Efficacy of Duloxetine on electrodiagnostic findings of Paclitaxel-induced peripheral neuropathy, does it have a prophylactic effect? A randomized clinical trial.

This study aimed to evaluate the efficacy of Duloxetine on electrodiagnostic findings of Paclitaxel-induced peripheral neuropathy in patients with breast cancer. This randomized, double-blind clinical trial was conducted on 40 patients with breast cancer who received Paclitaxel as their first chemotherapy session. All the patients were randomly allocated into two groups, intervention (20 subjects) and placebo (20 subjects). The intervention group received 30 mg duloxetine/day in the first week, followed by 60 mg (twice daily) until 8 weeks. The patient neurotoxicity questionnaire (PNQ) was used to evaluate the severity of neuropathy. Nerve conduction study was also performed. The evaluations were performed at the baseline and 8 weeks after the treatment. Out of 20 subjects in the placebo group, 10 (50%) patients had neurotoxicity (two milds, three moderate, four severe, and one incapacitated), according to PNQ. However, in the duloxetine group, two patients had mild neurotoxicity ( P = 0.03). Significant differences between groups related to the mean of Median Sensory Latency ( P <0.001), Median Motor Latency ( P < 0.001), and Median Motor velocity ( P = 0.001) were reported. However, the relative risk of polyneuropathy between the two groups (relative risk: 1) was not significant. Regarding the results, duloxetine could be an effective treatment for preventing paclitaxel-induced peripheral neuropathy in patients with breast cancer, and an electrodiagnostic study confirmed this effect.

Concomitant Up-Regulation of Hsa- Mir-374 and Down-Regulation of Its Targets, GSK-3ß and APC, in Tissue Samples of Colorectal Cancer.

BACKGROUND: The WNT-pathway is involved in several cancers, including colorectal cancer (CRC). Many cell signaling components and pathways are controlled by microRNAs. The main purpose of the present study was to investigate the expression of hsa-miR-374, and its two target genes of the Wnt-pathway in CRC clinical samples. METHODS: In this study, we predicted the miRNAs targeting key genes of WNT-pathway using bioinformatics algorithms. The expression levels of hsa-miR-374, APC and GSK-3ß on 48 pairs of Formalin-Fixed Paraffin-Embedded (FFPE) CRC tumors and marginal-tumors were evaluated using real time-PCR. Additionally, the hsa-miR-374a-5p precursor sequence was amplified by whole-blood DNA as a template. This amplicon was cloned into pEGFP-c1 expression vector and transfected into SW742 cells. Aside from this, MTT assay was performed to evaluate the effect of miR-374 on cell viability. RESULTS: The bioinformatics analysis indicated that hsa-miR-374 binds to the regulatory region the key components of WNT-pathway, including APC and GSK-3ß considering the recognition elements and mirSVR scores. Our results revealed significant down-regulation of GSK-3ß (0.94 times, p= 0.0098) and APC (0.96 times, p= 0.03) and up-regulation of miR-374 (1.22 times, p= 0.0071) on tumor samples compared with their normal pairs. Meanwhile, the results of the over-expression of miR-374 showed down-regulation of APC and GSK-3ß. MTT-assay also indicated that the miR-374 increased cell survival. CONCLUSION: The results of our study indicated a concomitant change in the expression of miR-374 and its two related target genes, in clinical samples of CRC. Hsa-miR-374 might be as a helpful biomarker or therapeutic target in CRC.

Spiritual care interventions in nursing: an integrative literature review.

As an important part of the holistic care, spiritual care is considered an indicator of care quality. This study aims to identify and characterize nursing spiritual care interventions. In order to identify and select resources, an integrative review was done. The search was conducted in national and international databases such as Google Scholar, Scopus, INML, Iran Medex, Iran Doc, Web of Science, Wiley, SID, ProQuest, Ovid, Science Direct, PubMed, ebrary, Sage, CINAHL, and Magiran from 1994 to 2018. As a result, 1625 articles were detected, 59 of which were included in synthesis. Data extraction and analysis presented eight categories of spiritual care interventions in the field of nursing including (1) the exploration of spiritual perspective, (2) healing presence, (3) the therapeutic use of self, (4) intuitive sense, (5) patient-centeredness, (6) meaning-centered therapeutic interventions, (7) the creation of a spiritually nurturing environment, and (8) the documentation and evaluation of spiritual care.

