Motor function and respiratory capacity in patients with late‐onset pompe disease

Introduction: The relationship between skeletal muscle strength and respiratory dysfunction in Pompe disease has not been examined by quantitative methods. We investigated correlations among lower extremity proximal muscle strength, respiratory function, and motor performance. Methods: Concentric strength of the knee extensor and flexor muscles was measured with a dynamometer, and pulmonary function was evaluated using spirometry in 7 adult patients. The 6‐minute walk test and the 4‐step stair‐climb test were used for assessing aerobic endurance and anaerobic power, respectively. Results: Anaerobic motor performance correlated with strength of both thigh muscles. Respiratory function did not correlate with either muscle strength or motor function performance. Conclusions: Respiratory and lower extremity proximal muscles could be affected differentially by the disease in individual patients. Motor performance is influenced by thigh muscle strength and is less dependent of respiratory capacity in our cohort of ambulatory patients. Muscle Nerve 49:603–606, 2014     

Restricting Kidney Transplant Wait‐Listing for Obese Patients: Let's Stop Defending the Indefensible

The allocation of limited medical resources represents an ethical dilemma that continues to generate lively debates. While the allocation of allografts to wait‐listed patients is done in a transparent manner, with its rules open to public debate and prone to continuous improvement, the practice of wait‐listing is not centrally regulated, and its rules are often less scrutinized. Denial of kidney transplant wait‐listing to obese individuals has been a common practice by most transplant centers. On the face of it, this practice is justified by commonly accepted ethical standards, yet there is now mounting evidence that these justifications do not withstand closer scrutiny. A candid and open debate in the Nephrology and Transplant community is needed to examine the true motivations that underlie the practice of denying wait‐listing to obese individuals, and to find a solution that is truly in the best interest of our patients.     

Bone and mineral disorders after kidney transplantation: Therapeutic strategies

Mineral and bone diseases (MBD) are common in patients with chronic kidney disease who undergo kidney transplantation. The incidence, types and severity of MBD vary according to the duration of chronic kidney disease, presence of comorbid conditions and intake of certain medications. Moreover, multiple types of pathology may be responsible for MBD. After successful reversal of uremia by kidney transplantation, many bone and mineral disorders improve, while immunosuppression, other medications, and new and existing comorbidities may result in new or worsening MBD. Chronic kidney disease is also common after kidney transplantation and may impact bone and mineral disease. In this article, we reviewed the prevalence, pathophysiology, and impact of MBD on post-transplant outcomes. We also discussed the diagnostic approach; immunosuppression management and potential treatment of MBD in kidney transplant recipients.     

Maximal strength,power, and aerobic endurance adaptations to concurrent strength and sprint interval training

Purpose

This study was designed to examine whether concurrent sprint interval and strength training (CT) would result in compromised strength development when compared to strength training (ST) alone. In addition, maximal oxygen consumption (VO₂max) and time to exhaustion (TTE) were measured to determine if sprint interval training (SIT) would augment aerobic performance.

Methods

Fourteen recreationally active men completed the study. ST (n = 7) was performed 2 days/week and CT (n = 7) was performed 4 days/week for 12 weeks. CT was separated by 24 h to reduce the influence of acute fatigue. Body composition was analyzed pre- and post-intervention. Anaerobic power, one-repetition maximum (1RM) lower- and upper-body strength, VO₂max and TTE were analyzed pre-, mid-, and post-training. Training intensity for ST was set at 85 % 1RM and SIT trained using a modified Wingate protocol, adjusted to 20 s.

Results

Upper- and lower-body strength improved significantly after training (p < 0.001) with no difference between the groups (p > 0.05). VO₂max increased 40.9 ± 8.4 to 42.3 ± 7.1 ml/kg/min (p < 0.05) for CT, whereas ST remained unchanged. A significant difference in VO₂max (p < 0.05) was observed between groups post-intervention (CT: 42.3 ± 7.1 vs. ST: 36.0 ± 3.0 ml/kg/min). A main effect for time and group was observed in TTE (p < 0.05). A significant main effect for time was observed in average power (p < 0.05).

Conclusion

Preliminary findings suggest that performing concurrent sprint interval and strength training does not attenuate the strength response when compared to ST alone, while also improves aerobic performance measures, such as VO₂max at the same time.     

