Awareness and knowledge of breast cancer rehabilitation among Saudi Arabia physical therapists.

OBJECTIVE: This study aimed to evaluate the physical therapists' knowledge and awareness of breast cancer, treatment modalities, contraindications, and clinical guidelines. SUBJECTS AND METHODS: A cross-sectional survey was conducted from December 2020 to May 2021 in Saudi Arabia. The sample size was determined using the Raosoft sample size calculator, which indicated the need for 67 participants. All physical therapists of both sex in private and public hospitals in Ha'il and non-Ha'il regions were included in the study. Data was collected by a structured Google form questionnaire, consisting of 4 main domains with a maximum score of 43. RESULTS: 57 physical therapists participated in the current study, out of which 31 were from the Ha'il region (42.1% male, 57.9% female) with a mean age of 29±7 years and a mean experience 6±7years. The referral of breast cancer patients was only 22.8%. Interestingly only 22.8% of the hospital has specific setups for oncology rehabilitation, and 12.3% have reported positive about continuing professional development (CPDs) workshops for breast cancer organized by their hospitals. 5.3% of patients with breast cancer are aware of the benefit of oncology rehabilitation, while 22.8% of patients come for follow-up sessions in the rehabilitation department. According to multiple regression, only gender was statistically significant for prediction, p<0.05. Females increased the mean score by 5.996 more than males. Female therapists are 38.2% more aware than males. CONCLUSIONS: Although physical therapists have a low level of knowledge and an average level of awareness, with a higher number of women than men, attitudes toward physical therapy are quite high, and the profession is practiced exceptionally well.

A randomized controlled trial examining the impact of low vs. moderate-intensity aerobic training in post-discharge COVID-19 older subjects.

OBJECTIVE: Post-COVID-19 patients complained of pain, fatigue, breathlessness, and reduction in quality of life which required planned intervention. This study aimed to compare the impact of 10 weeks of low vs. moderate-intensity aerobic training on physical fitness, psychological status, and quality of life in post-COVID-19 older subjects. PATIENTS AND METHODS: 72 patients were randomized into 3 equal groups, moderate-intensity exercise (MIG, n = 24), low-intensity exercise (LIG, n = 24), and control group (CG, n = 24). The exercise was done 40 min/4 times per week for 10 weeks. We measured exercise capacity using the six-minute walking test, 1 min sit-to-stand test, post-COVID-19 functional scale (PCFS), and quality of life using the SF-36 questionnaire and HAMILTON Anxiety and Depression Scale (HADS). RESULTS: There was no difference between groups regarding the demographic and most clinical characteristics of the subjects. Compared with CG there were statistically significant improvements in studying groups (MIG and LIG) with (p < 0.05) in most outcomes and the improvement was higher in MIG than in LIG in most outcomes. CONCLUSIONS: 10-week moderate-intensity and low-intensity aerobic training programs are effective with superior effect to moderate-intensity. Moderate-intensity aerobic exercise is more effective and feasible in post-discharge COVID-19 older subjects regarding exercise capacity, quality of life, and psychological status than low-intensity aerobic exercise.

Evaluating the effects of different dental devices on implantable cardioverter defibrillators.

INTRODUCTION: The implantable cardioverter defibrillator (ICD) is an electronic device that emits electrical signals to the heart via lead wires and electrodes. It is used for cardiac rhythm monitoring and treatment. Because electronic dental devices have been shown to produce electromagnetic fields, we hypothesize that they may interfere with ICD function. METHODS: Nine dental devices (heat carrier, electronic apex locator, electric pulp tester, unipolar electrosurgery unit, electric motor, curing light, and 3 gutta-percha guns) were tested in this study for their ability to interfere with the function of 4 ICDs (2 single-chambered and 2 dual-chambered ICDs). ICD activity was monitored for 30 seconds using an ICD programmer (Medtronic 2090; Minneapolis, MN) and evaluated through an electrogram test strip printout. RESULTS: Electromagnetic interference was detected with the electric motor, curing light, electric pulp tester, and electrosurgery unit although no electromagnetic disturbances were detected with these devices. No electromagnetic interferences were observed for the gutta-percha guns, heat carrier, and apex locator. However, the electrosurgery unit affected the dual-chambered ICD (Consulta CRT-D, Medtronic) and delivered therapies for fibrillation when no ventricular fibrillation was present. CONCLUSIONS: Our results suggest that the electrosurgery unit produces electromagnetic disturbances with unwanted therapy delivery shock and potentially clinically significant outcomes.

Epigenetic modifications in cancer.

Cancer initiation and progression is controlled by both genetic and epigenetic events. The complexity of carcinogenesis cannot be accounted for by genetic alterations alone but also involves epigenetic changes. Epigenetics refers to the study of mechanisms that alter gene expression without altering the primary DNA sequence. Epigenetic mechanisms are heritable and reversible, and include changes in DNA methylation, histone modifications and small noncoding microRNAs (miRNA). Disruption of epigenetic processes can lead to altered gene function and malignant cellular transformation. Aberrant epigenetic modifications probably occur at a very early stage in neoplastic development, and they are widely described as essential players in cancer progression. Recent advances in epigenetics offer a better understanding of the underlying mechanism(s) of carcinogenesis and provide insight into the discovery of putative cancer biomarkers for early detection, disease monitoring, prognosis, and risk assessment. In this review, we summarize the current literature on epigenetic changes causing genetic alterations that are thought to contribute to cancer, and discuss the potential impact of epigenetics future research.