ORCID Profile
0000-0001-6200-9244
Current Organisations
Odense University Hospital
,
Australian Catholic University
,
Austin Health
,
University of Southern Denmark
,
Universitas Indonesia Fakultas Kedokteran
,
University of Indonesia
,
Danone Specialized Nutrition Indonesia
,
SDU
,
University of Melbourne
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Publisher: Elsevier BV
Date: 12-2003
Publisher: Oxford University Press (OUP)
Date: 05-02-2021
Abstract: Left ventricular ejection fraction (LVEF) is standard of care for evaluating chemotherapy-associated cardiotoxicity, although global longitudinal strain (GLS) offers advantages. However, neither change in LVEF or GLS has been associated with short-term symptoms, functional capacity, or long-term heart failure (HF) risk. We sought to determine whether an integrative measure of cardiovascular function (VO2peak) that is strongly associated with HF risk would be more sensitive to cardiac damage induced by cancer treatment than LVEF, GLS, or cardiac biomarkers. Patients (n = 206, 53 ± 13 years, 35% male) scheduled to commence anti-cancer treatment completed assessment prior to, and within 6 months after therapy. Changes in echocardiographic measures of LV function (LVEF, GLS), cardiac biomarkers (troponin and BNP), and cardiorespiratory fitness (VO2peak) were measured. LV function was normal prior to treatment (LVEF 61 ± 5% GLS −19.4 ± 2.1), but VO2peak was only 88 ± 26% of age-predicted. After treatment, VO2peak was reduced by 7 ± 15% (equivalent of 7 years normal ageing, P & 0.0001) and the rates of functional disability (defined as VO2peak ≤ 18 mL/min/kg) almost doubled (15% vs. 26%, P = 0.016). In contrast, small, reductions in LVEF (59 ± 5% vs. 58 ± 5%, P = 0.03) and GLS (−19.4 ± 2.1 vs. −18.9 ± 2.2, P = 0.002) and an increase in troponin levels (4.0 ± 6.9 vs. 26.4 ± 26.2 ng/mL, P & 0.0001) were observed. Anti-cancer treatment is associated with marked reductions in functional capacity that occur independent of reductions in LVEF and GLS. The assessment of VO2peak prior to, and following treatment may be a more sensitive means of identifying patients at increased risk of HF.
Publisher: Elsevier BV
Date: 12-2019
Publisher: Oxford University Press (OUP)
Date: 30-10-2018
Abstract: Anthracycline chemotherapy may be associated with decreased cardiac function and functional capacity measured as the peak oxygen uptake during exercise ([Formula: see text] peak). We sought to determine (a) whether a structured exercise training program would attenuate reductions in [Formula: see text] peak and (b) whether exercise cardiac imaging is a more sensitive marker of cardiac injury than the current standard of care resting left ventricular ejection fraction (LVEF). Twenty-eight patients with early stage breast cancer undergoing anthracycline chemotherapy were able to choose between exercise training (mean ± SD age 47 ± 9 years, n = 14) or usual care (mean ± SD age 53 ± 9 years, n = 14). Measurements performed before and after anthracycline chemotherapy included cardiopulmonary exercise testing to determine [Formula: see text] peak and functional disability ([Formula: see text] peak 18 ml/min/kg), resting echocardiography (LVEF and global longitudinal strain), cardiac biomarkers (troponin and B-type natriuretic peptide) and exercise cardiac magnetic resonance imaging to determine stroke volume and peak cardiac output. The exercise training group completed 2 × 60 minute supervised exercise sessions per week. Decreases in [Formula: see text] peak during chemotherapy were attenuated with exercise training (15 vs. 4% reduction, P = 0.010) and fewer participants in the exercise training group met the functional disability criteria after anthracycline chemotherapy compared with those in the usual care group (7 vs. 50%, P = 0.01). Compared with the baseline, the peak exercise heart rate was higher and the stroke volume was lower after chemotherapy ( P = 0.003 and P = 0.06, respectively). There was a reduction in resting LVEF (from 63 ± 5 to 60 ± 5%, P = 0.002) and an increase in troponin (from 2.9 ± 1.3 to 28.5 ± 22.4 ng/mL, P 0.0001), but no difference was observed between the usual care and exercise training group. The baseline peak cardiac output was the strongest predictor of functional capacity after anthracycline chemotherapy in a model containing age and resting cardiac function (LVEF and global longitudinal strain). The peak exercise cardiac output can identify patients at risk of chemotherapy-induced functional disability, whereas current clinical standards are unhelpful. Functional disability can be prevented with exercise training.
Publisher: American Physical Society (APS)
Date: 30-10-2003
Publisher: Cold Spring Harbor Laboratory
Date: 14-12-2021
DOI: 10.1101/2021.12.13.21267758
Abstract: Indonesia has an ageing population that can develop mobility health-related problems in the future, including osteoporosis, arthritis, sarcopenia, low back pain, neck pain, and peripheral neuropathy. However, there are limited references and research that look upon mobility health and problems surrounding it in Indonesia. To improve understanding on issues surrounding mobility health in Indonesia through a semi-structured interview with relevant experts. Semi-structured qualitative interviews via phone calls were conducted with eight different experts. Data were analysed using reflexive thematic analysis. Experts with experience dealing with mobility (bone, muscle, joint, movement) related issues for more than ten years, working in Indonesia, and communicating in English or Bahasa Indonesia were included. Four themes were then identified across the experts on issues surrounding mobility health in Indonesia this includes [1] screening and assessment of mobility health, [2] treatment for mobility health problems, [3] awareness c aign, [4] supplement for mobility health. Diagnostic modalities for mobility health are abundant but still expensive. Treatment of mobility health with herbal medicine ( jamu ) might be beneficial. Fortified food or milk can improve mobility health. Social media can be a promising tool to increase awareness regarding mobility health. In general, there needs to be a change in mindset from curative to prevention in both health care providers and the general population.
