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Objectives: Nausea is one of the most important symptoms of patients undergoing chemotherapy. This study aims to determine the effects of aromatherapy with sour lemon on nausea in patients undergoing chemotherapy. Methods: A total of 50 patients undergoing chemotherapy were randomly assigned to experimental and placebo (control) groups. The two groups completed the visual analogue scale for nausea before and the first to the fourth week after starting the intervention. The intervention was performed during chemotherapy. Using a dropper, a paper towel was saturated with 3 drops of sour lemon essential oil; however, for the control group, 3 mL of water as a placebo was spread on a paper towel. The intervention in the experimental and control groups was performed once a week for 4 weeks during weekly chemotherapy sessions. Results: At the beginning of the study, no significant difference was observed between the mean score of nausea in the two groups (P>0.05). The first to the fourth week after starting the intervention, significant differences were observed between the mean score of nausea in the two groups (P<0.05). The results of the repeated measures analysis of variance indicated that the mean score of nausea changed over time in the experimental group, indicating a gradual decrease in the mean score of nausea (P<0.05). Discussion: Our findings indicated that aromatherapy with sour lemon can be effective in reducing nausea in patients undergoing chemotherapy. [ABSTRACT FROM AUTHOR]

Purpose: Today, the Internet provides access to many patients' experiences, which is crucial in assessing the quality of healthcare services. This paper introduces a model for detecting cancer patients' opinions about healthcare services in the Persian language, both positive and negative. Method: To achieve the objectives of this study, a combination of sentiment analysis (SA) and topic modeling approaches was employed. All pertinent comments made by cancer patients were collected from the patient feedback form of the Tehran University of Medical Science (TUMS) Cancer Institute (CI) in Iran, from March to October 2021. Conventional evaluation metrics such as accuracy, precision, recall, and F-measure were utilized to assess the performance of the proposed model. Result: The experimental findings revealed that the proposed SA model achieved accuracies of 89.3%, 92.6%, and 90.8% in detecting patients' sentiments towards general services, healthcare services, and life expectancy, respectively. Based on the topic modeling results, the topic "Metastasis" exhibited lower sentiment scores compared to other topics. Additionally, cancer patients expressed dissatisfaction with the current appointment booking service, while topics such as "Good experience," "Affable staff", and "Chemotherapy" garnered higher sentiment scores. Conclusion: The combined use of SA and topic modeling offers valuable insights into healthcare services. Policymakers can utilize the knowledge obtained from these topics and associated sentiments to enhance patient satisfaction with cancer institution services. [ABSTRACT FROM AUTHOR]

Introduction: The number of women diagnosed with breast cancer has been rising globally over the past few decades. Upon hearing of a breast cancer diagnosis, women face many challenges including emotional distress, body image issues and sexual dysfunction. Regarding the importance of sexuality for breast cancer patients, this paper aims to validate the sexual health needs of women with breast cancer. Aim: To assess the sexual health needs of women with breast cancer and a need for further research. Materials and Methods: This research is a rapid review conducted in Iran, in April 2020. Databases of PubMed, Cochrane Library, Scopus and Web of Science as well as the Iranian Scientific Information Database (SID), were searched with mentioned keywords, "Female Breast Cancer", "Sex Counselling", "Female Sexual Dysfunction" and "Sexual Health Needs". Results: This review included 16 studies with one randomised clinical trial, four cross-sectional, four review articles, three qualitative articles, three mixed-method studies and one cohort. This study highlights four major sexuality-related information needs of women with breast cancer including: informational need about sexual activity; informational need about fertility-preserving options before starting breast cancer treatment; informational need about prosthesis or breast reconstruction surgery, and informational need about physical changes caused by breast cancer treatments. Conclusion: This review highlight the importance of sexual health needs for female breast cancer patients. However, little attention has been received from women's health professionals and researchers and further research on sexuality and breast cancer is recommended to affirm these research findings. [ABSTRACT FROM AUTHOR]

Purpose: High levels of depression and anxiety in the family caregivers of a patient with cancer affect their quality of life. The purpose of this study was to investigate the effects of a mindful self-compassion (MSC) training program on self-compassion in the family caregivers of patients with cancer. Design/methodology/approach: In 2020, this quasi-experimental study used convenience sampling to select 92 family caregivers of patients with cancer presenting to the oncology ward of Seyed-Al-Shohada Hospital, Isfahan, Iran. The subjects randomly assigned to two groups participated in an online MSC program for 1.5 months. All the participants completed a self-compassion scale (Neff) before, immediately after and one month after the intervention. The data were analyzed using the Mann–Whitney U test, the Chi-squared test, the LSD test, the t-test and repeated measures ANOVA. Findings: The total mean score of self-compassion, respectively, obtained as 64.64 ± 8.23 and 64.44 ± 4.94 in the experimental and control groups before the intervention significantly increased to 81.15 ± 7.94 and 64.06 ± 5.22 immediately after and 78.94 ± 8.22 and 64.22 ± 4.85 one month after the intervention (P < 0.001). Practical implications: Given the potential for negative psychological impacts for patients, caregivers and clinicians in cancer care, the online MSC program can be recommended to support and reduce psychological distress in them. Originality/value: This paper examined the effect of the online MSC program on self-compassion in the family caregivers of patients with cancer and can contribute to our understanding of the value of integrating mental health of caregivers and care of patients with cancer. [ABSTRACT FROM AUTHOR]

In-person, individual counseling using the PLISSIT model is a well-known approach to help people with sexual problems. Evidence suggests that Grouped Sexuality Education (GSE) can be as effective as in-person sexuality education. The efficacy of PLISSIT versus GSE has not previously been evaluated in women with Breast Cancer (BC). In this paper, we report on the effect of PLISSIT versus GSE on self-reported sexual behaviors experienced by women after a BC diagnosis (n = 75). The women were randomly allocated into three groups, with 25 women in each arm. Data analysis of the intention-to-treat population (n = 65) revealed efficacy of both GSE and PLISSIT in improving sexual behaviors (p < 0.0001) with a positive change in sexual capacity, motivation and performance after 6- and 12-weeks post-intervention follow ups. We found the GSE model showed a greater efficacy than the PLISSIT model. Due to the substantial needs faced by women with cancer and the cost associated with implementing the PLISST model, GSE seems to be more effective. We recommend GSE for Iranian communities where management of sexual problems is at an early stage and where the sexuality of women with cancer is routinely overlooked. [ABSTRACT FROM AUTHOR]

Background: Metastatic colorectal cancer (mCRC) constitutes a significant health burden globally, accompanied by elevated mortality rates. This study aimed to assess the cost-effectiveness of regorafenib, an orally administered multi-kinase inhibitor, compared to the combination of Cetuximab and Irinotecan (CetIri) as third-line therapy for mCRC in Iran. Method: A model-based cost-utility analysis was conducted employing a semi- Markov model for a hypothetical cohort of 1,000 patients, integrating time-dependent transition probabilities. From the perspective of the Iranian healthcare payer, the analysis included direct medical costs, such as therapy, monitoring, and adverse effectrelated expenses, sourced from national databases in Iran. A yearly discount rate of 5% was applied to both costs and outcomes. Data analysis utilized Microsoft Excel, R version 4.1.3, and TreeAge Pro Healthcare version 2022 software, with the significance threshold set at 0.05. Results: The base-case analysis revealed that regorafenib offers a cost saving of $12,154 and an incremental gain of 0.1 quality-adjusted life years per patient over a 19-month horizon compared with the CetIri regimen. Probabilistic sensitivity analysis showed a greater than 99% probability of regorafenib being cost-effective. Conclusion: Consistent with existing evidence, the findings advocate regorafenib as a cost-effective alternative to CetIri for third-line treatment of mCRC in Iran, considering the specific healthcare system context. Given the foundational assumptions, caution is advised when extrapolating these results to other regions. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer is one of the most prevalent types of cancer in Iran. Detection and removal of polyps in colorectal cancer can significantly decrease the morbidity and mortality of the disease. The present study aimed to describe the characteristics of patients who had been detected with colorectal neoplasia. Method: This descriptive study was conducted on all the people who had been referred to the Research Institute for Gastroenterology and Liver Diseases for receiving colonoscopy services during 2017-2019. Information was collected through questionnaires designed based on four categories, namely personal information, clinical history, pharmacological history, and pathological results. We used logistic regression analysis to investigate the relationship between independent risk factors and colorectal neoplasia. Results: The total number of the patients referred to the hospital was 2826. The percentage of males was 43.06. There was a low statistically significant relationship between gender and having neoplasia (P = 0.053). We found that the history of diabetes was associated with neoplasia (P = 0.007). Watery diarrhea and abdominal pain had a relationship with colorectal neoplasia and P-values; they were both below 0.001. Moreover, weight loss and inflammatory bowel disease had a significant statistical relationship and P-values were 0.02 and <0.001, respectively. Conclusion: In Iran, most colonic polyps are located in the left colon and also polyps that are situated in different locations. Our study could strongly suggest some important risk factors, such as age, smoking, and body mass index, whose impact on colorectal neoplasia has been reported by other papers. [ABSTRACT FROM AUTHOR]

