1
|
Chung A, Ashok D, Avinashi V, Barkey J, Bortolin K, Burnett D, Chen B, Critch J, Drouin É, Griffin J, Hulst J, Marcon M, Martinez A, Persad R, Sherlock M, Huynh H. A150 MODERATE AGREEMENT IN ENDOSCOPIC DISEASE SCORING OF PEDIATRIC EOSINOPHILIC ESOPHAGITIS AMONG PEDIATRIC GASTROENTEROLOGISTS IN CANADA. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991383 DOI: 10.1093/jcag/gwac036.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Endoscopy is an important tool in assessing the severity of gastrointestinal diseases including Eosinophilic Esophagitis (EoE). Agreement regarding endoscopy outcomes is important when using tools such as the Endoscopic Reference Score for EoE (EREFS). Purpose Our goal was to determine interrater and intrarater agreement of EREFS among Canadian pediatric gastroenterologists. Method Survey-based study of interrater and intrarater reliability amongst pediatric gastroenterologists with interest in pediatric EoE. Participants were sourced from the Canadian Pediatric EoE Network. Participants were asked how many years of training they’ve had with endoscopy for pediatric EoE and their comfort in disease scoring for pediatric EoE. Pediatric EoE cases were identified from the pediatric EoE registry at the Stollery Children’s Hospital with an endoscopic video associated with each case. Participants were asked to score each video using the EREFS questionnaire for the proximal, middle and distal segments of the esophagus. 15 endoscopic videos were evaluated, with 3 cases provided each week over a period of 5 weeks. Additional data included ratings of the video quality and endoscopy quality. Of 15 cases, 12 were unique cases, distributed evenly in severity between no active disease to severe disease. 3 cases were repeated to assess intrarater reliability. The maximum grade of the proximal, middle and distal segments of the esophagus for each component endoscopic finding (edema, rings, exudates, furrows, strictures) were used for reliability calculations. Fleiss Kappa was calculated for all EREFS items and for each component endoscopic finding. Cohen’s Kappa was calculated to assess intrarater reliability. Result(s) Fifteen participants were recruited for the study. The participants had a median of 12 years (IQR: 7, 19) of clinical experience in endoscopy for pediatric EoE. The majority of participants were “comfortable” (i.e., 4 on 5-point scale) with EREFS scoring for pediatric EoE. Fleiss Kappa for all EREFS items was 0.481. For each component endoscopic finding (edema, rings, exudates, furrows, strictures), Fleiss Kappa was 0.365, 0.293, 0.548, 0.263, 0.445 respectively. Cohen’s Kappa had a median of 0.620 (IQR: 0.593, 0.704). The majority of raters rated video quality and endoscopy quality as “good” (i.e., 4 on 5-point scale). Conclusion(s) There is moderate interrater reliability in EREFS scoring for pediatric EoE. Interrater reliability was between fair to moderate for each component endoscopic finding. Intrarater reliability was good. This study shows there is room for improvement in disease scoring for pediatric EoE. This could be in the form of additional training, expert-defined conventions, or centralized reading which have reduced variability in endoscopic reporting for adult GI disease in past studies and could be used in a follow-up study to attempt to improve agreement. Additionally, incorporating EREFS into routine clinical practice may increase agreement amongst endoscopists. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
Collapse
|
2
|
Burnett D, Avinashi V, Hoang T, Otley A, Persad R, Sherlock M, Huynh H. A143 PEDIATRIC EOSINOPHILIC ESOPHAGITIS IN CANADA: A MULTI-CENTER COHORT WITH FOCUS ON THE STRICTURING PHENOTYPE. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991379 DOI: 10.1093/jcag/gwac036.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Eosinophilic esophagitis (EoE) is a chronic eosinophil-predominant esophageal inflammatory condition, and is now recognized as one of the most common organic causes of dysphagia in pediatrics. While fibrostenotic esophageal strictures are a common complication of adult EoE, characterization of the stricturing phenotype in pediatric EoE remains at an early stage. Purpose Describe the Canadian pediatric EoE experience, with focus on the stricturing phenotype. Method New pediatric EoE diagnoses from 2015-2018 were retrospectively identified in Vancouver (BC), Northern Alberta (AB), Hamilton (ON) and Nova Scotia (NS). Incidence rates were calculated using 2016 Federal census data. Clinical, endoscopic and histologic data were gathered for each