Effect of a 16-Session Qigong Program in Non-Hodgkin Lymphoma Survivors: A Randomized Clinical Trial.

Background: The treatment associated with non-Hodgkin lymphoma patients may cause adverse effects on their physical and psychological condition. The aim of this study is to detect the response to an eight-week, 16-session, 60-min presential Qigong program in anxiety, depression and vagal nerve activity alongside a control group. Methods: A randomized controlled clinical trial was managed. Randomization was carried out by generating a numerical sequence of three cycles through the software EPIDAT 4.1. Numbers were placed in sealed opaque envelopes for assignment to the different groups. Results: Anxiety levels were substantially decreased in the experimental group, with a large effect size (F = 30.38, p < 0.00). Depression levels had an improvement in the experimental group in contrast to the control group, reaching statistical significance (F = 19.19, p < 0.00). Heart Rate Variability unveiled significant results in terms of between-group differences, with a large effect size in the HRV Index (F = 15.80, p < 0.00), SDNN (F = 8.82, p < 0.00), and RMSSD (F = 6.72, p < 0.01) in the time domain, and a medium effect size in the HF (F = 9.78, p < 0.003), LF (F = 9.78, p < 0.00), and LF/HF Ratio (F = 18.44, p < 0.00) in the frequency domain, which were all bettered in the experimental group, after the Qigong program. Conclusions: Qigong therapy can be an effective therapeutic activity in consonance with traditional medicine to improve psychological health and autonomic nervous system balance in non-Hodgkin lymphoma survivors.

Coping Strategies in Elderly Colorectal Cancer Patients.

In Spain, 34,331 new cases of colorectal cancer were diagnosed in 2018 and 15,923 individuals died from this disease in the same year. The highest incidence of colorectal cancer is among individuals aged 65-75 years and the physiological consequences of aging, alongside the effects of the disease and its treatment, can exacerbate their physical deterioration and cognitive impairment and reduce their social relationships. The learning of coping strategies may help to improve the quality of life of patients after cancer diagnosis. To test the hypothesis that the utilization of coping strategies can improve the quality of life of elderly patients with colorectal cancer, PubMed and EBSCO databases were searched, up to 2021, using the following terms: "coping strategies and colorectal cancer" with "anxiety", "quality of life", "depression", "unmet needs", "optimism", "intimacy", "distress", "self-efficacy" and "self-esteem" with Boolean operators "AND", "OR". The literature search retrieved 641 titles/abstracts written in English. After an exhaustive analysis, only 7 studies met the inclusion criteria. Randomized evidence was scant and was reported only in 3/7 of the studies analyzed. Data from available randomized evidence support that patients improved on their depression and quality of life and felt more prepared to deal with their cancer. Coping strategies in patients with colorectal cancer were effective in improving patient adaptation to their new situation. Healthcare professionals working with these patients should receive training in this complementary treatment, to be able to conduct comprehensive care in order to improve the quality of life of these patients.

Autonomic Imbalance in Lymphoma Survivors.

Among the types of blood cancers, non-Hodgkin lymphoma is the most common. The usual treatments for this type of cancer can cause heart failure. A descriptive observational study was conducted that included 16 non-Hodgkin lymphoma survivors and 16 healthy controls matched by age and sex. Vagal tone was evaluated in the short term with a three-channel Holter device, and the time and frequency domains were analyzed following a previously accepted methodology to evaluate cardiac autonomic balance. The results of the analysis revealed that the standard deviation of the NN interval (F = 6.25, p = 0.021) and the square root of the mean of the sum of the differences between NN intervals (F = 9.74, p = 0.004) were significantly higher in healthy subjects than in lymphoma survivors. In the heart rate variability (HRV) index, there were no significant differences between the groups (F = 0.03, p = 0.85), nor in the parameters of the frequency domains LF (F = 1.94, p = 0.17), HF (F = 0.35, p = 0.55), and the ratio LF/HF (F = 3.07, p = 0.09). HRV values were lower in non-Hodgkin lymphoma survivors in the first year after treatment, resulting in autonomic imbalance compared to healthy paired subjects.

