Medicine and Health Sciences Commons^™

Methods To Improve Rehabilitation Of Patients Following Breast Cancer Surgery: A Review Of Systematic Reviews, Siew Yim Loh Assoc Prof, Aisha Nadia Ms

Siew Yim Loh

Context: Breast cancer is the most prevalent cancer amongst women but it has the highest survival rates amongst all cancer. Rehabilitation therapy of post-treatment effects from cancer and its treatment is needed to improve functioning and quality of life. This review investigated the range of methods for improving physical, psychosocial, occupational, and social wellbeing in women with breast cancer after receiving breast cancer surgery. Method: A search for articles published in English between the years 2009 and 2014 was carried out using The Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, PubMed, and ScienceDirect. Search …

The Affordable Care Act: A “Preventative-Focused” Healthcare Regime To Improve Reproductive Cancer Outcomes Among Women Of Lower Socio-Economic Status, Rachele M. Hendricks

Rachele M Hendricks-Sturrup

No abstract provided.

Randomized Phase Iii Trial Of Piroxicam In Combination With Mitoxantrone Or Carboplatin For First-Line Treatment Of Urogenital Tract Transitional Cell Carcinoma In Dogs., Sara D. Allstadt, C O. Rodriquez, B Boostrom, R B. Rebhun, K A. Skorupski

Sara Allstadt, DVM, Diplomate ACVIM (Oncology)

BACKGROUND: Reported response rates of transitional cell carcinoma (TCC) in dogs to piroxicam in combination with either mitoxantrone or carboplatin are similar; however, it is unknown whether either drug might provide superior duration of response. HYPOTHESIS/OBJECTIVES: To determine if the progression-free interval (PFI) of dogs with TCC treated with mitoxantrone and piroxicam was different than that of dogs receiving carboplatin and piroxicam. The hypothesis was that the efficacy of mitoxantrone is no different from carboplatin. ANIMALS: Fifty dogs with TCC without azotemia. METHODS: Prospective open-label phase III randomized study. Either mitoxantrone or carboplatin was administered every 3 weeks concurrently with …

The Kuala Lumpur Qigong Trial For Women In The Cancer Survivorship Phase-Efficacy Of A Three-Arm Rct To Improve Qol, Siew Yim Loh Assoc Prof

Siew Yim Loh

Background: Qigong is highly favoured among Asian breast cancer survivors for enhancing health. This study examined the hypothesis that quality of life (QoL) in the Qigong group is better than the placebo (aerobic) or usual care group. Materials and Methods: A total of 197 participants were randomly assigned to either the 8-week Kuala Lumpur Qigong Trial or control groups in 2010-2011. Measurement taken at baseline and post-intervention included QoL, distress and fatigue. Analysis of covariance (ANCOVA) and Kruskal Wallis were used to examine for differences between groups in the measurements. Results : There were 95 consenting participants in this 8week …

Global Quantitative Assessment Of The Colorectal Polyp Burden In Familial Adenomatous Polyposis Using A Web-Based Tool, Patrick M. Lynch, Jeffrey S. Morris, William A. Ross, Miguel A. Rodriguez-Bigas, Juan Posadas, Rossa Khalaf, Diane M. Weber, Valerie O. Sepeda, Bernard Levin, Imad Shureiqi

Jeffrey S. Morris

Background: Accurate measures of the total polyp burden in familial adenomatous polyposis (FAP) are lacking. Current assessment tools include polyp quantitation in limited-field photographs and qualitative total colorectal polyp burden by video.

Objective: To develop global quantitative tools of the FAP colorectal adenoma burden.

Design: A single-arm, phase II trial.

Patients: Twenty-seven patients with FAP.

Intervention: Treatment with celecoxib for 6 months, with before-treatment and after-treatment videos posted to an intranet with an interactive site for scoring.

Main Outcome Measurements: Global adenoma counts and sizes (grouped into categories: less than 2 mm, 2-4 mm, and greater than 4 mm) were …

Physical Activity And Quality Of Life Of Cancer Survivors: A Lack Of Focus For Lifestyle Redesign, Jia Ern Lee Ms, Siew Yim Loh Assoc Prof

Siew Yim Loh

Physical activity is a component of lifestyle activity and one that has been increasingly seen as 'the medicine' to cure chronic diseases, including certain types of cancer. Physical activity has potent impact on mortality but only if it is well incorporated as lifestyle activity may it allow a better outcome of the quality of life of cancer survivors. This paper presents a review on the evidence of physical activity being actively promoted as lifestyle activity amongst cancer survivors, for the last five years. MATERIALS AND METHODS: Electronic databases were systematically searched for randomized controlled trials incorporated as lifestyle activity through …

