Building a biopsychosocial model of cancer-related fatigue: the BIOCARE FActory cohort study protocol.

BACKGROUND: Cancer-related fatigue (CRF) is the most common side effect of cancer and cancer treatment. CRF prevalence is up to 50% in breast cancer patients and can continue several years after cancer remission. This persistent subjective sense of exhaustion is multifactorial. Numerous parameters have been evidenced to be related to CRF across biological, physical, psychological, social and/or behavioral dimensions. Although CRF has been studied for many years, the majority of previous studies focused on only one dimension, i.e., physical function. Moreover, few studies investigated CRF longitudinally with repeated measures. These are the two main obstacles that limit the understanding of CRF mechanisms. The purpose of this study is to create a biopsychosocial model of CRF with simultaneous and longitudinal anthropometric, clinical, biological, physical, psychological and sociological parameters. METHODS: BIOCARE FActory is a multicentric prospective study that will consist of an 18-month follow-up of 200 women diagnosed with breast cancer. Four visits will be scheduled at diagnosis, after treatments, and 12 and 18 months after diagnosis. The same procedure will be followed for each visit. Each session will be composed of anthropometric data collection, a semi-structured interview, cognitive tests, postural control tests, neuromuscular fatigability tests and a cardiorespiratory fitness test. Clinical and biological data will be collected during medical follow-ups. Participants will also complete questionnaires to assess psychological aspects and quality of life and wear an actigraphy device. Using a structural equation modeling analysis (SEM), collected data will build a biopsychosocial model of CRF, including the physiological, biological, psychological, behavioral and social dimensions of CRF. DISCUSSION: This study aims to highlight the dynamics of CRF and its correlates from diagnosis to post treatment. SEM analysis could examine some relations between potential mechanisms and CRF. Thus, the biopsychosocial model will contribute to a better understanding of CRF and its underlying mechanisms from diagnosis to the aftermaths of cancer and its treatments. TRIAL REGISTRATION: This study is registered at ClinicalTrials.gov ( NCT04391543 ), May 2020.

Handgrip fatiguing exercise can provide objective assessment of cancer-related fatigue: a pilot study.

PURPOSE: As a subjective symptom, cancer-related fatigue is assessed via patient-reported outcomes. Due to the inherent bias of such evaluation, screening and treatment for cancer-related fatigue remains suboptimal. The purpose is to evaluate whether objective cancer patients' hand muscle mechanical parameters (maximal force, critical force, force variability) extracted from a fatiguing handgrip exercise may be correlated to the different dimensions (physical, emotional, and cognitive) of cancer-related fatigue. METHODS: Fourteen women with advanced breast cancer, still under or having previously received chemotherapy within the preceding 3 months, and 11 healthy women participated to the present study. Cancer-related fatigue was first assessed through the EORTC QLQ-30 and its fatigue module. Fatigability was then measured during 60 maximal repeated handgrip contractions. The maximum force, critical force (asymptote of the force-time evolution), and force variability (root mean square of the successive differences) were extracted. Multiple regression models were performed to investigate the influence of the force parameters on cancer-related fatigue's dimensions. RESULTS: The multiple linear regression analysis evidenced that physical fatigue was best explained by maximum force and critical force (r = 0.81; p = 0.029). The emotional fatigue was best explained by maximum force, critical force, and force variability (r = 0.83; p = 0.008). The cognitive fatigue was best explained by critical force and force variability (r = 0.62; p = 0.035). CONCLUSION: The handgrip maximal force, critical force, and force variability may offer objective measures of the different dimensions of cancer-related fatigue and could provide a complementary approach to the patient reported outcomes.

Leg ability factors in tennis players.

We investigated the effects of leg stiffness on running speed, jump height and leg power in 13 male 2(nd)- and 3(rd)-series ranked tennis players (23 ± 3 years old, 73.2 ± 8.4 kg, 1.81 ± 0.06 m). Leg stiffness and jump height were assessed using jumping and hopping tests. Mean running speeds over 20 m and 40 m (speed20 and speed40, respectively) were determined from a sprint test. Theoretical maximal leg power (P(maxth)) was extrapolated from a force-velocity test performed on a cycle ergometer. Leg stiffness averaged 478.7 ± 181.7 N.m⁻¹.kg⁻¹ (34,808 ± 12,573 N.m⁻¹. It was significantly correlated to speed20 and counter movement jump height (r=0.60, P=0.028 and r=0.58, P=0.0407, respectively). There were also significant correlations between P (maxth) and counter-movement jump height (r=0.59, P=0.0335) and between P(maxth) and speed40 (r=0.58, P=0.0393). This study characterizes leg stiffness in tennis players and brings new information concerning the way it is related to several other muscular biomechanical parameters.