Breastfeeding Shows a Protective Trend toward Adolescents with Higher Abdominal Adiposity

ObjectiveThe question of whether breastfeeding has a protective effect against the development of overweight or obesity later in life remains controversial, especially during adolescence. The objective was to assess the relationship between breastfeeding and adolescents’ body composition.MethodsThe HELENA study is a cross-sectional study involving 3,528 adolescents from 10 European cities. The outcome measures were body weight and height, subscapular skinfolds as well as waist circumferences. Breastfeeding, smoking status, and parental socioeconomic status were assessed by self-administered questionnaires. Dietary intake was recorded using two 24-hour recall surveys. Two adjustment approaches were used: i) covariance analysis adjusted for confounding factors (propensity score adjustment) and ii) multivariate quantile regression.ResultsAfter adjustment, no significant associations were observed between breastfeeding and body composition parameters (BMI Z-score; sum of skinfolds; waist-to-height ratio). An adjusted quantile regression analysis showed a non-significant trend for a protective effect of breastfeeding toward the highest percentiles of adiposity in boys but not in girls. This is of particular interest with respect to the superiority of the waist-to-height ratio over waist circumference and BMI for detecting cardiometabolic risk factors.ConclusionThis first European study, including a large set of factors influencing adolescents’ body composition, showed a non-significant trend toward a protective effect of breastfeeding on highest percentiles of adolescent''s abdominal adiposity.Key Words: Breastfeeding, Body composition, Adolescents, Waist-to-height ratio, BMI, Propensity score     

Superior vena cava graft infection in thoracic surgery: a retrospective study of the French EPITHOR database

 Open in a separate windowOBJECTIVESTo report our experience on the management of superior vena cava graft infection.METHODSBetween 2001 and 2018, patients with superior vena cava synthetic graft or patch reconstruction after resection of intrathoracic tumours or benign disease were selected retrospectively from the French EPITHOR database and participating thoracic centres. Our study population includes patients with superior vena cava graft infection, defined according to the MAGIC consensus. Superior vena cava synthetic grafts in an empyema or mediastinitis were considered as infected.RESULTSOf 111 eligible patients, superior vena cava graft infection occurred in 12 (11.9%) patients with a polytetrafluoroethylene graft secondary to contiguous contamination. Management consisted of either conservative treatment with chest tube drainage and antibiotics (n = 3) or a surgical graft-sparing strategy (n = 9). Recurrence of infection appears in 6 patients. Graft removal was performed in 2 patients among the 5 reoperated patients. The operative mortality rate was 25%.CONCLUSIONSSuperior vena cava graft infection may develop as a surgical site infection secondary to early mediastinitis or empyema. Graft removal is not always mandatory but should be considered in late or recurrent graft infection or in infections caused by aggressive microorganisms (virulent or multidrug resistant bacteria or fungi).     

Trait Emotional Intelligence and Internet Gaming Disorder Among Gamers: The Mediating Role of Online Gaming Motives and Moderating Role of Age Groups

Personality differences are important determinants of problematic online behaviors. The purpose of the present study was to investigate the mediating role of loneliness, depression, and online gaming motives and moderating role of age on the relationship between trait emotional intelligence (EI) and Internet gaming disorder (IGD) via the construction of a multiple mediation model. A total of 478 online gamers completed a self-report online survey, including validated psychometric scales assessing the aforementioned constructs. Results indicated that trait EI was directly and indirectly associated with IGD and that the motive of escape was a partial mediator between trait EI and IGD among the total sample and adult gamers, but not among adolescents. Moreover, trait EI was associated with coping, skill development, fantasy, and recreation gaming motives only among total sample and adult gamers, and the escape motive was positively associated with IGD among total sample and adult gamers. However, among these relationships, only the association between trait EI and fantasy was significantly moderated by age group. Furthermore, the direct effect of trait EI was stronger among adolescent gamers when compared to adult gamers. Results showed that trait EI is inversely associated with IGD and affects gaming for different motives among adolescent and adult gamers.

     

Comparison Evaluation of the Biological Effects of Sterigmatocystin and Aflatoxin B1 Utilizing SOS-Chromotest and a Novel Zebrafish (Danio rerio) Embryo Microinjection Method

Aflatoxin B1 (AFB1) is a potent mycotoxin and natural carcinogen. The primary producers of AFB1 are Aspergillus flavus and A. parasiticus. Sterigmatocystin (STC), another mycotoxin, shares its biosynthetic pathway with aflatoxins. While there are abundant data on the biological effects of AFB1, STC is not well characterised. According to published data, AFB1 is more harmful to biological systems than STC. It has been suggested that STC is about one-tenth as potent a mutagen as AFB1 as measured by the Ames test. In this research, the biological effects of S9 rat liver homogenate-activated and non-activated STC and AFB1 were compared using two different biomonitoring systems, SOS-Chromotest and a recently developed microinjection zebrafish embryo method. When comparing the treatments, activated STC caused the highest mortality and number of DNA strand breaks across all injected volumes. Based on the E. coli SOS-Chromotest, the two toxins exerted the same genotoxicities. Moreover, according to the newly developed zebrafish microinjection method, STC appeared more toxic than AFB1. The scarce information correlating AFB1 and STC toxicity suggests that AFB1 is a more potent genotoxin than STC. Our findings contradict this assumption and illustrate the need for more complex biomonitoring systems for mycotoxin risk assessment.