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Impact of Sp3 and BIRC 5 Expression on the Survival of Adrenocortical Carcinoma Patients
No full textSurvivin (also known as baculoviral inhibitor of apoptosis repeat containing 5 or BIRC5) is a member of inhibitor of apoptosis proteins family and linked to the poor prognosis of several cancers. The Specificity protein (Sp) transcription factors Sp1 and Sp3 are known to regulate BIRC5. Even though the role of Sp transcription factors in regulating BIRC5 is known, their correlation among cancer patients’ survival is not evaluated in detail. The purpose of this project was to study the correlation of Sp3 and Birc5 expression with prognosis in adrenocortical carcinoma utilizing the data sets available in The Cancer Genome Atlas (TCGA). Adrenocortical carcinoma (ACC) is a rare and aggressive cancer originating in the adrenal cortex, the outer layer of the adrenal glands. ACC is characterized by the uncontrolled growth of cells in the adrenal cortex, leading to the formation of tumors. These tumors can produce excess hormones, causing various symptoms. ACC is often diagnosed at an advanced stage, and surgical resection is the primary treatment. Prognosis is generally poor, emphasizing the need for improved early detection methods and targeted therapies. Using the TCGA data set comprising 79 samples, the impact of the overexpression of Sp3 or BIRC5 on ACC patient survival was analyzed. Results indicated that survival of patients exhibiting elevated levels of Sp3 or BIRC5 was significantly low (Sp3: p=0.0041; BIRC5: p=0.0001) compared to those with lower expression of these markers. Furthermore, considering sex as a variable, we observed a significant difference in survival for the patients with differential expression of Sp3 and BIRC5 (Sp3: p=0.0015; BIRC5: p= 0.0001). Survival rates were notably low across both female and male patients. Consistent with published literature on other cancer types, our observations revealed a negative impact of BIRC5 and Sp3 overexpression on the survival of ACC patients. Emerging evidence suggests the involvement of genetic and biological factors that may contribute to variations in tumor behavior. This research offers valuable insights into the importance of BIRC5 and Sp proteins in cancer. This may shed light on the identification of high-risk populations based on the expression of these markers and encourage the development of targeted interventions. Effective interventions or targeted therapies can potentially enhance overall survival rates for individuals with cancer by improving management strategies
A Paravaginal Epidermal Inclusion Cyst Presenting as Chronic Bilateral Pelvic Pain
No full textBackground: Epidermal inclusion cysts are benign masses that typically present as subcutaneous nodules with a visible central punctum. These cysts are lined with stratified squamous epithelium and become filled with keratin as they grow below the skin. In the case of unmanaged cyst growth, surrounding structures may be affected, resulting in pain and impairment of bodily function. Epidermoid cysts may be seen anywhere on the body, often coinciding with inflamed hair follicles. These cysts are one of the most common types of vulvar cysts, but are rarely seen originating deep in the paravaginal region. Previous literature has reported a few cases of paravaginal epidermoid cysts, but there is limited clinical information regarding epidermoid cysts without a visible protuberance on physical examination. The lack of reported cases suggests that this clinical presentation is rare. Case Presentation: A 21-year old nulliparous female initially presented to the clinic with chronic bilateral pelvic and lower back pain that started one week prior to her menstrual cycle. The patient reportedly faced similar symptoms for many months with progressive pain and bloating. She disclosed a known history of fibromyalgia, but denied any history of trauma to her pelvic or lower back area. Given the patient’s complaints, the patient was initially treated with a Depo-Provera injection for possible endometriosis and was counseled on further steps if the injection did not provide relief of her symptoms. The patient returned to the clinic months later for evaluation of a pelvic mass found in the emergency department via imaging. The patient stated that the Depo-Provera injection did not alleviate her symptoms and reported additional symptoms of frequent urination, and urinary retention requiring increased effort. Diagnostic imaging revealed an approximately 6 cm x 4 cm tender cystic mass in the left lower pelvis displacing the left posterior wall of the bladder and abutting the rectum. There was no visual distention of the perineum, vulva, or vagina. The unusual location of the cyst concealed its visualization on physical examination, an atypical presentation of a subcutaneous cyst. Surgical excision was performed and pathological analysis revealed a deep epidermal inclusion cyst filled with caseous debris extending into the ischiorectal fossa. Conclusion: This case study examines an unusual presentation of a symptomatic paravaginal epidermal inclusion cyst extending into the ischiorectal fossa without a visual protuberance on examination nor identifiable risk factors such as prior trauma and surgery
