Knowledge, attitudes, and practices related to breast cancer screening among female Jordanian university employees: A cross-sectional study

INTRODUCTION

To improve participation in breast screening programs, the level of knowledge about BC, attitudes, and practices of women in different sections of society must be understood. This study aimed to measure the level of knowledge of BC risk factors, signs and symptoms and determine current mammography practices among female employees at Jordanian universities.

METHODS

A cross-sectional descriptive study was conducted on female employees at Jordanian government universities. Data was collected using a structured questionnaire that included: sociodemographic characteristics, knowledge of BC risk factors, knowledge of BC symptoms and knowledge, attitude and practice of mammography as an early detection method.

RESULTS

A total of 362 participants completed the questionnaire. Overall, 174 scored ≥50% correct answers regarding BC risk factors, while 231 scored ≥50% correct answers regarding BC signs and symptoms. Half of the participants (n = 184, 50.8%) understood mammography to be an early BC detection method. Among those participants, 95 (51.6%) were eligible for screening and 39 (21.2%) had had a previous mammogram. The main reason for not engaging in mammography was the absence of BC signs and symptoms (37.2%). Profession, educational level and family history of BC were associated with increased knowledge of BC risk factors, signs and symptoms (p = 0.01). Lecturers in medical faculties exhibited the highest level of knowledge about mammography compared to participants in other professions (p = 0.02).

CONCLUSION

Only 79 participants had good to excellent knowledge about BC. Participants' profession was the major indicator for awareness of BC and mammography as an early detection method.

IMPLICATIONS FOR PRACTICE

The findings of this study reinforce the importance of providing BC educational programs for university employees in Jordan to increase awareness of BC and mammography.

Use of social media for the improvement of safety knowledge and awareness among Saudi Arabian phlebotomists

Purpose

The purpose of this study is to investigate the use of social media for the improvement of safety knowledge and awareness among phlebotomists.

Methods

As this study was intended to arrive at specific conclusions using empirical evidence, a deductive quantitative cross-sectional online survey design was adopted. A total of 521 phlebotomists participated in the survey, and 86 incomplete responders were removed, resulting in a final sample of 435 considered in this study. T-tests and ANOVA were used to analyze the data.

Results

A total of 41.6% stated that social media was very effective, and 31.5% stated that it was somewhat effective in improving safety knowledge and awareness. in addition, this study revealed no major differences between male and female participants (p > 0.05) with respect to the effectiveness of social media. However, statistically significant differences (p < 0.05) among the age groups were identified in relation to the effectiveness of social media and the intention to use it in the future.

Conclusion

Social media applications are effective for knowledge dissemination among healthcare professionals.

Integrated computational approaches assisted development of a novel multi-epitope vaccine against MDR Streptococcus pseudopneumoniae

The emergence of antibiotic resistance (AR) in bacteria is becoming an alarming health concern because it allows them to adapt themselves to changing environments. It is possible to prevent the spread of AR in many ways, such as reducing antibiotic misuse in human and veterinary medicine. Streptococcus pseudopneumoniae is one of these AR bacterial species that can cause pneumonia in humans and is responsible for high mortality and morbidity rates. It is oval shaped gram-positive bacterium that shows resistance to several antibiotics like penicillin, tetracycline, ciprofloxacin, erythromycin, and co-trimoxazale and no approved vaccine is available to overcome diseases of the pathogen. Thus, substantial efforts are necessary to select protective antigens from a whole genome of pathogens that are easily tested experimentally. The in silico designed vaccine was safe and potent in immunizing individuals against the aforementioned pathogens. Herein, we utilized a subtractive genomic approach to identify potential epitope-based vaccine candidates against S. pseudopneumoniae. In total, 50850 proteins were retrieved from the NCBI, representing the complete genome of S. pseudopneumoniae. Out of the total, CD-HIT analysis identified 1022 proteins as non-redundant and 49828 proteins as redundant and further subjected for subcellular localization in which bulk of proteins was located in the cytoplasm, with seven extracellular proteins (penicillin-binding protein, alpha-amylase, solute-binding protein, hypothetical protein, CHAP domain-containing protein, polysaccharide deacetylase family protein, hypothetical protein). Six immune cells epitopes (SNLQSENDRL, RNDSLQKQAR, NPTTTSEGF, KVKKKNNKK, AYSQGSQKEH, and SVVDQVSGDF) were predicted with the help of the IEDB server. To design a multi-epitopes vaccine these immune cell epitopes were together by GPGPG and adjuvant linker to enhance immune response efficacy. The 3D structure of the designed vaccine was modeled and conducted molecular docking and dynamic simulation studies were to check the binding efficacy with immune cells receptor and dynamic behavior of the docked complex. Finally, we concluded that the designed vaccine construct can provoke a proper and protective immune response against S. pseudopneumoniae.

