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At least 19 recordsLinked to original sources

Enhancing Self Care Among Oral Cancer Survivors Using a Digital Approach: The Empowered Survivor Trial.

BACKGROUND: Oral and oropharyngeal cancer survivors experience debilitating physical and psychosocial challenges. Little knowledge exists on the efficacy of interventions to enhance self-efficacy in managing these challenges, increase survivorship preparedness, and improve health-related quality of life (HRQoL). METHODS: Individuals (n&#xa0;=&#xa0;643) diagnosed with oral or oropharyngeal cancer diagnosed within past 3&#xa0;years were randomized to a digital intervention, Empowered Survivor (ES) or a Generic Online Intervention (GO). Primary (self-efficacy, preparedness, HRQoL) and secondary outcomes (self-care activities) were measured at Baseline, 2-months, and 6-months. RESULTS: Participants assigned to ES reported greater self-efficacy and increased self-care activities of oral self-exams, swallowing, and mobility exercises than those assigned to GO (self-efficacy: 2&#xa0;months, p&#xa0;=&#xa0;0.003, 6-months, p&#xa0;<&#xa0;0.001; self-care activities). CONCLUSIONS: The ES enhanced self-efficacy and increased self-care activities. Further examinations of survivorship preparedness and HRQoL in oral and oropharyngeal cancer are warranted. TRIAL REGISTRATION: Registered on clinicaltrials. gov as NCT04713449.

Humans

Squamous cell carcinoma of the tongue in a nine year renal transplant survivor: a case report with a discussion of the risk of development of epithelial carcinomas in renal transplant survivors.

A case of squamous cell carcinoma of the tongue in a 26-year-old man developing nine years after renal transplantation is presented. This is the first such case to be reported. Within seven months, widespread tumor metastases resulted in death. Pathologic examination of the transplanted kidney demonstrated neither re-establishment of glomerulonephritis nor evidence of rejection, and lack of significant renal disease was confirmed by electron microscopy. This long term survival without development of renal pathology is also of great interest.

Adolescent

Height, weight, and head circumference in survivors of marasmus and kwashiorkor.

The physical growth of 44 survivors of marasmus and 43 survivors of kwashiorker 7 1/2 years after their hospitalization and cure from malnutrition has been evaluated. The collected data on height, weight, and head circumference of these 87 previously malnourished children have been compared with data on height, weight, and head circumference of 559 children of the same age and sex from the same environment who have never been malnourished. The statistical analysis of the data indicate the following conclusions. 1) The survivors of marasmus are shorter and lighter and have a smaller head circumference than controls. The observed difference is statistically significant. 2) The survivors of kwashiorkor have the same physical stature as controls. 3) The survivors of marasmus are shorter and lighter and have a smaller head circumference than survivors of kwashiorkor. 4) The survivors of marasmus who were hospitalized for treatment of malnutrition when younger than 1 year have the same physical stature as the survivors of marasmus who were hospitalized for treatment of malnutrition when older than 1 year.

Adolescent

Barriers and Facilitators of Help-Seeking for LGBTQ+ Survivors of Sexual Violence: A Systematic Review.

People who identify as LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer, plus) are known to experience similar or higher levels of sexual violence compared to their heterosexual cisgender counterparts. However, sexual violence research has largely focused on heterosexual female survivors of male perpetrated crime. Thus, the unique support needs and help-seeking patterns of LGBTQ+ survivors are poorly understood. This review addresses this gap by systematically exploring literature on barriers and facilitators to help-seeking for LGBTQ+ survivors of sexual violence. Four databases (PsycINFO, CINAHL, MEDLINE, and Web of Science) were searched to identify relevant material, with 35 articles (30 qualitative, 1 quantitative, and 4 mixed-methods) meeting the inclusion criteria. Data were extracted and analyzed using a narrative synthesis. The topic was investigated almost exclusively cross-sectionally. Barriers included discrimination experiences, myths and stereotypes, feelings of shame and self-blame, and rejection of victim status. Additional barriers were reported by survivors who hold multiple minority identities, in particular LGBTQ+ people of color and sex workers. Facilitators to help-seeking included the intrinsic need to connect with others, social encouragement and empowerment, and positive disclosure experiences. The Power Threat Meaning framework provides insight into these findings by presenting help-seeking behaviors as adaptive responses to increase a sense of safety following a traumatic experience. The analyzed data indicate several implications for the development and improvement services to support LGBTQ+ survivors. They further serve to highlight the need for additional robust research, conducted with an intersectional lens, to explore the needs of sexual and gender minority survivors of sexual violence.

