Dietary Carbohydrate Promotes Cell Survival in Cancer Via the Up-Regulation of Fat Mass and Obesity-Associated Gene Expression Level

@#Cancer cells are mainly dependent on glycolysis for their growth and survival. Dietary carbohydrates play a critical role in the growth and proliferation of cancer and a low-carbohydrate diet may help slow down the growth of tumours. However, the exact mechanisms behind this effect are unclear. This review study aimed to investigate the effect of fat mass and obesity-associated (FTO) gene in the association between dietary carbohydrates and cancer. This study was carried out using keywords such as polymorphism and/or cancer and/or dietary carbohydrate and/or FTO gene. PubMed and Science Direct databases were used to collect all related articles published from 1990 to 2018. Recent studies showed that the level of FTO gene expression in cancer cells is dramatically increased and may play a role in the growth of these cells through the regulation of the cellular metabolic pathways, including the phosphoinositide 3-kinases/protein kinaseB (PI3K/AKT) signaling pathway. Dietary carbohydrate may influence the FTO gene expression by eliminating the inhibitory effect of adenosine monophosphate-activated protein kinase (AMPK) on the FTO gene

Genomic Profiling of Chronic Myelogenous Leukemia: Basic and Clinical Approach

Chronic myeloid leukemia (CML) is a hematological stem cell cancer driven by BCR-ABL1 fusion protein. We review the previous and recent evidence on the significance of CML in diagnostic and clinic management. The technical monitoring of BCR-ABL1 with quantitative real time-PCR has been used in assessing patient outcome. The cytogenetic mark of CML is Philadelphia chromosome, that is formed by reciprocal chromosomal translocations between human chromosome 9 and 22, t(9:22) (q³⁴:q¹¹). It makes a BCR-ABL1 fusion protein with an anomaly tyrosine kinase activity that promotes the characteristic proliferation of progenitor cells in CML and acute lymphoblastic lymphoma. The targeting of BCR-ABL1 fusion kinase is the first novel paradigm of molecularly targeted curing.

Cost-effectiveness of three rounds of mammography breast cancer screening in Iranian women

Background: Breast cancer is the most common cancer in Iranian women as is worldwide. Mammography screening has been introduced as a beneficial method for reducing mortality and morbidity of this disease

Objectives: We developed an analytical model to assess the cost effectiveness of an organized mammography screening program in Iran for early detection of the breast cancer

Patients and Methods: This study is an economic evaluation of mammography screening program among Iranian woman aged 40 - 70 years. A decision tree and Markov model were applied to estimate total quality adjusted life years [QALY] and lifetime costs

Results: The results revealed that the incremental cost effectiveness ratio [ICER] of mammography screening in Iranian women in the first round was Int. 37,350 dollars per QALY gained. The model showed that the ICER in the second and third rounds of screening program were Int.141,641 dollars and Int. 389,148 dollars respectively

Conclusions: Study results identified that mammography screening program was cost-effective in 53% of the cases, but incremental cost per QALY in the second and third rounds of screening are much higher than the accepted payment threshold of Iranian health system. Thus, evaluation of other screening strategies would be useful to identify more cost-effective program. Future studies with new national data can improve the accuracy of our finding and provide better information for health policy makers for decision making

YKL-40 gene expression and plasma levels of CD30 are not affected by isoflurane or propofol: pilot study

Background: It has been hypothesized that the body's response to anesthesia techniques can increase risk of cancer recurrence and metastatic disease after surgery and also can modulate immune responses. Some acute inflammatory markers have been measured to survey the immunomodulatory effect of anesthesia, but in this research, we studied the plasma level of CD30 and YKL-40 gene expression which can present major changes of the immune system

Materials and Methods: Our study was a controlled before and after study. 34 women with biopsy-proven breast cancer were randomized to receive either propofol general anesthesia [n=17] or standard isoflurane general anesthesia [n=17]. There were no significant differences between the two patient groups in age, body weight, and height, length of general anesthesia, operative time and group of surgery. The blood samples were collected in two different sets, before anesthesia and 72-h postoperatively. Soluble CD30 [sCD30] plasma level was measured by ELISA and YKL-40/CHI3L1 gene expression was evaluated by real-time-PCR

