Medicine and Health Sciences Commons^™

An Analysis Of Major Issues For Culturally-Minded Professionals In Women's Health Care, Victoria Clark

Victoria Clark

Esophageal Diagnosis Of A Malignant Aspergilloma, Muneer Al Zoby, Nancy Munn,, Yousef Shweihat

Nancy J. Munn

A 59-year-old male patient developed a new 4 cm × 6 cm cavitary left upper lung lesion over a 2 months period. The patient had a prior history of a surgically resected Stage IA non-small cell lung cancer in the right upper lobe 3 years prior. He was treated for possible infection with radiographic improvement on subsequent imaging. Further imaging after 3 months revealed an oval soft tissue density within the cavity with air crescent sign. Bronchoscopy with transbronchial biopsies showed an acute and chronic granulomatous inflammation. Aspergillus fumigatus was noted on culture and voriconazole was initiated. Subsequent imaging showed …

Esophageal Diagnosis Of A Malignant Aspergilloma, Muneer Al Zoby, Nancy Munn,, Yousef Shweihat

Yousef R. Shweihat

A 59-year-old male patient developed a new 4 cm × 6 cm cavitary left upper lung lesion over a 2 months period. The patient had a prior history of a surgically resected Stage IA non-small cell lung cancer in the right upper lobe 3 years prior. He was treated for possible infection with radiographic improvement on subsequent imaging. Further imaging after 3 months revealed an oval soft tissue density within the cavity with air crescent sign. Bronchoscopy with transbronchial biopsies showed an acute and chronic granulomatous inflammation. Aspergillus fumigatus was noted on culture and voriconazole was initiated. Subsequent imaging showed …

Perilymphatic Irx-2 Cytokine Therapy To Enhance Tumor Infiltrating Lymphocytes And Pd-L1 Expression Preceding Curative-Intent Therapy In Early Stage Breast Cancer, Joanna Pucilowska, Venkatesh Rajamanickam, Katherine Sanchez, Valerie Conrad, Alison Conlin, Shagheyegh Aliabadi-Wahle, Shu-Ching Chang, Gary Grunkemeier, Nikki Moxon, Staci Mellinger, Maritza Martel, James Egan, Monil Shah, David B Page

Shu-Ching Chang, PhD, MS

Background: Cytokines are being explored as a therapeutic strategy to modulate the tumor microenvironment and facilitate immunotherapy benefit in breast cancer. Here, we investigate a locoregional therapeutic approach whereby cytokines (IRX-2) are administered into the subcutaneous peri-areolar tissue (in an anatomic distribution similar to sentinel lymph node mapping) to facilitate immune cell recruitment/activation within the draining lymph nodes and tumor in ESBC. IRX-2 is derived from ex vivo phytohemagglutinin-stimulated lymphocytes and contains multiple cytokines including IL-1β, IL-2, TNF-α, IFN-γ, IL-6, IL-8, and GM-CSF, with stable concentrations from lot to lot. Preclinically, IRX-2 activates T-cells and natural killer (NK) cells, facilitates …

Single Cell Sequencing To Identify Tcrs That Recognize Autologous Tumor Cells After Vaccination With Allogeinic Dribble Vaccine, Hong-Ming Hu, Christopher C. Paustian, Zhifa Wen, Tarsem L. Moudgil, Traci L. Hilton, Sam Bookhardt, Guangjie Yu, Eric Tran, Venkatesh Rajamanickam, Walter Urba, Rachel E. Sanborn, Bernard A. Fox

Eric Tran, PhD

Background: Adoptive immunotherapy with tumor-specific TCR gene-modified T cells has the potential to eradicate bulky disease. Traditional methods of TCR identification require lengthy in vitro culture to generate clonal T-cell populations, which adds time and complexity to this promising therapy. Here we described a simplified and reliable method to identify TCRs by single cell TCR sequencing of cells sorted with antibodies against T-cell surface markers that are up-regulated only when they are stimulated with specific tumor cell antigens.

