Association of DROSHA rs6877842, rs642321 and rs10719 polymorphisms with increased susceptibility to breast cancer: A case-control study with genotype and haplotype analysis.

BACKGROUND: Multiple lines of evidence suggest that single nucleotide polymorphisms (SNPs) in genes encoding components of the microRNA processing machinery may underlie susceptibility to various human diseases, including cancer. OBJECTIVE: The present study aimed to investigate whether rs6877842, rs642321 and rs10719 SNPs of DROSHA, a key component of the miRNA biogenesis pathway, are associated with increased risk of breast cancer. METHODS: A total of 100 patients diagnosed with breast cancer and 100 healthy women were included. Following extraction of DNA, genotyping was performed by tetra primer- amplification refractory mutation system-PCR (T-ARMS-PCR) technique. Under the co-dominant, dominant and recessive inheritance models, the association between DROSHA SNPs and breast cancer risk was determined by logistic regression analysis. The association of DROSHA SNPs with patients' clinicopathological parameters was assessed. Also, haplotype analysis was performed to evaluate the combined effect of DROSHA SNPs on breast cancer risk. RESULTS: We observed a statistically significant association between DROSHA rs642321 polymorphism and breast cancer susceptibility (P < 0.05). Under the dominant inheritance model, DROSHA rs642321 polymorphism was significantly associated with increased risk of breast cancer (OR: 6.091; 95% CI: 3.291-11.26; P = 0.0001). Our findings demonstrated that DROSHA rs642321 T allele can contribute to the development of breast cancer (OR: 3.125; 95% CI: 1.984-4.923; P = 0.0001). We also found that GTC and GTT haplotypes conferred significant risk for breast cancer (OR: 2.367; 95% CI: 1.453-3.856; P = 0.0001 and OR: 7.944; 95% CI: 2.073-30.43; P = 0.0001, respectively). CONCLUSIONS: These results provide the first evidence that DROSHA rs642321 polymorphism is associated with increased risk of breast cancer. However, further studies are needed to firmly validate these findings.

Paraben Content in Adjacent Normal-malignant Breast Tissues from Women with Breast Cancer.

OBJECTIVE: Accumulation of estrogenic compounds and other carcinogens in normal breast tissues contributes to unpredictable breast cancer incidence during adolescence and throughout life. To assess the role of parabens in this phenomenon, the paraben content of adjacent normal-malignant breast tissues is measured in women with breast cancer living in Isfahan Province, Iran. METHODS: Adjacent normal-malignant breast tissue samples were obtained from 53 subjects. The parabens including methyl-paraben (MePB), ethyl-paraben (EtPB), propyl-paraben (PrPB), and butylparaben (BuPB) were extracted from the sample supernatant and then subjected to gas chromatography analysis. RESULTS: Some risk factors for breast cancer were stimulated by parabens in adjacent malignant-normal breast tissues among young and middle-aged women with breast cancer. We observed a significant association for dose-response pattern of MePB [OR = 98.34 (11.43-185.2), P = 0.027] for both ER+ and PR+ women and MePB [OR = 164.3 (CI: 112.3-216.3), P < 0.001] for HER2+ women than women with negative receptors. The risk of 95-fold increase in MePB dose and 164-fold increase in ΣPBs dose were significant for women with hereditary breast cancer in first-degree relatives. CONCLUSION: These results may promote future epidemiology studies and strategies to improve women's lifestyle and consume paraben-free products.

Comparing the effects of simulation-based training, blended, and lecture on the simulated performance of midwives in preeclampsia and eclampsia.

