Patterns and Trends of Herbal Medicine Use among Patients with Gynecologic Cancer

Abstract Background More and more information about complementary and integrative medicine is becoming available, especially among cancer patients. However, little is known about the use of herbal medicine by patients with gynecologic cancers. This study aimed to assess the use of herbal products by gynecologic cancer patients compared with healthy controls. Methods This cross-sectional study was conducted at the Department for Gynecology and Obstetrics of Erlangen University Hospital and included 201 patients with gynecologic cancer and 212 healthy controls. Use of herbal medicines was evaluated using a standardized questionnaire. Medical information on cancer patients was collected from hospital records. Group comparisons were done using a logistic regression model. Risk ratios were assessed using a Poisson regression model. Results Gynecologic cancer patients used herbal medicine significantly less often than healthy persons. 69% of gynecologic cancer patients and 81% of healthy participants reported using herbal products. 40% of cancer patients and 56% of healthy persons reported using plants for medicinal purposes. Motives of cancer patients for using herbal medicine included treatment of cancer-related symptoms. The major source of information for both groups was family and friends. Conclusions Although herbal medicine was used less by patients with gynecologic cancer, herbal products were used by both cancer patients and healthy individuals. To provide cancer patients with optimal therapy, oncologists should be informed about the herbal products used by their patients as this will allow them to take their patientsʼ self-medication with herbal medicine into account. Counseling by oncologists on the use of herbal medicine should be encouraged.

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Risk factors for lower limb lymphedema in gynecologic cancer patients after initial treatment

International Journal of Clinical Oncology ◽

10.1007/s10147-019-01608-6 ◽

2020 ◽

Vol 25 (5) ◽

pp. 963-971 ◽

Cited By ~ 2

Author(s):

Teruyo Kunitake ◽

Tatsuyuki Kakuma ◽

Kimio Ushijima

Keyword(s):

Risk Factors ◽

Cancer Patients ◽

Lower Limb ◽

Initial Treatment ◽

Gynecologic Cancer ◽

Significant Risk ◽

Structural Models ◽

University Hospital ◽

Time Model ◽

Gynecology And Obstetrics

Abstract Background Most studies on lower limb lymphedema have been conducted in gynecologic cancer patients who underwent surgery for gynecologic malignancy. This study aimed to evaluate the risk factors for lower limb lymphedema development in gynecologic cancer patients who underwent initial treatment. Methods A retrospective cohort design was used to follow 903 gynecologic cancer patients who underwent treatment at Kurume University Hospital between January 1, 2013 and December 31, 2015. Data analyses were performed in 356 patients, and the patients were followed up until December 31, 2017. The model comprised two components to facilitate statistical model construction. Specifically, a discrete survival time model was constructed, and a complementary log–log link model was fitted to estimate the hazard ratio. Associations between risk factors were estimated using generalized structural models. Results The median follow-up period was 1083 (range 3–1819) days, and 54 patients (15.2%) developed lower limb lymphedema, with a median onset period of 240 (range 3–1415) days. Furthermore, 38.9% of these 54 patients developed lower limb lymphedema within 6 months and 85.2% within 2 years. International Federation of Gynecology and Obstetrics stage, radiotherapy, and number of lymph node dissections (≥ 28) were significant risk factors. Conclusion Simultaneous examination of the relationship between lower limb lymphedema and risk factors, and analysis among the risk factors using generalized structural models, enabled us to construct a clinical model of lower limb lymphedema for use in clinical settings to alleviate this condition and improve quality of life.

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The Characteristics of Adverse Drug Reactions in Cancer Patients: An Analysis of Spontaneously Reported Cases

Korean Journal of Medicine ◽

10.3904/kjm.2020.95.2.104 ◽

2020 ◽

Vol 95 (2) ◽

pp. 104-113

Author(s):

Hae-Soo Jeon ◽

Hee-Kyoo Kim ◽

Gil-Soon Choi

Keyword(s):

