Effects of exposure to media messages about limiting breast cancer screening: A qualitative experimental study.

OBJECTIVE: Examine how women aged 35-50 respond to messages about limiting cancer screening. METHODS: A national sample of women aged 35-50 (n = 983) were randomly assigned to read one of four media vignettes: three provided information about potential harms of mammograms using evidence, norms, or an anecdote strategy, and one provided no such information. Participants listed thoughts they had about the message, and after coding these themes, we tested for associations between the themes evoked, message exposure, and mammogram history. RESULTS: Thematic categories included emotions (8 %); behavioral intentions (14 %); and cognitions, attitudes, and beliefs (67 %). Pro-screening attitudes, questioning, and cues to get screened were most prevalent. The anecdote message often elicited pro-screening attitudes, while the evidence message often elicited negative emotions and anger, as well as questioning or skeptical responses. Those with a history of mammograms expressed more pro-screening attitudes and disagreed with the message more often. CONCLUSIONS: Media messaging about guideline-supported care, especially when it involves reducing a clinical service that is routine and valued by patients, may evoke counterarguing, skepticism, and other negative responses. PRACTICE IMPLICATIONS: Clinicians should recognize the role of the media in potentially shaping women's attitudes, beliefs, and intentions when it comes to breast cancer screening.

Nutrition as prevention for improved cancer health outcomes: a systematic literature review.

BACKGROUND: Among adults with cancer, malnutrition is associated with decreased treatment completion, more treatment harms and use of health care, and worse short-term survival. To inform the National Institutes of Health Pathways to Prevention workshop, "Nutrition as Prevention for Improved Cancer Health Outcomes," this systematic review examined the evidence for the effectiveness of providing nutrition interventions before or during cancer therapy to improve outcomes of cancer treatment. METHODS: We identified randomized controlled trials enrolling at least 50 participants published from 2000 through July 2022. We provide a detailed evidence map for included studies and grouped studies by broad intervention and cancer types. We conducted risk of bias (RoB) and qualitative descriptions of outcomes for intervention and cancer types with a larger volume of literature. RESULTS: From 9798 unique references, 206 randomized controlled trials from 219 publications met the inclusion criteria. Studies primarily focused on nonvitamin or mineral dietary supplements, nutrition support, and route or timing of inpatient nutrition interventions for gastrointestinal or head and neck cancers. Most studies evaluated changes in body weight or composition, adverse events from cancer treatment, length of hospital stay, or quality of life. Few studies were conducted within the United States. Among intervention and cancer types with a high volume of literature (n = 114), 49% (n = 56) were assessed as high RoB. Higher-quality studies (low or medium RoB) reported mixed results on the effect of nutrition interventions across cancer and treatment-related outcomes. CONCLUSIONS: Methodological limitations of nutrition intervention studies surrounding cancer treatment impair translation of findings into clinical practice or guidelines.

Cervical Cancer Screening Among Immigrant and Refugee Women: Scoping-Review and Directions for Future Research.

The purpose of this study is to explore existing research on determinants of cervical cancer screening among immigrants and refugees in the U.S. A scoping review was conducted on 77 studies targeting immigrant and/or refugee women in the U.S., investigating factors related to cervical cancer screening. Sixty-three percent of studies were conducted in the past ten years, and included 122,345 women. Studies predominately explored knowledge, beliefs and barriers related to cervical cancer and screening. Common beliefs included fear of cancer, treatment and death. Participants perceived pap smears to be associated with embarrassment, pain and fear. Barriers to screening were reported in three categories: psychosocial (shame and embarrassment), communication (inability to speak in English), and barriers related to access (lack of insurance or primary care provider). Study findings indicate research focused at the individual-level and future research should focus on exploring multilevel influences on cancer screening uptake.

Excited-State Dynamics of Dithienylethenes Functionalized for Self-Supramolecular Assembly.

The photoswitching and competitive processes of two photochromic dithienylethenes (DTEs) functionalized at both sides with 2-ureido-4[1H]-pyrimidone (UPy) quadruple hydrogen-bonding recognition patterns have been investigated with NMR experiments, ultrafast spectroscopy, and density functional theory (DFT) calculations. The originality of these molecules is their ability to form large supramolecular assemblies induced by light for the closed form (CF) species while the open form (OF) species exist as small oligomers. Photochromic parameters have been determined and photochemical pathways have been rationalized with clear distinction between the antiparallel (OF-AP) and parallel (OF-P) species. A new photocyclization pathway via triplet manifold has been evidenced. The effect of the supramolecular assembly on the photochemical response is discussed. Unlike the photoreversion process, which is unaffected by supramolecular assembly, rate constants of the photocyclization reaction and intersystem crossing process are sensitive to the presence of small OF oligomers.

