A Cross-Sectional Evaluation of Knowledge About Breast Cancer and Perceived Barriers to the Uptake of Mammogram Screening Among Northern Saudi Women: A Population-Based Study

Muhannad Faleh Alanazi,1 Ashokkumar Thirunavukkarasu,2 Maily Alrowily,3 Nouf Alaqel,4 Abdulelah Alaqel,5 Mutlaq Alruwaili,5 Nouf Nashmi M Alazmi,5 Osamah Alhassan,5 Mona Fahad M Aljarallah,5 Afrah Mohaimeed Altaymani5 1Division of Radiology, Department of Internal Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia; 2Department of Community and Family Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia; 3Aljouf Health Cluster, Ministry of Health, Sakaka, Aljouf, Saudi Arabia; 4Department of Diagnostic Radiology, Prince Mutab Bin Abdulaziz Hospital, Sakaka, Aljouf, Saudi Arabia; 5College of Medicine, Jouf University, Sakaka, Aljouf, Saudi ArabiaCorrespondence: Muhannad Faleh Alanazi, Division of Radiology, Department of Internal Medicine, College of Medicine, Jouf University, Sakaka, 72388, Saudi Arabia, Tel +966555 393 871, Email [email protected]: Mammogram screening (MS) is the gold-standard method for early detection of breast cancer (BC), and its use has been proven to minimize BC-related deaths and reduce treatment costs. However, recent epidemiological surveys have reported that rates of mammogram uptake by the Saudi female population are low. Here, we assessed the knowledge of BC and perceived barriers to MS uptake among pre-eligible northern Saudi women.Participants and Methods: We administered a standard and validated Arabic questionnaire to 400 women aged 40– 69 years. SPSS version 21.0 (IBM Corporation, Armonk, NY, USA) was used for data analysis. We applied logistic regression analysis to find the factors associated with participants’ knowledge of BC and MS. Spearman correlation test was applied to find the correlation between knowledge and barrier scores.Results: The study participants reported that smoking habits (61.3%) and unhealthy food habits (57.8%) were the most common risk factors for BC. Of the studied participants, 56.3% had low or medium degrees of knowledge about BC risk factors and MS. The degree of knowledge was significantly associated with education level (adjusted odds ratio [aOR], 2.35; 95% confidence interval [CI]. = 1.61– 3.13; P = 0.008) and a family history of BC (aOR, 3.66; 95% CI, 1.94– 5.49; P < 0.001). Fear of a BC diagnosis (50.8%) and concerns regarding test procedures were the most common barriers to MS uptake. We also found a negative correlation between participants’ knowledge and perceived barriers to MS (rho = − 0.389, P < 0.001).Conclusion: We recommend that concerned authorities offer women multiple health education sessions covering BC risk factors and the necessity for pre-eligible women to undergo MS spaced at regular intervals at different facilities. Furthermore, a multicentric mixed-methods survey is warranted to find the qualitative aspects of barriers to MS.Keywords: breast cancer, screening, risk factors, mammogram, knowledg

