Atypical case of subcutaneous filariosis in a cat caused by Dirofilaria immitis.

Subcutaneous dirofilariosis is a well-known disease caused mainly by Dirofilaria repens and described in several mammalian species including humans, dogs, and cats. Additionally, early developing stages of the heartworm Dirofilaria immitis are rarely reported in subcutaneous localization from humans and dogs. To our knowledge, confirmed clinical evidence of this condition has not been described in the cats yet, even if the feline hosts can be affected either by the classic adult-related heartworm form or heartworm-associated respiratory disease (HARD) caused by immature stages. A 2 year old, spayed male cat was presented for three subcutaneous nodules on the head and trunk. The cat lived in Northern Italy and was regularly vaccinated and treated monthly with an antiparasitic spot on formulation containing selamectin. One of the three nodules was surgically excised and examined. Histology showed the presence of a nodular lesion in the subcutis characterized by a severe inflammatory infiltrate composed of macrophages, small lymphocytes, with fewer eosinophils, and mast cells, supported by a proliferation of mature fibroblasts (fibrosis). Inflammatory cells were multifocally surrounding sections of parasites identified as adult nematodes. Microscopic features were compatible with D. immitis, which has been molecularly confirmed (98.2% identity to D. immitis isolate OP107739). The cat tested negative for D. immitis antigenemia and the two remaining nodules disappeared spontaneously in a few months. In region where heartworm is prevalent, aberrant localization of D. immitis should be considered in the differential diagnoses of subcutaneous filarial worms in cats and dogs.

Feline ventral abdominal wall angiosarcoma: haemangiosarcoma or lymphangiosarcoma? Clinical and pathological characteristics in nine cases.

OBJECTIVES: Angiosarcomas are rare malignant mesenchymal neoplasms of endothelial cell origin with a predilection to the ventral abdominal wall in cats. Larger case series describing this entity are lacking. METHODS: Two referral centre laboratory databases were searched for angiosarcoma of the ventral abdominal wall. Nine cases with a histological diagnosis were included. Immunohistochemistry (factor VIII and PROX-1 antibodies) was used to phenotype them as haemangiosarcoma or lymphangiosarcoma. RESULTS: All cats presented with a ventral abdominal mass, five of which were producing a serosanguinous discharge. Eight underwent tumour staging and pulmonary metastases were suspected in one cat (but not histologically confirmed). With histopathology alone, a diagnosis of angiosarcoma and lymphangiosarcoma was made in four and five cases, respectively. After immunohistochemistry, five cases had a haemangiosarcoma phenotype and four had a lymphangiosarcoma phenotype, including two cases of lymphangiosarcoma that were reclassified as hemangiosarcoma. Eight cats received treatment (either surgery with or without adjuvant therapies or medical management alone). Six cats were euthanased due to local disease progression. The median survival time for haemangiosarcoma was 166 days (range 137-381), and for lymphangiosarcoma it was 197 days (range 67-208). Two cats with haemangiosarcoma remained alive for a follow-up period of 329 and 580 days, respectively. CONCLUSIONS AND RELEVANCE: Feline ventral abdominal angiosarcomas are rare locally aggressive neoplasms. While histology often provides a diagnosis of angiosarcoma, immunohistochemistry is ultimately required to differentiate between haemangiosarcoma and lymphangiosarcoma phenotypes. Further studies are required to evaluate whether the different phenotypes have an impact on treatment response and outcome.

Standardization of canine meningioma grading: Validation of new guidelines for reproducible histopathologic criteria.