Assessment of Digit Skin Temperatures Via Infrared Thermography Under Different Climatic Conditions
No full textThe responsiveness of the manual/pedal digits (i.e., finger/toes) to temperature changes makes them valuable indicators of thermoregulatory function. Further, while infrared thermography is used in many medical settings, its utility in assessing acute changes in digit skin temperatures remains poorly established. Accordingly, this research investigated the use of forward-looking infrared (FLIR) imaging as a methodological tool for analyzing digital skin temperatures across varying climatic conditions. A Teledyne FLIR E76 camera and associated FLIR Studio software were used to assess peripheral digit skin temperatures in a sample of 10 living human subjects (3 female, 7 male). Images of each hand and foot were captured every 5 minutes over a 45-minute period during exposure to four controlled climatic conditions in an environmental chamber. These experimental conditions included a control (22°C and 50% humidity), hot-humid (37°C and 85% humidity), hot-dry (44°C and 15% humidity), and cold-dry (5°C and 80% humidity) exposures. All images were taken at a perpendicular angle from the skin surface at a distance of 0.45 mm, as measured using the camera's laser-guided range finder function. Baseline images were similarly taken during a preliminary rest period prior to each experimental exposure. This resulted in a total of 2,200 images collected from the left hand and left foot of the 25 participants. Following theoretical expectations, preliminary findings indicate peripheral digit temperatures predictably decrease during the cold-dry exposure, while the hot-dry and hot-humid exposures induce increases in digit temperatures. These preliminary results suggest that infrared thermography likely provides an expedient mechanism for accurately assessing peripheral skin temperatures in humans under different climatic conditions. Infrared thermography may thus have valuable applications for assessing thermoregulatory function in both clinical and research settings
Evaluating A Matter of Balance Series for Fall Prevention in Rural Texas: Findings and Implications
No full textResearch Appreciation Day Award Winner - SaferCare Texas, 2024 Excellence in Patient Safety Research Award - 3rd PlacePurpose: Nearly one-third of US adults over age 65 fall annually (CDC, 2023) and falling continues to be among the leading causes of unintentional injury death in Texas (Texas DSHS, n.d.), necessitating interventions that address confidence, physical activity, and awareness. In response to these challenges, the A Matter of Balance series has been designed to enhance the well-being of participants in rural Texas by addressing these crucial components. This study seeks to evaluate the effectiveness of the A Matter of Balance series in mitigating the impact of falls among older adults in rural communities.
Methods: A secondary analysis was conducted on 164 surveys collected from A Matter of Balance participants in 2023. All participants were from counties meeting the Health Resources and Services Administration (HRSA) definition of rural, and the project received grant funding from HRSA. A paired t-test was used to compare scores on a pre-post test design. The study focused on measuring improvements in knowledge about ways to reduce falls, protecting yourself if you fall, increasing physical strength, becoming steadier on your feet, and getting up if there is a fall. The analysis aimed to provide insights into the impact of the A Matter of Balance series on the well-being of participants.
Results: The findings of the study indicate significant improvements in participants' well-being because of their engagement in the A Matter of Balance series. Statistical analyses demonstrated substantial enhancements in knowledge about ways to reduce falls (p <.001), protect yourself if you fall (p <.001), increase physical strength (p <.001), becoming steadier on your feet (p <.001), and getting up if there is a fall (p <.001). These results collectively underscore the effectiveness of the A Matter of Balance series in addressing key parameters related to fall prevention.
