To investigate the effect of perioperative period nursing on the quality of life of patients with breast reconstruction with Latissimus Dorsi Flap. A total of 90 patients with breast reconstruction with Latissimus Dorsi Flap were enrolled from January 2018 to November 2019. Grouped by digital table method, 90 cases patients were divided into experimental group and control group, with 45 cases in each group. The control group received clinical routine nursing, the observation group received targeted nursing intervention measures during perioperative period. The satisfaction and the occurrence of postoperative adverse reactions of the two groups were compared. The average length of hospital stay and postoperative upper limb rehabilitation training compliance; upper limb function score and quality of life score before and after nursing; incidence of upper limb numbness and scar contracture. The nursing satisfaction of the experimental group was statistically significant compared with the control group (P<0.05). The postoperative hospital stay was significantly less than that of the control group, and the postoperative upper limb rehabilitation training compliance was higher than that of the control group. The difference was statistically significant (P<0.05). There was little difference in quality of life score and upper limb function score between the two groups before treatment. The difference was not statistically significant. After nursing, the quality of life score and upper limb function score of the experimental group patients. The difference was statistically significant (P<0.05). The incidence of upper limb numbness and scar contracture in the experimental group was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion The application of rehabilitation nursing after modified radical mastectomy for breast cancer is effective in the treatment of modified radical mastectomy for breast cancer. It can effectively improve the upper limb function, reduce the incidence of upper limb complications, and improve the quality of life and satisfaction of patients. Perioperative nursing intervention in patients with I stage of latissimus dorsi flap after breast modified radical mastectomy can effectively prevent the occurrence of serious complications and improve the satisfaction of breast reconstruction and the success rate of operation.
In order to study WSTF (Williams syndrome transcription factor) regulation mechanism involved in Ras signal related to breast cancer cells. Western blot was used to detect WSTF phosphorylation and histone modification levels. GST pull-down was conducted to testify the interaction between WSTF, PCAF and MOF. Acetyltransferase activity of PCAF and MOF was tested via HAT activity assay. ChIP and Real-time PCR were applied to confirm gene expression. In vivo tumor growth analysis was used to test tumor formation capability. Results revealed an interaction between WSTF, PCAF and MOF. WSTF phosphorylation increased following Ras activation with enhancement of the association between WSTF and PCAF while the association between WSTF and MOF was attenuated. The changes resulted in an increase of PCAF activity and decrease of MOF, and upregulation of H3K9ac and downregulation of H4K16ac followed by gene expression changes and enhancement of tumor formation. In conclusion, WSTF involved in regulation of PCAF and MOF, meanwhile, tumor formation was affected as a consequence of changes of H3K9ac, H4K16ac and tumor related gene expression.
Ras signal regulates the pathway activity through the extracellular signal regulated kinase (ERK1/2) phosphorylation, Ras mutations or abnormal activation will lead to cancer. In order to study the effects on MCF-7 breast cancer cells proliferation and migration when histone H4K16 acetylating (H4K16ac) in activated Ras signaling pathway, we did a series of experiments. Western blot was used to detect the expression level of ERK1/2, p-ERK1/2, H4 and H4K16ac in different transfected groups. Immunohistochemical technique was used to detect the levels of p-ERK1/2 and H4K16ac in breast cancer tissues and adjacent tissues. The mutant plasmids were constructed to activate cellular Ras signaling pathway and to simulate intracellular H4K16ac. The proliferation ability of cells was detected by CCK-8 technology, and the migration ability of cells was detected by Transwell. In the control group, the activated Ras signal group, and the simulated H4K16ac group, the relative expression levels of p-ERK1/2 were 0.285±0.017, 0.407±0.026, 0.373±0.028; the relative expression levels of H4K16ac were 0.331±0.013, 0.082±0.005, 0.082±0.007. The expression of p-ERK1/2 in breast cancer tissue and adjacent tissue was 0.064±0.001 and 0.051±0.001, respectively; the expression of H4K16ac was 0.028±0.003 and 0.063±0.005, respectively. The proliferation and migration of cancer cells increased by 34.8% and 103.1% respectively (p<0.05), when the Ras signaling pathway was activated. Compared with the cancer cells activated Ras signal pathway, the proliferation and migration of cells simulated H4K16ac were decreased by 25.1% and 42.7% respectively (p<0.05). We demonstrated that after the Ras signal pathway was activated, the expression level of p-ERK1/2 rose, resulting in the decrease of H4K16ac. The increase of H4K16ac will inhibit the Ras signaling pathway activity, thus inhibit proliferation and migration of breast cancer cells. H4K16ac plays an important role in proliferation and migration from breast cancer tissues to normal breast tissues.
