Vascular access for autologous peripheral blood stem cells collection by large volume leukapheresis: Single center experience.

INTRODUCTION: Peripheral blood stem cell (PBSC) harvesting requires reliable and safe vascular access. In our institution, a change of practice was implemented and the central venous catheter (CVC) placement for all autologous PBSC collections was abandoned in favor of a careful evaluation of peripheral venous access (PVA) for each individual patient. The aim of this prospective study was to evaluate the rate of patients with adequate peripheral veins for autologous PBSC collection and compare patient characteristics, collection efficacy, and complication rate between patients with PVA and CVC. METHOD: Peripheral veins were assessed by the apheresis nurse team in all patients referred between January 2020 and July 2021 to autologous PBSC collection. Only in case of difficult venous access, CVC was inserted. Large volume leukapheresis (LVL) procedures, which processed ≥3 total blood volumes, were performed. RESULTS: In 65 (57%) patients PVA was used, while 49 (43%) patients required placement of short-term CVC. Peripheral venous access was successfully used significantly more often in males (69.8%) (P = 0.010), and patients with multiple myeloma (71.0%) than in patients with non-Hodgkin's lymphoma (35.9%) and Hodgkin's lymphoma patients (33.3%) (P < 0.001). There was a significant difference in the type of prior administered chemotherapy; in the patients who received cytostatics free chemotherapy, PVA was used more often (75.0%) (P = 0.007). In terms of the efficacy and safety of LVLs, there were no differences between procedures performed using PVA and CVCs. CONCLUSION: Peripheral venous access is feasible for autologous PBSC collection in more than a half of patients, in particular in those with multiple myeloma. Changes in the treatment of multiple myeloma, using new proteasome inhibitors-based and immunomodulatory agents that do not adversely affect peripheral veins, have enabled the use of PVA even at the high blood flow rates required by LVL. Peripheral venous access is not associated with safety issues or with a lesser collection efficiency, and it is cost-effective as well. Each patient referred to autologous PBSC collection needs to be evaluated individually by the experienced apheresis team for the most appropriate venous access.

From Sarcopenia to Depressive Symptoms in Elderly: A Path Analysis.

BACKGROUND: Sarcopenia is an age-related progressive, generalized skeletal muscle disorder involving the accelerated loss of muscle function and muscle mass. The aim of this study was to assess the complex relationship between sarcopenia, malnutrition, cognitive impairment, physical activity, and depression in the elderly, with the potential role of quality of life as a mediator in these associations. METHODS: A cross-sectional study was conducted on a sample (n = 298) of elderly patients admitted to Special Hospital for Rehabilitation "Termal", Vrdnik, Serbia. Sarcopenia, the risk for malnutrition, cognitive impairment, physical activity, quality of life, and depressive symptoms were measured by standardized instruments. Additional data included sociodemographic characteristics. Simultaneous assessment of the direct and indirect relationships of all determinants was performed by path analysis. RESULTS: A total of 40% (n = 120) of the elderly were diagnosed with sarcopenia, and 42.6% had depression symptoms. The risk of malnutrition was present in 23.5%, cognitive impairment in 5.4%, and a low level of physical activity was reported in 26.2% of elderly participants. The mean reported quality of life measured by Sarcopenia and Quality of Life Questionnaire was 60 (on the scale ranging from 0 to 100; where a higher score reflects a higher quality of life). The best-fitted model (χ2/DF = 1.885, NFI = 0.987, CFI = 0.993, GFI = 0.997, RMSEA = 0.055) highlighted the mediating effect of quality of life between sarcopenia, malnutrition, cognitive impairment, lower level of physical activities and depression. According to the model, quality of life was a direct negative predictor of depressive symptoms in the elderly, while malnutrition positively affected depression. CONCLUSIONS: The presented path model may assist rehabilitation centers in developing strategies to screen for sarcopenia and risk of malnutrition, and promote physical activity in elderly, aiming to prevent their negative effects on mental health. For the elderly currently affected by sarcopenia, we consider regenerative medicine and stem cell therapy, which, in view of their etiology, could be a potential therapeutic strategy for sarcopenia.

