Influence of pre-diagnostic cigarette smoking on colorectal cancer survival: overall and by tumour molecular phenotype.

BACKGROUND: Smoking is a risk factor for incident colorectal cancer (CRC); however, it is unclear about its influence on survival after CRC diagnosis. METHODS: A cohort of 706 CRC patients diagnosed from 1999 to 2003 in Newfoundland and Labrador, Canada, was followed for mortality and recurrence until April 2010. Smoking and other relevant data were collected by questionnaire after cancer diagnosis, using a referent period of '2 years before diagnosis' to capture pre-diagnosis information. Molecular analyses of microsatellite instability (MSI) status and BRAF V600E mutation status were performed in tumour tissue using standard techniques. Multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with Cox proportional hazards regression, controlling for major prognostic factors. RESULTS: Compared with never smokers, all-cause mortality (overall survival, OS) was higher for current (HR: 1.78; 95% CI: 1.04-3.06), but not for former (HR: 1.06; 95% CI: 0.71-1.59) smokers. The associations of cigarette smoking with the study outcomes were higher among patients with ≥40 pack-years of smoking (OS: HR: 1.72; 95% CI: 1.03-2.85; disease-free survival (DFS: HR: 1.99; 95% CI: 1.25-3.19), those who smoked ≥30 cigarettes per day (DFS: HR: 1.80; 95% CI: 1.22-2.67), and those with microsatellite stable (MSS) or MSI-low tumours (OS: HR: 1.38; 95% CI: 1.04-1.82 and DFS: HR: 1.32; 95% CI: 1.01-1.72). Potential heterogeneity was noted for sex (DFS HR: 1.68 for men and 1.01 for women: P for heterogeneity=0.04), and age at diagnosis (OS: HR: 1.11 for patients aged <60 and 1.69 for patients aged ≥60: P for heterogeneity=0.03). CONCLUSIONS: Pre-diagnosis cigarette smoking is associated with worsened prognosis among patients with CRC.

Diet and drug consumption in a group of elderly residing in rural Newfoundland.

Dietary intakes and drug consumption were recorded for 24 seniors in a Newfoundland outport. Food frequency questionnaires suggested that the food groups consumed least adequately by the seniors were grain products and meat and alternatives: 71% did not consume the recommended daily minimum intake of grain products and 66.7% did not meet the minimum intake recommended for meat and alternatives. Inadequate consumption of milk products and vegetables and fruit was reported by 33.3% and 29.2% of the respondents respectively. All respondents used at least one medication on a regular basis. When the regular usage of both prescription and nonprescription drugs was considered, drug consumption ranged from one to eight. Antihypertensives and antianginals had the highest reported usage. This study suggests that many seniors simultaneously experience two factors with potentially negative effects on their nutritional status--high drug usage and poor dietary intake.

The contribution of dietary iron to iron status in a group of elderly subjects.

Although it is widely accepted that body iron stores of elderly individuals are largely adequate, recent findings from our laboratory suggest that as many as 9% of a "healthy" sample showed signs of an inadequate body store of this nutrient. In an attempt to see if iron consumption may be a contributing factor, we compared dietary intakes of total iron, heme iron, nonheme iron, ascorbic acid, calcium, dietary fibre, tea and coffee between 19 healthy seniors with inadequate iron stores and 108 healthy seniors with good iron status. The daily consumption of total iron was significantly higher in those with good iron stores. Thus, dietary iron is an important contributor to iron status in old age.

Relationship between nutritional status and immune function of elderly people.

Thirty-four malnourished subjects between the ages of 61 and 97 years were given appropriate food supplement(s) for a period of 6 consecutive months. They were followed for a subsequent 6 months during which time there was no nutritional intervention. Nutritional assessment and immunological evaluation were performed at 0, 6, and 12 months. Nutritional assessment included anthropometry, biochemistry, and clinical examination. Immunological evaluation included serum complement C3 concentration, delayed cutaneous hypersensitivity skin test, and the enumeration of total lymphocytes, rosetting T-cells, CD4+ cells, and CD8+ cells. Immune function improved by the end of the supplementation period. Six months of nutritional supplementation significantly increased the percentage of lymphocytes represented by mature T-cells.

Polyamine and amino acid content, and activity of polyamine-synthesizing decarboxylases, in liver of streptozotocin-induced diabetic and insulin-treated diabetic rats.

1. Concentrations of polyamines, amino acids, glycogen, nucleic acids and protein, and activities of ornithine decarboxylase and S-adenosylmethionine decarboxylase, were measured in livers from control, streptozotocin-diabetic and insulin-treated diabetic rats. 2. Total DNA per liver and protein per mg of DNA were unaffected by diabetes, whereas RNA per mg of DNA and glycogen per g of liver were decreased. Insulin treatment of diabetic rats induced both hypertrophy and hyperplasia, as indicated by an increase in all four of these constituents to or above control values. 3. Spermidine content was increased in the livers of diabetic rats, despite the decrease in RNA, but it was further increased by insulin treatment. Spermine content was decreased by diabetes, but was unchanged by insulin treatment. Thus the ratio spermidine/spermine in the adult diabetic rat was more typical of that seen in younger rats, whereas insulin treatment resulted in a ratio similar to that seen in rapidly growing tissues. 4. Ornithine decarboxylase activity was variable in the diabetic rat, showing a positive correlation with endogenous ornithine concentrations. This correlation was not seen in control or insulin-treated rats. Insulin caused a significant increase in ornithine decarboxylase activity relative to control or diabetic rats. 5. S-Adenosylmethionine decarboxylase activity was increased approx. 2-fold by diabetes and was not further affected by insulin. 6. Hepatic concentrations of the glucogenic amino acids, alanine, glutamine and glycine were decreased by diabetes. Their concentrations and that of glutamate were increased by injection of insulin. Concentrations of ornithine, proline, leucine, isoleucine and valine were increased in livers of diabetic rats and were decreased by insulin. Diabetes caused a decrease in hepatic concentration of serine, threonine, lysine and histidine. Insulin had no effect on serine, lysine and histidine, but caused a further fall in the concentration of threonine.