Depressive symptoms, eating psychopathology, and physical activity in obese breast cancer survivors

Psychosocial problems such as depression are present as long-term sequelae of breast cancer and its treatment in a substantial minority of patients. In general and patient populations, lifestyle factors such as obesity and physical activity have been associated with depression, and these and related characteristics may be associated with depression in breast cancer survivors. The purpose of this cross-sectional study was to examine factors associated with depression in overweight or obese women (n=85) who had been diagnosed and treated for early stage breast cancer. Depressive symptoms were measured with the Beck depression inventory (BDI), eating psychopathology was assessed with the eating disorder examination--questionnaire (EDE-Q), and physical activity was estimated with the seven-day physical activity recall. BDI was directly correlated with global EDE-Q score (r=0.56, P<0.01) and inversely associated with age (r=-0.22, P<0.05) in bivariate analysis. Controlling for body mass index, age, education and other factors, BDI was directly associated with global EDE-Q score (P<0.001) and inversely associated with level of physical activity (P<0.05) in a model that explained 61% of the variance. Eating attitudes and behaviors, and physical activity level, are independently associated with depressive symptoms in overweight or obese breast cancer survivors.     

Tentorial Schwannoma: A Case Report and Review of the Literature

Summary Introduction Schwannomas are most often found in association with the eighth cranial nerve, but may also arise from any other cranial nerve. They are rarely found in an intra-parenchymal location. Unusual locations for intracranial schwannomas have also been reported in association with neurofibromatosis. Clinical presentation A 23-year-old male without von Recklinghausen’s disease presented with intermittent dizziness and difficulty swallowing. Past medical history was significant for a motor vehicle accident (MVA) without loss of consciousness 6 months prior. Magnetic resonance imaging revealed a large tentorial-based tumor. At surgery the origin of the tumor was clearly the tentorium, and while the trigeminal nerve was displaced, it easily separated from the mass. There was no attachment to any other cranial nerve in the immediate vicinity and postoperative cranial nerve examination was unremarkable. Pathological review was consistent with schwannoma. Conclusion While there are few reported cases of tentorial-based schwannoma, these tumors have been noted in unusual locations within the intracranial vault, and clinicians should be aware of this diversity of origin.     

Metabolism-dependent mutagenicity of a compound containing a piperazinyl indazole motif: Role of a novel p450-mediated metabolic reaction involving a putative oxaziridine intermediate

Compound 1a (6-chloro-5-{3-[4-(1H-indazol-3-yl)-piperazin-1-yl]-propyl}-3,3-dimethyl-1,3-dihydro-indol-2-one) was mutagenic to Salmonella typhimurium TA98 in the presence of rat liver S9 subcellular fraction. The metabolism of 1a in rat liver S9 or microsomes demonstrated that it underwent a P450-mediated N-deindazolation (loss of indazole ring) as a predominant metabolic pathway. To investigate a possible link between metabolism and mutagenicity, a structural analogue 1b (6-chloro-5-{3-[4-(1H-indazol-3-yl)-piperidin-1-yl]-propyl}-3,3-dimethyl-1,3-dihydro-indol-2-one), the cleaved product 2a (6-chloro-3,3-dimethyl-5-(3-piperazin-1-yl-propyl)-1,3-dihydro-indol-2-one), and the core motif 3a (3-piperazinyl indazole) were evaluated in the Ames assay. It was found that 1b was not mutagenic to Salmonella typhimurium TA98 in the absence or presence of a metabolic activating system. In contrast to 1a, 1b did not undergo the metabolic cleavage (loss of indazole ring). Marginal mutagenicity of 2a to TA98 was observed with rat liver S9, whereas 3a was shown to be a promutagen. It was further demonstrated that 1a inactivated P450 3A, the principle enzyme catalyzing the N-deindazolation reaction, in an NADPH-, time-, and concentration-dependent manner. The kinetics of inactivation was characterized by a K(I) of 8.1 microM and k(inact) of 0.114 min(-1). The differences in mutagenicity between 1a and 1b suggest that a chemical bond extending from the 3-position of the indazole to a heteroatom (as part of another cyclic ring) is a prerequisite for the toxicity. The metabolic process leading to the elimination of the indazole from the rest of the molecule apparently plays a key role in causing mutagenicity. It is postulated that the N-deindazolation of 1a proceeds via an oxaziridine intermediate, the formation of which is indirectly inferred from the presence of benzoic acid in microsomal incubations. Benzoic acid is thought to be derived from the hydrolysis of 3-indazolone, an unstable product generated from the oxaziridine. Evidence suggests that the electrophilic oxaziridine intermediate may be responsible for the mutagenicity and inactivation of P450 3A.     

