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Application of protection motivation theory (PMT) on skin cancer preventive behaviors amongst primary school students in rural areas of Fasa city-Iran.
Khani Jeihooni, A, Bashti, S, Erfanian, B, Ostovarfar, J, Afzali Hasirini, P
BMC cancer. 2022;(1):21
Abstract
BACKGROUND Considering that exposure to sunlight in childhood and adolescence has an important role in skin cancer, so it seems that training protective behaviors in this period is more effective. OBJECTIVES To survey the application of protection motivation theory (PMT) on skin cancer preventive behaviors among students in rural areas of Fasa city, Iran. METHODS This study was done in two stages: Phase I of this study, the descriptive-analytic and cross-sectional study was conducted in 2018 to investigate the predictive value of the protection motivation theory on skin cancer preventive behaviors. In the second stage, a quasi-experimental interventional study was conducted on 400 primary school students in 2019. The educational intervention was performed in the experimental group for 8 sessions. Data were collected using a demographic information questionnaire and protection motivation theory before and six months after the intervention. RESULTS The constructs of protection motivation theory predicted 58.6% of skin cancer preventive behaviors. The results indicated that there was no significant difference between the two groups in terms of knowledge, perceived sensitivity, perceived severity, reward, fear, protection motivation, response efficacy, self-efficacy, response costs, and the skin cancer preventive behaviors in before the intervention (p > 0.05). However, six months after the intervention, the experimental group showed a significant increase in each of the mentioned constructs and skin cancer protective behaviors (p < 0.05). CONCLUSION This study showed the effectiveness of the intervention based on the PMT constructs in adoption of skin cancer preventive behaviors in 6 months' post intervention in primary school students.
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To see or not to see: Impact of viewing facial skin cancer defects prior to reconstruction.
Veldhuizen, IJ, Lee, EH, Kurtansky, NR, van Hensbergen, LJ, Dusza, SW, Hölscher, MC, van der Hulst, RRWJ, Ottenhof, MJ, Pusic, AL, Hoogbergen, MM
Archives of dermatological research. 2021;(10):847-853
Abstract
Patient expectations of the scar after Mohs micrographic surgery (MMS) are often not realistic, leading to subsequent psychosocial sequelae such as anxiety, depression, and avoidance of social situations. When patient expectations are not met, this may also contribute to a decrease in patient satisfaction after surgery. Therefore, altering expectation levels may change patient satisfaction and psychosocial distress levels after surgery. To assess whether patient satisfaction improves in patients after MMS when patients view the surgical defect prior to reconstruction. Patients undergoing facial MMS between December 2017 and September 2019 were included. Patients received or did not receive a mirror after MMS to view the surgical defect before closing the defect. Patients were asked to complete the Dutch FACE-Q Skin Cancer before, one-week, three-months, and one-year after MMS. A total of 113 patients where included. One-hundred-eight (95.6%), 113 (100%), and 93 (82.3%) questionnaires were completed, one-week, three-months, and one-year follow-up, respectively. Satisfaction with facial appearance and appraisal of scars significantly improved over time for all patients, no such improvement was seen for appearance-related distress. Female patients who looked in the mirror had higher satisfaction with facial appearance than female patients who did not look in the mirror. Also, lower appearance-related distress scores were seen in patients who looked in the mirror prior to a flap reconstruction. Showing the defect in the mirror prior to the reconstruction may result in higher patient satisfaction in female patients and patients before undergoing a flap reconstruction.
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Integrated Safety Analysis of Abrocitinib for the Treatment of Moderate-to-Severe Atopic Dermatitis From the Phase II and Phase III Clinical Trial Program.
