Experiences of Family Communication and Cascade Genetic Testing for Hereditary Cancer in Medically Underserved Populations-A Qualitative Study.

We sought to explore the intrafamilial communication and cascade genetic testing (CGT) experiences of patients with hereditary cancer from diverse, medically underserved populations and their relatives. Participants included patients receiving oncology care at an urban, safety net hospital in Texas or comprehensive cancer center in Alabama and their first-degree relatives. In-depth semi-structured qualitative interviews were completed wherein patients shared their experiences with genetic counseling (GC), genetic testing (GT), and communicating their results to relatives. Relatives shared their experiences receiving information from the patient and considering CGT. Interviews were transcribed, coded, and themes were identified. Of 25 participating patients, most recalled key aspects of GC and their GT results. Most (80%) patients shared their results with relatives, but only some relatives underwent CGT; patients reported low perceived susceptibility to hereditary cancer as a common barrier to CGT for their relatives. Of 16 participating relatives, most reported feeling distress upon learning the patient's GT results. Relatives were fearful of learning their own CGT results but identified prevention and early detection as CGT benefits. Interviews identified opportunities during family communication to improve relatives' perceived susceptibility to hereditary cancer. Tailored resources may support patients and relatives experiencing distress and fear during GT. PREVENTION RELEVANCE: This study of intrafamilial communication and cascade genetic testing experiences of patients with hereditary cancer and their relatives from diverse, medically underserved populations identified relatives' perceived susceptibility to hereditary cancer risks, distress, and fear as frequent reactions and barriers to testing. These results may inform future hereditary cancer prevention efforts.

Nutritional Parameters, Biomass Production, and Antioxidant Activity of Festuca arundinacea Schreb. Conditioned with Selenium Nanoparticles.

Festuca arundinacea Schreb. is a widely used type of forage due to its great ecological breadth and adaptability. An agricultural intervention that improves the selenium content in cultivated plants has been defined as bio-fortification, a complementary strategy to improve human and non-human animals' nutrition. The advancement of science has led to an increased number of studies based on nanotechnologies, such as the development of nanoparticles (NPs) and their application in crop plants. Studies show that NPs have different physicochemical properties compared to bulk materials. The objectives of this study were (1) to determine the behavior of F. arundinacea Schreb. plants cultivated with Se nanoparticles, (2) to identify the specific behavior of the agronomic and productive variables of the F. arundinacea Schreb. plants, and (3) to quantify the production and quality of the forage produced from the plant (the bioactive compounds' concentrations, antioxidant activity, and the concentration of selenium). Three different treatments of SeNPs were established (0, 1.5, 3.0, and 4.5 mg/mL). The effects of a foliar fertilization with SeNPs on the morphological parameters such as the root size, plant height, and biomass production were recorded, as well as the effects on the physicochemical parameters such as the crude protein (CP), lipids (L), crude fiber (CF), neutral detergent fiber (NDF), acid detergent fiber (ADF), carbohydrates (CH), the content of total phenols, total flavonoids, tannins, quantification of selenium and antioxidant activity 2,2'-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), and 2,2-diphenyl-1-picrylhydrazyl (DPPH). Significant differences (p < 0.05) were found between treatments in all the response variables. The best results were obtained with foliar application treatments with 3.0 and 4.5 mg/mL with respect to the root size (12.79 and 15.59 cm) and plant height (26.18 and 29.34 cm). The F. arundinacea Schreb. plants fertilized with 4.5 mg/L had selenium contents of 0.3215, 0.3191, and 0.3218 mg/Kg MS; total phenols of 249.56, 280.02, and 274 mg EAG/100 g DM; and total flavonoids of 63.56, 64.96, and 61.16 mg QE/100 g DM. The foliar biofortified treatment with a concentration of 4.5 mg/mL Se NPs had the highest antioxidant capacities (284.26, 278.35, and 289.96 mg/AAE/100 g).

Treatment with intermittent calcitriol and calcium reduces bone loss after renal transplantation.

BACKGROUND: Bone loss occurs during the first 6 months after renal transplantation (RT), and corticosteroid therapy plays an important role. Although calcium plus vitamin D administration prevents corticosteroid-induced osteoporosis, its use in RT recipients is limited by the risk of hypercalcemia. METHODS: This double-blind, randomized, and controlled prospective intervention trial examined the effect of intermittent calcitriol (0.5 microg/48 h) during the first 3 months after RT, plus oral calcium supplementation (0.5 g/day) during 1 year with calcium supplementation alone. The primary outcome measure was the change in bone mineral density (BMD) at 3 and 12 months after RT; we also explored whether the effect of calcitriol on BMD was different among vitamin D receptor (VDR) genotypes (BsmI). Forty-five recipients were randomized to calcitriol therapy (CT) and 41 were randomized to placebo (PL). RESULTS: Both groups had a similar degree of pre-existing hyperparathyroidism (197 +/- 229 vs. 191 +/- 183 pg/mL), but a more pronounced decrease of parathyroid hormone (PTH) levels after RT was observed in CT patients (at 3 months: 61.4 +/- 42.2 vs. 85.7 +/- 53.1 pg/mL, P= 0.02; at 12 months: 67.3 +/- 33.7 vs. 82.6 +/- 37 pg/mL; P= 0.08). CT patients preserved their BMD at the total hip significantly better than those on PL (3 months: 0.04 +/- 3.3 vs. -1.93 +/- 3.2%, P= 0.01; 12 months: 0.32 +/- 4.8 vs. -2.17 +/- 4.4%, P= 0.03); significant differences were noted at the intertrochanter, trochanter, and Ward's triangle. Differences did not reach significance at the femoral neck. Two CT patients (4.4%) and 4 PL patients (9.8%) developed a hypercalcemic episode during the first 3 months after RT. The effect of CT on BMD at 3 months was more prominent in recipients with the at-risk allele of the VDR gene (P= 0.03). CONCLUSION: Therapy with low-dose calcium supplements during 1 year, plus intermittent calcitriol for 3 months after RT, is safe, decreases PTH levels more rapidly, and prevents bone loss at the proximal femur; a more pronounced effect is seen in recipients with at least one at-risk allele of the VDR genotype.