Comparison of organic and inorganic germanium compounds in cellular radiosensitivity and preparation of germanium nanoparticles as a radiosensitizer

Purpose: The aim of this work is to compare the radiosensitizing effect between organic and inorganic germanium compounds and to investigate whether nanometer-sized germanium particles can act as radiosensitizers.

Materials and methods: Bis (2-carboxyethylgermanium) sesquioxide (Ge-132), germanium oxide (GeO₂) and germanium nanoparticles were used in this study. Cell viability was determined by clonogenic survival assay. Cellular DNA damage was evaluated by alkaline comet assay, confocal microscopy and the cellular level of phospho-histone H2AX (γ-H2AX).

Results: Nanometer-sized germanium particles were fabricated. They have a similar radiosensitizing effect as that of GeO₂. Conversely, Ge-132 did not enhance the radiosensitivity of cells. Comet assay was employed to evaluate the level of DNA damage and confirmed that inorganic germanium compounds enhanced cellular radiosensitivity. Notably, the comet assay indicated that the nanoparticle itself caused a higher level of DNA damage. The possibility that germanium nanoparticles per se caused DNA damage was ruled out when the cellular level of γ-H2AX was examined.

Conclusions: We demonstrated that inorganic but not organic germanium compounds exerted radiosensitizing effect in cells. Nanometer-sized germanium particles were fabricated and were able to enhance the radiosensitivity of cells. Confounding effect may occur when comet assay is used to estimate the level of DNA damage in the presence of germanium nanoparticles.     

The risk of cancer among patients with sleep disturbance: a nationwide retrospective study in Taiwan

PurposeTo investigate the risk of cancer among patients with nonapnea sleep disorders (SDs).MethodsWe included newly diagnosed SD patients aged 20 years and older without antecedent cancer between 2000 and 2010 from the National Health Insurance Research Database. Standardized incidence ratios (SIRs) of cancers were calculated to compare the cancer incidence of patients with SD with that of the general population.ResultsDuring the 10-year study period, 2062 cancers developed among 63,381 SD patients, who were observed for 382,826 person-years (median follow-up of 6.23 years). The SIR for all cancers was 1.19 (95% confidence interval [CI], 1.14–1.24). For specific cancer types, SD patients exhibited an increased SIR for liver and lung cancers (1.44; 95% CI, 1.28–1.61 and 1.34; 95% CI, 1.18–1.51, respectively).ConclusionsWe observed that overall cancer risk is increased among Asian SD patients. In terms of individual cancers, the risks of liver and lung cancers were elevated. Clinicians should be aware of the possibility of increased liver and lung cancers among SD patients in Taiwan. A prospective study is necessary to confirm these findings.     

Promoters of and barriers to cervical cancer screening in a rural setting in Tanzania

Objective

To investigate promoters and barriers for cervical cancer screening in rural Tanzania.

Methods

We interviewed 300 women of reproductive age living in Kiwangwa village, Tanzania. The odds of attending a free, 2-day screening service were compared with sociodemographic variables, lifestyle factors, and knowledge and attitudes surrounding cervical cancer using multivariable logistic regression.

Results

Compared with women who did not attend the screening service (n = 195), women who attended (n = 105) were older (OR 4.29; 95% CI, 1.61–11.48, age 40–49 years versus 20–29 years), listened regularly to the radio (OR 24.76; 95% CI, 11.49–53.33, listened to radio 1–3 times per week versus not at all), had a poorer quality of life (OR 4.91; CI, 1.96–12.32, lowest versus highest score), had faced cost barriers to obtaining health care in the preceding year (OR 2.24; 95% CI, 1.11–4.53, yes versus no), and held a more positive attitude toward cervical cancer screening (OR 4.64; 95% CI, 1.39–15.55, least versus most averse).

Conclusion

Efforts aimed at improving screening rates in rural Tanzania need to address both structural and individual-level barriers, including knowledge and awareness of cervical cancer prevention, cost barriers to care, and access to health information.     