New insights into the photoswitching mechanisms of normal dithienylethenes.

The photoswitching and competitive processes of the referent photochromic diarylethene derivative 1,2-bis(2,4-dimethyl-5-phenyl-3-thienyl)perfluorocyclopentene (DTE) and a novel bridged analog DTE-m5 have been investigated by state-of-the-art TD-DFT calculations and ultrafast spectroscopy supported by advanced chemometric data treatments. Focusing on DTE, the overall deactivation pathway of both antiparallel (AP) and parallel (P) conformers of the open form (OF) (1 : 1 in solution) has been resolved and rationalized starting from the Franck-Condon (FC) region to the ground state recovery. For the photo-excited P conformer, after ultrafast relaxation (∼200 fs) towards the S1 relaxed state, an expected ISC occurred (55 ps) to produce a triplet state, 3P, the latter relaxing within 2.5 µs. Concerning the AP conformer, the photocyclization reaction is reported to proceed immediately (100 fs) starting from the FC region while the relaxed singlet state is populated in parallel. For the first time, we discovered that the latter state evolves through an unexpected ISC process (1 ps) giving rise to a second triplet state,3AP. For DTE-m5, by slightly constraining the molecule with the bridge, this triplet becomes reactive and participates in the formation of 10% of closed form (CF) probably through an adiabatic mechanism. Concerning the photoreversion, in accordance with the literature, we report on a two-step process, a 190 fs vibrational relaxation followed by a 6 ps ring-opening reaction. For the overall species at the singlet or triplet manifold, the use of advanced MCR-ALS allows us to obtain specific spectral signatures. This study is therefore a new step within the comprehension of DTE photochemistry.

Can betaine pyridinium derivatives be used to control the photoejection of cation?

Using a combination of advanced DFT/TDDFT calculations together with ultrafast and stationary spectroscopies we have investigated the photochemistry and cationic complexation ability of 1-pyridinio-benzimidazolate (PyB) and analogs substituted by 15-aza-5-crown (PyB-Aza) or dimethyl-amino groups (PyB-DiMe). Focusing on PyB-Aza, the first aim was to assess the competitive complexation of the imidazole bridge vs. the macrocycle. In acetonitrile, it was found by absorption and emission that the imidazole moiety binds efficiently through lateral electrostatic interaction of high charge density cations and especially Ca(2+) to form a 1 : 1, metal : ligand (M : L) complex. Modulation of the complexation toward para substitution of the phenyl ring with a donor group is reported with values ranging from log K = 3.4 to 6.8. Complexation values are properly predicted by DFT calculations. From a photochemical point of view, for the same series, the trend is parallel to the rate of the photo-release process, found to be less than 200 femtosecond (fs), the fastest photorelease characteristic time reported so far. Unlike photoinduced charge transfer molecules linked with an aza-crown group, the mechanism appears simpler with no participation of loose complexes due to the macrocavity effect. Relaxation mechanisms after cation ejection are discussed as well. Finally, even if any photoinduced translocation of cation is reported for the PyB-Aza molecule between two complexation sites, a discussion about the use of betaine pyridinium as a molecular tool for the smart manipulation of cation systems is initiated.

Traumatic isolated perforation of lower oesophagus.

One of the rarest cases of non-iatrogenic oesophageal perforation is falling from height. We report a case of a 26 year old man with oesophageal perforation resulting from a fall of 12 meter height. A pneumomediastinum in the absence of a pneumothorax and contrast extravasation from the oesophagus on CT evoked a perforation of the aerodigestive tract. No other injuries were seen. A non-operative management was pursued with good outcomes.

[Diagnostic accuracy of Epworth sleepiness scale in the acute phase of myocardial infarction]. / Intérêt du score d'Epworth à la phase aiguë d'infarctus du myocarde.

