Evaluation of heart rate recovery in relation to playing position in professional soccer players.

AIM: The aim of the study was the evaluation of the autonomic cardiac function in professional soccer players by heart rate recovery (HRR) measurement after 1' or 2' of active recovery (HRR1 or HRR2, respectively) from an exercise stress test. METHODS: Ninety-two adult professional soccer players (aged 25.27 ± 4.06 years). The exercise test was performed using a cycle ergometer with a ramp protocol. The subjects began with a load of 25W that was increased by 3W every 6 seconds, followed by an active recovery phase. We assessed the heart rate at rest (HRr), the PR interval, the QT and QTc intervals, the QRS axis, the QRS duration, the maximal heart rate, and the heart rate and heart rate recovery after 1 or 2 minutes from suspension of the load. RESULTS: The HRR1 was significantly slower (20.53 SD 6.67) among goalkeepers in comparison with other roles (HRR1 30.7 SD 6.62; P<0.01). There were also significant differences among the HRR1 values of forwards (27.11 SD 4.04), midfielders (HRR1 31.31 SD 7.43), and defenders (HRR1 32.10 SD 9.55). Goalkeepers had a significantly higher heart rate at rest (HRr, 65.69 SD 10.90) than other players (HRr 57.24 SD 6.21; P<0.01). CONCLUSION: These data show better autonomic function in roles with alternate aerobic-anaerobic activity compared to other roles. The results agree with the data in other literature about the positive action of intense aerobic-anaerobic physical activity on cardiovascular autonomic system adjustment.

Chlordiazepoxide and dizocilpine, but not morphine, selectively impair acquisition under a novel repeated-acquisition and performance task in rats.

RATIONALE: Some classes of drugs can selectively affect learning (i.e., acquisition of behavior) at doses that do not affect performance (i.e., previously learned behavior). Some drugs (e.g., benzodiazepines) show selective effects on acquisition across a wide variety of tasks. Other drugs [e.g., N-methyl-D-aspartate (NMDA) antagonists and opiate agonists], however, show selective effects under some tasks, but not others. OBJECTIVES: The purpose of this study was to examine the effects of the NMDA-antagonist dizocilpine (0.01-0.3 mg/kg), the opiate-agonist morphine (1.0-17.0 mg/kg), and the benzodiazepine chlordiazepoxide (3.0-30.0 mg/kg) in rats under a novel repeated-acquisition and performance task. METHODS: Nose pokes to a correct location within a 2x3 stimulus array on a computer touch screen were reinforced with food. In the acquisition component, the correct location changed across sessions but remained constant within sessions; in the performance component, the correct location was constant both across and within sessions. RESULTS: Both chlordiazepoxide and dizocilpine selectively impaired accuracy in the acquisition component at doses that did not affect accuracy in the performance component or overall response speed. Morphine, however, did not affect acquisition without affecting performance or response speed. CONCLUSIONS: These results with rats resembled those previously obtained for response-sequence learning in primates, rather than those previously reported for spatial learning in rats. Therefore, previous discrepancies in results for NMDA antagonists and opiate agonists across tasks probably were not a function of the species studied, but, rather, they more likely were a function of unique variables controlling acquisition within each task.

Biocompatibility of Trillium Biopassive Surface-coated oxygenator versus uncoated oxygenator during cardiopulmonary bypass.

OBJECTIVE: To determine if the Trillium Biopassive Surface (Medtronic Cardiopulmonary, Minneapolis, MN) coating added to the cardiopulmonary bypass oxygenator reduces inflammatory mediators, blood loss, and transfusion requirements. DESIGN: Prospective, randomized, and blinded human trial. SETTING: Tertiary care academic medical center. PARTICIPANTS: Thirty adult patients undergoing elective coronary artery bypass graft surgery. INTERVENTIONS: Patients received visually identical coated or uncoated oxygenators. MEASUREMENTS AND MAIN RESULTS: Hemoglobin, hematocrit, leukocyte count, platelet count, terminal complement complex, complement activation, myeloperoxidase, beta-thromboglobulin, prothrombin fragment 1.2, plasmin-antiplasmin, heparin concentration, activated coagulation time, and fibrinogen concentration were measured. Blood loss and blood product usage were recorded. In both groups, there were significant inflammatory alterations with the initiation of cardiopulmonary bypass. In the postprotamine samples, the coated oxygenator group had small but significant increases in hemoglobin, hematocrit, and leukocyte count. There were no differences in inflammatory mediators, blood loss, or transfusion requirements between the coated and uncoated groups. CONCLUSION: This human trial of Trillium Biopassive Surface-coated oxygenators did not show clinical benefits or clinically important biochemical results.

