Association between Complementary and Alternative Medicine Use and Fear of Cancer Recurrence among Breast Cancer Survivors.

BACKGROUND: This study aimed to evaluate the association between complementary and alternative medicine (CAM) use and fear of cancer recurrence (FCR) among breast cancer survivors, using a validated multidimensional FCR-assessing instrument. Despite the debate over its medical effects, the use of CAM in breast cancer survivors is increasing. METHODS: We recruited 326 breast cancer survivors who had completed the primary cancer treatment. Information on CAM use was obtained using a self-administered questionnaire, and FCR was assessed using the Korean version of the FCR Inventory (FCRI). Multivariate linear regression analysis was performed to evaluate the association between CAM use and FCR. RESULTS: CAM users had higher total FCR scores than CAM non-users after covariate adjustment (CAM users: 74.6 vs. CAM non-users: 68.7; P=0.047). Among the FCRI subscales, CAM users showed higher coping strategy scores (CAM users: 22.3 vs. CAM non-users: 20.6; P=0.034) in the multivariable adjusted analysis. The use of multiple types of CAM was associated with increased FCR in a dose-dependent manner (P=0.002). CONCLUSION: Breast cancer survivors who used CAM had a higher FCR than CAM non-users. The dose-response relationship between the use of multiple types of CAM and FCR suggests that breast cancer survivors who use multiple types of CAM should be provided with appropriate psychological interventions to decrease FCR.

The Effect of High Dose Intravenous Vitamin C During Radiotherapy on Breast Cancer Patients' Neutrophil-Lymphocyte Ratio.

Background: Breast cancer is very common, and the incidence is growing every year. Most breast cancers are treated with radiation after surgery. As a side effect of radiation therapy, inflammation, as well as the neutrophil-lymphocyte ratio (NLR), level increases. However, high NLR levels act as independent prognostic factors for increased mortality in all cancers. In this study, the authors investigated whether administration of vitamin C, which is effective in suppressing inflammation, may help to reduce high levels of NLR produced by radiation therapy. Methods: This study was performed retrospectively among 424 patients who were diagnosed with breast cancer and were treated with postoperative radiotherapy at Kosin University Gospel Hospital from January 2011 to December 2017. Among them, 354 patients received radiation therapy without vitamin C (the control group), and 70 experimental patients received vitamin C intravenously twice a week for at least 4 weeks during radiation therapy. The experimental group was divided into two groups according to the dose administrated: a low-dose vitamin C group (less than 1 g/kg, 52 patients) and a high-dose vitamin C group (more than 1 g/kg, 18 patients). The authors conducted three NLR measurements: before and after radiation therapy and at 3 months after radiation therapy; the authors then compared the change in NLR over time between the groups using repeated measures analysis of variance. Results: In the control group and the low-dose vitamin C-administered group, NLR was increased at the endpoint compared to before the radiotherapy, whereas NLR values in the high-dose vitamin C group were 8.4 ± 1.7, 5.9 ± 1.3, and 4.3 ± 1.5, showing a continuous decrease and a statistically significant difference (pinteraction = 0.033). These results were similarly observed in models adjusted by the patient's age and American Joint Committee on Cancer stage, with borderline significance (pinteraction = 0.065). Conclusions: Elevated NLR, a measure of systemic inflammation, has been associated with higher mortality cancer patients, including breast cancer patients. In this observational study, NLR was significantly decreased during radiation therapy in patients administered high-dose vitamin C.

Anti-viral activity of compounds from Agrimonia pilosa and Galla rhois extract mixture.

Hepatitis C virus (HCV) infection is a significant health problem, with a worldwide prevalence of about 170 million. Recently, the development of direct acting antiviral (DAA) as a therapeutic agent for HCV has been rapidly increasing. However, DAA has a side effect and is costly. Therefore, it is still necessary to develop a therapeutic agent to treat HCV infection using products. Agrimonia pilosa (AP) and Galla rhois (RG) are traditional medicines and are known to display therapeutic activity on various diseases. Notably, they have been reported to have an anti-viral effect on HBV and influenza virus infections. It is expected that anti-viral activity will increase when two extracts are mixed. To investigate their anti-viral activity, the expression level of HCV Core 1b and NS5A was measured. Remarkably, AP, RG, and their mixed compound (APRG64) strongly inhibited the expression of viral proteins, which led us to identify their metabolites. A total of 14 metabolites were identified using liquid chromatography mass spectrometry (LC-MS). These metabolites were evaluated for their anti-HCV activity to identify active ingredients. In conclusion, our results unveiled that anti-HCV activity of Agrimonia pilosa and Galla rhois extract mixture could lead to the development of a novel therapy for HCV infection.

