Pooled analysis of monocyte distribution width in subjects with SARS‐CoV‐2 infection

Do genetic polymorphisms in angiotensin converting enzyme 2 (ACE2) gene play a role in coronavirus disease 2019 (COVID-19)?

Abstract Although some demographic, clinical and environmental factors have been associated with a higher risk of developing coronavirus disease 2019 (COVID-19) and progressing towards severe disease, altogether these variables do not completely account for the different clinical presentations observed in patients with comparable baseline risk, whereby some subjects may remain totally asymptomatic, whilst others develop a very aggressive illness. Some predisposing genetic backgrounds can hence potentially explain the broad inter-individual variation of disease susceptibility and/or severity. It has been now clearly established that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2…

Physical activity and laryngeal cancer

Although an active lifestyle physical has been convincingly associated with a decreased risk of developing many forms of cancers, including neck and head malignancies, uncertainty surrounds the relationship between physical activity (PA) and laryngeal carcinogenesis. Epidemiologic evidence, garnered from some well-conducted cross-sectional, prospective and retrospective studies, seemingly attests that the impact of PA may be not so straightforward in lowering laryngeal cancer risk as for other malignancies. Reasonable consensus has been reached that moderate-intensity PA may generate the larger potential benefits, whilst the effect of high-intensity PA appears more controversial and even co…

How does the journal impact factor affect the CV of PhD students?

In his editorial “Dear DORA”, Howy Jacobs commented on the recent San Francisco Declaration of Research Assessment (DORA) to address the misuse of the journal impact factor (IF) and discussed alternatives. DORA stipulates that the IF must not be used as a surrogate measure of the quality of individual research articles, or to assess an individual scientist's contributions in hiring, promotion and funding decisions. DORA and many other commentators, such as Howy Jacobs, therefore advocate the use of additional, alternative metrics and other measures to make a more fair and realistic judgment about the quality of a scientist's or …

Altitude exposure in sports: the Athlete Biological Passport standpoint

The Athlete Biological Passport (ABP) is principally founded on monitoring an athlete's biological variables over time, to identify abnormal biases on a longitudinal basis. Several factors are known to influence the results of these markers. However, the manner in which the altitude factor is taken into account still needs to be standardized. Causal relationships between haematological variables should be correctly integrated into ABP software. In particular, modifications of haematological parameters during and after exposure to different altitudes/hypoxic protocols need to be properly included within detection models. Copyright © 2013 John Wiley & Sons, Ltd.

An overview of doping in sports

The history of doping field can be outlined in three major stages: (1) early stage in which drug abuse took place during sports performance and competition and gas chromatography was used for its detection; (2) approximately in the 1970s when androgenic anabolic steroids were introduced; (3) In the recent era when the fields of biochemistry, physiology, toxicology, genomics, genetics, immunology, and molecular biology were integrated and applied routinely. Advanced omics technology and gene doping age may be applied in near future. This review will discuss commonly abused materials, both their adverse and harmful effects, and the alleged benefits in conjunction with the current standards in…

The hMTH1 paradox: antioxidants recommended in cancer?

Summary Activated Ras GTPase signalling is a critical driver of oncogenic transformation and malignant disease. Cellular models of RAS-dependent cancers have been used to identify experimental small-molecules, such as SCH51344, but their molecular mechanism of action remains generally enigmatic. Here, using a chemical proteomic approach we identify the target of SCH51344 as the human mutT homologue MTH1, a nucleotide pool sanitising enzyme. Loss-of-function of MTH1 impaired growth of KRAS tumour cells whereas MTH1 overexpression mitigated sensitivity toward SCH51344. Searching for more drug-like inhibitors, we identified the kinase inhibitor crizotinib as a nanomolar suppressor of MTH1 acti…

Cardiac troponin release during and after endurance exercise: epidemiologic health implications.

p16INK4a, NAD+, and Sestrins: New Targets for Combating Aging-Related Chronic Illness?

Aging-related chronic illness is a price we have to pay to live longer. Prevalent among the oldest old, the condition limits their functional independence and also aggravates the course of several age-related chronic diseases. Thus, the search is on for efficient therapies that will mitigate age-related pathologies. In this article, we point out the potential clinical implications of recent provocative basic research in the field. New possible targets have been recently discovered, are clearly involved in age-related pathologies and might benefit the treatment of other age-related conditions, particularly metabolic diseases.

Topical application of the Wnt/β-catenin activator methyl vanillate increases hair count and hair mass index in women with androgenetic alopecia

Activation of the WNT/β-catenin pathway has emerged as a potential therapeutic target in androgenetic alopecia (AGA). Methyl vanillate (MV) - a safe plant-derived ingredient - has been recently shown to activate the WNT/β-catenin signaling. Objectives Two distinct substudies were conducted. First, we designed a 6-month, uncontrolled, open-label clinical study to investigate whether topically applied MV may increase hair count and hair mass index (HMI) in female AGA. Second, we conducted a molecular study on the effect of MV on WNT10B mRNA expression in scalp biopsies of women with AGA. A total of 20 Caucasian women (age range: 25-57 years) with AGA (Sinclair grade 1-2) were included. The re…

Sudden Cardiac and Noncardiac Death in Sports: Epidemiology, Causes, Pathogenesis, and Prevention

AbstractAlthough few doubts remain that physical exercise should be widely promoted for maintenance of health and fitness, the risk of adverse events such as sudden death (especially due to cardiac causes, i.e., sudden cardiac death [SCD]) during exercise remains tangible. The overall risk of sudden death in athletes is relatively low (i.e., usually comprised between 0.1 and 38/100,000 person-years), and globally comparable to that of the general population. However, up to 20% of all sudden death cases are still recorded while exercising. The most frequent underlying disorders encountered in SCD are hypertrophic cardiomyopathy and coronary artery disease (CAD), representing three quarters o…

Plasma Antithrombin Values Are Significantly Decreased in Coronavirus Disease 2019 (COVID-19) Patients with Severe Illness

Body Mass Index and Risk for Intubation or Death in SARS-CoV-2 Infection

The hybrid algorithm (Hbmr) to fight against blood doping in sports

Epidemiological, biological and clinical update on exercise-induced hemolysis

Exercise-induced hemolysis can be conventionally defined as rupture and destruction of erythrocytes during physical exercise. The currently available epidemiologic information attests that a substantial degree of exercise-induced hemolysis is commonplace after short-, medium-, long- and ultra-long distance running, as reflected by significant decrease of serum or plasma haptoglobin and significant increase of plasma concentration (or overall blood content) of free hemoglobin. This paraphysiological intravascular hemolysis is typically mild (average variations of hemolysis biomarkers are usually comprised between 1.2- and 1.8-fold), almost self-limiting (completely resolving within 24-48 hou…

Neuromuscular electrical stimulation: a new therapeutic option for chronic diseases based on contraction-induced myokine secretion

Myokines are peptides known to modulate brain neuroplasticity, adipocyte metabolism, bone mineralization, endothelium repair and cell growth arrest in colon and breast cancer, among other processes. Repeated skeletal muscle contraction induces the production and secretion of myokines, which have a wide range of functions in different tissues and organs. This new role of skeletal muscle as a secretory organ means skeletal muscle contraction could be a key player in the prevention and/or management of chronic disease. However, some individuals are not capable of optimal physical exercise in terms of adequate duration, intensity or muscles involved, and therefore they may be virtually deprived…

Allopurinol prevents cardiac and skeletal muscle damage in professional soccer players

Xanthine oxidase (XO), a free radical-generating enzyme, is involved in tissue damage produced during exhaustive exercise. Our aim was to test whether allopurinol, a powerful inhibitor of XO, may be effective in preventing exercise-induced tissue damage in soccer players. Twelve soccer players were randomized into two experimental groups. One received allopurinol, before a match of the premier Spanish Football League, and the other placebo. Allopurinol prevented the exercise-induced increase in all the markers of skeletal muscle damage analyzed: creatine kinase, lactate dehydrogenase, aspartate aminotransferase, and myoglobin. Creatine kinase-MB isoenzyme and highly sensitive troponin T, sp…

Laboratory medicine and sports : between Scylla and Charybdis

Laboratory medicine is complex and contributes to the diagnosis, therapeutic monitoring and follow-up of acquired and inherited human disorders. The regular practice of physical exercise provides important benefits in heath and disease and sports medicine is thereby receiving growing focus from almost each and every clinical discipline, including laboratory medicine. Sport-laboratory medicine is a relatively innovative branch of laboratory science, which can provide valuable contributions to the diagnosis and follow-up of athletic injuries, and which is acquiring a growing clinical significance to support biomechanics and identify novel genomics and "exercisenomics" patterns that can help i…

The health risks of acute exercise should also matter to internal medicine.

Diagnostic electrophysiological study in a highly trained young woman with presyncopal symptoms during exercise: a case report

Right ventricular outflow tract (RVOT) ventricular tachycardia (VT) is frequent and occurs in patients without structural heart disease, especially in highly trained athletes. Most of the studies on cardiac adaptations to exercise have been investigated in male athletes. Women, however, are increasingly participating in sports and electrical and structural adaptations in male and female athletes differ significantly. These cardiac adaptations dissimilarities between males and females have potential implications in diagnosing certain types of arrhythmias. We present here a case of a 35-year-old highly-trained woman endurance athlete that attended the clinic complaining about chest pain and d…

Mean speed in professional cycling: No evidence of decline

Abstract The aim of this article was to evaluate the mean speed progression of the three major cycling stage races in order to empirically establish whether excellent in performance in professional cycling is to some extent correlated with the trend of blood doping and anti-doping throughout more than a century of official cycling competitions. We retrieved data about the mean speed of the winners of the Tour de France, Giro d’Italia and Vuelta a Espana, since their beginning. A linear correlation has then been calculated between the years and the mean speed in km/h for each single major cycling stage race, as well as for the mean speed of the winners of the three major cycling stage races …

Global epidemiology of atrial fibrillation: An increasing epidemic and public health challenge.

Background Atrial fibrillation is the most frequent cardiac arrhythmia. It has been estimated that 6–12 million people worldwide will suffer this condition in the US by 2050 and 17.9 million people in Europe by 2060. Atrial fibrillation is a major risk factor for ischemic stroke and provokes important economic burden along with significant morbidity and mortality. Aim We provide here comprehensive and updated statistics on worldwide epidemiology of atrial fibrillation. Methods An electronic search was conducted for atrial fibrillation. The epidemiologic information was retrieved from the Global Health Data Exchange database, which is regarded as one of the most comprehensive worldwide catal…

Effects of endurance exercise on serum concentration of calcitonin gene-related peptide (CGRP): A potential link between exercise intensity and headache

Abstract Background Calcitonin gene-related peptide (CGRP) is a powerful neuropeptide that is strongly involved in headache pain pathogenesis by triggering vasodilation, mast cell degranulation and neurogenic inflammation. This evidence has prompted us to investigate the acute influence of endurance exercise on CGRP concentration in blood. Methods The study population consisted of 48 male amateur runners, who ran a half-marathon distance at 75%–85% of maximal oxygen uptake. Blood was drawn before the run (pre-run) and immediately after each runner ended his trial (post-run). The serum concentration of CGRP was measured with a commercial enzyme-linked immunosorbent assay (ELISA) technique. R…

Association between climate and new daily diagnoses of COVID-19

AbstractBackgroundAlthough evidence is accumulating that climate conditions may positively or negatively influence the scale of coronavirus disease 2019 (COVID-19) outbreaks, uncertainty remains concerning the real impact of climate factors on viral transmission. Methods. The number of new daily cases of COVID-19 diagnosed in Verona (Italy) was retrieved from the official website of Veneto Region, while information on daily weather parameters in the same area was downloaded from IlMeteo website, a renowned Italian technological company specialized in weather forecasts. The search period ranged between March 1 to November 11, 2020. The number of new daily COVID-19 cases and meteorological da…

Trace elements levels in centenarian ‘dodgers’

Trace element bioavailability can play a role in several metabolic and physiological pathways known to be altered during the aging process. We aimed to explore the association of trace elements with increased lifespan by analyzing the circulating levels of seven trace elements (Cr, Cu, Fe, Mn, Mo, Se and Zn) in a cohort of healthy centenarians or ‘dodgers’ (≥100 years, free of major age-related diseases) in comparison with sex-matched younger elderly controls. Centenarians showed significant lower Cu (783.7 (76.7, 1608.9) vs 962.5 (676.3, 2064.4) μg/mL, P < 0.001), but higher Fe (1.3 (0.4, 4.7) vs 1.1 (0.5, 8.4) μg/mL, P = 0.003) and Se (85.7 (43.0, 256.7) vs 77.8 (24.3, 143.8) ng/mL, P = 0…

