فهرست مطالب mona joudi

Current data indicate that serum vitamin D and susceptible C-reactive protein (hs-CRP) levels, both indicative of the inflammatory state, have the potential to predict the onset and severity of chronic pain. Therefore, the objective was to assess the intensity of pain experienced after breast cancer treatment and its relationship with these two parameters.
In this cross-sectional study between 2019 and 2021, 201 patients were enrolled. The McGill Pain Questionnaire was employed to evaluate localized pain intensity at the site six months after the conclusion of cancer treatments. Patients were stratified based on the type of breast surgery, with or without a tissue expander, axillary region surgery, chemotherapy treatment, radiotherapy treatment, serum vitamin D levels, serum hs-CRP levels, and pain intensity. Data analysis was performed using SPSS 21 software with a significance level set at 0.05.
Among the patients, 67.6% (136 individuals) reported mild pain, 31.3% (63 individuals) reported moderate pain, and 1% (2 individuals) reported severe pain. The results of this study demonstrated a positive correlation between high serum hs-CRP levels and increased pain intensity, with serum marker levels being higher in patients experiencing more severe pain compared with those with milder pain. However, no statistically significant association was observed between various serum concentrations of vitamin D and pain intensity (P = 0.12).
Elevated levels of inflammatory factors, such as hs-CRP, are linked to a higher likelihood of developing chronic post-surgical pain.

Breast cancer is the most common type of cancer in many countries, accounting for over 18% of all cancers in females. There are more than one million new cases of breast cancer each year. Most women diagnosed with breast cancer are over the age of 50, but younger women can also get breast cancer. About one in seven women are diagnosed with breast cancer during their lifetime. There's a good chance of recovery if it's detected at an early stage. In Iran, breast cancer is the most common cancer among women, making up 21.4% of all female cancers. The mortality rate of this cancer is 4.33 for every 100,000 people. The purpose of this research is to see how often different kinds of early breast cancer come back and how long people live after being diagnosed.

This retrospective study evaluated the medical records of 500 breast cancer patients at two hospitals in Mashhad, Iran during April 2006 to March 2016. We used SPSS software, version 16 (SPSS Inc., Chicago, IL, USA) to analyze data. A P value less than 0.05 means that the results are considered statistically significant.

We included 230 women with breast cancer. The average overall survival was 130.7 months, with 83.2% of people surviving for five years and 78.8% surviving for 10 years. The stage of the disease is strongly linked to the recurrence (P=0.000). Additionally, the specific type of disease is also strongly related to disease recurrence (P=0.01) or metastasis (P=0.01). Patients who have the triple-negative subtype had the highest chance of the cancer spreading and recurrence compared to patients with other subtypes.

The different types of breast cancer are strongly linked to the disease recurrence or metastasis. Patients with triple-negative subtypes had the most cases of cancer spreading to other parts of the body and coming back again, compared to other subtypes. Our findings also showed that patients with the triple-negative disease had the worst overall and disease-free survivals.

The large body of research, from theorizing to empirical findings, suggests that positive cognitive Re-evaluation of trauma may further support positive post-traumatic outcomes by enhancing post-traumatic growth. The aim of this study was to investigate the direct and indirect role coping strategies, core beliefs disruption, social support, spirituality, religious cope and intrusive rumination with PTG and also examining the mediating role of positive re-evaluation and rumination were within the framework of a causal model.

The present study was a cross-sectional study that was done using causal modeling methods that included path analysis and structural equation modeling. The statistical population included all cancer patients who referred to Omid Oncology Hospital and Imam Reza Oncology Ward in Mashhad in 1398. Sampling method was available. 420 patients with cancer answered the questionnaires used in this study. Data were analyzed using SPSS-16 version and PLS software (version2).

