CAM usage, cardiovascular risk behavior, and treatment compliance of long-term head and neck cancer survivors

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Abstract

Abstract. Background: Co-morbidities have a high impact on the outcome for head and neck cancer patients. The main problems are cardiovascular diseases. Which type of risk behavior is shown by long-term survivors? Materials and methods: We re-analyzed data of two published studies regarding the following factors: affinity to CAM, alcohol consumption, nicotine consumption (study 1), physical activity (study 2). Study 1 has included 310 ENT tumor patients out of a total of 1,013 participants. Study 2 has included 55/155 head and neck cancers. Results: Head and neck cancer patients show a lower rate of CAM using (42.6% versus 51% in total population). They have reported continued alcohol consumption in 189/310 (61%) patients and nicotine abuse in 85/310 (27%) patients. Study 2 has shown a decreasing percentage of physical active patients, from 64% before cancer diagnosis to 38% after the disease. Only 9% of the interviewed patients were informed about local offers in their own region. Conclusion: Head and neck cancer survivors show a deficit in knowledge and active prevention to especially avoid cardiovascular co-morbidities. Further educational work is necessary to improve patient’s competence. 

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Zinc, copper, and blood pressure: Human population studies

William E. Carpenter, Derek Lam, Glenn M. Toney … (2013)

Summary Copper and zinc are essential trace biometals that regulate cardiovascular homeostasis, and dysregulation of these metals has been linked to vascular diseases, including hypertension. In this article, we review recent human population studies concerning this topic, focusing on: 1) the relationship between blood pressure and levels of zinc and copper; 2) correlations between trace metals, the renin-angiotensin system, obesity, and hypertension; 3) the relationship between environmental metal pollution and the development of hypertension; and 4) methods commonly employed to assay zinc and copper in human specimens. Moreover, based on the findings of these studies, we suggest the following topics as the basis for future investigations: 1) the potential role of environmental metal pollution as a causal factor for hypertension; 2) metal profiles within specific pathogenic subsets of patients with hypertension; 3) standardizing the experimental design so that the results between different studies are more comparable; and 4) the requirement for animal experiments as complementary approaches to address mechanistic insight that cannot be studied in human populations.

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The value of the chloride: sodium ratio in differentiating the aetiology of metabolic acidosis.

D. Taylor, A Durward, I Murdoch … (2001)

Stewart's physicochemical approach to acid-base balance defines the aetiology of a metabolic acidosis by quantifying anions of tissue acids (TA), which consist of unmeasured anions (UMA) and/or lactate. We hypothesised that an increase in TA during metabolic acidosis would lead to a compensatory fall in the plasma chloride (Cl) relative to sodium (Cl:Na ratio) in order to preserve electro-neutrality. Thus, the Cl:Na ratio could be used as a simple alternative to the anion gap in identifying raised TA. Two hundred and eighty two consecutive patients who were admitted to our Paediatric Intensive Care were enrolled in the study. We obtained 540 samples (admission n = 282, 24 h n = 258) for analysis of blood chemistry, lactate and quantification of TA and UMA. Samples were subgrouped into those with metabolic acidosis (standard bicarbonate 3 mEq/l). Metabolic acidosis occurred in 46% of samples, of which 52.3% (120/230) had increased UMA. The dominant component of TA was UMA rather than lactate, and these two components did not always rise in tandem. Our hypothesis of relative hypochloraemia was supported by a lower Cl:Na ratio (P 0.79) excluded TA (PPV 81%, LR 4.5). Base deficit (BD) and lactate performed poorly. In metabolic acidosis due to TA, plasma Cl concentration decreases relative to sodium. The Cl:Na ratio is a simple alternative to the AG for detecting TA in this setting.

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Brain uptake, retention, and efflux of aluminum and manganese.

Robert A. Yokel (2002)

My colleagues and I investigated the sites and mechanisms of aluminum (Al) and manganese (Mn) distribution through the blood-brain barrier (BBB). Microdialysis was used to sample non-protein-bound Al in the extracellular fluid (ECF) of blood (plasma) and brain. Brain ECF Al appearance after intravenous Al citrate injection was too rapid to attribute to diffusion or to transferrin-receptor-mediated endocytosis, suggesting another carrier-mediated process. The brain:blood ECF Al concentration ratio was 0.15 at constant blood and brain ECF Al concentrations, suggesting carrier-mediated brain Al efflux. Pharmacological manipulations suggested the efflux carrier might be a monocarboxylate transporter (MCT). However, the lack of Al (14)C-citrate uptake into rat erythrocytes suggested it is not a good substrate for isoform MCT1 or for the band 3 anion exchanger. Al (14)C-citrate uptake into murine-derived brain endothelial cells appeared to be carrier mediated, Na independent, pH independent, and energy dependent. Uptake was inhibited by substrate/inhibitors of the MCT and organic anion transporter families. Determination of (26)Al in rat brain at various times after intravenous (26)Al suggested a prolonged brain (26)Al half-life. It appears that Al transferrin and Al citrate cross the BBB by different mechanisms, that much of the Al entering brain ECF is rapidly effluxed, probably as Al citrate, but that some Al is retained for quite some time. Brain influx of the Mn(2+) ion and Mn citrate, determined with the in situ brain perfusion technique, was greater than that attributable to diffusion, suggesting carrier-mediated uptake. Mn citrate uptake was approximately 3-fold greater than the Mn(2+) ion, suggesting it is a primary Mn species entering the brain. After Mn(2+) ion, Mn citrate, or Mn transferrin injection into the brain, brain Mn efflux was not more rapid than that predicted from diffusion. The BBB permeation of Al and Mn is mediated by carriers that may help regulate their brain concentrations.