Educating African American men about the prostate cancer screening dilemma: a randomized intervention.

BACKGROUND: Until there is a definitive demonstration that early diagnosis and treatment of prostate cancer reduces disease-related mortality, it is imperative to promote informed screening decisions by providing balanced information about the potential benefits and risks of prostate cancer screening. Within a community/academic collaboration, we conducted a randomized trial of a printed booklet and a videotape that were designed for African American (AA) men. The purpose of the trial was to determine the effect of the interventions on knowledge, decisional conflict, satisfaction with the screening decision, and self-reported screening. METHODS: Participants were 238 AA men, ages 40 to 70 years, who were members of the Prince Hall Masons in Washington, DC. Men were randomly assigned to the (a) video-based information study arm, (b) print-based information study arm, or (c) wait list control study arm. Intervention materials were mailed to men at home. Assessments were conducted at baseline, 1 month, and 12 months postintervention. Multivariate analyses, including ANCOVA and logistic regression, were used to analyze group differences. RESULTS: The booklet and video resulted in a significant improvement in knowledge and a reduction in decisional conflict about prostate cancer screening, relative to the wait list control. Satisfaction with the screening decision was not affected by the interventions. Self-reported screening rates increased between the baseline and the 1-year assessment, although screening was not differentially associated with either of the interventions. In exploratory analyses, prostate-specific antigen testing at 1 year was more likely among previously screened men and was associated with having low baseline decisional conflict. CONCLUSIONS: This study represents one of the first randomized intervention trials specifically designed to address AA men's informed decision making about prostate cancer screening. We have developed and evaluated culturally sensitive, balanced, and disseminable materials that improved knowledge and reduced decisional conflict about prostate cancer screening among AA men. Due to the high incidence and mortality rates among AA men, there is a need for targeted educational materials, particularly materials that are balanced in terms of the benefits and risks of screening.     

Interaction of HPV-18 and nitrosomethylurea in the induction of squamous cell carcinoma

A strong correlation exists between the presence of specifictypes of human papillomavirus (HPV) and the development of anogenitalcancer, as well as significant epidemiologic evidence suggestingsmokers are at increased risk of developing cervical, vulvarand/or anal carcinomas. Primary and human papillomavirus type18 (HPV-8)-immortalized human keratinocytes were used to addressthe co-carcinogenic potential of HPV and nitrosomethylurea (NMU)in tumorigenesis. Only cells containing HPV-18 and treated withNMU and the tumor-promoting phorbol ester, TPA, were transformedto a malignant phenotype. An in vitro system is described whichinitiates studies involving the mechanisms of HPV and chemicalcarcinogen co-operation in the etiology of squamous cell carcinomas.     

Integrated analysis of genome‐wide copy number alterations and gene expression in microsatellite stable,CpG island methylator phenotype‐negative colon cancer

Microsatellite stable (MSS), CpG island methylator phenotype (CIMP)‐negative colorectal tumors, the most prevalent molecular subtype of colorectal cancer, are associated with extensive copy number alteration (CNA) events and aneuploidy. We report on the identification of characteristic recurrent CNA (with frequency >25%) events and associated gene expression profiles for a total of 40 paired tumor and adjacent normal colon tissues using genome‐wide microarrays. We observed recurrent CNAs, namely gains at 1q, 7p, 7q, 8p12‐11, 8q, 12p13, 13q, 20p, 20q, Xp, and Xq and losses at 1p36, 1p31, 1p21, 4p15‐12, 4q12‐35, 5q21‐22, 6q26, 8p, 14q, 15q11‐12, 17p, 18p, 18q, 21q21‐22, and 22q. Within these genomic regions we identified 356 genes with significant differential expression (P < 0.0001 and ±1.5‐fold change) in the tumor compared to adjacent normal tissue. Gene ontology and pathway analyses indicated that many of these genes were involved in functional mechanisms that regulate cell cycle, cell death, and metabolism. An amplicon present in >70% of the tumor samples at 20q11‐20q13 contained several cancer‐related genes (AHCY, POFUT1, RPN2, TH1L, and PRPF6) that were upregulated and demonstrated a significant linear correlation (P < 0.05) for gene dosage and gene expression. Copy number loss at 8p, a CNA associated with adenocarcinoma and poor prognosis, was observed in >50% of the tumor samples and demonstrated a significant linear correlation for gene dosage and gene expression for two potential tumor suppressor genes, MTUS1 (8p22) and PPP2CB (8p12). The results from our integration analysis illustrate the complex relationship between genomic alterations and gene expression in colon cancer. © 2013 Wiley Periodicals, Inc.     

