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1.
Nutrients ; 16(2)2024 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-38257136

RESUMO

Elite football is associated with the increased risk of illness, although targeted supplementation can reduce illness risk. This study assessed the effects of a supplement containing turmeric root within a black pepper and fat-soluble blend, vitamin C and vitamin D, on upper respiratory symptoms (URS), gastrointestinal symptoms (GIS), muscle soreness, and markers of inflammation and gut permeability in elite male footballers. Twenty-three footballers completed 3 weeks of no intervention (CON), followed by 16 weeks of daily consuming 60 mL of a commercially available supplement containing raw turmeric root (17.5 g, estimated to contain 700 mg of curcumin), vitamin C (1000 mg), and vitamin D3 (3000 IU/75 mcg) (SUP). URS and GIS were measured daily. Immediately (0 h), 40, and 64 h after six competitive matches (two in CON, four in SUP), the subjective soreness and plasma concentrations of creatine kinase [CK], c-reactive protein [CRP], and intestinal fatty-acid binding protein [I-FABP] were assessed. URS incidence (p < 0.001), GIS (p < 0.05), and plasma [I-FABP] at 0 h (p < 0.05) were greater during CON versus SUP. At 40 h, [CRP] was greater than 0 h during CON (p < 0.01) but not SUP (p = 0.204). There were no differences in soreness or [CK]. This study indicates that turmeric root, vitamin C, and vitamin D supplementation over 16 weeks can reduce URS, GIS, and post-match [I-FABP] in elite footballers.


Assuntos
Ácido Ascórbico , Futebol Americano , Curcuma , Vitaminas , Suplementos Nutricionais , Vitamina D , Proteína C-Reativa , Creatina Quinase
2.
Artigo em Inglês | MEDLINE | ID: mdl-37877059

RESUMO

Left Ventricular Non-Compaction Cardiomyopathy (LVNC) is a rare myocardial disorder characterized by abnormal myocardial tissue formation in which the left ventricular wall appears to be trabecular with prominent intertrabecular recesses. The diagnosis of LVNC is predominantly reliant on cardiac imaging, namely thoracic echocardiography, however, cardiac MRI is indicated in conditions in which echocardiography is inconclusive. Diagnostic criteria for both echocardiography and cardiac MRI differ, however, the general principle of diagnosis is a comparison of the thickness of non-compacted to compacted myocardial tissue. The management of LVNC is nearly identical to that of Heart Failure with reduced Ejection Fraction (HFrEF), however, anticoagulation is an additional measure of management to the thrombogenic nature of non-compacted myocardial tissue. Here, we discuss a case of LVNC and the current data on its management.

3.
Cochrane Database Syst Rev ; 9: CD015236, 2023 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-37753791

RESUMO

BACKGROUND: Cystic fibrosis (CF) is a multisystem disease; the importance of growth and nutritional status is well established given their implications for lung function and overall survivability. Furthermore, it has been established that intestinal microbial imbalance and inflammation are present in people with CF. Oral prebiotics are commercially available substrates that are selectively utilised by host intestinal micro-organisms and may improve both intestinal and overall health. OBJECTIVES: To evaluate the benefits and harms of prebiotics for improving health outcomes in children and adults with CF. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis Trials Register compiled from electronic database searches and handsearching of journals and conference abstract books. We also searched the reference lists of relevant articles and reviews. Date of last search: 19 October 2022. We also searched PubMed and online trials registries. Date of last search: 13 January 2023. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs assessing the efficacy of prebiotics in children and adults with CF. We planned to only include the first treatment period from cross-over RCTs, regardless of washout period. DATA COLLECTION AND ANALYSIS: We did not identify any relevant trials. MAIN RESULTS: We did not identify any relevant trials for inclusion in this review. AUTHORS' CONCLUSIONS: This review did not find any evidence for the use of prebiotics in people with CF. Until such evidence is available, it is reasonable for clinicians to follow any local guidelines and to discuss the use of dietary prebiotics with their patients. Large and robust RCTs assessing the dietary prebiotics of inulin or galacto-oligosaccharides or fructo-oligosaccharides, or any combination of these, are needed. Such studies should be of at least 12 months in duration and assess outcomes such as growth and nutrition, gastrointestinal symptoms, pulmonary exacerbations, lung function, inflammatory biomarkers, hospitalisations, intestinal microbial profiling, and faecal short-chain fatty acids. Trials should include both children and adults and aim to be adequately powered to allow for subgroup analysis by age.