Association between environmental pollution and prevalence of coronavirus disease 2019 (COVID-19) in Italy

AbstractThe novel coronavirus disease 2019 (COVID-19) has recently been upgraded to a pandemic by the World Health Organization due to the alarming levels of spread and severity. Since several lines of evidence also attest that Lombardy region has an extraordinarily high level of environmental pollution, we aimed to explore the potential epidemiological association between the number of cases of COVID-19 and environmental pollution in Italy. Data on environmental pollution in Italy were retrieved from the 2019 annual report of the organization Legambiente (League for the Ambient). The adjusted correlation between the number of days in which environmental pollutants exceeded established limi…

Metabolic Impacts of Confinement during the COVID-19 Pandemic Due to Modified Diet and Physical Activity Habits

While the detrimental effects of a chronic positive energy balance due to a sedentary lifestyle have been well established, the impacts of a short period of abruptly reduced physical activity and overeating arising from strict confinement due to the COVID-19 pandemic will soon start to emerge. To reasonably anticipate major consequences according to the available evidence, we hereby review the literature for studies that have explored the health impacts of several weeks of a reduction in physical activity and daily step-count combined with modified eating habits. These studies identify as main metabolic consequences increases in insulin resistance, total body fat, abdominal fat and inflamma…

Repeated Testing in SARS-CoV-2 Infection

Prothrombotic State Induced by Middle-Distance Endurance Exercise in Middle-Aged Athletes

AbstractSince the impact of possible prothrombotic factors on blood coagulation resulting from exercise remains elusive, this study investigated the acute effects of middle-distance endurance running on blood coagulation parameters in middle-aged athletes. The study population consisted of 33 male endurance runners who were engaged in a 21.1 km run under competitive conditions. Blood samples were collected before the run, immediately after the run, and 3 hours after run completion. Samples were assessed for activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen, D-dimer, factor VIII (FVIII), von Willebrand factor antigen (VWF:Ag), endogenous thrombin potential (area…

Effectiveness and safety of electrical cardioversion for acute-onset atrial fibrillation in the emergency department: a real-world 10-year single center experience.

OBJECTIVE Despite limited evidence, electrical cardioversion of acute-onset atrial fibrillation (AAF) is widely performed in the emergency department (ED). The aim of this study was to describe the effectiveness and safety of electrical cardioversion of AAF performed by emergency physicians in the ED. METHODS All episodes of AAF electrically cardioverted in the ED were retrieved from the database for a 10-year period. Most patients not already receiving anticoagulants were given enoxaparin before the procedure (259/419). Procedural complications were recorded, and the patients were followed-up for 30 days for cardiovascular and hemorrhagic complications. RESULTS Four hundred nineteen eligib…

Blood rheology effect of submaximal exercise on young subjects

Nowadays cardiac and metabolic diseases are a matter of concern. Exercise is a valid treatment and method of prevention for not only adults, but also young subjects. Physical activity causes transient blood rheology impairment in adults. However little is known about the effects of exercise on blood flow characteristics in young subjects. The aim of the study was to assess the effects of a light aerobic exercise session on blood rheology in young subjects. Ten young subjects (aged 12-16 years) performed 1 hour of submaximal aerobic exercise (70% HRmax). Blood samples were drawn just before and after exercise. We determined blood and plasma viscosity, fibrinogen, erythrocyte deformability an…

Current limitations of the Athlete's Biological Passport use in sports.

The Athletes Biological Passport (ABP) has received both criticisms and support during this year. In a recent issue of The Lancet, Michael Wozny considered that the use of the ABP makes it more difficult to take banned substances and that it was successfully used against the Italian elite cyclist Franco Pellizotti. After that, Italy's anti-doping tribunal considered that there was not enough evidence to prove manipulation of his own blood profile in Pellizotti's case. However, the UCI appealed to the Court of Arbitration for Sport (CAS) that sanctioned Pellizotti with a suspension of 2 years. Since its implementation, some problems have emerged. From 2010 to date, a large number of reports …

Inhibition of xanthine oxidase to prevent statin-induced myalgia and rhabdomiolysis

Although statins remain the cornerstone of lipid-lowering therapy for reducing the burden of atherosclerotic vascular disease, their administration has been associated with muscle-related adverse effects, including myalgia and rhabdomyolysis. Such adverse events are probably due to reduced antioxidant defenses associated with fewer intermediate metabolites in the cholesterol synthesis pathway. We hypothesize that the concomitant inhibition of xanthine oxidase via coadministration of allopurinol with statins could diminish reactive oxygen species (ROS)-related muscle damage, which would have in turn have positive effects on both the incidence of muscle-related adverse events and cardiovascul…

Exercising recommendations for paroxysmal AF in young and middle-aged athletes (PAFIYAMA) syndrome.

We have recently described a new syndrome: strenuous endurance exercise-related atrial fibrillation (AF) under the acronym of ‘paroxysmal AF in young and middle-aged athletes’ (‘PAFIYAMA’). Provided that other risk factors for AF and underlying conditions have been excluded (1), the diagnostic criteria for this syndrome entail a number of conditions, classified as major and minor. An enhanced risk of AF has been clearly documented in endurance athletes (top-class, elite and recreational) (2-5), and such risk typically ranges between 1.2- to 15-fold compared to the general, sedentary population (the better cardiovascular fitness, the higher incidence of AF) (6-11). Anecdotally, the last auth…

Antisense lipoprotein[a] therapy: State-of-the-art and future perspectives

Several lines of evidence now attest that lipoprotein[a] (Lp[a]) is a significant risk factor for many cardiovascular disorders. This enigmatic lipoprotein, composed of a single copy of apolipoprotein B (apoB) and apolipoprotein[a] (apo [a]), expresses peculiar metabolism, virtually independent from lifestyle interventions. Several therapeutic options have hence been proposed for lowering elevated Lp[a] values, with or without concomitant effect on low density lipoprotein (LDL) particles, mostly encompassing statins, ezetimibe, nicotinic acid, lipoprotein apheresis, and anti-PCSK9 monoclonal antibodies. Since all these medical treatments have some technical and clinical drawbacks, a novel s…

Irisin: A new potential hormonal target for the treatment of obesity and type 2 diabetes

Mitochondrial biogenesis in health and disease. Molecular and therapeutic approaches.

Mitochondrial biogenesis (MB) is the essential mechanism by which cells control the number of mitochondria. Cells respond to different physiologic, metabolic, and pathologic changes by regulating this organelle with high morphological and functional adaptability. A considerable number of proteins, transcription factors, upstream regulatory proteins and secondary mechanisms are involved in MB and the stabilization of new mitochondrial DNA. These MB activators and regulators, including the main participating proteins (e.g. PGC-1α and mtTFA), are candidates for therapeutic intervention in diverse diseases, like neurodegenerative disorders, metabolic syndrome, sarcopenia, cardiac pathophysiolo…

Protective effect of trehalose-loaded liposomes against UVB-induced photodamage in human keratinocytes

Trehalose, a naturally occurring non-reducing disaccharide, is known to act as a major protein stabilizer that can reduce ultraviolet B (UVB)-induced corneal damage when topically applied to the eye. However, due to the low skin permeability of trehalose, which makes the development of topical formulations difficult, its use as a skin photoprotective agent has been limited. Previous findings demonstrated that liposomes may significantly improve the intracellular delivery of trehalose. Therefore, the present study aimed to assess the protective effects of trehalose-loaded liposomes against UVB-induced photodamage using the immortalized human keratinocyte cell line, HaCaT. The effects were al…

Sestrins: Novel antioxidant and AMPK-modulating functions regulated by exercise?

Oxidative stress results from damage to tissues caused by free radicals and is increased by exercise. Peroxiredoxins (PRXs) maintain the cellular reducing environment by scavenging intracellular hydrogen peroxide. It has been recently noted that physical exercise has a positive effect on the PRX system, exerting a protective effect against oxidative stress-induced damage. However, other compounds, such as sestrins (SESNs), a stress-inducible protein family with antioxidant properties, should also be considered in the function of PRXs. SESNs are clearly involved in the regeneration process of PRXs and therefore may also be modulated by physical exercise. In addition, SESNs are clearly involv…

COVID-19 and obesity: links and risks

Applicable to the fields of endocrinology, as well as for specialists in cardiovascular disease (CVD), obesity has numerous cardiometabolic unfavorable consequences. Obesity is by far the leading c...

Prognostic value of troponin I in atrial fibrillation

To evaluate whether circulating cardiac troponin I (cTnI) levels are associated with worst outcomes in patients with atrial fibrillation (AF).Consecutive patients visiting the emergency room (ER) with a new episode of a previously diagnosed AF or a new diagnosis of AF during ER admission between January 1st, 2010 and December 31st, 2015, were enrolled in the study (n = 2617). After applying exclusion criteria and eliminating repeated episodes, 2013 patients were finally included. Of these, 1080 patients with at least one cTnI measurement in the ER were selected and classified into 4 groups according to cTnI quartiles: Q1 (n = 147) cTnI10 ng/L (Group 1); Q2 (n = 254): 10-19 ng/L (Group 2); Q…

Red blood cell distribution width: A marker of anisocytosis potentially associated with atrial fibrillation

The incorporation of biomarkers in the actually used risk scores seem to be helpful for early identifying atrial fibrillation (AF) patients at higher risk. The aim of this critical review of the scientific literature is to investigate the potential clinical significance of red blood cell distribution width (RDW) in AF. A systematic electronic search was carried out to identify all articles describing an epidemiological association between RDW and AF in adult human populations. Data abstraction was conducted on a final number of 35 articles (13 cross-sectional, 12 prospective and 10 retrospective studies). The results of these epidemiological investigations were all virtually concordant to e…

Implications of obesity in exceptional longevity.

Except for the world’s poorest regions, it is estimated that global obesity [body mass index (BMI) >30 kg/m 2 ] prevalence will reach 18% (men) and >21% (women) by 2025 (1). Recent nationally representative surveys in the US for the 2013–2014 period indicate age-adjusted obesity prevalence of 35.0% and 40.4% among adult men and women, respectively (2) and of 17.0% for children and adolescents aged 2–19 years (3).

Exercise as an Adjuvant Intervention in Opiate Dependence

We read with interest the article by Weinstock et al. in whichthe authors propose exercise as an adjuvant intervention inopiate agonist treatment based on current research findings(1).The use of an opiate agonist, such as buprenorphine, butmainly, methadone, for the treatment of opiate dependenceis currently an effective therapy for this type of addiction.The main benefits of this treatment occur through a relieffrom craving narcotic drugs, a temporally suppression ofwithdrawal symptoms, and by blocking the euphoric effectsof opiates (2). Unfortunately, patients needing treatment foropiatedependenceoftenfaceavarietyofco-occurringissues,suchashepatitisBandCvirusesorhumanimmunodeficiencyvirus (H…

Response to: Is newly diagnosed diabetes a stronger risk factor than pre‐existing diabetes for COVID ‐19 severity?

Protecting against sedentary lifestyle, left atrial enlargement and atrial fibrillation.

Putative impact of the COVID-19 pandemic on anxiety, depression, insomnia and stress

Cardiometabolic non-response to aerobic exercise: Identifying subclinical ischaemic coronary disease

Sin financiación 5.864 JCR (2019) Q1, 18/138 Cardiac & Cardiovascular Systems 1.459 SJR (2019) Q1, 58/362 Cardiology and Cardiovascular Medicine; Q2, 36/104 Epidemiology No data IDR 2019 UEM

Desmopresssin and hemodilution: implications in doping.