The findings generally showed that positive Re-evaluation mediated between post-traumatic growth and social support variables, presence and search for meaning, positive religious cope, negative religious cope, deliberate rumination, and core beliefs disruption. Deliberate rumination was also a mediator between growth and core beliefs disruption and automatic rumination. On the other hand, social support, presence and search for meaning, core beliefs disruption and deliberate rumination, problem-based and emotion-based coping methods had a direct and positive effect, and intrusive rumination and self-distraction coping had a direct and negative effect on growth.

The results of the present study showed that in addition to confirming the direct paths of coping, social support, spirituality, deliberate rumination, core beliefs disruption in growth, positive re-evaluation of one of the explanatory passages of social support paths, religious cope, spirituality, intrusive rumination, core beliefs disruption It was about post-traumatic growth.

It is necessary to identify the factors affecting the posttraumatic growth of cancer patients to minimize the consequences of its psychological trauma.    

This study aimed to determine the structural relationships of coping styles, the collapse of core beliefs, social support, spirituality/religious coping with posttraumatic growth variables, and the mediating role of positive reassessment and deliberate mental rumination within a causal pattern. 

This cross-sectional study was performed using path analysis and structural equation modeling (SEM) by convenience sampling method on 213 patients with breast cancer in Mashhad, Iran, in 2019.  The pattern of variables relationships was tested in a conceptual model by SEM and used the partial least squares regression method to test the measurement pattern and research hypotheses.  In the measurement model section, three convergent validity indices, i.e., Average Variance Extracted (AVE), Composite Reliability (CR), and the Cronbach α, and in the structural model section, two indicators of coefficient of determination (R2) and Stone-Geisser coefficient (Q²). 

The Mean±SD age of the patients was 52±16 years. The standardized coefficients of the overall effect of core beliefs pathways, positive religious coping, search for meaning, presence of meaning, deliberate rumination over positive re-evaluation were 0.953, 0.386, -0.250, 0.248, and 0.238, respectively (P=0.001).  The direct coefficient of the positive reassessment path to posttraumatic growth was 0.085 (P=0.01). Also, the coefficient of collapse path of core beliefs to intrusive rumination was 0.687, which was significant at the level of P=0.0001.  Finally, the standardized coefficients of the overall effect of all paths for negative religious coping, the collapse of core beliefs, presence of meaning, problem-based coping style, search for meaning, deliberate rumination, social support, positive religious coping, emotion-based coping, intrusive rumination over posttraumatic growth were -0.481, 0.227, 0.182, 0.146, -0.136, 0.066, 0.060, 0.059, 0.056, and -0.043, respectively (P=0.0001).

The results of the present study showed that in addition to confirming the direct paths of independent variables to the posttraumatic growth, positive reassessment had a mediating role between pathways of the presence and search of meaning, conscious rumination, religious coping, and the collapse of core beliefs in posttraumatic growth.

Cervical cancer is the second most common cancer in less developed countries. Chemoradiation is the standard treatment for advanced cervical cancer, but there is a lack of radiotherapy equipment in developing country. Therefore, this study was performed with aim to evaluate the pathologic response, treatment complication and survival rate of patients with locally advanced squamous cell carcinoma (SCC) of cervix who were not candidate for chemoradiation with use of chemotherapy before surgery.

In this single group, before-after randomized clinical trial, 24 patients with FIGO stages IB2, IIA2, and IIB squamous cell carcinoma (SCC), who were not candidate for standard chemoradiation due to different causes, received 3 courses of neoadjuvant paclitaxel (135mg/m2)+ Cisplatin (75mg/m2) chemotherapy regimen. Then, surgery was performed. Clinical response to neoadjuvant chemotherapy and treatment side effects were assessed after each course. Wertheim hysterectomy was done 4 to 6 weeks later in those with favorable response. In the absence of major risk factors in the surgical pathology, patients received 3 additional cycles of adjuvant chemotherapy. In high risk patients, adjuvant chemoradiotherapy was performed. Data was analyzed by SPSS software (version 21) and Chi-square, and Kaplan Mayer tests. P

Among 24 patients, 13 cases (54.2%) and 17 (73.9%) had FIGO stageIIB and gradeII tumors, respectively. Parametrial involvement was presented in 13 patients (54.2%). Seven patients were excluded. 17 patients underwent surgical resection. Four high risk patients and were candidate for chemoradiation. Clinical and complete pathological response rate were 17 cases (70.8%) and 8 cases (47.1%), respectively. With a median follow up of 18.5 months, mean of overall survival and disease free survival of patients treated with the study protocol were 24.51 and 25.71 month, respectively. The mean of overall survival of whole patients (24 cases) was 30.8 month (CI: 95%, 29/38-32/26).  

