Background Westernization and etiologic heterogeneity may play a role in the rising breast cancer incidence in Asian American (AA) women. We report breast cancer incidence in Asian-origin populations. Methods Using a specialized Surveillance, Epidemiology, and End Results-9 Plus API Database (1990–2014), we analyzed breast cancer incidence overall, by estrogen receptor (ER) status, and age group among non-Hispanic white (NHW) and AA women. We used age-period-cohort models to assess time trends and quantify heterogeneity by ER status, race and ethnicity, and age. Results Overall, breast cancer incidence increased for most AA ethnicities (Filipina: estimated annual percentage change [EAPC] = 0.96%/year, 95% confidence interval [CI] = 0.61% to 1.32%; South Asian: EAPC = 1.68%/year, 95% CI = 0.24% to 3.13%; Chinese: EAPC = 0.65%/year, 95% CI = 0.03% to 1.27%; Korean: EAPC = 2.55%/year, 95% CI = 0.13% to 5.02%; and Vietnamese women: EAPC = 0.88%/year, 95% CI = 0.37% to 1.38%); rates did not change for NHW (EAPC = -0.2%/year, 95% CI = -0.73% to 0.33%) or Japanese women (EAPC = 0.22%/year, 95% CI = -1.26% to 1.72%). For most AA ethnicities, ER-positive rates statistically significantly increased, whereas ER-negative rates statistically significantly decreased. Among older women, ER-positive rates were stable for NHW and Japanese women. ER-negative rates decreased fastest in NHW and Japanese women among both age groups. Conclusions Increasing ER-positive incidence is driving an increase overall for most AA women despite declining ER-negative incidence. The similar trends in NHW and Japanese women (vs other AA ethnic groups) highlight the need to better understand the influences of westernization and other etiologic factors on breast cancer incidence patterns in AA women. Heterogeneous trends among AA ethnicities underscore the importance of disaggregating AA data and studying how breast cancer differentially affects the growing populations of diverse AA ethnic groups.
Purpose/Objective: Stroke caregivers face many challenges after a family member experiences stroke. Because caregivers play such a crucial role in health care, there is a need for more interventions in webbased formats that focus on caregiver psycho-education and skills building. A pilot study was devised to determine the feasibility, acceptability, and value of an active, 4-week telephone and web-based intervention for stroke caregivers. Method/Design: A one-group, pretest-posttest design with a mixed-methods approach was used. Qualitative data supplemented the quantitative findings. Community-dwelling caregivers of stroke patients were recruited from the Veterans Health Administration. Quantitative data were collected pre and postintervention. Semistructured interviews were completed with a subsample of caregivers to capture more detail about the acceptability and value of the intervention. Results: Ninety-three caregivers were recruited; 72 caregivers completed the intervention and 21 withdrew (77% completion rate). From pre-to posttest, caregiver depression (p = .008) and caregiver burden (p = .013) decreased. Problem-solving abilities and health-related quality of life showed no change. Seventy-eight percent of caregivers rated the intervention sessions with the nurses as very helpful or extremely helpful, and 76% reported using the problem-solving strategies a moderate amount to extremely often. Interviews suggest that the intervention was valuable and led to new strategies to relieve stress and prioritize health. Conclusions/Implications: The intervention was feasible to implement and acceptable to caregivers. This intervention shows promise for fulfilling a need for more web-based interventions that focus on skills building and psycho-education, but more rigorous testing is needed to determine effectiveness. Impact and ImplicationsThere is a shortage of active, tailored interventions for family stroke caregivers that focus on skills building and psychoeducation that can also be delivered in telehealth formats and accommodate caregivers' busy lives. An intervention was developed to meet these needs, with the goal of reducing caregiver depressive symptoms and caregiver burden. Theoretically grounded in stress and coping theory and using a systematic approach to problem-solving, we offer a brief yet comprehensive intervention to reduce
Leukocytoclastic vasculitis can be an uncommon and/or underreported adverse event of immune checkpoint inhibitor therapy, an established cancer treatment option. Differentiation among other cutaneous manifestations of adverse medication reactions—such as Stevens–Johnson syndrome, erythema multiforme, and drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome—is crucial for guiding management.
