ABSTRACT

BACKGROUND: Maintaining the ability to perform self-care is a critical goal in patients with cancer. We assessed whether the patient-reported ability to walk 4 m and wash oneself predict survival in patients with pre-terminal cancer.

METHODS: We performed a prospective observational study on 169 consecutive hospitalized patients with cancer (52% female, 64 ± 12 years) and an estimated 1-12 months prognosis at an academic, inpatient palliative care unit. Patients answered functional questions for 'today', 'last week', and 'last month', performed patient-reported outcomes (PROs), and physical function assessments.

RESULTS: Ninety-two (54%) patients reported the ability to independently walk 4 m and 100 (59%) to wash 'today'. The median number of days patients reported the ability to walk 4 m and wash were 6 (IQR 0-7) and 7 (0-7) days ('last week'); and 27 (5-30) and 26 (10-30) days ('last month'). In the last week, 32% of patients were unable to walk 4 m on every day and 10% could walk on 1-3 days; 30% were unable to wash on every day and 10% could wash on 1-3 days. In the last months, 14% of patients were unable to walk 4 m on every day and 10% could only walk on 1-10 days; 12% were unable to wash on every day and 11% could wash on 1-10 days. In patients who could walk 'today' average 4 m gait speed was 0.78 ± 0.28 m/s. Patients who reported impaired walking and washing experienced more symptoms (dyspnoea, exertion, and oedema) and decreased physical function (higher Eastern Cooperative Oncology Group Performance Status, and lower Karnofsky Performance Status and hand-grip strength [unable vs. able to walk 'today': 205 ± 87 vs. 252 ± 78 Newton, P = 0.001; unable vs. able to wash 'today': 204 ± 86 vs. 250 ± 80 Newton, P = 0.001]). During the 27 months of observation, 152 (90%) patients died (median survival 46 days). In multivariable Cox proportional hazards regression analyses, all tested parameters were independent predictors of survival: walking 4 m 'today' (HR 0.63, P = 0.015), 'last week' (per 1 day: HR 0.93, P = 0.011), 'last month' (per 1 day: HR 0.98, P = 0.012), 4 m gait speed (per 1 m/s: HR 0.45, P = 0.002), and washing 'today' (HR 0.67, P = 0.024), 'last week (per 1 day HR 0.94, p=0.019), and 'last month' (per 1 day HR 0.99, P = 0.040). Patients unable to walk and wash experienced the shortest survival and most reduced functional status.

CONCLUSIONS: In patients with pre-terminal cancer, the self-reported ability to walk 4 m and wash were independent predictors of survival and associated with decreased functional status.

PMID:37222009 | DOI:10.1002/jcsm.13247

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PubMed articles on: Cardio-Oncology

Barbed palatal surgery: single stage or multilevel setting-a systematic review by the Young Otolaryngologists of the Italian Society of Otolaryngology

Eur Arch Otorhinolaryngol. 2023 May 25. doi: 10.1007/s00405-023-08018-5. Online ahead of print.

ABSTRACT

Chemotherapy was conventionally applied to kill cancer cells, but regrettably, they also induce damage to normal cells with high-proliferative capacity resulting in cardiotoxicity, nephrotoxicity, peripheral nerve toxicity, and ovarian toxicity. Of these, chemotherapy-induced ovarian damages mainly include but are not limited to decreased ovarian reserve, infertility, and ovarian atrophy. Therefore, exploring the underlying mechanism of chemotherapeutic drug-induced ovarian damage will pave the way to develop fertility-protective adjuvants for female patients during conventional cancer treatment. Herein, we firstly confirmed the abnormal gonadal hormone levels in patients who received chemotherapy and further found that conventional chemotherapeutic drugs (cyclophosphamide, CTX; paclitaxel, Tax; doxorubicin, Dox and cisplatin, Cis) treatment significantly decreased both the ovarian volume of mice and the number of primordial and antral follicles and accompanied with the ovarian fibrosis and reduced ovarian reserve in animal models. Subsequently, Tax, Dox, and Cis treatment can induce the apoptosis of ovarian granulosa cells (GCs), likely resulting from excessive reactive oxygen species (ROS) production-induced oxidative damage and impaired cellular anti-oxidative capacity. Thirdly, the following experiments demonstrated that Cis treatment could induce mitochondrial dysfunction through overproducing superoxide in GCs and trigger lipid peroxidation leading to ferroptosis, first reported in chemotherapy-induced ovarian damage. In addition, N-acetylcysteine (NAC) treatment could alleviate the Cis-induced toxicity in GCs by downregulating cellular ROS levels and enhancing the anti-oxidative capacity (promoting the expression of glutathione peroxidase, GPX4; nuclear factor erythroid 2-related factor 2, Nrf2 and heme oxygenase-1, HO-1). Our study confirmed the chemotherapy-induced chaotic hormonal state and ovarian damage in preclinical and clinical examination and indicated that chemotherapeutic drugs initiated ferroptosis in ovarian cells through excessive ROS-induced lipid peroxidation and mitochondrial dysfunction, leading to ovarian cell death. Consequently, developing fertility protectants from the chemotherapy-induced oxidative stress and ferroptosis perspective will ameliorate ovarian damage and further improve the life quality of cancer patients.

PMID:37225709 | DOI:10.1038/s41419-023-05859-0

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PubMed articles on: Cardio-Oncology

Patient-reported ability to walk 4 m and to wash: New clinical endpoints and predictors of survival in patients with pre-terminal cancer

J Cachexia Sarcopenia Muscle. 2023 May 24. doi: 10.1002/jcsm.13247. Online ahead of print.

 

 

ABSTRACT

Immune checkpoint inhibitors (ICI) have changed the prognosis of many tumors. However, concerning associated cardiotoxicity has been reported. Little is known about the real-life incidence-specific surveillance protocols or the translational correlation between the underlying mechanisms and the clinical presentation of ICI-induced cardiotoxicity. The lack of data from prospective studies led us to review the current knowledge and to present the creation of the Spanish Immunotherapy Registry of Cardiovascular Toxicity (SIR-CVT), a prospective registry of patients receiving ICI that aims to examine the role of hsa-miR-Chr8:96, (a specific serum biomarker of myocarditis) in the early diagnosis of ICI-induced myocarditis. An exhaustive prospective cardiac imaging study will be performed before and during the first 12 months of treatment. The correlation between clinical, imaging, and immunologic parameters may improve our understanding of ICI-induced cardiotoxicity and enable simpler surveillance protocols. We assess ICI-induced cardiovascular toxicity and describe the rationale of the SIR-CVT.

PMID:37227656 | DOI:10.1007/s12094-023-03217-2

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PubMed articles on: Cardio-Oncology

Chemotherapy impairs ovarian function through excessive ROS-induced ferroptosis

Cell Death Dis. 2023 May 24;14(5):340. doi: 10.1038/s41419-023-05859-0.

 

ABSTRACT

INTRODUCTION: Breast cancer treated with adjuvant hypofractionation radiotherapy with two different techniques, i.e., volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) and their effects in terms of loco-regional control and adverse effects in terms of cutaneous, pulmonary, and cardiac outcomes are compared.

MATERIALS AND METHODS: This is a prospective non-randomized observational study. VMAT and IMRT plan for 30 breast cancer patients who were supposed to receive adjuvant radiotherapy were prepared using a hypofractionation schedule. The plans were dosimetrically evaluated.

OBJECTIVE: Dosimetric comparative analysis of IMRT and VMAT in hypofractionated radiotherapy in breast cancer is done and tested whether VMAT has a dosimetric advantage over IMRT. These patients were recruited for a clinical assessment of toxicities. They were followed up for at least three months.

RESULT: On dosimetric analysis, planning target volume (PTV) coverage (PTV_ V95) of both VMAT (96.41 ± 1.31) and IMRT (96.63 ± 1.56) were similar with significantly lower monitor units required with VMAT plans (1,084.36 ± 270.82 vs 1,181.55 ± 244.50, p = 0.043). Clinically, all patients tolerated hypofractionation through VMAT (n = 8) and IMRT (n = 8) satisfactorily in the short term. No cardiotoxicity or appreciable falls in pulmonary function test parameters were observed. Acute radiation dermatitis poses challenges similar to standard fractionation or any other delivery technique.

CONCLUSION: PVT dose, homogeneity, and conformity indices were similar in both VMAT and IMRT groups. In VMAT, there was high-dose sparing of some critical organs like the heart and lungs at the cost of the low-dose baths to these organs. Increased risk of secondary cancer will require a decade-long follow-up study to indict the VMAT technique. As we move toward precision in oncology, "one-size-fits-all" can never be an acceptable dictum. Each patient is unique and therefore we must offer, and the patient must "choose wisely."

PMID:37228558 | PMC:PMC10206676 | DOI:10.7759/cureus.38045

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PubMed articles on: Cardio-Oncology

Cardiovascular toxicity of checkpoint inhibitors: review of associated toxicity and design of the Spanish Immunotherapy Registry of Cardiovascular Toxicity

Clin Transl Oncol. 2023 May 25. doi: 10.1007/s12094-023-03217-2. Online ahead of print.

 

ABSTRACT

BACKGROUND: Previous studies focused on the impact of cardiovascular diseases (CVD) risk factors in breast cancer patients with chemotherapy (CT) or radiotherapy (RT). This study aimed to identify the impact of tumor characteristics on CVD death in these patients.

METHODS: Data of female breast cancer patients with CT or RT between 2004 and 2016 were included. The risk factors of CVD death were identified using Cox regression analyses. A nomogram was constructed to evaluate the predicted value of tumor characteristics, and then validated by the concordance indexes (C-index) and calibration curves.

RESULT: A total of 28,539 patients were included with an average follow-up of 6.1 years. Tumor size > 45 mm (adjusted HR = 1.431, 95% CI = 1.116-1.836, P= 0.005), regional (adjusted HR = 1.278, 95% CI = 1.048-1.560, P= 0.015) and distant stage (adjusted HR = 2.240, 95% CI = 1.444-3.474, P< 0.001) were risk factors of CVD death for breast cancer patients with CT or RT. The prediction nomogram of tumor characteristics (tumor size and stage) on CVD survival was established. The C-index of internal and external validation were 0.780 (95% Cl = 0.751-0.809), and 0.809 (95% Cl = 0.768-0.850), respectively. The calibration curves showed consistency between the actual observation and nomogram. The risk stratification was also significant distinction (P < 0.05).

