Children and adults with repaired tetralogy of Fallot (rTOF) have an impaired exercise capacity, a less active lifestyle and an increased long-term risk of adverse outcomes compared with healthy ...peers. This study aimed to summarise the current evidence for the effectiveness and safety of exercise training interventions in patients with rTOF.
PubMed/MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus and reference lists of relevant articles were searched for prospective studies published by November 2021. Random-effects meta-analysis and descriptive synthesis were performed to assess the effectiveness and safety of exercise training in patients with rTOF.
Of the 9677 citations identified, 12 articles were included that reported on 10 unique studies and covered 208 patients with rTOF (range of mean/median age: 7.4-43.3 years). All studies implemented 2 to 7 aerobic or respiratory training sessions per week with durations ranging from 6 to 26 weeks. Meta-analysis of the included randomised controlled trials showed that exercise training was associated with a significant improvement in peak VO
(pooled mean difference: +3.1 mL/min/kg; 95% CI: 0.76 to 5.36 mL/min/kg, p=0.019). Cardiac imaging studies revealed no subclinical adverse remodelling after the exercise interventions. No serious adverse events including arrhythmias were reported in these studies.
Current evidence suggests that exercise training can improve exercise capacity in patients with rTOF with a low risk for adverse events. Exercise prescription may be a safe and effective tool to help improving outcomes in patients with rTOF.
CRD42021292809.
Our objective was to optimize the CA technique on mammal embryos.
1000 frozen 2-cell embryos from B6CBA mice were used. Based on a literature review, and after checking post-thaw embryo viability, ...the main outcome measures included: 1) comparison of the embryo recovery rate between 2 CA protocols (2 agarose layers and 3 agarose layers); 2) comparison of DNA damage by the CA on embryos with (ZP+) and without (ZP−) zona pellucida; and 3) comparison of DNA damage in embryos exposed to 2 genotoxic agents (H2O2 and simulated sunlight irradiation (SSI)). DNA damage was quantified by the % tail DNA.
1) The recovery rate was 3,3% (n=5/150) with the 2 agarose layers protocol and 71,3% (n=266/371) with the 3 agarose layers protocol. 2) DNA damage did not differ statistically significantly between ZP− and ZP+ embryos (12.60±2.53% Tail DNA vs 11.04±1.50 (p=0.583) for the control group and 49.23±4.16 vs 41.13±4.31 (p=0.182) for the H2O2 group); 3) H2O2 and SSI induced a statistically significant increase in DNA damage compared with the control group (41.13±4.31% Tail DNA, 36.33±3.02 and 11.04±1.50 (p<0.0001)).
The CA on mammal embryos was optimized by using thawed embryos, by avoiding ZP removal and by the adjunction of a third agarose layer.
•Retaining zona pellucida and using frozen embryos simplified the Comet Assay technique.•The adjunction of a third agarose layer reduced embryo loss.•The use of frozen embryos allows subsequent analysis if required.•This new tool could be used to analyze DNA damage in embryos after in vivo or in vitro exposure.
A seven-year-old, spayed female, domestic longhair cat was referred for management of a sudden aortic thromboembolism (ATE). Echocardiography showed hypertrophic cardiomyopathy with severe left ...atrial enlargement. Ultrasonography of the abdominal aorta confirmed a large thrombus at the level of the aortic trifurcation, involving both iliac arteries. Considering the recent onset and bilateral involvement of the iliac arteries, the cat underwent emergent surgical embolectomy (SE) of the aortoiliac embolus. A standard caudal celiotomy was performed and the abdominal aorta was identified. Vessel loops with tourniquets were placed around the abdominal aorta proximal to the thrombus and on both iliac arteries distal to the thrombus. A full-thickness incision was made in the ventral surface of the aorta. The aortic thromboembolus was removed. The trifurcation was subsequently flushed with sterile saline. The SE resulted in a good outcome, with both clinical and ultrasound signs of complete reperfusion of the rear limbs within a few hours. Long-term treatment included antiplatelet drugs, furosemide and benazepril. Eighteen months after surgery, the cat was free of clinical signs, without recurrence of ATE or congestive heart failure. Based on the present case, SE could be considered as a feasible alternative to traditional conservative treatment in cats with a very recent onset of bilateral ATE.
