Acute Effects of the Dry Needling Session on Gastrocnemius Muscle Biomechanical Properties, and Perfusion with Latent Trigger Points - A Single-Blind Randomized Controlled Trial in Mixed Martial Arts Athletes.

The study aimed to evaluate the immediate effects of a dry needling (DN) therapy session on biomechanical properties, muscle power, perfusion, and pressure pain threshold of the gastrocnemius muscle with latent trigger points. Twenty mixed martial arts athletes (MMA) were randomly divided into two groups: experimental (eDN, n = 10) and sham (qDN, n = 10) to undergo one session of DN either with a real or a qazi needle. The measurements were taken at rest, 1-5 minutes after the DN (Post1-5min) and 24h after the DN (Post24h). DN significantly increased the muscle perfusion (Post1-5min and Post24h, p < 0.001), reduced its tone (Post1-5min and Post24h, p < 0.001) and stiffness (Post1-5min, p < 0.05; Post24 h, p < 0.001), and improved its elasticity (Post1-5min and Post24h, p < 0.001). DN also caused a significant increase in pressure pain threshold (Post1-5min, p < 0.001; Post24h, p < 0.05) and in muscle power (Post24h, p < 0.01). The DN session increased the blood perfusion and improved the biomechanical properties of the gastrocnemius muscle, which led to improved muscle power. The DN also had an analgesic effect. These effects were maintained at 24 h, which suggests that DN could facilitate muscle recovery in a post-exercise period of MMA athletes.

Pelvic organ prolapse surgical training program in Bangladesh and Nepal improves objective patient outcomes.

INTRODUCTION AND HYPOTHESIS: The DAK Foundation (Sydney) has facilitated pelvic organ prolapse (POP) repairs performed by local gynecologists for underprivileged women in Bangladesh and Nepal since 2014. Initially, there was no long-term patient follow-up. When 156 patients were examined at least 6 months after their surgery, an unacceptably high rate of prolapse recurrence and shortened vaginas was identified. This demonstrated the need for surgical up-skilling in both countries. Our hypothesis is that the introduction of a surgical training program in low-resource countries can significantly improve patient outcomes after pelvic floor surgery. METHODS: One-on-one surgical re-training was undertaken to up-skill the gynecologists in fascial vaginal repair and vaginal apical reconstruction utilizing sacrospinous fixation (SSF). Following the surgical up-skilling, a further 289 women (between 6 and 18 months post-operatively) were examined to determine patient outcomes. Outcome measures were: 1. Prolapse recurrence: POPQ (pelvic organ prolapse quantification [1]) ≥ stage 2 2. Vaginal length < 4 cm RESULTS: Prior to implementation of the surgical training program, 76% of patients had recurrent prolapse ≥ stage 2, and 56% had a vagina < 4 cm in length. Following the training program, prolapse recurrence was reduced to 45% with significant reductions in the apical, anterior and posterior compartments. The incidence of unacceptable vaginal shortening was 4%. We could not rely on patient symptoms to determine whether they had recurrences. CONCLUSION: Clinical patient follow-up to determine surgical outcome is essential in low-resource settings. We have demonstrated that surgical up-skilling in vaginal hysterectomy, vaginal repair and introduction of SSF were necessary to achieve acceptable prolapse recurrence rates in our programs in Bangladesh and Nepal.

Neutral electrolyzed oxidizing water is effective for pre-harvest decontamination of fresh produce.

