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At least 631 records · Page 35Linked to original sources
PubMed2003

[Neuro-immune interactions in psychopathology with the example of interferon-alpha-induced depression].

The use of interferon (IFN)-alpha for the treatment of viral diseases or cancers is associated with neuropsychiatric side effects in a large number of patients. The mechanisms by which cytokines induce these symptoms, as well as the vulnerability factors for these effects, have not been yet fully elucidated. Systematic clinical studies, combining biochemical approaches, functional brain imaging and treatment intervention, have been initiated to better understand the phenomenology, pathophysiology, and preventive strategies of the neuropsychiatric effects of IFN-alpha in patients with malignant melanoma or chronic hepatitis C. The findings indicate differential phenomenology and treatment responsiveness of the neurovegetative and mood/cognitive symptoms induced by IFN-alpha, suggesting distinct underlying mechanisms. Impaired neuroendocine function, fronto-striatal dysfunction and decreased monoamine were found to contribute to the pathophysiology of core symptoms of IFN-alpha-induced depression, including symptoms of mood alterations, cognitive dysfunction, anhedonia and psychomotor retardation. In addition, some behavioral and biological markers of the vulnerability for IFN-alpha-induced depression were identified. These findings provide important information concerning the relationship between cytokines and depression.

Depression↗
PubMed1998

Aspects of altered metabolism in children with cancer.

Severe weight loss associated with cancer continues to be a major cause of morbidity in cases of childhood malignancy. The etiology is not completely understood but is probably multifactorial, including reduced ingestion and altered metabolism of nutrients. Changes in the host metabolism of protein, fat and carbohydrate in the cancer-bearing host have been demonstrated both in animal models and in patients. Changes include increased protein turnover and loss of the normal compensatory mechanisms seen in starvation. Additionally, increased lipid breakdown results in depletion of lipid stores and changes in carbohydrate metabolism result in an energy-losing cycle. The increase in protein turnover seen in children with leukemia may be related to the tumor, the chemotherapy administered or to related conditions such as febrile neutropenia. The role of endogenous mediators of cancer cachexia has not yet been clearly elucidated, although tumor necrosis factor, interleukin I and interleukin 6 appear to be involved. Studies of energy expenditure in children with cancer have indicated that certain patients with a raised metabolic rate are at particular risk of severe weight loss. The challenge is to identify these vulnerable patients and to provide adequate nutritional support early in treatment and therefore avoid the deleterious effects of cachexia.

Animals↗
PubMed1999

Neurodevelopmental outcome of infants with acute lymphoblastic leukemia: a Children's Cancer Group report.

BACKGROUND: Infants diagnosed with acute lymphoblastic leukemia (ALL) are considered the patient subgroup at the highest risk for central nervous system (CNS) disease, both at presentation and as an isolated extramedullary relapse. In addition, they are highly vulnerable to adverse developmental sequelae from CNS-directed therapy. METHODS: Thirty patients younger than 12 months at diagnosis (12 males, 18 females) in first hematologic remission were evaluated after completion of ALL therapy (mean age = 62.1 months; standard deviation = 17.2 months; range = 38-102 months). CNS-directed treatment included very high dose infusions of methotrexate (MTX) and intrathecal cytarabine and MTX. Three patients had meningeal leukemia that required additional therapy. Children were administered the McCarthy Scales of Children's Abilities, and parents completed a sociodemographic questionnaire to obtain information about occupation and education. RESULTS: Mean scores on all 6 cognitive and motor indices of the McCarthy Scales were in the average range (Verbal = 52.0; Perceptual = 53.6; Quantitative = 49.6; General Cognitive Index [GCI] = 102.1; Memory = 49.2; Motor = 51.0). Score distributions for each neurodevelopmental index were comparable to age-based population standards. One patient obtained a GCI that exceeded 2 standard deviations above the mean; none scored more than 2 standard deviations below. There was no report of developmental disabilities or neurologic disorders for any of the patients. Risk factors, including age at diagnosis, gender, additional CNS-directed treatment, and family socioeconomic status, were not associated with developmental outcome. CONCLUSIONS: Test findings indicated a generally positive neurodevelopmental outcome for ALL patients diagnosed in infancy who were treated with very high dose MTX as CNS-directed therapy. Combined with the reduction in the isolated CNS relapse rate achieved by the Children's Cancer Group (CCG) clinical trial CCG-107, the results of this study represent a substantial improvement in neurodevelopmental outcome for very young patients compared with infants treated for ALL in the past.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Carotid artery resection for head and neck cancer.

