The effect of music therapy on non-stress test results and anxiety levels in high-risk pregnant women: A randomized controlled trial.

AIM: This study was conducted to determine the effects of music therapy on non-stress test results and anxiety levels in high-risk pregnant women. METHODS: This randomized controlled study was conducted in pregnant women who were hospitalized in the High-Risk Pregnancy Service of Meram Medical Faculty Hospital, Konya, Turkey, between April 1 and July 31, 2021. In the intervention group (n = 58), a 20-min music therapy with ney sounds was performed, while in the control group (n = 58), routine care practices were applied. Hüseyni maqam of ney was selected, a melodic mode used by Turks for music therapy. Data were collected using the Descriptive Information Form, the Non-Stress Test Evaluation Form, and the State-Trait Anxiety Inventory. RESULTS: After music therapy, the intervention group experienced increased mean acceleration (p = 0.010) and foetal movement rates (p < 0.001) while no such difference was observed in the control group. The state anxiety levels of pregnant women differed significantly between the intervention and control groups (p < 0.001). Regression analysis showed that music therapy reduced state anxiety levels in pregnant women by a factor of 4.6 (p < 0.001). CONCLUSION: Based on the findings, music therapy was found to enhance acceleration and foetal heart rate in high-risk pregnant women while reducing state anxiety levels.

The relationship between maternal functioning and birth memory and trauma.

AIM: This study aimed to determine the relationship between birth memory and trauma and maternal functioning in the postpartum period. METHODS: This cross-sectional study included 584 mothers in the postpartum period between 1 January 2022 and 1 April 2022. Data were collected using a personal information form, the Barkin Index of Maternal Functioning (BIMF), the Birth Memories and Recall Questionnaire (BirthMARQ) and the City Birth Trauma Scale (CityBiTS). RESULTS: The participants' mean scores for the overall BIMF, BirthMARQ and CityBiTS were 81.41 ± 9.28, 80.30 ± 21.21 and 15.85 ± 11.30, respectively. Their sociodemographic characteristics did not affect their maternal functioning; however, maternal functioning improved with the number of pregnancies. While emotional memory (BirthMARQ subscale) negatively affected maternal functioning (p < 0.001), the centrality of memory (BirthMARQ subscale) positively affected maternal functioning (p < 0.001). The hyperarousal (CityBiTS subscale) score significantly and negatively affected the total maternal functioning score, explaining 6 % of its variance (F = 9.176, p = 0.001). CONCLUSION: This study demonstrated that birth memory and trauma affected maternal functioning. The mother's functional status in the postpartum period reflects the physical and psychosocial changes associated with pregnancy and birth. Therefore, for women to have positive birth memories and emotions when recalling the birth, their emotional health and physical care should be supported during labour and the postpartum period.

Psychological effects of the COVID-19 pandemic on primary healthcare professionals in Turkey: One year into the pandemic.

AIM AND OBJECTIVES: This study aimed to determine the psychological effects of the COVID-19 pandemic on healthcare professionals working in primary care settings in the first year of the pandemic. BACKGROUND: The healthcare industry has faced an unprecedented burden in the COVID-19 pandemic. Primary care professionals experienced the high level of psychological problems. DESIGN AND METHODS: A total of 793 healthcare professionals from different regions of Turkey participated in this cross-sectional study. The STROBE (Strengthening the reporting of observational studies in epidemiology) checklist was used in the study. Data were collected online. RESULTS: It has been found that more than half of healthcare professionals experienced severe depression, three-quarters experienced anxiety, and almost half experienced stress. It was also found that about half of the participants experienced a high degree of acute and chronic fatigue, and one-fifth experienced low inter-shift recovery. CONCLUSION: The effects of the COVID-19 pandemic on the mental health of primary care professionals, especially nurses and midwives, are alarming. The problems that arise from the flawed healthcare delivery models and gender inequality, which worsen the usual psychological effects of the pandemic on primary care professionals, should be addressed urgently. RELEVANCE TO CLINICAL PRACTICE: Psychological support and rehabilitative services should be expanded to eliminate the short- and long-term psychological effects of the pandemic on healthcare professionals.