Blood doping improves physical performance in sport. This is the reason why the antidop- ing authorities subject athletes to blood tests. Plasma volume expanders are prohibited agents used to reduce an artifi cial increase in hemato- logical values using diff erent illegal practices. The aim of our study was to test whether desmo- pressin (DDAVP)-induced hemodilution would alter the concentration of hematological param- eters used to detect blood doping in sports. This was an intra-subject crossover study. Venous blood samples were obtained from eight physi- cally active males on two occasions. On the fi rst o ccasion the subjects ingested 1.5 L of mineral water and 4.3 μ g / kg of DDAVP. O…

Consumer wearable technologies to identify and monitor exercise-related arrhythmias in athletes

PURPOSE OF REVIEW: The aim of this study was to synthesize the current evidence supporting and against the use of wearable devices to detect underlying heart conditions in athletes and the most significant limitations. RECENT FINDINGS: Although several large studies have been conducted to evaluate the ability of wearables devices to identify atrial fibrillation among the general population, no studies evaluating their ability to detect other exercise-related arrhythmias in athletes are very sparse. Most of the studies or case reports are focused on the wearables' reliability and accuracy compared with standard ECG. Only small studies evaluating the accuracy of one wearable device in athlete…

Physical Exercise and DNA Injury

Regular, low-intensity physical activity is currently advocated for lowering the risk of developing many acute and especially chronic diseases. However, several lines of evidence attest that strenuous exercise may enhance inflammation and trigger the generation of free radical-mediated damage, thus overwhelming the undisputable benefits of regular, medium-intensity physical activity. Since reactive oxygen species are actively generated during high-intensity exercise, and these reactive compounds are known to impact DNA stability, we review here the current evidence about strenuous exercise and DNA injury. Despite the outcome of the various studies cannot be pooled due to considerable variat…

Statins and other drugs: Facing COVID-19 as a vascular disease

Angiotensin-converting enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARBs), and HMG-CoA reductase inhibitors ("statins") have been hypothesized to affect COVID-19 severity. However, up to now, no studies investigating this association have been conducted in the most vulnerable and affected population groups (ie, older adults residing in nursing homes). The objective of this study was to explore the association of ACEi/ARB and/or statins with clinical manifestations in COVID-19-infected older adults residing in nursing homes.We undertook a retrospective multicenter cohort study to analyze the association between ACEi/ARB and/or statin use with clinical outcome of COVID-19. The …

Association between irisin and homocysteine in euglycemic and diabetic subjects

Abstract Objectives The aim of study was to explore whether a relationship exists between homocysteine and irisin in type 2 diabetes (T2D) patients—a population with a high risk of developing cardiovascular disease—and euglycemic controls. Design and methods 69 T2D patients and 75 control subjects (adjusted by body mass index (BMI)) were included in the study. Irisin and homocysteine concentrations and anthropometric and biochemical variables were determined. Results Levels of homocysteine were significantly higher (11.0 ± 3.0 vs 12.4 ± 4.2 μmol/l) and levels of irisin were lower (279 ± 58 vs 263 ± 38 ng/ml) in T2D patients. When both T2D and controls were considered, irisin was found to co…

Eosinophil count in coronavirus disease 2019: more doubts than answers

Time-dependent results in troponin exercise-induced fluctuations

Physical activity - an important preanalytical variable

The concentration of several biochemical and hematological biomarkers is strongly influenced by a number of preanalytical variables. Several lines of evidence attest that short, middle, and long-term exercise, as well as the relative intensity of physical effort (from mild to strenuous), may influence a broad array of laboratory variables. The amount of extracellular release and clearance from blood of most of these biomarkers is markedly influenced by the biological characteristics of the molecule(s), level of training, type, intensity and duration of exercise, and time of recovery after training. It is hence noteworthy that test results that fall outside the conventional reference ranges …

Mean platelet volume in arterial and venous thrombotic disorders

Abstract The mean platelet volume (MPV) is an easy, rapid and inexpensive laboratory parameter which basically mirrors platelet size. Due to the essential role of platelets in hemostasis, many studies have assessed the MPV value in patients with arterial and venous thrombotic disorders. These have then been summarized in some interesting meta-analyses and recent studies that will be discussed in this narrative review. Taken together, the currently available evidence suggests that the MPV may be substantially increased in concomitance with acute episodes of coronary artery disease, venous thromboembolism, portal vein thrombosis, stroke, erectile dysfunction and preeclampsia. In many of these…

Updated overview on interplay between physical exercise, neurotrophins, and cognitive function in humans

Highlights • Physical exercise maintains or improves cognitive functions, and neurotrophin receptor signaling may play an important role. • A positive relationship exists between physical exercise and circulating brain-derived neurotrophic factor levels. • Less clear evidence has been found for a relationship between physical exercise and other neurotrophin levels, such as nerve growth factor, neurotrophin-3, and neurotrophin-4. • The postexercise variation of brain-derived neurotrophic factor might be associated with improvement of neurocognitive functioning. • Physical exercise may be an inexpensive and safe strategy for boosting brain-derived neurotrophic factor release, thus preserving …

Exercise acts as a drug; the pharmacological benefits of exercise

The beneficial effects of regular exercise for the promotion of health and cure of diseases have been clearly shown. In this review, we would like to postulate the idea that exercise can be considered as a drug. Exercise causes a myriad of beneficial effects for health, including the promotion of health and lifespan, and these are reviewed in the first section of this paper. Then we deal with the dosing of exercise. As with many drugs, dosing is extremely important to get the beneficial effects of exercise. To this end, the organism adapts to exercise. We review the molecular signalling pathways involved in these adaptations because understanding them is of great importance to be able to pr…

Oxidative Stress and Inflammation in COVID-19-Associated Sepsis: The Potential Role of Anti-Oxidant Therapy in Avoiding Disease Progression

Since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak emerged, countless efforts are being made worldwide to understand the molecular mechanisms underlying the coronavirus disease 2019 (COVID-19) in an attempt to identify the specific clinical characteristics of critically ill COVID-19 patients involved in its pathogenesis and provide therapeutic alternatives to minimize COVID-19 severity. Recently, COVID-19 has been closely related to sepsis, which suggests that most deceases in intensive care units (ICU) may be a direct consequence of SARS-CoV-2 infection-induced sepsis. Understanding oxidative stress and the molecular inflammation mechanisms contributing to COVI…

Exercise as a Model to Study Oxidative Stress

Physical exercise generates free radicals. The major source of radicals in exercise appears to be extracellular. Our experiments show that xanthine oxidase is a key player in the generation of superoxide during exercise. Mitochondrial contribution appears to be less important: during high oxygen utilization by mitochondria in state 3, the proportion of oxygen that is converted to superoxide is on an order of magnitude lower than in resting, state 4 conditions. Exercise-induced radicals constitute a double-edged sword: high intensity ­exercise causes the generation of relatively high concentrations of radicals that cause oxidative stress and eventually damage. On the other hand, low intensit…

Influence of training and a maximal exercise test in analytical variability of muscular, hepatic, and cardiovascular biochemical variables.

Short, middle, and long-term exercise, as well as the relative intensity of the physical effort, may influence a broad array of laboratory results, and it is thereby of pivotal importance to appropriately differentiate the 'physiologic' from the 'pathological' effects of exercise. Therefore, the values of some biomarkers in physically active subjects may be cautiously interpreted since the results may fall outside the conventional reference ranges. It has been demonstrated that middle and long-term endurance and/or strenuous exercise triggers transient elevations of muscular and cardiac biomarkers. However, no data have been published about the effect of short-term maximal exercise test on …

Exercise training intensity and connexin 43 expression in hypertrophic cardiomyopathy.

• Moderate-intensity exercise improved peak oxygen consumption in hypertrophic cardiomyopathy.

Diabetes mellitus association with coronavirus disease 2019 ( COVID ‐19) severity and mortality: A pooled analysis

Highlights There are ~ 2-fold increased odds of severe coronavirus disease 2019 (COVID-19) and a ~ 2-fold increased risk of odds of mortality in patients with history of diabetes mellitus compared to those without diabetes mellitus. Patients with a history of diabetes mellitus should be closely monitored if they get infected with COVID-19. Results of meta-analysis showing association of diabetes mellitus with severity (Panel A) of disease and mortality (Panel B) in coronavirus disease 2019 (COVID-19) patients.

Physical exercise as an epigenetic modulator: Eustress, the "positive stress" as an effector of gene expression.

Physical exercise positively influences epigenetic mechanisms and improves health. Several issues remain unclear concerning the links between physical exercise and epigenetics. There is growing concern about the negative influence of excessive and persistent physical exercise on health. How an individual physically adapts to the prevailing environmental conditions might influence epigenetic mechanisms and modulate gene expression. In this article, we put forward the idea that physical exercise, especially long-term repetitive strenuous exercise, positively affects health, reduces the aging process, and decreases the incidence of cancer through induced stress and epigenetic mechanisms. We pr…

“Ultra-sensitive” cardiac troponins: Requirements for effective implementation in clinical practice

The measurement of cardiac troponins, either cardiac troponin I or T, has become the culprit of clinical decision making in patients with suspected acute coronary syndrome (ACS), especially in those with non-ST elevation myocardial infarction (NSTEMI). The leading analytical mainstays of cardiac troponin immunoassays include the limit of blank (LoB), limit of detection (LoD), functional sensitivity, the 99th percentile of a healthy reference population, along with the percentage of “ostensibly healthy” subjects displaying measurable values 50% in the general healthy population. The very recent commercialization of methods with further improved analytical sensitivity (i.e., “ultra-sensitive”…

In Reply – Association of Renin Angiotensin System Blockers with Outcomes in Patients With COVID-19

Routine cardiac troponin assessment after percutaneous coronary intervention

: Although the angiographic and procedural success of percutaneous coronary intervention (PCI) is now very high, some severe complications may still develop, including periprocedural myocardial infarction (MI). An accurate diagnosis of this condition is essential for guiding the clinical management, as these patients may need a tailored management. The current recommendations for diagnosing periprocedural myocardial infarction based on the fourth universal definition appear at first sight straightforward, but the clinical and prognostic significance of routine periprocedural cardiac troponin (cTn) assessment remains uncertain. The current scientific evidence suggests that the likelihood of …

Predicting mortality with cardiac troponins: recent insights from meta-analyses.

Abstract The introduction of cardiac troponin (cTn) testing in clinical practice has been one of the most important breakthroughs that have occurred in the recent history of laboratory medicine. Although it is now uncontestable that cTn values are essential for diagnosing acute coronary syndrome (ACS), solid evidence is also emerging that assessment of either cardiac troponin I (cTnI) or T (cTnT) may provide valuable prognostic information in the general healthy population, as well as in patients with a vast array of cardiac and extra-cardiac diseases. We have hence performed a critical review of the scientific literature for identifying meta-analyses which have investigated the potential c…

Increased Cardiovascular Risk Associated With E-Cigarette Use

Epigenetic Mechanisms as Key Regulators in Disease

Epigenetics is a rapidly growing field of research which studies the changes in the gene expression that do not involve changes in the nucleotide sequence. The cellular metabolism is directly connected to epigenetic regulation through the inflow of different metabolites such as S-adenosylmethionine, acetyl-CoA, and α-ketoglutarate among others, which serve as substrates or cofactors for chromatin-modifying enzymes. These metabolites define how our lifestyle (i.e., nutrition, physical activity, and other healthy behaviors) acts on gene expression by epigenetic mechanisms. Therefore, proper coordination between components of the epigenetic machineries is essential for the correct control of t…

Exercise and antioxidant supplements in the elderly

Abstract Both exercise and aging increase reactive oxygen species (ROS), which can result in damage to cells. Aging is the result of damage caused by ROS to the mitochondrial genome in post mitotic cells and numerous studies have demonstrated an increase in ROS or their byproducts with exercise. ROS can cause oxidative stress as they overwhelm the antioxidant cellular defenses. Therefore interventions aimed at limiting or inhibiting ROS production, such as supplementation with antioxidant vitamins, should be able to reduce fatigue during muscle contraction and the rate of formation of aging changes with a consequent reduction of the aging rate and disease pathogenesis. However, it has been …

Worldwide burden of LDL cholesterol: Implications in cardiovascular disease

Abstract Background and aim an increased value of low-density lipoprotein cholesterol (LDL-C) is now universally considered a major cardiovascular disease (CVD) risk factor. LDL-C is included in the vast majority of worldwide cardiovascular risk prediction algorithms, as well as in the guidelines for cardiovascular risk prevention. We aimed to provide an overview of the worldwide adverse healthcare impact of low-density lipoprotein cholesterol (LDL-C). Methods and results Data on the epidemiologic burden of LDL-C >1.3 mmol/L were retrieved from Global Health Data Exchange (GHDx) registry. The current burden is 94.92 million disability-adjusted life years (DALYs), with an exponential increas…