BACKGROUND: Carotid artery resection has been shown to yield a chance of cure in patients with advanced head and neck carcinoma involving the carotid artery. However, the criteria for the identification of those who are vulnerable to neurologic injury after resection have not been established. Interposition grafting may minimize the risk of neurologic morbidity, although it is technically difficult when there is involvement of the internal carotid artery close to the skull base. METHODS: We studied 24 patients with head and neck tumor involvement of the carotid artery. We performed carotid artery resection in 16 of them, including 10 in whom the carotid artery was reconstructed with interposition grafts covered with muscle flaps. When it was thought that the reconstruction would be difficult, positron emission tomography was performed during balloon test occlusion of the internal carotid artery to assess the adequacy of hemispheric collateral blood flow before carotid resection. In one patient with interposition graft, carotid rupture occurred as a result of wound infection, but none of the other patients experienced perioperative death, persistent hemiplegia, or delayed stroke. RESULTS: Twelve patients have survived longer than 8 months, and seven (43.8%) were alive without disease at 12 months after resection, whereas all four patients who could not be treated operatively died within 8 months as a result of local primary tumors. CONCLUSIONS: Carotid artery resection is the only therapy offering any potential for cure or palliation. Positron emission tomography is a rapid quantitative means of determining the cerebral blood flow, particularly when resection is planned without reconstruction.

Aged↗
PubMed2001

Health effects of tobacco use and exposure.

Tobacco is still widely consumed in a variety of different ways, mainly as smokeless tobacco and cigarette smoking. Four traits characterize tobacco use whatever the way of using it: 1) addiction linked to nicotine is behind all the tobacco hazards; 2) individual variation in tobacco susceptibility; 3) dose-response relationship; 4) time-lag effect. Smokeless tobacco, chewed or snuffed can lead mainly to inflammation of the oral cavity and oral cancers. Cigarette smoking accounts for 65-85% of global tobacco consumption. Active smoking can cause: 1) respiratory disorders culminating in chronic obstructive pulmonary disease (COPD) and emphysema; 2) cardiovascular hazards by way of increased vascular spasm and atherosclerosis leading to acute and chronic myocardial events, cerebral and peripheral vascular diseases; 3) cancers: twelve types are caused or related to cigarette smoking. Lung cancer is still the leading cause of cancer death in most high-income countries where data are available. An excess mortality is associated with smoking, with a 2-fold greater risk in smokers than in nonsmokers throughout middle age. The exposed pregnant woman subjects herself and her pregnancy to risks, and her fetus to growth retardation and perinatal morbidity and mortality. Passive smoking implicates 20-80% of the whole population. It can be nearly as harmful as active smoking depending upon risk factors, and can lead to short as well as to long-term effects. Children are the most vulnerable population particularly during the first years of life. Passive smoking increases risks for higher and lower respiratory tract illness but a smoke-free environment improves all these disorders. Ischemic heart diseases and lung cancer are the main risks for non smoking adults exposed to cigarette smoke. Tobacco use and exposure is the single most important source of preventable morbidity, disability and premature mortality. But giving up smoking helps at any time, the sooner the better. Health professionals should be the key advocates in tobacco prevention.

Female↗
PubMed2002

Women's experiences with ovarian cancer: reflections on being diagnosed.

The purpose of this qualitative study was to describe the perspectives of women living with ovarian cancer about their experiences with diagnosis, treatment, and follow-up care. A convenience sample of 18 women was interviewed using an open-ended interview guide. This paper will focus on their perspectives during the peri-diagnostic period. Most of the women in this study experienced changes in their bodies--bloating, weight gain around their middles, indigestion, bowel changes, and abdominal pain. The vagueness of the symptoms and lack of awareness by the women and, in the women's opinion, health care professionals caused delays in diagnosis and initial investigations of other body systems. The symptoms were often dismissed by the women as being related to normal body changes such as childbirth, menopause, or stress responses. It was often not until the women's symptoms became severe or included pain that referrals were made to relevant specialists. At this point, many of the women were physically and emotionally spent, leaving them vulnerable and in a weakened state for confronting the diagnosis and coping with the difficult course of treatment. Clearly, the subtle, nebulous nature of the symptoms confounded the diagnosis of ovarian cancer for these women, resulting in patient delays and physician delays.

Adult↗
PubMed1996

Stress and quality of life following cervical cancer.

Significant progress has been made in understanding the psychologic and behavioral aspects of cervical cancer. Descriptive data indicate acute trauma and disruption with the diagnosis and treatment, yet the majority of women return to precancer life. The notable exception to this is sexual functioning, which remains an area of significant morbidity. Future research will need to test variables that predict which women will be vulnerable to sexual dysfunction. Sexual self-concept (sexual self-schema), which is the extent to which a woman has a positive view of her own sexuality, appears to provide valuable information. The identification of such variables is an important step toward designing interventions for enhancing quality of life for patients with cervical cancer.

Female↗
PubMed2006

Self-esteem: a hidden concern in oral health.

Little is known about the impact of oral health on self-esteem. The purpose of this descriptive study was to identify the frequency of low self-esteem in vulnerable persons who received oral health care at an academic nursing center. Participants (N = 86) completed the Index of Self-Esteem (Hudson, 1982b), answered open-ended questions concerning oral health care practices, and participated in an oral health examination. We found that 53% demonstrated low self-esteem, 67% (n = 58) had minor dental problems, and 33% (n = 28) had major dental problems. Oral health problems were ranked in importance along with cancer, diabetes, high blood pressure, and asthma. Oral hygiene included no tooth brushing, infrequent tooth brushing, flossing, chewing gum, and using mouth wash. This study emphasizes the roles of the community health nurse in assessing oral health (particularly among a vulnerable population), advocating for policy change, and providing education.

Adult↗
PubMed2001

Smoking cessation in cancer prevention.

Tobacco smoking is the largest preventable risk factor for morbidity and mortality in industrialized countries. WHO estimates that tobacco will become the largest single health problem by 2020, causing an estimated 8.4 million deaths annually. Tobacco has central importance in the etiology of cancers of the lung, head and neck, urinary tract, and pancreas. Reducing the number of young people who take up smoking and helping those who have started to smoke to quit the habit are the key ways of preventing these cancers. Tobacco- or nicotine-dependence is a common, chronic, relapsing medical condition. Studies of twins have implicated genetic factors in most of the differences in vulnerability to tobacco smoke and in the persistence of the smoking phenotype. The available interventions for reducing tobacco use and treatment for nicotine dependence offer public health officials and clinicians the greatest single opportunity for disease prevention. Five medications -- nicotine chewing gum, nicotine patches, nicotine inhalers, nicotine nasal sprays and bupropion -- and behavioural therapy appear to be both effective and safe: they double the quitting rates and are associated with a dropout rate due to adverse events of less than 5%.

Antidepressive Agents, Second-Generation↗
PubMed1999

A study of postdiagnosis breast cancer concerns for women living in rural and remote Queensland. Part II: Support issues.