Methods: A tumor-infiltrating lymphocyte (TIL) culture with T cells reactive against autologous tumor was generated from a brain metastasis of a patients …

Cellular Senescence And Their Role In Liver Metabolism In Health And Disease: Overview And Future Directions, Matthew Schade, Jacqueline A. Sanabria, Rodrigo Aguilar, Milad Modarresi, Brad Gillon, Zach Hunter, Jacqueline Fannin, Amrita Mallick, Henri Brunengraber, Juan Sanabria

Juan R. Sanabria

Chronic liver disease has globally risen mainly due to a prevalent Hepatitis C Virus (HCV) infection rate and an epidemic of obesity. It is estimated by the year 2030, 2.2 billion people around the world will be overweight and 1.1 billion people will be obese. Diabetes and obesity are the main risk factors for the development of the metabolic syndrome and in the liver of Non-Alcoholic Fatty Liver Disease (NAFLD) which could progress to NASH related cirrhosis and liver malignancy. At present there is not effective therapy for NASH besides loss of weight and exercise. Furthermore, optimal management of HCC …

Metabolomic Analysis Of Liver Tissue From The Vx2 Rabbit Model Of Secondary Liver Tumors, Rafael A. Ibarra, J. E. Dazard, Y. Sandlers, F. Rehman, R. Abbas, R. Kombu, G. F. Zhang, H. Brunengraber, Juan R. Sanabria

Juan R. Sanabria

Purpose. The incidence of liver neoplasms is rising in USA. The purpose of this study was to determine metabolic profiles of liver tissue during early cancer development. Methods. We used the rabbitVX2 model of liver tumors (LT) and a control group consisting of sham animals implanted with Gelfoam into their livers (LG). After two weeks from implantation, liver tissue from lobes with and without tumor was obtained from experimental animals (LT+/LT−) as well as liver tissue from controls (LG+/LG−). Peaks obtained by Gas Chromatography-Mass Spectrometry were subjected to identification. 56 metabolites were identified and their profiles compared between groups using …

Case Study Of Persons With Cancer Participating In A Community-Based Exercise Program: An Exploration Of Meaning And Change, Barbara K. Haas, Melinda Hermanns, Christina Melin-Johanson

Barbara Haas

Increasingly, research supports the importance of incorporating exercise into the cancer care paradigm. While quantitative studies have substantiated the significant effects of exercise on physical functioning, the individual’s perspective of participating in an exercise program has rarely been considered. The purpose of this study was to explain the impact of a community based exercise program on the lives of persons with cancer and their caregivers. Based on Bandura’s Social Cognitive Theory, a single explanatory case study with multiple embedded units of analyses was conducted. Interviews were conducted with 10 individuals representing participants with cancer, their caregivers, and health care providers. …

Commonest Cancers In Pakistan - Findings And Histopathological Perspective From A Premier Surgical Pathology Center In Pakistan., Zubair Ahmad, Romana Idress, Saira Fatima, Nasir Uddin, Arsalan Ahmed, Khurram Minhas, Aisha Memon, Syeda Samia Fatima, Muhammad Arif, Sheema H Hasan, Rashida Ahmed, Shahid Pervez, Naila Kayani Naila Kayani

Zubair Ahmad

Abstract CONTEXT: There are no recent authoritative data about incidence and prevalence of various types of cancers in Pakistan. AIM: To determine the frequency of malignant tumors seen in our practice and provide a foundation for building a comprehensive cancer care strategy. MATERIALS AND METHODS: 10,000 successive cases of solid malignant tumors reported in 2014 were included. All cases had formalin fixed, paraffin embedded specimens available and diagnosis was based on histological examination of H and E stained slides plus ancillary studies at the Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi. The latest …

Commonest Cancers In Pakistan - Findings And Histopathological Perspective From A Premier Surgical Pathology Center In Pakistan., Zubair Ahmad, Romana Idress, Saira Fatima, Nasir Uddin, Arsalan Ahmed, Khurram Minhas, Aisha Memon, Syeda Samia Fatima, Muhammad Arif, Sheema H Hasan, Rashida Ahmed, Shahid Pervez, Naila Kayani Naila Kayani

Rashida Ahmed

Abstract CONTEXT: There are no recent authoritative data about incidence and prevalence of various types of cancers in Pakistan. AIM: To determine the frequency of malignant tumors seen in our practice and provide a foundation for building a comprehensive cancer care strategy. MATERIALS AND METHODS: 10,000 successive cases of solid malignant tumors reported in 2014 were included. All cases had formalin fixed, paraffin embedded specimens available and diagnosis was based on histological examination of H and E stained slides plus ancillary studies at the Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi. The latest …

Pakistan - Country Profile Of Cancer And Cancer Control 1995-2004, Yasmin Bhurgri, Asif Bhurgri, Sania Nishter, Ashfaq Ahmed, Ahmed Usman, Shahid Pervez, Naila Kayani, Rashida Ahmed, Sheema H. Hassan, Ahmed Riaz, Hadi Bhurgri, Imtiaz Bashir

Rashida Ahmed

No abstract provided.