patient’s initial clinical encounter and for any esophagogastroduodenoscopies (EGD) until the end of the follow-up period (fall 2019). Result(s) 332 new EoE cases were identified during the study period across all 4 sites. The incidence of EoE in patients less than 15 years old was 9.1 (AB), 6.5 (NS), 3.1 (BC) and 5.4 (combined) per 100,000 person-years. Incidence was not calculated for Hamilton due to risk of ascertainment bias given their catchment area overlaps with multiple other centers. Of identified cases, 40 (12.0%) had endoscopically-identified esophageal strictures at diagnosis or during the follow-up period, with a subset of 11 (3.3%) of these patients undergoing mechanical esophageal dilation. Another 11 (3.3%) patients had more subtle signs of esophageal narrowing (ex. mucosal rents), while the majority had no evidence of esophageal narrowing (281, 84.6%). The median age at diagnosis was higher in the cohort with strictures (12.4 years, IQR 8.9-14.1) than those without (10.3 years, IQR 6.1-13.6) but with wide IQR's. A similar trend was seen for the median duration of symptoms at diagnosis (1.5 years, IQR 0.5-3 versus 1.0 years, IQR 0.6-2.8). Patient reported food bolus impaction (OR 9.8, 95% CI 3.9-19.9) and dysphagia (OR 3.3, 95% CI 1.3-7.8) were associated with stricturing disease, with other symptoms less clearly linked. Trachealization was the endoscopic finding most closely associated with esophageal strictures (OR 5.7, 95% CI 2.8-11.5). Esophageal stricture(s) were noted on 72 EGDs, including 27 endoscopic esophageal dilations, but excluding 10 esophageal dilations by interventional radiology. Of the 65 EGDs done in follow-up of a known esophageal stricture (see Table), 4 of 31 had resolution of this finding post mechanical dilation, and 19 of 39 had resolution of the stricture after initiation of new medical or dietary treatments (without dilation). Conclusion(s) EoE is common in Canadian children, with esophageal strictures within a few years of diagnosis in 12% of cases. Interestingly, a large portion of strictures resolved without mechanical dilation, which seems to point away from fibrosis as the primary driver of esophageal strictures in this patient population. Please acknowledge all funding agencies by checking the applicable boxes below CAG, Other Please indicate your source of funding; Women and Children's Health Research Institute Disclosure of Interest None Declared
Collapse
|
3
|
Burnett D. Perceptions of Dietetics Majors Regarding Career Choices Including Foodservice Management. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.08.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
4
|
Duffrin M, Holben D, Evans R, c. Wang, Burnett D, Henes S, Baum A, De Chabert-rRos J, Diaz S. The FoodMASTER Initiative Deep South Network: Impacting STEM Education Learning Environments with Food-Based Activities. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.08.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
5
|
Ross P, Nikfarjam M, Nguyen N, Aghmesheh M, Burnett D, Wasan H, Turner D, Croagh D. SO-2 Comparison of resected vs non-resected patients with unresectable locally advanced pancreatic cancer (LAPC) receiving P-32 microparticles with gemcitabine/nab-paclitaxel or FOLFIRINOX chemotherapy in the PanCO study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
6
|
Mermis J, Barry A, Bustos A, Burnett D. 260: Feasibility of telehealth-based aerobic exercise training program for adults with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01685-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
7
|
Burnett D, Evans R. Barriers to Evaluating Psychological Factors Related to Food and Weight Concerns Reported by US Registered Dietitians. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
8
|
Bortolin KA, Ashok D, Avinashi V, Barkey J, Burnett D, Critch J, Drouin E, Griffin J, Huynh H, Marcon P, Martinez A, Persad R, Sherlock M, Waterhouse C, Hulst JM. A14 WIDE VARIATION IN CLINICAL MANAGEMENT OF PAEDIATRIC EOSINOPHILIC ESOPHAGITIS: A CANADIAN EXPERIENCE. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Eosinophilic esophagitis (EoE) is a chronic disorder treated by food elimination diet (FED), topical steroids and/or proton-pump inhibitors (PPI). Serial endoscopies and biopsies assess response to therapy. EoE management has evolved as guidelines are updated.
Aims
To identify practice variation among Canadian paediatric gastroenterologists (PG) who care for children with EoE.
Methods
An online survey using REDCap about decision-making in children with EoE was distributed to PG in Canada in November 2020.
