Breast Cancer Risk From Modifiable and Non-Modifiable Risk Factors among Palestinian Women: A Systematic Review and Meta-Analysis

Objective: Breast cancer (BC) is known as one of the deadliest forms of cancer, and it is increasing globally. Identifying risk factors for BC is a key point in developing preventive strategies to reduce its occurrence. Herein, we aimed to conduct a systematic review and meta-analysis focus on the risk factors for BC in Palestine. Material and Methods: We performed a systematic search via PubMed, MEDLINE, SCOPUS, Science Direct, Cochrane library, Emerald Insight, and Google scholar for identifying studies published on BC risk factors up to March 2021. Pooled odds ratios (OR) are calculated using fixed and random-effect models. Data were processed using Review Manager 5.4 (RevMan 5.4). Results: From a total of 73 articles, seven case-control studies met the criteria for systematic review. Meta-analysis results showed that of the known modifiable risk factors for BC, diabetes mellitus (DM) had the highest odds ratio (OR = 4.97, 95% CI 3.00- 8.25) followed by hypertension (OR = 3.21, 95% CI 1.96-5.23), obesity (BMI >30 Kg/m2) (OR = 2.90, 95% CI 2.00- 4.21), and passive smoking (OR = 1.50, 95% CI 1.12- 2.02). Controversially, breastfeeding (OR = 0.37, 95% CI 0.23- 0.61) was protective factor in BC. Of non-modifiable risk factors for BC has reached menopause had the highest odds ratio (OR = 3.74, 95% CI 2.64- 5.29), followed by family history of BC (OR = 2.63, 95% CI 1.07-6.44) and age (≥ 40 years) (OR = 2.49, 95% CI 1.43-4.34). Conclusions: The most significant predictors of BC in Palestine were DM, hypertension, passive smokers, age (>40), reached menopause, and family history of BC. Almost all these risk factors are consistent with known risk factors for breast cancer in other parts of the world.     

Risk profile of myocardial infarction in young versus older adults

Background

In developing countries, the number of adults who develop myocardial infarction (MI) at a young age is high. The popularity of waterpipe smoking (WPS) has increased among the same age group. It is unknown if WPS contributes to the incidence of early-onset MI.

Risk factors for paediatric cancer in the Gaza Strip: a case-control study

Background

Cancer is a serious health problem and the third leading cause of death in the occupied Palestinian territory, both in adults and children. For most children younger than 18 years who have cancer, there is no obvious cause. The aim of this study was to identify the main risk factors for paediatric cancer in the Gaza Strip.

Management of acute meningococcal septicaemia in Al-Nasser Paediatric Hospital: a retrospective cohort study

Background

Acute meningococcal septicaemia is a fulminant disease, and mortality and long-term morbidity can be very high if not treated appropriately. We aimed to evaluate case fatality rate of all children admitted with acute meningococcal septicaemia.

Management of thoracic empyema: review of 112 cases

To review our experience in treatment of patients with thoracic empyema at a teaching hospital chart of patients were retrospectively reviewed over a 72-month period. A total of 112 patients (94 men, 18 women, mean age: 39, range: 6-89 years) underwent therapeutic procedures for thoracic empyema between 2001-2006. The causes of empyema included parapneumonic empyema (60.7%), thoracic trauma (20.5%), surgical procedures (7.1%) and seeding from an extra-pulmonary source (11.7%). Multiloculated empyemas were documented in 45 patients (40%). Insertion of chest tube was the first procedure in 103 patients (92%). Nineteen patients (17%) were treated by thoracotomy, ten patients (8.9%) had fibrinolytic therapy, eight patients (7.2%) underwent video assisted thoracic surgery (VATS) and sixteen patients (14.3%) had subsequent radiologic-guided drainage. Thoracotomy-Decortication was successful in 90% of patients undergoing surgery and the least successful intervention was tube thoracostomy alone. Twelve of 112 patients (10.7%) died in the hospital including one patient in the thoracotomy group. Long-term follow-up was available in 67 patients including all of patients requiring surgery and fibrinolytic therapy. Thirty four patients (50%) obtained complete functional recovery. Simple drainage as the first procedure for the treatment of thoracic empyema has a high failure rate. Selection of a therapeutic option should be based on age, underlying disease, stage of the empyema, state of the loculation, local expertise and availability. Surgical procedures such as VATS or thoracotomy are recommended as the first procedure in elderly patients and advanced empyema.