Oxaliplatin-induced neuropathy and colo-rectal cancer patient's quality of life: Practical lessons from a prospective cross-sectional, real-world study.

BACKGROUND: Colon cancer is one the most common forms of cancer in both sexes. Due to important progress in the field of early detection and effective treatment, colon and rectal cancer survivors currently account for 10% of cancer survivors worldwide. However, the effects of anti-cancer treatments, especially oxaliplatin-based chemotherapy, on the quality of life (QoL) have been less evaluated. Although the incidence of severe chemotherapy-induced neuropathy (CIPN) in clinical studies is below 20%, data from real-world studies is scarce, and CIPN is probably under-reported due to patient selection and the patients' fear that reporting side-effects might lead to treatment cessation. AIM: To determine the impact of CIPN on QoL in colorectal cancer patients with a recent history of oxaliplatin-based chemotherapy. METHODS: We performed a prospective cross-sectional study in two major Romanian oncology tertiary hospitals-the Regional Institute of Oncology Iași (Iasi, Romania) and the Fundeni Clinical Oncology Institute (Bucharest, Romania). All consecutive patients with colon or rectal cancer, undergoing Oxaliplatin-based chemotherapy that consented to enroll in the study, were assessed by means of two questionnaires-the EORTC QQ-CR29 (quality of life in colon and rectal cancer patients) and the QLQ-CIPN20 (assessment of neuropathy). Several demographical, social, clinical and treatment data were also collected. Statistical analysis was performed by means of SPSS v20. The student t test was used to assess the relationship between the QLQ-CIPN20 and QLQ-CR29 results. Kaplan Meyer-curves were used to report 3-year progression-free survival (PFS) in patients that discontinued chemotherapy vs those that completed the recommended course. RESULTS: Of the 267 patients that fulfilled the inclusion criteria in the pre-specified time frame, 101 (37.8%) agreed to participate in the clinical study. At the time of the enrolment in the study, over 50% of the patients had recently interrupted their oxaliplatin-based chemotherapy, most often due to neuropathy. Almost 85% of the responders reported having tingling or numbness in their fingers or hands, symptoms that were associated with pain in over 20% of the cases. When comparing the scores in the two questionnaires, a statistically significant relationship (P < 0.001) was found between the presence of neuropathic symptoms and a decreased quality of life. This correlation was consistent when the patients were stratified by sex, disease stage, comorbidities and the presence of stoma or treatment type, suggesting that neuropathy in itself may be a reason for a decreased quality of life. At the 3 year final assessment, median recurrence-free survival in stage III patients was 26.88 mo. When stratified by completion of chemotherapy, median recurrence free-survival of stage III patients that completed chemotherapy was 28.27 mo vs 24.33 mo in patients that discontinued chemotherapy due to toxicity, a difference that did not reach statistical significance. CONCLUSION: CIPN significantly impacts QoL in colorectal cancer patients. CIPN is also the most frequent reason for treatment discontinuation. Physicians should actively assess for CIPN in order to prevent chronic neuropathy.

Chemometric Optimization of Biologically Active Compounds Extraction from Grape Marc: Composition and Antimicrobial Activity.

The article focuses on the optimization of the extraction process of biologically active compounds (BAC) from grape marc-a by-product of the wine industry. The influence of temperature, specifically 30 °C, 45 °C and 65 °C, and ethanol concentration in solutions, specifically 0-96% (v/v) on the extraction yield of polyphenols, flavonoids, tannins and anthocyanins, were investigated. The composition of individual polyphenols, anthocyanins and organic acids, antioxidant activity (DPPH and ABTS) and CIELab chromatic characteristics of the grape marc extracts (GME), were characterized. The microbiostatic and microbicidal effects in direct contact of GME with pathogenic microorganisms, Bacillus subtilis, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, were determined in vitro. The influence of extraction parameters on the total polyphenol content (TPC), total flavonoid content (TFC), tannin content (TC), total anthocyanin content (TAC) and their interdependencies were studied using information analysis. A mathematical model was developed on cubic spline functions. The analysis of individual compounds showed the presence of a wide range of flavonoids (procyanidin B2, procyanidin B1, hyperoside and quercetin), flavones (catechin), hydroxybenzoic acid derivatives (gallic, protocatechuic, p-hydroxybenzoic acids, m-hydroxybenzoic acid, syringic acid), hydroxycinic acid derivatives and ferulic acid methyl ester. The malvidol-3-glucoside was the main anthocyanin identified in the extract. A high amount of tartaric acid was also found. GME showed significant antimicrobial activity against Gram-positive bacteria and lower activity against Gram-negative bacteria.