Pre-harvest sanitization of irrigation water has potential for reducing pathogen contamination of fresh produce. We compared the sanitizing effects of irrigation water containing neutral electrolyzed oxidizing water (EOW) or sodium hypochlorite (NaClO) on pre-harvest lettuce and baby spinach leaves artificially contaminated with a mixture of Escherichia coli, Salmonella Enteritidis and Listeria innocua (~1 × 108 colony-forming units/mL each resuspended in water containing 100 mg/L dissolved organic carbon, simulating a splash-back scenario from contaminated soil/manure). The microbial load and leaf quality were assessed over 7 days, and post-harvest shelf life evaluated for 10 days. Irrigation with water containing EOW or NaClO at 50 mg/L free chlorine significantly reduced the inoculated bacterial load by ≥ 1.5 log10, whereas tap water irrigation reduced the inoculated bacterial load by an average of 0.5 log10, when compared with untreated leaves. There were no visual effects of EOW or tap water irrigation on baby spinach or lettuce leaf surfaces pre- or post-harvest, whereas there were obvious negative effects of NaClO irrigation on leaf appearance for both plants, including severe necrotic zones and yellowing/browning of leaves. Therefore, EOW could serve as a viable alternative to chemical-based sanitizers for pre-harvest disinfection of minimally processed vegetables.

Mental health screening in women with severe pelvic organ prolapse, chronic fourth-degree obstetric tear and genital tract fistula in western Uganda.

INTRODUCTION AND HYPOTHESIS: High levels of mental health dysfunction have been identified in women with genital tract fistula. The aim of this study was to use the General Health Questionnaire-28 (GHQ-28) to screen women in western Uganda with severe pelvic organ prolapse, chronic fourth-degree obstetric tear and genital tract fistula for risk of mental health dysfunction. METHODS: Women undergoing surgery for severe pelvic organ prolapse, chronic fourth-degree obstetric tear, and genital tract fistula were interviewed using the GHQ-28 to screen for the risk of mental health dysfunction. RESULTS: A total of 125 women completed the GHQ-28, including 22 with pelvic organ prolapse, 47 with fourth-degree obstetric tear, 21 with genital tract fistula, and 35 controls. Nearly all women with these serious gynaecological conditions were positive for the risk of mental health dysfunction. In the domain assessing symptoms of severe depression, women with fourth-degree obstetric tear and genital tract fistula scored higher than women with pelvic organ prolapse. CONCLUSIONS: A significant risk of mental health dysfunction was identified in women with severe pelvic organ prolapse and chronic fourth-degree obstetric tear. These rates are similar to the high rates of mental health dysfunction in women with genital tract fistula. Identification and management of mental health dysfunction in women with these conditions should be a priority.

The Combined Effects of High-Intensity Interval Exercise Training and Dietary Supplementation on Reduction of Body Fat in Adults with Overweight and Obesity: A Systematic Review.

Excessive body fat is associated with various comorbidities including cardiovascular disease, type 2 diabetes mellitus and certain types of cancer. The search for effective, relatively easy to maintain body-fat reduction interventions has been ongoing. We aimed to review the current literature to assess the effectiveness of high-intensity interval training with and without dietary supplementation on body fat loss, concentration of markers of metabolic health and aerobic capacity of adults with overweight and obesity. Seventy full-text articles were assessed to determine their eligibility and thirteen were included in the review. The methodology of this systematic review was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Almost all studies (93%) demonstrated effectiveness of high-intensity interval training of various protocols in reducing body fat, improving metabolic health and aerobic capacity of adults with overweight and obesity. These effects were enhanced by an addition of a dietary supplement, such as green tea or ginger or other. Although combining HIIT with dietary supplementation seem to improve body composition, metabolic health and aerobic capacity in adults with overweight and obesity in some instances to a greater extent than HIIT alone, it does not seem to be necessary to combine these two interventions.

Impact of physical functional capacity on quality of life in patients with interstitial lung diseases.

This study aimed to investigate the physical functioning predictors for health-related quality of life (HRQL) decline in patients with idiopathic interstitial fibrosis (IPF), sarcoidosis and other interstitial lung disease (ILD). The study enrolled 52 patients with ILD and 16 healthy individuals. Participants' HRQL was assessed using the 36-item Short-Form Health Survey questionnaire. Spirometry, physical performance, and daily physical activity (PA) were monitored. Patients with IPF showed significantly lower PA compared to patients with other ILD (p = 0.002)and sarcoidosis (p = 0.01). The type of disease aetiology had no significant effect on aerobic capacity, HRQL and fatigue. Patients with ILD showed significant greater fatigue, lower physical functioning and greater physical aspects scores compared to the control group (F=6.0; p = 0.018; F=12.64; p = 0.001, respectively). A significant positive correlation was observed between 6-minute walking distance (6MWD) and the physical domain of HRQL (r = 0.35, p = 0.012) and PA and the physical aspects of HRQL (r = 0.37, p = 0.007). This study revealed that the key predictors for HRQL decline were lower lung function, lower PA and physical performance.