CONCLUSION: Tumor size and stage were related to the risk of CVD death for breast cancer patients with CT or RT. The management of CVD death risk in breast cancer patients with CT or RT should focus not only on CVD risk factors but also on tumor size and stage.

PMID:37229229 | PMC:PMC10203988 | DOI:10.3389/fcvm.2023.1149633

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PubMed articles on: Cardio-Oncology

Editorial: Cardio-oncology and reverse cardio-oncology: the manifold interconnections between heart failure and cancer

Front Physiol. 2023 May 9;14:1205810. doi: 10.3389/fphys.2023.1205810. eCollection 2023.

NO ABSTRACT

PMID:37228811 | PMC:PMC10203590 | DOI:10.3389/fphys.2023.1205810

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PubMed articles on: Cardio-Oncology

Dosimetric Comparison of Hypofractionated Regimen in Breast Cancer Using Two Different Techniques: Intensity-Modulated Radiation Therapy (IMRT) and Volumetric-Modulated Arc Therapy (VMAT)

Cureus. 2023 Apr 24;15(4):e38045. doi: 10.7759/cureus.38045. eCollection 2023 Apr.

 

ABSTRACT

BACKGROUND: In addition to cardiotoxicity, ocular toxicity induced by chemotherapeutic agents is not uncommon.

OBJECTIVE: This study aimed to explore the association between ocular adverse events and major adverse cardiovascular events (composite endpoint) caused by chemotherapy, and whether specific ocular events could be potential predictors of some specific components of the composite endpoint.

METHODS: A total of 5378 newly diagnosed patients (age > 18 y/o) with any malignancy or metastatic solid tumors who received chemotherapy from January 1997 to December 2010 were enrolled from the Taiwan National Health Insurance Research Database. Patients who developed new incident ocular diseases were classified as the study group, and those who did not develop incident ocular diseases as the control group.

RESULTS: After propensity score matching, there was a significant increase in the incidence of stroke in the ocular diseases group compared to the no ocular diseases group (13.4% vs. 4.5%, p < 0.0001). Tear film insufficiency, keratopathy, glaucoma, and lens disorders were associated with a significantly higher risk of stroke. A longer duration of methotrexate and a longer duration with higher total amount of tamoxifen were associated with both incident ocular diseases and incident stroke. Cox proportional hazards regression showed that the only independent risk factor for stroke was incident ocular diseases [Adjusted relative risk (95% confidence interval): 2.96 (1.66-5.26), p = 0.0002]. In addition, incident ocular disease was the most significant risk factor compared with other traditional cardiovascular risk factors.

CONCLUSIONS: Incident ocular diseases related to chemotherapy were associated with a significantly higher risk of stroke.

PMID:37229341 | PMC:PMC10203719 | DOI:10.6515/ACS.202305_39(3).20221005A

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PubMed articles on: Cardio-Oncology

The impact of tumor characteristics on cardiovascular disease death in breast cancer patients with CT or RT: a population-based study

Front Cardiovasc Med. 2023 May 9;10:1149633. doi: 10.3389/fcvm.2023.1149633. eCollection 2023.

 

ABSTRACT

The overall survival of advanced melanoma has improved dramatically. Immunotherapies, specifically checkpoint inhibitors, have played a large role in this improvement. These agents have also shown benefit in the adjuvant setting, are approved for treatment of resected stage II, III, and IV melanoma, and play an evolving role in the neoadjuvant setting. Although generally well tolerated, immune-related adverse events occur and can be severe. Here we focus on some severe and potentially long term toxicities, including cardiovascular and neurologic toxicities. Our understanding of the acute and long-term toxicities of immune checkpoint inhibitors continues to evolve. Oncologists must continue to balance cancer risk and treatment-related toxicities.

PMID:37229626 | DOI:10.1200/EDBK_390594

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PubMed articles on: Cardio-Oncology

The Incident Ocular Diseases Related to Chemotherapy in Cancer Patients are Associated with Increasing Risk of Incident Stroke

Acta Cardiol Sin. 2023 May;39(3):435-448. doi: 10.6515/ACS.202305_39(3).20221005A

 

ABSTRACT

Oncologic emergencies are a wide spectrum of oncologic conditions caused directly by malignancies or their treatment. Oncologic emergencies may be classified according to the underlying physiopathology in metabolic, hematologic, and structural conditions. In the latter, radiologists have a pivotal role, through an accurate diagnosis useful to provide optimal patient care. Structural conditions may involve the central nervous system, thorax, or abdomen, and emergency radiologists have to know the characteristics imaging findings of each one of them. The number of oncologic emergencies is growing due to the increased incidence of malignancies in the general population and also to the improved survival of these patients thanks to the advances in cancer treatment. Artificial intelligence (AI) could be a solution to assist emergency radiologists with this rapidly increasing workload. To our knowledge, AI applications in the setting of the oncologic emergency are mostly underexplored, probably due to the relatively low number of oncologic emergencies and the difficulty in training algorithms. However, cancer emergencies are defined by the cause and not by a specific pattern of radiological symptoms and signs. Therefore, it can be expected that AI algorithms developed for the detection of these emergencies in the non-oncological field can be transferred to the clinical setting of oncologic emergency. In this review, a craniocaudal approach was followed and central nervous system, thoracic, and abdominal oncologic emergencies have been addressed regarding the AI applications reported in literature. Among the central nervous system emergencies, AI applications have been reported for brain herniation and spinal cord compression. In the thoracic district the addressed emergencies were pulmonary embolism, cardiac tamponade and pneumothorax. Pneumothorax was the most frequently described application for AI, to improve sensibility and to reduce the time-to-diagnosis. Finally, regarding abdominal emergencies, AI applications for abdominal hemorrhage, intestinal obstruction, intestinal perforation, and intestinal intussusception have been described.

PMID:37205309 | PMC:PMC10185441 | DOI:10.37349/etat.2023.00138

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A Brain, A Heart, and the Courage: Balancing Benefit and Toxicity of Immunotherapy in Melanoma

Am Soc Clin Oncol Educ Book. 2023 May;43:EDBK39059. doi: 10.1200/EDBK_390594.

 

ABSTRACT

BACKGROUND: Venous thromboembolism (VTE) is the leading cause of preventable hospital death in the US. Guidelines from the American College of Chest Physicians and American Society for Hematology recommend providing pharmacological VTE prophylaxis to acutely or critically ill medical patients at acceptable bleeding risk, but there is currently only one validated risk assessment model (RAM) for estimating bleeding risk. We developed a RAM using risk factors at admission and compared it with the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) model.

METHODS: A total of 46,314 medical patients admitted to a Cleveland Clinic Health System hospital from 2017-2020 were included. Data were split into training (70%) and validation (30%) sets with equivalent bleeding event rates in each set. Potential risk factors for major bleeding were identified from the IMPROVE model and literature review. Penalized logistic regression using LASSO was performed on the training set to select and regularize important risk factors for the final model. The validation set was used to assess model calibration and discrimination and compare performance with IMPROVE. Bleeding events and risk factors were confirmed through chart review.

RESULTS: The incidence of major in-hospital bleeding was 0.58%. Active peptic ulcer (OR = 5.90), prior bleeding (OR = 4.24), and history of sepsis (OR = 3.29) were the strongest independent risk factors. Other risk factors included age, male sex, decreased platelet count, increased INR, increased PTT, decreased GFR, ICU admission, CVC or PICC placement, active cancer, coagulopathy, and in-hospital antiplatelet drug, steroid, or SSRI use. In the validation set, the Cleveland Clinic Bleeding Model (CCBM) had better discrimination than IMPROVE (0.86 vs. 0.72, p < .001) and, at equivalent sensitivity (54%), categorized fewer patients as high-risk (6.8% vs. 12.1%, p < .001).

CONCLUSIONS: From a large population of medical inpatients, we developed and validated a RAM to accurately predict bleeding risk at admission. The CCBM may be used in conjunction with VTE risk calculators to decide between mechanical and pharmacological prophylaxis for at-risk patients.

PMID:37205327 | PMC:PMC10187332 | DOI:10.1101/2023.04.29.23289304

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PubMed articles on: Cancer & VTE/PE

Role of artificial intelligence in oncologic emergencies: a narrative review

Explor Target Antitumor Ther. 2023;4(2):344-354. doi: 10.37349/etat.2023.00138. Epub 2023 Apr 28.

 

ABSTRACT

BACKGROUND: Venous thromboembolism (VTE) is a preventable, common vascular disease that has been estimated to affect up to 900,000 people per year. It has been associated with risk factors such as recent surgery, cancer, and hospitalization. VTE surveillance for patient management and safety can be improved via natural language processing (NLP). NLP tools have the ability to access electronic medical records, identify patients that meet the VTE case definition, and subsequently enter the relevant information into a database for hospital review.

OBJECTIVE: We aimed to evaluate the performance of a VTE identification model of IDEAL-X (Information and Data Extraction Using Adaptive Learning; Emory University)-an NLP tool-in automatically classifying cases of VTE by "reading" unstructured text from diagnostic imaging records collected from 2012 to 2014.

METHODS: After accessing imaging records from pilot surveillance systems for VTE from Duke University and the University of Oklahoma Health Sciences Center (OUHSC), we used a VTE identification model of IDEAL-X to classify cases of VTE that had previously been manually classified. Experts reviewed the technicians' comments in each record to determine if a VTE event occurred. The performance measures calculated (with 95% CIs) were accuracy, sensitivity, specificity, and positive and negative predictive values. Chi-square tests of homogeneity were conducted to evaluate differences in performance measures by site, using a significance level of .05.

