scholarly journals Is muscle and protein loss relevant in long‐term fasting in healthy men? A prospective trial on physiological adaptations

2021 ◽  
Author(s):  
Claire Laurens ◽  
Franziska Grundler ◽  
Anthony Damiot ◽  
Isabelle Chery ◽  
Anne‐Laure Le Maho ◽  
...  
Keyword(s):  
Prospective Trial ◽  
Protein Loss ◽  
Healthy Men ◽  
Physiological Adaptations

Use Of Tai Chi Elements To Increase Respiratory Amplitude

2019 ◽  
pp. 11-20
Author(s):  
Mihai-Alexandru Citea ◽  
Marius Neculaes
Keyword(s):  
High Performance ◽  
Tai Chi ◽  
Sports Club ◽  
Optimal Functioning ◽  
Physiological Adaptations ◽  
Competitive Activity ◽  
Abdominal Breathing ◽  
Study Participants ◽  
Different Levels

High performance sport has a major impact on the physiological adaptations of the respiratory system. The importance of the optimal functioning of this system is essential to achieve top results in high performance sport but also in maintaining a long term health status. Science journals present numerous studies that highlight the benefits of practicing Tai Chi on the general population, with effects ranging from improving cardiac function, to influencing the immune system. The purpose of this study is to identify whether by practicing Tai Chi forms a athlete can change their breathing pattern and develop their respiratory amplitude. The subjects of the study were 22 fencing practitioners, accredited at the Iași Municipal Sports Club (C.S.M. Iași), aged between 14 and 18 years, with over 3 years of competitive activity. Materials and method: The study participants were evaluated initially and at the end of 7 months of practice. The frequency was 3 sessions per week, and the duration of each session was 20-30 minutes. The evaluation consisted in measuring the circumference of the thorax at 3 different levels: subaxillary, medial thorax (T6-T7) and lower rib (diaphragmatic) in maximal inspiration and expiration. Conclusions: A constant evolution is observed in most of the exposed cases. In cases where this evolution is not visible, a change in the breathing mode can be noticed, transforming from an upper rib breathing into a thoracic or abdominal breathing. With the exception of one case, all subjects had an improvement of the value in the lower rib level.

scholarly journals Combined low-dose everolimus and low-dose tacrolimus after Alemtuzumab induction therapy: a randomized prospective trial in lung transplantation

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alberto Benazzo ◽  
Ara Cho ◽  
Anna Nechay ◽  
Stefan Schwarz ◽  
Florian Frommlet ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Lung Transplantation ◽  
Kidney Function ◽  
Induction Therapy ◽  
Low Dose ◽  
Prospective Trial ◽  
Control Group ◽  
Long Term Outcomes ◽  
Maintenance Immunosuppression

Abstract Background Long-term outcomes of lung transplantation are severely affected by comorbidities and development of chronic rejection. Among the comorbidities, kidney insufficiency is one of the most frequent and it is mainly caused by the cumulative effect of calcineurin inhibitors (CNIs). Currently, the most used immunosuppression protocols worldwide include induction therapy and a triple-drug maintenance immunosuppression, with one calcineurin inhibitor, one anti-proliferative drug, and steroids. Our center has pioneered the use of alemtuzumab as induction therapy, showing promising results in terms of short- and long-term outcomes. The use of alemtuzumab followed by a low-dose double drug maintenance immunosuppression, in fact, led to better kidney function along with excellent results in terms of acute rejection, chronic lung allograft dysfunction, and survival (Benazzo et al., PLoS One 14(1):e0210443, 2019). The hypothesis driving the proposed clinical trial is that de novo introduction of low-dose everolimus early after transplantation could further improve kidney function via a further reduction of tacrolimus. Based on evidences from kidney transplantation, moreover, alemtuzumab induction therapy followed by a low-dose everolimus and low-dose tacrolimus may have a permissive action on regulatory immune cells thus stimulating allograft acceptance. Methods A randomized prospective clinical trial has been set up to answer the research hypothesis. One hundred ten patients will be randomized in two groups. Treatment group will receive the new maintenance immunosuppression protocol based on low-dose tacrolimus and low-dose everolimus and the control group will receive our standard immunosuppression protocol. Both groups will receive alemtuzumab induction therapy. The primary endpoint of the study is to analyze the effect of the new low-dose immunosuppression protocol on kidney function in terms of eGFR change. The study will have a duration of 24 months from the time of randomization. Immunomodulatory status of the patients will be assessed with flow cytometry and gene expression analysis. Discussion For the first time in the field of lung transplantation, this trial proposes the combined use of significantly reduced tacrolimus and everolimus after alemtuzumab induction. The new protocol may have a twofold advantage: (1) further reduction of nephrotoxic tacrolimus and (2) permissive influence on regulatory cells development with further reduction of rejection episodes. Trial registration EUDRACT Nr 2018-001680-24. Registered on 15 May 2018

scholarly journals Long-Term Skills Retention Following a Randomized Prospective Trial on Adaptive Procedural Training