The Effect of High-Intensity Interval Exercise on Short-Term Glycaemic Control, Serum Level of Key Mediator in Hypoxia and Pro-Inflammatory Cytokines in Patients with Type 1 Diabetes-An Exploratory Case Study.

Type 1 diabetes (T1D) is associated with hyperglycaemia-induced hypoxia and inflammation. This study assessed the effects of a single bout of high-intensity interval exercise (HIIE) on glycaemia (BG) and serum level of pro-inflammatory cytokines, and an essential mediator of adaptive response to hypoxia in T1D patients. The macronutrient intake was also evaluated. Nine patients suffering from T1D for about 12 years and nine healthy individuals (CG) were enrolled and completed one session of HIIE at the intensity of 120% lactate threshold with a duration of 4 × 5 min intermittent with 5 min rests after each bout of exercise. Capillary and venous blood were withdrawn at rest, immediately after and at 24 h post-HIIE for analysis of BG, hypoxia-inducible factor alpha (HIF-1α), tumour necrosis factor alpha (TNF-α) and vascular-endothelial growth factor (VEGF). Pre-exercise BG was significantly higher in the T1D patients compared to the CG (p = 0.043). HIIE led to a significant decline in T1D patients' BG (p = 0.027) and a tendency for a lower BG at 24 h post-HIIE vs. pre-HIIE. HIF-1α was significantly elevated in the T1D patients compared to CG and there was a trend for HIF-1α to decline, and for VEGF and TNF-α to increase in response to HIIE in the T1D group. Both groups consumed more and less than the recommended amounts of protein and fat, respectively. In the T1D group, a tendency for a higher digestible carbohydrate intake and more frequent hyperglycaemic episodes on the day after HIIE were observed. HIIE was effective in reducing T1D patients' glycaemia and improving short-term glycaemic control. HIIE has the potential to improve adaptive response to hypoxia by elevating the serum level of VEGF. Patients' diet and level of physical activity should be screened on a regular basis, and they should be educated on the glycaemic effects of digestible carbohydrates.

The imperative of arachidonic acid in early human development.

This review is about the role of arachidonic acid (ArA) in foetal and early growth and development. In 1975 and '76, we reported the preferential incorporation of ArA into the developing brain of rat pups, its conservation as a principal component in the brains of 32 mammalian species and the high proportion delivered by the human placenta for foetal nutrition, compared to its parent linoleic acid (LA). ArA is quantitatively the principal acyl component of membrane lipids from foetal red cells, mononuclear cells, astrocytes, endothelium, and placenta. Functionally, we present evidence that ArA, but not DHA, relaxes the foetal mesenteric arteries. The placenta biomagnifies ArA, doubling the proportion of the maternal level in cord blood. The proportions of ArA and its allies (di-homo-gamma-linolenic acid (DGLA), adrenic acid and ω6 docosapentaenoic acid) are similar or higher than the total of ω3 fatty acids in human milk, maintaining the abundant supply to the developing infant. Despite the evidence of the importance of ArA, the European Food Standard Agency, in 2014 rejected the joint FAO and WHO recommendation on the inclusion of ArA in infant formula, although they recommended DHA. The almost universal dominance of ArA in the membrane phosphoglycerides during human organogenesis and prenatal growth suggests that the importance of ArA and its allies in reproductive biology needs to be re-evaluated urgently.

Handcycling Training in Men with Spinal Cord Injury Increases Tolerance To High Intensity Exercise.