Telehealth system: A randomized controlled trial evaluating the impact of an internet-based exercise intervention on quality of life, pain, muscle strength, and fatigue in breast cancer survivors.

BACKGROUND: The chronicity status of breast cancer survivors suggests a growing need for cancer rehabilitation. Currently, the use of technology is a promising strategy for providing support, as reflected in the emergence of research interest in Web-based interventions in cancer survivorship. METHODS: A randomized controlled trial was conducted that included a total of 81 participants who had completed adjuvant therapy (except hormone treatment) for stage I to IIIA breast cancer. Participants were randomly assigned to an 8-week Internet-based, tailored exercise program (n = 40) or to a control group (n = 41).The instruments used at baseline, 8 weeks, and 6-month follow-up were the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 and its breast cancer module, the Brief Pain Inventory, the handgrip dynamometer, the isometric abdominal test, the back dynamometer, the multiple sit-to-stand test, and the Piper Fatigue Scale. RESULTS: After the intervention, the telerehabilitation group had significantly improved scores for global health status, physical, role, cognitive functioning, and arm symptoms (all P < .01) as well as pain severity (P = .001) and pain interference (P = .045) compared with the control group. Significant improvements also were observed favoring the telerehabilitation group for affected and nonaffected side handgrip (both P = .006), abdominal, back and lower body strength (all P < .01), and total fatigue (P < .001). These findings were maintained after 6 months of follow-up, except for role functioning, pain severity, and nonaffected side handgrip. Analysis was based on an intention-to-treat principle. CONCLUSIONS: This program may improve adverse effects and maintain benefits in breast cancer survivors. The results of this study have encouraging implications for cancer care. Cancer 2016;122:3166-74. © 2016 American Cancer Society.

Prevalence, Risk Factors, and Levels of Burnout Among Oncology Nurses: A Systematic Review.

PROBLEM IDENTIFICATION: To determine (a) the average levels of emotional exhaustion (EE), depersonalization (D), and personal accomplishment (PA) among oncology nurses; (b) the prevalence of low, medium, and high levels of burnout for each dimension; and (c) the risk factors for burnout.
. LITERATURE SEARCH: A systematic review was carried out using the CUIDEN, CINAHL®, LILACS, ProQuest, PubMed, SciELO, and Scopus databases. 
. DATA EVALUATION: The 436 search results obtained were reduced to a final sample of 27 articles after applying the inclusion and exclusion criteria.
. SYNTHESIS: With respect to levels of burnout, published results differ in their conclusions. In general, they indicate that oncology nurses feel little sense of PA and suffer from EE, although few signs of D exist. 
. CONCLUSIONS: Oncology nurses present high levels of EE and of reduced PA. A large proportion of these nurses are at risk of developing burnout. Age, work experience, workload, and communication skills are among the factors that may influence development of the syndrome. 
. IMPLICATIONS FOR PRACTICE: Programs should be developed to identify interventions that would reduce EE and enhance feelings of PA. In addition, risk factors and protective measures should be studied more comprehensively.

Pressure Pain Sensitivity Maps of the Neck-Shoulder Region in Breast Cancer Survivors.