Female genital self-image and body appreciation in Turkish women: a mixed methods study.

The study investigated negative genital self-image in women and determined the effect of education on natural/normal female genital appearance diversity on the change in women's genital self-image. The type of research is a mixed method descriptive study. The participants were 259 women living in Turkey. In the first stage of the study, female genital self-image levels and body appreciation levels were evaluated. In the second stage of the study, women were interviewed thoroughly about negative female genital self-image, and then, visual education presentation was made on natural/normal female genital diversity. One week after the presentation, the women's genital self-image levels were re-evaluated. In the first phase of the study, the mean Female Genital Self-Image Scale (FGSIS) total score was 22.07 ± 4.07 and the mean Body Appreciation Scale (BAS) total score was 42.40 ± 8.13 of the women. Higher FGSIS and BAS scores showed an increase in women's positive genital self-image and body appreciation. The relationship between the FGSIS and the BAS scale scores of the women was found to be significantly correlated (r = 0.401, p < 0.001). In the second stage of the study, four main themes were examined as "positive thoughts," "size and image," "metaphors related to genital organs," and "negative thoughts." In conclusion, in the first phase, it was determined that women's feeling of discomfort with their sexual organs during sexual intercourse, comparing their genital organs with other women's genital organs, thinking of genital organ aesthetic surgery, and BAS scores were associated with FGSIS scores. In the second phase, women's positive or negative feelings and thoughts about their genital self-image were revealed.

The Effect of Supportive Care for Pregnant Women During Labor on Breastfeeding Self- Efficacy and the Perception of Childbirth in a Central Region of Turkey.

OBJECTIVE: This study aimed to evaluate the effect of support given to pregnant women during labor on their perception of childbirth and their breastfeeding self-efficacy. METHODS: This descriptive and relational study was conducted with 331 primigravid women who had a vaginal delivery in a maternity unit from December 15, 2018, to March 15, 2020. Data were collected using a descriptive characteristics form prepared by the researcher and based on the relevant literature, the Scale of Women's Perception for Supportive Care Given During Labor (SWPSCDL), the Perception of Birth Scale (POBS), and the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF)." The data were analyzed using descriptive statistics, a t test, a variance test, and Pearson's correlation. RESULTS: The mean total SWPSCDL, POBS, and BSES-SF scores of the participating women were 102.19 (±14.99), 54.75 (±9.39), and 76.24 (±11.37), respectively. A positive correlation was found between supportive care for women during delivery and both women's perceptions of childbirth and breastfeeding efficacy. In addition, training given in antenatal classes positively increased the perception of support during delivery among the women. CONCLUSION: Supportive care given during delivery had a positive effect on the perception of childbirth and on breastfeeding self-efficacy. Interventions to encourage more couples to participate in training given at antenatal classes and to improve the working conditions of midwives working in delivery rooms would contribute to the support that pregnant women require during delivery and would provide a more positive delivery experience for these women.

Urinary Incontinence in Turkish Women: A Qualitative Study on Daily Life and Sexual Health.

PURPOSE: The study was performed to determine how urinary incontinence (UI) affects women's daily lives and sexual health and how UI is perceived. DESIGN: Qualitative descriptive phenomenological design was used. SUBJECTS AND SETTING: The study was conducted in a family health center in Konya, Turkey, with official permission of the ministry of health. Study participants comprised 101 women with UI, but data from 12 women were excluded because they refused to respond to questions; therefore, data analysis is based on responses from 89 respondents. METHODS: Data were compiled via in-depth interviews using a semistructured questionnaire. Data collection and analysis processes were carried out simultaneously. Study data were examined using phenomenological content and thematic analyses. Document portraits and a code map of data were created using qualitative data analysis software. RESULTS: Participants' mean age was 46.25 (SD: 11.68) years. Thirty-three codes were identified to detect the effects of UI on women's daily lives. These codes were reviewed and combined into 5 main themes: religious issues, sexual problems, feeling restricted, psychological exposure, and internalization. CONCLUSIONS: Urinary incontinence causes women to experience environmental, psychological, and religious challenges during daily life. Healthcare professionals should give counsel and assistance by determining the issues for women with UI to promote coping with problems and offer referral for specialist care when necessary.

