BACKGROUND: Although caffeine (CAF) supplementation has been shown to improve exercise performance, its dose-dependent effect on CAF metabolism has not been sufficiently investigated. The aim of this study was to evaluate the effects of 3, 6 and 9 mg of CAF/kgBM on changes of CAF and paraxanthine (PRX) in the serum and saliva at four time-points. METHODS: In a randomized, double-blind, placebo-controlled crossover design, acute pre-exercise supplementation in 26 moderately-trained athletes, participating in high-intensity functional training (HIFT), was examined. The study protocol involved CAF/PRX biochemical analyses of serum and saliva with respect to CYP1A2 polymorphism and CYP1A2 enzyme activity. RESULTS: Despite significant differences between the serum and saliva levels of CAF and PRX, there was no difference in the PRX/CAF ratio. The interaction effect of dose and time-points for PRX concentration was revealed. The main effects of dose were observed for CAF and the PRX/CAF ratio. The main effect of time-points was registered only for serum CAF. CONCLUSIONS: Dose- and time-dependent effect of CAF supplementation on CAF and PRX in the serum and saliva of athletes was confirmed, but there was no effect of the CAF dose on CYP1A2 enzyme activity, nor was there an interaction of CYP1A2 with enzyme inducibility. The CAF/PRX correlation indicated the possibility of interchangeable use of serum and/or saliva analyses in exercise studies. CLINICAL TRIAL REGISTRATION: This trial was registered prospectively at ClinicalTrials.gov (NCT03822663, registration date: 30/01/2019).
- Publication type
- Journal Article MeSH
OBJECTIVE: Ankylosing Spondylitis Disease Activity Score based on C-reactive protein (ASDAS-CRP) is recommended over ASDAS based on erythrocyte sedimentation rate (ASDAS-ESR) to assess disease activity in axial spondyloarthritis (axSpA). Although ASDAS-CRP and ASDAS-ESR are not interchangeable, the same disease activity cut-offs are used for both. We aimed to estimate optimal ASDAS-ESR values corresponding to the established ASDAS-CRP cut-offs (1.3, 2.1, and 3.5) and investigate the potential improvement of level of agreement between ASDAS-ESR and ASDAS-CRP disease activity states when applying these estimated cut-offs. METHODS: We used data from patients with axSpA from 9 European registries initiating a tumor necrosis factor inhibitor. ASDAS-ESR cut-offs were estimated using the Youden index. The level of agreement between ASDAS-ESR and ASDAS-CRP disease activity states was compared against each other. RESULTS: In 3664 patients, mean ASDAS-CRP was higher than ASDAS-ESR at both baseline (3.6 and 3.4, respectively) and aggregated follow-up at 6, 12, or 24 months (1.9 and 1.8, respectively). The estimated ASDAS-ESR values corresponding to the established ASDAS-CRP cut-offs were 1.4, 1.9, and 3.3. By applying these cut-offs, the proportion of discordance between disease activity states according to ASDAS-ESR and ASDAS-CRP decreased from 22.93% to 19.81% in baseline data but increased from 27.17% to 28.94% in follow-up data. CONCLUSION: We estimated the optimal ASDAS-ESR values corresponding to the established ASDAS-CRP cut-off values. However, applying the estimated cut-offs did not increase the level of agreement between ASDAS-ESR and ASDAS-CRP disease activity states to a relevant degree. Our findings did not provide evidence to reject the established cut-off values for ASDAS-ESR.
