Taste Alterations Do Not Affect Change in Food Habits and Body Weight in Breast Cancer Patients

Background/Aim: Chemotherapy-induced taste alterations (TAs) affect approximately 53-84% of breast cancer patients with significant consequences on flavor perception, possibly leading to food aversion and changes in daily dietary habits. The aim of this study was to investigate the relationship between TAs and changes in food habits and body weight among early breast cancer (EBC) patients undergoing adjuvant chemotherapy. Patients and Methods: TAs were prospectively evaluated in 182 EBC patients from April 2014 to June 2018. TAs, dietary habits, and body weight were collected by a trained dietician. TAs were classified into different subtypes according to the following basic taste perception: metallic, sweet, bitter, salty, sour, and umami taste. Results: During adjuvant chemotherapy, a significant reduction in the consumption of bread, breadsticks, red meat, fat salami, snacks, added sugar, milk, and alcoholic beverages was observed, regardless of TAs onset. No correlation between these dietary changes and different TAs subtypes was found. Body weight remained stable in most EBC patients (71.4%) and was not influenced by TAs onset and by different TAs subtypes. Conclusion: EBC patients change their dietary habits during adjuvant chemotherapy, mostly following the World Cancer Research Fund recommendations, irrespective of TAs onset and without affecting body weight

Re-use of wastewater for a sustainable forest production and climate change mitigation under arid environments

Over the last decades biotic and abiotic constrains together with human actions are determining a substantial environmental pressure, particularly in dry lands as the south of the Mediterranean region. From very long time, indeed, simultaneous drivers such as demographic growth, climate change and socio-economic factors are weakening the previous homeostasis between human needs and natural resources on the regional scale.Resulting pressures are determining environmental degradation and increase of desertification risk for the arid and semiarid lands. Water quality and availability are both crucial points limiting people well-being and livelihoods in the same context. Scarcity of fresh water and heavy and mismanaged production of wastewater are the main factors affecting water resources. Increasing pollution of soil and ground waters reduces the possibility of sustainable development of local communities with relevant social consequences. The FAO's supporting program in north Africa aims to: a) develop new and cheaper phytotechnologies (e.g. constructed wetland system; innovative treatment system for reuse of waste water for fertigation); b) treat wastewater for water quality protection; c) promote land recovery by means of sustainable multipurpose forestry; d) adopt bioengineering interventions to stop slopes erosion and protect urban, and semi-urban infrastructures; e) create pilot demonstrative areas to test multi-purpose sustainable agroforestry systems. Within this frame, an integrated approach was designed to promote innovative sustainable water management and multipurpose forestry, in order to mitigate the effects of climate change, promote land recovery, and improve the livelihoods of local population. The present paper aims to provide an overview of the FAO project GCP/RAB/013/ITA. Particularly, two pilot studies are shown and discussed

Identification of cork characters for phenotypic selection

Global change effects can determine major changes in species distribution and productivity. In the Mediterranean region of the severity of hot and dry periods is growing and an increased frequency of extreme events and a major vulnerability of natural ecosystems is evident. Cork oak (Quercus suber L.) is widely spread in the West Mediterranean region and its economic and social is important

Long-term survivors with immunotherapy in advanced NSCLC: is 'cure' within reach?

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Sleep disturbances and restless legs syndrome in postmenopausal women with early breast cancer given adjuvant aromatase inhibitor therapy

Whether adjuvant therapy with aromatase inhibitors (AIs) causes sleep disturbances or not in postmenopausal women with early breast cancer (EBC) is still a controversial issue

PD-L1 for selecting non-small-cell lung cancer patients for first-line immuno-chemotherapy combination: a systematic review and meta-analysis

Aim: With the final aim to explore the first-line treatment options for non-small-cell lung cancer (NSCLC) patients, we performed a systematic review and literature-based meta-analysis of available clinical trials exploring immunotherapy in combination versus standard histology-based chemotherapy. Materials & methods: We evaluated interactions according to type of treatment-add-on strategy: immunotherapy in combination versus standard chemotherapy-based regimens. Hazard ratio (HR) for overall survival (OS) and progression-free survival (PFS) were extracted and cumulated. Results: Seven trials (4278 patients) were included. The addition of immunotherapy to standard chemotherapy-based regimens significantly increased OS (HR 0.74; p = 0.001) and PFS (HR 0.61; p < 0.0001) compared with standard-of-care in NSCLC patients in first-line setting. Conclusion: Immunotherapy-based regimens constantly improved OS and PFS compared with chemotherapy in first-line treatment of nononcogene-addicted NSCLC

Subject-specific features of excitation/inhibition profiles in neurodegenerative diseases

