Influence of Androgen Deprivation Therapy on the Development of Sarcopenia in Patients with Prostate Cancer: A Systematic Review

The changes in body composition during androgen deprivation therapy (ADT) in patients suffering from prostate cancer (PCa) are recognized by professionals more often as biomarker for effective treatment. The aim of this study was to investigate the impact of ADT on the sarcopenia development in PCa. The following databases were used: PubMed, Embase, Web of Science and Scopus databases. Out of 2183 studies, 7 were included in this review. The fixed-effect model was used in the meta-analysis. A significant increase in SATI (Subcutaneous Adipose Tissue Index) of 0.32 (95% CI: 0.13-0.51) p = 0.001, decrease in SMI (Skeletal Muscle Index) of -0.38 (95% CI: -0.57 to -0.19) p < 0.0001, and SMD (Skeletal Muscle Density) of -0.46 (95% CI: -0.69 to -0.24) p < 0.0001 were observed. No statistical association was visible between ADT and changes in BMI (Body Mass Index), 0.05 (95% CI: -0.18-0.28), p = 0.686, and VATI (Visceral Adipose Tissue Index): 0.17 (95% CI: -0.02 to 0.37), p = 0.074. In conclusion, the ADT significantly contributes to the body composition changes and sarcopenia development.

Prognostic factors in patients with uterine sarcoma: the SARCUT study

OBJECTIVE

Uterine sarcomas are a rare and heterogeneous group of malignancies that include different histological sub-types. The aim of this study was to identify and evaluate the impact of the different prognostic factors on overall survival and disease-free survival of patients with uterine sarcoma.

METHODS

This international multicenter retrospective study included 683 patients diagnosed with uterine sarcoma at 46 different institutions between January 2001 and December 2007.

RESULTS

The 5-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma, and adenosarcoma was 65.3%, 78.3%, 52.4%, and 89.5%, respectively, and the 5-year disease-free survival was 54.3%, 68.1%, 40.3%, and 85.3%, respectively. The 10-year overall survival for leiomyosarcoma, endometrial stromal sarcoma, undifferentiated sarcoma and adenosarcoma was 52.6%, 64.8%, 52.4%, and 79.5%, respectively, and the 10-year disease-free survival was 44.7%, 53.3%, 40.3%, and 77.5%, respectively. The most significant factor associated with overall survival in all types of sarcoma except for adenosarcoma was the presence of residual disease after primary treatment. In adenosarcoma, disease stage at diagnosis was the most important factor (hazard ratio 17.7; 95% CI 2.86 to 109.93).

CONCLUSION

Incomplete cytoreduction, tumor persistence, advanced stage, extra-uterine and tumor margin involvement, and the presence of necrosis were relevant prognostic factors significantly affecting overall survival in uterine sarcoma. The presence of lymph vascular space involvement and administration of adjuvant chemotherapy were significantly associated with a higher risk of relapse.

Microbiome Composition in Microscopic Colitis: A Systematic Review

Believed to be a rare cause of chronic diarrhoea, microscopic colitis (MC) is a condition with rising incidence. Many prevalent risk factors and the unknown pathogenesis of MC rationalise the need for studies on microbiota composition. PubMed, Scopus, Web of Science and Embase were searched. Eight case-control studies were included. The risk of bias was assessed with the Newcastle-Ottawa Scale. Clinical details on the study population and MC were poor. The most consistent result among the studies was a decreased Akkermansia genus in faecal samples. Other results were inconsistent due to the different taxonomic levels of the outcomes. Possible changes in different taxa were observed in patients who suffered from MC compared to healthy controls. The alpha diversity compared between MC and the diarrhoea control may suggest potential similarities. The beta diversity in MC compared to healthy and diarrhoeal populations showed no significant outcomes. The microbiome composition in MC possibly differed from the healthy control, but no agreement regarding taxa was made. It might be relevant to focus on possible factors influencing the microbiome composition and its relationship with other diarrhoeal diseases.