- MeSH
- Spondylitis, Ankylosing * blood diagnosis MeSH
- Axial Spondyloarthritis * blood diagnosis MeSH
- C-Reactive Protein * analysis MeSH
- Adult MeSH
- Blood Sedimentation * MeSH
- Middle Aged MeSH
- Humans MeSH
- Registries MeSH
- Severity of Illness Index * MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
COVID-19 vaccine uptake varied across countries, in part due to vaccine hesitancy fueled by a lack of trustworthy information. To help health workers provide evidence-based answers to common questions about COVID-19 vaccines and vaccination, and thereby, assist individuals ́ decisions on vaccine acceptance, COVID-19 InfoVaccines, a joint WHO-EU project, was launched in February 2021 to support COVID-19 vaccine rollout in 6 Eastern European countries. COVID-19 InfoVaccines was made available in seven languages and shared on social media networks. A total of 262,592 users accessed COVID-19 InfoVaccines.com between February 11, 2021, and January 31st, 2023. The users were most interested in: general questions; vaccine efficacy and duration of protection; vaccine safety; vaccine co-administration, and dose-interval and interchangeability; though the interest in a specific theme varied in function of the epidemiological situation. A total of 118,510 (45.1%) and 46,644 (17.7%) users scrolled up to 35% and 75% of the COVID-19 InfoVaccines webpage, respectively. The average engagement rate was 71.61%. The users accessed COVID-19 InfoVaccines from 231 countries and territories, but the majority were in Ukraine (N = 38,404; 14.6%), Spain (N = 23,327; 8.9%), and Argentina (N = 21,167; 8.1%). Older Facebook users were more interested in COVID-19 information than younger individuals (X2 p-value < .0001). Two hundred twenty-eight videos were shared on YouTube. The average Click-Through-Rate on Facebook was 7.82%, and that on YouTube was 4.4%, with 60 videos having a Click-Through-Rate >5%, falling in the range of average YouTube video Click-Through-Rate (2% - 10%). As misinformation about vaccines and vaccination spreads easily and can negatively impact health-related decisions, initiatives like COVID-19 InfoVaccines are crucial to facilitate access to reliable information.
- MeSH
- COVID-19 * prevention & control epidemiology MeSH
- Adult MeSH
- Humans MeSH
- Vaccination Hesitancy statistics & numerical data MeSH
- SARS-CoV-2 immunology MeSH
- Social Media * MeSH
- World Health Organization MeSH
- Vaccination * statistics & numerical data psychology MeSH
- COVID-19 Vaccines * administration & dosage MeSH
- Health Education methods MeSH
- Health Personnel statistics & numerical data MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Administration of oral medicinal products as crushed tablets or open capsules is an important delivery option for patients suffering from dysphagia. To obtain full interchangeability of generics with the original products, demonstration of bioequivalence (BE) between both products administered as crushed tablets/open capsules was required for poorly soluble product by European Medicines Agency (EMA) at the time of development of our rivaroxaban and deferasirox generic products. We present the results of two BE studies with modified administration of these products, which compared relative bioavailability between generic and reference products. In the rivaroxaban study, the test product was administered as a capsule sprinkled on and mixed with applesauce, whereas the reference tablet was crushed and administered with applesauce under fed conditions. In the deferasirox study, both treatments were administered as crushed tablets under fasting conditions. Both studies applied a two-way crossover design and were conducted after a single-dose in healthy volunteers. The 90% confidence interval of the geometric mean ratio area under the analyte concentration versus time curve, from time zero to the time of the last measurable analyte concentration and maximum measured analyte concentration over the sampling period of the test to reference ratio were 103.36-110.37% and 97.98-108.45% for rivaroxaban, respectively, and 96.69-107.29% and 94.19-109.45% for deferasirox, respectively. Thus, the BE criteria (80.00-125.00%) were met in both studies which demonstrated that bioavailability was not affected when the test and reference products were administered in the form of crushed tablet/open capsule. These results support the argument of redundancy of crushed product studies for poorly soluble drugs, which is in line with the currently revised position of the EMA on this topic.