Humans

Physical growth and neurointegrative performance of survivors of protein--energy malnutrition.

1. The anthropometric measurements and neurointegrative performance of seventy-nine children aged 6--12 years who had survived kwashiorkor in early childhood were compared to those of 142 children who served as controls. 2. For the boys the differences in height and weight between those who had survived protein--energy malnutrition (PEM) and the controls were significant (P less than 0.01). 3. For the girls the differences in height and weight between those who had survived PEM and the controls were not significant. 4. In the tests chosen, the performances of the survivors of PEM was significantly poorer than that of the controls. 5. There was no improvement in the performance when thirteen survivors were reassessed at 10 years of age. 6. There was a significant difference in scholastic performance between the survivors of PEM and the normal controls. The scholastic performance of the siblings of PEM survivors was also significantly better than that of the PEM survivors. 7. The dietary intakes at the time of reassessment were unsatisfactory in 25% of the survivors, but did not relate to their scholastic abilities.

Adolescent

Persistent trauma three decades after the Halabja massacre: psychological symptom profiles and hair cortisol levels in gas attack survivors.

BACKGROUND: Survivors of the 1988 Halabja chemical attack have experienced severe, chronic trauma, yet limited research has examined the long-term psychological and biological consequences of chemical warfare exposure more than three decades later. AIMS: To examine long-term post-traumatic stress disorder (PTSD) symptoms, depression/anxiety symptoms, somatic symptoms and perceived stress among survivors of the Halabja chemical attack, and to investigate the associations of trauma exposure, sociodemographic factors and hair cortisol concentrations (HCCs) with psychological symptom severity and symptom profiles. METHOD: A total of 209 survivors of the Halabja chemical attack participated in structured interviews using culturally adapted and field-tested instruments, including the Post-Traumatic Stress Disorder Checklist for DSM-5, Hopkins Symptom Checklist-25, the Patient Health Questionnaire-13, the Perceived Stress Scale-14 and an adapted War and Adversity Exposure Checklist-26. Hair cortisol and cortisone concentrations were assessed as biomarkers of chronic stress. Data were analysed using correlations, independent-samples t-tests, multiple linear regression analyses, multinomial logistic regression and latent profile analysis (LPA). RESULTS: Survivors demonstrated a substantial long-term psychological symptom burden. Overall, 87.6% of participants exceeded the cut-off for probable PTSD symptoms, and 75.1% exceeded the cut-off for elevated depression/anxiety symptoms. Most participants (81.8%) reported exposure to 11 or more lifetime traumatic events. Men reported significantly greater cumulative trauma exposure, whereas women reported significantly greater somatic symptom severity. Higher educational attainment and employment were consistently associated with lower psychological symptom severity across multiple outcomes. HCCs were not significantly associated with PTSD symptoms or latent symptom-profile membership after adjustment for trauma exposure and psychosocial variables. The LPA identified four symptom-severity classes characterised by differing levels of PTSD and depression/anxiety symptoms. Greater cumulative trauma exposure and lower social support were associated with membership in more severe symptom classes. CONCLUSIONS: Survivors of the Halabja chemical attack continue to experience substantial psychological distress more than three decades after exposure. Long-term symptom severity appears to be more strongly associated with cumulative trauma exposure and psychosocial adversity than with HCCs. The findings highlight substantial heterogeneity in symptom presentation and support the need for long-term, culturally sensitive and trauma-informed mental health interventions for survivors of chemical warfare and mass violence.

Halabja chemical attack

Integrating genetic predictors into subsequent breast cancer risk prediction in survivors of childhood cancer.