RESULTS: The VTE model of IDEAL-X "read" 1591 records from Duke University and 1487 records from the OUHSC, for a total of 3078 records. The combined performance measures were 93.7% accuracy (95% CI 93.7%-93.8%), 96.3% sensitivity (95% CI 96.2%-96.4%), 92% specificity (95% CI 91.9%-92%), an 89.1% positive predictive value (95% CI 89%-89.2%), and a 97.3% negative predictive value (95% CI 97.3%-97.4%). The sensitivity was higher at Duke University (97.9%, 95% CI 97.8%-98%) than at the OUHSC (93.3%, 95% CI 93.1%-93.4%; P<.001),P

CONCLUSIONS: The VTE model of IDEAL-X accurately classified cases of VTE from the pilot surveillance systems of two separate health systems in Durham, North Carolina, and Oklahoma City, Oklahoma. NLP is a promising tool for the design and implementation of an automated, cost-effective national surveillance system for VTE. Conducting public health surveillance at a national scale is important for measuring disease burden and the impact of prevention measures. We recommend additional studies to identify how integrating IDEAL-X in a medical record system could further automate the surveillance process.

PMID:37206160 | PMC:PMC10193259 | DOI:10.2196/36877

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PubMed articles on: Cancer & VTE/PE

Incidental versus symptomatic pulmonary embolism in patients without cancer

Vasc Med. 2023 May 19:1358863X231171614. doi: 10.1177/1358863X231171614. Online ahead of print.

NO ABSTRACT

PMID:37205723 | DOI:10.1177/1358863X231171614

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PubMed articles on: Cancer & VTE/PE

A Novel Risk Assessment Model Predicts Major Bleeding Risk at Admission in Medical Inpatients

medRxiv. 2023 May 2:2023.04.29.23289304. doi: 10.1101/2023.04.29.23289304. Preprint.

 

ABSTRACT

Air pollution is a major contributor to the global burden of disease and has been linked to several diseases and conditions, including cardiovascular disease. The biological mechanisms are related to inflammation and increased coagulability, factors that play an important role in the pathogenesis of venous thromboembolism (VTE, i.e., deep vein thrombosis or pulmonary embolism). This study investigates if long-term exposure to air pollution is associated with increased VTE incidence. The study followed 29 408 participants from the Malmö Diet and Cancer (MDC) cohort, which consists of adults aged 44-74 recruited in Malmö, Sweden between 1991 and 1996. For each participant, annual mean residential exposures to particulate matter <2.52.5) and <1010), nitrogen oxides (NOx) and black carbon (BC) from 1990 up to 2016 were calculated. Associations with VTE were analysed using Cox proportional hazard models for air pollution in the year of the VTE event (lag0) and the mean of the prior 1-10 years (lag1-10). Annual air pollution exposures for the full follow-up period had the following means: 10.8 μg/m3 for PM2.5, 15.8 μg/m3 for PM10, 27.7 μg/m3 for NOx, and 0.96 μg/m3 for BC. The mean follow-up period was 19.5 years, with 1418 incident VTE events recorded during this period. Exposure to lag1-10 PM2.5 was associated with an increased risk of VTE (HR 1.17 (95%CI 1.01-1.37)) per interquartile range (IQR) of 1.2 μg/m3 increase in PM2.5 exposure. No significant associations were found between other pollutants or lag0 PM2.5 and incident VTE. When VTE was divided into specific diagnoses, associations with lag1-10 PM2.5 exposure were similarly positive for deep vein thrombosis but not for pulmonary embolism. Results persisted in sensitivity analyses and in multi-pollutant models. Long-term exposure to moderate concentrations of ambient PM2.5 was associated with increased risks of VTE in the general population in Sweden.

PMID:37209899 | DOI:10.1016/j.envpol.2023.121841

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PubMed articles on: Cancer & VTE/PE

Exploring the Applicability of Using Natural Language Processing to Support Nationwide Venous Thromboembolism Surveillance: Model Evaluation Study

JMIR Bioinform Biotech. 2022 May 8;3(1):10.2196/36877. doi: 10.2196/36877.

 

ABSTRACT

Venous thromboembolism (VTE) is a common and impactful complication of cancer. Several clinical prediction rules have been devised to estimate the risk of a thrombotic event in this patient population, however they are associated with limitations. We aimed to develop a predictive model of cancer-associated VTE using machine learning as a means to better integrate all available data, improve prediction accuracy and allow applicability regardless of timing for systemic therapy administration. A retrospective cohort was used to fit and validate the models, consisting of adult patients who had next generation sequencing performed on their solid tumor for the years 2014 to 2019. A deep learning survival model limited to demographic, cancer-specific, laboratory and pharmacological predictors was selected based on results from training data for 23,800 individuals and was evaluated on an internal validation set including 5,951 individuals, yielding a time-dependent concordance index of 0.72 (95% CI = 0.70-0.74) for the first 6 months of observation. Adapted models also performed well overall compared to the Khorana Score (KS) in two external cohorts of individuals starting systemic therapy; in an external validation set of 1,250 patients, the C-index was 0.71 (95% CI = 0.65-0.77) for the deep learning model vs 0.66 (95% CI = 0.59-0.72) for the KS and in a smaller external cohort of 358 patients the C-index was 0.59 (95% CI = 0.50-0.69) for the deep learning model vs 0.56 (95% CI = 0.48-0.64) for the KS. The proportions of patients accurately reclassified by the deep learning model were 25% and 26% respectively. In this large cohort of patients with a broad range of solid malignancies and at different phases of systemic therapy, the use of deep learning resulted in improved accuracy for VTE incidence predictions. Additional studies are needed to further assess the validity of this model.

PMID:37214902 | PMC:PMC10197737 | DOI:10.21203/rs.3.rs-2870367/v1

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PubMed articles on: Cancer & VTE/PE

Long-term ambient air pollution and venous thromboembolism in a population-based Swedish cohort

Environ Pollut. 2023 May 18:121841. doi: 10.1016/j.envpol.2023.121841. Online ahead of print.

 

ABSTRACT

OBJECTIVE: Pulmonary cement embolism is a rare but underestimated complication of vertebroplasty due to the relative lack of study and examination. This study aims to investigate the incidence of pulmonary cement embolism in patients with spinal metastasis who undergo PVP with RFA and to analyze the relative risk factors.

METHODS: A total of 47 patients were retrospectively included and classified into pulmonary cement embolism (PCE) group and non-pulmonary cement embolism (NPCE) group by comparing pre- and postoperative pulmonary CT scan images. The demographic and clinical information of the patients was obtained. Demographic data in the two groups were compared using the chi-square test for qualitative data and the unpaired t test for quantitative data. Multiple logistic regression analysis was used to identify risk factors related to pulmonary cement embolism.

RESULTS: Pulmonary cement embolism was detected in 11 patients (23.4%), and all patients were asymptomatic and followed up regularly. Risk analysis showed that multiple segments (≥3, p=0.022), thoracic vertebrae (p=0.0008), and unipedicular puncture approach (p=0.0059) were risk factors for pulmonary cement embolism. There was a high incidence of pulmonary cement embolism if bone cement leaked into the para vertebral venous plexus in the thoracic vertebra (p<0.0001).

CONCLUSION: The number of involved vertebrae, lesion location, and puncture approach are independent risk factors for pulmonary cement embolism. There was a high incidence of pulmonary cement embolism if bone cement leaked into the para vertebral venous plexus in the thoracic vertebra. Surgeons should consider these factors when formulating therapeutic strategies.

PMID:37213292 | PMC:PMC10196379 | DOI:10.3389/fonc.2023.1129658

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PubMed articles on: Cancer & VTE/PE

Application of Machine Learning to the Prediction of Cancer-Associated Venous Thromboembolism

Res Sq. 2023 May 8:rs.3.rs-2870367. doi: 10.21203/rs.3.rs-2870367/v1. Preprint.

 

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) is the most common arrythmia in patients with cancer, especially breast, gastrointestinal, respiratory, urinary tract, and hematological malignancies. Catheter ablation (CA) is a well-established, safe treatment option in healthy patients; however, literature regarding safety of CA for AF in patients with cancer is limited and confined to single centers.

OBJECTIVE: We aimed to assess the outcomes and peri-procedural safety of CA for AF in patients with certain types of cancer.

METHODS: The NIS database was queried between 2016 and 2019 to identify primary hospitalizations with AF and CA. Hospitalizations with secondary diagnosis of atrial flutter and other arrhythmias were excluded. Propensity score matching was used to balance the covariates between cancer and non-cancer groups. Logistic regression was used to analyze the association.

RESULTS: During this period 47,765 CA procedures were identified, out of which 750 (1.6%) hospitalizations had a diagnosis of cancer. After propensity matching, hospitalizations with cancer diagnosis had higher in-hospital mortality (OR 3.0, 95% CI 1.5-6.2, p=0.001), lower home discharge rates (OR 0.7, 95% CI 0.6-0.9, p<0.001)<0.001)

CONCLUSION: Patients with cancer who underwent CA for AF had significantly higher odds of in-hospital mortality, major bleeding, and pulmonary embolism. Further larger prospective observational studies are needed to validate these findings.

PMID:37224412 | DOI:10.1080/00325481.2023.2218188

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PubMed articles on: Cancer & VTE/PE

Risk factors for pulmonary cement embolism after percutaneous vertebroplasty and radiofrequency ablation for spinal metastases

Front Oncol. 2023 May 5;13:1129658. doi: 10.3389/fonc.2023.1129658. eCollection 2023.

 

ABSTRACT

In the last 10 years the introduction of the direct oral anticoagulants (DOACs) has revolutionized the anticoagulant treatment, one of the cornerstones of the therapy for cardiovascular diseases. Thanks to their efficacy at least not inferior compared to vitamin K antagonists and their better safety profile, particularly with regard to intracranial bleeding, DOACs are now the first choice for the prevention of cardioembolism in patients with non-valvular atrial fibrillation and for the treatment of venous thromboembolism (VTE). Other areas of clinical use for DOACs include the prevention of VTE in orthopedic and oncology surgery and in outpatient cancer patients treated with anticancer therapy, or the use of low-dose in association with aspirin in patients with coronary or peripheral artery disease.An increased risk of gastrointestinal bleeding has been reported for some DOACs. In addition, DOACs have also experienced some failures including stroke prevention in patients with mechanical prosthetic valves or rheumatic diseases and VTE therapy in patients with antiphospholipid antibody syndrome. Also, no data are available on DOACs in some particular areas, including severe renal impairment and thrombocytopenia.In recent years, the clinical use of factor XI and factor XII inhibitors has been proposed. Currently, factor XI inhibitors have more clinical data than factor XII inhibitors. This article will report the rationale for the clinical use and the main evidences currently available on factor XI inhibitors.