Assuntos
Fibrose Cística , Adulto , Criança , Humanos , Fezes , Hospitalização , Inflamação , Estado Nutricional , Prebióticos
4.
JACS Au ; 3(3): 879-888, 2023 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-37006778

RESUMO

Selenium (Se) has become an environmental contaminant of aquatic ecosystems as a result of human activities, particularly mining, fossil fuel combustion, and agricultural activities. By leveraging the high sulfate concentrations relative to Se oxyanions (i.e., SeO n 2-, n = 3, 4) present in some wastewaters, we have developed an efficient approach to Se-oxyanion removal by cocrystallization with bisiminoguanidinium (BIG) ligands that form crystalline sulfate/selenate solid solutions. The crystallization of the sulfate, selenate and selenite, oxyanions and of sulfate/selenate mixtures with five candidate BIG ligands are reported along with the thermodynamics of crystallization and aqueous solubilities. Oxyanion removal experiments with the top two performing candidate ligands show a near quantitative removal (>99%) of sulfate or selenate from solution. When both sulfate and selenate are present, there is near quantitative removal (>99%) of selenate, down to sub-ppb Se levels, with no discrimination between the two oxyanions during cocrystallization. Reducing the selenate concentrations by 3 orders of magnitude or more relative to sulfate, as found in many wastewaters, led to no measurable loss in Se removal efficiencies. This work offers a simple and effective alternative to selective separation of trace amounts of highly toxic selenate oxyanions from wastewaters, to meet stringent regulatory discharge limits.

6.
Scand J Med Sci Sports ; 33(7): 1221-1230, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37051807

RESUMO

INTRODUCTION: Exercise-induced bronchoconstriction (EIB) is not only highly prevalent in people with asthma, but can also occur independently, particularly in athletes. Fractional exhaled nitric oxide (FeNO) is an indirect biomarker of type 2 airway inflammation that has an established role in the assessment and management of asthma. The aim was to evaluate the value of FeNO in the assessment of EIB in athletes. METHOD: Multicenter retrospective analysis. In total, 488 athletes (male: 76%) performed baseline FeNO, and spirometry pre- and post-indirect bronchial provocation via eucapnic voluntary hyperpnea (EVH). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for established FeNO thresholds-that is, intermediate (≥25 ppb) and high FeNO (≥40 ppb and ≥ 50 ppb)-and were evaluated against objective evidence of EIB (≥10% fall in FEV1 ). The diagnostic accuracy of FeNO was calculated using receiver operating characteristics area under the curve (ROC-AUC). RESULTS: Thirty-nine percent of the athletes had a post-EVH fall in FEV1 consistent with EIB. FeNO values ≥25 ppb, ≥40 ppb, and ≥ 50 ppb were observed in 42%, 23%, and 17% of the cohort, respectively. The sensitivity of FeNO ≥25 ppb was 55%, which decreased to 37% and 27% at ≥40 ppb and ≥ 50 ppb, respectively. The specificity of FeNO ≥25 ppb, ≥40 ppb, and ≥ 50 ppb was 66%, 86%, and 89%, respectively. The ROC-AUC for FeNO was 0.656. CONCLUSIONS: FeNO ≥40 ppb provides good specificity, that is, the ability to rule-in a diagnosis of EIB. However, due to the poor sensitivity and predictive values, FeNO should not be employed as a replacement for indirect bronchial provocation in athletes.