A preliminary reliability and validity study of the Chinese version of the self-efficacy for exercise scale for older adults

Background

Population ageing affects most undeveloped, developing and developed countries. Less than a quarter of older people undertake a level of physical activity worldwide that is sufficient to lead to health benefits. Understanding older people’s confidence regarding engaging in exercise helps to structure physical activity interventions that motivate them to initiate and adhere to regular exercise. Estimates of the reliability and validity of the English version of the self-efficacy for exercise (SEE) scale has been widely tested and shown to be valid for use in various settings and among older people. The reliability and validity of a Chinese version of the SEE for older adults has not been tested.

Aim

To undertake a preliminary assessment of the reliability and validity of the SEE scale when applied to the older Chinese adults.

Methods

The Chinese version of the self-efficacy for exercise (SEE-C) scale was tested on a sample of 192 older people from Taiwan with a mean age of 71.2 years recruited between October and December 2003.

Results

There was acceptable internal consistency of the SEE-C scale. The fit of the measurement model to the data for the SEE-C scale was acceptable. There was evidence of validity of the measure based on hypothesis testing: health status predicted exercise self-efficacy, and exercise self-efficacy predicted physical activity. Those who exercised regularly (n = 102) had a higher mean SEE-C score (5.3) than those who did not (2.9, n = 90).

Conclusion

This preliminary validation study provided evidence for the reliability and validity of the Chinese version of the SEE scale. Future testing of the SEE-C scale needs to be carried out to see whether these results are generalisable to older Chinese people living in urban areas and with different characteristics. A test of the scale among younger adults for a wider use of the instrument is also warranted.     

An outbreak of tuberculosis in a bacillus Calmette-guérin-vaccinated military population

The purpose of this study was to investigate an outbreak of tuberculosis (TB) in a bacillus Calmette-Guérin-vaccinated military population and propose an appropriate method of control. We divided 593 subjects into "close contacts" and "non-close contacts" of an index case and examined all subjects by chest X-radiography (CXR). For "close contacts," we performed several tests for patients with abnormal CXRs. "Non-close contacts" had no pulmonary infiltration and no evidence of TB. We administered tuberculin skin tests (TST) to 21 "close contacts" who had pulmonary infiltrations. Seven patients had a TST > or =18 mm, two of whom had active pulmonary TB. We administered antituberculous agents to all seven patients for 6 months. Fourteen subjects with TSTs <18 mm had no evidence of TB during the 18-month follow-up period. Among the other 178 "close contact" subjects with no infiltrations evident on the initial CXR, one patient developed TB pleuritis. We conclude that it is important to use early treatment for "close contacts" of a TB index case by performing the TST and testing for pulmonary infiltration on CXRs.     

Life-threatening hypersensitivity pneumonitis induced by docetaxel (taxotere).

4 patients with advanced non-small-cell lung cancer (NSCLC) treated with docetaxel developed life-threatening pneumonitis requiring mechanical ventilation. Docetaxel (30-60 mg x m(-2), according to a different protocol) was infused within one hour with standard premedications. One patient's pneumonitis occurred 5 days after the first dose of docetaxel, and that of the other 3 between the 2nd and 6th cycles. Based on the clinical course, radiological findings of an interstitial pneumonitis, and exclusion of other possible resultant causes, including metastatic cancer, radiation pulmonary injury, infection, or connective tissue disease, hypersensitivity pneumonitis was diagnosed. The patients were treated with hydrocortisone at 1200 mg per day or methylprednisolone at 240 mg per day. Although 3 of the 4 had a partial improvement in lung oxygenation, all patients' conditions of hypersensitivity pneumonitis persisted and were complicated by other events, such as hospital-acquired infection and tension pneumothorax. The presence of this unusual hypersensitivity pneumonitis, which was so severe as to be life-threatening and refractory to high-dose corticosteroid therapy, should be taken into account during docetaxel treatment.     

Risk of dementia among patients with Sjogren's syndrome: A nationwide population-based cohort study in Taiwan

Objective

Autoimmunity may play a role in early-stage dementia. The association between Sjogren's syndrome (SS) and dementia remains unknown. This study was conducted to provide epidemiologic evidence for this relationship.