Cancer Patients ◽

Clinical Features ◽

Adverse Drug Reactions ◽

Antineoplastic Agents ◽

Medical Information ◽

University Hospital ◽

World Health ◽

Drug Reactions ◽

Iodinated Contrast ◽

Health Organization

Background/Aims: Although the number of domestic adverse drug reactions (ADRs) reported in Korea is rapidly increasing, the analysis of ADRs in cancer patients remains limited. We sought to investigate the clinical features of ADRs in cancer patients.Methods: ADR data were collected from a spontaneous reporting system at single university hospital, between July 2010 and June 2015. ADR cases assessed to be “unlikely” or “unclassifiable” as per the criteria of the World Health Organization-Uppsala Monitoring Center were excluded. Additional medical information was retrospectively collected from chart reviews, and clinical features of ADRs were analyzed.Results: In total, 1,455 cases were reported. Of these, 822 ADRs (52.1%) were observed in cancer patients. The mean age of cancer patients was 60.8 years (range, 17–90 years), and 45.9% were male. The most prevalent clinical features were gastrointestinal abnormalities (32.6%), such as nausea and vomiting, followed by skin (28.5%) and neurologic manifestations (26.0%). Fifty-one (6.2%) and 296 cases (36.0%) were classified as severe and moderate, respectively. The most common causative agents were parenteral nutrition (PN) supplements (40.4%), followed by antibiotics (17.8%), analgesics (16.7%), iodinated contrast media (ICM, 10.6%), and vitamins (3.9%). Antineoplastic agents were responsible for 2.9% of cases. PN supplements were commonly associated with severe reactions.Conclusion: Although it is well known that antibiotics, ICM, and analgesics induce ADRs, PN supplements, vitamins, and antineoplastic agents should also be considered as common causes of ADRs in cancer patients. Further investigation and monitoring to determine the causality associated with these agents is required.

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Changes in the Vaginal Microbiome and Associated Toxicities Following Radiation Therapy for Gynecologic Cancers

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2021.680038 ◽

2021 ◽

Vol 11 ◽

Author(s):

Despina Tsementzi ◽

Rebecca Meador ◽

Tony Eng ◽

Pretesh Patel ◽

Joseph Shelton ◽

...

Keyword(s):

Radiation Therapy ◽

Cancer Patients ◽

Gynecologic Cancer ◽

Cancer Therapies ◽

Healthy Controls ◽

Vaginal Microbiome ◽

Vaginal Symptoms ◽

Persistent Symptoms ◽

Healthy Women ◽

Symptom Persistence

Postmenopausal women often suffer from vaginal symptoms associated with atrophic vaginitis. Additionally, gynecologic cancer survivors may live for decades with additional, clinically significant, persistent vaginal toxicities caused by cancer therapies, including pain, dyspareunia, and sexual dysfunction. The vaginal microbiome (VM) has been previously linked with vaginal symptoms related to menopause (i.e. dryness). Our previous work showed that gynecologic cancer patients exhibit distinct VM profiles from healthy women, with low abundance of lactobacilli and prevalence of multiple opportunistic pathogenic bacteria. Here we explore the association between the dynamics and structure of the vaginal microbiome with the manifestation and persistence of vaginal symptoms, during one year after completion of cancer therapies, while controlling for clinical and sociodemographic factors. We compared cross-sectionally the vaginal microbiome in 134 women, 64 gynecologic patients treated with radiotherapy and 68 healthy controls, and we longitudinally followed a subset of 52 women quarterly (4 times in a year: pre-radiation therapy, 2, 6 and 12 months post-therapy). Differences among the VM profiles of cancer and healthy women were more pronounced with the progression of time. Cancer patients had higher diversity VMs and a variety of vaginal community types (CTs) that are not dominated by Lactobacilli, with extensive VM variation between individuals. Additionally, cancer patients exhibit highly unstable VMs (based on Bray-Curtis distances) compared to healthy controls. Vaginal symptoms prevalent in cancer patients included vaginal pain (40%), hemorrhage (35%), vaginismus (28%) and inflammation (20%), while symptoms such as dryness (45%), lack of lubrication (33%) and dyspareunia (32%) were equally or more prominent in healthy women at baseline. However, 24% of cancer patients experienced persistent symptoms at all time points, as opposed to 12% of healthy women. Symptom persistence was strongly inversely correlated with VM stability; for example, patients with persistent dryness or abnormally high pH have the most unstable microbiomes. Associations were identified between vaginal symptoms and individual bacterial taxa, including: Prevotella with vaginal dryness, Delftia with pain following vaginal intercourse, and Gemillaceaea with low levels of lubrication during intercourse. Taken together our results indicate that gynecologic cancer therapy is associated with reduced vaginal microbiome stability and vaginal symptom persistence.