Assuntos
Asma , Broncoconstrição , Humanos , Masculino , Teste da Fração de Óxido Nítrico Exalado , Testes de Provocação Brônquica , Estudos Retrospectivos , Óxido Nítrico , Testes Respiratórios , Atletas , Reino Unido
7.
Eur J Appl Physiol ; 123(8): 1599-1625, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36917254

RESUMO

Respiratory function has become a global health priority. Not only is chronic respiratory disease a leading cause of worldwide morbidity and mortality, but the COVID-19 pandemic has heightened attention on respiratory health and the means of enhancing it. Subsequently, and inevitably, the respiratory system has become a target of the multi-trillion-dollar health and wellness industry. Numerous commercial, respiratory-related interventions are now coupled to therapeutic and/or ergogenic claims that vary in their plausibility: from the reasonable to the absurd. Moreover, legitimate and illegitimate claims are often conflated in a wellness space that lacks regulation. The abundance of interventions, the range of potential therapeutic targets in the respiratory system, and the wealth of research that varies in quality, all confound the ability for health and exercise professionals to make informed risk-to-benefit assessments with their patients and clients. This review focuses on numerous commercial interventions that purport to improve respiratory health, including nasal dilators, nasal breathing, and systematized breathing interventions (such as pursed-lips breathing), respiratory muscle training, canned oxygen, nutritional supplements, and inhaled L-menthol. For each intervention we describe the premise, examine the plausibility, and systematically contrast commercial claims against the published literature. The overarching aim is to assist health and exercise professionals to distinguish science from pseudoscience and make pragmatic and safe risk-to-benefit decisions.


Assuntos
COVID-19 , Doença Pulmonar Obstrutiva Crônica , Humanos , Pandemias , Pseudociência , Exercícios Respiratórios
8.
Front Allergy ; 3: 994947, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36249343

RESUMO

Introduction: Exercise-induced bronchoconstriction (EIB) is a prevalent condition in athletes. EIB screening studies identify many athletes with undiagnosed EIB. Moreover, there is a poor relationship between EIB and dyspnea symptoms recalled from memory. Purpose: This study investigated: (I) the prevalence of EIB in British university field hockey athletes; (II) the effect of sex and diagnostic criteria on EIB prevalence; and (III) the association between EIB and contemporaneous dyspnea symptoms. Methods: 52 field hockey athletes (age: 20 ± 2 years; height: 173 ± 9 cm; body mass: 72 ± 10 kg; male = 31; female = 22) completed a eucapnic voluntary hyperpnea (EVH) test with multi-dimensional dyspnea scores measured 3-10 mins post-EVH. A test was deemed positive (EIB+) if a fall index (FI) ≥10% in FEV1 occurred at two consecutive time points post-test (FIATS). Two further criteria were used to assess the effect of diagnostic criteria on prevalence: FI≥10%, determined by a pre-to-post-EVH fall in FEV1 of ≥10% at any single time-point; and FI≥10%-NORM calculated as FI≥10% but with the fall in FEV1 normalized to the mean ventilation achieved during EVH. Results: EIB prevalence was 19% and greater in males (30%) than females (5%). In EIB+ athletes, 66% did not have a previous diagnosis of EIB or asthma and were untreated. Prevalence was significantly influenced by diagnostic criteria (P = 0.002) ranging from 19% (FIATS) to 38% (FI≥10%-NORM). Dyspnea symptoms were higher in EIB+ athletes (P ≤ 0.031), produced significant area under the curve for receive operator characteristics (AUC ≥ 0.778, P ≤ 0.011) and had high negative prediction values (≥96%). Conclusion: Overall, 19% of university field hockey athletes had EIB, and most were previously undiagnosed and untreated. EVH test diagnostic criteria significantly influences prevalence rates, thus future studies should adopt the ATS criteria (FIATS). Contemporaneous dyspnea symptoms were associated with bronchoconstriction and had high negative prediction values. Therefore, contemporaneous dyspnea scores may provide a useful tool in excluding a diagnosis of EIB.