PMID:37227204 | DOI:10.1714/4041.40204

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PubMed articles on: Cancer & VTE/PE

Safety of catheter ablation for atrial fibrillation in patients with cancer: a nationwide cohort study

Postgrad Med. 2023 May 24. doi: 10.1080/00325481.2023.2218188. Online ahead of print.

 

ABSTRACT

Up to 15-20% of cancer patients experience one or more episodes of venous thromboembolism during cancer disease. Approximately 80% of all cancer-associated venous thromboembolic events occur in non-hospitalized patients. Routine thromboprophylaxis for outpatients with cancer who start new anticancer treatment is currently not recommended by the international guidelines due to the high heterogeneity of these patients in terms of VTE or bleeding risks, the difficulties in selecting patients at high risk, and the uncertainty of duration of prophylaxis. Although the international guidelines endorsed the Khorana score for estimating the thrombotic risk in ambulatory cancer patients, the discriminatory performance of this score is not completely convincing and varies according to the cancer type. Consequently, a minority of ambulatory patients with cancer receive an accurate screening for primary prophylaxis of VTE. The aim of this review is to provide support to physicians in identifying those ambulatory patients with cancer for whom thromboprophylaxis should be prescribed and those that should not be candidate to thromboprophylaxis. In absence of high bleeding risk, primary thromboprophylaxis should be recommended in patients with pancreatic cancer and, probably, in patients with lung cancer harboring ALK/ROS1 translocations. Patients with upper gastrointestinal cancers are at high risk of VTE, but a careful assessment of bleeding risk should be made before deciding on antithrombotic prophylaxis. Primary prevention of VTE is not recommended in cancer patients at increased risk of bleeding as patients with brain cancer, with moderate-to-severe thrombocytopenia or severe renal impairment.

PMID:37227679 | DOI:10.1007/s11739-023-03306-8

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PubMed articles on: Cancer & VTE/PE

A new anticoagulant strategy: the factor XI inhibitors

G Ital Cardiol (Rome). 2023 Jun;24(6):0-454. doi: 10.1714/4041.40204.

 

ABSTRACT

OBJECTIVES: The objectives of this study were to assess the changes in the left myocardial function after chemotherapy for childhood lymphoma and observe the predictive or monitor value for cancer treatment-related cardiac dysfunction (CTRCD) by speckle-tracking echocardiography.

METHODS: A total of 23 children with histopathological diagnoses of lymphoma were included, with age-matched normal controls. Comparative analysis of clinical serological tests and left heart strain parameters in children with lymphoma, including left ventricular global longitudinal strain (LVGLS); global myocardial work (GMW) indices, which include global work index (GWI), global constructive work (GCW), global wasted work, and global work efficiency; and the LS of subendocardial, middle, and subepicardial layer myocardium during left ventricular systole were measured: left atrial strain of reservoir phase (LASr), left atrial strain of conduit phase (LAScd), and left atrial strain of contraction phase (LASct).

RESULTS: One-way ANOVA showed that GLS, GWI, GCW, LASr, and LAScd were closely associated with CTRCD and multivariate logistic regression analysis showed that GLS was the most sensitive predictor for detecting patients at lofty risk of anthracycline-related cardiotoxicity. Both before and after chemotherapy, GLS in the left ventricle showed a pattern of basal segment < middle segment < apical segment and subepicardial < middle < subendocardial layer (p < 0.05), and the degree of decrease also showed a regular pattern of epicardial layer < middle layer < subendocardial layer while the difference was not significant (p > 0.05). After chemotherapy, maximum flow rate in early mitral relaxation/left atrial systolic maximum flow rate (E/A) and left atrial volume index of each group were in the normal range, and the values of LASr, LAScd, and LASct slightly increased in the second cycle and decreased significantly in the fourth cycle after chemotherapy, reaching the lowest level; LASr and LAScd were positively correlated with GLS.

CONCLUSION: LVGLS is a more sensitive and earlier indicator to predict CTRCD compared with conventional echocardiography-related parameters and serological markers, and GLS of each myocardial layer showed a certain regularity. Left atrial strain can be used for early monitoring of cardiotoxicity in children with lymphoma after chemotherapy.

PMID:37215605 | PMC:PMC10196234 | DOI:10.3389/fped.2023.1163664

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PubMed articles on: Cancer & VTE/PE

Ambulatory cancer patients: who should definitely receive antithrombotic prophylaxis and who should never receive

Intern Emerg Med. 2023 May 25. doi: 10.1007/s11739-023-03306-8. Online ahead of print.

 

ABSTRACT

To describe the population with early malignant melanoma, we performed a cohort study on the basis of the Epidemiological Registry of Malignant Melanoma in Colombia-Asociacion Colombiana de Hematologia y Oncologia. From January 2011 until December 2021, 759 patients were included; the average age was 66 years, 57% were women, acral lentiginous histology was found in 27.8% of patients, and the median follow-up was 36.5 months. The prognostic factors for overall survival in our population are Eastern Cooperative Oncology Group 3-4 (hazard ratio [HR], 13.8), stage III (HR, 5.07), received radiotherapy (HR, 3.38), ulceration on histology (HR, 2.68), chronic sun exposure (HR, 2.3), low income (HR, 2.04), previous local surgery (HR, 0.27), and have received adjuvant treatment (HR, 0.41).

PMID:37216624 | DOI:10.1200/GO.22.00377

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PubMed articles on: Cardio-Oncology

Assessment of left heart dysfunction to predict doxorubicin cardiotoxicity in children with lymphoma

Front Pediatr. 2023 May 5;11:1163664. doi: 10.3389/fped.2023.1163664. eCollection 2023.

 

ABSTRACT

BACKGROUND: According to current guidelines, a surgical biopsy is rarely required when a high-confidence radiologic interstitial lung disease (ILD) diagnosis is made on thin-section high-resolution computed tomography (HRCT). Nevertheless, disowning HRCT scans diagnosed by biopsy are more common than presumed. Our study aimed to describe the concordance rate between HRCT scans and pathological diagnoses of ILDs obtained by surgical biopsy. The current guideline suggests the use of surgical lung biopsy (SLB) in patients with newly detected ILD of unknown cause.

METHODS: Patients who underwent mini-invasive surgical biopsies for interstitial lung diseases from January 2018 to August 2022 were analyzed. The HRCT scans were reviewed by an observer blinded to the patient's clinical information. The concordance between histological and HRCT-scan were assessed.

RESULTS: Data from 104 patients with uncertain low confidence diagnosis of interstitial lung diseases at HRCT were analyzed. Most of the patients are male (65; 62.5%). The more frequent HRCT pattern were: alternative diagnoses (46; 44.23%), UIP probable (42; 40.38%), UIP indeterminate (7; 6.73%), and non-specific interstitial pneumonia (NSIP) (9, 8.65%). The more common histological diagnosis was UIP definite (30; 28.84%), hypersensitivity pneumonia [HP](19; 18.44%), NSIP (15; 14.42%), sarcoidosis (10; 9.60%). In 7 (20%) cases, the final pathological finding denies HRCT-scans diagnoses; indeed, a moderate agreement was observed between HRCT-scan findings and the definitive histological diagnosis (kappa index: 0.428).

CONCLUSIONS: HRCT-scan has limitations if the objective is to define interstitial lung diseases accurately. Consequently, pathological assessment should be taken into account in order to provide more accurate tailored treatment strategies because the risk is to wait from 12 to 24 months to ascertain if the ILD will be treatable as progressive pulmonary fibrosis (PPF). Undeniably true, video-assisted surgical lung biopsy (VASLB) with endotracheal intubation and mechanical ventilation is associated with a risk of mortality and morbidity that is far from nil. Nevertheless, in recent years a VASLB approach performed in awake subjects under loco-regional anesthesia (awake-VASLB) has been suggested as an effective method to obtain a highly confident diagnosis in patients with diffuse pathologies of the lung parenchyma.

PMID:37218142 | DOI:10.23736/S2724-5691.23.09948-3

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PubMed articles on: Cardio-Oncology

Clinical Outcomes and Prognostic Factors of Patients With Early Malignant Melanoma in One Latin American Country: Results of the Epidemiological Registry of Malignant Melanoma in Colombia Study

JCO Glob Oncol. 2023 May;9:e2200377. doi: 10.1200/GO.22.00377.

 

ABSTRACT

Anthracyclines such as doxorubicin (Dox) are effective chemotherapeutic agents; however, their use is hampered by subsequent cardiotoxicity risk. Our understanding of cardiomyocyte protective pathways activated following anthracycline-induced cardiotoxicity (AIC) remains incomplete. Insulin-like growth factor binding protein (IGFBP) 3 (Igfbp-3), the most abundant IGFBP family member in the circulation, is associated with effects on the metabolism, proliferation, and survival of various cells. Whereas Igfbp-3 is induced by Dox in the heart, its role in AIC is ill-defined. We investigated molecular mechanisms as well as systems-level transcriptomic consequences of manipulating Igfbp-3 in AIC using neonatal rat ventricular myocytes and human-induced pluripotent stem cell-derived cardiomyocytes. Our findings reveal that Dox induces the nuclear enrichment of Igfbp-3 in cardiomyocytes. Furthermore, Igfbp-3 reduces DNA damage, impedes topoisomerase IIβ expression (Top2β) which forms Top2β-Dox-DNA cleavage complex leading to DNA double-strand breaks (DSB), alleviates detyrosinated microtubule accumulation-a hallmark of increased cardiomyocyte stiffness and heart failure-and favorably affects contractility following Dox treatment. These results indicate that Igfbp-3 is induced by cardiomyocytes in an effort to mitigate AIC.

PMID:37219486 | DOI:10.1096/fj.202201885RR

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PubMed articles on: Cardio-Oncology

Correlation between high-resolution computed tomography appearance and histopathological features in the diagnosis of interstitial lung diseases. A real-life study

Minerva Surg. 2023 May 23. doi: 10.23736/S2724-5691.23.09948-3. Online ahead of print.

