Background: The chemotherapeutic agent oxaliplatin can cause acute and chronic forms of peripheral neuropathy. The aim of this study was to evaluate the incidence of chronic neuropathy and its risk factors in colorectal cancer (CRC) patients treated with FOLFOX or XELOX regimens in the Oncology Ward of Hazrate-Rasoul Hospital in Tehran. Materials and Methods: A total of 130 patients with CRC were entered into our study, aged over 18 years, without history of receiving other neurotoxic agents or other predisposing factors such as diabetes or neurologic diseases and kidney and liver dysfunction. For the FOLFOX regimen, patients received oxaliplatin, 85 mg/m2, every 2 weeks for 12 courses and with the XELOX regimen, oxaliplatin was 130mg/m 2 , every 3 weeks for 8 courses. Based on Common Toxicity Criteria (CTC or NCI-CTC v.3), the patients were divided into 5 groups (grades) based on the severity of their symptoms. Results: Fifty-seven patients (43.8%) were male and 73(56.2%) female. Some 19 patients (14.7%) had BMI<20, 97(74.6%) were between 20-25 and 14 (10.8%) ≥25. In 105 patients (80.7%) neuropathy was found. There was significant correlation between BMI, hypomagnesaemia and especially, severity of anemia in patients with neuropathy compared to those without. Conclusions: Oxaliplatin regimens can induce chronic neuropathy in CRC patients, with anemia, high BMI and hypomagnesaemia as risk factors that can predispose to this kind of neurotoxicity.
The aim of present study was to investigate the prevalence of factor V Leiden (FVL) c.1691G>A, prothrombin g.20210G>A and methylenetetrahydrofolate reductase (MTHFR) c.677C>T in deep vein thrombosis (DVT) patients and their possible association with DVT in western Iran. Eighty DVT patients with the mean age of 42.07 +/- 13.0 years including 44 women and 36 men and 100 sex-matched healthy individuals with the mean age of 37.63 +/- 13.3 years from Kermanshah Province of Iran with ethnic background of Kurd were studied for FVL c.1691G>A, prothrombin g.20210G>A and MTHFR c.677C>T by PCR-restriction fragment length polymorphism (RFLP) method using MnlI, HindIII and HinfI restriction enzymes, respectively. Prevalence of FVL was 11.4% in patients and 2% in control group. A significant association was found between FVL mutation and DVT with odds ratio (OR) of 6.3 [95% confidence interval (CI) = 1.32-30.05; P = 0.012]. The prevalence of prothrombin g.20210G>A variant in patients (3.8%) was nonsignificantly higher than control individuals (1.0%; OR 3.8; 95% CI = 0.39-37.81; P = 0.32). The prevalence of MTHFR c.677C>T in patients was 38.7% that was not statistically different from control group (44% P = 0.12). Venous thrombosis in legs was the most frequent clinical manifestation (n = 75), corresponding to 93.8% of the thromboembolism, followed by pulmonary thromboembolism (6.2%). We have, for the first time, determined the prevalence of inherited thrombophilia in a homogenous ethnic group of DVT patients and shown that FVL may be a risk factor for DVT in western Iran.
Background: Lots of research has been dedicated to negative consequences of cancer, but few probably studied personal growth and self-enhancement and its related variables after experiencing this disease. The aim of this research was to predict posttraumatic growth based on coping strategies and gender in patients with cancer.Methods: Using a correlational method and a questionnaire tool, 120 patients (65 females and 55 males, mean age 47 ± 14.72) were selected among hospitalized patients in Firouzgar, Ayatollah Taleghani and Rasoul Akram hospitals in Tehran. They completed post traumatic growth inventory (PTGI) and coping responses inventory (CRI). Descriptive statistics, independent t-test, correlation tests and multiple linear regression were used for data analysis by SPSS version 20. Results: Findings indicated that among problem-oriented coping strategies, cognitive assessment and seeking social support explains 53% of PTG changes (P < 0.001). However, emotion-oriented strategies, including emotional inhibition and somatic inhibition, had no significant relation with PTG. The regression model also revealed that more use of problem-oriented strategies can predict more PTG rate. The results of the t-test showed that there was no significant difference between men and women regarding the PTG score and coping strategies application (P > 0.05). Conclusions:Results showed that problem-oriented strategies especially re-evaluation can support the patients to strive to reconceptualize their experience and make it easier to deal with. In this regard, clinical interventions such as training problemfocused coping skills and facilitating measures to provide social support may also be helpful.Keywords: Cancer, Coping Strategies, Posttraumatic Growth, Gender BackgroundCancer is a major medical problem with more than 200 types regarded as one of the leading causes of death in Iran so that it takes the lives of 205 men and 300 women every year (1). Diagnosis of cancer, added to disrupting normal flow of lives of the patients and changing their social roles and relationships can create unexpected challenges in core beliefs about oneself and the whole world (2). Its return may be marked with high levels of turbulence, sadness, fear, and existential crises (3).In spite of many researches dedicated to negative consequences of cancer, some findings indicate that experiencing pain in some traumatic events may be associated with better feeling and wider perception about personal growth; these positive psychological changes are known as post-traumatic growth (PTG) or cognitive-existential development (4). For instance, Barakat et al. (5) conducted a research on 150 patients with cancer and reported 85% personal growth followed by positive changes during cancer treatment process; experience that was reported by patients with different types of cancer such as bone marrow, lung, colon, testicular and prostate. In a cross-sectional study on patients with breast cancer (stage 0 -3), the time elapsed since diagnosis was a strong ...