Effect of recovery duration on the force-velocity relationship.

The aim of this study was to investigate the effect of different Recovery Duration (RD) between each sprint (30 s, 1 min, 3 min, 5 min, 10 min and 24 h) during the force-velocity test and to analyse associated anaerobic parameters such as maximal anaerobic power and blood lactate concentrations. Twelve male physical education students aged from 18 to 26 years took part in this study. Maximal anaerobic power (Pmax) was not statistically different whatever the recovery duration (from 885 to 938 watts, for RD 30 s to RD 24 h, respectively). This was associated with a tendency during the longer RD tests for optimal velocity to decrease (p = ns) while optimal force increased (p < 0.05). Blood lactate concentrations were regularly increased from 1.7 to a 9 mmol x l(-1) plateau at sprint 4 for RD tests < 10 min and were quite stable from the second sprint with an associated value from 2.2 to 4.7 mmol x l(-1) for RD 10 min and RD 24 h. In spite of statistically different values for [L]s between the tests, the power developed for each sprint remained unchanged. These data indicate that the attainment of maximal power seems independent from the recovery duration (> 10 s) and the pre-blood lactate values observed between each sprint during the force-velocity test. The way to reach Pmax was different between the tests. Different partition of energetic pathways are suggested. In conclusion, the force-velocity test could be performed with a shorter and the arbitrary five minutes recovery duration.

Serum insulin-like growth factor I and physical performance in prepubertal Bolivian girls of a high and low socio-economic status.

The aim of the study was to determine if a decrease in serum insulin-like growth factor I (Igf-I) levels under marginal malnutrition is responsible for the lower physical performance of girls of a low socio-economic status (LSES). Girls were selected after physical examination (Tanner's stage 1) and anthropometric measurements (height, body mass or mb, body mass index or BMI = mb height2). Lean body mass mb,1 was measured after skinfold thickness determination; serum IGE-I, by radioimmunoassay; maximal O2 consumption, (VO2max), directly during incremental exercise up to exhaustion; and maximal aerobic power (Wmax), using the force-velocity test. LSES girls (n = 31) had been malnourished in the past and, currently, were suffering from marginal malnutrition: they were smaller (135.2 +/- 5.5 vs 146.1 +/- 4.3 cm), lighter (31.7 +/- 3.9 vs 37.6 +/- 5.0 kg), exhibited a lower mb,1 (24.2 +/- 2.5 vs 27.5 +/- 3.0 kg) but same BMI compared with HSES (high socio-economic status) girls (n = 32). Igf-I levels (27.7 +/- 7.9 vs 34.1 +/- 6.5 nmol.1(-1), VO2max (45.26 +/- 4.72 vs 50.74 +/- 6.02 ml. min-1.kg-1 LBM) and Wmax (6.00 +/- 1.15 vs 8.70 +/- 1.53 W.kg-1 mb,1 were lower in LSES girls. Moreover, the differences in every parameter were not the consequence of the younger age (10.8 +/- 0.9 vs 11.2 +/- 0.6 years) of the LSES girls. Our results provide evidence that the lower Wmax of undernourished prepubertal girls was partly the consequence of alterations in muscle function at the qualitative level, as a result of a decrease in Igf-I levels. Conversely, under normal nutritional conditions, anthropometric characteristics only are explicatory factors for physical performances.

A 5-min running field test as a measurement of maximal aerobic velocity.

Based on a theoretical approach from world record running data, we have previously calculated that the most suitable duration for measuring maximal aerobic velocity (Vamax) by a field test was 5 min (Vamax(5)). The aim of this study was, therefore, to check this hypothesis on 48 men of various levels of physical fitness by comparing (Vmax(5)) with (Vamax) determined at the last step of a progressive treadmill exercise test when the subject felt exhausted (Vamax(t)) and during a test on a running track, behind a cyclist (following an established protocol) (Vamax(c)). For each test, (VO2max) was also measured by a direct method on a treadmill (VO2max(1)) and calculated by an equation for field tests (VO2max(5) and VO2max(c)). The Vamax(5) [17.1 (SD 2.2) km.h-1] and (Vamax(c)) [(18.2 (SD 2.4) km.h-1] were significantly higher than (Vamax(t)) [16.9 (SD 2.6) km.h-1; P < 0.001]. The (Vamax(t)) was strongly correlated with (Vamax(5)) (r = 0.94) and (Vamax(c)) (r = 0.95) (P < 0.001). The best identity and correlation between (Vamax(5)) and track performances were found in the runners (n = 9) with experience over a distance of 3,000 m. The VO2max(5) and (VO2max(c)) were higher than VO2max(t) (+ 5.0% and + 13.7%, respectively; P < 0.001) and VO2max(t) was highly correlated with Vamax(5) (r = 0.90; P < 0.001). These results suggest that the 5-min field test, easy to apply, provided precise information on Vamax and to a lesser degree on VO2max.