'We don't want to manage poverty': community groups politicise food insecurity and charitable food donations

Charitable assistance is a common response to food insecurity in many affluent countries. The coalition featured in this case study is explicitly concerned with social justice, mitigating the potential for charitable assistance to mask the extent of food insecurity, its root causes and its long-term consequences. The coalition structure has assisted community workers in transcending day-to-day routines, so as to reflect on the politics of food insecurity and institutionalised responses to this problem. Coalition members have defined food security as an objective whose achievement will entail comprehensive reform. One noteworthy outcome has been to recommend that member groups not redistribute a number of foodstuffs commonly donated by individuals and corporations. In grappling with a tension between responding to immediate needs for food and addressing the root causes of these needs, community workers have paid attention to public health.     

Extrapulmonary Tuberculosis among Somalis in Minnesota

To analyze extrapulmonary tuberculosis in Somalis living in Minnesota, we reviewed surveillance and public health case management data on tuberculosis cases in ethnic Somalis in Minnesota from 1993 through 2003. The presence of these recent immigrants substantially affects the local epidemiology and clinical manifestation of tuberculosis.     

Entire potato consumption improves lipid metabolism and antioxidant status in cholesterol-fed rat

Background Vegetables and fruits are rich sources of a variety of nutrients, including vitamins (E and C), trace minerals, and dietary fibers, and many other classes of biologically active compounds such as carotenoids and polyphenols, which are often assumed to protect against degenerative pathologies such as cardiovascular diseases. Although potato is considered as a starchy food, it is also included in the category of vegetables by its micronutrient content. Aim of the study In the present study, we investigated in the rat the effect of a potato-enriched diet on lipid metabolism and antioxidant protection. Results Feeding rats a potato-enriched diet for 3 weeks led to a significant decrease in cholesterol and triglyceride levels in plasma (respectively, −30%, P<0.0001 and −36%, P<0.05) and cholesterol level in liver (−42%, P<0.0001). Antioxidant status was also improved by potato consumption. TBARS levels in heart were decreased and vitamin E/triglycerides ratio in plasma was improved. Conclusions Our present results suggest that consumption of cooked potatoes (consumed with skin) may enhance antioxidant defense and improve the lipid metabolism. These effects could be interesting for prevention of cardiovascular disease.     

Chemoprophylaxis and the epidemiological characteristics of re-emergent P. vivax malaria in the Republic of Korea

OBJECTIVE: In the Republic of Korea (ROK), soldiers stationed where there is a risk of contracting malaria have received antimalarial chemoprophylaxis since 1997. However, chemoprophylaxis may facilitate the development of drug resistance, and late primary attacks in individuals who have received chemoprophylaxis are becoming more frequent. We investigated the association between chemoprophylaxis and the epidemiological characteristics and effectiveness of treatment for re-emergent Plasmodium vivax malaria, using a nationwide malaria database. METHODS: Among soldiers at risk of malaria between 1999 and 2001, we reviewed all P. vivax malaria cases (1158) that occurred before 31 December 2003. Early and late primary attacks were defined as cases occurring 2 months after the last day of exposure to risk of malaria, respectively. FINDINGS: Of these cases, 634 (72.0%) had received chemoprophylaxis, and 324 (28.0%) had not. Cases occurred mostly in summer, with a peak in July-August. Stratification by chemoprophylaxis history revealed different times to onset. Early primary attacks were more prevalent in the group not receiving chemoprophylaxis, while in the group receiving chemoprophylaxis most cases were late primary attacks. Of the latter, 312 out of 461 (67.7%) did not take primaquine regularly. After treatment of the first attack, 14 (1.2%) of 1158 were re-treated; all re-treated cases were cured using the same doses and regimen used for the first treatment. CONCLUSION: In ROK, the increase in late primary episodes of re-emergent P. vivax malaria is associated with the use of antimalarial chemoprophylaxis.     