9.
Age Ageing ; 51(8)2022 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-35932242

RESUMO

BACKGROUND: falls are common in older people, but associations between falls, dementia and frailty are relatively unknown. The impact of the COVID-19 pandemic on falls admissions has not been studied. AIM: to investigate the impact of dementia, frailty, deprivation, previous falls and the differences between years for falls resulting in an emergency department (ED) or hospital admission. STUDY DESIGN: longitudinal cross-sectional observational study. SETTING: older people (aged 65+) resident in Wales between 1 January 2010 and 31 December 2020. METHODS: we created a binary (yes/no) indicator for a fall resulting in an attendance to an ED, hospital or both, per person, per year. We analysed the outcomes using multilevel logistic and multinomial models. RESULTS: we analysed a total of 5,141,244 person years of data from 781,081 individuals. Fall admission rates were highest in 2012 (4.27%) and lowest in 2020 (4.27%). We found an increased odds ratio (OR [95% confidence interval]) of a fall admission for age (1.05 [1.05, 1.05] per year of age), people with dementia (2.03 [2.00, 2.06]) and people who had a previous fall (2.55 [2.51, 2.60]). Compared with fit individuals, those with frailty had ORs of 1.60 [1.58, 1.62], 2.24 [2.21, 2.28] and 2.94 [2.89, 3.00] for mild, moderate and severe frailty respectively. Reduced odds were observed for males (0.73 [0.73, 0.74]) and less deprived areas; most deprived compared with least OR 0.75 [0.74, 0.76]. CONCLUSIONS: falls prevention should be targeted to those at highest risk, and investigations into the reduction in admissions in 2020 is warranted.


Assuntos
COVID-19 , Demência , Fragilidade , Idoso , COVID-19/epidemiologia , Estudos Transversais , Demência/diagnóstico , Demência/epidemiologia , Serviço Hospitalar de Emergência , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Hospitais , Humanos , Masculino , Pandemias , Reino Unido/epidemiologia , País de Gales/epidemiologia
10.
J Investig Med High Impact Case Rep ; 10: 23247096221101858, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35608025

RESUMO

Clival osteomyelitis is a potentially life-threatening skull base infection. It is rare and generally challenging to diagnose and treat. Clival osteomyelitis is typically seen in the pediatric population and is very rare in the adult population. It occurs as a complication of recurring paranasal infections and malignant otitis externa. The exact pathophysiology of osteomyelitis of the clivus is relatively uncertain. Here, we describe a case of a 36-year-old man with medical history significant for hypertension and poorly controlled type 1 diabetes mellitus who experienced recurrent paranasal sinus infection for 2 years. He received multiple antibiotic treatments and underwent adenoidectomy without substantial improvement of symptoms. Ultimately, a diagnosis of the clival osteomyelitis through the help of a computed tomography (CT) scan of the paranasal sinus and neck was made. This diagnosis allowed for adequate intervention and treatment of our patient with subsequent resolution of his presenting symptoms. This case highlights the importance of high suspicion for clival osteomyelitis in patients with recurring sinus infections.


Assuntos
Osteomielite , Otite Externa , Adulto , Criança , Fossa Craniana Posterior , Humanos , Masculino , Osteomielite/diagnóstico , Otite Externa/complicações , Otite Externa/diagnóstico , Otite Externa/patologia , Base do Crânio/diagnóstico por imagem , Base do Crânio/patologia , Tomografia Computadorizada por Raios X
11.
Age Ageing ; 51(1)2022 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-34673925

RESUMO

BACKGROUND: falls are common in older people, but evidence for the effectiveness of preventative home adaptations is limited. AIM: determine whether a national home adaptation service, Care&Repair Cymru (C&RC), identified individuals at risk of falls occurring at home and reduced the likelihood of falls. STUDY DESIGN: retrospective longitudinal controlled non-randomised intervention cohort study. SETTING: our cohort consisted of 657,536 individuals aged 60+ living in Wales (UK) between 1 January 2010 and 31 December 2017. About 123,729 individuals received a home adaptation service. METHODS: we created a dataset with up to 41 quarterly observations per person. For each quarter, we observed if a fall occurred at home that resulted in either an emergency department or an emergency hospital admission. We analysed the data using multilevel logistic regression. RESULTS: compared to the control group, C&RC clients had higher odds of falling, with an odds ratio (OR [95% confidence interval]) of 1.93 [1.87, 2.00]. Falls odds was higher for females (1.44 [1.42, 1.46]), older age (1.07 [1.07, 1.07]), increased frailty (mild 1.57 [1.55, 1.60], moderate 2.31 [2.26, 2.35], severe 3.05 [2.96, 3.13]), and deprivation (most deprived compared to least: 1.16 [1.13, 1.19]). Client fall odds decreased post-intervention; OR 0.97 [0.96, 0.97] per quarter. Regional variation existed for falls (5.8%), with most variation at the individual level (31.3%). CONCLUSIONS: C&RC identified people more likely to have an emergency fall admission occurring at home, and their service reduced the odds of falling post-intervention. Service provisioning should meet the needs of an individual and need varies by personal and regional circumstance.