 

ABSTRACT

Oncologic patients are subjected to four major treatment types: surgery, radiotherapy, chemotherapy, and immunotherapy. All nonsurgical forms of cancer management are known to potentially violate the structural and functional integrity of the cardiovascular system. The prevalence and severity of cardiotoxicity and vascular abnormalities led to the emergence of a clinical subdiscipline, called cardiooncology. This relatively new, but rapidly expanding area of knowledge, primarily focuses on clinical observations linking the adverse effects of cancer therapy with deteriorated quality of life of cancer survivors and their increased morbidity and mortality. Cellular and molecular determinants of these relations are far less understood, mainly because of several unsolved paths and contradicting findings in the literature. In this article, we provide a comprehensive view of the cellular and molecular etiology of cardiooncology. We pay particular attention to various intracellular processes that arise in cardiomyocytes, vascular endothelial cells, and smooth muscle cells treated in experimentally-controlled conditions in vitro and in vivo with ionizing radiation and drugs representing diverse modes of anti-cancer activity.

PMID:37221467 | PMC:PMC10207659 | DOI:10.1186/s11658-023-00451-y

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PubMed articles on: Cardio-Oncology

Integrative transcriptomics and cell systems analyses reveal protective pathways controlled by Igfbp-3 in anthracycline-induced cardiotoxicity

FASEB J. 2023 Jun;37(6):e22977. doi: 10.1096/fj.202201885RR.

 

ABSTRACT

BACKGROUND: Maintaining the ability to perform self-care is a critical goal in patients with cancer. We assessed whether the patient-reported ability to walk 4 m and wash oneself predict survival in patients with pre-terminal cancer.

METHODS: We performed a prospective observational study on 169 consecutive hospitalized patients with cancer (52% female, 64 ± 12 years) and an estimated 1-12 months prognosis at an academic, inpatient palliative care unit. Patients answered functional questions for 'today', 'last week', and 'last month', performed patient-reported outcomes (PROs), and physical function assessments.

RESULTS: Ninety-two (54%) patients reported the ability to independently walk 4 m and 100 (59%) to wash 'today'. The median number of days patients reported the ability to walk 4 m and wash were 6 (IQR 0-7) and 7 (0-7) days ('last week'); and 27 (5-30) and 26 (10-30) days ('last month'). In the last week, 32% of patients were unable to walk 4 m on every day and 10% could walk on 1-3 days; 30% were unable to wash on every day and 10% could wash on 1-3 days. In the last months, 14% of patients were unable to walk 4 m on every day and 10% could only walk on 1-10 days; 12% were unable to wash on every day and 11% could wash on 1-10 days. In patients who could walk 'today' average 4 m gait speed was 0.78 ± 0.28 m/s. Patients who reported impaired walking and washing experienced more symptoms (dyspnoea, exertion, and oedema) and decreased physical function (higher Eastern Cooperative Oncology Group Performance Status, and lower Karnofsky Performance Status and hand-grip strength [unable vs. able to walk 'today': 205 ± 87 vs. 252 ± 78 Newton, P = 0.001; unable vs. able to wash 'today': 204 ± 86 vs. 250 ± 80 Newton, P = 0.001]). During the 27 months of observation, 152 (90%) patients died (median survival 46 days). In multivariable Cox proportional hazards regression analyses, all tested parameters were independent predictors of survival: walking 4 m 'today' (HR 0.63, P = 0.015), 'last week' (per 1 day: HR 0.93, P = 0.011), 'last month' (per 1 day: HR 0.98, P = 0.012), 4 m gait speed (per 1 m/s: HR 0.45, P = 0.002), and washing 'today' (HR 0.67, P = 0.024), 'last week (per 1 day HR 0.94, p=0.019), and 'last month' (per 1 day HR 0.99, P = 0.040). Patients unable to walk and wash experienced the shortest survival and most reduced functional status.

CONCLUSIONS: In patients with pre-terminal cancer, the self-reported ability to walk 4 m and wash were independent predictors of survival and associated with decreased functional status.

PMID:37222009 | DOI:10.1002/jcsm.13247

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PubMed articles on: Cardio-Oncology

An integrative review of nonobvious puzzles of cellular and molecular cardiooncology

Cell Mol Biol Lett. 2023 May 23;28(1):44. doi: 10.1186/s11658-023-00451-y.

 

ABSTRACT

BACKGROUND: Maintaining the ability to perform self-care is a critical goal in patients with cancer. We assessed whether the patient-reported ability to walk 4 m and wash oneself predict survival in patients with pre-terminal cancer.

METHODS: We performed a prospective observational study on 169 consecutive hospitalized patients with cancer (52% female, 64 ± 12 years) and an estimated 1-12 months prognosis at an academic, inpatient palliative care unit. Patients answered functional questions for 'today', 'last week', and 'last month', performed patient-reported outcomes (PROs), and physical function assessments.

RESULTS: Ninety-two (54%) patients reported the ability to independently walk 4 m and 100 (59%) to wash 'today'. The median number of days patients reported the ability to walk 4 m and wash were 6 (IQR 0-7) and 7 (0-7) days ('last week'); and 27 (5-30) and 26 (10-30) days ('last month'). In the last week, 32% of patients were unable to walk 4 m on every day and 10% could walk on 1-3 days; 30% were unable to wash on every day and 10% could wash on 1-3 days. In the last months, 14% of patients were unable to walk 4 m on every day and 10% could only walk on 1-10 days; 12% were unable to wash on every day and 11% could wash on 1-10 days. In patients who could walk 'today' average 4 m gait speed was 0.78 ± 0.28 m/s. Patients who reported impaired walking and washing experienced more symptoms (dyspnoea, exertion, and oedema) and decreased physical function (higher Eastern Cooperative Oncology Group Performance Status, and lower Karnofsky Performance Status and hand-grip strength [unable vs. able to walk 'today': 205 ± 87 vs. 252 ± 78 Newton, P = 0.001; unable vs. able to wash 'today': 204 ± 86 vs. 250 ± 80 Newton, P = 0.001]). During the 27 months of observation, 152 (90%) patients died (median survival 46 days). In multivariable Cox proportional hazards regression analyses, all tested parameters were independent predictors of survival: walking 4 m 'today' (HR 0.63, P = 0.015), 'last week' (per 1 day: HR 0.93, P = 0.011), 'last month' (per 1 day: HR 0.98, P = 0.012), 4 m gait speed (per 1 m/s: HR 0.45, P = 0.002), and washing 'today' (HR 0.67, P = 0.024), 'last week (per 1 day HR 0.94, p=0.019), and 'last month' (per 1 day HR 0.99, P = 0.040). Patients unable to walk and wash experienced the shortest survival and most reduced functional status.

CONCLUSIONS: In patients with pre-terminal cancer, the self-reported ability to walk 4 m and wash were independent predictors of survival and associated with decreased functional status.

PMID:37222009 | DOI:10.1002/jcsm.13247

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PubMed articles on: Cardio-Oncology

An integrative review of nonobvious puzzles of cellular and molecular cardiooncology

Cell Mol Biol Lett. 2023 May 23;28(1):44. doi: 10.1186/s11658-023-00451-y.

 

ABSTRACT

Chemotherapy was conventionally applied to kill cancer cells, but regrettably, they also induce damage to normal cells with high-proliferative capacity resulting in cardiotoxicity, nephrotoxicity, peripheral nerve toxicity, and ovarian toxicity. Of these, chemotherapy-induced ovarian damages mainly include but are not limited to decreased ovarian reserve, infertility, and ovarian atrophy. Therefore, exploring the underlying mechanism of chemotherapeutic drug-induced ovarian damage will pave the way to develop fertility-protective adjuvants for female patients during conventional cancer treatment. Herein, we firstly confirmed the abnormal gonadal hormone levels in patients who received chemotherapy and further found that conventional chemotherapeutic drugs (cyclophosphamide, CTX; paclitaxel, Tax; doxorubicin, Dox and cisplatin, Cis) treatment significantly decreased both the ovarian volume of mice and the number of primordial and antral follicles and accompanied with the ovarian fibrosis and reduced ovarian reserve in animal models. Subsequently, Tax, Dox, and Cis treatment can induce the apoptosis of ovarian granulosa cells (GCs), likely resulting from excessive reactive oxygen species (ROS) production-induced oxidative damage and impaired cellular anti-oxidative capacity. Thirdly, the following experiments demonstrated that Cis treatment could induce mitochondrial dysfunction through overproducing superoxide in GCs and trigger lipid peroxidation leading to ferroptosis, first reported in chemotherapy-induced ovarian damage. In addition, N-acetylcysteine (NAC) treatment could alleviate the Cis-induced toxicity in GCs by downregulating cellular ROS levels and enhancing the anti-oxidative capacity (promoting the expression of glutathione peroxidase, GPX4; nuclear factor erythroid 2-related factor 2, Nrf2 and heme oxygenase-1, HO-1). Our study confirmed the chemotherapy-induced chaotic hormonal state and ovarian damage in preclinical and clinical examination and indicated that chemotherapeutic drugs initiated ferroptosis in ovarian cells through excessive ROS-induced lipid peroxidation and mitochondrial dysfunction, leading to ovarian cell death. Consequently, developing fertility protectants from the chemotherapy-induced oxidative stress and ferroptosis perspective will ameliorate ovarian damage and further improve the life quality of cancer patients.

PMID:37225709 | DOI:10.1038/s41419-023-05859-0

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PubMed articles on: Cardio-Oncology

Patient-reported ability to walk 4 m and to wash: New clinical endpoints and predictors of survival in patients with pre-terminal cancer

J Cachexia Sarcopenia Muscle. 2023 May 24. doi: 10.1002/jcsm.13247. Online ahead of print.

