MSBR improved mood, breast- and endocrine-related quality of life, and well-being more effectively than standard care in women with stage 0 to III breast cancer, and these results persisted at three months. To our knowledge, this study provided novel evidence that MBSR can help alleviate long-term emotional and physical adverse effects of medical treatments, including endocrine treatments. MBSR is recommended to support survivors of breast cancer.

AimTo systematically review and critically appraise the evidence on the effectiveness of Mindfulness-Based Stress Reduction (MBSR) for cancer supportive care. MethodsA comprehensive search of major biomedical databases including Medline, EMBASE, CINAHL, PsycINFO and the Cochrane Library was conducted. Specialist complementary and alternative medicine (CAM) databases including AMED and CISCOM were also searched. Additionally, efforts were made to identify unpublished and ongoing research. Relevant research was categorised by study type and appraised according to study design. Clinical commentaries were obtained for each study and included in the review.

No abstract

The impact of living with metastatic breast cancer (MBC) is considerable and psychosocial support can be beneficial. Mindfulness-based stress reduction (MBSR) can help self-management of anxiety, depression, quality of life (QoL), and fatigue and has been evaluated in early-stage breast cancer but not MBC. This study investigated the acceptability and feasibility of providing MBSR for women with MBC and of introducing MBSR into a National Health Service (NHS) setting. A mixed methods convergent design was used. Eligible women with MBC, an Eastern Cooperative Oncology Group (ECOG) score of 0 to 2, stable disease, and life expectancy of at least 6 months were invited to attend (by their oncologist) an 8-week MBSR course. Qualitative interviews with patients, a focus group, and interview with NHS staff were held to explore acceptability and feasibility of MBSR. Questionnaires at baseline, during (weeks 4, 8), and after (weeks 16, 24) the course measured fatigue, anxiety and depression, mindfulness, disease-specific QoL, and generic preference based QoL. Of 100 women approached, 20 joined the study. One woman dropped out prior to the intervention due to illness progression. Nineteen women took part in 3 MBSR courses. Recruitment to 2 of the 3 courses was slow. Commitment to 8 weeks was a reason for non-participation, and proved challenging to participants during the course. Participants found the course acceptable and reported many cumulative and ongoing benefits. These included feeling less reactive to emotional distress and more accepting of the disruption to life that occurs with living with MBC. There was high attendance, completion of course sessions, adherence to home practice, excellent follow-up rates, and high questionnaire return rates. MBSR was acceptable to MBC patients, who perceived benefits such as improved anxiety and QoL; but the MBSR course requires a considerable time commitment. There is scope to tailor the intervention so that it is less intensive.

No abstract

The plasma level of factor VII activity was a risk factor for the development of ischemic heart disease (IHD) in a prospective epidemiological study of hemostatic factors. We have previously reported significant correlations between factor VII clotting activity or antigen and lipid fractions in a group of 132 young men (<30 years old) at low risk for IHD and concluded that control of the plasma factor VII level may be linked to lipid metabolism in normal male physiology. Because factor VII is one of four vitamin K-dependent procoagulant proteins, we hypothesized that plasma levels of all these proteins would be similarly controlled in normal physiology. In an extension of this study, we have measured two additional vitamin K-dependent clotting factors (prothrombin [factor II] and factor X activity), as well as factor VII activity and antigen and fasting serum lipid fractions in healthy young men and women (<30 years old) at low risk for T he Northwick Park Heart Study identified elevated plasma factor VII clotting activity as a predictive risk factor for ischemic heart disease (EHD) in a prospective study of 1511 middle-aged men.1 -2 Other investigators have reported a positive correlation between factor VII levels and total serum cholesterol, 2 -3 triglycerides, 3 7 and the large, trigryceride-rich lipoproteins, especially very-low-density lipoproteins (VLDL). 48 The correlations of factor VII activity with lipid fractions in these studies may have reflected pathophysiological changes related to the presence of silent or subclinical arteriosclerosis in the middle-aged and older subjects in the studies.We have previously demonstrated that young adults (mean age, 35 years) at high risk for IHD had significantly higher plasma factor VII activity and antigen levels than comparable young adults at low risk. 9 We subsequently found that a similar group of high-risk young adults (mean age, 34.8 years) also had significant elevations of prothrombin, factor IX, and factor X clotting activities, as well as factor VII, compared with young adults at low risk. 10 We have also found a strong positive correlation of factor VII activity and antigen with fasting levels of total serum cholesterol, serum triglycerides, high-density lipoprotein cholesterol (HDL-C), or low-density lipoprotein cholesterol IHD. In the women, we found significant positive correlations of factor VII antigen with total or HDL cholesterol and of prothrombin or factor X with total or LDL cholesterol. In the men, factor VII activity or antigen correlated with total cholesterol, triglycerides, HDL cholesterol, or LDL cholesterol; prothrombin or factor X correlated with total cholesterol, triglycerides, or LDL cholesterol. In contrast, we found no significant correlations of fibrinogen with any of the lipid fractions in our groups of men or women. Our data support the hypothesis that control of the levels of the vitamin K-dependent procoagulant proteins is linked to lipid metabolism in the normal physiology of both men and women. (Arterioscler Thro...

The Northwick Park Heart Study found that elevation of factor VII in middle-aged subjects was an independent risk factor for subsequent ischemic heart disease. The present study was designed to determine whether factor VII elevation is present at a younger age and whether zymogen or activated factor VII is responsible for this elevation. A group of 20 asymptomatic first degree relatives (mean age 34.9 years) of patients with premature ischemic heart disease were compared with 15 age-matched normal subjects at low risk of ischemic heart disease and 15 older subjects with established ischemic heart disease (mean age 49.7 years). Factor VII procoagulant, coupled amidolytic and antigenic assays, as well as fasting serum triglyceride and cholesterol assays, were performed on all three groups. Factor VII antigen and coagulant activity was significantly elevated in first degree relatives, as was factor VII antigen in the patients with ischemic heart disease. The increased factor VII level in these subjects was caused by elevated factor VII zymogen, not activated factor VII. The results of this study, combined with those of previous studies, suggest that factor VII may be a useful additional marker of the risk for ischemic heart disease and merits further investigation.

Prospective epidemiological studies found that the plasma level of factor VII activity was a risk factor for ischemic heart disease (LHD). Our laboratory previously demonstrated that young adults (mean age, 35 years) at high risk of IHD had significantly higher plasma factor VII activity and antigen levels than did comparable young adults at low risk. To study the relation of factor VIT with lipid metabolism in even younger adults (<30 years), using standard techniques we measured plasma factor VII activity and antigen, plasma fibrinogen, and fasting serum lipid fractions in healthy male and female subjects who were at low risk of IHD and who were not on medication. Factor VII antigen correlated significantly with total serum cholesterol, fasting serum triglycerides, and high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol (p<0.01), and factor VII activity correlated with total and HDL cholesterol (p<0.05) in the men (n=132); however, fibrinogen level did not correlate significantly with any lipid level in this group. We found no significant correlation of factor VII activity or antigen with any lipid levels in the women (n=65). Our data support the hypothesis that control of plasma factor VII level is linked to lipid metabolism in normal physiology in men. Thus, factor VII level may reflect the mechanism by which male gender imparts added risk for IHD, independent of other established risk factors. This study also supports the use of the factor VH antigen assay, a highly reproducible method, in studies of the relation of factor VH to the risk of IHD. ( A prospective epidemiological study of ischemic heart disease (IHD), the Northwick Park Heart . Study, reported that the concentration of plasma factor VII procoagulant activity was positively associated with an increased risk of ischemic events due to coronary artery disease 1 and of cardiovascular death 2 in a group of 1,511 middle-aged men. The authors found that factor VII activity was an independent risk factor for IHD by multivariate analysis. 2 Other investigators have also reported increased levels of factor VII clotting activity in men at risk for cardiovascular disease, 3 in male survivors of acute myocardial infarction, 4 in men with >50% stenosis of at least one major coronary artery who had sustained a previous infarction, 5 in men who had a myocardial infarction or sudden cardiac death, 6 in male and female patients with nonnotriglyceridemic hypercholesterolemia, 7 and in those with primary hyperlipidemia. 8 In these studies, factor VII levels were shown to be positively correlated with cholesterol 1A9 and trigrycerides. VII level correlated strongly with the level of large, triglyceride-rich lipoproteins, especially the very low density lipoproteins. 1011 In all of the aforementioned studies, the correlations of factor VII with lipids may have been due to the presence in the study population of subjects who already had coronary artery disease. It remained to be determined whether the plasma factor VII level could be linked ...