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e24116 Background: Obesity rates in the US have increased dramatically in recent years. Breast cancer treatment is associated with additional weight gain, and among patients with breast cancer, obesity and weight gain are associated with negative outcomes such as reduced progression-free and overall survival due to cardiometabolic co-morbidities. New evidence suggests that cardiometabolic comorbidities themselves can further accelerate breast cancer progression. We used a WFPB dietary intervention because it results in significant weight loss and larger improvements in cardiometabolic outcomes than a traditional, calorie-restricted omnivore diet. Methods: Patients with stage 4 breast cancer receiving treatment were randomized 2:1 into: 1) a WFPB dietary intervention (N = 19) or 2) usual care (N = 9) for 8 weeks with assessments at baseline, 4, and 8 weeks. Our WFPB diet consisted of education and an ad libitum whole-food, plant-based diet; 3 prepared meals a day were provided to WFPB subjects for the duration of the trial. The diet included fruits, vegetables, whole grains, legumes, nuts/seeds and excluded meat, dairy, and eggs. Outcomes include compliance, weight, cardiometabolic outcomes, and cancer progression markers. Effects of the WFPB on the outcomes were assessed by comparing marginal means by arm estimated at 8 weeks from the analysis of covariance model controlling for baseline. Results: Dietary compliance was high, with 95% of WFPB subjects consuming ≥80% of their calories from “on plan” foods. The WFPB group (mean baseline BMI = 31.6 kg/m2), on average, lost 6.7% (p < 0.01) of their total body weight. Adjusting for baseline weight, the WFPB group lost 8.9 lbs. more (p < 0.01) and 5.8% more of their total body weight (p < 0.01) than the control group. Conclusions: Our WFPB dietary intervention resulted in clinically meaningful and statistically significant improvements in weight and cardiometabolic outcomes, with a trend towards improving a clinically used cancer progression marker. Larger studies with longer interventions are needed to confirm these findings and investigate the sustainability of the benefits. Clinical trial information: NCT03045289. [Table: see text]

Background and study aims: Video capsule endoscopy (VCE) is limited by incomplete procedures. There are also contraindications to the standard ingestion of the capsule that require endoscopic placement. Our aim was to compare the study completion rate of VCE after oral ingestion and endoscopic deployment. Patients and methods: We performed a review of all VCE from April 2010 through March 2013. Inpatient and outpatient cohorts grouped by the method of capsule delivery were formed and compared. Multivariable logistic regression modeling was utilized adjusting for variables with a P value ≤ 0.1 in group comparisons. Log-rank analysis was used to compare transit times. Results: A total of 687 VCE were performed, including 316 inpatient (36 endoscopic deployment, 280 oral ingestion) and 371 outpatient (20 endoscopic deployment, 351 oral ingestion). For VCE on hospitalized patients, the completion rates were similar after endoscopic deployment and oral ingestion (72 % vs 73 %, P = 0.94). The completion rates were also similar for ambulatory patients (90 % vs 87 %, P = 0.69). There remained no difference after multivariable modeling for inpatients (P = 0.71) and outpatients (P = 0.46). Total transit times were not significantly different. Conclusions: VCE completion rates and total transit times are similar after oral or endoscopic deployment for both hospitalized and ambulatory patients. Endoscopic placement is effective in patients with contraindications to standard oral ingestion, but should otherwise be avoided to limit unnecessary procedural risks and costs.

Knee joint effusion has been shown to cause a reflex inhibition of the quadriceps musculature. However, the effect of effusion on knee joint proprioception has not been thoroughly investigated. This issue is further clouded by the debate surrounding the role of the muscle spindle and joint mechanoreceptors in providing afferent feedback to the central nervous system. This case study examines the effects of a chronic effusion on knee joint proprioception. Possible suggestions for the results are discussed, and areas for further study are offered.