Neoadjuvant chemotherapy in patients with locally advanced cervical cancer despite acceptable pathologic response is not associated with survival advantage.

Gastric cancer is the second global leading cause of death from cancer and the most common gastrointestinal cancer in Iran. This condition is usually diagnosed at advance stages where treatment options are limited. Recently, heat shock proteins (HSPs) have been reported to be overexpressed in a wide range of malignancies and considered as promising candidate biomarkers and therapeutic targets for gastric adenocarcinoma. The aim of the present study was to compare HSPs protein expression between non-tumoral and tumoral sections from patients with gastric adenocarcinoma and determine HSPs protein expression correlation with histological stage, tumoral grade and prognosis.

Immunohistochemistry was used to assess the expression levels of HSP27, 70 and -90 proteins on both tumoral and non-tumoral (margin of tumor as control group) sections in 80 patients with gastric adenocarcinoma. Further analyses were histology, grade and stage of tumor (Tumor, node, and metastasis), HSPs expression level, clinicopathological significances, and survival rate.

The expression of HSPs was significantly increased in tumoral sections compared with non-tumoral sections (P<0.001). The HSP27 expression was correlated with tumors on the corpus of stomach (P=0.049). Patients younger than 63 years revealed higher expression levels of HSP70 (P=0.040). High expression levels of HSP90 were further assessed in well-differentiated and intestinal types of tumors (P=0.009 and P=0.019). Overexpressed levels of HSP27 and 90 were associated with the reduced survival rate of patients (P=0.017 and P=0.018).

HSP27 and HSP 90 are potential prognostic biomarkers of patients’ survival rate. Patients harboring positive HSP27 and HSP 90 expression display worse disease-free survival compared to those with negative HSP27 and HSP 90 expression. Differential expression of HSPs may play crucial roles in the initiation and progression of gastric cancer and can be exploited as future therapeutic targets.

Cancer antigen 15-3 and carcinoembryonic antigen are used in clinical and laboratory diagnosis of metastatic breast cancer. Previous studies have noted conflicting results about the association between carcinoembryonic antigen and cancer antigen 15-3 in metastatic breast cancer. The present study examined serum tumor marker levels of carcinoembryonic antigen and cancer antigen 15-3 among patients with different subtypes of metastatic breast cancer. In this cross-sectional study, we assessed metastatic breast cancer patients diagnosed between 2005 and 2012 who referred to academic Hospitals affiliated with Mashhad University of Medical Sciences. The patients were selected by systematic randomization sampling. Demographic, clinical, pathological, and therapeutic data were collected from patients’ hospital records. Statistical analyses were performed by Statistical Package for the Social Sciences version 16.0 software. A total of 298 eligible patients enrolled in the study. Patients’ median age was 48.39±12.57 years. Elevated serum levels of carcinoembryonic antigen were identified in 65.17% of patients and cancer antigen 15-3 in 57.29% of patients. Based on molecular subtype categorization, 109 (39.5%) patients were human epidermal growth factor receptor 2 negative and 105 (38.0%) patients were in the luminal group. There was no significant correlation between serum carcinoembryonic antigen and cancer antigen 15-3 with subtypes of the tumor. The most common sites for metastasis were bones and liver, respectively. However, there was no significant correlation between serum carcinoembryonic antigen and cancer antigen 15-3 with the site of metastasis. There was a significant association between serum carcinoembryonic antigen level and stages IIA and IV. One of the most significant findings of the current study was the increased serum carcinoembryonic antigen and cancer antigen 15-3 levels in most metastatic breast cancer participants. We postulate that regular measurement of serum cancer antigen 15-3 and carcinoembryonic antigen could be useful for earlier detection and prediction of outcomes.