The Influence of Temperature, Storage Conditions, pH, and Ionic Strength on the Antioxidant Activity and Color Parameters of Rowan Berry Extracts.

Recent trends in the food industry combined with novel methods in agriculture could transform rowan into a valuable raw material with potential technological applications. Thus, the aim of this research was to investigate the content of bioactive compounds in its fruits and to assess the color and antioxidant stability of the extracts prepared from such fruits during various thermal treatments and at different pH and ionic strength values. Various spectrophotometric methods, HPLC, and capillary electrophoresis were used to quantify the concentrations of bioactive compounds-polyphenols, carotenoids, organic acids, and to assess antioxidant activity and color. The results show that rowan berries contain circa 1.34-1.47 g/100 g of polyphenols among which include catechin, epicatechin, ferulic acid methyl ester, procyanidin B1, etc.; ca 21.65 mg/100 g of carotenoids including zeaxanthin, ß-cryptoxanthin, all-trans-ß-carotene, and various organic acids such as malic, citric, and succinic, which result in a high antioxidant activity of 5.8 mmol TE/100 g. Results also showed that antioxidant activity exhibited high stability when the extract was subjected to various thermal treatments, pHs, and ionic strengths, while color was mainly impacted negatively when a temperature of 100 °C was employed. This data confirms the technological potential of this traditional, yet often overlooked species.

Not just eosinophilic fasciitis.

This case report describes a rare case of progressive muscle weakness in a patient treated for eosinophilic fasciitis (EF) for many years before being diagnosed with a second autoimmune disease: dermatomyositis. Our case is a report of a 65-year-old male diagnosed with eosinophilic fasciitis 7 years before being evaluated in our service at Mayo Clinic in Jacksonville, Florida, due to progressive muscle weakness despite the chronic treatment with methotrexate. Contrast-enhanced magnetic resonance imaging of the lower extremity showed enhancement throughout the thigh musculature, which led us to pursue biopsies of the fascia and muscle in order to confirm the diagnosis of EF associated with myopathy. This case illustrates the need to consider the possibility of myopathy in patients diagnosed with EF whenever muscle weakness is more prominent than expected.

Rose Hips, a Valuable Source of Antioxidants to Improve Gingerbread Characteristics.

The present study analyzes the complex of bioactive compounds from rose hips pulp powder (RHP) obtained after separating the seeds from Rosa canina L. in order to obtain the oil. The extract prepared from RHP was characterized in terms of the total content of polyphenols, flavonoids, cinnamic acids, flavonols, carotenoids, but also the content of individual polyphenols and carotenoids, antioxidant activity, and CIELab color parameters. The effects of some salts, potentially present in foods, and pH variations were examined to predict possible interactions that could occur when adding rosehip pulp as a food component. The results turned out to be a high content of polyphenols, carotenoids and antioxidant activity. The main phenolic components are procyanidin B1, chlorogenic acid, epicatechin, procyanidin B2, gallic acid, salicylic acid, and catechin. The carotenoid complex includes all-trans-ß-carotene, all-trans-lycopene, zeaxanthin, α-cryptoxanthin, ß-cryptoxanthin, rubixanthin, cis-ß-carotene, cis-γ-carotene and cis-lycopene. The addition of CaCl2 and NaCl to the RHP extract reduced the antioxidant activity and the strong acidic environment (pH to 2.5) decreased the antioxidant activity by 29%. The addition of rose hip powder to gingerbread has improved its general characteristics, and increased its antioxidant activity and microbiological stability, the effects of 4% RHP being the most important.