Concurrent left ventricular myocardial diffuse fibrosis and left atrial dysfunction strongly predicts incident heart failure and all-cause mortality

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): British Heart Foundation

Academy of Medical Sciences

Background

LV myocardial interstitial fibrosis has been reported to influence LA morphology and function via LV remodelling and diastolic dysfunction. However, this association, as well as their combined influence on clinical outcomes remains poorly characterised.

Aim

To evaluate the relationship between left ventricular (LV) fibrosis quantified by native T1 times and left atrial (LA) global and phasic function and their impact on clinical outcomes.

Methods

A total of 40,818 UK Biobank participants with cardiovascular magnetic resonance data were included. Native T1 mapping was performed using Shortened Modified Look-Locker Inversion recovery sequence with global myocardial T1 estimated by an automatic segmentation framework. Ten parameters of LA phasic function were calculated from normalised LA volume-time curves derived by a three-dimensional sparse active shape model. LV parameters (mass, end-diastolic volume, and ejection fraction) were extracted by a fully convolutional neural network. Multivariable regression models were used to assess the associations between T1 and LA parameters. Lastly, survival analysis was performed to assess the interplay between T1, LA function and incident heart failure, atrial fibrillation, major adverse cardiovascular event (MACE) and all-cause mortality.

Results

The mean age of study population was 64.0 ± 7.7 years; 47.8% were men. Higher T1 values were associated with larger LA minimum size (Beta= 0.89ml per 100ms; 95% confidence interval (CI) = 0.62, 1.17), and lower LA global emptying fraction (Beta= -0.012 per 100ms; CI= -0.015, -0.010), LA reservoir function (Beta= -0.060 per 100ms; CI= -0.083, -0.037) and LA booster function (Beta= -0.014 per 100ms; CI= -0.017, -0.011). Among LA phasic functional parameters, LA booster function is most strongly associated with T1. Survival analysis revealed concurrent high T1 and low LA function had a significant influence on incident heart failure (Hazard Ratio [HR] = 2.99; CI=1.91,2.01), atrial fibrillation (HR = 4.86; CI=3.51-6.54), MACE (HR = 1.86; CI = 1.36-2.54) and all-cause mortality (HR = 1.86; CI=1.22-2.82) compared to either parameter alone, even after accounting for LV parameters (Figure 1).

Conclusion

This is the first study to robustly demonstrate the associations between myocardial diffuse fibrosis and reduced LA global and phasic functional measurements. We reveal the independent prognostic role of high T1 values accompanied by low LA function in predicting adverse clinical outcomes in a general population. These findings advance our understanding of the relationships between myocardial fibrosis and LA biomechanics at an early, subclinical stage, and highlight the additive value of incorporating these biomarkers into clinical decision making.

The association between native myocardial T1 relaxation times and left atrial phasic structure and function: the UK Biobank Imaging Enhancement study

Introduction

Left ventricular (LV) myocardial fibrosis is posited to result in left atrial (LA) changes via LV remodelling and diastolic dysfunction, though the association remains poorly characterised. Native myocardial T1 mapping is a non-invasive modality that quantifies diffuse myocardial fibrosis. This study examines the relationship between LV fibrosis (quantified by native T1 times) and LA function, drawing upon data from the UK Biobank.

Methods

40,818 participants underwent cardiovascular magnetic resonance (CMR) using steady-state free precession imaging at 1.5 Tesla. Native T1-mapping was performed using the Shortened Modified Look-Locker Inversion recovery technique (ShMOLLI), with global myocardial T1 estimated by an automatic segmentation framework. Nine parameters of LA phasic function were calculated (representing global, reservoir, conduit and booster components) from normalised LA volume-time curves. LV parameters (LV Mass, end-diastolic volume and ejection fraction) were extracted by a convolutional neural network. Multivariable logistic regression models were used to assess the association between T1 (exposure) and LA function (outcome). Mediation analysis was performed to assess the role of LV parameters as a mediator for the association between T1 and LA function. Lastly, potential non-linear relationships between T1 and LA function were investigated using Restrictive Cubic Spline (RCS) modelling, with model fit assessed via the Akaike Information Criterion (AIC).