 

ABSTRACT

Cancer alters the function of multiple organs beyond those targeted by metastasis1,2. Here we show that inflammation, fatty liver and dysregulated metabolism are hallmarks of systemically affected livers in mouse models and in patients with extrahepatic metastasis. We identified tumour-derived extracellular vesicles and particles (EVPs) as crucial mediators of cancer-induced hepatic reprogramming, which could be reversed by reducing tumour EVP secretion via depletion of Rab27a. All EVP subpopulations, exosomes and principally exomeres, could dysregulate hepatic function. The fatty acid cargo of tumour EVPs-particularly palmitic acid-induced secretion of tumour necrosis factor (TNF) by Kupffer cells, generating a pro-inflammatory microenvironment, suppressing fatty acid metabolism and oxidative phosphorylation, and promoting fatty liver formation. Notably, Kupffer cell ablation or TNF blockade markedly decreased tumour-induced fatty liver generation. Tumour implantation or pre-treatment with tumour EVPs diminished cytochrome P450 gene expression and attenuated drug metabolism in a TNF-dependent manner. We also observed fatty liver and decreased cytochrome P450 expression at diagnosis in tumour-free livers of patients with pancreatic cancer who later developed extrahepatic metastasis, highlighting the clinical relevance of our findings. Notably, tumour EVP education enhanced side effects of chemotherapy, including bone marrow suppression and cardiotoxicity, suggesting that metabolic reprogramming of the liver by tumour-derived EVPs may limit chemotherapy tolerance in patients with cancer. Our results reveal how tumour-derived EVPs dysregulate hepatic function and their targetable potential, alongside TNF inhibition, for preventing fatty liver formation and enhancing the efficacy of chemotherapy.

PMID:37225988 | DOI:10.1038/s41586-023-06114-4

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PubMed articles on: Cardio-Oncology

Chemotherapy impairs ovarian function through excessive ROS-induced ferroptosis

Cell Death Dis. 2023 May 24;14(5):340. doi: 10.1038/s41419-023-05859-0.

 

ABSTRACT

PURPOSE: This systematic review aims to compare the efficacy and safety of multilevel and single level surgery, including barbed pharyngoplasties, in the treatment of obstructive sleep apnea (OSA).

METHODS: The study followed PRISMA guidelines and searched PubMed/MEDLINE, Google Scholar, and Ovid databases for studies evaluating the effect of barbed pharyngoplasties on adults with OSA. Prospective and retrospective cohort studies were included with pre- and post-treatment comparisons of sleep tests and self-reported clinical outcomes. Exclusion criteria were non-English studies, case reports, reviews, conference abstracts, letters, and pediatric studies. Successful surgery was classified using Sher's criteria.

RESULTS: The study selected a total of 1014 patients from 26 studies, 24 of which were longitudinal studies with 10 retrospective trials and 14 prospective studies. The average age of the patients was 46.9 years, with an average Body Mass Index (BMI) of 25.6 kg/m2. Most of the patients were male (84.6%). The study included only palatal surgical techniques with barbed sutures, and patients who underwent cardio-respiratory monitoring and Drug Induced Sleep Endoscopy (DISE) before surgery. Mean Apnea Hypopnea Index (AHI) preoperative was 32.9/h, AHI postoperative was 11.9/h, and mean reduction of AHI was 62.3%. The most commonly adopted palatoplasty was Barbed Repositioning Pharyngoplasty (BRP) in 16 out of 26 studies, followed by its subsequent modifications in 3 studies.

CONCLUSIONS: Barbed pharyngoplasties appear to be effective both on objective measurement and subjective scores. DISE represents a fundamental tool to assess uni-level or multilevel obstruction. When retro-palatal collapse is present, barbed pharyngoplasty appears to be effective. Barbed pharyngoplasties maintain their good results both in single level or multilevel surgery. Randomized clinical controlled trials with multi-center cooperation and long-term study are necessary.

PMID:37227471 | DOI:10.1007/s00405-023-08018-5

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PubMed articles on: Cardio-Oncology

Tumour extracellular vesicles and particles induce liver metabolic dysfunction

Nature. 2023 May 24. doi: 10.1038/s41586-023-06114-4. Online ahead of print.

 

ABSTRACT

Immune checkpoint inhibitors (ICI) have changed the prognosis of many tumors. However, concerning associated cardiotoxicity has been reported. Little is known about the real-life incidence-specific surveillance protocols or the translational correlation between the underlying mechanisms and the clinical presentation of ICI-induced cardiotoxicity. The lack of data from prospective studies led us to review the current knowledge and to present the creation of the Spanish Immunotherapy Registry of Cardiovascular Toxicity (SIR-CVT), a prospective registry of patients receiving ICI that aims to examine the role of hsa-miR-Chr8:96, (a specific serum biomarker of myocarditis) in the early diagnosis of ICI-induced myocarditis. An exhaustive prospective cardiac imaging study will be performed before and during the first 12 months of treatment. The correlation between clinical, imaging, and immunologic parameters may improve our understanding of ICI-induced cardiotoxicity and enable simpler surveillance protocols. We assess ICI-induced cardiovascular toxicity and describe the rationale of the SIR-CVT.

PMID:37227656 | DOI:10.1007/s12094-023-03217-2

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PubMed articles on: Cardio-Oncology

Barbed palatal surgery: single stage or multilevel setting-a systematic review by the Young Otolaryngologists of the Italian Society of Otolaryngology

Eur Arch Otorhinolaryngol. 2023 May 25. doi: 10.1007/s00405-023-08018-5. Online ahead of print.

 

🙏 Cuerpo y Mente 🧠

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🍝 ¿Tienes antojo de pasta?

Prueba esta deliciosa receta con aguacate y albahaca que no solo es saludable, sino también llena de sabores frescos y nutritivos. A diferencia de las salsas tradicionales cargadas de calorías, esta receta utiliza pasta integral para un aporte extra de fibra.

Tiempo de preparación: 15 minutos

Ingredientes (para 4 personas):

- 320 gramos de macarrones integrales

- 1 aguacate

- 50 gramos de aceitunas negras

- Un puñado de hojas de albahaca

- 1/2 limón

- 4 cucharadas de aceite de oliva

- 40 gramos de queso parmesano

- Sal y pimienta al gusto

Instrucciones:

1- Pela el aguacate, córtalo por la mitad y retira el hueso. Tritura la pulpa en el vaso de la batidora con el jugo de medio limón, 3 cucharadas de agua, sal y pimienta.

2- Prepara el aceite de albahaca. Lava un puñado de hojas de albahaca y mézclalas con el aceite de oliva y una pizca de sal.

3- Corta las aceitunas deshuesadas en rodajas.

4- Saca virutas de queso parmesano con la ayuda de un pelador y resérvalas.

5- Cuece la pasta en abundante agua salada hasta que esté al dente, respetando el tiempo indicado por el fabricante. Escúrrela bien y colócala en un cuenco grande.

6- Incorpora la crema de aguacate a la pasta y remueve bien.

7- Divide la preparación en 4 platos llanos, rocíala con el aceite de albahaca, añade las aceitunas y sirve de inmediato, decorando con las virutas de queso parmesano.

¡Disfruta de esta deliciosa y saludable opción de pasta!

🙏 @cuerpo_mente 🧠

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13 November 2023

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¿Alguna vez has oído hablar del "Efecto Mozart"?🎻

🧠 El "Efecto Mozart" es la idea intrigante de que escuchar música clásica, especialmente las obras del genio Wolfgang Amadeus Mozart, puede tener impactos positivos en la cognición y el rendimiento intelectual. Aunque ha habido debates en la comunidad científica sobre la validez de estos efectos, no podemos negar la fascinación que despiertan.

💡 ¿Cómo se originó? En 1993, un estudio publicado en la revista "Nature" sugirió que la exposición a la Sonata para Dos Pianos en Re Mayor, K. 448 de Mozart, mejoraba temporalmente las habilidades espaciales de los participantes.

Sin embargo, la validez de estos hallazgos ha sido objeto de debate en la comunidad científica.

🤷‍♂️ La controversia: Aunque algunos estudios respaldan la idea de beneficios cognitivos, otros cuestionan su replicabilidad y generalización a otras áreas intelectuales. ¿Es realmente la música de Mozart una fórmula mágica para potenciar nuestra mente?

🎶 ¡Experimentemos juntos! Te invitamos a escuchar algunas composiciones de Mozart y compartir tus experiencias.

¿Has sentido alguna vez ese impulso de creatividad o claridad mental después de escuchar su música? ¡Queremos conocer tus historias!

🙏 @cuerpo_mente 🧠

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14 November 2023

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🙏 Cuerpo y Mente 🧠

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Te presentamos algunos consejos para ayudarte en tu proceso de pérdida de peso.🙏

🙏 @cuerpo_mente 🧠

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15 November 2023

15:45

🙏 Cuerpo y Mente 🧠

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¡Hola, apreciados seguidores del canal @cuerpo_mente!

🥗 ¿Te has preguntado alguna vez sobre la importancia de esos microorganismos en tu intestino? Resulta que son esenciales para nuestra salud inmunológica, cerebral y hormonal. ¡Te lo contamos!

#podcast ⬇️⬇️⬇️

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15:45

Podcast de Cuerpo y Mente – Intestino Sano Mente Sana.mp3

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🎤 Intestino Sano, Mente Sana

Seis herramientas clave para mejorar la salud de tu microbioma intestinal.

¿Pondrías en práctica estos consejos?

¡Coméntanos! 👉https://t.me/cuerpoymentechat

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16 November 2023

16:11

🙏 Cuerpo y Mente 🧠

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🥜 Beneficios de los cacahuates para la salud 🥜

Los cacahuates, más que un simple aperitivo, ofrecen una gama de beneficios para la salud. Su contenido en fosfatidilcolina mejora la función cognitiva y la memoria, según un estudio reciente en Clinical Nutrition (2021). Este compuesto vital aumenta la vitalidad de las células cerebrales, beneficiando la respuesta al estrés y la memoria.

Ricos en calcio y aminoácidos esenciales, los cacahuates contribuyen al crecimiento y desarrollo de los niños, fortaleciendo huesos e impulsando la inteligencia y la memoria. Además, las catequinas antioxidantes en la piel de cacahuete y la lisina retrasan el envejecimiento, mientras que la vitamina E y el zinc mantienen la piel juvenil.

Los cacahuates, por su abundancia en grasas y fibra, también alivian el estreñimiento y promueven la salud cardiovascular. Investigaciones recientes, como la de la American Heart Association (2021), indican que el consumo regular se asocia con un menor riesgo de ictus y enfermedad cardiovascular.

Finalmente, estos frutos secos son aliados de la lactancia materna, gracias a sus ácidos grasos y proteínas.

