Medical principles and practice : international journal of the Kuwait University, Health Science Centre
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Review
Overcoming Resistance to Endocrine Therapy in Breast Cancer: New Approaches to a Nagging Problem.
In the majority of women, breast cancer progresses through increased transcriptional activity due to over-expressed oestrogen receptors (ER). Therapeutic strategies include: (i) reduction of circulating ovarian oestrogens or of peripherally produced oestrogen (in postmenopausal women) with aromatase inhibitors and (ii) application of selective ER modulators for receptor blockade. The success of these interventions is limited by the variable but persistent onset of acquired resistance and by an intrinsic refractiveness which manifests despite adequate levels of ER in about 50% of patients with advanced metastatic disease. ⋯ Multiple mechanisms contributing to therapeutic failure have been proposed: (i) loss or modification of ER expression including epigenetic mechanisms, (ii) agonistic actions of selective ER modulators that may be enhanced through an increased expression of co-activators, (iii) attenuation of the tamoxifen metabolism through expression of genetic variants of P450 cytochromes which leads to more or less active metabolites and (iv) increased growth factor signalling particularly through epidermal growth factor receptor activation of pathways involving keratinocyte growth factor, platelet-derived growth factor, and nuclear factor x03BA;B. In addition, the small non-coding microRNAs, recently recognized as critical gene regulators, exhibit differential expression in tamoxifen-sensitive versus resistant cell lines. Several studies suggest the potential of using these either as targets or as therapeutic agents to modulate EMT regulators as a means of reversing the aggressive metastatic phenotype by reversal of the EMT, with the added benefit of re-sensitization to anti-oestrogens.
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Randomized Controlled Trial
Comparison of the Apical Sealing Ability of Calcium Silicate-Based Sealer and Resin-Based Sealer Using the Fluid-Filtration Technique.
The aim was to evaluate the apical sealing ability of tricalcium silicate-based (MTA Fillapex®) and resin-based (AH Plus®) sealers at 24 h, 7 days and 4 weeks. ⋯ In this study, the tricalcium silicate-based sealer promoted proper sealing when used for filling the root canals.
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To investigate patients' satisfaction with nursing care by measuring the gap between patients' expectations of care and perceptions of the actual care provided and to identify the areas of nursing care that need improvement. ⋯ Our study showed negative gaps for the 5 nursing service quality dimensions evaluated. This could provide nurses with information about the aspects of nursing care that promote more positive patient outcomes and satisfaction.
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Comparative Study
A Comparative Study of Oral Health Parameters in Molar Incisor Hypomineralization and High-Caries-Risk Children Aged 8-11 Years.
To compare oral health parameters: decayed missing filled teeth (dmft, DMFT), gingival index and plaque index in high-caries-risk children and children with molar incisor hypomineralization (MIH). ⋯ The children in the MIH group had higher DMFT than those without MIH. Hence, the presence of MIH could have a detrimental effect on oral health parameters, especially on DMFT values.
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The aim of this study was to evaluate the impact of different prosthodontic planning methods on the morphological symmetry of maxillary anterior teeth. ⋯ In this study, the single tooth symmetry had improved after the digital wax-up. However, the conventional wax-up had a minimal impact on single tooth symmetry. ASMA was minimally affected by the two wax-ups.