Results: The results showed that the anesthetics, propofol and isoflurane, have no effect on the expression of YKL-40. Despite increased in the expression of YKL-40 that was observed in patients receiving isoflurane, this increase was not statistically significant. There was no significant increase or decrease in plasma concentrations of sCD30

Conclusion: YKL-40 and sCD30 are not affected by isoflurane or propofol. So, in immunological perspective, there is no preference in use of isoflurane or propofol in breast cancer patients

First experience of intraoperative radiation therapy in cerebral high grade glioma in Iran: a report of three cases and literature review

Introduction: Among the high grade cerebral gliomas, Glioblastoma multiform for instance, would be the main pattern of local recurrence causes clinical deterioration and deaths. This has observed 2 - 3 cm upon the initial lesion. During the period of 2 - 4 weeks post-surgery, remaining tumor cells have re-grown until radiochemotherapy has initiated. So it has seemed clear that improved local control could hopefully translate into improved survival. As a matter of fact, mass reduction has insufficiently achieved in almost every case of GBM as that the tumor cell number has not fallen below a "threshold" that tumor control might achieve by the host immune system. Intraoperative Radiation therapy has been one of those add-on therapies, which has performed during or directly after resection and cleared the tumor cavity from microscopically remaining cells. Although IORT has presented a novel and feasible principle, the method faced a number of technical and geometrical errors and limitations, which has decreased its potential in the reports of previous studies. Examples could be mentioned as incomplete target volume coverage that seemed as the greatest influence on survival, due to irradiation with an inadequate electron cone size, due to angle errors, or inadequately low energies. In contrast to the previously used forward-beaming electron cones, spherical irradiation sources were specifically attractive in brain tumor IORT, even in post resection cavities with normal complex shapes

Case Presentation: We have been reporting 3 cases of high grade gliomas, one recurrent GBM, one primary glioma grade III, and the last one recurrent Rhabdoid GBM, which have been fulfilling our entrance criteria of IORT procedure, by using spherical applicators, which has been increasingly discussed in recent studies

Conclusions: It was the first experience of intraoperative radiation therapy for cerebral malignant tumours in Iran. Finally, we had a brief overview on the past and present IORT strategies in the treatment of GBM

Oral lymphoma prevalence in Iranian population: a multicenter retrospective study

Background: Oral lymphoma is the second most common malignancy of the head and neck region after malignant epithelial tumors

Objectives: Considering the lack of a multicenter study on the frequency of oral lymphoma in Iran, this study aimed to assess the relative frequency of oral lymphomas in Iran during a 6-year period

Materials and Methods: This multicenter, retrospective, cross-sectional study was conducted in two phases. In the first phase, cases of oral lymphoma registered in the cancer research center [CRC] of Shahid Beheshti university of medical sciences were extracted. The patient records and pathology reports of these patients were retrieved from the archives and age, sex and microscopic type site of the lesions were evaluated

Results: Oral lymphoma accounts for 1% of head and neck malignancies and 8% of all lymphomas. From 2003 to 2008, a total of 437 new cases of oral lymphomas had been registered in the CRC. Diffuse large B-cell lymphoma was found to be the most common form of oral lymphoma in the 6-year period with 240 [54.9%] registered cases. The majority of detected cases were in the 6th and 7th decades of life with a male to female ratio of 1: 84. Tonsils were the most common site of occurrence of lymphoma in the oral cavity [77.8%]

Conclusions: The age of onset, site of involvement, sex of patients, and histopathological subtype of oral lymphomas in the Iranian population were found to be similar to those of most other countries

Effectiveness of group training based on acceptance and commitment therapy on anxiety and depression of women with breast cancer