Results
62 PG completed the survey (response rate 69%, 62/94). The majority work in academic centres (92%). 3 centers indicated an accrual of >50 new patients per year; 9/16 centres have >100 patients in follow-up. An EoE Clinic is present in 5 centres.
Diagnosis: Familiarity with the 2018 AGREE and 2020 AGA EoE guidelines was found to be 57% and 67% respectively. Criteria required to diagnose EoE according to current guidelines were correctly indicated by 42% of PG. (Figure 1).
Endoscopy: The majority of PG (95%) adhere to guidelines in terms of required number and location of biopsies for the initial diagnosis. Ideal timing of repeat endoscopy after change in therapy in patients who are not in histological remission was 8–12 weeks by 67% of PG, timing in stable patients on maintenance therapy varied (33% only if patient is symptomatic). 25% used the EREFS Score in reporting endoscopic findings.
Therapy: Improvement of symptoms was the highest ranked goal (64%), followed by remission of histologic findings (30%). A treatment algorithm was in place in 4 centers. The majority routinely assess adherence to therapy (73%) and consult a dietitian for FED (77%). Most (87%) do not consult an allergist for initial management. Preferred choices of 1st-line therapy varied among PG (Figure 2). When FED was selected, 32% of PG started with 1 food, 32% started with 2 foods, most frequently excluding dairy, followed by wheat. 14 (26%) start with ≥6 FED. Prescription of budesonide slurry was consistent among PG with doses of 1 and 2 mg/day in children <10 and >10 years, respectively.
Conclusions
The is the first Canadian study to assess the variation in management of children with EoE by PG. Overall, PG demonstrated good adherence to the guidelines in terms of initial diagnosis, but differences in maintenance therapy choice and timing of endoscopies. The results highlight a need for standardized management algorithms to deliver uniform care to this growing group. Grounding these guidelines in evidence will warrant a significant investment in further paediatric EoE research.
Funding Agencies
None
Collapse
|
9
|
Burnett D, Tolman A, Bloser P. Perceptions of U.S. Registered Dietitian Nutritionists on Performance and Value of Certified Dietary Managers. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
10
|
Burnett D, Persad R, Huynh HQ. A196 INCIDENCE OF PEDIATRIC EOSINOPHILIC ESOPHAGITIS IN EDMONTON ZONE AND RISK OF STRICTURING AT DIAGNOSIS. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Eosinophilic esophagitis (EoE) is a common cause of esophageal dysfunction in children. A subset of children have a more severe phenotype of EoE, complicated by esophageal stricturing. Limited work has been done to characterize this phenotype.
Aims
To determine the incidence of EoE, and the frequency of esophageal stricturing in pediatric EoE.
Methods
We retrospectively identified all new cases of EoE at the Stollery Children’s Hospital from 2015–2018 using esophageal biopsy reports for the province of Alberta (CoPath database), EoE clinic lists and an OR database for esophageal dilatation at the Stollery. Electronic medical records (EMR) were reviewed to confirm EoE diagnosis. For each confirmed case, clinical data was captured from the outpatient EMR and gastroscopy/pathology reports. A review of peri-endoscopy OR/nursing charts was performed on a subset of patients (n=75) to capture scope adverse event. Statistics Canada 2016 census data was used to calculate incidence rates.
Results
185 new cases of EoE were diagnosed at our center during the study period (see table). For patients < 15 years old living in Edmonton zone (n=73), the incidence over the 4 years was 11.1 cases per 100,000 person years {8.7 (0–4 year-old), 7.6 (5–9 year old), and 18.1 (10–14 year old)}. There was limited variation in incidence in the 4 years (9.1–12.1 per 100,000 person years). 8 of 185 (4%) patients had endoscopically confirmed esophageal strictures, 4 of which required mechanical dilation (mean 3.75 dilations per patient, range 1–6). 11/185 (5.9%) patients had more subtle signs of esophageal narrowing, but no strictures. No perforations or episodes of significant bleeding were reported in peri-endoscopy charts reviewed for 239 gastroscopes, including 16 dilations. Pain was reported after 15% of all scopes, including 50% of the 28 scopes with strictures and 63% of the 16 scopes involving dilations.
Conclusions
Edmonton zone has one of the highest incidences of EoE reported in children. In this cohort, 4% had esophageal stricture (half required dilatation) and 5.9% had more subtle narrowing. Patients with strictures were older, had more frequent food impaction and longer duration of symptoms (Table). This data will be included in an ongoing multicenter case-control study across Canada.