Breast cancer is the most common malignancy of females. Breast cancer is a heterogenic disease; it consists of several subtypes based on the expression of different genes. Risk factors associated with each subtype is not completely understood, yet. Moreover, recognizing the cancer subtypes may alter the treatment plan. The aim of this study was to evaluate different breast cancer subtypes in women more than 65-year-old. This was a cross-sectional study done on patients with breast cancer aged 65 years and older presenting to clinics of Emam Reza and Omid Hospitals, Mashhad, Iran between 2005 and 2015. Statistical analysis was carried out using SPSS ver. 16. P<0.05 was considered statistically significant.A total of 225 breast cancer patients age 65 and older were included in our study. When we categorized our patients by breast cancer subtypes, 69.8% had the Luminal A, B subtype, 23.1% had Triple-Negative subtype, and the remaining 7.1% had HER-2 enriched subtype.Different breast cancer subtypes in patients aged 65-year-old and higher were Luminal A, B, HER-2 enriched and Triple-negative, respectively. We also showed that patients with Luminal A, B subtypes had significantly higher BMI and BSA compared to other subtypes.

Esophageal squamous cell carcinoma (ESCC) is a common malignancy in gastrointestinal tract.
This study was conducted to investigate the frequency of human epidermal growth factor receptor 2 (HER2), over-expression in patients with ESCC, and its correlation with pathologic response in cases undergoing neo-adjuvant, chemoradiation, and survival.
In this cross sectional study, 68 patients with non-metastatic esophageal SCC, who had undergone neo-adjuvant chemotherapy containing cisplatin and 5FU in conjunction with radiotherapy between 2007 and 2014 were evaluated. HER2 expression assessed by Immunohistochemistry and HER2 score was also calculated for each specimen. Tumor response to neoadjuvant chemoradiotherapy was evaluated in surgical blocks according to tumor regression grading (TRG) system. Patients were followed up every 3 months in first 2 years and every 6 months afterwards.
The result of Hercep test was positive in 42.8% of cases, among whom 33.8% were 2 and 8.8% were 3. Her2 score was above 100 in 38.3%. Complete pathologic response was observed in 32.3%. There was no significant difference in the rate of complete response between patients with positive and negative HER-2 over-expression (P = 0.71). There was also no significant correlation between Her2 score among groups with favorable and unfavorable response to chemoradiation (P = 0.796 and 0.743). There was no difference in overall survival in Her2 positive and negative groups (3 years survival was 45 and 54 months, P = 0.32). Overall survival significantly reduced in patients with Her2 score above 100 (P = 0.045).
Her2 positive in ESCC had no effect on tumors biologic behaviors and its response to chemoradiation. Although no correlation was observed between Her2 expression and survival; Her2 score above 100 was associated with shorter survival.

Breast cancer can be categorized into different histopathological subtypes based on gene expression profiles. The aim of this study was to evaluate the clinicopathological features and overall survival (OS) of various subtypes of breast cancer in order to help diagnosis and guide treatment.
The clinicopathologic features of 1095 patients with breast cancer diagnosed over a 10–year period between 2001 and 2011were analyzed. Kaplan–Meier method was used to analyze the disease-free survival (DFS) and overall survival (OS). Calculation of hazard ratio (HR) was conducted by multivariate Cox regression.
According to the clinicopathologic characteristics of 1095 cases, 42% were luminal A subtype, 19.2% luminal B, 23% triple negative and 15% Her-2. The lowest (46.88±12.59 years) and highest (50.54±12.32 years) mean age were in triple negative and Her2 groups, respectively. There was a significant correlation between histology subtype and age, BMI, lymph node, type of surgery, and stage of disease. Overall survival (OS) and disease free survival (DFS) were significantly shorter in Her-2 breast cancer patients (P The results of this study showed the importance of clinicopathological studies of molecular types which helps early diagnosis and identification of best strategy to treat the disease.

