Photocopy of typescript. / Digitized by Kansas Correctional Industries

Thesis (M.Sc. (Medical Laboratory Sciences)) -- University of the North, 1986 / Refer to the document

Thesis (MPH.) -- University of Limpopo, 2015 / Cervical cancer is a serious public health problem in both developed and developing countries. It is said to be the leading cause of death for women from developing countries as compared to other types of cancers. The aim of the study was to determine the initial clinical presentation of cervical cancer patients at the Pietersburg Hospital, Limpopo Province in South Africa. The objectives were to establish the demographic profile of cervical cancer patients, to identify the stage at initial clinical presentation, and to describe the factors that led to initial clinical presentation of cervical cancer patients at the Pietersburg Hospital in Limpopo Province, South Africa.The researcher conducted a quantitative retrospective cross-sectional survey by examining the records of cervical cancer patients seen for a period of three years from January 2012 to December 2014 at the Pietersburg. The results indicated that most patients, particularly the elderly, presented for the first time at the hospital with advanced stages of cervical cancer. Factors, such as age and place of residence contributed to this late presentation. There is a need for improved data capturing of information about marital status and parity to further assess the influence these two elements might have on the clinical presentation of cervical cancer. Furthermore, availability and facilities for screening should be improved because early detection of cervical cancer prevents progression to advanced stage of the disease. More awareness campaigns about risk factors of cervical cancer have to be implemented and a study is needed to establish why most patients with advanced stage cervical cancer are from Sekhukhune and Vhembe Districts, particularly the former Venda and Gazankulu Regions.

Cancer-related fatigue (CRF) is a persistent and debilitating problem for many breast cancer survivors. Although many CRF measurement tools are available, no consensus exists on the most appropriate tool to use for breast cancer survivors. The purpose of this project was to identify the best method of assessing CRF in breast cancer survivors. The practice-focused question inquired about the most appropriate way to assess fatigue in breast cancer survivors. The central concepts of the project were CRF and cancer survivorship. This project was informed by the theory of health as expanding consciousness and Mishel's theory of uncertainty in illness. The sources of evidence included multi-database searches and literature from professional organizations. Results were tracked using preferred reporting items for systematic reviews and metasystems and a literature review matrix. The search identified 14 sources, which were assessed for quality using the grading of recommendations, assessment, development, and evaluation process. The results of this systematic review did not support the use of any particular assessment tool; however, 2 clinical practice guidelines recommended screening using a numerical severity scale followed by detailed assessment of clinically significant fatigue using available assessment tools. Screening can be implemented into the survivorship clinic, allowing nurses to identify potentially clinically significant fatigue so that further workup is done and interventions are implemented. Identifying, assessing, and intervening for clinically significant fatigue can improve the quality of life for breast cancer survivors, contributing to positive social change.

Il est connu depuis de nombreuses années que le métabolisme des cellules cancéreuses diffère de celui des cellules saines. La Restriction Calorique (RC) est connue pour prolonger la durée de vie et pour limiter l’oncogenèse. Ainsi, il a été montré que la RC et ses mimétiques comme le 2-deoxyglucose (2DG) augmentent l’efficacité de la chimiothérapie et peuvent aussi induire une immunité anti-tumorale. J’ai pu montrer qu’en régulant le métabolisme via la restriction calorique (ou des mimétiques) nous pouvions moduler l’expression de la protéine anti-apoptotique Mcl-1. Ainsi nous avons établi in vivo et in vitro que la RC restaure la sensibilité des cellules de lymphome à l’apoptose induite par un inhibiteur de Bcl-2/XL, l’ABT-737. Nous avons aussi établi que ces effets sont indépendants de la protéine p53 et/ou des « protéines BH3-only ». La deuxième partie de mon travail a été d’élucider les mécanismes moléculaires mis en place lors de la Chimiothérapie Hyperthermique Intra péritonéale (CHIP) pouvant expliquer les effets bénéfiques observés chez les patients atteints d’une carcinose péritonéale (CP). Une partie de ces bénéfices sont dus à la mise en place d’une immunité anti-tumorale. En utilisant des modèles in vivo et in vitro j’ai mis en évidence l’implication de la protéine du choc thermique 90 (Hsp90) dans l’effet observé. Ainsi, l’inhibition spécifique de la Hsp90 réverse les effets protecteurs de la CHIP, soulignant l’importance de cette protéine dans notre modèle d’immunité anti-tumorale. / The link between cell metabolism and cancer at the cellular level has long been known. Caloric restriction (CR) is known to prolong lifespan and to protect from cancer incidence. The molecular mechanisms involved in these benefic effects have been evaluated and may offer new opportunities for therapeutic intervention. Moreover, CR and CR-mimetics such as 2-deoxyglucose (2DG) has been shown to enhance chemotherapy efficiency and to induce an anti-cancer immune response. During the period of my PhD I demonstrated how the modulation of metabolism through caloric restriction or through its mimetics could significantly reduce the expression of the anti-apoptotic protein Mcl-1 and sensitize lymphoma-bearing mice to apoptosis induced by a Bcl-2/XL inhibitor, ABT-737. We have demonstrated that CR can control Mcl-1 translation and sensitize cells to ABT-737-induced death regardless of the presence or absence of p53 and/or of the main “BH3-only proteins”. Then, I focused on deciphering the molecular mechanisms allowing the Hyper-thermic Intra-Peritoneal Chemotherapy (HIPEC) to be beneficial to patients suffering from peritoneal carcinomatosis. Part of the protective effect was mediated through the induction of an efficient anti-cancer immune response. Next, I showed the involvement of heat shock proteins 90 (Hsp90) in the observed effect. Indeed, when Hsp90 was blocked we lost the protection induced by the HIPEC-treated cells, therefore underling the role of Hsp90 in this HIPEC-dependent induction of anti-cancer immune response.