Health effect of vegetable-based diet: lettuce consumption improves cholesterol metabolism and antioxidant status in the rat

BACKGROUND & AIMS: It is often assumed that fruits and vegetables contribute to protect against degenerative pathologies such as cardiovascular diseases. Besides epidemiological observations, scientific evidences for their mechanism of action are scarce. In the present study, we investigated the mean term and post-prandial effects of lettuce ingestion on lipid metabolism and antioxidant protection in the rat. RESULTS: Feeding rats a 20% lettuce diet for 3 weeks resulted in a decrease cholesterol LDL/HDL ratio and a marked decrease of liver cholesterol levels (-41%). Concurrently, fecal total steroid excretion increased (+44%) and apparent absorption of dietary cholesterol was significantly depressed (-37%) by the lettuce diet. Lettuce diet also displayed an improvement of vitamin E/TG ratio in plasma and limited lipid peroxidation in heart as evidenced by TBARS. In post-prandial experiment, lettuce intake significantly increased both ascorbic acid and alpha-tocopherol plasma levels which contribute to improve plasma antioxidant capacity within 2 h of consumption. Other lipid-soluble antioxidants (lutein and vitamin E) may also improve the plasma antioxidant capacity. CONCLUSION: Lettuce consumption increases the total cholesterol end-products excretion and improves antioxidant status due to the richness in antioxidants (vitamins C, E and carotenoids). In our model, lettuce clearly shows a beneficial effect on lipid metabolism and on tissue oxidation. Therefore regular consumption of lettuce should contribute to improve protection against cardiovascular diseases.     

Mammaglobin and CRxA-01 in pleural effusion cytology: potential utility of distinguishing metastatic breast carcinomas from other cytokeratin 7-positive/cytokeratin 20-negative carcinomas

BACKGROUND: The most common causes of malignant pleural effusions in women are metastatic lung carcinomas and breast carcinomas. It is often very difficult to distinguish between breast carcinomas and other metastatic carcinomas when they share a similar morphology and a similar cytokeratin profile (CK7-positive/CK20-negative [CK7+/CK20-]). To better differentiate between metastatic mammary carcinomas and other metastatic carcinomas in pleural effusion cytology, the authors studied the potential use of a novel antibody, CRxA-01, which was identified by a cDNA subtraction library, together with a well characterized antibody against mammaglobin. METHODS: A computer search for patients with malignant pleural effusion specimens between January 1992 and November 2002 generated 228 patients, 71 of whom had cell block material and a known clinical history. Primary malignancies among these patients included 20 breast carcinomas, 32 lung carcinomas, 4 endometrial carcinomas, 9 ovarian carcinomas, 4 gastrointestinal carcinomas, and 2 genitourinary carcinomas. All specimens were immunostained with anti-CK7, CK20, CRxA-01, and mammaglobin antibodies. Only CK7-positive/CK20-negative (CK7+/CK20-) specimens were included in the current study, and only definitive membranous staining for CRxA-01 and cytoplasmic staining for mammaglobin were considered to be positive. RESULTS: For patients with metastatic breast carcinomas, mammaglobin was positive in 11 of 20 (55%) tissue specimens and CRxA-01 was positive in 12 of 20 (60%) tissue specimens. When CRxA-01 and mammaglobin were used together, 16 of 20 (80%) tissue specimens were positive for mammaglobin or/and CRxA-01 antibodies. This staining pattern was not seen for tissue specimens from patients with other metastatic carcinomas. Two of 4 (50%) uterine carcinoma specimens and 6 of 9 (67%) ovarian carcinoma specimens were positive for CRxA-01 only. CONCLUSIONS: CRxA-01 and mammaglobin were expressed in most metastatic breast carcinoma specimens. Other CK7+/CK20- carcinoma specimens did not express mammaglobin and showed weak or negative staining for CRxA-01. When used together, CRxA-01 and mammaglobin greatly improved the sensitivity and specificity for the detection of metastatic breast carcinoma in pleural effusion specimens.     

Health-related quality of life in women previously treated for early-stage breast cancer

This study describes health-related quality of life (HRQOL) in women previously treated for early stage breast cancer relative to general population and breast cancer norms. It also identifies correlates and multivariate predictors of physical and mental HRQOL. 2582 women who were up to four years post-treatment for early stage breast cancer completed the RAND-36 Health Survey and reported personal and cancer-related information. Participants reported generally high HRQOL that was comparable to norms for women in the general population and other women with breast cancer. In multivariate analyses, better physical HRQOL was associated with fewer psychological symptoms, lower body mass index, better sleep quality, and more physical activity. Better mental HRQOL was associated with better sleep quality, fewer life events, less pain, and fewer gastrointestinal symptoms. Interventions targeting psychosocial symptoms, weight reduction, physical activity, sleep hygiene, and pain could result in improved HRQOL in these women.