Antimicrobial susceptibility of Rhodococcus equi strains isolated from foals in Chile.

Rhodococcus equi is responsible for foal pneumonia worldwide, with a significant economic impact on the production and breeding of horses. In Chile, the first case was reported in 2000, and since then, its incidence has been increasing. Distinctive characteristics of R. equi as an intracellular pathogen in macrophages, emergence of virulence plasmids encoding surface lipoprotein antigens, and appearance of antibiotic resistance against macrolides and rifampicin have significantly complicated the treatment of R. equi pneumonia in foals. Therefore, in vitro susceptibility studies of first-line and newer antibiotics against R. equi are the first step to establishing effective treatments and optimizing new therapeutic options. The aim of the present study is to determine the susceptibility profile of fourteen strains of R. equi isolated from foals in Chile to several antibiotics of the macrolide group including azithromycin, amikacin, tildipirosin and gamithromycin as well as others such as rifampicin, doxycycline and ceftiofur. Identification of R. equi in collected isolates from foals in Chile has been performed by CAMP test and PCR based on detecting of the gene encoding the 16 S rRNA. The presence of genes encoding virulence plasmids was also determined using PCR. Results obtained have demonstrated presence of virulent R. equi strains in Chile. In vitro susceptibility pattern to different antibiotics has shown better results for doxycycline and rifampicin similar to previous studies performed. Current macrolides have been evaluated in order to consider alternative treatment options in a context of emerging resistance to classic macrolides and rifampicin, obtaining better results with gamithromycin (MIC range of 0.125 to 128 mg/ml) than with tildipirosin (MIC range of 16 to 128 mg/ml). An adequate diagnosis of bacterial susceptibility based on antibiograms is necessary to treat the Rhodococcus equi infection in foals.

A novel liquid chromatography-fluorescence method for the determination of delafloxacin in human plasma.

Delafloxacin is a novel fluoroquinolone antibiotic that was approved by the European Medicine Agency to treat bacterial infections of the skin and underlying tissues, and community-acquired pneumonia. Despite being in the market since 2019 in the European Union, there is no published liquid chromatography-fluorescence method for delafloxacin quantification in biological samples. A novel, rapid, and sensitive high-performance liquid chromatographic method was developed to determine delafloxacin in human plasma using its native fluorescence. Plasma delafloxacin concentrations were determined by reverse-phase chromatography with fluorescence detection at 405/450 nm of excitation/emission wavelengths. Delafloxacin was separated on a Kromasil C18 column 250 × 4.6 mm id, 5 µm using isocratic elution. The mobile phase was a mixture of 0.05% trifluoroacetic acid/acetonitrile (52/48). Retention times were 5.4 and 11.6 min for delafloxacin and valsartan (internal standard), respectively. Regression calibration curves were linear over the range of 0.1-2.5 µg/mL. The lower limit of detection was 0.05 µg/mL, and the lower limit of quantification was 0.1 µg/mL. Accuracy and precision were always <11%, and the limit of quantification was <16%. Mean recovery was 98.3%. This method can be applied to determine delafloxacin in human plasma and could be useful to perform pharmacokinetic studies.

Short-term effects of lumbopelvic complex stability training in elite female road cyclists.

OBJECTIVES: The purpose of this study was to determine the effects of short-term lumbopelvic stability training on muscular endurance and stability in elite female cyclists. METHODS: Twenty-four female road cyclists were randomly allocated to a core training group (CTG, n=12) or control group (CG, n=12). In addition to their scheduled training the CTG performed a core training program, that consisted of 6 core exercises performed in a session every other day until a total of 8 training sessions were completed. The CG did not receive the core training program and completed their scheduled training. The lumbopelvic-hip complex was assessed pre- and post-core program included the following exercises: single leg deadlift (SLD), bird-dog (BD), plank test (PT), and side-bridge plank test (SPT). RESULTS: In comparison to CG, CTG significantly improved the time to failure in PT, SPT-Left, and SPT-Right (p<0.05). Further, CTG resulted in a significant decrease in SLD (p<0.05) compared to CG for the three accelerometry measures. CONCLUSION: The present results indicate that following 8 sessions of lumbopelvic stability training muscular endurance and core stability were enhanced.

