AIMS: This work aims to evaluate the efficacy of nutritional supplementation with a glutamine-enriched oligomeric diet (GEOD) compared to a standard polymeric diet (SPD) in terms of oncology treatment-related diarrhea (OTRD) (frequency and consistency of stools), gastrointestinal toxicity, and functional and nutritional progress. METHODS: This prospective cohort study compared two groups of patients with rectal cancer in treatment with neoadjuvant chemotherapy and radiotherapy who were at risk of malnutrition. Patients were randomized to receive either 400 ml of GEOD or of SPD from the start of radiotherapy to 30 days after its completion. RESULTS: Eighty patients were recruited, 40 per arm. The GEOD arm had improved stool consistency and a greater reduction in the number of stools compared to the SPD arm (p < 0.001). The relative risk (RR) of developing diarrhea in the GEOD arm was 0.059 (95% CI 0.015-0.229). There was a reduced risk of developing intestinal mucositis in the GEOD arm compared to the SPD arm [RR 0.202 (95% CI 0.102 - 0.399)]. The GEOD arm had greater improvements in functional and nutritional status (p < 0.001). CONCLUSIONS: GEOD had a protective effect in terms of the development of gastrointestinal toxicity associated with chemotherapy and radiotherapy treatment in patients with rectal cancer.
Glutamine , Rectal Neoplasms , Humans , Prospective Studies , Rectal Neoplasms/drug therapy , Rectal Neoplasms/radiotherapy , Diet , Diarrhea/etiology
Introduction: Spinal cord injury (SCI) can cause paralysis, for which effective therapeutic strategies have not been developed yet. The only accepted strategy for patients is rehabilitation (RB), although this does not allow complete recovery of lost functions, which makes it necessary to combine it with strategies such as plasma-synthesized polypyrrole/iodine (PPy/I), a biopolymer with different physicochemical properties than PPy synthesized by conventional methods. After SCI in rats, PPy/I promotes functional recovery. Therefore, the purpose of this study was to increase the beneficial effects of both strategies and identify which genes activate PPy/I when applied alone or in combination with a mixed scheme of RB by swimming and enriched environment (SW/EE) in rats with SCI. Methods: Microarray analysis was performed to identify mechanisms of action underlying the effects of PPy/I and PPy/I+SW/EE on motor function recovery as evaluated by the BBB scale. Results: Results showed robust upregulation by PPy/I in genes related to the developmental process, biogenesis, synapse, and synaptic vesicle trafficking. In addition, PPy/I+SW/EE increased the expression of genes related to proliferation, biogenesis, cell development, morphogenesis, cell differentiation, neurogenesis, neuron development, and synapse formation processes. Immunofluorescence analysis showed the expression of ß-III tubulin in all groups, a decreased expression of caspase-3 in the PPy/I group and GFAP in the PPy/I+SW/EE group (p < 0.05). Better preservation of nerve tissue was observed in PPy/I and PPy/SW/EE groups (p < 0.05). In the BBB scale, the control group scored 1.72 ± 0.41, animals with PPy/I treatment scored 4.23 ± 0.33, and those with PPy/I+SW/EE scored 9.13 ± 0.43 1 month after follow-up. Conclusion: Thus, PPy/I+SW/EE could represent a therapeutic alternative for motor function recovery after SCI.