INTRODUCTION: Preeclampsia is the most common medical complication in pregnancy; along with bleeding and infection, it is one of the three causes of death in pregnant women. Most of these deaths were due to delays in the diagnosis and improper midwifery management and care. On the other hand, the quality of midwifery education has a profound effect on the proper provision of services. Therefore, the present study has been done to compare the effect of simulation-, blended-, and lecture-based education on simulated midwife performance in the management of preeclampsia and eclampsia. MATERIALS AND METHODS: This three-group clinical trial study was performed on 90 midwives of selected hospitals in Mashhad in 2016. Midwives were divided into three groups of simulation-, blended-, and lecture-based education using the random number table. The simulation group was trained for 6 h at the Center for Clinical Skills, the blended group was trained for 4 h by lecture, and 6 weeks through the educational website, and the lecture group was trained for 6 h through lecture. An objective structured clinical test was performed before and 2 weeks after the intervention. Data were analyzed using SPSS Version 16 software and descriptive statistics, paired t-test, one-way ANOVA, and Wilcoxon and Kruskal-Wallis tests. Significance level was considered to be P < 0.05 in all cases. RESULTS: The mean score of midwives' performance was not statistically significant before education in all three groups (P < 0.05). The mean score of midwives' performance was significantly increased in all three groups 2 weeks after education (P < 0.001), and the results of intergroup comparison showed that the mean score of performance in the simulation group was significantly higher than the blended group and the lecture group (P < 0.001), and it was higher in the blended group compared to the lecture group (P < 0.001). CONCLUSION: Education increased the midwives' simulated performance in preeclampsia and eclampsia. The performance of the management of preeclampsia and eclampsia in the simulation educational group is more than that of the blended and lecture groups, so we can use the simulation education which is a self-centered method.

Interacting Timescales in Perspective-Taking.

Through theoretical discussion, literature review, and a computational model, this paper poses a challenge to the notion that perspective-taking involves a fixed architecture in which particular processes have priority. For example, some research suggests that egocentric perspectives can arise more quickly, with other perspectives (such as of task partners) emerging only secondarily. This theoretical dichotomy-between fast egocentric and slow other-centric processes-is challenged here. We propose a general view of perspective-taking as an emergent phenomenon governed by the interplay among cognitive mechanisms that accumulate information at different timescales. We first describe the pervasive relevance of perspective-taking to cognitive science. A dynamical systems model is then introduced that explicitly formulates the timescale interaction proposed. This model illustrates that, rather than having a rigid time course, perspective-taking can be fast or slow depending on factors such as task context. Implications are discussed, with ideas for future empirical research.

Role Playing for Improving Women's Knowledge of Breast Cancer Screening and Performance of Breast Self-Examination

Background: To enhance knowledge and performance of screening as a strategy to control breast cancer, use of effective teaching methods is necessary. The objective of this study was to determine the effect of role-playing on knowledge of breast cancer screening and performance of breast self-examination (BSE). Methods: A quasi experimental design was used. Women enrolled in community cultural centers (n=314) were randomly divided into two educational groups: role playing (intervention) and lecture (control). Data were collected using a structured questionnaire before and after intervention. Reliability of the questionnaire was determined as 0.80 by Cronbach's alpha. The women were followed up regarding performance of BSE one month later. Results: Of the 314 women, 113 (36%) and 132 (42%) had low and medium levels of knowledge, respectively. More than a third (38.2%) reported that TV and radio were the most important information sources for breast cancer and screening. There were significant differences between mean scores of knowledge before and after the intervention in both groups, but change was greater with role playing (31.3±1.9 as compared to 23.5±1.3) (P=0.001). After a month of educational intervention, 75.7% and 69.8% of those in role playing and control groups had undergone BSE. Conclusion: It appears that application of a role playing method by providers improves women's knowledge and behavior with respect to breast cancer screening.

Cost-effectiveness of surgical excision versus Mohs micrographic surgery for nonmelanoma skin cancer: A retrospective cohort study.