Breast cancer is the most common cancer in women that as a sudden event has profound effects on all aspects of patients' lives. Psychosocial interventions may play important roles in reducing anxiety and depression among breast-cancer survivors. Therefore, group training based on acceptance and commitment therapy may help women to cope better with their condition, and decrease their anxiety and depression. In a quasi-experimental study, 30 patients with breast cancer were selected by convenience sampling method and randomly assigned to 2 experimental and control groups. The experimental group attended acceptance and commitment training classes for 8 weeks continuously [each class lasting 90 minutes]. Participants in both the experimental and control groups completed Beck Anxiety Inventory [BAI] and Beck Depression Inventory [BHI-II] as a pretest and posttest. Analysis of Covariance was used as the statistical method. In acceptance and commitment group training, anxiety and depression significantly decreased [p<0/05]. These changes were not observed in the control group. The results showed that group training based on acceptance and commitment therapy is an effective method in reducing anxiety and depression. Hence psychological interventions can be used to reduce psychological difficulties of women with breast cancer

National health guidelines in I.R of Iran, an innovative approach for developing countries

Guidelines have produced and used in complex environment of health care system with its ethical, economical, legal and other aspects; that should be taken into account in any country. Modifying the format and content of guidelines might facilitate their usage and lead to improved quality of care and cost containment. We have produced this tool for explained above purpose. A coordinating national team has settled at the office of minster of health and medical education, supported by a guideline review committee. An innovative and appropriate approach for adapting national health guidelines has consisted of eight steps, have defined For preparing the draft of each guideline a technical team which, including main author, her/his co-workers have nominated. The authors of each topic have systematically searched databases of the proposed Twenty-two International Sites, and then have selected at least five sources of them that were more relevant. The final recommendations have proposed by agreement of technical team and Guideline Review Committee. In less than 5 months, more than 500 authors in whole country have selected to prepare guidelines and, approximately 150 guidelines have provided in three volumes of the published and distributed book. Each guideline had a national ID number, constant forever; all topics should be reviewed every 3-5 years. National health guideline[s] would be essential means for policy making in health system and increased the cost containment and quality of care. Ministry of Health and Medical Education should provide and distribute the guidelines based on its accountability to legal responsibility

Evaluating resident physicians' knowledge, attitude, and practice regarding the pain control in cancer patients

Pain has been one of the most debilitating symptoms of cancer. The aim of this study was to evaluate residents' knowledge, attitude, and practice regarding pain control in cancer patients. In a descriptive study, 69 randomly selected third-year various residents practicing in teaching hospitals of Shahid Beheshti School of medicine participated in this study. They have provided their demographic characteristics and completed a questionnaire, based on their "knowledge", "attitude" and "practice" regarding cancer pain and its management. Data analysis has performed using SPSS v.19. A p value of less than 0.05 has considered as significant. Obtained Data from 69 participants including 32 anesthesiology residents has included to our study. The average scores were 35.8 +/- 6.1 [ranging from 20 to 49] for the residents' attitude, 25.1 +/- 9.1 [ranging from 0 to 53] for their knowledge and 11.2 +/- 4.1 [ranging from 0 to 17] for their practice. The overall scores of the questions have related to attitude and knowledge were higher for residents of anesthesiology but the difference was not statistically significant [A: 37.1 +/- 4.9 vs. 34.7 +/- 6.8, p=0.106, K: 27.2 +/- 11.8 vs. 23.3 +/- 5.6, p=0.076]. The average score for questions on physician' practice was significantly higher in residents of anesthesiology [P: 12.8 +/- 3.2 vs. 9.7 +/- 4.2, p=0.001]. In order to provide patients with adequate pain relief, it has seemed advisable for medical schools to focus on improving the educational curriculum and integrating it into clinical practice

High body mass index and young age are not associated with post-mastectomy pain syndrome in breast cancer survivors: a case-control study

