Complementary and alternative medicine and musculoskeletal pain in the first year of adjuvant aromatase inhibitor treatment in early breast cancer patients.

BACKGROUND: Patients with breast cancer (BC) show strong interest in complementary and alternative medicine (CAM), particularly for adverse effects of adjuvant endocrine treatment - e.g., with letrozole. Letrozole often induces myalgia/limb pain and arthralgia, with potential noncompliance and treatment termination. This analysis investigated whether CAM before aromatase inhibitor (AI) therapy is associated with pain development and the intensity of AI-induced musculoskeletal syndrome (AIMSS) during the first year of treatment. PATIENTS AND METHODS: The multicenter phase IV PreFace study evaluated letrozole therapy in postmenopausal, hormone receptor-positive patients with early BC. Patients were asked about CAM use before, 6 months after, and 12 months after treatment started. They recorded pain every month for 1 year in a diary including questions about pain and numeric pain rating scales. Data were analyzed for patients who provided pain information for all time points. RESULTS: Of 1396 patients included, 901 (64.5%) had used CAM before AI treatment. Throughout the observation period, patients with CAM before AI treatment had higher pain values, for both myalgia/limb pain and arthralgia, than non-users. Pain increased significantly in both groups over time, with the largest increase during the first 6 months. No significant difference of pain increase was noted regarding CAM use. CONCLUSIONS: CAM use does not prevent or improve the development of AIMSS. Pain intensity was generally greater in the CAM group. Therefore, because of the risk of non-compliance and treatment discontinuation due to the development of higher pain levels, special attention must be paid to patient education and aftercare in these patients.

Photobiomodulation of freshly isolated human adipose tissue-derived stromal vascular fraction cells by pulsed light-emitting diodes for direct clinical application.

A highly interesting source for adult stem cells is adipose tissue, from which the stromal vascular fraction (SVF)-a heterogeneous cell population including the adipose-derived stromal/stem cells-can be obtained. To enhance the regenerative potential of freshly isolated SVF cells, low-level light therapy (LLLT) was used. The effects of pulsed blue (475 nm), green (516 nm), and red (635 nm) light from light-emitting diodes applied on freshly isolated SVF were analysed regarding cell phenotype, cell number, viability, adenosine triphosphate content, cytotoxicity, and proliferation but also osteogenic, adipogenic, and proangiogenic differentiation potential. The colony-forming unit fibroblast assay revealed a significantly increased colony size after LLLT with red light compared with untreated cells, whereas the frequency of colony-forming cells was not affected. LLLT with green and red light resulted in a stronger capacity to form vascular tubes by SVF when cultured within 3D fibrin matrices compared with untreated cells, which was corroborated by increased number and length of the single tubes and a significantly higher concentration of vascular endothelial growth factor. Our study showed beneficial effects after LLLT on the vascularization potential and proliferation capacity of SVF cells. Therefore, LLLT using pulsed light-emitting diode light might represent a new approach for activation of freshly isolated SVF cells for direct clinical application.

[Herbal medicine--taking a position. Effectiveness and usefulness of herbal preparations]. / Pflanzliche Arzneimittel--eine Standortbestimmung. Wirksamkeit und Nutzen der Phytopharmaka.

During the discussion on the elimination of certain groups of drugs and disorders from the list of obligatory services to be remunerated by state health insurances, vague, undefined terms such as "controversial" are being applied to phytopharmaceuticals and their fields of application. This may be traced back to an ignorance and global rejection of available scientific documentation. The rational background of modern phytopharmaceuticals are discussed.

[Stool behavior following the administration of antacids]. / Stuhlverhalten nach Gabe von Antazida.

The direct correlation between the dosage of magnesium in antacids and the appearance of partly massive diarrheas in ulcus-patients known from literature could be confirmed. The clinically relevant dosage of antacids of 420 mval NK/day, divided in six individual dosages, resulted in diarrheas from the second to fourth day in 32 percent of the test persons when antacid A with a high content of magnesium was administered. There was no hint for a constipating effect of Solugastril gel at these high dosages (= 12 individual doses). Indeed the application of an Al-Ca-antacid may result in a slight fecal impaction, however, at the same time also to an increase of stool frequency, which is similar to that obtained with antacid B having a lower content of magnesium. The antacid can be regarded as neutral concerning stool frequency and consistency in the majority of test persons. From all four tested antacids the triple-combination (Al, Mg, Ca), showed the least important deviations from the preceding norms concerning stool frequency and consistency. The triple-combination shows an absolutely neutral stool behaviour. Serum electrolytes remained in the normal range with the Al-Ca- and the Al-Mg-Ca-antacid; whereas after application of antacid. A with high magnesium content, important increases of magnesium could be observed after seven days already, which were also dealt with in the literature.