Assuntos
Acidentes por Quedas , Hospitalização , Acidentes por Quedas/prevenção & controle , Idoso , Estudos de Coortes , Feminino , Humanos , Estudos Retrospectivos , País de Gales/epidemiologia
12.
Clin Sci (Lond) ; 135(24): 2729-2748, 2021 12 22.
Artigo em Inglês | MEDLINE | ID: mdl-34918742

RESUMO

Low-grade inflammation is often an underlying cause of several chronic diseases such as asthma, obesity, cardiovascular disease, and type 2 diabetes mellitus (T2DM). Defining the mediators of such chronic low-grade inflammation often appears dependent on which disease is being investigated. However, downstream systemic inflammatory cytokine responses in these diseases often overlap, noting there is no doubt more than one factor at play to heighten the inflammatory response. Furthermore, it is increasingly believed that diet and an altered gut microbiota may play an important role in the pathology of such diverse diseases. More specifically, the inflammatory mediator endotoxin, which is a complex lipopolysaccharide (LPS) derived from the outer membrane cell wall of Gram-negative bacteria and is abundant within the gut microbiota, and may play a direct role alongside inhaled allergens in eliciting an inflammatory response in asthma. Endotoxin has immunogenic effects and is sufficiently microscopic to traverse the gut mucosa and enter the systemic circulation to act as a mediator of chronic low-grade inflammation in disease. Whilst the role of endotoxin has been considered in conditions of obesity, cardiovascular disease and T2DM, endotoxin as an inflammatory trigger in asthma is less well understood. This review has sought to examine the current evidence for the role of endotoxin in asthma, and whether the gut microbiota could be a dietary target to improve disease management. This may expand our understanding of endotoxin as a mediator of further low-grade inflammatory diseases, and how endotoxin may represent yet another insult to add to injury.


Assuntos
Asma/etiologia , Endotoxinas , Inflamação/fisiopatologia , Adipocinas , Asma/fisiopatologia , Dieta/efeitos adversos , Microbioma Gastrointestinal , Humanos , Obesidade
13.
Cureus ; 13(8): e17346, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34567887

RESUMO

Infective endocarditis (IE) secondary to Staphylococcus aureus and streptococcus species comprises the majority of cases in literature with Gram negative bacterial insults occurring infrequently. Serratia marcescens is a Gram negative bacillus which is classified as motile, non-lactose fermenting, and a facultative anerobe. The presumed risk factor for the development of S. marcescens IE is intravenous drug use (IVDU). We report two cases of IE causes by S. marcescens: first case describes IE of tricuspid and aortic valve requiring surgical intervention further complicated by epidural abscess. The second case was associated with renal and splenic infarct. These cases highlight the severity and complicated nature of S. marcescens IE. Given S. marcescens IE has been infrequently described in the literature, we believe that our cases are worth reporting to contribute to the present incidence and management of S. marcescens IE.

