Biomedical subjects

Jennifer Steel

Publications and source records attributed to Jennifer Steel.

6 recordsLinked to original sources

PubMed2006

Selecting patients for breast-conserving therapy: the importance of lobular histology.

BACKGROUND: Concerns exist regarding the ability to select patients with lobular carcinoma for breast-conserving therapy (BCT) using mammography. The purpose of this study was to compare the conversion rate from BCT to mastectomy among patients with lobular (ILC) and ductal carcinoma (IDC), and to compare the number of resections needed to obtain negative margins. METHODS: In all, 349 patients with pure or mixed ILC were identified from a database and 318 were successfully matched to 2 controls with IDC on the basis of year of diagnosis, menopausal status, and stage of disease. Conditional logistic regression was used to control for matching. RESULTS: Patients with ILC were older, had larger tumors (2.6 vs. 2.1 cm; P<.001), and were more likely to have contraindications to BCT (25% vs. 20%). In patients thought to be candidates for BCT, no difference in success rate was noted on the basis of histologic type after controlling for age and stage. In those undergoing BCT, no difference in the number of procedures was seen on the bases of histology after adjustment for age and stage. CONCLUSIONS: Patients with ILC are not more likely to fail BCT than those with IDC, nor do they require more operations to obtain negative margins. These results do not support the use of more extensive preoperative evaluation such as magnetic resonance imaging in patients with ILC.

Adult↗

PubMed2005

Sexual functioning in patients with hepatocellular carcinoma.

BACKGROUND: The objectives of the current study were to assess the rates of sexual dysfunction in patients with hepatocellular carcinoma (HCC) and compare the rates of sexual morbidity with a sample of patients diagnosed with chronic liver disease (CLD) and the general population. It was expected that patients diagnosed with HCC would have a greater prevalence of sexual dysfunction than those diagnosed with CLD and the general population, respectively. Furthermore, those patients who reported a sexual dysfunction would also have a poorer quality of life (QOL). METHODS: Twenty-one men diagnosed with HCC and 23 men diagnosed with CLD completed a battery of questionnaires that included the Sexual History Questionnaire and the Functional Assessment of Cancer Therapy-Hepatobiliary. RESULTS: Results indicated that 41% of patients reported a current sexual problem (29% of HCC patients and 71% of patients with CLD) and 43% met the Diagnostic and Statistical Manual of Mental Disorders-4th edition (DSM-IV) criteria for at least 1 type of sexual dysfunction (25% of patients with HCC and 75% of patients with LD). Of the total sample, 68% reported being diagnosed with a comorbid medical condition or taking a medication that had potential sexual side effects. After eliminating cases with comorbid medical conditions and/or who were taking medications that contributed to sexual morbidity, the rate of sexual problems were found to be similar to that of the general population. Clinically significant differences were found with regard to the QOL. People who were experiencing sexual problems also reported a poorer QOL. CONCLUSIONS: Although a large percentage of sexual dysfunction may have been secondary to comorbid medical problems and medications, treatment of the sexual dysfunction is still warranted.

Carcinoma, Hepatocellular↗

PubMed2004

Quality of life in patients diagnosed with primary hepatocellular carcinoma: hepatic arterial infusion of Cisplatin versus 90-Yttrium microspheres (Therasphere).

BACKGROUND: The aims of the study were to test the difference in health-related quality (HRQL) of life and survival in patients diagnosed with primary hepatocellular carcionma (HCC) and treated with either hepatic arterial infusion (HAI) of Cisplatin or 90-Yttrium microspheres (Therasphere). METHOD: The design of the study was a non-randomized parallel cohort study. Twenty-eight patients participated in the present study. HRQL was assessed by administration of the Functional Assessment of Cancer Therapy-Hepatobiliary. Survival was measured using Kaplan Meier methods. RESULTS: The results of present study suggest treatment with Therasphere) had an advantage in regard to HRQL and survival when compared to Cisplatin. At 3-month follow-up, patients who were treated with Therasphere had a higher level of functional well-being as well as overall quality of life when compared to patients treated with Cisplatin. At 6-month follow-up patients (treated with Therasphere) continued to have better functional well-being when compared to patients being treated with HAI of Cisplatin. At 6-month follow-up, survival was found to be similar for patients treated with Therasphere when compared to patients being treated with Cisplatin. CONCLUSIONS: Preliminary data suggest that treatment with Therasphere has a modest advantage in regard to HRQL when compared patients treated with HAI of Cisplatin. Future research with Therasphere, that includes a larger sample size and longer follow-up, is necessary to make definitive conclusions regarding the efficacy and effect on HRQL.

