Factors contributing to weight loss, nutrition-related concerns and advice received by adults undergoing cancer treatment.

PURPOSE: The opinions and perceptions of patients are crucial throughout the cancer treatment process, as treatment is more effective when patient concerns are addressed. The present study was designed to identify history of weight loss since initiation of cancer treatment, specific nutrition-related problems and concerns (including food aversions, factors contributing to poor food intake and perceived nutrition-related problems), nutrition advice received by cancer treatment patients, and relations between items studied and reported unintentional weight loss. MATERIAL AND METHODS: A 23-item survey was completed by a convenience sample of 79 patients from treatment centers at a community hospital and oncologist office, of which 66 were included in the final analysis. Descriptive statistics included means, standard error, 95% confidence intervals, and frequency distributions. ANOVA and Pearson chi2 were used to evaluate differences in responses by treatment type and relations between items studied and reported unintentional weight loss. Twenty-seven (41%) of the 66 (27 males, 39 females) were receiving radiation, 20 (30%) chemotherapy, and 19 (29%) both. RESULTS: Unintentional weight loss occurred for 41% since initiation of treatment (13% deficit), 27% had food aversions, 52% reported factors contributing to poor food intake, 50% had nutrition-related problems since initiation of treatment, and 89% had received nutrition advice. The prevalence of unintentional weight loss was significantly greater among patients who reported having food aversions, factors that had contributed to poor food intake, or nutrition-related problems. CONCLUSIONS: This study demonstrates that adults commonly present with factors that contribute to poor food intake and perceive nutrition-related problems resulting from cancer treatment. Further, there is a greater prevalence of unintentional weight loss among those who report food aversions and perceive nutrition-related problems. The findings provide a framework that may aid healthcare providers in recognizing nutrition-related concerns and needs of cancer patients.

Estrogen profiles in postmenopausal African-American women in a wheat bran fiber intervention study.

High dietary fiber intake has been hypothesized to lower blood estrogen concentrations, an effect thought to be beneficial for decreasing breast cancer risk. This study investigated the association between dietary supplementation of wheat bran and circulating estrogen levels in postmenopausal African-American women participating in a community intervention trial. Seventeen postmenopausal women (aged 63 +/- 1.6 yr) participated in the study. Nutritional status was assessed and blood and 24-hour urine samples were collected before and after five to six weeks of daily supplementation of the diet with 35 g of wheat bran cereal (11.6 g insoluble dietary fiber) marked with 28 mg of riboflavin. Riboflavin confirmed that all postmenopausal participants adhered to the intervention protocol. Nine of the 17 postmenopausal women were taking some form of estrogen replacement therapy (PM-ERT). Baseline hormone levels in the PM-ERT group did not significantly change after the dietary intervention. Estradiol (96.8 +/- 20.3 vs. 113.8 +/- 23.3 pg/ml), androstenedione (0.47 +/- 0.06 vs. 0.45 +/- 0.06 ng/ml), and sex hormone-binding globulin (SHBG, 107 +/- 13.5 vs. 106.6 +/- 13.3 nmol/l) levels remained constant. In the eight postmenopausal women who were not receiving exogenous hormones (PM), wheat bran consumption was not associated with predicted decreased levels of estradiol (25.7 +/- 2.7 vs. 31.0 +/- 1.9 pg/ml), estrone (38.3 +/- 10.1 vs. 39.3 +/- 10.6 pg/ml), and androstenedione (0.78 +/- 0.08 vs. 0.68 +/- 0.11 ng/ml) or with increased concentrations of SHBG (35.2 +/- 6.4 vs. 34.8 +/- 6.5 nmol/l). Participants receiving ERT had baseline and postintervention levels of estradiol and SHBG significantly higher and androstenedione significantly lower than those not receiving ERT. No association between wheat bran supplementation and hormone levels was found in PM or PM-ERT African-American participants. These results in postmenopausal women are in contrast to findings of earlier studies in premenopausal women indicating that wheat bran fiber decreases serum sex hormones. Estrogen levels in postmenopausal women are only 5-10% of those in premenopausal women; therefore, a high wheat bran fiber diet alone may not be sufficient to depress these low levels even further.