Canine meningiomas are currently graded using the human grading system. Recently published guidelines have adapted the human grading system for use in dogs. The goal of this study was to validate the new guidelines for canine meningiomas. To evaluate the inter-observer agreement, 5 veterinary surgical pathologists graded 158 canine meningiomas following the human grading system alone or with the new guidelines. The inter-observer agreement for histologic grade and each of the grading criteria (mitotic grade, invasion, spontaneous necrosis, macronucleoli, small cells, hypercellularity, pattern loss and anaplasia) was evaluated using the Fleiss kappa index. The diagnostic accuracy (sensitivity and specificity) was assessed by comparing the diagnoses obtained with the 2 grading systems with a consensus grade (considered the reference classification). The consensus histologic grade was obtained by agreement between 4 experienced veterinary neuropathologists following the guidelines. Compared with the human grading alone, the canine-specific guidelines increased the inter-observer agreement for: histologic grade (κ = 0.52); invasion (κ = 0.67); necrosis (κ = 0.62); small cells (κ = 0.36); pattern loss (κ = 0.49) and anaplasia (κ = 0.55). Mitotic grade agreement remained substantial (κ = 0.63). The guidelines improved the sensitivity in identifying grade 1 (95.6%) and the specificity in identifying grade 2 (96.2%) meningiomas. In conclusion, the new grading guidelines for canine meningiomas are associated with an overall improvement in the inter-observer agreement and higher diagnostic accuracy in diagnosing grade 1 and grade 2 meningiomas.

Multiparametric Prediction Models for Coronavirus Disease 2019 Vaccine Selection: Results of a Comparative Population-Based Cohort Study.

BACKGROUND: An understanding vaccine-dependent effects on protective and sustained humoral immune response is crucial to planning future vaccination strategies against coronavirus disease 2019 (COVID-19). METHODS: In this multicenter, population-based, cohort study including 4601 individuals after primary vaccination against COVID-19 ≥ 4 months earlier we compared factors associated with residual antibody levels against severe acute respiratory syndrome coronavirus-2 receptor-binding domain (RBD) across different vaccination strategies (BNT162b2, mRNA-1273, or ChAdOx1). RESULTS: Our main model including 3787 individuals (2 × BNT162b2, n = 2271; 2 × mRNA-1273, n = 251; 2 × ChAdOx1, n = 1265), predicted significantly lower levels of anti-RBD antibodies after 6 months in individuals vaccinated with ChAdOx1 (392.7 binding antibody units per milliliter [BAU/mL]) compared with those vaccinated with BNT162b2 (1179.5 BAU/mL) or mRNA-1273 (2098.2 BAU/mL). Vaccine-dependent association of antibody levels was found for age with a significant predicted difference in BAU/ml per year for BNT162b2 (-21.5; 95% confidence interval [CI], -24.7 to -18.3) and no significant association for mRNA-1273 (-4.0; 95% CI, -20.0 to 12.1) or ChAdOx1 (1.7; 95% CI, .2 to 3.1). The predicted decrease over time since full immunization was highest in mRNA-1273 (-23.4; 95% CI, -31.4 to -15.4) compared with BNT162b2 (-5.9; 95% CI, -7 to -4.8). CONCLUSIONS: Our study revealed population-based evidence of vaccine-dependent effects of age and time since full immunization on humoral immune response. Findings underline the importance of individualized vaccine selection, especially in elderly individuals.

Post-COVID: effects of physical exercise on functional status and work ability in health care personnel.