Conclusion: In conclusion, the A Matter of Balance series proves to be a successful intervention in enhancing the well-being of participants in rural Texas. By adopting increased confidence, reducing concern, and promoting physical activity, the program addresses the challenges associated with falls among older adults. These positive outcomes support the continued dissemination of the A Matter of Balance series, emphasizing its potential to contribute to the overall health and quality of life of older adults in rural communities.Health Resources and Services Administration (HRSA), US Department of Health and Human Services (HHS). Grant number U1QHP2873
Racial/Ethnic Disparities and Immunotherapeutic Advances in the Treatment of Hepatocellular Carcinoma
No full textHepatocellular carcinoma (HCC) remains one of the leading causes of death among many associated liver diseases. Various conventional strategies have been utilized for treatment, ranging from invasive surgeries and liver transplants to radiation therapy, but fail due to advanced disease progression, late screening/staging, and the various etiologies of HCC. This is especially evident within racially distinct populations, where incidence rates are higher and treatment outcomes are worse for racial/ethnic minorities than their Caucasian counterparts. However, with the rapid development of genetic engineering and molecular and synthetic biology, many novel strategies have presented promising results and have provided potential treatment options. In this review, we summarize past treatments, how they have shaped current treatments, and potential treatment strategies for HCC that may prove more effective in the future.This research received no external funding
Treatment Patterns and Survival Outcomes of Immune Checkpoint Inhibitors in Advanced Non-Small Cell Lung Cancer Survival at a Safety-Net Hospital
No full textBackground: Immune checkpoint inhibitors (ICI) have transformed the treatment of advanced non-small cell lung cancer (aNSCLC) without driver mutations. KEYNOTE 189 trial showed median overall survival (OS) of 21.8 months (m) for chemotherapy with ICI (CT-ICI) compared to 12.1m for chemotherapy (CT). Since a large percentage of underserved cancer patients in the United States receive care from safety-net hospitals (SNH), this poses the question: Are these patients benefitting from ICI? Herein, we report the treatment and survival patterns of patients with aNSCLC at John Peter Smith Hospital (JPS), a SNH in North Texas. Methods: Patient data were obtained from the JPS tumor registry for this retrospective study. Eligible patients were diagnosed at JPS from 1/1/2017 to 12/31/2021 with stages IIIB/IIIC/IV NSCLC. Patients with driver mutations were excluded. Electronic records were reviewed for programmed death ligand 1 (PD-L1) testing and first-line treatments. OS was calculated from diagnosis to death (if applicable) or the last chart entry before 5/31/2023. Covariates were sex, race, age at diagnosis, stage, histology and PDL-1. Log-rank tests were used to compare survival distributions. OS probability within each treatment group was modeled using a Kaplan-Meier curve. The log-normal accelerated failure time model was used to estimate the effects of covariates on survival. Results: 195 patients were included: 48% Non-Hispanic White, 35% Black, 12% Hispanic, and 6% Asian. 59% were males. 81% of patients had stage IV disease. Treatments were as follows: 29 CT, 27 CT-ICI, 15 ICI, and 15 chemoradiation (CRT). 106 (54%) patients did not receive any treatment (NT). CRT was used in 75% of treated stages IIIB/IIIC. Median OS for CT, CT-ICI, ICI, CRT, and NT were 6.6m, 22.6m, 23.6m, 23.4m, and 2.7m, respectively. The log-rank test detected a statistically significant difference in OS between CT-ICI and CT (p < 0.001) and between ICI and CT (p=0.003) but no difference between CT-ICI and ICI (p=1). 66% of patients underwent PDL-1 testing: PDL-1 <1%, PDL-1 1-49%, and PDL-1 ≥ 50% had longer OS with p=0.02, p=0.01 and p<0.001 respectively compared to those not tested. Conclusions: Our study is the first in SNH population, with OS similar to published trials. aNSCLC patients who received first-line CT-ICI or ICI had better survival compared to CT alone regardless of PDL-1 results. We should study the reasons why most patients did not receive any treatment and extend the benefit of ICIs to as many patients with aNSCLC as possible
Is there a relationship between Religious Affiliation and Adherence to Recommended Cervical Cancer Screening Guidelines?