Chromosomal abnormalities in HPV-16-immortalized oral epithelial cells

Human papilloma virus (HPV) type 16 has an established associationwith anogenital carcinoma, and to some extent with human oralsquamous cell carcinoma. We hypothesize that HPV type 16 iscapable of inducing chromosomal and cell cycle changes in culturedoral epithelial cells. Normal human oral epithelial cells wereimmortalized with recom-binant retrovirus containing the E6/E7open reading frames of HPV type 16. These cells have been inculture for more than 350 passages and over 4 years. Flow cytometrydemonstrated an average of 42% nuclear aneuploidy in HPV 16-immortalizedcells; 16% in normal controls (probably tetrasomy). Cytogeneticanalysis demonstrated significant progression of chromosomalabnormalities. Cells at early passage (p10) showed trisomy 20,with no other major changes. At passage 18, trisomy lq and monosomy13 were seen in addition to trisomy 20. At passage 61 therewere two distinct cell populations (‘a’ and ‘b’),with multiple chromosomal changes including trisomy 5q,14,20in one line and 7p,9q,11q in the other. Both populations hadmonosomy 3p, with monosomy 8p in one population and monosomy13 in the other. At passage 136, the cells were essentiallyidentical to population ‘b’ of passage 61. At thispassage, mutation of the p53 gene was detected at codon 273of exon 8, with G to T conversion (Arg to Leu). This was absentin the normal cells from which this line was developed. Passage262 contained the two major cell populations, each with a sub-groupwith additional chromosomal changes such as l0p monosomy. Cellsfrom passages 217 and 305 were injected into nude mice a yearapart Both failed to produce tumors, as did normal cells. Inconclusion, we present an HPV type 16-immortalized oral epithelialcell line (IHGK) with extensive and progressive chromosomalabnormalities, invasive growth in culture and yet no tumor formationin nude mice. We suggest that the question as to whether HPValone can induce transformation is still open.     

Fostering coping skills and resilience in Home Enteral Nutrition (HEN) consumers.

BACKGROUND: Home enteral nutrition (HEN) is a lifesaving therapy that provides benefits along with countless challenges. This qualitative study examined how HEN consumers learned to cope successfully with HEN-related challenges and uncovered how healthcare providers could help foster the process of coping in other HEN consumers. METHODS: Twelve adult HEN consumers who perceived that they were coping successfully and overcoming the adversity associated with HEN, and met the criteria for resilience using the Resilience Scale, self-selected for the study. Participants engaged in a series of 2 in-depth interviews. Data were coded and analyzed using grounded theory methodology. RESULTS: One overarching theme and 5 main categories emerged from the data, revealing that these individuals coped successfully with HEN by developing an attitude of personal responsibility to accept new life conditions, take charge of their own well-being, seek and accept support, maximize independence and normality, and focus on the positive. In addition, these participants used a variety of problem- and emotion-focused coping strategies and shared resilient characteristics such as self-efficacy and perseverance. CONCLUSIONS: Implications for clinical practice and HEN education, along with suggestions for healthcare providers to foster coping with HEN are provided. An educational manual with self-help suggestions for adult HEN consumers is also available at http://www.copingwell.com.     

Burkholderia gladioli osteomyelitis in association with chronic granulomatous disease: case report and review

We describe a case of insidious small bone osteomyelitis and soft tissue abscess with Burkholderia gladioli in a 6-year-old Caucasian boy with chronic granulomatous disease. DNA sequencing of the 16S ribosomal RNA gene confirmed the bacterial identification. Clinical cure was achieved with a combination of antimicrobial therapy and surgical debridement. A review of infections caused by Burkholderia spp., other than Burkholderia cepacia complex, in pediatric patients with chronic granulomatous disease is provided.     

Live viral vaccines in patients with partial DiGeorge syndrome: clinical experience and cellular immunity

Partial DiGeorge syndrome (pDGS) is an inherited primary immunodeficiency syndrome (incidence, 1:3000 live births) primarily affecting cellular immune function; partial, infers thymic hypoplasia with detectable circulating T-lymphocytes and adequate function. No guidelines exist regarding the recommendations for use of live viral vaccines (LVVs) in this extensive population of pediatric patients. We reviewed the experience with live viral vaccines in our cohort of patients with pDGS. Of 53 patients, 25 (47%) had received a live viral vaccine. No significant adverse events were recorded in association with administration of live viral vaccines. There was no statistically significant difference between cellular immune function at initial presentation between those patients that received live viral vaccines and those that did not. Adequate cellular immune function was documented for 15 of the 25 LVV recipients at the time of vaccine administration without significant change from baseline. These observations suggest that live viral vaccines appear safe in patients with pDGS and stable immune function.