Mitochondrial biogenesis in exercise and in ageing☆

Mitochondrial biogenesis is critical for the normal function of cells. It is well known that mitochondria are produced and eventually after normal functioning they are degraded. Thus, the actual level of mitochondria in cells is dependent both on the synthesis and the degradation. Ever since the proposal of the mitochondrial theory of ageing by Jaime Miquel in the 70's, it was appreciated that mitochondria, which are both a target and a source of radicals in cells, are most important organelles to understand ageing. Thus, a common feature between cell physiology of ageing and exercise is that in both situations mitochondria are critical for normal cell functioning. Mitochondrial synthesis i…

Red Blood Cell Distribution Is a Significant Predictor of Severe Illness in Coronavirus Disease 2019

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; As red blood cell distribution width (RDW) significantly predicts clinical outcomes in patients with respiratory tract infections and in those with critical illnesses, we performed a critical analysis of the literature to explore the potential prognostic role of this laboratory parameter in coronavirus disease 2019 (COVID-19). &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; An electronic search was conducted in Medline, Scopus and Web of Science, using the keywords “coronavirus disease 2019” OR “COVID-19” AND “red blood cell distribution width” OR “RDW” in all fields, up to the present time, with no language restriction. Studies reporting t…

Different types of storage devices for blood transportation in the anti-doping field

Inhibition of Xanthine Oxidase by Allopurinol Prevents Skeletal Muscle Atrophy: Role of p38 MAPKinase and E3 Ubiquitin Ligases

International audience; Abstract Top Alterations in muscle play an important role in common diseases and conditions. Reactive oxygen species (ROS) are generated during hindlimb unloading due, at least in part, to the activation of xanthine oxidase (XO). The major aim of this study was to determine the mechanism by which XO activation causes unloading-induced muscle atrophy in ratsand its possible prevention by allopurinol, a well-known inhibitor of this enzyme. For this purpose we studied one of the main redox sensitive signalling cascades involved in skeletal muscle atrophy i.e. p38 MAPKinaseand the expression of two well known muscle specific E3 ubiquitin ligases involved in proteolysis, …

Fit Is It in COVID-19, Future Pandemics, and Overall Healthy Living.

Influence of spurious dilution and hyperglycemia on erythrocytes and platelets evaluated with two different hematological analyzers

The integrity of whole blood samples may be compromised by suboptimal collection practices. Therefore, we investigated the influence of spurious hyperglycemia on erythrocytes and platelets, assessed with two hematological analyzers using optical or impedance technique. Three K2EDTA blood specimens were collected from 12 healthy subjects, pooled and divided into four aliquots. The first aliquot was left untreated (glucose concentration 4.4 mmol/L), whereas scalar amounts of standard 5% glucose solution were added to the remaining, generating glucose contamination of 5% (19.2 mmol/L), 10% (33 mmol/L) and 20% (62 mmol/L). Hematological testing was then performed using Siemens Advia 2120 and Sy…

Pharmacological properties of physical exercise in the elderly.

Scientific evidence links physical activity to several benefits. Recently, we proposed the idea that exercise can be regarded as a drug. As with many drugs, dosage is of great importance. However, to issue a public recommendation of physical activity in aging is not an easy task. Exercise in the elderly needs to be carefully tailored and individualized with the specific objectives of the person or group in mind. The beneficial effects of exercise in two of the main age-related diseases, sarcopenia and Alzheimer's Disease, are dealt with at the beginning of this report. Subsequently, dosage of exercise and the molecular signaling pathways involved in its adaptations are discussed. Exercise a…

The loss of muscle mass and sarcopenia: non hormonal intervention.

Muscle aging is a key component of the increase in frailty in human populations. The generation of critical levels of power is a prerequisite to perform simple tasks of daily living, such as rising from a chair or climbing stairs. There is great scientific and social interest to determine which behaviors can lead to the maintenance of the muscle mass in young immobilized subjects and in the elderly. Several hormonal treatments have been proposed for the treatment of sarcopenia. However, the side effects associated to these treatments emphasize the need of finding non-toxic and non-hormonal treatments that help increase muscle strength, improve muscle function, and decrease the degree of dep…

El cribado preoperatorio negativo mediante RT-PCR no garantiza la no infección por SARS-CoV-2

Benefits of skeletal-muscle exercise training in pulmonary arterial hypertension: The WHOLEi + 12 trial

Pulmonary arterial hypertension is often associated with skeletal-muscle weakness. The purpose of this randomized controlled trial was to determine the effects of an 8-week intervention combining muscle resistance, aerobic and inspiratory pressure-load exercises on upper/lower-body muscle power and other functional variables in patients with this disease. Participants were allocated to a control (standard care) or intervention (exercise) group (n = 20 each, 45 ± 12 and 46 ± 11 years, 60% women and 10% patients with chronic thromboembolic pulmonary hypertension per group). The intervention included five, three and six supervised (inhospital) sessions/week of aerobic, resistance and inspirato…

Variation of serum and urinary neutrophil gelatinase associated lipocalin (NGAL) after strenuous physical exercise.

AbstractStrenuous exercise may trigger acute complications, such as exertional rhabdomyolysis and gastrointestinal complaint. As less is known about the potential renal impairment after long distance running, we assessed creatinine and neutrophil gelatinase associated lipocalin (NGAL) in serum (sNGAL) and urine (uNGAL) before and after an ultramarathon.The study population consisted of 16 trained male athletes who ran a 60 km ultramarathon. Blood and spot urine samples were collected 20 min before and immediately after the run. Creatinine was assessed by Jaffe assay on Beckman Coulter AU5800 and renal function was expressed as estimated glomerular filtration rate (eGFR) by MDRD formula. NGA…

Front-of-Package Nutrition Labeling and Obesity Implications

Hemoglobin point-of-care testing: the HemoCue system.

Besides the use of traditional laboratory resources, the diagnosis of anemia can also be accomplished by assessing hemoglobin (Hb) concentration with point-of-care testing (POCT) devices such as the HemoCue test systems. In several situations, these devices might suitably replace traditional laboratory testing, including several areas of health care where a very rapid Hb measurement might be required to make immediate therapeutic decisions. The use of these devices, however, should fulfill some basic criteria, including economic, clinical, and regulatory issues; appropriate training of the users and knowledge of test requirements, performance, limitations, and potential interferences; the u…

No evidence of adverse cardiac remodeling in former elite endurance athletes

Background: The impact of high exercise loads on a previously healthy heart remains controversial. We examined the consequences of decades of strenuous endurance exercise at the highest competition level on heart dimensions and volumes as well as on serum biomarkers of cardiac fibrosis/remodeling. Methods and results: We compared echocardiographic measurements and serum biomarkers of cardiac fibrosis/remodeling [troponin I, galectin-3, matrix metallopeptidase-2 and -9, N-terminal pro-brain natriuretic peptide, carboxy-terminal propeptide of type I procollagen, and soluble suppressor of tumorigenicity-2 (sST-2)/interleukin(IL)-1R4] in 53 male athletes [11 former professional ('elite') and 42…

Angiotensin-Converting Enzyme 2 and Antihypertensives (Angiotensin Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors) in Coronavirus Disease 2019

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, is being defined as the worst pandemic disease of modern times. Several professional health organizations have published position papers stating that there is no evidence to change the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in the management of elevated blood pressure in the context of avoiding or treating COVID-19 infection. In this article, we review the evidence on the relationship between the renin-angiotensin-aldosterone system and COVID-19 infection. In agreement with current guidelines, patients with hypertension should continue taki…

Non-coding RNAs and Coronary Artery Disease

Coronary artery disease (CAD) is the leading death cause worldwide. Non-coding RNA (ncRNA) are key regulators of genetic expression and thus can affect directly or indirectly the development and progression of different diseases. ncRNA can be classified in several types depending on the length or structure, as long non-coding RNA (lncRNA), microRNA (miRNA) and circularRNA (circRNA), among others. These types of RNA are present within cells or in circulation, and for this reason they have been used as biomarkers of different diseases, therefore revolutionizing precision medicine. Recent research studied the capability of circulating ncRNA to inform about CAD presence and predict the outcome …

Empagliflozin Induces White Adipocyte Browning and Modulates Mitochondrial Dynamics in KK Cg-Ay/J Mice and Mouse Adipocytes

Background: White adipose tissue (WAT) browning is a promising target for obesity prevention and treatment. Empagliflozin has emerged as an agent with weight-loss potential in clinical and in vivo studies, but the mechanisms underlying its effect are not fully understood. Here, we investigated whether empagliflozin could induce WAT browning and mitochondrial alterations in KK Cg-Ay/J (KKAy) mice, and explored the mechanisms of its effects.Methods: Eight-week-old male KKAy mice were administered empagliflozin or saline for 8 weeks and compared with control C57BL/6J mice. Mature 3T3-L1 adipocytes were treated in the presence or absence of empagliflozin. Mitochondrial biosynthesis, dynamics, a…

The role of mitochondrial derived peptides (MDPs) in metabolism

Red blood cell distribution width: A simple parameter with multiple clinical applications

The red blood cell distribution width (RDW) is a simple and inexpensive parameter, which reflects the degree of heterogeneity of erythrocyte volume (conventionally known as anisocytosis), and is traditionally used in laboratory hematology for differential diagnosis of anemias. Nonetheless, recent evidence attests that anisocytosis is commonplace in human disorders such as cardiovascular disease, venous thromboembolism, cancer, diabetes, community-acquired pneumonia, chronic obstructive pulmonary disease, liver and kidney failure, as well as in other acute or chronic conditions. Despite some demographic and analytical issues related to the routine assessment that may impair its clinical usef…

Role of non-coding RNAs as biomarkers of deleterious cardiovascular effects in sepsis.

The mechanisms occurring during sepsis that produce an increased risk of cardiovascular (CV) disease (CVD) are poorly understood. Even less information exists regarding CV dysfunction as a complication of sepsis, particularly for sepsis-induced cardiomyopathy. However, recent research has demonstrated that non-coding RNAs, including microRNAs, long non-coding RNAs, and circular RNAs, play a crucial role in genetic reprogramming, gene regulation, and inflammation during the development of CVD. Here we describe experimental findings showing the importance of non-coding RNAs mediating relevant mechanisms underlying CV dysfunction after sepsis, so contributing to sepsis-induced cardiomyopathy. …

Undetected coronary artery disease in apparently healthy athletes

UEM1901 5.864 JCR (2019) Q1, 18/138 Cardiac & Cardiovascular Systems 1.459 SJR (2019) Q1, 58/362 Cardiology and Cardiovascular Medicine; Q2, 36/104 Epidemiology No data IDR 2019 UEM

Hs-cTnT levels in professional soccer players throughout a season: No evidence of sustained cardiac damage

a Research Institute of the Hospital 12 de Octubre (“i + 12”), Madrid, Spain b Research Institute “Dr. Vina Giner”, Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Martir, Valencia, Spain c School of Medicine, Catholic University of Valencia San Vicente Martir, Valencia, Spain d Human Performance Laboratory, MAPEI Sport Research Center, Italy e Department of Physical Education and Sports, University of Valencia, Valencia, Spain f Laboratory of Experimental Biochemistry & Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milano, Italy g Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy

Effects of acute exercise and allopurinol administration on soluble urokinase plasminogen activator receptor (suPAR).

Background Although physical exercise acutely increases the most widely used inflammatory biomarkers, there is no information on its effect on soluble urokinase plasminogen activating receptor (suPAR), a circulating biomarker increasingly used for the assessment of systemic inflammation. Methods suPAR was assessed with the quantitative suPARnostic Standard ELISA Assay (Virogates, Birkerod, Denmark) in 12 professional football players before and after a football match. The athletes were divided into two experimental groups. An oral dose of 300 mg of allopurinol was administered to one group of six participants four hours before a match; the other six participants received placebo. Results Se…

Association between physical fitness and mean platelet volume in professional soccer players.

Serum Concentration of Growth Differentiation Factor-15 Is Independently Associated with Global Platelet Function and Higher Fibrinogen Values in Adult Healthy Subjects

AbstractGrowth differentiation factor-15 (GDF-15) has recently emerged as a strong and independent predictor of cardiovascular events and mortality. However, the pathophysiological mechanisms underlying this important association remain speculative. This study was aimed to investigate the potential associations between the serum concentration of GDF-15 and clinical or laboratory parameters in a population of ostensibly healthy subjects. The study population consisted of 44 healthy volunteers enrolled from the laboratory staff (14 males and 30 females; mean age, 47 ± 11 years), who had their blood collected for assessing complete blood cell count, GDF-15, serum creatinine, albumin, cardiac t…

Methodological considerations to determine the effect of exercise on brain-derived neurotrophic factor levels.