Background and Aims: Recognizing the ability to adapt coping mechanisms in response to the unique issues present in various Iranian societies underscores the importance of considering culture and religion when interacting with diverse groups of individuals. The objective of this study was to assess the reliability and validity of the fear of progression questionnaire‐short form (FoP‐Q‐SF) in Iranian breast cancer patients. Methods: In this methodological cross‐sectional research design, 400 Iranian breast cancer patients completed the FoP‐Q‐SF in 2023. We assessed the characteristics, content, and both exploratory and confirmatory construct validity of the measures. To evaluate the reliability and construct validity of the FoP‐Q‐SF, we calculated Cronbach's α, McDonald's omega, and the Intraclass Correlation Coefficient. Results: The average age of the patients was 49.18 (standard deviation = 16.14) years. The results of exploratory factor analysis revealed that a single‐factor structure, specifically the self‐efficacy scale, accounted for 65.045% of the total variance. The findings from the confirmatory factor analysis indicated a satisfactory model fit. The reliability analysis indicated that the internal consistency and stability of the measures were acceptable. Conclusion: The short Persian version of the FoP‐Q‐SF exhibits satisfactory validity and reliability. Thus, we recommend using this questionnaire to assess the fear of disease progression among breast cancer patients in Iran. [ABSTRACT FROM AUTHOR]

Background: The prevalence of tobacco use among various cancer types in Iran remains a significant concern, necessitating a comprehensive analysis to understand the extent and patterns of consumption. This study aimed to systematically review and analyze existing literature to delineate the prevalence of tobacco use across different cancer types in Iran, thereby providing a robust basis for future interventions and policy formulations. Methods: Adhering to the PRISMA guidelines, we conducted a systematic review and meta-analysis of literature available in PubMed and Scopus databases. The initial search identified 351 records, out of which 44 studies were selected based on their relevance and design. These studies spanned various time frames, starting from the 2001s up until 2022, and encompassed diverse geographical locations and cancer types in Iran. To avoid bias and potential data overlap, we opted to incorporate a single comprehensive study from the Golestan Cohort, encompassing all data, while excluding 10 other studies. Our final analysis incorporated data from 34 studies, which accounted for 15,425 patients and 5,890 reported smokers. Statistical analyses were performed to calculate the overall proportion of tobacco consumption and to conduct subgroup analyses based on different variables such as cancer types, gender, geographical locations, and types of tobacco used. Results: The analysis revealed a substantial prevalence of tobacco use among cancer patients in Iran, with an overall consumption rate of 43%. This rate varied significantly, ranging from 10 to 88% across individual studies. Subgroup analyses further highlighted disparities in tobacco consumption rates across different demographics, geographic areas, and cancer types. Notably, the 'ever' smokers category exhibited the highest prevalence of tobacco use. The study also identified a worrying trend of high cigarette smoking rates, along with variable consumption patterns of other forms of tobacco, including waterpipe, 'Naas', and 'Pipe'. Conclusions: This systematic review and meta-analysis underscores a significant association between tobacco consumption and various cancer types in Iran, with a prevalence rate among cancer patients being three times higher than the average Iranian population. The findings indicate substantial heterogeneity in tobacco use patterns, emphasizing the need for targeted interventions to address this pressing health issue. The study serves as a critical resource for shaping future policies and strategies aimed at curbing tobacco use and mitigating its adverse effects on cancer prevalence in Iran. [ABSTRACT FROM AUTHOR]

Sentinel lymph node (SLN) biopsy is the standard surgical approach to detect lymph node metastasis in breast cancer. Machine learning is a novel tool that provides better accuracy for predicting positive SLN involvement in breast cancer patients. This study obtained data from 2890 surgical cases of breast cancer patients from two referral hospitals in Iran from 2000 to 2021. Patients whose SLN involvement status was identified were included in our study. The dataset consisted of preoperative features, including patient features, gestational factors, laboratory data, and tumoral features. In this study, TabNet, an end-to-end deep learning model, was proposed to predict SLN involvement in breast cancer patients. We compared the accuracy of our model with results from logistic regression analysis. A total of 1832 patients with an average age of 51 ± 12 years were included in our study, of which 697 (25.5%) had SLN involvement. On average, the TabNet model achieved an accuracy of 75%, precision of 81%, specificity of 70%, sensitivity of 87%, and AUC of 0.74, while the logistic model demonstrated an accuracy of 70%, precision of 73%, specificity of 65%, sensitivity of 79%, F1 score of 73%, and AUC of 0.70 in predicting the SLN involvement in patients. Vascular invasion, tumor size, core needle biopsy pathology, age, and FH had the most contributions to the TabNet model. The TabNet model outperformed the logistic regression model in all metrics, indicating that it is more effective in predicting SLN involvement in breast cancer patients based on preoperative data. [ABSTRACT FROM AUTHOR]

Objective: Patients with leukemia suffer from significant psychological, spiritual, and social symptoms. Therefore, the current research aimed to study the impact of spiritual end-of-life support on the quality of life for leukemia patients. Method: To this end, the present quasi-experimental research with a pre-test and post-test design was performed. The sample included 60 cancer patients randomly assigned to intervention and control groups through the method of permutation block. The experimental group received spiritual support intervention for eight sessions of 60 minutes, while the control group received no intervention. Patients filled out the questionnaire of World Health Organization Quality of Life. The World Health Organization conducts a three-phase assessment to measure the quality of life. These phases include a pre-test, which is conducted before any intervention takes place. Then comes the post-test, which occurs after the intervention. Finally, there is a follow-up assessment conducted two months after the post-test. The obtained results were analyzed by repeated-measures analysis and independent samples t-test using SPSS software. Results: The findings from the repeated measures analysis revealed that there was a statistically significant interaction between time and group (P = 0.01). In other words, being compared to the control group, the spiritual support significantly increased the life quality of the patients in the experimental group. The experimental group witnessed a sustained enhancement in the quality of life for a period of two months following the intervention (follow-up, P = 0.01). Conclusion: Ultimately, the provision of spiritual support has the potential to enhance the overall well-being of individuals approaching the end of their lives, offering solace and aiding them in comprehending the true essence and purpose of their existence. [ABSTRACT FROM AUTHOR]

Background: Sentinel lymph node biopsy (SLNB) is primarily performed to detect axillary lymph node involvement and determine the need for surgical axillary lymph node dissection (ALND). However, the procedure is expensive and necessitates the use of radio-labelled colloids that are not readily available to a large number of patients. It also carries the risk of producing occasional false negative results. Objectives: This study aimed to define highly specific ultrasound parameters to ascertain axillary lymph node involvement as an alternative or complementary method to SLNB in selected patients who require ALND. Patients and Methods: In this prospective cross-sectional study, 256 patients with confirmed breast cancer were selected through non-probability purposive sampling. The selected patients were referred to Omid Hospital, a tertiary educational oncology center in Mashhad, Iran, from 20I8 to 2022. This study identified highly specific cut-off points for ultrasound parameters to determine lymph node involvement in comparison with the histological diagnosis post-SLNB or ALND. Measurements were taken of the tumor size, the cortical thickness of the axillary lymph node, the short axis diameter of the node, and the count of lymph nodes with a cortical thickness of ≥ 3 mm. Results: Among 256 patients with a mean age of 46.41 ± 10.77 years, 202 (87.9%) had histologically confirmed metastatic adenopathy. The ultrasound cut-off values identified to define metastasis with high certainty were as follows: A tumor size > 50.5 mm (with 97% specificity), a difference in cortical thickness of ≥ 4.5 mm (with 100% specificity), a short axis diameter of the node > 12 mm (with 95% specificity), more than three lymph nodes with a cortical thickness of ≥ 3 mm (with 943% specificity), and a cortical thickness of ≥ 6 mm (with 95% specificity). Conclusion: Highly specific ultrasound findings can diagnose lymph node metastasis with a high degree of certainty and can used as an alternative method to SLNB. A difference of ≥ 45 mm between the cortical thickness of the suspected lymph node and the contralateral lymph node and a cortical thickness of ≥ 6 mm are ultrasound findings that can detect lymph nodes involvement, with a specificity ranging from 95% to 100%. [ABSTRACT FROM AUTHOR]

Background: Gastric cancer (GC) is a leading cause of cancer-related deaths, emphasizing the importance of timely diagnosis for effective treatment. Machine learning models have shown promise in assisting with GC diagnosis. Objectives: This study aimed at comparing the performance of various feature selection methods in identifying influential factors related to GC based on lifestyle using machine learning models. The ultimate goal was to enhance early detection and treatment of the disease. Methods: The data of patients from Shahid Ayatollah Modarres Hospital and Shohadaye Tajrish Hospital between 2013 and 2021 were utilized. Three feature selection methods (filter, wrapper, and filter-wrapper) were employed. The k-fold method validated each model. Four classifiers k Nearest Neighbor (kNN), Decision Tree (DT), Random Forest (RF), and Gradient-Boosted Decision Trees (GBDT) compared their outputs based on feature selection methods. Results: The filter-wrapper method outperformed others, achieving an area under the ROC curve and Fl score of 95.8% and 94.7%, respectively. GBDT also performed well. The wrapper and RF classifiers achieved an area under the ROC curve and Fl scores of 95.7% and 93.6%, respectively, after the filter-wrapper method. Without feature selection methods, the RF classifier had an area under the ROC curve and F1 scores of 95.6% and 91.7%, respectively, surpassing other classifiers. Conclusions: This study suggests that appropriate feature selection methods for identifying influential factors related to GC based on lifestyle can facilitate early diagnosis and treatment. The filter-wrapper method demonstrated the best performance in this regard. [ABSTRACT FROM AUTHOR]