Funding Agencies
CAGWomen and Children’s Health Research Institute (Univ. Alberta)
Collapse
|
11
|
Burnett D, Carney MA, Carruth L, Chard S, Dickinson MX, Gálvez A, Garth H, Hardin J, Hite A, Howard H, Manderson L, Mendenhall E, Saldaña-Tejeda A, Simmons D, Vasquez E, Vasquez E, Warin M, Yates-Doerr E. Anthropologists Respond to The Lancet EAT Commission. BIONATURA 2020. [DOI: 10.21931/rb/2020.05.01.2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The Lancet Commissions are widely known as aspirational pieces, providing the mechanisms for consortia and networks of researchers to organize, collate, interrogate and publish around a range of subjects. Although the Commissions are predominantly led by biomedical scientists and cognate public health professionals, many address social science questions and involve social science expertise. Medical anthropologist David Napier was lead author of the Lancet Commission on Culture and Health (2014), for example, and all commissions on global health (https://www.thelancet.com/global-health/commissions) address questions of social structure, everyday life, the social determinants of health, and global inequalities.
Collapse
|
12
|
Burnett D, Evans R. Evaluating Psychological Factors Related to Food and Weight Concerns: 10-Year Follow-up Study with US Registered Dietitian Nutritionists. J Acad Nutr Diet 2019. [DOI: 10.1016/j.jand.2019.08.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
13
|
Kumar N, Kumar N, Karvonen-Gutierrez C, Musch DC, Musch DC, Harlow S, Burnett D, Valenzuela C, Woodward MA, Shtein R, Niziol LM, Moroi SE. Validity of the Titmus Vision Screener: A Comparison with the Snellen Chart. ACTA ACUST UNITED AC 2019. [DOI: 10.14302/issn.2470-0436.jos-19-2693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Given limited knowledge regarding validity of the Titmus vision screener, we sought to compare visual acuity measurements obtained from the Titmus with that from the Snellen chart and assess the validity properties of the Titmus as a screening instrument to detect vision impairment. Visual acuity was measured in 150 participants recruited from an academic ophthalmology practice, using the Snellen chart as well as the Titmus vision screener. Visual acuities from the Titmus and Snellen were compared and validity of the Titmus vision screener was assessed by computing sensitivity and specificity. Using Snellen visual acuity as the reference standard, the sensitivity of the Titmus vision screener to detect vision impairment, defined as visual acuity worse than 20/40, was 92% (95% CI (72.5, 98.6)) and the specificity was 64% (95% CI (57.9, 70.1)). Comparisons of the precise visual acuity level revealed poor agreement between the two methods (weighted Kappa: 0.15, 95% CI (0.08, 0.21)). Visual acuities obtained from the Titmus were, on average, two lines worse than Snellen visual acuities. ((logMAR Snellen – logMAR Titmus) = - 0.19 ± 0.29, 95% confidence interval (CI) (-0.23, -0.16)). Titmus vision screener is a sensitive tool to detect visual impairment. However high false positive results and poor agreement with Snellen limits its widespread use in clinical applications.
