فهرست مطالب

  • Volume:13 Issue: 6, 2020
  • تاریخ انتشار: 1399/04/16
  • تعداد عناوین: 7
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  • Mahsa Ahadi, Motahareh Heibatollahi, Sara Zahedifard* Page 1
    Background

    Breast cancer is the most prevalent neoplasm diagnosed in Iranian women.

    Objectives

    The current study was performed to measure the hormone receptor status and its possible connection with the patient’s age, tumor size, histological grade, and lymph node status and involvement in patients with invasive ductal breast cancer (IDBC)

    Methods

    A total of 103 women with IDBC recently diagnosed at the Department of Pathology of Shohada-E-Tajrish Hospital were entered into this study. The mean age of the patients was 48.4 years, and 59.2% of cases were 50 years old or less.

    Results

    Most lesions (78.6%) were more than 2 cm at their greatest dimension. Grade-II lesions were observed in a large number of patients and 59.8% of cases had lymph node involvement. Positive ER, PR, and HER-2/neu were detected in 59%, 57%, and 29% of patients, respectively. A significant correlation was found between patients’ age and histologic score, tumor dimension and both histologic score and nuclear grade, and, finally, between lymph node involvement and nuclear grade.

    Conclusions

    According to previous studies, the evaluation of hormone receptor status in patients with breast cancer is strongly recommended. Here, by studying its possible connection with the patient’s age, tumor size, histological grade, and lymph node metastasis, we detected some biomarkers, which could be used as prognostic indices in these patients. These biomarkers could help us in the clinical management of patients with IDBC by providing the best therapeutic options.

    Keywords: Breast Cancer, Estrogen Receptor (ER), Progesterone Receptor (PR), Human Epidermal Growth Factor Receptor-2 (HER2), Proliferation Marker Ki-67
  • Kourosh Zarea, Maryam Rassouli, Maryam Hazrati, Shahram Molavynejad, Samira Beiranvand * Page 2
    Background

    There is an increasing demand for Hospice Palliative Care (HPC) due to the aging population, increased incidence of cancer, and other chronic diseases, as well as recent advances in care and treatment.

    Objectives

    The present study was conducted to examine the nature and structure of HPC services and to describe and compare them in the United Kingdom (UK), Canada, Australia, Japan, India, Jordan, and Iran to extract general conclusions and suggestions for developing HPC systems in Iran.

    Methods

    In the current descriptive-comparative study, from 2018 to 2019, HPC delivery systems in the selected countries and Iran were reviewed based on the World Health Organization (WHO) guideline, and the similarities and differences among them were explained.

    Results

    Developing the National HPC Program and its integration into the health system are important activities. The most common source of financing is donation. The services are mainly provided to patients with cancer. Human resource development includes curriculum reform, creating specialty, subspecialty disciplines, and holding training courses. Other activities include designing national guidelines, the free access to opioids, research development, the establishment of the national information network, and the quality control programs. Iran lacks any formal structure and program of HPC services and they are provided in a scattered and very limited manner as part of general palliative services.

    Conclusions

    HPC services are in a mediate and low level in developed countries and Iran, respectively. Before the establishment of the HPC delivery system, a complicated range of economic, social, cultural, and political factors must be considered.

    Keywords: Hospice Palliative Care, End-of-Life, Delivery System, Service
  • Foroogh Eshaghi, Haniyeh Bashi Zadeh Fakhar *, Masood Ghane, Javad Shokry Page 3
    Background

    Different types of Streptococcus gallolyticus are associated with malignant bowel cancer.

    Objectives

    The aim of this study was to compare two culture and molecular methods in identifying Streptococcus gallolyticus in patients with colon diseases.

    Methods

    A descriptive study was conducted to detect Streptococcus gallolyticus in 55 patients with colon diseases referring to hospitals in Babol and Chalus, Iran. A polymerase chain reaction and culture technique were performed. Detection of Streptococcus gallolyticus after deoxyribonucleic acid (DNA) extraction from designed primers (PCO3, PCO4) was used for SODA gene. From the general culture medium, brain heart infusion (BHI) broth and specific medium for bacterial growth and detection were used. Then, the characteristics of the two methods were evaluated.

    Results

    Of 55 biopsy samples of patients with colon diseases, 3 samples (5.5%) with 95% confidence interval were positive and 52 (94.5%) were reported negative in terms of DNA of Streptococcus gallolyticus. According to the culture test, 9 (16.4%) were positive and 46 (83.6%) were negative for diagnosis of Streptococcus gallolyticus bacteria. Based on the diagnostic agreement between the two methods, the ratio of 9 positive cases of culture method to 3 positive cases by polymerase chain reaction (PCR) method (3.6%) were reported positive both in terms of molecular and positive culture, and 7 (12.7%) out of 9 (16.4%) were negative. To investigate the agreement between the culture and PCR methods, the Kappa test was used, which was statistically significant (P < 0.015). Other studies which have been conducted using the culture method, reported a significant relationship between the family history of colorectal cancer, diabetes, and the presence of Streptococcus gallolyticus bacteria.

