Do cancer patients change their diet in the e-health information era? A review of the literature and a survey as a proposal for the Italian population.

In recent years, there has been an explosion in the amount of available information on cancer in parallel with an ever-increasing number of cancer survivors. Cancer patients and long-term survivors are known to be more sensitive to health-related information and dietary changes could represent a potential consequence of this huge availability of messages. In our review about dietary changes after cancer diagnosis, we found that this topic is particularly investigated among the breast cancer population. The literature examined show that breast cancer patients modify their eating habits after diagnosis in a percentage that varies between approximately 30% and 60%. The most reported changes were an increased consumption of fruit and vegetables, a decrease in the consumption of red meat, fats and sugary foods. Patients who reported changes were more likely to be younger, with higher educational levels and with a longer period of time since their diagnosis of cancer. It also emerged that cancer patients are often more likely to use supplements. This topic has not been investigated in cancer patients in Italy, therefore, we propose an approach to explore it with a structured questionnaire: The "ECHO SURVEY - Eating habits CHanges in Oncologic patients".

[Food allergy and asthma]. / Allergia alimentare e asma.

The prevalence of asthma in patients suffering from food allergy or food intolerance had been studied in 1339 subjects. Of them, 165 patients (12.8%) were affected by asthma. However only 77 (5.7%) had positive prick tests for food antigens and 52 of these have a significant benefit when a suitable oligoallergenic diet was introduced. 35 out of patients were positively tested with a double-blind food challenge. The most frequent food antigen involved were milk and its derivatives and cereals, but some importance have also the additives to the food. In conclusion, in our patients suffering from food allergy or food intolerance asthma was present in 12.8% of the cases, but in only 77 (5.7%) the symptoms might be due to diet. When tested with oligoallergenic diet or with food challenge the percentage of positivity fall to 3.9% and 2.6% respectively.

Double-blind cross-over trial of oral sodium cromoglycate in patients with irritable bowel syndrome due to food intolerance.

Twenty patients with irritable bowel syndrome due to food intolerance were randomized to either oral sodium cromoglycate or placebo in a double-blind cross-over trial. The study consisted of treatment with either sodium cromoglycate or placebo for 8 weeks, followed by the cross-over treatment for 8 further weeks. Patients were allowed to eat the offending foods during the study. Eighteen patients completed the study. Analysis of patients' diary card scores showed a statistically significant difference in favour of sodium cromoglycate. There was a long carry-over effect in the active-placebo order group. Therefore oral sodium cromoglycate seems to be a useful treatment in patients with irritable bowel syndrome and proven food intolerance.

[Comparison of RAST with an immunoenzyme method in simultaneous determination of IgE specific for numerous air allergens]. / Confronto con il RAST di un metodo immunoenzimatico per la determinazione contemporanea delle IgE specifiche verso numerosi aeroallergeni.

Recently, a new immunoenzymatic test (Allergy Screen Profile, ASP) has been proposed for the simultaneous determination of IgE specific for five inhaled allergens (Dermatophagoides, animal dander, trees, grass pollen and Parietaria). For evaluation of this test we compared the results obtained in twenty-seven patients suffering from respiratory allergy with RAST with those obtained using the new test. In 84.3% of cases there was positive concordance between the two tests. The specificity of ASP ranged from 71.4% to 100% and the sensitivity from 76.9% to 95.2% for the different allergens examined. A good correlation between ASP and RAST was particularly evident for Dermatophagoides, animal dander and trees. Therefore, ASP appears to be a suitable test for the simultaneous determination of IgE specific for different allergens.

[The assessment of the incidence of food allergy or intolerance in patients with respiratory allergy]. / Valutazione della frequenza di allergia o intolleranza alimentare in pazienti affetti da allergia respiratoria.

