Is there a higher frequency of anal dysplasia and infection by human papillomavirus in Crohn's disease patients?

The aim of this study was to compare the frequency of dysplasia and human papillomavirus (HPV) infection in the anal canal of patients with Crohn's disease (CD) with a control group and assess whether there is a correlation between use of immunosuppressants and anal manifestation of CD. Patients with CD and control individuals were submitted to anal cytology and material collection for polymerase chain reaction (PCR). The cytology was classified as normal, atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), or high-grade (HSIL). PCR was considered positive or negative according to virus presence or absence. A total of 117 patients were included (54 in the control group and 63 in the CD group, being 32 without and 31 with immunosuppressants). ASCUS and LSIL were found in 25.9 and 22.2% of control patients and 28.6 and 39.7% of CD patients. HPV was identified in 14.8% of the control group and 27% of the CD group. In CD patients, HPV was found in 37.5 and 16.1% of those without and with immunosuppressants, respectively. Patients with perianal involvement had 15.6% of PCR positivity. There was no statistical difference in dysplasia and infection by HPV between the groups. Use of immunosuppressants did not influence the result, but anal manifestation was inversely proportional to viral detection.

Is there a higher frequency of anal dysplasia and infection by human papillomavirus in Crohn's disease patients?

The aim of this study was to compare the frequency of dysplasia and human papillomavirus (HPV) infection in the anal canal of patients with Crohn's disease (CD) with a control group and assess whether there is a correlation between use of immunosuppressants and anal manifestation of CD. Patients with CD and control individuals were submitted to anal cytology and material collection for polymerase chain reaction (PCR). The cytology was classified as normal, atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), or high-grade (HSIL). PCR was considered positive or negative according to virus presence or absence. A total of 117 patients were included (54 in the control group and 63 in the CD group, being 32 without and 31 with immunosuppressants). ASCUS and LSIL were found in 25.9 and 22.2% of control patients and 28.6 and 39.7% of CD patients. HPV was identified in 14.8% of the control group and 27% of the CD group. In CD patients, HPV was found in 37.5 and 16.1% of those without and with immunosuppressants, respectively. Patients with perianal involvement had 15.6% of PCR positivity. There was no statistical difference in dysplasia and infection by HPV between the groups. Use of immunosuppressants did not influence the result, but anal manifestation was inversely proportional to viral detection.

Beneficial Effects of Ischemic Preconditioning in Resistance Exercise Fade Over Time.

This study evaluated the effect of ischemic preconditioning (IPC) on resistance exercise performance in upper limbs. After 12-RM load determination, 21 men attended 4 trials separated by 3 days in a randomized crossover design: IPC (4×5-min occlusion 220 mmHg/reperfusion 0 mmHg) in arms and in thighs, and SHAM (equal to the IPC protocol but "occlusion" at 20 mmHg) in arms and in thighs. 8 min following the respective interventions, the subjects performed one set of resistance exercise in elbow flexion with the 12-RM load until concentric failure. The number of repetitions increased for both protocols in arm (IPC=14.1±2.5 and SHAM=14.4±3.0) and in thigh (IPC=14.3±2.2 and SHAM=13.4±1.7). However, the number of repetitions tended to decrease over the 4 trials and no more effect was found in the fourth trial. Therefore, IPC or SHAM may enhance performance in resistance exercise for upper limbs, but this effect apparently fades over time.

Cold Water Immersion is Acutely Detrimental but Increases Performance Post-12 h in Rugby Players.

We evaluated the effectiveness of cold water immersion on recovery of performance (i. e., the ability of repetitively performing a physical test) in rugby players acutely and 12 h later. 8 male rugby union players (23±4.7 years; 176.9±4.5 cm; 87.5±8.6 kg) performed a rugby-specific exercise protocol (40 min) followed by recovery strategies: cold water immersion (8.9±0.6°C; 9 min with 1 min out of water, repeated twice) or control (players remained seated for 20 min) in a random order. The players underwent performance tests (countermovement and 30 s continuous jumps and agility T) at 4 time points: at baseline, immediately after rugby-specific exercise, post-recovery strategies and 12 h later. The performance of the agility and countermovement jump test were not different between cold water immersion and control immediately post rugby-specific exercises and 12 h thereafter. However, the 30 s continuous jump test performance decreased immediately but increased 12 h later after cold water immersion compared with control. Perception of recovery was better in the cold water immersion group compared with controls post 12 h exercise. Cold water immersion improves 30 s continuous jump performance, total quality recovery and seems to be an easy and practical tool for coaches and players, especially during congested periods of the season when fast recovery (~12 h) for the following activity is essential.

Myths and Facts About the Effects of Ischemic Preconditioning on Performance.