Diffuse large B cell lymphoma (DLBL) is the most common type of lymphoma worldwide, representing about 25% of all non-Hodgkin lymphomas. Among these lymphomas, primary DLBL of the central nervous ...system (CNS) is a rare category listed at 2016 revision of the World Health Organization classication of lymphoid neoplasms. First line treatment is based on methotrexate (MTX), with studies showing complete remission rates of 30 to 60% in patients who receive high-dose MTX, alone or in combination with other agents. The rarity of primary CNS lymphomas makes randomized trials dicult to do, but regimens usually include MTX plus one of the following drugs: cytarabine, procarbazine, temozolomide or rituximab in CD20 positive tumors.
to present a case of primary CNS lymphoma presenting as multiple lesions in the cerebellum.
We present a case of a 57-year-old female patient, without comorbidities or HIV seropositivity, diagnosed with diffuse large B cell lymphoma with cerebellar origin. During a period of 4 months the patient presented progressive difficulties to accomplish everyday activities quickly evolved, and were accompanied by aphasia, dysarthria, lack of motor coordination, nausea and vomiting. Her handwriting was unintelligible. A brain MRI showed enhanced leptomeningeal area associated with middle cerebellar peduncle lesions on both sides. Biopsy confirmed the diagnosis of lymphoma with immunohistochemistry showing positivity for CD20 and 40% Ki67. Bone marrow biopsy was normal and the serology for HIV, Epistein-Barr virus and hepatitis B and C viruses were negative. She was treated high dose induction immunochemotherapy with methotrexate (four doses of 3.5 g/m2), cytarabine (two cycles of 2 g/m2, twice a day for 2 days) and rituximab (four doses of 375 mg/m2). After the first cycle, the patient developed foreign accent syndrome (FAS) changing from her Brazilian accent to a Portuguese accent (within the same language). Despite FAS, other neurological symptoms ameliorated and the patient can once again write with her normal handwriting, have conversations and read. She was referred to complementary whole-brain radiotherapy.
Literature on cerebellar primary central nervous system lymphoma is scarce.1 A review of PCNSL reported only 9% of tumors with cerebellar involvement. The addition of high-dose cytarabine to high-dose methotrexate seems to be associated with improved response in patients with primary CNS lymphoma. However, cerebellar toxicity is a dose-dependent adverse effect of cytarabine and a concern in cases with previous cerebellar syndrome. FAS may be related to involvement of ’linguistic cerebellum’2 but apparently not associated with cytarabine. We showed that this combination was possible, without major neurologic events.
Early diagnosis and treatment is important for the successful management of this aggressive and uncommon cerebellar tumor. Symptomatic improvement was fast after MTX initiation and the addition of cytarabine is feasible.
Background: Preventive measures remain the best approach to control the spread of hepatitis B virus (HBV) infection. Patients and Methods: To evaluate the effectiveness of vaccination against HBV, we ...conducted a 20-year retrospective study on 100 subjects, born to hepatitis B surface antigen (HBsAg)-positive mothers, who had received postexposure prophylaxis at the Clinic of Infectious Diseases (Siena University, Italy) during 1984-2004. All patients were tested for the presence of HBsAg, anti-HBs and anti-HB core antigen (anti-HBc). Results: Two subjects (2%) acquired the infection as shown by the presence of anti-HBc. Of the 98 patients who did not acquire the infection, 62 of these (63.3%) had an anti-HBs concentration considered protective (double dagger 10 mIU/ml). The percentage of protected subjects decreased in relation to time from vaccination with a significant reduction (p = 0.009) of anti-HBs geometric mean titre (GMT) after 5 years, which reached the level of 10 mIU/ml after about 15 years. No patients without protective concentration have acquired the infection as of today. Only 12% of the HBsAgpositive mothers were followed in specialized structures after pregnancy, reflecting the scarce knowledge of the problem in the general population. Conclusion: Our data, while confirming the effectiveness of anti hepatitis B vaccination, highlight the need for postvaccination follow-up, particularly in high-risk categories, to prolong protection, through booster doses if necessary. We show, moreover, the importance of maintaining active surveillance in the territory to improve follow-up to chronic carriers and to sensitize families.