Effect of altitude and socioeconomic status on VO2max and anaerobic power in prepubertal Bolivian girls.

The aim of this work was to evaluate the effects of high altitude and low socioeconomic status (SES) on aerobic and anaerobic power in 11-yr-old Bolivian girls. At both high (3,600 m) and low (420 m) altitudes, low-SES groups of girls were compared to similarly aged, high-SES girls. At low altitude, low-SES girls were also compared with younger high-SES girls with the same anthropometric characteristics. Anthropometric data were similar between high-SES and low-SES girls at both altitudes, but low-SES girls showed a 9-mo growth delay. Maximal O2 uptake was significantly lower for low-SES girls at both altitudes. Values did not differ when expressed relative to body weight at high altitude for high-SES vs. low-SES girls (37.6 +/- 1.2 vs. 39.3 +/- 1.0 ml.min-1.kg body wt-1), but a difference persisted at low altitude between high- and low-SES girls (37.5 +/- 1.0 vs. 34.7 +/- 0.7 ml.min-1.kg body wt-1). Anaerobic power (Pmax, force-velocity test; Pwing, Wingate test) was reduced for low-SES girls at both altitudes, whatever the mode of expression. For a given SES, the relative anaerobic performances were lower at low altitude. At low altitude, low-SES girls developed lower anaerobic power than did younger high-SES girls with similar anthropometric characteristics. In conclusion, at both altitudes, the reduction of anaerobic performances observed in girls of low SES could not be totally explained by anthropometric factors. Structural and/or functional muscle alterations are suggested. Moreover, at low altitude, tropical and other factors may have contributed to differences in performance between low- and high-SES girls.

Blood lactate after maximal and supramaximal exercise in 10- to 12-year-old Bolivian boys. Effects of altitude and socioeconomic status.

The aim of this paper was to analyze the effects of chronic hypoxia and socioeconomic level on blood lactate concentrations obtained after maximal exercise and a 30-s Wingate test in 145 Bolivian boys (mean age: 10.8 years). Among the boys studied at high altitude (HA) (La Paz, 3600m) and at low altitude (LA) (Santa Cruz de la Sierra, 420m), 23 (HAHSES) and 48 (LAHSES) were from a high socioeconomic status (HSES), and 44 (HALSES) and 30 (LALSES) from a low socioeconomic status (LSES). The pubertal development was evaluated by salivary testosterone level ([T]). Blood samples were collected from the earlobe for blood lactate determination 2 min after cessation of maximal exercise ([L]v) and of a 30-s Wingate test ([L]w). Results (means +/- SD) showed: (1) [T] was significantly lower at HA: HA (HSES + LSES): 139.0 +/- 46.6 vs LA (HSES + LSES) = 186.2 +/- 53.7 pmole.1-1 (p = 0.0001). There was no significant difference between HAHSES and HALSES but LALSES was significantly lower than LAHSES. When the four groups were pooled, significant positive correlations between [L] and [T] were found; (2) for a same level of socioeconomic conditions, [L]v and [L]w were significantly lower at HA: HAHSES = 4.9 +/- 1.5 vs LAHSES = 7.4 +/- 2.1 and HALSES = 4.8 +/- 1.4 vs LALSES = 6.3 +/- 1.5 mmole.l-1 for [L]v; HAHSES = 5.1 +/- 1.0 vs LAHSES = 6.2 +/- 1.4 and HALSES = 4.6 +/- 1.0 vs LALSES = 5.3 +/- 1.4 mmole.l-1 for [L]w; (3) except for [L]v at HA, the HSES boys exhibited higher [L]v and [L]w than the LSES children for a same altitude; (4) there were significant linear relationships between the power developed during the 30-s Wingate test and [L]w.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of orchiectomy on EDL muscle ultrastructure and energy-supplying enzymes in growing male guinea pigs.

