Frontiers in physiology
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Frontiers in physiology · Jan 2018
Cardiac Biomarkers Predicting MACE in Patients Undergoing Noncardiac Surgery: A Meta-Analysis.
Objective: The present meta-analysis was aimed to systematically evaluate the effectiveness and accuracy of brain natriuretic peptide (BNP), cardiac troponin (cTn), high sensitive C reactive protein (hs-CRP) and CRP for predicting postoperative major adverse cardiovascular events (MACE) in patients undergoing noncardiac surgery. Methods: A total of 26 relevant studies with 7,877 participants were collected from five databases, namely PubMed, Embase, China National Knowledge Infrastructure (CNKI), CQVIP and the Wanfang Database until August 10, 2018. And the Review Manager Version 5.3 and Stata/SE 12 software were used for data syntheses in the meta-analysis. ⋯ Comparing with normal levels of cTnI/cTnT, increased cTnI/cTnT was associated with nearly 5-fold more higher risk of MACE [RR:5.52, 95%CI: 4.62-6.58, P < 0.001]; elevated cTnI faced a 5-fold risk [RR:5.21, 95%CI: 3.96-6.86, P < 0.001]; elevated cTnT resulted in nearly 6-fold higher risk [RR:5.73, 95%CI: 4.55-7.22, P < 0.001]. The elevation of hs-CRP was associated with nearly 4-fold higher risk of MACE in comparison with normal concentration [RR:3.73, 95%CI: 2.63-5.30, P < 0.001]. Conclusion: According to the results of our meta-analysis, the elevations of BNP/NT-proBNP, cTnI/cTnT, and hs-CRP, pre-operation or post-operation immediately, can predict much higher risk of postoperative MACE in patients undergoing noncardiac surgery.
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Frontiers in physiology · Jan 2018
Impact of Different Tidal Volume Levels at Low Mechanical Power on Ventilator-Induced Lung Injury in Rats.
Tidal volume (VT) has been considered the main determinant of ventilator-induced lung injury (VILI). Recently, experimental studies have suggested that mechanical power transferred from the ventilator to the lungs is the promoter of VILI. We hypothesized that, as long as mechanical power is kept below a safe threshold, high VT should not be injurious. ⋯ Multiple linear regression analyses indicated that VT was able to predict changes in IL-6 and CC16, whereas ΔP,L predicted pHa, oxygenation, amphiregulin, and syndecan-1 expression. In the model of ARDS used herein, even at low mechanical power, high VT resulted in VILI. VT control seems to be more important than RR control to mitigate VILI.
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Frontiers in physiology · Jan 2018
The Individual and Combined Effects of Multiple Factors on the Risk of Soft Tissue Non-contact Injuries in Elite Team Sport Athletes.
Aim: Relationships between athlete monitoring-derived variables and injury risk have been investigated predominantly in isolation. The aim of this study was to evaluate the individual and combined effects of multiple factors on the risk of soft-tissue non-contact injuries in elite team sport athletes. Methods: Fifty-five elite Australian footballers were prospectively monitored over two consecutive seasons. ⋯ Injury-prone players, identified via player identity in the mixed model, were at > 5 times higher risk of injuries compared to robust players (hazard ratio 5.4, 90% confidence limits 3.6-12) despite adjusting for training load and previous injuries. Combinations of multiple risk factors were associated with extremely large increases in risk; for example, a hazard ratio of 22 (9.7-52) was observed for the combination of high acute load, recent history of a leg injury, and a substantial reduction in the adductor squeeze test score. Conclusion: On the basis of our findings with an elite team of Australian footballers, the information from athlete monitoring practices in team sports should be interpreted collectively and used as a part of the injury prevention decision-making process along with consideration of individual differences in risk.
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Frontiers in physiology · Jan 2018
Effects of an Eight-Week Superimposed Submaximal Dynamic Whole-Body Electromyostimulation Training on Strength and Power Parameters of the Leg Muscles: A Randomized Controlled Intervention Study.
The purpose of this study was to assess the effects of dynamic superimposed submaximal whole-body electromyostimulation (WB-EMS) training on maximal strength and power parameters of the leg muscles compared with a similar dynamic training without WB-EMS. Eighteen male sport students were randomly assigned either to a WB-EMS intervention (INT; n = 9; age: 28.8 (SD: 3.0) years; body mass: 80.2 (6.6) kg; strength training experience: 4.6 (2.8) years) or a traditional strength training group (CON; n = 9; age: 22.8 (2.5) years; body mass: 77.6 (9.0) kg; strength training experience: 4.5 (2.9) years). Both training intervention programs were performed twice a week over a period of 8 weeks with the only difference that INT performed all dynamic exercises (e.g., split squats, glute-ham raises, jumps, and tappings) with superimposed WB-EMS. ⋯ A significant time × group interaction effect was merely observed for Fmax on the LE where follow-up post hoc testing showed significantly higher improvements in the INT group from PRE to POST and PRE to FU (INT: +7.7%, p < 0.01; CON: +2.1%). These findings indicate that the combination of dynamic exercises and superimposed submaximal WB-EMS seems to be effective in order to improve leg strength and power. However, in young healthy adults the effects of superimposed WB-EMS were similar to the effects of dynamic resistance training without EMS, with the only exception of a significantly greater increase in leg extension Fmax in the WB-EMS group.