Objective measurement of mood change induced by contemporary music.

A myriad of previous studies from a variety of disciplines has shown several effects of music on mind and body. This study investigated the relationship between different categories of contemporary music (n = 6) and the mood states of a group of students (n = 12), using the Profile of Mood States (POMS), to measure mood before and after exposure to these different pieces of music. When analysed together, all six pieces of music produced an overall change in mood (P = 0.008) as measured by 2-way repeated measures analysis of variance (ANOVA). When each category was examined individually, four categories of music produced highly significant changes in mood: the tense category (score -4.0 +/- 1.8 POMS Units; P < 0.001); depressed category (+0.5 +/- 0.2; P < 0.001); angry category (+0.9 +/- 1.6; P < 0.03); and the all moods category (1.6 +/- 0.3; P < 0.04). One piece of dance music produced changes in all mood categories, giving the largest positive mean mood change. By contrast, the popular/independent music, associated with the tense category, produced the largest negative mean mood change. The five POMS mood states were analysed separately for each piece of music. These findings are consistent with previous work. In addition, the finding of the effects of specific music categories on mood may have important implications for therapy in mental health and mental health nursing.

Lecithin-cholesterol acyltransferase activity in normocholesterolaemic and hypercholesterolaemic roosters: modulation by lipid apheresis.

Lipid apheresis, a recently described procedure for the elimination of lipid but not apolipoproteins from plasma, was applied to normocholesterolaemic and hypercholesterolaemic roosters. Lipid apheresis resulted in an immediate reduction in plasma unesterified cholesterol concentration, which was sustained for 150 min. The reduction in unesterified cholesterol concentration was higher in the normocholesterolaemic animals than in the hypercholesterolaemic animals. Lipid apheresis induced changes in the ratio of plasma unesterified to total cholesterol in normocholesterolamic animals but not in hypercholesterolaemic animals. In hypercholesterolaemic animals, lecithin-cholesterol acyltransferase (LCAT) activity was not affected by lipid apheresis, whereas in normocholesterolaemic animals LCAT activity was acutely reduced for 150 min after lipid apheresis. Saturated LCAT kinetics occurred in the hypercholesterolaemic animals but not in the normocholesterolaemic animals. LCAT obeyed Michaelis-Menten kinetics. After lipid apheresis, there was a pool of unesterified cholesterol that was available as substrate for LCAT to a greater extent in hypercholesterolaemic animals than in normocholesterolaemic animals. These observations may have important implications for lipid apheresis as a treatment for atherosclerosis.

CR16, a novel proline-rich protein expressed in rat brain neurons, binds to SH3 domains and is a MAP kinase substrate.

CR16 is a glucocorticoid-regulated gene expressed in subpopulations of neurons in the brain, including the hippocampus. The CR16 open reading frame encodes a 45 kDa protein containing 32% proline. To begin characterizing the CR16 protein, a rabbit polyclonal antibody was raised against an Escherchia coli-produced fusion protein containing amino acids 370-438 of CR16. The antibody identifies a protein doublet of 68 and 72 kDa by sodium-dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) from hippocampal extracts and from insect cells expressing the CR16 open reading frame from a baculovirus construct. However, when hippocampal extracts are electrophoresed on nondenaturing polyacrylamide gels, the CR16 protein migrates as a 48 kDa protein that better correlates with the size of the open reading frame. Examination of the primary amino acid sequence reveals at least 12 sequence homologies to the abl-SH3 binding domain consensus sequence XPXXPPP psi XP. In addition, CR16 has at least 36 copies of the PXXP motif, which is contained in all known SH3 binding domains. Solution and filter binding assays confirm that CR16 selectively binds SH3 domains. The CR16 primary amino acid sequence also contains at least eight consensus MAP kinase phosphorylation sites, five of which are in the potential SH3 binding domains. The CR16 protein, immunoprecipitated from rat brain, is an in vitro substrate for the purified enzyme. However, phosphorylation of CR16 does not greatly affect the binding of the various SH3 domains in our assay system. These data strongly suggest that the function of CR16 is to mediate one or more signal transduction pathways in CNS neurons, in addition to being a glucocorticoid-regulated gene.