This paper presents the recent findings from a study on the postdiagnosis support needs of women with breast cancer living in rural and remote Queensland. The findings presented in this discussion focus on support needs from the perspective of the women experiencing breast cancer as well as health service providers. The tyranny of distance imposes unique hardships, such as separation from family and friends, during a time of great vulnerability for treatment, the need to travel long distances for support and follow-up services, and extra financial burdens, which can combine to cause strains on the marital relationship and family cohesion. Positive indications are, however, that the rural communities operate on strong, informal networks of support. This network of family, friends and community can, and does, play an active role in the provision of emotional and practical support.

Adult↗
PubMed2001

[Known methods can reduce tobacco dependence drastically].

Tobacco smoking is the largest preventable risk factor for morbidity and mortality in industrialized countries. WHO estimates that tobacco will become the largest single health problem by 2020, causing an estimated 8.4 million deaths annually. Tobacco has central importance in the etiology of cancers of the lung, head and neck, urinary tract, and pancreas. Reducing the number of young people who take up smoking and helping those who have started to smoke to quit the habit are the key ways of preventing these cancers. Tobacco- or nicotine-dependence is a common, chronic, relapsing medical condition. Studies of twins have implicated genetic factors in most of the differences in vulnerability to tobacco smoke and in the persistence of the smoking phenotype. The available interventions for reducing tobacco use and treatment for nicotine dependence offer public health officials and clinicians the greatest single opportunity for disease prevention. Five medications--nicotine chewing gum, nicotine patches, nicotine inhalers, nicotine nasal sprays and bupropion--and behavioural therapy appear to be both effective and safe: they double the quitting rates and are associated with a dropout rate due to adverse events of less than 5%.

Antidepressive Agents, Second-Generation↗
PubMed2005

Novel role of p53 in maintaining mitochondrial genetic stability through interaction with DNA Pol gamma.

Mitochondrial DNA (mtDNA) mutations and deletions are frequently observed in cancer, and contribute to altered energy metabolism, increased reactive oxygen species (ROS), and attenuated apoptotic response to anticancer agents. The mechanisms by which cells maintain mitochondrial genomic integrity and the reason why cancer cells exhibit more frequent mtDNA mutations remain unclear. Here, we report that the tumor suppressor molecule p53 has a novel role in maintaining mitochondrial genetic stability through its ability to translocate to mitochondria and interact with mtDNA polymerase gamma (pol gamma) in response to mtDNA damage induced by exogenous and endogenous insults including ROS. The p53 protein physically interacts with mtDNA and pol gamma, and enhances the DNA replication function of pol gamma. Loss of p53 results in a significant increase in mtDNA vulnerability to damage, leading to increased frequency of in vivo mtDNA mutations, which are reversed by stable transfection of wild-type p53. This study provides a mechanistic explanation for the accelerating genetic instability and increased ROS stress in cancer cells associated with loss of p53.

Cell Line, Tumor↗
PubMed2004

Telomere length mediates the effects of telomerase on the cellular response to genotoxic stress.

Telomerase inhibition may be a novel anti-cancer strategy that can be used in combination with conventional therapies, such as DNA damaging agents. There are conflicting reports as to whether and to what extent telomerase and telomere length influence the sensitivity of cells to genotoxins. To understand the relationship between telomere length, telomerase expression, and sensitivity to genotoxic stress, we expressed the catalytic subunit of telomerase, hTERT, in human fibroblasts having different telomere lengths. We show that telomerase confers resistance to ionizing radiation, bleomycin, hydrogen peroxide, and etoposide only in cells with short, presumably near-dysfunctional, telomeres. This resistance depended on the ability of telomerase to elongate the short telomeres, and telomerase did not protect cells with long telomeres. Interestingly, although long telomeres had no effect on sensitivity to etoposide and bleomycin, they exacerbated sensitivity to hydrogen peroxide, supporting the idea that, compared to other types of DNA damage, telomeres are particularly vulnerable to oxidative damage. Our findings identify a mechanism and conditions under which telomerase and telomeres affect the response of human cells to genotoxic agents and may have important implications for anti-cancer interventions.