Turkish validity and reliability study of male genital self-image scale (MGSIS).

OBJECTIVE: This study, which was carried out in order to determine the Turkish validity and reliability of the "Male Genital Self-Image Scale" in a population sample of Turkish men, is of methodological type. METHODS: In the study, language, content, construct validity, and reliability methods were used for the intercultural adaptation of the scale. The data collection process of the scale was carried out with 336 men who applied to the Family Medicine Polyclinic of a hospital. In the language and content validity phase, the opinions of experts with technical and cultural knowledge were consulted. The data of the study were collected with the Sociodemographic Characteristics Form and the Male Genital Self-Image Scale. RESULTS: As a result of experts evaluation, the Content Validity Ratio value was determined as 0.83. At the stage of construct validity, the suitability of the single-factor model of the items of the Male Genital Self-Image Scale was tested. It was determined that all items contributed significantly to the factor (0.62-0.92). As a result of the Confirmatory Factor Analysis, the measurement model was statistically validated (χ2 = 32.083, p = 0.001, χ2/df = 2.917, RMSEA = 0.076). The Cronbach's alpha reliability coefficient was calculated as α = 0.92 in the analysis performed to evaluate the internal consistency of Male Genital Self-Image Scale. CONCLUSION: The results of the study revealed that Male Genital Self-Image Scale is a valid and reliable tool to evaluate genital self-image in Turkish men.

Effects of aging and inflammation on catalase activity in human dental pulp.

OBJECTIVES: In this study, it was aimed to examine the catalase activity in clinically healthy and caries-related inflamed symptomatic human dental pulps of young and old individuals. DESIGN: Sixty pulp samples from young and old healthy donors, were collected depending on pulpal status. 48 samples were used for spectrophotometric analysis and 12 samples for immunohistochemistry. Healthy pulps were maintained from non-carries, extracted third molars. Reversible and irreversible pulpitis samples were obtained by pulp extirpation during endodontic treatment. Following homogenization catalase enzyme activity was determined by spectrophotometry. Additionally, two pulp tissue samples from each group were fixed and evaluated for catalase immunoreactivity. RESULTS: Catalase enzyme activity in old healthy pulp samples were significantly higher than healthy young samples (p ≤ 0.05). Reversible and irreversible pulpitis samples indicated significantly decreased activity compared to healthy samples in elderly group (p ≤ 0.05). Young reversible pulpitis samples showed significantly increased catalase activity when compared to irreversible pulpitis and the reversible pulpitis samples in elderly group (p ≤ 0.05). Immunohistochemical evaluation indicated that there was intense catalase immunoreactivity in young patients with reversible pulpitis compared with reversible pulpitis in elderly group. However, weak immunoreactivity was observed in young irreversible pulpitis and elderly reversible pulpitis samples. CONCLUSIONS: The pulp tissues presented different levels of catalase activities against pulpitis and aging.

Maternal attachment and mental health status in mothers who have babies with infantile colic.

