Exercise interventions for advanced cancer palliative care patients: A systematic literature review and descriptive evidence synthesis of randomized controlled trials.

BACKGROUND: Exercise is often recommended for cancer patients. However, for advanced cancer palliative care patients, it is unclear whether exercise, as a lifestyle intervention, is beneficial for palliative outcomes. AIM: To examine randomized controlled trials assessing the effectiveness of lifestyle exercise interventions on palliative outcomes in patients with advanced stage cancer. DESIGN: Systematic review and descriptive evidence synthesis. DATA SOURCES: Pubmed/Medline, Embase, CINAHL, PsychInfo, and Web of Science were systematically searched from inception to 2022. Two reviewers identified articles and removed duplicates. Next two reviewers independently screened titles and abstracts and then assessed full-texts articles for eligibility. Finally, all six reviewers examined full-text articles for eligibility and conducted the evidence synthesis. RESULTS: Eight randomized controlled trials were included. Studies were heterogeneous making direct comparisons challenging, but were grouped along three categories: aerobic, resistance, or resistance-aerobic exercises. One of three aerobic studies had positive quality-of-life outcomes. Fatigue improved in one aerobic and one combination resistance-aerobic study. Most resistance-aerobic studies and one aerobic study showed improved physical function. All resistance studies showed improvement in at least one outcome. Across all studies, ill health was the most common reason for participant dropout. The most commonly used assessment tools were: Functional Assessment of Cancer Therapy: Fatigue, European Organization for Research and Treatment of Cancer Quality-of-life Questionnaire Core 30, and accelerometer. CONCLUSION: Current randomized controlled trials regarding effects of exercise interventions on palliative outcomes for advanced cancer patients show great variability. While studies show promise, no generalizable conclusions can be made. Further research is needed.

The dependence of electron transfer efficiency on the conformational order in organic monolayers.

The electron transfer through an organized organic monolayer of alkyl chains adsorbed on a silicon wafer has been studied. The silicon was used as an electrode in a three-electrode electrochemical cell, and the current versus voltage response was measured. The results show that when the chains in the monolayer are in the "all trans" configuration, the charge transfer efficiency is higher than when the chains have a "gauche" configuration. A mechanism rationalizing all the observations is suggested.

Management, treatment and outcomes of acute appendicitis in an elderly population: a single-center experience.

INTRODUCTION: Only 5-10% of cases of acute appendicitis (AA) are diagnosed above the age of 60 years. Complicated AA is more common in the elderly, who also have more comorbidities. The goals of this study were to describe our experience with elderly patients and identify predictors of increased morbidity. MATERIAL AND METHODS: Patients ≥65 years who were treated for AA between 2006 and 2013 were selected. The control consisted of patients aged 20-45 years, who were randomly selected from a pool of 900 patients. RESULTS: Seventy-four patients ≥65 years, mean age of 74.6 ± 7.4, were included. Time from onset of symptoms to surgery was similar between the groups. CT scan was performed for all patients in the elderly group compared to 55.6% in the younger group (p < 0.001). 77% of the younger patients underwent laparoscopic appendectomy compared to 43.2% of the elderly patients (p < 0.001). Pathological findings of severe appendicitis were significantly more common in the elderly group (39.2 vs. 10.5%, p < 0.001). Sixteen elderly patients (21.6%) developed complications, compared with 4 patients (3.2%) in the younger group (p < 0.001). The length of stay was longer in the elderly group and even longer for patients with complications (p < 0.001). There was no mortality. Cardiac disease was the only independent predictor of peri-operative complications (OR = 4.2). CONCLUSIONS: Severe forms of acute appendicitis and post-operative morbidity are higher in the elderly population. Cardiac disease is the only predictor for increased morbidity. Although CT scan was performed universally in the elderly group, it did not appear to increase time from presentation to surgery.

Comparative efficacy of oral sustained released bronchodilator in stable asthmatics.

Double blind randomized trial of oral conventional and sustained release bronchodilators was undertaken to observe comparative efficacy in 30 patients older than 15 years. All cases selected were stable asthmatics at least for last 2 years having FEV1 improvement > or = 20%. Basal Pulmonary functions like FEV1, FVC and PEFR were recorded before and after drug administration at 1/2, 1, 2, 3, 4, 6, 8, 10, 12 and 24 hours. Four drug regimens were given as a single dose in the morning on randomized crossover manner on 1st, 4th, 7th and 10th days, sustained release theophylline 300 mg+salbutamol 4 mg (Drug I), salbutamol 4 mg + theophylline 300 mg (Drug II), salbutamol sustained released (asthalin SA) 8 mg (Drug III), salbutamol sustained released (ventorlin CR) 8 mg (Drug IV). Mean FEV1 changes observed at 0, 6 and 12 hours for all the drugs were compared which showed no statistical significance (t = 2.3876). Therefore, we conclude that using single dose fixed combination of oral salbutamol and aminophylline either in a plain or slow released form have no additive bronchodilator effect as compared to salbutamol alone in stable asthmatics.

Successes and challenges to implementing an early childhood supplemental feeding program in rural Honduras: a qualitative study.

BACKGROUND: Malnutrition is a major cause of childhood illness, stunted growth and death worldwide. A supplemental nutrition program for young children was implemented in Guachipilincito, Honduras. This study explores early successes and challenges to implementing this program. METHODS: We conducted a qualitative, semi-structured, key informant interview study in 2012. Two researchers analyzed interview transcripts using the immersion/crystallization method of qualitative analysis. RESULTS: The program evolved from addressing macronutrient deficiency in 2010, to targeting micronutrient deficiency. Successes include: consistent food distribution, positive community feedback and establishment of a Honduran community oversight committee. Challenges include: tracking growth data, sharing of food among family members, and long-term sustainability. Next steps include: obtaining stable funding, utilizing local food suppliers, and increasing crop diversity. Participants identified cultural and economic factors contributing to challenges with these steps. CONCLUSION: While the feeding program is having successes, it still faces many challenges. Additional interviews with Honduran-based staff, community leaders and program recipients may identify the best ways to address these challenges.