Androgen Deprivation Therapy for Prostate Cancer Influences Body Composition Increasing Risk of Sarcopenia

Computed tomography (CT) scans used in treatment response assessment in prostate cancer (PCa) patients are a useful tool for nutritional status evaluation. The aim of this study was to assess the nutritional status, including sarcopenia development based on CT scans, in PCa patients and its association with progression-free survival (PFS). Sixty-four PCa patients were included (group 1: 34 patients undergoing androgen deprivation therapy (ADT) with docetaxel due to newly diagnosed, hormone-sensitive, metastatic PCa and group 2: 30 patients with castration-resistant metastatic PCa continuing ADT therapy with enzalutamide or abiraterone acetate). Nutritional status was evaluated with anthropometrical parameters, Nutritional Risk Score (NRS), and CT scans at the L3 vertebrae. Survival analyses were performed. According to NRS, nutritional status was significantly related to PFS. In both groups, there was a significant reduction in muscle tissue (total muscle tissue and skeletal muscle index). A significant increase in the distribution of adipose tissue (subcutaneous fat, visceral fat, subcutaneous adipose tissue index, and visceral adipose tissue index) in group one was observed. Sarcopenia was diagnosed in patients but with no influence on PFS. Significant reduction in muscle mass and increase in fat mass was observed in patients treated for PCa with no impact on PFS. The NRS was related to PFS in PCa patients and associated with body composition, assessed by CT after the castration therapy. Long-term castration combined with abiraterone therapy with prednisone or enzalutamide significantly influenced muscle tissue and may lead to sarcopenia development.

Influence of Probiotics in Prevention and Treatment of Patients Who Undergo Chemotherapy or/and Radiotherapy and Suffer from Mucositis, Diarrhoea, Constipation, Nausea and Vomiting

The administration of probiotics to patients treated with chemo- and/or radiotherapy is assumed to be beneficial. The aim of this study was to evaluate the effects of probiotic intake on the severity of selected gastrointestinal side effects of chemotherapy and radiotherapy. The searched databases included PubMed, Web of Science, and Scopus from which twenty-one studies were included. Most of them concerned diarrhoea, however, two of the studies examined constipation, another two nausea and vomiting, and eight of the included studies regarded mucositis. The total number of patients equalled 2621. The time of the conducted therapy, the administered species, neoplasm pathology, and adjuvant therapy varied. The outcome was assessed by gathering information about the statistical significance of the improvements. An enhancement was observed in thirteen studies, where probiotics had a significant impact on each of the included chemo- and/or radiotherapy side effects. However, the heterogeneity of the assessed data makes it impossible to state a firm conclusion.

Influence of Gluten-Free Diet on Gut Microbiota Composition in Patients with Coeliac Disease: A Systematic Review

The aim of this study was to assess the changes in microbiota composition during a gluten-free diet (GFD) in coeliac disease (CD) patients. The systematic search followed databases such as PUBMED (MEDLINE), SCOPUS, WEB OF SCIENCE and EMBASE. Out of 843 initially screened papers, a total number of 13 research papers were included. A total of 212 patients with CD on GFD, in comparison to 174 healthy individuals and 176 untreated patients with CD, were examined. Analysis of the microbial community based primarily on faecal samples and duodenal biopsies. Bifidobacterium was noticed to be less abundant in the study group than in both control groups, while the abundance of Bacteroides was more numerous in the group of CD patients on GFD. Staphylococcaceae prevailed in untreated CD patients. Despite the fact that the GFD was not able to fully restore commensal microorganism abundance, the treatment was associated with the greater abundance of selected beneficial bacteria and lower presence of pathogenic bacteria associated with worsening of CD symptoms.

