A prospective multicentre study in Sweden and Norway of mental distress and psychiatric morbidity in head and neck cancer patients

A Swedish/Norwegian head and neck cancer study was designed to assess prospectively the levels of mental distress and psychiatric morbidity in a heterogeneous sample of newly diagnosed head and neck cancer patients. A total of 357 patients were included. The mean age was 63 years, and 72% were males. The patients were asked to answer the HAD scale (the Hospital Anxiety and Depression scale) six times during 1 year. The number of possible or probable cases of anxiety or depression disorder was calculated according to standardized cut-offs. Approximately one-third of the patients scored as a possible or probable case of a major mood disorder at each measurement point during the study year. There were new cases of anxiety or depression at each time point. The anxiety level was highest at diagnosis, while depression was most common during treatment. Females were more anxious than males at diagnosis, and patients under 65 years of age scored higher than those over 65. Patients with lower performance status and more advanced disease reported higher levels of mental distress and more often scored as a probable or possible cases of psychiatric disorder. Our psychometric analyses supported the two-dimensional structure and stability of the HAD scale. The HAD scale seems to be the method of choice for getting valid information about the probability of mood disorder in head and neck cancer populations. The prevalence of psychiatric morbidity found in this study emphasizes the importance of improved diagnosis and treatment

Changes in serum lipids and postprandial glucose and insulin concentrations after consumption of beverages with beta-glucans from oats or barley: a randomised dose-controlled trial

Objectives: To investigate side by side the effects on serum lipoproteins and postprandial glucose and insulin concentrations of beverages enriched with 5 or 10 g of beta-glucans from oats or barley. Design and setting: An 8-week single blind, controlled study with five parallel groups carried out at two centres under identical conditions. Interventions: During a 3-week run-in period all subjects consumed a control beverage. For the following 5-week period four groups received a beverage with 5 or 10 g beta-glucans from oats or barley and one group continued with the control beverage. Blood samples in weeks 0, 2, 3, 7 and 8 were analysed for serum lipids, lipoproteins, glucose and insulin. Postprandial concentrations of glucose and insulin were compared between control and the beverage with 5 g of beta-glucans from oats or barley. Results: Compared to control, 5 g of beta-glucans from oats significantly lowered total-cholesterol by 7.4% ( P<0.01), and postprandial concentrations of glucose ( 30 min, P = 0.005) and insulin ( 30 min, P = 0.025). The beverage with 10 g of beta-glucans from oats did not affect serum lipids significantly in comparison with control. No statistically significant effects compared to control of the beverages with barley beta-glucans were found. Conclusions: A daily consumption of 5 g of oat beta-glucans in a beverage improved the lipid and glucose metabolism, while barley beta-glucans did not

Fermented, ropy, oat-based products reduce cholesterol levels and stimulate the bifidobacteria flora in humans

This investigation determined the effects of fermented oat-based products containing both native and microbial beta-glucans on plasma lipids and on fecal total bacterial count and Bifidobacterium ssp. The study was randomized, double blind with 3 parallel groups. Sixty-two free-living volunteers with moderately increased plasma cholesterol levels were recruited. In the final analysis, 56 subjects remained, as 6 subjects had left the study either due to lack of time (n = 2), unwillingness to continue the regimen (n = 2), or for other reasons (n = 2). During the first 3 weeks, all subjects received a fermented dairy-based product (control product, run-in period). On the following 5 weeks, I group continued with the control product, whereas the other 2 groups were given fermented oat-based products (intervention period, 3-3.5 g native beta-glucans per day). One of the oat products (ropy) was cofermented with an exopolysaccharide-producing strain, Pediococcus damnosus 2.6. A significant (P = .022) reduction in total cholesterol by 6% was observed in volunteers who had eaten the fermented, ropy, oat-based product compared with the control group. No other significant changes in plasma lipids were found. A significant increase in total bacterial count (P = .001) and Bifidobacterium ssp (P = .012) was observed in fecal samples from volunteers in the group who had eaten the fermented, ropy, oat-based product. This study shows that a fermented, ropy, oat-based product, containing both native and microbial glucans, can reduce the blood cholesterol level and also stimulate the bifidobacteria flora in the gastrointestinal tract. (c) 2005 Elsevier Inc. All rights reserved

Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&amp;N35

PURPOSE: The aim of this study was to define the scales and test the validity, reliability, and sensitivity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-H&N35, a questionnaire designed to assess the quality of life of head and neck (H&N) cancer patients in conjunction with the general cancer-specific EORTC QLQ-C30. PATIENTS AND METHODS: Questionnaires were given to 500 H&N cancer patients from Norway, Sweden, and the Netherlands as part of two prospective studies. The patients completed the questionnaires before, during (Norway and Sweden only), and after treatment, yielding a total of 2070 completed questionnaires. RESULTS: The compliance rate was high, and the questionnaires were well accepted by the patients. Seven scales were constructed (pain, swallowing, senses, speech, social eating, social contact, sexuality). Scales and single items were sensitive to differences between patient subgroups with relation to site, stage, or performance status. Most scales and single items were sensitive to changes, with differences of various magnitudes according to the site in question. The internal consistency, as assessed by Cronbach's alpha coefficient, varied according to assessment point and within subsamples of patients. A low overall alpha value was found for the speech and the senses scales, but values were higher in assessments of patients with laryngeal cancer and in patients with nose, sinus, and salivary gland tumors. Scales and single items in the QLQ-H&N35 seem to be more sensitive to differences between groups and changes over time than do the scales and single items in the core questionnaire. CONCLUSION: The QLQ-H&N35, in conjunction with the QLQ-C30, provides a valuable tool for the assessment of health-related quality of life in clinical studies of H&N cancer patients before, during, and after treatment with radiotherapy, surgery, or chemotherapy

An oat bran meal influences blood insulin levels and related gene sets in peripheral blood mononuclear cells of healthy subjects

The understanding of how fibre-rich meals regulate molecular events at a gene level is limited. This pilot study aimed to investigate changes in gene expression in peripheral blood mononuclear cells (PBMCs) from healthy subjects after consumption of an oat bran-rich meal. Fifteen subjects (8 men and 7 women, aged 20–28 years) ingested meals with oat bran or a control meal after an overnight fast. Blood samples for analysis of postprandial glucose, insulin and triglyceride concentrations were taken during 3 h, while PBMCs for microarray gene expression profiling from five men and five women were taken before and 2 h after the meal. Analysis of transcriptome data was performed with linear mixed models to determine differentially expressed genes in response either to meal intake or meal content, and enrichment analysis was used to identify functional gene sets responding to meal intake and specifically to oat bran intake. Meal intake as such affected gene expression for genes mainly involved in metabolic stress; indicating increased inflammation due to the switch from fasting to fed state. The oat bran meal affected gene sets associated with a lower insulin level, compared with the control meal. The gene sets included genes involved in insulin secretion and β-cell development, but also protein synthesis and genes related to cancer diseases. The oat bran meal also significantly lowered postprandial blood insulin IAUC compared to control. Further studies are needed to compare these acute effects with the long-term health effects of oat bran