Individuals with spinal cord injury are characterised by reduced physical capacity as compared to able-bodied persons, and are at risk of developing cardiovascular disease. The study aimed to evaluate the differences in physiological responses to an exercise test in handcycling-trained vs. able-bodied-trained and non-trained men. Eight males with spinal cord injury who were trained in handcycling, eighteen able-bodied males who were trained in powerlifting, and fourteen physically active non-athletes performed a graded arm crank ergometer test. The following physiological indices were measured before and during the test: heart rate, oxygen uptake, and blood lactate concentrations. Aerobic capacity was significantly higher in athletes with spinal cord injury compared to able-bodied athletes (p<0.01) and the control group (p<0.01). The heart rate achieved by handcycling-trained athletes was significantly lower as compared to powerlifters (p<0.01), however, the oxygen pulse was significantly higher (p<0.05). Handcycling-trained athletes reached significantly higher peak power (Pmax) during the graded arm exercise in comparison with powerlifters, and significantly higher post exercise blood lactate concentration (p<0.05). The lactate threshold was observed at a significantly higher P in individuals with spinal cord injury compared to able-bodied-trained (p<0.05) and non-trained men (p<0.001). Athletes with spinal cord injury were found to have excellent aerobic capacity and better physiological adaptation to the maximal graded exercise test as compared to able-bodied-trained men. These findings emphasize the importance of regular physical exercise and its potential therapeutic role in the prevention of cardiovascular disease in patients with spinal cord injury.

Fungicide resistance characterized across seven modes of action in Botrytis cinerea isolated from Australian vineyards.

BACKGROUND: Botrytis bunch rot, caused by Botrytis cinerea, is an economically important disease of grapes in Australia and across grape-growing regions worldwide. Control of this disease relies on canopy management and the application of fungicides. Fungicide application can lead to the selection of resistant B. cinerea populations, which has an adverse effect on the management of the disease. Characterizing the distribution and severity of resistant B. cinerea populations is needed to inform resistance management strategies. RESULTS: In this study, 724 isolates were sampled from 76 Australian vineyards during 2013-2016 and were screened against seven fungicides with different modes of action (MOAs). The resistance frequencies for azoxystrobin, boscalid, fenhexamid, fludioxonil, iprodione, pyrimethanil and tebuconazole were 5%, 2.8%, 2.1%, 6.2%, 11.6%, 7.7% and 2.9%, respectively. Nearly half of the resistant isolates (43.8%) were resistant to more than one of the fungicides tested. The frequency of vineyards with at least one isolate simultaneously resistant to one, two, three, four or five fungicides was 19.7%, 7.9%, 6.6%, 10.5% and 2.6%. Resistance was associated with previously published genotypes in CytB (G143A), SdhB (H272R/Y), Erg27 (F412S), Mrr1 (D354Y), Bos1 (I365S, N373S + Q369P, I365S + D757N) and Pos5 (V273I, P319A, L412F/V). Novel genotypes were also described in Mrr1 (S611N, D616G), Pos5 (V273L) and Cyp51 (P347S). Expression analysis was used to characterize fludioxonil-resistant isolates exhibiting overexpression (6.3-9.6-fold) of the ABC transporter gene AtrB (MDR1 phenotype). CONCLUSION: Resistance frequencies were lower when compared to most previously published surveys of B. cinerea resistance in grape and other crops. Nevertheless, continued monitoring of critical MOAs used in Australian vineyards is recommended. © 2021 Society of Chemical Industry.

The Effect of Omega-3 Fatty Acid Supplementation on Serum Adipocytokines, Lipid Profile and Biochemical Markers of Inflammation in Recreational Runners.

