Interface between obesity with dysfunctional metabolism and inflammation, and the triple-negative breast cancer in African American women.

Obesity has dramatically increased over the past fifty years. In the last decade, it has been noted that augmented body mass, metabolic abnormalities, and the relevant "obese" tumor microenvironment (TME) are connected with signaling molecular networks, which in turn, may contribute to aggressive tumor biology in some patients with breast malignancies. This article presents the associations between obesity, metabolic derangements, inflammatory processes in the adipose tissue or TME, and aggressive behavior of triple-negative breast cancer (TNBC) in African American (AA) women. It also describes some abnormal molecular signaling patterns in the "obese" TME with relevance to TNBC biology. Ethnic disparities in TNBC can be due to a variety of biological features (e.g., genetic mutations and tumor heterogeneity), comorbidities (e.g., cardio-metabolic diseases, including diabetes mellitus), and reproductive factors (e.g., multiparty or short breastfeeding period). Such a constellation of biological variables potentially leads to the association between obesity, metabolic derangements, inflammatory processes in the adipose tissue or TME, and aggressive behavior of TNBC in AA women. Since the TNBC and its TME can display very aggressive behavior, it is crucial that the afflicted AA women make efforts to maintain healthy body weight, "flexible" metabolism, and a well-functioning immune system. Further studies are merited to explore the multi-disciplinary factors that can affect TNBC prevention, management, and outcomes to optimize treatment strategies and survival among AA women.

Diseases of the oral cavity in light of the newest epigenetic research: Possible implications for stomatology.

Epigenetics is the study of inheritable changes in gene expression without changes in the underlying deoxyribonucleic acid (DNA) sequence. The main mechanisms of epigenetic regulation include DNA methylation, modifications in histones, and micro-ribonucleic acids (miRNA). Recent research evidence has shown that environmental and lifestyle factors dynamically interact with the genome, influencing epigenetic changes, from development to the later stages of life. This happens across a spectrum, from physiological to pathological conditions, such as genetic defects, developmental disorders, infectious or inflammatory processes, cancers, mental disorders, and substance abuse. Epigenetic studies have been conducted in various medical disciplines (e.g., oncology, internal medicine or psychiatry), adding valuable insight to standard medical approaches. However, in stomatology, epigenetic research is still in its infancy; thus, this review is aimed at presenting the role of epigenetic mechanisms in diseases of the oral cavity, including periodontal diseases, caries, developmental anomalies, and oral carcinoma. In addition, this paper reveals new insights into epigenetic biomarkers that can be helpful in the detection, early diagnosis, prognosis, and treatment of different oral diseases. Moreover, this review is focused on the possible clinical implications (diagnostic and therapeutic) of epigenetics, in the form of some noninvasive methods that can possibly be used in the future for the screening, work-up, outcome prediction and novel treatments of some dental diseases. Finally, this paper highlights that an epigenetic approach can be useful for designing novel interventions that will improve the management of oral malignancies or developmental abnormalities.

Hypertriglyceridemia - Common Causes, Prevention and Treatment Strategies.

BACKGROUND: Prevention and treatment of dyslipidemias represent the key issues of Cardiovascular Disease (CVD) prophylaxis. Consequently, the effective management of different types of lipid disorders, including hypertriglyceridemia, should be a priority for the healthcare practitioners (e.g.: cardiology and endocrinology specialists, primary care physicians, dietitians, and pharmacists), who provide medical care, as well as for the patients, who receive this care, and need to be directly engaged in it, in order to improve their outcomes. The aim of this review is to facilitate the translation of current trends in hypertriglyceridemia management into a daily practice. The article focuses on the common causes and consequences of hypertriglyceridemia, and discusses diagnostic evaluation and therapeutic options for patients with high Triglyceride (TG) levels and CVD risk. CONCLUSION: This review presents the main practice-related strategies, based on the current guidelines for the management of dyslipidemias and CVD risk, according to the European Society of Cardiology (ESC), the European Atherosclerosis Society (EAS), and the American College of Cardiology (ACC)/American Heart Association (AHA), including both non-pharmacological, and pharmacological approaches. It also addresses the beneficial impact of pharmaceutical Care (PC) interventions on clinical outcomes of patients with lipid disorders and CVD risk (in light of Randomized Controlled Trials (RCT) data), and underlines the importance of close cooperation between physicians and pharmacists, who manage such patients.

Care of cancer patients with liver and bone metastases - the place of pharmaceutical care in a balanced plan, focused on the patient's needs and goals.

Metastatic cancer, especially in the growing population of geriatric patients, presents a big challenge to these patients, as well as to treatment teams and the entire health care system. This article describes some common medical problems faced by patients with metastases to liver and bone, and presents a diagnostic approach, and therapeutic management of various symptoms, relevant to advanced stages of the malignant disease. The article highlights the importance of patient education on various aspects of metastatic cancer, and underscores the unique position of pharmacists practicing pharmaceutical care, which is particularly beneficial in this group of patients with advanced malignancy. Also, this paper emphasizes that achieving a proper balance between managing the malignant disease and maintaining the patients' quality of life, especially in the elderly population, should involve coordinated efforts of the oncology treatment team, primary care physicians, pharmacists, therapists and nurses, as well as patients, their families and caregivers.