Brain pathologies are characterized by microscopic changes in neurons and synapses that reverberate into large scale networks altering brain dynamics and functional states. An important yet unresolved issue concerns the impact of patients' excitation/inhibition profiles on neurodegenerative diseases including Alzheimer's Disease, Frontotemporal Dementia, and Amyotrophic Lateral Sclerosis. In this work, we used The Virtual Brain (TVB) simulation platform to simulate brain dynamics in healthy and neurodegenerative conditions and to extract information about the excitatory/inhibitory balance in single subjects. The brain structural and functional connectomes were extracted from 3T-MRI (Magnetic Resonance Imaging) scans and TVB nodes were represented by a Wong-Wang neural mass model endowing an explicit representation of the excitatory/inhibitory balance. Simulations were performed including both cerebral and cerebellar nodes and their structural connections to explore cerebellar impact on brain dynamics generation. The potential for clinical translation of TVB derived biophysical parameters was assessed by exploring their association with patients' cognitive performance and testing their discriminative power between clinical conditions. Our results showed that TVB biophysical parameters differed between clinical phenotypes, predicting higher global coupling and inhibition in Alzheimer's Disease and stronger N-methyl-D-aspartate (NMDA) receptor-dependent excitation in Amyotrophic Lateral Sclerosis. These physio-pathological parameters allowed us to perform an advanced analysis of patients' conditions. In backward regressions, TVB-derived parameters significantly contributed to explain the variation of neuropsychological scores and, in discriminant analysis, the combination of TVB parameters and neuropsychological scores significantly improved the discriminative power between clinical conditions. Moreover, cluster analysis provided a unique description of the excitatory/inhibitory balance in individual patients. Importantly, the integration of cerebro-cerebellar loops in simulations improved TVB predictive power, i.e., the correlation between experimental and simulated functional connectivity in all pathological conditions supporting the cerebellar role in brain function disrupted by neurodegeneration. Overall, TVB simulations reveal differences in the excitatory/inhibitory balance of individual patients that, combined with cognitive assessment, can promote the personalized diagnosis and therapy of neurodegenerative diseases

Morphometric vertebral fractures in breast cancer patients treated with adjuvant aromatase inhibitor therapy: A cross-sectional study

BACKGROUND: The impact of long-term adjuvant therapy with aromatase inhibitors (AIs) on vertebral fracture (VF) risk is still unclear. OBJECTIVE: In this cross-sectional study, we explored the prevalence and determinants of VFs in breast cancer (BC) patients before and during AI therapy. Each woman underwent a dual-energy X-ray absorptiometry (DXA) to evaluate bone mineral density (BMD) and identify VFs by a quantitative morphometric approach. Blood samples were collected to measure serum hormone and calcium levels. RESULTS: We consecutively included 263 postmenopausal women with hormone receptor-positive early BC. One-hundred-sixty-nine women were AI-naïve, and 94 were AI-treated. AI-treated patients had lower BMD at total hip (p=0.01) and lumbar spine (p=0.03), higher serum vitamin D (p<0.001) and parathyroid hormone (p=0.006) values as compared to AI-naïve patients. The prevalence of VFs was 18.9% in AI-naïve patients, and 31.2% in those assessed during AI therapy (odds ratio 1.90, 95% CI 1.1-3.5, p=0.03). In AI-naïve patients, VFs were associated with older age (p=0.002) and lower BMD values at femoral neck (p=0.04) and total hip (p=0.007), whereas VFs occurred without association with any parameter analyzed in AI-treated patients. In AI-treated group, the prevalence of VFs was not significantly different between patients with osteoporosis and those with normal BMD (36.7% vs. 20.0%; p=0.31). CONCLUSIONS: In women with early BC, AI therapy is associated with high prevalence of radiological VFs, which were shown to be independent of BMD values during the adjuvant treatment. These findings may be clinically relevant since they may lead to a change in management of AI-induced skeletal fragility. Specifically, the results of this study provide a rationale for performing a morphometric evaluation of VFs in all women undergoing treatment with AIs

Clinical implication of changes in body composition and weight in patients with early-stage and metastatic breast cancer

Breast cancer represents the most frequent cancer among women in Western countries. Although physicians and patients have witnessed a significant evolution in both treatment strategies and personalized medicine (the identification of featured patients\u2019 subsets such as HER2-driven disease), the identification of additional prognostic clinical predictors referring to patients\u2019 dietary habits represents a research area aiming to further improve the overall management of this disease. In this regard, body composition (i.e. the relative proportion of fat and muscles) and its changes have recently generated growing interest. A large body of evidence supports the relationship between overweight or weight gain and poor outcome in patients with early-stage breast cancer during adjuvant, and more recently, also neoadjuvant therapy. Nevertheless, available data on post-diagnosis weight variations and mortality report controversial results. Indeed, the limited data produced in the metastatic setting do not indicate an impact of body size on the outcome of these patients. With these perspectives, this review aims to elucidate the complex association between weight, body composition and breast cancer outcome, across the different settings of such disease. The more recent and important findings are highlighted, emphasizing the potential role of body composition assessment to predict individualize chemotherapy dosing, toxicity and efficacy, in order to improve the overall health status and prognosis of such still to date growing patients\u2019 population