¡Cuida tu salud con los cacahuates!

🙏 @cuerpo_mente 🧠

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17 November 2023

14:05

🙏 Cuerpo y Mente 🧠

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Bailar con frecuencia trae consigo una serie de beneficios para la salud. 🕺💃

🙏 @cuerpo_mente 🧠

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18 November 2023

16:18

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🚭 ¿Te has preguntado alguna vez qué sucede en tu organismo cuando fumas un cigarrillo? En este video, te detallamos el impacto del humo en tus pulmones y cómo afecta tanto al cerebro como al sistema circulatorio.

¿A qué esperas? ¡Deja de fumar!

🙏 @cuerpo_mente 🧠

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19 November 2023

14:31

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🍆 Berenjenas rellenas: Una receta deliciosa y saludable

Descubre cómo preparar fácilmente en casa unas exquisitas berenjenas rellenas. Esta receta, rápida y saludable, será un deleite para toda la familia. A continuación, te presentamos los pasos detallados.

Tiempo de Preparación: 45 minutos

Ingredientes:

- 2 berenjenas

- 1 pimiento rojo

- 1 pimiento amarillo

- 1 pimiento verde

- 1 calabacín

- 1 cebolleta

- 100 ml de salsa de tomate

- 4 huevos

- 50 gr de queso rallado

- Aceite y sal

Elaboración:

Paso 1: Lava y corta las berenjenas por la mitad a lo largo. Vacíalas y cocina al vapor durante 5 minutos. Colócalas boca abajo para drenar el exceso de líquido.

Paso 2: Lava y corta todas las verduras en dados.

Paso 3: Sofríe la cebolleta y los pimientos en una cazuela con aceite durante 10 minutos. Añade la berenjena y el calabacín y cocina por 10 minutos más. Sazona, agrega la salsa de tomate, mezcla y retira del fuego. Precalienta el horno a 200 °C.

Paso 4: Rellena las medias berenjenas con las verduras y colócalas en una bandeja. Rompe un huevo sobre cada una y espolvorea con queso.

Paso 5: Hornea hasta que el huevo se cuaje y sirve.

¡Disfruta de estas deliciosas berenjenas rellenas con tu familia!

🙏 @cuerpo_mente 🧠

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20 November 2023

15:37

🙏 Cuerpo y Mente 🧠

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💋Inhala el futuro, exhala el pasado y vive el presente💋

¡Feliz lunes!

🙏 @cuerpo_mente 🧠

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21 November 2023

15:39

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🛌 ¡La importancia de nuestras posturas para la salud cardiovascular!

Recientemente, epidemiólogos del University College de Londres llevaron a cabo un estudio exhaustivo en busca de determinar las prácticas más beneficiosas para el sistema cardiovascular. Los resultados, obtenidos tras clasificar las distintas posturas desde lo más beneficioso hasta lo más perjudicial, ofrecen una perspectiva clara sobre la relación entre nuestras acciones diarias y la salud del corazón.

Según las conclusiones de este estudio, tumbarse y dormir se destacan como las prácticas más saludables, superando a ponerse en cuclillas y sentarse, especialmente cuando se realiza frente al televisor. Además, estar de pie se posiciona como una opción más saludable que dormir, mientras que caminar se revela como una actividad aún más beneficiosa que permanecer de pie.

🙏 @cuerpo_mente 🧠

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18:31

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¡Hay que verlo! 21.11.2023 01:34:26

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Un ingeniero creó un robot que se fumó un paquete de cigarrillos al día durante un mes 🚬

Como resultado del experimento, los 'pulmones' de algodón del robot se cubrieron de una sustancia similar al fuel 🫁

👉 @hayqverlo

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22 November 2023

16:23

🙏 Cuerpo y Mente 🧠

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¡Hola, apreciados seguidores del canal @cuerpo_mente!

💡 Hoy nos sumergiremos en el fascinante mundo de la creatividad y cómo potenciarla para mejorar nuestra vida diaria. En este episodio, descubriremos que la creatividad no es exclusiva de algunos privilegiados, ¡sino que está al alcance de todos nosotros!

#podcast ⬇️⬇️⬇️

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16:23

Podcast de Cuerpo y Mente – Potencia tu Creatividad.mp3

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04:40, 4.3 MB

🎤 Potencia tu Creatividad

Consejos para potenciar el pensamiento creativo.

¿Te han parecido útiles estos consejos?

¡Coméntanos! 👉https://t.me/cuerpoymentechat

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23 November 2023

15:23

🙏 Cuerpo y Mente 🧠

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Descubre cómo el exceso de azúcar afecta tu cuerpo en esta explicación apta para niños y adultos por igual.

🙏 @cuerpo_mente 🧠

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21:55

🙏 Cuerpo y Mente 🧠

Base de gatos 23.11.2023 16:37:07

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Sigue el ejemplo de estos gatos deportistas

¿Tu día necesita... gatitos? 😼 ¡Suscríbete!

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24 November 2023

16:02

🙏 Cuerpo y Mente 🧠

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🥛 ¿Alguna vez te has preguntado por qué experimentas molestias después de disfrutar de un delicioso helado o un vaso de leche? ¡La respuesta podría estar en la lactosa!

La intolerancia a la lactosa es más común de lo que pensamos. Se debe a la falta de una enzima llamada lactasa, que normalmente descompone la lactosa en azúcares más simples para que el cuerpo los pueda absorber fácilmente. Cuando hay una deficiencia de lactasa, la lactosa no se descompone adecuadamente, lo que puede llevar a síntomas incómodos como hinchazón, gases y diarrea.

¿Cómo puedes saber si eres intolerante a la lactosa? Presta atención a tu cuerpo. Si experimentas malestar después de consumir productos lácteos, podría ser una señal. Sin embargo, es importante no autodiagnosticarse. Consulta a un profesional de la salud para obtener un diagnóstico preciso.

Pero, ¡no temas! La intolerancia a la lactosa no significa que debas renunciar por completo a esos placeres lácteos. Hay alternativas disponibles, como leches sin lactosa, yogures y quesos, así como suplementos de lactasa que pueden ayudarte a disfrutar de tus alimentos favoritos sin preocupaciones.

Recuerda que cada cuerpo es único, y lo que funciona para uno puede no ser igual para otro. Escucha a tu cuerpo, experimenta con alternativas y descubre qué opciones son las mejores para ti.

🙏 @cuerpo_mente 🧠

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25 November 2023

17:36

🙏 Cuerpo y Mente 🧠

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⚪️¡Vamos a inundar nuestras mentes con vibraciones positivas!⚪️

☀️ Afirmación del día: "Hoy, elijo enfocarme en las soluciones en lugar de los problemas. Cada desafío es una oportunidad para crecer y aprender".

Las afirmaciones positivas no son solo palabras; son una poderosa herramienta para dar forma a nuestra perspectiva y transformar nuestra realidad. Al incorporar afirmaciones positivas en nuestra rutina diaria, podemos cultivar una mentalidad más positiva y resiliente.

¿Cómo usar las afirmaciones?

⚪️ Repite con intención: Tómate un momento cada día para repetir las afirmaciones en voz alta con sinceridad y convicción.

⚪️ Escribe tus propias afirmaciones: Personaliza tus afirmaciones según tus metas y desafíos personales. ¡Hazlas tuyas!

⚪️ Crea un ritual: Incorpora las afirmaciones en tu rutina diaria, ya sea al despertar, antes de dormir o durante momentos de pausa.

💡 Desafío Positivo: ¿Te unes al desafío de hoy? Comparte en los comentarios una afirmación positiva que te inspire o cuéntanos cómo las afirmaciones han impactado positivamente en tu vida.

🙏 @cuerpo_mente 🧠

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2 November 2023

16:35

🙏 Cuerpo y Mente 🧠

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Mitos y realidades del veganismo 🥬🚫🥩

Los veganos optan por evitar todo producto de origen animal, desde carne hasta lácteos, miel y aditivos como la gelatina. A menudo, también evitan productos de cuero y piel. Pero, ¿qué hay detrás de los mitos?

1. Los veganos no obtienen suficiente proteína — Falso, pero... Es falso que los veganos carezcan de proteínas. Pueden obtenerlas de cereales, legumbres y frutos secos. Por ejemplo, la soja contiene 35 gramos de proteína por cada 100 gramos. Sin embargo, las proteínas vegetales se absorben más lentamente, por lo que es importante asesorarse con un médico antes de cambiar a una dieta vegana. 💪

2. El veganismo es una manera fácil de perder peso — Falso. Aunque algunos experimentan una pérdida de peso inicial al volverse veganos, no es garantía de alcanzar una figura ideal. Una dieta desequilibrada rica en carbohidratos puede, paradójicamente, aumentar el peso. 🍔🏃‍♂️

3. Los veganos no obtienen suficientes vitaminas y minerales — Verdadero, pero... Investigaciones indican que el 28% de los veganos experimentan deficiencias de vitaminas y minerales esenciales, como la B12 y los ácidos grasos omega-3. Para evitar esto, se recomiendan suplementos alimenticios y una dieta vegana equilibrada. 💊🍏

4. El veganismo garantiza una salud sólida — Falso, pero... El veganismo no asegura una salud sólida. Una dieta desequilibrada o carente de ejercicio puede causar problemas. Sin embargo, renunciar a la carne y productos de origen animal disminuye el riesgo de ciertos cánceres y enfermedades cardíacas. 🫀🏥

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3 November 2023

16:50

🙏 Cuerpo y Mente 🧠

10 minutos de meditación_ Enfocada en la respiración.mp3

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10:20, 9.4 MB

🧘 Si has tenido la oportunidad de escuchar el último episodio de nuestro podcast Meditación Contra la Depresión y te has familiarizado con los beneficios de la meditación para la relajación y la lucha contra la depresión, te invitamos a participar en una meditación guiada centrada en la respiración.

Dedica tan solo 10 minutos de tu día para concentrarte en el presente y expandir tu mente hacia nuevas posibilidades.

🙏 @cuerpo_mente 🧠

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4 November 2023

15:32

🙏 Cuerpo y Mente 🧠

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¿Padeces el síndrome de intestino irritable?