PURPOSE: Post-COVID fatigue significantly limits recovery and return-to-work in COVID-19 survivors. We aimed to assess the effects of physical exercising on post-COVID-19-symptoms, physical/mental capacities and workability within a workplace-health-promotion project in health-care personnel. MATERIALS AND METHODS: Thirty-two HCWs were enrolled in two groups based on Post-COVID-Functional Scale (PCFS) scores: (1) severe (SSG, n = 11) and (2) mild (MSG, n = 21) symptoms. The participants underwent an eight week exercise intervention program consisting of two supervised resistance exercise sessions per week plus individual aerobic exercise recommendations. Primary outcome-parameter for physical fitness was VO2peak. Further, physical function (6MWT, 30 s sit-to-stand test (30secSTS)), mental health (anxiety (GAD-7), depression (PHQ-9), stress (PSS-10), fatigue (BFI), resilience (BRS)), cognitive capacity (MoCA) and workability (WAI) were assessed at baseline, after 4 weeks and after completion of exercise intervention. RESULTS: VO2peak improved significantly in the SSG by 2.4 ml/kg/min (95% CI [1.48; 3.01], adj.p < 0.001) and non-significantly in the MSG by 1.27 ml/kg/min (adj.p = 0.096). Both groups significantly improved their 30secSTS (p = 0.0236) and 6MWT (p = 0.0252) outcomes in both follow-ups (4 weeks and 8 weeks after inclusion). The SSG improved more than the MSG in VO2peak and 6MWT both after 4 and 8 weeks, respectively, although not statistically significant; findings were vice versa for the 30secSTS. 30secSTS outcomes correlated significantly with mental health outcomes and workability. CONCLUSIONS: Post-COVID exercise intervention improved physical fitness, psychological outcomes and workability in HCWs. Cases with severe fatigue showed higher benefit levels compared to those with mild symptoms. The safe and highly feasible 30secSTS correlated well with physical and mental outcomes and better workability in COVID-19 survivors.Implications for rehabilitationPhysical exercising showed to be an effective intervention method in the rehabilitation of COVID-19 survivors suffering from post-COVID syndrome by positively affecting both physical and mental health.In health care workers suffering from post-COVID syndrome, increases in physical performance are directly related to improvements in work ability.The 30 s sit-to-stand test (30secSTS) showed promising results as clinical assessment tool.The results of this study indicate that physical exercising will need to play a large and substantial role over the next years in the rehabilitation of COVID-19 survivors suffering from post-COVID-19-syndrome as it positively affects both physical and mental dimensions of the post-COVID-19-syndrome as well as work ability.

FindICI: Using machine learning to detect linguistic inconsistencies between code and natural language descriptions in infrastructure-as-code.

Linguistic anti-patterns are recurring poor practices concerning inconsistencies in the naming, documentation, and implementation of an entity. They impede the readability, understandability, and maintainability of source code. This paper attempts to detect linguistic anti-patterns in Infrastructure-as-Code (IaC) scripts used to provision and manage computing environments. In particular, we consider inconsistencies between the logic/body of IaC code units and their short text names. To this end, we propose FindICI a novel automated approach that employs word embedding and classification algorithms. We build and use the abstract syntax tree of IaC code units to create code embeddings used by machine learning techniques to detect inconsistent IaC code units. We evaluated our approach with two experiments on Ansible tasks systematically extracted from open source repositories for various word embedding models and classification algorithms. Classical machine learning models and novel deep learning models with different word embedding methods showed comparable and satisfactory results in detecting inconsistent Ansible tasks related to the top-10 used Ansible modules.

Mouse pneumonia model by Acinetobacter baumannii multidrug resistant strains: Comparison between intranasal inoculation, intratracheal instillation and oropharyngeal aspiration techniques.

Infectious pneumonia induced by multidrug resistant (MDR) Acinetobacter baumannii strains is among the most common and deadly forms of healthcare acquired infections. Over the years, different strategies have been put in place to increase host susceptibility to MDR A. baumannii, since only a self-limiting pneumonia with no or limited local bacterial replication was frequently obtained in mouse models. Direct instillation into the trachea or intranasal inoculation of the bacterial suspension are the techniques used to induce the infection in most of the preclinical models of pneumonia developed to date. More recently, the oropharyngeal aspiration procedure has been widely described in the literature for a variety of purposes including pathogens administration. Aim of this study was to compare the oropharyngeal aspiration technique to the intranasal inoculation and intratracheal instillation in the ability of inducing a consistent lung infection with two MDR A. baumannii clinical isolates in immunocompromised mice. Moreover, pneumonia obtained by bacteria administration with two out of three techniques, intratracheal and oropharyngeal, was characterised in terms of histopathology of pulmonary lesions, biomarkers of inflammation level and leukocytes cells infiltration extent after mice treatment with either vehicle or the antibiotic tigecycline. The data generated clearly showed that both strains were not able to colonize the lungs when inoculated by intranasal route. By contrast, the bacterial load in lungs of mice intratracheally or oropharyngeally infected significantly increased during 26 hours of monitoring, thus highlighting the ability of these strains to generate the infection when directly instilled into the lower respiratory airways. Furthermore, the intragroup variability of mice was significantly reduced with respect to those intranasally administered. Tigecycline was efficacious in lung bacterial load and cytokines release reduction. Findings were supported by semi-quantitative histopathological evaluation of the pulmonary lesions and by inflammatory biomarkers analysis. To conclude, both intratracheal instillation and oropharyngeal aspiration techniques showed to be suitable methods for inducing a robust and consistent pneumonia infection in mice when difficult MDR A. baumannii clinical isolates were used. Noteworthy, oropharyngeal aspiration not requiring specific technical skills and dedicated equipment, was proven to be a safer, easier and faster technique in comparison to the intratracheal instillation.