Is the physical fitness of schoolchildren dependent on their physical activity levels and nutritional status? The experience from Serbia.

Introduction: Introduction: based on the presumed relationship between physical activity and physical fitness, it seems reasonable to expect that being active would result in sufficient fitness levels. However, the relationship between physical activity and fitness is not so plausible and needs deeper exploration. Objectives: we conducted a study aimed at exploring: a) the potential variation in physical activity level by gender and school grade; and b) the effect of physical activity level, gender, and nutritional status on physical fitness test results. Methods: a total of 2795 males and 2614 females participated in the study (11-14 years). Their physical fitness was assessed by measuring anthropometric status, muscular fitness, endurance, flexibility, agility, and cardiorespiratory fitness, while their physical activity was assessed using the Physical Activity Questionnaire (PAQ-A). Results: a higher percentage of boys were highly active, while a higher percentage of girls were scarcely active (χ2 [2, n = 5017] = 151.4, p < 0.01). Decline in physical activity with age was higher in girls than in boys (χ2 [6, n = 5409] = 90.4, p < 0.01). MANOVA revealed a significant effect of gender (V = 0.009, F [6, 3669] = 5.29, p < 0.01), nutritional status (V = 0.193, F [12, 7340] = 65.16, p < 0.01) and physical activity levels (V = 0.043, F [12, 7340] = 13.60, p < 0.01) on tests outcomes. Conclusions: our study has shown that activity level in Serbian schoolchildren declines with age and is affected by nutritional status. Nutritional status represents a significant factor confounding physical fitness scores, regardless of activity levels.

Introducción: Introducción: basado en la presumible relación entre la actividad física y la condición física, parece razonable esperar que ser activo físicamente resulte en niveles suficientes de condición física. Sin embargo, la relación entre la actividad física y la forma física no es tan plausible y necesita una exploración más profunda. Objetivos: realizamos un estudio con el objetivo de explorar: a) la variación potencial en el nivel de actividad física en función del género y el grado escolar; y b) el efecto del nivel de actividad física, el género y el estado nutricional en el resultado de las pruebas de condición física. Métodos: un total de 2795 hombres y 2614 mujeres participaron en el estudio (11-14 años). Su condición física se evaluó midiendo el estado antropométrico, la aptitud muscular, la resistencia, la flexibilidad, la agilidad y la aptitud cardiorrespiratoria, mientras que la actividad física se evaluó mediante el Cuestionario de Actividad Física (PAQ-A). Resultados: un mayor porcentaje de niños eran muy activos, mientras que un mayor porcentaje de niñas eran poco activas (χ2 [2, n = 5017] = 151,4, p < 0,01). La disminución de la actividad física con el incremento de la edad fue mayor en las niñas que en los niños (χ2 [6, n = 5409] = 90,4, p < 0,01). El MANOVA reveló un efecto significativo del género (V = 0.009, F [6, 3669] = 5.29, p < 0.01), el estado nutricional (V = 0.193, F [12, 7340] = 65.16, p < 0.01) y los niveles de actividad física (V = 0.043, F [12, 7340] = 13.60, p < 0.01) en los resultados de las pruebas. Conclusiones: nuestro estudio ha demostrado que el nivel de actividad física en los escolares serbios disminuye con la edad y se ve afectado por el estado nutricional. El estado nutricional representa un factor significativo que confunde las puntuaciones de condición física, independientemente de los niveles de actividad.

Association between Chromatin Structural Organization of Peripheral Blood Neutrophils and Self-Perceived Mental Stress: Gray-Level Co-occurrence Matrix Analysis.

