Oxidant free radical initiated chain polymerization of protein and other biomolecules and its relationship to diseases

We review the evidence for free radical initiated chain polymerization of biomolecules. Our hypothesis predicts damaging effects of this chain polymerization. Free radical lipid peroxidation could initiate the chain polymerization of amyloid peptides and other biomolecules found in Alzheimer's disease. Reactions forming polymers present in other neurodegenerative diseases could follow the same pathway. Antioxygenic nutrients could protect against free radical oxidant damage, thereby delaying or preventing the onset of Alzheimer's disease and other neurodegenerative diseases The onset of Alzheimer's disease could be delayed if the initiation of free radical chain polymerization were inhibited or limited by nutrients that act as chain terminators or provide reducing conditions to reduce peroxidized lipids in the brain. Vitamins E and C and coenzyme Q are chain terminators. Selenium, sulfur amino acids and vitamin C provide reducing conditions.     

Developing patient-centred strategies to optimize the management of vasomotor symptoms in breast cancer patients: a survey of health care providers

Purpose

Vasomotor symptoms (VMS) such as hot flashes and night sweats are common in breast cancer patients and can affect both quality of life and treatment adherence. However, there is limited practical data to guide clinicians in the optimal selection of therapeutic strategies. A survey of health care providers was performed to better understand perspectives and prescribing practices for managing this problem.

Methods

Canadian health care providers who treat patients with early stage breast cancer (EBC) participated in an anonymous electronic survey. Participants provided their perspectives on the prevalence and severity of VMS among patients with EBC, outlined their management strategies, and provided feedback on the perceived efficacy of interventions for VMS.

Results

Responses were received from 65 providers including breast oncologists (36/65, 55%) and nurses with oncology expertise (29/65, 45%). Seventy-seven percent of participants reported regularly asking patients about VMS, and most indicated that bothersome VMS occurred in the majority of patients. Health care providers cited hot flash severity and sleep disruption as the most important issues for patients. The most common first- and second-line interventions recommended were lifestyle modifications (n?=?32/65, 49.2%) and pharmacologic strategies (n?=?27/65, 41.5%), respectively. Most respondents felt that interventions, including pharmacologic, over-the-counter, and complementary therapies, were only “somewhat effective”. Overall, half of respondents (n?=?35/65, 54%) reported being “confident” in managing VMS.

Conclusion

Given the variability of treatment recommendations, and health care provider uncertainty around the benefits of therapies for VMS, more ‘real-world’ trials are needed to optimize patient care.