Although numerous studies have demonstrated the effect of ischemic preconditioning (IPC) in clinical application, the effectiveness of this procedure on performance and physiological variables is still debatable. Therefore a systematic review was performed, including a meta-analysis and evaluation of the quality of the papers that addressed this scope. The electronic databases of the National Library of Medicine (PubMed), Google Scholar (using [advanced search], [all fields]) and other online journals were searched, for the following descriptors: a) "ischemic preconditioning"; b) "blood flow" and "hyperemia"; c) "blood flow occlusion," combined with "exercise performance", "athletes", "exercise" and "performance". Relevant studies were included, if they conformed to strict pre-formulated criteria, excluding systematic review articles, meta-analyses and studies with only animals or non-healthy subjects. The 20 studies included had high quality scores (87%). The majority of the studies lacked statistical significance (P<0.05) for both performance and physiological variables when comparing IPC, placebo and control groups. Most studies showed that IPC has no significant influence on performance. The few studies with significant differences mainly described an improvement only in performance without altered physiological parameters. Therefore, the influence of IPC on performance is still unclear and physiologically highly debatable.

Are the Beneficial Effects of Ischemic Preconditioning on Performance Partly a Placebo Effect?

The acute effect of ischemic preconditioning (IPC) on the maximal performance in the 100-m freestyle event was studied in recreational swimmers. 15 swimmers (21.0±3.2 years) participated in a random crossover model on 3 different days (control [CON], IPC or SHAM), separated by 3-5 days. IPC consisted of 4 cycles of 5-min occlusion (220 mmHg)/5-min reperfusion in each arm, and the SHAM protocol was similar to IPC but with only 20 mmHg during the occlusion phase. The subjects were informed that both maneuvers (IPC and SHAM) would improve their performance. After IPC, CON or SHAM, the volunteers performed a maximal 100-m time trial. IPC improved performance (p=0.036) compared to CON. SHAM performance was only better than CON (p=0.059) as a tendency but did not differ from IPC performance. The individual response of the subjects to the different maneuvers was very heterogeneous. We conclude that IPC may improve performance in recreational swimmers, but this improvement could mainly be a placebo effect.

Acute effect of ischemic preconditioning is detrimental to anaerobic performance in cyclists.

We verified the acute effect of ischemic preconditioning (IPC) in cyclists before high-intensity and short-duration activity. 15 amateur cyclists participated in a random crossover model on 2 different days [IPC or CONTROL (CON)]. Ischemic preconditioning consisted of 4 cycles of 5 min occlusion/5 min reperfusion in each thigh. After IPC or CON, volunteers performed a series of Wingate tests to evaluate anaerobic performance (maximal [Pmax] and medium [Pmed] power output, total anaerobic power, and fatigue index). Blood lactate concentrations were assessed at 6 min after each Wingate test. Ischemic preconditioning decreased Pmax (p<0.05), Pmed (p<0.01), and total anaerobic power (p<0.01) in the first Wingate, and decreased Pmed (p<0.01) and total anaerobic power (p<0.01) in the second Wingate (p<0.01). No significant differences were found in blood lactate or fatigue index between IPC and CON. In conclusion, our results indicate that IPC has a detrimental acute effect on anaerobic performance in amateur cyclists. Compared with positive results of previous studies, the effect of IPC seems to be dependent on the type of exercise.

Detection and typing of human papillomavirus in cutaneous warts of patients infected with human immunodeficiency virus type 1.

BACKGROUND: Cutaneous warts are caused by human papillomavirus (HPV). To date, more than 120 different types of HPV are known, of which 80 have been completely characterized. Prevalence studies on types of HPV present in cutaneous warts have been carried out in immunocompetent individuals and immunosuppressed organ allograft recipients, but not in human immunodeficiency virus (HIV)-positive patients. OBJECTIVES: To determine the HPV types present in cutaneous warts of HIV-infected patients. METHODS: Twenty-five biopsies of cutaneous warts from HIV-infected patients and 14 samples from control non-HIV-infected patients were studied. HPV detection was performed by polymerase chain reaction using two sets of primers: MY09/MY11 and RK91. The type of HPV was determined by restriction fragment length polymorphism analysis and direct sequencing of the amplified products. RESULTS: HPV DNA was detected in 64% of cutaneous warts from HIV-infected patients and in 79% of samples from the control group. The HPV types identified in HIV-infected patients were: HPV 2 (38%), 57 (31%), 27 (12%), 6 (12%) and 7 (6%). HPV 2/27/57 predominated in both groups, being present in 81% of lesions from HIV-infected patients and 82% of samples from non-HIV-infected patients. HPV 6, a genital HPV type rarely found in cutaneous lesions, was detected in two warts from HIV-infected patients and in one lesion of the immunocompetent group. HPV 7, characteristically associated with butcher's warts, and recently detected in oral and perioral lesions of HIV-infected patients, was found for the first time in a non-facial lesion of an HIV-infected patient. CONCLUSIONS: This is the first study evaluating the prevalence of HPV types in cutaneous warts of HIV-infected patients and immunocompetent individuals in Brazil.