OBJECTIVE: The aim of the present study was to report pressure pain sensitivity topographical maps of the frontal and dorsal parts of the shoulder region, and locate the pressure pain sensitive areas in breast cancer survivors compared with matched healthy control subjects. METHODS: Twenty-two breast cancer survivors (BCS) and 22 matched control subjects participated. A numeric pain rating scale of the neck-shoulder area and pressure pain thresholds (PPTs) was assessed bilaterally over 28 points in the frontal and dorsal neck-shoulder area. Topographical pain sensitivity maps of the upper trapezius, pectoral, and anterior deltoid areas were computed. RESULTS: A three-way analysis of variance was carried out to evaluate the differences in PPTs. The BCS reported spontaneous neck pain (mean ± SD 3.6 ± 2.8), pain in the affected shoulder (4.3 ± 2.7), and pain in the non-affected shoulder (0.9 ± 1.8). Additionally, the BCS exhibited bilaterally lower PPTs in all the measurement points as compared with the control subjects (P < 0.05). The PPTs were lower at the superior part of the trapezius muscle (P < 0.001), the musculotendinous insertion, the anterior part of the deltoid muscle (P < 0.001), and the tendon of the pectoral muscle (P < 0.001) as compared with the control subjects. CONCLUSIONS: The results suggest the sensitization processes in the BCS and give preliminary evidence to most sensitive areas in the superior part of the upper trapezius and musculotendinous insertion of the pectoral muscle.

Effectiveness of Lumbopelvic Exercise in Colon Cancer Survivors: A Randomized Controlled Clinical Trial.

INTRODUCTION: This study evaluated the effectiveness of lumbopelvic exercise in improving health-related fitness, anthropometric measurements, and body composition in colon cancer survivors (CCS). METHODS: Forty-six CCS (35% female, n = 14) were assigned to two groups for this randomized controlled clinical trial: a trunk muscle stabilization exercise program group (CO-CUIDATE) and a usual-care group. The CO-CUIDATE program was conducted for 8 wk (three times per week). The primary end point was isometric abdominal strength measured using the trunk curl test. The secondary end points used were isometric back strength, functional capacity, lower-body flexibility, weight, and anthropometric measurements evaluated at baseline, after the physical exercise program and after 6 months of follow-up. A trained member of the research group with 5 yr of experience working with cancer patients and who was blinded to the patient group assessed the variables. All physical tests were conducted with multiple observations. RESULTS: The adherence to intervention was 88.36%, and two dropouts (10.5%) were recorded. Minor side effects, including discomfort with the exercises in the first sessions, were reported by the participants. ANOVA demonstrated significant differences in group-time interactions for isometric abdominal strength (F = 7.7; P = 0.001), functional capacity (F = 4.6; P = 0.015), lower-body flexibility (right, F = 4.3, P = 0.021 and left, F = 3.6, P = 0.034), and waist circumference (F = 5.7; P = 0.07), which were the best values for the CO-CUIDATE group. No significant changes in isometric back strength, weight, hip circumference or body composition were observed. CONCLUSION: An 8-wk program based on stabilization exercises is a promising strategy to increase health-related fitness and to reduce waist circumference in CCS. An exercise program based on lumbopelvic exercise is a feasible intervention to improve the control of deep abdominal muscles and health-related fitness.

Heart Rate Variability in Breast Cancer Survivors After the First Year of Treatments: A Case-Controlled Study.

The same aggressive treatments that have led to a reduction in the breast cancer may also have adverse effects on cardiac autonomic balance. The objective of this study was to compare heart rate variability (HRV) between breast cancer survivors in the first year posttreatment and healthy women, controlling for known confounders. This descriptive case-controlled study included 22 breast cancer survivors and 22 healthy age- and sex-matched controls. Short-term HRV was measured using an accepted methodology to assess the cardiac autonomic balance. One-way analysis of covariance results revealed that heart rate was significantly higher (F = 15.86, p < .001) and the standard deviation of normal-to-normal (NN) interval (F = 19.93, p = .001), square root of mean squared differences of successive NN intervals (F = 18.72, p = .001), HRV index (F = 5.44, p = .025), and high-frequency (F = 5.77, p = .03) values were significantly lower in the breast cancer survivors than in the matched controls. The principal finding of the presence of a cardiovascular imbalance in breast cancer survivors in comparison to healthy age-matched controls suggests that HRV study could be a clinically useful tool to detect cardiovascular disease in early-stage breast cancer survivors.

