Etiology of Breast Development and Asymmetry

Etiology of breast development and asymmetry is a fascinating research topic physiologically as well as pathophysiology from a certain condition. The shape, contour, and size of the breast are unique to each female. These factors are influenced by genetics, weight, exercise, menstruation cycles, pregnancy, menopause status, and age. An attempt was made to research the breast development at fetal development and transitioning into adulthood and menopause. Additionally, we compare breast development in males to the developments in females. Although breast asymmetry is experienced by all women, it ranges from grossly undetectable to the need for surgical intervention. It is thought that breast asymmetry has intrinsic and extrinsic factors that determine the type and the extent of asymmetry observed. Hormones at play and their effect on breast asymmetry throughout breast development has been charted. Breast asymmetry is most often secondary to benign breast disorders and unassociated with a risk for malignancy. As the perception of one’s body image is an integral part of self-confidence, breast asymmetry has the potential to affect every woman’s quality of life, regardless of the degree of asymmetry. Throughout this effort, our aim was to analyze and understand breast development in males and females, breast changes from the prepubertal to post-menopausal period, benign pathological changes, summarizing the etiologies of breast asymmetry, and their effects on quality of life

Characteristics of Patients Experiencing Extrapyramidal Symptoms or Other Movement Disorders Related to Dopamine Receptor Blocking Agent Therapy

Purpose/background: Dopamine receptor blocking agents (DRBAs), also known as antipsychotics, are medications widely used to treat a growing number of mental health diagnoses. However, their utility is limited by the potential to cause serious adverse movement reactions. Akathisia, dystonia, parkinsonism, and tardive dyskinesia (collectively known as extrapyramidal symptoms or EPSs) are associated with reduced social and occupational functioning, negative patient attitudes toward treatment, and nonadherence to pharmacotherapy. Neuroleptic malignant syndrome is a life-threatening reaction that can result from DRBA use and cause musculoskeletal dysfunction. The aim of this study is to profile patients who have developed DRBA-related movement adverse effects and identify risk factors significantly associated with each subtype of EPSs or other movement disorders (OMDs) such as neuroleptic malignant syndrome. Methods/procedures: A report of all potential DRBA-related EPSs or OMDs occurrences within a large community hospital network was generated using International Classification of Diseases, Ninth Revision (ICD-9) and 10th Revision (ICD-10) billing codes. Each patient encounter was manually reviewed to confirm that a documented case of DRBA-related EPSs or OMDs had indeed occurred and subsequently determine the likely causative agent(s). Findings/results: The resultant cohort of 148 patients experiencing unique DRBA-related EPS or OMD events was analyzed. The average patient was female, middle-aged, and overweight. The most common DRBAs precipitating EPSs or OMDs were haloperidol and quetiapine. In the population studied, age was significantly associated with the subtype of EPSs experienced such that those patients with akathisia and dystonia tended to be younger, whereas those with tardive dyskinesia tended to be older. Body mass index (BMI) category was also negatively correlated with the incidence of dystonia. In addition, it was observed that exposure to specific DRBAs, classes, and routes of administration significantly affected the risk of developing different subtypes of EPSs or OMDs in the study population. Implications/conclusions: To our knowledge, this is the first study to describe an association between age and BMI with the risk of akathisia and dystonia, respectively, in patients taking DRBAs. Other trends observed with age and BMI in patients developing DRBA-related EPSs support previously reported findings. Expanding the knowledge base of individual characteristics associated with the risk of developing different subtypes of EPSs or OMDs can help providers and patients anticipate and attempt to mitigate these reactions, and may ultimately improve adherence to DRBA therapy

Etiology of Breast Development and Asymmetry

Etiology of breast development and asymmetry is a fascinating research topic physiologically as well as pathophysiology from a certain condition. The shape, contour, and size of the breast are unique to each female. These factors are influenced by genetics, weight, exercise, menstruation cycles, pregnancy, menopause status, and age. An attempt was made to research the breast development at fetal development and transitioning into adulthood and menopause. Additionally, we compare breast development in males to the developments in females. Although breast asymmetry is experienced by all women, it ranges from grossly undetectable to the need for surgical intervention. It is thought that breast asymmetry has intrinsic and extrinsic factors that determine the type and the extent of asymmetry observed. Hormones at play and their effect on breast asymmetry throughout breast development has been charted. Breast asymmetry is most often secondary to benign breast disorders and unassociated with a risk for malignancy. As the perception of one’s body image is an integral part of self-confidence, breast asymmetry has the potential to affect every woman’s quality of life, regardless of the degree of asymmetry. Throughout this effort, our aim was to analyze and understand breast development in males and females, breast changes from the prepubertal to post-menopausal period, benign pathological changes, summarizing the etiologies of breast asymmetry, and their effects on quality of life

