Introduction: Breast cancer is the most common cancer among Jordanians. Breast cancer patients suffer from several negative consequences after treatment and these include pain, fatigue, sexual problems, appearance and body image concerns, with psychological dysfunction. This could affect the patient quality of life and psychological well-being. To the best of our knowledge, there is no published quantitative data on the quality of life and psychological well-being of breast cancer patients in Jordan. The objective of this study was to obtain such data and assess predictors with calculated scores. Methods: In this cross-sectional study conducted among breast cancer patients in Jordan diagnosed in 2009 and 2010, assessment was performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Breast Module (QLQ-BR23) and the Hospital Anxiety and Depression Scale (HADS). Clinical, demographic and psychosocial indicators that could predict patient quality of life scores were collected. Results: The number of patients interviewed was 236 (mean age=$50.7{\pm}10.7$ years). The mean Global Health score for the QLQ-C30 was $63.7{\pm}20.2$ SD. Among functional scales, "social functioning" scored the highest ($mean=78.1{\pm}28.6$ SD), whereas "emotional functioning" scored the lowest ($mean=59.0{\pm}SD\;33.5$). For the QLQ-BR23, the worst scores within the functional scales were for "body image" ($mean=52.1{\pm}36.8$ SD) and "future perspective" ($mean=52.9{\pm}38.5$ SD). The worst symptom was "upset by hair loss" ($mean=69.8{\pm}43.0$). The mean HADS scores was $18.{\pm}9.0$ SD. Out of study participants, 53% scored abnormal on the anxiety scale and 45% on the depression scale. Severe depression and severe anxiety were detected among 8% and 14% of study participants, respectively. Statistically significant predictors for individual scores were similar to those reported in published studies, such as the presence of recurrence since baseline, family history of cancer, low educational status, current social problems, extent of the disease, presence of financial difficulties, and employment status. Conclusions and Recommendations: Breast cancer survivors in Jordan have overall good quality of life scores when compared with patients from Western countries. However, their psychological wellbeing is more impaired. There is an urgent need for psychosocial support programs and psychological screening and consultation for breast cancer patients at hospitals of the Ministry of Health in Jordan.
Background: Ginseng is a commonly used herbal medicine in treating various medical conditions. Chronic gut inflammation is a recognized factor for the development of colorectal cancer (CRC). In this project, Asian ginseng berry polysaccharide preparations were used to assess their effects on CRC and related immune regulation mechanisms. Methods: Ginseng berry polysaccharide extract (GBPE) and purified ginseng berry polysaccharide portion (GBPP) were used to evaluate their activities on human HCT-116 and HT-29 CRC cell proliferation. Interleukin-8 secretion analysis was performed on HT-29 cells. Naive CD4 cell isolation and T-helper cell differentiation were performed and determined using flow cytometry for Th1 and Treg in addition to cell cycle and apoptotic investigation. Results: GBPE and GBPP significantly inhibited interleukin-8 secretion and cancer cell proliferation, inhibited CD4+IFN-γ+ cell (Th1) differentiation, and decreased CD4+FoxP3+ cell (Treg) differentiation. Compared to the GBPE, GBPP showed more potent antiinflammatory activities on the malignant cells. This is consistent with the observation that GBPP can also inhibit Th1-cell differentiation better, suggesting that it has an important role in antiinflammation, whereas Treg cells hinder the body's immune response against malignancies. Supported by cell cycle and apoptosis data, GBPE and GBPP, at various degrees, remarkably enhanced the anticancer activities of 5-fluorouracil. Conclusion: Data from this project suggested that Asian ginseng berry potentially has clinical utility in managing enteric inflammation and suppressing CRC through immunomodulation mechanisms.
Background: The efficacy of standard treatment of Helicobacter pylori (H. pylori) is declining because of antibiotic resistance. Clarithromycin resistance is also increasing in many Asian countries. The aim of this study was to determine the antibiotic susceptibility patterns of H. pylori infection and clinical association in Laos. Materials and Methods: A total of 329 Lao dyspeptic patients who underwent gastroscopy at Mahosot Hospital, Vientiane, Laos during December 2010-March 2012 were enrolled in this study. During gastroscopy, 4 biopsies were collected (2 each from the antrum and body) for CLO-test and histopathology. Only the positive CLO-test gastric tissues was stored at $-80^{\circ}C$ in a freezer until DNA was extracted and a GenoType$^{(R)}$HelicoDR test was conducted for detecting mutations in the rrl gene encoding 23S rRNA (clarithromycin resistance) and mutations in gyrA gene (fluoroquinolone resistance). Results: Of the total, 119 Lao patients (36.2%) were infected with H. pylori including 59 males (49.6%) and 60 females (50.4%) with a mean age of 46 years. Clarithromycin and fluoroquinolone resistance of H. pylori infection was demonstrated in 15 (12.6%) and 16 strains (13.4%) respectively. In clarithromycin resistance, the number of patients who had education above primary school and $BMI{\geq}25kg/m^2$ were significantly higher than those who had education below primary school and BMI<$25kg/m^2$ (23.1% vs 7.5%, P-value= 0.036 and 20.5% vs 8%, P-value= 0.048, respectively). In fluoroquinolone resistance, the number of lowland Lao was significantly higher than those of non-lowland (highland and midland) Lao ethnic groups (16.7% vs 0%, P-value= 0.039). Conclusions: H. pylori infections remain common in Laos. Clarithromycin and fluoroquinolone resistance with H. pylori infection are growing problems. Education above primary school and $BMI{\geq}25kg/m^2$ might be predictors for clarithromycin resistance and lowland Lao ethnicity might be predictors for fluoroquinolone resistance with H. pylori infection in Laos.
Assi, Tarek;Rassy, Marc;Nassereddine, Hussein;Sader-Ghorra, Claude;Abadjian, Gerard;Ghosn, Marwan;Kattan, Joseph
Asian Pacific Journal of Cancer Prevention
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제16권8호
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pp.3443-3446
/
2015
Background: Testicular tumors constitute a rare type of cancer affecting adolescents and young adults with recent reports confirming an increase in incidence worldwide. The purpose of this study was to estimate the epidemiological characteristics and histological subtypes of testicular tumors in the Lebanese population according to the WHO classification of testicular and paratesticular tumors. Materials and Methods: In this single institutional retrospective study, all patients diagnosed with a testicular tumor in Hotel-Dieu de France Hospital University in Beirut between 1992 and 2014 were enrolled. The age, subtype based on the 2004 WHO classification and body side of tumor were analyzed. Results: A total of two hundred and forty-four (244) patients diagnosed with a testicular tumor in our institution were included in the study. Two hundred and one patients (82.4% of all testicular tumors) had germ cell tumors (TGCT). Among TGCT, 50% were seminomatous tumors, 48% non-seminomatous tumors (NST) and 2% were spermatocytic seminomas. The NST were further divided into mixed germ cell tumors (63.9%), embryonic carcinomas (18.6%), teratomas (15.4%) and yolk sac tumors (2.1%). The mean age for testicular tumors was 32 years. The mean age for germ cell tumors was 31 years and further subtypes such as seminomatous tumors had a mean age of 34 years, 28 years in non-seminomatous tumors and 56 years in spermatocytic seminoma. Patients with right testicular tumor were the predominant group with 55% of patients. Three patients (1.2%) presented with bilateral tumors. Conclusions: The distribution of different subgroups and the mean age for testicular tumors proved comparable to most countries of the world except for some Asian countries. Germ cell tumors are the most common subtype of testicular tumors with seminomatous tumors being slightly more prevalent than non-seminomatous tumors in Lebanese patients.
Effects of different levels of molasses in a concentrate supplement on milk yield of cows grazing Setaria grass pastures were investigated. Thirty Friesian cows, 6-7 years old with mean pre-experimental body weight of $428{\pm}6.5$ kg, in early stage of lactation were randomly allotted to five dietary treatments in a completely randomized design experiment that lasted for 126 days. Experimental dietary treatments were forage alone and forage/concentrate mixtures with molasses included at 0, 5, 10 or 15% levels designated as $T_1$, $T_2$, $T_3$, $T_4$ and $T_5$, respectively. The parameters studied were voluntary dry matter (DM) intake, average daily live weight change (LWC), milk yield, body condition score (BCS) and apparent nutrient digestibility coefficients. The DM and energy contents of Setaria grass were low compared to the concentrate diets. Fibre fractions-NDF, ADF, ADL, hemicellulose and cellulose; and gross energy were higher in concentrate mixtures than in the forage. Total DM intake (forage+concentrate mixtures) was significantly higher (p<0.001) in cows on the concentrate mixtures. LWC was not significantly different (p>0.05) between the cows. Average milk yields were significantly different (p<0.05) between cows. Fat corrected milk (FCM) was similar among cows in the treatments. BCS was better (p<0.001) in cows on concentrate mixtures. Digestibilities of DM, CP, NDF, ADF, ADL, OM, and energy were significantly higher (p<0.001) in cows on $T_2$, $T_3$, $T_4$ and $T_5$ than in those on $T_1$. There were no significant differences in the digestibility of DM, CP, NDF, ADF and ADL (p>0.001) in cows on concentrate mixtures. This study therefore demonstrated that lactating dairy cows in Fiji need a level of readily fermented energy source such as molasses in their diets; however, a level above 10% is not nutritionally suitable for lactating dairy cows. Based on data on production parameters-milk yield, fat corrected milk, body condition score and apparent nutrient digestibility coefficients-molasses levels that range between 5-10% are recommended, however, 10% is the best and therefore recommended for inclusion in the concentrate mixture of lactating dairy cows on a basal diet of Setaria sphacelata in Fiji.
