bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular risk factors in young adult survivors of childhood malignancies.
Authors: Sulicka-Grodzicka Joanna , Surdacki Andrzej , Krolczyk Jaroslaw , Grodzicki Tomasz 
Published: February 2017

138 Background: Survivors of childhood cancer are at increased risk of early cardiovascular (CV) diseases related to previous cancer therapy, chronic stress and unhealthy behaviors, as well as traditional cardiovascular risk factors. The aim of the study was to assess the prevalence of cardiovascular risk factors in young adult survivors of childhood malignancies. Methods: Medical records of 155 adult childhood cancer survivors were analyzed to extract data on cancer treatment, demographical characteristics, family history, smoking, blood pressure (BP), lipids, fasting glucose, creatinine measured during a routine visit in our follow-up clinic for adult childhood cancer survivors. Results: The prevalence of traditional CV risk factors was high, with 55% of patients presenting with prehypertension (office systolic BP 120-139 mmHg or diastolic 80-89 mmHg) and 15,4% with hypertension (BP ≥ 140 mmHg and/or ≥ 90 mmHg or being on antihypertensive drugs). The prevalence of overweight and obesity was 23,5% and 3,7%, respectively. A classic “atherogenic lipid profile” (28% patients with elevated total cholesterol and 27% with elevated LDL cholesterol) was more common than a dyslipidemic pattern (elevated triglycerides 11% and reduced HDL cholesterol 7,8%). Two or more CV risk factors were found in 50% of patients and only 16% did not have any of traditional risk factors. Conclusions: Major CV risk factors are common in very young adults with cancer history in the childhood and may substantially increase risk for future CV events in this population. These finding support the need for screening of adult survivors of childhood malignancy for early detection and treatment of modifiable risk factors. [Table: see text]
Feasibility and acceptability of integrated cardiac rehabilitation in outpatients referred for autologous bone marrow transplantation.
Authors: Pituskin Edith , Rothe Derek , Cox-Kennett Nanette , Gyenes Gabor , Paterson Ian , Sandhu Irwindeep , Venner Chris 
Published: February 2017

139 Background: High-dose chemotherapy (HDCT) and bone marrow/hematopoietic cell transplantation (BMT) is established therapy for many malignancies. While advances in transplant practise have led to improved cancer-specific outcomes, HDCT negatively impacts healthy organ function via direct effects (ie high-dose cytotoxic injury to organ systems) and indirect effects (i.e., functional disability). The resulting cardiometabolic sequelae such as dyslipidemia, hypertension, diabetes, and weight gain (with lean body mass loss) contribute to the significantly increased rates of cardiovascular (CV) mortality and heart failure (HF) observed in HDCT survivors. Cardiac rehabilitation/secondary prevention (CR/SP) programs are a level 1 recommendation in multiple CV diseases, reducing CV risk and events. Currently, the feasibility of integrating standard CR/SP programs in outpatients (PTS) referred for HDCT is unknown. Aim: To prospectively evaluate feasibility and acceptability of routine referral tocardiovascular rehabilitation/secondary prevention (CR/SP) in unselected lymphoma PTSreferred for autologous HDCT/BMT. Methods: Lymphoma PTS referred for HDCT/BMT were screened and referred to the CR/SP program. Baseline exercise testing was performed prior to HDCT/BMT. Upon recovery (6 weeks) testing was repeated, and PTS were invited to participate in a 6-week standard CR/SP program of exercise rehabilitation and CV risk reduction education. Results: 20 PTS were referred for HDCT/BMT from January 1, 2015 to July 1, 2015. All were referred to the CR/SP program. 100% underwent exercise testing, and all proceeded to BMT without adverse cardiovascular outcomes or mortality. High levels of satisfaction of CR/SP program components were reported. Conclusions: In unselected PTS, seamless integration of CR/SP within standard HDCT/BMT care is feasible and acceptable. We expect short term measurable impacts including reduced symptom burden and improved quality of life. Longer term impacts will evaluate CV morbidity and mortality. This work will inform patient-centered care and improve supportive and survivorship care across the cancer continuum.
Patient preferences for research access to administrative data in Ontario.
Authors: Tian Chenchen , Brown Catherine , Perez Cosio Andrea , Leung Yvonne , Lagrotteria Alisa , Liang Mindy , Gill Gursharan , Wong Lauren , Sinnesael Kendra , Noronha Cheryl , Willing Stephanie , Bell Erin N , Vennettilli Ashlee , Edwards Jackie , Pater Joseph L. , Howell Doris , Kassam Zahra , Liu Geoffrey , Hay Annette E. 
Published: February 2017

144 Background: Clinical trials collect outcome data until the trial ends. Subsequent health data is often available in government or health care administrative databases, yet this information is often not made available to researchers. We assessed patient preferences of long-term linkage of such administrative databases to clinical trials databases. Methods: A self-reported questionnaire was administered to outpatients in clinics of academic and community cancer centres. Cancer patients were presented with a hypothetical scenario of a clinical trial and asked about their willingness to allow confidential research access to their personal health information contained in administrative databases. Results: Of 524 patients, 54% were females, median age was 60 (range 19–93), 81% were Caucasian, and 61% had post-secondary education. Of cancer sites, 20% had breast cancer, 17% GI, 14% GU, 13% hematology, 12% thoracic, 12% head/neck and 11% gynecologic cancers. One-third (33%) had participated in a clinical trial. An overwhelming 93% allowed confidential access to health information in administrative databases (59% always, 34% depending on circumstances) including access to initials and birth dates, to be used to match information across databases (70% always, 23% depending on circumstances). Only 3% were unwilling to release their information under any circumstances. When asked about other identifiable information, such as name and address, more than 74% allowed the secure storage of this information at the central study coordinating center. In a new cohort of 103 patients, 84% preferred long-term data to be continually available to researchers after the clinical trial has ended; only 9% did not want this option. Results were similar across all sociodemographic subgroups studied including patients who had prior participation in clinical trials, although older patients were even more likely to allow access than younger patients (p = 0.02). Conclusions: The vast majority of patients were willing to have their long-term outcome data collected through government and health care administrative databases made available to clinical trial researchers, to improve our understanding of long-term outcomes of trial procedures and drugs.
Identifying dehydration risk in head and neck cancer patients undergoing radiation therapy using remote, sensor-based monitoring: A randomized controlled trial.
Authors: Peterson Susan K. , Shinn Eileen H. , Garden Adam S. , Patrick Kevin , Shete Sanjay , Shen Chan , Martch Stephanie L. , Farcas Emilia , Lin Kai , Raab Frederic , Asomaning Nancy , Christie Israel , Nandigam Viswanath , Chen Tony , Yan Yan , Beadle Beth Michelle 
Published: February 2017

152 Background: Early identification and mitigation of cancer therapy-induced complications can improve quality of life and reduce complications and health care costs. We are evaluating the efficacy of a system, called CYCORE (CYberinfrastructure for Comparative effectiveness Research), to systematically and accurately collect daily weight, blood pressure, pulse and symptom data from head and neck cancer (HNC) survivors during their 6 to 7-week radiation treatment (RT) regimen using home-based biometric and other sensors integrated with a cyber-physical system. Aims include: 1) evaluate CYCORE’s efficacy in reducing hospitalization and emergency room visits related to dehydration; and, 2) evaluate related impact on costs related to treating dehydration. Methods: Remote, sensor-based monitoring via CYCORE identifies HNC survivors at increased risk for dehydration (i.e., reduced blood pressure and weight, increased pulse, and patient-reported outcomes (PROs) including decreased food and fluid intake). Upon initation of RT, HNC survivors are randomized to either: 1) standard care plus use of the CYCORE system, wherein biometric sensor data and PROs (e.g., pain, nausea, medications, food/fluid intake) are collected ; or, 2) standard care. Outcomes include hospital and emergency room admissions, and related costs. Results: To date, 113 survivors are enrolled (88.9% recruitment and 90.3% retention rates). Those randomized to CYCORE take daily home readings of weight, blood pressure and pulse via Bluetooth-enabled devices, and complete daily PRO assessments on a mobile application. Survivors’ data are available for viewing and clinical decision-making via a Web-based interface by their physicians and other providers. Previously, 59% of HNC survivors on RT showed physiologic signs of dehydration while using the CYCORE system. Worse ratings of nausea and vomiting predicted dehydration risk. Conclusions: CYCORE may serve as one model for integrating mobile and sensor technologies during critical periods of cancer care that occur outside of the clinic setting, and may improve management of treatment side effects, quality of life, and greater satisfaction with care. Clinical trial information: NCT02253238.
Chemotherapy-induced peripheral neuropathy management.
Authors: Schloss Janet Margaret , Colosimo Maree , Vitetta Luis 
Published: February 2017