The influence of body mass index on survival in breast cancer patients.

INTRODUCTION: More than half of breast cancer survivors (BCSs) are obese at diagnosis and experience approximately 50% to 96% of weight gain during treatment that could physically affect their survival. The aim of the study was to evaluate the influence of body mass index (BMI) on physical, anthropometric, and physiological parameters in BCSs. PATIENTS AND METHODS: A cross-sectional study was conducted with 147 BCSs. Health-related fitness, anthropometric measures, cardiovascular state, and cancer-related fatigue (CRF) were assessed for our analysis and 3 groups were formed. RESULTS: Tests of force handgrip (affected side: F = 3.44; P < .05; nonaffected side: F = 3.067; P < .05), functional capacity (F = 3.239; P = .043), and endurance of trunk flexors (×2 = 8.264; P = .016) were significantly lower in obese BCSs compared with the normal-weight group, whereas systolic (F = 5.839; P = .004) and diastolic blood pressure (F = 8.794; P < .001), waist circumference (F = 85.81; P < .001), and arm circumference at 10 cm (affected side: F = 23.530; P < .001; nonaffected side: F = 17.095; P < .001) and 5 cm (affected side: F = 21.751; P < .001; nonaffected side: F = 22.490; P < .001) were significantly greater in BCSs with higher BMI compared with other groups. No significant differences were observed between groups regarding lower limb endurance, resting heart rate or CRF. CONCLUSION: This study demonstrated the influence of obesity on health-related fitness, anthropometric measures, and cardiovascular state.

Nerve pressure pain hypersensitivity and upper limb mechanosensitivity in breast cancer survivors: a case-control study.

OBJECTIVE: This study aims to investigate the presence of bilateral pressure pain hypersensitivity in arm trunk nerves and upper limb mechanosensitivity in breast cancer patients with neck-shoulder pain after medical treatments. METHODS: Twenty-two breast cancer survivors (mean age 49.05 ± 7.8 years) and matched healthy controls (mean age 50.76 ± 7.6 years) participated in the study. Neck and shoulder pain was evaluated using an 11-point numerical point rating scale. Pressure pain thresholds (PPTs) were bilaterally assessed over the median, radial, and ulnar nerve trunks and tibialis muscle, and the neurodynamics of the upper limb by neural tolerance to movement was evaluated in the median, radial, and ulnar nerves. RESULTS: Thirteen (59.1%) patients reported spontaneous neck pain, and 16 (72.7%) patients showed spontaneous shoulder/axillary pain. Analysis of variance revealed that breast cancer survivors showed significant between-group but not between-side differences over the median nerve trunk (group: P = < 0.001; side: P = 0.146), radial nerve trunk (group: P = < 0.001; side: P = 0.300), ulnar nerve trunk (group: P = < 0.001; side: P = 0.744), and tibialis anterior muscle (group: P = < 0.001; side: P = 0.118). The patients also showed statistically significant differences in range of motion (ROM) between groups and between sides in ULNT1(MEDIAN)(group: P = < 0.001; side: P = < 0.001) and ULNT(ULNAR) (group: P = 0.009; side: P = 0.002). The analysis did not show statistically significant differences in ROM between groups, but there was a statistical significance between sides for ULNT(RADIAL) (group: P = 0.081; side: P = 0.046). CONCLUSIONS: Breast cancer survivors present bilateral and widespread neural hypersensitivity, as they did in muscular tissue in previous studies. Breast cancer survivors demonstrate a reduction in ROM during ULNTs in the affected side.

Has catechol-O-methyltransferase genotype (Val158Met) an influence on endocrine, sympathetic nervous and humoral immune systems in women with fibromyalgia syndrome?