BACKGROUND: The study aimed to evaluate the effects of a 3-week ω-3 PUFA supplementation on serum adipocytokines (i.e., adiponectin, leptin), neuregulin-4 (NRG4) and erythrocyte omega-3 (ω-3) fatty acid content, as well as the blood antioxidant defense capacity in non-elite endurance runners. METHODS: Twenty-four runners were randomized into two groups: the supplemented group, who received omega free fatty acids extract containing 142 mg of EPA, 267 mg of DHA, 12 mg of vitamin E and 5 µg of vitamin D, each administrated at a dose of six capsules twice a day for three weeks, or the placebo group. Venous blood samples were withdrawn at the start and at the end of the study protocols to estimate serum biochemical variables. RESULTS: A significantly higher ω-3 index and lower AA/EPA ratio was observed after ω-3 PUFA compared to pre-supplementation levels (p < 0.001 and p < 0.001, respectively). An increase in baseline adiponectin and NRG4 levels, as well as a decrease of leptin concentration and lipid profile improvement, were observed in subjects after a ω-3 PUFA diet. The increased ω-3 index had a significant effect on TNFα levels and a serum marker of antioxidant defense. CONCLUSIONS: The ω-3 PUFA extract with added vitamin E and D supplementation may have a positive effect on the function of the adipocyte tissue, as well as the ability to prevent cardiovascular complications in athletes.

Changes in the levels of indoleamine phytochemicals during véraison and ripening of wine grapes.

Melatonin and serotonin have previously been described in mature wine grapes and finished wines, but the metabolism of these signalling molecules in the development of wine grapes has not previously been investigated. We harvested wine grapes at different stages of development from lag phase through véraison from eight different commercial vineyards representing a diversity of growing conditions, management practices, merlot varietals and localized ecosystems to determine whether different patterns in melatonin and serotonin can be found in wine grapes during seed development and berry maturation. Melatonin was detected in 45% of the fully developed purple, postvéraison grapes but only found in 23% of prelag phase samples. However, the actual concentration of melatonin was highest in wine grapes harvested at the early stage of véraison when the seed is developing. Serotonin was not detected in any of the prelag phase grapes but was consistently detected in 30-35% of grapes harvested during the véraison transition at consistent levels of about 8-10 mug/g. Interestingly, the nitrogen storage compound gamma-aminobutyric acid was also found at about 115 mug/g in 77% of early stage green grapes and declined in both prevalence and concentration with ripening. Together, these data are indicative of a potential role for these molecules in the development and maturation of wine grapes.

Comparing three postoperative treatment protocols for extensor tendon repair in zones V and VI of the hand.

OBJECTIVE: This pilot study compared the effectiveness of 3 postoperative rehabilitation protocols for patients with Zones V and VI extensor tendon lacerations. METHOD: Twenty-seven patients were recruited from 3 sites and randomly assigned to 1 of 3 established treatment protocols: immobilization, early passive motion (EPM), and early active motion (EAM). Outcome measures were collected at 3, 6, and 12 wk after treatment and included total active motion (TAM). RESULTS: At the end of Week 12, data on 24 injured digits of 18 patients were available for analysis. When data at Weeks 3, 6, and 12 were compared, patients in all groups showed steady improvement in TAM, but digits under the EAM treatment improved to a greater extent over time (F[2, 46] = 75.6, p < .001). CONCLUSION: Patients with Zones V and VI extensor tendon injuries treated with the EAM protocol recovered range of motion more rapidly.

Bereavement debriefing sessions: an intervention to support health care professionals in managing their grief after the death of a patient.

Health care professionals experience grief when caring for children with life-threatening conditions. Harriet Lane Compassionate Care, the pediatric palliative care program of the Johns Hopkins Children's Center, created an action plan to support health care professionals; one intervention-- the bereavement debriefing session - was specifically aimed at providing emotional support and increasing one's ability to manage grief. A structured format for conducting bereavement debriefing sessions was developed, and 113 sessions were held in a three-year period; data were collected to capture themes discussed. Bereavement debriefing sessions were conducted most frequently after unexpected deaths or deaths of long-term patients. Though attendance included all disciplines, nurses attended the sessions most often. Self-report evaluation forms revealed that health care professionals found the sessions helpful. Bereavement debriefing sessions can be one aspect of an effective approach to supporting health care professionals in managing their grief in caring for children with life-threatening conditions.

Moderate intensity exercise in hypoxia increases IGF-1 bioavailability and serum irisin in individuals with type 1 diabetes.