Background: Linea nigra and gynaecomastia are presumably markers of estrogen function and impaired androgen receptor activity in certain disease conditions. Since prostate cancer (PCa) is androgen-dependent, Linea nigra (LN) and gynaecomastia could be potentially non-invasive modalities used in the risk assessment of patients during screening and diagnosis for prostate cancer. Objectives: This study aims to determine the relationship between prostate cancer with Linea nigra and gynaecomastia. Methods: This is a comparative descriptive cross-sectional study on forty patients, twenty with benign prostatic enlargement (BPE) and twenty with PCa, who presented to the urology outpatient department or were admitted to the urology ward of the hospital. A proforma data collection sheet collated demographic information, clinical presentation, prostate-specific antigen (PSA) levels, and Linea nigra and gynecomastia presence. The data obtained were analyzed using the SPSS Version 25 software. Chi-square and Spearmanâs Rank analysis was used to test for association and relationship at a 95% confidence interval, with a pResults: The mean age was 71.0250 ± 11.01years, ranging from 39 to 96years. Linea nigra was seen in two (5%) and absent in thirty-eight (95%) of all the patients. The modal age range was the 70-79-year group, and none had linea nigra. Gynaecomastia was seen in four (10%) and absent in thirty-six (90%) of the patients. One patient in the age range of 50-59years, two in the 60-69years range and one in the 80-89 age range had gynaecomastia. A patient with BPE and three with PCa had gynaecomastia. There was no statistically significant association or relationship between gynaecomastia and prostate cancer. There was a significant association between gynaecomastia and PSA (p=0.008) but none between PSA and Linea nigra. Conclusion: Our study shows no statistically significant association between Linea nigra and gynaecomastia with prostate cancer. There is an association between gynaecomastia and PSA that require further evaluation. More extensive studies are needed to elucidate any relationships.
The Notch signaling pathway is a fundamental intercellular signaling system that regulates cell fate decisions in terms of proliferation and differentiation in multiple tissues. Abnormal activation of Notch1 signaling pathway leads to a variety of diseases, including the malignant tumors. Dysregulated Notch receptor activity has been implicated in breast cancer but the epigenetic mechanisms remains not clear. Compared to adjacent tissues, high expression of NIC1 and low expression of H4K16ac were found in cancer tissues. Notch1 knocked down in the breast cancer cell line MCF-7 resulted in increased H4K16ac expression and a parallel reduction in their proliferation and migration capacity. Our study prompting H4K16ac to participate in the signal transduction of Notch1 in breast cancer cells. These results confirm Notch1 as a signal triggering epigenetic mechanisms in breast cancer cells, which may have implications in tumor dissemination, metastasis and proliferation. The identification of specific factors interacting with NOTCH signaling could thus be relevant to fully understanding the role of NOTCH in breast neoplasia.
Dichloroacetate (DCA) is a promising anticancer drug that exerts potent anticancer effects in many clinical oncology studies. On biochemical and pharmacological bases, this article aims at gaining a better understanding of DCA anticancer effects. Ketone bodies oxidation (ketolysis) is an important source of energy to many cancer cells. Here, it is proved that DCA antagonizes acetoacetate and targets cancer cells' energetics through inhibiting ketolysis as novel evidence-based anticancer mechanisms. DCA was reported to inhibit oxidation of both ketone bodies (acetoacetate and β-hydroxybutyrate) in addition to palmitate. Acetoacetate diverted pyruvate metabolism from pyruvate dehydrogenase (PDH) to pyruvate carboxylation while DCA increased the oxidation of glucose through PDH. This suggests an antagonism between DCA and ketone bodies. Moreover, DCA was reported to inhibit β-hydroxybutyrate uptake by the extra-splanchnic tissues and decrease the clearance of ketone bodies. That may be explained by structural antagonism between DCA and ketone bodies leading to a competitive uptake at target tissues i.e. DCA may competitively antagonize ketone bodies. In a previous study, DCA infusion in starved rats caused a significant decrease in blood glucose, plasma insulin, blood lactate and pyruvate concentrations but significantly increased concentrations of ketone bodies (β-hydroxybutyrate and acetoacetate) (Blackshear et al., 1974). Based on that, DCA inhibits ketone bodies utilization for energy production. In conclusion, DCA enhances anticancer immunity, targets anaerobic cancer cell populations (via targeting Warburg effect) and targets aerobic cancer cell populations through targeting mitochondrial energy generating pathways e.g. ketolysis.