In this study we have evaluated the possible relationship between food allergens and hypersensitivity to grass pollens. One hundred-thirty patients with grass pollen pollinosis and symptoms probably related to adverse reaction to foods were selected. Skin prick test for food allergens was positive in 79 patients (60.7%) Statistical analysis using chi-square test showed a high significant relationship between grass pollen and nuts, peanuts, beans and peas (p less than 0.0001). Elimination diet and challenge test allowed us to identify the responsible foods in 61 out 79 patients (77.2%). Twelve patients were affected by food allergy (challenge test, skin prick test and RAST positive and concordant); 49 patients suffered from intolerance. Possible causes of this high relationship are discussed.

[Prevalence of food allergy in patients with urticaria-angioedema syndrome]. / Prevalenza dell'allergia alimentare in pazienti affetti da sindrome orticaria-angioedema.

We have studied 239 patients, 53 males and 186 females, mean age 31.9, affected by urticaria-angioedema syndrome. Fifty-three patients didn't complete the study. One-hundred-three of the other 186 patients went on elimination diet: 111 patients suffered from chronic urticaria-angioedema syndrome and 21 subjects suffered from acute syndrome. Eighty-one out of the 132 patients obtained good results from dietetic management (p less than 0.001). Double blind challenge test was positive in 42 subjects: 29 patients suffered from Food Allergy and 13 patients from Food Intolerance. Thus, the prevalence of Food Allergy in patients who completed dietetic management was 21.9% (29 patients out of 132). If we evaluate all the 186 patients affected by urticaria-angioedema syndrome, the prevalence of Food Allergy is 15.5%.

[Eczema and food allergy in the adult]. / Eczema e allergia alimentare nell'adulto.

We have evaluated the relationship between eczema and food by using elimination diet and subsequently open and double blind challenge test in 15 patients. The clinical manifestations of 14 subjects were improved by elimination diet. Challenge test was positive in 10 patients. Nuts, tomatoes, milk, eggs and cereals were most frequently involved. Six patients suffered from food allergy (F.A.), 4 patients from food intolerance (F.I.) and 4 patients from suspected F.I. With the use of dietary elimination procedure the symptoms completely disappeared. The results obtained for the treatment of eczema with this procedure may be very encouraging.

[Nasal polyps and food intolerance: is there any correlation]. / Poliposi nasale e intolleranza alimentare: esiste una qualche correlazione?

Nasal polyposis is a relatively frequent disease of poorly known aetiopathogenesis. In this study the Authors have evaluated the relationship between nasal polyposis and food using elimination diet and the double-blind challenge test. Of twenty-two patients examined, 16 (72.8%) completed the study. Six out of 16 subjects improved when on diet and challenged with specific foods. Two patients were affected by food allergy and 4 by food intolerance. Physical evaluation of nasal polyposis showed an improvement in all 6 patients, while rhinomanometric evaluation showed an improvement in 4 out of 6 patients, after diet. Most patients had an alteration of immunological tests involving IgE or circulating immunocomplexes-mediated mechanism.

[Treatment of Behçet's syndrome with colchicine]. / Trattamento della sindrome di Behçet con Colchicina.

The aim of the present study was to investigate the usefulness of colchicine in the treatment of Behçet's syndrome. Ten patients suffering from Behçet's syndrome were selected for this purpose. The patients were treated with 1 mg/day of colchicine associated with 1 mg of betametasone during the initial florid phase of the disease. After the acute phase, betametasone was withdrawn. The patients were observed for a period ranging from 5 to 23 months. Biochemical and immunological parameters were measured at time 0 and every month in order to monitor the disease and the possible side effects of colchicine. All patients had a satisfactory control of the disease without showing any toxic effect.

Is the Melkersson-Rosenthal syndrome related to the exposure to food additives? A case report.

We present a case of Melkersson-Rosenthal syndrome that occurred in an adult patient who experienced intolerance to the food additives sodium benzoate and tartrazine. The main symptoms were the facial swelling, hypertrophy of the gums, and a typical infiltration of lymphocytes and plasma cells around the small vessels observed in the biopsy of the gums. No involvement of facial nerves was present, and other disorders of granulomatosis have been excluded. All clinical manifestations went into remission once the food additives were excluded from the usual diet.