Background: Overexpression or amplification of human epidermal growth factor receptor-2 (HER2) is associated with grade of malignancy and a poor prognosis in breast cancer (BC). The aim of this study was to evaluate of value of HER2 as a prognostic marker, and to analyze associations with common histopathological parameters in BC cases. Materials and Methods: Between of 2007 to 2014, 260 patients with BC referred to Oncology Clinic provided cancer tissue samples which underwent immunohistochemistry (IHC) for markers. ER and PR positivity was defined as ≥10% positive tumor cells with nuclear staining. HER2-positive was defined as either HER2 gene amplification by fluorescent in situ hybridization (FISH) or scored as 3+ by IHC. For HER2 (2+), FISH was performed to determine HER2 positivity. Results: The mean age at diagnosis for the patients with HER2-negative was significantly higher than in HER2-positive cases. Also, there were significant correlations between histological grade, nuclear grade, lymph node metastasis, tumor size, ER status, PR status, p53 overexpression and Ki-67 index with HER2 expression. HER2-negative lesions were of higher grade and more likely to be ER-negative, PR-negative, p53-positive, lymph node metastasis, with a tumor size<2cm and also Ki-67≥20% as compared to the HER2-positive group. Conclusions: Contrary to the results of other studies, HER2-positive tumors in our study had a lower Ki-67 index and were p53-positive. Also, Ki-67 proliferation index ≥20% in more studies was associated with p53-positive.Therefore, tumors which are HER2-positive and have a Ki-67≥20% had a more aggressive behavior compared to HER2-positive and Ki-67<20% lesions.
Glomangiosarcoma is a rare malignant mesenchymal tumor. Despite malignant histopathological feature of glomangiosarcoma, metastasis was observed extremely rare in these tumors. Moreover, malignant glomus tumor with stomach origination and simultaneous metastasis to liver and lymph nodes were not reported so far. This report presented a 57-year-old male patient with an exophytic gastric glomangiosarcoma in lesser sac and simultaneous liver and lymph node metastasis.
Background:Recurrent breast cancer (BC) after initial treatments is usually associated with poor outcome. The objective of this study is to evaluate baseline characteristics of BC patients to determine their prognostic influence of recurrences.Materials and Methods:In this retrospective study of 481 BC patients, 182 patients who had recurrence within the first, second, or third 5 years after diagnosis were included in the study. The significant prognostic factors associated with late or very late recurrence were selected according to the Akaike Information Criterion. Early recurrence was defined as initial recurrence within 5 years following curative surgery irrespective of site. Likewise, late recurrence was defined as initial recurrence after 5 years. Also, very late recurrence was defined as initial recurrence after 10 years.Results:During the follow-up period, 182 recurrences occurred (local recurrence or distant metastasis). All patients were treated with chemotherapy and radiotherapy and the patients with estrogen receptor (ER)- or progesterone receptor (PR)-positive had hormone therapy. There was a significant correlation between histological grade and receptors status with recurrence. In binary logistic regression analysis, ER and PR were significant prognostic factors for early recurrence.Conclusion:High histological grade and immunohistochemical markers (ER- and PR-negative or human epidermal growth factor receptor 2-positive) are risk factors for recurrence, especially in early recurrence and also between of them, ER is the more significant prognostic factor in early recurrence.
Background: Anemia is a key indicator of malignancy risk and iron deficiency anemia (IDA) is the most considerable contributor, accounting for 50% of all causes of anemia. The present study aimed at evaluating the endoscopic and colonoscopic findings in patients with IDA without gastrointestinal (GI) symptoms. Methods: One-hundred and eighteen patients with IDA were selected for this cross sectional study. IDA was defined according to the world health organization criteria. All patients were assessed by endoscopy and colonoscopy. Results: Out of 118 patients with IDA without GI symptoms, 84 patients (71.2%) were older than 50 years and 40 patients (33.9%) were male. According to colonoscopy reports, colon cancer was prominent finding in 10.2% of patients and based on Endoscopic findings, gastritis (16.9%). Of 20 gastritis patients, 19 patients were tested for Helicobacter pylori (H. pylori) that was positive in 13 patients (68.4%). Out of 12 patients with colon cancer, 8 patients (66.7%) were males and 4 (33.3%) of them were females (P = 0.030) that the most common cancers were right-side colons and well differentiated adenocarcinoma. Conclusions: Colon cancer in male patients with IDA has significant risk and asymptomatic patients with IDA have an increased risk of gastric and colorectal neoplasia and should undergo examination of the upper and lower GI tract. Also, gastritis with H. pylori can positively associate with colon and gastric cancers in patients with IDA. Further studies are necessary to assess the association between IDA and risk of malignancy.
While histologic and immunohistochemistric examinations revealed no toxicity in all G-CSF-injected eyes, significant ERG changes were observed in all doses except for the dose of 30 µg/0.1 ml.
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