Fruit and vegetable consumption among adults in Saudi Arabia, 2013

Charbel El Bcheraoui,1 Mohammed Basulaiman,2 Mohammad A AlMazroa,2 Marwa Tuffaha,1 Farah Daoud,1 Shelley Wilson,1 Mohammad Y Al Saeedi,2 Faisal M Alanazi,2 Mohamed E Ibrahim,2 Elawad M Ahmed,2 Syed A Hussain,2 Riad M Salloum,2 Omer Abid,2 Mishal F Al-Dossary,2 Ziad A Memish,2 Abdullah A Al Rabeeah,2 Ali H Mokdad1 1Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; 2Ministry of Health of the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia Background: Dietary risks were the leading risk factors for death worldwide in 2010. However, current national estimates on fruit and vegetable consumption in the Kingdom of Saudi Arabia (KSA) are nonexistent. We conducted a large household survey to inform the Saudi Ministry of Health (MOH) on a major modifiable risk factor: daily consumption of fruits and vegetables. Methods: The Saudi Health Interview Survey is a national multistage survey of individuals aged 15 years or older. It includes questions on sociodemographic characteristics, tobacco consumption, diet, physical activity, health care utilization, different health-related behaviors, and self-reported chronic conditions. We used a backward elimination multivariate logistic regression model to measure association between the Centers for Disease Control and Prevention (CDC)-recommended daily consumption of fruits and vegetables and different factors. Results: Between April and June 2013, a total of 10,735 participants completed the survey. Overall, 2.6% of Saudis aged 15 years or older met the CDC guidelines for daily consumption of fruits and vegetables. The likelihood of meeting the CDC guidelines increased with age; among women; among persons who graduated from elementary or high school or had a higher education; among residents of Makkah, Al Sharqia, Ha&rsquo;il, or Jizan; among those who consumed at least two servings of meat or chicken per day; among those who visited a health care facility for a routine medical exam within the last 3 years; and among those who have been diagnosed with hypertension. Conclusion: We have showed that KSA is in dire need of improving the diet of its population. Our findings call for urgent research to understand the reasons for low fruit and vegetable consumption, focusing on price or preference in order to develop and implement culturally and country-relevant solutions to increase the consumption of fruits and vegetables. Keywords: Kingdom of Saudi Arabia, fruits, vegetables, dietary risks, die

Glial Cells in the Schizophrenia Puzzle: Angiotensin II Role

Schizophrenia is a neuropsychiatric disease with 1% worldwide prevalence and characterized by a deep distortion in thought and perception, cognitive dysfunction, and social behavioral deficits. After the discovery of the antipsychotic effects of chlorpromazine, a large body of evidence pointed out to the neurotransmission misbalance as the main factor in the development of this pathology. Nowadays, it is known that schizophrenia is related to a pluri-factorial etiopathogenesis where gene factors, neuroinflammation, and brain microenvironment?s alterations are taken into account as well. In this sense, glial cells (oligodendrocytes, astrocytes, and microglial cells) are essential pieces in brain microenvironment with crucial roles in synaptic establishment and function, neuroinflammation, and metabolic and ion homeostasis, among others. Currently, glial cells are the target of numerous researches on the race to puzzle out the schizophrenia etiopathology.Among the multiplicity of regulatory substances involved in glial cell functionality, it becomes outstanding the newly described roles for brain angiotensin II (Ang II). This neuropeptide, through its AT1 receptors (AT1-R), expressed in neurons and glial cells modulates brain homeostasis and several neurotransmission systems (dopaminergic, glutamatergic, and GABAergic) and has a pro-inflammatory role in pathological conditions. In this way, Ang II has been involved in cognition processes, stress responses, and mental disorders such as schizophrenia, addiction, Parkinson?s, and Alzheimer?s diseases.In this chapter, we aimed to summarize the role of the glial cells in the schizophrenia with a special reference to AT1-R involvement in this complex scenario.Fil: Occhieppo, Victoria Belen. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Farmacología Experimental de Córdoba. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Instituto de Farmacología Experimental de Córdoba; ArgentinaFil: Basmadjian, Osvaldo Martin. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Farmacología Experimental de Córdoba. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Instituto de Farmacología Experimental de Córdoba; ArgentinaFil: Marchese, Natalia Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Farmacología Experimental de Córdoba. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Instituto de Farmacología Experimental de Córdoba; ArgentinaFil: Rodríguez, Anahí. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Farmacología Experimental de Córdoba. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Instituto de Farmacología Experimental de Córdoba; ArgentinaFil: Jaime, Andrea del Valle. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Farmacología Experimental de Córdoba. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Instituto de Farmacología Experimental de Córdoba; ArgentinaFil: Herrera Lopez, Malena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Farmacología Experimental de Córdoba. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Instituto de Farmacología Experimental de Córdoba; ArgentinaFil: Bregonzio Diaz, Claudia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Farmacología Experimental de Córdoba. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Instituto de Farmacología Experimental de Córdoba; Argentin

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease