The Impact of Thyroid Cancer and Post-Surgical Radioactive Iodine Treatment on the Lives of Thyroid Cancer Survivors: A Qualitative Study

BACKGROUND: Adjuvant treatment with radioactive iodine (RAI) is often considered in the treatment of well-differentiated thyroid carcinoma (WDTC). We explored the recollections of thyroid cancer survivors on the diagnosis of WDTC, adjuvant radioactive iodine (RAI) treatment, and decision-making related to RAI treatment. Participants provided recommendations for healthcare providers on counseling future patients on adjuvant RAI treatment. METHODS: We conducted three focus group sessions, including WDTC survivors recruited from two Canadian academic hospitals. Participants had a prior history of WDTC that was completely resected at primary surgery and had been offered adjuvant RAI treatment. Open-ended questions were used to generate discussion in the groups. Saturation of major themes was achieved among the groups. FINDINGS: There were 16 participants in the study, twelve of whom were women (75%). All but one participant had received RAI treatment (94%). Participants reported that a thyroid cancer diagnosis was life-changing, resulting in feelings of fear and uncertainty. Some participants felt dismissed as not having a serious disease. Some participants reported receiving conflicting messages from healthcare providers on the appropriateness of adjuvant RAI treatment or insufficient information. If RAI-related side effects occurred, their presence was not legitimized by some healthcare providers. CONCLUSIONS: The diagnosis and treatment of thyroid cancer significantly impacts the lives of survivors. Fear and uncertainty related to a cancer diagnosis, feelings of the diagnosis being dismissed as not serious, conflicting messages about adjuvant RAI treatment, and treatment-related side effects, have been raised as important concerns by thyroid cancer survivors

Atención al paciente oncológico en tiempos de COVID-19

Introduction: with the emergence of the new coronavirus and the wide worldwide distribution, its effects in people with some comorbidities are a global concern. Cancer is a disease with a high incidence and prevalence in society, included among the main causes of mortality.Objective: to describe the management of cancer patients during COVID-19Method: a literature review of articles published up to June 2020 was carried out, using the Pubmed / Medline, SCOPUS and SciELO databases. 28 references were selected for the preparation of the present.Development: cancer has variable clinical and prognostic behaviors that generally lead to states of immunosuppression caused by the therapeutics used for its treatment; Therefore, they are more vulnerable to infectious diseases. The proper care of this group of people is the responsibility of the health systems. Some measures are based on social distancing, either in reducing the number of companions of the patient in the consultation or chemotherapy sessions, the prohibition of visits to hospitalized patients and the use of technologies with the use of teleconsultations for routine follow-up, as well as the change from intravenous to oral treatmentsConclusions: the study of the behavior of COVID-19 in cancer patients is under development. The measures that the institutions take to achieve quality care for people with cancer are varied and are based mainly on social distancing.Introducción: con el surgimiento del nuevo coronavirus y la amplia distribución mundial, es una preocupación global sus efectos en personas con algunas comorbilidades. El cáncer es una enfermedad con alta incidencia y prevalencia en la sociedad, incluida entre las principales causas de mortalidad.Objetivo: describir el manejo del paciente oncológico durante la COVID-19Método: se realizó una revisión de la literatura de artículos publicados hasta junio del 2020, utilizando las bases de datos de Pubmed/Medline, SCOPUS y SciELO. Se seleccionaron 28 referencias para la elaboración de la presente.Desarrollo: el cáncer posee comportamientos clínicos y pronóstico variables que generalmente conllevan a estados de inmunosupresión causada por la terapéutica empleada para su tratamiento; por lo cual presentan mayor vulnerabilidad ante enfermedades infecciosas. Es responsabilidad de los sistemas de salud la correcta atención a este grupo de personas. Algunas medidas se basan en el distanciamiento social, ya sea en la reducción de la cantidad de acompañantes del paciente en la consulta o las sesiones de quimioterapia, la prohibición de las visitas a los pacientes hospitalizados y el empleo de las tecnologías con el uso de las teleconsultas para el seguimiento rutinario, así como el cambio de tratamientos por vía intravenosa a vía oralConclusiones: el estudio del comportamiento de la COVID-19 en pacientes oncológicos está en desarrollo. Las medidas que tomen las instituciones para lograr una atención de calidad a las personas que poseen cáncer son variadas y se basan sobre todo en el distanciamiento social