Cardiotoxic effects of radiotherapy and strategies to reduce them in patients with breast cancer: An overview.

Cardiotoxicity of various anticancer therapies, including radiotherapy (RT), can lead to cardiovascular (CV) complications, and their severity depends on many factors, including the site of action, the applied dose, the method of administration, the presence of pre-existing CV diseases, or CV risk factors, the individual patient characteristics, and the current or previous use of antineoplastic therapies. Cardiotoxicity can occur immediately upon administration of the anticancer therapy or it may have a delayed onset (months or years after the treatment). For an oncology treatment team, it is essential that the patients with cancer are in their best cardiac condition before they initiate anticancer therapy, during remission, and after its termination, and thus, a collaboration with cardiologists is of utmost importance. This article reviews cardiotoxicity associated with RT, focusing on patients with breast cancer. In addition, it outlines the main management strategies to assess, monitor, reduce, or possibly prevent RT-induced cardiotoxicity, based on the current research evidence. Medline literature review relating to this subject was performed, using the electronic search for the keywords "radiotherapy" and "cardiotoxicity" on PubMed for inclusion of the previous publications, and further search of reference articles on the detection and management of radiation-related heart disease in patients with breast cancer was conducted.

Benefits of antihypertensive medications for anthracycline- and trastuzumab-induced cardiotoxicity in patients with breast cancer: Insights from recent clinical trials.

Advances in oncologic therapies have allowed many patients with breast cancer to achieve better outcomes and longer survival. However, this progress has been tempered by cardiotoxicity, associated with anticancer therapies, ranging from subclinical abnormalities to irreversible life-threatening complications, such as congestive heart failure or cardiomyopathy. In particular, exposure to chemotherapy (CHT), including anthracyclines and trastuzumab, can lead to cardiac dysfunction with short- or long-term consequences, among patients with breast cancer. The aim of this study is to highlight the potential role of commonly used cardiac medications in the prevention of anthracycline- and trastuzumab-mediated cardiotoxicity, in women with breast cancer, based on evidence from recent clinical trials. This overview is focused on the use of antihypertensive medications, such as angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, outlining their cardioprotective effects in this patient population. In addition, the importance of biomarkers and modern imaging tests, as potential tools for detection and monitoring of cardiac dysfunction, induced by CHT, as well as some practical preventive and therapeutic strategies for cardio-oncology treatment teams, involved in the management of a growing number of women with breast cancer have been outlined. The content of this overview is based on a literature search of PubMed, within the last 5 years, mostly in relevance to the human epidermal growth factor receptor 2-positive patients with breast cancer, treated with anthracycline or trastuzumab therapy (in addition to surgery and/or radiation therapy [RT] regimen).

Novel strategies for Alzheimer's disease treatment: An overview of anti-amyloid beta monoclonal antibodies.

Alzheimer's disease (AD) is a multifactorial, progressive neurodegenerative disorder with a poor prognosis, and thus, novel therapies for AD are certainly needed in a growing population of elderly patients or asymptomatic individuals, who are at risk for AD, worldwide. It has been established that some AD biomarkers such as amyloid-beta load in the brain, precede the onset of the disease, by approximately 20 years. Therefore, the therapy to prevent or effectively treat AD has to be initiated before the emergence of symptoms. A goal of this review is to present the results of recent clinical trials on monoclonal antibodies against amyloid beta, used for the treatment of AD and also to address some of the current challenges and emerging strategies to prevent AD. In recent trials, a monoclonal antibody, i.e. solanezumab has shown some beneficial cognitive effects among mild AD patients. Ongoing studies with gantenerumab and crenezumab will examine when exactly the AD treatment, aimed at modifying the disease course has to be started. This review was based on Medline database search for trials on passive anti-AD immunotherapy, for which the main timeframe was set from 2012 to 2015.

Back and neck pain among school teachers in Poland and its correlations with physical activity.

BACKGROUND: Back pain represents one of the most common diseases across various populations of workers worldwide. This study analyzes the prevalence and severity of back pain, based on selected demographic variables, and the relationship with physical activity among school teachers. MATERIAL AND METHODS: The study included 998 professionally active teachers (840 females and 158 males) from the southern part of Poland. Validated psychometric tools, namely: 1) for evaluation of disability due to back pain - a Polish version of the Oswestry Disability Index (ODI) and Neck Disability Index (NDI), 2) for physical activity assessment - the Subjective Experience of Work Load (SEWL) as well as the authors' supplementary questionnaire, addressing demographic and anthropometric variables were used. RESULTS: There was no correlation between age and the NDI scores in females (r = 0.027), in contrast to males (r = 0.202; p ≤ 0.05). Statistically significant correlations (p ≤ 0.05) were reported between: age and the ODI, in both females (r = 0.219) and males (r = 0.180). No associations between the body mass index (BMI)-ODI, and BMI-NDI were found. In the case of women, disability related to low back pain (LBP) had a negative impact on the indicators of their activity during work, sports, and leisure time. In the case of men, the NDI and ODI scores did not differ, based on activity indicators. CONCLUSIONS: Our findings confirm that back pain represents a serious concern among teachers. Age appears to be a prognostic factor, while no association between the BMI and LBP has been revealed. The limitation of physical activity leads to more frequent back pain.

