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Biomedical subjects

E Salminen

Publications and source records attributed to E Salminen.

At least 19 recordsLinked to original sources

The effect of beta-glucan on the glycemic and insulin index.

OBJECTIVE: To determine the effects of oat products with increasing beta-glucan content on the glycemic (GI) and insulin indexes (II) of oat products, and to establish the effect of physical properties of beta-glucan on these physiological responses. DESIGN: Test group (n=10) randomly attended to three glucose tolerance tests and glycemic response tests for four oat bran products. SETTINGS: Functional Foods Forum and the Department of Food Chemistry, University of Turku, and the Department of Food Technology, University of Helsinki. SUBJECTS: One male and nine female volunteers were recruited from university students and staff, and all completed the study. INTERVENTIONS: GI and II of different products were calculated for each subject using the average of parallel glucose tolerance tests and the subsequent glycemic/insulinemic responses for each product. Average indexes for products were calculated according to the individual data. RESULTS: The glycemic responses to oat products with increasing amounts of beta-glucan had lower peak values than the reference glucose load. The amount of extractable beta-glucan had a high correlation between the glycemic and insulinemic response. CONCLUSION: In addition to the total amount of beta-glucan in oat products, the amount of extractable beta-glucan in oat products explains the magnitude of the decrease in glycemic responses to carbohydrate products.

Adult↗

Unmet needs in information flow between breast cancer patients, their spouses, and physicians.

This study focused on the needs and sources of disease information of breast cancer patients and their spouses during early disease in two settings: at the department of oncology (AD) and on a rehabilitation course (RC). The aim was to characterize those patients and spouses who are not content with average information. Eighty percent of AD and 31% of RC patients were content with the available information (p < 0.001) and 75% of AD spouses and 43% of RC spouses reported similarly (p = 0.008). Higher education, younger age, and shorter time (<1 year) since diagnosis indicated a greater need for information among patients, whereas among spouses, only education level was associated with it. More information was needed on prognosis, cancer as a disease, its influence on daily life, and treatment effects. In both groups, the same proportion of patients reported to have felt involved in decision making sufficiently (60%), inadequately (27%), and 19% versus 16% did not want to be actively participating in decision making. The patients were mostly satisfied with participation in decision making, but they expressed unsatisfactory needs on information during early years of breast cancer. Similarly, their spouses were not content with available information.

Adult↗

Dietary attitudes and changes as well as use of supplements and complementary therapies by Australian and Finnish women following the diagnosis of breast cancer.

OBJECTIVE: This study investigated self-reported dietary attitudes and changes, and use of complementary approaches among breast cancer patients in relation to age, education and time since diagnosis. DESIGN AND SETTING: Australian (ABC, N=215) and Finnish (FBC, N=139) breast cancer patients were surveyed at the university cancer centres with voluntary participation. Logistic regression models were used to adjust for differences in demographic patient characteristics between the groups. The influence of demographic variables was further studied separately or combined. RESULTS: In all, 30% of FBC patients and 39% of ABC patients reported having changed their diet (P=0.033). Higher education, younger age and longer time from diagnosis were significantly associated with the probability of changes. The main changes reported included reduced consumption of animal fat, sugar and red meat, and increased consumption of fruits and vegetables. In all, 6% of ABC and 4% of FBC patients had stopped smoking and 24% of ABC and 27% of FBC patients reported to have increased their level of physical exercise. Choices were associated with age (P<0.007), length of the disease history (P <0.01) and level of education (P <0.002). CONCLUSION: One-third of breast cancer patients surveyed reported to have changed their dietary habits. Both populations reported a need for dietary and lifestyle counselling. This need was experienced as poorly recognised by the physicians at present, and warrants future studies in dietary behaviour of breast cancer patients.

Adult↗

Effect of adjuvant androgen deprivation on thyroid function tests in prostate cancer patients.