Synthetic dye's substitution with chokeberry extract in jelly candies.

Matching the general trend of replacing synthetic additives with healthier natural products, the present research studies the effects of different concentrations of chokeberry extract which substitute carmoisine dye in jelly candies. Also, the colour and antioxidant properties of the aforementioned extract and their changes at various pH and in presence of different mineral salts from foods are analysed. The phenolic content of the extract was determined using HPLC and spectrophotometric methods. A high concentration of polyphenols was found in the chokeberry extract, of which around 97% were flavonoids. Catechin, epicatechin, ferulic acid and its methyl esther, protocatechuic, gallic and para-hydroxybenzoic acids were the major phenolics identified in the extract. The total antioxidant activity decreased in acidic media, while close-to-neutral and alkaline pH values did not exhibit any effect on this parameter. Furthermore, the green/red colour parameter, the chroma and the hue angle were enhanced in the most acidic media (pH 2.3 and 3.5). From the studied salts, CaCl2 and KNO3 had the most significant effects on colour. The chokeberry extract proved to be suitable as replacement of carmoisine dye in jelly candies, as the physicochemical and microbiological properties comply with the regulated requirements. More than that, the extract improved the antioxidant and sensory properties of jellies in all studied concentrations and the best total sensory score was obtained for 1.5% extract. After 5 and 50 days of storage, the microbiological properties were improved in candies prepared with aronia extracts compared to carmoisine, as the total viable count registered important diminutions.

Potential Application of Hippophae Rhamnoides in Wheat Bread Production.

Sea buckthorn (Hippophae rhamnoides) berries are well known for their content in bioactive compounds, high acidity, bright yellow color, pleasant taste and odor, thus their addition in a basic food such as bread could be an opportunity for modern food producers. The aim of the present research was to investigate the characteristics and the effects of the berry' flour added in wheat bread (in concentration of 1%, 3% and 5%) on sensory, physicochemical and antioxidant properties, and also bread shelf life. Berry flour contained total polyphenols-1467 mg gallic acid equivalents (GAE)/100 g, of which flavonoids-555 mg GAE/100 g, cinnamic acids-425 mg caffeic acid equivalents (CAE)/100 g, flavonols-668 mg quercetin equivalents (QE)/100 g. The main identified phenolics were catechin, hyperoside, chlorogenic acid, cis- and trans-resveratrol, ferulic and protocatechuic acids, procyanidins B1 and B2, epicatechin, gallic acid, quercetin, p- and m-hydroxybenzoic acids. The antioxidant activity was 7.64 mmol TE/100 g, and carotenoids content 34.93 ± 1.3 mg/100 g. The addition of berry flour increased the antioxidant activity of bread and the shelf life up to 120 h by inhibiting the development of rope spoilage. The obtained results recommend the addition of 1% Hippophae rhamnoides berry flour in wheat bread, in order to obtain a product enriched in health-promoting biomolecules, with better sensorial and antioxidant properties and longer shelf life.

Influence of pH and ionic strength on the color parameters and antioxidant properties of an ethanolic red grape marc extract.