The association between submarine service and multimorbidity: a cross-sectional study of Korean naval personnel.

OBJECTIVE: We aimed to estimate the prevalence of multimorbidity (≥2 chronic health problems) among Korean submariners and to evaluate the association between submarine service and multimorbidity and disease burden. STUDY DESIGN AND SETTING: This cross-sectional study included 590 naval personnel who visited a Korean primary care clinic during 2014-2015. Data regarding general characteristics and morbidities were collected from medical records, and disease burden was assessed using the Cumulative Illness Rating Scale (CIRS). Multiple logistic regression analysis was used to evaluate the association between submarine service and multimorbidity and disease burden. RESULTS: The prevalence of multimorbidity was 11.7% among 180 non-submariners and 32.2% among 410 submariners. The prevalence of multimorbidity and the CIRS scores gradually increased with age. Submarine service was associated with higher risk of multimorbidity and disease burden compared with non-submarine service even after adjusting for age, alcohol consumption, smoking status and naval rank. However, a dose-response relationship was not evident between the duration of submarine service and the risk of multimorbidity as well as high disease burden. CONCLUSIONS: Submarine service was significantly associated with a higher risk of multimorbidity and greater disease burden than non-submarine service. This finding suggests that multidimensional and holistic healthcare approaches are needed for submariners.

Optimization of combinations of bactericidal and bacteriostatic treatments to control Listeria monocytogenes on cold-smoked salmon.

Contamination of cold-smoked salmon by Listeria monocytogenes is a major concern for the seafood industry. The objectives of this study were to (i) determine the most effective bactericidal treatment for L. monocytogenes on salmon and (ii) optimize bactericidal and bacteriostatic treatment combinations to identify cost-effective treatments against L. monocytogenes on salmon. L. monocytogenes challenge trials were conducted in brain heart infusion (BHI) and on salmon disks that were supplemented with bactericidal compounds nisin (NIS), lauric arginate (LAE), ε-polylysine (EPL), and chitosan (CHIT). Subsequently, the most effective bactericidal compound was further tested by concurrent application of a blend of organic acid salts containing potassium lactate and sodium diacetate (PLSDA). L. monocytogenes populations were measured at 7 °C over 60 days, and initial cell density (N0), maximum initial log reduction (Nr), lag phase (λ), maximum growth rate (µmax), and maximum cell density (Nmax) over 60 days storage were estimated. Time to recover to initial cell density (Tinitial) was also compared for combinations of bactericidal and bacteriostatic treatments. Varying degrees of antimicrobial effects were observed with bactericidal compounds in BHI. However, when tested on salmon, only NIS significantly decreased initial L. monocytogenes populations by approximately 2 log CFU/g, and reduced Nmax by approximately 1.5 logCFU/g compared to untreated control (CTRL). Nr achieved by the combined treatment of NIS and PLSDA was approximately 2 log CFU/g regardless of the presence of PLSDA, and a dose-dependent increase in Nr was observed with increasing NIS concentrations. PLSDA alone or in combination with 20 ppm NIS was most effective at delaying growth of L. monocytogenes. The greatest reduction in Nmax was observed with the combination of 20 ppm NIS and PLSDA; Nmax was 3.1 log CFU/g lower compared to CTRL. Comparison of Tinitial indicated that PLSDA with NIS can effectively retard growth of L. monocytogenes to its initial level (following initial reduction) and offers a cost benefit over using high concentrations of NIS alone. In summary, the combined application of NIS (for a bactericidal effect) and PLSDA (for a bacteriostatic effect) proved to be an effective treatment option to reduce initial levels as well as minimize subsequent growth of L. monocytogenes throughout the expected shelf-life of cold-smoked salmon.