Association between Anxiety, Depressive Symptoms, and Quality of Life in Patients Undergoing Diagnostic Flexible Video Bronchoscopy

Bronchoscopy is one of the basic invasive procedures in pulmonology accompanied by patients’ anxiety. This study aimed to find an association between predictors of state anxiety/depression and patient’s quality of life (QOL) with pulmonary symptoms undergoing diagnostic flexible video bronchoscopy (FVB). A total of 125 adult patients before FVB were included in a prospective observational study. The quality of life (QOL) was assessed by WHOQOL-BREF questionnaire, the depression possibility by the Beck’s Depression Inventory-II (BDI-II), and the anxiety level by Spielberger’s State-Trait Anxiety Inventory (STAI-S; STAI-T). Results show that the older patients and patients with more comorbidities showed a significantly higher anxiety level. The previous FVB under deep sedation significantly reduced state anxiety. A significantly positive association was found between the STAI score and total BDI-II score. More severe symptoms of anxiety were especially related to lower QOL (physical health, psychological and environmental domains) in patients. Statistically higher trait anxiety in lower social QOL domain scores was observed. Our findings show that high state and trait anxiety were associated with higher depression scores and lower quality of life in the elderly. It seems that the elderly and patients at risk of depression development require more attention in the clinical setting to minimize the anxiety accompanying the bronchoscopy.

Should the dosage of propofol be higher and independent of immunosuppressive therapy in adult cystic fibrosis patients undergoing sedation during flexible video bronchoscopy?

OBJECTIVE

Flexible video bronchoscopy (FVB) performed under sedation is a useful procedure in adults with cystic fibrosis (CF). Propofol dosage for CF is poorly described, although it is of high importance for professionals. The study aimed to assess whether propofol dosage should be higher in adults CF undergoing sedation during FVB.

PATIENTS AND METHODS

50 adult CF and non-CF patients undergoing sedation during FVB were included. Clinical features of studied patients were assessed. In CF group spirometry, liver enzymes, inflammatory biomarkers, albumin, protein concentration, WBC were estimated. Propofol and fentanyl dosage was calculated. Multiple regression model was performed.

RESULTS

CF patients were characterized by a lower mean value of body weight and lower mean requirement of total propofol (135 mg in CF vs. 145 mg in non-CF). Calculated propofol dose per kg of body weight was significantly higher in CF (2.43 mg/kg vs. 2.04 mg/kg) and did not depend on the bronchopulmonary disease stage. Propofol dose per kg of body weight was predicted by CF status (CF vs. non-CF), sex, and age.

CONCLUSIONS

Adult CF patients not receiving immunosuppressive therapy require higher propofol dose per kg of body weight compared to non-CF, independently on bronchopulmonary disease stage showing a narrow therapeutic window for propofol in CF group.

Interventions Preventing Vaginitis, Vaginal Atrophy after Brachytherapy or Radiotherapy Due to Malignant Tumors of the Female Reproductive Organs-A Systematic Review

BACKGROUND

Radiotherapy, as a method of treatment of cervical and uterine cancers, may induce severe late-onset vaginal side effects. Unfortunately, little evidence on the management of adverse effects has been presented. This study aimed to evaluate the available interventions which reduce symptoms of vaginitis and vaginal atrophy by improving dyspareunia, mucosal inflammation, vaginal pH and vaginal dryness in women who have undergone brachytherapy or radiotherapy due to uterine or cervical malignancies.

MATERIALS AND METHODS

A comprehensive literature search was performed following PRISMA guidelines. The systematic search was conducted using electronic databases, namely Scopus, Web of Science and PubMed, between October and November 2020 to identify randomized controlled trials (RCT) and, prospective randomized studies (PRS).

RESULTS

The analyzed population consists of 376 patients with uterine or cervical cancer, treated with hyaluronic acid, vitamin A, vitamin E, alpha-tocopherol acetate and dienestrol. Intervention with HA along with vitamin A and vitamin E revealed advantage in endpoints such as reduced dyspareunia, vaginal mucosal inflammation, vaginal dryness, bleeding, fibrosis and cellular atypia. Administration of alpha-tocopherol acetate reduced vaginal mucosal inflammation and improved vaginal acanthosis, whereas dienestrol resulted in reduced dyspareunia, vaginal caliber and bleeding.