The aim of present study was to investigate the influences of pH and several salts on the antioxidant activity and color of an ethanolic grape marc extract. Furthermore, the phenolic content of the extract was analyzed using HPLC and spectrophotometric methods while the total antioxidant activity was assessed by the reaction with ABTS radical. Gallic acid, procyanidins B1, B2, polydatin, catechin, epicatechin, hyperoside, ferulic, chlorogenic, and salicylic acids were among the main identified polyphenols. Different pH values had slight influence on the antioxidant activity, the highest value being determined for pH 3.7. The redness, chroma, and hue were significantly enhanced at pH 3.7 and 2.6. The chromaticity decreased at pH = 5.5 and pH = 7.4, so the extract should be used with care in products with such media. The presence of salts did not noticeably affect the antioxidant activity, except the higher concentrations of CaCl2 , which decreased the antioxidant activity but enhanced the color intensity. PRACTICAL APPLICATION: The data presented in this paper could be used for the development of a new food dye with antioxidant properties of natural origin. The optimal medium conditions (i.e., pH and ionic strength) for the use of an ethanolic red grape marc extract have been identified. The information could be used in product development and product formulation, especially when functional foodstuffs are envisaged. Consequently, this paper would be of significant interest for food chemists, food technologists, food manufacturers, and especially manufacturers of food dyes and all those using natural substances in their production process.

Bioanalysis of pentoxifylline and related metabolites in plasma samples through LC-MS/MS.

Analytical aspects related to the assay of pentoxifylline (PTX), lisofylline (M1) and carboxypropyl dimethylxanthine (M5) metabolites are discussed through comparison of two alternative analytical methods based on liquid chromatography separation and atmospheric pressure electrospray ionization tandem mass spectrometry detection. One method is based on a 'pure' reversed-phase liquid chromatography mechanism, while the second one uses the additional polar interactions with embedded amide spacers linking octadecyl moieties to the silicagel surface (C-18 Aqua stationary phase). In both cases, elution is isocratic. Both methods are equally selective and allows separation of unknowns (four species associated to PTX, two species associated to M1) detected through specific mass transitions of the parent compounds and owning respective structural confirmation. Plasma concentration-time patterns of these compounds follow typical metabolic profiles. It has been advanced that in-vivo formation of conjugates of PTX and M1 is possible, such compounds being cleaved back to the parent ones within the ion source. The first method was associated with a sample preparation procedure based on plasma protein precipitation by strong organic acid addition. The second method used protein precipitation by addition of a water miscible organic solvent. Both analytical methods were fully validated and used to assess bioequivalence between a prolonged release generic formulation and the reference product, under multidose and single dose approaches.

LC-MS/MS assay of quinapril and its metabolite quinaprilat for drug bioequivalence evaluation: prospective, concurrential and retrospective method validation.

BACKGROUND: The bioequivalence of two pharmaceutical formulations containing 10 mg quinapril was assessed by assaying the untransformed drug and its active metabolite quinaprilat from plasma samples. RESULTS: A gradient elution liquid chromatographic separation coupled to positive atmospheric pressure electrospray ionization and tandem mass spectrometry detection was used and validated. Sample preparation is simple and uses protein precipitation through addition of an acetonitrile:methanol (8:2 v/v) mixture. The method has a run time of 6.3 min. Carvedilol was used as an internal standard. The multiple reactions monitoring mode was used for both quantitation and structural confirmation of target compounds. Linear 1/x²-weighted regressions characterize detector response function up to concentrations of 1000 ng/ml for quinapril and 2000 ng/ml for quinaprilat. Low limits of quantitation of 5 ng/ml for quinapril and 10 ng/ml for quinaprilat were found. Intra- and inter-day variability of the results were found below 15%. Long- (-20°C/6 months) and short-term (25°C/48 h) stability of analytes in plasma, as well as freeze and thaw stability (six cycles) were demonstrated. CONCLUSION: The method was found to be selective, precise, accurate and robust when applied to a large number of unknown samples.

New substituted 2-(pyrazol-1-yl)-dialkylacetanilides with potential local anesthetic and antiarrhythmic action. Part II.

Nine substituted 2-(pyrazol-1-yl)-dialkylacetanilides were synthesized by N-alkylation of pyrazole and its derivatives with several 2-iodoacetanilides. The new compounds exhibited local anesthetic and antiarrhythmic actions. They have been characterized by elemental chemical analysis, UV-Vis, IR, 1H NMR, 13C NMR, SM spectra and pharmacology research.