A probability representation for phase information from multiwavelength anomalous dispersion.

A probability distribution function, cast in the representation of Hendrickson & Lattman [Acta Cryst. (1970), B26, 136-143], has been derived for the phase information from measurements of multiwavelength anomalous diffraction (MAD). This probability function readily permits one to determine figure-of-merit weights similar to those used in isomorphous replacement, and the coefficients that characterize this distribution function facilitate the combining of MAD phasing with results from other sources of phase information. This probability representation was derived in the course of a structural analysis of selenobiotinyl streptavidin from MAD data and applications have also been made in the structure determinations of interleukin-1 alpha and a drug complex with brominated DNA.

Metabolism of kadsurenone and 9,10-dihydrokadsurenone in rhesus monkeys and rat liver microsomes.

The metabolism of the PAF antagonists kadsurenone and tritium-labeled 9,10-dihydrokadsurenone was studied in rhesus monkeys and rat liver microsomes. The monkey metabolites of the two drugs were isolated as their glucuronide conjugates from the urine of iv dosed males. The metabolites from both monkey and microsomal metabolism were purified by reverse phase HPLC and identified by spectral (NMR, UV, and mass spectrometric) analysis. The principal pathway of biotransformation of the tritium-labeled 9,10-dihydrokadsurenone in monkeys was hydroxylation of the C-5 propyl side chain to give two metabolites, 10-hydroxy-9,10-dihydrokadsurenone and 9-hydroxy-9,10-dihydrokadsurenone. These compounds were excreted as glucuronides. Microsomal incubation of tritium-labeled 9,10-dihydrokadsurenone yielded the 10-, 9-, and 8-hydroxy-9,10-dihydrokadsurenone as major metabolites. Kadsurenone was also metabolized at the C-5 side chain, an allyl group. The monoglucuronide of 9,10-dihydroxykadsurenone was isolated from monkey urine. Spectral analysis was not definitive as to the site of conjugation, and the structure of the metabolite was assigned as the C-10 conjugate. A major metabolite of rat liver microsomal incubation of kadsurenone was 9,10-dihydroxykadsurenone.

Effect of phototherapy light, sodium bisulfite, and pH on vitamin stability in total parenteral nutrition admixtures.

The three sections of this study extend previous research into losses of vitamins A, C, E, thiamin, riboflavin, and folic acid from total parenteral nutrition (TPN) admixtures. First, phototherapy light on TPN admixtures containing one of four amino acid solutions was studied. Experimental conditions included presence or absence of Intralipid iv fat emulsion, plastic bag or glass bottle storage container, and storage time of up to 48 hrs. The second phase studied stability of the same vitamins (except vitamin E) for 48 hrs in admixtures containing the amino acid solution which has no bisulfite, in glass bottles; with or without Intralipid; and with added sodium bisulfite (final concentrations of 0, 1, 2, 3, 4, 5 and 10 mEq/liter). Third, vitamin C and thiamin levels were measured in admixtures containing the amino acid solution with no bisulfite, without Intralipid, stored in glass bottles with various bisulfite concentrations (0, 1, 2, or 3 mEq/liter) and three pH levels (5.5, 6.5, and 6.75 pH). Exposure of TPN admixtures to phototherapy light caused losses of vitamins A, C, and riboflavin. Intralipid inclusion significantly reduced losses of vitamin A and riboflavin, but did not appear to affect vitamin C levels. The smallest vitamin C losses were noted in admixtures containing amino acid solutions A or B. Phototherapy light did not affect thiamin levels. Bisulfite had no affect on vitamin C, riboflavin, or folic acid levels. Vitamin A levels were maintained with bisulfite concentrations less than 3 mEq/liter. At 3 mEq/liter bisulfite, admixtures with Intralipid showed 50% loss of vitamin A.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthritogenic effects of Mycoplasma arthritidis T cell mitogen in rats.

