scholarly journals HGCSG1902 Multicenter, Prospective, Observational Study of Chemotherapy-induced Dysgeusia in Gastrointestinal Cancer

Author(s):  
Ken Ito ◽  
Satoshi Yuki ◽  
Hiroshi Nakatsumi ◽  
Yasuyuki Kawamoto ◽  
Kazuaki Harada ◽  
...  

Abstract PurposeDysgeusia is an adverse event caused by chemotherapy. Although retrospective studies have shown zinc administration improves dysgeusia, there have been no prospective studies. The present study examined effects of zinc therapy on dysgeusia in patients with gastrointestinal cancer.MethodsThis multicenter, prospective, observational study enrolled patients with dysgeusia during chemotherapy treatment. Patients received treatment of no intervention (control), polaprezinc p.o., or zinc acetate hydrate p.o. and serum zinc levels were measured at 0 (baseline), 6, and 12 weeks. Dysgeusia was assessed using CTCAE v5.0 and Subjective Total Taste Acuity (STTA) criteria using questionnaires at baseline and 12 weeks.ResultsFrom February 2020 to June 2021, 180 patients were enrolled from 17 institutes. There were no differences in mean serum zinc levels in each group at baseline (67.3, 66.6, and 67.5 μg/dL in the no intervention, polaprezinc, and zinc acetate hydrate groups, respectively. P = 0.846) and the mean changes in serum zinc level in the three groups from baseline to after 12 weeks were −3.8, +14.3, and +46.6 μg/dl, respectively. The efficiency rates of dysgeusia were 33.3%, 36.8%, and 34.6% using CTCAE and 33.3%, 52.6%, 32.7% using STTA in the no intervention, polaprezinc, and zinc acetate hydrate groups, respectively. The polaprezinc group showed a significantly improved STTA score compared with the no intervention group (P = 0.045).ConclusionThere was no significant correlation between the degree of serum zinc elevation and improvement in dysgeusia, suggesting that polaprezinc, but not zinc acetate hydrate, is effective in improving chemotherapy-induced dysgeusia.Trial registration number UMIN000039653. Date of registration, March 2, 2020.

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2077
Author(s):  
Jiun-Chi Huang ◽  
Ya-Chin Huang ◽  
Pei-Yu Wu ◽  
Wen-Hsien Lee ◽  
Yi-Chun Tsai ◽  
...  

Diastolic dysfunction is an emerging challenge among hemodialysis (HD) patients, and the associations between serum zinc with echocardiographic parameters and diastolic function remain uncertain. A total of 185 maintenance HD patients were stratified by the tertiles of serum zinc level to compare their clinical characteristics and echocardiography. Correlations of serum zinc levels with echocardiographic parameters were examined using Pearson’s analysis. Univariate and multivariate logistic regression analyses were performed to investigate the determinants of E/e’ ratio >15 and left atrial volume index (LAVI) > 34 mL/m2, both indicators of diastolic dysfunction. Patients belonging to the first tertile of serum zinc level had a significantly higher E/e’ ratio and LAVI. Serum zinc levels were negatively correlated with E (r = −0.204, p = 0.005), E/e’ ratio (r = −0.217, p = 0.003), and LAVI (r = −0.197, p = 0.007). In a multivariate analysis, older age, diabetes, coronary artery disease, and lower serum zinc levels (OR = 0.974, 95% CI = 0.950–0.999, p = 0.039) were significantly associated with E/e’ ratio >15. Furthermore, diabetes and lower serum zinc levels (OR = 0.978, 95% CI = 0.958–0.999, p = 0.041) were significantly associated with LAVI >34 mL/m2. Reduced serum zinc level was significantly associated with diastolic dysfunction among HD patients. Further prospective studies are warranted to investigate whether zinc supplementation can attenuate cardiac dysfunction in maintenance HD patients.


2020 ◽  
Vol 7 (3) ◽  
pp. 588
Author(s):  
Madhubalan T. ◽  
Chidambaranathan S. ◽  
Ramamoorthy R.