No full textResearch Appreciation Day Award Winner - School of Public Health, 2024 Research Award - 1st PlacePurpose: Cervical cancer is a preventable disease that, despite growing research and health advancements, remains a public health concern in the United States (US).The United States Preventative Services Task Force (USPSTF) recommends cervical cancer screenings (CCS) for individuals with a cervix aged 21 to 65 years of age. Adherence Guidelines recommend cytology tests (Pap smears) for individuals 21 to 29 years of age and cytology tests alone or with a high-risk human papillomavirus (hrHPV) test for individuals aged 30 to 65 years old. In 2023, 74.2% of US-eligible adults were determined to adhere to these guidelines. Research has indicated many influential social and cultural factors of CCS adherence, including religion. However, to our knowledge, no studies have been conducted in the US to assess the specific influences of Christian denominations on CCS adherence. Research indicates that discussions about sexual health may be stigmatized among Christian denominations in the US. Additionally, testing for HPV may be viewed as a rejection of abstinence, which is advocated by my many Christian denominations, further applying social stigmas to CCS screening. Therefore, this study explored associations between CCS guideline adherence and religious denomination affiliation, accounting for other demographic characteristics. Method: Women aged21-49 years old (n =4561) were examined for USPSTF CCS adherence from the National Survey of Family Growth (2017-2019). A weighted multivariable logistic regression was used to examine the likelihood of adhering to CCS guidelines by Christian denomination compared to no religious affiliation, controlling for race/ethnicity, education, and age group. Adherence was determined by the last reported Pap test and last reported HPV test, with up-to-date status varying across age groups in accordance with USPSTF guidelines (21-29 years old compared to 30+ years old). Women reporting a history of a hysterectomy were excluded from the analysis. Results: Overall, 56.3% of participants adhered to the CCS guidelines. The rates of adherence to CCS guidelines across the available Christian denominations were 65.8% among Black Protestants, 59.0%amongMainline Protestants, 53.2% among Catholics, 49.6% among Evangelical Protestants,49.3%for those of another Religion, and 58.7% for those with no religious affiliation. Evangelical Protestants and individuals self-identifying with non-Christian religions had lower odds of screening guidelines compared to those with no religious affiliation(OR = 0.80, 95%CI [0.66, 0.98]and OR=0.67,95%CI [0.52,0.86],respectively).Women who self-identified as non-Hispanic Black were more likely to adhere to CCS guidelines than non-Hispanic White women(OR= 1.96, CI [1.52, 2.53]).Women 30 years or older were less likely to adhere than 21–29-year-olds (OR = 0.19,CI [0.16,0.22]).Compared to individuals who obtained bachelor's degrees, there was no significant association with the odds of CCS adherence among other educational levels in the multivariable model. Conclusion: Associations were observed between adhering to CCS guidelines and religious denomination after accounting for race/ethnicity, age, and education. Women who were Evangelic Protestants or part of a non-Christian religion were less likely to adhere. Additional studies should further evaluate associations and advise culturally tailored campaigns to reduce CCS stigmas and increase overall adherence
Neuroprotective and Anti-Inflammatory Activities of Hybrid Small-Molecule SA-10 in Ischemia/Reperfusion-Induced Retinal Neuronal Injury Models
