Introduction: There have been few well controlled altitude and hypoxic training studies to date. This thesis investigated the effects of altitude and (sham controlled) intermittent hypoxic training (IHT) on exercise capacity, and the associated physiological adaptations. Methods: Chapter 3 investigated how living and training at 2320 m or at sea level affected total haemoglobin mass (tHb) and race performance in highly trained swimmers. Chapter 4 investigated how IHT or normoxic training affected cardiopulmonary variables and the incremental exercise limit of tolerance (T-Lim), in highly trained runners. Chapter 5 investigated how single-legged IHT or normoxic training affected phosphorus-31 nuclear magnetic resonance spectroscopy assessed muscle energetics. Results: In Chapter 3, tHb increased significantly more after altitude (+0.6 ± 0.4 g•kg-1, or +4.4 ± 3.2%) than after sea level (+0.03 ± 0.1 g•kg-1, or +0.3 ± 1.0%), but the changes in swimming performances were not different between groups, and there were no correlations between tHb and performance changes. In Chapter 4, submaximal heart rate in normoxia decreased significantly more after IHT than after normoxic training (-5 ± 5 vs. -1 ± 5 b∙min-1), and submaximal "V" ̇O2 in hypoxia significantly decreased, only after IHT. T-Lim in hypoxia significantly increased post-IHT, but there were no between group differences. In Chapter 5, the phosphocreatine recovery time constant was speeded significantly more in the IHT compared to the normoxic trained leg, when tested in hypoxia (-25 ± 8% vs. -13 ± 6%), but not in normoxia (-16 ± 15% vs. -9 ± 10%). Conclusions: Altitude training likely increases tHb, but this is not necessarily associated with improved athletic performance. IHT may induce other non-haematological adaptations; potentially an enhanced skeletal muscle oxidative capacity, but evidence for exercise capacity gains is lacking. The precise underlying causes for these adaptations require further investigation, as does any translation to athletic performance.

Chronic inflammation is intimately linked with cancer development and progression and therefore reducing or eliminating inflammation represents a logical treatment and prevention strategy. Studies have shown that anti-inflammatory agents have anti-tumour effects in cancers, with reduced metastases and mortality. Current use of anti-inflammatory agents in the treatment and prevention of cancer is limited by their toxicity and side effects. The emerging field of nanotechnology allows the fundamental properties of a drug to be altered, creating a product with improved reactivity and bioavailability, leading to more targeted treatments and reduced dosage. In the present study, the genotoxic effects of three commonly used anti-inflammatory drugs; aspirin, ibuprofen and hydrocortisone, in their bulk and nano forms were evaluated on peripheral blood lymphocytes of healthy donors using the comet assay and the micronucleus assay. In order to determine any anti-cancer effects, these agents were also tested in peripheral blood lymphocytes in patients with haematological cancers. The glucocorticoid hydrocortisone was also evaluated for anti-oxidant capacity. Our results demonstrate that the nano versions of each drug produced a different response than the bulk counterpart, indicating that a reduction in particle size had an impact on the reactivity of the drug. Our results also indicate that the nano versions of each drug were less genotoxic than the bulk formulation, further emphasising the potential of nanoparticles as an improvement to current treatment options. We also found an anti-oxidant effect with hydrocortisone, with a more profound effect seen with the nano formulation.