PURPOSE: The aim of this study was to determine maternal attachment and mental health status in mothers of babies with infantile colic. DESIGN: Cross-sectional online survey. SETTING: The study was conducted on messaging and social media platforms, and groups related to mothers and babies. PARTICIPANTS: 380 mothers, 107 of whom had babies with infantile colic and 273 of whom had healthy babies, participated in the study. MEASUREMENT TOOLS AND FINDINGS: A Personal Information Form, the Maternal Attachment Inventory, and the Depression, Anxiety and Stress Scale were used to collect data. No statistically significant relationship was found between infantile colic status and maternal attachment. The depression, anxiety and stress scores of the mothers who had babies with infantile colic were significantly higher compared to the mothers with healthy babies (p<0.05). Additionally, as the depression scores of the mothers increased, their maternal attachment levels decreased (p <0.05). KEY CONCLUSIONS: Maternal depression, anxiety and stress make it difficult for mothers to provide care for their babies. Therefore, health professionals should screen mothers who have babies with infantile colic in the postpartum period in terms of mental health. Besides, the mothers should be provided with support to assist them in coping with their Babies' colic. IMPLICATIONS FOR PRACTICE: Health professionals should be aware that infantile colic negatively affects the mental health of mothers and increases the frequency of follow-ups of these mothers in the postpartum period. More research is needed to examine the effects of infantile colic on maternal attachment.

Factors Affecting Primiparous Pregnant Women's Prenatal Attachment Levels, Childbirth Self-Efficacy Beliefs, and Labor Worry Levels.

This study aimed to identify the factors affecting primiparous pregnant women's prenatal attachment levels, childbirth self-efficacy beliefs, and labor worry levels. This cross-sectional study was conducted with 351 pregnant women. The data were collected by using a Personal Information Form, the Prenatal Attachment Inventory, the Oxford Worries about Labour Scale, and the Childbirth Self-Efficacy Inventory. The mean Prenatal Attachment Inventory, Oxford Worries About Labour Scale and Childbirth Self-Efficacy Inventory scores of the participants were 40.53 ± 10.32, 21.82 ± 6.8, and 201.35 ± 23.21, respectively. The data obtained in the study showed that the care offered in the preconception period affected the participating pregnant women's prenatal attachment, labor worry, and childbirth self-efficacy levels. With individualized preconception care provided by health personnel, not only will awareness be increased but also women will be able to have a more positive pregnancy and labor experience.

Effects of health literacy education on adaptation to pregnancy, self-efficacy, fear of childbirth and health literacy in Turkish pregnant women: A randomized, controlled trial.

This research aims to evaluate the effects of health literacy (HL) education on Turkish pregnant women's adaptations to pregnancy, self-efficacy, fear of childbirth and HL levels. This was a randomised, controlled trial. The research was carried out in the Marmara region of Turkey between July 2018 and April 2019. This research was conducted with three groups including one control (n = 73) and two intervention (n = 109) groups. One of the intervention groups was given antenatal education (AE) for improving HL (HL-AE) (n = 53), and the other was provided AE (n = 56) only. A Pregnancy Information Form, Prenatal Self-Evaluation Questionnaire, Fear of Childbirth and The Postpartum Period Scale, General Self-Efficacy Scale and Turkey Health Literacy Scale-32 were used for data collection. Results show that adaptation to pregnancy, general self-efficacy and HL levels significantly improved while fear of childbirth decreased in the group that was provided HL-AE intervention group. Additional when the pre-education and post-education scale scores were compared in the AE group, it was found that there was a significant difference in other scale scores, but not for fear of childbirth.

Spiritual care, compassion and associated factors of midwives working in delivery rooms.

AIM: This study aimed to determine the level of spiritual care and compassion among midwives working in delivery rooms and associated factors. METHODS: A descriptive design was utilized to collect data using self-report questionnaires from 181 midwives working in delivery rooms in Turkey. Data were collected between 1 February 2020 and 20 March 2020. RESULTS: The mean Spiritual Care-Giving Scale (SCGS) (min: 25- max: 175) and Compassion Scale (CS) (min: 24- max: 120) scores were 147.88 ± 17.84 and 96.37 ± 12.84. It was determined that there was a significant difference between the SCGS and CS scores of the midwives based on age, working year, work schedule, job satisfaction and traumatic birth experiences. Furthermore, there were positive correlations between scores on certain SCGS and CS subdimensions. CONCLUSION: Midwifery is a continuously evolving profession based on helping others. However, long working hours and their exposure to traumatic birth events negatively affect both spiritual caregiving and compassion levels of midwives. Working conditions of midwives need to improve and this would contribute to the quality of maternal healthcare. Also, studies should be conducted in different contexts, societies and cultures to identify barriers to compassionate and spiritual care during childbirth.