14.
JMIR Aging ; 4(2): e24728, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33890864

RESUMO

BACKGROUND: Falls in older people commonly occur at home. Home assessment and modification (HAM) interventions can be effective in reducing falls; however, there are some concerns over the validity of evaluation findings. Routinely collected data could improve the quality of HAM evaluations and strengthen their evidence base. OBJECTIVE: The aim of this study is to conduct a systematic review of the evidence of the use of routinely collected data in the evaluations of HAM interventions. METHODS: We searched the following databases from inception until January 31, 2020: PubMed, Ovid, CINAHL, OpenGrey, CENTRAL, LILACS, and Web of Knowledge. Eligible studies were those evaluating HAMs designed to reduce falls involving participants aged 60 years or more. We included study protocols and full reports. Bias was assessed using the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I) tool. RESULTS: A total of 7 eligible studies were identified in 8 papers. Government organizations provided the majority of data across studies, with health care providers and third-sector organizations also providing data. Studies used a range of demographic, clinical and health, and administrative data. The purpose of using routinely collected data spanned recruiting and creating a sample, stratification, generating independent variables or covariates, and measuring key study-related outcomes. Nonhome-based modification interventions (eg, in nursing homes) using routinely collected data were not included in this study. We included two protocols, which meant that the results of those studies were not available. MeSH headings were excluded from the PubMed search because of a reduction in specificity. This means that some studies that met the inclusion criteria may not have been identified. CONCLUSIONS: Routine data can be used successfully in many aspects of HAM evaluations and can reduce biases and improve other important design considerations. However, the use of these data in these studies is currently not widespread. There are a number of governance barriers to be overcome to allow these types of linkage and to ensure that the use of routinely collected data in evaluations of HAM interventions is exploited to its full potential.

15.
Med Sci Sports Exerc ; 53(7): 1482-1494, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33481485

RESUMO

INTRODUCTION: The ergogenic effects of respiratory alkalosis induced by prior voluntary hyperventilation (VH) are controversial. This study examined the effects of prior VH on derived parameters from the 3-min all-out cycling test (3MT). METHODS: Eleven men ( = 46 ± 8 mL·kg-1·min-1) performed a 3MT preceded by 15 min of rest (CONT) or VH ( = 38 ± 5 L·min-1) with PETCO2 reduced to 21 ± 1 mm Hg (HYP). End-test power (EP; synonymous with critical power) was calculated as the mean power output over the last 30 s of the 3MT, and the work done above EP (WEP; synonymous with W') was calculated as the power-time integral above EP. RESULTS: At the start of the 3MT, capillary blood PCO2 and [H+] were lower in HYP (25.2 ± 3.0 mm Hg, 27.1 ± 2.6 nmol·L-1) than CONT (43.2 ± 2.0 mm Hg, 40.0 ± 1.5 nmol·L-1) (P < 0.001). At the end of the 3MT, blood PCO2 was still lower in HYP (35.7 ± 5.4 mm Hg) than CONT (40.6 ± 5.0 mm Hg) (P < 0.001). WEP was 10% higher in HYP (19.4 ± 7.0 kJ) than CONT (17.6 ± 6.4 kJ) (P = 0.006), whereas EP was 5% lower in HYP (246 ± 69 W) than CONT (260 ± 74 W) (P = 0.007). The ΔWEP (J·kg-1) between CONT and HYP correlated positively with the PCO2 immediately before the 3MT in HYP (r = 0.77, P = 0.006). CONCLUSION: These findings suggest that acid-base changes elicited by prior VH increase WEP but decrease EP during the all-out 3MT.


Assuntos
Teste de Esforço/normas , Hiperventilação , Consumo de Oxigênio/fisiologia , Adulto , Voluntários Saudáveis , Humanos , Masculino , Adulto Jovem
16.
Age Ageing ; 49(6): 1056-1061, 2020 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-32946551