Objectives: Physical exercise up-regulates brain-derived neurotrophic factor (BDNF) in the brain and blood. However, there is yet no consensus about the adequate blood processing conditions to standardize its assessment. We aimed to find a reliable blood sample processing method to determine changes in BDNF due to exercise. Design and methods: Twelve healthy university students performed an incremental cycling test to exhaustion. At baseline, immediately after exercise, and 30 and 60 min of recovery, venous blood was drawn and processed under different conditions, i.e. whole blood, serum coagulated for 10 min and 24 h, total plasma, and platelet-free plasma. BDNF concentration was measured …

Adropin and apelin fluctuations throughout a season in professional soccer players: Are they related with performance?

Myokines are likely to be involved in the whole-body metabolic adaptive changes that occur in response to regular exercise. We aimed to investigate the association of the two myokines (adropin and apelin) with physical performance in professional soccer players. To this purpose, we analyzed the fluctuations of circulating levels of both adropin and apelin in professional soccer players during a season and evaluated the possible association of these myokines with the performance level. Creatine kinase (CK) and lactate dehydrogenase (LDH) activity as well as iron, transferrin and high-sensitivity C-Reactive protein (hsCRP), ferritin, soluble transferrin receptor (sTfR), free testosterone/cort…

Physical inactivity and low fitness deserve more attention to alter cancer risk and prognosis.

Abstract Sedentary lifestyle is associated with elevated cancer risk whereas regular physical activity (PA) and high cardiorespiratory fitness (CRF) have the opposite effect, with several biologic mechanisms mediating such associations. There is a need for lifestyle interventions aimed at increasing the PA levels and CRF of the general population and particularly cancer survivors. Furthermore, provocative data suggest a dose-dependent benefit of increasing levels of PA and/or CRF against cancer risk or mortality. Thus, current PA guidelines (≥150 min/wk of moderate-to-vigorous PA) may not be sufficiently rigorous for preventing cancer nor for extending cancer survivorship. Research targetin…

Antiplatelet Therapy in Marathon Runners: More Harm than Benefits?

We read with interest the article by Arthur J. Siegel, who recently concluded that prophylactic aspirin for primary prevention of cardiac events in marathon runners may be a viable approach for lowering the global risk of cardiovascular events in these subjects. Although there is a credible hysiological basis for supporting this provocative suggesion, and the use of nonsteroidal anti-inflammatory drugs is requent in athletes, there are, however, some issues that hould be considered, and which would globally overwhelm he hypothetical advantages of antiplatelet therapy in this eculiar setting. First, there is no controlled, randomized study that has efinitely proven the existence of any poten…

Cardiac Injury in COVID-19–Echoing Prognostication∗

Background Myocardial injury is frequent among patients hospitalized with coronavirus disease-2019 (COVID-19) and is associated with a poor prognosis. However, the mechanisms of myocardial injury remain unclear and prior studies have not reported cardiovascular imaging data. Objectives This study sought to characterize the echocardiographic abnormalities associated with myocardial injury and their prognostic impact in patients with COVID-19. Methods We conducted an international, multicenter cohort study including 7 hospitals in New York City and Milan of hospitalized patients with laboratory-confirmed COVID-19 who had undergone transthoracic echocardiographic (TTE) and electrocardiographic…

Strenuous exercise and the heart: are we not seeing the wood for the trees?

The health benefits of regular moderate-intensity physical activity (e.g. brisk walking, jogging) are well established and include, among others, a lower risk of all-cause mortality and cardiovascular disease (CVD). Yet whether such benefits, especially with regard to CVD, are also conferred by higher exercise levels is a matter of growing controversy in the medical literature. For instance, Guash and Mont recently expressed understandable concern about the link between regular strenuous endurance exercise. 4.036 JCR (2014) Q1, 29/123 Cardiac and cardiovascular systems UEM

Immunoglobulin E (IgE) and ischemic heart disease. Which came first, the chicken or the egg?

Several lines of evidence demonstrate that the immune system plays a pivotal role in development and progression of ischemic heart disease (IHD). More recently, a series of biological and clinical investigations has generated new interest about the existence of a relationship between a specific class of immunoglobulin, that is immunoglobulin E (IgE), and IHD. Data obtained in several epidemiological studies have convincingly demonstrated that the concentration of total serum IgEs is significantly increased in patients with IHD and often correlates with the prognosis. The putative mechanisms are essentially mediated by a physiological interaction between IgEs and mast cells, which triggers t…

Is it time to be concerned about the effects of e-cigarettes on cardiovascular health?

In Reply - Cardiorespiratory Fitness Attenuates the Impact of Risk Factors Associated With COVID-19 Hospitalization

Critical role of cardiac magnetic resonance in the diagnosis of left-dominant arrhythmogenic cardiomyopathy: A paradigmatic case in a recreational middle-aged athlete

Physical inactivity and cardiovascular disease at the time of coronavirus disease 2019 (COVID-19).

PPARδ Modulation by GW501516: An Unsuccessful Exercise Mimetic.

Rest heart rate and mortality: More physical exercise for the rabbit?

Anti-gout drugs as potential therapy for atrial fibrillation.

Atrial fibrillation (AF) is an important cardiovascular disease in theelderly [1]. Noticeably, it has been increasingly demonstrated thatserum uric acid (UA) is associated with AF [2–9]. In a recent meta-analysis performed by Tamariz and coworkers, the authors concludedthat high levels of UA and AF are clearly associated [10]. Interestingly,serum UA has been linked to AF in obstructive sleep apnea patients[11], whereas it has been also associated with thromboembolic risk inpatients with nonvalvular AF [12].The treatment of gout, a metabolic disorder caused by chronic hyper-uricemia, is based on administration of colchicine, xanthine oxidase (XO)competitive inhibitors such as allopurinol, and…

Anemia, heart failure and exercise training

We read with interest the recent article by Wang et al. in which theauthors evaluated in anemic patients with heart failure whether exer-tionalperiodicbreathing influences rheological/hemodynamicfunctions[1]. For this purpose, the authors performed an incremental exercisetestusing a bicycle ergometer. In this regard, it has been generally assumedby some researchers, exercise physiologists and scientists that the incre-ment in blood hemoglobin (Hb) content is among the main hematolog-ical adaptations to endurance exercise training. This misconception isbased in the data published in diffe rent studies carried out severalyearsago [2].Inarecentmanuscript byBakeretal. [3],theauthorsdem-onstrated…

Alternate methods to prevent protease use as a masking agent in sport.

Telmisartan as metabolic modulator: a new perspective in sports doping?

The World Antidoping Agency (WADA) has introduced some changes in the 2012 prohibited list. Among the leading innovations to the rules are that both 5-aminoimidazole-4-carboxamide-1-[beta]-D-ribofuranoside (peroxisome proliferator�activated receptor-[delta] [PPAR-[delta]]-5' adenosine monophosphate-activated protein kinase [AMPK] agonist) and GW1516 (PPAR-[delta]-agonist) are no longer categorized as gene doping substances in the new 2012 prohibited list but as metabolic modulators in the class �Hormone and metabolic modulators.� This may also be valid for the angotensin II receptor blocker telmisartan. It has recently been shown that telmisartan might induce similar biochemical, biological…

Increased average longevity among the "Tour de France" cyclists.

It is widely held among the general population and even among health professionals that moderate exercise is a healthy practice but long term high intensity exercise is not. The specific amount of physical activity necessary for good health remains unclear. To date, longevity studies of elite athletes have been relatively sparse and the results are somewhat conflicting. The Tour de France is among the most gruelling sport events in the world, during which highly trained professional cyclists undertake high intensity exercise for a full 3 weeks. Consequently we set out to determine the longevity of the participants in the Tour de France, compared with that of the general population. We studi…

Potential drawbacks of frequent asymptomatic coronavirus disease 2019 (COVID-19) testing

Link between cardiovascular disease and the risk of falling: a comprehensive review of the evidence.

Falls are associated with increased morbidity and mortality, rising hospital readmission rates, decreased patient independence, and strained healthcare resources. In aged populations and individuals with multimorbidity, cardiovascular conditions may contribute towards an increased propensity to fall. The prevalence of cardiovascular conditions generally increases with age, and understanding potential fall risk factors may help to minimize the risk of falls and develop preventive interventions. Acting on even one such risk factor or introducing an appropriate intervention may reduce the overall propensity for a patient to fall. Further prevention strategies primed towards cardiovascular ailm…

COVID-19: unravelling the clinical progression of nature’s virtually perfect biological weapon

Coronavirus disease 2019 (COVID-19) pandemic has shocked the world and caused morbidity and mortality on an unprecedented level in the era of modern medicine. Evidence generated to-date on the virulence and pathogenicity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) suggests that COVID-19 may be considered a perfect storm, caused by a nature’s virtually perfect biological weapon. This conclusion is supported by an updated analysis of pathogenesis and clinical progression of this infectious disease. It is now readily apparent that COVID-19 is not a clear-cut disorder, but is instead a gradually evolving pathology, characterized by a series of stages sustained by different m…

Coronavirus disease 2019 (COVID-19): the portrait of a perfect storm

The “novel” coronavirus disease 2019 (abbreviated “COVID-19”) is the third coronavirus outbreak emerging during the past two decades. This infectious disease, sustained by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has been recently declared a global pandemic by the World Health Organization. Despite the concerning epidemiological burden, many people, including some policymakers, are underestimating this pandemic and are remaining enigmatically inactive against a human pathology which, for a combination of reasons, can be reasonably defined as a perfect storm (i.e., the “wrong virus” at the “wrong time”). These many paradigmatic aspects include SARS-CoV-2 structure and pe…

Large-scale epidemiological data on vascular disorders of the intestine

Objectives: This article aims to provide updates on the worldwide epidemiology of vascular disorders of the intestine.Methods: A comprehensive search for obtaining worldwide epidemiologic informati...

Epigenetic biomarkers: A new perspective in laboratory diagnostics.

Epigenetics comprises the study of chemical modifications in the DNA and histones that regulates the gene expression or cellular phenotype. However, during the last decade this term has evolved after the elucidation of different mechanisms (microRNAs and nuclear organization of the chromosomes) involved in regulating gene expression. Epigenetics and the new designed technologies capable to analyze epigenetic changes (e.g., methylated DNA, miRNAs expression, post-translational modifications on histones among others) have disclosed an appealing scenario that will offer for the biomedical sciences new biomarkers for the study of neurodegenerative diseases, multifactorial complex diseases, rare…

Protective Effects of Statins Administration in European and North American Patients Infected with COVID-19: A Meta-Analysis

AbstractSevere acute respiratory syndrome coronavirus 2 has spread rapidly throughout the world, becoming an overwhelming global health emergency. The array of injuries caused by this virus is broad and not limited to the respiratory system, but encompassing also extensive endothelial and systemic tissue damage. Since statins effectively improve endothelial function, these drugs may have beneficial effects in patients with coronavirus disease 2019 (COVID-19). Therefore, this investigation aimed to provide an updated overview on the interplay between statins and COVID-19, with particular focus on their potentially protective role against progression toward severe or critical illness and deat…

Circulating irisin detection: Does it really work?

The recent discovery of irisin has generated considerable interest in the scientific community. However, many studies on the biochemistry and biology of this intriguing hormone yielded controversial results in humans, which were mostly attributable to a number of drawbacks in the methods used for its detection and measurement.

Exertional hematuria: definition, epidemiology, diagnostic and clinical considerations

Abstract Exertional hematuria can be considered a subcategory of exercise-induced hematuria, characterized by painless appearance of erythrocytes in urine after recent physical exercise, not directly attributable to external traumatic injuries to the genitourinary system, and spontaneously resolving with rest. Although its frequency has enormous heterogeneity, depending on the athlete population, duration and intensity of exercise, technique used for identifying or quantifying hematuria and relative diagnostic thresholds, what clearly emerges from the scientific literature is that a certain degree of hematuria is commonplace after non-contact sports, especially running. This exertional hema…

In reply-Angiotensin-Converting Enzyme 2 and the Resolution of Inflammation: In Support of Continuation of Prescribed Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers.