Vitamin K2 (Menaquinone) Supplementation And Its Benefits In Cardiovascular Disease, Osteoporosis, And Cancer, Grant S. Buchanan, Md, Thomas Melvin, Brandon Merritt, Charles Bishop, Md, Franklin D. Shuler, Md, Phd

Franklin D. Shuler

Vitamin K is known to play an essential role in the coagulation cascade; however, a growing body of research has found that a subtype of this vitamin, vitamin K2 (menaquinone) may have a beneficial effect in osteoporosis, cardiovascular disease, and cancer. This purpose of this article is to provide a comprehensive review of recent literature regarding menaquinone and its role in human health. This review discusses the physiology of menaquinone, its clinical benefits in cardiovascular disease, osteoporosis, and cancer, and how it may interact with certain medications. The authors conclude that menaquinone supplementation has been shown to improve carboxylation of …

An Examination Of Chimpanzee Use In Human Cancer Research, Jarrod Bailey

Jarrod Bailey, PhD

Advocates of chimpanzee research claim the genetic similarity of humans and chimpanzees make them an indispensable research tool to combat human diseases. Given that cancer is a leading cause of human death worldwide, one might expect that if chimpanzees were needed for, or were productive in, cancer research, then they would have been widely used. This comprehensive literature analysis reveals that chimpanzees have scarcely been used in any form of cancer research, and that chimpanzee tumours are extremely rare and biologically different from human cancers. Often, chimpanzee citations described peripheral use of chimpanzee cells and genetic material in predominantly human …

Hospice And Pain Management In Nursing Home Residents With Cancer, Jacob N. Hunnicutt, Jennifer Tjia, Kate L. Lapane

Jennifer Tjia

Background: The prevalence of untreated pain in nursing home residents with cancer is unacceptably high. Hospice may increase the likelihood of receiving pain management at the end of life.

Objectives: To estimate whether receipt of hospice in nursing homes increases the receipt of pain management for nursing home residents with cancer at the end of life.

Methods: We conducted a cross-sectional study on a national sample of Medicare decedents who had cancer and were nursing home residents during the last 90 days of life in 2011–2012. We used the last Minimum Data Set (MDS) 3.0 assessment before death and the …

Effective Transitional Therapy For Adolescent And Young Adult Patients With Cancer: An Integrative Literature Review, Katherine Jones Masterton, Joseph D. Tariman Phd

Joseph D Tariman PhD, RN, ANP-BC, FAAN

Policy Implications Of Oral Agents, Sandra L. Spoelstra, Barbara A. Given, Charles W. Given, Marcia Grant

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

OBJECTIVE: With the increasing use of oral antineoplastic agents in cancer management, patients and family members need to understand of how to obtain, safely handle, and store the medication, how and when the medications should be taken, and when to report toxic side effects to accomplish efficacious treatment. DATA SOURCES: Research based articles and conference presentations. CONCLUSION: Cancer centers to modify policies, protocols, or practices to assure safe and proper administration of oral antineoplastic agents. IMPLICATIONS FOR NURSING PRACTICE: Clinicians need to monitor and facilitate administration of oral antineoplastic agents, and ultimately improve clinical outcomes.

Testing The Differential Effects Of Symptom Management Interventions In Cancer, Alla Sikorskii, Charles W. Given, Azfar-E-Alam Siddiqi, Victoria Champion, Ruth Mccorkle, Sandra L. Spoelstra, Barbara A. Given

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Objective: The purpose of this study was to test for moderating effects of patient characteristics on self-management interventions developed to address symptoms during cancer treatment. Patient’s age, education and depressive symptomatology were considered as potential moderators. Methods: A secondary analysis of data of 782 patients from two randomized clinical trials was performed. Both trials enrolled patients with solid tumors undergoing chemotherapy. After completing baseline interviews, patients were randomized to a nurse-delivered intervention versus intervention delivered by a “coach” in trial I, and to a nurse-delivered intervention versus an intervention delivered by an automated voice response system in trial II. In …