Methods based on the evaluation of textural patterns in microscopy, such as the "gray-level co-occurrence matrix" (GLCM) analysis are modern and innovative computer and mathematical algorithms that can be used to quantify subtle structural changes in cells and their organelles. Potential application of GLCM method in the fields of psychophysiology and psychiatry to this date has not been systematically investigated. The main objective of our study was to test the existence and strength of the association between chromatin structural organization of peripheral blood neutrophils and levels of self-perceived mental stress. The research was done on a sample of 100 healthy student athletes, and the Depression, Anxiety, and Stress Scales (DASS-21) were used for the estimation of psychological distress. Chromatin textural homogeneity and uniformity were negatively correlated (p < 0.01) with mental distress and had relatively good discriminatory power in differentiating participants with normal and elevated stress levels. As an addition, we propose the creation of a machine learning model based on binomial logistic regression that uses these and other GLCM features to predict stress elevation. To the best of our knowledge, these results are one of the first to establish the link between neutrophil chromatin structural organization quantified by the GLCM method and indicators of normal psychological functioning.

B regulatory cells and monocyte subpopulations in patients with chronic graft-vs-host disease.

AIM: To assess the correlations of B regulatory cells (Bregs) and monocyte subsets in peripheral blood with the National Institutes of Health (NIH)-consensus-defined clinical manifestations of chronic graft-vs-host disease (cGvHD), in an attempt to establish their role as cellular biomarkers. METHODS: This multidisciplinary prospective study enrolled adult cGVHD patients treated in the University Hospital Center Zagreb and University of Zagreb School of Medicine. Immunophenotypic subpopulations of CD24highCD38high Bregs (CD27-, CD27+, and total) and monocyte (classical, intermediate, and non-classical) counts were correlated with demographic, transplant, and cGVHD-related data. Bivariate correlation analysis was performed to evaluate the correlations between Bregs and monocytes subsets and cGVHD organ involvement, as well as cGVHD severity and immunosuppression intensity. RESULTS: Twenty-two adult patients (54.5% female) with cGVHD were enrolled. The median (range) age was 44.5 years (24-65). All patients were transplanted for hematologic malignancies and 40.9% had severe NIH cGVHD global score. The median time from cGVHD diagnosis to the analysis was 16.6 months (0-176). The organ most frequently affected with cGVHD were the eyes (68.2%), skin (45.5%), lungs (45.5%), and liver (40.9%). Lower total and CD27-Bregs counts were correlated with worse cGVHD severity, higher immunosuppression intensity, and lung cGVHD, in terms of cell count, but also with skin cGVHD, in terms of percentages. Patients with liver and joint/fascia cGVHD had a lower percentage of non-classical monocytes and patients with more severe global NIH score had a higher classical monocytes count. CONCLUSION: Different organs affected by cGVHD are differently associated with different subpopulations of Bregs and monocytes.

The Influence of Tobacco Use on Pulmonary Function in Elite Athletes.

OBJECTIVE: We sought to investigate the prevalence of smoking and lung function in the large cohort of elite athletes. METHODS: This cross-sectional study included 804 athletes competing at international level who were consecutively examined from January to December 2017. Elite athletes were classified in four groups of sport disciplines (skill, power, endurance and mixed): skill (n = 141), power (n = 107), endurance (n = 105) and mixed sport disciplines (n = 451). All participants underwent pre-participation screening, including spirometry. RESULTS: Study included 745 (92.7%) non-smokers, 20 (2.5%) former smokers and 39 (4.8%) active smokers. The percentage of body fat was higher and the percentage of muscle was lower in active smokers than in non-smokers and former smokers. Active smokers were more prevalent among skill and mixed than in power and endurance sports. FEV1 and FVC, as well as FEV1/FVC ratio, were significantly lower in active smokers than in non-smokers. There was no significant difference in PEF assessed in absolute values and in percentages. Forced expiratory flows, evaluated at the usual intervals (25%, 50% and 75% of FVC), were significantly lower in active smokers than in non-smokers. FEV1 and MEF25 were the lowest among active smokers in the skill sport group, whereas FEV1/FVC, MEF50 and MEF25 were the lowest among active smokers in the power sport group. In mixed and endurance disciplines there was no difference in pulmonary function between non-smokers, former smokers and active smokers. CONCLUSION: Pulmonary function was reduced in active smokers and these differences were the most prominent in skill and power sports. The percentage of body fat was the highest and percentage of muscle was the lowest in active smokers.