The intraarticular injection of Mycoplasma arthritidis T cell mitogen (MAM) produced significant joint swelling with inflammation in DA rats. Histologic examination of the joint initially showed edema below the synovial surface layer with light polymorphonuclear and focal lymphoid cell infiltration. Widespread but incomplete shedding of the surface layer of the synovial membrane and hypertrophy and hyperplasia of the subsynovium with fibroblasts and macrophages were observed subsequently. The hyperplastic process began to resolve by Day 5 and almost completely disappeared by Day 7 with healing of the surface layer, leaving virtually no trace of the preceding acute episode. Arthritis in animals with previous adjuvant induced arthritis was not exacerbated by the intraarticular injection of MAM.

Effect of red pepper and black pepper on the stomach.

Spices have long been implicated as a cause of gastric mucosal injury. We assessed the effects of red and black pepper on the gastric mucosa using double-blind intragastric administration of test meals containing red pepper (0.1-1.5 g) or black pepper (1.5 g) to healthy human volunteers; aspirin (655 mg) and distilled water were used as positive and negative controls, respectively. Serial gastric washes were performed after test meal administration and gastric contents were analyzed for DNA, pepsin, blood, sodium, potassium, parietal cell secretion, and nonparietal cell secretion. Both red pepper and black pepper caused significant increases in parietal secretion, pepsin secretion, and potassium loss. Gastric cell exfoliation (as reflected in DNA loss into gastric contents) was increased after red or black pepper administration; the increase after red pepper administration was dose dependent. Mucosal microbleeding was seen after spice administration and one subject had grossly visible gastric bleeding after both red pepper and black pepper administration. There were no significant differences from control between the test meals, in nonparietal volume, fractional recovery of the gastric secretions, or sodium secretion. Finally, no spice was significantly different from aspirin in any parameter studied; indeed, aspirin was comparable to the higher doses of pepper. The long-term result of daily pepper ingestion is unknown. Whether spices are detrimental, beneficial (e.g., inducing an adaptive cytoprotective response), or have no significant long-term effect on the gastric mucosa is unknown and deserves further study.

Serum levels of vitamin C in relation to dietary and supplemental intake of vitamin C in smokers and nonsmokers.

Serum vitamin C levels were compared in smokers and nonsmokers in relation to dietary and supplemental intake of vitamin C, using data from the Second National Health and Nutrition Examination Survey. Smokers reported a lower mean daily intake (53 mg) of vitamin C than nonsmokers (65 mg) and a higher percentage (41% compared to 31%) consuming less than 70% RDA. Smoking status of respondents was judged by carboxyhemoglobin levels or by questionnaire. With both methods, percent of nonsupplemented smokers with serum vitamin C 0.3 mg/dl or less was two or more times as high as nonsupplemented nonsmokers at similar dietary intake levels. When smokers and nonsmokers with similar dietary vitamin C intake were ranked by serum C level, median and mean serum C for smokers was consistently lower than nonsmokers by approximately 0.2 mg/dl. By using the parallel bioassay methods, it was estimated that smokers would need an additional 59 mg/day dietary vitamin C (95% confidence interval of 52-68 mg/day) based on median values or 65 mg/day (53-79 mg/day) based on mean values to attain serum C levels comparable to nonsmokers.

Urinary alkalinization and smoking cessation.