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is underdiagnosed in cardiologist daily practice, especially in patients with acute coronary syndrome. Its diagnosis is based on a polysomnography study. The Epworth Sleepiness Scale (ESS) stands as a simple and rapid means to select patients for the sleep investigation. AIM: The aim of this study was to determine the diagnostic accuracy of the ESS for screening OSAS in patients with ST elevation myocardial infarction. METHODS: We conducted a prospective study of 120 consecutive patients admitted for acute myocardial infarction, from April 2011 to March 2012. Daytime sleepiness was evaluated using the ESS, when patients were in the intensive care unit. All patients have undergone an overnight sleep study using a portable diagnostic device, in the 15 days following the acute coronary syndrome. The diagnostic of OSA was considered as apnea-hypopnea index (AHI) of ≥5 events/hour, severe OSA was defined as AHI of ≥30. RESULTS: The study included 120 patients comprising 102 men and 18 women. The mean age was 58 ± 12 years. Smoking was the major cardiovascular risk factor with 72% of all patients; prevalence of diabetes was 40% and hypertension was found in 44% of the population. The prevalence of OSA was 79%. Severe OSA was diagnosed in 16% of all patients and mean AHI was 15.76 ± 14.93. Mean ESS was 2.2 ± 1.84 in the global population while it was 5.2 ± 1.2 in patients with severe OSAS. Multivariate analysis showed that ESS score ≥ 4 was an independent predictive factor for severe OSA (OR=28; 95% IC: 8-101; P<0.001). CONCLUSION: The prevalence of OSA in patients with acute myocardial infarction was very high. ESS score ≥ 4 was an independent predictive factor for severe OSA. Despite its subjective feature, the ESS seems to be an interesting score for screening patients to undergo polysomnography.

[Prevalence and predictors of obstructive sleep apnea in patients admitted for acute myocardial infarction]. / Prévalence et facteurs prédictifs du syndrome d'apnée obstructive du sommeil au décours de l'infarctus du myocarde.

BACKGROUND: Obstructive sleep apnea has been implicated in the pathogenesis and aggravation of coronary atherosclerosis. However, it remains underdiagnosed in cardiology practice. AIM: The aim of this study was to determine the prevalence of obstructive sleep apnea and the predictors of severe sleep apnea in patients admitted for ST elevation myocardial infarction. METHODS: This was a prospective study which has included 120 patients hospitalized for ST elevation myocardial infarction, from April 2011 to March 2012. All patients have undergone an overnight sleep study using a portable polygraphy device, in the 15 days following the acute coronary syndrome. The diagnostic of obstructive sleep apnea was considered as apnea-hypopnea index of ≥ 5 events per hour, severe sleep apnea was defined as apnea -hypopnea index of ≥ 30. Subjective daytime sleepiness was assessed by the Epworth sleepiness scale. All patients have had an oxygen saturation monitoring in the coronary care unit using a pulse oxymeter, before undergoing the sleep study. RESULTS: The study population was made up of 102 men and 18 women. The mean age was 58 ± 12 years. Smoking was the major cardiovascular risk factor found in 72% of all patients, diabetes and hypertension were represented in 40% and 44% of the population, respectively. Eighty-seven percent of patients were admitted in the first 24 hours of symptom onset. A primary percutaneous coronary intervention was performed in 60% of cases while fibrinolysis was done in 10% of patients. The prevalence of obstructive sleep apnea was 79%. Mean apnea-hypopnea index was 15.76 ± 14.93 and severe form was diagnosed in 16% of all patients. Multivariate analysis showed that Epworth sleepiness score of ≥ 4 and nocturnal desaturation below 82% were independent predictive factors for severe obstructive sleep apnea. CONCLUSION: Prevalence of obstructive sleep apnea was very high in patients admitted for acute myocardial infarction. Epworth sleepiness score of ≥ 4 and nocturnal desaturation below 82% were independent predictive factors for severe form of sleep apnea.

Clinical and molecular characterization of a combined 17p13.3 microdeletion with partial monosomy 21q21.3 in a 26-year-old man.

We led a clinical and molecular characterization of a patient with mild mental delay and dysmorphic features initially referred for cytogenetic exploration of an azoospermia. We employed FISH and array CGH techniques for a better definition and refinement of a double chromosome aberration associating a 17p microdeletion with partial monosomy 21q due to 1:3 meiotic segregation of a maternal reciprocal translocation t(17;21)(p13.3;q21.2) revealed after banding analysis. Brain MRI depicted partial callosal and mild diffuse cerebral atrophies, but without expected signs of lissencephaly. The patient's karyotype formula was: 45,XY,der(17)t(17;21)(p13.3;q21.2)mat,-21. FISH study confirmed these rearrangements and array CGH analysis estimated the loss sizes to at least 635 kb on chromosome 17 and to 15.6 Mb on chromosome 21. The absence of lissencephaly and major brain malformations often associated with 17p terminal deletions could be attributed to the retention of PAFAH1B1, YWHAE and CRK genes. Dysmorphic features, moderate mental impairment and minor brain malformations could result from the 21q monosomy and particularly the partial deletion of the APP-SOD1 region. Azoospermia should result from gamete apoptosis induced by a control mechanism triggered in response to chromosome imbalances. Our study provides an additional case for better understanding and delineating both 17p and 21q deletions.