Incidence Trend of Gastrointestinal Cancer in Markazi, in the Center of Iran, Population-Based Cancer Registry Results: 2010-2014.

BACKGROUND: Gastrointestinal cancers are considered as the most common type of cancer among men and the second most common cancer in women after breast cancer in Iran. This study was performed to investigate the epidemiology of gastrointestinal cancer in Markazi Province. METHODS: This is an epidemiological study in which data was gathered from the population-based cancer registry program in the Markazi province of Iran during the years 2010-2014. Data were recorded in Excel software and coded based on ICD-O. All cases out of Markazi provinces were excluded from study, and cases with code C-15-C20 were included in this study. Stata 11 was used to analyze the data. RESULTS: In this study, 2975 new cases of gastrointestinal cancer in Markazi province were included in the analysis. The highest number of cancers was stomach (with 1595 cases), followed by colorectal cancer (980 cases), esophageal cancer (318 cases), and finally small bowl cancer (82 cases). The mean age of gastro-intestinal cancer diagnosis was 65.07 years. The results showed that with increasing age, the incidence of gastro-intestinal cancers increased, and in all sites and both sexes, the highest incidence of gastro-intestinal cancer was in the age group above 70 years. In both sexes, the age specific rate of stomach cancer was higher than other sites (with highest incidence in 2013) followed by colorectal cancer, esophageal cancer, and small bowl cancer. CONCLUSIONS: The results showed similar incidence rate of gastrointestinal cancer in Markazi province to other provinces in Iran. This study found that stomach cancer is the most common cancer in the Markazi province; therefore, identifying effective and preventing factors is necessary.

The effect of applying Spiritual Care Model on well-being and quality of care in cancer patients.

PURPOSE: The study was an attempt to explore the effect of applying spiritual model of nursing care on spiritual well-being and quality of spiritual care in cancer patients. METHOD: A quasi-experimental study, the present inquiry was carried out with control and intervention groups with participation of 72 patients and 63 nurses in an advanced center in Iran. The Spiritual Care Model (SCM) was designed by the researchers in this study and was performed on the intervention group by nurses after they received proper training. The data were collected using Demographic Information Questionnaire, Spiritual Well-Being Scale (SWBS), and Spiritual Care Delivery Rating Scale (SCDRS) in pre-intervention and post-intervention stages and were analyzed with SPSS v.16. RESULTS: Before the intervention, the means for spiritual well-being and the quality of spiritual care were not significantly different for the intervention and control groups (p < 0.05). After the intervention, i.e., upon discharge from the hospital, the mean of spiritual well-being in the intervention group was significantly higher than that of the control group (p < 0.001). Based on the opinions of both nurses and patients, the mean of the spiritual care quality was significantly higher in the intervention group in comparison to that in the control group once the intervention was over (p < 0.001). CONCLUSION: Given the positive effect of the SCM on enhancing the spiritual care quality and improving the patients' spiritual well-being, it is recommended that the SCM be used as a proper guideline and as a model for boosting nurses' professional performance in spiritual care.

The Relationship Between rs3212986C>A Polymorphism and Tumor Stage in Lung Cancer Patients.