The Challenges Of Oral Agents As Antineoplastic Treatments, Barbara A. Given, Sandra L. Spoelstra, Marcia Grant

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

OBJECTIVE: Given the increasing use of oral antineoplastic agents in cancer management, patient adherence is critical to successful treatment outcomes. This article reviews the scope of the problem and issues of adherence to oral antineoplastic agents. DATA SOURCES: Research based and other articles, newsletters, and conference presentations. CONCLUSION: Suboptimal adherence to oral antineoplastic agents is a significant clinical problem that may result in disease or treatment complications, adjustment in treatment regimen, disease progression, and premature death. IMPLICATIONS FOR NURSING PRACTICE: Healthcare providers need to monitor and facilitate adherence by identifying barriers and implementing strategies to assure adherence, and therefore, improve …

Assessment And Measurement Of Adherence To Oral Antineoplastic Agents, Sandra L. Spoelstra, Charles W. Given

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

OBJECTIVES: The increase in oral anticancer medications with complex regimens creates a need to assure patients are taking therapeutic dosages as prescribed. This article reviews the assessment and measurement of adherence to oral antineoplastic agents. DATA SOURCE: Research and journal articles from CINAHL and Pub Med. CONCLUSION: Assessing and measuring adherence to oral antineoplastic should include three dimensions: the percentage of medications taken, the duration, and the timing of taking the medication. IMPLICATIONS FOR PRACTICE: Clinicians need to conduct ongoing assessment and measurement of adherence to oral antineoplastic agents. This includes eliciting patient report of adherence, pill counts, drug diaries, …

A Randomized Controlled Trial Of The Feasibility And Preliminary Efficacy Of A Texting Intervention On Medication Adherence In Adults Prescribed Oral Anti-Cancer Agents: Study Protocol, Sandra L. Spoelstra, Charles W. Given, Alla Sikorskii, Constantinos K. Coursaris, Atreyee Majumder, Tracy Dekoekkoek, Monica Schueller, Barbara A. Given

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Aim: The aim of this study was to report a study protocol that examines feasibility, preliminary efficacy and satisfaction of a text message intervention on the outcome of medication adherence in adult patients prescribed oral anti-cancer agents. Background: Administration of oral anti-cancer agents occurs in the home setting, requiring patients to self-manage the regimen as prescribed. However, many barriers to medication adherence exist: regimens are often complex, with cycling of two or more medications; side effects of treatment; most cancer patients are older with comorbid conditions and competing demands; and cognitive decline and forgetfulness may occur. Research indicates patients miss …

A Trial Examining An Advanced Practice Nurse Intervention To Promote Medication Adherence And Symptom Management In Adult Cancer Patients Prescribed Oral Anti-Cancer Agents: Study Protocol, Sandra L. Spoelstra, Peggy S. Burhenn, Tracy Dekoekkoek, Monica Schueller

Sandra L. Spoelstra, PhD, RN, FGSA, FAAN

Aim: To report a study protocol that refines then examines feasibility, preliminary efficacy, and satisfaction of ADHERE, an intervention using motivational interviewing and brief cognitive behavioral therapy as a mechanism for goal-oriented systematic patient education to promote symptom management and adherence among cancer patients prescribed oral anti-cancer agents. Background: Cancer treatment with oral anti-cancer agents shifts responsibility for managing treatment from clinicians in supervised cancer centers to patients and their caregivers. Thus, a need exists to standardize start-of-care for support patient self-management of care at home. Design: A two-phase quasi-experimental sequential design with repeated measures. Methods: Sixty five adult patients …

Point In Time The Fitsteps For Life Exercise Program Improves Quality Of Life Of Persons With Cancer, Barbara Haas, Gary Kimmel, Melinda Hermanns

Barbara Haas

This poster was presented at the National Collegiate Honors College Conference in Fall of 2014 at Denver, Colorado.

Rural Disparities In Cancer Care: A Review Of Its Implications And Possible Interventions, Raj Singh, Lynne J. Goebel Md

Lynne J. Goebel

Cancer care has greatly improved in the last few decades, as evidenced by a 22% decline in the overall cancer-related death rate in the United States since 1991. However, the question presents itself whether rural residents, for whom the latest advancements are not as accessible, are also realizing these benefits as much as their urban counterparts. The aim of this study is to provide are view of the literature regarding the disparities in cancer care facing rural Appalachia and specifically West Virginia (WV) as well as possible solutions towards bridging this gap. We find that WV has a higher cancer …

Point In Time The Fitsteps For Life Exercise Program Improves Quality Of Life Of Persons With Cancer, Barbara Haas, Gary Kimmel, Melinda Hermanns

Melinda Hermanns

This poster was presented at the National Collegiate Honors College Conference in Fall of 2014 at Denver, Colorado.