Antineoplastic Agents↗
PubMedDate not supplied

Self-esteem, social support, and mental health in survivors of testicular cancer: a comparison based on relationship status.

Testicular cancer is the most frequent malignancy in men between 20 and 40 years of age. This is a period in life in which important life events take place, such as starting a career and establishing a relationship. The goal of the study was to explore self-esteem, social support, and mental health in 3 groups of survivors of testicular cancer: singles, those with the same partner as at diagnosis (relationship during testicular cancer), and those with a partner they met after completion of treatment (relationship after testicular cancer). A total of 129 survivors completed the Social Support List, the Rosenberg self-esteem scale, and the subscale mental health of the RAND-36. Mean time since diagnosis for single survivors was 8.3 years (range 1-23), for survivors with a relationship during testicular cancer 9.3 years (range 1-24), and for survivors with a relationship after testicular cancer 13.6 years (range 1-24). Levels of social support were equal in groups, but satisfaction with support was not. Survivors with a relationship during testicular cancer were most satisfied with support, and had the highest self-esteem and mental health. Survivors with a relationship after testicular cancer reported the next best levels of functioning but had the same mental health as singles. Singles and survivors with a relationship established after testicular cancer had a lower mental health than a reference group of men. The difference in self-esteem between singles and survivors of testicular cancer with a relationship during testicular cancer appeared most distinct and was clinically relevant. Mental health was predicted by different factors for the 3 groups. Being single at diagnosis seems to cause a vulnerability that remains when survivors do develop a relationship after treatment is completed because these groups are at risk for a lower mental health.

Adult↗
PubMed1997

Assessment and management of chemotherapy-induced mucositis in children.

Oral mucositis is one of the most common side effects of cancer treatment. The oral mucosa is comprised of membranes of a high mitotic index with rapid epithelial turnover and maturation rates. This causes the mucosa to be vulnerable to the adverse effects of chemotherapy. Chemotherapy alters the integrity of the mucosa, the microbial flora which normally inhabit the oral cavity, salivary quantity and composition, as well as the epithelial maturation. As a result, the child receiving chemotherapy may experience significant pain, dysphagia, alteration in nutritional status, and risk of infection. Severe mucositis can also delay therapy that may compromise the child's treatment and chance for cure. Not all chemotherapy-induced mucositis can be prevented. However, with proper management, the severity and duration of oral complications can be minimized.

Antineoplastic Agents↗
PubMed2006

Albinism in Africa as a public health issue.

BACKGROUND: Oculocutaneous albinism (OCA) is a genetically inherited autosomal recessive condition and OCA2, tyrosine-positive albinism, is the most prevalent type found throughout Africa. Due to the lack of melanin, people with albinism are more susceptible to the harmful effects of ultraviolet radiation exposure. This population must deal with issues such as photophobia, decreased visual acuity, extreme sun sensitivity and skin cancer. People with albinism also face social discrimination as a result of their difference in appearance. The World Health Organization is currently investigating the issues concerning this vulnerable population. METHODS: Systematic electronic search of articles in PubMed concerning albinism in Africa. Furthermore, a World Health Organization (WHO) pilot survey of albinism was drafted in English, French and Portuguese, and distributed to African countries through WHO African Regional Offices (AFRO) in an attempt to gather further information on albinism. RESULTS: Epidemiologic data on albinism, such as prevalence, were available for South Africa, Zimbabwe, Tanzania and Nigeria. Prevalences as high as 1 in 1,000 were reported for selected populations in Zimbabwe and other specific ethnic groups in Southern Africa. An overall estimate of albinism prevalences ranges from 1/5,000-1/15,000. In addition, both the literature review and the survey underscored the medical and social issues facing people with albinism. CONCLUSION: The estimated prevalence of albinism suggests the existence of tens of thousands of people living with albinism in Africa. This finding reiterates the need for increased awareness of and public health interventions for albinism in order to better address the medical, psychological and social needs of this vulnerable population.

Africa↗