Plasticizer detection in urine samples after autologous blood transfusion

Effects of Exercise on the Immune Function of Pediatric Patients With Solid Tumors

The purpose of this study was to assess the effects of an in-hospital exercise intervention during neoadjuvant chemotherapy on the inflammatory profile and immune cell subpopulation in 20 children with solid tumors (control [n = 11] and exercise group [n = 9]). Although no significant interaction (group × time) effect was found with an analysis of variance test, we found a trend toward an interaction effect for natural killer cells expressing the immunoglobulin-like receptor KIR2DS4, with their numbers remaining stable in the exercise group but increasing in controls. Our data support that exercise interventions are safe in pediatric cancer patients with solid tumors during chemotherapy tre…

Prognostic Value of Troponins in Patients With or Without Coronary Heart Disease: Is it Dependent on Structure and Biology?

Convincing evidence has emerged that cardiac troponins (cTns) T and I are the biochemical gold standard for diagnosing cardiac injury, and may also be used as efficient screening and risk stratification tools, especially when measured with the new high-sensitivity (hs-) immunoassays. In this narrative review, we aim to explore and critically discuss the results of recent epidemiological studies that have attempted to characterise the prognostic value of cTns in patients with or without cardiovascular disease, and then interpret this information according to cTn biology. Overall, all recent studies agree that higher blood levels of cTns reflect the larger risk of cardiovascular events and/or…

Presepsin value predicts the risk of developing severe/critical COVID-19 illness: results of a pooled analysis

AMP-activated protein kinase (AMPK) signaling pathway: A potential mechanism involved in PAFIYAMA syndrome?

Efecto del ejercicio físico sobre las alteraciones cognitivas y el estrés oxidativo en un modelo transgénico APP/PSN1 para la enfermedad de Alzheimer

Resumen Introduccion Los efectos beneficiosos del ejercicio fisico, tanto en el tratamiento como en la prevencion de distintas enfermedades, han sido ampliamente establecidos. La demencia mas frecuente, la enfermedad de Alzheimer (EA) es un trastorno donde el ejercicio ha demostrado causar notables mejoras fisiopatologicas y cognitivas. En el presente trabajo estudiamos el efecto del ejercicio fisico sobre el estres oxidativo y la cognicion en el modelo murino doble transgenico (2×Tg) para la EA, APP/PSN1, basado fundamentalmente en la deposicion cerebral de placas de β-amiloide. Material y metodos Dieciocho ratones de 10 meses de edad fueron divididos en 4 grupos experimentales: 2×Tg entre…

Special Article - Exercise-induced right ventricular injury or arrhythmogenic cardiomyopathy (ACM): The bright side and the dark side of the moon.

There is still debate on the range of normal physiologic changes of the right ventricle or ventricular (RV) function in athletes. Genetic links to arrhythmogenic cardiomyopathy (ACM) are well-established. There is no current consensus on the importance of extensive exercise and exercise-induced injury to the RV. During the intensive exercise of endurance sports, the cardiac structures adapt to athletic load over time. Some athletes develop RV cardiomyopathy possibly caused by genetic predisposition, whilst others develop arrhythmias from the RV. Endurance sports lead to increased volume and pressure load in both ventricles and increased myocardial mass. The extent of volume increase and cha…

Intermittent hypobaric hypoxia applicability in myocardial infarction prevention and recovery.

Abstract Intermittent hypobaric hypoxia (IHH) has been the focus of important research in cardioprotection, and it has been associated with several mechanisms. Intermittent hypobaric hypoxia inhibits prolyl hydroxylases (PHD) activity, increasing the stabilization of hypoxia-inducible factor-1 (HIF-1) and activating crucial adaptative genes. It has been hence suggested that IHH might be a simple intervention, which may offer a thoughtful benefits to patients with acute myocardial infarction and no complications. Nevertheless, several doubts exist as to whether IHH is a really safe technique, with little to no complications in post-myocardial infarction patients. Intermittent hypobaric hypox…

Serum irisin levels, precocious myocardial infarction, and healthy exceptional longevity.

Abstract Background Skeletal muscles produce irisin. Growing controversy exists on the association between this myokine and chronic disease risk. On the basis of the potential protective effects that irisin could exert on both vascular function and skeletal muscle mass, we hypothesized that an elevated level of this molecule may contribute to successful aging. Methods Serum irisin levels were measured using enzyme-linked immunosorbent assay in disease-free centenarians, young healthy controls, and patients with precocious acute myocardial infarction. Results We found the highest levels of serum irisin in disease-free centenarians (35.3 ± 5.5 ng/mL) compared with young healthy controls (20.7…

Clinical and demographic characteristics of patients dying from COVID-19 in Italy vs China.

Abstract Coronavirus disease 2019 (COVID‐19), an infectious outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2),1 has now progressed to global pandemic.2 Besides the compelling need to understand the novel biological pathways underlying the virulence and pathogenicity of SARS‐CoV‐2 in humans to enable the development of appropriate interventions and therapies,3,4 the noticeable difference in mortality rates between Asian and European populations is one of the most significant issues demanding the attention of biologists, epidemiologists and clinicians around the world. This article is protected by copyright. All rights reserved.

Rapid hemodilution induced by desmopressin after erythropoietin administration in humans

We have shown that treatment with desmopressin has a very effective hemodilution effect in healthy humans. These results led us to suggest the possible role of desmopressin to mask blood doping in sports. Based on our results, the World Anti-Doping Agency included the desmopressin in the 2011 List of Prohibited Substances and Methods. On this occasion, the aim of our study was to test the desmopressin-induced hemodilution after rHuEpo administration in humans. This was an intra-subject, crossover study in which five physically active males acted as their own controls. A basal blood sample was taken on their first visit to the laboratory. The next day, the subjects began the treatment. They …

Serum Copeptin and Midregion Proadrenomedullin (MR-proADM) After an Ultramarathon

Background Although it is widely acknowledged that physical activity confers several health benefits, it remains uncertain whether strenuous and physically demanding exercise might determine biological effects that might turn to be ultimately unfavorable for health. Copeptin and midregion proadrenomedullin (MR-proADM) are emerging cardiovascular and stress biomarkers, but little is known about the influence of strenuous physical exercise on their concentrations. Methods The present study was performed to investigate the variation of copeptin and MRproADM, along with that of serum creatinine and estimated glomerular filtration rate before and after a 60 km ultramarathon in 16 healthy Caucasi…

Modulation of Heart Rate by Acute or Chronic Aerobic Exercise. Potential Effects on Blood Pressure Control.

It was initially assumed that heart rate and arterial blood pressure were modulated by normal respiration and muscle contraction. The arterial baroreflex, an inverse relationship between blood pressure and heart rate, was later reported. Nonetheless, it was then assumed that those responses involved vagal modulation. We summarize available evidence on the modulation of heart rate by acute or chronic aerobic exercise as well as its potential implications on blood pressure (BP) control. Numerous studies have tried to clarify whether aerobic exercise modifies neurally-mediated vasoconstriction, but they report contradictory results. In view of these incongruities, the aim of this narrative rev…

Intravenous iron therapy in patients with heart failure. A double-edged sword

We read with interest the article of Beck-da-Silva et al., who recently concluded that intravenous (IV) iron seems to be superior over oral supplementation for improving functional capacity of heart failure patients [1]. Irrespective of the study design, involving comparison of functional outcomes between two different means of iron supplementation, we raise some clinical issues about the rationale underlying this investigation. According to the data published by Beck-da-Silva et al., the modest number of patients (n = 23) enrolled in this multicenter investigation had moderate anemia (i.e., hemoglobin concentration comprised between 90 and 120 g/L) but no evidence of iron deficiency, which…

Searching for a clinically validated definition of “asymptomatic” COVID‐19 infection

Influence of middle-distance running on muscular micro RNAs

A specific subset of micro RNAs (miRs), including miR-133 and miR-206, is specifically expressed in muscle tissue, so that they are currently defined as muscular miRs (myomiRs). To further elucidate the role of myomiRs in muscle biology, we measured miR-133a and miR-206 in plasma of 28 middle-age recreational athletes. The study population consisted of 28 middle aged, recreation athletes (11 women and 17 men; mean age, 46 years) who completed a 21.1 km, half-marathon. The plasma concentration of miR-133a and miR-206, the serum concentration of creatine kinase (CK) and high-sensitivity (HS) cardiac troponin T (cTnT), as well as capillary lactate, were measured before and immediately after th…

Effect of training status on the changes in platelet parameters induced by short–duration exhaustive exercise

It is now well known that hemostasis is directly involved in the benefits induced by physical activity. It has recently been shown that the baseline mean platelet volume (MPV) may be a predictor of endurance performance. We aimed to explore whether platelet parameters are associated with VO2max as well as running duration and speed in a short-duration exhaustive exercise test. Thirty healthy male subjects (10 sedentary and 20 trained) performed an incremental running test until exhaustion. MPV, platelet distribution width (PDW), platelet (Plt) count, and plateletcrit (Pct) were determined before exercise, immediately after exercise and after 30′ recovery. Training status did not produce any…

Atrial fibrillation in athletes and non-athletes: evidence of different causative mechanisms

Health risks and potential remedies during prolonged lockdowns for coronavirus disease 2019 (COVID-19)

Abstract As coronavirus disease 2019 (COVID-19) pandemic continues, an increasing number of countries and territories are adopting restrictive measures based on physical (“social”) distancing, aimed at preventing human-to-human transmission and thereby limiting virus propagation. Nationwide lockdowns, encompassing mass quarantine under stay-at-home ordinances, have already been proven effective to contain the COVID-19 outbreak in some countries. Nevertheless, a prolonged homestay may also be associated with potential side effects, which may jeopardize people’s health and thus must be recognized and mitigated in a way without violating local ordinances. Some of the most important undesirable…

PTK2 rs7460 and rs7843014 polymorphisms and exceptional longevity: a functional replication study

Focal adhesion is critical for cell survival. The focal adhesion kinase (FAK, or PTK2) is an important component of the human interactome and thus is a potential longevity-related protein. Here we studied the association between two PTK2 gene single-nucleotide polymorphisms (SNPs) (rs7843014, rs7460) and exceptional longevity (EL). In addition to gaining insight into their functionality by determining luciferase gene reporter activity, we studied the genotype/allele frequency of these two SNPs among three different cohorts: (1) Spanish centenarians (n=175, 100–111 years, 144 women) and healthy controls (n=355, 20–50 years, 284 women); (2) Italian centenarians (n=79, 100–104 years, 40 women)…

Exercise, Neuroplasticity, and Growth Factors in Adolescence

Cardiac magnetic resonance in the diagnosis of the unusually detected acute myocarditis in the young people: a case report

Myocarditis is among the causes of arrhythmic sudden cardiac death (SCD) in young athletes, with viral infection being the most common cause worldwide. Myocarditis recently has been reported as one of the cardiac complications of coronavirus disease 2019 (COVID-19) in athletes. Here we present a case of a 20-year-old male recreational soccer player with an episode of loss of consciousness in the context of respiratory infection. The patient reports having woken up with symptoms of an upper respiratory tract infection, and after playing a soccer match, he developed dizziness and a headache. He then suffered vasovagal syncope without loss of sphincter control. Physical examination, heart ausc…

Fit Is It for Cardiovascular Disease Prediction, Prevention, and Treatment

Erythropoietin and Myocardial Infarction

Erythropoietin (EPO) has the potential to improve ischemic tissue by mobilizing endothelial progenitor cells and enhancing neovascularization. We hypothesized that combining EPO with human chorionic gonadotrophin (hCG) would improve post–myocardial infarction (MI) effects synergistically.

Does abdominal obesity influence immunological response to SARS-CoV-2 infection?

Several hundred studies, 40 systematic reviews, and nearly 20 meta-analyses had been published by early 2021, confirming an increased need for medical services for people living with overweight or ...

Autism spectrum disorders: possible implications of BDNF modulation through epigenetics

Inconsistency in circulating irisin levels: what is really happening?