Effectiveness Of A Patient Self- Management Program For Breast Cancer As A Chronic Illness: A Non- Randomised Controlled Clinical Trial, Siew Yim Loh Assoc Prof, Tanya Packer Prof, Karunthan Chinna Assoc Prof, Kia Fatt Quek Assoc Prof

Siew Yim Loh

Purpose Patient self-management enables living with a chronic disease effectively. This study examines the effectiveness of a 4-week self-management programme to enable self-management of the numerous after-effects and with breast cancer as a chronic disease. Methods Upon ethical approval, 147 multiethnic survivors (stages I–III breast cancer) received either a 4-week self-management intervention (n=68) or usual care (n=78) on a controlled clinical trial in a medical centre. The facilitator led group intervention provides self-management support and skills for managing the medical, emotional and role tasks. Survivors completed the pre- and post-intervention measures on quality of life, distress and participation inventory. Results …

Clausena Excavata Burm. F. (Rutaceae): A Review Of Its Traditional Uses, Pharmacological And Phytochemical Properties., Dr Syam Mohan

Syam Mohan

The present review describes the morphological, traditional, phytochemical and pharmacological aspects of Clausena excavata (Burm. f., Rutaceae). The plant grows wild in the tropical and subtropical parts of Asia and represents one of the richest sources of medicinal natural products. It is intensively used currently in traditional medicine for treatment of different illnesses. One part or a mixture of two or more parts of the plant in the form of powder or liquid doze is usually given to the patient. Phytochemically, many pure compounds from several secondary metabolite groups of C. excavata have been isolated from different parts of the …

Chloroform Fraction Of Centratherum Anthelminticum (L.) Seed Inhibits Tumor Necrosis Factor Alpha And Exhibits Pleotropic Bioactivities: Inhibitory Role In Human Tumor Cells, Dr Syam Mohan

Syam Mohan

We investigated the antioxidant potential, cytotoxic effect, and TNF-α inhibition activity with NF-κB activation response in a chloroformfraction of Centratherum anthelminticum seeds (CACF). The antioxidant property of CACF was evaluated with DPPH, ORAC, and FRAP assays, which demonstrated significant antioxidant activity. The cytotoxicity of CACF was tested using theMTT assay; CACF effective inhibitory concentrations (IC50) for A549, PC-3, MCF-7, and WRL-68 cells were 31.42 ± 5.4, 22.61 ± 1.7, 8.1±0.9, and 54.93±8.3 μg/mL, respectively. CACF effectively and dose-dependently inhibited TNF-α release, in vitro and in vivo. CACF inhibited TNF-α secretion in stimulated RAW264.7macrophage supernatants with an IC50 of 0.012 μg/mL, …

In Vitro Anti-Inflammatory, Cytotoxic And Antioxidant Activities Of Boesenbergin A, A Chalcone Isolated From Boesenbergia Rotunda (L.) (Fingerroot), Dr Syam Mohan

Syam Mohan

The current in vitro study was designed to investigate the anti-inflammatory, cytotoxic and antioxidant activities of boesenbergin A (BA), a chalcone derivative of known structure isolated from Boesenbergia rotunda. Human hepatocellular carcinoma (HepG2), colon adenocarcinoma (HT-29), non-small cell lung cancer (A549), prostate adenocarcinoma (PC3), and normal hepatic cells (WRL-68) were used to evaluate the cytotoxicity of BA using the MTT assay. The antioxidant activity of BA was assessed by the ORAC assay and compared to quercetin as a standard reference antioxidant. ORAC results are reported as the equivalent concentration of Trolox that produces the same level of antioxidant activity as …

Synthesis Of Chalcones With Anticancer Activities., Dr Syam Mohan

Syam Mohan

Several chalcones were synthesized and their in vitro cytotoxicity against various human cell lines, including human breast adenocarcinoma cell line MCF-7, human lung adenocarcinoma cell line A549, human prostate cancer cell line PC3, human adenocarcinoma cell line HT-29 (colorectal cancer) and human normal liver cell line WRL-68 was evaluated. Most of the compounds being active cytotoxic agents, four of them with minimal IC50 values were chosen and studied in detail with MCF-7 cells. The compounds 1, 5, 23, and 25 were capable in eliciting apoptosis in MCF-7 cells as shown by multiparameter cytotoxicity assay and caspase-3/7, -8, and -9 activities …

Cucurbitacin L 2-O- Glucoside Demonstrates Apoptogenesis In Colon Adenocarcinoma Cells (Ht-29): Involvement Of Reactive Oxygen And Nitrogen Species Regulation, Dr Syam Mohan