Background: Bladder cancer is one of the most common cancers worldwide and also in Iran. Understanding of bladder cancer epidemiology is of great value for policymakers and assists in the prevention and early detection of the disease. Objectives: The aim of the present study was to report national and subnational incidence trends of bladder cancer in Iran between 2003 and 2015. Methods: This study investigated the age-standardized incidence rates (ASIRs) per annum of bladder cancer from 2003 to 2015 in Iran using the data from the cancer registration system of the Ministry of Health and Medical Education of Iran. The crude incidence rates were calculated by dividing incident cases by the country and province population, which were provided by the Statistic Center of Iran. Age standardization was performed using the WHO standard population, and ASIRs were compared by age, sex, and province. Results: The ASIR of bladder cancer increased from 8.35 in 2003 to 13.57 in 2015 in men. The ASIR of bladder cancer also showed a mild increase in females, 2.12 in 2003 versus 2.86 in 2015. The province of Yazd had the highest rate of bladder cancer in men, and West Azerbaijan had the highest rate for women (15.13 and 7.79 per 100,000), while Sistan va Baluchestan and Ilam had the lowest ASIRs formen and women (3.01 and 0.96 per 100,000, respectively). Conclusions: The increasing trend of bladder cancer incidence in Iran, despite the clear decreasing global trend accompanying to ongoing aging of the population highlights the diseases as a potential health problem in the upcoming years in Iran. Therefore, it is necessary for health organizations to implement effective research and control programs in the country to prevent further increases in disease burden. [ABSTRACT FROM AUTHOR]

Background: Cancer disease is considered one of the basic health problems in the world, which threatens the health of human life. It causes numerous personal, family and social damages in physical, psychological, and social dimensions. Objectives: The present study aimed at investigating health literacy and cognitive dysfunction on the quality of life of cancer survivors to make better decisions for the daily functioning, quality of life, and work capacity of cancer survivors so that their lives can be spent with more peace and less stress. Methods: With a descriptive correlational design, 350 cancer survivors of the Cancer Research Cancer, Shahid Beheshti University of Medical Sciences (ShohadayTajrish Hospital) from September 2021 to November 2021, who had been treated for at least one year, volunteered online and in person. The questionnaires were the Cognitive Failure Questionnaire, Cancer Health Literacy Test, and Quality of Life in Adult Cancer Survivors questionnaire. Results: Pearson correlation showed a negative relationship between cognitive dysfunction and quality of life; so, path analysis showed that 25% of the quality of life is predicted by cognitive dysfunction, but cancer health literacy was not correlated with the quality of life of cancer survivors. Conclusions: According to the findings, the optimization of cognitive functions after treatment was emphasized to increase the quality of life of cancer survivors. [ABSTRACT FROM AUTHOR]

Introduction: Squamous cell carcinoma accounts for about 90% of head and neck cancers. The present study aimed to investigate the epidemiology and anatomical involvement pattern of squamous cell carcinoma (SCC) in the head and neck region from 2013-2021 in Imam Khomeini Hospital, Kermanshah, Iran. Material & Methods: This descriptive cross-sectional study was conducted on all the patients with SCC of the head and neck treated at Imam Khomeini Medical Center in Kermanshah over a period of 10 years. Demographic and pathological information was extracted from the patients' medical records. Then, the obtained data was analyzed in SPSS software (version 23). Findings: Out of 299 patients identified with SCC, 236 (78.9%) were male, and the remaining were female. The majority of the patients (48.8%) fell within the age group of 55-72 years, with 57.9% reporting a history of smoking and 76.9% residing in urban areas. Among those studied, the most commonly affected site was the larynx, accounting for 49.5% (148) of cases. The highest incidence of head and neck cancers in both men and women was observed in 2019, with 15.9% and 15.7% of cases, respectively. Discussion & Conclusion: The results of this study showed that most patients were older men over 50, who mostly lived in the city and smoked. The most anatomical site of involvement was the larynx. Therefore, it is recommended to pay attention to these risk factors to prevent and control these cancers. [ABSTRACT FROM AUTHOR]

Introduction and objectives: Telephone follow-up (TFU) is a method that can be recommended for patients with chronic disease, including patients with nonmuscle-invasive bladder cancer (NMIBC) after transurethral resection of the bladder (TURB). This project aimed to improve postdischarge TFU of patients with TURB in a tertiary care system and referral system in Tabriz, Iran. Methods: This evidence implementation project used the JBI evidence implementation framework. Two audit criteria were used. A baseline audit was conducted, followed by the implementation of multiple strategies. The project was finalized with a follow-up audit to evaluate changes in practice. Results: The aggregated data collated from the urology ward demonstrated that all criteria had achieved 0% compliance in the baseline audit round. Strategies such as patient education about TFU, educational pamphlets developed according to the latest validated guidelines, and a mobile app for education material about bladder cancer, diagnosis, management, and follow-up were implemented. The Phase 3 follow-up showed an 88% increase in compliance with staff education about the postdischarge TFU as a component of comprehensive discharge planning and a 22% achievement of timely patient follow-up by telephone. Conclusions: A clinical audit is an effective approach to promoting postdischarge TFU in bladder cancer cases following TURB. TFU for bladder cancer patients who underwent TURB is an optimal goal that is easily achieved through patient, nursing staff, and residents' education using the latest guidelines. [ABSTRACT FROM AUTHOR]

Given the situation of cancer patients as vulnerable patients and the threat of COVID-19 in the society, integration of home-based palliative care services into the healthcare system is essential. The aim of this qualitative study was to explore the current barriers of integration of palliative care services from hospital to home for cancer patients during the COVID-19 Pandemic and to provide suggestions to resolve them. Semi-structured interviews were conducted with 25 stakeholders in the healthcare system, including health policy makers, healthcare providers, clinical home healthcare experts, home healthcare researchers, university faculty members, clergy, family caregivers, and cancer patients. Data were analyzed using directed content analysis method based on the World Health Organization Public Health Strategy for Palliative Care. Challenges were extracted in 4 main categories, containing education barriers (3 subcategories), implementation barriers (9 subcategories), policy barriers (5 subcategories), and drug availability barriers (2 subcategories). Based on the results, removing the barriers and establishing a strong infrastructure for home-based palliative care services is recommended in the healthcare system by concentrating on 4 essential factors, that is, utilizing a coordinating nurse during the process of patient's hospital discharge, establishment of connecting outpatient palliative care clinics to home healthcare centers, access to palliative care tele-medicine and development of a comprehensive and flexible home-based palliative cancer care model in our context. [ABSTRACT FROM AUTHOR]

Background: There is evidence of a direct relationship between peptic ulcer disease (PUD) and the risk of gastric cancer. This study determined the prevalence of gastric cancer in individuals with solitary proximal or distal gastric ulcers admitted to Shahid Rahimi Hospital in Khorramabad, Iran, from 2019 to 2021. Materials and Methods: In this cross-sectional study, 635 patients were included. Age group and sex as well as data related to the year of admission, pathological examination, and location of the ulcer, were recorded in a researcher-made checklist. Data were analyzed using the SPSS software version 22 at a significance level of 0.05. Results: Out of the 635 patients, 66.3% (421) were male, and 33.7% (214) were women. The mean age was 62.5±17.7 years. Overall, 16.7% of patients with gastric ulcers were diagnosed with gastric cancer by pathological examination. The frequency of malignancy was highest in the 80 years and older age group. There was a considerable association between malignancy and age group (P˂0.001; df=4; χ2=27.24). There was no significant association between malignancy and sex (P=0.144). A significant relationship was observed between malignancy and ulcer location (P˂0.001). Proximal ulcers were malignant in 24.6% of the cases (n=74), while distal ulcers were malignant in 9.6% (n=32). Conclusion: Older patients, men, and patients with gastric ulcers are more likely to develop gastric cancer. Therefore, more effective strategies should be developed to prevent this fatal condition. [ABSTRACT FROM AUTHOR]