Collapse
|
14
|
Burnett D, Kao DH, Yap J, Turner J. A157 FECAL MICROBIOTA TRANSPLANT FOR RECURRENT CLOSTRIDIUM DIFFICILE INFECTION: A SINGLE CENTER PEDIATRIC EXPERIENCE. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
15
|
Chase C, Rude B, Cavinder C, Zoller J, Burnett D. 465 Effect of forage quality on muscle glycogen utilization by exercised horses. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
16
|
Thompson R, McCarty K, Lemire R, Pannell K, Owen M, Lemley C, Burnett D. PSXV-37 Effect of maternal melatonin supplementation during late gestation on relative expression of adipogenic genes in adipose tissue and skeletal muscle of bovine fetuses at 240 days of gestation. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
17
|
Burnett D, Lee Y. Assessing the Effectiveness of ServSafe® Online: A Pilot Study. J Acad Nutr Diet 2018. [DOI: 10.1016/j.jand.2018.06.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
18
|
Hu X, Racek A, Bellile E, Nascimento T, Bender M, Toback R, Burnett D, Khatib L, McMahan R, Kovelman I, Ellwood R, DaSilva A. Brain Functional Changes before, during, and after Clinical Pain. J Dent Res 2018; 97:523-529. [DOI: 10.1177/0022034517750136] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
19
|
Holtcamp A, Sukumaran A, Karisch B, Burnett D, Dinh T. Color, Metmyoglobin Reductase Activity, and Lipid Oxidation in Ground Beef Patties during Retail Display from Angus Steers Fed Endophyte-Infected Tall Fescue Seeds. MEAT AND MUSCLE BIOLOGY 2018. [DOI: 10.22175/rmc2018.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
20
|
Burnett D, Evans R. Changes from 2008 to 2013 in US RD Interest and Preferred Format for Continuing Professional Education Related to Evaluating Psychological Factors Related to Food and Weight Concerns and Making Referrals. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
21
|
Burnett D, Evans R. Changes in Factors Influencing U.S. Registered Dietitians' Intentions to Make Referrals for Psychological Factors Related to Food and Weight Concerns. J Acad Nutr Diet 2016. [DOI: 10.1016/j.jand.2016.06.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
22
|
Coble K, Burnett D, Goodband RD, Gonzalez JM, Usry JL, Tokach MD, Pluske J, DeRouchey JM, Woodworth JC, Dritz SS, Flohr JR, Vaughn MA. 299 Effect of diet type and added copper on growth performance, carcass characteristics, total tract digestibility, gut morphology, and mucosal mRNA expression of finishing pigs. J Anim Sci 2016. [DOI: 10.2527/msasas2016-299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
23
|
Woodhouse L, Adams S, Burnett D, Casazza G, Chandler C, Domek J, Gustafson M, Keim N, Sheets C, Souza E. Effects of a Hypocaloric Diet and Exercise Intervention on Circulating Zinc and Inflammatory Markers in Obese, Sedentary, Insulin‐Resistant Women. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.761.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
24
|
Coad J, Canela-Oleaga J, Bautista-Sturla C, Grisez B, Neil B, Malecki W, Burnett D. A Novel Minimally Invasive Endometrial Cryoablation Device: Validation in Extirpated Human Uteri. J Minim Invasive Gynecol 2013. [DOI: 10.1016/j.jmig.2013.08.147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
25
|
Burnett D, Klemp JR, Porter C, Schmitz KJ, Fabian CJ, Kluding P. Abstract P2-11-17: Pilot Study to Evaluate a Home-based Exercise and Weight Loss Intervention on Cardiopulmonary Fitness and Markers of Breast Cancer Risk in Postmenopausal Breast Cancer Survivors. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p2-11-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: BrCa survivors have an estimated 4-fold increase in risk for developing cardiovascular disease compared to women never treated for breast cancer and a nearly 3-fold increase in breast cancer mortality in women with an exercise capacity (VO2max) less than 28mL kg−1 min−1. Cardiac events are the second most common cause of death in long-term breast cancer (BrCa) survivors.
Purpose: We conducted a study to investigate the effects of standard exercise or structured exercise on targeted cardiovascular outcomes during a home-based diet and exercise intervention for breast cancer survivors.
Method: Cross-sectional within- and between-group design. A total of 19 breast cancer survivors, average age of 52.6+/−9.3, were enrolled in the study. A convenient sample was enrolled into two exercise groups receiving either: standard (150 minutes per week of usual care (exercise without instruction) cardiovascular exercise + resistance training) or structured (150 minutes per week of gradual increased intensity cardiovascular exercise + resistance training) exercise instruction along with a group based behavioral weight loss intervention. All participants underwent baseline and 17 week assessments including maximal exercise testing (VO2max and minutes on the treadmill), measurements of body composition (weight, BMI, % body fat), and assessment of quality of life.
Results: We report on the 16 participants who completed the baseline and 17 week assessments (9 = Standard Exercise Group; 7 = Structured Exercise Group). The structured exercise group exhibited significantly greater improvements in measures of cardiorespiratory fitness: VO2max (p = 0.05) and duration on treadmill (p = 0.02). No significant differences were noted for all other cardiorespiratory fitness testing outcomes. Significant improvements from baseline to 17 weeks were seen across both groups for all measures of body composition. Lean body mass did not significantly change from baseline to 17 weeks in both groups. There were no significant between group differences for change in body composition.
Conclusion: In this study, both standard exercise and structured exercise improved CR fitness measured by VO2max, but the structured exercise group experienced significantly greater improvements.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-11-17.
Collapse
|