scholarly journals Cancer worry among BRCA1/2 pathogenic variant carriers choosing surgery to prevent tubal/ovarian cancer: course over time and associated factors

2022 ◽  
Author(s):  
Majke H. D. van Bommel ◽  
Miranda P. Steenbeek ◽  
Joanna IntHout ◽  
Rosella P. M. G. Hermens ◽  
Nicoline Hoogerbrugge ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Associated Factors ◽  
Latent Class ◽  
Pathogenic Variant ◽  
Cancer Worry ◽  
Clinical Trial Registration ◽  
Factors Associated ◽  
Post Surgery ◽  
Risk Reducing ◽  
Over Time

Abstract Objective High cancer risks, as applicable to BRCA1 and BRCA2 pathogenic variant (PV) carriers, can induce significant cancer concerns. We examined the degree of cancer worry and the course of this worry among BRCA1/2-PV carriers undergoing surgery to prevent ovarian cancer, and identified factors associated with high cancer worry. Methods Cancer worry was evaluated as part of the multicentre, prospective TUBA-study (NCT02321228) in which BRCA1/2-PV carriers choose either novel risk-reducing salpingectomy with delayed oophorectomy or standard risk-reducing salpingo-oophorectomy. The Cancer Worry Scale was obtained before and 3 and 12 months after surgery. Cancer worry patterns were analysed using latent class growth analysis and associated factors were identified with regression analysis. Results Of all 577 BRCA1/2-PV carriers, 320 (57%) had high (≥ 14) cancer worry pre-surgery, and 54% had lower worry 12 months post-surgery than pre-surgery. Based on patterns over time, BRCA1/2-PV carriers could be classified into three groups: persistently low cancer worry (56%), persistently high cancer worry (6%), and fluctuating, mostly declining, cancer worry (37%). Factors associated with persistently high cancer concerns were age below 35 (BRCA1) or 40 (BRCA2), unemployment, previous breast cancer, lower education and a more recent BRCA1/2-PV diagnosis. Conclusions Some degree of cancer worry is considered normal, and most BRCA1/2-PV carriers have declining cancer worry after gynaecological risk-reducing surgery. However, a subset of these BRCA1/2-PV carriers has persisting major cancer concerns up to 1 year after surgery. They should be identified and potentially offered additional support. Clinical trial registration The TUBA-study is registered at ClinicalTrials.gov since December 11th, 2014. Registration number: NCT02321228.

scholarly journals 3196 Assessing the Relationship between Resilience and Pain Catastrophizing in Patient Reported Outcomes following Total Knee Replacement

2019 ◽  
Vol 3 (s1) ◽  
pp. 119-119
Author(s):  
Vesta Nwankwo ◽  
William Jiranek ◽  
Steven George ◽  
Janet Bettger
Keyword(s):  
Missing Values ◽  
Latent Class ◽  
Pain Catastrophizing ◽  
Outcome Measurement ◽  
Measurement Information ◽  
Preoperative Treatment ◽  
Post Surgery ◽  
Patient Reported ◽  
The Impact ◽  
Over Time

OBJECTIVES/SPECIFIC AIMS: The aim of the present study is to explore the relationships between resilience, pain catastrophizing, and functional outcomes in pre-and post-operative TKR patients. The primary outcome is the ability of the Brief Resilience Scale (BRS) to predict function using the Knee injury and Osteoarthritis Outcome Score Joint Replacement (KOOS, JR.) and overall health on the Patient-Reported Outcome Measurement Information System Global Health (PROMIS GH). METHODS/STUDY POPULATION: Recruited patients will provide informed consent during in-person office visits. At the pre-surgery intake appointment, patients will provide demographic information and complete baseline questionnaires assessing resilience, pain catastrophizing, knee stiffness, pain, and function, and impression of overall health. In-person or electronic follow-up assessments will be administered post-surgery at 6-week, 3-month, and 6-month appointments. RESULTS/ANTICIPATED RESULTS: We aim to recruit 150 patients for this study. We do not expect a difference in sociodemographic characteristics of the patient sample. P-values will be based on t-tests and correlations calculated by comparing only non-missing values. Each outcome measure will be examined at each time point and trajectories will be calculated to determine the change in each outcome over time. Using latent class growth modeling we will examine individual change over time for each outcome (BRS, PCS, PROMIS GH, and KOOS JR.), and the association of resilience and pain with change in function (KOOS, JR. total score) and overall health (PROMIS GH). DISCUSSION/SIGNIFICANCE OF IMPACT: To our knowledge, this is the only known study that will compare resilience, pain catastrophizing and longitudinal health outcomes in a single paradigm. Results will hopefully inform the design and implementation of future studies that will assess the impact of preoperative treatment of vulnerable patients. The ultimate goal is to improve functional recovery by using pre-identified psychological constructs as intervention points. Ideally, the same measures would be implemented, however, details of this plan will be established following completion of this study.