OBJECTIVE: Stress can play an important role in etiology of fibromyalgia syndrome (FMS) by activating the hypothalamic-pituitary-adrenal (HPA) axis, the sympathetic nervous system (SNS), and altering the immune system. The current study examined the influence of catechol-O-methyltransferase (COMT) Val158Met genotypes on salivary markers of HPA axis (cortisol), SNS (α-amylase), and immune (IgA) systems in women with FMS. METHODS: Seventy-six women with FMS diagnosed according to the American College of Rheumatology criteria participated in the study. Salivary cortisol, α-amylase activity, salivary flow rate, and IgA concentration were collected from nonstimulated saliva. A numerical pain rate scale (0 to 10) was used to assess the intensity of pain, whereas functional ability was determined using the Fibromyalgia Impact Questionnaire (FIQ). After amplifying Val158Met polymorphisms by polymerase chain reaction, 3 COMT genotypes were considered: Val/Val, Val/Met, and Met/Met. RESULTS: Women with FMS with the Met/Met genotype reported higher α-amylase activity, lower salivary flow rate, and lower IgA concentration than those women with FMS carrying the Val/Met (P<0.05) or Val/Val (P<0.01) genotypes. No difference in cortisol concentration (P>0.70) was found. These results were not associated with the intensity of pain, disability, and medication intake. CONCLUSIONS: The results suggest that women with FMS with the Met/Met genotype exhibit greater disturbed activity of the SNS and humoral immune system. These results provide initial evidence of a link between Val158Met polymorphism and dysfunctions in the SNS and humoral immune system in women with FMS.

The Piper Fatigue Scale-Revised: translation and psychometric evaluation in Spanish-speaking breast cancer survivors.

BACKGROUND: Cancer-related fatigue (CRF) is the most common and distressing symptom reported by breast cancer survivors. The primary aim of this study was to translate and evaluate psychometrically for the first time a Spanish version of the Piper Fatigue Scale-Revised (S-PFS-R). METHODS: One hundred and eleven women with stage I-IIIA breast cancer who had completed their primary cancer therapy in the previous 6 months with the exception of hormone therapy completed the S-PFS-R, the Profile of Mood States (POMS) Fatigue (POMS-F) and Vigor subscales (POMS-V), and bilateral force handgrip testing. Data analysis included test-retest reliability, construct validity, criterion-related validity, and exploratory factor analyses. RESULTS: Test-retest reliability was satisfactory (r > 0.86), and all subscales showed moderate to high construct validity estimates [corrected item-subscale correlations (Pearson r = ≥ 0.65)]. The exploratory factor analysis revealed four dimensions with 75.5% of the common variance explained. The S-PFS-R total score positively correlated with the POMS-F subscale (r = 0.50-0.78) and negatively with the POMS-V subscale (r = -0.13 to -0.44) confirming criterion-related validity. Negative correlations among force handgrip testing, subscales, and total scores were weak (r = -0.26 to -0.29). CONCLUSIONS: The Spanish version of PFS-R shows satisfactory psychometric properties in a sample of breast cancer survivors. This is the first study to translate the PFS-R into Spanish and further testing is warranted.

Depressed mood in breast cancer survivors: associations with physical activity, cancer-related fatigue, quality of life, and fitness level.

PURPOSE: One out of five cancer survivors suffer from depression after oncology treatment. The aim of this study was to examine the relationship between depression and quality of life (QoL), cancer-related symptoms, physical activity level, health-related fitness, and salivary flow rate in breast cancer survivors. METHOD: 108 breast cancer survivors in the year after the conclusion of treatment were included in this cross-sectional study. Demographic and clinically relevant information, cancer-related fatigue (Piper Fatigue Scale), QoL (QLQ-Br23 module), pain intensity VAS scale, salivary flow rate, physical activity level (Minnesota Leisure Time Physical Activity Questionnaire), and health-related fitness were assessed in all participants. Depressed mood was measured with the Profile of Mood States (POMS) Depression subscale. RESULTS: Significant positive correlations between depressed mood and fatigue, systemic side effects, perceived shoulder pain, and breast-arms symptoms (r ranged between .57 and .28, P < .01) were found. In addition, significant negative correlations between depressed mood and body image, future perspective, force handgrip, and physical activity level (r ranged between -.41 and -.19; p < .05) were found. Regression analyses revealed that cancer-related fatigue, physical activity level, systemic side effects, and body image were significant predictors of depressed mood, and when combined, they explained 39.6% of the variance in depressed mood. CONCLUSIONS: Cancer-related fatigue, physical activity level, and QoL partially explain the variability of depressed mood in breast cancer survivors. This paper facilitates a better understanding of the relationship between depressed mood and possible factors associated with it.

