A Pilot Study of Side Effects of Cancer Therapies and their Impact on Satisfaction with Life.

This survey aimed at getting a first insight into diverse side effects and their association with satisfaction with life as well as the use of complementary and alternative medicine (CAM) in cancer patients. A total of 100 patients in a German University Hospital were included. General side effects like fatigue, fever, headache, limb pain and sleep disorders had a significant influence on the patients' satisfaction with life (p = .034 and p = .032, respectively). Concerning CAM, we could not detect any association between the frequency of side effects and the use of CAM. Improving the treatment of side effects may have a strong impact on patients' satisfaction with life.

Extra-skeletal impact of vitamin D supplementation protocol in an adult population with cystic fibrosis.

BACKGROUND: Due to lack of vitamin D absorption in patients with cystic fibrosis (CF), vitamin D supplementation becomes necessary. Our aim was to study the association between serum vitamin D levels and key clinical factors, such as nutritional status, pulmonary function and pulmonary exacerbations (PEx) frequency, in an adult CF population. METHODS: Prospective analysis of a published vitamin D (VitD3) supplementation protocol (N = 200 adult patients) over a follow-up period of 5 years. Data were collected from the medical files before (baseline) and after (follow-up) the implementation of the VitD3 supplementation protocol, between 2009 and 2014. Serum samples to measure vitamin D were also collected at baseline and follow-up. RESULTS: A positive relationship between serum vitamin D and lung function was observed at baseline (R = 0.158, P = 0.027), but it disappeared at follow-up (P = 0.454). There was no association between serum vitamin D levels and body mass index. At follow-up, patients with significantly higher serum vitamin D levels were women, older in age, had CF-related diabetes or had a history of recurring PEx. CONCLUSION: No direct link was observed between heightened serum vitamin D and lung function or BMI in an adult CF population. We suggest that better compliance to treatments and closer follow-up from health professionals could partially explain why such patients reached higher vitamin D serum levels.

[Stress fracture in athletes and prevalence of extensive rehabilitation]. / Fracture de fatigue chez le sportif et prise en charge intensive de rééducation.

OBJECTIVE: The aim of this work was to review the literature for the place of extensive rehabilitation for athletes with stress fractures. METHOD: We searched the Medline and Embase databases using the keywords stress fracture, sports, rehabilitation, management and treatment. Only French and English articles were included, and articles about bone physiology, animal models, and spine and chest localisations were excluded. From 468 scientific articles, 62 were chosen because they corresponded to literary reviews or to therapeutic evaluations. RESULTS: Treatment of stress fracture is justified according to risk factors, stress-fracture complications, the precocity of diagnosis, the therapeutic method and when the athlete needs to return to the sport. The most common treatment is discontinuing the sport, followed by rest. The progressive resumption of sport is rarely described but must take into account mechanical constraints that can be controlled by the use of shoes adapted to a supple ground. Some treatments such as immobilization by pneumatic splint surgery or use of electric fields are controversial. CONCLUSION: Extensive treatment of stress fractures is mainly dedicated to high-level athletes who need to regain previous physical capacities as soon as possible.

Digestive and metabolic effects of potato and maize fibres in human subjects.

The physiological effects of dietary fibres in humans are due to their physico-chemical properties. However, it is difficult to predict these effects simply by measuring certain characteristics in vitro. Studies in human subjects are still required to assess the effectiveness of new substrates. The aim of the present study in healthy human subjects was to evaluate the effects of two novel fibres, potato (PF) and maize (MF), on fasting and postprandial blood concentrations of carbohydrate and lipid metabolites as well as on stool output and transit time. The chemical composition, water-binding capacity (WBC) and fermentative properties of the fibres were also characterized in order to determine their possible involvement in digestive and metabolic effects. Stools, as well as breath and blood samples, were collected after consumption for 1 month of either a basal diet (control) or a basal diet supplemented with fibre (15 g/d). MF resisted fermentation better than PF and had lower digestibility. However, both fibres increased faecal output of dry matter, neutral sugars and water. There was an inverse relationship between stool weight and orofaecal transit time, although only MF significantly reduced transit time. Orocaecal transit was lengthened by PF, probably because of its high WBC. PF ingestion also decreased postprandial plasma levels of total and esterified cholesterol but had no effect on fasting concentrations. In contrast, MF lowered fasting cholesterolaemia and increased free:esterified cholesterol. These particular physiological and fermentative properties suggest that PF and MF would be suitable ingredients in a healthy diet.

