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  • 1
    Abstract: BACKGROUND: Evidence from randomized controlled trials is growing that exercise interventions are beneficial in cancer patients receiving allogeneic stem cell transplantation (allo-HCT). However, information about adherence to exercise interventions and exercise contamination in control groups is lacking. This information is crucial for the interpretation of study results. We therefore examined the determinants of exercise adherence and contamination in different treatment periods during (inpatient) and after (outpatient) allo-HCT. METHODS: One hundred fifty-three patients scheduled for allo-HCT were randomized to a 1-year partly supervised exercise intervention (endurance and resistance exercise) or to a control group. Adherence was assessed via exercise logs and contamination via questionnaires. RESULTS: Adherence varied between 66 % (inpatient) and 78 % (outpatient) in different treatment periods. During (inpatient) transplantation period, higher adherence was significantly associated with lower fatigue (P = 0.004) and with having children at home (P = 0.049). Adherence after discharge was positively associated with endurance performance (P = 0.003); higher adherence after day 100 was associated with exercise activity prior allo-HCT (P = 0.010) and higher adherence after discharge (P = 0.001). Contamination among controls was high with 54 % and significantly associated with muscle strength (P = 0.025) and fatigue (P = 0.050). CONCLUSION: Exercise adherence in different treatment periods was determined by different variables, and contamination among controls was evident. These findings may have important implications for correct interpretation of randomized exercise intervention trials.
    Type of Publication: Journal article published
    PubMed ID: 27189616
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  • 2
    Keywords: CANCER ; Germany ; DIAGNOSIS ; DISEASE ; NEW-YORK ; PATIENT ; QUALITY ; ASSOCIATION ; BREAST ; breast cancer ; BREAST-CANCER ; HEALTH ; DIFFERENCE ; WOMEN ; INVOLVEMENT ; SAFETY ; UNITED-STATES ; PREDICTORS ; PREVALENCE ; PAIN ; REGRESSION ; ASSOCIATIONS ; THERAPIES ; physician ; HEALTH-CARE ; QUALITY-OF-LIFE ; ATTITUDES ; complementary and alternative medicine ; coping ; ONCOLOGISTS ; quality of life ; SURVIVORS
    Abstract: Goals of the work: The aim of this study was to assess the period prevalence and identify predictors of the use of complementary and alternative medicine ( CAM) among women with breast cancer. Patients and methods: In a cross-sectional study, 263 women participating in a quality of life survey reported on CAM use. Differences between CAM users and nonusers were evaluated using logistic regression. Results: About 3 years after diagnosis the period prevalence of CAM use among women with breast cancer was 36%. Younger women reported usage of CAM more often than older women. Associations between remote disease, pain and psychosocial variables were found. Involvement in self-help groups and active participation in leisure activities were associated with CAM use; this may indicate differences in the patients' ability to cope with the disease. Most patients were informed of CAM by a physician. Conclusions: Involvement in self-help groups and leisure activities were associated with CAM use, indicating differences in the patients' ability to cope. Further research is necessary to evaluate the safety of CAM and to determine the value of CAM in health care
    Type of Publication: Journal article published
    PubMed ID: 15338384
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  • 3
    Keywords: RISK ; INTERVENTION ; ASSOCIATION ; breast cancer ; HEALTH ; WOMEN ; exercise ; WEIGHT ; PHYSICAL-ACTIVITY ; quality of life ; FATIGUE ; FUNCTIONAL ASSESSMENT ; Yoga
    Abstract: To obtain estimates of time to recruit the study sample, retention, facility-based class attendance and home practice for a study of yoga in breast cancer survivors, and its efficacy on fatigue, quality of life (QOL), and weight change. Sixty-three post-treatment stages 0-III borderline overweight and obese (body mass index a parts per thousand yen24 kg/m(2)) breast cancer survivors were randomly assigned to a 6-month, facility- and home-based viniyoga intervention (n = 32) or a waitlist control group (n = 31). The yoga goal was five practices per week. Primary outcome measures were changes in QOL, fatigue, and weight from baseline to 6 months. Secondary outcomes included changes in waist and hip circumference. It took 12 