Does Sex Impact the Differences and Relationships in the One Repetition Maximum Performance Across Weightlifting Overhead Pressing Exercises?

ABSTRACT: Soriano, MA, García-Ramos, A, Calderbank, J, Marín, PJ, Sainz de Baranda, P, and Comfort, P. Does sex impact the differences and relationships in the one repetition maximum performance across weightlifting overhead pressing exercises? J Strength Cond 36(7): 1930-1935, 2022-This study aimed to determine the impact of sex on the differences and relationships of the one repetition maximum (1RM) performance between 3 overhead pressing exercises (push press [PP], push jerk [PJ] and split jerk [SJ]). 15 men (body mass [BM]: 82.3 ± 9.9 kg; weightlifting training experience: 2.6 ± 1.6 years) and 15 women (BM: 64.4 ± 7.0 kg; weightlifting training experience: 2.2 ± 1.4 years) participated in this study. A ratio-scaled (1RM·BM-1) was used for the comparison between them. The 1RM of the 3 exercises were evaluated within the same testing session using a combined 1RM assessment method. The interaction effect of exercise and sex did not reach statistical significance (p = 0.671; η2 = 0.001). In contrast, there were significant main effects of exercise (p ≤ 0.01) and sex (p < 0.001) with medium (η2 = 0.096) and large effect sizes (η2 = 0.306), respectively. A similar main effect of exercise was reported for both men (PP [1.0 ± 0.1 kg·kg-1] < PJ [1.1 ± 0.2 kg·kg-1] ∼ SJ [1.2 ± 0.2 kg·kg-1]) and women (PP [0.8 ± 0.1 kg·kg-1] < PJ [0.9 ± 0.2 kg·kg-1] ∼ SJ [0.9 ± 0.2 kg·kg-1]). The 1RM performance of the 3 exercises was significantly correlated for men (r [range] = 0.856-0.963) and women (r [range] = 0.636-0.925). Sex does not affect the differences in the 1RM performance across weightlifting overhead pressing exercises. However, stronger correlations and lower variation in the 1RM performance during the PP, PJ, and SJ are expected for men compared with women.

Susceptibility of caprine mastitis pathogens to tildipirosin, gamithromycin, oxytetracycline, and danofloxacin: effect of serum on the in vitro potency of current macrolides.

Mastitis is a significant disease in dairy ruminants, causing economic losses to the livestock industry and severe risks to public health. Antibiotic therapy is one of the most crucial practices to treat mastitis, although the susceptibility of caprine mastitis pathogens to current antibiotics has not been tested under standard or modified incubation conditions. This work evaluated the in vitro activity of tildipirosin, gamithromycin, oxytetracycline, and danofloxacin against caprine mastitis pathogens incubated following standard conditions of Clinical and Laboratory Standards Institute (CLSI) and deviation method by 25% supplementation with goat serum. Mycoplasma agalactiae, Escherichia coli, Staphylococcus aureus, Streptococcus spp., and coagulase-negative Staphylococci (CNS) were isolated from dairy goats with mastitis in Spain. Minimum inhibitory concentrations (MICs) were determined using the broth microdilution technique. The lowest MIC90 under standard conditions was obtained with danofloxacin for mastitis-causing pathogens. An exception was M. agalactiae, where danofloxacin and oxytetracycline obtained low values. However, after adding serum, gamithromycin showed the lowest MIC50 for S. aureus, Streptococcus spp., and CNS. The lowest MIC50 was obtained with all the antibiotics tested (< 0.125 µg/ml) against M. agalactiae. Supplementing with serum resulted in a significant variation in tildipirosin and gamithromycin MIC values for CNS, S. aureus, M. agalagtiae, and E. coli. In brief, the MIC for antibiotics used against mastitis should be determined under conditions closely resembling intramammary infections to obtain representative susceptibility patterns against mastitis pathogens. Caprine mastitis pathogens were broadly susceptible to danofloxacin under standard conditions. The potency of macrolides against caprine mastitis pathogens increases when serum is present in culture media.

Addition of plerixafor to G-CSF in poor mobilizing healthy related donors overcame mobilization failure: An observational case series on behalf of the Grupo Español de Trasplante Hematopoyético (GETH).