PURPOSE: Female survivors of childhood cancer are at high risk for developing breast cancer. The contributions of most general population primary breast cancer genetic predictors to this risk have not been explored. METHODS: Analyses included females who survived &#x2265;5 years after their childhood cancer diagnosis with available array (N&#x2009;=&#x2009;2096, subsequent breast cancer [SBC]=218) or whole-genome sequencing (WGS; N&#x2009;=&#x2009;3292, SBC=101) data from the Childhood Cancer Survivor Study and St. Jude Lifetime Cohort. We computed 99 externally-validated primary breast cancer polygenic risk scores (PRS). Using deep-coverage WGS, ClinVar-annotated pathogenic/likely pathogenic (P/LP) variants in breast cancer susceptibility genes were identified. Cox proportional hazards models assessed associations with SBC risk, adjusting for treatments and genetic ancestry. RESULTS: Among 5388 female survivors (genetic ancestry, European: N&#x2009;=&#x2009;4,752; African: N&#x2009;=&#x2009;444; East Asian: N&#x2009;=&#x2009;192), 319 developed SBC. Most (90.9%) PRSs were nominally associated with SBC risk (P&#x2009;<&#x2009;0.05), but effect sizes varied substantially. PRSs with superior discriminatory ability had greater genome-wide coverage (e.g., 6.4 million-variant PRS, HR per SD&#x2009;=&#x2009;1.71, 95% CI&#x2009;=&#x2009;1.43 to 2.05; P&#x2009;=&#x2009;4.2x10-9) and 7.7-fold higher odds (P&#x2009;=&#x2009;7.0x10-4) of including variants in multiple DNA damage repair pathways compared with PRSs with weaker risk associations. Among survivors with WGS, 1.6% carried P/LP variants in clinical testing panel genes, which was associated with a 7.4-fold greater risk (95% CI&#x2009;=&#x2009;3.16 to 17.19). Including genetic factors improved SBC risk prediction by age 40 (P&#x2009;<&#x2009;0.001) compared to treatment exposures alone. CONCLUSIONS: Externally-validated primary breast cancer genetic susceptibility predictors are relevant for SBC risk prediction and should be prioritized for risk stratification in survivors.

Journal Article

The Effect of Pain Catastrophizing on Acupuncture Treatment for Chronic Pain in Cancer Survivors.

CONTEXT: Pain catastrophizing (PC) predicts worse pain outcomes in cancer survivors. However, little is known whether PC influences pain outcomes of nonpharmacological treatments such as acupuncture. OBJECTIVES: This study aimed to assess the impact of PC on acupuncture efficacy for chronic pain in cancer survivors. METHODS: This secondary analysis of PEACE trial used two-sample t-test and Pearson's chi-squared test to analyze the pain outcomes of cancer survivors who received electroacupuncture (EA) or battlefield acupuncture (BFA). PC was measured using Pain Catastrophizing Scale (PCS). The Brief Pain Inventory (BPI) was used to measure pain severity and interference at the primary endpoint (week 12). RESULTS: Among 266 participants, 41 (15.41%) had a high baseline PC. Among those receiving EA, high PC patients had greater reductions in pain severity (-3.9 vs. -2.1, P = 0.006) and pain interference (-3.8 vs. -2.6, P = 0.04) than low PC. PC was not associated with pain outcomes in BFA group (P > 0.05 for both severity and interference). Among patients with high PC, a greater proportion were responders in the EA group than those in BFA group (83.3% vs. 43.5%, P = 0.009). Among low PC patients, there was no significant difference in the proportion of responders between the EA and BFA groups (66.1% vs. 64.5%, P = 0.8). CONCLUSION: We found that cancer survivors with high baseline PC had greater pain reductions with EA than BFA and compared to low PC patients. These findings suggest that EA may serve as a targeted treatment option for vulnerable patients with high PC and further support precision pain management.

Humans

A qualitative study of cancer survivors' exercise behaviour 4 months after a telerehabilitation program.

PURPOSE: Although telerehabilitation can improve access to exercise programs for cancer survivors, it is not known if these programs lead to ongoing change in exercise habits. This study explored participant experiences of exercise 4 months after finishing specialized cancer exercise-based telerehabilitation. METHOD: A qualitative study embedded in a randomized controlled trial evaluated exercise-based cancer telerehabilitation delivered in groups. Data were collected via semistructured interviews that were audio-recorded and transcribed verbatim. Seventeen adult cancer survivors (age 21 to 80) were purposively sampled 4 months after completing exercise-based cancer telerehabilitation. Data were coded independently by two researchers and analyzed inductively within an interpretive description framework. RESULTS: The overarching theme was telerehabilitation was perceived to facilitate positive exercise intentions. Participants said they were empowered to exercise through knowledge, opportunity, and connection gained through telerehabilitation. They described acting on their positive intentions to exercise to varying degrees following telerehabilitation, depending on their context. A subtheme was that exercise was challenging in their new reality created by cancer. Comorbidities, ongoing side effects, previous exercise experience, and personal factors were considered by some to influence their ability to exercise. CONCLUSION: Telerehabilitation may facilitate positive intent to maintain exercise. Cancer survivors may need ongoing support after telerehabilitation to act on positive exercise intentions due to health-related difficulties. IMPLICATIONS FOR CANCER SURVIVORS: Participation in telerehabilitation may be a positive first step to initiate exercise, but ongoing support to maintain positive behavior changes is likely to be needed for people without previous exercise experience.