To investigate the influence of androgens on muscle maturation during growth, guinea pigs were orchiectomized (CX) or sham operated (SO) at the end of weaning. Extensor digitorum longus (EDL) muscles were removed at weeks 4, 8, and 12 of postnatal development. According to their contractile and metabolic characteristics, four fiber types were distinguished, called I, IIa, IIbox, and IIbglyc. Muscle maturation consisted of a concomitant decrease in percentages of type IIa and IIbglyc fibers and increase in the percentage of IIbox fibers in both groups. At week 12, fiber distributions were not different between the two groups. Citrate synthase activity fell and phosphofructokinase and lactate dehydrogenase (LDH) activities rose from week 4 to week 12 and were the same in CX and SO. Muscular LDH subunits increased in SO and decreased in CX during this period. In conclusion, fiber type distribution and enzyme activities at puberty were not androgen dependent in guinea pig EDL muscle. Conversely, these hormones acted on LDH isozyme distribution through the enhancement of the most glycolytic LDH fractions.

Effect of chronic hypoxia and socioeconomic status on VO2max and anaerobic power of Bolivian boys.

The aim of this work was to analyze the effects of altitude and socioeconomic and nutritional status on maximal oxygen uptake (VO2max) and anaerobic power (P) in 11-yr-old Bolivian boys. At both high (HA) (3,600 m) and low (LA) (420 m) altitudes, the boys were divided into high (HA1, n = 23, LA1, n = 48) and low (HA2, n = 44, LA2, n = 30) socioeconomic levels. Anthropometric characteristics, VO2max, and P [maximal P (Pmax) during a force-velocity test and mean P (P) during a 30-s Wingate test] were measured. Results showed that 1) anthropometric parameters were not different between HA1 and LA1 and HA2 and LA2 boys, but HA2 and LA2 boys were two years behind HA1 and LA1 boys in development; 2) VO2max was not different in boys from the same altitude, but at HA VO2max was 10% lower than at LA (HA1 = 37.2 +/- 5.6, HA2 = 38.9 +/- 6.4, LA1 = 42.5 +/- 5.8, LA2 = 42.5 +/- 5.3 ml.min-1 x kg-1 body wt); and 3) Pmax and P were higher in well-nourished than in undernourished boys, but there was no difference in Pmax and P between HA1 and LA1 and HA2 and LA2 boys (HA1 = 6.8 +/- 1.0, HA2 = 5.5 +/- 0.8, LA1 = 7.1 +/- 1.0, LA2 = 5.3 +/- 0.9 W/kg for Pmax; HA1 = 5.2 +/- 0.8, HA2 = 4.5 +/- 0.9, LA1 = 5.2 +/- 0.7, LA2 = 4.0 +/- 0.6 W/kg for P).(ABSTRACT TRUNCATED AT 250 WORDS)

Interrelationships between plasma insulin-like growth factor-I (IGF-I) concentrations and plasma sex hormone levels in the growing male guinea-pig.

The aim of the present study was to determine the influence of androgens on Insulin-like Growth Factor-I (IGF-I) release at puberty in male guinea-pigs. After the animals were orchiectomised (CX) or sham-operated (SO) at the end of weaning, plasma testosterone (T), dihydrotestosterone (DHT) and IGF-I levels were measured by RIA at the 4th (W4), 8th (W8) and 12th (W12) week after delivery. Body weight (BW) was recorded before sampling at each stage of the experiment. Body growth was maximal between W4 and W8 for both SO (+97%) and CX (+84%). However SO were heavier than CX at W8 and W12. In SO, a surge of plasma IGF-I levels was observed between W4 and W8, concomitantly to the increase of androgen levels (IGF-I: +86%, P less than 0.01; T: +190%, P less than 0.001; DHT: +18%; P less than 0.01). Significant correlations between IGF-I, T, DHT and BW were found only from W4 to W8 but not from W8 to W12. In CX, IGF-I levels were higher than in SO at W4 (+72%, P less than 0.01) and at W12 (+39%, P less than 0.01). A surge of IGF-I levels (+47%, P less than 0.01) was also observed but was delayed compared to SO (between W8 and W12 vs W4 and W8). BW and IGF-I levels were significantly correlated during this period. Because the surge of IGF-I levels may occur even in absence of gonads, these results give evidence that the increases in IGF-I and androgens at puberty were independent in guinea-pigs during this period.(ABSTRACT TRUNCATED AT 250 WORDS)

[Meningioma of the scalp. Apropos of a case]. / Méningiome du cuir chevelu. A propos d'une observation.

The authors report a case of scalp meningioma in a five-months old baby. The mass was removed totally and the following neuroradiological studies proved the absence of an intracranial meningioma. They present the histogenesis of the meningioma and Lopez's classification.