The result of comparison and analysis study of institutionalization and exchange status of environmental education in South Korea, the People's Republic of China, and Japan, Northeast Asian countries that are closely related to Korea, is summarized as the following: First, this study shows that the process of environmental education institutionalization requires an instigation. For example, a specific environmental policy is established after raising awareness to modify environmental policies, as the result of aggravation of damage due to pollution. Therefor, it is the necessary process for the establishment of an environmental policy in order to proceed environmental education institutionalization. Second, even though institutionalization processes of environmental education for the three countries are considered to be very similar, differences are apparent if one carefully examines the content of environmental education for each country. In particular, South Korea, the People's Republic of China, and Japan all agree that environmental education is necessary, but differ in their ideas of main body for advocating institutionalization, as well as maintenance level of environmental education. Third, the order of establishment of environmental education institutionalization is Japan, South Korea and China and there exists about a 10 years time gap between each country. Fourth, the environmental education exchange was formed between South Korea and the People's Republic of China and between South Korea and Japan, first. Then it was enlarged to TEMM(Tripartite Environment Ministers Meeting) and TEEN(Tripartite Environmental Education Network) among three countries.
Purpose: To date, there is no region-specific guideline for pediatric endoscopy training. This study aimed to illustrate the current status of pediatric endoscopy training in Asia-Pacific region and identify opportunities for improvement. Methods: A cross-sectional survey, using a standardized electronic questionnaire, was conducted among medical schools in the Asia-Pacific region in January 2024. Results: A total of 57 medical centers in 12 countries offering formal Pediatric Gastroenterology training programs participated in this regional survey. More than 75% of the centers had an average case load of <10 cases per week for both diagnostic and therapeutic endoscopies. Only 36% of the study programs employed competency-based outcomes for program development, whereas nearly half (48%) used volume-based curricula. Foreign body retrieval, polypectomy, percutaneous endoscopic gastrostomy, and esophageal variceal hemostasis, that is, sclerotherapy or band ligation (endoscopic variceal sclerotherapy and endoscopic variceal ligation), comprised the top four priorities that the trainees should acquire in the autonomous stage (unconscious) of competence. Regarding the learning environment, only 31.5% provided formal hands-on workshops/simulation training. The direct observation of procedural skills was the most commonly used assessment method. The application of a quality assurance (QA) system in both educational and patient care (Pediatric Endoscopy Quality Improvement Network) aspects was present in only 28% and 17% of the centers, respectively. Conclusion: Compared with Western academic societies, the limited availability of cases remains a major concern. To close this gap, simulation and adult endoscopy training are essential. The implementation of reliable and valid assessment tools and QA systems can lead to significant development in future programs.
Al-Astani Tengku Din, Tengku Ahmad Damitri;Shamsuddin, Shazana Hilda;Idris, Fauziah Mohamad;Wan Mansor, Wan Nor Ariffin;Abdul Jalal, Muhammad Irfan;Jaafar, Hasnan
Asian Pacific Journal of Cancer Prevention
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제15권9호
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pp.3939-3944
/
2014
Background: To elucidate the role of rapamycin and PF4 on apoptosis regulation via Bax (pro-apoptosis), Bcl-2 (anti-apoptosis) and survivin activation on the growth in the 1-methyl-1-nitrosourea-induced invasive breast carcinoma model. Materials and Methods: Thirty five female Sprague Dawley rats at age 21-day old were divided into 4 groups; Group 1 (control, n=10), Group 2 (PF4, n=5), Group 3 (rapamycin, n=10) and Group 4 (rapamycin+PF4, n=10). MNU was administered intraperitionally, dosed at 70mg/kg body weight. The rats were treated when the tumors reached the size of $14.5{\pm}0.5mm$ and subsequently sacrificed after 5 days. Rapamycin and PF4 were administered as focal intralesional injections at the dose of $20{\mu}g$/lesion. The tumor tissue was then subjected to histopathological examinations for morphological appraisal and immunohistochemical assessment of the pro-apoptotic marker, Bax and anti-apoptotic markers, Bcl-2 and survivin. Results: The histopathological pattern of the untreated control cohort showed that the severity of the malignancy augments with mammary tumor growth. Tumors developing in untreated groups were more aggressive whilst those in treated groups demonstrated a transformation to a less aggressive subtype. Combined treatment resulted in a significant reduction of tumor size without phenotypic changes. Bax, the pro-apoptotic marker, was significantly expressed at higher levels in the rapamycin-treated and rapamycin+PF4-treated groups compared to controls (p<0.05). Consequently, survivin was also significantly downregulated in the rapamycin-treated and rapamycin+PF4-treated group and this was significantly different when compared to controls (p). Conclusions: In our rat model, it could be clearly shown that rapamycin specifically affects Bax and survivin signaling pathways in activation of apoptosis. We conclude that rapamycin plays a critical role in the induction of apoptosis in MNU-induced mammary carcinoma.