    Conclusions

    Considering the advantages, disadvantages, and the characteristics of both methods, none of them can be considered as a comprehensive, standard test at present. The simultaneous use of the two methods is recommended in cases where achieving fast results prevails, or when there is a likelihood of sample infection or late-growing microorganisms.

    Keywords: PCR, Culture, Streptococcus gallolyticus, Colon Diseases
  • Farzad Allameh, Morteza Fallah Karkan, AmirHossein Rahavian, Bahram Mofid, Samira Azghandi, Amirreza Abedi *, Abbas Basiri, Saeed Montazeri Page 4
    Background

    At present, there is a lack of evidence concerning urinary complications caused by intensity-modulated radiation therapy (IMRT) used for the management of prostate cancer (PCa).

    Objectives

    This study aimed at identifying the nature and severity of post-IMRT urinary symptoms in patients with PCa.

    Methods

    This prospective study was performed with consecutive patients, who had clinically localized PCa (cT1c-cT2c) and had undergone IMRT treatment from 2016 to 2019. At 1, 6, and 12 months of follow-up, medical history, physical information, prostate-specific antigen values, International Prostate Symptom Score (IPSS), medication use, Radiation Therapy Oncology Group (RTOG), acute and late toxicity, and Q max were collected.

    Results

    A total of 127 patients with a mean age of 71.04 ± 7.1 years received IMRT and underwent 12 months of follow-up. The mean IPSSs at baseline versus those at 1, 6, and 12 months after IMRT was 14.5 ± 6.8 versus 13.3 ± 6.1, 12.3 ± 5.3, and 10.4 ± 4.2, respectively (P < 0.000). The mean prostate volume was 38.2 ± 12.1 cc. At the last follow-up, 31 patients (24.4%) took genitourinary (GU) medications.

    Conclusions

    This study showed that the majority of GU side effects caused by primary IMRT for PCa treatment are transient. Treatment triggered an acute increase in obstructive urinary symptoms, which peaked during the first month after IMRT. In most patients, in the course of 6 months, symptoms returned to baseline.

    Keywords: Quality of Life, Prostate Cancer, IPSS, Intensity-Modulated Radiation Therapy, Genitourinary Toxicities
  • Arghavan Etebarian, Mohamadreza Moravej * Page 5
    Introduction

    Plasma cell tumors are monoclonal neoplastic proliferation of plasma cells which are divided into three groups: solitary bone plasmacytoma (SBP) and extramedullary plasmacytoma (EMP) which are localized forms, and multiple myeloma (MM) which is the disseminated form. Skull, long bones, and vertebrae are common sites for SBP and its presence in maxillofacial area is rare. There is a possibility that SBP converts to MM and some authors believe that it can be the early stage of MM.

    Case Presentation

    Here, we present a 59-year old male patient with a mass in maxillary bone enlarging after tooth extraction. Cone beam computed tomography (CBCT) confirmed the existence of a poorly defined lesion in the left maxilla. The microscopic evaluation and immunohistochemical studies confirmed the diffuse and monoclonal population of cells, indicating the diagnosis of plasma cell tumor. There was also no evidence of bone marrow involvement in the aspiration.

    Conclusions

    Early and precise diagnosis of SBP is a crucial element to rule out the possibility of MM. It must be kept in mind that there is possibility of recurrence or progression to MM after treatment which can completely change the course of disease, and this emphasizes the importance of regular follow up.

    Keywords: Multiple Myeloma, Maxilla, Plasma Cell Tumors, Solitary Bone Plasmacytoma
  • MirHossein Aghaei, Zohreh Vanaki *, Eesa Mohammadi Page 6

    Palliative care is one of the most basic care approaches for providing care to patients with life-threatening illnesses. Applying theories in palliative care provision results in such cares’ development and organization and guides health care providers in this direction. One of the caring theories that can be focused on palliative care is Watson’s human caring theory, which despite its applicability in palliative care, has not been studied much. Thus, this study aimed at assessing how to use this theory in palliative care that can be applied to health care providers in all clinical specialties and societies with different cultures.

    Keywords: Palliative Care, Human Caring, Jean Watson Theory
  • Davood Soroosh, Seyed Alireza Javadinia* Page 7