[Physical treatment of deep venous thrombosis: bed rest or mobilization?]. / Trattamento fisico della trombosi venosa profonda: riposo a letto o mobilizzazione?

The need of prolonged bed-rest for the treatment of Deep Venous Thrombosis (DVT), which was considered essential to control the thrombotic phenomenon and to prevent Pulmonary Embolism (PE) until ten years ago, has now been critically reviewed in the light of the great success of the Low Molecular Weight Heparin (LMWH) in medical therapy of DVT. There is a great evidence for bed-rest and immobility to play a pivotal role in the growth and in the progression of a venous thrombosis. The Authors emphasize, both on the international reports and their own experience, that, in most cases, medical treatment of DVT consists of an outpatient--ambulatory care based on immediate mobilization and ambulation, on external compression therapy, on early LMWH administration and late oral anticoagulation. This regimen provides great benefits in order to prevent PE, to improve the quality of life, to reduce the hospital and the anticoagulant monitoring charges.

[Compression therapy in deep venous thrombosis]. / La terapia compressiva della trombosi venosa profonda.

External compression, both intermittent by pneumatic pumps and continuous by anelastic or elastic bandages and by graduate compression stockings, play a pivotal role in prophylaxis of Deep Venous Thrombosis (DVT). The use of external compression in DVT therapy and in prophylaxis of pulmonary embolism (PE) and of post-thrombotic syndrome has not been validated as well as in DVT prophylaxis. The pathophysiologic properties of the external compression and the most recent evidences about the early mobilization of the patients with DVT and about Low Molecular Weight Heparin (LMWH) therapy suggest the advantages of the external compression. The authors review the most important clinical investigations about early use of external compression in DVT joined with pharmacological therapy: the results have been the reduction of the growth of the thrombus, the reduction of PE ratio, the prevention of the post-thrombotic syndrome, the indirect improvement of the quality of life. Finally the authors confirm the recommendations about the use of physical therapy with early mobilization and external compression joined with LMWH anticoagulation in DVT.

Postphlebitic syndrome: clinical activity and tolerability of desmin, new LMW dermatan sulfate.

One hundred patients suffering from postphlebitic syndrome of the lower limbs were enrolled in an open, randomized, and multicenter (six centers) trial for a period of eighteen months. Patients were randomly assigned to three treatment groups to receive (for ninety consecutive days) Desmin, a new low-molecular-weight dermatan sulfate, at the dose, respectively, of 100 mg once daily by subcutaneous (SC) route (36 patients), 100 mg twice a day by SC route (33 patients), and 200 mg once daily by intramuscular (IM) route (31 patients). The general and local tolerability and the clinical efficacy of the drug were evaluated by means of clinical, instrumental, and laboratory parameters. Desmin is effective in the decompensation stage of postphlebitic syndrome; this was demonstrated by a significant reduction in the severity of a number of typical symptoms as well as by the drug's positive effect on venous tone as confirmed by phlebotensiometric examination. The daily dose of 200 mg (either SC or IM) was more effective than the 100 mg dose. The results obtained at the end of the trial (ninety days) were statistically better than those obtained after thirty days of treatment. This trial demonstrated that both the systemic and the local (at the site of injection) tolerability of the drug, administered for three months, were good and without significant variations in the laboratory parameters monitored.

[Diarrhea associated with antibiotic therapy]. / Diarrea associata alla terapia con antibiotici.

The authors suggest rational procedures to prevent the antibiotic associated diarrhea (AAD) Clostridium difficile positive or not, considering its high cost (both to stay in Hospital and for specific therapy). Twenty-four cases of diarrhea starting during antibiotic therapy and until one month from its interruption was assessed. Twelve (50%) was found Clostridium difficile (+); 12 (50%) was Clostridium difficile (-); no case of pseudomembranous colitis was found. Two hospitalized patients shared the room with others suffering from diarrhea Clostridium difficile (+) developing the same illness although precautions were used both by physicians and by nursing staff. Four patients had diarrhea after domiciliary antibiotic therapy. Vancomycin (1-2 g/die p.o.) was effective therapy in patients with important diarrhea (more than 10 withdrawals in a day). Two cases with moderate diarrhea (less than 6 withdrawals in a day) Clostridium difficile (+) recovered without antibiotic therapy. The authors propose: a) rational antibiotic use; b) isolation of affected patients; c) sanitary measures in dejections treatment.