154 Background: Neurological complications such as chemotherapy-induced peripheral neuropathy (CIPN) and neuropathic pain are frequent side-effects of neurotoxic chemotherapy agents. An increasing survival rate and frequent administration of adjuvant chemotherapy treatments involving neurotoxic agents makes it imperative that accurate diagnosis, prevention and treatment of these neurological complications be implemented to minimize the burden experienced by patients undergoing these treatments. Methods: To determine the potential use of pharmaceuticals, nutraceuticals and herbal medicines as adjuvants in cancer treatments a critical literature review was conducted by electronic and manual search on nine databases. These include PubMed, the Cochrane Library, Science Direct, Scopus, EMBASE, MEDLINE, Google Scholar and two Chinese databases CNKI and CINAHL. Thirty studies were selected for pharmaceutical agents, twenty-four studies for nutraceuticals and thirty-four studies for herbal medical trials. Seven acupuncture trials were also identified in relation to CIPN management. Data was collated and organised into chemotherapy drugs, agent’s trialled, number of participants, results and recommendations. Results: For pharmaceutical agents, amifostine has possible ototoxicity protection for children in cisplatin and duloxetine as a treatment option for pain. For nutraceuticals, vitamin E was found to have protective abilities for cisplatin ototoxicity, omega 3 fatty acids for taxane administration and vitamin B6 and lipoic acid for oxaliplatin CIPN. In herbal medicine, Goshajinkigan showed great promise for oxaliplatin-IPN protection. Vitamin B12 deficiencies have also been found to increase the onset and severity of CIPN. Conclusions: Currently, no pharmaceutical, nutraceutical or complementary agent has been found to be completely beneficial in preventing or treating CIPN. It is suggested clinicians identify the best option from the research to assist patients in both possible prevention and treatment of CIPN. In addition, research has found that a vitamin B12 deficiency may potentiate moderate to severe CIPN presentation and testing of this vitamin is suggested.
Patient-provider communication and decision making regarding adjuvant endocrine therapy-related symptom management: Provider perspectives.
Authors: Turner Kea , Samuel Cleo A. , Donovan Heidi AS , Van Londen G J. 
Published: February 2017

156 Background: Adjuvant endocrine therapy (AET)-related symptom management (SM) among breast cancer survivors (BCS) is greatly influenced by the quality of patient-provider communication; yet, few studies have examined provider perspectives on patient-provider communication and decision-making for AET-related SM. We assessed provider perspectives on AET-related SM to identify challenges and opportunities for improvement in patient-provider communication and decision-making. Methods: We conducted 3 focus groups (FGs) with a multidisciplinary group of health care providers (n = [6] physician; n = [7] non-physician) experienced in caring for BCS undergoing AET. We utilized semi-structured discussion guides to elicit provider perspectives on patient-provider communication and decision-making for AET-related SM as well as recommendations for improvement. All FGs were held at the University of Pittsburgh, audiotaped, and transcribed. We analyzed FG transcripts using qualitative software to identify key themes. Results: Providers described multiple challenges to patient-provider communication and decision-making for AET-related SM. Providers reported that BCS are often uncertain whether their symptoms are related to AET and unsure of whom to speak with about their symptoms. Providers also felt that patients are reluctant to bring up symptoms for fear that bringing up symptoms would detract from their care. Providers agreed that patient-provider communication influences BCS’ awareness and beliefs about SM. Providers indicated that provider communication strategies such as probing for symptoms, setting realistic treatment expectations, and assessing patient satisfaction with their SM plan enhances patient decision-making about AET-related SM. Conclusions: Although providers identified several challenges related to patient-provider communication and decision-making, many of these challenges are amenable to change through provider-level interventions. Future efforts aimed at improving AET-related SM should include strategies that address patient-provider communication and decision-making.
Improved Nutrition in Adolescents and Young Adults after childhood cancer: INAYA—A pilot study.
Authors: Quidde Julia , Koch Barbara , Bokemeyer Carsten , Escherich Gabriele , Buchholz Daniel , Valentini Luzia , Stein Alexander , von Grundherr Julia 
Published: February 2017