As formalin-fixed, paraffin-embedded (FFPE) tissue is being utilized for next-generation sequencing (NGS) in research and clinical settings, we conducted a study through the Surveillance, Epidemiology and End Results (SEER)-Linked Virtual Tissue Repository (VTR) Pilot Program to determine the quality of sequencing data obtained using FFPE-derived DNA and RNA. Forty-eight pancreatic ductal adenocarcinoma (PDAC) patients, comprising 24 case-control pairs based on survival time (≥5 years [cases] vs <24 months [controls]), were selected. Participating SEER registries obtained selected diagnostic tissue blocks collected clinically and stored for 4-18 years. DNA and RNA were extracted from the FFPE specimens for 36 patients (18 pairs). Whole genome (WGS) and whole exome sequencing (WES) were performed on tumor and normal DNA from 16 patients, and a methylation array was conducted on tumor DNA from 6 of these patients. RNA-Seq was conducted on tumor RNA from 36 patients. The median coverage depths for tumor were above 300x for WES and 60x for WGS. However, the majority of sequencing reads (>60%) were duplicates. Concordant mutations (SNVs, MNVs and indels) were >50% by WGS and WES from the majority of samples (n=11, 69%), and the most common discordant mutations were C>T. On average, mutant allele frequencies (MAFs) were 20% in coding regions and 15% across the whole genome, consistent with tumor content as measured by methylation analysis for five tumor samples (18%, 22%, 28%, 42%, and 50%). WES and/or WGS revealed that specimens for five of 27 PDAC subjects tested had a high fraction of variants overlapping with germline variants in dbSNP (≥20%), indicating that tumor cellularity was low among these samples. TP53, KRAS, CDKN2A, SMAD4, and RNF43 were the most frequently mutated genes from these specimens, consistent with genes reported in studies using fresh frozen tissue. Point mutations comprised most of the gene variants, and indels were found in CDKN2A, SMAD4, and RNF43. Most of the mutation status (e.g. missense, nonsense or indels) were concordantly called by WES and WGS (e.g., 81% for TP53, 100% CDKN2A, 94% SMAD4, and 94% RNF43). Most discordant calls were mutations identified by WES but not WGS (e.g., 8 [50%] for KRAS and 3 [19%] TP53). All samples yielded RNA-Seq reads with <30% exonic mapping, 39% (14) of which had <10% exonic mapping. Our study provided important evidence for NGS applications on DNA and RNA from archival PDAC FFPE tissue specimens stored for up to 18 years. These findings demonstrate that, with sufficient tumor content and coverage depth, FFPE-derived DNA is adequate for identifying somatic driver gene mutations in PDAC patients and that the it is feasible to utilize the population-based, SEER-Linked VTR as an infrastructure for obtaining diagnostic tissue for molecular studies. Citation Format: Yao Yuan, Alison Van Dyke, Valentina Petkov, Alyssa Tuan, Aatur Singhi, Lynn Matrisian, Lola Rahib, John Pearson, Katia Nones, Nicola Waddell, Yongmei Zhao, Tsai-wei Shen, Bao Tran, Jyoti Shetty, Elizabeth Gillanders, Danielle Carrick, Rosemary Cress, Lloyd Mueller, Brenda Hernandez, Charles Lynch, Thomas Tucker, Xiao-Cheng Wu, Lynne Penberthy. Evaluation of next generation sequencing of DNA and RNA from archival formalin-fixed, paraffin-embedded pancreatic cancer tissue: A pilot study of the SEER-linked virtual tissue repository [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 224.
objective of this work is the translation into Portuguese, adaptation to Brazilian culture and validation of the "IBD Disk" in Brazil. Methods: Adults patients with inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC) were recruited from January 2020 to March 2021, in follow-up at a reference center in IBD in Brazil. Sworn translations and retro-translations of the "IBD Disk" were performed and all parameters were analyzed by a committee composed of 3 physicians and a nutritionist who work with IBD, all fluent in the English language. Results: The translation and back-translation of the "IBD Disk" was carried out, with agreement between the sworn translators. In the final stage, the general assessment of the comprehensibility of all the items in the tool was high. The quality and adequacy indicators showed excellent adequate values. The IBD-Disk was evaluated for its reliability and reliability. The item-total correlation coefficients ranged from 0.518 to 0.750, considered ideal (reference .0.3). The total instrument presented Cronbach's alpha of 0.921 and composite reliability of 0.881, values above the cut-off point, therefore considered satisfactory. Conclusion(s):The Portuguese version of IBD-Disk is a reliable and valid tool to assess disability in Brazilian IBD patients.
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