Effects of space spray application methods on fenitrothion efficacy and development of resistance in Culex pipiens.

Efficacy of fenitrothion as thermal fogging (TF) or ultra-low volume (ULV) applications against 6 successive generations of caged adult Culex pipiens and subsequent development of resistance in both adults and larvae were investigated in this study. In addition, larval acetylcholinesterase (AChE) activity was measured in each generation. Results indicated that the ULV application method was significantly more effective (P < 0.05) than TF against the adults in all treated generations. Selection pressure of TF and ULV applications on the adults after 5 generations resulted in larval resistance by ratios of 30.92- and 28.18-fold, respectively. A gradual decrease in the larval AChE activity was observed with increasing resistance as generations progressed. The AChE activity of susceptible larvae was higher than that of the F5 resistant generation in TF and ULV treatments by 6- and 8-fold, respectively. The results indicated that both the biological efficacy of fenitrothion and the rapidity of resistance development were affected by the application methods.

New frontiers for the perioperative data method for IOL calculation following corneal refractive surgeries.

PURPOSE: To evaluate the efficiency of the perioperative data method for intraocular lens (IOL) calculation after correction of myopia and hyperopia with different techniques, including reoperated cases. METHODS: Thirty-five eyes (26 patients) that developed cataract after corneal refractive procedures were evaluated retrospectively. They were categorized according to initial error of refraction into myopes and hyperopes and according to types of refractive procedures into ablative, incisional, both, or others. Reoperated cases were also considered. Number of refractive procedures was noted. Time interval between the first procedure and cataract extraction was indicated. Perioperative method was used to calculate the K value. SRK/T formula was used to calculate IOL power. Difference between intended and finally achieved manifest refraction was an indicator for efficiency of the calculation. RESULTS: Postoperatively, 77.2% of cases had manifest refraction +/-1.5 D of intended refraction. There was no difference between myopes and hyperopes in terms of final manifest refraction, best-corrected visual acuity, and difference between intended and finally achieved manifest refraction. Similarly were groups of different types of surgeries. Efficiency of the method decreased with high axial lengths and low IOL powers. Neither the number of refractive surgeries nor time interval between surgeries affected efficiency of the method. CONCLUSIONS: The perioperative data method is equally effective for myopes and hyperopes. The types, numbers of refractive procedures, as well as the time interval between refractive surgery and cataract extraction do not alter the credibility of the method. In high degrees of myopia, the method gives less accurate results.

[MRI and pituitary adenoma]. / IRM et adénomes hypophysaires.

Pituitary is the most important gland of the organism which can be affected by many diseases, especially by adenomatous processes. Classically macroadenoma, microadenoma and picoadenoma are described, according to the size of the pituitary adenoma. The diagnosis of microadenoma was long considered a highly difficult task and that of picoadenoma was impossible by computed tomography. Recently, the high resolution of multiplanar MRI has enabled the diagnosis of microadenomas measuring less than 3 mm (picoadenoma). For macroadenoma, MRI not only contributes to diagnosis but is particularly important to assess the extension and to detect possible complications. The aim of our study is to illustrate MRI features in pituitary adenoma.

[Inflammatory pseudotumor of the spleen and radiopathologic correlation]. / Pseudotumeur inflammatoire de la rate et corrélation radio-anatomopathologique.

Inflammatory pseudotumors of the spleen (IPTS) are rare. We report a case of an IPTS in a 48-year-old woman who was admitted for drug eruption. During her hospitalization, she complained of abdominal pain. Physical examination and laboratory investigations were unremarkable. The abdominal ultrasonography and hepatic MRI detected a heterogeneous mass in the spleen measuring approximately 5 cm in diameter. Partial splenectomy was performed. Histologically, the splenic mass was composed of an admixture of inflammatory cellular elements with hemorrhage and sclerosis, suggestive of an IPTS. The postoperative course was uneventful. The authors attempt to make a radiopathologic correlation of this rare tumor.