A Recurrent Inflammatory Myofibroblastic Tumor-like Lesion of the Splenic Capsule in a Kitten: Clinical, Microscopic and Ultrastructural Description.

OBJECTIVE: To describe the findings of an unusual splenic tumor in a kitten. METHODS: A grossly multinodular mass arising from the splenic capsule of a 7-month-old male Havana kitten was echographically detected and surgically removed by splenectomy, then analyzed microscopically and ultrastructurally. RESULTS: The mass showed features of an inflammatory myofibroblastic tumor. TREATMENT AND OUTCOME: Two months after surgical excision, the mass recurred in the same intra-abdominal area but disappeared after 2 months of anti-inflammatory therapy. Follow-up at 18 months after surgery revealed resolution of the disease. CLINICAL RELEVANCE: Inflammatory myofibroblastic tumor in cats have been rarely reported and are usually in the orbital region. In the present report, an unusual multinodular gross presentation, a recurrence over time, and a favorable clinical course, are described.

Online Videos as a Source of Physiotherapy Exercise Tutorials for Patients with Lumbar Disc Herniation-A Quality Assessment.

Background: During the last few decades the prevalence of lumbar disc herniation has been increasing constantly, thereby imposing a significant socioeconomic burden. Physiotherapy plays a crucial role in both surgical and conservative treatment of lumbar disc herniation, consequently the current COVID-19 pandemic with concomitant lockdowns has led to a shortage of physiotherapeutical care. In the light of these recent events publicly available physiotherapy tutorials may be a useful tool to address this problem. Aim: The main aim of this study was to assess the quality of online physiotherapy exercise tutorials for lumbar disc herniation. Materials & Methods: With YouTube being a widely known and used platform we screened 240 of the most viewed videos. A total of 76 videos met the inclusion criteria and were statistically analyzed. The videos were assessed using Global Quality Score, DISCERN Score and JAMA benchmark criteria and in regard to their applicability. Results: They displayed a wide range of views (44,969 to 5,448,717), likes (66 to 155,079) and dislikes (6 to 2339). The videos were assessed using Global Quality Score, DISCERN Score and JAMA benchmark criteria and in regard to their applicability. Neither the number of "Views", "Likes", nor "Dislikes" was found to have a significant association with any of the quality measures used in this study. Conclusion: Overall quality grade was determined as "moderate". Based on the data examined in this study, the use of YouTube videos as a source of therapy advice for lumbar spine disc herniation cannot be recommended universally.

Paraneoplastic ganglioradiculoneuritis in a cat with a plasma cell tumour.

