Reliability of Medical Records in Diagnosing Inflammatory Breast Cancer in Egypt

BACKGROUND: Inflammatory breast cancer (IBC) is a rare, aggressive breast cancer diagnosed clinically by the presence of diffuse erythema, peau d\u27orange, and edema that arise quickly in the affected breast. This study evaluated the validity of medical records in Gharbiah, Egypt in identifying clinical signs/symptoms of IBC. For 34 IBC cases enrolled in a case-control study at the Gharbiah Cancer Society and Tanta Cancer Center, Egypt (2009-2010), we compared signs/symptoms of IBC noted in medical records to those recorded on a standardized form at the time of IBC diagnosis by clinicians participating in the case-control study. We calculated the sensitivity and specificity of medical records as compared to the case-control study for recording these signs/symptoms. We also performed McNemar\u27s tests. RESULTS: In the case-control study, 32 (94.1%) IBC cases presented with peau d\u27orange, 30 (88.2%) with erythema, and 31 (91.2%) with edema. The sensitivities of the medical records as compared to the case-control study were 0.8, 0.5, and 0.2 for peau d\u27orange, erythema, and edema, respectively. Corresponding specificities were 1.0, 0.5, and 1.0. p values for McNemar\u27s test were CONCLUSION: Medical records lacked information on signs/symptoms of IBC, especially erythema and edema, when compared to the case-control study. Deficient medical records could have implications for diagnosis and treatment of IBC and proper documentation of cases in cancer registries

High Proportion of Inflammatory Breast Cancer in the Population-Based Cancer Registry of Gharbiah, Egypt

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72192/1/j.1524-4741.2009.00755.x.pd

Exposure to phthalates among premenstrual girls from rural and urban Gharbiah, Egypt: A pilot exposure assessment study

<p>Abstract</p> <p>Background</p> <p>Phthalates have been identified as endocrine active compounds associated with developmental and reproductive toxicity. The exposure to phthalates in premenstrual Egyptian females remains unknown. The objective of this study was to characterize phthalate exposure of a potentially vulnerable population of premenstrual girls from urban and rural Egypt.</p> <p>Materials and methods</p> <p>We collected one spot urine sample from 60 10-13 year old females, 30 from rural Egypt, and 30 from urban Egypt from July to October 2009. Samples were analyzed for 11 phthalate metabolites. Additionally, we collected anthropometrics as well as questionnaire data concerning food storage behaviors, cooking practices, and cosmetic use. Phthalate metabolite concentrations were compared between urban and rural Egyptians as well as to age and gender matched Americans.</p> <p>Results</p> <p>Monoethyl phthalate (MEP), was detected at the highest concentration in urine of Egyptian girls (median: 43.2 ng/mL in rural, 98.8 ng/mL in urban). Concentrations of urinary metabolites of di-(2-ethylhexyl) phthalate and dibutyl phthalate were comparable between Egyptians and age matched US girls. Storage of food in plastic containers was a statistically significant predictor of urinary mono-isobutyl phthalate (MiBP) concentrations when comparing covariate adjusted means.</p> <p>Conclusions</p> <p>Urinary concentrations of phthalate metabolites were similar in Egyptian and US populations, suggesting that phthalate exposure also occurs in developing nations. Dietary intake is likely an important route of exposure to phthalates in both urban and rural populations.</p

Global survey of the roles, satisfaction, and barriers of home healthcare nurses on the provision of palliative care

Background: the World Health Assembly urges members to build palliative care (PC) capacity as an ethical imperative. Nurses provide PC services in a variety of settings, including the home and may be the only health care professional able to access some disparate populations. Identifying current nursing services, resources, and satisfaction and barriers to nursing practice are essential to build global PC capacity. Objective: to globally examine home health care nurses' practice, satisfaction, and barriers, regarding existing palliative home care provision. Design: needs assessment survey. Setting/Subjects: five hundred thirty-two home health care nurses in 29 countries. Measurements: a needs assessment, developed through literature review and cognitive interviewing. Results: nurses from developing countries performed more duties compared with those from high-income countries, suggesting a lack of resources in developing countries. Significant barriers to providing home care exist: personnel shortages, lack of funding and policies, poor access to end-of-life or hospice services, and decreased community awareness of services provided. Respondents identified lack of time, funding, and coverages as primary educational barriers. In-person local meetings and online courses were suggested as strategies to promote learning. Conclusions: it is imperative that home health care nurses have adequate resources to build PC capacity globally, which is so desperately needed. Nurses must be up to date on current evidence and practice within an evidence-based PC framework. Health care policy to increase necessary resources and the development of a multifaceted intervention to facilitate education about PC is indicated to build global capacity

Evaluation of serum14-3-3η protein and Sema3A levels in rheumatoid arthritis: diagnostic and prognostic value