Surgery is usually the first treatment for breast cancer which is followed by some complications such as chronic pain. Post mastectomy pain syndrome [PMPS] is a common complication among breast cancer survivors and is considered as a chronic neuropathic pain in the side of surgery which persists more than three months. The exact mechanisms and related risk factors of the chronic pain after breast surgery are unknown. The aim of this study was to investigate the association of body mass index [BMI] and age with PMPS. In this case-control study, a total of 122 women were assessed; of these, 61 women were diagnosed with PMPS and selected as cases and 61 pain-free patients were selected as controls. The demographic and clinical characteristics of participants were collected through questionnaires and medical record of patients. Logistic regression model was used to determine the association of BMI and age with PMPS, adjusted for demographic and clinical characteristics. No significant differences were found in means of weight [68.02 +/- 8.80 vs. 68.67 +/- 11.82, p=0.726], BMI [26.38 +/- 3.28 vs. 27.10 +/- 6.03, p=0.410], and age [46.34 +/- 11.67 vs. 48.54 +/- 12.57, p=0.319] between those with PMPS and those not reporting PMPS. A non-significant slight increase in odds ratio of PMPS was observed in obese category compared to normal weight category [OR=1.152 [95% CI 0.405-3.275], p=0.908], but after adjusting the confounding factors, the risk of pain development was attenuated in obese subjects [OR=0.748 [95% CI 0.228-2.459], p=0.633]. Also, non-significant decrease in odds ratios of PMPS was found in 20-39 y, 40-49 y, and 50-59 y ages categories compared to oldest age category [adjusted OR= 0.781 [95% CI 0.213-2.866], p=0.576; adjusted OR=0.485 [95% CI 0.152- 1.554], p=0.183; adjusted OR=0.735 [95% CI 0.206-2.627], p=0.628; respectively]. In contrast with some observational studies, present study showed that high BMI and younger age might not be associated with increased risk of PMPS development. Further research is necessary to determine the main risk factors and directionality and causal mechanisms for associations of these risk factors with chronic pain after mastectomy

Relationships between family levels of socioeconomic status and distribution of breast cancer risk factors

Not only the expand development of knowledge for reducing risk factors, but also the improvement in early diagnosis and treatment of cancer, and socioeconomic inequalities could affect cancer incidence, diagnosis stage, and mortality. The aim of this study was investigation the relationships between family levels of socioeconomic status and distribution of breast cancer risk factors. This descriptive cross-sectional study has conducted on 526 patients who were suffering from breast cancer, and have registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from March 2008 to December 2013. A reliable and valid questionnaire about family levels of socioeconomic status has filled by interviewing the patients via phone. For analyzing the data, Multinomial logistic regression, Kendal tau-b correlation coefficient and Contingency Coefficient tests have executed by SPSS[19]. The mean age of the patients was 48.30 [SD=11.41]. According to the results of this study, there was a significant relationship between family socioeconomic status and patient's age at diagnosis of breast cancer [p value<0.001]. Also, the relationships between socioeconomic status and number of pregnancies, and duration of breast feeding were significant [p value> 0.001]. In the multiple logistic regressions, the relationship between excellent socioeconomic status and number of abortions was significant [p value> 0.007]. Furthermore, the relationships between moderate and good socioeconomic statuses and smoking were significant [p value=0.05 and p value=0.02, respectively]. The results have indicated that among those patients having better socioeconomic status, age at cancer diagnosis, number of pregnancies and duration of breast feeding was lower, and then number of abortions was more than the others. According to the results of this study, it was really important to focus on family socioeconomic status as a critical and effective variable on breast cancer risk factors among the Iranian women

Prediction of lung cells oncogenic transformation for induced radon progeny alpha particles using sugarscape cellular automata