AIM: This study aimed to determine the effect of moderate intensity continuous exercise (Ex) and hypoxia (Hyp) on serum brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1) and its binding protein-3 (IGFBP-3), irisin and cytokines levels in patients with type 1 diabetes (T1D). METHODS: A total of 14 individuals with T1D (age: 28.7 ± 7.3 years) and 14 healthy adults (age: 27.1 ± 3.9 years) performed 40-min continuous Ex at moderate intensity (50% lactate threshold) on a cycle ergometer in normoxia (Nor) and Hyp (FiO2 = 15.1%) Biochemical factors, glucose concentrations and physiological variables were measured at rest, immediately and up to 24 h after both Ex protocols. RESULTS: Patients with T1D had significantly lower pre-Ex serum concentrations of BDNF (p < 0.05, p < 0.01), and total IGF-1 (p < 0.001, p < 0.05) and significantly higher irisin levels (p < 0.05, p < 0.01) in Nor and Hyp, compared with healthy subjects. Ex significantly increased in T1D group serum BDNF (in Nor only p < 0.05) and total IGF-1 levels in Nor and Hyp (p < 0.001 and p < 0.01, respectively). Immediately after Ex in Hyp, freeIGF-1 (p < 0.05) and irisin levels (p < 0.001) were significantly higher compared with the levels induced by Ex alone. Free IGF-1 and irisin serum levels remained elevated in 24 h post-Ex in Hyp. In T1D, significant blood glucose (BG) decrease was observed immediately after Ex in Hyp (p < 0.001) and in 24 h recovery (p < 0.001) compared with pre-Ex level. CONCLUSION: The study results suggest that moderate intensity continuous Ex has beneficial effect on BDNF and IGF-1 levels. Ex in hypoxic conditions may be more effective in increasing availability of IGF-1. The alterations in the post-Ex irisin levels and IGF-1 system may be contributing to more effective glycaemia control in patients with T1D.

Inclusion and Quality of Life for Older Adults: Nurses Advocating for Policy Change.

Social inclusion and social determinants of health (SDH) are key to healthy aging, and a failure to adequately address these influences can lead to negative health consequences such as the development and worsening of chronic conditions. Health policy is needed that prioritizes aging well in place as an "upstream" approach to address SDH and thereby improve health outcomes and promote quality of life. Globally, nurses are well positioned to advocate for such policy, given their commitment to fostering social inclusion and quality of life for older adults. This article presents a policy submission, made by nurses enrolled in a graduate health policy course, to Canada's Standing Committee on Human Resources and Social Development and the Status of Persons with Disabilities, for the Committee's report on Advancing Inclusion of and Quality of Life for Seniors ().

Comparative antibacterial activities of neutral electrolyzed oxidizing water and other chlorine-based sanitizers.

There is increasing demand for safe and effective sanitizers for irrigation water disinfection to prevent transmission of foodborne pathogens to fresh produce. Here we compared the efficacy of pH-neutral electrolyzed oxidizing water (EOW), sodium hypochlorite (NaClO) and chlorine dioxide (ClO2) against single and mixed populations of E. coli, Listeria and Salmonella under a range of pH and organic matter content. EOW treatment of the mixed bacterial suspension resulted in a dose-dependent (<1 mg/L free chlorine), rapid (<2 min) and effective (4-6 Log10) reduction of the microbial load in water devoid of organic matter under the range of pH conditions tested (pH, 6.0, 7.0, 8.4 and 9.2). The efficacy of EOW containing 5 mg/L free chlorine was unaffected by increasing organic matter, and compared favourably with equivalent concentrations of NaClO and ClO2. EOW at 20 mg/L free chlorine was more effective than NaClO and ClO2 in reducing bacterial populations in the presence of high (20-100 mg/L) dissolved organic carbon, and no regrowth or metabolic activity was observed for EOW-treated bacteria at this concentration upon reculturing in rich media. Thus, EOW is as effective or more effective than other common chlorine-based sanitizers for pathogen reduction in contaminated water. EOW's other characteristics, such as neutral pH and ease of handling, indicate its suitability for fresh produce sanitation.