Abstract Background Serum14-3-3η protein plays an important role in the pathogenesis of rheumatoid arthritis (RA) as it is a joint-derived proinflammatory mediator. Semaphorin3A (Sema3A) plays an immune regulatory and bone remodeling role in many autoimmune diseases. Their role in rheumatoid arthritis needs to be evaluated for diagnostic and prognostic prospective values. Results The serum level of protein 14-3-3n was significantly higher in patients with RA than those in healthy controls. Serum 14-3-3η has a significant positive correlation with RF and ACPA, but not with either DAS28, ESR, or CRP. Serum 14-3-3η levels were significantly correlated with radiographically assessed joint damage. Serum Sema3A levels were decreased in rheumatoid arthritis patients compared to controls. There were also negative correlations with disease duration and activity score (DAS28), ESR, CRP, and RF. Conclusion The discriminative ability of 14-3-3η was comparable to RF and ACPA enhancing its diagnostic capacity. Sema 3A might serve as a predictive marker for radiographic severity and could have a potential therapeutic role in RA

Role of interleukin-35 in rheumatoid arthritis pathogenesis and its relation to disease activity and joint damage

Aim This study aimed to discuss the role of interleukin-35 (IL-35) in the pathogenesis of rheumatoid arthritis (RA) and its relation to disease activity and radiological severity. Patients and methods Thirty patients diagnosed with RA were selected from the outpatient clinic and inpatient unit of Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University Hospitals fulfilling the American College of Rheumatology/European League Against Rheumatism 2010 criteria for the diagnosis of RA, and 20 apparently healthy individuals who were matched in age and sex participated as controls. Patients with other autoimmune diseases, malignancy, or any current infections were excluded. Disease activity score in 28 joints was assessed for all patients. Rheumatoid factor, anticyclic citrullinated peptide, complete blood count, erythrocyte sedimentation rate and C-reactive protein and serum level of IL-35 measured by enzyme-linked immunosorbent assay were evaluated. The degree of joint destruction was assessed by Larsen score. Results Of the RA patients, 73.3%showed low serum levels of IL-35 with significant difference compared with controls, and its levels showed negative association with disease activity. IL-35 serum levels were significantly correlated with hemoglobin level, erythrocyte sedimentation rate, C-reactive protein, and rheumatoid factor and not correlated with anticyclic citrullinated peptide antibodies. Also IL-35 serum levels significantly correlated with radiological disease severity were assessed by Larsen score. Conclusion IL-35 had an immunoregulatory role in RA pathogenesis as its serum level is significantly low in RA patients and correlated with different parameters of disease activity and radiological severity

Egyptian_familial_breast_cancer_exome_variants

Exome variants from five breast cancer families collected in Gharbiah disctrict, Egypt. DNA was extracted from blood cells using a FlexiGene DNA kit. Exome sequencing was done with TrueSeq Exome Enrichment Kit and on HiSeq2500, paired-end 2x150 at 100X coverage. Exome sequences were mapped to hg19 using Burrows-Wheeler Aligner and pre-processed with Picard Toolkit. Variants were called using Freebayes and annotated with ANNOVAR

Changes in Uterine Cancer Incidence Rates in Egypt

Background. Uterine cancer is one of the top-ranking cancers in women with wide international variations in incidence rates. Developed countries have higher incidence rates than the developing countries. Egypt has significantly lower incidence of uterine cancer than other countries in the Middle East. This study aimed at verifying the incidence rate of uterine cancer and characterizing the demographic and clinical profiles of patients residing in the Gharbiah province in the Nile delta region of Egypt. Methods. Data from 660 uterine cancer patients diagnosed during the period of 1999 to 2010 were abstracted from the Gharbiah Cancer Registry, the only population-based registry in Egypt. The data included age, marital status, number of children, residence, smoking, occupation, date and basis of diagnosis, tumor topography, morphology, stage and grade, and treatment. Crude rate, age-standardized rate (ASR), and age-specific rate were calculated and associated with demographic and clinical characteristics of patients. Results. The study confirmed the low ASR of uterine cancer in Egypt, (4.1 per 100,000 (95% CI: 3.8–4.4)). The incidence rate increased significantly over the 12-year period. The crude rate (CR) was 1.95, 95% CI (1.64–2.25) in 1999–2002; 2.9, 95% CI (2.5–3.2) in 2003–2006; and 3.5, 95% CI (3.1–3.9) in 2007–2010. The rate ratio was 1.5, 95% CI (1.2–1.8) in 2003–2006 and 1.8, 95% CI (1.5–2.2) in 2007–2010 compared to 1999–2002. The majority of patients (83%) were postmenopausal with the highest age-specific rate in the 60–69-year age group (22.07 per 100,000 (95% CI: 19.3–25.2). The majority of patients were diagnosed at early stages (60% localized and 5% regional), had adenocarcinoma (68%), and resided in urban areas (54%). Conclusions. The study confirmed the low incidence rate of uterine cancer in the Gharbiah province of Egypt and significant increase in incidence in recent years. Future studies should focus on verifying the possible effect of hysterectomy on lowering the incidence, the factors related to the changes in rates between rural and urban areas, and the possible impact of nutritional and epidemiologic transitions on the increasing rates