Plerixafor (Mozobil, Sanofi) is approved for using in patients with lymphoma and multiple myeloma when steady-state mobilization strategies fail. Although off-label use of plerixafor in healthy related donors (HRD) is known, limited data are available and no recommendations exist to guide its use in this setting. With the aim of collecting data from HRDs who received plerixafor in our country, we designed an observational case series study within the Spanish Group of Hematopoietic Transplant and Cell Therapy (GETH). Plerixafor was administered subcutaneously to 30 HRDs at a median dose of 0.24 mg/Kg (interquartile range (IQR): 0.23-0.25) because mobilization failure after using mobilization with G-CSF (mobilization failure was defined as collection of <4.0 × 106 CD34+ cells/Kg recipient). All HRDs received G-CSF at a median dose of 11 µg/Kg/day (IQR: 10-12) for 4-5 days. Leukocytapheresis after G-CSF mobilization was performed in 23 (77 %) HRDs collecting a median of 1.6 × 106 CD34+ cells/Kg recipient weight (IQR: 0.9-2.5). Addition of plerixafor allowed the collection of a higher median number of CD34 cells (4.98 × 106 CD34+ cells/Kg recipient weight (IQR: 3.5-5.8)) when compared with the collection of CD34+ cells with G-CSF alone (p < 0.01). The final median total number of CD34+ cells collected was 6.1 × 106/Kg recipient weight (IQR: 4.8-7.3). Mild adverse events related with plerixafor administration were reported in 8 (27 %) donors. In conclusion, addition of plerixafor after G-CSF mobilization failure in HRDs allowed collecting higher number of CD34+ cells in comparison with steady-state mobilization.

The effects of whole-body vibration on EMG activity of the lower body muscles in supine static bridge position.

OBJECTIVES: The purpose of the current study was to firstly examine the effects of different whole-body vibration (WBV) frequencies in the lower-body muscles when applied simultaneously during a bridge exercise. Secondly, determine if there were any sex differences in the lower-body muscles of WBV during the bridge. METHODS: Seven females and 7 males completed 2 familiarization and 1 test sessions. In the test session participants were randomized to complete one 30 s bout of a bridge exercise for 3 separate conditions followed by 3-min of rest. The 3 conditions (a) No-WBV (without WBV); (b) WBV-30 (30 Hz, low amplitude); (c) WBV-50 (50 Hz, low amplitude) were performed on a WBV platform. Muscle activity of the biceps femoris (BF), semitendinosus (ST), gluteus maximus (Gmax), multifidus muscle (MF) muscles were measured. RESULTS: Muscle activity was increased with WBV in the BF and ST muscles at WBV-30 and WBV-50 conditions (p<0.05) vs. no-WBV. During No-WBV and WBV-50 conditions, males had a higher biceps femoris activity compared to females for (p<0.05) 45 and 27 %, respectively; however, during all conditions females had a high level of Gmax activity (57%) than males (p<0.05). CONCLUSION: Additional vibration at 30 and 50 Hz during the bridge exercise could be a useful method to enhance hamstring muscle activity.

Effect of cycling exercise on lumbopelvic control performance in elite female cyclists.

OBJECTIVES: The purpose of the present study is to assess the effects of an intense cycling training session on the stability of the lumbopelvic-hip complex through two dynamic exercise tests - the single-leg-deadlift (SLD) and a variation of the bird-modified dog (BD), via the OCTOcore application. METHODS: Thirty-one elite female road cyclists were self-evaluated with their own smartphones, before and immediately after finishing their training sessions. Right, left and composite were measured for each exercise test. RESULTS: There was a significant time effect on performance for both the SLB and BD tests (p<0.05; η2=0.137), and the SLD and BD tests were increased with respect to the pre-test at 15% and 17%, respectively. CONCLUSION: An intense cycling training session produced significant alterations in lumbopelvic behavior in the elite female cyclists. The OCTOcore application demonstrated that it was a sensitive tool in detecting these changes and it could easily be used by the cyclists themselves.

A fast, cost-saving and sensitive method for determination of cefuroxime in plasma by HPLC with ultraviolet detection.