- MeSH
- Administration, Oral MeSH
- Deferasirox MeSH
- Drugs, Generic * MeSH
- Humans MeSH
- Rivaroxaban * MeSH
- Tablets MeSH
- Therapeutic Equivalency MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
BACKGROUND: There is a continuing interest in finding effective methods for scar treatment. Dry needling is gaining popularity in physiotherapy and is defined by Western medicine as a type of acupuncture. The terms acupuncture and dry needling have been used interchangeably so we have focused on the efficacy of dry needling or acupuncture in scar treatment. OBJECTIVE: The aim of this systematic review was to determine the usefulness of dry needling or local acupuncture for scar treatment. In our search process, we used the terms 'acupuncture,' 'needling,' or 'dry needling' to identify all relevant scientific papers. We have focused on the practical aspects of local management of different scar types with dry needling or acupuncture. SEARCH STRATEGY: The search strategy included different combinations of the following keywords: 'scar', 'keloid', 'dry needling', 'needling', 'acupuncture', 'treatment', 'physical therapy'. This systematic review was conducted in accordance with PRISMA guidelines. MEDLINE (PubMed, EBSCOHost and Ovid), EMBASE (Elsevier), and Web of Science databases were searched for relevant publications from inception through October 2023. INCLUSION CRITERIA: The studies that investigated the effectiveness of dry needling or acupuncture for scar treatment were included. DATA EXTRACTION AND ANALYSIS: The main extraction data items were: the needling technique; needle: diameter, length; needling locations; manual needling manipulation; number of sessions; settings; outcomes and results. RESULTS: As a result of a comprehensive search, 11 manuscripts were included in the systematic review, of which eight were case reports, two were randomized trials and one study concerned case series. Two case reports scored 2-4 out of 8 points on the JBI checklist, five studies scored 5-7, and one study scored 8 points. The methodological quality of the two clinical trials was rated as good or fair on the PEDro scale. The case series study scored 7 of 10 points on the JBI checklist. A meta-analysis was not possible as only two randomized trials, eight case reports, and one case series were eligible for review; also, scar assessment scales and pain severity scales were highly heterogeneous. CONCLUSIONS: The studies differed regarding the delivery of dry needling or local acupuncture for scar treatment. Differences included treatment frequency, duration, number of treatments, selection of needle insertion sites, number of needles used, angle of needle placement, and use of manual needling manipulation. SYSTEMATIC REVIEW REGISTRATION: INPLASY no. 202310058.
OBJECTIVES: Stroke volume (SV) and cardiac output monitoring is a cornerstone of hemodynamic assessment. Noninvasive technologies are increasingly used in children. This study compared SV measurements obtained by transcutaneous Doppler ultrasound techniques (ultrasonic cardiac output monitor [USCOM]), transthoracic echocardiography jugular (TTE-J), and parasternal (TTE-P) views performed by pediatric intensivists (OP-As) with limited training in cardiac sonography (20 previous examinations) and pediatric cardiologists (OP-Bs) with limited training in USCOM (30 previous examinations) in spontaneously ventilating children. METHODS: A single-center study was conducted in 37 children. Each operator obtained 3 sets of USCOM SV measurements within a period of 3 to 5 minutes, followed with TTE measurements from both apical and jugular views. The investigators were blinded to each other's results to prevent visual and auditory bias. RESULTS: Both USCOM and TTE methods were applicable in 89% of patients. The intraobserver variability of USCOM, TTE-J, and TTE-P were less than 10% in both investigators. The SV measurements by OP-As using USCOM, TTE-J, and TTE-P were 46.15 (25.48) mL, 39.45 (20.65) mL, and 33.42 (16.69) mL, respectively. The SV measurements by OP-Bs using USCOM, TTE-J, and TTE-P were 43.99 (25.24) mL, 38.91 (19.98) mL, and 37.58 (19.81) mL, respectively.The percentage error in SV with USCOM relative to TTE-J was 36% in OP-As and 37% in OP-Bs. The percentage error in SV with TTE-P was 33% relative to TTE-J in OP-As and 21% in OP-Bs. CONCLUSIONS: Our findings show that the methods are not interchangeable because SV values by USCOM are higher in comparison with the SV values obtained by TTE. Both methods have low level of intraobserver variability. The SV measurements obtained by TTE-P were significantly lower compared with the TTE-J for the operator with limited training in echocardiography. The TTE-P requires longer practice compared with the TTE-J; therefore, we recommend to prefer TTE-J to TTE-P for inexperienced operators.