A review of critical factors in the conduct and interpretation of the human repeat insult patch test.

This paper reviews key factors that are critical to the conduct and interpretation of Human Repeat Insult Patch Tests (HRIPTs). A methodology for HRIP testing is described and general guidelines for evaluation of responses indicative of induction and elicitation of skin sensitization and skin irritation are detailed. Understanding and applying these key factors is crucial to the design of such studies and reliability of the resulting data when used in the overall risk assessment process.

The effect of high intensity physical exercise and hypoxia on glycemia, angiogenic biomarkers and cardiorespiratory function in patients with type 1 diabetes.

BACKGROUND: An integral part of the treatment of diabetes is physical activity. Scientific reports have shown the beneficial effects of hypoxia and exercise on cardiovascular and metabolic variables in patients with diabetes. OBJECTIVES: The aim of the study was to assess the effect of normobaric hypoxia and exercise on the serum concentrations of proangiogenic factors and glycemia in patients with type 1 diabetes. MATERIAL AND METHODS: A total of 28 adults (aged 30.4 years ±9.7 years), suffering from diabetes for 12.1 years ±6.0 years and healthy individuals, participated in the following trials: normoxic (Nor) and hypoxic (Hy) rest and Nor and Hy incremental exercise test (Ex) (FIO2 = 15.2%). The Altitude Trainer Hypoxico System (HYP-123 Hypoxic Generator, LOWOXYGEN Technology GmbH, Berlin, Germany) corresponding to a height of about 2500 m above sea level was used in the study. Exercise tests were performed on a cycle ergometer Excalibur Sport (Lode B.V., Groningen, The Netherlands). Cardiorespiratory variables, glycemia, angiogenic and hematological indices were measured at rest and in response to both exercise protocols. RESULTS: The present data confirmed that the patients with type 1 diabetes demonstrated a good level of aerobic capacity and fitness. NorEx and HyEx resulted in a significant decrease in serum glucose concentration (p < 0.05 vs p < 0.01). Patients with diabetes had higher baseline hypoxia induced factor-1alpha levels compared to healthy adults (p < 0.05), which increased after exposure to hypoxia and hypoxia with exercise (p < 0.001). Hypoxia significantly decreased baseline transforming growth factor-ß (TGF-ß) (p < 0.05) and had a significant effect on tumor necrosis factor-α level (TNF-α) (F = 4.9; p < 0.05). CONCLUSIONS: Our study demonstrated that hypoxia combined with exercise reduces glycemia and may induce significant benefits in the prevention of diabetes cardiovascular complications.

Effects of Hypoxia during Continuous and Intermittent Exercise on Glycaemic Control and Selected Markers of Vascular Function in Type 1 Diabetes.

OBJECTIVES: The aim of the study was to assess the effect of continuous and intermittent exercise in hypoxia on glycaemic control and selected markers of vascular function in patients with Type 1 diabetes (T1D). METHODS: 12 patients suffering from T1D for 12.1±6.0 years and 12 healthy adults performed: continuous exercise (ExC) and intermittent exercise (ExInt) in normoxia and hypoxia (FiO2=15.1%). Glycaemia and proangiogenic factors concentrations were measured at rest and immediately after exercise. RESULTS: T1D patients' glycaemia decreased in response to ExC (p<0.01) and ExInt (p<0.05) under hypoxic conditions. ExInt in normoxia (p<0.05) and hypoxia (p<0.05) reduced HIF-1α in the T1D group. A tendency for vascular endothelial growth factor to increase after ExInt in hypoxia (6.0±3.8 vs. 17.1±13.07 pg/mL) and a proinflammatory cytokine TNF-α level to decrease (33.2±19.1 vs. 25.1±14.4 pg/mL) was found in the same group. CONCLUSIONS: Combining exercise with hypoxia may allow more effective short-term glycaemic control in T1D. Intermittent exercise with hypoxia could stabilize the secretion of selected proangiogenic factors and reduce inflammation, potentially leading to improved vascular function.