CASE SUMMARY: An 8-year-old neutered female domestic longhair cat was presented for investigation of a 48 h history of lethargy and pelvic limb ataxia. MRI of the spinal cord and vertebral column (C1 to sacrum) and brain was unremarkable. Lumbar cerebrospinal fluid analysis revealed pleocytosis and increased protein concentration. Thoracic radiographs and abdominal ultrasound were unremarkable. Anti-inflammatory doses of prednisolone were administered. Clinical deterioration occurred over the following 2 days, with the development of lower motor neuron deficits in both thoracic limbs. On repetition of the MRI, bilateral enlargement, T2-weighted hyperintensity, and marked contrast enhancement of the C7, C8 and T1 nerve roots, spinal nerves and brachial plexuses were observed. Infectious disease testing was negative. An immune-mediated inflammatory process was suspected and immunosuppressive doses of prednisolone were commenced. The clinical signs improved transiently, but marked deterioration occurred after 2 weeks. The patient was euthanased and a post-mortem examination was performed. A lymphocytic inflammatory infiltrate was detected in the C7, C8 and T1 nerve roots and dorsal root ganglia, and neoplastic plasma cells were identified in multiple organs. A diagnosis of non-cutaneous extramedullary plasmacytoma with multiorgan involvement and paraneoplastic ganglioradiculoneuritis was reached. RELEVANCE AND NOVEL INFORMATION: Paraneoplastic ganglioradiculoneuritis in association with a plasma cell neoplasia has not been previously reported in the cat and should be considered as a differential diagnosis for cats with clinical or imaging evidence of an inflammatory process affecting the nerve roots, spinal nerves or brachial plexuses.

Review on Canine Oral Melanoma: An Undervalued Authentic Genetic Model of Human Oral Melanoma?

Oral melanoma (OM) is a highly aggressive tumor of the oral cavity in humans and dogs. Here we review the phenotypic similarities between the disease in these 2 species as the basis for the view that canine OM is a good model for the corresponding human disease. Utility of the "canine model" has likely been hindered by a paucity of information about the extent of the molecular genetic similarities between human and canine OMs. Current knowledge of the somatic alterations that underpin human tumorigenesis and metastatic progression is relatively limited, primarily due to the rarity of the disease in humans and consequent lack of opportunity for large-scale molecular analysis. The molecular genetic comparisons between human and canine OMs that have been completed indicate some overlap between the somatic mutation profiles of canine OMs and a subset of human OMs. However, further comparative studies featuring, in particular, larger numbers of human OMs are required to provide substantive evidence that canine OMs share mechanisms of tumorigenesis with at least a subset of human OMs. Future molecular genetic investigations of both human and canine OMs should investigate how primary tumors develop a metastatic gene expression signature and the genetic and epigenetic alterations specific to metastatic sites. Such studies may identify genetic alterations and pathways specific to the metastatic disease which could be targetable by new drugs.

Effects of a structured exercise program on physical performance and function, quality of life and work ability of physically active breast cancer survivors : A retrospective data analysis.

BACKGROUND: Purpose of this retrospective data analysis was to depict the effects of a structured off-season conditioning program with breast cancer survivors competing in dragon boat paddling. METHODS: In this study 10 breast cancer survivors (mean age 52.0 ± 5.4 years) who had finished the primary cancer treatment and who were paddlers of the Vienna Pink Dragon self-help group underwent a structured 10-week exercise program as part of their routine supportive treatment. Upper extremity strength, endurance capacity, shoulder flexibility, quality of life and work ability were assessed at baseline and after completion of the exercise program. RESULTS: Out of 10 patients 8 completed more than 80% of the exercise sessions. A multivariate analysis of variance (MANOVA) of the pooled exercise effects showed a very large effect size (Η2 = 0.982); however, the change from baseline to follow-up was non-significant (p = 0.363). In the European Organisation for Research and Treatment of Cancer Quality of Life of Cancer Patients Questionnaire (EORTC QLQ-C30) the exercise program led to a significant improvement of body image (p = 0.02) and less arm symptoms in the affected arm (p = 0.04). CONCLUSION: A structured and well-planned exercise intervention program can have a large effect on the physical performance of pretrained breast cancer survivors. Moreover, it can increase the body image and decrease the arm symptoms in this population.

Can reminders improve adherence to regular physical activity and exercise recommendations in people over 60 years old? : A randomized controlled study.