Background The nucleotide excision repair (NER) system is one of the most important deoxyribonucleic acid (DNA) repair mechanisms and is critical for chemotherapy resistance. We conducted the present study to investigate the association between two polymorphisms of excision of repair cross-complementing group 1 (ERCC1), the key component of the NER pathway, and the clinicopathological features of patients with non-small cell lung cancer (NSCLC). Methods A total of 38 patients with confirmed NSCLC were included in our study. DNA was extracted from peripheral blood. ERCC1 rs3212986 (8092) and rs11615 (118) were genotyped using molecular assays including polymerase chain reaction (PCR) with restriction fragment length polymorphism (by MboII and HpyCH4 enzymes) and sequencing. Results The PCR results indicated the correct performance of the genomics extraction and molecular protocols. The distribution of C/C, C/A and A/A genotypes at position 8092 was 42.10%, 47.36%, and 10.52% respectively (P=0.03). Multivariate regression analysis showed that there was a significant correlation between C8092A (rs3212986) polymorphism and metastasis, grade of the tumor, and response to treatment. Individuals carrying the rs3212986 CA genotype and A allele had a significantly worse response to the treatment. Also, the correlation between alteration at this genomics location and patients with NSCLC who used to smoke cigarettes was positive. However, no significant association was detected between rs11615 C118>T polymorphism and demographic characteristics of patients with NSCLC. Conclusion We concluded that in lung cancer patients there is a relationship between tumor stage and rs3212986C>A polymorphism.

Evaluation of Splicing on X-box Binding Protein Transcript in Tissue Samples of Colorectal Cancer.

Background The genetic etiology of colorectal cancer (CRC) is the occurrence of mutation in the genes involved in signal transduction pathways including that of cellular responses to endoplasmic reticulum (ER) stress. This study examines alterations of pre-messenger ribonucleic acid (pre-mRNA) splicing in X-box binding protein (XBP) transcripts related to the ER stress pathway in CRC. Materials and methods In this study, samples were deparaffinized and underwent RNA extraction. A total of 30 synthesized complementary deoxyribonucleic acid (cDNA) templates from the extracted RNAs related to tumor and non-tumor CRC samples, collected over three years and containing pathological data, were subjected to semi-quantitative reverse transcriptase polymerase chain reaction (sqRT-PCR). These cDNA templates were amplified in reaction tubes with specific primers for both spliced and non-spliced isoforms of XBP. Results with P< .05 were considered statistically significant. Results Microscopic assessment represented lymphocyte-rich effusion in tumor samples. sqRT-PCR electrophoresis results showed spliced and non-spliced forms of XBP messenger RNA in the studied samples. In addition, our data showed there were more than 7.8 times the total number of spliced variants in the marginal tumor samples than in the tumor tissue samples (P<.05). Conclusion Alterations of expression in genes involved in stress signaling pathways in cancer have been identified previously. Our results showed an inverse relationship between XBP splicing and CRC tumor tissue, possibly lead to the inactivation of apoptosis in the downstream response to ER stress. However, we propose that the remaining genes in this pathway should undergo gene expression analysis using a greater number of samples.

Association of rs1042522 SNP with Clinicopathologic Factors of Breast Cancer Patients in the Markazi Province of Iran.

BACKGROUND: The nucleotide changes in different genetic loci increased the incidence risk of breast cancer. AIM: The aim of present study was to investigate genotype distribution at codon 72 of the TP53 gene (rs1042522) in breast cancer patients to achieve a potential diagnostic marker related to some demographic feathers. METHODS: In our case-control study, blood samples were collected from a total of 34 patients harboured breast cancer. DNA was extracted, and nested-PCR was performed. Products were digested with AccII and subsequently were sequenced. Results were compared with samples characteristics. RESULTS: The PCR results indicated the correct implementation of extraction and amplification protocol. The genotypic distribution at codon 72 of TP53 in control group was 20%, 62.4% and 16.6% for Arg (wildtype), Arg/Pro (heterozygous) and Pro (homozygous variant) respectively. Also, this distribution in the patient group was 23.52% homozygous, 50% heterozygous, and 26.47% another homozygous variant (Adjusted odds ratio: 1.12 and 95%CI = 0.57 to 2.2, P = 0.03). The absence of Arg at codon 72 of TP53 is relevant with age higher than 40 years and metastasis to other organs. CONCLUSION: Polymorphism at codon 72 of TP53 was associated with high-grades of breast cancer risk and different responses to chemotherapy treatment. It is recommended genotype distribution of codon 72 of TP53 before chemotherapy.