CONCLUSIONS

Vaginal suppositories were found to be clinically effective at the management of late-onset vulvovaginal side effects after radiotherapy.

Role of Probiotics in Modulating Human Gut Microbiota Populations and Activities in Patients with Colorectal Cancer-A Systematic Review of Clinical Trials

BACKGROUND

Growing attention has been given to the role of nutrition and alterations of microbial diversity of the gut microbiota in colorectal cancer (CRC) pathogenesis. It has been suggested that probiotics and synbiotics modulate enteric microbiota and therefore may be used as an intervention to reduce the risk of CRC. The aim of this study was to evaluate the influence of probiotics/synbiotics administration on gut microbiota in patients with CRC.

METHODS

PubMed, Scopus, and Web of Science were searched between December 2020 and January 2021. Randomized controlled trials (RCTs) recruiting adults with CRC, who have taken probiotics/synbiotics for at least 6 days were included. Changes in gut microbiota and selected biochemical and inflammatory parameters (i.e., hsCRP, IL-2, hemoglobin) were retrieved.

RESULTS

The search resulted in 198 original research articles and a final 6 were selected as being eligible, including 457 subjects. The median age of patients was 65.4 years old and they were characterized by the median BMI value: 23.8 kg/m². The literature search revealed that probiotic/synbiotic administration improved enteric microbiota by increasing the abundance of beneficial bacteria such as Lactobacillus, Eubacterium, Peptostreptococcus, Bacillus and Bifidobacterium, and decreased the abundance of potentially harmful bacteria such as Fusobacterium, Porhyromonas, Pseudomonas and Enterococcus. Additionally, probiotic/synbiotic intervention improved release of antimicrobials, intestinal permeability, tight junction function in CRC patients.

CONCLUSIONS

The use of probiotics/synbiotics positively modulates enteric microbiota, improves postoperative outcomes, gut barrier function and reduces inflammatory parameters in patients suffering from CRC.

Dietary and cardio-metabolic risk factors in patients with Obstructive Sleep Apnea: cross-sectional study

Background

Little is known about the role of dietary intake in obstructive sleep apnea (OSA), which could prove important in improving clinical outcomes for people with obesity and/or cardiovascular disease within these populations. Reduction in energy intake typically results in weight loss, markedly improving metabolic parameters and ameliorating OSA severity. The aim of this study was to evaluate the association of dietary and cardio-metabolic risk factors with OSA severity.

Methods

This was a cross-sectional study. A total of 75 volunteers at risk of OSA were recruited from 153 patients suffering from sleep disturbance at the Department of Pulmonology, Allergology and Respiratory Oncology at the Poznan University of Medical Sciences. Polysomnography was used for OSA diagnosis. Sleep quality was assessed by the Pittsburgh Sleep Quality Index. Blood pressure, parameters of glucose (fasting glucose, glucose tolerance test) and lipid metabolism (TC, LDL-C, HDL-C, TG) were assessed using routine enzymatic methods. Dietary intake was evaluated by 24-hr dietary recalls and Food Frequency Questionnaire. Ordinal logistic regression models were used for association of background characteristics and dietary intake with OSA severity. All analyses were adjusted for age, sex, BMI, smoking and alcohol intake.

Results

A higher percentage of smokers were observed in patients with mild OSA, while alcohol intake was the highest in severe OSA patients. Approximately 60% of the studied patients were self-reported poor sleepers. Results from ordinal logistic regression models showed that higher intakes of alcohol intake were associated with increased odds of severe OSA; whereas higher HDL-C levels were associated with lower odds (OR 0.01; 95% CI [0.0003–0.55]). Significantly higher odds of high OSA severity were observed in patients with disturbed sleep stages and obstructive sleep apnea. Moreover, the investigation of nutrient intake in relation to OSA severity showed that a higher intake of dietary fiber was associated with decreased OSA severity (OR 0.84; 95% CI [0.71–0.98]).