Androgen deprivation (AD) used in the treatment of prostate cancer is known to alter concentrations of sex hormones and their binding globulins. Less is known as to its effect on thyroid hormones. In this prospective study the effects of AD on thyroid function were clarified. Levels of serum thyroid stimulating hormone (TSH), free thyroxine (FT4) and thyroid binding globulin concentrations were measured in prostate cancer patients treated with either radical radiotherapy and androgen deprivation for 12 months (AD) or radical radiotherapy alone (RT). Measurements were made at baseline, and at 3, 6 and 12 months. At baseline and at 3 months the results of thyroid function tests did not differ significantly between groups. A significant decline in serum testosterone in the AD group was accompanied by a significant decline in FT4 at 6 and 12 months, while no significant changes in thyroid function were observed in the RT group. The decline in FT4 among AD patients did not evoke a normal TSH response. Prolonged use of AD hampers the interpretation of thyroid test results. This finding has substantial implications for the follow-up of patients in hormonally treated prostate cancer.

Aged↗

Androgen deprivation and cognition in prostate cancer.

Androgen deprivation (AD) is commonly used in neoadjuvant and adjuvant setting with prostate cancer (PC) radiotherapy. This prospective study assessed whether cognitive functioning is impaired during 12 months of AD therapy. Longitudinal testing of 25 patients treated with AD and curative radiotherapy was undertaken at baseline, and at 6 and 12 months. CogniSpeed software was used for measuring attentional performances. Other cognitive performances were evaluated using verbal, visuomotor and memory tests. The Beck depression inventory was employed to evaluate depressive mood and EORTC QLQ-C30 for quality of life (QoL). During longitudinal testing of the AD group, no impairment in cognitive performances was found. Instead, improvement was observed in object recall (immediate, P=0.035; delayed, P<0.001), and in semantic memory (P=0.037). In QoL, impairment in physical function was observed. Androgen deprivation of 12 months appears to be associated with preserved cognitive functioning, although physical impairment occurs. These results have implications for counseling and psychosocial support of patients in the context of treatment options in PC.

Aged↗

The methane production of poultry slaughtering residues and effects of pre-treatments on the methane production of poultry feather.

The biological methane production rate and yield of different poultry slaughtering residues were studied. Poultry offal, blood, and bonemeal were rich in proteins and lipids and showed high methane yields, 0.7-0.9, 0.5, and 0.6-0.7 m3 kg(-1) volatile solids(added), respectively (270-340, 100, and 150-170 m3 ton(-1) wet weight). Blood and bonemeal produced methane rapidly, whereas the methane production of offal was more delayed probably due to long-chain fatty acid inhibition. The length of delay depended on the source and concentration of inoculum and incubation temperature, sewage sludge at 35 degrees C having the shortest delay of a few days, while granular sludge did not produce methane within 94 days of incubation. Feather showed a somewhat lower methane yield, 0.21 m3 kg(-1) volatile solids(added) (50 m3 ton(-1) wet weight). Combined thermal (120 degrees C, 5 min) and enzymatic (commercial alkaline endopeptidase, 2-10 g l(-1)) pre-treatments increased its methane yield by 37 to 51%. Thermal (70-120 degrees C, 5-60 min), chemical (NaOH 2-10 g l(-1), 2-24 h), and enzymatic pre-treatments were less effective, with methane yield increasing by 5 to 32%. Based on the present results, anaerobic digestion of the studied poultry slaughtering residues appears a promising possibility because of the high methane yield and nitrogen content of these residues (8 to 14% N of total solids), whereas pre-treatments were shown to improve the methane production of feather.

Abattoirs↗

Docetaxel with epirubicin--investigations on cardiac safety.