Alpha particle irradiation from radon progeny is one of the major natural sources of effective dose in the public population. Oncogenic transformation is a biological effectiveness of radon progeny alpha particle hits. The biological effects which has caused by exposure to radon, were the main result of a complex series of physical, chemical, biological and physiological interactions. The cellular and molecular mechanisms for radon-induced carcinogenesis have not been clear yet. Various biological models, including cultured cells and animals, have been found useful for studying the carcinogenesis effects of radon progeny alpha particles. In this paper, sugars cape cellular automata have been presented for computational study of complex biological effect of radon progeny alpha particles in lung bronchial airways. The model has included mechanism of DNA damage, which has been induced alpha particles hits, and then formation of transformation in the lung cells. Biomarkers were an objective measure or evaluation of normal or abnormal biological processes. In the model, the metabolism rate of infected cell has been induced alpha particles traversals, as a biomarker, has been followed to reach oncogenic transformation. The model results have successfully validated in comparison with "in vitro oncogenic transformation data" for C3H 10T1/2 cells. This model has provided an opportunity to study the cellular and molecular changes, at the various stages in radiation carcinogenesis, involving human cells. It has become well known that simulation could be used to investigate complex biomedical systems, in situations where traditional methodologies were difficult or too costly to employ

Granzyme H serum levels variations with both reproductive hormone receptors, and related hormone receptors in breast cancer patients

Breast Cancer [BC] is the most common cancer in Iranian women, meanwhile the Iranian patients are relatively young. Granzyme H [GZMH] is a functional cytotoxic serine protease of NK cell granules, which expands the cell death-inducing repertoire of innate immune system. GZMH is constitutively and highly expressed in human NK cells, in order to possess chymotrypsin-like [chymase] enzymatic activity. The purpose of this study was to determine GZMH level, in BC and healthy women. 30 breast cancer patients, and 30 control women in premenopausal status, have participated in this study. GZMH, Estrogen levels, and ER,PR have been measured in cancer and healthy women subsequently, as using ELISA, Radioimmunoassay, and Immunohistochemistry methods. Mean GZMH value was lower in BC than healthy women [p<0.0001]. Our study has implicated suppressor existence, or the problem for producing of GZMH in patients group, and levels of estrogen that could not effect on making positive ER, PR

Predicting PTG based upon self-efficacy and perceived social support in cancer patients

Despite the fact that being exposed to traumatic and stressful events could have severe consequences, studies have shown that even in the wake of negative events such as cancer diagnosis, we see some changes and positive impacts in scheme, philosophy of life and self-perception, a process which is called Post Traumatic Growth [PTG]. The aim of the current research is to define share of self-efficacy and perceived social support in the prediction of PTG. The research is a correlation type. For this aim, 95 patients with cancer came to Shohadaye Tajrish Hospital, Tehran, Vali-e-Asr Hospital, Zanjan, and Mehraneh Charity Institute, Zanjan in 2012 have been selected based on available sampling and evaluated regarding self-efficacy, and perceived social support and PTG. Data analysis using Pearson correlation and regression analysis [simple and multiple] showed that self-efficacy and Perceived Social Support in cancer patients have direct significant relation with variable of PTG and explain 13.5%, 10.6% and jointly 20.7% of PTG changes respectively. The research findings show that the variables of self-efficacy and Perceived Social Support explain significantly the PTG and these psychological variables can be used to provide improvement plans and mental health and PTG facilities

Efficacy of group logotherapy on decreasing anxiety in women with breast cancer

Breast cancer is the most incident cancer and the fifth cause of death due to malignancies among Iranian women. A strong breast cancer patients' sense of meaning and purpose in life appears to decrease anxiety in their life. The present study has investigated the effectiveness of group Logotherapy on the reduction of anxiety in women with breast cancer. The research was quasi-experimental with pre-test, post-test and control group. For this purpose, 30 patients with breast cancer were randomly divided into two experimental group and control group. Then, all patients completed the Beck Anxiety Inventory [BAI]. The experimental group received Logotherapy-based group counseling for eight sessions; however, the control group did not receive any specific training. In the end, both groups were tested again. After collecting the questionnaires, data was analyzed by the statistic software SPSS version 18 and using analysis of covariance. The research results showed that group Logotherapy was effective in reducing anxiety in women with breast cancer [p<0.005]. In other words, this intervention could reduce anxiety in the experimental group. The results suggest that in line with current medical treatment, psychosocial interventions can be used to reduce anxiety in the breast cancer patients

estimation of survival function for colon cancer data in Tehran using non-parametric Bayesian model

