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Articles by A Rashid
Total Records ( 2 ) for A Rashid
  S. K Park , G Andreotti , A Rashid , J Chen , P. S Rosenberg , K Yu , J Olsen , Y. T Gao , J Deng , L. C Sakoda , M Zhang , M. C Shen , B. S Wang , T. Q Han , B. H Zhang , M Yeager , S. J Chanock and A. W. Hsing

Biliary tract cancer encompasses tumors of the gallbladder, bile duct and ampulla of Vater. Gallbladder cancer is more common in women, whereas bile duct cancer is more common in men, suggesting that sex hormones may play a role in the etiology of these cancers. The intracellular action of estrogens is regulated by the estrogen receptor (ESR); thus, we examined the role of common genetic variants in ESR genes on the risk of biliary tract cancers and stones in a population-based case–control study in Shanghai, China (411 cancer cases, 895 stone cases and 786 controls). We genotyped six single-nucleotide polymorphisms (SNPs), four in ESR1 (rs2234693, rs3841686, rs2228480 and rs1801132) and two in ESR2 (rs1256049 and rs4986938). In all participants, the ESR1 rs1801132 (P325P) G allele was associated with excess risks of bile duct [odds ratio (OR) = 1.7, 95% confidence interval (CI) 1.1–2.8] and ampulla of Vater cancers (OR = 2.1, 95% CI 0.9–4.9) compared with the CC genotype. The association with bile duct cancer was apparent among men (OR = 2.8, 95% CI 1.4–5.7) but not among women (P-heterogeneity = 0.01). Also, the ESR2 rs4986938 (38 bp 3' of STP) GG genotype was associated with a higher risk of bile duct cancer (OR = 3.3, 95% CI 1.3–8.7) compared with the AA genotype, although this estimate was based on a small number of subjects. None of the other SNPs examined was associated with biliary tract cancers or stones. False discovery rate-adjusted P-values were not significant (P > 0.1). No association was found for ESR1 haplotype based on four SNPs. These preliminary results suggest that variants in ESR genes could play a role in the etiology of biliary tract cancers, especially bile duct cancer in men.

  S Julian , A Rashid , R Baker , A Szczepura and M. Habiba

Background. Despite their growing influence on patient management and outcomes, very little is known about patients’ perceptions of clinical guidelines. This is a significant omission, particularly for services advocating patient-centred care and informed decision making.

Objectives. To explore the knowledge and attitudes of women with menstrual disorders towards the use of evidence-based clinical guidelines for their condition.

Methods. Semi-structured interviews were conducted with women with menstrual disorders.

Results. Some women were not aware of the existence of clinical guidelines for their condition. Many were unsure as to their exact nature. The most consistent interpretation of guidelines was as a ‘set of rules’. Numerous positive aspects of the use of guidelines were identified, for example, ensuring quality and safety for patients, earlier diagnosis, reducing waiting times and improving continuity of care. Negative views involved seeing guidelines as a tool for rationing and concerns over inflexibility. Patients recognized that implementation of guidelines in general practice can be problematic, especially if resources are not made available. An unmet need for information became apparent in this group of patients. Many women felt that they should have access to guidelines that are being used in their medical care and that guidelines had the potential to act as an information resource for patients.

Conclusions. A patient-centred service should endeavour to increase patient awareness of the existence and use of clinical guidelines. A patient version of clinical guidelines may be useful in promoting patients involvement in decision making and may improve outcomes.

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