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[en] Currently, a lot of space and time is devoted to the therapy of oncologic diseases itself. To reach the good therapy results, complex care of the oncologic patient is needed. Management of complications linked with the disease itself and management of complications emerged after administration of chemotherapy, radiotherapy or targeted therapy, plays a significant role. In addition to infectious, hematological, neurological, cardiac or other complications, metabolic complications are relatively extensive and serious. One of the most frequent metabolic complications in oncology is tumor lysis syndrome, hyperuricemia, hypercalcaemia and syndrome of inappropriate secretion of antidiuretic hormone. (author)
[en] The aim of this study was to compare the variations in the concentrations of tocopherols and retinol in obese adults in the postprandial state after the intake of a Mediterranean or Western-style breakfast. The study was designed as a randomized, controlled intervention trial in the postprandial state, for which 24 male adults (12 obese and 12 of normalweight) were recruited. After a fat challenge, blood samples were collected at different times postprandially and α-tocopherol, γ-tocopherol and retinol concentrations were determined in serum by HPLC. The Mediterranean-style meal produced a greater increase in serum α-tocopherol levels in both obese and normal-weight subjects, compared to the Western-style meal, indicating that the composition of the food affects the concentration of tocopherols in the postprandial state. However, the serum concentrations of γ-tocopherol and retinol remained unmodified. In conclusion, the presence of α-tocopherol in the meal could contribute to the protection of the Mediterranean-style meal against atherosclerosis in the postprandial state.
[es]El objetivo de este estudio fue comparar las variaciones en la concentración de tocoferoles y retinol en adultos obesos en el estado postprandial tras la ingesta de un desayuno mediterráneo u occidental. Consiste en un ensayo de intervención aleatorio y controlado, en el que participaron 24 adultos varones (12 obesos y 12 normopeso). Tras la ingesta de dichas comidas, se determinaron las concentraciones de α-tocoferol, γ-tocoferol y retinol en el suero de las muestras sanguíneas mediante HPLC. La comida de estilo mediterráneo aumentó los niveles séricos de α-tocoferol en sujetos obesos y de peso normal, en comparación con una comida de estilo occidental, lo que indica que la composición del alimento afecta a su concentración sérica. Sin embargo, referente al γ-tocoferol y retinol, permanecieron sin modificaciones. En conclusión, la presencia de α-tocoferol en una comida de estilo mediterráneo podría contribuir a la protección contra la aterosclerosis en el estado postprandial
[en] Although different measures of adiposity might differentially classify people as overweight or obese, studies that have compared body-mass index (BMI) with other measures of adiposity have found that, at higher BMIs (eg, 30 kg/m2 and above), classification using BMI gives similar results to other approaches, such as dual-energy x-ray absorptiometry. More broadly, in selecting risk factor metrics for population health reporting, two other issues should be kept in mind. First, it is important to consider how different metrics represent the health consequences of risk factors. For example, a systematic review of epidemiological studies reported that, taken together, studies that assessed BMI and other measures of adiposity did not show that any of these measures had superior discriminatory capability for adverse cardiometabolic outcomes; any reported difference was “too small to be of any clinical relevance”. Second, to be useful for population health surveillance, data should be readily available through population-based surveys. Height and weight can be measured in population-based surveys, whereas methods like dual-energy x-ray absorptiometry are too complex for use, even in a clinical setting. Nonetheless, to the extent that data are available, how the classification of individuals and prevalence in the population vary on the basis of the specific adiposity metric used should be explored in large, global databases, such as those used by the NCD Risk Factor Collaboration, as has been done for diabetes. ME reports a charitable grant from AstraZeneca Young Health Programme and personal fees from Scor and Third Bridge, all outside the submitted work. All other authors declare no competing interests. (author)
[en] This work investigates the role of oleanolic acid (OA), isolated from the olive (Olea europaea L.) leaf, as a radical scavenger and inhibitor of the hydrolyzing enzymes of dietary carbohydrates. New evidence is provided showing that OA may capture 2,2’-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) and peroxyl radicals, and also exert a strong and non-competitive inhibition of α-glucosidase (IC50 10.11 ± 0.30 µM). The kinetic and spectrometric analyses performed indicate that OA interacts with this enzyme inside a hydrophobic pocket, through an endothermic and non spontaneous process of a hydrophobic nature. These are two possible mechanisms by which OA may facilitate a better control of post-prandial hyperglycaemia and oxidative stress, so contributing to preserving insulin signalling. Obesity, insulin resistance and Type 2 Diabetes Mellitus are considered the first pandemics of the 21st century. In this sense, OA might be used in future preventive and therapeutic strategies, as an ingredient in new drugs and functional foods.