The aim was to evaluate clinical and subclinical cardiac toxicity of epirubicin-docetaxel (ET) combination. Breast cancer patients were given epirubicin (75 mg/m2 for 15 min), followed 1 h later by a 1-h infusion of docetaxel (75 mg/m2) q3w as first-line treatment. Cardiac function was monitored using a 24-h ambulatory electrocardiogram (ECG), left ventricular ejection fraction (LVEF), physical examination and chest radiography. The median LVEF did not decrease during the course of the treatment: median LVEF was 64% prior to treatment and 68% after cycle 8. The 24-h ECG did not reveal any significant changes in heart rate variability. The number of extrasystoles or cardiac arrhythmia did not increase with the ET treatment. No patient experienced congestive heart failure during treatment or the mean follow-up of 34 months. We conclude that first-line ET caused no major cardiac changes during 6 months of treatment (8 cycles) or during follow-up. Twenty-four-hour ECG, combined with echocardiography to measure LVEF, was a feasible method for the close monitoring of the cardiac effects during chemotherapy.

Adult↗

Anaerobic digestion of organic solid poultry slaughterhouse waste--a review.

This work reviews the potential of anaerobic digestion for material recovery and energy production from poultry slaughtering by-products and wastes. First, we describe and quantify organic solid by-products and wastes produced in poultry farming and poultry slaughterhouses and discuss their recovery and disposal options. Then we review certain fundamental aspects of anaerobic digestion considered important for the digestion of solid slaughterhouse wastes. Finally, we present an overview of the future potential and current experience of the anaerobic digestion treatment of these materials.

Abattoirs↗

Breast cancer patients have unmet needs for dietary advice.

GOAL: This study investigated ideas and attitudes of breast cancer patients in two countries with reference to information on diet and their need for dietary counselling. PATIENTS AND METHODS: Australian breast cancer (ABC) patients (n=215) surveyed for alterations in dietary habits after diagnosis were compared with breast cancer patients in Finland (FBC; n=139). A validated questionnaire was used. Logistic regression models were used to adjust for differences in demographic patient characteristics between the groups. RESULTS: Eight per cent of FBC and 54% of ABC patients saw diet as a factor contributing to their disease (P<0.00001). Thirty per cent of FBC and 39% of ABC reported changing their diet after being informed of the diagnosis (P=0.033). Higher education, younger age and longer (>1 year) time to diagnosis were significantly associated with the probability of changing diet among the Australian patients. The main reason given was the desire for cure. The most common source of information was the mass media, and a need for more information on dietary factors relating to disease was expressed by 32% of patients in each group. CONCLUSION: Ideas about the importance of diet varied significantly among ABS and FBC patients. The lack of precise dietary recommendations for the individual situation was commonly mentioned, and patients depended on information obtained from outside their treatment centre.

Journal Article↗

FDG-PET imaging in the management of non-small-cell lung cancer.

Lung cancer is currently the leading cause of cancer-related death in both men and women in most Western countries. Tumour stage is the strongest prognostic factor and the most important parameter guiding treatment decision making. Metabolic positron emission tomography imaging with fluorodeoxyglucose (FDG-PET) has consistently proved superior to conventional imaging for staging of non-small-cell lung cancer and provides information of greater prognostic significance than can be obtained using conventional approaches. FDG-PET has been approved in the USA, Germany and the UK as a basic and invaluable tool in the management of lung cancer.

Carcinoma, Non-Small-Cell Lung↗

Epirubicin/docetaxel regimen in progressive breast cancer-a phase II study.

The purpose of this investigation was to evaluate the efficacy and toxicity of 6 months' treatment with the combination of epirubicin and docetaxel in metastatic breast cancer. Thirty-eight women (mean age 51 years, range 35-72) with metastatic breast cancer were treated with a regimen of epirubicin 75 mg/m and docetaxel 75 mg/m every 3 weeks, given 4 times if progression was seen upon evaluation after 4 courses or 8 times in responding/stable patients. The patients received 285 cycles of combination treatment and two treatments with docetaxel or epirubicin alone. When neutropenia with fever was observed, further cycles were given with dose reduction. The median cumulative docetaxel dose was 462 mg/m (range 199-600) and that of epirubicin 476 mg/m (range 199-740). The overall response rate was 54% (95% CI 37-71), with a median duration of response of 14.8 months (95% CI 8.8-27.8). Median time to progression was 12 months, median survival 26 months. Neutropenia below 0.5 x 10 /l occurred following 113 (39%) of the total of 285 cycles given; 21 patients (55%) were hospitalized for febrile neutropenia. We conclude that dose tailoring is required in treatment with an epirubicin and docetaxel regimen to avoid grade 3/4 adverse effects in a significant number of patients treated for metastatic breast cancer.

