Synchronized Pedaling with Martial Arts Improves Quality of Life of Women with Breast Cancer.

Physical exercise improves the physical condition of women who have been undergone surgery for breast cancer. This study evaluated the effect of a new martial arts program that combined aerobic endurance and muscle strength exercises on improving upper limb function and aerobic performance of women who have undergone breast cancer surgery. Fifty-three women who had previously undergone breast cancer surgery with axillary lymph node dissection, radiotherapy and/or chemotherapy participated in the twelve-week program. Participants were randomly assigned to two groups; a study group (28 participants) in which participants carried out a synchronized pedaling with martial arts routine of 2 sessions per week, and a control group (22 participants) who received usual care. Study group participants demonstrated a significant increase in right hand and quadriceps strength, maximum oxygen consumption, max power-to-weight ratio, muscle mass percentage and a decrease in fat mass percentage (p≤0.05). A controlled training system like synchronized pedaling with martial arts, which combines aerobic and strength exercises, appears suitable for improving the muscle strength and aerobic capacity of these breast cancer participants.

Catecholamines and Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury.

Paroxysmal sympathetic hyperactivity (PSH) affects a significant minority of people in the intensive care unit after severe traumatic brain injury. Systematic research has yet to elucidate or quantify the extent of the role of the catecholamines or adrenocortical and thyroid axis hormonal influences in the condition. Data were prospectively collected on 80 consecutive patients, 18 of whom developed clinical signs of PSH (22.5%). Catecholamine and hormonal data were collected sequentially at 4-h intervals or during and between episodes of PSH. Evaluated variables showed 200-300% increases in catecholamines and, to a lesser extent, adrenocortical hormones during paroxysms. The majority of PSH episodes (72%) were noted to be in response to an observable triggering event. These changes were not observed in subjects without PSH. These data go some way to explain why PSH produces adverse consequences in survivors of TBI with the condition.

Efecto del ejercicio intenso en el sistema inmune, medido a través de la activación del complemento y de la proteína C-reactiva / Effect of exhaustive exercise on the immune system, measured through complement activation and C-reactive protein

La influencia del ejercicio en la respuesta inflamatoria sistémica ha sido objeto de debate desde hace más de diez años, sin embargo son muy escasos los estudios originales que hayan analizado su activación y son practicamente inexistentes los estudios translacionales que hayan extrapolado los resultados analíticos a la realidad de los deportistas. Objetivo: El objetivo de este trabajo ha sido determinar el efecto del ejercicio intenso sobre dos marcadores inflamatorios conocidos: la activación del Complemento y de la Proteína C-reactiva. Métodos: Diez deportistas sanos y bien entrenados fueron sometidos, después de firmar el consentimiento informado, a tres series consecutivas de 800 metros a velocidad máxima con intervalos de 60 segundos entre series en pista abierta. Inmediatamente antes y después del ejercicio se tomaron muestras de sangre venosa para determinación de CK, pH, Lactato, Complemento y Proteína C-reactiva. Tres días antes, en el Laboratorio de Medicina Deportiva se realizó un estudio Antropométrico y cálculo de V02max. Resultados: Se obtuvieron incrementos significativos en CK plasmática (114,7 ± 80,3, p = 0,005) y en lactato (17,27 ± 5,5,p = 0.005) tras la realización de la prueba en pista. Ambos parámetros, el aumento de CK y lactato después del ejercicio, se correlacionaron significativamente (r = 0,751, r2 = 0,574, p = 0,012). El incremento de CK actuó como factor predictor de la elevación de la fracción C3 del Complemento (p = 0,003). La Proteína C-reactiva no se incrementó tras el ejercicio. Conclusión: El ejercicio intenso funcionó como factor de activación inmediato de la respuesta inflamatoria sistémica medida en términos de elevación de las fracciones C3 y 4 del complemento. Se requieren nuevos estudios para determinar el beneficio fisiológico de esta activación y discriminar los efectos perjudiciales que esta activación podría causar en otros entornos (AU)