Background: A seizure is a paroxysmal time-limited change in motor activity and or behavior that results from abnormal electrical activity in the brain. Seizures are common in the pediatric age group and occur in approximately 10% of children. Most seizures in children are provoked by somatic disorders originating outside the brain such as high fever, infection, syncope, head trauma, hypoxia, or toxins. To determine whether children with febrile convulsion have decreased serum zinc level when compared to normal children and children with fever without convulsions.Methods: The study included children admitted with bronchiolitis in between during the period of September 2018 to January 2019 at Department of Pediatrics, Raja Muthiah Medical College and Hospital. It is a case-control study. A sample size of 50 was selected for each group Totally 3 Groups, 1. Children with febrile convulsions,2. Children with fever without convulsions, 3. Normal Children.Results: The mean serum zinc level in children with febrile convulsions was 42.9 mcg/dl. The serum zinc level in children with fever and normal children was 70 mcg/dl and 71 mcg/dl respectively. On comparing the serum zinc level among the three groups statistical significance was obtained between children with febrile convulsions and the other two groups namely normal children and children with fever alone. Thus, decreased serum zinc level is a significant predisposing factor for febrile convulsions. By using Posthoc Multiple comparisons test we came to know that the Fever convulsion group is significantly different from fever and normal group. There is no significant difference between fever and normal group.Conclusions: This study shows that serum zinc levels are decreased in children with febrile convulsions, thus indicating that zinc deprivation plays a significant role in the pathogenesis of febrile convulsions.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Satoshi Matsui ◽  
Tomonaga Ameku ◽  
Daisuke Takada ◽  
Shinji Ono

Abstract Background Hypozincemia contributes to phosphate-induced vascular calcification in model animals of renal failure, but the association between hypozincemia and aortic stenosis (AS) prevalence in patients with end-stage kidney disease remains unreported in clinical settings. Methods To investigate the association between hypozincemia and AS prevalence in patients undergoing hemodialysis, we designed a single-center cross-sectional study. Our outcome “AS” was defined as prevalence of moderate or severe AS or surgical history for AS. Depending on serum zinc levels, we divided patients undergoing hemodialysis into deciles. The association between hypozincemia and AS prevalence was analyzed via logistic regression adjusted for age, sex, dialysis vintage, diabetes history, serum albumin, and history of taking calcium-containing phosphate binder. Results Ninety-three patients undergoing hemodialysis were eligible. The mean serum zinc level was 61.3 ± 13.9 μg/dL. Twelve patients who belonged to 1st decile had serum zinc levels ≤ 48 μg/dL. Of these twelve patients, six patients (50 %) had AS. On the other hand, of eighty one patients who belonged to 2nd–10th deciles (serum zinc levels > 48 μg/dL), thirteen patients (16 %) had AS. Hypozincemia (serum zinc levels ≤ 48 μg/dL) was associated with AS prevalence (P = 0.038; odds ratio 4.43; 95% confidence interval 1.09–18.0). Conclusions AS was more prevalent in patients undergoing hemodialysis with severe hypozincemia in our cross-sectional study, although interventional studies are required to elucidate the benefit of zinc supplementation for AS progression.


2021 ◽  
Author(s):  
Hironobu Hata ◽  
Yojiro Ota ◽  
Katsuhiko Uesaka ◽  
Yutaka Yamazaki ◽  
Tsubasa Murata ◽  
...  

