Habib, Omran S;Hameed, Lamis A;Ajeel, Narjis A;Al-Hawaz, Mazin H;Al-Faddagh, Zaki A;Nasr, Ghalib N;Al-Sodani, Ali H;Khalaf, Asaad A;Hasson, Hasson M;Abdul-Samad, Aida A
Asian Pacific Journal of Cancer Prevention
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제17권sup3호
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pp.191-195
/
2016
Breast cancer is the most frequent cancer in females. Its incidence is higher in developed countries than in developing ones partly due to variation in risk exposure and partly due to better detection methods. Scattered evidence in Basrah, Iraq, suggests that breast cancer has been increasing at a significant pace in recent years. This study aimed to measure the current level of risk of breast cancer among females in Basrah and to describe the time trend over almost a decade of years. Data on breast cancer cases from all sources of cancer registration in Basrah governorate were compiled for the years 2005-2012. The data for each year were first checked separately for duplicate reporting of cases among various sources. Then the eight files were pooled together and checked again for any duplicate cases among years of registration. The final set of data contained 2,284 cases of breast cancer (2,213 female cases and 71 male cases). All patients were inhabitants of Basrah governorate at the time of diagnosis. Figures on the Basrah population were obtained from various sources including the Ministry of Health, Ministry of Planning and Developmental Collaboration and local household surveys. It was possible to have total population estimates for each year and by age and sex. The data were imported into SPSS (version 17) software. Age specific and year specific incidence rates were calculated. The age standardized incidence rate was also calculated using world population as the standard population to be 34.9 per 100,000 females. Age-wise, no case was reported among children aged less than 15 years and the incidence increased with advancing age reaching a peak of 123.8/100,000 females at the age range of 50-54 years. The time trend of the crude incidence rate showed only modest increased risk with passage of years and no age shift could be documented in this study. Breast cancer in females in Basrah is a significant health problem. The current incidence rate (crude, 23.7/100,000, age-standardized, 34.9/100,000) is high and justifies intensive efforts to improve early detection of cases, provide better treatment amenities and introduce long term preventive measures. Using the age standardized incidence rate as reported in this paper, it is possible to put the risk in Basrah within a regional and international context.
The methods used for risk assessment from exposure to chemicals are well established. in most cases where toxicity other than carcinogenesis is being considered, the standard method relies on establishing the No Observed Adverse Effect Level (NOAEL) in the most sensitive animal toxicity study and using an appropriate safety factor (SF) to determine the exposure which would be associated with an acceptable risk. For carcinogens a different approach is used because it has been argued there is no threshold of effect. Thus mathematical equations are used to extrapolate from the high doses used in ani-mal experiments. These methods have been strongly criticised in recent years on several grounds. The most cogent criticisms are a) the equations are not based on a thorough understanding of the mechanisms of carcinogenesis and b) the outcome of a risk assessment based on such models varies more as a consequence of changes to the assumptions and equation used than it does from the data derived from carcinogenicity experiments. Other criticisms include the absence of any measure of the variance on the risk assessment and the selection of default values that are very conservative. Recent advances in the application of risk assessment emphasise that measures of both the exposure and the hazard should be considered as a distribution of values. The outcome of such a risk assessment provides an estimate of the distribution of the risks.
Well differentiated thyroid cancers (WDTC), including papillary (80%) and follicular (10%) types, are the most common endocrine cancers globally. Over the last few decades most the diagnosed cases have fallen into low risk categories. Radioactive iodine-131 (RAI) has an established role in reducing recurrence and improving the survival in high risk patients. In patients with primary tumor size <1 cm, RAI is not recommended by many thyroid societies. However, low risk WDTC has been an arena of major controversies, most importantly the role and dose of adjuvant RAI for remnant ablation to minimize chances of recurrence and improving survival. This review is an attempt to update readers about the previous and existing practice based on results of non-randomized trials and evolving trends fueled by recently published randomized studies.
Background: Gall bladder cancer (GBC) is highly fatal disease with poor prognosis, with a 5 year survival rate of <10%. It is relatively rare cancer worldwide; however it is the sixth cancer and second most common gastrointestinal tract cancer in Nepalese women. The study focused on associations of certain demographic, lifestyle, dietary, and reproductive factors with gall bladder cancer. Materials and Methods: We conducted a hospital-based matched case control study on newly diagnosed cases of primary GBC at BP Koirala Institute of Health Sciences and BP Koirala Memorial Cancer Hospital. Controls were healthy non-GBC relatives of cancer patients, matched for age, sex and marital status (in case of females) with cases at a ratio of 1:2. Data were collected between April 2012-April 2013 by semi structured interview from both cases and controls. Analyses were carried out with SPSS. Conditional logistic regression was used to find odds ratios and 95% confidence intervals for bivariate and multivariate analysis. Results: A total of 50 cases and 100 controls were enrolled in this study. On bivariate analysis, factors found to be significantly associated with gallbladder cancer were illiteracy (OR=3.29, CI=1.06-10.2), history of gallstone disease (OR=27.6, CI=6.57, 115.6), current smoker (OR=2.42, CI=1.005-5.86), early menarche <13 years (OR=2.64, CI=1.09-6.44), high parity more than 3 (OR=3.12, CI=1.25,7.72), and use of mustard oil (OR=3.63, CI=1.40, 9.40). A significant protective effect was seen with high consumption of fruits at least once a week (OR=0.101, CI=0.03-0.35). On multivariate analysis, history of gallstone disease, early menarche, current smoker and high consumption of fruits persisted as significant factors. Conclusions: History of gallstone disease, cigarette smoking and early menarche were associated with increased risk of gallbladder cancer while high consumption of fruits was found to have a protective effect.