The discovery of irisin as a novel and promising peptidic hormone for the treatment of obesity and diabetes has recently been reported. As a result, great hopes have been raised based on this finding, hypothesizing that irisin might provide additional benefits, not only for obesity and diabetes, but also for a wide range of pathological conditions requiring therapeutical and clinical attention. However, controversial results and conclusions on circulating irisin concentrations and correlations with other variables, including its role in metabolism, have recently been reported. Although laboratory assessment of irisin by ELISA is easily available and may provide interesting information for t…

Web searches for anxiolytic drugs during the COVID-19 outbreak in the USA

Several lines of evidence attest that the ongoing coronavirus disease 2019 (COVID-19) pandemic is accompanied by a vast array of physiological problems in the community.1 Since the emergence or magnification of anxiety disorders in the general population has also been suggested during the COVID-19 outbreak,2 we aimed to provide further insights on this matter by performing an electronic search in Google Trends (Google Inc, Mountain View, CA, USA), using the terms corresponding to the most common anxiolytic medicines used in the USA (ie, ‘Alprazolam’, ‘Diazepam’, ‘Lorazepam’, and ‘Clonazepam’) along with their brand names (‘Xanax’, ‘Valium’, ‘Ativan’, and ‘Klonopin’, respectively), and setti…

Exercise as the master polypill of the 21st century for the prevention of cardiovascular disease

To the Editor,The growing pandemic of cardiovascular diseases (CVD) has para-doxically paralleled advances in pharmacology, and CVD remains theleading cause of death worldwide. Therapeutic strategies aiming atcontrolling several CVD risk factors simultaneously in individualswithout evidence of CVD are expensive and difficult to implement.Thus, the development of fixed-dose drug combinations of antiplatelettogether with blood pressure (BP) and cholesterol-lowering drugs,i.e., polypills, is gaining attention to prevent CVD [1,2] and all-causemortality [3], even after an acute coronary syndrome [4]. Despite thepotential of polypills to increase adherence at a lower cost [5], peoplerandomized to …

New Molecular Targets and Lifestyle Interventions to Delay Aging Sarcopenia

The term sarcopenia was originally created to refer age-related loss of muscle mass with consequent loss of strength (Morley et al., 2001). There are now four international definitions of sarcopenia (Cruz-Jentoft et al., 2010; Muscaritoli et al., 2010; Morley et al., 2011). In essence they all agree, requiring a measure of walking capability [either low gait speed or a limited endurance (distance) in a 6-min walk], together with an appendicular lean mass of <2 SDs of a sex and ethnically corrected normal level for individuals 20–30 years old. Sarcopenia is a prevalent health problem among the elderly. On average, 5–13 and 11–50% of people aged 60−70 years and ≥80 years, respectively suffer …

Alpha-amylase serum levels in professional soccer players are not related with physical fitness.

Backgorund Recent evidence has showed that serum or salivary values of α-amylase predict endurance running performance. In this study we investigate whether serum α-amylase concentration may be associated with training status during a competitive season and after a detraining period in professional soccer players. Methods The study population consisted in 15 male professional soccer players from an Italian major league team (age [mean±SD] 27±5 years, weight 76.9±4.1 kg, height 1.82±0.05 m). Serum α-amylase levels were measured 3 times during the last part of a competitive season (January, March and May) and just before preseason training (July). Results Metabolic and cardiovascular fitness …

Could thiazolidinediones increase the risk of heart failure in Friedreich's ataxia patients?

Clinical evidence and the recent decisions of the European Medicines Agency and the Food and Drug Administration challenge the safety of thiazolidinediones treatment. Recently, this treatment has been suggested for Friedreich's ataxia because thiazolidinediones improve neurological symptoms. Hypertrophic cardiomyopathy is the most prevalent cardiac feature and the cause of premature death in Friedreich's ataxia patients. We recommend that therapy with peroxisome proliferator-activated receptor-gamma agonists like thiazolidinediones be taken with caution, as they cause a decrease in the number of fast fibers and an increase in mitochondrial biogenesis in cardiac muscle because of the inducti…

Vitamin C supplementation does not improve hypoxia-induced erythropoiesis.

Martinez-Bello,Vladimir E., Fabian Sanchis-Gomar, Daniel Martinez-Bello, Gloria Olaso-Gonzalez, Mari Carmen Gomez-Cabrera, and Jose Viña. Vitamin C Supplementation Does Not Improve Hypoxia-Induced Erythropoiesis. High Alt Med Biol 13:269–274, 2012.—Hypoxia induces reactive oxygen species production. Supplements with antioxidant mixtures can compensate for the decline in red cell membrane stability following intermittent hypobaric hypoxia by decreasing protein and lipid oxidation. We aimed to determine whether supplementation with vitamin C is implicated in the regulation of erythropoiesis and in the oxygen-carrying capacity of the blood, and also whether antioxidant supplementation prevents…

Antidepressant Effects of Exercise: A Role for the Adiponectin-PGC-1α-kynurenine Triad?

It is well-recognized that exercise improves mental health, e.g., by decreasing depressive behaviors, improving hippocampal-dependent learning and neurogenesis, and increasing dendritic plasticity. Yet how exercise influences the brain at the molecular level is not clearly understood. Yau et al recently reported that the antidepressant effects of physical exercise are mainly mediated by adiponectin, an adipocyte-secreted hormone ('adipocytokine') with neuroprotective effects at the central nervous system level (Yau et al., 2014). 4.155 JCR (2015) Q1, 12/83 Physiology; Q2, 63/187 Cell biology UEM

Microcentrifuge or Automated Hematological Analyzer to Assess Hematocrit in Exercise? Effect on Plasma Volume Loss Calculations

The assessment of plasma volume loss (∆PV) induced by exercise can be estimated from changes in hematocrit (Htc) and hemoglobin (Hb), and it is essential when investigating the metabolic or biologic response to exercise of circulating biomarkers. We aimed to ascertain whether the estimation of ∆PV may differ when Hb and Htc are determined by automated hematological analyzer (AHA) versus manual methods. Twenty-five healthy male subjects performed a maximal running incremental exercise. Blood samples were taken before exercise, immediately after exercise, and after a 30-min recovery. Hb and Htc (Htc-AHA) were determined by an AHA. Htc was also determined by microcentrifugation (Htc-M). The ∆P…

Do Antioxidant Vitamins Prevent Exercise-Induced Muscle Damage? A Systematic Review

Free radicals produced during exercise play a role in modulating cell signaling pathways. High doses of antioxidants may hamper adaptations to exercise training. However, their benefits are unclear. This review aims to examine whether vitamin C (VitC) and/or vitamin E (VitE) supplementation (SUP) prevents exercise-induced muscle damage. The PubMed, Web of Science, Medline, CINAHL, and SPORTDiscus databases were searched, and 21 articles were included. Four studies examined the effects of acute VitC SUP given pre-exercise: in one study, lower CK levels post-exercise was observed; in three, no difference was recorded. In one study, acute VitE SUP reduced CK activity 1 h post-exercise in condi…

Does midlife obesity really lower dementia risk?

Letter about: Qizilbash, N., Gregson, J., & Pocock, S. (2015). Does midlife obesity really lower dementia risk? The Lancet Diabetes & Endocrinology, 3(7), 501-502. 16.320 JCR (2015) Q1, 2/131 Endocrinology & metabolism UEM

Strenuous endurance exercise and right ventricular systolic function: no evidence of long-term sequelae.

a Faculty of Medicine, Department of Physiology, University of Valencia, Valencia, Spain b Fundacion de Investigacion del Hospital Clinico Universitario Valencia (FIHCUV-INCLIVA), Valencia, Spain c Faculty of Health and Sport Science, University of Zaragoza, Huesca, Spain d Hospital Universitario 12 de Octubre, Research Institute (i + 12), Madrid, Spain e HospitalUniversitario Miguel Servet, Zaragoza, Spain f Cardiology Service, Hospital Universitario Miguel Servet, Zaragoza, Spain g European University of Madrid, Madrid, Spain h Faculty of Medicine, Physical Education and Sports Section, University of Zaragoza, Zaragoza, Spain

Elite athletes live longer than the general population: a meta-analysis

OBJECTIVE: To perform a meta-analysis of cohort studies aimed at providing an accurate overview of mortality in elite athletes. PATIENTS AND METHODS: We reviewed English-language scientific articles available in Medline and Web of Science databases following the recommendations of the Meta-analyses Of Observational Studies in Epidemiology group. We searched for publications on longevity and professional or elite athletes (with no restriction on the starting date and up to March 31, 2014). RESULTS: Ten studies, including data from a total of 42,807 athletes (707 women), met all inclusion criteria. The all-cause pooled standard mortality ratio (SMR) was 0.67 (95% CI, 0.55-0.81; P<.001) with n…

Mitochondria as sources and targets of damage in cellular aging.

Mitochondria are considered as the most important cellular sources and targets of free radicals. They are also a source of signalling molecules that regulate cell cycle, proliferation, and apoptosis. Denham Harman postulated the free radical theory of aging in 1956. Previously Rebecca Gershman showed that radiation toxicity could be attributed to free radical damage. Subsequently, Jaime Miquel formulated the mitochondrial free radical theory of aging. We have shown that mitochondrial size, membrane potential, inner membrane mass and peroxide production is altered inside cells in old animals. These result in an increase in the oxidative damage to mitochondrial DNA with aging that can be prev…

Sex-Specific Ventricular Arrhythmias and Mortality in Cardiac Resynchronization Therapy Recipients

OBJECTIVES The study goal was to examine whether there are sex-related differences in the incidence of ventricular arrhythmias and mortality in CRT-defibrillator (CRT-D) recipients. BACKGROUND Few studies have evaluated sex-related benefits of cardiac resynchronization therapy (CRT). Moreover, data on sex-related differences in the occurrence of ventricular tachyarrhythmias in this population are limited. METHODS A multicenter retrospective study was conducted in 460 patients (355 male subjects and 105 female subjects) from the UMBRELLA (Incidence of Arrhythmia in Spanish Population With a Medtronic Implantable Cardiac Defibrillator Implant) national registry. Patients were followed up thro…

Periodontitis, coronary heart disease and myocardial infarction: treat one, benefit all

: Periodontal disease is conventionally defined as an inflammatory condition affecting the tissues surrounding and supporting the teeth (i.e. gum and periodontium). Recent statistics show that the prevalence of this condition is continuously growing worldwide, thus raising severe healthcare concerns, not only for local problems emerging from poor oral health, but also for the potential risk of developing systemic complications. Therefore, this article aims to provide an update on the intriguing association between periodontitis, coronary heart disease (CHD) and/or myocardial infarction (MI). Taken together, the available published information seems to support the existence of a significant …

Vitamin D, precocious acute myocardial infarction, and exceptional longevity

Recent studies have reported low circulating levels of 25-hydroxyvitamin D (25(OH)D), the biologically active form of vitamin D, in patients with cardiovascular disease (CVD) [1], hypertension [2], carotid atherosclerosis [3], atrial fibrillation [4], and heart failure [5]. Moreover, vitamin D deficiency has been associated with all-cause mortality [6,7] and predicts adverse cardiac events in patients with established CVD [8] or after acute myocardial infarction (AMI) [9]. In turn, vitamin D supplementation improves the modulation of autonomic tone [10]. 4.638 JCR (2015) Q1, 24/124 Cardiac and cardiovascular systems UEM

Cardiac troponin elevation in patients with influenza virus infections

The association between acute infections and cardiac injury, including myocarditis and acute myocardial infarction, is now well established. We have performed a systematic literature review for analyzing the results of epidemiological studies that measured cardiac troponins (cTn) in patients with Influenza virus infections. Overall, 14 articles were finally identified and analyzed. Taken together, the results of the scientific literature suggest that cTn elevation is a relatively rare phenomenon in patients with Influenza virus infection, with frequency generally comprised between 0 and 33%, more likely in elderly patients with significant comorbidities. In patients with modest cTn elevatio…

Exercise Effects on Erythrocyte Deformability in Exercise-induced Arterial Hypoxemia

Exercise-induced arterial hypoxemia (EIAH) is often found in endurance-trained subjects at high exercise intensity. The role of erythrocyte deformability (ED) in EIAH has been scarcely explored. We aimed to explore the role of erythrocyte properties and lactate accumulation in the response of ED in EIAH. ED was determined in 10 sedentary and in 16 trained subjects, both before and after a maximal incremental test, and after recovery, along with mean corpuscular volume (MCV) and red blood cell lactate concentrations. EIAH was found in 6 trained subjects (∆SaO2=-8.25±4.03%). Sedentary and non-EIAH trained subjects showed reduced ED after exercise, while no effect on ED was found in EIAH train…

Blood and urinary abnormalities induced during and after 24-hour continuous running: A case report

In this reported clinical case, a healthy and well-trained male subject [aged 37 years, maximal oxygen uptake (V[Combining Dot Above]O2max) 64 mL·kg·min] ran for 23 hours and 35 minutes covering 160 km (6.7 km/h average running speed). The analysis of hematological and biochemical parameters 3 days before the event, just after termination of exercise, and after 24 and 48 hours of recovery revealed important changes on muscle and liver function, and hemolysis. The analysis of urine sediments showed an increment of red and white blood cells filtrations, compatible with transient nephritis. After 48 hours, most of these alterations were recovered. Physicians and health professionals who monito…

'Olympic' centenarians: are they just biologically exceptional?