Adult↗

Feasibility of prolonged use of interferon-alpha in metastatic kidney carcinoma: a phase II study.

BACKGROUND: Interferon-alpha has proven effective in the treatment of metastatic renal cell carcinoma. However, the optimal schedule has not yet been determined. The authors have studied the efficacy and toxicity of prolonged use interferon-alpha2a (IFN-alpha) in metastatic renal cell carcinoma (RCC). Interferon-alpha was administered intermittently for outpatients. METHODS: Seventy-five patients with metastatic RCC without prior biochemotherapy were treated. During the first month, the IFN-alpha dose was increased from 4.5 to 18 million units (MU) 3 times a week to define the individual maximal tolerated dose for each patient. The treatment was continued at the maximal tolerated dose with a 1-week pause each month until either progression or intolerable toxicity was observed or up to 2 years. RESULTS: The overall response rate (5 complete response [CRs] and 8 partial responses [PRs]) was 17% (95% confidence interval, 10-28%). Stable disease was observed in 32 patients (43%). Three late objective responses (4%) occurred after 12 months treatment. The median progression free time of all patients was 12.3 months, and median survival time was 19.3 months. The median duration of response in CR/PR patients was 16 months. In multivariate analysis independent prognostic factors were poor performance status (P = 0.004), presence of bone metastases (P = 0.001), and time to metastases less than 24 months (P = 0.003), which predicted poor survival. Six patients (8%) discontinued the treatment because of fatigue, elevation of liver enzymes, or cardiac arrhythmias. No life-threatening side effects were observed. CONCLUSIONS: Prolonged and intermittently administered IFN-alpha2a three times per week in 3 weekly cycles in metastatic RCC is a feasible and effective therapy. A prolonged treatment duration of more than 12 months for stable and responding patients is beneficial and may improve the outcome of patients with RCC.

Adult↗

F-18 fluorodeoxyglucose positron emission tomography staging in radical radiotherapy candidates with nonsmall cell lung carcinoma: powerful correlation with survival and high impact on treatment.

BACKGROUND: Successful treatment of nonsmall cell lung carcinoma (NSCLC) with radical radiotherapy (RT) requires accurate delineation of tumor extent. Conventional computed tomography-based noninvasive staging often estimates intrathoracic thoracic tumor extent incorrectly and fails to detect distant metastasis. High sensitivity and specificity are reported for F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) staging in potentially resectable NSCLC. The authors investigated FDG-PET staging in radical RT candidates with unresectable NSCLC. METHODS: The authors prospectively studied 153 consecutive patients with unresectable NSCLC who were candidates for radical RT after conventional staging and had PET scans. Patients were allocated both "before PET" and "after PET" stages. Subsequent management was recorded. Survival analysis was used to compare validity of pre-PET and post-PET staging. RESULTS: After PET, 107 patients (70%) actually received radical therapies (radical RT with or without concurrent chemotherapy, n = 102; radical surgery, n = 5); 46 patients (30%) received palliative treatment because of PET-detected distant metastasis (n = 28; 18%) or extensive locoregional disease (n = 18; 12%). Palliative therapies were RT (n = 33), chemotherapy (n = 12), or supportive care (n = 1). All five surgically treated patients underwent potentially curative resections after downstaging by PET. For radically treated patients, post-PET stage (P = 0.0041) but not pre-PET stage (P = 0.19) was strongly associated with survival. Radically treated patients survived longer than those treated palliatively (P = 0.02; 1-year survival, 69% and 44%, respectively; 2-year survival, 44% radical; no palliative patients had 2-yr follow-up). CONCLUSIONS: Positron emission tomography-assisted staging detected unsuspected metastasis in 20%, strongly influenced choice of treatment strategy, frequently impacted RT planning, and was a powerful predictor of survival. Potential impact of FDG-PET is even greater in radical RT candidates with NSCLC than in surgical candidates.