BACKGROUND: Nonmelanoma skin cancer rates are increasing worldwide. Mohs micrographic surgery and surgical excision (SE) are the two treatment methods for this type of cancer. The current paper aims at determining and comparing the cost-effectiveness of SE and Mohs micrographic surgery. MATERIALS AND METHODS: The current study has a retrospective cohort design. A number of 630 patients suffering from nonmelanoma skin cancer who at some point of time during the years 2007-2014 referred to the Al-Zahra or Seyed Al-Shohada Hospitals in Isfahan. Patients were followed up for 4 years, and then the incremental cost-effectiveness ratio (ICER) of the two methods was calculated. RESULTS: The average (minimum-maximum) cost of the SE and Mohs surgery methods in Iran was obtained as 18,550,170 (2335,800-260,898,262) and 12,236,890 (6488,340-41,161,700) Iranian Rial, respectively. Recurrence percentage was also reported as 7.9% and 8.7% for SE and Mohs micrographic surgery, respectively (P > 0.05). The ICER of SE in comparison with Mohs surgery was calculated as 7891,600 Iranian Rials per recurrence avoided. CONCLUSION: Mohs surgery is less expensive than SE, it seems like Mohs surgery is more affordable, however further studies in different populations of the country are needed.

Psychological status in Iranian patients with ulcerative colitis and its relation to disease activity and quality of life.

BACKGROUND: Psychological profile of inflammatory bowel disease patients is not well studied in Iran. We investigated the psychological status of Iranian patients with ulcerative colitis (UC) and its relationship with disease activity and quality of life (QOL). MATERIALS AND METHODS: A cross-sectional study was conducted on adult UC patients. The Lichtiger Colitis Activity Index, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, and WHOQOL-BREF, were completed by the patients. RESULTS: From 120 studied patients, 35 (29.2%), 48 (40.0%), and 46 (38.3%) had significant anxiety, depression, and psychological distress, respectively. Anxiety, depression, and psychological distress were strongly correlated with disease activity (r = 0.357 to 0.439, P < 0.01). Disease activity was negatively correlated with all QOL dimensions (r = -0.245 to -0.550, P < 0.01). Anxiety, depression, and psychological distress were also negatively correlated with all QOL domains (r = -0.356 to -0.789, P < 0.01). In the regression models, anxiety was independently associated with active disease (ß = 4.150, P = 0.049). Furthermore, disease activity was associated with the physical health (ß = -0.371, P < 0.001). For almost all of the QOL domains, depression and psychological distress were independent predictors (ß = -0.296 to -0.453, P < 0.001). CONCLUSION: Anxiety, depression, and psychological distress are highly frequent in UC patients of our society and are strongly associated with disease activity. Depression and psychological distress are important predictors of poor QOL in these patients. Further prospective studies, as well as clinical trials, are warranted in this regard.

Self-serving dishonest decisions can show facilitated cognitive dynamics.

We use a novel task to test two competing hypotheses concerning the cognitive processes involved in dishonesty. Many existing accounts of deception imply that in order to act dishonestly one has to use cognitive control to overcome a bias toward the truth, which results in more time and effort. A recent hypothesis suggests that lying in order to serve self-interest may be a rapid, even automatic tendency taking less time than refraining from lying. In the current study, we track the action dynamics of potentially dishonest decisions to investigate the underlying cognitive processes. Participants are asked to privately predict the outcome of a virtual coin flip, report their accuracy and receive bonus credit for accurate predictions. The movements of the computer cursor toward the target answer are recorded and used to characterize the dynamics of decisions. Our results suggest that when a self-serving condition holds, decisions that have a high probability of being dishonest take less time and experience less hesitation.

Geographic distribution of cancer cases in isfahan province/2006-2010.

