The EORTC QLQ-C15-PAL questionnaire: validation study for Spanish bone metastases patients

Purpose

Quality of life (QL) is a key outcome for advanced disease cancer patients. The European Organization for Research and Treatment of Cancer (EORTC) has developed the QLQ-C15-PAL questionnaire, a short version of the QLQ-C30 for palliative care. The aim of the present study is to validate the QLQ-C15-PAL for use with Spanish patients with bone metastasis.

Methods

For this study, we used a consecutive sample of stage IV cancer patients with bone metastases who started radiotherapy with palliative intention. Two assessments were proposed for each patient: one on the first day of treatment and one a month after the end of the radiotherapy sessions. Psychometric evaluation of the structure, reliability, and validity was undertaken.

Results

One hundred and sixteen patients completed the first questionnaire and seventy five completed the second. Multitrait scaling analysis showed that all items met the standards for convergent validity, and all except the fatigue scale met the standards for divergent validity. Cronbach’s coefficient met the 0.7 alpha criterion on all scales except pain (second assessment). Most QLQ-C15-PAL areas had low-to-moderate correlations with the other areas. Significant differences appeared in the comparisons between groups with regard to: patients who died before the second assessment (six areas); patients receiving chemotherapy before starting radiotherapy in the two assessments (three and four areas, respectively); the performance status in the two assessments (nine and eight areas); and the number of RT sessions received (four). Quality of life was better in the second assessment in nine areas.

Conclusion

The QLQ-C15-PAL is a reliable and valid instrument when applied to a sample of Spanish patients. These results are in line with those of other validation studies.     

Metabolic Syndrome,Cognitive Impairment and the Role of Diet: A Narrative Review

Background: This narrative review presents the association between metabolic syndrome (MetS), along with its components, and cognition-related disorders, as well as the potential reversal role of diet against cognitive impairment by modulating MetS. Methods: An electronic research in Medline (Pubmed) and Scopus was conducted. Results: MetS and cognitive decline share common cardiometabolic pathways as MetS components can trigger cognitive impairment. On the other side, the risk factors for both MetS and cognitive impairment can be reduced by optimizing the nutritional intake. Clinical manifestations such as dyslipidemia, hypertension, diabetes and increased central body adiposity are nutrition-related risk factors present during the prodromal period before cognitive impairment. The Mediterranean dietary pattern stands among the most discussed predominantly plant-based diets in relation to cardiometabolic disorders that may prevent dementia, Alzheimer’s disease and other cognition-related disorders. In addition, accumulating evidence suggests that the consumption of specific dietary food groups as a part of the overall diet can improve cognitive outcomes, maybe due to their involvement in cardiometabolic paths. Conclusions: Early MetS detection may be helpful to prevent or delay cognitive decline. Moreover, this review highlights the importance of healthy nutritional habits to reverse such conditions and the urgency of early lifestyle interventions.     

Polygenic analysis suggests the involvement of calcium signaling in executive function in schizophrenia patients

European Archives of Psychiatry and Clinical Neuroscience - Cognitive deficits are increasingly recognized as a core dimension rather than a consequence of schizophrenia (SCZ). The previous...     

Baseline MRI atrophy predicts 2-year cognitive outcomes in early-onset Alzheimer’s disease

Journal of Neurology - MRI atrophy predicts cognitive status in AD. However, this relationship has not been investigated in early-onset AD (EOAD, < 65 years) patients...     

Learning ethics through everyday problems: informed consent

The teaching of bioethics and its importance in clinical relationships is to a certain extent complicated when we address students of medicine, young people who are more used to dealing with and solving strictly clinical problems. Informed Consent is one of the aspects of professional practice that is generally and widely accepted in Western societies, although difficulties are still encountered in explaining it from a purely theoretical model. This situation led us to design an educational strategy to make the Informed Consent concept more understandable.     

Assessment of Trace Elements and Stable Isotopes of Three Ardeid Species at Birama Swamp, Cuba

The Birama Swamp is the second largest wetland in the Caribbean region and it is inhabited by large populations of waterbirds. Here we report, for the first time, the foraging ecology and pollutant levels of three Ardeidae species: Cattle egret (Bubulcus ibis), Snowy egret (Egretta thula), and Tricolored heron (E. tricolor) breeding in this wetland using stable-isotope (δ ¹⁵N and δ ¹³C) and trace elements [mercury (Hg), lead (Pb), and selenium (Se)] analysis of chick feathers. Our results showed that individuals from all species occupied similar trophic levels. However, we found significant differences for δ ¹³C, with the highest values in cattle egret indicating its use of terrestrial habitats and a generalist and opportunist behavior. No significant differences were found for Pb among species. Yet, Hg levels were greater and similar in tricolored heron and snowy egret than in cattle egret, which was associated with their greater use of aquatic environments. Snowy egret had the lowest values of Se differing significantly with the other two species suggesting a different relative use of prey type. Modeling log-Hg concentration in relation to δ ¹⁵N and δ ¹³C showed an independent and significant relationship among species but without interaction with species level indicating that within a particular species, higher Hg levels were associated with higher δ ¹⁵N values. There was no interaction between δ ¹⁵N and δ ¹³C in the general linear models for Se and Pb in all species. We found an association between δ ¹⁵N and species in Pb for snowy egret. The foraging habitat use of these species and the low levels of pollutants, which are lower than in other similar habitats in other areas of the world, indicated that there is not risk of negative effects in juvenile birds of the Birama Swamp colony that may impair their survival. Our results can be used as a baseline to achieve management regulations.     

Induction of Apoptosis in HT-29 Cells by Extracts from Isothiocyanates-rich Varieties of Brassica Oleracea

Among the vegetables with anti-carcinogenic properties, members of the genus Brassica are the most effective at reducing the risk of cancer. This property may be explained by their principle bioactive compounds, isothiocyanates (ITCs). The aim of this study was to measure the amounts of ITCs in extracts from vegetables of the Brasssica genus and assay them for potency of induction of apoptosis in a colorectal cancer cell line (HT-29). ITCs were determined by the cyclocondensation assay with 1,2-benzenedithiol and induction of apoptosis by assessment of cell viability, caspase-3 activity and DNA fragmentation. Purple cabbage extract showed the highest ITC concentration per gram, fresh weight, followed by black cabbage and Romanesco cauliflower. At ITC concentrations of 7.08 μ g/mL these extracts decreased cell viability and induced caspase-3 and DNA fragmentation at 48h. Brussels sprouts showed the strongest effects on cell viability and caspase-3 activity. Varieties of Brassica Oleracea are rich sources of ITCs that potently inhibit the growth of colon cancer cells by inducting apoptosis. All the extracts showed anticancer activity at ITC concentrations of between 3.54 to 7.08 μ g/mL, which are achievable in vivo. Our results showed that ITC concentration and the chemopreventive responses of plant extracts vary among the varieties of Brassica Oleracea studied and among their cultivars.