- MeSH
- Child MeSH
- Echocardiography * methods MeSH
- Humans MeSH
- Cardiac Output MeSH
- Monitoring, Physiologic methods MeSH
- Prospective Studies MeSH
- Stroke Volume MeSH
- Ultrasonics * MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
Kontinuální monitorace glykemie je velkým přínosem pro péči o pacienty s diabetem mellitem. Výstupy z dat z měření jsou popisovány novými parametry hodnocení kompenzace glykemií, mezi které patří „glucose management indicator“ (GMI). Ten určitým způsobem imituje hodnotu HbA1c, ne vždy však lze tyto hodnoty jednoduše zaměnit.
Continuous glucose monitoring is a significant benefit in care of patients with diabetes. By using CGM systems, a variety of new parameters, such as “glucose management indicator ” (GMI), were established to describe glycaemic control of patients. GMI can in some ways imitate glycated haemoglobin, but is not always easily interchangeable.
- Keywords
- kontinuální monitorace glykemie,
- MeSH
- Diabetes Mellitus diagnosis MeSH
- Glucose analysis MeSH
- Glycated Hemoglobin analysis MeSH
- Humans MeSH
- Blood Glucose Self-Monitoring * methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Ciele: Sledovat zmeny chirurgicky indukovaného astigmatizmu rohovky a stability umelej vnútroocnej šošovky (IOL) v case po operácii katarakty. Porovnat zamenitelnost meraní medzi automatickým keratorefraktometrom (AKRM) a biometrom. Materiál a metodika: Prospektívna observacná štúdia, v ktorej sme sledovali dané parametre na 25 ociach (25 pacientov) v prvom dni, prvom týždni, prvom a v tretom mesiaci po nekomplikovanej operácii katarakty. Ako nepriamy ukazovatel zmeny stability IOL sme použili astigmatizmus indukovaný IOL (rozdiel medzi refraktometriou a keratometriou). Na analýzu zhody medzi prístrojmi sme použili Blant-Altmanovú metódu. Výsledky: V horeuvedených casových bodoch klesal chirurgicky indukovaný astigmatizmus nasledovne: 0,65 D; 0,62 D; 0,60 D a 0,41 D (v prvom dni, týždni, mesiaci a tretom mesiaci). Astigmatizmus indukovaný zmenou polohy umelej vnútroocnej šošovky sa menil nasledovne: 0,88 D; 0,59 D; 0,44 D a 0,49 D. Zmeny v oboch parametroch boli štatisticky signikantné (p<0,05). Merania hodnoty astigmatizmu aj uhla astigmatizmu nevykazovali štatisticky signikantný rozdiel medzi prístrojmi (p>0,05). Záver: Chirurgicky indukovaný astigmatizmus aj astigmatizmu indukovaný IOL signikantne klesal v case (p < 0,05). Pokles chirurgicky indukovaného astigmatizmu rohovky bol najvýraznejší medzi prvým a tretím mesiacom po operácii. U astigmatizmu indukovaného IOL bol najväcší pokles do prvého mesiaca po operácii. Rozdiely v meraní medzi biometrom a AKRM boli štatisticky nesignikantné, avšak klinická zamenitelnost medzi danými metódami je otázna, obzvlášt u merania uhlu astigmatizmu.
Aims: To analyze changes in surgically induced corneal astigmatism and articial intraocular lens (IOL) stability over time following cataract surgery. To compare the interchangeability of measurements between an automatic keratorefractometer (AKRM) and a biometer. Material and methods: In this prospective observational study, the above-mentioned parameters were collected from 25 eyes (25 subjects) on the first day, first week, first and third month after uncomplicated cataract surgery. We used IOL-induced astigmatism (difference between refractometry and keratometry) as an indirect indicator of IOL stability change. We used the Blant-Altman method to analyze consistency between devices. Results: At the above time points, surgically induced astigmatism (SIA) decreased as follows: 0.65 D; 0.62 D; 0.60 D and 0.41 D (in the first day, week, month and third month respectively). Astigmatism induced by changes of the position of the IOL varied as follows: 0.88 D; 0.59 D; 0.44 D and 0.49 D. Changes in both parameters were statistically significant (p<0.05). Neither the measurements of the astigmatism value nor the astigmatism angle showed a statistically significant difference between the devices (p>0.05). Conclusion: Both surgically induced astigmatism and astigmatism induced by IOL decreased over time, in which both changes were statistically significant. The decrease in SIA was most pronounced between the first and third month after surgery. For IOL-induced astigmatism, the greatest decrease was within the first month after surgery. The differences in measurement between the biometer and AKRM were statistically insignificant, but the clinical interchangeability between the given methods is questionable, especially with regard to measurement of the astigmatism angle.