Syam Mohan

Emerging evidence suggests that reactive oxygen (ROS) and nitrogen (RNS) species can contribute to diverse signalling pathways of inflammatory and tumour cells. Cucurbitacins are a group of highly oxygenated triterpenes. Many plants used in folk medicine to treat cancer have been found to contain cucurbitacins displaying potentially important anti-inflammatory actions. The current study was designed to investigate the anti-ROS and -RNS effects of cucurbitacin L 2-O-β-glucoside (CLG) and the role of these signaling factors in the apoptogenic effects of CLG on human colon cancer cells (HT-29). This natural cucurbitacin was isolated purely from Citrullus lanatus var. citroides (Cucurbitaceae). The results …

Dentatin Induces Apoptosis In Prostate Cancer Cells Via Bcl-2, Bcl-Xl, Survivin Downregulation, Caspase-9, -3/7 Activation And Nf-Kb Inhibition., Dr Syam Mohan

Syam Mohan

This study was set to investigate antiproliferative potential of dentatin (a natural coumarin isolated from Clausena excavata Burm. F) against prostate cancer and to delineate the underlying mechanism of action. Treatment with dentatin dose-dependently inhibited cell growth of PC-3 and LNCaP prostate cancer cell lines, whereas it showed less cytotoxic effects on normal prostate epithelial cell line (RWPE-1). The inhibitory effect of dentatin on prostate cancer cell growth was due to induction of apoptosis as evidenced by Annexin V staining and cell shrinkage. We found that dentatin-mediated accumulation of reactive oxygen species (ROS) and downregulated expression levels of antiapoptotic molecules …

Barriers To Participation In A Randomized Controlled Trial Of, Siew Yim Loh Assoc Prof

Siew Yim Loh

range from patient-related, through institutional-related to staff-related factors. This paper highlights the low response rate and the recruitment barriers faced in our Qigong exercises trial. Materials and Method: The Qigong trial is a three-arm trial with a priori power size of 114 patients for 80% power. The University Malaya Medical Centre database showed a total of 1,933 patients from 2006-2010 and 751 patients met our inclusion criteria. These patients were approached via telephone interview. 131 out of 197 patients attended the trial and the final response rate was 48% (n=95/197). Results: Multiple barriers were identified, and were regrouped as patientrelated, …

Cancer-Behavior-Coping In Women With Breast Cancer: Effect Of A Cancer Self-Management Program, Siew Yim Loh Assoc Prof

Siew Yim Loh

Objective: The Cancer Behavior Inventory (CBI), a measure of self-efficacy for coping with cancer, was used to examine the feasibility and impact of a self-management program for women with breast cancer. This controlled clinical trial was conducted on newly diagnosed breast cancer patients, using a time series, block design. Sixty-nine patients were allocated to receive four weekly sessions of the self-management training program, while 78 patients were allocated to the control (usual-care) group. Results: A significant difference was found between the means of the experimental and the control group at post-test (T2; P=.01) and at follow-up (T3; P=.02). The multivariate …

Barriers To Exercise: Perspectives From Multiethnic Cancer, Siew Yim Loh Assoc Prof

Siew Yim Loh

Background: Many cancer survivors are still not active enough to reap the benefits of physical activity. This study aimed to explore the correlation between perceived barriers and participation in exercise among multiethnic Malaysian women with breast cancer. Methods: A cross-sectional study using a pre-post questionnaire and a media-clip as a cancer control strategy was conducted on a random sample of women with breast cancer. The tools were structured questionnaires to collect socio-medical demographic and physical activity data (e.g. barriers, exercise self-efficacy). Results: A statistically significant relationship between level of physical activity before and after diagnosis of breast cancer (n=51, χ2=70.14, …

Cardiovascular And Cancer Mortality In Brazil, Paulo A. Lotufo

Paulo A Lotufo

Cancer are not surpassing Cardiovascular Diseases. Here you have an evaluation of mortality in Brazil. The debate was ignited by paper from IARC (International Agency for Research on Cancer) that forecasts cancer deaths surpassing heart diseases rates during de 2020’s. There is no dispute about the fact that - at least in the US and other countries - the decline of mortality deaths for heart diseases presenting a faster pace compared to cancer death rates. It is an epidemiological evidence that must be analyzed and some headline fueling hype as “heart diseases as an old agenda of public health and …

Identification Of Ovarian Cancer Symptoms In Health Insurance Claims Data., Paula Diehr, Sean Devlin

Paula Diehr

Background: Women with ovarian cancer have reported abdominal=pelvic pain, bloating, difficulty eating or feeling full quickly, and urinary frequency=urgency prior to diagnosis. We explored these findings in a general population using a dataset of insured women aged 40–64 and investigated the potential effectiveness of a routine review of claims data as a prescreen to identify women at high risk for ovarian cancer. Methods: Data from a large Washington State health insurer were merged with the Seattle-Puget Sound Surveillance, Epidemiology and End Results (SEER) cancer registry for 2000–2004. We estimated the prevalence of symptoms in the 36 months prior to diagnosis …

A Bootstrap-Anfis Framework For Oral Cancer Prognosis Based On Clinical And Genomic Markers, Chang S. W., Sameem A. K., Rosnah Binti Zain, Merican A. F. M. A.