Postpartum Urinary Incontinence: A Qualitative Study on Sexuality and Life Experiences of Muslim Turkish Women.

OBJECTIVES: The study was planned to identify the sexuality and life experiences of Muslim Turkish women with urinary incontinence (UI) within 12 months postpartum. METHODS: A qualitative study was conducted using a semistructured interview. Data were collected between July and December 2019 via an in-depth, face-to-face interview technique using an interview form. The qualitative data obtained in this study were analyzed with the content analysis technique. RESULTS: The main themes related to sexuality and life experiences of the women with UI in the postpartum period were identified as "problems in daily life," "emotional effects," "baby-related effects," and "spouse's and family's attitudes." CONCLUSIONS: As a result, it was found that women in the postpartum period were affected by UI in terms of behavioral, emotional, and social aspects.

Protective Effects of Antioxidant Chlorophyllin in Chemically Induced Breast Cancer Model In vivo.

Glutathione-related enzymes belong to the protection mechanism of the cells against harmful oxidative damage and chemicals. Glutathione S-transferase (GST) is frequently over-expressed in various cancer cells and is involved in drug resistance. Chlorophyllin is an antioxidant molecule interfering with the GST P1-1 activity. The purpose of this study is to evaluate the short- and long-term protective effects of chlorophyllin as an antioxidant molecule on DNA damage, antioxidant enzyme activities, trace elements, and minerals in chemically induced breast cancer model in vivo. In our study, N-methyl-N-nitrosourea (MNU) was used for inducing breast carcinogenesis in female Sprague-Dawley rats. A total of 36 rats were divided into groups as short term and long term. Each group was divided into four sub-groups as control group received physiological saline solution (n = 3), Chl group (n = 5) received chlorophyllin, MNU group (n = 5) was administered MNU, and Chl + MNU group (n = 5) was treated with both chlorophyllin and MNU. Results illustrated that chlorophyllin had a significant anti-genotoxic effect in the short term, and glutathione-related enzyme activities were protected by chlorophyllin treatment in MNU-induced breast cancer model. Additionally, MNU administration impaired mineral and trace element levels including Na, Mg, K, Fe, Zn, and Co in the liver, kidney, spleen, heart, and tumor tissues; however, adverse effects of MNU were recovered upon chlorophyllin treatment in the indicated tissues of the rats. In conclusion, chlorophyllin can be used as an antioxidant molecule to ameliorate adverse effects of MNU by enhancing antioxidant enzyme activities and regulating trace element and mineral balance in several organs and tumor tissue in the breast cancer model.

Midwives' experiences of witnessing traumatic hospital birth events: A qualitative study.

AIMS AND OBJECTIVES: The aim of this study was to investigate in detail the traumatic birth experiences of midwives in the delivery rooms, and their attitudes, reactions, and coping strategies. METHODS: The design of the study is descriptive and the purposive sampling method was used. This approach is ideal for a preliminary exploration of the nature of a phenomenon. Between October 2018 and January 2019, semi-structured interviews were conducted with a purposeful sample of midwives. The research was carried out with the participation of 29 midwives, who work in labour and birth room. They were asked to describe a particular stressful situation they had experienced during the birth process, their emotions about the event, and their coping strategies and support systems. All interviews were digitally recorded, stored in a database, and transferred to MAX Qualitative Data Analysis 18.1.0 for analysis. FINDINGS: As a result of the content analysis, three main themes emerged: psychological impact, defensive practice, and expectations in terms of support from the hospital. It was revealed that, after the traumatic birth, midwives experienced highly emotional exhaustion in the form of sadness, flashbacks, guilt, fear, and empathy, and they performed an increasingly defensive practice. During the interviews, we observed that 19 midwives needed psychological support. Besides, midwives explicitly stated that they were not prepared enough for traumatic events and that most traumatic births were simply ignored in their workplace. Eventually, it was determined that midwives received support mostly from their colleagues in case of a traumatic birth. CONCLUSION(S): Midwives need to feel valued and be supported by their institutions in coping with emotional stress. Therefore, performing clinical inspections by experienced or specialist midwives may serve as a supporting framework for reducing defensive interventions.