Patient-Centered Communication And Prognosis Discussions With Cancer Patients, Cleveland G. Shields, Casey J. Coker, Shruti S. Poulsen, Jennifer M. Doyle, Kevin Fiscella, Ronald M. Epstein, Jennifer J. Griggs

Shruti Poulsen

To examine physician communication associated with prognosis discussion with cancer patients.

Adherence, Persistence, And Treatment Fatigue In Multiple Myeloma, Sandra Kurtin, Kathleen Colson, Joseph D. Tariman Phd, Beth Faiman, Elizabeth Finley-Oliver

Joseph D Tariman PhD, RN, ANP-BC, FAAN

Targeting Dusps In Glioblastomas–Wielding A Double‐Edged Sword, Sheila Abraham, Swapna Asuthkar, William Lee, Srinivasulu Chigurupat, Andrew Tsung, Kiran Kiran

Sheila Prabhakar Abraham

Several dual-specificity phosphatases (DUSPs) that play key roles in the direct or indirect inactivation of different MAP kinases (MAPKs) have been implicated in human cancers over the past decade. This has led to a growing interest in identifying DUSPs and their specific inhibitors for further testing and validation as therapeutic targets in human cancers. However, the lack of understanding of the complex regulatory mechanisms and cross-talks between MAPK signaling pathways, combined with the fact that DUSPs can act as a double-edged sword in cancer progression, calls for a more careful and thorough investigation. Among the various types of brain cancer, …

"What Should Happen Before Asymptomatic Men Decide Whether Or Not To Have A Psa Test?"A Report On Three Community Juries, Chris Degeling, Lucie Rychetnik, Kristen Pickles, Rae Thomas, Jennifer Doust, Robert Gardiner, Paul Glasziou, Ainsley Newson, Stacy Carter

Jenny Doust

OBJECTIVES: To elicit the views of well informed community members on the ethical obligations of general practitioners regarding prostate-specific antigen (PSA) testing, and what should be required before a man undergoes a PSA test. DESIGN AND SETTING: Three community juries held at the University of Sydney over 6 months in 2014. PARTICIPANTS: Forty participants from New South Wales, of diverse social and cultural backgrounds and with no experience of prostate cancer, recruited through public advertising: two juries of mixed gender and ages; one all-male jury of PSA screening age. RESULTS: In contrast to Royal Australian College of General Practitioners guidelines, …

"What Should Happen Before Asymptomatic Men Decide Whether Or Not To Have A Psa Test?"A Report On Three Community Juries, Chris Degeling, Lucie Rychetnik, Kristen Pickles, Rae Thomas, Jennifer Doust, Robert Gardiner, Paul Glasziou, Ainsley Newson, Stacy Carter

Rae Thomas

OBJECTIVES: To elicit the views of well informed community members on the ethical obligations of general practitioners regarding prostate-specific antigen (PSA) testing, and what should be required before a man undergoes a PSA test. DESIGN AND SETTING: Three community juries held at the University of Sydney over 6 months in 2014. PARTICIPANTS: Forty participants from New South Wales, of diverse social and cultural backgrounds and with no experience of prostate cancer, recruited through public advertising: two juries of mixed gender and ages; one all-male jury of PSA screening age. RESULTS: In contrast to Royal Australian College of General Practitioners guidelines, …

Benefits And Barriers Of Cancer Practitioners Discussing Physical Activity With Their Cancer Patients, Justin Keogh, Alicia Olsen, Mike Climstein, Sally Sargeant, Lynette Jones

Sally Sargeant

Our aim was to synthesise the existing empirical literature and theoretical perspectives on the physical activity (PA) promotion practices and determinants of cancer clinicians and health professionals. We conducted a narrative review of theory and evidence to develop practice recommendations for improving the promotion of PA to cancer patients. Surveyed health professionals were aware of many benefits of PA for their cancer patients, although only ~40 % promoted PA to selected cancer patients. Walking was the most commonly promoted form of PA, with this promoted to assist patients control their weight and cardiovascular health risk. Barriers to promotion of PA …