4.036 JCR (2014) Q1, 29/123 Cardiac and sardiovascular systems UEM

Why is COVID-19 especially impacting the African American population?

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the ongoing coronavirus disease 2019 (COVID-19) pandemic, penetrates human cells through direct binding with ...

Should atrial fibrillation be considered a cardiovascular risk factor for a worse prognosis in COVID-19 patients?

Erythropoietin and the heart: physiological effects and the therapeutic perspective.

Erythropoietin (Epo) has been thought to act exclusively on erythroid progenitor cells. The identification of Epo receptor (EpoR) in non-haematopoietic cells and tissues including neurons, astrocytes, microglia, immune cells, cancer cell lines, endothelial cells, bone marrow stromal cells, as well as cells of myocardium, reproductive system, gastrointestinal tract, kidney, pancreas and skeletal muscle indicates that Epo has pleiotropic actions. Epo shows signals through protein kinases, anti-apoptotic proteins and transcription factors. In light of interest of administering recombinant human erythropoietin (rhEpo) and its analogues for limiting infarct size and left ventricular (LV) remodel…

Venous Thrombosis Associated with HMG-CoA Reductase Inhibitors

Abstract Among the various hypolipidemic drugs, 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors (also known as "statins") belong to a heterogeneous class of compounds, sharing an identical hypocholesterolemic effect that develops through direct inhibition of a rate-limiting step in endogenous cholesterol synthesis. Their mechanism of action entails competitive inhibition of HMG-CoA reductase. Several lines of evidence suggest that the pleiotropic effects of statins may also play a role in prevention of venous thrombosis, wherein hypercholesterolemic patients are characterized by enhanced thrombin generation, increased susceptibility to endothelial dysfunction and plate…

Exercise effects on cardiovascular disease: from basic aspects to clinical evidence.

Contains fulltext : 283453.pdf (Publisher’s version ) (Closed access) Cardiovascular (CV) disease (CVD) remains the leading cause of major morbidity and CVD- and all-cause mortality in most of the world. It is now clear that regular physical activity (PA) and exercise training (ET) induces a wide range of direct and indirect physiologic adaptations and pleiotropic benefits for human general and CV health. Generally, higher levels of PA, ET, and cardiorespiratory fitness (CRF) are correlated with reduced risk of CVD, including myocardial infarction, CVD-related death, and all-cause mortality. Although exact details regarding the ideal doses of ET, including resistance and, especially, aerobi…

Vitamin D and Cardiovascular Health

The principal source of vitamin D in humans is its biosynthesis in the skin through a chemical reaction dependent on sun exposure. In lesser amounts, the vitamin can be obtained from the diet, mostly from fatty fish, fish liver oil and mushrooms. Individuals with vitamin D deficiency, defined as a serum level of 25 hydroxyvitamin D < 20 ng/dl, should be supplemented. Vitamin D deficiency is a prevalent global problem caused mainly by low exposure to sunlight. The main role of 1,25 dihydroxyvitamin D is the maintenance of calcium and phosphorus homeostasis. However, vitamin D receptors are found in most human cells and tissues, indicating many extra-skeletal effects of the vitamin, particula…

Exploring the association between extra-cardiac troponin elevations and risk of future mortality

Although the measurement of cardiac troponin I (cTnI) and T (cTnT) has now become the cornerstone for diagnosing cardiac injury, both ischemic and non-ischemic, recent evidence has become available that many patients display extra-cardiac causes of cTn elevations and carry a considerably enhanced risk of future mortality. The current literature data suggests that cTn elevations may be equally common in patients with cardiac and extra-cardiac diseases. Among the latter cohort of patients, the leading extra-cardiac diseases which may be responsible for either cTnI or cTnT elevations include infectious diseases/sepsis, pulmonary disorders, renal failure, malignancy, as well as gastrointestinal…

PPARgamma agonist pioglitazone does not enhance performance in mice

Peroxisome-proliferator-activated receptor (PPAR) delta and adenosine monophosphate (AMP)-activated protein kinases (AMPKs) regulate the metabolic and contractile characteristics of myofibres. PPAR proteins are nuclear receptors that function as transcription factors and regulate the expression of multiple genes. AMPK has been described as a master metabolic regulator which also controls gene expression through the direct phosphorylation of some nuclear proteins. Since it was discovered that both PPARdelta agonists (GW1516) and AMPK activators (5-aminoimidazole-4-carboxamide-1-β-D-ribofuranoside, known as AICAR) are very effective performance-enhancing substances in sedentary mice, the Worl…

Google Searches for Taste and Smell Loss Anticipate Covid-19 Epidemiology

AbstractBackgroundAs evidence emerged that loss of taste and/or loss of smell is frequently triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we investigated whether Google searches volume for these two disease-specific symptoms could be associated with disease epidemiology in United States (US).Materials and MethodsWe performed an electronic search in Google Trends using the keywords “taste loss” and “smell loss” within the US. The Google searches volume was correlated with the number of new weekly cases of coronavirus disease 2019 (COVID-19) in the country.ResultsThe weekly Google searches for taste and smell loss exhibited a trend similar to that of new…

Concise update on colorectal cancer epidemiology

Colorectal cancer is a type of gastrointestinal malignancy originating from either the colon or rectum. In this short report we provide a concise update on recent colorectal cancer statistics, especially concerning frequency, mortality, life expectancy and risk factors. Overall, colorectal cancer is the third more frequent malignant disease around the world (1.85 million of new cases/years; 10.2% of total malignancies), with 2.27% cumulative risk of onset between 0–74 years. The age-standardized rate increases by over 10-fold before the age of 50 up to ≥85 years, whilst men have ~50% enhanced risk compared to women (the 0–74 years risk is 2.75% in men and 1.83% in women, respectively). Alth…

An Eighteen-Minute Submaximal Exercise Test to Assess Cardiac Fitness in Response to Aerobic Training

Romagnoli, M, Alis, R, Sanchis-Gomar, F, Lippi, G, and Arduini, A. An 18-minute submaximal exercise test to assess cardiac fitness in response to aerobic training. J Strength Cond Res 32(10): 2846-2852, 2018-We aimed to evaluate the utility of a submaximal heart rate recovery (HRR) test to monitor changes in cardiac fitness after aerobic training. Twenty healthy subjects were assigned to a control (n = 10) or a training (n = 10) group. Subjects in the training group performed 8 weeks of bicycle training, followed by 8 weeks of detraining. Heart rate recovery was assessed after exercises at 65% and 80% HRmax. The HRR test was performed at weeks 0 (W0), 4 (W4), 8 (W8), and 16 (W16) in the tra…

Atrial fibrillation in highly trained endurance athletes — Description of a syndrome

Atrial fibrillation (AF) is the most common heart arrhythmia, the risk of which typically increases with age. This condition is commonly associated with major cardiovascular diseases and structural heart damage, while it is rarely observed in healthy young people. However, increasing evidence indicates that paroxysmal AF can also onset in young or middle-aged and otherwise healthy endurance athletes (e.g., cyclists, runners and cross-country skiers). Here we review the topic of AF associated with strenuous endurance exercise (SEE), for example cycling, running and cross-country skiing, especially at a competitive level, and we propose the definition of a new syndrome based on the accumulati…

Improvement in sprint performance: doping or nature?

Coronavirus Disease 2019–Associated Coagulopathy

Patients with the severe form of coronavirus disease 2019 (COVID-19) have been frequently found to suffer from both arterial and venous thrombotic events due to the perpetuation of a hypercoagulable state. This phenomenon, termed COVID-19-associated coagulopathy (CC), is now considered a major component of the pathophysiology of this novel infectious disease, leading to widespread thrombosis. While at first, the vascular insults may be limited to the pulmonary microvasculature, as the disease progresses, systemic involvement occurs, culminating in distant organ thrombosis and multi-organ dysfunction syndrome. In this review article, we discuss recent insights into the pathophysiologic mecha…

Hemoconcentration induced by exercise: Revisiting the Dill and Costill equation

The Dill and Costill equation is used to estimate the exercise-induced hemoconcentration. However, this cal- culation requires drawing an extra whole-blood sample, which cannot be frozen and has to be analyzed with dedi- cate instrumentation in a relative short time. The aim of the present study was to explore the usefulness of some serum biochemical parameters to estimate hemoconcen- tration induced by exhaustive exercise. Fourteen healthy male subjects (19-34 years) performed a15-min running test at 110% of anaerobic threshold speed. Hemoglobin, hematocrit, brain natriuretic peptide (BNP), creatinine, gamma-glutamyltransferase (GGT), total-proteins, albu- min, total calcium (Ca), K + ,N a…

Irisinemia: A Novel Concept to Coin in Clinical Medicine?

Skeletal muscle can express and release substances such as cytokines or other peptides capable of modulating metabolic processes. These cytokines, named ‘myokines', function as hormones either locally within the muscle or by targeting distant organs. A novel peptidic myokine named ‘irisin' has been recently identified. It has been noted that circulating irisin levels are lower in type 2 diabetes (T2D) compared with nondiabetic controls as well as in patients with chronic kidney disease. In addition, a negative correlation between the hemoglobin A1c (HbA1c) and circulating levels of irisin has been also observed. Thus, the blood concentration of irisin may reflect the metabolic status of pat…

Cardiac troponin I and T: Exploring popularity with Google Trends

The implementation of high-sensitivity cardiac troponin T (hs-cTnT) assays and a cutoff based on the 99th cTnT percentile in the evaluation of patients with suspected acute coronary syndrome has not been uniform due to uncertain effects on health benefits and utilization of limited resources.Clinical and laboratory data from patients with chest pain or dyspnea at the emergency de¬partment (ED) were evaluated before (n = 20516) and after (n = 18485) the lowering of the hs-cTnT cutoff point from 40 ng/L to the 99th hs-cTnT percentile of 14 ng/L in February 2012. Myocardial infarction (MI) was diagnosed at the discretion of the attending clinicians responsible for the patient.Following lowerin…

Secondhand smoke and ischaemic heart disease: demographic characteristic of a worldwide healthcare problem

Effects of acute exercise and xanthine oxidase inhibition on novel cardiovascular biomarkers.

Several sports have been associated with a postexercise increase of cardiac, liver, and skeletal muscle biomarkers of injury. Exhaustive or acute physical exercise causes an increased generation of reactive oxygen species, resulting in cellular injury. Thus, exercise and training may trigger pathophysiological changes in serum concentrations of a variety of biomarkers. In this study, we aimed to evaluate the variation of novel biomarkers of stress and cardiovascular disease such as copeptin, midregional part of proadrenomedullin (MR-proADM), growth differentiation factor 15 (GDF15), soluble vascular endothelial growth factor receptor, and placental growth factor along with uric acid before …

Obesity and Outcomes in COVID-19: When an Epidemic and Pandemic Collide.

Obesity has reached epidemic proportions in the United States and in much of the westernized world, contributing to considerable morbidity. Several of these obesity-related morbidities are associated with greater risk for death with coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 penetrates human cells through direct binding with angiotensin-converting enzyme 2 receptors on the cell surface. Angiotensin-converting enzyme 2 expression in adipose tissue is higher than that in lung tissue, which means that adipose tissue may be vulnerable to COVID-19 infection. Obese patients also have worse outcomes with COVID-19 infection, including respiratory failure, n…

Inflammation and coronary artery disease: The exercise paradox

CT-Determined Maximum Pulmonary Artery to Ascending Aorta Diameter Ratio in Nonsevere COVID-19 Patients

Influence of ABO blood group on sports performance

Background: Despite being a recessive trait, the O blood group is the most frequent worldwide among the ABO blood types. Since running performance has been recognized as a major driver of evolutionary advantage in humans, we planned a study to investigate whether the ABO blood group may have an influence on endurance running performance in middle-aged recreational athletes. Methods: The study population consisted of 52 recreational, middle-aged, Caucasian athletes (mean age: 49±13 years, body mass index, 23.4±2.3 kg/m 2 ), regularly engaged in endurance activity. The athletes participated to a scientific event called “Run for Science” (R4S), entailing the completion of a 21.1 km (half-marat…

PAFIYAMA syndrome evidence in highly trained population