000			03227nam a22002897i 4500
001			016331430
003			IQ-KoUCL
005			20150902092805.0
006			m d
007			cr |||||||||||
008			100922s2012 xxk obm 000 0 eng
040			_adlc _bdlc _edlc _cUk _dUk
082	0	4	_a616.9944907 _223
100	1		_ajo armes _eauthor.
245	1	3	_afatigue in cancer
300			_a1 online resource
440			_afatigue in cancer
502			_aThesis (Ph.D.)--St George's, University of London, 2012.
504			_aIncludes bibliographical references.
520	3		_aBackground: 30-40% of women successfully treated for breast cancer experience chronic fatigue for up to five years after the end of therapy. They experience a number of associated problems including reduced quality of life, lower mood and concentration difficulties. The causes of these problems and the underlying biological pathogenesis of these symptoms are unclear. The primary objective of this research was to identify whether there were differences in objective activity, cognitive function and inflammatory cytokines between fatigued and non-fatigued women post-treatment. Methods: This was a cross-sectional observational study. Women were recruited from a nurse-led follow-up clinic at St George's hospital over a two-and-a-half-year period. These women were categorised on the basis of a semi-structured interview as to whether they met the criteria to be a case of cancer-related fatigue syndrome (CRFS) or acted as a control. All participants completed a set of questionnaires, activity recording, cognitive testing and had blood taken for analysis. Samples were sent to a commercial company for analyte panel testing (88 markers) and were also analysed using proteomic techniques (including mass spectrometry) to identify any differences in plasma proteins between groups. Results: 114 women were recruited; 45 cases and 69 controls. A between group analysis demonstrated statistically significant differences in sleep quality (p=0.02) and daytime activity (p=0.03) on activity recording, and slower processing speed (p=0.009) and impaired verbal memory (p=0.03) on cognitive testing. Blood analysis demonstrated statistically significant differences (p<0.03) with raised inflammatory cytokines on commercial testing (interleukin 18, vascular endothelial growth factor and macrophage inflammatory protein 1) and increased non-specific inflammatory markers on an exploratory proteomic analysis (serum amyloid A and collectin). Conclusions: Statistically significant differences in subjective symptoms, e.g. difficulty concentrating, and linked objective data, e.g. reduced cognitive processing speed, were identified. These differences were associated with evidence of an underlying prolonged inflammatory response (indicated by raised cytokine levels) in the CRFS group. Future work should examine these observed differences prospectively before, during and after treatment.
600			_ajo armes
710	2		_aSt. George's Hospital (London, England). _bMedical School, _edegree granting institution.
903			_a568717
942			_2ddc _cBK
999			_c137187 _d137187