Background: Chemotherapy is associated with a wide range of physical and psychological side effects, so complementary and alternative therapies may be practiced as an independent treatment or combined with the standard ones to improve health-related quality of life of cancer patients. Laughter yoga has predominantly been used as a complementary therapy to enhance health and wellbeing of ordinary people and patients with chronic diseases. However, to date, few studies have evaluated the effects of this modern exercise on cancer patients undergoing chemotherapy in clinical settings, to the best of the authors' knowledge. the present study aimed to investigate the effects of Laughter Yoga on the health-related quality of life of cancer patients undergoing chemotherapy. Methods: This study was a two-group randomized clinical trial on 69 cancer patients undergoing chemotherapy at Reza Radiotherapy and Oncology Center, Iran in 2018. Patients were randomly divided into intervention and control groups. The intervention group received laughter yoga for four sessions at one-week intervals. Each session consists of one part and lasts for 20–30 min. Patients' health-related quality of life was assessed before and after the laughter yoga sessions using Quality of Life Questionnaire European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) version 3.0. SPSS Statistics (v.20 software was used to conduct Chi-square, independent t-test, Mann-Whitney, Wilcoxon and paired t-tests analyses of the data. Results: The number of participants in intervention and control groups were 34 and 35, there was no significant difference of demographic and disease related characteristics and pre-intervention HRQOL between two groups. In the intervention group, there is significant difference between pre- and post-intervention scores (Mean ± Standard Deviation) of emotional functioning (12.99 ± 10.49), physical functioning (0.78 ± 6.08), role functioning (3.43 ± 7.97), fatigue (-8.82 ± 22.01), pain (-8.33 ± 11.78), sleep disturbance (-15.68 ± 18.77), and global health and quality of life (6.37 ± 5.04) (p < 0.05). There was no significant change in the control group. Participants reported no adverse events. Conclusions: A structured laughter yoga intervention in a hospital setting effectively improved health-related quality of life for cancer patients undergoing chemotherapy. Benefits to many patients could be expected if this would become a part of routine care. Trial Registration: This study was registered in the Iranian Registry of Clinical Trials (no. IRCT20180429039463N1) on 21/08/2018. [ABSTRACT FROM AUTHOR]

This randomized controlled clinical trial aimed to examine the effect of spirituality-based palliative care on pain, nausea, vomiting, and the quality of life in 80 Iranian colon cancer inpatients from January to June 2020 in southern Iran. Patients were randomly assigned to an intervention group and a control group. The intervention group took part in four 120-min sessions while the control group received standard care. Pain, nausea, vomiting, and quality of life were assessed before the intervention and one month after the intervention. Data were analyzed using paired t-test and independent t-test. Between-groups differences analysis showed a significant difference in the quality of life scores, pain score, as well as nausea and vomiting scores following the one-month intervention. In conclusion, this group spirituality-based palliative care intervention might be beneficial in improving quality of life and reducing symptoms. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to estimate the survival rates among Iranian gastric cancer patients and to evaluate if the survival has improved during the last three decades. Background: Gastric cancer is one of the most common cancers in Iran with high mortality. Methods: A systematic review and meta-analysis of all published studies addressing gastric cancer survival in Iran was performed. International databases of Scopus, Web of Science, PubMed, and Iranian databases were included in the study. The study included databases from their inception till February 2022. Due to the inherent heterogeneity, we used a random effect model to pool the survivals in three categories of one, three, and five-year survivals. Results: Thirty-three studies with total cases of 17,207 were included in the study. The overall (pooled) one, three, and five-year survivals were estimated as 58.9% (95% CI: 0.52, 0.66), 29.9% (95% CI: 0.25, 0.35), and 18.2% (95% CI: 0.15, 0.23), respectively. Results of subgroup analysis for the calendar years of study showed that the one, three, and five-year survival rates increased during the last three decades but the results were not statistically significant. There was the disparity in survival based on geographic distribution. Conclusion: The results of our study which has pooled many studies for a long period of time clearly indicate that the survival rates of gastric cancer patients have improved. As the improvement of survival may be due to many factors, more studies is needed to understand the dynamic behind this improvement. [ABSTRACT FROM AUTHOR]

Simple Summary: Colorectal cancer (CRC) is increasing in low- and middle-income countries, likely due to changing lifestyle habits, including diet. We found that a higher total choline intake was associated with an elevated risk of CRC, as well as glycerophosphocholine (GPC) and sphingomyelin (SM). Conversely, betaine intake was associated with a decreased risk of CRC. Consequently, it is possible to focus on the intake of betaine sources and manage the use of animal products as references for SM or other choline types with risks of CRC. Background: Colorectal cancer (CRC) is increasing in low- and middle-income countries, likely due to changing lifestyle habits, including diet. We aimed to investigate the relationship between dietary betaine, choline, and choline-containing compounds and CRC risk. Methods: We analyzed data from a case–control study, including 865 CRC cases and 3206 controls from Iran. Detailed information was collected by trained interviewers using validated questionnaires. The intake of free choline, phosphocholine (Pcho), glycerophosphocholine (GPC), phosphatidylcholine (PtdCho), and sphingomyelin (SM), as well as of betaine was estimated from food frequency questionnaires and categorized into quartiles. The odds ratios (OR) and 95% confidence intervals (CI) of CRC for choline and betaine quartiles were calculated using multivariate logistic regression by adjusting for potential confounders. Results: We observed excess risk of CRC in the highest versus lowest intake of total choline (OR = 1.23, 95% CI 1.13, 1.33), GPC (OR = 1.13, 95% CI 1.00, 1.27), and SM (OR = 1.14, 95% CI 1.01, 1.28). The intake of betaine exerted an inverse association with CRC risk (OR = 0.91, 95% CI 0.83, 0.99). There was no association between free choline, Pcho, PtdCho, and CRC. Analyses stratified by gender showed an elevated OR of CRC in men for SM intake OR = 1.20, 95% CI 1.03, 1.40) and a significantly decreased CRC risk in women for betaine intake (OR = 0.84, 95% CI 0.73, 0.97). Conclusion: Dietary modifications leading to an increase in betaine sources and managing the use of animal products as references for SM or other choline types might contribute to decreasing the risk of CRC. [ABSTRACT FROM AUTHOR]

Breast cancer may be associated with religious/spiritual problems for women. This multimethod qualitative study aims to show the components of religious/spiritual intervention strategies in breast cancer cases in Iran. The religious/spiritual intervention strategies were arranged according to the patient's religious/spiritual problems based on the proposed tree diagram. This working model includes answering questions regarding the religious/spiritual cause(s) of the disease; distinguishing between divine justice and getting sick; describing the patient's attitude toward God and its effect on viewing the disease; explaining the patient's feelings and emotional relationship with God; identifying weakened religious/spiritual beliefs and replacing them with accepted beliefs; and using daily practices to communicate with God. Implications of the findings and usefulness of this model are discussed. Spiritual care providers can use this model to provide religious/spiritual care services to Iranian Muslim women with breast cancer. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the epidemiology of basal cell carcinoma (BCC) and the probability of having another lesion in patients diagnosed with BCC. Methods: This descriptive-analytical study was conducted from 2015 to 2017, based on the data from patients with definitive diagnoses of BCC in two university hospitals in Birjand. In this study, 85 patients with BCC were selected based on pre-defined inclusion criteria and then divided into two groups, including single and subsequent asynchronous lesions in another anatomic area. In this study, the information was collected by census method from diagnosed patients two years after surgery. The subsequent lesions in other anatomical areas were investigated, then tumor risk factors were compared in the two groups. Results: The mean age of the patients was 67.83 ± 12.29, and the youngest and the oldest patients were 38 and 92 years old, respectively. Among the studied patients, 75.3% had a history of sun exposure. The most common occupations of the patients were farmer, rancher, and housekeeper. Head and neck regions were involved in 96.5%. The patients with subsequent asynchronous BCC in another facial skin region were 10.6% (CI95: 4.06 - 17.14). These patients have been subject to several simultaneous risk factors in their medical history; most of them were farmers older than 65 years. Two patients experienced three lesions in three different anatomical regions at different times. There was no statically significant difference between the two groups regarding mean age (P = 0.47), gender (P = 0.73), pathologic subtype (P = 0.06), and other risk factors (P > 0.05). Conclusions: This study confirms the likelihood of having a subsequent lesion in other anatomical regions in patients diagnosed with BCC. Patients with a history of BCC require prolonged follow-up because of the probability of new BCC developing. [ABSTRACT FROM AUTHOR]

Simple Summary: Comprehensive studies on non-hematologic tumors in patients with inborn errors of immunity are scarce. Using a well-established registry of patients with long-term follow-up, molecular defects associated with these cancers were reported for the first time among these patients. Using the retrospective data available of this national registry of patients with primary immune defects, we clarified that almost all cancer hallmarks are involved in the development of non-hematologic cancers in patients presenting with non-hematologic cancers. Inborn errors of immunity (IEI) are a heterogeneous group of inherited disorders, and almost 500 genes associated with these disorders have been identified. Defects in IEI genes lead to diverse clinical manifestations including increased susceptibility to recurrent or prolonged infections, immune dysregulation phenotypes (such as severe atopy, allergy, autoimmunity, and uncontrolled inflammation, lymphoproliferation), as well as predisposition to malignancies. Although the majority of IEI patients present hematologic cancers, the characteristics of other types of cancers are not well described in these groups of patients. By investigating 5384 IEI patients registered in the Iranian national registry the clinical and immunologic phenotypes of patients with non-hematologic cancers were compared with other malignant and non-malignant patients. Solid tumors were reported <20% of malignant IEI patients (n = 27/144 patients) and appeared to be very heterogeneous by type and localization as well as molecular defects (mainly due to DNA repair defect resulted from ATM deficiency). The correlation between the type of malignancy and survival status was remarkable as patients with non-hematologic cancers survive higher than IEI patients with hematologic cancers. Our findings showed that different types of malignancy could be associated with specific entities of IEI. Therefore, the education of physicians about the risk of malignancies in IEI is required for personalized treatment and appropriate management of patients. [ABSTRACT FROM AUTHOR]