Introducción: tanto en las mujeres con cáncer de mama y cáncer ginecológico como en los hombres con carcinoma prostático, los sofocos, la astenia y el insomnio son síntomas frecuentes y molestos que alteran la calidad de vida. Objetivo: evaluar la eficacia del aporte de triptófano como tratamiento de los sofocos, la astenia y el insomnio en pacientes con cáncer de próstata, de mama y cervicouterino. Materiales y métodos: estudio de intervención sin grupo de control en el Servicio de Oncología Radioterápica del HUCA, en el período de julio de 2018 a julio de 2019. Se incluyeron en total 60 pacientes con cáncer de próstata, de mama y cervicouterino que habían recibido tratamiento con radioterapia y hormonoterapia, y que presentaban sofocos, astenia e insomnio. Se administraron 3 g de L-triptófano al día. Resultados: se reportan un aumento significativo del valor del triptófano sérico al final del estudio (p < 0,001) y una disminución significativa de las puntuaciones de los síntomas estudiados; aunque no hemos hallado ninguna significación estadística entre ellos, sí se aprecia una mejoría significativa de cada uno de los síntomas, así como una mejoría de la calidad de vida (p < 0,001). Conclusiones: el estudio actual sugiere que, en los pacientes con cáncer de mama, de próstata o cervicouterino y síntomas de sofocos, astenia e insomnio, el aporte de triptófano como suplemento nutricional se tolera bien, mejora la calidad de vida y puede asociarse a una mejoría de los valores obtenidos en las escalas de los síntomas referidos, aunque no se demuestra ninguna relación estadísticamente significativa con la elevación del triptófano en sangre. (AU)
Introduction: in women with breast cancer and gynecologic cancer, as well as in men with prostate carcinoma, hot flashes, asthenia, and insomnia are common and bothersome symptoms that impair quality of life. Objective: to evaluate the effectiveness of tryptophan intake as a treatment for hot flushes, asthenia, and insomnia in patients with prostate, breast, and uterine cervical cancer. Materials and methods: intervention study without a control group at the HUCA Radiation Oncology Service, from July 2018 to July 2019. A total of 60 patients with prostate, breast, or uterine cervical cancer who had received treatment with radiotherapy and hormone therapy, and who presented with hot flushes, asthenia, and insomnia were included. L-tryptophan was administered at a dose of 3 g per day. Results: a significant increase in serum tryptophan levels at the end of the study (p < 0.001) and a significant decrease in the scores of the study symptoms were reported. Although statistical significance was not found, a significant improvement in each symptom was observed, as well as an improvement in quality of life (p < 0.001). Conclusions: the study suggests that, in patients with breast, prostate, or uterine cervical cancer, and symptoms such as hot flushes, asthenia, and insomnia, the administration of tryptophan as a nutritional supplement is well tolerated, improves quality of life, and is associated with improvement in the scale scores of the symptoms of interest, although no statistically significant relationship with increased blood tryptophan levels was found. (AU)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Tryptophan/therapeutic use , Prostatic Neoplasms/complications , Breast Neoplasms/complications , Uterine Cervical Neoplasms/complications , Dietary Supplements , Hot Flashes/drug therapy , Hot Flashes/etiology , Asthenia/drug therapy , Asthenia/etiology , Sleep Wake Disorders/drug therapy , Sleep Wake Disorders/etiology
INTRODUCTION: Introduction: in women with breast cancer and gynecologic cancer, as well as in men with prostate carcinoma, hot flashes, asthenia, and insomnia are common and bothersome symptoms that impair quality of life. Objective: to evaluate the effectiveness of tryptophan intake as a treatment for hot flushes, asthenia, and insomnia in patients with prostate, breast, and uterine cervical cancer. Materials and methods: intervention study without a control group at the HUCA Radiation Oncology Service, from July 2018 to July 2019. A total of 60 patients with prostate, breast, or uterine cervical cancer who had received treatment with radiotherapy and hormone therapy, and who presented with hot flushes, asthenia, and insomnia were included. L-tryptophan was administered at a dose of 3 g per day. Results: a significant increase in serum tryptophan levels at the end of the study (p < 0.001) and a significant decrease in the scores of the study symptoms were reported. Although statistical significance was not found, a significant improvement in each symptom was observed, as well as an improvement in quality of life (p < 0.001). Conclusions: the study suggests that, in patients with breast, prostate, or uterine cervical cancer, and symptoms such as hot flushes, asthenia, and insomnia, the administration of tryptophan as a nutritional supplement is well tolerated, improves quality of life, and is associated with improvement in the scale scores of the symptoms of interest, although no statistically significant relationship with increased blood tryptophan levels was found.