Get PDFEmbolism, hyperglycemia, high intraocular pressure-induced increased reactive oxygen species (ROS) production, and microglial activation result in endothelial/retinal ganglion cell death. Here, we conducted in vitro and in vivo ischemia/reperfusion (I/R) efficacy studies of a hybrid antioxidant-nitric oxide donor small molecule, SA-10, to assess its therapeutic potential for ocular stroke. METHODS: To induce I/R injury and inflammation, we subjected R28 and primary microglial cells to oxygen glucose deprivation (OGD) for 6 h in vitro or treated these cells with a cocktail of TNF-alpha, IL-1beta and IFN-gamma for 1 h, followed by the addition of SA-10 (10 microM). Inhibition of microglial activation, ROS scavenging, cytoprotective and anti-inflammatory activities were measured. In vivo I/R-injured mouse retinas were treated with either PBS or SA-10 (2%) intravitreally, and pattern electroretinogram (ERG), spectral-domain optical coherence tomography, flash ERG and retinal immunocytochemistry were performed. RESULTS: SA-10 significantly inhibited microglial activation and inflammation in vitro. Compared to the control, the compound SA-10 significantly attenuated cell death in both microglia (43% vs. 13%) and R28 cells (52% vs. 17%), decreased ROS (38% vs. 68%) production in retinal microglia cells, preserved neural retinal function and increased SOD1 in mouse eyes. CONCLUSION: SA-10 is protective to retinal neurons by decreasing oxidative stress and inflammatory cytokines.This work was supported by Bright Focus Foundation grants (G2018056 and G2018168) awarded to SA and BM and by grants from the National Institute of Health R01EY029823) awarded to SA and R21EY028690 awarded to SR
Contraceptive Method Use and Insurance Status among U.S. Women aged 15-49 years
No full textPurpose: Healthy People 2030 set a goal to reduce unintended pregnancies to 36.5%, from the current baseline of 43%. Different methods of contraception have varying efficacy and effectiveness for pregnancy prevention. Insurance coverage is a key determinant for contraception access. This study aimed to investigate disparities in contraceptive method choice based on insurance status.
Methods: This was a cross-sectional study of a nationally representative sample of women aged 15-49, using the 2017-2019 National Survey of Family Growth. Women not desiring pregnancy reported their insurance status and current method of contraception. Insurance status was operationalized as Private Insurance/Medi-Gap, Medicaid/CHIP, Medicare/other Government Insurance Plan, and Single-Service Plan. The outcome variable, current method of contraception, was operationalized into four categories: most effective methods (intrauterine devices (IUD), hormonal implant), moderately effective methods (pills, patch, ring, injectable), least effective methods (condoms, diaphragm, withdrawal, natural family planning, etc.)#_msocom_1, and no method of contraception. The association between insurance status and contraceptive method was assessed using multinomial logistic regression.
Results: Among the participants, reported insurance statuses were private insurance/medi-gap (56.38%), Medicaid/CHIP/State sponsored (25.16%), Medicare/Military/Other government insurance (4.77%), and Single Service Plan/Indian Health Service/Uninsured (13.69%). For current contraception method, the women self-reported using most effective methods (27.20%), moderately effective methods (27.98%), least effective methods (30.76%), and no method (14.02%). Women insured through a single service plan, the Indian Health Service, or uninsured had lower odds of using most effective methods than no method of contraception (OR=0.32, 95%CI=0.13, 0.77), and lower odds of using the moderately effective methods (OR=0.21, 95%CI=0.07, 0.58), versus no method of contraception, compared to women with private insurance. Additionally, women with Medicaid/CHIP/state-sponsored health plan have lower odds of using the moderately effective methods (OR = 0.382, 95%CI=0.18, 0.84) versus no method of contraception, compared to women with private insurance.
Conclusion: There were differences in contraceptive method choice based on insurance status. As all insurance plans are mandated to cover all FDA-approved methods of contraception, our study findings highlight the need to investigate further gaps in access, education, and freedom of choice. Future research should examine the causes underlying our findings and seek to identify potential strategies related to insurance status to improve access and reduce the risk of unintended pregnancy