No description available.

Thesis (M. D.)--University of Hong Kong, 2007. / Title proper from title frame. Also available in printed format.

Degree awarded (2003): EdDHRD, Counseling, Human and Organizational Studies, George Washington University / ABSTRACT OF DISSERTATION<p>The Effect of Patient Race upon Physicians Colorectal Cancer Screening: A Retrospective Medical Record Review and Physician Pattern Variable Analysis<p>There is a significant disparity in the health status of African-Americans and whites in the United States. Studies have revealed that African-Americans have higher mortality rates from colorectal cancer than whites. Differences in colorectal cancer screening of African-Americans compared to whites may account for a proportion of the excess mortality. This study evaluated internal medicine resident physicians colorectal cancer screening practices in African-American and white patients. Additionally, an analysis of physicians pattern variable orientation was performed to determine if there was a relationship between physicians orientation and adherence to colorectal cancer screening guidelines.<p>A retrospective review of medical records from January 2002 through March 2002 was conducted to assess internal medicine resident physicians performance of colorectal cancer screening. Univariate analysis revealed that there were statistically significant differences in the rate at which physicians performed rectal examinations (p=0.0039), fecal occult blood testing (p=0.0006) and colonic examinations (p<0.0001) in African-American compared to white patients. Multivariate analysis, evaluating patient race, patient gender, patient age and physician gender, demonstrated that patient race was the only factor significant for not performing colorectal cancer screening tests.<p>Physicians perspectives about the medical profession and the delivery of medical services were assessed by evaluating pattern variable orientations. Integrative, value and motivational orientations of the physicians were determined by using semi-structured interviews. All of the physicians had a self-orientation (integrative pattern variable), a universalistic-achievement orientation (value pattern variables) and a specificity orientation (motivational pattern variable). However, the physicians differed in their affectivity-affective neutrality orientation (motivational pattern variable). All of the physicians who had an affective orientation toward their patients adhered to colorectal cancer screening recommendations. The physicians who expressed affective neutrality toward their patients did not adhere to colorectal cancer screening recommendations.<p>This study revealed significant differences in the performance of colorectal cancer screening in African-American compared to white patients. Additionally, physicians pattern variable orientations correlated with adherence to practice guidelines. This study is important because it provides information about physician practice patterns. The results of this study can serve as the basis for the development of educational interventions for physicians that can improve health care delivery. / Advisory Committee: Dr. John Williams, Dr. David Schwandt (Chair), Dr. Andrea Casey, Dr. Jeffrey Lenn, Dr. Victor Scott

The number of women living with a breast cancer diagnosis will continue to increase with growing breast cancer incidence rates, greater utilization of early detection, and longer length of survival times. The prevalence of complementary and alternative medicine (CAM) is likely to increase as well, making it important to determine the nature and extent of CAM use in this population. This study explored CAM use and the influence of the control constructs in the context of the theory of cognitive adaptation. Computer-assisted telephone interviews were completed with 551 women diagnosed with breast cancer in Portland, Oregon. Results indicated that two-thirds (66%) of the women used at least one CAM therapy during the past 12 months. The majority of women had high perceptions of cancer control and believed the CAM therapies were important in influencing the course of the cancer. Logistical regression analysis found that significant demographic predictors of CAM use were younger age, higher education, and private insurance. Confirmatory factor analysis was used to refine and test the construct validation of the Cancer Locus of Control scale. Results supported a three-factor model (control over cause of cancer, control over course of cancer, and religious control of cancer) of the scale. Results of multinomial logistical regression indicated that higher perceptions of control over the course of the cancer significantly predicted CAM use in three categories. Religious control over the cancer was not a predictor of CAM use. The findings from this study will help health care professionals and policy makers identify patient needs that go beyond surgery, chemotherapy and radiation, and address patient-centered health-related goals and outcomes for optimal health and recovery from breast cancer. / Graduation date: 2002

Breast cancer is of a primary concern in women, although it can occur in men. It is the second leading cause of cancer related deaths amongst women, and it is estimated that roughly 39,840 women will die of this disease this year. Breast cancer occurs across all populations and ethnicities. When African-Americans (AA) present with breast cancer, they usually have poorly differentiated tumors, and are more likely to be diagnosed with an advanced stage tumor. When compared to Caucasian (Cau) women, African-American women also have higher breast cancer mortality. The causes of these differences are not yet definitively known, but it has been suggested that the disparities that are present between African-American and Caucasian women are due to a number of factors. A few which have been mentioned are differences in Body Mass Index (BMI), socioeconomic status, health care coverage, and the level of obtained education that exists between the two ethnic groups. Although these factors may account for a small percentage of the difference seen between the two ethnic groups, the underlying cause that may explain why African-American women are at a greater risk of developing aggressive breast cancer may be due to differences in gene expression. A focus of my research project is the comparison of genome-wide gene expression differences between African-American and Caucasian women. Preliminary results from the comparison of normal breast tissue (obtained from reduction mammoplasty) from Caucasian and African-American women suggest there are marked differences in gene expression patterns. Pathway analysis of differentially expressed genes shows that they are involved in protein folding and the immune response. I am currently expanding this study to include a comparison of 10 AA to 10 Cau normal breast samples. These samples are being LCM dissected to separately compare gene expression in epithelial and stromal tissue. Cross comparisons between ethnic groups and tissue types will provide an understanding of normally occurring differences between AA and Cau women, which may help to explain the observed cancer disparities. Data from the study of normal tissue will be compared to gene expression data from triple negative breast cancer (TNBC) patients from both ethnicities.