RESUMO

BACKGROUND: home advice and modification interventions aim to promote independent living for those living in the community, but quantitative evidence of their effectiveness is limited. AIM: assess the risk of care home admissions for people with different frailty levels receiving home advice and modification interventions against a control group who do not. STUDY DESIGN AND SETTING: matched control evaluation using linked longitudinal data from the Secure Anonymised Information Linkage (SAIL) Databank, comprising people aged 60-95, registered with a SAIL contributing general practice. The intervention group received the Care & Repair Cymru (C & RC) service, a home advice and modification service available to residents in Wales. METHODS: frailty, age and gender were used in propensity score matching to assess the Hazard Ratio (HR) of care home admissions within a 1-, 3- and 5-year period for the intervention group (N = 93,863) compared to a matched control group (N = 93,863). Kaplan-Meier curves were used to investigate time to a care home admission. RESULTS: the intervention group had an increased risk of a care home admission at 1-, 3- and 5-years [HR (95%CI)] for those classified as fit [1-year: 2.02 (1.73, 2.36), 3-years: 1.87 (1.72, 2.04), 5-years: 1.99 (1.86, 2.13)] and mildly frail [1-year: 1.25 (1.09, 1.42), 3-years: 1.25 (1.17, 1.34), 5-years: 1.30 (1.23, 1.38)], but a reduced risk of care home admission for moderately [1-year: 0.66 (0.58, 0.75), 3-years: 0.75 (0.70, 0.80), 5-years: 0.83 (0.78, 0.88)] and severely frail individuals [1-year: 0.44 (0.37, 0.54), 3-years: 0.54 (0.49, 0.60), 5-years: 0.60(0.55, 0.66)]. CONCLUSIONS: HRs indicated that the C & RC service helped to prevent care home admissions for moderately and severely frail individuals. The HRs generally increased with follow-up duration.


Assuntos
Fragilidade , Idoso , Idoso Fragilizado , Fragilidade/diagnóstico , Fragilidade/terapia , Hospitalização , Humanos , Vida Independente , Modelos de Riscos Proporcionais , País de Gales
17.
Mar Drugs ; 18(5)2020 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-32397317

RESUMO

Fucoidans are known to be effective inhibitors of inflammation, and of virus binding and cellular entry. Undaria pinnatifida-derived fucoidan (UPF) was assessed in a severe influenza A (H1N1, PR8) infection model in mice. Initially, UPF was gavaged at 3.52 mg daily in a treatment model. Gross lung pathology (consolidation) was significantly reduced as compared to controls. UPF was then presented as a feed supplement at a rate of either nil, 3.52 mg/day or 7.04 mg/day in a prophylactic model, dosed three days before infection. A significant improvement was observed in the clinical signs of ill-health, as well as a reduction in gross lung pathology in animals treated with the higher dose, although there was no significant reduction in lung viral titres.


Assuntos
Suplementos Nutricionais , Influenza Humana/dietoterapia , Polissacarídeos/administração & dosagem , Alga Marinha/química , Undaria/química , Administração Oral , Animais , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Humanos , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vírus da Influenza A Subtipo H1N1/patogenicidade , Influenza Humana/diagnóstico , Influenza Humana/patologia , Influenza Humana/virologia , Pulmão/patologia , Pulmão/virologia , Camundongos , Índice de Gravidade de Doença , Carga Viral
18.
Med Sci Sports Exerc ; 52(11): 2402-2411, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32366795

RESUMO

INTRODUCTION: Prior upper body exercise reduces the curvature constant (W') of the hyperbolic power-duration relationship without affecting critical power. This study tested the hypothesis that prior upper body exercise reduces the work done over the end-test power (WEP; analog of W') during a 3-min all-out cycling test (3MT) without affecting the end-test power (EP; analog of critical power). METHODS: Ten endurance-trained men (V˙O2max = 62 ± 5 mL·kg·min) performed a 3MT without (CYC) and with (ARM-CYC) prior severe-intensity, intermittent upper body exercise. EP was calculated as the mean power output over the last 30 s of the 3MT, whereas WEP was calculated as the power-time integral above EP. RESULTS: At the start of the 3MT, plasma [La] (1.8 ± 0.4 vs 14.1 ± 3.4 mmol·L) and [H] (42.8 ± 3.1 vs 58.6 ± 5.5 nmol·L) were higher, whereas the strong ion difference (41.4 ± 2.2 vs 30.9 ± 4.6 mmol·L) and [HCO3] (27.0 ± 1.9 vs 16.9 ± 3.2 mmol·L) were lower during ARM-CYC than CYC (P < 0.010). EP was 12% lower during the 3MT of ARM-CYC (298 ± 52 W) than CYC (338 ± 60 W; P < 0.001), whereas WEP was not different (CYC: 12.8 ± 3.3 kJ vs ARM-CYC: 13.5 ± 4.1 kJ, P = 0.312). EP in CYC was positively correlated with the peak [H] (r = 0.78, P = 0008) and negatively correlated with the lowest [HCO3] (r = -0.74, P = 0.015). CONCLUSIONS: These results suggest that EP during a 3MT in endurance-trained men is sensitive to fatigue-related ionic perturbation.


