Study results have shown that chronic exposure to cigarette smoke affects the taste function in humans. However, neither the quantitative impact on taste sensitivity nor the time-course of taste ...recovery on stopping smoking have been precisely examined.
The experimental design included 2 phases, (i) a case-control phase comparing the taste sensitivity level measured by Electrogustometric (EGM) thresholds from various parts of the tongue (locus) between smokers (
= 83) and non-smokers (
= 48), (ii) a follow-up study looking at the taste sensitivity recovery in smokers after smoking cessation (
= 24) and compared with non-smokers.
Smokers exhibited significantly lower taste sensitivity than non-smokers - the higher the nicotine dependence (Fagerström scores), the lower the taste sensitivity. After smoking cessation, EGM thresholds decreased progressively, and reached the taste sensitivity range of non-smokers depending on locus and time. After 2 weeks a recovery could be observed on the 3 Tip and the 2 edge loci; the recovery in the posterior loci was complete after 9 weeks, and in the dorsal loci recovery was observed only after 2 months or more.
Smoking cessation does lead to a rapid recovery of taste sensitivity among smokers, with recovery time found to differ based on the sensitivity of loci of the tongue. The use of EGM could potentially be explored as a motivational tool for smoking cessation.
Breast cancer epidemiology Sancho-Garnier, Hélène; Colonna, Marc
La Presse médicale (1983)
48, Številka:
10
Journal Article
Recenzirano
The breast is the leading cancer site in women throughout the world. That said, breast cancer incidence varies widely, ranging from 27/100,000
(Central-East Asia and Africa) to 85-94/100,000
...(Australia, North America and Western Europe). Its frequency in France is among the highest in Europe. While in most countries, its incidence has been increasing for more than 40 years, in a few other countries (USA, Canada, Australia, France…), it has been decreasing since 2000-2005. Possibly due to a substantial reduction of hormone-based treatments at menopause, the decrease may be transient. It is also the leading cause of female cancer deaths in almost all countries, with the exception of the most economically developed, in which it is currently second to lung cancer. That much said, for thirty years in highly industrialized countries such as France, breast cancer mortality has been declining. Taken together, early diagnosis and improved treatment explain this success. In France, 5-year survival and 10-year survival approximate 88 % and 78 % respectively; these rates are among the most elevated in Western Europe. Excess mortality due to breast cancer is consequently low (<5 %) but variable according to age, and maximal during the first two years of follow-up. Several thousand epidemiological studies on risk factors for breast cancer have been carried out worldwide; it is difficult to draw up an overall assessment, especially insofar as the identified factors interact and vary according to whether the cancers occur before or after menopause and depending on their histological, biological (receptors) or molecular characteristics. Moreover, their prevalence varies in time and from one region to another. For the majority of these factors, the level of relative risk is≤2. Genetic particularities: presence of proliferative mastopathy, a first child after 35 years of age and thoracic irradiation are the sole factors entailing relative risk from 2 to 5 (comparatively speaking, the risk levels associated with tobacco consumption reach values from 10 to 20, and in some cases even higher). However, exposure to risk factors≤2 may be relatively frequent and consequently favorable to development of a substantial number of breast cancers. Estimation (based on degree of risk and frequency of exposure) of the proportion of risk attributable to a given factor facilitates decision-making aimed at determining the most effective primary prevention actions. Taking into consideration the identified factors pertaining to post-menopausal cancers, only 35 % 23 to 45 % of the attributable proportions could be reduced by primary prevention. In view of achieving this level of reduction, it is possible to put forward the following recommendations: for the women themselves: have a first child before the age of 30, breastfeed for several months, engage in sufficiently intense and regular physical activity, avoid or reduce excess weight after turning thirty, avoid exposure to active or passive smoking, limit alcohol consumption; for their physicians: do not prescribe pointless thoracic irradiations (unnecessary mammography in particular) or unjustified hormonal treatments. *persons/years.
Patients with breast cancer undergoing chemotherapy and radiotherapy experience fatigue and other treatment side effects. Integrative therapies combining physical activity and dietary counseling are ...recommended; however to date no large randomized controlled trial has been conducted during adjuvant therapy. The Adapted Physical Activity and Diet (APAD) intervention was evaluated for its ability to decrease fatigue (primary outcome), anxiety, depression, body mass index (BMI), and fat mass, and enhance muscular and cognitive performances, and quality-of-life (QoL).
Women diagnosed with early breast cancer (N = 143, mean age = 52 ± 10 years) were randomized to APAD or usual care (UC). APAD included thrice-weekly moderate-intensity mixed aerobic and resistance exercise sessions and 9 dietetic consultations. Patient-reported outcomes (PROs) and anthropometric, muscular, and cognitive variables were measured at baseline, 18 weeks (end of chemotherapy), and 26 weeks (end of radiotherapy and intervention), and at 6- and 12-month post-intervention follow-ups. Multi-adjusted linear mixed-effects models were used to compare groups over time.