Submitted by Rosangela Silva (rosangela.silva3@unioeste.br) on 2017-08-30T14:31:00Z No. of bitstreams: 2 Denise Michelle Indras.pdf: 1849747 bytes, checksum: 07aa936d5e799c6b5d67a84cd73ad9eb (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-08-30T14:31:00Z (GMT). No. of bitstreams: 2 Denise Michelle Indras.pdf: 1849747 bytes, checksum: 07aa936d5e799c6b5d67a84cd73ad9eb (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-02-07 / The popular use of medicinal plants are common practices and among them is a bottle, a multiple plant base product, which promises to cure various diseases. Many animal studies show in hepatic, renal enzymes and our hematological parameters after administration of plant extracts. The objective of this study was to verify a correlation between the use of multiple medicinal plants with hepatic, renal and hematological found in a patient that made use of bottle, composed of echinacea, graviola, ipé purple, sucupira and cat's claw. The bottle has 4.32 mg.mL-1 of alcohol. Pharmacological and UV/Scan tests were performed, showing some classes of secondary metabolites in plant and bottle species. A bioassay was performed with Artemia salina, and a bottle had mortality up to a concentration of 0.1 mg.mL-1. Cytotoxic effects on erythrocytes revealed hemolytic activity for echinacea, graviola, purple ipe and sucupira. The Escherichia coli test showed sensitivity to graviola, purple ipe, sucupira and cat's claw. In vivo experiment using mice. Two treatments were performed, single dose and 30 days, administering water, alcohol and bottle by gavage. Biochemical, coagulation, hematological and histopathological parameters were evaluated. In the single dose treatment were alterations of uric acid, cholesterol, creatinine, alkaline phosphatase, iron and glucose (p<0.05). Already in the treatment of 30 days were alterations of uric acid, total and indirect bilirubins, creatinine, alkaline phosphatase, glucose, triglycerides, red blood cells and leukocytes (p<0.05), beyond hepatic sinusoidal dilatation. The data showed that the alcohol present in the bottle can alter biochemical, hematological parameters and cause liver damage in rats. The bottle, although not showing alterations in important biochemical and hematological parameters, but had more pronounced hepatic histopathological alterations. / O uso popular de plantas medicinais são práticas comuns e entre elas está a garrafada, produto a base de múltiplas plantas, que promete curar várias doenças. Muitos estudos com animais mostram alterações em enzimas hepáticas, renais e nos parâmetros hematológicos após administração de extratos vegetais. O objetivo deste estudo foi verificar a correlação entre o uso de múltiplas plantas medicinais com as alterações hepáticas, renais e hematológicas encontradas em um paciente que fez uso de garrafada, composta por equinácea, graviola, ipê roxo, sucupira e unha de gato. A garrafada possui 4,32 mg.mL-1 de álcool. Foram realizados testes farmacognósticos e UV/Varredura, mostrando algumas classes de metabólitos secundários nas espécies vegetais e na garrafada. Foi realizado bioensaio com Artemia salina, e a garrafada teve mortalidade até a concentração de 0,1 mg.mL-1. Efeitos citotóxicos em eritrócitos revelaram atividade hemolítica para equinácea, graviola, ipê roxo e sucupira. O teste com Escherichia coli mostrou sensibilidade para graviola, ipê roxo, sucupira e unha de gato. No experimento in vivo utilizando ratos Wistar foram realizados dois tratamentos, dose única e 30 dias, administrando água, álcool e garrafada por gavagem. Foram avaliados parâmetros bioquímicos, de coagulação, hematológicos e histopatológicos. No tratamento com dose única foram encontradas alterações de ácido úrico, colesterol, creatinina, fosfatase alcalina, ferro e glicose (p<0,05). Já no tratamento de 30 dias foram encontradas alterações de ácido úrico, bilirubinas total e indireta, creatinina, fosfatase alcalina, glicose, triglicerídeos, hemácias e leucócitos (p<0,05), além de dilatação sinusoidal hepática. Os dados mostraram que o álcool presente na garrafada pode alterar parâmetros bioquímicos, hematológicos e causar danos ao fígado de ratos. A garrafada, apesar de não mostrar alterações em parâmetros bioquímicos e hematológicos importantes, teve alterações histopatológicas hepáticas mais pronunciadas.

Preclinical testing is an important part of cancer drug development. The aim of this thesis was to establish and evaluate preclinical in vitro methods useful in the development of new anticancer drugs. In paper I, the development of non-clonogenic assays (FMCA-GM) using CD34+ stem cells for assessment of haematological toxicity was described. A high correlation was seen when comparing the 50% inhibitory concentrations (IC50) from FMCA-GM with the IC50 from the established clonogenic assay (CFU-GM). In paper II, FMCA-GM was complemented with additional cell models, establishing a normal cell panel. In vitro toxicity towards the five normal cell types was compared with known clinical adverse event profiles. The normal cell panel roughly reflected the tissue specific toxicities but was most useful in the prediction of therapeutic index. In paper III the use of peripheral blood lymphocytes from human, dog, rat and mouse to detect species differences in cellular drug sensitivity was described. Good agreement between our method and the established CFU-GM assay was observed. In paper II the benefit of using primary tumour cells from patients to predict cancer diagnosis-specific activity was studied. The in vitro activity of fourteen anticancer drugs was tested in tumour samples of both haematological and solid tumour origin. In general, clinical activity was well reflected. In paper IV, the efficacy and toxicity models were applied for experimental follow-up of a novel inhibitor of the ubiquitin-proteasome system, CB3 (Phosphoric acid, 2,3-dihydro-1,1-dioxido-3-thienyl diphenyl ester). In the preliminary characterization of CB3, antitumour activity and a favourable toxicity profile were displayed, although the exact mechanism of action remains to be elucidated. CB3 will therefore be further investigated. In conclusion, the work presented here contributes to different parts of the preclinical drug development and the methods may aid in the characterization of anticancer compounds