Results

Higher T1 values were positively associated with larger LA volumes, and negatively associated with markers of LA global, reservoir and booster function. In the fully adjusted model, T1 was positively associated with larger LA minimum size (Beta: +0.034 SD per T1 SD; Confidence Interval (CI): 0.024, 0.045), and negatively associated with LA emptying volume (Beta: −0.017; CI: −0.027, −0.006), LA booster volume (Beta: −0.019; CI: −0.030, −0.008), LA emptying fraction (Beta: −0.052; CI: −0.062, −0.041), and LA reservoir function (Beta: −0.028; CI: −0.039, −0.017). Though adjustment for LV parameters did not fully attenuate the above relationships, LV parameters were consistent mediators between T1 and LA function, with proportional mediative effects ranging from 15% to 75%. Lastly, there is evidence of an inverted J-shaped relationship between T1 and LA function, with the associations becoming more apparent in the upper half of T1 ranges (turning points within 925–950 ms, median T1 = 930 ms) (p&lt;0.05).

Conclusion

This study demonstrates a consistent association between higher native T1 values (as a marker of myocardial fibrosis) and lower LA global and phasic functions. We also highlighted an interplay between T1 values, LV remodelling and LA dysfunction. These findings will facilitate our understanding of the disease processes underlying cardiac dysfunction and myocardial remodelling at an early, subclinical stage.

Funding Acknowledgement

Type of funding sources: Public hospital(s). Main funding source(s): This work was part of the portfolio of translational research of the National Institute for Health Research Biomedical Research Centre at Barts and The London School of Medicine and DentistryDr Nay Aung is supported by a Wellcome Trust Research Training Fellowship (203553/Z/16/Z)

Utilization of wearable smartwatch and its application among Saudi population

Study purpose

It is important to understand the users' perceptions toward the use of smartwatches and the various factors that affect the adoption of smart watches. These findings would contribute to the literature in understanding users' usage, preferences, needs, and expectations about smartwatches that would aid smartwatches designers and also decision-makers in integrating the smartwatch technology in various service-enabled areas such a healthcare, e-learning etc. To address this gap, the objective of this study was formulated to understand the actual consumers' perceptions of toward the use of smartwatches and explore the critical factors affecting the adoption and intention to use smartwatches in the Kingdom of Saudi Arabia.

Methods

A cross-sectional study was designed to assess the actual perception of use smartwatches and to investigate the influencing factors that affect the utilization among Saudi population using the survey technique. Questionnaire design was based on the domains of Technology Acceptance Model (TAM) to determine the factors affecting smartwatches utilization. The sample composed of Saudi Arabian residents aged 18 years and above. The response rate for the online questionnaire that was distributed through the social media applications was 58.61% representing 135 participants. The data was collected in November 2020 and analyzed using the Statistical Packages for Software Sciences (SPSS).

Results

The prevalence of participants who had knowledge about smartwatch was 94.1%. When comparing the demographic characteristics between those owning and not owning a smartwatch, it was found that educational level (X2 = 9.365; p = 0.025) and knowledge about smartwatch (X2 = 7.897; p = 0.005) had significant relationship with owning a smartwatch. When comparing between design aesthetic, perceived usefulness, ease of use, enjoyment and healthology in relation to the socio demographic characteristics, it was found that respondents in the older age group (≥45 years) (F = 11.797; p &lt;0.001) and those with master degree (F = 3.449; p = 0.002) observed to have significantly lower mean score in design aesthetic while females exhibited significantly higher score in perceived enjoyment and healthology (T = −3.629; p = 0.001) as well as design aesthetic (T = −2.070; p = 0.043).

Conclusion

Factors such as age, education, gender, income can significantly affect the adoption of wearable devices in Saudi Arabia.

Using mobile health applications to enhance physical activity in Saudi Arabia: a cross-sectional study on users' perceptions

BACKGROUND

This research aims to assess the users' perceptions of usability and quality of mobile health applications used for promoting physical activity in Saudi Arabia.

METHODS

This was a quantitative cross-sectional study. A survey was developed based on the Technology Acceptance Model (TAM) and the Mobile Application Rating Scale (MARS) and distributed among the Saudi population through social media to assess the users' perceptions of using mobile applications to enhance physical activity. The survey questionnaire consisted of 27 questions in six sections, including demographics (nine items), perceived usefulness (three items), perceived ease of use (three items), attitudes (three items), user experience (six items) and subjective quality (three items). All the participants were in Saudi Arabia and >15 y of age.

RESULTS

A total of 195 m-Health users participated in the survey. Of the total participants, 25.1% were overweight and 21.0% were obese. The workout frequency of most users was rarely (32.3%) and three to four times a week (29.2%). In addition, 55.9% of the users agreed that the application they use served all fitness levels and >80% either agreed or strongly agreed that it was easy for them to learn how to use the application. More than 70% of users agreed or strongly agreed that the application enhanced their knowledge of workouts and physical activity and >90% would recommend the application to others. There were no differences identified between the male and female participants and younger (<40 y) and older (>40 y) participants with respect to perceived usefulness and ease of use, attitudes, experiences and subjective quality. However, significant differences were observed between participants <40 y and >40 y of age in terms of perceived ease of use of mHealth applications.