Humans

Repair of DNA double-strand breaks after low radiation doses in childhood cancer survivors and matched cancer-free individuals.

DNA double-strand breaks (DSBs) which arise in G1- or G0-phase normal human cells are repaired by nonhomologous end-joining (NHEJ), a pathway which is important for cell survival but can cause mutations at the break sites. DSB repair by NHEJ is very efficient at high damage levels of 1 or more DSBs per cell, much less efficient at lower damage levels and almost absent if only ~0.05 DSBs per cell are induced. Here, we have analyzed the repair of high and low levels of radiation-induced DSBs in primary fibroblasts from 136 childhood cancer survivors, half of whom developed a second independent tumor later in life, and compared it to the response of primary fibroblasts from 68 individually matched cancer-free individuals. We measured the DSB repair efficiency by quantifying residual &#x3b3;H2AX foci with an automated scoring system at 24 h after irradiation with doses of 2.5, 5, 10, and 100 mGy, which induce about 0.0625, 0.125, 0.25, and 2.5 DSBs per cell, respectively. Although childhood cancer survivors and cancer-free individuals repaired DSBs after 10 and 100 mGy equally efficiently, their response to lower doses differed drastically. While repair in cancer-free individuals was inefficient after 2.5 mGy, childhood cancer survivors repaired DSBs after this dose as efficiently as after higher doses. These results indicate that most of the childhood cancer survivors analyzed here may harbor a genetic alteration that affects their response to low levels of DSBs. We suggest that such alterations may be either inherited or caused by previous tumor treatments.

Humans

Characteristics of long-term survivors in AML.

We examined the records of all patients with a diagnosis of acute myelogenous leukemia or acute myelo-monocytic leukemia seen between 1963--1975. Of 211 patients, 12 are alive and in complete remission from 179--48 months since diagnosis. Life table analysis reveals a survival plateau of 4--5% after five years. Three of the survivors have suffered relapses but still survive without evidence of disease. The clinical and laboratory characteristics of all the survivors are presented. The survivors have a significantly younger age at diagnosis than the nonsurvivors (P less than 0.005). However, no other factors could be identified as characteristic of the survivors' group.

Adolescent

Unchanged incidence of bronchopulmonary dysplasia in survivors of hyaline membrane disease.

To test the hypothesis that decreased mortality from severe HMD will result in increased morbidity from BPD, chest films of 30-day survivors of severe HMD were reviewed for evidence of Northway's Stage IV BPD. During July, 1970 to June, 1971, 20 survivors of severe HMD were identified; one case of Stage IV BPD was found in this group. During July 1974-June 1975, 80 survivors of severe HMD were identified; five infants had BPD. In spite of more survivors of severe HMD, no increase in the incidence of BPD could be demonstrated.

Bronchial Diseases

Immune reactivity of cells from long-term rat renal allograft survivors.

Lewis rats receiving an LBN kidney allograft demonstrate no signs of rejection if they are pretreated with donor spleen cells and antiserum reactive with the donor alloantigen. We examined the cellular reactivity of long-term kidney allograft survivors. Normal proliferative and cytolytic responses were obtained with spleen cells from long-term survivors, in marked contrast to the diminished responses of cells from neonatally tolerant rats or the heightened cytolytic response of cells from rats that had rejected a renal allograft. Serum from long-term renal allograft survivors as well as serum obtained from rats at the time of transplantation did not suppress proliferative or cytolytic responses of normal cells. The results of this study suggest that long-term renal allograft survivors possess the precursors of those cells which are responsible for proliferative and cytolytic responses in mixed leukocyte cultures, but that they have not been sensitized to their renal allograft.

Animals

Repolarization abnormalities in survivors of out-of-hospital ventricular fibrillation.

Survivors of out-of-hospital ventricular fibrillation (VF) are at high risk for recurrent VF, probably reflecting continued myocardial electrical instability. In this study 12-lead ECGs of 125 VF survivors with coronary heart disease were examined and compared to those of 98 ambulatory post-MI patients. The study was part of an effort to define clinical identifiers of patients likely to develop sudden cardiac death. Ventricular fibrillation survivors were commonly had premature ventricular complexes (PVCs):30% versus 13% (P less than 0.01). In addition, ECGs of VF survivors showed a significantly greater prevalence of ST-segment depression (46% versus 10%), T wave flattening (52% versus 26%), and QTc prolongation (35% versus 18%). It is proposed that these repolarization abnormalities represent asynchronous repolarization, which together with frequent PVCs, may set the stage for re-entrant ventricular dysrhythmias and ultimately VF. It is also possible that repolarization abnormalities together with premature ventricular contractions might serve as markers of patients with coronary heart disease who are at increased risk for sudden cardiac death.