The aim of this thesis was to evaluate the effect of increased concentrations of nitrite to Nile tilapia (Oreochromis niloticus) at different concentrations of chloride. Tilapias adults were exposed for 14 days to nitrite at the concentration of 3 mg.l?1 NO2? (i.e. concentration commonly found in recirculation systems). After 14 days the experimental fishes were divided into 4 group, which differed in concentrations of nitrite and chloride. These groups of fish were held in different conditions for the next seven days. Using standard clinical procedures the following haematologic biochemical parameters were determined: RBC, WBC, Hb, PCV, MetHb, MCV, MCH, MCHC, NO2-, GLU, Ca, Mg, TP, NH3. The tested nitrite concentration was not high enough to cause strong differences of pursued parameters. Only some of them (Hb, MetHb, MCHC) were statistically significant.

Submitted by Neusa Fagundes (neusa.fagundes@unioeste.br) on 2018-03-06T13:43:20Z No. of bitstreams: 2 Denise_Indras2017.pdf: 1849754 bytes, checksum: 50210fe1707e46e56182c87ddece4b5c (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-03-06T13:43:20Z (GMT). No. of bitstreams: 2 Denise_Indras2017.pdf: 1849754 bytes, checksum: 50210fe1707e46e56182c87ddece4b5c (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-02-07 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / The popular use of medicinal plants are common practices and among them is a bottle, a multiple plant base product, which promises to cure various diseases. Many animal studies show in hepatic, renal enzymes and our hematological parameters after administration of plant extracts. The objective of this study was to verify a correlation between the use of multiple medicinal plants with hepatic, renal and hematological found in a patient that made use of bottle, composed of echinacea, graviola, ipé purple, sucupira and cat's claw. The bottle has 4.32 mg.mL-1 of alcohol. Pharmacological and UV/Scan tests were performed, showing some classes of secondary metabolites in plant and bottle species. A bioassay was performed with Artemia salina, and a bottle had mortality up to a concentration of 0.1 mg.mL-1. Cytotoxic effects on erythrocytes revealed hemolytic activity for echinacea, graviola, purple ipe and sucupira. The Escherichia coli test showed sensitivity to graviola, purple ipe, sucupira and cat's claw. In vivo experiment using mice. Two treatments were performed, single dose and 30 days, administering water, alcohol and bottle by gavage. Biochemical, coagulation, hematological and histopathological parameters were evaluated. In the single dose treatment were alterations of uric acid, cholesterol, creatinine, alkaline phosphatase, iron and glucose (p<0.05). Already in the treatment of 30 days were alterations of uric acid, total and indirect bilirubins, creatinine, alkaline phosphatase, glucose, triglycerides, red blood cells and leukocytes (p<0.05), beyond hepatic sinusoidal dilatation. The data showed that the alcohol present in the bottle can alter biochemical, hematological parameters and cause liver damage in rats. The bottle, although not showing alterations in important biochemical and hematological parameters, but had more pronounced hepatic histopathological alterations. / O uso popular de plantas medicinais são práticas comuns e entre elas está a garrafada, produto a base de múltiplas plantas, que promete curar várias doenças. Muitos estudos com animais mostram alterações em enzimas hepáticas, renais e nos parâmetros hematológicos após administração de extratos vegetais. O objetivo deste estudo foi verificar a correlação entre o uso de múltiplas plantas medicinais com as alterações hepáticas, renais e hematológicas encontradas em um paciente que fez uso de garrafada, composta por equinácea, graviola, ipê roxo, sucupira e unha de gato. A garrafada possui 4,32 mg.mL-1 de álcool. Foram realizados testes farmacognósticos e UV/Varredura, mostrando algumas classes de metabólitos secundários nas espécies vegetais e na garrafada. Foi realizado bioensaio com Artemia salina, e a garrafada teve mortalidade até a concentração de 0,1 mg.mL-1. Efeitos citotóxicos em eritrócitos revelaram atividade hemolítica para equinácea, graviola, ipê roxo e sucupira. O teste com Escherichia coli mostrou sensibilidade para graviola, ipê roxo, sucupira e unha de gato. No experimento in vivo utilizando ratos Wistar foram realizados dois tratamentos, dose única e 30 dias, administrando água, álcool e garrafada por gavagem. Foram avaliados parâmetros bioquímicos, de coagulação, hematológicos e histopatológicos. No tratamento com dose única foram encontradas alterações de ácido úrico, colesterol, creatinina, fosfatase alcalina, ferro e glicose (p<0,05). Já no tratamento de 30 dias foram encontradas alterações de ácido úrico, bilirubinas total e indireta, creatinina, fosfatase alcalina, glicose, triglicerídeos, hemácias e leucócitos (p<0,05), além de dilatação sinusoidal hepática. Os dados mostraram que o álcool presente na garrafada pode alterar parâmetros bioquímicos, hematológicos e causar danos ao fígado de ratos. A garrafada, apesar de não mostrar alterações em parâmetros bioquímicos e hematológicos importantes, teve alterações histopatológicas hepáticas mais pronunciadas.