Abstract Background: Zinc is mainly absorbed in the duodenum and proximal jejunum, which are removed during pancreaticoduodenectomy (PD). Little is known about the adverse oral events and skin disorders caused by zinc deficiency after PD. Herein, we reviewed studies regarding the development of zinc deficiency after PD and presented the case of a patient with zinc deficiency after PD, who required home intravenous zinc replacement.Case presentation: A 73-year-old woman with glossitis, taste disorder, and acrodermatitis enteropathica-like eruption on her fingers presented to the Division of Dentistry and Oral Surgery 69 days after PD. Her serum zinc level markedly decreased to 30 μg/dL. Oral zinc administration was inadequate to treat hypozincemia after PD; therefore, multi-trace elements were injected intravenously under readmission. Her serum zinc levels recovered, and the lesions gradually improved. Furthermore, a central venous port was implanted to maintain normal serum zinc levels, and she continued self-injecting zinc at home.Conclusion: Zinc deficiency after PD rarely occurs. The clinical oncologist community, including dentists responsible for the oral care of cancer patients, should be aware of dysgeusia associated with zinc deficiency after cancer surgery, as well as that induced by chemotherapy or head and neck radiation therapy.


2021 ◽  
Author(s):  
Jee Wook Kim ◽  
Min Soo Byun ◽  
Dahyun Yi ◽  
Jun Ho Lee ◽  
Min Jung Kim ◽  
...  

Abstract Background: Despite the known associations between zinc levels and Alzheimer’s disease (AD) dementia and related cognitive impairment, the underlying neuropathological links remain poorly understood. We tested the hypothesis that serum zinc level is associated with cerebral beta-amyloid protein (Ab) deposition. Additionally, we explored associations between serum zinc levels and other AD pathologies [i.e., tau deposition and AD-signature cerebral glucose metabolism (AD-CM)] and white matter hyperintensities (WMHs), which are measures of cerebrovascular injury. Methods: A total of 241 cognitively normal older adults between 55 and 90 years of age were enrolled. All the participants underwent comprehensive clinical assessments, serum zinc level measurement, and multimodal brain imaging, including Pittsburgh compound B-positron emission tomography (PET), AV-1451 PET, fluorodeoxyglucose (FDG)-PET, and magnetic resonance imaging. Zinc levels were stratified into three categories: < 80 µg/dL (low), 80 to 90 µg/dL (medium), and > 90 µg/dL (high). Results: A low serum zinc level was significantly associated with increased Ab retention. In addition, apolipoprotein E ε4 allele (APOE4) status moderated the association: the relationship between low zinc level and Ab retention was significant only in APOE4 carriers. Although a low zinc level appeared to reduce AD-CM, the relationship became insignificant on sensitivity analysis including only individuals with no nutritional deficiency. The serum zinc level was associated with neither tau deposition nor the WMH volume. Conclusions: Our findings suggest that decreased serum zinc levels are associated with elevation of brain amyloid deposition. In terms of AD prevention, more attention needs to be paid to the role of zinc.


2019 ◽  
Vol 32 (10) ◽  
pp. 1083-1087 ◽  
Author(s):  
Kei Yoshida ◽  
Tatsuhiko Urakami ◽  
Remi Kuwabara ◽  
Ichiro Morioka

Abstract Background and methods We investigated the frequency of zinc deficiency in Japanese children with idiopathic short stature, and evaluated whether serum zinc levels correlated with background factors, including age and standard deviation scores (SDSs) for height and serum insulin-like growth factor (IGF)-1 levels. The study subjects consisted of 89 Japanese children. Results The mean serum zinc level was 79 ± 12 (49–108) μg/dL. Of all the children, 48.3% had a low zinc level, in the 60–80 μg/dL range, and 6.7% had zinc deficiency with a zinc level below 60 μg/dL. The majority with a low zinc level and zinc deficiency were asymptomatic other than for short stature. We found no significant correlations of serum zinc with age, or the SDSs for height and serum IGF-1 levels, in either the entire subject population or those with a zinc level below 80 μg/dL. Conclusions We found a low zinc level to be common in Japanese children with idiopathic short stature, whereas actual zinc deficiency was rare. However, other as yet unknown mechanisms not associated with the growth hormone (GH)-IGF-1 axis could be involved in growth retardation in idiopathic short stature.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Lindsey Mattern ◽  
Cheng Chen ◽  
Leslie A McClure ◽  
John Brockman ◽  
Mary Cushman ◽  
...  