Sensory feedback restoration in leg amputees improves walking speed, metabolic cost and phantom pain.

Conventional leg prostheses do not convey sensory information about motion or interaction with the ground to above-knee amputees, thereby reducing confidence and walking speed in the users that is associated with high mental and physical fatigue1-4. The lack of physiological feedback from the remaining extremity to the brain also contributes to the generation of phantom limb pain from the missing leg5,6. To determine whether neural sensory feedback restoration addresses these issues, we conducted a study with two transfemoral amputees, implanted with four intraneural stimulation electrodes7 in the remaining tibial nerve (ClinicalTrials.gov identifier NCT03350061). Participants were evaluated while using a neuroprosthetic device consisting of a prosthetic leg equipped with foot and knee sensors. These sensors drive neural stimulation, which elicits sensations of knee motion and the sole of the foot touching the ground. We found that walking speed and self-reported confidence increased while mental and physical fatigue decreased for both participants during neural sensory feedback compared to the no stimulation trials. Furthermore, participants exhibited reduced phantom limb pain with neural sensory feedback. The results from these proof-of-concept cases provide the rationale for larger population studies investigating the clinical utility of neuroprostheses that restore sensory feedback.

Generalized Poincaré plots analysis of heart period dynamics in different physiological conditions: Trained vs. untrained men.

BACKGROUND: Recently we proposed a new method called generalized Poincaré plot (gPp) analysis which gave a new insight into the pattern of neurocaridac control. In this study we examined potential of gPp method to reveal changes in cardiac neural control in young athletes during three conditions: supine rest, running and relaxation, with respect to untrained subjects. METHODS: This method is based on the quantification of Pearson's correlation coefficients r(j, k), between symmetrical (j = k) and asymmetrical summed j previous and k following RR intervals up to the 100th order (j,k≤100). RESULTS: Differences between groups were obtained at all levels of this analysis. The main result is the significant difference of NAI, normalized index of asymmetry, between groups in running, which was originated in different positions of local maxima of r(j, k). Compared with untrained subjects, these findings indicate modified neural control and altered intrinsic heart rate behavior in athletes which are related to some kind of memory mechanism between RR intervals. CONCLUSION: Obtained results provide great potential of gPp method analysis in the recognition of changes in neurocardiac control in healthy subjects. Further studies are needed for identification of altered cardiac regulatory mechanisms whose background may be useful in the evaluation of genesis of athletes neurocardiovascular pathology.

An automated mini buffy coat preparation method for use in mini extracorporeal photopheresis treatment of graft-vs-host-disease in a low body weight pediatric patient.

A mini extracorporeal photopheresis (mini-ECP) "off line" technique has been developed for use in the treatment of small children and patients with apheresis contraindications. Until now various methods have been used for buffy coat separation from whole blood. In this report we describe a protocol for mini buffy coat preparation using the automated Sepax laboratory separator for "off line" ECP treatment in a low body weight child with graft-vs-host-disease. According to our results this alternative method has been proven feasible and tolerable.

The relationship between right heart and aerobic capacity in large cohort of young elite athletes.