There are many acceptable approaches ranging from light to moderate intravenous sedation or analgesic drugs that are used to provide pain control in dilatation and curettage. We report the use of hypnosis as a nonpharmacologic approach to control pain in this manner.

Breast cancer is the most common type of cancer in women. 35% of breast cancer is reported in women older than 70 years. This study was performed with aim to evaluate the clinical characteristics of breast cancer among women above 70 years.
In this multi-central, retrospective and descriptive study, 2723 files of women with breast cancer referred to Mashhad Omid hospital and Reza Radiation oncology centre from 2001 to 2012 were evaluated. All the necessary data about age, family history, tumour pathology, clinical stage of tumour, hormone receptor status, Her2 protein status, type of surgery and type of adjuvant therapy ( radiotherapy, chemotherapy, hormone therapy ) were extracted from these files. Data was analysed with SPSS software (version 16). P The most common pathology was invasive ductal carcinoma (89.4%). 106 cases (65.8%) had positive estrogen receptor, 79 (9.8%) positive progesterone receptor and 89 (64.49%) negative Her2. Most patients (71.4%) had undergone modified radical mastectomy. The most common clinical stage was IIB (33.54%).
The most common type of breast cancer in women above 70 years is invasive ductal carcinoma and the most common stage of disease is IIB. Most patients are positive estrogen receptor and negative HER2. Therefore, it is recommended to pay more attention to their specific clinical characteristics in choosing their treatment approach.

Since renal cell carcinoma (RCC) is an aggressive tumor with unpredictable behavior، 30-50% of patients have metastatic lesions at the time of tumor diagnosis. The most common sites of cancer metastasis includes bones، lungs، liver and brain; however metastasis to the cervix rarely occurs and only few cases have been reported worldwide. Case report: A 57 years old woman referred with nonspecific abdominal pain from 10 month later، without weight loss and vaginal bleeding. After CT scanning of the abdomen and pelvis، a mass in the superior part of the left kidney was seen and nephrectomy was performed. Pathology reports the third stage of renal cell carcinoma extending to the renal capsule، but the capsule was not ruptured and had no lymph node involvement. After the surgery، patient''s pain was relief and considering completing removal of the tumor، no complementary therapies were done. One year follow up of surgery، the patient underwent hysterectomy operation due to a uterine mass in diagnostic CT scan of abdominopelvic and pathological examination confirmed a renal cell carcinoma metastasis to cervix.

This report emphasized the probability of RCC metastasis to the cervix، despite its rarity.

IntroductionAnorectal myectomy and anal dilation under anesthesia could be an effective way in the treatment of patients with ultrashort_segment Hirschprung.In this article we studied [S1]the outcomes of anorectal myectomy.Materials and MethodsOur study group was [S2]61 patients with the disease who had reffered to SHEIKH hospital from the second half of 1386 to the first half of 1388. Barium enema and anorectal myectomy was performed in all patient[S3].Follow up after myectomy was in the second week after surgery and then monthly[S4].For the complications and results, patients were also divided in to 3 groups based on the presence or absence of ganglion cell in the muscular resectal region,and the results were compared in each [S5]group.ResultsBleeding, infection of the operation zone, sepsis, entrocolitis, and anal stenosis was not observed in any patient after surgery. 4 patients had gas incontinence and 3 had fecal incontinence after surgery which was cured in 3-6 months with bio-feedback orders. 40 patients (87.5%) had complete remission after surgery and 2(4.17%) had partial remission and 4(8.33%) had no remission at all. Based on these results, there is no relation between gender, complications of surgery and the results of surgery. ConclusionAnorectal myectomy could be an effective treatment strategy for patients with following situations: absence of anatomical abnormalities-[S6]chronic constipation in spite of medical treatment-[S7]absence of transitional zone in barium enema-[S8]failure of anorectal reflex relaxation with rectal distention in anorectal manometry.