Conclusions

The severity of OSA is related to higher alcohol consumption and disturbed sleep. The significantly lower dietary fiber intake in patients with severe OSA is of particular importance for dietary consulting in clinical practice, which may positively influence cardiometabolic outcomes.

An analysis of the meal pattern at the nutrient level in Polish women

BACKGROUND

Before the 1990's, access to a variety of foods in Eastern Europe was limited, which could have influenced the currently analyzed dietary behaviors pertaining to overweight and obesity development. The aim of this study was to describe the daily profile of meal patterns in Polish women aged 50-70 at the nutrient level.

METHODS

The anthropometrical parameters of four-hundred and fifty Polish women aged 50-70 were assessed. Three 24-hour dietary recalls and validated questionnaires regarding socio-demographic-economic status and meal frequency were applied. Timing in food intake was considered as follow: 6:00-8:59 CET - breakfast, 9:00-11:59 CET - morning snacks, 12:00-14:59 CET - lunch, 15:00-17:59 CET - afternoon snacks, 18:00-21:00 CET - dinner. Statistical analyses were conducted using Tukey's multiple comparison tests and discriminant analysis.

RESULTS

No statistically significant differences were found in socio-demographic-economic and anthropometrical characteristics between women categorized to differentiated meal frequency intakes. However, the subjects from the 5-meal-per-day group were characterized by higher anthropometrical parameters, the statistically lowest percentage of regularity in meal consumption and skipping meals related to shortest breaks between meals. At the nutrient level, potassium, niacin, vitamin E and vitamin D were selected in the discriminant analysis as the nutrients most strongly related to different dietary behaviors.

CONCLUSIONS

Our findings did not provide sufficient evidence that diverse nutrient intake could lead to the development of a specific nutritional profile in Polish women.

Independent psychometric validation of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Endometrial Cancer Module (EORTC QLQ-EN24)

The endometrial cancer (EC)-specific Quality of Life module of the European Organization for Research and Treatment of Cancer (EORTC QLQ-EN24), was developed and validated in one study. We independently validated and assessed the psychometric properties of the instrument. Two hundred and eight women with EC before surgery, during adjuvant treatment and follow-up; in three different cancer centres completed the EORTC QLQ-C30 and the EN24. The questionnaire's completion rate was 100%, except sexuality items, that were answered by 35% of patients. All item-scale correlations for the multi-item scales exceeded the .4 criterion and correlated well with their own scale, while correlations with the other scales were low. The internal consistency of all multi-item scales were satisfactory (Cronbach's alpha coefficients ranging from .77 to .97). Discriminance for single-item scales was low. The QLQ-EN24 module discriminated well between clinically different patients, and there were no differences in quality of life questionnaire scales between patients with body mass index ≤30 when compared to those with >30. This validation study supports the reliability, as well as convergent and divergent validity of the EORTC QLQ-EN24. The module is a useful instrument for the assessment of QOL in patients with EC. However, data concerning sexuality should be interpreted with caution.

Synchronic inverse seasonal rhythmus of energy density of food intake and sleep quality: a contribution to chrono-nutrition from a Polish adult population

BACKGROUND/OBJECTIVES

There is evidence which suggests that sleep behavior and dietary intake are interlinked. Thus, we investigated whether a seasonal rhythm in food-energy density exists, and how this relates to quality of sleep.

SUBJECTS/METHODS

Two hundred and thirty adult volunteers were investigated across the four seasons. Anthropometrical measurements were obtained and The Pittsburgh Sleep Quality Index was used for an assessment of sleep quality and disturbances. The dietary intake was evaluated using a 24 h dietary recall. Generalized estimating equations were used to estimate seasonal changes in energy density and sleep quality, as well as the association of energy density with sleep quality. All analyses were adjusted for age, sex, education, occupation and shift-work.