2018 ◽  
Vol 75 (6) ◽  
pp. 1589-1597 ◽  
Author(s):  
Adriana G. Ramirez ◽  
Yinin Hu ◽  
Helen Kim ◽  
Sara K. Rasmussen
Keyword(s):  
Prospective Trial ◽  
Procedural Training ◽  
Skills Retention ◽  
Randomized Prospective Trial

Long-term outcome of a prospective trial of steroid withdrawal after kidney transplantation

Surgery ◽  
1999 ◽  
Vol 125 (2) ◽  
pp. 155-159 ◽  
Author(s):  
Ty B. Dunn ◽  
Massimo Asolati ◽  
Dawn M. Holman ◽  
Vandad Raofi ◽  
Borko Jovanovic ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Prospective Trial ◽  
Steroid Withdrawal ◽  
Term Outcome ◽  
Long Term Outcome

Long-Term Inhalative Sedation in Children With Pulmonary Diseases

2020 ◽  
pp. 088506662095339
Author(s):  
Jochen Meyburg ◽  
David Frommhold ◽  
Johann Motsch ◽  
Navina Kuss
Keyword(s):  
Side Effects ◽  
Lung Function ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Prospective Trial ◽  
Pediatric Intensive Care ◽  
Normal Lung ◽  
Beneficial Effects

Objectives: To describe safety and feasibility of long-term inhalative sedation (LTIS) in children with severe respiratory diseases compared to patients with normal lung function with respect to recent studies that showed beneficial effects in adult patients with acute respiratory distress syndrome (ARDS). Design: Single-center retrospective study. Setting: 12-bed pediatric intensive care unit (PICU) in a tertiary-care academic medical center in Germany. Patients: All patients treated in our PICU with LTIS using the AnaConDa® device between July 2011 and July 2019. Measurements and Main Results: Thirty-seven courses of LTIS in 29 patients were analyzed. LTIS was feasible in both groups, but concomitant intravenous sedatives could be reduced more rapidly in children with lung diseases. Cardiocirculatory depression requiring vasopressors was observed in all patients. However, severe side effects only rarely occured. Conclusions: In this largest cohort of children treated with LTIS reported so far, LTIS was feasible even in children with severely impaired lung function. From our data, a prospective trial on the use of LTIS in children with ARDS seems justified. However, a thorough monitoring of cardiocirculatory side effects is mandatory.

scholarly journals Deficiencies in Scientific Evidence for Medical Management of Gender Dysphoria

2019 ◽  
Vol 87 (1) ◽  
pp. 34-42 ◽  
Author(s):  
Paul W. Hruz
Keyword(s):  
Gender Identity ◽  
Gender Dysphoria ◽  
Small Sample Size ◽  
Scientific Evidence ◽  
Prospective Trial ◽  
Scientific Data ◽  
Small Sample ◽  
Sex Characteristics ◽  
Biological Sex

Individuals who experience a gender identity that is discordant with biological sex are increasingly presenting to physicians for assistance in alleviating associated psychological distress. In contrast to prior efforts to identify and primarily address underlying psychiatric contributors to gender dysphoria, interventions that include uncritical social affirmation, use of gonadotropin-releasing hormone agonists to suppress normally timed puberty, and administration of cross-sex steroid hormones to induce desired secondary sex characteristics are now advocated by an emerging cohort of transgender medicine specialists. For patients with persistent gender dysphoria, surgery is offered to alter the appearance of breasts and genital organs. Efforts to address ethical concerns regarding this contentious treatment paradigm are dependent upon reliable evidence on immediate and long-term risks and benefits. Although strong recommendations have been made for invasive and potentially irreversible interventions, high-quality scientific data on the effects of this approach are generally lacking. Limitations of the existing transgender literature include general lack of randomized prospective trial design, small sample size, recruitment bias, short study duration, high subject dropout rates, and reliance on “expert” opinion. Existing data reveal significant intervention-associated morbidity and raise serious concern that the primary goal of suicide prevention is not achieved. In addition to substantial moral questions, adherence to established principles of evidence-based medicine necessitates a high degree of caution in accepting gender-affirming medical interventions as a preferred treatment approach. Continued consideration and rigorous investigation of alternate approaches to alleviating suffering in people with gender dysphoria are warranted. Summary: This paper provides an overview of what is currently known about people who experience a gender identity that differs from their biological sex and the associated desire to engage the medical profession in alleviating associated discomfort and distress. The scientific evidence used to support current recommendations for affirming one’s preferred gender, halting normally timed puberty, administering cross-sex hormones, and surgically altering primary and secondary sexual traits are summarized and critically evaluated. Serious deficits in understanding the cause of this condition, the reasons for the marked increase in people presenting for medical care, together with immediate and long-term risks relative to benefit of medical intervention are exposed.

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