- MeSH
- Astigmatism * diagnosis etiology MeSH
- Cataract Extraction methods adverse effects MeSH
- Lens Implantation, Intraocular methods adverse effects MeSH
- Cataract MeSH
- Humans MeSH
- Lenses, Intraocular MeSH
- Artificial Lens Implant Migration MeSH
- Prospective Studies MeSH
- Refractometry methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Observational Study MeSH
BACKGROUND: Gastrointestinal anastomoses are performed in many patients every year. The pathogenesis of aberrant anastomotic healing and the causes of intestinal leakage are not fully understood. The present study gathered and critically evaluated histological quantitative data to deepen current knowledge of anastomotic healing in the small and large intestine and its complications and outline the options for further experimental in vivo research in large porcine animal models. METHODS: Three groups of porcine intestinal anastomoses were compared: small intestine without defect (SI; n = 7), small intestine with an additional defect (SID; n = 8), and large intestine (LI; n = 7). Multilevel sampling (2112 micrographs) and stereological methods were used for histological quantification of proliferation (Ki-67 immunohistochemistry), neutrophil infiltration (myeloperoxidase staining), vascularity (von Willebrand factor) and type I and type III collagen formation (picrosirius red in polarized light) within the region of anastomosis compared to the region outside of anastomosis. RESULTS: Quantitative histological evaluation revealed the following results. i) Proliferation, vascularity, and collagen, but not neutrophils, were more highly expressed within the anastomosis than outside of the anastomosis region. ii) Porcine large and small intestine were not interchangeable based on histological evaluation of surgical experiments. The presence or absence of an additional experimental defect strongly affected healing, but the healing seemed complete after 21 days. iii) The microscopic structure of small intestine segments was more affected by their proximity to the anastomosis than the structure of large intestine segments. CONCLUSIONS: Histological quantification was more laborious than the previously used semiquantitative scoring system evaluating the healing rate of intestinal anastomoses, but it provided detailed maps of biological processes within individual intestine layers. The primary data collected in the study are open and available for power sample analyses to calculate the minimum numbers of samples justified in future experiments on porcine intestines. The porcine intestine is a promising animal model with translational potential for human surgery.
- MeSH
- Anastomosis, Surgical methods MeSH
- Wound Healing * MeSH
- Humans MeSH
- Swine MeSH
- Intestines MeSH
- Intestine, Small * MeSH
- Intestine, Large MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: This study aimed to determine the acute effect of agonist and antagonist conditioning activities (CA) on medicine ball throw performance among female softball players. METHODS: Thirteen national-level female softball players (age 22.2 ± 3.1 years; body mass 68.3 ± 11.3 kg; softball experience 7.3 ± 2.4 years) performed 3 medicine ball chest throws before conditioning activity (CA) and after CA respectively in 3rd, 6th, and 9th minute. CA was the bench press and bent-over barbell row with 2 sets of 4 repetitions at 60% and 80% of one-repetition maximum, and 2 sets of 4 repetition bodyweight push up. RESULTS: Two-way ANOVA revealed an increase in throwing distance (p < 0.001) after bent over barbell row and push-up exercise, and an increase in throwing speed (p < 0.001) after bench press and push-up. All performance increases were in moderate effect size (Cohen d 0.33-0.41), and no differences were found between the experimental CA. CONCLUSIONS: We conclude that upper body throwing performance is similar after antagonist exercise and agonist CA, both agonist and antagonist CA increase muscle power. In the resistance training practice, we recommend the interchange of agonist and antagonist CA using bodyweight push-up or submaximal intensity (80% of 1RM) bench press and bent over barbell row to succeed post-activation performance enhancement in upper limbs.
- Publication type
- Journal Article MeSH