We sought to investigate right heart remodeling and function in elite athlees, as well as the relationship between parameters of right ventricular (RV) and right atrial (RA) remodeling and indices of aerobic capacity. Elite male athletes (n = 352) underwent echocardiographic examination including the evaluation of RV and RA parameters. Maximal cardiopulmonary exercise testing was performed to measure maximal oxygen consumption (VO2max), ventilatory anaerobic threshold (VAT) and heart rate reserve (HRR). The right heart remodeling was different between groups. Soccer players had significantly higher RV and RA diameters indexed for BSA. RV filling pressure assessed by tricuspid E/e' ratio was the lowest in soccer players, suggesting somewhat better RV diastolic function. Functional capacity also varies between groups of athletes. VO2max was the highest among soccer players, somewhat lower in basketball players and and the lowest among water polo players (55.3 ± 5.6 vs. 52.1 ± 5.9 vs. 53.5 ± 4.8 ml/kg/min, p < 0.001). Age, average weekly duration of training, percentage of body fat, as well as parameters of cardiopulmonary fitness (VO2max, O2 pulse, HRR), correlated well with parameters of RV and RA structure and function in the whole study population. However, systolic blood pressure at rest, VO2max and LV mass index are independently associated with RV and RA structure, whereas duration of training shows the best association with parameters of RV systolic and diastolic function. Even though soccer, water polo and basketball belong to the same group of sports, there is a significant difference in RV and RA remodeling between these three groups. It seems that right heart adaptation is the most pronounced in soccer players, who also have the highest maximal oxygen consumption. Further studies are necessary to investigate the mechanisms of these differences.

Autologous blood as a source of platelet gel for the effective and safe treatment of oral chronic graft-versus-host disease.

BACKGROUND: Oral chronic graft-versus-host disease (cGvHD) impairs oral function and patients' quality of life. Some lesions are refractory to local and systemic immunosuppressive therapy, and new therapeutic modalities are required. The aim of the study was to assess the efficacy and safety of topical application of autologous platelet gel (PG) in patients with oral cGvHD. STUDY DESIGN AND METHODS: PG was prepared from autologous blood and applied on ulcerous lesions using an automated system. The oral cGvHD was assessed using the 273-point Oral Mucositis Rating Scale (OMRS) prior and after completion of the PG treatment. The overall response to treatment of particular topography expressed as the total score on OMRS was compared to total score on National Institutes of Health cGvHD Oral Mucosal Score (NIH OMS). The pain intensity was measured by the Numeric Pain Rating Scale (NRS). RESULTS: In five patients, 12 autologous blood collections were performed; median 3 (range 1-3) per patient, and 26 PG applications were performed; median 6 (range 2-8) per patient. PG applications reduced lesions in oral cGvHD: median OMRS total score was reduced for 43.2% (range 9.6%-47.3%), and median NIH OMS total score for 27.3% (range 20.0%-50.0%) from baseline values. Median of pain intensity reduction on NRS scale was 57.1% (range 50%-100%). No side effects were observed. CONCLUSION: Application of autologous PG in oral cGvHD showed as an efficient and safe treatment option for patients who do not respond to standard local treatment.

Haemolysis, pure red cell aplasia and red cell antibody formation associated with major and bidirectional ABO incompatible haematopoietic stem cell transplantation.

BACKGROUND: Acute and delayed haemolysis, alloimmunisation and pure red cell aplasia (PRCA) are potential complications after ABO incompatible haematopoietic stem cell transplantation (HSCT). The aims of this study were to investigate acute and delayed red blood cell (RBC) antibody-associated complications, including haemolysis, PRCA and alloimmunisation in major and bidirectional ABO incompatible HSCT. MATERIALS AND METHODS: We retrospectively examined the transplant courses of 36 recipients of bone marrow or peripheral blood stem cells from ABO incompatible donors and evaluated the current practice of performing plasmapheresis in patients with higher isoagglutinin titres. We investigated the role of ABO incompatibility in haematopoietic recovery, transfusion requirements, alloimmunisation and PRCA. RESULTS: Laboratory signs of acute haemolysis were noted in five (14%) patients, one (3%) of whom had clinically overt haemolysis. Patients with haemolysis had IgM titres ≥1:8 and received >16 mL of RBC in the HSCT. In patients with higher titres, plasmapheresis performed prior to the transplant prevented acute haemolysis. Delayed haemolysis was not recorded in the follow up. Haematopoietic recovery and transfusion requirements did not differ notably between patients with and without haemolysis. De novo RBC antibodies were detected in two (5.5%) patients after HSCT, and PRCA was noted in one (3%) patient. DISCUSSION: Carried out with adequate graft processing, plasmapheresis and blood component support, haemolysis is not a common complication after HSCT. Our results confirm that the occurrence of haemolysis depends on larger RBC volumes and higher isoagglutinin titres. Despite the reduction of patients' isoagglutinin titres by plasmapheresis, we still noted a critical combination for the development of laboratory signs of haemolysis (IgM titre ≥1:8 and RBC volume >16 mL). De novo immunisation to RBC antigens and PRCA are rare events following ABO incompatible HSCT.