PURPOSE: The purpose of the study was to investigate whether additional reminders could enhance adherence to a 12-week program consisting of regular physical activity. METHODS: The study collective consisted of pensioners insured with the Austrian Insurance Fund for Civil or Public Servants. They were made aware of our program through the public service union. The subjects were randomized to an intervention group (group A) that received reminders and to a control group (group B) that did not receive such notifications. Adherence to physical activity was assessed by the use of diaries. RESULTS: Group A performed 96 min more moderate intensity regular physical activity per week than group B (group A median 269 min, r = 0-1560 min; group B median 173 min, r = 0-2700 min). The Mann-Whitney U-test showed no significant differences (p = 0.080) between the study groups. There was no difference in muscle strengthening activity (group A: median: 2, r = 0-13 sessions; group B: median: 2, r = 0-20 sessions). CONCLUSION: The major positive observation was that both the experimental and control group participants exceeded the recommended level of physical activity. Nevertheless, there were some differences concerning the minutes of physical activity performed in favor of the intervention group.

Airborne human papillomavirus (HPV) transmission risk during ablation procedures: A systematic review and meta-analysis.

BACKGROUND: Human Papillomavirus (HPV) is associated with development of oropharyngeal cancer. Aim of this review was to assess airborne transmission risk of infectious particles from HPV lesions to airway mucosa of medical staff during established ablation procedures. METHODS: A systematic review of human and animal studies, published before 09/2020, relevant to airborne HPV transmission. Controlled studies reporting prevalence of HPV-associated upper airway (nasal/oral/pharyngeal) disease in staff performing ablation procedures (laser, loop electrosurgical excision [LEEP], cryosurgery) on HPV lesions were included in meta-analysis. Additionally, we aimed for a comprehensive systematic overview of studies regarding occupational risk of airborne HPV transmission and safety measures during ablation procedures. RESULTS: A total of n = 30 original studies report outcomes related to HPV transmission risk in medical staff conducting ablation procedures. HPV DNA detection in ablation smoke (n = 7), matching HPV genotypes on ablated HPV lesions and face/airways of medical staff after ablation (n = 2), and evidence for infectivity of papillomavirus in ablation smoke (n = 3, animal models only) were reported. Three case reports describe occupational HPV disease of upper airway mucosa. Three controlled studies assessed warts (in CO2 laser-users only); when pooling all controls (general population, non-laser users), nasal/oral/pharyngeal lesion sites were more common amongst laser-users (OR = 5.75; 95%CI[1.55, 21.38]; p < .001). DISCUSSION: Airborne HPV dispersal with matching "high-risk" HPV-genotypes in airways of medical staff after ablations (LEEP and CO2-laser) and cases of HPV-associated upper airways neoplasms based on exposure to laser and LEEP smoke are documented. Upper airway mucosa is a more common anatomical site for warts in CO2 laser users compared to controls. Simple safety measures greatly reduce HPV contamination and transmission risk.

High-intensity interval training in the prehabilitation of cancer patients-a systematic review and meta-analysis.

PURPOSE: To evaluate the impact of high-intensity interval training (HIIT) on health-related outcome parameters in the prehabilitation of patients diagnosed with cancer. METHODS: A systematic review and meta-analysis of comparative studies on HIIT in cancer prehabilitation conducted by screening standard databases from their inception to March 30, 2020. Outcomes of interest included cardiorespiratory fitness, feasibility, safety, clinical, and patient-reported outcomes. RESULTS: Of the 855 identified studies, 8 articles met the inclusion criteria (7 randomized, 1 non-randomized controlled trial) with a total of 896 patients. The study protocols were heterogeneous, but the methodological quality ranged from good to high according to PEDro scale. Meta-analysis revealed a significant improvement of peak oxygen consumption (VO2peak) achieved with HIIT compared to usual care. Furthermore, HIIT was feasible and safe, showing low risk of adverse events and positive effects on health-related outcomes in prehabilitative settings. CONCLUSION: In the phase of prehabilitation, HIIT has potential health benefits in patients diagnosed with cancer and is feasible and safe to perform. Nonetheless, larger randomized controlled trials focusing on long-term effects (such as cancer recurrence or survival rates) are missing, to underline the potential relevance of HIIT for cancer patients.

Sarcocystis gigantea infection associated with granulomatous eosinophilic myositis in a horse.

