Supervised, structured and individualized exercise in metastatic breast cancer: a randomized controlled trial.

Physical exercise both during and after curative cancer treatment has been shown to reduce side effects. Evidence in the metastatic cancer setting is scarce, and interventions that improve health-related quality of life (HRQOL) are much needed for patients with metastatic breast cancer (MBC). The multinational randomized controlled PREFERABLE-EFFECT trial assessed the effects of exercise on fatigue and HRQOL in patients with MBC. In total, 357 patients with MBC and a life expectancy of ≥6 months but without unstable bone metastases were recruited at eight study centers across five European countries and Australia. Participants were randomly assigned (1:1) to usual care (control group, n = 179) or a 9-month supervised exercise program (exercise group, n = 178). Intervention effects on physical fatigue (European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-FA12 scale) and HRQOL (EORTC QLQ-C30 summary score) were determined by comparing the change from baseline to 3, 6 (primary timepoint) and 9 months between groups using mixed models for repeated measures, adjusted for baseline values of the outcome, line of treatment (first or second versus third or higher) and study center. Exercise resulted in significant positive effects on both primary outcomes. Physical fatigue was significantly lower (-5.3 (95% confidence interval (CI), -10.0 to -0.6), Bonferroni-Holm-adjusted P = 0.027; Cohen's effect size, 0.22) and HRQOL significantly higher (4.8 (95% CI, 2.2-7.4), Bonferroni-Holm-adjusted P = 0.0003; effect size, 0.33) in the exercise group than in the control group at 6 months. Two serious adverse events occurred (that is, fractures), but both were not related to bone metastases. These results demonstrate that supervised exercise has positive effects on physical fatigue and HRQOL in patients with MBC and should be recommended as part of supportive care.ClinicalTrials.gov Identifier: NCT04120298 .

Changes in treatment of aortic valve diseases for acute and elective indications during the COVID-19 pandemic: A retrospective single-center analysis from 2019 to 2020.

BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic had an impact on the quality of healthcare services and led to many changes in the treatment of cardiac pathologies. OBJECTIVES: To assess the differences in the clinical manifestations, management and outcomes of patients with aortic valve diseases (AVDs) treated invasively before and during the pandemic. MATERIAL AND METHODS: This retrospective single-center study involved patients with AVDs treated by means of balloon aortic valvuloplasty (BAV), transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR) in 2019 and 2020. They were divided into groups with respect to the year of intervention (2019 compared to 2020) and the priority of admission (urgent compared to elective). Preoperative characteristics, early outcomes and probability of annual survival were compared between the groups. RESULTS: The number of patients admitted urgently increased from 37 in 2019 to 54 in 2020, with a higher prevalence of men in 2020 (83.3% compared to 56.8%, respectively). Elective cases, on the other hand, declined from 279 in 2019 to 256 in 2020. Among the latter, more subjects had manifestations of heart failure (p < 0.001), coronary artery disease (CAD; p = 0.002), hypertension (p = 0.006), as well as had a history of a stroke (p = 0.002). In the meantime, more TAVI and fewer SAVR procedures were performed in 2020 (86 compared to 127 and 192 compared to 125, respectively; p < 0.001). In 2020, TAVI individuals had risk of death (according to the EuroSCORE scale) than in 2019 (p < 0.001). The probability of annual survival was comparable (p = 0.769) among AVD patients treated before and during the coronavirus pandemic (91.3% compared to 88.3%, respectively). CONCLUSION: Although during the COVID-19 pandemic more nonelective and higher-risk AVD individuals received interventional treatment, the outcomes were comparable to the pre-pandemic era (2019). Our findings support highly valuable, less invasive therapeutic methods for treating aortic pathologies during the pandemic.

The Antioxidant Content of Coffee and Its In Vitro Activity as an Effect of Its Production Method and Roasting and Brewing Time.

Coffee is one of the most popular beverages in the world. The high production and health properties of coffee make it one of the best among daily drinks. Coffee is wrongly identified as only a stimulant because of its caffeine content. On the other hand, coffee is one of the best sources of other bioactive compounds, such as flavonoids and phenolic acids. Organic coffee is produced without artificial fertilizers and pesticides. Not only the high quality of beans but also roasting and brewing times guarantee the best taste and quality of coffee beverages. The aim of the present experiment was to determine the best level of roasting and brewing time for organic and conventional coffee. The experiment was carried out with Peru coffee beans from organic and conventional farms. The contents of caffeine and bioactive compounds were measured in different roasted and brewed coffee drinks. The obtained results showed that the conventional coffee contained significantly more caffeine, total flavonoids, and quercetin derivatives than the organic coffee. On the other hand, the organic coffee was characterized by a higher level of almost all bioactive compounds. The best level of roasting was determined to be medium, and the optimal brewing time was 3 minutes.

Physical exercise for functional capacity, blood immune function, fatigue, and quality of life in high-risk prostate cancer patients during radiotherapy: a prospective, randomized clinical study.

BACKGROUND: During radiotherapy (RT), prostate cancer (PCa) patients may report cancer related fatigue (CRF), which impairs functional capacity, psychological status, and quality of life (QoL). RT can induce cytokine responses that could play a role in mediating radiation toxicity by increasing inflammation. While it is known that physical exercise plays an important anti-inflammatory role in healthy adults, its specific anti-inflammatory effects in PCa patients with CRF have not yet been determined. AIM: Previous studies have shown that physical exercise in cancer patients undergoing RT improves cardiac fitness, muscle strength, and QoL, however it is still unknown how physical exercise affects inflammation and its specific consequences in PCa patients. Therefore, the purpose of this trial was to examine the effect of supervised physical exercise on inflammatory blood markers, as well as the relationship of these parameters with functional capacity, fatigue, and QoL in high-risk PCa patients undergoing RT. DESIGN: This was a prospective, two-arm randomized controlled clinical trial. SETTING: The study was performed in our outpatients center. POPULATION: Fifty-four high-risk PCa men were randomly allocated to two groups prior to undergoing RT. METHODS: Twenty-seven patients performed supervised, moderate-intensity physical exercise (exercise group; EG) and the other 27 formed a control group that carried out normal daily physical activity (usual group; UG). The following parameters were assessed before and after RT: functional capacity, changes in blood count variables and production of pro-inflammatory cytokines (interleukin [IL]-1ß, IL-6, tumor necrosis factor [TNF]-α), fatigue, and QoL (using FACT-F score and EORTC questionnaires). RESULTS: No significant differences existed between the study groups at baseline assessment. After RT, there was a significant improvement in functional capacity (P<0.05) and a decrease in pro-inflammatory cytokine levels (P>0.05) and fatigue (P<0.05) in the EG compared to the UG. Fatigue level was significantly higher in the UG (F[2.126]; P<0.05) after RT than before. Physical exercise had no effect on the correlation between inflammatory blood markers and functional capacity and fatigue scores provided by study participants. CONCLUSIONS: Regular, moderate-intensity physical exercise improves functional capacity, decreases the production of inflammatory markers and fatigue, and has a positive influence on QoL in high-risk PCa patients during RT. CLINICAL REHABILITATION IMPACT: This is one of the first studies to examine the effects of supervised exercise training on pro-inflammatory cytokine levels during RT in PCa patients by measuring functional capacity, fatigue, and QoL.