Nizam, Zahary Mohd;Abdul Aziz, Ahmad Aizat;Kaur, Gurjeet;Abu Hassan, Muhammad Radzi;Mohd Sidek, Ahmad Shanwani;Lee, Yeong Yeh;Mazuwin, Maya;Ankathil, Ravindran
Asian Pacific Journal of Cancer Prevention
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제14권2호
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pp.619-624
/
2013
Background: Colorectal cancer (CRC) exists in a more common sporadic form and less common hereditary forms, associated with the Lynch syndrome, familial adenomatous polyposis (FAP) and other rare syndromes. Sporadic CRC is believed to arise as a result of close interaction between environmental factors, including dietary and lifestyle habits, and genetic predisposition factors. In contrast, hereditary forms such as those related to the Lynch syndrome result from inheritance of germline mutations of mismatch repair (MMR) genes. However, in certain cases, the influence of low penetrance alleles in familial colorectal cancer susceptibility is also undeniable. Aim: To investigate the genotype frequencies of MLH1 promoter polymorphism -93G>A and to determine whether it could play any role in modulating familial and sporadic CRC susceptibility risk. Methods: A case-control study comprising of 104 histopathologically confirmed CRC patients as cases (52 sporadic CRC and 52 Lynch syndrome patients) and 104 normal healthy individuals as controls was undertaken. DNA was extracted from peripheral blood and the polymorphism was genotyped employing PCR-RFLP methods. The genotypes were categorized into homozygous wild type, heterozygous and homozygous variants. The risk association between these polymorphisms and CRC susceptibility risk was calculated using binary logistic regression analysis and deriving odds ratios (ORs). Results: When risk association was investigated for all CRC patients as a single group, the heterozygous (G/A) genotype showed a significantly higher risk for CRC susceptibility with an OR of 2.273, (95%CI: 1.133-4.558 and p-value=0.021). When analyzed specifically for the 2 types of CRC, the heterozygous (G/A) genotype showed significantly higher risk for sporadic CRC susceptibility with and OR of 3.714, (95%CI: 1.416-9.740 and p-value=0.008). Despite high OR value was observed for Lynch syndrome (OR: 1.600, 95%CI: 0.715-3.581), the risk was not statistically significant (P=0.253). Conclusion: Our results suggest an influence of MLH1 promoter polymorphism -93G>A in modulating susceptibility risk in Malaysian CRC patients, especially those with sporadic disease.
BACKGROUND/OBJECTIVES: The association between tea consumption and risk of coronary heart disease (CHD) remains controversial. This study aimed to determine whether tea consumption has an effect on CHD risk in Chinese adults. SUBJECTS/METHODS: In this hospital-based case-control study, 267 cases of CHD and 235 non-CHD controls were enrolled. Blood samples from all cases were examined. Cardiac function indices (left ventricular ejection fraction, left ventricular end-diastolic dimension, lactate dehydrogenase, and creatine kinase of the muscle or brain type), blood lipid index (high-density lipoprotein cholesterol), and blood coagulation function indices (fibrinogen and activated partial thromboplastin time) were recorded. Tea consumption of study participants was assessed by a specifically designed questionnaire. The baseline characteristics of the study populations were recorded, and CHD-related biomarkers were detected. Differences in baseline characteristics of the study participants were examined using t-tests for continuous variables and chi-squared tests for categorical variables. Unconditional logistic regression was used to measure the association between tea and CHD. RESULTS: There were significant differences in cardiac function indices, blood lipid index, and blood coagulation indices between CHD cases and controls (P < 0.05). We found tea consumption reduced CHD risk in female participants (adjusted odds ratio (OR) = 0.484, 95% CI: 0.242-0.968, P = 0.0403). Regarding the type of tea consumed, the risk of CHD was reduced in women who drank partially fermented tea (adjusted OR = 0.210, 95% CI: 0.084-0.522, P = 0.0008). Analytic results for the amount of tea consumed per unit time showed CHD risk was reduced in women who consumed 1-2 cups of tea per day (adjusted OR = 0.291, 95% CI: 0.131-0.643, P = 0.0023). A tea-drinking frequency of > 6 days/week was beneficial for CHD prevention (adjusted OR = 0.183, 95% CI: 0.049-0.679, P = 0.0112). When analyzed according to the duration of tea consumption, the risk of CHD was reduced in participants who had been drinking tea for 10-20 years (adjusted OR = 0.360, 95% CI: 0.137-0.946, P = 0.0382). CONCLUSIONS: Tea consumption is associated with a reduced risk of CHD in female but not male populations in Guangzhou.
Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative surgical site infections (SSIs) after craniotomy. Methods: This study was a retrospective case-control study of 103 patients who had craniotomies between March 2007 and December 2008. A retrospective review of prospectively collected databases of consecutive patients who underwent craniotomy was done. SSIs were defined by using the Centers for Disease Control criteria. Twenty-six cases (infection) and 77 controls (no infection) were matched for age, gender and time of surgery. Descriptive analysis, t-test, $\chi^2$-test and logistic regression analyses were used for data analysis. Results: The statistical difference between cases and controls was significant for hospital length of stay (>14 days), intensive care unit stay more than 15 days, Glasgrow Coma Scale (GCS) score (${\leq}7$ days), extra-ventricular drainage and coexistent infection. Risk factors were identified by logistic regression and included hospital length of stay of more than 14 days (odds ratio [OR]=23.39, 95% confidence interval [CI]=2.53-216.11) and GCS score (${\leq}7$ scores) (OR=4.71, 95% CI=1.64-13.50). Conclusion: The results of this study show that patients are at high risk for infection when they have a low level of consciousness or their length hospital stay is long term. Nurses have to take an active and continuous approach to infection control to help with patients having these risk factors.
Kim, Hee-Soon;Kim, Tae-Im;Ju, Young-Hee;Lim, Ji-Young;Ha, Young-Ok;Yoo, Ha-Na
Child Health Nursing Research
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제18권3호
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pp.95-100
/
2012
Purpose: The purpose of this study was to facilitate home visits to assess the current rate of child abuse in order to provide an agenda for the early detection and prevention of child abuse and neglect in Korea. Methods: For this retrospective descriptive research, 20 public health centers were selected, 1,991 families were visited and 2,680 children were assessed. Results: We found 415 cases (15.5%) of potential abuse and 7 cases (0.3%) of actual abuse. The greatest risk group was to children age 4 to 6 years. According to the HOME Inventory, there were 17 infants (5.8%) presenting a potential risk for child abuse and neglect. Conclusion: Visitation screening is highly recommended for prevention in the high-risk preschool age group.
DNA ploidy is an important prognostic parameter in paediatric B-ALL, but the significance of the S-phase fraction is unclear. In present study, DNA ploidy was assessed in 40 pediatric B-ALL cases by flow cytometry. The DI (DNA index) and percentage of cells in S-phase were calculated using Modfit software. Aneuploidy was noted in 26/40 (65%) cases. A DI of 1.10-1.6 (hyperdiploidy B) was noted in 20/40 (50%) and 6/40 (15%) had a DI>1.60 (triploid and tetraploid range). Some 14/40 (35%) cases had a diploid DI between 0.90-1.05. None of the cases had a DI <0.90 (hypodiploid) or in the 1.06-1.09 (hyperdiploid A) range. The mean S-phase fraction was 2.6%, with 24/40 (60%) having low and 16/40 (40%) high S-phase fractions. No correlation was noted with standard ALL risk and treatment response factors with DI values or S-phase data, except for a positive correlation of low S-phase with high NCI risk category (p=0.032). Overall frequency of hyperdiploidy in our cohort of B-ALL patients was very high (65%). No correlation between hyperdiploidy B and low TLC or common B-phenotype was observed in our study as 42% cases with DI 1.10-1.6 had TLC> $50{\times}10^9$ and 57.1% CD 10 negativity. The study also highlighted that S-phase fraction analysis does not add any prognostic information and is not a useful parameter for assessment in ALL cases. However, larger studies with long term outcome analysis are needed to derive definitive conclusions.
Objective : Burr hole drainage has been widely used to treat chronic subdural hematoma (CSDH). However, the incidence of recurrent CSDH varies from 3.7 to 30% after surgery. The authors attempted to elucidate the risk factors associated with the recurrence of CSDH in one burr hole drainage technique. Methods : A total of 255 consecutive cases who underwent one burr hole drainage for CSDH were included in this study. Twenty-four patients (9.4%) underwent a repeated operation because of the recurrence of CSDH. We analyzed retrospectively the demographic, clinical and radiologic factors associated with the recurrence of CSDH. Results : In this study, two risk factors were found to be independently associated with the recurrence of CSDH. The incidence of CSDH recurrence in the high- and mixed-density groups was significantly higher than those in the low- and iso-density groups (p<0.001). Bleeding tendency such as in leukemia, liver disease and chronic renal failure was also significantly associated with recurrence of CSDH (p=0.037). Conclusion : These results suggest that high- and mixed- density shown on computed tomographic scan was closely relates with a high incidence of recurrence. Therefore, the operation could be delayed in those cases unless severe symptoms or signs are present. Reoperation using the previous burr hole site is a preferred modality to treat the recurrent CSDH.
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