Telehealth system (e-CUIDATE) to improve quality of life in breast cancer survivors: rationale and study protocol for a randomized clinical trial.

BACKGROUND: Breast cancer survivors suffer physical impairment after oncology treatment. This impairment reduces quality of life (QoL) and increase the prevalence of handicaps associated to unhealthy lifestyle (for example, decreased aerobic capacity and strength, weight gain, and fatigue). Recent work has shown that exercise adapted to individual characteristics of patients is related to improved overall and disease-free survival. Nowadays, technological support using telerehabilitation systems is a promising strategy with great advantage of a quick and efficient contact with the health professional. It is not known the role of telerehabilitation through therapeutic exercise as a support tool to implement an active lifestyle which has been shown as an effective resource to improve fitness and reduce musculoskeletal disorders of these women. METHODS / DESIGN: This study will use a two-arm, assessor blinded, parallel randomized controlled trial design. People will be eligible if: their diagnosis is of stages I, II, or IIIA breast cancer; they are without chronic disease or orthopedic issues that would interfere with ability to participate in a physical activity program; they had access to the Internet and basic knowledge of computer use or living with a relative who has this knowledge; they had completed adjuvant therapy except for hormone therapy and not have a history of cancer recurrence; and they have an interest in improving lifestyle. Participants will be randomized into e-CUIDATE or usual care groups. E-CUIDATE give participants access to a range of contents: planning exercise arranged in series with breathing exercises, mobility, strength, and stretching. All of these exercises will be assigned to women in the telerehabilitation group according to perceived needs. The control group will be asked to maintain their usual routine. Study endpoints will be assessed after 8 weeks (immediate effects) and after 6 months. The primary outcome will be QoL measured by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 version 3.0 and breast module called The European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life questionnaire. The secondary outcomes: pain (algometry, Visual Analogue Scale, Brief Pain Inventory short form); body composition; physical measurement (abdominal test, handgrip strength, back muscle strength, and multiple sit-to-stand test); cardiorespiratory fitness (International Fitness Scale, 6-minute walk test, International Physical Activity Questionnaire-Short Form); fatigue (Piper Fatigue Scale and Borg Fatigue Scale); anxiety and depression (Hospital Anxiety and Depression Scale); cognitive function (Trail Making Test and Auditory Consonant Trigram); accelerometry; lymphedema; and anthropometric perimeters. DISCUSSION: This study investigates the feasibility and effectiveness of a telerehabilitation system during adjuvant treatment of patients with breast cancer. If this treatment option is effective, telehealth systems could offer a choice of supportive care to cancer patients during the survivorship phase. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01801527.

The handgrip strength test as a measure of function in breast cancer survivors: relationship to cancer-related symptoms and physical and physiologic parameters.