Profile of viral hepatitis patients in Dakhliya, Oman.

OBJECTIVE: With the availability of routine serological diagnosis of all the major forms of viral hepatitis, namely, A, B, C, D, E consequent to initiation of National Viral Hepatitis Surveillance, the twin objective of the study was to assess the trend of various types of viral hepatitis and analyze the profile of the patients in the region of Al Dakhliya. METHODS: A one year prospective cohort, of all the suspects of viral hepatitis enrolled from 01/08/2003 to 31/07/2004 involving all health facilities (a total of 18 health institutions) of Dakhliya region, Sultanate of Oman, was subjected to centralized laboratory confirmation. Notification of viral hepatitis confirmed cases was the tool for analysis. A subset of unconfirmed viral hepatitis cases that were admitted and discharged from the referral hospital were retrieved and analyzed utilizing their computerized hospital records. RESULTS: There was a shift of incidence of hepatitis B towards higher age groups (32.4 +/- 16.2 years) with only one case under 15 years of age (p<0.0001). While as under 15 year age group was less prone to hepatitis C (p<0.05), it had a high incidence for hepatitis A with mean age 11.4 +/- 13.9 years (p<0.01). Hepatitis E incidence had a higher mean age of 44.6 +/- 24.1 years with insignificant linear trend (p>0.05). CONCLUSION: Progress in decline of viral hepatitis B has occurred at a rapid pace during the last decade following successful intervention of immunization against hepatitis with an almost 100% coverage. Affliction of younger age groups to hepatitis A is indicative of continued transmission of the disease in the community demanding improvements in preventive practices to curb any impending outbreak.

[Solitary eosinophilic granuloma of the orbit: a case report]. / Granulome éosinophile isolé de l'orbite. A propos d'un cas.

The authors report a case of eosinophilic granuloma involving the roof and the lateral wall of the left orbit in a 5-year-old boy. The clinical presentation and especially the imaging features (computed tomography and MRI) suggested a malignant tumor and the final diagnosis was obtained by fine needle aspiration biopsy with histopathologic examination. Despite its alarming radiologic appearance, there was spontaneous healing of the eosinophilic granuloma with restitution ad-integrum of the bone.

[Neurosarcoidosis as the first manifestation of sarcoidosis: diagnosis difficulty. A case report]. / Problème diagnostique d'une neurosarcoïdose révélatrice. A propos d'un cas.

Clinically apparent involvement of the nervous system occurs in a relatively small number of patients with sarcoidosis. The diagnosis of neurosarcoidosis is often difficult and particularly in patients who lack either pulmonary or systemic manifestations of sarcoidosis. Furthermore clinical and imaging features of neurosarcoidosis are extremely variable. We report a case of neurosarcoidosis which had been considered and treated at first as tuberculosis. Only the occurrence, two years later, of pulmonary manifestations of sarcoidosis enabled the diagnosis.

Pamidronate causes apoptosis of plasma cells in vivo in patients with multiple myeloma.

Anti-resorptive bisphosphonates, such as pamidronate, are an effective treatment for osteolytic disease and hypercalcaemia in patients with multiple myeloma, but have also been shown to cause apoptosis of myeloma cell lines in vitro. In this study, we found that a single infusion of pamidronate, in 16 newly diagnosed patients with multiple myeloma, caused a marked increase in apoptosis of plasma cells in vivo in 10 patients and a minimal increase in four patients (P < 0.05). The nitrogen-containing bisphosphonates pamidronate and zoledronic acid also induced apoptosis of authentic, human bone marrow-derived plasma cells in vitro. Apoptosis of plasma cells in vitro was probably caused by inhibition of the mevalonate pathway and loss of prenylated small GTPases, as even low concentrations (>or= 1 micro mol/l) of zoledronic acid caused accumulation of unprenylated Rap1A in cultures of bone marrow mononuclear cells in vitro. GGTI-298, a specific inhibitor of geranylgeranyl transferase I, also induced apoptosis in human plasma cells in vitro, suggesting that geranylgeranylated proteins play a role in signalling pathways that prevent plasma cell death. Our results suggest that pamidronate may have direct and/or indirect anti-tumour effects in patients with multiple myeloma, which has important implications for the further development of the more potent nitrogen-containing bisphosphonates, such as zoledronic acid, in the treatment of myeloma.