Significant beneficial effects of the APAD intervention were observed on all PROs (i.e., fatigue, QoL, anxiety, depression) at 18 and 26 weeks. The significant effect on fatigue and QoL persisted up to 12-month follow-up. Significant decreases in BMI, fat mass, and increased muscle endurance and cognitive flexibility were observed at 26 weeks, but did not persist afterward. Leisure physical activity was enhanced in the APAD group vs UC group at 18 and 26 weeks. No significant effect of the intervention was found on major macronutrients intake.
A combined diet and exercise intervention during chemotherapy and radiotherapy in patients with early breast cancer led to positive changes in a range of psychological, physiological and behavioral outcomes at the end of intervention. A beneficial effect persisted on fatigue and QoL at long term, i.e., 1 year post-intervention. Diet-exercise supportive care should be integrated into the management of early breast cancer patients.
The APAD study was prospectively registered on ClinicalTrials.gov (NCT01495650; date of registration: December 20, 2011).
Abstract Organized national mammographic screening has been adopted as the gold standard for breast cancer early detection in western countries; however it may not be the most cost-effective approach ...to early detection in low and middle income countries (LMC) as it is very demanding in terms of human and financial resources. Moreover, its benefit to harm ratio has been questioned lately, particularly in women <50 years, the age group which produces the majority of breast cancer cases in LMC. In the past few years, evidence about alternatives to mammographic screening that would benefit LMC populations have been produced. They are reviewed and discussed in the present paper, together with evidence about mammographic screening relevant to LMC. Alternative screening tests (clinical breast-exam and self breast-exam) are examined, then the pro- and cons- for various strategies (opportunistic screening, population based screening and clinical downstaging) are discussed.
In France smoking initiation rates amongst 11 to 16 year-olds are worryingly high. Several studies show that early initiation to psycho-active substances is a strong predictor of tobacco addiction. ...Decreasing the age at which tobacco use starts represents a key challenge for reducing tobacco usage. Implementing an intervention trial using educational workshops based on the Theory of Planned Behavior (TPB) and covering the 4 years of secondary school could be effective.
"PEPITES" is an interventional research, using a cluster randomized design. It will allow assessing the effectiveness of interventions both in reducing the tobacco initiation rate and the regular smoking rate of secondary school pupils. We will also evaluate the process of the implementation of the study and thus will help to the transferability of the intervention. A partnership convention was signed between the JDB Foundation and the National Education authority which designated 6 secondary state schools for the PEPITES trial. The 6 schools were randomly allocated to 3 groups of 2 clusters each: 1 control group, 2 different intervention groups with 2 workshops per year during 4 years; In one of this group the 2 last workshops will be dedicated to measure the loss of taste due to tobacco smoking. In each school, all pupils in year 1 with a signed parental authorization (744 pupils) have been included in the trial. The interventions targets one of the variables of the TPB and the reinforcement of psycho-social competencies. We estimated that we could detect a reduction of increase ≥5.5 and 8% respectively in the 2 principal outcomes (risk α of 5%, and β of 80%).
Carrying out a randomized prevention trial in the school environment raises specific problems which it seems useful to detail for other educational actors who would like to perform a similar study. This discussion concerns the acceptation and cooperation of the National Education partners, the risks of contamination, the information given to parents and pupils and their consent, and the representativeness of the schools involved.
ISRCTN85812512 . Registered 15 May 2018 by BioMed Central. (retrospectively registered).
Abstract Low-dose computed tomography (LDCT) screening recommendations for lung cancer are contradictory. The French National Authority for Health commissioned experts to carry a systematic review on ...the effectiveness, acceptability and safety of lung cancer screening with LDCT in subjects highly exposed to tobacco. We used MEDLINE and Embase databases (2003–2014) and identified 83 publications representing ten randomised control trials. Control arms and methodology varied considerably, precluding a full comparison and questioning reproducibility of the findings. From five trials reporting mortality results, only the National Lung Screening Trial found a significant decrease of disease-specific and all-cause mortality with LDCT screening compared to chest X-ray screening. None of the studies provided all information needed to document the risk-benefit balance. The lack of statistical power and the methodological heterogeneity of European trials question on the possibility of obtaining valid results separately or by pooling. We conclude, in regard to the lack of strong scientific evidence, that LDCT screening should not be recommended in subjects highly exposed to tobacco.
Highlights ► Organized cervical cancer screening is lacking in most of countries of the EMENA. ► The majority of cervical cancers are diagnosed late, leading to high mortality. ► Women face many ...political, cultural, and financial barriers to gaining access to screening. ► Management of abnormal screening results is neither widely available nor standardized. ► Even with mass vaccination, organized screening programs will still be necessary.
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