Association between physiological oscillations in self-esteem, narcissism and internet addiction: A cross-sectional study.

Internet addiction is a novel and relatively uninvestigated form of dependence that is fairly common in adolescent population. Previous research has indicated that it may be associated with other mental health problems, such as dysthymic mood and narcissistic behavior. In our study, we tested the existence and strength of relationship between Internet addiction, self-esteem and narcissism in a student population. On a sample of 244 students, we also investigated social networking activities, such as number of self-portrait photographs ("selfies"), and their potential connection with self-esteem and narcissism. Each participant completed a questionnaire consisting of Young Internet Addiction Test, Rosenberg Self-Esteem scale, and Narcissistic Personality Inventory. There was a statistically significant negative correlation between internet addiction score and self-esteem. Internet addiction increased as self-esteem decreased and vice versa. On the other hand, there was a positive correlation between internet addiction and narcissism. NPI score and number of self-portrait photographs (selfies) on Facebook were also in a positive relationship. Conversely, NPI score increased as the self-esteem decreased. The results of the study are in accordance with our previous findings on Internet use and mental health, confirming that Internet addiction is a potentially a serious public health problem.

An improved design of optical sensor for long-term measurement of arterial blood flow waveform.

We present here the improved design and development of optical sensor for non-invasive measurements of arterial blood flow waveform. The sensor is based on a physical principle of reflective photoplethysmography (PPG). As the light source we used serially connected infrared diodes whereas NPN silicon phototransistors were used as light detectors. The electronic components were molded into square package and poured with silicone. Such preparation produced an elastic superficies that allowed excellent attachment of the sensor on the skin's surface. Moreover, a serial connection of infrared diodes and phototransistors completely eliminated signal artifacts caused by minor muscle contractions. The sensor recording performances were examined at the photoplethysmographic sites on three different arteries; the commune carotid, femoral and radial and, on each site the sensor demonstrated remarkable capability to make a consistent, reproducible measurements. Because of the advantageous physical and electrical properties, the new sensor is suitable for various cardiovascular diagnostics procedures, especially when long-term measurements of arterial blood flow waveform are required, for monitoring of different parameters in cardiovascular units and for research.

Heart rate recovery in elite athletes: the impact of age and exercise capacity.

There is compelling evidence that postexercise heart rate recovery (HRR) is a valid indicator of sympaticovagal balance. It is also used in prescription and monitoring of athletic training. The purpose of our study was to determine HRR after maximal exercise among elite athletes with respect to age. A total of 274 elite male Caucasian athletes were randomly selected from the larger sample and divided into two groups: adolescent (group Y) and adult athletes (≥18 years; group A). They performed maximal cardiopulmonary exercise testing on a treadmill. Heart rate recovery was calculated as the rate of decline of HR from peak exercise to rates 1, 2 and 3 min after cessation of exercise (HRR1, HRR2 and HRR3). A significantly higher HRR1 was found in group A (29·5 ± 15·6 versus 22·4 ± 10·8, P<0·001), but HRR3 was higher in group Y (82·7 ± 10·2 versus 79·9 ± 12·25; P = 0·04). Stepwise multivariate linear regression analysis showed that, among all subjects, the HRR1 alone was independently associated with age (P<0·001). The maximal oxygen consumption (VO2 max) was in a negative relationship with HRR1 and in a positive one with HRR3 (P<0·05) with respect to all athletes. The HRR during 3 min postexercise should be reported for the purpose of better assessing functional adaptation to exercise among elite athletes as well as the age-associated differences in recovery. Higher values of HRR1 should be expected in older athletes, and HRR3 could be used as an index of aerobic capacity, irrespective of age.