CONCLUSION

mHealth users across Saudi Arabia believe that the mHealth applications have good usability and quality factors. As a result, they can motivate people and help them achieve their goals in relation to physical activities.

Knowledge and attitude of Saudi Arabian citizens towards telemedicine during the COVID-19 pandemic

Background

The objective of this study was to investigate the knowledge and attitudes of Saudi Arabian citizens towards telemedicine during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

A cross-sectional survey was designed to carry out this study. The electronic survey, prepared using Google Forms, was distributed to 1500 randomly selected citizens of Saudi Arabia. A total of 330 participants completed and returned the questionnaire. Basic statistics were used to describe the data.

Results

The majority of the respondents (73.9%) were female. More than half of them (54.8%) were >35 y of age and had graduate or postgraduate degrees (65.5%). A total of 96.7% of the respondents were Saudis. Most of the participants (70.0%) were familiar with the term ‘telemedicine’ and thought that telemedicine (92.1%) could reduce transportation costs. Of the respondents, 58.8% had not seen a telemedicine system before and 67.0% indicated that they had not previously used telemedicine services. A total of 87.3% of the participants agreed or strongly agreed that telemedicine was a useful tool during the COVID-19 pandemic. Also, more than half of the participants agreed or strongly agreed that telemedicine facilitates the diagnosis of people (58.8%), increases communication (58.2%), reduces clinic visits (85.9%) and performs tasks quickly (70.3%). Also, 51.5% of the respondents disagreed or strongly disagreed that telemedicine affects patient privacy.

Conclusions

The outcomes indicated that most of the participants had a positive attitude towards the use of telemedicine as a response to the COVID-19 pandemic in Saudi Arabia. They believed that telemedicine saves time, labour and costs and is an effective tool to treat coronavirus patients at a safe distance. However, the government should develop programs to raise awareness in the population about the use of telemedicine for the treatment of various diseases that afflict the Saudi Arabian people. Likewise, a legal framework must be implemented to protect the privacy of patients and healthcare providers.

The Impact of WhatsApp on the Blood Donation Process in Saudi Arabia

Background

WhatsApp was the most popular messenger app used in Saudi Arabia with 71% of the total population using it in 2020. WhatsApp is increasingly being used as a tool for mobile health (m-health) interventions; however, concerning blood donation, there is a lack of research studies on the topic.

Objective

This study aims to measure the general awareness levels of the blood donation process and assess blood donation history, the motivators and inhibitors to donating blood, and to assess the impact of WhatsApp on the blood donation process in Saudi Arabia.

Methods

In this research study, a descriptive quantitative cross-sectional analysis was adopted. A questionnaire survey was designed using Google Forms and distributed online through social media applications to collect data. All citizens aged above 18 years of age were eligible to participate in the survey. There were a total of 150 participants in the study.

Results

More than 90% of participants were aware of their blood group, blood donation requirements, and causes to be deferred from the donation. Furthermore, 27% of participants donated blood because their relatives or friends needed blood, 26% donated due to human solidarity, 18% did not donate blood because of their health condition and 14% did not because of the fear of needles. About 33% of participants relied on WhatsApp to search for blood donors, and all the requests were fulfilled with blood donors. In addition, 94% of participants strongly believed that the WhatsApp application had a significant role in bridging the gap for blood banks' need for blood donors.

Conclusion

Social media applications such as WhatsApp can bridge the gap between blood banks, blood donors and the patients in need of blood in Saudi Arabia, where there is a shortage of blood donors.

P3627Characteristics and outcomes following myocardial infarction in patients with schizophrenia

Background

Patients with schizophrenia are a high-risk population due to a high prevalence of cardiovascular risk factors that translates into increased cardiovascular morbidity and mortality.

Purpose

To describe the characteristics of patients with schizophrenia experiencing a myocardial infarction (MI) and to analyse the 1-year major adverse cardiac events (MACE: all-cause mortality, reinfarction, stroke and heart failure) and prescriptions of guideline-recommended secondary preventive treatments at hospital discharge.

Methods

All patients with schizophrenia who experienced a MI in the period between 2000–2017 were identified and included from the SWEDEHEART registry and compared to patients without schizophrenia. Uni- and multivariable Cox proportional hazards and Kaplan-Meier survival models were used to compare the populations.