INTRODUCCIÓN: Introducción: tanto en las mujeres con cáncer de mama y cáncer ginecológico como en los hombres con carcinoma prostático, los sofocos, la astenia y el insomnio son síntomas frecuentes y molestos que alteran la calidad de vida. Objetivo: evaluar la eficacia del aporte de triptófano como tratamiento de los sofocos, la astenia y el insomnio en pacientes con cáncer de próstata, de mama y cervicouterino. Materiales y métodos: estudio de intervención sin grupo de control en el Servicio de Oncología Radioterápica del HUCA, en el período de julio de 2018 a julio de 2019. Se incluyeron en total 60 pacientes con cáncer de próstata, de mama y cervicouterino que habían recibido tratamiento con radioterapia y hormonoterapia, y que presentaban sofocos, astenia e insomnio. Se administraron 3 g de L-triptófano al día. Resultados: se reportan un aumento significativo del valor del triptófano sérico al final del estudio (p < 0,001) y una disminución significativa de las puntuaciones de los síntomas estudiados; aunque no hemos hallado ninguna significación estadística entre ellos, sí se aprecia una mejoría significativa de cada uno de los síntomas, así como una mejoría de la calidad de vida (p < 0,001). Conclusiones: el estudio actual sugiere que, en los pacientes con cáncer de mama, de próstata o cervicouterino y síntomas de sofocos, astenia e insomnio, el aporte de triptófano como suplemento nutricional se tolera bien, mejora la calidad de vida y puede asociarse a una mejoría de los valores obtenidos en las escalas de los síntomas referidos, aunque no se demuestra ninguna relación estadísticamente significativa con la elevación del triptófano en sangre.
Asthenia/drug therapy , Asthenia/etiology , Breast Neoplasms/complications , Dietary Supplements , Hot Flashes/drug therapy , Hot Flashes/etiology , Prostatic Neoplasms/complications , Sleep Initiation and Maintenance Disorders/drug therapy , Sleep Initiation and Maintenance Disorders/etiology , Tryptophan/therapeutic use , Uterine Cervical Neoplasms/complications , Female , Humans , Male , Quality of Life , Treatment Outcome
OBJECTIVES: To analyse the outcomes of patients undergoing Essure sterilization in a single institution, interns of complications and technique failure. PATIENTS AND METHODS: Retrospective descriptive study of 517 patients underwent definitive contraception with Essure device in outpatient hysteroscopy office without anesthesia and controlled at 3 months with abdominal radiography, ultrasonography and hysterosalpingography in selected cases. RESULTS: The success rates of the insertion of Essure was 96.8%, similar to data reported in the literature with 3.7% of vagal reactions, as most prevalent complication. 7 (1.35%) unintended pregnancies were observed. CONCLUSIONS: Essure is a permanent birth control device, with high rate of successful insertion and a low rate of complications. Unintended pregnancies in our study are high and we must change the protocols of placement and monitoring, considering hysterosalpingography as a routine control test.
Ambulatory Care/methods , Hysteroscopy , Sterilization, Tubal/methods , Adult , Female , Humans , Hysterosalpingography , Pregnancy , Pregnancy, Unplanned , Retrospective Studies , Treatment Failure , Treatment Outcome
OBJECTIVE: to identify subjects with impaired fasting glucose (IFG), from a group of apparently healthy individuals. METHODS: a cross-sectional study was undertaken in 1188 blood donors, with no family history of diabetes (T2D). All these individuals were subjected to a questionnaire, and biochemical tests. RESULTS: the prevalence of IFG was 15.9 %, 17.1 % in men and 12.9 % in women. The average blood glucose levels in subjects with IFG were 107.2 + or - 6.5 mg/dL in men and 106.0 + or - 6.1 mg/dL in women. Sixty percent of individuals with IFG showed insulin resistance. The diagnosis of metabolic syndrome (MS) in IFG subjects was 20.2 %, according to the NCEP/ATP III criteria, 21.4 % according to the International Diabetes Federation criteria; and 29.3 % according to the American Heart Association and the National Heart, Lung and Blood Institute criteria. Seventy percent of the subjects with IFG showed hypertriglyceridemia, 51 % showed hypercholesterolemia and 85 % were over-weight or obese. CONCLUSIONS: the prevalence of IFG was higher than expected, comparing with other populations reported in the literature. These apparently healthy subjects were not previously diagnosed and therefore have not received preventive actions to arrest the risk of T2D.
Blood Donors , Blood Glucose/analysis , Fasting , Glucose Metabolism Disorders/blood , Glucose Metabolism Disorders/diagnosis , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged
