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Surviving cancer but failing grades in school
January 2011 Volume 158 Number 1
Caffeine, inflammation, and BPD —James F. Padbury, MD
Surviving cancer but failing grades in school —Sarah S. Long, MD
Exercise training in cystic fibrosis —Robert W. Wilmott, MD
Copyright ª 2011 by Mosby Inc.
n this issue of The Journal, Chavez Valdez et al provide observations on the relationship between serum caffeine levels and cytokine concentrations in tracheal aspirates and peripheral blood. The rationale for the study was to examine the role of caffeine, a non-selective adenosine receptor antagonist, in the regulation of pro- and anti-inflammatory cytokines. The results show that serum caffeine levels were higher after more than a week of treatment than they were after the initial doses. The relationship between caffeine levels and pro-inflammatory cytokines was U-shaped, meaning that at low serum caffeine levels TNF-a, IL-1 and IL-6 were reduced in concentration but at higher caffeine levels their levels were increased. One of the touted advantages of caffeine for the treatment of apnea of prematurity was the purported absence of the ‘‘need’’ to monitor levels. This study suggests that there is a complex relationship between caffeine levels and pro-inflammatory cytokines, which may contribute to the severity of inflammatory conditions, such as bronchopulmonary dysplasia (BPD), in children with high caffeine levels. This has important management and therapeutic implications. We may need to monitor caffeine levels if, indeed, these studies can be corroborated and a relationship between plasma caffeine levels, evoked inflammation, and BPD is further established. Article page 57 <
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he authors of this study from France help re-frame a key outcome of cancer survivors. The study’s strength is that the population (1) represents modern cancer therapeutics; (2) spans the adolescent age groups; and (3) compares cancer survivor outcomes against the general population, as well as siblings. Importantly, it shows that school performance (using the outcome of failing a grade) is a different outcome than neurocognitive test results. We need to compare therapies using this as one stand-alone outcome and study, recognize, and implement helpful strategies for those at-risk (especially adolescents). Article page 135 <
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o investigate whether there are sex-based differences in training responses, a 6week exercise training program and more than 300 young men and women with cystic fibrosis attending an inpatient rehabilitation center were evaluated. In this issue of The Journal, Gruber et al show baseline differences in fitness levels between the male and female subjects with essentially similar responses to training, although the men had a greater increase in peak work. The largest responses were observed in those individuals with the lowest baseline fitness levels, not the lowest pulmonary function. Article page 71 <
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Caffeine, inflammation, and BPD —James F. Padbury, MD
Surviving cancer but failing grades in school —Sarah S. Long, MD
Exercise training in cystic fibrosis —Robert W. Wilmott, MD
Copyright ª 2011 by Mosby Inc.
n this issue of The Journal, Chavez Valdez et al provide observations on the relationship between serum caffeine levels and cytokine concentrations in tracheal aspirates and peripheral blood. The rationale for the study was to examine the role of caffeine, a non-selective adenosine receptor antagonist, in the regulation of pro- and anti-inflammatory cytokines. The results show that serum caffeine levels were higher after more than a week of treatment than they were after the initial doses. The relationship between caffeine levels and pro-inflammatory cytokines was U-shaped, meaning that at low serum caffeine levels TNF-a, IL-1 and IL-6 were reduced in concentration but at higher caffeine levels their levels were increased. One of the touted advantages of caffeine for the treatment of apnea of prematurity was the purported absence of the ‘‘need’’ to monitor levels. This study suggests that there is a complex relationship between caffeine levels and pro-inflammatory cytokines, which may contribute to the severity of inflammatory conditions, such as bronchopulmonary dysplasia (BPD), in children with high caffeine levels. This has important management and therapeutic implications. We may need to monitor caffeine levels if, indeed, these studies can be corroborated and a relationship between plasma caffeine levels, evoked inflammation, and BPD is further established. Article page 57 <
I
he authors of this study from France help re-frame a key outcome of cancer survivors. The study’s strength is that the population (1) represents modern cancer therapeutics; (2) spans the adolescent age groups; and (3) compares cancer survivor outcomes against the general population, as well as siblings. Importantly, it shows that school performance (using the outcome of failing a grade) is a different outcome than neurocognitive test results. We need to compare therapies using this as one stand-alone outcome and study, recognize, and implement helpful strategies for those at-risk (especially adolescents). Article page 135 <
T
o investigate whether there are sex-based differences in training responses, a 6week exercise training program and more than 300 young men and women with cystic fibrosis attending an inpatient rehabilitation center were evaluated. In this issue of The Journal, Gruber et al show baseline differences in fitness levels between the male and female subjects with essentially similar responses to training, although the men had a greater increase in peak work. The largest responses were observed in those individuals with the lowest baseline fitness levels, not the lowest pulmonary function. Article page 71 <
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A1