Results

The main results are shown in Table 1. Compared to the general population (n=285,325), patients with schizophrenia (n=1,008) were younger (63 vs 71 years), had a higher smoking burden and prevalence's of diabetes, heart failure, chronic obstructive pulmonary disorder and major bleeding (all p-values <0.05). On the contrary, lower prevalence's of diagnosed hypertension, hyperlipideamia, previous myocardial infarction, renal disease and peripheral artery disease were seen in this population. Lastly, patients with schizophrenia were less likely to be discharged with aspirin, P2Y12 inhibitors, ACE-inhibitors/angiotensin receptor blockers, beta blockers and statins (all p-values <0.005).

Table 1. Clinical endpoints at 5-years for patients with schizophrenia following a MI compared to patients without schizophrenia End-points Unadjusted HR (95% CI) Adjusted HR (95% CI) Model 1 Model 2 Model 3 MACE 1.35 (1.23–1.47)* 2.44 (2.23–2.67)* 2.20 (1.79–2.72)* 2.05 (1.63–2.58)* Mortality 1.44 (1.31–1.59)* 2.99 (2.72–3.29)* 2.53 (2.00–3.21)* 2.38 (1.84–3.09)* Reinfarction 1.00 (0.82–1.24) 1.53 (1.25–1.89)* 1.41 (0.86–2.30) 1.29 (0.77–2.13) Stroke 1.03 (0.80–1.34) 1.67 (1.29–2.17)* 1.72 (1.00–2.97) 1.72 (1.00–2.98) Heart failure 1.25 (1.10–1.42)* 2.14 (1.88–2.42)* 1.49 (1.13–1.98)* 1.39 (1.04–1.86)* *p<0.005. Model 1: adjusted for age and sex; Model 2: adjusted for age and sex, smoking, comorbidities, previous CAG and previous PCI; Model 3: adjusted for age and sex, smoking, comorbidities, previous CAG and previous PCI, discharge medications and treatment with CAG and PCI.

Conclusion

Patients with schizophrenia remain a high-risk population who experience a MI almost 10 years earlier than patients without schizophrenia and have worse outcome. Improved primary and secondary preventive measures are urgently warranted.

Relationship between MCP1 (-2518A>G) gene variants and ovarian cancer in Turkish population

The monocyte chemoattractant protein-1 (MCP-1) gene polymorphism(-2518A&gt;G)  in the regulatory region of the MCP-1 protein has been reported to be associated with cancer risk. In this study we aimed to investigate the relationship of MCP-1 (-2518A&gt;G) gene polymorphism and ovarian cancer. MCP-1 genotyping was performed using polymerase chain reaction from blood samples ofovarian cancer patient (n=56) and a control groups (n=52).There was a significant difference in MCP1 (-2518A&gt;G) genotypes between the patient and control groups (p=0.049; x2=6.042). AA carriers were significantly higher in the control group (p=0.014) whereas AG genotype and G allele carriers were significantly higher in the ovarian cancer group (p=0.029, p=0.014, respectively). This study suggests that MCP-1 (-2518A&gt;G) AG genotype and G allele could be considered as risk factor for susceptibility to ovarian cancer.

Targeting of BCR-ABL: Lessons learned from BCR-ABL inhibition

In 1960 researchers reported that balanced translocation between chromosomes 22 and 9 resulted in the generation of Philadelphia chromosome. This breakthrough revolutionized our knowledge related to leukemia biology and contemporary studies revealed that chromosomal translocation resulted in the fusion between the 5' segment of BCR gene and 3' segment of the ABL gene to form BCR/ABL fusion gene. Research over the years has progressively and systematically improved our understanding of the genetic and proteomic basis of Leukemia. Genome-wide profiling studies, including genome sequencing and microarray analysis, have helped us in identification of different intracellular signaling cascades that are frequently mutated in Leukemia.  We partition this multi-component review into different sections related to biochemical characteristics of BCR-ABL+ cells, underlying mechanism of generation of mutations and crosstalk of BCR-ABL with various intracellular signaling cascades. We also summarize how BCR-ABL encoding mRNA is negatively regulated by different miRNAs and the strategies which are currently being used to effectively target BCR-ABL protein. We also provide an overview of the natural products which have been used for targeting of BCR-ABL protein. Better understanding of the protein network of Philadelphia positive leukemic cells will prove to be helpful in getting a step closer to personalized medicine.

How sesquiterpenes modulate signaling cascades in cancers

Data obtained from high-throughput technologies has started to shed light on the interplay between signal transduction cascades and chromatin modifications thus adding another layer of complexity to the already complex regulation of the protein network. Based on the insights gleaned from almost a decade of research, it has now been convincingly revealed that sesquiterpenes effectively modulated different intracellular signaling cascades in different cancers. In this review we summarize how sesquiterpenes mediated Wnt, Shh, Notch and TRAIL induced signaling cascades.