Large volume leukapheresis is efficient and safe even in small children up to 15 kg body weight.

BACKGROUND: The collection of peripheral blood stem cells, although now a routine procedure, is still a challenge in low body weight children because of specific technical and clinical issues. For paediatric patients it is crucial to obtain an adequate number of CD34+ cells with the minimum number of procedures: this can be done using large volume leukapheresis (LVL). MATERIALS AND METHODS: We analysed the efficacy and safety of 54 autologous LVL performed in 50 children (33 [66%] males and 17 [34%] females), median age 2 years (range, 1-5) and median body weight 12 kg (range, 6-15). The procedures were performed with a COBE Spectra previously primed with red blood cells; ACD-A solution and heparin were used as anticoagulants. RESULTS: The target CD34+ cell dose (≥5×10/kg body weight) were collected with one LVL in 46 (92%) patients, while four (8%) patients needed another procedure. All our LVL were well tolerated. Side effects were observed in five (9.2%) patients and one procedure had to be discontinued because of catheter-related haemorrhage. The platelet count decreased significantly (p<0.001) after each procedure but without bleeding or need for transfusion support. DISCUSSION: Our experience confirms that LVL is efficient and safe even in small children, if the procedure is adjusted considering the weight and age of child. The most important factors are good venous access, adequate preparation of the child's electrolyte status, and surroundings in which the small child as well as parents feel comfortable, and can tolerate the procedure better. Although a median platelet loss of 50% can be expected, LVL is safe and reduces the overall number of procedures required. It can be recommended for peripheral blood stem cell collection even in small body weight children with malignant diseases, particularly those who mobilise low numbers of CD34+ cells.

Beneficial and harmful effects of exercise in hypertensive patients: the role of oxidative stress.

Oxidative stress has been implicated in the development and progression of hypertension. This review presents a comprehensive summary of original investigations focused on exercise-induced oxidative stress in hypertensive individuals. Single bouts of exercise can induce an acute state of oxidative stress. Chronic low-to-moderate exercise training improves the antioxidative defense and reduces the disease severity. However, the data that are currently available on the chronic intensive interval training-induced modification of the redox state in hypertensive patients are insufficient to draw adequate conclusions.

Chromatin Fractal Organization, Textural Patterns, and Circularity of Nuclear Envelope in Adrenal Zona Fasciculata Cells.

Despite previous research efforts in the fields of histology and cell physiology, the relationship between chromatin structural organization and nuclear shape remains unclear. The aim of this research was to test the existence and strength of correlations between mathematical parameters of chromatin microarchitecture and roundness of the nuclear envelope. On a sample of 240 nuclei of adrenal zona fasciculata cells stained using the DNA-specific Feulgen method, we quantified fractal parameters such as fractal dimension and lacunarity, as well as textural parameters such as angular second moment (ASM), entropy, inverse difference moment, contrast, and variance. Circularity of the nuclear envelope was determined from the nuclear area and perimeter. The results indicate that there is a statistically significant negative correlation between chromatin ASM and circularity. Moreover, there was a statistically significant positive correlation between chromatin fractal dimension and envelope circularity. This is the first study to demonstrate these relationships in adrenal tissue, and also one of the first studies to test the connection between circularity and fractal and gray-level co-occurrence matrix parameters in DNA-specific Feulgen stain. The results could be useful both as an addition to the current knowledge on chromatin/nuclear envelope interactions, and for design of future computer-assisted research software for evaluation of nuclear morphology.

Effect of short-term exercise training in patients following acute myocardial infarction treated with primary percutaneous coronary intervention.