RESULTS

Mean food energy density was significantly higher in winter as compared with other seasons (P<0.05), although no seasonal variations were observed in macronutrient intake (fat and protein). Overall, the sleep quality was low (score value >5) in all seasons, with the lowest quality occurring in winter and the highest in spring (P<0.05). The components of sleep quality score showed that winter had statistically (P<0.05) poorer subjective sleep quality, sleep latency and sleep disturbances, but lower daytime dysfunction compared with spring and summer. After adjusting for seasonal effects (correlated outcome data) and shift-work, energy density was found to be inversely associated (P<0.0001) with sleep quality.

CONCLUSIONS

An inverse association between seasonal fluctuation of food energy density and sleep quality was found with winter time, associated with the intake of higher energy dense food products and the lowest sleep quality.

Quality of life, depression and dietary intake in Obstructive Sleep Apnea patients

Background

The aim of this study was to analyze the association between depression, quality of life and dietary intake in newly diagnosed Obstructive Sleep Apnea (OSA) patients.

Methods

From 153 eligible patients suffering from sleep disturbances, 64 met inclusion and exclusion criteria. The polysomnography was used for OSA diagnosis. The quality of life (QOL) was assessed by WHOQOL-BREF questionnaire, self-reported chronotype by morningness-eveningness questionnaire and level of depression by Beck’s Depression Inventory. Blood pressure and parameters of glucose and lipid metabolism were assessed by routine methods. The dietary intake was evaluated by 24-hr dietary recalls.

Results

Significantly negative associations were found between depression inventory and QOL. Better QOL for physical health and social relationships was observed in the “definitely morning” chronotype. The “morning type” of patients was positively related to the intake of fat, monounsaturated fatty acids and vitamin B12. Correlations between QOL and diastolic blood pressure, HDL-cholesterol, TG, fasting glucose, as well as protein and vitamin B6 intake were found.

Conclusions

In conclusion, both chornotype and depression influence QOL in OSA patients where morning type is associated with better physical health and social relationships and increase in depression index deteriorate physical health, psychological and social relationship QOL domains. QOL as well as depression and chornotype are also influenced by selected cardio-metabolic factors and dietary intake.

Influence of body weight changes on survival in patients undergoing chemotherapy for epithelial ovarian cancer

OBJECTIVE

Epithelial ovarian cancer is a highly fatal gynecologic malignancy with a poor prognosis. Therefore, identification of new modifiable prognostic factors is important. Due to the fact that the effect of body weight changes during chemotherapy for EOC is still not very well known we aimed to describe, considering evidence, role of body weight changes in relation to survival.

MATERIALS AND METHODS

Between October 2014 and August 2015 we systematically searched the following databases: Medline, Scopus, Web of Science and EMBASE to identify the studies describing the influence of body weight changes on survival in patients undergoing chemotherapy for EOC.

RESULTS

We identified 601 potentially relevant publications, however finally only one article was included for data extraction and analysis. The overall survival in the selected paper was significantly associated with body weight changes during the first-line chemotherapy. Nevertheless, no influence on progression free survival was found.

CONCLUSIONS

The analyzed data provides initial evidence, showing poorer overall survival  associated with body weight loss and improved overall survival associated with body weight gain during primary chemotherapy for epithelial ovarian cancer. Prospective and retrospective trials are an urgent calling to confirm this conclusion.