The prevalence rate of overweight and obesity among adult patient population in Poland, according to the LIPIDOGRAM2004 and LIPIDOGRAM2006 studies, in context of previous Polish national screening surveys.

An increase of the body mass often aggravates cardiovascular risk factors. In Poland, over the past 25 years, some epidemiological studies, focused on body mass disorders were conducted. Their results suggest an increase of the prevalence rate of overweight and obesity. The goal of the studies LIPIDOGRAM2004 and LIPIDOGRAM2006 was to assess the prevalence rate of abnormal body mass among adult patients remaining under the care of family physicians in Poland. 17.065 patients in 2004 and 17.152 in 2006, older than 30 years, recruited by 675 study physicians in 444 sites across Poland, were involved into these studies. It was found that approximately 3/4 of the patients included into these studies had BMI > or = 25 kg/m2. Overweight rate was much more prevalent among men than women (48,0% vs. 39,2% in 2004, p<0,0001; 47,4% vs. 39,7% in 2006, p<0,0001). In 2004, obesity was present in above 30% of the participants, including small, but statistically significant difference in the population of men (32,8% vs. 31,2%, p<0,05). In 2006, an increase in the prevalence of obesity in men, compared to women was reported (34,7% vs. 31,6%, p<0,001). Health care actions aimed at decreasing these phenomena would require targeted efforts of family physicians, in collaboration with a multidisciplinary team of specialists.

Prevention of coronary heart disease in primary medical care in Poland: results from the LIPIDOGRAM study.

AIMS: To determine: (1) achievement of cholesterol therapy goals in patients receiving lipid-lowering drugs in Polish primary care between the years 2004 and 2006; (2) the characteristics of patients that are associated with attainment of these goals. DESIGN: Cross-sectional study in randomly selected Polish primary care practices. METHOD: 5248 patients aged over 30 years in 2004 and 5386 patients in 2006, who were taking cholesterol-lowering treatment took part in the study. Physicians recorded demographic and medical history data using a standardized questionnaire, including weight and height, and collected blood samples of patients to determine their cholesterol level. RESULTS: 18.5% of patients attained their optimal goals of therapy (total cholesterol, TC; low-density lipoprotein cholesterol, LDL-C) in 2004 compared to 25.2% in 2006 (p < 0.001). In both 2004 and 2006, more patients achieved their target levels for LDL-C than for TC and statins were the most commonly used medication (85% and 91%, respectively). Male sex, smoking, and higher education were the strongest correlates of the therapeutic outcome. The odds ratio of achieving cholesterol therapy goals in men, non-smokers, and university graduates was estimated at 1.51, 0.70, 1.38 in 2004 and 1.50, 0.73, 1.34 in 2006, respectively. CONCLUSION: There was a measurable improvement in the effectiveness of hypercholesterolaemia treatment between 2004 and 2006 but the majority of patients remain inadequately treated, with goals not being achieved. There is a need to raise the standard of lipid-lowering management in Poland.

An analysis of factors determining serum leptin concentration in healthy and infected newborns.

OBJECTIVE: The effect leptin on fetal growth in healthy and infected newborns is not well known. This study is aimed at: 1) evaluating serum leptin concentration in full term and preterm, healthy and infected newborns, according to their gender, birth asphyxia, intrauterine and neonatal infections, and 2) assessing the correlation between serum leptin levels and anthropometric parameters among healthy and infected newborns. MATERIALS AND METHODS: The study involved 146 newborns: 73 full-term and 73 preterm, 86 male and 60 female, 56 healthy and 90 infected, aged from 2nd to 4th day of life. Anthropometric parameters, including: birth weight, length, head and chest circumference, and serum leptin concentration were measured in all the subjects. Intrauterine and neonatal infections were diagnosed by the standard criteria. RESULTS: In this study, it was found that both healthy and infected, but full-term newborns had significantly higher mean leptin concentration than the premature ones (p<0.05). Statistically significant (p<0.05), positive correlations were found between serum leptin level and gestational age, birth weight, head and chest circumference, both in healthy, and in infected newborns. CONCLUSIONS: Findings of this study suggest that the serum leptin concentration in full term newborns is higher than in the preterm ones, and in females it is higher than in males, 2) among both healthy and infected newborns, there is a positive, linear correlation between the serum leptin concentration and anthropometric parameters, 3) intrauterine and neonatal infections do not have a significant influence on serum leptin concentration. The role of leptin in fetal growth deserves further research.