Chronic oat bran intake alters postprandial lipemia and lipoproteins in healthy adults.

This study evaluates the possible interaction between chronic oat bran intake and the postmeal metabolic response. Six normolipidemic men consumed three different diets for 14 d, at the end of which they consumed a test meal. The diets were C (control), basal low-fiber diet (15.6 g fiber/d) and a low-fiber (2.8 g fiber) test meal; OB (oat bran), basal low-fiber diet and a 40-g oat bran-enriched test meal (12.8 g fiber); and OB-A (oat bran-adaptation), 14-d oat bran (40 g/d) supplemented diet (23.8 g fiber/d) and an oat bran test meal (12.8 g fiber). The diets were fed in a random order. Fasting and postmeal blood samples were obtained for 7 h and lipoproteins were isolated. Adding oat bran to the test meals markedly reduced the postmeal insulin rise (P < 0.05). Compared with the low-fiber control diet, the effects elicited postprandially by adding oat bran to a single meal were enhanced after 14 d of oat bran feeding, ie, increased plasma triglycerides, phospholipids, and free cholesterol; decreased plasma esterified cholesterol; increased chylomicron and small-sized triglyceride-rich lipoprotein triglycerides; increased LDL and HDL free cholesterol; and decreased HDL esterified cholesterol. Thus, chronic oat bran feeding alters the postmeal response in human subjects.

Effects of pea and soybean fibre on postprandial lipaemia and lipoproteins in healthy adults.

To evaluate some possible mechanisms whereby total dietary fibre (TDF) may affect lipid metabolism in humans, six normolipidaemic males ingested on separate days a low-fibre test meal (2.8 g TDF) containing 70 g fat and 756 mg cholesterol, enriched with 10 g TDF in the form of either pea fibre or soybean fibre. Fasting and post-meal blood samples were obtained for 7 h and chylomicrons (CM) were isolated. Lipoproteins (VLDL+CM remnants, LDL, HDL) were isolated from the baseline samples and the samples of the 2-3 h triglyceride peaks. As compared to the postprandial response given by the control low-fibre test meal, adding fibre induced no change in serum glucose, insulin or Apo A1 and Apo B variations. The serum triglyceride response was not altered by adding fibres but the 2-3 h chylomicron triglyceride rise was increased (P < or = 0.05) by soybean fibre. VLDL+CM remnants, LDL and HDL triglyceride variations were unchanged with fibres. Cholesterolaemia decreased postprandially for 6 h, and was further lowered in the presence of pea fibre. This resulted from a marked decrease in serum esterified cholesterol. The chylomicron cholesterol and phospholipid rise was lowered in the presence of either fibre. The postprandial changes in the free cholesterol concentrations of the various lipoprotein classes were not altered by fibre whereas changes from baseline in esterified cholesterol concentrations were reduced by soybean fibre in LDL and amplified by soybean and pea fibres in HDL. The results obtained show that dietary fibre present in legumes may alter postprandial lipaemia and lipoproteins in humans to a variable extent. These effects could be related to some long-term metabolic effects.

Effects of a diet deficient in essential fatty acids on the glomerular hypercellularity occurring in the course of nephrotoxic serum nephritis in rats.

An accelerated model of nephrotoxic serum nephritis (NTN) was induced in two groups of Sprague-Dawley rats on the following regimens: (a) a diet deficient in essential fatty acids that contained 20% coconut oil (rats A); (b) a diet supplemented with essential fatty acids that contained 20% safflower oil (rats B). Animals from both groups developed a severe proteinuria reaching its maximum 4 days after the injection of nephrotoxic serum (NTS). Kidney tissue was studied by light and immunofluorescent microscopy 2 to 21 days after NTS injection. The glomeruli of rats A exhibited much more fibrinoid deposition than did those of rats B. A comparable glomerular infiltration by mononuclear cells was observed in both groups of animals between the 2nd and 5th day following the injection of NTS. The number of intrinsic glomerular cells incorporating 3H-thymidine in vivo, however, was significantly lower in rats A than it was in rats B. The outgrowth capacity of glomerular cells in vitro was significantly lower in glomerular explants from rats A than it was in glomerular explants from rats B. These findings demonstrate that, in this model of rat NTN, a diet deficient in essential fatty acids has no major effects on the course of the disease during the first 3 weeks following NTS injection. They further show that the proliferation of intrinsic glomerular cells can be modulated by altering prostaglandin metabolism.