Medicina
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Review Meta Analysis
Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials.
Background and Objectives: Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. ⋯ The subgroups whose blood samples were collected immediately after exercise demonstrated negative changes in their TNF-α, IL-8, and IL-10 levels. Conclusions: Probiotic supplementation resulted in significant positive changes in the IFN-γ and salivary IgA levels and negative changes in the IL-10 and TNF-α levels. No significant changes in the IL-1β, IL-2, IL-4, IL-6, IL-8, or CRP levels were observed after probiotic use in athletes.
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Background and Objectives: Anterior cruciate ligament (ACL) injuries are common injuries in athletes, and, accordingly, ACL reconstruction (ACLR) is one of the most common orthopedic surgical procedures performed on athletes. This study aims to compare the 6-month post-operative isokinetic knee strength evaluations of the semitendinous/gracilis (ST/G) ACLR technique performed on healthy (HK) and ACLR knees of athletes. Materials and Methods: A retrospective cohort of 29 athletes from various sports branches who underwent ST/G ACLR technique by the same surgeon were evaluated. ⋯ Conclusions: The findings showed that the ST/G 6-month post-operative isokinetic knee strength in athletes produced high results in HK, and, when evaluated in terms of returning to sports, the H/Q ratios on the ACLR side were sufficient to make the decision to return to sports. It was found that the ACLR side was slower than the HK side in the reciprocal transitions, particularly in the Flx phase. We believe that this results from the deformation of the hamstring muscle after reconstruction of the ST/G ACLR side.
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Background and Objectives: Vertebral artery hypoplasia (VAH) is a controversial risk factor for cerebral infarction. The aim of this study was to analyze the prevalence of vertebral artery hypoplasia and to evaluate its association with vertebrobasilar cerebrovascular accidents. Materials and Methods: The study was conducted in the Neurology Departments of the Republican Vilnius University Hospital from 2015 to 2020. ⋯ There was no difference in the rates of other risk factors between PCI/VAS patients with and without VAH. Conclusions: Vertebral artery hypoplasia is not a rare finding in individuals without symptoms of cerebrovascular accident, but more frequent in patients with vertebrobasilar cerebral infarction or vertebrobasilar artery syndrome. Vertebral artery hypoplasia can be considered a risk factor for posterior circulation infarction in subjects under 65 years of age.
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Review Meta Analysis
Beta-Blocker Use after Discharge in Patients with Acute Myocardial Infarction in the Contemporary Reperfusion Era.
Background and objectives: The effect of beta-blocker use after discharge on patients with acute myocardial infarction (AMI) in the contemporary reperfusion era remains ambiguous. By applying meta-analysis, we sought to assess the role of beta-blockers in the contemporary reperfusion era. Materials and Methods: Randomized controlled trials (RCT) and observational studies using propensity score matching, comparing use of beta-blockers with non-use of beta-blockers, in patients with AMI after discharge. ⋯ No significant differences were found in major adverse cardiovascular events (MACE, OR: 0.88, 95% CI: 0.66 to 1.17, I2 = 78.4%), heart failure (OR: 0.56, 95% CI: 0.29 to 1.08, I2 = 0) or stroke (OR: 1.13, 95% CI: 0.92 to 1.39, I2 = 0). For patients with preserved left ventricular function, beta-blocker use after discharge may have also reduced the risk of all-cause mortality (OR: 0.61, 95% CI: 0.44 to 0.84, I2 = 0). Conclusions: Use of beta-blockers after discharge may still be beneficial for AMI patients in the contemporary reperfusion era, with or without preserved left ventricular function.
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Pulmonary embolism (PE) can have a wide range of hemodynamic effects, from asymptomatic to a life-threatening medical emergency. Pulmonary embolism (PE) is associated with high mortality and requires careful risk stratification for individualized management. ⋯ In terms of initial therapeutic choice and long-term management, intermediate-risk (or submassive) PE remains the most challenging subtype. The definitions, classifications, risk stratification, and management options of intermediate-risk PE are discussed in this review.