Cefuroxime (CFX) is a broad-spectrum second-generation cephalosporin and one of the best choices for antibiotic prophylaxis. However, when used in critically ill patients, it may present changes in its pharmacokinetic properties. Therefore, therapeutic drug monitoring of CFX is necessary for effective dosing strategies. A simple, rapid and sensitive liquid chromatographic method with UV detection was developed and validated for the quantification of CFX in plasma. The method involved a single-step precipitation of proteins with methanol and trifluoroacetic acid. Cefuroxime was analyzed on a Brisa LC2 C18 column in isocratic mode consisting of 0.1% trifluoroacetic acid in water and acetonitrile (75:25) with UV detection at a wavelength of 280 nm. The retention times of CFX and cephazolin (internal standard) were 9.8 and 7.4 min, respectively. The calibration curve was linear over a concentration range of 0.25-50 µg/ml. The limits of detection and quantification were 0.1 µg/ml and 0.25 µg/ml, respectively. The accuracy and precision were always <10%. The mean recovery was 93.52%. This fast and simple method could be applied in routine analysis and pharmacokinetic studies.

[Old age and the new ICD-11: Position of the Latin American Academy of Medicine for Older PersonsA velhice e a nova CID-11: posição da Academia Latino-americana de Medicina do Idoso]. / La vejez y la nueva CIE-11: posición de la Academia Latinoamericana de Medicina del Adulto Mayor.

Since 1948, the World Health Organization has been publishing the International Statistical Classification of Diseases and Related Health Problems (ICD), a coded system of causes of disease and death with an in-depth revision every 10-15 years. In its latest revision, the ICD-11 uses nomenclature characterizing old age as "initial and final geriatric periods," implying the medicalization of this stage of life, which has created confusion and sparked controversy. This article discusses the new nomenclature proposed, given the current knowledge about old age and the aging process and its most accepted definition. The ICD not only classifies diseases but periods of life and "health-related problems," and old age per se is not a health-related problem for many people at this stage of life. It is therefore essential to change or provide a more nuanced definition of the term "old age" in the ICD-11, so it is not perceived as a symptom, sign, or anomalous clinical outcome, and to introduce nomenclature that more accurately reflects pathological aging. Two terms that are enjoying growing experimental and bibliographic support are "fragility" and "loss of intrinsic capacity," which offer greater precision when defining the condition of a person who is not experiencing healthy aging.

Desde 1948, a Organização Mundial da Saúde publica um sistema codificado de causas de doença e morte sob o nome de Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID), com revisões profundas a cada 10-15 anos. Sua última versão, a CID-11, utiliza determinada terminologia para caracterizar a velhice como "períodos geriátricos iniciais e finais", o que implica uma medicalização dessa fase da vida que tem gerado confusão e polêmica. Este artigo discute a nova terminologia proposta à luz dos conhecimentos atuais sobre a velhice e o processo de envelhecimento, e sua definição mais aceita. A CID não classifica apenas as doenças, mas também períodos da vida e "problemas de saúde", sendo que a velhice por si só não representa um problema de saúde para muitos que se encontram nesta fase da vida. A partir dessa perspectiva, é imprescindível alterar ou qualificar o verbete "velhice" da CID-11 para que não seja percebido como sintoma, sinal ou resultado clínico anormal, e em seu lugar introduzir termos que melhor reflitam o estado de envelhecimento patológico. Entre os termos que têm crescente suporte experimental e bibliográfico estão "fragilidade" e "perda de capacidade intrínseca", que proporcionam uma precisão muito maior na definição da condição de quem não goza de um envelhecimento saudável.

Enrofloxacin and its major metabolite ciprofloxacin in green sea turtles (Chelonia mydas): An explorative pharmacokinetic study.