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Knowledge and Attitudes Toward Use of Herbal Medicine Among Saudi Arabian Patients

Current Topics in Nutraceutical Research ◽

10.37290/ctnr2641-452x.18:303-309 ◽

2020 ◽

Vol 18 (4) ◽

pp. 303-309

Author(s):

Ali Mohamed Alshabi

Keyword(s):

Herbal Medicine ◽

Chronic Diseases ◽

Adult Population ◽

Healthcare Providers ◽

University Hospital ◽

Medicine Use ◽

Cross Sectional ◽

Herbal Products ◽

Inflammatory Bowel ◽

Structured Questionnaire

Herbal medicine is gaining popularity among healthcare providers and patients alike, for treating various health disorders. Main objective of this study was to determine the prevalence of herbal medicine use among the adult population in Najran, and to identify the factors associated with herbal medicine use. A cross-sectional descriptive study was conducted from September 2018 to January 2019 at Najran University Hospital in Najran, in which a total of 1000 randomly selected adult (> 18 years) patients were recruited. The data was collected using a structured questionnaire. The prevalence of herbal medicine use was found to be 46.1%. The majority of participants believed that using herbal products is safe (51.9%) and beneficial (62.7%). Some 44.5% of participants had previously used herbal products for treatment. Herbal medicine use was higher in patients with chronic diseases such as inflammatory bowel disease (63.0%), asthma (51.2%), diabetes (47.1%), cancer (46.7%), and hypertension (44.1%). The percentage of herbal medicine use among participants without chronic disease was found to be 43.5%. In conclusion, the prevalence of herbal medicine use is relatively low in Najran region when compared with other parts of Saudi Arabia. The most important determinants of herbal medicine use were increasing age, higher salary and chronic diseases.

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Correlation Between Bone Marrow Dose Volumes and Acute Hematologic Toxicity in Postoperative Gynecologic Cancer Patients: Principal Component Regression Model

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2014.05.714 ◽

2014 ◽

Vol 90 (1) ◽

pp. S186

Author(s):

Q. Li ◽

Y. Wu ◽

J. Chen

Keyword(s):

Bone Marrow ◽

Regression Model ◽

Cancer Patients ◽

Gynecologic Cancer ◽

Principal Component Regression ◽

Principal Component ◽

Hematologic Toxicity ◽

Dose Volumes

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Evaluating the effect of a group pre-treatment chemotherapy psycho-education session for chemotherapy-naive gynecologic cancer patients and their caregivers

Gynecologic Oncology ◽

10.1016/j.ygyno.2020.10.007 ◽

2021 ◽

Vol 160 (1) ◽

pp. 234-243

Author(s):

Diana Samoil ◽

Nazek Abdelmutti ◽

Lisa Ould Gallagher ◽

Nazlin Jivraj ◽

Naa Kwarley Quartey ◽

...

Keyword(s):

Cancer Patients ◽

Gynecologic Cancer ◽

Education Session ◽

Pre Treatment

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Overexpression of microRNA-21 in the Serum of Breast Cancer Patients

MicroRNA ◽

10.2174/2211536608666190318105757 ◽

2019 ◽

Vol 9 (1) ◽

pp. 58-63

Author(s):

Batool Savari ◽

Sohrab Boozarpour ◽

Maryam Tahmasebi-Birgani ◽

Hossein Sabouri ◽

Seyed Mohammad Hosseini

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Cancer Progression ◽

Tumor Resection ◽

Tumor Grade ◽

Healthy Controls ◽

Breast Cancer Patients ◽

Serum Samples ◽

Post Surgery ◽

Polymerase Chain

Background: Breast cancer is the most common cancer diagnosed in women worldwide. So it seems that there's a good chance of recovery if it's detected in its early stages even before the appearances of symptoms. Recent studies have shown that miRNAs play an important role during cancer progression. These transcripts can be tracked in liquid samples to reveal if cancer exists, for earlier treatment. MicroRNA-21 (miR-21) has been shown to be a key regulator of carcinogenesis, and breast tumor is no exception. Objective: The present study was aimed to track the miR-21 expression level in serum of the breast cancer patients in comparison with that of normal counterparts. Methods: Comparative real-time polymerase chain reaction was applied to determine the levels of expression of miR-21 in the serum samples of 57 participants from which, 42 were the patients with breast cancer including pre-surgery patients (n = 30) and post-surgery patients (n = 12), and the others were the healthy controls (n = 15). Results: MiR-21 was significantly over expressed in the serum of breast cancer patients as compared with healthy controls (P = 0.002). A significant decrease was also observed following tumor resection (P < 0.0001). Moreover, it was found that miR-21 overexpression level was significantly associated with tumor grade (P = 0.004). Conclusion: These findings suggest that miR-21 has the potential to be used as a novel breast cancer biomarker for early detection and prognosis, although further experiments are needed.

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P005 Rheumatology virtual clinics during COVID-19: are our patients satisfied?