BACKGROUND: To facilitate analysis, interpreting and sharing cancer data and investigation spatial and geographical aspect of cancers in Isfahan province, cancer cases distribution was displayed using geographic information systems (GIS). METHODS: About 118,000 cancer data, which were confirmed in national cancer registration unit were extracted. Age-specific incidence rate and age standardized rate (ASR) of cancer cases from 2006 to 2010 was calculated for Isfahan province and its different districts. Distribution of ASR was determined according to sex and age groups. Spatial maps were drawn with the help of Arc GIS version 10 (ESRI, Redland, CA, USA) software in choropleth based maps. The data are classified in GIS environment by means of quantile method. Data were described with the help of maps spatially. RESULTS: Age standardized rate of cancers was higher in men than in women (134.58 vs. 115.4). The highest ASR was reported in the Isfahan (ASR: 133) and lowest in the Chadegan counties (ASR: 28). Different geographical distribution patterns of cancers were seen in district level. Cancer incidence was higher in the Isfahan, Lenjan, Fereidon Shahr and Falavarjan districts (134.3, 117.2, 113.5 and 111.1 respectively) among men and in Isfahan, Shahin Shahr, Lenjan and Najafabad districts (122.8, 102.3, 94 and 93 respectively) among women. The incidence rates of most cancers were lowest in the North East region of the province compared to the rest of the region. CONCLUSIONS: Using GIS for visual displaying of cancers facilitated communication with the policymakers and community. This study provided hypotheses about differences in the incidence of cancer in Isfahan districts. Higher age-specific incidence rate in the Isfahan city is probably a reflection of problems in addressing the patients in cancer registration. Complementary studies are needed to evaluate lower ASR in the North East regions of the province.

Hormonal and reproductive risk factors associated with breast cancer in Isfahan patients.

BACKGROUND: Breast cancer is the most prevalent type of cancer among Iranian females; it is noteworthy that the condition of this type of cancer among Iranian women does not significantly differ from what has been reported from other countries. Considering the importance of this issue, identification of the backgrounds factors and risk factors of the breast cancer risk are highly needed. Therefore, the present study is aimed to compare the risk factors of resident patients of Isfahan province, Iran, with accredited risk factors by other countries and also identify the importance of each factor in the incidence of cancer. MATERIALS AND METHODS: The present work is a case-control study, which was conducted in 2011. In order to conduct the study, 216 women who had been clinically identified with breast cancer were selected from Seiedo-Shohada Hospital, Isfahan, Iran, as the case group. Moreover, 41 healthy women who were the relatives of the selected patients (i.e., sisters and aunts) were selected as the control group. The data and information of the patients from 1999 to 2010 were collected from either assessing the database system of the center for breast cancer research or interviewing the patients through phone. To analyze the data, multiple logistic regression method was applied. RESULTS: The range of age among selected individuals in this study was from 20-75 years old. The determinant factors for odds of breast cancer included in the applied multiple logistic regression model were the use of oral contraceptive pills (OCPs) (odds ratio [OR] =0.18, 95% confidence interval [CI] = 0.04-0.75) as the protective factor, hormone replacement therapy (OR = 10.2, 95% CI = 1.18-88.89) and menopause at old age (OR = 1.26, 95% CI = 1.11-2.12) as the risk factors. Furthermore, there was not seen any significant relationship between age, vocation, and marital status with odds of breast cancer in multiple model. CONCLUSION: Based on the results, use of OCPs as protective factor, hormone replacement therapy, and menopause at old age are identified as the risk factors in developing breast cancer among women. Influencing and modifiable factors should be considered very important in society based interventions and preventive interventions planning.

Investigation of the age trends in patients with breast cancer and different sizes of tumors in Breast Cancer Research Center of Isfahan University of Medical Sciences in 2001-2010.