The present study aimed to assess the pharmacokinetic features of enrofloxacin (ENR) and its major metabolite, ciprofloxacin (CIP) in green sea turtles (Chelonia mydas) after single intravenous (i.v.) and intramuscular (i.m.) administration at two dosages of 5 and 7.5 mg/kg body weight (b.w.). The study used 10 animals randomly divided into equal groups. Blood samples were collected at assigned times up to 168 hr. The concentrations of ENR and CIP in turtle plasma were quantified by a validated high-performance liquid chromatography equipped with fluorescence detector (HPLC-FLD). The concentration of ENR in the experimental turtles with respect to time was pharmacokinetically analyzed using a noncompartment model. The concentrations of ENR in the plasma were quantified up to 144 hr after i.v. and i.m. administrations at dosages of 5 and 7.5 mg/kg b.w., whereas CIP was quantified up to 96 and 144 hr, respectively. The elimination half-life values of ENR were 38.7 and 50.4 hr at dose rates of 5 and 7.5 mg/kg b.w. after i.v. administration, whereas CIP was 33.6 and 22.6 hr, respectively. The maximum concentration (Cmax ) values of ENR were 2.07 and 2.59 µg/ml at dose rates of 5 and 7.5 mg/kg b.w., respectively. The value of area under the curve from 0 to 24 hr (AUC0-24 )/minimum inhibitory concentration (MIC) ratio of ENR was >125 for bacteria with MIC of 0.12 and 0.13 µg/ml after the administration of 5 mg/kg by i.m. and i.v. administration, respectively. Based on the pharmacokinetic data, susceptibility break-point and pharmacokinetic (PK)/pharmacodynamic (PD) indices, i.m. single administration of ENR at a dosage of 5 mg/kg b.w. might be clinically appropriate for treatment of susceptible bacteria in green sea turtles (Chelonia mydas).

Validity and Reliability of a Standardized Protocol for Assessing the One Repetition Maximum Performance During Overhead Pressing Exercises.

ABSTRACT: Soriano, MA, García-Ramos, A, Torres-González, A, Castillo-Palencia, J, Ayuso, V, Marín, PJ, and Comfort, P. Validity and reliability of a standardized protocol for assessing the one repetition maximum performance during overhead pressing exercises. J Strength Cond Res 35(11): 2988-2992, 2021-The aim of this study was to determine the validity of performing 3 one repetition maximum (1RM) assessments for the push press (PP), push jerk (PJ), and split jerk (SJ) in sequence in one testing session vs. the criterion method (testing on separate days), while determining the between-session reliability of the combined assessment. Twenty-two well-trained men (n = 22; age: 28.5 + 1.3 years; height: 1.80 + 0.04 m; body mass: 84.9 + 1.9 kg; training experience: 4.27 + 4.08 years) participated in this study. The 1RM was assessed in a sequential order in the same testing session (combined 1RM assessment) for the PP, PJ, and SJ on 2 occasions, to determine between-session reliability. The 1RM for each exercise was also examined on 3 separate sessions to compare the results against the combined method. A high reliability, low variability, and low measurement error were evident for the PP (intraclass correlation coefficient [ICC] = 0.960; coefficient of variation [CV] = 1.8%; smallest detectable difference [SDD] = 7.1%), PJ (ICC = 0.978; CV = 1.5%; SDD = 5.4%) and SJ (ICC = 0.987; CV = 0.8%; SDD = 4.6%). In addition, there were no significant (p > 0.05) or meaningful (η2 ≤0.001) differences between the single and combined assessments. The high reliability and validity of the combined assessment suggest that practitioners and researchers may simplify the testing procedure by assessing the 1RM during the 3 main overhead pressing exercises in a single testing session.

Increased collection efficiency of CD34+ cells after mobilization with preemptive use of plerixafor followed by leukocytapheresis on the same day.

BACKGROUND: Plerixafor should be administered 6 to 11 hours before starting leukocytapheresis. However, we have been using plerixafor followed by leukocytapheresis according to different time schedules since 2007. Our objective was to compare the CD34+ cell collection efficiency (CE1) of the first leukocytapheresis performed after using plerixafor at different time intervals. STUDY DESIGN AND METHODS: Same-day schedule refers to the administration of plerixafor at 10:00 AM and starting the leukocytapheresis on the same day at 4:00 PM (6 hours interval). Next-day schedule refers to the administration of plerixafor at 8:00 PM and starting the leukocytapheresis on the next day (10:00 AM or 4:00 PM; either a 14- or 20-hr interval). Variables that might influence the CE1 of CD34+ cells were analyzed by longitudinal linear regression with a random effects model derived by generalized estimating equations. RESULTS: The median CE1 of CD34+ cells was higher in the group of 30 patients who underwent leukocytapheresis on the same day when compared with the group of 62 patients who underwent leukocytapheresis on the next day (65.8% vs. 56.7%; p < 0.01). In the longitudinal linear regression analysis, only the time from plerixafor administration to leukocytapheresis start was associated with a statistically significant decrease in the CE1 of CD34+ cells (CE1 change -0.034%; p < 0.01). CONCLUSION: Higher CE1 of CD34+ cells was observed when patients underwent leukocytapheresis on the same day after receiving plerixafor in comparison with administering plerixafor and underwent leukocytapheresis on the next day. Larger studies are necessary to confirm present results.