months to complete recruitment. Participants attended a mean of 19.6 classes and practiced at home a mean of 55.8 times during the 6-month period. At follow-up, 90% of participants completed questionnaires and 87% completed anthropometric measurements. QOL and fatigue improved to a greater extent among women in the yoga group relative to women in the control group, although no differences were statistically significant. Waist circumference decreased 3.1 cm (95% CI, -5.7 and -0.4) more among women in the yoga compared with the control group, with no difference in weight change. This study provides important information regarding recruitment, retention, and practice levels achieved during a 6-month, intensive yoga intervention in overweight and obese breast cancer survivors. Yoga may help decrease waist circumference and improve quality of life; future studies are needed to confirm these results
    Type of Publication: Journal article published
    PubMed ID: 21207071
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  • 4
    Abstract: PURPOSE: Cancer patients frequently experience reduced physical fitness due to the disease itself as well as treatment-related side effects. However, studies on physical fitness in pancreatic cancer patients are missing. Therefore, we assessed cardiorespiratory fitness and muscle strength of pancreatic cancer patients. METHODS: We included 65 pancreatic cancer patients, mostly after surgical resection. Cardiorespiratory fitness was assessed using cardiopulmonary exercise testing (CPET) and 6-min walk test (6MWT). Hand-held dynamometry was used to evaluate isometric muscle strength. Physical fitness values were compared to reference values of a healthy population. Associations between sociodemographic and clinical variables with patients' physical fitness were analyzed using multiple regression models. RESULTS: Cardiorespiratory fitness (VO2peak, 20.5 +/- 6.9 ml/min/kg) was significantly lower (-24%) compared to healthy reference values. In the 6MWT pancreatic cancer patients nearly reached predicted values (555 vs. 562 m). Maximal voluntary isometric contraction (MVIC) of the upper (-4.3%) and lower extremities (-13.8%) were significantly lower compared to reference values. Overall differences were larger in men than those in women. Participating in regular exercise in the year before diagnosis was associated with greater VO2peak (p 〈 .05) and MVIC of the knee extensors (p 〈 .05). CONCLUSIONS: Pancreatic cancer patients had significantly impaired physical fitness with regard to both cardiorespiratory function and isometric muscle strength, already in the early treatment phase (median 95 days after surgical resection). Our findings underline the need to investigate exercise training in pancreatic cancer patients to counteract the loss of physical fitness.
    Type of Publication: Journal article published
    PubMed ID: 28417202
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    Electronic Resource
    Electronic Resource
    Springer
    Supportive care in cancer 1 (1993), S. 2-2 
    ISSN: 1433-7339
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Supportive care in cancer 1 (1993), S. 19-25 
    ISSN: 1433-7339
    Keywords: Cancer ; Hypercalcaemia ; Humoral hypercalcaemia ; Management
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hypercalcaemia is a well-recognised complication in partients with several types of cancer. Since determination of the serum calcium has become routine particularly in hospital patients, the identification of hypercalcaemia associated with cancer has increased. Cancer is the most common cause of hypercalcaemia arising in hospitalised patients, and overall approximately onethird of all patients presenting with hypercalcaemia have an underlying cancer. In Western countries, the common causes of hypercalcaemia are cancers of the lung and breast. The median survival of patients with hypercalcaemia and cancer is only 5 weeks, indicating that in many patients treating hypercalcaemia may not achieve prolonged survical, even if symptoms are palliated. The clinical presentations of hypercalcaemia are well known, encompassing gastrointestinal, neurological, cardiovascular and renal symptoms. Management approaches have evolved over the past few years from hydration and use of drugs that promote calcium excretion to new treatments that inhibit bone resorption.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1433-7339
    Keywords: Hypercalcemia ; Cancer ; Osteolysis ; Bone metastases ; Bisphosphonates