Urinary incontinence experiences of pregnant women: A qualitative study.

OBJECTIVE: The research was carried out to determine the life experiences of pregnant women who have urinary incontinence problems. METHODS: The type of the research is of qualitative type. Views of pregnant women were coded according to repeating frequencies; then thematic grouping was done. Both common views and individual repetitions of the pregnant women were coded. During the study, 52 pregnant women stated that they had urinary incontinence problems. However, five pregnant women did not want to participate in the study and six pregnant women wanted to leave during the interview. Interviews ended with 41 pregnant women. RESULTS: In the study, the mean age of the pregnant women was determined as 29.75 ± 4.83, and the mean gestational week was 27.85 ± 5.60. The views of pregnant women are divided into five main themes and 16 sub-themes. The main themes for the urinary incontinence life experiences of pregnant women were determined as "strategies to take precautions, psychological effects, pregnancy and baby-specific effects, physical effects and changes in their relationship with the spouse." CONCLUSION: As a result, it was determined that urinary incontinence problem negatively affected the life experience of pregnant women.

Psychological effects of nurses and midwives due to COVID-19 outbreak: The case of Turkey.

PURPOSE: The study was carried out to determine the psychological impact levels of nurses and midwives due to the COVID-19 outbreak. METHODS: The research is planned in a descriptive type. Nurses and midwives working in any health institution in Turkey constituted the population of the research. The questionnaire form of the study was shared on social media tools between 01 and 14 April 2020 and a total of 758 nurses and midwives were included in the study sample. Personal Information Form, State-Trait Anxiety Inventory and Intolerance of Uncertainty Scale were used as data collection tools. RESULTS: Participants who attended the study were 56.9% of nurses and 43.1% of midwives. Approximately half of the nurses and midwives (48.8%) participating in our study contacted the patient with suspected COVID-19, and 29.8% provided care to the patient diagnosed with COVID-19. Nurses and midwives were scored 52.75 ± 9.80 for State Anxiety, 44.87 ± 7.92 for Trait Anxiety Inventory and 35.16 ± 9.42 for Intolerance of Uncertainty Scale. It has been determined that 54.5% of nurses and midwives have been making their lives worse since the outbreak started, 62.4% had difficulties in dealing with the uncertain situation in the outbreak, 42.6% wanted psychological support and 11.8% had alienated from their profession. It was determined that there was a difference between scale scores and difficulties in work, family and private life due to COVID-19. CONCLUSION: As a result, it is seen that the midwives and nurses in our country have high psychological effects due to the COVID-19 outbreak.

Improvement in the Current Therapies for Hepatocellular Carcinoma Using a Systems Medicine Approach.

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death primarily due to the lack of effective targeted therapies. Despite the distinct morphological and phenotypic patterns of HCC, treatment strategies are restricted to relatively homogeneous therapies, including multitargeted tyrosine kinase inhibitors and immune checkpoint inhibitors. Therefore, more effective therapy options are needed to target dysregulated metabolic and molecular pathways in HCC. Integrative genomic profiling of HCC patients provides insight into the most frequently mutated genes and molecular targets, including telomerase reverse transcriptase, the TP53 gene, and the Wnt/ß-catenin signaling pathway oncogene (CTNNB1). Moreover, emerging techniques, such as genome-scale metabolic models may elucidate the underlying cancer-specific metabolism, which allows for the discovery of potential drug targets and identification of biomarkers. De novo lipogenesis has been revealed as consistently upregulated since it is required for cell proliferation in all HCC patients. The metabolic network-driven stratification of HCC patients in terms of redox responses, utilization of metabolites, and subtype-specific pathways may have clinical implications to drive the development of personalized medicine. In this review, the current and emerging therapeutic targets in light of molecular approaches and metabolic network-based strategies are summarized, prompting effective treatment of HCC patients.