173 Background: By the use of multimodal therapies the chance of cure and survival improves and thus the risk for long-term side effects are increasing in „Adolescents and Young Adult“ cancer survivors (AYAs) . Compared to the general population AYAs have a 5 to 15-fold increased risk of cardiovascular diseases. Therefore, the improvement of modifiable lifestyle risk factors is of importance. Besides general information supplied during survivorship care nutrition habits in AYAs remain bad. Methods: The INAYA trial enrolled AYAs between 18-39 years to receive an intensified individual nutrition counseling based on a 3-day dietary records at 4 defined timepoints. At week 0 and 12 AYAs got personal counseling during follow-up care and consultation hours and at week 2 and 6 by telephone. Primary endpoint was change in nutritional intake measured by the Healthy Eating Index of the European Prospective Investigation into Cancer and Nutrition (HEI-EPIC). Secondary endpoints were (selection): quality of life (QoL), change in weight and waist-hip ratio. Results: 23 AYAs (11 female, 12 male, 21.9 ± 4.3 years of age, BMI: 21.6 ± 1.7 kg/m²) after treatment for childhood malignancies (12x hodgkin lymphoma, 6x leukaemia, 2x sarcoma, 2x carcinoma, 1x blastoma) were included. At baseline 14 patients (pts) were of normal weight, 4 pts overweight and 5 pts underweight (WHO criteria). 56.5% (n = 13) reported gastrointestinal symptoms (e.g. flatulence, change in stool consistency, stomach pain). According to HEI-EPIC a good, moderate and bad nutritional intake was seen in 4.3%, 73.9% and 21.7% of the pts. A high salt intake was seen in 6 pts (26%). Dietary habits improved after nutrition counseling at week 0, 2 and 6. 43.7% (n = 10) took more time to eat, 47.8% (n = 11) increased their fluid intake to ≥ 1.5 l/d and 21.7% (n = 5) changed their weight positively. Up to now 8 pts completed the study. Median HEI-EPIC score improved from 46 points (baseline) to 66 points (week 12). Final results are expected for November 2015. Conclusions: Intensified nutrition counselling improves dietary intake and nutrition status in AYAs.
Effect of weight history on ability to lose weight after a 6-month randomized controlled weight loss trial in overweight breast cancer survivors: The Lifestyle, Exercise and Nutrition (LEAN) study.
Authors: Sanft Tara Beth , Harrigan Maura , Cartmel Brenda , Playdon Mary , Zhou Yang , Loftfield Erikka , Irwin Melinda L 
Published: February 2017