Background and Purpose: Despite zinc’s role as an anti-oxidant and anti-inflammatory agent, prospective studies relating zinc levels to ischemic stroke risk are lacking. We aimed to examine the association between serum zinc levels and incidence of ischemic stroke in a US population. Methods: Using a case-cohort study nested within the REGARDS (REasons for Geographic and Racial Differences in Stroke) cohort, participants were randomly selected from the REGARDS cohort to generate a sub-cohort ( n= 2,346). All incident ischemic stroke cases as of September 2012 ( n =660) were included, with 62 incident cases overlapping in the sub-cohort. Serum zinc levels were measured at baseline. Barlow-weighted Cox’s proportional hazards regression models were used to calculate multivariable-adjusted hazard ratios (HR) and the corresponding 95% confidence intervals (CI) of ischemic stroke by serum zinc levels. Results: The median zinc level for the sub-cohort was 121.19 μg/dL (interquartile range 104.86 to 140.39 μg/dL). Serum zinc levels were inversely associated with incidence of ischemic stroke after adjustment for potential confounders (quartile 4 vs. quartile 1: HR=0.78, 95% CI: 0.61-0.98, p=0.03 for trend). When stratified by pre-specified factors (sex, race, region), only sex showed a significant modification (p=0.03 for interaction). The inverse association was more pronounced among females (quartile 4 vs. quartile 1: HR=0.58, 95% CI: 0.41-0.84, p<0.01 for trend) than males (quartile 4 vs. quartile 1: HR=1.08, 95% CI: 0.78-1.51, p=0.92 for trend). Conclusions: Serum zinc concentration was inversely associated with incidence of ischemic stroke, especially among women, indicating that low zinc levels may be a risk factor for ischemic stroke.


2018 ◽  
Vol 5 (4) ◽  
pp. 1518 ◽  
Author(s):  
Ubaidur Rehman H. ◽  
Shamshad Ahmed Khan ◽  
Prakash R. Saldanha

Background: Febrile seizures are the most common form of convulsion in children with the aged between 6 months to 6 years. Different studies have shown that reduction of zinc leads to the incidence of febrile seizures in children. This study was conducted with the goal of examination of the zinc level in the patients with Febrile Seizures.Methods: This cross sectional study was conducted on 50 children in two equal groups of children with febrile seizures, febrile children without seizures. In order to examine the zinc level blood samples were taken of all subjects and the zinc level of these patients was determined. The data was analyzed using the SPSS-16 statistical software and by descriptive statistical tests.Results: 31 males (47.2%) and 19 female children (52.8%) with the average age of 27.23±15.3 months were examined. The two groups had no significant difference in terms of age and sex. The average of zinc level in the patients with Febrile Seizures was 57.4 µg/dL and it was 116 µg/dL in the febrile children without FS there was a significant difference between the two groups in terms of the zinc level (P=0.01).Conclusions: The low serum zinc level in the group of patients with Febrile Seizures compared with children without febrile seizures indicate the existence of a relationship between the serum zinc level and development of FS in children aged between 6 months and 6 years.


Author(s):  
Regina I. Ejemot-Nwadiaro ◽  
Edisua H. Itam ◽  
Emmanuel N. Ezedinachi