Simpson, EL, Silverberg, JI, Nosbaum, A, Winthrop, KL, Guttman-Yassky, E, Hoffmeister, KM, Egeberg, A, Valdez, H, Zhang, M, Farooqui, SA, et al
American journal of clinical dermatology. 2021;(5):693-707
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Abstract
BACKGROUND Pivotal phase III studies demonstrated that abrocitinib, an oral, once-daily, JAK1-selective inhibitor, is effective treatment for moderate-to-severe atopic dermatitis (AD) as monotherapy and in combination with topical therapy. OBJECTIVE The aim of this study was to evaluate the long-term safety of abrocitinib 200 mg and 100 mg in an integrated analysis of a phase IIb study, four phase III studies, and one long-term extension study. METHODS Two cohorts were analyzed: a placebo-controlled cohort from 12- to 16-week studies and an all-abrocitinib cohort including patients who received one or more abrocitinib doses. Adverse events (AEs) of interest and laboratory data are reported. RESULTS Total exposure in the all-abrocitinib cohort (n = 2856) was 1614 patient-years (PY); exposure was ≥ 24 weeks in 1248 patients and ≥ 48 weeks in 606 (maximum 108 weeks). In the placebo-controlled cohort (n = 1540), dose-related AEs (200 mg, 100 mg, placebo) were nausea (14.6%, 6.1%, 2.0%), headache (7.8%, 5.9%, 3.5%), and acne (4.7%, 1.6%, 0%). Platelet count was reduced transiently in a dose-dependent manner; 2/2718 patients (200-mg group) had confirmed platelet counts of < 50 × 103/mm3 at week 4. Incidence rates (IRs) were 2.33/100PY and 2.65/100 PY for serious infection, 4.34/100PY and 2.04/100PY for herpes zoster, and 11.83/100PY and 8.73/100PY for herpes simplex in the 200-mg and 100-mg groups, respectively. IRs for nonmelanoma skin cancer, other malignancies, and major adverse cardiovascular events were < 0.5/100PY for both doses. Five venous thromboembolism events occurred (IR 0.30/100PY), all in the 200-mg group. There were three deaths due to gastric carcinoma (diagnosed at day 43), sudden death, and COVID-19. CONCLUSION Abrocitinib, with proper patient and dose selection, has a manageable tolerability and longer-term safety profile appropriate for long-term use in patients with moderate-to-severe AD. TRIAL REGISTRIES ClinicalTrials.gov: NCT02780167, NCT03349060, NCT03575871, NCT03720470, NCT03627767, NCT03422822.
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Fecal microbiota transplant overcomes resistance to anti-PD-1 therapy in melanoma patients.
Davar, D, Dzutsev, AK, McCulloch, JA, Rodrigues, RR, Chauvin, JM, Morrison, RM, Deblasio, RN, Menna, C, Ding, Q, Pagliano, O, et al
Science (New York, N.Y.). 2021;(6529):595-602
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Abstract
Anti-programmed cell death protein 1 (PD-1) therapy provides long-term clinical benefits to patients with advanced melanoma. The composition of the gut microbiota correlates with anti-PD-1 efficacy in preclinical models and cancer patients. To investigate whether resistance to anti-PD-1 can be overcome by changing the gut microbiota, this clinical trial evaluated the safety and efficacy of responder-derived fecal microbiota transplantation (FMT) together with anti-PD-1 in patients with PD-1-refractory melanoma. This combination was well tolerated, provided clinical benefit in 6 of 15 patients, and induced rapid and durable microbiota perturbation. Responders exhibited increased abundance of taxa that were previously shown to be associated with response to anti-PD-1, increased CD8+ T cell activation, and decreased frequency of interleukin-8-expressing myeloid cells. Responders had distinct proteomic and metabolomic signatures, and transkingdom network analyses confirmed that the gut microbiome regulated these changes. Collectively, our findings show that FMT and anti-PD-1 changed the gut microbiome and reprogrammed the tumor microenvironment to overcome resistance to anti-PD-1 in a subset of PD-1 advanced melanoma.
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E7777 in Japanese patients with relapsed/refractory peripheral and cutaneous T-cell lymphoma: A phase I study.