174 Background: Because obesity portends a higher risk of breast cancer mortality, achieving a healthy weight is recommended for breast cancer survivors. The impact of weight history on the ability to lose weight is unclear. We previously reported a 6.2 + 0.7% vs. 2.1 + 0.9% weight loss (p = .0003) in 100 breast cancer survivors randomized to a 6-month weight loss intervention vs. usual care. We examined whether weight history modified the effect of the intervention on body weight changes. Methods: Breast cancer survivors with a BMI > 25 kg/m2were randomized to usual care or 6-month, 11-session diet and exercise-counseling intervention. Baseline and 6 month weight and height were measured; weight at ages 18 and 35, 5 years and 1 year before and at diagnosis were self-reported. We defined weight history as: 1) change in weight between each time point and baseline; and 2) duration of obesity (i.e., number of years of having a BMI > 30 between age 18 and baseline). Generalized linear models were used to evaluate mean changes at 6 months between the intervention and usual care groups, adjusted and stratified by weight history variables. Results: Mean age and time since diagnosis were 59 + 7 years and 2.9 + 2.1 years, respectively. BMI increased over time (age 18 BMI = 21.8 + 2.9; baseline BMI = 32.4 + 6.5). Number of years being obese was 5.3 + 8.2 years (range 0-40 years). BMI at baseline, change in BMI from various time points to baseline, and years of obesity did not modify weight loss results. After adjusting for weight history, women randomized to intervention vs. usual care lost 6.1 + 0.7% vs. 2.0 + 0.9%, p = .0006, respectively. Conclusions: Participants reported a history of steady weight gain over time. The duration of obesity did not modify weight loss results. Weight history did not hinder survivors’ ability to lose clinically meaningful weight via a structured intervention.
Support for physical activity among young cancer survivors.
Authors: Washington Pamela Kim 
Published: February 2017

177 Background: There is strong evidence that physical activity mitigates negative psychosocial effects and sequelae associated with adjuvant chemotherapy among cancer survivors. Given the many benefits of physical activity in this population, it is important to understand the factors that influence continued participation post diagnosis. One possible determinant that has received little attention to date is the influence of social support. This study is unique in that it is the first to explore the role of social support for physical activity among young survivors of breast cancer through the use of mixed methods. Methods: Survey data (n = 273) were used to determine actual levels of moderate and vigorous physical activity. These data were subsequently used to identify women of interest to participate in face-to-face qualitative interviews. Semi-structured interviews (n = 31) were conducted with a subset of women from the quantitative sample. Participants were Bay Area women who were age 55 or less and premenopausal at the time of diagnosis and who also received adjuvant chemotherapy. Following qualitative analyses, hypotheses were developed to test the association between social support and obtaining recommended levels of physical activity through the use of logistic regression analyses using a sample of 273 women. Results: Qualitative analyses indicated that women who have a partner with whom they engage in physical activity are more likely to adopt and maintain physical activity behaviors over time. Regression analyses provide evidence that women who have support specifically for physical activity are more likely to meet recommended activity guidelines (b = .030, OR = 1.030 per unit of scale, p = .003, C.I. = 1.01 – 1.05). Conclusions: When considering correlates of physical activity, social support specific to physical activity may be important or even pivotal in assisting survivors to adopt and/or maintain participation in a given activity at recommended levels.
Breast cancer recurrence risk-reduction beliefs and behaviors among African American breast cancer survivors.
Authors: Smith Selina , Ansa Benjamin E. , Yoo Wonsuk , Whitehead Mary S. , Coughlin Steven S. 
Published: February 2017

180 Background: A growing body of evidence suggests that breast cancer (BC) recurrence risk is linked to lifestyle behaviors. This study examined correlations between BC recurrence, risk reduction beliefs and related behaviors among African American (AA) breast cancer survivors (BCSs). Methods: 191 AA BCSs, mean age = 56.3 years (standard deviation = 11.4 years) completed a lifestyle assessment tool. Results: Most respondents believed that being overweight (52.7%), lack of physical activity (48.7%) and a high fat diet (63.2%) are associated with BC recurrence. 66.3% considered themselves overweight; one third (33.5%) endorsed that losing weight could prevent BC recurrence; another third (33%) did not, while the remainder (33.5%) don’t know; and nearly half (47.9%) believed that BC recurrence could be prevented by increasing physical activity. 87.3% survivors with BMI < 25 Kg/M2 reported no recurrence compared to 75.7% with BMI > 25 Kg/M2 (p = 0.0580); almost all the women (99.2%) answered ‘yes’ to seeking professional help to lose weight, 79.7% of which were recurrence-free (p = 0.0508). Conclusions: These results provide information about AA BCSs’ beliefs and behaviors protective against BC recurrence. Additional research is warranted to determine the effectiveness of educational interventions for AA BCSs that promote consumption of a healthy diet and engaging in regular physical activity.