OBJECTIVE: The aim of this study was to examine the relationship of muscular strength, as measured by the handgrip strength (HGS) test, with pain, fitness, fatigue, mood, and autonomic nervous system function in breast cancer survivors. DESIGN: A cross-sectional study comprising 95 breast cancer survivors was conducted. HGS; heart rate variability; pressure pain threshold of the neck, shoulder, hand, and tibia of the affected side; and fitness level (6-min walk test, neck-shoulder mobility, vertical jump, sit-to-stand test, and trunk curl test) were assessed as outcomes. Participants completed the Fatigue Piper Scale and Profile of Mood States questionnaires and the neck-shoulder visual analog scale. Correlation was conducted to examine the relationship of HGS with pain, fitness, fatigue, and mood. RESULTS: We observed a fair relationship of HGS with shoulder pain and a moderate to fair relationship with fitness (all P < 0.01; ρ range, 0.24-0.56). The relationship between HGS and heart rate variability (high-frequency domain) was weak (P = 0.049, ρ = 0.23). Likewise, the relationship between HGS and Profile of Mood States subscales ranged from weak to fair (all P < 0.001; ρ range, -0.22 to -0.36). HGS showed a weak relationship with Fatigue Piper Scale (all P < 0.01; ρ range, -0.28 to -0.35). Passive shoulder flexion, fatigue, and vertical jump were independent and significant predictors of HGS (P < 0.01; R = 0.466). CONCLUSIONS: These results suggest that the HGS test might be an important correlate of health in breast cancer survivors. This finding suggests that HGS could be recommended as an adjuvant method of evaluation, which may help with efficiency of clinical practice. Further research on breast cancer patients is needed to confirm or refute these findings.

Effect of ibuprofen on proliferation, differentiation, antigenic expression, and phagocytic capacity of osteoblasts.

Ibuprofen is a nonselective nonsteroidal antiinflammatory drug commonly prescribed for acute postsurgical and posttraumatic pain. However, little known is about the effect of this drug on osteoblasts. In this study, we aimed to investigate the effect of ibuprofen on cell proliferation, differentiation, antigenic profile, and phagocytic activity, in a human MG-63 osteosarcoma cell line, as a model of osteoblasts. Flow cytometry was used to study proliferation, antigenic profile, and phagocytic activity, and radioimmunoassay was used to determine osteocalcin synthesis as a cell differentiation marker. Our results showed that therapeutic doses of ibuprofen (5 and 25 µM) did not modify cell proliferation and osteocalcin synthesis in the MG-63 cellular line. However, treatment with a higher dose (25 µM) increased the expression of antigens CD21, CD44, CD80, CD86, and HLA-DR and decreased phagocytic activity. The results indicate that a therapeutic dose of ibuprofen has no adverse effects on growth of the osteoblast-like cells. Treatment with ibuprofen alone may produce some cell activation, which would explain the increase in expression of membrane markers and decrease in phagocytic capacity.

Effects of indomethacin, nimesulide, and diclofenac on human MG-63 osteosarcoma cell line.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most widely prescribed drugs worldwide and serve as treatment of some degenerative inflammatory joint diseases. The aim of the present study was to investigate the influence of different concentrations of three NSAIDs on cell proliferation, differentiation, antigenic profile, and cell cycle in the human MG-63 osteosarcoma cell line, incubated for 24 hr. All NSAIDs had an inhibiting effect on osteoblastic proliferation. Treatments for 24 hr had small but significant effects on the antigenic profile. No treatment altered osteocalcin synthesis. Indomethacin and nimesulide treatments arrested the cell cycle at G(0)/G(1). These results suggest that indomethacin, nimesulide, and diclofenac appear to have no effects on osteocalcin synthesis and a slight effect on the antigenic profile. They may delay bone regeneration due to their inhibiting effect on osteoblast growth. Therefore, these drugs should only be used in situations that do not require rapid bone healing.

The influence of patient attitude toward massage on pressure pain sensitivity and immune system after application of myofascial release in breast cancer survivors: a randomized, controlled crossover study.