Purpose: Food insecurity exists when access to nutritionally sufficient and secure foods or the ability to obtain admissible foods in socially acceptable ways is limited or uncertain. Food insecurity is most likely associated with chronic disease. However, research into the possible relationship between food insecurity and cancer, the world's second leading cause of death, is limited. The purpose of this study was to determine the level of food insecurity as well as the associated socioeconomic characteristics among cancer patients. Design/methodology/approach: A cross-sectional study was conducted on 240 cancer patients in Iran. The socioeconomic and 18-item U.S. Department of Agriculture (USDA) Food Security Questionnaires were used to measure general and socioeconomic characteristics, as well as food security status. Findings: The prevalence of food insecurity was 25.4% in the form of hunger and 52.5% in the form of hidden hunger. Only 22.1% of the patients were food secure. The results of the logistic regression analysis revealed that having children under 18 years old (P = 0.035), economic status (P < 0.001), age of the patient (P = 0.001), educational level of household's head and his spouse (P = 0.044 and P = 0.045, respectively, had statistically significant relationships with food insecurity. Originality/value: Cancer patients have a high rate of food insecurity. Considering the importance of food security for effective cancer treatment, the health system's attention to this issue, particularly by policymakers, appears to be required. [ABSTRACT FROM AUTHOR]

Background: The efficacy of various massage doses in palliative cancer care settings is still debated, and no specific protocol is available. Aim: Evaluating response to various massage doses for symptom cluster of pain-fatigue-sleep. Design: A 7-arm randomized-controlled trial with weekly massage for 4 weeks depending on the prescribed dose (15-, 30-, or 60-min; 2× or 3×/week) and a 4-week follow-up. The intensities of pain, fatigue, and sleep disturbance were measured using a 0–10 scale at nine-timepoint; baseline, weekly during the intervention, and the follow-up period. Then, the mean scores of the three symptoms were calculated as the symptom cluster intensity at each timepoint. IRCT.ir IRCT20150302021307N5. Setting/participants: Adults with cancer (n = 273) who reported all three symptoms at three oncology centers in Iran. Results: The odds of clinical improvement (at least 30% reduction in symptom cluster intensity from baseline) increased with dose-escalation significantly [(OR = 17.37; 95% CI = 3.87–77.90 for 60-min doses); (OR = 11.71; 95% CI = 2.60–52.69, for 30-min doses); (OR = 4.36; 95% CI = 0.94–20.32, for 15-min doses)]. The effect durability was significantly shorter at 15-min doses compared to 30- and 60-min doses. The odds of improvement for doses 3×/week was not significant compared to doses 2×/week (OR = 12.27 vs OR = 8.34); however, the effect durability for doses 3×/week was significantly higher. Conclusions: The findings indicated that dose-escalation increases the efficacy of massage for the pain-fatigue-sleep symptom cluster. Although the 60-min doses were found to be more effective, the 30-min doses can be considered more practical because they are less costly and time-consuming. Our findings can be helpful to develop massage guidelines in palliative care settings. Trial registration: Iranian Registry of Clinical Trials, IRCT20150302021307N5. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, care for cancer patients may be disrupted for several reasons, leading to disease progression. Home-Based palliative care, if properly managed, can provide easy and safe access to care services for these patients. This study aimed to explore stakeholders' perceptions of home-based palliative care for cancer patients during the pandemic. Methods: This qualitative study was conducted using conventional content analysis in Tehran, Iran, in 2021. By purposeful sampling, 19 participants, including cancer patients receiving home-based care services from the Iranian Cancer Control Center (MACSA) and their families, as well as the homecare providers, were recruited. The study data were generated by conducting 19 semi-structured interviews and a focus group session and analyzed based on the method proposed by Lundman and Graneheim. Results: Qualitative analysis of the data revealed 5 main categories: "need for remote services", "disease transmission reduction", "management requirements", "burnout", and "reducing hospital workload". Conclusion: The use of telemedicine, the existence of call centers, and the designing of appropriate guidelines, along with the help of qualified personnel, prevent the transmission of COVID-19 to cancer patients in-home palliative care and lead to the provision of comprehensive care to these patients. This approach to care helps avert staff burnout and reduces the number of occupied beds in hospitals. [ABSTRACT FROM AUTHOR]

Background: Respiratory diseases are the leading cause of morbidity and mortality in the survivors exposed to Sulfur Mustard (SM). The late abnormalities can be present as chronic bronchitis, tracheobronchial stenosis, asthma, bronchiectasis, airway narrowing, lung fibrosis, and lung cancers. This study aims to investigate the association between radiological findings and lung cancer development in patients exposed to sulfur mustard gas. Methods: We entered 719 victims exposed to SM during the Iran–Iraq war into our follow-up study in a consensus manner. They were periodically followed with Chest HRCT scans from 2001 to an interval of 2014–2019. The mean year interval between exposure and the last follow-up was 38 years. For confirming the lung cancer in those with evidence of malignancy in their imaging, fine needle aspiration/biopsy and/or surgical intervention were done. Results: Among 719 patients, 57% were free from any pathologic findings in their HRCT scan. Among the subjects who had the abnormal radiologic findings, Air Trapping (AT), Lung Fibrosis (LF), Bronchiectasis (B), and the evidence of lung cancer were found in 265 (36.9%), 207 (28.8%), 151 (21.0%), and 42 (5.8%), respectively. Adenocarcinoma (38.1%) was the most common type of cancer. The right lung was involved more than the left one regarding LF, B, and cancer (p value < 0.05). Considering the laterality, a significant correlation was found between the side of LF and B and the tumor side. Furthermore, it was shown that the lung lobes with LF were statistically correlated to tumor-involved lobes. The relative risk of AT and B existence for tumor development was 11.73 [4.87–28.26] and 10.14 [5.12–20.090], respectively. The most predictive finding was LF which caused the risk of developing tumor 17.75 [7.35–42.86] times higher in the patient with this pathology. By each increment of the number of LF and B, the risk of developing tumors increased by 51% and 76%, respectively. Conclusion: In survivors exposed to Sulfur Mustard, those with bronchiectasis and lung fibrosis have a significantly higher risk of developing lung cancers, so a close follow-up of these victims is recommended. Trial registration This study was confirmed by the institutional review board and ethics committee at Shiraz University of Medical Sciences (SUMS) with the ethical code IR.SUMS.MED.REC.1399.637. [ABSTRACT FROM AUTHOR]

Aim: To compare the acute radiation-induced bowel and bladder toxicities of two hypofractionated radiotherapy (HFRT) regimens in localised prostate cancer (PCa). Materials and methods: This trial consists of patients with histologically confirmed stage T1-T3aN0M0 PCa, a prostate-specific antigen concentration of 40 ng/mL or lower, and Eastern Cooperative Oncology Group performance status of 0–2. Participants were randomly assigned (1:1) to 56 Gy in 16 fractions over 4 weeks (arm A) or 70·2 Gy in 26 fractions over 5 weeks (arm B). Acute bowel and bladder toxicities were assessed using Radiation Therapy Oncology Group criteria. Results: Between June 2018 and December 2019, 40 patients were randomly assigned to treatment with 4-week (n = 20) and 5-week HFRT (n = 20). In the third month after completion of radiotherapy, the cumulative incidence of acute bowel and bladder toxicities of arms A and B was 20 versus 5% and 70 versus 85%, respectively. The cumulative incidence of grade 2 or worse bowel and bladder toxicities of the 5-week regimen was non-inferior to 4-week HFRT [bowel toxicity: 5% (arm A) versus 5% (arm B), bladder toxicity: 50% (arm A) versus 60% (arm B), p = 0·52). Findings: The 5-week regimen of HFRT is non-inferior to 4-week HFRT in terms of acute bowel and bladder toxicities. [ABSTRACT FROM AUTHOR]

BACKGROUND: Introduction: Patients with cancer as a life-threatening illness have needs in various dimensions. One of the most crucial dimension is spiritually. The present study was conducted to elucidate the spiritual needs of patients with cancer. METHODS: A qualitative approach involving face to face semi-structured interviews conducted in Arak city, Iran. In total, 24 participants were recruited through purposive sampling. All interviews were recorded and transcribed verbatim. The data were analyzed using content analysis. RESULTS: Patients' experiences of spirituality were classified into four themes, including spiritual needs (need to be in nature, need to communicate with others, need to perform religious practices, need for solitude and reflections, need to trust and security), strategies to address spiritual needs (physical activity, achieving inner peace, communication with the nurse or physician, doing dhikr (Zikr) and pray, reading the religious book and texts, making vows, paying attention to and loving others), reasons for not using spiritual resources (lack of belief in the healing powers of praying, believing in a better life after death), and impacts of spiritual beliefs (hope of Life, belief in divine destiny, trusting in God's support, accepting the divine test). CONCLUSION: Exploring the experiences, perceptions, and spiritual needs of cancer patients is of great importance in providing spiritual care as one of the critical aspects of holistic care. Nurses should be educated for assessing spiritual needs of patients to provide spiritual care. [ABSTRACT FROM AUTHOR]