Previous studies have shown that large doses of a urinary alkalinizing agent reduced cigarette consumption spontaneously among smokers. After establishing a safe daily dose of an alkalinizing agent, sodium bicarbonate, its effect upon smoking cessation rates among 72 enrollees in a smoking cessation program was studied. In the first study, we determined that sodium bicarbonate (3900 mg per day) significantly increased urinary pH (from 6.0 to 6.7) and lowered titratable acidity. Ascorbic acid (1500 mg per day) had no effect of pH or acidity. In a second study, a group given sodium bicarbonate surpassed a placebo control group (who were given 1500 mg per day ascorbic acid) in total daily cigarette reduction after 5 weeks and in week-to-week smoking reduction. The groups did not, however, differ in the number who achieved total abstinence.

Hydrocarbons in Victorian coastal ecosystems (Australia): chronic petroleum inputs to Western Port and Port Phillip Bays.

This study was undertaken to assess the impact of current land use practices, to provide data on which to base recommendations for petroleum discharge regulations, and to develop reliable methods for monitoring hydrocarbon pollution in Victorian coastal waters. Analyses of sediments and mussels were used to identify areas of chronic contamination and probable sources. A mussel transplant experiment detailed the movement of major industrial effluents. petroleum hydrocarbons varied from non-detectable to maximum values of 30 mg/g lipid in areas near points of continuous discharge. Problem areas were identified where tissue levels of hydrocarbons in mussels consistently exceeded 4 mg/g lipid and petroleum buildup was evident in sediments. Differences in chemical composition of hydrocarbons in various ecosystem components reflected biogeochemical processes acting to disperse, degrade, and transport hydrocarbons discharged into coastal waters. Results showed Port Phillip Bay is subject to much larger and more complex discharges of petroleum-containing wastes than Western Port from both discrete ship and shore-based inputs and from diffuse urban/industrial inputs, including surface run-off and atmospheric precipitation.

Nutritional status of elderly participants in a congregate meals program.

This study was conducted to determine the nutritional status of elderly subjects participating in a congregate meals program. Twenty-four-hour recalls, anthropometric measurements, and biochemical determinations were the criteria used to determine nutritional status of the 30 volunteers. Information regarding use of dietary supplements was also obtained. Ninety-three percent of the participants consumed diets providing at least 70 percent of the RDA for the 13 nutrients calculated. Seven percent consumed diets rated as "poor," but none of the participants consumed diets supplying less than 54 percent of the RDA. Twenty-seven percent of the sample reported daily use of dietary supplements. Height, weight, mid-arm circumference, triceps skinfold, and abdominal circumference were measured. The incidence of obesity was high, with 42 percent of the women and 78 percent of the men being over 119 percent of ideal body weight. Mid-arm circumference, triceps skinfold, and abdominal circumference data agreed with the weight-for-height data. The incidence of obesity was greater in this study than in other studies cited, and, as was not the case in other studies, the incidence of obesity was greater in men. Biochemical determinations included hemoglobin, hematocrit, serum albumin, serum folate, ascorbic acid, and vitamins A, B6, and B12. Comparison of biochemical data with accepted standards indicated that the nutritional status of the participants was adequate.

Effect of vitamin D and low dietary calcium on lead uptake and retention in rats.

The effects of cholecalciferol (formerly vitamin D-3) supplementation and alterations in dietary calcium levels on intestinal 210Pb absorption and tissue uptake were studied in weanling female Sprague-Dawley rats. Rats were placed in one of three groups: 1) normal dietary calcium with normal cholecalciferol; 2) low dietary calcium with normal cholecalciferol; or 3) normal dietary calcium with cholecalciferol supplementation. Blood 210Pb levels were determined at 3, 6, 12 and 24 hours following the administration of either an oral or an IP dose of 210Pb. Femur and kidney 210Pb activities were subsequently determined for all animals 24 hours after the administration of 210Pb. Cholecalciferol supplementation resulted in increased net intestinal absorption of 210Pb with uptake into femurs and kidneys. The effect of cholecalciferol to increase tissue uptake of 210Pb was shown to be independent of the effect of cholecalciferol on the gastrointestinal absorption of lead. A lowering of dietary calcium was shown to increase lead absorption with uptake into femurs; however, this increased tissue uptake of lead was shown to be dependent upon increased intestinal lead absorption and was not a direct effect of the low calcium diet.

