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1.
BMC Cancer ; 19(1): 414, 2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31046719

RESUMO

BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) can affect functional performance and quality of life considerably. Since balance training has proven to enhance physical function, it might be a promising strategy to manage CIPN-induced functional impairments. METHODS: Fifty cancer survivors with persisting CIPN after finishing their treatment were randomly allocated to an intervention (IG) or active control group (CG). The IG did endurance plus balance training, the CG only endurance training (twice weekly over 12 weeks). Pre- and post-assessments included functional performance, cardiorespiratory fitness, vibration sense, and self-reported CIPN symptoms (EORTC QLQ-CIPN20). RESULTS: Intention-to-treat analyses (n = 41) did not reveal a significant group difference (CG minus IG) for sway path in semi-tandem stance after intervention (primary endpoint), adjusted for baseline. However, our per-protocol analysis of 37 patients with training compliance ≥70% revealed: the IG reduced their sway path during semi-tandem stance (- 76 mm, 95% CI -141 - -17; CG: -6 mm, 95% CI -52 - 50), improved the duration standing on one leg on instable surface (11 s, 95% CI 8-17; CG: 0 s, 95%CI 0-5) and reported decreased motor symptoms (-8points, 95% CI -18 - 0; CG: -2points 95% CI -6 - 2). Both groups reported reduced overall- (IG: -10points, 95% CI -17 - -4; CG: -6points, 95% CI -11 - -1) and sensory symptoms (IG: -7points, 95% CI -15 - 0; CG: -7points, 95% CI -15 - 0), while only the CG exhibited objectively better vibration sense (knuckle: 0.8points, 95% CI 0.3-1.3; IG: 0.0points, 95% CI -1.1 - 0.9; patella: 1.0points, 95% CI 0.4-1.6: IG: -0.8points, 95% CI -0.2 - 0.0). Furthermore, maximum power output during cardiopulmonary exercise test increased in both groups (IG and CG: 0.1 W/kg, 95% CI 0.0-0.2), but only the CG improved their jump height (2 cm, 95% CI 0.5-3.5; IG: 1 cm, 95% CI -0.4 - 3.2). CONCLUSION: We suppose that endurance training induced a reduction in sensory symptoms in both groups, while balance training additionally improved patients' functional status. This additional functional effect might reflect the IG's superiority in the CIPN20 motor score. Both exercises provide a clear and relevant benefit for patients with CIPN. TRIAL REGISTRATION: German Clinical Trials Register (DRKS) number: DRKS00005419 , prospectively registered on November 19, 2013.


Assuntos
Antineoplásicos/efeitos adversos , Sobreviventes de Câncer/psicologia , Doenças do Sistema Nervoso Periférico/reabilitação , Adulto , Idoso , Idoso de 80 Anos ou mais , Aptidão Cardiorrespiratória , Tratamento Farmacológico , Treino Aeróbico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Doenças do Sistema Nervoso Periférico/fisiopatologia , Doenças do Sistema Nervoso Periférico/psicologia , Qualidade de Vida , Resultado do Tratamento
2.
BMC Med Genet ; 16: 56, 2015 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-26223887

RESUMO

BACKGROUND: Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is the most common disorder of mitochondrial fatty acid ß-oxidation and a target disease of newborn screening in many countries. CASE PRESENTATION: We report on two siblings with mild MCAD deficiency associated with a novel splice site mutation in the ACADM gene. The younger sibling was detected by newborn screening, while the older sister was missed, but diagnosed later on by genetic family testing. Both children were found to be compound heterozygous for the common c.985A > G (p.K329E) mutation and a novel splice site mutation, c.600-18G > A, in the ACADM gene. To determine the biological consequence of the c.600-18G > A mutation putative missplicing was investigated at RNA level in granulocytes and monocytes of one of the patients. The splice site mutation was shown to lead to partial missplicing of the ACADM pre-mRNA. Of three detected transcripts two result in truncated, non-functional MCAD proteins as reflected by the reduced octanoyl-CoA oxidation rate in both patients. In one patient a decrease of the octanoyl-CoA oxidation rate was found during a febrile infection indicating that missplicing may be temperature-sensitive. CONCLUSIONS: Our data indicate that the c.600-18G > A variant activates a cryptic splice site, which competes with the natural splice site. Due to only partial missplicing sufficient functional MCAD protein remains to result in mild MCADD that may be missed by newborn screening.


Assuntos
Acil-CoA Desidrogenase/deficiência , Acil-CoA Desidrogenase/genética , Erros Inatos do Metabolismo Lipídico/genética , Mutação de Sentido Incorreto/genética , Triagem Neonatal/métodos , Isoformas de Proteínas/genética , Análise Mutacional de DNA , Primers do DNA/genética , Feminino , Alemanha , Humanos , Recém-Nascido , Linhagem , Polimorfismo de Nucleotídeo Único/genética , Irmãos
3.
Int J Sports Med ; 31(5): 353-8, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20180173

RESUMO

Age-related impairment in gait patterns when simultaneously performing cognitive (CI) and/or motor (MI) interference tasks are associated with an increased risk of falling in seniors. The objective of this study was to investigate the impact of balance training (BT) on walking performance with and without concurrently performing a CI and/or MI task in seniors. Twenty healthy women (n=14) and men (n=6) were assigned to either an intervention (n=11, age 71.9+/-4.8 yrs) or a control group (n=9, age 74.9+/-6.3 yrs). The intervention group conducted a six week BT (3/week). Pre and post tests included the assessment of stride-to-stride variability during single (walking), dual (CI or MI+walking), and triple (CI+MI+walking) task walking on an instrumented walkway. BT resulted in statistically significant reductions in stride time variability under single (p=0.02, Delta34.8%) but not dual or triple-task walking. Significant improvements in the MI task (p=0.05, Delta39.1%), but not in the CI task were found while walking. Findings showed that improved performance during single-task walking did not transfer to walking under dual or triple-task conditions suggesting multi-task BT as an alternative training modality. Improvement of the secondary motor but not cognitive task may indicate the need for the involvement of motor and particularly cognitive tasks during BT.


Assuntos
Marcha/fisiologia , Equilíbrio Postural/fisiologia , Análise e Desempenho de Tarefas , Idoso , Idoso de 80 Anos ou mais , Atenção/fisiologia , Feminino , Humanos , Masculino , Desempenho Psicomotor , Inquéritos e Questionários , Suíça
4.
Antimicrob Agents Chemother ; 42(9): 2421-4, 1998 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9736574

RESUMO

The pharmacokinetics of meropenem were studied in nine anuric critically ill patients treated by continuous venovenous hemodiafiltration. Peak levels after infusion of 1,000 mg over 30 min amounted to 103.2 +/- 45.9 microgram/ml, and trough levels at 12 h were 9.6 +/- 3.8 microgram/ml. A dosage of 1,000 mg of meropenem twice a day provides plasma drug levels covering intermediately susceptible microorganisms. Further reductions of the dosage might be appropriate for highly susceptible bacteria or when renal replacement therapies with lower clearances are applied.


Assuntos
Injúria Renal Aguda/metabolismo , Hemodiafiltração , Tienamicinas/farmacocinética , Adulto , Idoso , Estado Terminal , Feminino , Humanos , Masculino , Meropeném , Pessoa de Meia-Idade
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