Introduction: Tuberculosis (TB) still remains a leading killer from a single infectious agent worldwide, especially in Asia and Africa. Achieving the Sustainable Development Goal (SDG) 3 will be contingent on addressing ways of reducing the impact of TB to the health, socio-economic and health system of populations most at risk. Micronutrients supplementation is increasingly being recognized as having great potentials to that effect. Objective: This study thus assessed the potential benefits or otherwise of zinc supplementation on tuberculosis treatment outcomes in Calabar, Nigeria. Methods: Eligible patients (81) out of the 182 assessed were randomized to receive anti-TB drug regimen plus oral administration of individual zinc, 25 mg daily for 60 days (intervention group), while the control group received anti-tuberculosis drug regimen only for 60 days. Both qualitative and quantitative data were collected. Clinical examination, Karnofsky performance scale index, direct sputum examination, anthropometric measurements and blood collection for haematological and zinc assessment were carried out before and 2 months after anti-TB treatment began.  Difference in treatment effects between and within groups for continuous variables was tested using t-test. Mantel-Haenszel summary estimate of the relative risk (RR) was used to test the clinical effectiveness of the intervention. The Pearson test was applied to determine the correlation between variables. Main Results: The mean serum zinc levels at 2 months of TB treatment were significantly higher in the intervention group (14.4 ± 0.37µmol/L) in comparison with the control (12.9 ± 0.37 µmol/L); (p = 0.004). A significant difference (p = 0.010) in the serum concentrations of zinc was observed between the two groups when adjustments were made for TB-HIV co-infection. Risk reduction of about 41% for acid fast bacilli (AFB) positivity (RR: 0.59; 95% CI 0.23 to 1.46) was observed after 2 months of anti-TB treatment in favour of the intervention group. Similarly, intervention group had significantly (p = 0.005) lower proportion of patients with serum zinc levels < 10.7 µmol/L (intervention: 5; Control 10) and (p = 0.030) BMI < 18.5 kg /m2 below the lower ranges ((intervention: 9; Control 16). There was a significant improvement in the haematological parameters as evidenced by significant higher proportion of patients in the intervention group than the control group with values above the lower ranges for these parameters with risk reductions in favour of the intervention group for lower ranges as 34%, 12%, 73% and 58% respectively for haemoglobin, albumin, serum total protein and globulins. Conclusion: Irrespective of HIV status in individuals with tuberculosis, zinc micronutrient supplementation significantly increases clinical outcomes, haematological parameters, improves nutritional status as proxied by anthropometric indices and leads to faster sputum smear conversion. The study adds to the growing body of evidence in support of the beneficial role of zinc in TB control.


2019 ◽  
Vol 6 (2) ◽  
pp. 722
Author(s):  
Syed Mohamed ◽  
Santosh Kumar ◽  
J. Kumutha

Background: During pregnancy, fast growth and cell differentiation takes place in both mother and foetus. Maternal nutritional factors play an important role in the growth of the neonate. Among the micronutrient zinc is an important micronutrient whose deficiency is associated with poor pregnancy outcomes. The objective the current study was to evaluate the relationship of serum zinc concentration of the maternal blood and the neonatal cord blood with that of the infant’s anthropometric measurements.Methods: A descriptive cross-sectional study was performed under the Department of Neonatology, Saveetha medical college. Duration of the study was from April 2017 to June 2018. The study included 82 singleton mother baby dyads born in Saveetha medical college. Anthropometric measurements such as birth weight, head circumference, neonate length apart from other clinical features of both the mother and neonates were recorded for statistical analysis. Serum zinc levels were estimated using 2-(5-bromo-2-pyridylazo)-5-(N-Propyl-N-sulfopropylamino)-phenol (5-Br-PAPS) protocol.Results: The mean maternal age of the study population is 25.3±2.3 years. Majority of the mother had natural mode of delivery (57%). The mean cord serum zinc level was found to be 94.0±1.6microgram /dl and the mother’s serum zinc level was 93.8±30.7microgram /dl (range from 49 to 171microgram /dl) which was not found to be statistically significant. Serum zinc levels of the cord was compared with the child anthropometrics and mother’s serum zinc levels to assess for the significance, but there was no correlation observed between the umbilical cord, and the birth weight (r=0.03), length of the child (r=-0.02), head circumference (r=-0.07) and mothers serum zinc levels (r=-0.002).Conclusions: According to our results authors were unable to establish a relationship between Neonates growth parameters and zinc levels in neonates cord blood and zinc levels in the mother. Further studies with a larger sample size and prospective design would establish a causal relationship between zinc and growth parameters in the neonate.


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