BACKGROUND: Exercise-based rehabilitation is an important part of treatment patients following acute myocardial infarction (MI). However, data are scarce on the efffects of short-term exercise programs in patients with acute MI treated with primary percutaneous coronary intervention (PPCI). AIM: To evaluate the effect of short-term exercise training on cardiopulmonary exercise testing (CPET) parameters in patients suffering acute MI treated with PPCI. STUDY DESIGN: Observational longitudinal study. SETTING: Inpatient cardiac rehabilitation. POPULATION: Sixty consecutive patients with MI treated with PPCI referred for rehabilitation. METHODS: We studied 60 consecutive patients with MI treated with PPCI reffered for rehabilitation to our institution. The study population consisted of 54 men and 6 women (age 52.0±8.4 years, left ventricular ejection fraction 54.1±8.1%), who participated in a 3-week clinical cardiac rehabilitation program. The program consisted of cycling for 7 times/week, and daily walking for 45 minutes at an intensity of 70-80% of the individual maximal heart rate. All patients performed symptom-limited CPET on a bicycle ergometer with a ramp protocol of 10 w/min. The CPET was also performed after cardiac rehabilitation programs. RESULTS: After 3 weeks of exercise-based cardiac rehabilitation program improved exercise tolerance as compared to baseline (peak workload 119.28±20.45 vs. 104.35±22.01 watts, respectively, P<0.001), as well as peak respiratory exchage ratio (1.10±0.14 vs. 1.04±0.01, respectively, P<0.001). Peak heart rate at rest, peak and after 1 minute of rest were also improved. Most importantly, peak VO2 (19.27±4.16 vs. 17.27±3.34 ml/kg/min, respectively, P<0.001), peak VCO2 (1.83±0.38 vs. 1.58±0.30, respectively, P<0.001), peak ventilatory exchange (53.73±12.47 vs. 45.50±11.32 L/min, respectively, P<0.001) and peak breathing reserve (55.20±12.36 vs. 60.18±14.19%, respectively, P<0.001) were also improved. No major adverse cardiac events were noted during the rehabilitation program. CONCLUSIONS: Our data indicate that short-term exercise training in patients with acute MI treated with PPCI is safe and improves functional capacity, as well as test duration, work load and heart rate response. CLINICAL REHABILITATION IMPACT: It appears that three week cardiac rehabilitation is an effective approach to improve exercise capacity in patients with acute MI treated with PPCI.

High-dose ifosfamide and mitoxantrone (HDIM) in patients with relapsed or refractory Hodgkin's lymphoma.

Relapsed/refractory Hodgkin's lymphoma (HL) is treated with salvage chemotherapy and autologous stem cell transplantation (ASCT). Optimal chemotherapy is unknown. We retrospectively analyzed outcomes of 58 patients treated with 2 cycles of high-dose ifosfamide and mitoxantrone (HDIM). HDIM consisted of ifosfamide 5 g/m(2)/day and MESNA 5 g/m(2)/day in continuous 24-h infusion (days 1 and 2), MESNA 2.5 g/m(2) over 12 h (day 3), and mitoxantrone 20 mg/m(2) (day 1) administered every 2 weeks. Stem cells were collected after the first cycle. Responding patients proceeded to ASCT. Toxicity was acceptable. Stem cell mobilization was successful in 96 % of patients. Overall response rate was 74 % (89 % in relapsing and 45 % in refractory patients) with 31 % complete remissions. After a median follow-up of 54 months, 5-year event-free survival was 56 % (69 % for relapsing and 35 % for refractory patients), and 5-year overall survival was 67 % (73 % for relapsing and 55 % for refractory patients). Significant adverse prognostic factors were refractoriness to previous therapy and HDIM failure. No differences in outcomes were noted between patients with early and late relapses or between complete and partial responders. HDIM is a well-tolerated and effective regimen for relapsed and refractory HL with excellent stem cell mobilizing properties. Patients failing HDIM may still benefit from other salvage options.