[es]Este trabajo estudia el papel del ácido oleanólico (OA), aislado de la hoja de olivo, como secuestrador de radicales libres e inhibidor de enzimas implicados en la hidrolisis de los carbohidratos de la dieta, dos mecanismos por los que el triterpeno podría mitigar la hiperglicemia postprandial y el estrés oxidativo. Se aportan nuevas evidencias que muestran que el OA puede capturar radicales ácido 2,2’-azino-bis-(3-etilbenzotiazolín)-6-sulfónico y peroxilo, y que ejerce una potente inhibición nocompetitiva de α-glucosidasa (IC50 10.11±0.30 µM). El análisis cinético y espectrométrico llevado a cabo indica que OA interacciona con este enzima en el interior de un bolsillo hidrofóbico, mediante un proceso endotérmico no espontáneo, de naturaleza hidrofóbica. Estos son dos posibles mecanismos por los cuales el OA puede facilitar un mejor control de la hiperglucemia postprandial y el estrés oxidativo, lo que contribuye a preservar la señalización de la insulina. La obesidad, la resistencia a la insulina y la diabetes mellitus tipo 2 se consideran la primera pandemia del siglo XXI. En este sentido, el OA podría ser utilizado en futuras estrategias preventivas y terapéuticas, como ingrediente de nuevos fármacos y alimentos funcionales.
[en] Objective: To assess the needs related to prenatal genetic counselling in a developing country. Methods: The prospective observational study was conducted at the Prenatal-Genetic Counselling Clinic of Aga Khan University Hospital, Karachi, from October 2007 to September 2010. In-depth interviews were conducted and the data was stored in the form of patient charts. Information was then extracted from the charts and entered into a structured questionnaire. Results: Of the 93 couples in the study, 49(53%) were in the self-referral group and 44(47%) were in the physician-referral group. Diagnosis was not given for previously affected children by the paediatrician or by obstetrician for recurrent miscarriages in 68(73%)cases. Besides, 20(22%) couples had voluntarily terminated a pregnancy without any tests because of the fear of having a diseased child. Eleven (12%) couples were looking for amniocentensis or chorionic villus sampling. Death in previous children was the main reason to seek genetic counselling and was seen in 57(61%) couples. Consanguinity was seen in 77(83%) couples. Conclusion: A clear deficiency of knowledge of genetics was seen among the non-genetic healthcare providers. Demand of antenatal genetic testing among the public was also seen, highlighting the need of diagnostic facility for genetic and metabolic disorders. However, this needs to be explored in the context of the existing healthcare infrastructure. (author)
[en] In radiotherapy treatment planning accurate CT data is essential. Computer tomography imaging has become mandatory for treatment planning in Radiotherapy. For obese patients when imaged with Diagnostic CT or even sometimes with large bore CT in the range 80 to 85 cm, corresponding image reconstruction FOV ranges between 50 cm to 65 cm. This implies that even if an obese patient is accommodated in the scanner, the CT data may have truncated image due to limitation in FOV size. The complete CT data is not available creating missing tissues laterally/obliquely where radiation beam path cannot be accurately derived due to lack of CT data and thereby giving error in monitor unit dose calculation
[en] A large amount of epidemiological evidence suggests that the impact of body weight on breast cancer risk should be heterogeneous throughout the life-stage of women. At birth, high weight has been positively associated with an increased risk of breast cancer. While, the body mass index (a relative body weight; BMI kg/m2) has been inversely associated with breast cancer risk among pre-menopausal women. The inverse trend had been observed in both Western and Asian population, with a relatively lower percentage of obesity and higher percentage of leanness, suggested that the inverse trend could be explained not only by the protective impact due to obesity, but also by the increased risk of breast cancer due to leanness. Among post-menopausal women, however, an elevated BMI has been positively associated with the development of breast cancer, particularly in the cases of estrogen receptor-positive (ER+) and progesterone receptor-positive (PR+) tumors. Currently, the mechanisms underlying the heterogeneous impacts between BMI on breast cancer risk and the life-stage of women remain poorly understood. We reviewed several proposed biological mechanisms that may contribute to the various impacts of relative body weight on breast cancer risk across life-stage. We also discussed the impact of BMI upon the outcome of endocrine therapy, particularly for aromatase inhibitor, in breast cancer patients. To prevent breast cancer incidence and recurrence, the desirable BMI of women may differ throughout their life-stage. To define the underlying mechanism for the various impacts of BMI in the context of breast cancer across various female life stages, further studies will be required.