L1-resistant metastatic urothelial cancer has modest activity and is associated with treatment-related toxicity similar to prior reports.
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Affiliation(s)
- Eric J Miller
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai/Tisch Cancer Institute, New York, New York, USA
| | - Tracy L Rose
- Division of Oncology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Benjamin L Maughan
- Division of Hematology and Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Matthew I Milowsky
- Division of Oncology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Mehmet A Bilen
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA
- Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Bradley C Carthon
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA
- Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Xin Gao
- Department of Internal Medicine, Division of Hematology/Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Suthee Rapisuwon
- Division of Hematology and Medical Oncology, Georgetown Lombardi Comprehensive Cancer Center, Medstar Georgetown University Hospital, Washington, DC, USA
| | - Qianqian Zhao
- Department of Biostatistics and Medical Informatics, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin, USA
| | - Menggang Yu
- Department of Biostatistics and Medical Informatics, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin, USA
| | - Neeraj Agarwal
- Division of Hematology and Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Matthew D Galsky
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai/Tisch Cancer Institute, New York, New York, USA
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