Adult↗

Superior efficacy of letrozole versus tamoxifen as first-line therapy for postmenopausal women with advanced breast cancer: results of a phase III study of the International Letrozole Breast Cancer Group.

PURPOSE: To compare the efficacy and tolerability of tamoxifen with that of letrozole, an oral aromatase inhibitor, with tamoxifen as first-line therapy in postmenopausal women with advanced breast cancer. PATIENTS AND METHODS: Nine hundred seven patients were randomly assigned letrozole 2.5 mg once daily (453 patients) or tamoxifen 20 mg once daily (454 patients). Patients had estrogen receptor- and/or progesterone receptor-positive tumors, or both receptors were unknown. Recurrence during adjuvant antiestrogen therapy or within the following 12 months or prior endocrine therapy for advanced disease precluded enrollment. One prior chemotherapy regimen for metastatic disease was allowed. The primary end point was time to progression (TTP). Secondary end points included overall objective response rate (ORR), its duration, rate and duration of clinical benefit, time to treatment failure (TTF), overall survival, and tolerability. RESULTS: TTP was significantly longer for letrozole than for tamoxifen (median, 41 v 26 weeks). Treatment with letrozole reduced the risk of progression by 30% (hazards ratio, 0.70; 95% confidence interval, 0.60 to 0.82, P =.0001). TTP was significantly longer for letrozole irrespective of dominant site of disease, receptor status, or prior adjuvant antiestrogen therapy. Similarly, TTF was significantly longer for letrozole (median, 40 v 25 weeks). ORR was higher for letrozole (30% v 20%; P =.0006), as was the rate of clinical benefit (49% v 38%; P =.001). Survival data are currently immature and not reported here. Both treatments were well tolerated. CONCLUSION: Letrozole was significantly superior to tamoxifen in TTP, TTF, ORR, and clinical benefit rate. Our results support its use as first-line endocrine therapy in postmenopausal women with advanced breast cancer.

Adult↗

Risk of a new primary cancer among patients with lung cancer of different histological types.

The risk of a new primary cancer (NPC) among 77548 Finnish lung cancer patients from 1953 to 1995 was analysed by the histological type of the lung cancer. The relative risks were expressed as standardised incidence ratios (SIR, ratio of the observed and expected numbers of cases). During the follow-up, 1148 NPCs were observed among men and 152 among women. After exclusion of lung cancers, the risk of NPC was elevated in both males (SIR 1.07; 95% confidence interval (CI) 1.00-1.14) and females (SIR 1.21; 95% CI 1.02-1.42). The excess was larger among lung cancer patients with small-cell carcinoma and adenocarcinoma than those with squamous-cell carcinoma. In all major histological groups of lung cancer, significant excess risks were found for cancers of the larynx (SIRs 2.94-4.25), and bladder (SIRs 2.16-2.86). Significantly elevated SIRs were also found for cancers of the stomach (SIR 1.42; 95% CI 1.12-1.76) and kidney (SIR 2.18; 95% CI 1.56-2.97) in squamous-cell carcinoma; for brain tumours (SIR 3.26; 95% CI 1.20-7.09) in small-cell carcinoma; and for cancers of the prostate (SIR 1.68; 95% CI 1.21-2.27) and thyroid (SIR 3.79; 95% CI 1.23-8.85), and brain tumours (SIR 2.34; 95% CI 1.07-4.43) in adenocarcinoma. The risk of contracting NPC at sites where the majority of tumours are adenocarcinomas was elevated among patients with adenocarcinoma of the lung, but not among squamous-cell or small-cell carcinoma patients. In adenocarcinoma, the excess risks of several smoking-related cancers tended to be somewhat lower than those in the other two histological categories. The relative risk of a NPC among patients diagnosed with lung cancer in 1985-1995 was higher than that of patients from earlier periods in all comparable follow-up categories (up to 10 years), possibly suggesting that the increased use of cytostatic drugs had increased the risk of NPC.