Muscle Activation in Middle-Distance Athletes with Compression Stockings.

The aim of this study was to evaluate changes in electromyographic activity with the use of gradual compression stockings (GCSs) on middle-distance endurance athletes' performance, based on surface electromyography measurement techniques. Sixteen well-trained athletes were recruited (mean ± SD: age 33.4 ± 6.3 years, VO2max 63.7 ± 6.3 mL·kg-1·min-1, maximal aerobic speed 19.7 ± 1.5 km·h). The athletes were divided into two groups and were assigned in a randomized order to their respective groups according to their experience with the use of GCSs. Initially, a maximum oxygen consumption (VO2max) test was performed to standardize the athletes' running speeds for subsequent tests. Afterward, electromyographic activity, metabolic, and performance variables for each group were measured with surface electromyography. In addition, blood lactate concentration was measured, both with and without GCSs, during 10 min at 3% above VT2 (second ventilatory threshold), all of which were performed on the track. Next, surface electromyography activity was measured during a 1 km run at maximum speed. No significant changes were found in electromyography activity, metabolic and performance variables with GCSs use (p > 0.164) in any of the variables measured. Overall, there were no performance benefits when using compression garments against a control condition.

Pharmacokinetics of cefonicid in lactating goats after intravenous, intramuscular and subcutaneous administration, and after a long-acting formulation for subcutaneous administration.

The single-dose disposition kinetics of cefonicid were determined in clinically normal lactating goats (n = 6) after intravenous (IV), intramuscular (IM) and subcutaneous (SC) administration of a conventional formulation, and after subcutaneous administration of a long-acting formulation (SC-LA). Cefonicid concentrations were determined by high performance liquid chromatography with ultraviolet detection. The concentration-time data were analysed by noncompartmental pharmacokinetic methods. Steady-state volume of distribution (Vss ) and clearance (Cl) of cefonicid after IV administration were 0.14 ± 0.03 L/kg and 0.51 ± 0.07 L/h·kg, respectively. Following IM, SC and SC-LA administration, cefonicid achieved maximum plasma concentrations of 14.46 ± 0.82, 11.98 ± 1.92 and 17.17 ± 2.45 mg/L at 0.26 ± 0.13, 0.42 ± 0.13 and 0.83 ± 0.20 hr, respectively. The absolute bioavailabilities after IM, SC and SC-LA routes were 75.34 ± 11.28%, 71.03 ± 19.14% and 102.84 ± 15.155%, respectively. After cefonicid analysis from milk samples, no concentrations were found above LOQ at any sampling time. From these data, cefonicid administered at 20 mg/kg each 12 hr after SC-LA could be effective to treat bacterial infections in lactating animals not affected by mastitis problems.

Pharmacokinetics of injectable marbofloxacin after intravenous and intramuscular administration in red-eared sliders (Trachemys scripta elegans).

Fluoroquinolone antibacterial drugs are currently used in reptilian medicine because of their broad spectrum of activity including the most frequent pathogens of these species. The disposition kinetics of marbofloxacin (MBX) at a single dose of 2 mg/kg were determined in healthy red-eared sliders after intravenous (IV) and intramuscular (IM) administration. The influence of renal portal system on the bioavailability of the drug was investigated by using forelimb and hindlimb as IM injection sites. Apparent volume of distribution at steady-state (Vss ) and systemic clearance (Cl) of marbofloxacin after IV administration were estimated to be 48.21 ± 5.42 ml/kg and 23.38 ± 2.90 ml/hr·kg, respectively. The absolute bioavailabilities after IM route were 45.96% (forelimb) and 52.09% (hindlimb). The lack of statistically significant differences in most of the pharmacokinetic parameters after the two IM injection sites suggests a negligible influence of renal portal system in clinical use of MBX, although the Cmax after IMfore administration is advantageous, having into account the concentration-dependent action of this antibiotic. The absence of visible adverse reactions in the animals and the advantageous pharmacokinetic properties suggest the possibility of its safe and effective clinical use in red-eared sliders.