Objectives: Radiotherapy is one of the treatments used for different types of cancer. Acute radiodermatitis is one of its most common complications. Despite the high prevalence of radiodermatitis, few studies investigated how to prevent or treat this complication. Hence, a standard treatment has not been introduced so far. We sought to evaluate the efficacy of Dermolina-Henna cream, a new polyherbal formulation, compared to Mometasone cream for alleviating acute radiodermatitis among breast cancer patients. Design: Randomized active-control double-blind clinical trial. Setting/Location: The oncology clinic of Shohaday-e Tajrish Hospital (Tehran, Iran). Subjects: Women older than 18 years with breast cancer undergoing radiotherapy. Interventions: Patients were instructed to apply a thin layer of Dermolina-Henna or Mometasone cream once daily on their lesions at least 3 h after radiotherapy for 4 weeks, and if grade I or II radiodermatitis developed, also afterward. Patients were visited weekly until end of study at after 4 weeks. Radiation Therapy Oncology Group standard questionnaires were evaluated and recorded every week as the primary outcome. Outcome measures: Primary outcome was defined as evaluating the efficacy of Dermolina-Henna cream to change the radiodermatitis grade, while the level of patients' satisfaction and the rate of adverse events recorded by patients were secondary outcomes. Results: The trends on decrease in number of lesions, erythema, radiodermatitis grade, burning sensation, pain, and itchiness were statistically significant for each treatment, separately (p < 0.001), except for radiodermatitis grade in Mometasone group (p = 0.4). Dermolina-Henna was significantly better than Mometasone in alleviating burning sensation (p < 0.001) and itchiness (p = 0.041). Approximately 3.7% of patients showed adverse events and 3.7% declared dissatisfaction in both groups. Conclusions: In summary, we showed that Dermolina-Henna cream and Mometasone cream were significantly effective in decreasing severity of radiodermatitis symptoms among patients with breast cancer. Dermolina-Henna cream was significantly superior to Mometasone cream in alleviating burning and itchiness. Clinical Trial Registration Number: IRCT20200115046144N1. [ABSTRACT FROM AUTHOR]

Background: Patients with cancer are at an increased risk of mortality from COVID-19 infection. So, they are prioritized for vaccination. However, there is limited data about the immunogenicity, safety, and effectiveness of inactivated vaccines in preventing COVID-19 infection, hospitalization, and mortality in patients with cancer. Objectives: This study aimed to report the clinical characteristics of patients who had a positive PCR test after being fully vaccinated with the Sinopharm BBIBP-CorV Vaccine. Methods: In this retrospective study, the data of patients with cancer were extracted from the electronic health records of a cancer center in Isfahan, Iran. All COVID-19 data from Isfahan province also was collected by Isfahan COVID-19 Registry (I-CORE). We described the clinical characteristics of patients with cancer who have a positive test more than 14 days after the second dose. Results: Two hundred twenty-two patients with cancer had at least one positive PCR test after the start of the COVID-19 vaccination. Of these, 9 (4.1%) breakthrough infections have occurred. Six (67%) of them had hematological malignancies. Six (67%) were hospitalized and 3 (33%) patients died. Two of them had recent chemotherapy and have hematological malignancies. Conclusions: Vaccination is a good way to protect the population from COVID-19 complications and mortality, but it should be considered that fully-vaccinated patients with cancer are at risk of severe outcomes. Nevertheless, prioritizing cancer patients, especially those with hematological malignancies, or receiving chemotherapies for booster vaccines and studying the effectiveness of each COVID-19 vaccine for patients with cancer should be considered. [ABSTRACT FROM AUTHOR]

Background: Interleukin-8 (IL-8) is a member of the pro-inflammatory chemokine family that has been reported to be overexpressed in various human tumors. This chemokine contributes to cancer cell survival, proliferation, metastasis, and angiogenesis. The purpose of this study was to examine the expression level and clinicopathological significance of IL-8 in colorectal cancer (CRC) tissues compared with adjacent normal colorectal tissues in the Iranian population. Materials and Methods: The population of the study consisted of 45 pathologically confirmed patients with CRC, including CRC and adjacent control tissues. The expression levels of the IL-8 gene were evaluated by quantitative real-time polymerase chain reaction (RT-qPCR). The correlation between the expression levels and the clinicopathological features was determined. Results: IL-8 gene expression was overexpressed in CRC samples compared with controls (fold change=5.5; P= 0.02). The area under the ROC curve for IL-8 indicates the potential of IL-8 as the diagnostic marker in CRC (P=0.012). Conclusion: IL-8, which is up-regulated in CRC tissues, can be used to distinguish inflammation-induced CRC from control samples. The significantly up-regulated level of IL-8 needs future investigation for consideration as a biomarker to evaluate the prognosis of CRC. [ABSTRACT FROM AUTHOR]

Background: Toxoplasma gondii infection (toxoplasmosis) has the potential to cause a serious disease in immunocompromised patients and can be fatal in this population. We conducted a systematic review and meta-analysis to assess comprehensively the pooled seroprevalence of toxoplasmosis among immunocompromised patients including HIV/AIDS patients, cancer patients, and transplant recipients in Iran. Methods: PubMed, Web of Science, Scopus, Embase, and Google Scholar databases (international) and Scientific Information Database (SID), Magiran, IranMedex, and IranDoc databases (national) were systematically searched for all reports that possibly contained data for T. gondii prevalence in different immunocompromised populations in Iran between 2013 and 2022. Results: Overall, IgG seroprevalence rate of toxoplasmosis in Iranian immunocompromised patients was 45.1% (95% confidence interval (CI), 37.4-52.9). IgG seroprevalence rate of toxoplasmosis in 12 studies that included 2279 cancer patients, 19 studies that included 2565 HIV/AIDS patients and in 3 studies that included 200 transplant recipients was 43.6% (95% CI, 30.2-57.0), 45.9% (95% CI, 34.8-57.1) and 45.8% (95% CI, 32.5-59.0), respectively. Moreover, IgM seroprevalence rate in the 26 studies was 2.6% (95% CI, 1.4-3.7). Conclusion: Our findings represent a high seroprevalence rate of Toxoplasma IgG among immunocompromised patients. Health improvement and education toward prevention of toxoplasmosis is of great importance for these susceptible populations. [ABSTRACT FROM AUTHOR]

Background: The current study aimed to determine the trends in esophageal cancer (EC) patients and examine the impact of the type and anatomical location of the tumor and the site of metastasis on their survival. Method: In this retrospective cohort study, we investigated 305 patients with a definite diagnoses of EC, who had been hospitalized at the Mahdie Hospital of Hamadan, Iran, during ten years from 2005-2015. EC-related survival considering different types and locations of the tumor, as well as the sites of metastasis, was evaluated. Survival was calculated using Kaplan-Meier curves and a multivariable Cox regression analysis (MVA) was performed. Results: Squamous cell carcinoma was found in 76.6% of the patients and 23.4% had adenocarcinoma (AC). There was a significant relationship between the location and pathological type of tumor; 87% of ACs happened in the lower part of the esophagus (P = 0.015). The 1- to 5-year relative survival of the patients was 46%, 25%, 22%, 12%, and 7%, respectively. The rate of death in liver, lung, brain, pancreas, abdomen, and lymph nodes metastasis were respectively 42.9%, 21.4%, 14.3%, 7.1%, 7.1%, and 7.1%. No significant relationships were observed between the tumor type and metastasis (P = 0.14) or between the tumor type and the location of metastasis (P = 0.7). Conclusion: Similar to other reports, the rate of survival was higher in AC type, yet the rate of total survival in Iran was much lower than that in developed countries. There were no differences in the survival rate concerning the location of the tumor. The obtained results did not show any relationships among the tumor type, the location of metastasis, and the total survival. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is one of the most prevalent types of cancer in Iranian women and the second cause of death in women worldwide. Gene mutations are the key determinants of the disease; therefore, the genetic study of this disease is of paramount importance. One of the genetic evaluation methods of this disease is microarray technology, which allows the examination of the simultaneous expression of thousands of genes. Clustering is the method for analyzing high-dimension data, which we used in the present research for collecting similar genes in separated clusters. Method: A descriptive and inferential statistical analysis was carried out to evaluate unsupervised learning models of gene expression analysis and five bi-clustering methods (including PLAID (PL), Fabia, Bimax, Cheng & Church (CC), and Xmotif) were compared. For this purpose, we obtained the microarray gene expression data for lapatinib-resistant breast cancer cell lines from previously published research. The enrichment efficacy of the clusters was evaluated with gene ontology, and the results of these five models were compared with the Jaccard index, variance stability, least-square error, and goodness of fit indices. Furthermore, the results of the best model were assessed for building a genes sets network with Bayesian networks. Results: After preprocessing, clustering was performed on the data with the dimension (4710 x 18) of the genes. Four models, except for CC, successfully found bi-clusters in the data set. The data evaluation revealed that the results of the models were almost the same, but the PL model performed better than the others, finding 11 bi-clusters; this model was used to build the network of gene sets. Conclusion: According to the results, the PL method was suitable for clustering the data. Accordingly, it could be recommended for data analysis. In addition, the gene sets network formed on gene expression data was incompetent. [ABSTRACT FROM AUTHOR]