Aged

Polygenic risk of coronary artery disease for long-term survivors of breast cancer.

BACKGROUND: Cardiovascular disease is a leading cause of death for long-term breast cancer survivors. We evaluated whether a polygenic risk score for coronary artery disease (CAD-PRS) was associated with the risk of incident CAD for survivors of unilateral or contralateral breast cancer. METHODS: The study included 1307 women with breast cancer first diagnosed at younger than 55&#x2009;years of age who participated in the Women's Environmental&#xa0;Cancer and Radiation Epidemiology Follow-up Study. The CAD-PRS was based on a PRS developed and validated in a separate population. We modeled the association between incident CAD and the CAD-PRS, adjusting for age, CAD risk factors, first (and second) breast cancer treatment, study recruitment phase, and genetic population stratification. We also explored whether the risk of CAD depended on interactions between the CAD-PRS and cardiotoxic cancer treatment. RESULTS: There were 66 incident CAD diagnoses reported at a median of 16&#x2009;years after breast cancer diagnosis. Participants with CAD-PRS&#x2009;at or above the median had a 2.48-times increased risk of CAD (95% confidence interval [CI]&#x2009;=&#x2009;1.44 to 4.29) relative to participants with CAD-PRS&#x2009;below the&#x2009;median. Anthracycline-based chemotherapy was associated with increased CAD risk (hazard ratio [HR]&#x2009;=&#x2009;2.04, 95% CI&#x2009;=&#x2009;1.04 to 3.98), and the association was not modified by the CAD-PRS. The association between incident CAD and left-sided radiation therapy (RT) was increased for those with CAD-PRS&#x2009;at or above the median (HR&#x2009;=&#x2009;2.90, 95% CI&#x2009;=&#x2009;1.26 to 6.68) but not for those with CAD-PRS&#x2009;below the median (HR&#x2009;=&#x2009;0.96, 95% CI&#x2009;=&#x2009;0.32 to 2.88). There was evidence of super-additive interaction between the CAD-PRS and left-sided RT (relative excess risk due to interaction&#x2009;=&#x2009;2.06, 95% CI&#x2009;=&#x2009;0.05 to 4.06). CONCLUSION: A genome-wide CAD-PRS was associated with nonfatal CAD risk for long-term breast cancer survivors, providing potential utility for personalized cardiovascular care, particularly after RT.

Humans

The Efficacy of Pharmacotherapy Intervention on Anthropometric Outcomes in Survivors of Childhood Brain Tumors: An Updated Systematic Review and Meta-Analysis.

INTRODUCTION: Many survivors of childhood brain tumors face long-term adverse health outcomes like obesity. Uncertainties surround the effect of interventions to manage obesity-related outcomes in survivors of childhood brain tumors. The goal of this updated systematic review and meta-analysis was to provide the best estimate of the treatment efficacy of pharmacotherapy intervention on anthropometric outcomes in this pediatric population. METHODS: We searched CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, PubMed, ClinicalTrials.gov, and ProQuest for articles published from January 1, 2015, to January 31, 2025. A meta-analysis was performed using the generic inverse-variance method in RevMan 5.4. Heterogeneity was assessed using the Cochrane Q test and the I2 statistic. We used the GRADE approach to determine the certainty of evidence. RESULTS: A total of six studies met the inclusion criteria: four newly identified studies published after January 1, 2015 (125 participants), and two from the previously published review (23 participants). The pooled estimate showed no significant change in body mass index z-score after intervention (mean difference&#x2009;=&#x2009;-0.02; 95% CI: -0.06 to 0.02, I2&#x2009;=&#x2009;0%; 4 studies, 94 participants; low certainty of evidence). Similar pooled effects were observed across other outcomes; however, individual studies reported significant changes in some outcomes within the treatment groups after the intervention. CONCLUSION: Pharmacological agents showed no significant change in anthropometric outcomes for survivors of childhood brain tumors. Further trials are needed to assess the efficacy of pharmacological agents and to identify subgroups most likely to benefit.

Humans

Impact of Nazi holocaust on children of survivors.

Case reports of children of Nazi holocaust survivors are sparse in psychiatric literature despite a relative abundance of material on the "survivor syndrome." The case presented here illustrates that the long-range effects of the holocaust include intrapsychic, familial, and cultureal pathogenic factors that may influence the psychologic development of the offspring of survivors.

Adult