[Migraine and food]. / Emicrania e alimenti.

The frequency of migraine has been studied in adult patients with suspected adverse reaction to foods. Migraine was present in 41 out of 300 patients (13.6%). 38 of these 41 subjects have been treated with elimination diet; 25 (65.7%) obtained a significant improvement of migraine and subsequently, performed challenge test. 24 patients were affected by food intolerance and only one by food allergy. The remaining 13 non-responder subjects suffering from migraine have been subsequently submitted to pharmacological treatment.

Pharmacokinetics of the enantiomers of indoprofen in man.

Indoprofen, a non-steroidal analgesic and antiinflammatory drug whose activity and safety in man have been established in a large number of studies, has an asymmetric carbon atom and can therefore occur as either the (+) or the (-) enantiomer. As it has been shown that its pharmacological effects are almost entirely due to the (+) isomer (d-indoprofen), some pharmacokinetic properties of the latter have been studied in man in comparison with the racemic mixture given by oral administration, d-indoprofen is cleared from plasma and excreted in urine (as unchanged plus conjugated drug) at a slower rate than l-indoprofen. Moreover, no stereospecific inversion of d-indoprofen to the inactive enantiomer occurs after either single or repeated (one week) administration. The pharmacokinetic behaviour of d-indoprofen in the human organism appears to be the same after administration of the racemic form or of the dextro-enantiomer, when the latter is given at half the dose.

Effects of caroxazone, a reversible monoamine oxidase inhibitor, on the pressor response to intravenous tyramine in man.

1 Caroxazone is a new antidepressant drug with reversible MAO-inhibitory activity. 2 The pressor effect of intravenously injected tyramine has been evaluated in six male healthy volunteers before, during oral treatment with caroxazone 200 mg three times daily and at different time intervals after discontinuation of treatment. 3 Caroxazone produces a moderate tyramine supersensitivity. 4 The reversibility of MAO-inhibition produced by caroxazone is clearly reflected by the time-course of tyramine supersensitivity. In fact, tyramine potentiation does not accumulate with caroxazone cumulative dose, while it is correlated to drug plasma levels and disappears rapidly (half-life 1.5 days) upon discontinuation of treatment. 5 caroxazone seems to be safer and more manageable than all other clinically available MAO-inhibitors which produce irreversible inactivation of MAO.

Effects of caroxazone, a reversible monoamine oxidase inhibitor, on the pressor response to oral tyramine in man.

1 A double-blind, placebo-controlled study was carried out in order to investigate the effects of caroxazone, a new antidepressant drug endowed with a reversible short-lasting MAO-inhibitory activity in man, on the blood pressure response to tyramine administered by the oral route. 2 The study was carried out in 9 healthy volunteers who were randomly assigned to treatment with caroxazone 200 mg three times daily (7 subjects) or with indistinguishable placebo (2 subjects). 3 The sensitivity to tyramine was assessed in each subject both before and after the 7-9 days of treatment. 4. While placebo did not modify the pressor response to tyramine, the threshold dose of tyramine which induced a rise in systolic blood pressure was lowered by about four-fold in 6 out of the 7 subjects treated with caroxazone. In the seventh subject the observed potentiation of peroral tyramine was not quantitatively evaluable. 5 Challenges performed in three subjects after discontinuation of treatment with caroxazone show that the effects of the compound are short-lasting, since the sensitivity to tyramine seems to regain the baseline value within 1-2 days. 6 Even if caroxazone potentiates peroral tyramine to a relatively low degree, a tyramine poor diet is recommended for patients during caroxazone treatment. 7 The reversibility of the MAO-inhibitory action of caroxazone is confirmed by the rapid return to normal values in the response to tyramine after discontinuation of treatment. This property of caroxazone would allow patients to return to a free diet in much less time than the safety limit of 2 weeks recommended for the currently used irreversible MAO-inhibitors.