Rheumatology ◽

10.1093/rheumatology/keab247.004 ◽

2021 ◽

Vol 60 (Supplement_1) ◽

Author(s):

Fajer A Altamimi ◽

Una Martin

Keyword(s):

Medical Information ◽

Worker Safety ◽

University Hospital ◽

Free Text ◽

Risk Of Infection ◽

Further Training ◽

Return Envelope ◽

The Right ◽

Reduced Risk

Abstract Background/Aims Telemedicine can be broadly defined as the use of telecommunication technologies to provide medical information and services. It can be audio, visual, or text. Its use has increased dramatically during the COVID-19 pandemic to ensure patient and healthcare worker safety. Any healthcare professional can engage with it. It carries benefits like reduced stress and expense of traveling, maintenance of social distancing, and reduced risk of infection. There are some potential drawbacks such as lack of physical examination, liability and technological issues. Methods A questionnaire was sent to 200 patients, selected from different virtual clinics (new and review, doctor and ANP led) run between March and May 2020 in the rheumatology department of University Hospital Waterford. We formulated 14 questions to cover the following aspects: demography, the purpose of the consult, punctuality, feedback, medico-legal concerns, and free text for comments. A self-addressed return envelope was included. Results 83 responses were received. 2 were excluded. The ratio of females to male respondents was 59: 41, with the majority over 60 years old. The main appointment type was review 67 (83%). 80% of patients were called either before or at the time of their scheduled appointment. The vast majority (98.8%) of our patients had confidence in our data protection and trusted our system to maintain their confidentiality. 95% stated that they felt comfortable, were given enough time to explain their health problem and felt free from stress. The respondents who preferred attending the clinic in person (17 in total) compared to the virtual were mostly follow up patients- 12 vs. 5 new. Conclusion Patient satisfaction among those surveyed was high, despite having to introduce the service abruptly during the COVID-19 pandemic. There are many improvements we can adopt to improve our service and even maintain after the pandemic as a way of communicating with our stable patients. As we are covering a large geographical catchment, we can continue to implement the virtual clinic for some appointments. We should prioritize our efforts on identifying the right patient and the type of service we can offer, further training of staff, and increasing awareness of the patients as to how to get the most out of a virtual appointment. Disclosure F.A. Altamimi: None. U. Martin: None. C. Sheehy: None.

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Oxidative stress in common variable immunodeficiency

European Journal of Inflammation ◽

10.1177/20587392211002411 ◽

2021 ◽

Vol 19 ◽

pp. 205873922110024

Author(s):

Sevgen Tanir Basaranoglu ◽

Sukru Cekic ◽

Emine Kirhan ◽

Melahat Dirican ◽

Sara S. Kilic

Keyword(s):

Oxidative Stress ◽

Common Variable Immunodeficiency ◽

Chronic Inflammatory Demyelinating Polyneuropathy ◽

Infectious Complications ◽

Clinical Syndrome ◽

University Hospital ◽

Unknown Etiology ◽

Healthy Controls ◽

Oxidative Stress Biomarkers ◽

Common Variable

Common variable immunodeficiency (CVID) is a heterogenous group of immunologic disorders of unknown etiology. Alterations of the normal cellular balance due to an increase in reactive oxygen species and/or decrease in antioxidant defense may lead to increased oxidative stress. We aimed to evaluate the levels of oxidative stress biomarkers in patients with CVID who had different presentations. We investigated the serum catalase (CAT), erythrocyte superoxide dismutase (SOD), erythrocyte reduced glutathione as antioxidants and serum malondialdehyde levels as lipid peroxidation marker in patients with CVID in Uludag University Hospital Department of Pediatric Allergy and Immunology’s outpatient clinics. In the analysis, there were 21 patients and 27 matched healthy controls. The median levels of CAT in patients with CVID was significantly lower than in healthy controls ( p = 0.04). Among the patients with CVID, 19% had autoimmune disease, one had Sjögren’s syndrome, one had autoimmune alopecia, one had juvenile rheumatoid arthritis, and one had chronic inflammatory demyelinating polyneuropathy. Patients with autoimmune complications had significantly lower CAT levels compared to the ones without autoimmune diseases ( p = 0.03). The patients without non-infectious complications (NICs) had lower SOD levels than the patients with NICs ( p = 0.05). The analysis of oxidative stress markers in the patients with CVID suggested a series of abnormalities in the anti-oxidant system. The clinical syndrome associations may be a useful tool for future studies to set prediction markers for the prognosis of patients with CVID.

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