Adolescent↗

PubMed2004

Psychological sequelae of childhood sexual abuse: abuse-related characteristics, coping strategies, and attributional style.

OBJECTIVE: The aim of this study was to test a model predicting the contribution of abuse-related characteristics and mediating variables such as coping and attributional style in the development of psychological sequelae in adults reporting a history of child sexual abuse (CSA). METHODOLOGY: Two hundred and eighty-five males and females from three settings (a nonpatient, psychiatric outpatient, and psychiatric inpatient) completed a battery of questionnaires that included a (1) Sexual History Questionnaire, (2) Ways of Coping Questionnaire, (3) Attributional Style Questionnaire, and (4) the SCL-90-R. RESULTS: Of the 285 participants, 33% reported unwanted or forced sexual contact before the age of 18 years. Participants who reported a history of CSA also reported higher levels of psychological distress when compared to those who did not report a history of abuse. In testing the model concerning the relationship between victim-offender characteristics, mediating variables and psychological distress in adulthood; two abuse-related characteristics (number of offenders and duration of abuse) were found to be directly associated with psychological distress in adulthood. Other abuse-related variables (i.e., relation with offender, force, resistance, age of onset, participation, and frequency of abuse) were found to be related to psychological distress in adulthood through the mediation of various coping strategies (i.e., Accepting Responsibility, Confrontive Coping) and attributions (i.e., internalization of the abuse). CONCLUSIONS: The results of the present study further our understanding regarding the relationship between abuse-related characteristics, mediating factors such as coping and attributional style and psychological distress in adults with a history of CSA. Future research should focus on the development of interventions that focus on variables amenable to psychotherapy to ameliorate the psychological sequelae of CSA.

Adaptation, Psychological↗

PubMed2003

Identification of RIP140 as a nuclear receptor cofactor with a role in female reproduction.

Nuclear receptors function as ligand-dependent transcription factors by recruiting cofactors that remodel chromatin and recruit the transcription machinery. RIP140 (receptor interacting protein with a molecular weight of 140 kDa) is a widely expressed corepressor that has the potential to inhibit the transcriptional activity of most, if not all nuclear receptors. Mice devoid of RIP140 indicate that it plays a crucial role in female fertility and in adipose biology. It is essential in the ovary for ovulation, specifically oocyte release but not luteinisation of mature follicles. Our goal is to identify the key nuclear receptor(s) and their target genes responsible for ovulation.

Adaptor Proteins, Signal Transducing↗

PubMed2003

Pre-migration trauma and HIV-risk behavior.

This study examined the relationship between pre-migration trauma and HIV-risk behavior in refugees from sub-Saharan Africa. The sample comprised 122 persons who had emigrated from sub-Saharan Africa and were currently residing in Sweden. Qualitative methods including individual interviews, focus groups, and interviews with key informants addressed questions regarding trauma experience and HIV-risk behavior. A history of pre-migration trauma was found to be associated with HIV-risk behavior. According to the participants, symptoms associated with post-traumatic stress disorder, depression, adjustment disorder, and substance use mediated the relationship between pre-migration trauma and sexual risk behavior. In contrast, a minority of the participants who reported pre-migration trauma but not psychological sequelae, or experienced post-traumatic growth, reported safer sexual practices. It appears that for some individuals, pre-migration trauma resulted in psychiatric sequelae, which may increase an individual's risk to be infected with HIV. Interventions targeted at individuals at increased risk (i.e. pre-migration trauma with unresolved psychiatric symptomatology) may facilitate the prevention of HIV and other sexually transmitted diseases in this population. Integration of multiple psychosocial and health issues is recommended for comprehensive treatment and prevention programs.

Adult↗