Chemosensory changes during chemotherapy

BACKGROUND

Chemosensory changes that occur during chemotherapy can significantly impact food enjoyment, quality of life and recovery.

AIM

To investigate chemosensory changes reported by oncology patients during chemotherapy.

METHODS

A mixed-method cross-sectional study design was used to explore 100 cancer patients' experiences of chemosensory changes during chemotherapy. All patients completed a questionnaire assessing their taste and smell preferences. A purposive sample of 30 patients underwent a semi-structured interview to elicit their thoughts on their experienced chemosensory changes. Descriptive statistics and themes were examined.

FINDINGS

The mean age of the sample was 50.56 years, and the majority of participants were female. The most stated taste alteration was bitter, while altered food preferences were also commonly experienced. Furthermore, most patients experienced unpleasant odours around food, while some experienced these odours even when food was not present. Overall, five themes were identified: changes in taste, changes in smell, changes in social life, altered comfort and food preferences.

CONCLUSION

Chemosensory changes related to cancer and its treatment impact a person's nutrient intake, food-related behaviours, quality of life and treatment response. Patients who experience chemotherapy-associated chemosensory changes require specialised nutritional therapy to increase their eating-related pleasure. As part of the nutritional assessment, chemosensory alterations should be evaluated regularly.

Prospective observational study of zinc deficiency symptoms during first-line chemotherapy for gastric and colorectal cancer

Background

Zinc deficiency during long-term chemotherapy and its related symptoms, including skin rash, taste disorders, and oral mucositis, have not been sufficiently investigated.

Methods

This prospective observational study enrolled patients with gastric and colorectal cancer who underwent standard first-line chemotherapy. According to the Practice Guidelines for Zinc Deficiency, zinc deficiency is defined as a serum level of <60 µg/dL. Serum zinc levels were measured before and after (1, 3, and 6 months) chemotherapy, and symptoms were assessed using the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events version 1.0. Repeated measures were analyzed using a generalized linear mixed model.

Results

Of the 61 enrolled patients, 48 who underwent standard first-line chemotherapy with fluoropyrimidine plus oxaliplatin were analyzed. Zinc deficiency was observed in 18 patients (38%) before chemotherapy. The least-squares means of serum zinc levels significantly decreased at 3 and 6 months of chemotherapy in 30 patients without zinc deficiency at the start of chemotherapy (both P<0.01) but not in 18 with zinc deficiency at the beginning. Changes in serum zinc levels during chemotherapy negatively correlated with changes in taste, rash, and itching (all P<0.04) in patients without zinc deficiency before treatment initiation.

Conclusions

Serum zinc levels decreased during chemotherapy in zinc-non-deficient patients at the beginning of chemotherapy and correlated with taste changes, skin rash, and itching. Therefore, investigating whether zinc supplementation ameliorates these symptoms is necessary.

[Hot water washing processing technology of Euodiae Fructus based on change laws of active components and tastes]

In order to establish the standardized processing technology of the hot water washing of Euodiae Fructus, this study, based on the traditional processing method of hot water washing of Euodiae Fructus recorded in ancient works and modern processing specifications of traditional Chinese medicine decoction pieces, took the yield of decoction pieces and the content of main components as the indicators and optimized the processing conditions by orthogonal test based on the results of single factor investigation. At the same time, electronic tongue technology was used to analyze the change law of the taste index of Euodiae Fructus during the hot water washing. The results of the single factor investigation showed that the content of the main components in Euodiae Fructus showed some regular changes during the processing. Specifically, the content of chlorogenic acid, hyperin, isorhamnetin-3-O-rutinoside, isorhamnetin-3-O-galactoside, and dehydroevodiamine decreased significantly, with average decreases of-23.75%,-27.80%,-14.04%,-14.03%, and-13.11%, respectively. The content of limonin increased significantly with an average increase of 19.83%. The content of evodiamine, rutaecarpine, evocarpine, and dihydroevocarpine showed fluctuating changes and generally increased, with average variation amplitudes of 0.54%,-3.78%, 2.69%, and 5.13%, respectively. The orthogonal test results showed that the optimum processing parameters for the hot water washing of Euodiae Fructus were as follows: washing time of 2 min, the solid-to-liquid ratio of 1∶10 g·mL~(-1), washing temperature of 80 ℃, washing once, and drying at 50 ℃. After the hot water washing processing, the average yield of Euodiae Fructus pieces was 94.80%. The content of limonin, evodiamine, and rutaecarpine was higher than those of raw pro-ducts, and the average transfer rates were 102.56%, 103.15%, and 105.16%, respectively. The content of dehydroevodiamine was lower than that of the raw products, and the average transfer rate was 83.04%. The results of taste analysis showed that the hot water washing could significantly reduce the salty, astringent, and bitter tastes of Euodiae Fructus. This study revealed the influence of the hot water washing on the content of main components and taste of Euodiae Fructus, and the processing technology of the hot water was-hing of Euodiae Fructus established in this study was stable, feasible, and suitable for industrial production, which laid a foundation for clarifying its processing principle and improving the quality standard and clinical application value of decoction pieces.

Oral manifestations in gastroesophageal reflux disease

Many systemic diseases exert their influence on oral health. Among these, gastroesophageal reflux disease (GERD) is the most common. In this study, 100 patients who were previously diagnosed with GERD were examined following a 12-hour fast and evaluated in terms of the severity (grade) of the disease as well as any oral, dental, and/or salivary pH changes. Results found 11 patients with tooth erosion. These patients were older, and their average mean duration of GERD was longer in comparison to those without erosion. There was an inverse relationship between salivary pH and the GERD duration and grade of severity. As the GERD grade increased, the severity of tooth erosion increased. Patients with erosion also exhibited oral mucosal changes. Thus severe, long-term GERD was found to be potentially detrimental to oral soft tissues, dental structures, and salivary pH, whereas milder forms of the disease did not necessarily cause dental side effects.