Background: Acute myeloid leukemia (AML) is a complex disease characterized by clonal expansion of undifferentiated myeloid precursors, resulting in impaired hematopoiesis and bone marrow failure. Different genetic and environmental factors are believed to be involved in the pathogenesis of AML. Notch signaling with a tumor suppressing plays a role in myeloproliferative disorder and is a negative regulator of myeloid progenitor commitment. Crosstalk between Notch signaling and CXCR4 axis is a matter of debate in AML. Method: In the current case-control study, we evaluated the expression level of CXCR4, JAG1, and MIB1, which are all involved or related to Notch signaling in adult AML patients. Blood samples were obtained from 25 AML and 17 healthy individuals and the expression level of the selected genes was evaluated via the real-time polymerase chain reaction. Results: Our results revealed the increased expression of JAG1, but decreased expression of CXCR4 in AML patients in Iranian population of AML patients. Moreover, some gender-associated effects on the expression of JAG1 and CXCR4 were detected, which may be related to sex hormones. The expression level of MIB1 did not change significantly. The correlation analysis showed no correlations between the age of the patients and the expression levels of the genes. Conclusion: Herein, for the first time, we suggested some new evidence regarding the complex role of Notch signaling-related genes (CXCR4 and JAG1) in the pathogenesis of AML in Iranian patients. [ABSTRACT FROM AUTHOR]

Rationale/Aim: Falls can have severe consequences particularly for older patients with cancer undergoing ambulatory care. The aim of the study is to identify the predictors of falls in older patients receiving cancer ambulatory care and evaluate the accuracy of the final multivariable model in detecting older patients with falls. Method: A retrospective study was conducted on 300 older patients aged 60 years and above that were referred for ambulatory care in three oncology clinics based at hospitals in Tehran, Iran. Participants completed a questionnaire comprising demographic, history of falls, and cancer‐related factors. Logistic regression was used to determine risk factors associated with falls. Results: A total of 35.3% of the older patients with cancer had experienced a fall in the 6 months following the start of their ambulatory care. The most important predictors of falls include the fourth stage of cancer (odds ratio [OR]: 6.47, 95% confidence interval [CI]: 3.20–13.08, p < 0.001), fear of falling (OR: 5.64, 95% CI: 2.58–12.33, p < 0.001), use of hearing (OR: 2.38, 95% CI: 1.07–5.29, p = 0.033) and visual aids (OR: 2.36, 95% CI: 1.12–5.01, p = 0.025), and the number of visits to the doctor (OR: 1.10, 95% CI: 1.01–1.21, p = 0.035). Conclusions: The results indicate that a reduction in falls is possible by introducing strategies to improve care for older patients in the advanced stage of cancer, eliminating the causes of fear of falling, examining and improving vision and hearing, and identifying and addressing the underlying causes of visits to the doctor. [ABSTRACT FROM AUTHOR]

In this experimental study, 200 cancer patients (100 subject in experimental group and 100 subjects in control group) referred to Amir Oncology Hospital in Shiraz were investigated. Educational intervention for experimental group consisted of 12 educational sessions for 50 to 55 minutes. A questionnaire including demographic information, PRECEDE constructs (knowledge, attitude, self-efficacy, enabling factors, and social support), was used to measure health promotion behaviors, patients' hope, and mental health before and 6 months after intervention. Six months after intervention, experimental group showed significant increase in knowledge, attitude, self-efficacy, enabling factors, social supports, health promotion behaviors, patients' hope, and mental health compared to the control group. This study showed the effectiveness of intervention based on PRECEDE constructs in mentioned factors 6 months after intervention. Hence, this model can act as a framework for designing and implementing educational intervention for health promotion behaviors of cancer patients. [ABSTRACT FROM AUTHOR]

Background: Ductal carcinoma in situ (DCIS) is widely recognized as the precursor of invasive ductal carcinoma (IDC). We aimed to compare clinicopathological characteristics and prognosis between IDC with and without coexisting DCIS stratified by biological subtypes to evaluate the clinical outcome of these two groups. Method: Data from 5814 patients with IDC (32.4) and IDC/DCIS (67.6%), who underwent surgery from December 1993 through December 2019, were retrospectively assessed. We evaluated the prognosis of IDC with coexisting DCIS in different molecular subtypes. Results: IDC/DCIS patients were younger (P < 0.001). They also presented with a low tumor grade and had less lymph node involvement compared with the pure IDC patients. Compared with the patients with IDC, luminal B subtype was more frequent in those with IDC/DCIS, with 19.4% versus 13.2 %; human epidermal growth factor receptor-2 enriched subtype was also more frequently observed, with 12.2 vs. 8.7%. The 5-year disease-free survival (DFS) was higher in the IDC/DCIS patients (P = 0.036). The survival outcomes significantly improved in the cases with a higher amount of DCIS. The presence of coexisting DCIS (P =0.038), tumor size (P < 0.001), lymph node status (P = 0.005), lymph vascular invasion (P = 0.02), and molecular subtypes (P < 0.001) were found to be DFS-associated independent prognostic factors. Conclusion: DCIS along with IDC were associated with improved prognosis. The presence of DCIS may be a marker of lower aggressiveness, and could be noticed as a prognostic factor in future treatment algorithms. [ABSTRACT FROM AUTHOR]

Background: Hodgkin lymphoma (HL) is one of the best curable malignancies. Randomized controlled studies have validated the benefit of hematopoietic stem cell transplant (HSCT) for patients with relapsed or primary refractory HL. This analysis aimed to identify significant prognostic factors on the recurrence of the disease after HSCT applying a cure rate model. Method: In this retrospective cohort study, there were 92 patients with HL who underwent HSCT from 2007 to 2014 with 18 months of follow-up in Tehran, Iran. The survival time was set as the time interval between transplantation and the recurrence of HL. In addition, we utilized hyper-Poisson distribution as discrete frailty to account the unobserved heterogeneity and random effects. Results: In non-cured cases, the mean of survival time was 318 (95% confidence interval, 144-493) days. The 1-, 3-, and 5-year survival rates were 88.9%, 83.4%, and 80.7%, respectively. A significant association was observed between the cured patients and the variables such as age, the experience of pre-transplantation relapse, hemoglobin (Hb), mononuclear cells (MNCs), and body surface area (BSA) at the time of transplantation. Conclusion: The study concluded that less than 30 years of age, a high level of Hb (g/dl), a low level of MNCs and BSA (m2), and the absence of pre-transplantation experience of relapse were associated with better survival following HSCT. Based on this study, post-transplant consolidation therapies could be considered for the treatment of HL patients after HSCT. [ABSTRACT FROM AUTHOR]

Background: Gastric cancer is one of the lethal cancers and there is no effective treatment for these patients and still, 5-year survival rate is about 25% to 30%. Finding reliable biomarkers for early-stage diagnosis, targeted therapy, and survival prediction is a priority in this cancer. Objectives: In this study we were trying to know about the molecular classification of gastric cancers in a group of patients from the South of Iran. Patients and Methods: In a cross sectional study, 50 specimens of gastric cancer were selected that have enough tissue to be stained by immunohistochemistry (IHC). IHC was performed for Her-2, mismatch repair genes (MLH-1, MSH-2, MSH-6, and PMS-2), and PDL-1. Frequency of positive makers was compared with survival and outcome. Results and Conclusion: In our study, deficient MMR (dMMR) was detected in 4 patients (8.0%). PD-L1 expression in tumor cells (TC) was observed in 1 of 4 cases (25%) with PMS2 loss. However, PD-L1 in TCs and TILs (tumor infiltrating lymphocytes) was negative in 1 case with MLH1 loss and in 3 of 4 cases with PMS2 loss, which was not statistically significant. All of our 50 cases were positive for MSH2 and MSH6, 24% of which showed TCs with PDL-1 expression and 32% of them in TIL. HER2 was positive in 2 (2/50, 4.0%) cases, among which all of the cases were positive for PD-L1 expression in TCs and TILs, respectively. However, in HER2-negative group, 26.2% (11/42) and 28.6% (12/42) of tumors were positive for PD-L1 in TCs and TILs, respectively. The expression rate of PD-L1 in HER2 negative TCs was significantly higher than that in HER2 positive TCs (P =.033). Immunohistochemistry for Her-2 was equivocal in 6 cases (12.0%) none of which expressed PD-L1 in tumor cells. In our study minimum and maximum survival times from detection of gastric cancer were 1 and 87 months, respectively. The mean ± SD and median ± SD of overall survival time were 30.69 ± 4.88 and 18 ± 1.45 months, respectively. One and 3-year survival rates of 40% and 24%, respectively. PD-L1 expression was not associated with survival, but its expression was associated with intestinal type Lauren classification and negative HER-2. PD-L1 positivity in tumor cells or tumor infiltrating lymphocytes was not an independent prognostic factor in gastric cancer. [ABSTRACT FROM AUTHOR]