The only Sarcocystis species currently known to inhabit the fibers of skeletal and cardiac muscles in horses are S. fayeri, S. bertrami, and S. asinus. We describe herein the invasion of myofibers in a horse by S. gigantea, a sheep-specific species with low virulence in the original host. A hunter gelding was referred to a veterinary surgeon in Newmarket (UK). The anamnestic data reported that the horse had an initial history of swelling of the right forelimb with fluid on the front of the carpus and edema spreading up the forearm. Subsequently, 2 firm lumps were found on the left pectoral muscle adjacent to the axilla of the left forelimb. Histologic examination of biopsies from the lumps revealed multifocal granulomatous eosinophilic myositis associated with intact and degenerate encysted parasites, consistent with Sarcocystis spp. Based on amplification and DNA sequencing of the 18S rRNA gene obtained from formalin-fixed, paraffin-embedded tissue blocks, S. gigantea was identified. The presence of sarcocysts in equine skeletal muscles has been considered an incidental finding, and there are only sporadic associated reports of myositis. Our finding suggests that some Sarcocystis spp. have a wider intermediate host range than believed previously, and that Sarcocystis of other species (not considered horse-associated) can invade the muscle fibers of equids, leading to myositis.

Effects of resistance exercise in prostate cancer patients : A systematic review update as of March 2020.

PURPOSE: The aim of this systematic review is to provide an update on the effects of resistance exercise (RE) in patients with prostate cancer (PCa), with special attention to the effects on sexual health. METHODS: A systematic search of the literature was conducted in March 2020 using the databases PubMed, MEDLINE, EMBASE, SCOPUS and the Cochrane Library. Only randomized, controlled trials published after 31 December 2016 were included in this update. Additionally, articles from current and previous reviews were utilized to provide a brief summary of the effects on sexual health. RESULTS: A total of 10 articles met the inclusion criteria, of which 5 were identified as independent studies. The remaining five articles presented additional data for studies, which have already been included. The identified studies further strengthened the evidence for positive effects on muscle strength, body composition and physical function. Positive effects on bone mineral density were apparent only when RE was combined with impact training. One article reported an improvement in fatigue and health-related quality of life. Only one study examined the effects of RE in isolation and three articles indicated positive effects of exercise on sexual health. CONCLUSION: Recent evidence supports the use of RE in PCa patient rehabilitation as a countermeasure for treatment side effects. Further research is necessary to ascertain the optimal delivery methods and illuminate the effects on health-related quality of life (HRQOL), fatigue and sexual health.

Resistance exercise and breast cancer-related lymphedema-a systematic review update and meta-analysis.

BACKGROUND: The purpose of this systematic review update and meta-analysis was to analyze resistance exercise (RE) intervention trials in breast cancer survivors (BCS) regarding their effect on breast cancer-related lymphedema (BCRL) status and upper and lower extremity strength. METHODS: Systematic literature search was conducted utilizing PubMed, MEDLINE, and Embase databases. Any exercise intervention studies-both randomized controlled and uncontrolled-which assessed the effects of RE on BCRL in BCS in at least one intervention group published between 1966 and 31st January 2020 were included. Included articles were analyzed regarding their level of evidence and their methodological quality using respective tools for randomized and nonrandomized trials of the Cochrane collaboration. Meta-analysis for bioimpedance spectroscopy (BIS) values as well as upper and lower extremity strength was conducted. RESULTS: Altogether, 29 studies were included in the systematic review. Results of six studies with altogether twelve RE intervention groups could be pooled for meta-analysis of the BCRL. A significant reduction of BCRL after RE was seen in BIS values (95% CI - 1.10 [- 2.19, - 0.01] L-Dex score). Furthermore, strength results of six studies could be pooled and meta-analysis showed significant improvements of muscular strength in the upper and lower extremities (95% CI 8.96 [3.42, 14.51] kg and 95% CI 23.42 [11.95, 34.88] kg, respectively). CONCLUSION: RE does not have a systematic negative effect on BCRL and, on the contrary, potentially decreases it.