Tudor tells about new twists in the story tale of SMURFs

Smad ubiquitin regulatory factors (SMURFS) belong to the HECT- family of E3 ubiquitin ligases. This family has two members, SMURF1 and SMURF2. SMURFs have emerged as well studied negative regulators of TGF induced intracellular signaling. However, increasingly it is being realized that SMURFs tactfully modulate an array of proteins in different cancers. This review sets spotlight on how SMURF1 and SMURF2 communicate with effectors of different signaling pathways during the multistep progression to cancer. We also summarize how microRNAs (miRNAs) effectively control SMURFs in different cancers. Role of SMURFs is context dependent in different cancers and better concepts related to miRNA regulation of SMURFs in different stages and steps of cancer will be helpful in efficient translation of laboratory findings to clinic.

Signaling lansdscape of prostate cancer

Research over the decades has gradually and sequentially shown that both intratumor heterogeneity and multifocality make prostate cancer difficult to target. Different challenges associated with generation of risk-stratification tools that correlate genomic landscape with clinical outcomes severely influence clinical efficacy of therapeutic strategies. Androgen receptor mediated signaling has gained great appreciation and rewiring of AR induced signaling cascade in absence of androgen, structural variants of AR have provided near complete resolution of genomic landscape and underlying mechanisms of prostate cancer. In this review we have attempted to provide an overview of most recent advancements in our knowledge related to different signaling cascades including TGF, SHH, Notch, JAK-STAT in prostate cancer progression and development.

The effects of melatonin on endometriotic lesions induced by implanting human endometriotic cells in the first SCID-mouse endometriosis-model developed in Turkey

OBJECTIVE

To evaluate the effects of melatonin on endometriotic lesions induced by implanting human endometriotic cells in SCID mice.

MATERIALS AND METHODS

Prospective, randomized, controlled, experimental study. Experimental Research Center of Yeditepe University (YUDETAM). Thirty female, non-pregnant, nulligravid severe combined immunodeficient (SCID) mice. Endometriotic cells collected from patients with endometriosis were implanted subcutaneously in 30 SCID mice. These mice were randomized into two study groups: in the first group, mice were administered melatonin (20 mg/kg/day) following induction of endometriosis for four weeks; in the second group, nothing was administered. All the mice were given a high dose of exogenous estradiol (50 µg/kg/d, twice weekly). Four weeks after inoculation, necropsies were performed and endometriotic lesions were collected. All the lesions were evaluated histopathologically and the levels of SOD and MDA were assessed in the lesions.

RESULTS

Successful implantation was observed in the 28 mice that survived. Mean MDA level was 5.0 ± 1.7 and 8.8 ± 2.6 in the melatonin and control groups, respectively (p = 0.01); mean SOD level was 1.1 ± 0.1 and 1.0 ± 0.1 in the melatonin and control groups, respectively (p = 0.49). Mean histopathological score was lower in the melatonin group (p = 0.04).

CONCLUSIONS

Melatonin was effective in the treatment of experimental endometriosis induced in SCID mice.

Effects of aloe vera gel on the induction of endometriosis and regression of endometrial explants in a rat model

PURPOSE OF INVESTIGATION

To evaluate the preventive and reducing effect of aloe vera gel on surgically-induced endometrial foci in rats.

MATERIALS AND METHODS

Twenty-four reproductive aged female non-pregnant, nulligravid Sprague-Dawley albino rats were used. The rats were randomly divided to three groups (Group 1: control, Group 2: aloe vera endometriosis formation, and Group 3: aloe vera endometriosis treatment). A peritoneal lavage using one-ml saline was taken at all the operations for determination of superoxide dismutase (SOD), malondialdehyde (MDA), and catalase (CAT). Forty-eight horns were implanted in 24 rats.

RESULTS

All the implants were properly formed after implantation. In Group 3, before aloe vera application, the sum of the volumes was 87.2 ± 20.4 mm³ and after treatment the volumes dropped to 28.9 ± 14.9 mm3 (p = 0.01). As evaluation of aloe vera on the formation of endometriosis in the second operation in Group 2, the sum of the volumes was 2.9±1.4 mm³ and in Group 1, 118.9 ± 20.0 mm3 (p = 0.001). Likewise, similar changes were observed in the histopatological scores.

CONCLUSION

The application of aloe vera was seen to raise antioxidant levels in the peritoneal fluid and to reduce oxidative stress markers. Aloe vera is effective in the inhibition of formation and regression of endometriotic lesions.