Background: Cancer is a chronic disease that affects different aspects of Quality of Life (QoL), including physical, financial, social, and emotional aspects. The PRECEDE-PROCEED model is a comprehensive method for assessing patients’ needs, and designing, implementing, and evaluating health promotion programs to meet their needs. This study aims to determine the effect of an educational program based on the PRECEDE-PROCEED model on Health-Related Quality of Life (HRQOL) and preventive behaviors in patients with breast cancer undergoing chemotherapy. Methods: This quasi-experimental impact evaluation study was performed on 90 outpatients with breast cancer (stages I and II) undergoing chemotherapy in Shahid Beheshti Hospital, Kashan, Iran from September 2018 to December 2019. The participants were randomly assigned into two groups of training (n=45) and control (n=45). The training group, in addition to routine care, received the educational program based on the PRECEDE-PROCEED model at eight two-hour group sessions for one month. The control group received routine care for cancer patients only. The participants completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and a researcher-made questionnaire based on the PRECEDE-PROCEED model (assessing predisposing, enabling, and reinforcing factors) before the study, immediately after, and two months after the intervention. Results: In the training group, the total Mean±SD of HRQOL before, immediately after, and two months after the intervention were 52.65±17.14, 64.79±15.66, and 63.95±18.63, respectively. Their total score of HRQOL and its dimensions (physical functioning, role functioning, emotional functioning, and symptoms) increased significantly over time (P<0.01). In this group, the scores of predisposing and enabling factors also increased immediately after and two months after the intervention (P<0.05); however, the score of reinforcing factors (social support) showed no significant increase (P>0.05). Conclusion: The educational program based on the PRECEDE-PROCEED model can improve the HRQOL and preventive behaviors in terms of predisposing factors (knowledge, attitude), and enabling factors (family support) in patients with breast cancer undergoing chemotherapy. We recommend this educational program for improving these patients’ QoL. [ABSTRACT FROM AUTHOR]

Introduction: Making appropriate plans for the provision of hospice care is considered a perceived need in the Iranian health system. The current study aimed to develop a model for establishing hospice care delivery system for the adult patients with cancer. Materials and Methods: This study is part (data of the third and fourth phases) of a larger study that has been done in four phases. This Health System Policy Research (HSPR) utilized a mixed qualitative-quantitative approach. At the first phase, a qualitative study was conducted which explained the care needs and the requirements for establishing this system from the stakeholders' perspective (directed content analysis). The second phase aimed to examine the current situation of hospice care delivery in Iran and identify and determine the similarities and differences among them in the selected countries (comparative study). At the third phase, the main areas of the model and the related indicators were extracted and prioritized by consulting with experts (Delphi survey). Then the model was formulated. At the fourth phase, the proposed model was validated and finalized in terms of importance, scientific acceptability, and feasibility. Results: Based on the developed model the first and the most important step in establishing the hospice care delivery system is laying the groundwork in the health system which requires focusing on policymaking. It is necessary to establish hospice centers and implement public awareness raising programs, train, and supply expert manpower, strengthen family physician and referral process, formulate clinical guidelines, encourage the private sector and NGOs(Non-Governmental Organizations (NGOs).) to invest, develop end-of-life and hospice care service packages, and create quality care indicators. The proposed model had moderate feasibility. Conclusion: This model was developed based on the current Iranian healthcare structure and the needs of terminally ill cancer patients. It can be used as a model tailored to the current state of the health system and community in Iran. It is suggested to use this model as a pilot at the regional level. [ABSTRACT FROM AUTHOR]

INTRODUCTION. Depression is a debilitating disease that is highly prevalent among cancer patients. Various studies in Iran have reported different prevalence. This systematic review and meta-analysis was conducted to estimate the overall prevalence of depression in Iranian women with breast cancer. MATERIAL AND METHODS. In this study, published articles in Persian and English were collected without time limit. Keyword searches for depression, depressive disorder, dysthymic disorder, major depressive disorder, breast cancer, breast neoplasm, and Iran and all of their potential combinations were performed in Scientific Information Database (SID), MagIran, PubMed, Scopus, Web of Science databases. The heterogeneity between studies was assessed using the Q-Cochrane test and, given the significant heterogeneity, a random-effects model was used to estimate the overall prevalence of depression. Data were analyzed using STATA version 11 software. RESULTS. The analysis of 22 selected articles with a total sample size of 3,082 showed that the overall prevalence of depression in women with breast cancer was 49.98% (95% confidence interval: 48.43-52.52). The prevalence of depression in Region 1 in the country was (28%; 95% confidence interval: 25.53-52.55) and in other regions, it was (63.79% with 95% confidence interval of 61.82-76.76). The highest and the lowest prevalence of depression were related to BDI (69.33%; 95% confidence interval: 67.19-71.48) and HADS (26.43%; 95% confidence interval: 23.14-29.72), respectively. CONCLUSIONS. Half of the Iranian women with breast cancer had depression. Given the overlap of physical symptoms of cancer with depression, identifying at-risk patients for controlling and providing therapeutic interventions seems necessary. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is one of the most prevalent female cancers in developing countries. It seems that breast cancer affects Iranian women a decade earlier than women from developed countries, however, there is not enough evidence for this hypothesis. Methods: This repeated cross-sectional study was carried out on 6057 Iranian women, living in Isfahan province, using historical data from 2001 to 2013 and 506,095 British women in the same period. The UK breast cancer data came from the ONS website (www.ons.gov.uk) on request for the period of 2001 to 2013. The weighted mean age of women with breast cancer was compared between Iran and the UK by the independent t-test using STATA 14 at a 5% significance level. Results: The age-standardized incidence rate (ASR) in Iran (Isfahan) increased from 22.0 to 68.0 per 100,000 populations from 2001 to 2013. The corresponding ASR in the UK increased from 152.4 to 169.8 per 100,000 population. The standardized mean age of breast cancer was 50.5 years (SD=12.6) and 63.6 years (SD=14.0) in Iranian and British women, respectively. Conclusion: These findings imply that Iranian women were, on average, diagnosed with breast cancer a decade earlier than English women. Therefore, screening for breast cancer should begin at lower ages for Iranian women. [ABSTRACT FROM AUTHOR]

Aim: Supporting cancer patients is one of the integral, ethical and professional components and concepts of nursing care. Given the prominence of nurses' understanding of their supportive role in providing quality and humane nursing care for cancer patients, it is crucial for them to acquire sufficient knowledge to achieve a positive attitude towards patient support. Design: Qualitative conventional content analysis approach was used. Methods: This study was conducted with a qualitative approach and conventional content analysis in 2020. Participants consisted of 18 nurses of different oncology wards of teaching hospitals in Northwestern Iran recruited using the purposive sampling method. Data were collected through semi‐structured interviews and analysed simultaneously with data collection (22 july ‐ 20 june 2020). Findings: The analysis of interviews showed that the main theme of "a canopy as a supportive role for cancer patients" was formed. In this theme, related subcategories included patient's psychological support (compassionate care with emotional support, having an intimate/friendly relationship with the patient and communicative behaviour facing patient needs), patient training (need‐based training, having good theoretical knowledge about the patient and having a role model for playing a supportive role for the patient) and supporting the patient with clinical self‐efficacy (being responsible with clinical competency, understanding the patient's behaviour and attempt to provide extra‐duty care). [ABSTRACT FROM AUTHOR]

Background: Breast cancer, as the most common prevalent cancer in Iran, is associated with severe psychological consequences. This study aimed to compare the effectiveness of Cognitive- Behavioral Therapy (CBT) with an integrated package of Gestalt Therapy and Cognitive- Behavioral Therapy (GT-CBT) on the self-efficacy of women with breast cancer. Methods: This research was a quasi-experimental study with a pre-test, post-test design and a control group. Sixty patients with breast cancer referred to the Cancer Clinic of Imam Khomeini Hospital in Tehran City, Iran, were recruited through a convenience sampling method. They were randomly assigned to the control (n=20), CBT (n=20), and GT-CBT (n=20) groups. The study data were collected by the Sherer self-efficacy scale and analyzed using descriptive (Mean±SD) and inferential statistics (analysis of covariance [ANCOVA]) in SPSS software, v. 20. Results: The results indicated that both CBT and GT-CBT have significantly increased the subjects' self-efficacy (Eta=0.73, F51, 2=70.60, P<0.001). Post hoc test indicated that GT-CBT is more effective than CBT (P<0.05). Conclusion: The effectiveness of GT-CBT on the subjects' self-efficacy was higher than CBT. Therefore, it is suggested to use integrated methods such as GT-CBT to enhance the self-efficacy of patients with breast cancer. [ABSTRACT FROM AUTHOR]