Publisher: Springer Science and Business Media LLC
Date: 28-08-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 26-02-2021
DOI: 10.1519/JSC.0000000000003990
Abstract: Bigaran, A, Howden, EJ, Foulkes, S, Janssens, K, Beaudry, R, Haykowsky, MJ, La Gerche, A, Fraser, SF, and Selig, SE. Prescribing exercise in early-stage breast cancer during chemotherapy: a simple periodized approach to align with the cyclic phases of chemotherapy. J Strength Cond Res 36(10): 2934–2941, 2022—To evaluate whether a periodized aerobic and resistance training plan aligned to the anthracycline chemotherapy (AC) cycles would be well tolerated, feasible, and attenuate the decline in peak oxygen uptake (V̇ o 2 peak) in breast cancer (BC) patients. Twenty-eight women with early-stage BC treated with AC self-selected to undertake exercise training (EX 47 ± 9 years, n = 14) or usual care (53 ± 9 years, n = 14) for 12 weeks as part of a nonrandomized controlled trial. The periodized EX was aligned to the cyclic phases of AC, including AC taper and nontaper weeks. Outcome measures included cardiopulmonary exercise testing. Attendance and adherence variables (relative dose intensity [RDI] and volume load) were calculated to quantify the dose of EX completed relative to the amount of EX prescribed. The mean session attendance was 76% (range 46–88%). The mean ± SD prescribed and completed dose of aerobic training was 332.3 ± 48.7 MET h·wk −1 and 380.6 ± 53.2 MET h·wk −1 ( p = 0.02), equating to a mean RDI of 89 ± 17%. For resistance training, the prescribed and completed cumulative dose was 128,264 ± 54,578 and 77,487 ± 26,108 kg ( p 0.001), equating to an RDI of 60 ± 11%. Adherence to the AC taper week RDI (52 ± 14%) for resistance training was significantly lower than the non-AC taper week (72 ± 8%, p = 0.02). The most frequent cause for EX interruption was hospitalization (35%), whereas AC-related illness was the most common cause for missed (57%) or modified EX sessions (64%). This periodized approach was mostly well tolerated for patients with BC. We speculate that a periodized approach may be both more palatable and useful, although this requires further investigation in a randomized controlled trial.
Publisher: MDPI AG
Date: 06-06-2023
DOI: 10.3390/NU15122642
Abstract: Recently, the immune system has been identified as one of the possible main bridges which connect the gut–brain axis. This review aims to examine available evidence on the microbiota–immunity–cognitive relationship and its possible effects on human health early in life. This review was assembled by compiling and analyzing various literature and publications that document the gut microbiota–immune system–cognition interaction and its implications in the pediatric population. This review shows that the gut microbiota is a pivotal component of gut physiology, with its development being influenced by a variety of factors and, in return, supports the development of overall health. Findings from current research focus on the complex relationship between the central nervous system, gut (along with gut microbiota), and immune cells, highlighting the importance of maintaining a balanced interaction among these systems for preserving homeostasis, and demonstrating the influence of gut microbes on neurogenesis, myelin formation, the potential for dysbiosis, and alterations in immune and cognitive functions. While limited, evidence shows how gut microbiota affects innate and adaptive immunity as well as cognition (through HPA axis, metabolites, vagal nerve, neurotransmitter, and myelination).
Publisher: Oxford University Press (OUP)
Date: 31-07-2020
DOI: 10.1093/PTJ/PZAA141
Publisher: Wiley
Date: 2019
DOI: 10.14814/PHY2.13971
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-03-2019
DOI: 10.1249/MSS.0000000000001970
Abstract: Anthracycline chemotherapy (AC) is associated with acute reductions in cardiopulmonary fitness (V˙O 2peak ). We sought to determine whether changes in V˙O 2peak and cardiac function persisted at 12 months post-AC completion, and whether changes in cardiac function explain the heightened long-term heart failure risk. Women with breast cancer scheduled for AC ( n = 28) who participated in a nonrandomized trial of exercise training (ET n = 14) or usual care (UC n = 14) during AC completed a follow-up evaluation 12 months post-AC completion (16 months from baseline). At baseline, 4 months, and 16 months, participants underwent a resting echocardiogram (left ventricular ejection fraction global longitudinal strain), a blood s le (troponin B-type natriuretic peptide), a cardiopulmonary exercise test, and cardiac MRI measures of stroke volume (SV), heart rate, and cardiac output (Qc) at rest and during intense exercise. Seventeen women (UC, n = 8 ET, n = 9) completed evaluation at baseline, 4 months, and 16 months. At 4 months, AC was associated with 18% and 6% reductions in V˙O 2peak in the UC and ET groups, respectively, which persisted at 16 months (UC, −16% ET, −7%) and was not attenuated by ET (interaction, P = 0.10). Exercise Qc was lower at 16 months compared with baseline and 4 months ( P 0.001), which was due to a blunted augmentation of SV during exercise ( P = 0.032 a 14% reduction in peak SV), with no changes in heart rate response. There was a small reduction in resting left ventricular ejection fraction (baseline to 4 months) and global longitudinal strain (between 4 and 16 months) and an increase in troponin (baseline to 4 months), but only exercise Qc was associated with V˙O 2peak ( R 2 = 0.47, P 0.01). Marked reductions in V˙O 2peak persisted 12 months after anthracycline-based chemotherapy, which was associated with impaired exercise cardiac function. Clinical Trial Registration: ACTRN12616001602415.
No related grants have been discovered for Ashley Bigaran.