Adenocarcinoma↗

Anaerobically digested poultry slaughterhouse wastes as fertiliser in agriculture.

Chemical and physical analysis, 27-d plant growth assays with carrot (Daucus carota) and Chinese cabbage (Brassica campestris var. chinensis), and 5-d phytotoxicity assays with Chinese cabbage and perennial ryegrass (Lolium perenne) were used to investigate the suitability of anaerobically digested poultry slaughterhouse waste for fertiliser in agriculture and the effect of aerobic post-treatment on the properties of the digested material. The digested material appeared to be rich in nitrogen. In 27-d assays with digested material as nitrogen source, carrots grew almost as well as those fertilised with a commercial mineral fertiliser used as reference, whereas, the growth of Chinese cabbage was inhibited. In further 5-d phytotoxicity assays, the digested material inhibited the germination and root growth of ryegrass and Chinese cabbage, apparently because of organic acids present in it. Aerobic post-treatment of the material reduced its phytotoxicity but, probably due to the volatilisation of ammonia, resulted in loss of nitrogen.

Abattoirs↗

Pharmacokinetics of finrozole (MPV-2213ad), a novel selective aromatase inhibitor, in healthy men.

AIMS: To investigate the pharmacokinetics of finrozole (MPV-2213ad), a novel competitive aromatase enzyme inhibitor, in healthy male volunteers. METHODS: The study was an open, partly randomized cross-over study including 23 volunteers receiving single doses of 3, 9 mg or 30 mg of finrozole as tablets or solution with 14 days between the administrations. The highest dose was given as tablets only. Serum concentrations of finrozole were determined using high performance liquid chromatography combined with mass spectrometry. RESULTS: The mean time to peak serum concentration ranged from 2.5 to 3.1, and 0.6-0.7 h after tablets and solution, respectively. The Cmax values increased as the dose increased. The calculated apparent mean elimination half-life (t(1/2,z)) was approximately 3 h after the solution, and approximately 8 h after the tablet. The AUC(0,infinity) after finrozole tablets increased proportionally from 3 mg to 9 mg and from 3 to 30 mg. The calculated relative mean bioavailabilities (AUC(0,infinity)-ratio) for the 3 mg and 9 mg doses of finrozole as tablets were 89% and 78%, respectively. CONCLUSIONS: The absorption of finrozole from the tablet formulation was relatively rapid, and the apparent elimination half-life was longer after the tablet than after the solution, probably reflecting overlap of the absorption with the elimination phase.

Administration, Oral↗

Imaging with F-18 FDG PET is superior to Tl-201 SPECT in the staging of non-small cell lung cancer for radical radiation therapy.

Thallium-201 (Tl-201) single photon emission computed tomography (SPECT) is funded for evaluation of malignancy in Australia and may have utility for staging of non-small cell lung cancer (NSCLC) if CT results are equivocal. Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) is superior to CT for staging NSCLC but is more expensive and less widely available than Tl-201 SPECT. Therefore, these techniques were prospectively compared in 27 radical radiation therapy candidates. Patients were allocated a conventional, PET and Tl-201 stage. Tumour to background ratios (TBR) were recorded for the primary on both techniques. Metastatic disease was confirmed by surgical pathology, serial imaging or clinical follow up. Tumour to background ratios were consistently higher for FDG PET than Tl-201 SPECT (P < 0.0001). Positron emission tomography detected all known primary tumours but Tl-201 failed to image four primary tumours (15%). In 10 of 18 cases of discordance between PET and Tl-201 SPECT regarding stage, corroboration was available from pathology or disease progression. Positron emission tomography was shown to have a 100% positive predictive value, including all three patients with PET-detected distant metastases (P=0.002). Results indicate that PET is superior to Tl-201 SPECT scanning in the staging of NSCLC for radical radiation therapy, and that the low sensitivity for detection of local and metastatic disease is likely to limit the clinical impact and cost-effectiveness of this technique despite its lower cost.

Aged↗