Descubre cómo estas plantas pueden brindarte alivio.🌱

🙏 @cuerpo_mente 🧠

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5 November 2023

14:42

🙏 Cuerpo y Mente 🧠

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Aquí tienes una receta original y saludable para tu domingo: Puré de Coliflor 🥦

El puré de coliflor es una opción nutritiva y baja en calorías, gracias a los beneficios de esta verdura, que pertenece a la misma familia que el brócoli, el romanesco, el repollo y la col. Su consumo regular puede ayudar a reducir el riesgo de varias enfermedades.

Tiempo de preparación: 20 minutos

Ingredientes (para 4 personas):

- 2 patatas

- 200 gramos de coliflor

- 70 gramos de judías verdes

- 100 gramos de salmón ahumado

- 4 cucharadas de yogur griego

- Eneldo picado

- 50 gramos de mantequilla

- Una pizca de nuez moscada

- Sal y pimienta al gusto

Elaboración:

Paso 1: Comienza por limpiar la coliflor, lavarla y dividirla en ramitos.

Paso 2: Pela las patatas y córtalas en trozos. Cocina las patatas y la coliflor en agua con sal durante 15 minutos. Luego, escúrrelas y aplástalas antes de mezclarlas con la mantequilla, el eneldo, la pimienta y la nuez moscada.

Paso 3: Limpia las judías verdes, córtalas en trozos y cuécelas en agua con sal durante 12 minutos. Escúrrelas y añádelas al puré.

Paso 4: Para presentar el puré, utiliza un aro de repostería colocado sobre un plato. Presiona ligeramente con el dorso de una cuchara y luego retira el aro con cuidado.

Un consejo adicional: Si deseas darle un toque de sabor adicional, puedes agregar tiras de salmón ahumado o un poco de yogur griego batido para disfrutar de contrastes deliciosos.

¡Buen provecho!

🙏 @cuerpo_mente 🧠

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6 November 2023

17:21

🙏 Cuerpo y Mente 🧠

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Beneficios del chocolate negro para la salud 🍫

El chocolate negro, derivado del cacao, se caracteriza por su alto contenido de cacao, lo que lo hace rico en minerales y compuestos vegetales protectores.

Apoyo a la salud cardiovascular ❤️

El consumo de chocolate negro se ha asociado con la reducción de la placa aterosclerótica en las arterias y un menor riesgo de enfermedad cardíaca. Estudios también han demostrado que puede ayudar a reducir la presión arterial y el colesterol LDL "malo". Estos efectos se deben a la presencia de compuestos antioxidantes y antiinflamatorios en el chocolate negro, lo que lo convierte en una opción deliciosa para mantener un corazón saludable.

Rico en minerales esenciales 🌟

El chocolate negro es una fuente sorprendente de minerales esenciales como el magnesio y el hierro. El magnesio es crucial para la regulación de la presión arterial y el azúcar en sangre, así como para la función muscular y nerviosa. Por su parte, el hierro es necesario para transportar oxígeno en el cuerpo y desempeña un papel en el crecimiento y desarrollo. Estos minerales son fundamentales para una salud óptima.

Consumo moderado y consideraciones ⚖️

A pesar de sus beneficios, el chocolate negro es relativamente alto en calorías y debe ser consumido con moderación. Su contenido de cafeína y teobromina puede tener efectos estimulantes, por lo que es importante evitar su consumo excesivo, especialmente para personas sensibles. Además, en etapas avanzadas del embarazo, el consumo de productos de cacao debe ser limitado, ya que podría tener efectos negativos en la salud fetal. Por tanto, disfrutar del chocolate negro en pequeñas cantidades es la clave para aprovechar sus beneficios sin riesgos.

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7 November 2023

16:43

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🪴Plantas y salud mental: una conexión innegable

El cuidado de las plantas es una práctica ancestral que ha perdurado a lo largo de la historia de la humanidad. En la época victoriana, las clases acomodadas comenzaron a cultivar plantas de interior, lo que no solo se debió a su exotismo, sino también a la influencia positiva que tenían en su estado de ánimo.

Este vínculo entre plantas y salud mental fue respaldado científicamente en el siglo XIX por Benjamin Rush, considerado el padre de la psiquiatría estadounidense. Él documentó la relación entre el cultivo de plantas y los beneficios emocionales en pacientes con trastornos mentales, lo que llevó a la incorporación de la jardinería en terapias en instituciones de salud mental.

Un estudio reciente realizado por el Grupo de Investigación de Naturación Urbana e Ingeniería de Biosistemas (Naturib) de la Universidad de Sevilla respalda aún más esta relación. La investigación involucró a más de 4.200 personas a nivel global y demostró que cuidar de las plantas durante el confinamiento por la crisis sanitaria de la COVID-19 tenía un impacto positivo en el estado de ánimo, aliviando tensiones y proporcionando comodidad.

La ciencia también nos dice que la conexión entre las plantas y la salud mental está arraigada en nuestro ADN. El contacto con la naturaleza desencadena la liberación de hormonas relacionadas con la felicidad, lo que nos hace sentir calmados, alegres y más creativos.

Por lo tanto, tener plantas en nuestro entorno, ya sea en casa o en el trabajo, puede ayudar a reducir el estrés y la ansiedad. Algunas recomendaciones incluyen elegir plantas con flores, hojas grandes, y tonalidades de verde amarillento para mejorar nuestro bienestar emocional.

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8 November 2023

14:08

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😁 Cómo dejar de sentirse cansado todo el tiempo

La fatiga, esa sensación constante de cansancio mental y físico, puede atribuirse a diversos factores, como elecciones de estilo de vida poco saludables, problemas en el trabajo y el estrés. Antes de abordarla, es crucial consultar a un profesional de la salud para descartar problemas médicos subyacentes.

🥗 Sugerencias dietéticas: Beber suficiente agua, moderar el consumo de cafeína y desayunar son recomendaciones clave para impulsar tu energía. Evita saltarte comidas y las dietas extremas, ya que privan al cuerpo de nutrientes esenciales. Incorpora alimentos ricos en hierro, especialmente si eres mujer, para prevenir la anemia.

🛌 Consejos para el sueño: Asegura un sueño adecuado, limita la cafeína y aprende técnicas de relajación para combatir el insomnio. Evita el uso de pastillas para dormir y actividades estimulantes en la cama.

🏃‍♂️ Cambios en el estilo de vida: Deja de fumar, reduce el tiempo sedentario y aumenta la actividad física. La consulta con un profesional médico es crucial, especialmente si has estado inactivo durante mucho tiempo o tienes condiciones médicas crónicas.

🧘‍♂️ Salud mental: Evalúa tu estilo de vida, aprende técnicas de relajación como la meditación y el yoga, y encuentra tiempo para el ocio y la diversión. La risa es un potente estimulante de energía.

Recuerda, para abordar la fatiga de manera efectiva, es fundamental considerar estos consejos y buscar el equilibrio en tu vida diaria.

¡Cuida de tu bienestar!

🙏 @cuerpo_mente 🧠

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16:29

🙏 Cuerpo y Mente 🧠

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¡Hola, apreciados seguidores del canal!

💪 Sabemos que mantener una dieta equilibrada y manejar el estrés son formas efectivas de fortalecer tu sistema inmunológico. Pero, ¿sabías que el ejercicio también puede ser una poderosa herramienta para combatir infecciones? Te lo explicamos.

#podcast ⬇️⬇️⬇️

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16:29

Podcast de Cuerpo y Mente – Ejercicio e Inmunidad.mp3

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03:36, 3.3 MB

🎤 Ejercicio e Inmunidad

Cómo el ejercicio fortalece tu sistema inmunológico.

¿Qué te ha parecido este episodio?

¡Coméntanos!

🙏 @cuerpo_mente 🧠

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17:14

🙏 Cuerpo y Mente 🧠

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¿Quieres saber cómo es que nunca me canso y siempre estoy llena de energía?

👉Descúbrelo👈

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18:55

🙏 Cuerpo y Mente 🧠

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00:10, 2.1 MB

¿Experimentas migrañas? Aprende cuáles alimentos debes evitar para reducir los episodios.

🙏 @cuerpo_mente 🧠

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9 November 2023

18:01

🙏 Cuerpo y Mente 🧠

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00:25, 6.5 MB

¡Descubre cómo funciona el sistema nervioso! 🧠

El sistema nervioso es un entramado de células y tejidos que controla todas nuestras funciones corporales y nos permite interactuar con el entorno. Desde el simple acto de mover un dedo hasta experimentar emociones intensas, todo está relacionado con este increíble sistema.

Está compuesto por dos partes principales: el sistema nervioso central (SNC) y el sistema nervioso periférico (SNP). El SNC está formado por el cerebro y la médula espinal, mientras que el SNP abarca los nervios que se extienden por todo nuestro cuerpo.

El cerebro, considerado el órgano más complejo, es responsable de procesar información, regular nuestras acciones y coordinar nuestras actividades diarias. Sin él, simplemente no seríamos nosotros.

Por otro lado, la médula espinal actúa como una "autopista" de transmisión de mensajes entre el cerebro y el resto del cuerpo. Además, es crucial para los reflejos automáticos y respuestas rápidas a estímulos externos.

No podemos olvidar mencionar las neuronas, las células fundamentales del sistema nervioso. Estas pequeñas maravillas son responsables de transmitir señales eléctricas y químicas, permitiendo la comunicación rápida entre diferentes partes del cuerpo.

A medida que aprendemos más sobre el sistema nervioso, también descubrimos su importancia para nuestra salud y bienestar. Comprender cómo cuidar y mantener un sistema nervioso saludable es fundamental para tener una vida plena y activa.

🙏 @cuerpo_mente 🧠

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10 November 2023

17:33

🙏 Cuerpo y Mente 🧠

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00:13, 1.9 MB

¿Conocías la reflexologia? 🦶

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11 November 2023

17:02

🙏 Cuerpo y Mente 🧠

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Una forma de vivir con mayor tranquilidad es aprendiendo a distinguir lo verdaderamente importante de lo que no lo es.

En esencia, es crucial identificar las pequeñas molestias y dejarlas en su lugar correcto: fuera.

Hay tonterías molestas que consumen energía y no vale la pena ocuparse de ellas.

🙏 @cuerpo_mente 🧠

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12 November 2023

14:37