Ohmachi, K, Ando, K, Ogura, M, Uchida, T, Tobinai, K, Maruyama, D, Namiki, M, Nakanishi, T
Cancer science. 2018;(3):794-802
Abstract
E7777, a recombinant cytotoxic fusion protein comprising diphtheria toxin fragments A and B and human interleukin-2, shares an amino acid sequence with denileukin diftitox but has improved purity and an increased percentage of active protein monomer species. A phase I study was carried out to evaluate the tolerability, safety, pharmacokinetics, and antitumor activity of E7777 in Japanese patients with relapsed/refractory peripheral and cutaneous T-cell lymphoma. E7777 (6, 12, and expanded 9 μg/kg/day) was given to 13 patients by i.v. infusion on five consecutive days per 21-day cycle. Dose-limiting toxicities, including increased alanine aminotransferase, hyponatremia (n = 2), hypokalemia, lymphopenia, fatigue, hypoalbuminemia, rash, and increased lipase (n = 1), were observed in all three patients in the 12 μg/kg/day cohort, whereas two of six patients in the 9 μg/kg/day cohort showed decreased appetite or fatigue. The maximum tolerated and recommended dose of E7777 was 9 μg/kg/day for five consecutive days per 21-day cycle. The objective response rate was 38% (5/13) and did not appear to depend on tumor expression of CD25. E7777 was well tolerated, assuming careful management of adverse events during treatment, and preliminary but clinically meaningful antitumor activity was observed. Subsequent studies of E7777 for T-cell lymphomas are warranted. This study was registered with www.ClinicalTrials.gov (NCT1401530).
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A qualitative study of the knowledge, behaviour and attitudes of patients with skin cancer regarding sunlight exposure and vitamin D.
Rutkowski, D, Farrar, MD, Osman, JE, Webb, AR, Rhodes, LE
Photodermatology, photoimmunology & photomedicine. 2017;(4):203-208
Abstract
BACKGROUND Solar UVR is a major cause of skin cancer but also an important source of vitamin D (VitD), essential for musculoskeletal health. Conflicting public health messages may confuse patients with skin cancer prone to further skin cancer. OBJECTIVE To explore the knowledge, behaviour and attitudes of patients with skin cancer to sunlight exposure and VitD sources. METHODS Patients (n = 10) previously treated for multiple basal cell cancer in a hospital setting participated in focus group sessions with semi-structured discussions to explore: knowledge of VitD, sun-avoidance behaviour and attitude towards sunlight exposure messages. Thematic data analysis was performed using software programme MAXQDA11. RESULTS Pre-existing knowledge of VitD was low. Most patients practised sun avoidance and were not inclined to increase exposure. Patients did not perceive VitD deficiency as a substantial risk to their own health, or a need to take VitD supplements. They aimed to increase VitD status through dietary intake, but knowledge of food VitD content was lacking. CONCLUSIONS The patients with skin cancer, appropriate to their heightened skin cancer risk, appeared unlikely to increase their sun exposure to gain VitD. However, education is required regarding the generally low levels of VitD in foodstuffs, and the requirement for supplements/fortified foods if strict sun avoidance is employed.
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Socioeconomic Status and Poor Health Outcome at 10 Years of Follow-Up in the Multi-Ethnic Study of Atherosclerosis.
Shea, S, Lima, J, Diez-Roux, A, Jorgensen, NW, McClelland, RL
PloS one. 2016;(11):e0165651
Abstract
BACKGROUND/OBJECTIVES Predictors of healthy aging have not been well-studied using longitudinal data with demographic, clinical, subclinical, and genetic information. The objective was to identify predictors of poor health outcome at 10 years of follow-up in the Multi-Ethnic Study of Atherosclerosis (MESA). DESIGN Prospective cohort study. SETTING Population-based sample from 6 U.S. communities. PARTICIPANTS 4,355 participants In the MESA Study. MEASUREMENTS Poor health outcome at 10 years of follow-up was defined as having died or having clinical cardiovascular disease, depression, cognitive impairment, chronic obstructive pulmonary disease, or cancer other than non-melanoma skin cancer. Absolute risk regression was used to estimate risk differences in the outcome adjusting for demographic variables, clinical and behavioral risk factors, subclinical cardiovascular disease, and ApoE genotype. Models were weighted to account for selective attrition. RESULTS Mean age at 10 years of follow-up was 69.5 years; 1,480 participants had a poor health outcome, 2,157 participants were in good health, and 718 were unknown. Older age, smoking, not taking a statin, hypertension, diabetes, and higher coronary calcium score were associated with higher probability of poor health outcome. After multivariable adjustment, participants in the lowest income and educational categories had 7 to 14% greater absolute risk of poor health outcome at 10 years of follow-up compared to those in the next highest categories of income or education (P = 0.002 for both). Those in the lowest categories of both income and education had 21% greater absolute risk of poor health outcome compared to those in the highest categories of both income and education. CONCLUSIONS Low income and educational level predict poor health outcome at 10 years of follow-up in an aging cohort, independent of clinical and behavioral risk factors and subclinical cardiovascular disease.