Background and aims: Treatment of Nephroblastoma (Wilmsâ tumor) in children is one of medicine's success stories. Due to improvements in surgical techniques, drug therapies, and radiation, 85 to 90 percent of children with Wilms tumor who receive state-of-the-art treatment are cured. While this is true for developed countries the outcomes of nephroblastoma (Wilmsâ tumor, WT) in our hospital and other developing countries are notably below those in these countries. There are continuous reviews and updates of clinical pathologic features, treatment designs, and treatment outcomes every 2 or 3 years, in the developed countries. However, in resource poor countries, such frequent reviews and updates are presently not affordable but, nevertheless, efforts should be made to undertake them every 5 or so years, to improve patient management and treatment outcomes. The objectives of this study were to review the clinical presentation and management of children with Wilms tumor and the factors influencing the outcome at Kenyatta National Referral and Teaching Hospital (KNH). This was a retrospective descriptive cross-sectional study. Analysis of the data was carried out using the statistical package for the social sciences (SPSS) software. The findings of the study will form a basis for revision of treatment design for patients diagnosed with Nephroblastoma at KNH, and by extension, other tertiary public health care facilities in Kenya. Patients and methods: The records of 140 WT patients, aged less than 16 years, who were treated in Kenyatta National Hospital, Kenya, during the period from January 1997 to December 2008 were reviewed. The management protocol followed the scheme of the US National Wilms Tumor Study Group (NSWTG). Results: Thirteen cases (38.2%) were diagnosed as stage I, 4 (11.8%) as stage II, 13 (38.2%) as stage III and 2 (5.9%) as stage IV. Eight cases had bilateral disease (stage V). Four-year overall survival (OS) and event free survival (EFS) rates were xx% and xx%, respectively. Univariate analysis by Log-rank test revealed statistically significant associations between OS and nodal status (p- value < 0.01), manifestation of gross hematuria (p-value 0.02), and tumor size of 10 centimeters or more (p-value 0.02). Multivariate analysis found only the nodal status to be independently associated with OS at a Hazard Ratio of 16.6 (p-value < 0.01). Eight of 13 stage I cases and 6/13 stage III cases had relapsed, with two-year post-relapse survival of 42.8%. Significantly poorer outcome was found in cases with early relapse within 200 days after enrollment (p-value 0.02). Conclusion: Childhood Wilmsâ tumor presents late in our setting with its consequent management challenges. The need to educate the populace and the primary healthcare providers on the benefits of early diagnosis and treatment of this condition cannot be overemphasized. Large tumor size and gross hematuria were associated with risk of a poorer outcome.
Background: Several studies have well-established the relationship between breast cancer and etiological hormonal factors. Therefore, the aim of this study was to determine breast cancer related awareness and approach toward exposure to diverse patterns of hormones among women in Northern Saudi Arabia. Methodology: This is a cross sectional survey included 400 Saudi femalesâ volunteers living in the city of Hail, Northern Saudi Arabia. Knowledge, awareness and approach toward exposure to diverse patterns of hormones and breast cancer risk were evaluated using different variables during interview. Results: On asking the participants the question âDoes the over exposure to hormones (ER) increases the risk of breast cancerâ Out of 387 respondents, 47.5% answered yes increases the risk of breast cancer. On asking the participants the question âDoes early puberty and late menopause increase the risk of breast cancerâ Out of 395 respondents, 35.2% answered yes increases the risk of breast cancer. Conclusion: Knowledge of hormonal breast cancer risk factors is not so strong so as to achieve the intended values in Northern Saudi Arabia. Knowledge of breast cancer risk factors can powerfully participate to the breast cancer prevention struggles, which will have the chief results mainly if started at an early age and continued over a lifetime.
Necrotizing fasciitis is an uncommon disease and a soft tissue infection that spreads along fascial planes with associated inflammation and necrosis. Herein, this study reported necrotizing fasciitis as a rare complication after bone marrow transplantation (BMT) in a Iranian patient and the efficacy of early treatment in improvement it. A 28-year-old lady had known case of first relapse of Hodgkinâs lymphoma that admitted for auto-BMT in 2016. Five years ago due to abdominal-pelvic massive lymphadenopathy, she was treated with six courses of ABVD regimen combined with involved filed irradiation. Due to Hodgkinâs relapse, the patient was treated with six courses of ICE regimen and after complete remission was selected for auto-BMT. Necrotizing fasciitis was reported by MRI and the patients was treated with combination of a number of antibiotics after fasciectomy. In conclusion, necrotizing fasciitis is a rare complication of BMT, especially autologous type that drug selection and rapid surgical fasciectomy are important decisions for prevention of mortality and morbidity of this complication.
Cervical cancer is cancer of the cervix which is caused by sexually-acquired infection with Human Papilloma Virus (HPV). Cervical cancer screening is the systematic application of Pap smear test to identify cervical abnormalities in an asymptomatic population. This paper tries to give an overview of cervical cancer screening practices and barriers in Nepal. During preparation of review paper various published Literature were obtained and reviewed from international journal and local newspaper and analyzed. In case of Nepal cervical cancer screening is still not giving high priority by women. Likewise Vaccine against HPV is not yet easily available in Nepal for early detection of cervical cancer due to lack of financial resources. High incidence of cervical cancer result due lack of awareness and knowledge, Pap test and HPV vaccine. Socio-cultural factors, low fund, less laboratory services, lack of privacy and informed consent pose barriers to have routine screening practices.
BACKGROUND:Epidemiologic studies have shown that inadequate physical activity was associated with cancers in whites and other ethnic groups, but in Mexican-Americans data are limited. This study aimed to measure the association between physical activity and reported cancer risk in Mexican-Americans.METHODS:Participants were drawn from the Cameron County Hispanic Cohort (n=3,391), a randomly selected Mexican-American cohort in Texas on the US-Mexico border. Physical activity was assessed using the International Physical Activity Questionnaire. Cancer was self-reported by the participants as being told by a health care provider that they had cancer.RESULTS:Ninety-nine participants of the cohort (2.94%) reported a diagnosis of cancer. Compared to participants who did not meet US physical activity guidelines, subjects who met physical activity guidelines of 150 moderate and vigorous minutes per week (≥ 600 METs) reduced their risk for cancer by 87% (OR=0.13; 95% CI: 0.03-0.54), and subjects with total minutes per week of moderate and vigorous/strenuous activity greater than 745 METs decreased cancer risk by 86% [odds ratio (OR)=0.14; 95% confidence interval (CI): 0.03-0.60] comparing with their counterparts, after adjusting for age, gender, body mass index, smoking and alcohol drinking status, education and total portions of fruit and vegetable intake.CONCLUSIONS:Meeting or exceeding recommended levels of moderate and vigorous physical activity was associated with a significantly reduced risk of reporting cancer by Mexican-Americans. Meeting or exceeding recommended levels of physical activity appears to be an effective target for cancer prevention and control among Mexican-Americans independent of BMI and other factors.
Different natural products are known for their use in conventional medicine and especially for their beneficial effect on chronic diseases including autoimmune and cancer. A purified natural extract sample from the Chinese herb Tripterygium wilfordii Hook F (known as Lei Gong Teng or Thunder of God Vine) containing diterpenoids and triepoxides, was associated with significant anti-tumor effects and with encouraging results. Additionally, another natural extract from apricot kernels, Amygdalin (also known as laetrile or vitamin B17) a cyanide- containing substance, has been reported as a potential anti-cancer molecule with numerous contradictions among different published data. For many years different scientist tried to investigate in vivo, in vitro and ex vivo the efficacy of all of these molecules but they all failed in giving clear robust positive conclusions and the opinions are contradictory. Most of the studies were focusing on the apoptotic effects that can lead to the programmed cell death (PCD), a noteworthy mechanism in cancer treatment. The present review summarizes published reports and gives a better understanding of the known abilities as well as the possible role of these specific natural extract molecules in the fight of cancer treatment, cure and prevention.
Purpose: In REDUCE, dutasteride was associated with a ~5% absolute reduction in the risk of biopsy-detected prostate cancer (PCa). Material and methods: We tested the influence of family history on the association between dutasteride and PCa diagnosis and calculated the number needed to treat (NNT) with dutasteride to avoid one PCa diagnosis. The REDUCE trial tested dutasteride 0.5mg/day for PCa risk reduction in men aged 50-75 with a serum PSA of 2.5-10.0ng/mL and a negative biopsy. Among men who underwent >1 on-study biopsy with complete data (n=6,415; 78.1%), the association between dutasteride and PCa risk as a function of PCa and/or breast cancer (BCa) family history was examined using multivariable logistic regression. Absolute risk reduction (ARR) and NNT were calculated. Results: On multivariate analysis, dutasteride was significantly associated with lower PCa risk in men without family history (25% lower; p<0.001), PCa family history only (37% lower; p=0.009), or BCa family history only (38% lower; p=0.04). While dutasteride lowered PCa risk in men with both PCa and BCa family history by 15%, this was not significant (p=0.69), though the number of men was small (n=115). ARRs were 6-9% for men with a PCa and/or BCa family history vs. 5% in men with no family history which translated into NNTs of 11-16 in men with PCa and/or BCa family history vs. 21 for men without family history. Conclusion: Using dutasteride as a model of chemoprevention, therapies targeting individuals with specific family histories may improve the risk-benefit profile. However, future studies are warranted to confirm our findings.