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Tumor-induced hypercalcemia (TIH) and tumor-induced osteolysis (TIO) are essentially due to a marked increase in osteoclast-mediated bone resorption. Parathyroid-hormone-like protein plays and essential role in TIH, and maybe in TIO, but other substances, such as growth factors or cytokines, could contribute to the osteoclast activation and osteoblast inhibition secondary to the neoplastic infiltration of the skeleton. Treatment of TIH essentially consists of volume repletion and administration of potent anti-osteolytic drugs. Intravenous administration of the bisphosphonate clodronate or pamidronate is particularly useful for this. Pamidronate at a dose of 1.0–1.5 mg/kg as a single 4-to 24-h infusion can normalize serum calcium in about 90% of hypercalcemic cancer patients. The apparently low response rate of bone metastases to systemic antineoplastic therapy seems essentially to reflect the relative insensitivity of our current methods for assessing response in TIO. Quantitative evaluation of pain and of newly developed biochemical markers of bone turnover could be particularly useful for early assessment of response. Prolonged administration of oral pamidronate could reduce by almost one-half the complications of TIO, and iterative bisphosphonate infusions could induce a dramatic relief of bone pain in one-third and a sclerosis of lytic lesions in one-fourth of the cases. These data must, however, be confirmed in randomized blind trials and many questions remain unanswered concerning the optimal therapeutic schemes. Despite these limitations, medical therapy of TIO by non-cytotoxic means has already become a reality.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1433-7339
    Keywords: Bacteremia in cancer patients ; Clinical significance ; Blood cultures ; Nosocomial bacteremia ; Diagnostic criteria for bacteremia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A total of 1051 bacteremic episodes (782 patients) were prospectively recorded in 10 cancer centers (9 French, 1 Belgian), with: patient's age (mean 53, range 1–89 years), underlying cancer, neutropenia (〈1000 neutrophils/μl; 233), signs and symptoms, type of i.v. line (percutaneous central: 534; peripheral: 228; central implanted: 304), treatment, blood culture system, number of positive blood culture bottles/total obtained, time to growth. Of all episodes, 23.2% occurred within 48 h of admission. The patients were receiving systemic antibiotics at sampling (on AB) in 34.6% of cases. The 1147 pathogens isolated (86 polymicrobial) were: E. coli (10.7%), Klebsiella-Enterobacter-Serratia (6.1%), other enterobacteriaceae (2.2%), Pseudomonas aeruginosa (4.8%), other nonfermenters (4.7%), coagulase-negative staphylococci (CNS, 40.8%), Staphylococcus aureus (9.9%), streptococci (5.4%), enterococci (2.2%), anaerobes (3.4%), yeasts (3.5%), and other bacteria (6.9%). The CDC (Centers for Disease Control) criteria (1988) were used to assess significance: group 1: pathogenic species (616 episodes; 59%); group 2: clinical signs and isolation of a “contaminant” species (47; 4.5%); group 3: as in group 2 with an i.v. line and empiric antibiotic treatment (181 episodes including 176 CNS; 17%); group 4: non-significant (207 episodes including 203 CNS; 20%). Groups 1–3, in which the episodes were considered to be significant (844 episodes; 80%) were compared with non-significant episodes (Fisher). Significant differences (P≤0.05) were seen in time to growth (median growth within 24 h vs 48 h), fever (86% vs 54%), chills (40% vs 3%), hypotension (10% vs 2%), septic shock (9% vs 1%), polymicrobial etiology (10% vs 0.5%), and initiation of empiric antibiotic treatment (71% vs 4%). Bacteremic episodes of CDC groups 1,3 and 4 were further studied in episodes with a single isolate as a doubtful clinical significance (482 episodes) and episodes with ≥2 bottles positive of probable clinical significance (569 episodes; 54%). In group 1 (218 doubtful, 398 probably significant episodes) significant differences were seen in chills (36% vs 52%), shock (7% vs 13%), polymicrobial (8% vs 17%), initiation of empiric antibiotic treatment (60% vs 72%); in group 3 (87 doubtful, 94 probably significant) in time to growth delay; in group 4 (177 doubtful, 30 probably significant) in proportion with implanted catheter (26% vs 52%), fever (62% vs 10%), and time to growth. This study confirms the predominant role of Gram-positive cocci in bacteremia occurring in cancer patients.
    Type of Medium: Electronic Resource
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