scholarly journals BRCA Genetic Test and Risk-Reducing Salpingo-Oophorectomy for Hereditary Breast and Ovarian Cancer: State-of-the-Art

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2562
Author(s):  
Masayuki Sekine ◽  
Koji Nishino ◽  
Takayuki Enomoto
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Cancer Patients ◽  
Genetic Test ◽  
State Of The Art ◽  
Parp Inhibitors ◽  
Pathogenic Variant ◽  
Breast And Ovarian Cancer ◽  
All Cause Mortality ◽  
Risk Reducing

In the field of gynecology, the approval of the PARP inhibitors (PARPi) has been changing the treatment of ovarian cancer patients. The BRCA genetic test and the HRD test are being used as a companion diagnosis before starting PARPi treatment. BRACAnalysis CDx® and Myriad myChoice® HRD test are widely used as a BRCA genetic test and HRD test, respectively. In addition, FoundationOne®CDx is sometimes used as a tumor BRCA test and HRD test. In clinical practice, gynecologists treating ovarian cancer are faced with making decisions such as whether to recommend the gBRCA test to all ovarian cancer patients, whether to perform the gBRCA test first or HRD test first, and so on. Regarding the judgment result of the HRD test, the cutoff value differs depending on the clinical trial, and the prevalence of gBRCA pathogenic variant rate is different in each histological type and country. A prospective cohort study showed that RRSO reduced all-cause mortality in both pre- and postmenopausal women; however, RRSO significantly reduced the risk of breast cancer for BRCA2 pathogenic variant carriers, but not for BRCA1 pathogenic variant carriers. Moreover, salpingectomy alone is said to not decrease the risk of developing ovarian or breast cancer, so further discussion is evidently required. We discuss the current situation and problems in doing BRCA genetic test and RRSO in this review article.

scholarly journals PREVALENCE AND RISK FACTORS OF HYPERKALEMIA AFTER LIVER TRANSPLANTATION

2018 ◽  
Vol 31 (1) ◽  
Author(s):  
Helem Sena RIBEIRO ◽  
Michelle Carvalho OLIVEIRA ◽  
Lucilene Rezende ANASTÁCIO ◽  
Simone Vasconcelos GENEROSO ◽  
Agnaldo Soares LIMA ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Retrospective Cohort ◽  
Associated Factors ◽  
Medication Use ◽  
Potassium Intake ◽  
Factors Associated ◽  
Transplant Patients ◽  
One Year ◽  
Over Time

ABSTRACT Background: There is a lack of data regarding hyperkalemia after liver transplantation. Aim: To evaluate the prevalence of hyperkalemia after liver transplantation and its associated factors. Methods: This retrospective cohort study evaluated 147 consecutive post-transplant patients who had at least one year of outpatient medical follow up. The data collection included gender, age, potassium values, urea, creatinine, sodium and medication use at 1, 6 and 12 months after. Hyperkalemia was defined as serum potassium concentrations higher than 5.5 mEq/l. Results: Hiperkalemia was observed in 18.4%, 17.0% and 6.1% of patients 1, 6 and 12 months after tranplantation, respectively. Older age (p=0.021), low creatinine clearance (p=0.007), increased urea (p=0.010) and hypernatremia (p=0.014) were factors associated with hyperkalemia, as well as the dose of prednisone at six months (p=0.014). Conclusion: Hyperkalemia was prevalent in less than 20% of patients in the 1st month after liver transplantation and decreased over time. Considering that hyperkalemia does not affect all patients, attention should be paid to the routine potassium intake recommendations, and treatment should be individualized.