Shi, Ru-Chun;Meng, Ai-Feng;Zhou, Weng-Lin;Yu, Xiao-Yan;Huang, Xin-En;Ji, Ai-Jun;Chen, Lei
Asian Pacific Journal of Cancer Prevention
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제16권16호
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pp.7117-7121
/
2015
Background: The effects of home nursing intervention on the quality of life in patients with nasopharyngeal carcinoma (NPC) after radiotherapy and chemotherapy are unclear. According to the characteristics of nursing home patients with nasopharyngeal carcinoma, we should continuously improve the nursing plan and improve the quality of life of patients at home. Materials and Methods: We selected 180 patients at home with NPC after radiotherapy and chemotherapy. The patients were randomly divided into experimental and control groups (90 patients each). The experimental group featured intervention with an NPC home nursing plan, while the control group was given routine discharge and outpatient review. Nursing intervention for patients was mainly achieved by regular telephone follow-up and home visits. We use the quality of life scale (QOL-C30), anxiety scale (SAS) and depression scale (SDS) to evaluate these patients before intervention, and during follow-up at 1 month and 3 months after the intervention. Results: Overall health and quality of life were significantly different between the groups (p<0.05), Emotional function score was significantly higher after intervention (p<0.05), as were cognitive function and social function scores after 3 months of intervention (p<0.05). Scores of fatigue, nausea and vomiting, pain, appetite and constipation were also significantly different between the two groups (p<0.05). Rates of anxiety and depression after 3 months of intervention were 11.1%, 22.2% and 34.4%, 53.3%, the differences being significant (p<0.05). Conclusions: NPC home nursing plan could effectively improve overall quality of life, cognitive function, social function (after 3 months) of patients, but improvement regarding body function is not suggested. Fatigue, nausea and vomiting, pain, appetite, constipation were clearly improved. We should further pursue a personalized, comprehensive measurements for nursing interventions and try to improve the quality of life of NPC patients at home.
Background: Tobacco and alcohol contain or may generate carcinogenic compounds related to cancers. CYP1A1 enzymes act upon these carcinogens before elimination from the body. The aim of this study was to investigate whether CYP1A1 T3801C polymorphism modulates the relationship between tobacco and alcohol-associated head and neck cancer (HNC) susceptibility among the northeast Indian population. Materials and Methods: One hundred and seventy histologically confirmed HNC cases and 230 controls were included within the study. The CYP1A1 T3801C polymorphism was determined using PCR-RFLP, and the results were confirmed by DNA sequencing. Logistic regression (LR) and multifactor dimensionality reduction (MDR) approaches were applied for statistical analysis. Results: The CYP1A1 CC genotype was significantly associated with HNC risk (P=0.045). A significantly increased risk of HNC (OR=6.09; P<0.0001) was observed in individuals with combined habits of smoking, alcohol drinking and tobacco-betel quid chewing. Further, gene-environment interactions revealed enhanced risks of HNC among smokers, alcohol drinkers and tobacco-betel quid chewers carrying CYP1A1 TC or CC genotypes. The highest risk of HNC was observed among smokers (OR=7.55; P=0.009) and chewers (OR=10.8; P<0.0001) carrying the CYP1A1 CC genotype. In MDR analysis, the best model for HNC risk was the three-factor model combination of smoking, tobacco-betel quid chewing and the CYP1A1 variant genotype (CVC=99/100; TBA=0.605; P<0.0001); whereas interaction entropy graphs showed synergistic interaction between tobacco habits and CYP1A1. Conclusions: Our results confirm that the CYP1A1 T3801C polymorphism modifies the risk of HNC and further demonstrated importance of gene-environment interaction.
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