OBJECTIVE: The purpose of this study was to evaluate the influence of patient's attitudes toward massage on pressure pain sensitivity and the immune effects of myofascial release in breast cancer survivors (BCS). METHODS: Twenty BCS participated. They presented to the laboratory at the same time of the day on 2 occasions separated by 2 weeks. At each session, they received either a myofascial release technique or control (special attention) intervention. Salivary flow rate, cortisol and immunoglobulin A (IgA) concentrations, and α-amylase activity were obtained before and immediately after intervention from saliva samples. Pressure pain thresholds (PPT) over the cervical spine and temporalis muscle were assessed bilaterally. The attitude toward massage (ATOM) scale was collected before the first session in all BCS. RESULTS: The analysis of covariance revealed a significant intervention × time interaction for salivary flow rate (P = .010), but not α-amylase (P = .111), IgA (P = .655), and cortisol (P = .363) in favor of the experimental group: BCS exhibited an increase of salivary flow rate after myofascial release intervention. When the ATOM scale was included in the analysis, significant influence on IgA (P = .001) was found: BCS with positive attitude had a significant increase in IgA (P > .05). The analysis of covariance did not find a significant intervention × time interaction for PPT over the cervical spine or temporalis muscle, with no effect of ATOM scales for PPT (P > .05). CONCLUSION: The current study suggests that myofascial release may lead to an immediate increase in salivary flow rate in BCS with cancer-related fatigue. We also found that the effect of myofascial release on immune function was modulated by a positive patient's attitude toward massage.

Influence of catechol-o-methyltransferase genotype (Val158Met) on endocrine, sympathetic nervous and mucosal immune systems in breast cancer survivors.

Stress can play an important role in development of cancer-related fatigue (CRF) by activating the hypothalamic-pituitary-adrenal (HPA) axis, the sympathetic nervous system (SNS), and altering the immune system. This study examined the influence of catechol-O-methyltransferase (COMT) Val158Met genotypes on salivary markers of HPA axis (cortisol), SNS (α-amylase) and immune (IgA) systems, as well as on CRF in breast cancer survivors (BCS). One-hundred BCS participated. After amplifying Val158Met COMT polymorphisms by polymerase chain reaction, three COMT genotypes were considered: Val/Val, Val/Met, Met/Met. Salivary cortisol, α-amylase activity, salivary flow rate, and IgA concentration were collected from non-stimulated saliva. CRF was assessed with the fatigue subscale of the Profile of Mood State (POMS) questionnaire. We found that BCS carrying Met/Met genotype reported higher cortisol concentration, α-amylase activity and greater CRF than those with Val/Met (P < 0.05) and Val/Val (P < 0.001) genotypes. No differences in salivary flow rate or IgA concentration (P > 0.20) were found. The results suggest that BCS carrying Met/Met genotype exhibit greater dysfunction of the HPA axis and SNS system associated with severe CRF. This study is important because it strives to understand biological factors that predispose some BCS to higher levels of CRF.

Effect of platelet-rich plasma on growth and antigenic profile of human osteoblasts and its clinical impact.

PURPOSE: In recent years, there has been widespread clinical use of platelet-rich plasma (PRP) to facilitate the regeneration of different tissues. However, few data are available on the effect of PRP on parameters other than cell growth. The aim of the present study was to evaluate the effect of PRP on the cell cycle, antigenic profile, and proliferation of primary cultured human osteoblasts. MATERIALS AND METHODS: The cells in the present study were derived from human bone sections obtained from healthy volunteers during third molar surgery. PRP was prepared from human venous blood and used to culture the cell line obtained from the same patient. Flow cytometry was used to study the cell cycle, antigenic profile, and proliferation. RESULTS: The treatment of osteoblasts with PRP modified the expression of CD54, CD80, CD86, and HLA-DR antigens. PRP treatment increased cell proliferation in the short term, but the cell proliferation capacity diminished in the long term, perhaps owing to cell exhaustion. No change in the cell cycle profile was observed in the PRP-cultured cells. CONCLUSIONS: These results suggest that PRP treatment accelerates bone neoformation with no cell cycle changes that might carry a risk of malignant transformation.