Natural products are the future of anticancer therapy: Preclinical and clinical advancements of Viscum album phytometabolites

Cancer is a multifaceted and genomically complex disease. Research over the years has gradually provided a near complete resolution of cancer landscape and it is now known that genetic/epigenetic mutations, inactivation of tumor suppressors, Overexpression of oncogenes, spatio-temporally dysregulated intracellular signaling cascades, epithelial to mesenchymal transition (EMT), metastasis and loss of apoptosis are some of the most extensively studied biological mechanisms that underpin cancer development and progression. Increasingly it is being realized that current therapeutic interventions are becoming ineffective because of tumor heterogeneity and rapidly developing resistance against drugs. Considerable biological activities exerted by bioactive ingredients isolated from natural sources have revolutionized the field of natural product chemistry and rapid developments in preclinical studies are encouraging. Viscum album has emerged as a deeply studied natural source with substantial and multifaceted biological activities. In this review we have attempted to provide recent breakthroughs in existing scientific literature with emphasis on targeting of protein network in cancer cells. We partition this review into different sections, highlighting latest information from cell culture studies, preclinical and clinically oriented studies. We summarized how bioactive ingredients of Viscum album modulated extrinsic and intrinsic pathways in cancer cells. However, surprisingly, none of the study reported stimulatory effects on TRAIL receptors. The review provided in-depth analysis of how Viscum album modulated Endoplasmic Reticulum Stress in cancer cells and how bioactive chemicals tactfully targeted cytoskeletal machinery in cancer cells as evidenced by cell culture studies. It is noteworthy that Viscum album has entered into various phases of clinical trials, however, there are still knowledge gaps in our understanding regarding how various bioactive constituents of Viscum album modulate intracellular signaling cascades in cancer. Better and deeper comprehension oncogenic signaling cascades will prove to be helful in getting a step closer to individualized medicine.

DNA repair genes in endometriosis

Several polymorphisms in the DNA repair gene are thought to have significant effects on cancer risk. We investigated the association of polymorphisms in the DNA repair genes XRCC1 Arg399Gln, XRCC3 Thr241Met, XPD Lys751Gln, XPG Asp1104His, APE1 Asp148Glu, and HOGG1 Ser326Cys with endometriosis risk. Genotypes were determined by PCR-RFLP assays in 52 patients with endometriosis and 101 age-matched healthy controls. Although there were no significant (P > 0.05) differences in the frequencies of genotypes or alleles of APE1, XRCC1, XPD, XPG, and HOGG1 genes between patients and controls, the frequency of the XRCC3 Thr/Thr genotype was significantly greater in endometriosis patients compared with controls (P = 0.005). XRCC3 Thr/Met genotypes (P = 0.022), and the Met allele (P = 0.005) seem to have a protective role against endometriosis. The distributions of genotypes and alleles of the genes APE1, XRCC1, XRCC3, XPD, XPG, and HOGG1 were not significantly associated with the different stages of endometriosis (P > 0.05). We conclude that the XRCC3 Thr/Thr genotype is associated with endometriosis in Turkish women.

Comparision of reproductive outcome of the women with hypogonadotropic hypogonadism and tubal factor infertility

OBJECTIVE

To evaluate the outcome of women with hypogonadotropic hypogonadism (HH) undergoing in-vitro fertilization (IVF).

MATERIALS AND METHODS

Data from 13 cycles often hypogonadotropic patients treated with in vitro fertilization from the period January 2006 to January 2008 were analyzed and compared with treatment results from 20 patients with tubal factor infertility (TI). All patients underwent ovarian hyperstimulation for IVF/ICSI at the same center. HH patients initiated the treatment by receiving daily injections of hMG. The patients in the control group were given the same dosage of recombinant FSH.

RESULTS

Demographic characteristics of the patients were comparable. Mean duration of stimulation was 13 days in the HH group and nine days in the TI group; the difference was significant (p < 0.001). Significantly more gonadotropins were used for the stimulation of HH patients (p < 0.05). Peak serum E2 concentration was found to be higher in the TI group. We evaluated the proportion of metaphase II (MII) oocytes to total oocytes retrieved in HH patients and found the number was similar to the TI group. Despite that fertilization and implantation rates were similar in both groups, the cancellation rate was higher in the HH group (23.1% vs 0). However pregnancy and live birth rates were similar.

CONCLUSIONS

The present study showed that HH women undergoing IVF/ICSI are good responders. The treatment of HH women with IVF/ICSI did not increase multiple pregnancies and OHSS rates over the TI group.

Knowledge and interest of Turkish women about cervical cancer and HPV vaccine

OBJECTIVE

We aimed to evaluate the knowledge and interest level of Turkish women about HPV, HPV vaccines and cervical cancer using a questionaire.