Reduced vitamin a levels of chicks fed anaerobically digested sewage sludge.

Diets containing 20% of air-dried anaerobically digested Fort Collins sewage sludge were fed to broiler chicks. The diets were balanced in protein and had the same vitamin and mineral supplement. The sludge diets containing approximately 2,500 ME kcal/kg compared to 3,000 ME kcal/kg in the control feed. Birds gained less body weight on sludge diets and liver vitamin A levels were reduced. Extrusion of cord-sludge mixture prior to diet formulations made the diet much poorer for supporting growth, reduced feed efficiency, and lowered liver vitamin A levels. It was concluded that ingestion of the sewage sludge impaired the utilization of vitamin A from the diet.

Selenium nutriture in total parenteral nutrition: intake levels.

More attention is being given to the essential trace elements in human nutrition, although there is much to be learned concerning requirements, function, and interactions. The extensive use of total parenteral nutrition (TPN) provides an opportunity for further study. To date, little attention has been paid to selenium (Se), an element for which both a deficiency and toxic state can exist. In a program to evaluate the effects of long-term TPN on Se nutriture, a avriety of solutions used in TPN have been analyzed. Se was not present in detectable levels in the following solutions: sodium acetate, Freamine II, NaCl, potassium phosphate, KCl, Folvite, Liquaemin Na, CaCl2, MgSO4, and NaHCO3. The solutions containing significant amounts of Se were: 50% dextrose 0.27 +/- 0.04 microgram/ml and 20% dextrose 0.27 +/- 0.08 microgram/ml (Travenol Laboratories); 50% dextrose 0.47 +/- 0.10 microgram/ml and 20% dextrose 0.35 +/- 0.07 microgram/ml (Abbott Laboratories); and 70% dextrose 0.33 +/- 0.08 microgram/ml (McGaw Laboratories). These data suggest that 200 to 400 microgram Se would be provided in the usual amounts of solution administered to an adult patient.

Vitamin A status of children in Sri Lanka.

A representative country-wide rural nutrition status survey determined the extent and distribution of vitamin A deficiency in Sri Lanka in children 6 through 71 months of age. Trained paramedical personnel recorded the presence or absence of selected ophthalmological signs and symptoms associated with vitamin A deficiency in 13,450 children. The results of the country-wide clinical survey indicate that a vitamin A deficiency problem of public health importance may exist in two of 15 health areas. Serum vitamin A levels were determined on 346 survey children from two of 15 health areas and compared with clinical findings for these areas. The lowest mean serum vitamin A, 26.3 microgram/100 ml, occurred in children with clinical eye findings. A high prevalence of clinical eye findings, 34%, and the low mean serum vitamin A value, 28.2 microgram/100 ml, were found in the group of chronically undernourished children--children who are less than 90% of their expected height for age. The survey results enabled planned redirection of the distribution of vitamin A capsules to preschool children in Sri Lanka to areas shown to have the highest prevalences of ophthalmological signs and symptoms and/or the highest prevalence of chronic undernutrition.

Effects of alpha-tocopherol acetate on the swimming endurance of trained swimmers.

Well-trained, competitive swimmers were divided into two groups. Group A was given 900 IU alpha-tocopherol acetate daily for 6 months while group B was given placebos. A swimming endurance test was given before the start of supplementation and after 1, 2, 5 and 6 months. No difference in swimmers' endurance was observed between the two groups during the 6-month period. There was also no difference in postexercise serum lactic acid levels. Younger, less well-trained, competitive swimmers were also divided into two groups. Group A received 900 IU alpha-tocopherol acetate daily while group B received placebos. Swimming times for these swimmers were erratic, reflecting a lack of training. alpha-Tocopherol did not appear to have any effect on their swimming endurance.