Assuntos
Ciclismo/fisiologia , Teste de Esforço , Exercício Físico/fisiologia , Consumo de Oxigênio/fisiologia , Resistência Física/fisiologia , Extremidade Superior/fisiologia , Adolescente , Adulto , Humanos , Masculino , Adulto Jovem
19.
ChemSusChem ; 13(23): 6381-6390, 2020 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-33411422

RESUMO

Direct air capture (DAC) technologies that extract carbon dioxide from the atmosphere via chemical processes have the potential to restore the atmospheric CO2 concentration to an optimal level. This study elucidates structure-property relationships in DAC by crystallization of bis(iminoguanidine) (BIG) carbonate salts. Their crystal structures are analyzed by X-ray and neutron diffraction to accurately measure key structural parameters including molecular conformations, hydrogen bonding, and π-stacking. Experimental measurements of key properties, such as aqueous solubilities and regeneration energies and temperatures, are complemented by first-principles calculations of lattice and hydration free energies, as well as free energies of reactions with CO2, and BIG regenerations. Minor structural modifications in the molecular structure of the BIGs are found to result in major changes in the crystal structures and the aqueous solubilities within the series, leading to enhanced DAC.

20.
Arthritis Res Ther ; 21(1): 172, 2019 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-31300004

RESUMO

BACKGROUND: Syndecans are heparan sulfate proteoglycans that occur in membrane-bound or soluble forms. Syndecan-3, the least well-characterised of the syndecan family, is highly expressed on synovial endothelial cells in rheumatoid arthritis patients. Here, it binds pro-inflammatory chemokines with evidence for a role in chemokine presentation and leukocyte trafficking into the joint, promoting the inflammatory response. In this study, we explored the role of soluble syndecan-3 as a binder of chemokines and as an anti-inflammatory and therapeutic molecule. METHODS: A human monocytic cell line and CD14+ PBMCs were utilised in both Boyden chamber and trans-endothelial migration assays. Soluble syndecan-3 was tested in antigen-induced and collagen-induced in vivo arthritis models in mice. ELISA and isothermal fluorescence titration assays assessed the binding affinities. Syndecan-3 expression was identified by flow cytometry and PCR, and levels of shedding by ELISA. RESULTS: Using in vitro and in vivo models, soluble syndecan-3 inhibited leukocyte migration in vitro in response to CCL7 and its administration in murine models of rheumatoid arthritis reduced histological disease severity. Using isothermal fluorescence titration, the binding affinity of soluble syndecan-3 to inflammatory chemokines CCL2, CCL7 and CXCL8 was determined, revealing little difference, with Kds in the low nM range. TNFα increased cell surface expression and shedding of syndecan-3 from cultured human endothelial cells. Furthermore, soluble syndecan-3 occurred naturally in the sera of patients with rheumatoid arthritis and periodontitis, and its levels correlated with syndecan-1. CONCLUSIONS: This study shows that the addition of soluble syndecan-3 may represent an alternative therapeutic approach in inflammatory disease.


Assuntos
Artrite Experimental/metabolismo , Artrite Reumatoide/metabolismo , Movimento Celular , Quimiocinas/metabolismo , Leucócitos/metabolismo , Sindecana-3/metabolismo , Animais , Artrite Reumatoide/patologia , Células Cultivadas , Quimiocina CCL7/metabolismo , Quimiotaxia de Leucócito/efeitos dos fármacos , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/metabolismo , Expressão Gênica/efeitos dos fármacos , Humanos , Leucócitos/citologia , Masculino , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos DBA , Ligação Proteica , Índice de Gravidade de Doença , Solubilidade , Sindecana-3/administração & dosagem , Sindecana-3/genética , Células THP-1 , Fator de Necrose Tumoral alfa/farmacologia
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