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A phase II randomized controlled trial of nicotinamide for skin cancer chemoprevention in renal transplant recipients.
Chen, AC, Martin, AJ, Dalziell, RA, McKenzie, CA, Lowe, PM, Eris, JM, Scolyer, RA, Dhillon, HM, Vardy, JL, Bielski, VA, et al
The British journal of dermatology. 2016;(5):1073-1075
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Recommended surgery of Kaposi's sarcoma nodules.
Tourlaki, A, Bellinvia, M, Brambilla, L
The Journal of dermatological treatment. 2015;(4):354-6
Abstract
BACKGROUND Classic Kaposi's sarcoma [KS] is a chronic, multifocal, vascular proliferation, which commonly presents purplish nodules on the distal extremities of elderly men. Excisional surgery is one of the traditional therapies, but is generally time consuming and costly. OBJECTIVE To evaluate the safety and efficacy of curettage for the treatment of KS nodules. METHODS A single arm, prospective study in patients with at least one KS nodule removed by curettage. Hemostasis was obtained using 130-volume hydrogen peroxide [H2O2] and the wound was left to heal by secondary intention. Follow-up was done after 15 days, 1, 3, 6 and 12 months. RESULTS Ninety patients [88 male, 2 female] with mean age of 75.8 years were enrolled. Eighty-two of the curetted nodules were localized on the lower limbs, five on the face, and three on the upper limbs. No postoperative complications were encountered, and cosmetic outcome was rated excellent by 87 patients and good by the remaining 3 patients. After 3 months, we noticed only minimal hypo-/hyperpigmentation in 59 cases, while in the remaining 31 patients the scar appeared imperceptible. Recurrence after 12 months was null. CONCLUSION Curettage followed by the application of H2O2 is a safe, effective and simple technique for the treatment of KS nodules in elderly patients.
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Isolated limb infusion with hyperthermia and chemotherapy for advanced limb malignancy: factors influencing toxicity.
Duprat Neto, JP, Mauro, AC, Molina, AS, Nishinari, K, Zurstrassen, CE, Costa, OF, Belfort, FA, Facure, L, Fregnani, JH
ANZ journal of surgery. 2014;(9):677-82
Abstract
BACKGROUND The isolated limb infusion (ILI) technique is a simpler and less invasive alternative to isolated limb perfusion, which allows regional administration of high-dose chemotherapy to patients with advanced melanoma and other malignancies restricted to a limb. METHODS Patients from two institutions, treated by ILI between 1998 and 2009 for extensive disease restricted to a limb, were included. The cohort included 31 patients with melanoma who presented with in-transit metastases or an extensive primary lesion, one patient with squamous cell carcinoma and another with epithelioid sarcoma not suitable for local surgical treatment. RESULTS A complete response was achieved in 26.3% of patients and a partial response in 52.6%. Toxicity was assessed according to the Wieberdink limb toxicity scale. Grade II toxicity was noted in 39.5% of patients, grade III in 50% and grade IV in 10.5%. Toxicity was correlated with the results of a number of clinical and laboratory tests. The toxicity of melphalan and actinomycin D was dose-dependent. For melphalan, the relationship between toxicity and mean dose was as follows: grade II--34.7 mg; grades III and IV--47.5 mg (P = 0.012). The relationship between toxicity and maximum serum creatine phosphokinase (CPK) was as follows: grade II--431.5 U/L; grades III and IV--3228 U/L (P = 0.010). CONCLUSION Toxicity after ILI is dose-dependent and serum CPK correlates with toxicity.