METHOD

A 25-item questionnaire was distributed to women in three different cities located in separate sociocultural locations.

RESULTS

At the closure of the study 143 women responded and returned the survey. Of the participants 62.2% (89) had a university degree, 36.4% (52) a high school education, and 1.4% (2) had lower school degrees; 98.5% of the women would consent to have their daughter vaccinated for HPV and 94.7% would consent to have their son vaccinated if vaccine provided prevention against cancer and related diseases. However in both cases women gave importance to the "cost" - unless vaccine could be free. On logistic regression analyses none of the variables (i.e., questions) in the survey predicted women's willingness to accept the vaccine for themselves or their children.

CONCLUSIONS

Women in Turkey would be willing to have themselves and their children receive HPV vaccine against cervical cancer and related diseases.

Short-term urinary flow impairment deregulates PAX2 and PCNA expression and cell survival in fetal sheep kidneys

Renal malformations account for most children with chronic renal failure and are often associated with urinary tract anatomical obstruction. We examined cellular and molecular events after experimental urinary flow impairment in fetal sheep. Ovine gestation lasts 144 to 150 days with the metanephros appearing at 27 to 30 days. We generated complete unilateral ureteric anatomical obstruction at 90 days when a few layers of glomeruli had formed. After 10 days, we recorded ureteric and pelvic dilatation with renal parenchymal weight greater than contralateral organs or those from unoperated fetuses. The nephrogenic cortex was replaced by disorganized cells separated by edema and prominent vascular spaces. Cortical histology was dominated by cysts associated with malformed glomerular tufts. Cystic epithelia expressed PAX2, a growth-stimulating transcription factor down-regulated during normal maturation, and proliferating cell nuclear antigen, a surrogate marker of cycling cells. Detection of apoptosis using propidium iodide and in situ end labeling showed a significant increase of the point prevalence of death in the obstructed cortex. Hence, PAX2 and proliferating cell nuclear antigen expression as well as death were deregulated, as we previously reported in human kidney malformations. Medullary collecting ducts and loops of Henle were also disrupted, correlating with impaired urinary dilution and sodium reabsorption. Therefore, complex aberrations of morphogenesis, gene expression, cell turnover, and urine composition occur relatively early after experimental impairment of fetal urinary flow.

A conditionally expressed third partner stabilizes or prevents the formation of a transcriptional activator in a three-hybrid system

We describe a three-hybrid system that involves three polypeptides that allow or prevent the formation of the transcriptional activator. Beside the two-hybrid fusion proteins, the third partner is under the control of the Met25 promoter, which is positively regulated in medium lacking methionine. We document a situation where such a third partner promotes interaction between two proteins, one fused to a DNA-binding domain and the other fused to an activator domain. This is demonstrated for cdk7-MAT1 interaction stabilized by the presence of cyclin H; these three polypeptides are found either free or associated with the transcription/DNA repair factor TFIIH. We also document the capacity of our system to conditionally inhibit the interaction between two polypeptides that otherwise elicit a positive two-hybrid response. This is demonstrated for Ras-Raf interaction precluded by an excess of Raf. The presence of a methionine-regulated promoter provides an "on" or "off" switch for the formation of the transcriptional activator, thus also providing an excellent control to evaluate the activation or inhibition properties of the third partner.

Receptor aggregation induced by antilutropin receptor antibody and biological response in rat testis Leydig cells

Antibodies against the lutropin receptor have been obtained by the monoclonal antibody technique. Mice were immunized with luteal membrane from ovaries from pseudopregnant rats, containing high lutropin receptor concentration. Hybridoma cells were obtained by fusing mouse myeloma cells with spleen cells from the immunized animal. Five clones were produced that secreted monoclonal antibodies that specifically inhibited lutropin binding to its receptor in a competitive fashion. Antibodies from three clones were capable of blocking biological response to lutropin (e.g., testosterone production by isolated rat Leydig cells). Antibodies secreted by two other clones, however, were capable of acting as Leydig cell stimulators. Immunofluorescence studies demonstrated the presence of receptor capping which may be associated with receptor-mediated testosterone production. Antagonist antibodies could be transformed into agonist by the addition of a second crosslinking anti-mouse IgG. The discovery of agonist antibodies against the receptor molecule proves that the biological information of the lutropin-receptor complex resides in the receptor and not in the hormone.

Monoclonal antibodies to Neurospora adenylate cyclase

A monoclonal antibody against Neurospora soluble adenylate cyclase was obtained. The antibody inhibits cyclase activities from several lower eucaryotic organisms but not activities associated to testicular cytosol or turkey erythrocyte membranes.