BACKGROUND: Breast cancer is the most common cause of death in women in the age range of 35-55 years. Each year, one or two cases of breast cancer per 1000 women are diagnosed as new cases. Despite the serious prognosis and high rate of morbidity, mortality, and pathogenicity, in the case of early diagnoses, the prognosis will be better. The aim of this study was to investigate the age trends in breast cancer patients with different sizes of tumors in Breast Cancer Research Center of Isfahan University of Medical Sciences in 2001-2010. MATERIALS AND METHODS: The information in radiotherapy and oncology of Isfahan University of Medical Sciences and Milad Hospital from 2001 to 2010 were coded and analyzed. Frequency of patients' age groups, tumor sizes and the year of cancer diagnosis were calculated. Correlation test was used for data analysis in statistical analysis in social science (SPSS) software version 18. FINDINGS: Among the 3722 patients with breast cancer, the highest relative frequency distribution, respectively was observed in the age of 40-49 years (34.4%), 50-59 years (26.6%), 30-39 years (17.7%), 60-69 years (13.2%), 20-29 years (2.5%), 70 years and older (5.2%) and less than 20 years. Relative frequency distribution of tumor sizes in a variety of 5 cm (T2) was with the frequency of 59.8%, and then 26% at 5 cm (T3), 10.5% at 2 cm (T1), 3.1% at T4 and 0.6 at In-situ, respectively. CONCLUSION: The investigation of age trends showed that diagnosis rate of breast cancer increased from 2001 to 2004. It reached its highest value in 2006 at the age range of 30-39 years. Then, the trend has been downward, and it has continued to decline until 2010, which could be the result of the equipping screening system and recording the malignant cases. 85.8% of the examined tumors in T2 and T3 group were visible and may be disturbing. Comparing the frequency distribution of the infected population showed that the highest incidence of breast cancer diagnosis were in the age range of 40-49 years. It seems that as long as the mass has not reached an obvious palpable state, it has not been diagnosed.

Comparison of satisfactions from mastectomy and Lump Ectome in breast cancer patients.

INTRODUCTION: The prevalence of breast cancer among women in compare to other types of cancers in all over the world and in Iran is high. Mastectomy surgery is one of the common treatments for these patients. Another method, which is less invasive, is Lumpectomy. This study comprised the satisfaction of patients under two types of surgery; Mastectomy and Lumpectomy. MATERIALS AND METHODS: In this cross-sectional study, two types of patients which had either, Mastectomy or Lumpectomy, were studied. RESULTS: From 119 patients which studied here, 80 patients (66.7%) were treated by mastectomy and 39 patients (32.5%) were treated under lumpectomy. Two groups had not significant differences in duration between diagnostic and surgery, the number of lymph nodes involved and the number of lymph nodes removed. Lumpectomy patients had higher pain and numbness in 24 h, 1 week after surgery and at the time of study than the other group. The observed difference was significant (P = 0.043). DISCUSSION: It is implied in previous studies that patients under lumpectomy had more satisfaction than patients under mastectomy. However, no differences were observed in quality-of-life between the two groups in some other studies. The differences between various studies might be for the sake of cultural variety and time interval between surgery and filling questionnaire.

Epidemiology and trend of cancer in Isfahan 2005-2010.

BACKGROUND: Cancer incidence rate is increasing in the world particularly in developing countries. The awareness regarding cancer incidence and distribution helps policy makers and researchers to design comprehensive plan for controlling cancer. The aim of this study was to determine the incidence rate and trend of cancer in Isfahan area, one of the most importance provinces of Iran. METHODS: Data of Isfahan cancer registry were derived from 2005 to 2010. Direct standardization through world standard population produced by the world health organization was used and adjusted standard rate (ASR) was calculated. The Poisson regression analysis was employed to estimate cancer incidence trend during 5 years. RESULTS: The new cases of cancer were 24771 patients from 2005 to 2010. Mean age of these patients was 56.1 ± 18.0 years and 54.6% were male. Male patients were approximately 7 years older than females. The most frequent cancer was gastrointestinal in men and breast cancer in women. The rate of cancer increased approximately 4 per 1000 population and incidence rate ratio (IRR) was 1.004 (95%CI: 1.002-1.005). CONCLUSIONS: The rate of cancer is increasing rapidly in Isfahan province. Cancer control and comprehensive prevention plan for Isfahan is necessary.