Burden of Breast Cancer in the Arab World: Findings from Global Burden of Disease, 2016.

Epidemiology of breast cancer in the Arab region is understudied as compared with Western countries. We aimed to examine breast cancer epidemiology in Arab countries from 1990 to 2016. We analyzed the Global Burden of Disease, 2016 data for breast cancer among women in 22 Arab countries. Epidemiological measures including incidence, mortality, and disability adjusted life years (DALYs) were analyzed for breast cancer in women from 1990 to 2016. We also measured the burden of breast cancer stratified by the sociodemographic index (SDI). Our analysis indicates that the incidence of breast cancer in Arab women has risen over the past 26 years, but is still lower than global averages. In 2016, there were 45,980 new cases (28/100,000) and 20,063 deaths (11/100,000) in the region. The burden of breast cancer as estimated by DALYs was also lower than the global rates and tended to increase with increasing SDI. Although some studies have reported that Arab women present with breast cancer at a younger age, our analysis of age-specific rates, indicates that this is not statistically significant. Our findings indicate that a comprehensive plan to improve public awareness, screening, diagnosis, and treatment is required to reduce the growing burden of breast cancer in the Arab world.

Basal Ganglia Calcification in Psychiatric Inpatients: A Case-Control Study.

BACKGROUND AND OBJECTIVE: Several case reports have noted basal ganglia calcification (BGC) as an incidental radiologic finding in patients presenting with psychiatric manifestations. In this study, we examined the clinical correlates of mental disorders in two groups of psychiatric patients, one with BGC and one with normal radiologic studies. METHODS: In a retrospective cross-sectional case-control study of patients admitted to the psychiatric ward in Al Ain Hospital between January 2011 and December 2013, we compared all 15 patients diagnosed with BGC and 30 control patients who had normal radiologic findings. RESULTS: The BGC group's psychiatric symptoms began when they were aged in their 30s and 40s, later than the controls' 20s and 30s (P=0.001). More of the BGC group than the controls had cognitive symptoms (60% versus 6.7%, P=0.001). The BGC group was more likely to have chronic medical comorbidities (66.7% versus 20%, P=0.003). The BGC group's mean serum calcium was lower than the controls' (P=0.003) and the C-reactive protein was higher (P=0.049). We did not find significant differences between the groups in psychiatric diagnoses; five of the 15 patients with BGC had mood disorders and four of the 15 had psychotic disorders. CONCLUSIONS: Patients with BGC tend to develop psychiatric symptoms later in life than other psychiatric patients, and have higher rates of medical comorbidities. Many patients with BGC have cognitive symptoms, which can be concurrent with a mood or psychotic disorder.

Deficiency of mitochondrial modulator MCJ promotes chemoresistance in breast cancer.

Despite major advances in early detection and prognosis, chemotherapy resistance is a major hurdle in the battle against breast cancer. Identifying predictive markers and understanding the mechanisms are key steps to overcoming chemoresistance. Methylation-controlled J protein (MCJ, also known as DNAJC15) is a negative regulator of mitochondrial respiration and has been associated with chemotherapeutic drug sensitivity in cancer cell lines. Here we show, in a retrospective study of a large cohort of breast cancer patients, that low MCJ expression in breast tumors predicts high risk of relapse in patients treated with chemotherapy; however, MCJ expression does not correlate with response to endocrine therapy. In a prospective study in breast cancer patients undergoing neoadjuvant therapy, low MCJ expression also correlates with poor clinical response to chemotherapy and decreased disease-free survival. Using MCJ-deficient mice, we demonstrate that lack of MCJ is sufficient to induce mammary tumor chemoresistance in vivo. Thus, loss of expression of this endogenous mitochondrial modulator in breast cancer promotes the development of chemoresistance.

Burden of virus-associated liver cancer in the Arab world, 1990-2010.

Hepatocellular carcinoma (HCC) is amongst the top three cancer causes of death worldwide with hepatitis B and C viruses (HBV/HCV) as the main etiological agents. An up-to-date descriptive epidemiology of the burden of HBV/HCV-associated HCC in the Arab world is lacking. We therefore determined the burden of HBV/HCV- associated HCC deaths in the Arab world using the Global Burden of Disease (GBD) 2010 dataset. GBD 2010 provides, for the first time, deaths specifically attributable to viral-associated HCC. We analyzed the data for the 22 Arab countries by age, sex and economic status from 1990 to 2010 and compared the findings to global trends. Our analysis revealed that in 2010, an estimated 752,101 deaths occurred from HCC worldwide. Of these 537,093 (71%) were from HBV/HCV-associated HCC. In the Arab world, 17,638 deaths occurred from HCC of which 13,558 (77%) were HBV/HCV-linked. From 1990 to 2010, the burden of HBV and HCV-associated HCC deaths in the Arab world increased by 137% and 216% respectively, compared to global increases of 62% and 73%. Age-standardized death rates also increased in most of the Arab countries, with the highest rates noted in Mauritania and Egypt. Male gender and low economic status correlated with higher rates. These findings indicate that the burden of HBV/HCV-associated HCC in the Arab world is rising at a much faster rate than rest of the world and urgent public health measures are necessary to abate this trend and diminish the impact on already stretched regional healthcare systems.