[Expression of BRCA1 protein in invasive and in situ carcinomas and its relation with marker of breast cancer stem cells [CD44] and prognostic factors in breast cancer patients]

Breast cancer is the most common cancer and the second cause of cancer death among women. Despite recent developments in therapeutic tools about 25% of all the involved cases die annually. The clinical, molecular, and pathologic features of breast cancer in BRCA1 mutation carriers suggest that BRCA1 may function as a stem-cell regulator. The purpose of the current study was to investigate the correlation between BRCA1 protein expression and clinicopathological characteristics, and putative cancer stem cell marker [CD44 [in breast carcinomas. In this experimental study, immunohistochemistry was performed on 156 primary operable breast tumors employing a monoclonal anti-BRCA1 primary antibody. The relation between BRCA1 expression and variations such as age and pathologic features and CD44 was studied by Chi square test. SPSS V.16 was also used for data analysis. Altered BRCA1 expression was significantly associated with high grade and poor prognosis breast tumors [p=0.006]. Mutated BRCA1 was also more often seen in early onset breast cancer patients [

OCT-4, an embryonic stem cell marker expressed in breast, brain and thyroid carcinomas compared to testicular carcinoma

Cancer stem cells are a small subpopulation of cells within a tumor which are responsible for maintaining the tumor mass. A number of factors such as OCT-4 that govern the fate of adult stem cells also play a role in malignant cell transformation. OCT-4 is a key regulator of self-renewal in embryonic stem cells; its expression is potentially correlated with tumorigenesis and can affect some aspects of tumor behavior such as tumor recurrence or resistance to therapies. We have investigated the potential expression of OCT-4 on a panel of tumors including breast, brain, thyroid and testicular carcinomas, using immunohistochemistry. The level of expression of OCT-4 was then compared to different tumor types and degree of differentiation. OCT-4 was expressed at the highest levels on nuclear site of seminoma compared with other tumors. The expression of OCT-4 was detectable in both nucleus and the cytoplasm of almost all breast tumors, but it was detectable at much lower level in normal breast tissues. OCT-4 expression was noted on poorly differentiated papillary carcinoma of thyroid compared to normal follicles of thyroid gland adjacent to the tumor. Breast carcinomas and papillary carcinomas of thyroid express elevated levels of embryonic stem cell gene OCT-4, suggesting that these tumors may contain cells indicative of embryonic-like stem cells. Identification of cancer stem cells in different malignant tumors may be useful for prognostic evaluation and administration of a new treatment which target this sub-population of tumor cells

concept of palliative care practice among Iranian general practitioners

General Practitioners [GPs] have the main responsibility in medical and particularly palliative care provision in most of countries, though this is not the current case in Iran. Development of 'family physician' approach in rural and most of the urban areas in Iran, GPs will have the main role in care provision. There is no formal palliative care education during general medical training in the country so far. Regarding the increasing number of people in need of palliative care services, it is essential to assess GPs' knowledge about palliative care to develop special palliative care educational programmes. A cross-sectional questionnaire survey was conducted on general practitioners participated in a formal Continuous Medical Education programme, using three scales. 216 GPs returned the completed questionnaires. More than half scored their knowledge about palliative care as weak, which was significantly related to their previous experience in caring of a terminally ill patient [p=0.001]. Less than one third stated their good ability to either assess or manage pain in end of life. Major gender differences were seen in different subscales such as communication with patients and carers, patient management, palliative care knowledge and skills, and psychological stress. This study revealed a profound lack of knowledge and experience among Iranian general practitioners about palliative care which was mostly in more complicated areas rather than common symptoms relief

Spiritual care at the end of life in the Islamic context, a systematic review

According to the statistics over 30000 deaths occur annually in Iran due to cancer with an incidence of over 70000 new cases; this growing rate is similar to the developing world. These figures do not take into account other chronic illnesses like diabetes, heart failure, gastro-intestinal disorders, chronic neurological disorders and lung disease, which all warrant palliative care. A systematic review was conducted until the end of 2007, to find out the ways that palliative care services are provided for Muslim patients suffering from cancer. Only three papers met the criteria as being original research either quantitative or qualitative, published during the last 10 years. Our findings conceded that very few papers are available in Islamic context about spiritual care at the end of life, where only one was quantitative. While cancer is rapidly increasing specially in developing world, the need of terminally ill patients with other conditions should be equally considered. Despite the fact that spirituality in Islamic societies exists profoundly, spiritual care must be institutionalised for patients who are in most need at their end of life, which needs more evidence