The influence of exercise in the systemic inflammatory response has been a subject of debate for over ten years. However very few original studies have analyzed their activation and are practically nonexistent translational studies that have extrapolated the analysis results to the reality of athletes. Purpose: We aimed to determine the effect of exhaustive exercise on two known inflammatory markers, the complement system and C-reactive protein, as a result of exhaustive exercise consisting of three intermittent bouts of 800 m at max speed interspersed with 30-s recovery intervals. Methods: Ten healthy volunteers were recruited. Anthropometric and V02max data were obtained in the laboratory and venous parameters of basal and immediate post-exercise CK, pH, lactate, complement and C-reactive protein were obtained on an open-air running track three days later. Results: Significant increases in plasma CK (114.7±80.3, p=0.005) and lactate (17.27±5.5, p=0.005) were noted. Both parameters, increased CK and lactate post-exercise, correlated significantly (r=0.751, r2=0.574, p=0.012). The complement system was activated, with the increase in CK predicting the increase in C3 (p=0.003). No post-exercise increase in C-reactive protein was found. Conclusion: The systemic inflammatory response measured in terms of increases of the complement C3 and 4 was activated by exhaustive exercise. New studies are required to determine the physiological benefit of this activation, and discriminate it from the prejudicial effects this activation could cause in other settings (AU)

Replacement of 24-h creatinine clearance by 2-h creatinine clearance in intensive care unit patients: a single-center study.

OBJECTIVE: To estimate the usefulness of 2-h creatinine clearance (CrCl) in the ICU and define variables that may reduce agreement. DESIGN: Prospective study. SETTING: Polyvalent ICU of a university hospital. PATIENTS: 359 patients. INTERVENTIONS: We compared 24-h CrCl (CrCl-24h), as the standard measure, with 2-h CrCl (CrCl-2h) (at the start of the period) and the Cockroft-Gault equation (Ck-G). MEASUREMENTS AND RESULTS: The 2-h sample was lost in two patients (0.6%) and the 24-h sample was lost in 50 patients (13.9%). The mean Ck-G was 87.4+/-3.05, with CrCl-2h 109.2+/-4.46 and CrCl-24h 100.9+/-4.21 ml/min/1.73 m2 (r2 of 0.88 for CrCl-2h and 0.84 for Ck-G). The differences from ClCr-24h were 21.8+/-3.3 (p<0.001) for the Ck-G and 8.3+/-2.6 (p<0.05) for CrCl-2h (p<0.05). In the subgroup of patients with CrCl-24h<100 ml/min/1.73 m2, the CrCl-24h value was 52.9+/-2.71 vs. 51.6+/-2.14 for CrCl-2h (p=ns) and 57.6+/-2.56 (p<0.001) for the Ck-G. Patients with CrCl<100 ml/min only showed variability in hyperglycemia during the 24-h period. CONCLUSIONS: In intensive care patients, 24-h CrCl results in a large proportion of non-valid determinations, even under conditions of close monitoring. Two-hour CrCl is an adequate substitute, even in patients who are unstable or who have irregular diuresis where a 24-h collection is impossible. The Cockroft-Gault equation seems less useful in this setting.

Risk factors for renal dysfunction in the postoperative course of liver transplant.

Renal dysfunction (RD) is a frequent complication after orthotopic liver transplantation (OLT), and it has an unfavorable effect on the prognosis of OLT patients. The purpose of our study was to identify possible risk factors for RD and its impact on survival. The possible relations of pre-, peri-, and postoperative variables to early-onset renal dysfunction (ED) (within the 1st 3 months), late-onset renal dysfunction (LD) (between 3 and 6 months), and chronic renal dysfunction (CRD) (beyond 6 months) was analyzed. We studied 245 liver transplants in 241 patients. RD was found in 64.1% of these patients, and 69% of the patients with RD recovered. LD was found in 16.7% of the transplant patients. In the multivariate analysis, baseline serum creatinine, perioperative volume of transfused bank-red blood cells, Acute Physiology and Chronic Health Evaluation (APACHE) II score at intensive care unit (ICU) admission, and infection were associated with the development of RD. Overall mortality was 27.8% and for the RD group, it was 33.5%. LD, but not ED, was related to lower survival (together with graft dysfunction and APACHE II score at ICU admission). In conclusion, ED is frequent alter OLT and is related to preexisting RD, the volume of transfused bank--red blood cells during surgery, higher APACHE II score at ICU admission, and infection. In general, the prognosis for ED is good, in contrast with that of LD, which is associated with diminished survival.