scholarly journals Factors associated with professional identity formation within psychiatry residency training: A longitudinal study

2021 ◽  
Author(s):  
Qian Hui Chew ◽  
Yvonne Steinert ◽  
Kang Sim
Keyword(s):  
Professional Identity ◽  
Identity Formation ◽  
Psychiatry Residency ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Developmental Stages ◽  
Rate Of Change ◽  
Psychiatry Residents ◽  
Factors Associated ◽  
Over Time

Abstract Introduction Conceptual frameworks for professional identity (PI) formation highlight the importance of developmental stages and socialization as the learner progresses from legitimate peripheral to full participation. Based on extant literature and clinical impressions, the authors aimed to explore factors associated with PI formation in psychiatry residents over time, and hypothesized that time in training, seniority status, and duration of exposure to psychiatry prior to residency would be associated with PI formation. Methods Eighty out of 96 psychiatry residents (response rate, 83.3%) from the National Psychiatry Residency Program in Singapore participated and rated their PI development using the Professional Self Identity Questionnaire (PSIQ) across four timepoints from January 2016–December 2019. The residents were classified as junior (first 3 years) or senior residents (years 4–5). Linear mixed model analyses were conducted, with time in training, seniority status (junior versus senior residents), duration of psychiatry postings prior to residency, and their interaction as associated factors with PI over time. Results Time in training, seniority, and duration of psychiatry postings before residency (all p < 0.01) were significantly associated with higher PSIQ scores at baseline. Over time, although all residents had increases in PSIQ scores, this rate of change did not differ significantly between junior and senior residents. Discussion Exposure to psychiatry postings before residency, time in learning, and seniority are factors which influence PI development in residents. This has implications for psychiatry residency selection and training, adequate clinical exposure during training rotations, and continual support for new and senior residents to foster PI formation over time.

scholarly journals Plasma Protein Biomarkers Associated with Higher Ovarian Cancer Risk in BRCA1/2 Carriers

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2300
Author(s):  
Hee-Sung Ahn ◽  
Jung Yoon Ho ◽  
Jiyoung Yu ◽  
Jeonghun Yeom ◽  
Sanha Lee ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Plasma Protein ◽  
Normal Subjects ◽  
Genetic Alterations ◽  
Enzyme Linked Immunosorbent Assay ◽  
Ovarian Cancer Risk ◽  
Protein Markers ◽  
Protein Biomarkers ◽  
Proteomics Approach ◽  
Risk Reducing

Ovarian cancer (OC) is the most lethal gynecologic malignancy and in-time diagnosis is limited because of the absence of effective biomarkers. Germline BRCA1/2 genetic alterations are risk factors for hereditary OC; risk-reducing salpingo-oophorectomy (RRSO) is pursued for disease prevention. However, not all healthy carriers develop the disease. Therefore, identifying predictive markers in the BRCA1/2 carrier population could help improve the identification of candidates for preventive RRSO. In this study, plasma samples from 20 OC patients (10 patients with BRCA1/2 wild type (wt) and 10 with the BRCA1/2 variant (var)) and 20 normal subjects (10 subjects with BRCA1/2wt and 10 with BRCA1/2var) were analyzed for potential biomarkers of hereditary OC. We applied a bottom-up proteomics approach, using nano-flow LC-MS to analyze depleted plasma proteome quantitatively, and potential plasma protein markers specific to the BRCA1/2 variant were identified from a comparative statistical analysis of the four groups. We obtained 1505 protein candidates from the 40 subjects, and SPARC and THBS1 were verified by enzyme-linked immunosorbent assay. Plasma SPARC and THBS1 concentrations in healthy BRCA1/2 carriers were found to be lower than in OC patients with BRCA1/2var. If plasma SPARC concentrations increase over 337.35 ng/ml or plasma THBS1 concentrations increase over 65.28 mg/ml in a healthy BRCA1/2 carrier, oophorectomy may be suggested.

Sign in / Sign up

Export Citation Format

Share Document