Efficacy and safety of one-day offline extracorporeal photopheresis schedule processing one total blood volume for treating patients with graft-versus-host disease.

BACKGROUND: Extracorporeal photopheresis (ECP) has been increasingly used as a second-line therapy for graft-versus-host disease (GVHD) but there is no consensus regarding the best therapeutic schedule. STUDY DESIGN AND METHODS: Our offline ECP schedule for treating patients with GVHD was retrospectively reviewed. Patients with acute GVHD were treated on 2 days per week for the first 2 weeks, followed by 1 day per week for 2 more weeks. After the first month of treatment, patients received treatment 1 day every 2 weeks for a minimum of 16 ECP procedures. Patients with chronic GVHD were treated on 1 day per week for 4 weeks followed by 1 day every 2 weeks for a minimum of 14 ECP procedures. RESULTS: Our series comprises 21 (45%) patients with acute GVHD and 26 (55%) patients with chronic GVHD who received 667 ECP procedures. A median (interquartile range [IQR]) of 1.0 (1.0-1.12) total blood volume was processed. Patients with acute and chronic GVHD received ECP procedures during a median of 49 (IQR, 14-103) and 180 (IQR, 111-274) days, respectively. Mild citrate-induced symptoms were present in 98 (46%) and 232 (51%) procedures in patients with acute and chronic GVHD, respectively. Overall response rate (ORR) and overall survival (OS) were 57 and 38% (95% confidence interval [CI], 17%-59%), respectively, for patients with acute GVHD. For patients with chronic GVHD, ORR and OS were 77 and 61% (95% CI, 18%-87%), respectively. CONCLUSION: Our new offline ECP schedule for treating patients with acute and chronic GVHD was efficacious and safe.

Cross transfer acute effects of foam rolling with vibration on ankle dorsiflexion range of motion.

INTRODUCTION: Foam roller is a device used as a massage intervention for rehabilitation and fitness performance. OBJECTIVE: To examine the effects on the ankle dorsiflexion mobility of the foam roller as well as the combination of foam roller and vibration applied to the ankle plantarflexors muscles, and to observe the possible cross-effect. METHODS: Thirty-eight undergraduate students participated in the study (19 males and 19 females). This study investigated. Three conditions (3 sets of 20 s) were performed in a randomized order (independent variables): 1) foam roller (Roller), 2) foam roller and vibration (Roller+VIB), and 3) no foam roller or vibration (Control). to determine whether of foam roller with or without vibration would benefit ankle dorsiflexion mobility. Ankle dorsiflexion ROM and plantar flexor were measured in both legs before and immediately after the treatment. RESULTS: A cross-effect was found in the non-stimulated leg. There was a significant effect on ankle mobility of Roller and Roller+VIB conditions (6% and 7%, p<0.001). CONCLUSION: Foam roller massage and vibration stimulus' foam roller massage increase ankle mobility producing a cross-effect.

Can whole body vibration exercises affect growth hormone concentration? A systematic review.

Whole body vibration (WBV) has been recognized as an effective alternative exercise modality to resistance exercise for its ability in enhancing force and power, generating capacity in skeletal muscle, increasing bone mass and improving cardiovascular function. Since the effect of WBV exercises on growth hormone (GH) levels has been never compared and discussed, the aim of this study was to review systematically the literature to verify the WBV effects on GH concentration. By using PubMed, Scopus and PEDRo databases with the keywords 'growth hormone' or GH and 'whole body vibration' or WBV, we found and analysed 12 papers (182 subjects recruited), verifying their level of evidence (National Health and Medical Research Council hierarchy of evidence) and the methodological quality (PEDRo scale). Although WBV induced GH responses in nine out of 12 publications, caution should be however taken when considering the results due to the markedly different methodologies among these publications.