In the 1992–1995 runs CDF has collected large samples of
J
ψ
,
ψ(2
S) and ϒ identified through their muonic decay. In the charmonium system all production sources have been separately measured and ...compared with the theoretical predictions. A large excess of direct production has been observed for both
ψ(2
S) and
J
ψ
. The relative production rate for the
χ
c
1 and
χ
c
2 has also been measured. The unexpected results have lead to a profound revisitation of the theory of the production of
Q
Q
bound states in high energy hadronic collisions.
Recently, concern has increased regarding the spread of methicillin-resistant Staphylococcus aureus (MRSA) in the community. We studied 812 subjects from central Italy to establish the rates of nasal ...carriage of S. aureus, and antibiotic susceptibility patterns, in the community. The prevalence of S. aureus nasal carriage was 30.5%. Only one subject, with predisposing risk factors for acquisition, was identified as carrier of MRSA (prevalence of 0.12%). The presence of MRSA in the community of our area still appears to be a rare event. Among methicillin-susceptible S. aureus (MSSA) isolates, a surprisingly high rate (18%) of resistance to rifampin was observed.
Large-size Resistive Micromegas have been chosen for the upgrade of the forward muon spectrometer of the ATLAS experiment, the New Small Wheel project. These chambers, together with small-strip Thin ...Gap Chambers (sTGC), allow reconstruction of high-momentum muon tracks in a high-radiation environment and provide a robust low-threshold single-muon trigger. A collaboration of seven INFN units built 32 SM1 type chambers, corresponding to one fourth of the total number needed for this upgrade. Each SM1 chamber has a surface of approximately 2 m2 and four sensitive layers. The production was shared among five INFN construction sites and it was completed in fall 2020. The construction methods, as well as the results of the quality tests done on components of the detector and on the assembled chambers, are reported in the present paper.
A healthy 27-year-old woman presented, four months after childbirth, ingravescent pain and claudication of the left lower limb. Magnetic Resonance Imaging of the lumbosacral and iliac regions showed ...widespread muscular-skeletal lesions. The patient underwent surgery; Cryptococcus neoformans was isolated from surgical samples. Liposomal amphotericin B, fluconazole and itraconazole were administered. Laboratory findings showed lymphocytopenia, with reduction of CD4+ lymphocytes (23 cells per cubic millimeter) in the absence of HIV infection and any other defined immunodeficiency. This is a rare case of muscular-skeletal cryptococcal infection isolated in a subject affected with idiopathic CD4+ lymphocytopenia.
Recent reports suggest an association between
Chlamydia pneumoniae and chronic coronary heart disease. This case-control study investigates the relationship between the presence of immunoglobin G ...(IgG) and immunoglobin A (IgA) when measured by means of microimmunofluorescence (MIF) and angiographically diagnosed coronary disease. Cases (
n=150) were angiography patients with at least one coronary artery lesion occupying at least 50% of the luminal diameter. Controls (
n=49) were angiography patients with no detectable signs of coronary artery disease and patients (
n=56) without signs or symptoms of coronary disease and with normal ECG results. No significant differences were revealed between the seroprevalence of IgG and IgA and geometric mean titers (GMT) as measured in cases and controls. When cases were compared with controls whose angiographic results were normal, after adjusting for established risk factors (cholesterol, smoking, hypertension, diabetes, age, gender and family history), the estimated risk of coronary artery disease was 0.79 (95% confidence interval (C.I.), 0.31–1.99) for the presence of IgG and was 0.94 (95% C.I., 0.37–2.39) for IgA. When cases were compared with controls with normal ECG results, the adjusted odds ratio (O.R.) for coronary artery disease was 1.17 (95% C.I., 0.52–2.62) for the presence of IgG and 0.82 (95% C.I., 0.36–1.86) for the presence of IgA. These results do not support an association between
C. pneumoniae infection and coronary disease.
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