Prof. Dr. Rosnah Binti Zain

The incidence of oral cancer is high in Malaysia especially for those of Indian ethnic origin. In this research, an oral cancer prognosis prediction model will be developed by using Bootstrap-ANFIS techniques. The aim of this research is to improve the prediction of oral cancer survival and to identify the key clinical and genomic markers for the survival prediction of oral cancer. The proposed model is designed to handle small medical dataset with limitations in terms of time, cost and tissue samples.

Self Management Pilot Study On Women With Breast Cancer:, Siew Yim Loh Assoc Prof

Siew Yim Loh

Objective: With increasing survival rates, breast cancer is now considered a chronic condition necessitating innovative care to meet the long-term needs of survivors. This paper presents the findings of a pilot study on self-management for women diagnosed with breast cancer and their implications for Asian health care providers. Methods: A pre-test/ post-test pilot study was conducted to gain preliminary insights into program feasibility and barriers to participation, and to provide justification for a larger trial. Results: The study found the 4 week self management program feasible and acceptable, with a favourable trend in quality of life. The recruitment barriers ranged …

A Transforming Met Mutation Discovered In Non-Small Cell Lung Cancer Using Microarray-Based Resequencing, Torstein Tengs

Dr. Torstein Tengs

We have designed resequencing microarrays to test the performance of this platform when interrogating a large number of exons (164 total) from genes associated with cancer. To evaluate false positive and negative rates, dideoxy sequencing was done for 335,420 bases interrogated by the arrays. From the array data, calls could be made forw97.5% of the bases, and false positive rates were very low with only a single mutation reported from the array dataset for which the corresponding dideoxy trace had a clean wildtype sequence. For the nucleotide positions where array calls were made, false negative rates were 1.41% for heterozygous …

Sensitive Mutation Detection In Heterogeneous Cancer Specimens By Massively Parallel Picoliter Reactor Sequencing, Torstein Tengs

Dr. Torstein Tengs

The sensitivity of conventional DNA sequencing in tumor biopsies is limited by stromal contamination and by genetic heterogeneity within the cancer. Here, we show that microreactor-based pyrosequencing can detect rare cancer-associated sequence variations by independent and parallel sampling of multiple representatives of a given DNA fragment. This technology can thereby facilitate accurate molecular diagnosis of heterogeneous cancer specimens and enable patient selection for targeted cancer therapies.

Detection Of Oncogenic Mutations In The Egfr Gene In Lung Adenocarcinoma With Differential Sensitivity To Egfr Tyrosine Kinase Inhibitors, Torstein Tengs

Dr. Torstein Tengs

The complete sequencing of the human genome and the development of molecularly targeted cancer therapy have promoted efforts to identify systematically the genetic alterations in human cancer. By high-throughput sequencing of tyrosine kinase genes in human non-small-cell lung cancer, we identified somatic mutations in the kinase domain of the epidermal growth factor receptor tyrosine kinase gene (EGFR) that are correlated with clinical response to EGFR tyrosine kinase inhibitors (TKIs). We have shown that these mutant forms of EGFR induce oncogenic transformation in different cellular systems. Cells whose growth depends on EGFR with mutations in exons 19 and 21 are sensitive …

Treatment Modality And Quality Differences For Black And White Breast Cancer Patients Treated In Community Hospitals, Paula Diehr

Paula Diehr

This study assessed the relationship of race and patterns of care, defined by an expert NCI-appointed committee, for 7,781 patients with breast cancer treated in 107 hospitals in 45 communities between 1982 and 1985. After control for age and stage of disease, black patients had significantly different care from white patients for four of the ten patterns examined. They were less likely to have a progesterone receptor assay or to be referred for postmastectomy rehabilitation, two patterns deemed desirable for all patients. Black patients were also more likely to receive liver scans and radiation therapy in situations in which these …

The Effect Of Age On The Care Of Women With Breast Cancer In Community Hospitals, Paula Diehr, Joe Chu

Paula Diehr

We studied the process of care received by 1,680 female breast cancer patients treated in 17 community hospitals. The probability of receiving various diagnostic, consultation, therapy, or rehabilitation services was almost always significantly associated with patient age for one or more disease stages. Most often there was a linear trend for older patients to receive fewer services (e.g., biopsies prior to definitive treatment, number of lymph nodes examined, chemotherapy, radiation therapy) but other age patterns also were found. Age was not significantly associated with clinical staging or estrogen receptors.