Investigating the cell biological mechanisms regulated by the cellular prion protein

Transmissible spongiform encephalopathies (TSEs) are rare, uniformly fatal neurodegenerative disorders that can affect many mammalian species, including humans. A hallmark of these diseases is the conversion of cellular prion protein (PrPC) into an abnormally folded form. This misfolded PrPC is infectious, since it can provide a template for pathogenic conversion of PrPC in a new host. In addition to any toxicity of the misfolded protein, loss of normal PrPC function could be involved in the neurodegenerative processes. However, the physiological role of PrPC is still poorly understood and this project has aimed to address that lack of knowledge. Out of the many putative functions ascribed to PrPC, the most commonly proposed is that it protects cells from stress. In contrast, I have found that stable transfection of the prion protein gene into SH-SY5Y neuroblastoma cells increases cell death in response to serum removal from the culture medium. Following treatment with several chemical toxins, two out of four stably transfected clones did, generally, display greater viability than untransfected cells that do not express detectable levels of PrPC. However, knockdown of PrPC expression by RNA interference had no effect on this stress resistance, indicating that it may not have been mediated directly by PrPC. Given the lack of robust stress protection afforded by PrPC transfection, proteomic analyses of the cells were carried out to identify alternative processes that were perturbed as a result of PrPC expression. The results obtained suggested roles for PrPC in cytoskeletal organisation and cell cycle regulation. Various proteins involved in cytoskeletal organisation were confirmed by western blotting to be differentially expressed in some or all of the stably transfected clones. Additionally, the expression changes to proteins involved in cell cycle regulation resulted in slower proliferation of the clones compared with untransfected cells, a difference that was reduced following RNA interference-mediated knockdown of PrPC. Taken together, these data suggested that specific growth factor-activated pathways were differentially regulated in the stably transfected clones. One candidate pathway was nerve growth factor (NGF) signalling, which promotes neuronal survival and differentiation as well as regulating various processes outside of the nervous system. PrPC-transfection resulted in altered expression of receptors for NGF, suggesting that the stably transfected clones were, indeed, responding differently to NGF stimulation. However, the molecular mechanism responsible for these expression changes remains to be determined, since co-immunoprecipitation experiments did not identify any physical interactions between PrPC and the NGF receptors. Nonetheless, a role for PrPC in modulating NGF signalling has the potential to explain many of the diverse phenotypic observations in PrPC-null mice and might indicate that loss of PrPC function is an important part of TSE pathogenesis

Dietary Patterns and Self-Harm Risk In Adolescents

Adolescent deliberate self-harm is a major public health concern not only due to the immediate physical harm that it causes, but also due to its strong association with psychological distress, suicide, and high comorbidity with mental disorders. Dietary intake and nutritional deficiencies may act as crucial factors in the prevalence and incidence of mental disorders, including depression. Dietary patterns and nutrition offer key modifiable targets for the prevention of mental disorders and could be beneficial in modulating self-harm amongst adolescents. This study investigated whether dietary patterns influence self-harm outcomes in adolescents. Risk factors that positively predicted self-harm included identifying as female and high vegetarian dietary pattern scores (p \u3c0.001), however no other dietary patterns were significant. Future investigations examining alternative eating patterns, especially amongst female vegetarians, could help predict self-harm amongst adolescents

Toxoplasma Encephalitis following Tandem Autologous Hematopoietic Stem Cell Transplantation: A Case Report and Review of the Literature

Infection with Toxoplasma gondii is a rare but often fatal complication in hematopoietic stem cell transplantation (HSCT) recipients. Most cases have been reported in allogeneic (allo-) HSCT recipients, with only narrative reports following autologous HSCT (ASCT). We report the case of a 58-year-old Caucasian male presenting with toxoplasma encephalitis following tandem ASCT for myeloma and successfully treated with diagnosis by polymerase chain reaction analysis of cerebrospinal fluid. He was treated with sulfadiazine and pyrimethamine (with leucovorin) followed by pyrimethamine and atovaquone as secondary prophylaxis while receiving subsequent therapy for progressive multiple myeloma. Toxoplasmosis is a potential complication in allo-HSCT as well as ASCT recipients and should be considered in any post-HSCT patient with neurological dysfunction. Rapid diagnosis and immediate antimicrobial treatment are essential to avoid morbidity and mortality