Introduction: Haematological malignancies (HMs) are a rare and diverse group of malignancies accounting for 9% of cancers globally. These group of malignancies differ by age, sex, subtypes, morphology and geography. The burden and the patterns of diversity of HMs is poorly understood in low and middle-income countries including Kenya. Aim: To analyse the time trends of incidence of haematological malignancies in Kenya by broad subtypes from 2000–2013 and to compare differences in trends of HMs between Nairobi and Uasin Gishu counties for the period 2007-2013. Methods: A retrospective study including all HMs for all ages and sex diagnosed in the period of 2000-2013. Information used was from two population based cancer registries; Eldoret and Nairobi cancer registry. Crude incidence rates were directly standardized with the world population to obtain the age-standardized rates (ASR). Sex rate ratios (SRR) and incident rate ratios (IRR) were then calculated to compare the number of excess cases between sexes and counties. Ms Excel and STATA13 software were used to conduct a time trend analysis of haematological malignancies by broad subtypes of non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), myeloma and leukaemia. Using the estimated annual percentage change (APC), increase or decrease in trends of HMs was determined. Results: In Kenya, the mean age at diagnosis for all HMs was 32 years. NHL was the most commonly diagnosed HM in Kenya accounting for 43.6% of the cases. The main basis of diagnosis for NHL and HL cases was by cytology while for myeloma and leukaemia was by histology. A male excess was noted in the NHL, myeloma and leukaemia cases with an exemption of a female excess in the HL cases. Trends in incidence of HMs in Kenya increased by 9.8% with the myeloma subtype contributing greatly to the observed increase. By counties, Uasin Gishu county reported a higher number of HM cases per 100000 than Nairobi county (Uasin Gishu-97.6 per 100000 and Nairobi-69.9 per 100000). On the contrary, Nairobi marked a higher increase in trends of HMs than Uasin Gishu county. Conclusion: Trends of haematological malignancies are increasing in Kenya and special attention needs to be given to these under-reported group of malignancies. Finally, this study does support the dire need for a national cancer registry in the country.

The aim of this study was to provide a short German self-report measurement, assessing subjective CRCI for a broad variety of cancer survivors. For this purpose, the AFI (Attentional Function Index) was translated into German and psychometric properties have been presented in the following publication among a sample of 1312 haematological cancer survivors. In the resulting article the factorial structure of the German translation of the AFI, the internal consistency among the total score and each subscale, construct validity and the associations of the AFI sum score with medical and socio-demographic variables are provided. Comparisons to the English version are additionally drawn. With the validated AFI, researchers and clinicians in German-speaking countries may now have new tool to assess, and thus improve an important component of QoL in cancer survivors [38].