Life After Brain Injury - Family Perspectives

Background: Children who are Traumatic Brain Injury (TBI) survivors experience changes to their occupational engagement and participation in family life. Families and children who are TBI survivors may experience long-term, chronic disabilities, yet these complex experiences are under researched and underserved. Objective: This research focused on the following questions: What are the lived experiences of children who have survived brain injury and their families upon returning to their homes, schools and communities? What are the helpful and necessary supports and what are the barriers to engaging in meaningful occupations? How can in depth examination of these phenomena better inform OT practice and interprofessional collaboration in service to this community? Methods: In collaboration with University of California, San Francisco (UCSF) Brain Recovery Education Initiative (BREd) clinic, two participants were recruited through convenience sampling. Semi-structured virtual interviews were conducted with 2 parts: Part 1 - Participants discussed lived experiences of life after their child’s brain injury; Part 2- Participants provided family perspectives on common Pediatric TBI assessments (PedsQL & NeuroQoL & PEM-CY). The constant comparison method was utilized in the coding process. To establish coding rigor, consensus coding to 100% was employed across all 5 researchers. Results: This analysis was focused on part 1 of our methods and focused on the lived experiences of the families of children who are brain injury survivors. Preliminary themes were (1) Psychosocial Changes with sub themes of Psychosocial Changes Within the Child and Psychosocial Changes Within the Parent; and (2) Supports with sub themes of Beneficial Supports and Missing Supports. The most notable occupational impacts across all three settings of home, school, and community were impacts on activities of daily living (ADLs) specifically toileting and dignity issues and socialization changes. Implications: Occupational therapists (OT) can fill in the current gaps in service as there is inadequate support when transitioning from a medical setting and therefore medical model of intervention to returning to home, school, and community. OTs are excellent resources to support schools for the return of children who are TBI survivors and advocate for their needs as well as addressing stigmas associated with TBIs. Interprofessional teams can provide impactful services by recognizing and proactively partaking in child and family centered care. Best practices move beyond traditional medical and rehabilitation models and focus on child and family occupational engagement in context. Conclusion: Children who are TBI survivors and their families have complex experiences that are inadequately addressed. Their multifaceted experiences emphasize the need for future interventions including OT and ongoing research in this area

Therapeutic relevance of the protein phosphatase 2A in cancer

Chromosomal Instability (CIN) is regarded as a unifying feature of heterogeneous tumor populations, driving intratumoral heterogeneity. Polo-Like Kinase 1 (PLK1), a serine-threonine kinase that is often overexpressed across multiple tumor types, is one of the key regulators of CIN and is considered as a potential therapeutic target. However, targeting PLK1 has remained a challenge due to the off-target effects caused by the inhibition of other members of the polo-like family. Here we use synthetic dosage lethality (SDL), where the overexpression of PLK1 is lethal only when another, normally non-lethal, mutation or deletion is present. Rather than directly inhibiting PLK1, we found that inhibition of PP2A causes selective lethality to PLK1-overexpressing breast, pancreatic, ovarian, glioblastoma, and prostate cancer cells. As PP2A is widely regarded as a tumor suppressor, we resorted to gene expression datasets from cancer patients to functionally dissect its therapeutic relevance. We identified two major classes of PP2A subunits that negatively correlated with each other. Interestingly, most mitotic regulators, including PLK1, exhibited SDL interactions with only one class of PP2A subunits (PPP2R1A, PPP2R2D, PPP2R3B, PPP2R5B and PPP2R5D). Validation studies and other functional cell-based assays showed that inhibition of PPP2R5D affects both levels of phospho-Rb as well as sister chromatid cohesion in PLK1-overexpressing cells. Finally, analysis of clinical data revealed that patients with high expression of mitotic regulators and low expression of Class I subunits of PP2A improved survival. Overall, these observations point to a context-dependent role of PP2A that warrants further exploration for therapeutic benefits.status: publishe