Colon cancer is the third cause of cancer deaths. Although colon cancer survival time has increased in recent years, the mortality rate is still high. The Cox model is the most common regression model often used in medical research in survival analysis, but most of the time the effect of at least one of the independent factors changes over time, so the model cannot be used. In the current study, the survival function for colon cancer patients in Tehran is estimated using non-parametric Bayesian model. In this survival study, 580 patients with colon cancer who were recorded in the Cancer Research Center of Shahid Beheshti University of Medical Sciences since April 2005 to November 2006 were studied and followed up for a period of 5 years. Survival function was plotted with non-parametric Bayesian model and was compared with the Kaplan-Meier curve. Of the total of 580 patients, 69.9% of patients were alive. 45.9% of patients were male and the mean age of cancer diagnosis was 65.12 [SD= 12.26] and 87.7 of the patients underwent surgery. There was a significant relationship between age at diagnosis and sex and the survival time while there was a non-significant relationship between the type of treatment and the survival time. The survival functions corresponding to the two treatment groups cross, in comparison with the patients who had no surgery in the first 30 months, showed a higher level of risk in the patients who underwent a surgery. After that, the survival probability for the patients undergoing a surgery has increased. The study showed that survival rate has been higher in women and in the patients who were below 60 years at the time of diagnosis

Ethics of palliative surgery in esophageal cancer

Surgery is one of the important palliative methods for patients with esophageal cancer. In addition to concerns related to clinical decision making, various moral challenges are encountered in palliative surgery. Some of them are related to patients and their illness, others to surgeons, their attitudes, skills and knowledge base. Pertinent moral challenges are addressed and analyzed with respect to prevailing perspectives in normative ethics [Ross style pluralism]. Demands regarding sensibility and precaution in this clinical setting represent substantial challenges with regard to the beneficence, non-maleficence, justice, autonomy and proper patient information. Moreover, variations in definition of palliative surgery as well as limited scientific evidence in efficacy, effectiveness and efficiency pose methodological and moral problems. We have shown that ethical principles [beneficence, non-maleficence, and justice] in all procedures and treatments in esophageal cancer, including psychological problems of the patients are effective in improving their quality of life. Both surgical skills and moral sensibility are required to improve surgical palliative care in esophageal cancer, and should be taken into account not only in clinical practice but also in education and research

Comparing the performance of image enhancement methods to detect microcalcification clusters in digital mammography

Mammography is the primary imaging technique for detection and diagnosis of breast cancer; however, the contrast of a mammogram image is often poor, especially for dense and glandular tissues. In these cases the radiologist may miss some diagnostically important microcalcifications. In order to improve diagnosis of cancer correctly, image enhancement technology is often used to enhance the image and help radiologists. This paper presents a comparative study in digital mammography image enhancement based on four different algorithms: wavelet-based enhancement [Asymmetric Daubechies of order 8], Contrast-Limited Adaptive Histogram Equalization [CLAHE], morphological operators and unsharp masking. These algorithms have been tested on 114 clinical digital mammography images. The comparison for all the proposed image enhancement techniques was carried out to find out the best technique in enhancement of the mammogram images to detect microcalcifications. For evaluation of performance of image enhancement algorithms, the Contrast Improvement Index [CII] and profile intensity surface area distribution curve quality assessment have been used after any enhancement. The results of this study have shown that the average of CII is about 2.61 for wavelet and for CLAHE, unsharp masking and morphology operation are about 2.047, 1.63 and 1.315 respectively. Experimental results strongly suggest that the wavelet transformation can be more effective and improve significantly overall detection of the Computer-Aided Diagnosis [CAD] system especially for dense breast. Compare to other studies, our method achieved a higher CII