Link between Food Energy Density and Body Weight Changes in Obese Adults

Regulating the energy density of food could be used as a novel approach for successful body weight reduction in clinical practice. The aim of this study was to conduct a systemic review of the literature on the relationship between food energy density and body weight changes in obese adults to obtain solid evidence supporting this approach. The search process was based on the selection of publications in the English language listed in public databases. A meta-analysis was performed to combine individual study results. Thirteen experimental and observational studies were identified and included in the final analysis. The analyzed populations consist of 3628 individuals aged 18 to 66 years. The studies varied greatly in terms of study populations, study design and applied dietary approaches. The meta-analysis revealed a significant association between low energy density foods and body weight reduction, i.e., -0.53 kg when low energy density foods were eaten (95% CI: -0.88, -0.19). In conclusions, this study adds evidence which supports the energy density of food as a simple but effective measure to manage weight in the obese with the aim of weight reduction.

Time-dependent changes in dynamic mechanical properties of irradiated bone

The increased use of allograft tissue for musculoskeletal repair has brought more focus to the safety of allogenic tissue and the efficacy of various sterilization techniques. The currently available literature contains few examples of studies on long-lasting strains of bones but no example for irradiated bones. In this study the bovine femurs from a 2-year-old animal were machine cut and irradiated with the doses of 10, 15, 25, 35, 45 and 50 kGy. The dynamic mechanical analysis was performed at 1 Hz at the room temperature in a 3-point bending configuration for 2880 minutes. The final values of E' and E″ were dose independent but they were reached at different periods. For this reason, so called "critical point" was introduced for the further analysis. All the examined sample groups were characterized by statistically significant lower values of the critical point in comparison with the control samples (p<0.05) but the biggest differences were observed between the control samples and the samples irradiated with the doses of 10, 15 and 25 kGy. Current results and literature review suggest that the dose of 35 kGy is the optimal dose for ionizing radiation sterilization.

Oxidative stress markers in uterine fibroids tissue in pre- and postmenopausal women

Uterine fibroids are common benign tumors of the reproductive organ and occur in approximately 50-80% of women of reproductive age. The pathogenesis of uterine fibroids is multifactorial and includes: sex hormones, genetic factors, cytokines, and oxidative stress.

OBJECTIVE

The aim of this study was to investigate the oxidative stress markers in tissue samples of women with uterine fibroids, with further analysis on size and menopausal status.

MATERIALS AND METHODS

Fifty-nine patients with the mean age 50.6 (35 premenopausal and 24 postmenopausal) who underwent standard gynecological procedures were recruited in the study. All women had histologically proven uterine leiomyoma. Samples were collected ex vivo immediately after resection. Glutathione peroxidase (GPX), catalase (CAT), and the ferric reducing ability of plasma (FRAP) were measured.

RESULTS

The activity of GPX was significantly higher in fibroid samples than in myometrium (0.070 +/- 0.042 vs. 0.057 +/- 0.027 U/mg of protein, p < 0.05), activity of CAT did not differ between samples (1.13 +/- 0.86 vs. 1.23 +/- 0.51 U/mg of protein, p > 0.05), and FRAP presented higher values in fibroid samples than in myometrium (4.58 +/- 6.29 vs. 3.04 +/- 3.81 mM Fe(+2)/mg of protein), but the difference was not statistically significant (p = 0.06). In the subgroups analyses, there were no statistically significant differences when comparing the activity of GPX, CAT, and FRAP in fibroid samples from pre- and postmenopausal women, as well as when comparing fibroid samples of small size (< 50 mm) and large size (≥ 50 mm) tumors.

CONCLUSION

Oxidative stress markers are changed in fibroid tissue samples showing that oxidative stress may play an important role in this tumor formation, although without influencing menopausal status nor tumor size.

Evaluation of residual tumor locations in advanced ovarian cancer patients after incomplete primary cytoreduction

BACKGROUND

Nowadays complete primary cytoreduction can be achieved in a large number of patients suffering from advanced ovarian cancer. However, there is a group of patients in whom complete tumor resection remains impossible. The authors analyzed the intraoperative limiting factors in patients with residual tumor after primary surgery treated in the present institution.

MATERIALS AND METHODS

Patients with advanced epithelial ovarian cancer (FIGO Stage IIIB-IV), who underwent primary incomplete surgery in the present institution between 2006 and 2008 were included in this study. Patients' records were evaluated regarding to intraoperative findings and final surgical results.

RESULTS

The authors identified 39 eligible patients in their registry. Twenty-six (66.7%) patients underwent surgery with residual tumor < 1 cm and 13 (33.3%) ≥ 1 cm. The most frequent location of residual tumor limiting complete surgery was disseminated bowel carcinomatosis in 34 (87.2%) patients. Moreover significant differences in tumor residuals locations and operative time between patients with residuals < 1 cm and ≥ 1 cm were reported (p < 0.05).

CONCLUSIONS

The most frequent reason for incomplete primary cytoreduction remains disseminated carcinomatosis. However, in patients with residuals under one cm, its frequency is significantly higher. The complication rate is comparable in patients independently of residual tumor < 1 cm and ≥ 1 cm. Therefore the cytoreductive efforts should be made even in primarily not completely operated patients in order to achieve residuals under one cm.

Successful maintenance of body weight reduction after individualized dietary counseling in obese subjects

The aim of this study was to describe the effectiveness of individualized dietary counseling in obese subjects based on narrative interview technique on the maintenance of body weight reduction, changes in dietary behaviors, including type of cooking and physical activity. One-hundred subjects out of four-hundred patients met the inclusion criteria. Individually, 45-minute educational program with motivation counseling was performed in 0, 6 and 12 weeks of the study. Patients were advised to follow individually well-balanced diet for 12 weeks. The individuals were asked about the changes in their dietary habits (Food Frequency Questionnaire). The mean percentage of body weight changes from the baseline were as follows: in 6th week- 5.9%, in 12th week - 10.9% and in 52th week - 9.7% (P < 0.0001), however there were no statistically significant changes while comparing body weight in 12th and 52th week. The maintenance of body weight reduction was connected with the dietary habits changes, mainly the type of cooking and increased consumption of vegetable oils. In conclusion, individualized dietary counseling, based on narrative interview technique is an effective intervention for obesity treatment that may help maintain body weight reduction and adapt the pro-healthy changes in type of cooking and sources of dietary fat.

Dietary habits changes and quality of life in patients undergoing chemotherapy for epithelial ovarian cancer

PURPOSE

The aim of this study was to evaluate dietary habit changes in patients undergoing chemotherapy for epithelial ovarian cancer.

METHODS

Sixty one patients undergoing chemotherapy for epithelial ovarian cancer were enrolled to the study and 44 completed. The dietary intake was evaluated by 7-day food records, and the changes in dietary intake and food-preparing methods were estimated based on a 101-item semiquantitative food frequency questionnaire. Nutritional status was checked with the use of body weight and height, waist and hip circumferences, skinfolds and subjective global assessment tool. Quality of life was measured with the use of EORTC QLQ-C30 and EORTC QLQ-OV28.

RESULTS

Despite high average body mass index (BMI) (26.7-28.0 kg/m(2)), malnutrition risk was observed in 43.7 and 10.7 % of patients receiving first-line and subsequent-line chemotherapy, respectively (p < 0.001). Dietary intake and quality of life did not differ between the studied groups. A lot of dietary habits changes were observed. Women undergoing subsequent-line chemotherapy consumed more frequently rye bread, pasta, buttermilk, vegetable, fruit, oils, nuts, and juices. Women undergoing first-line chemotherapy consumed more milk, cottage cheese, cream, eggs, fish and seafood, meat offal, salty snacks, and jam. Additionally, women undergoing subsequent-line chemotherapy more often applied cooking in water (p < 0.0001) and baking (p < 0.05).

CONCLUSIONS

Women undergoing chemotherapy for ovarian cancer change their dietary habits in a pro healthy direction, and these changes are more expressed in patients undergoing subsequent-line chemotherapy.