Derzeit ist es gängige Praxis, die Chemotherapie entsprechend der Körperoberfläche des Patienten zu dosieren. Diese Praxis ist jedoch nicht ideal, da es Patienten gibt, die starke Nebenwirkungen haben und andere, die kaum Nebenwirkungen aufweisen. Damit intelligentere Dosierungsschemata entwickelt werden können und prophylaktische Maßnahmen zum Verhindern von Therapienebenwirkungen besser geplant werden können, ist die Kenntnis der Faktoren erforderlich, welche die Nebenwirkungen verursachen. Die hämatologischen Nebenwirkungen der Chemotherapie sind dabei am stärksten ausgeprägt und führen oft zu Dosiserosionen, Zeitverschiebungen zwischen den Chemotherapiezyklen oder sogar zu einem Abbruch der Therapie. Das hat wiederum negative Auswirkungen auf den Therapieerfolg. In dieser Arbeit wurden daher Prognosemodelle für chemotherapieinduzierte hämatologische Nebenwirkungen aufgebaut. Die Daten von 1399 Patienten mit aggressivem Non-Hodgkin-Lymphom und einem breiten Altersspektrum von 18-75 Jahren aus der NHL-B1/B2-Studie (Pfreundschuh et al. 2004a und b) gingen in die Analyse ein. Es wurden für die jüngeren (<= 60 Jahre) und die älteren Patienten (> 60 Jahre) multivariate Proportionale Odds Regressionsmodelle für die drei hämatopoetischen Linien der Leukozytopenie, Thrombozytopenie und Anämie gerechnet und an zwei unabhängigen Datensätzen, auch unter Rituximab-haltigen Chemotherapieschemata, validiert. Die hier entwickelten Modelle konnten ein breites Heterogenitätsspektrum für die hämatologischen Nebenwirkungen erklären. Bemerkenswert ist, dass einige der Faktoren für hämatologische Nebenwirkungen gleichzeitig auch Faktoren des Internationalen Prognostischen Index für das Therapieergebnis sind. Die im ersten Chemotherapiezyklus beobachtete Nebenwirkung war der stärkste prognostische Faktor. Mit einigen der Modelle konnte die kumulative Nebenwirkung über die Chemotherapiezyklen hinweg gezeigt werden. Die Demonstration des Zusammenhangs zwischen den für Leukozytopenie ermittelten Risikogruppen und den klinisch relevanten Größen Infektion, Antibiotikagabe, Hospitalisierungstage und therapieassoziierte Todesfälle ist ein sehr wichtiges Ergebnis der Arbeit. Es wurde eine Internetseite (www.toxcalculator.com) entwickelt, welche den Ärzten die Möglichkeit bietet, die bei dem Patienten vorliegenden Prognosefaktoren einzugeben und dann die Modellvorhersagen für die zu erwartenden hämatologischen Nebenwirkungen zu erhalten. Die Ergebnisse der Arbeit wurden in der hochrangigen Zeitschrift ‚Annals of Oncology‘ publiziert (Ziepert et al. 2008).

Chronic inflammation is intimately linked with cancer development and progression and therefore reducing or eliminating inflammation represents a logical treatment and prevention strategy. Studies have shown that anti-inflammatory agents have anti-tumour effects in cancers, with reduced metastases and mortality. Current use of anti-inflammatory agents in the treatment and prevention of cancer is limited by their toxicity and side effects. The emerging field of nanotechnology allows the fundamental properties of a drug to be altered, creating a product with improved reactivity and bioavailability, leading to more targeted treatments and reduced dosage. In the present study, the genotoxic effects of three commonly used anti-inflammatory drugs; aspirin, ibuprofen and hydrocortisone, in their bulk and nano forms were evaluated on peripheral blood lymphocytes of healthy donors using the comet assay and the micronucleus assay. In order to determine any anti-cancer effects, these agents were also tested in peripheral blood lymphocytes in patients with haematological cancers. The glucocorticoid hydrocortisone was also evaluated for anti-oxidant capacity. Our results demonstrate that the nano versions of each drug produced a different response than the bulk counterpart, indicating that a reduction in particle size had an impact on the reactivity of the drug. Our results also indicate that the nano versions of each drug were less genotoxic than the bulk formulation, further emphasising the potential of nanoparticles as an improvement to current treatment options. We also found an anti-oxidant effect with hydrocortisone, with a more profound effect seen with the nano formulation.