Comparison of antioxidant reserve capacity of children with acyanotic & cyanotic congenital heart disease.

BACKGROUND & OBJECTIVES: Oxidative stress can cause many diseases and increases the risk of post-operative complications in children with congenital heart disease. For these reasons, this study was aimed to investigate the differences between cyanotic and acyanotic paediatric patients who underwent heart surgery with markers of oxidative stress. METHODS: Eighty five patients were included in the study. The samples taken before the surgery and within the first 24 h after the surgery were evaluated for haemoglobin (Hb), leukocytes, uric acid, glutathione (GSH), malondialdehyde and total antioxidant capacity. Cyanotic, acyanotic, hyperoxygenated, normo-oxygenated, cardiac surgery with or without cardiopulmonary bypass (CPB) comparisons were made. RESULTS: Positive correlation was found between age and pre-operative total antioxidant status values. Cyanotic and acyanotic patients did not have different antioxidant reserve capacities preoperatively. Although pre-operative thiobarbituric acid reactive substances (TBARS) levels were significantly lower in cyanotic patients, post-operative levels were higher. TBARS levels increased and GSH levels reduced postoperatively. The level of oxygenation did not cause a significant difference on markers of oxidative stress. The duration of CPB did not have negative effects on oxidative stress. INTERPRETATION & CONCLUSIONS: Cyanotic and younger patients were found to be more vulnerable to oxidative stress. The increased levels of TBARS and the decreased levels of GSH could be the indicators of oxidative damage depending on many factors such as surgery, CPB, ischaemia/reperfusion, inflammation, iron overload and oxygenation. The level of oxygenation does not cause a noticeable difference in oxidative stress. CPB causes oxidative stress, but if it is conducted appropriately, the duration of CPB does not cause a significant negative impact on oxidative stress.

Dual actions of the antioxidant chlorophyllin, a glutathione transferase P1-1 inhibitor, in tumorigenesis and tumor progression.

Glutathione (GSH) and enzymes related to this antioxidant molecule are often overexpressed in tumor cells and may contribute to drug resistance. Blockade of glutathione transferases (GSTs) has been proposed to potentiate the efficacy of chemotherapeutic drugs in cancer. The aim of this study was to evaluate the effect of chlorophyllin that has antioxidant properties, and also interferes with the activity of GST P1-1, on breast cancers in vitro and in vivo. The in vivo studies were conducted using an N-methyl- N-nitrosourea (MNU)-induced chemical carcinogenesis model in laboratory rats. DNA damage, GST activity, and GSH levels were determined in liver and tumor tissues. Treatment with chlorophyllin increased the GSH levels in the liver and significantly decreased DNA damage in the blood, liver, and tumor tissues. Even though tumorigenesis was delayed in rats receiving chlorophyllin before MNU injections, once the tumors emerged, the progression of tumor appeared to be faster than in the animals that received the carcinogen only. Out of nine breast cell lines, GST P1-1 expression was detected in MCF-12A, MDA-MB-231, and HCC38. Concomitant incubation with chlorophyllin and docetaxel did not significantly affect cell proliferation and viability. Chlorophyllin displayed genoprotective effects that initially delayed tumorigenesis. However, once the tumors were established, it may act as a promoter that facilitates tumor growth, potentially by a mechanism independent of cell proliferation and viability. Our results underline the pros and cons of antioxidant treatment in cancer, even if it has a capacity to inhibit GST P1-1.