Effect of training intensity distribution on aerobic fitness variables in elite soccer players: a case study

The aim of this article was to quantify the distribution of training intensities and its effect on aerobic fitness in professional elite soccer players. Fourteen professional soccer players were observed during the prechampionship training period (6 weeks). Treadmill running speed and heart rates (HRs) at 2 and 4 mmol · L(-1) blood-lactate concentrations were assessed pre and posttraining. Training intensities were categorized using 3 HR zones: low intensity (

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HR 4 mmol · L(-1)). Analysis of the 504 individual training sessions showed that 73 ± 2.5, 19 ± 2.8, and 8 ± 1.4% of the total training time was spent at low, moderate, and high intensity, respectively (p < 0.001). Speed at 2 and 4 mmol · L(-1) significantly improved posttraining (5 and 7%, respectively, p < 0.01). Training spent at high intensity was significantly related to relative speed improvements at 2 mmol · L(-1) (r = 0.84, p < 0.001;) and 4 mmol · L(-1) (r = 0.65, p = 0.001). Players spent almost two-thirds of their training time at low intensities. However, only the time spent at high intensity (>90% of maximal HR) was related to changes in aerobic fitness. These results support the usefulness of the quantification of aerobic training load using HR. Furthermore, it stresses the effectiveness of the high-intensity training in soccer.     

Recurrence of erythema induratum of Bazin in a patient under chemotherapy for breast cancer

Erythema induratum of Bazin (EIB) is a chronic nodular eruption occurring on the lower legs of young and middleaged women which is considered the most common tuberculid. A 54-year-old woman, in treatment with chemotherapy for breast cancer, presented subcutaneous erythematous plaques and nodules on the lower limbs. She had been diagnosed with EIB 3 years earlier and diagnostic work-up showed at that time signs suggestive of latent tuberculosis. The suspect of a recurrent form of EIB was confirmed by histopathological examination. A peculiar feature of our report consists in the recurrence of EIB, which is regarded as a hyperergic response against M. tuberculosis antigens, in a patient who was receiving chemotherapy with well-known immunosuppressive effects.     

High-intensity aerobic interval training and resistance training are feasible in rectal cancer patients undergoing chemoradiotherapy: a feasibility randomized controlled study

BackgroundThere has been growing evidence of the benefits of high-intensity aerobic interval training (HIIT) and resistance training (RES) for populations with cancer. However, these two modalities have not yet been performed alone in rectal cancer patients undergoing neoadjuvant chemoradiotherapy (NACR T). Therefore, this study aimed to determine the feasibility of HIIT and RES in rectal cancer patients undergoing NACR T.Materials and methodsRectal cancer patients set to undergo NACRT were randomly assigned to HIIT intervention, RES intervention, or the usual care. Feasibility of HIIT and RES was assessed by measuring recruitment rate, adherence (retention rate, attendance rate, and exercise sessions duration and intensity), and adverse events. Endpoints (changes in fatigue, health-related quality of life, depression, daytime sleepiness, insomnia, sleep quality, functional exercise capacity, and executive function) were assessed at baseline and at week 5.ResultsAmong the 20 eligible patients, 18 subjects were enrolled and completed the study, yielding a 90% recruitment rate and 100% retention rate. Attendance at exercise sessions was excellent, with 92% in HIIT and 88% in RES. No exercise-related adverse events occurred.ConclusionThis study demonstrated that HIIT and RES are feasible in rectal cancer patients undergoing NACR T.Trial registrationwww.clinicaltrials.gov, {"type":"clinical-trial","attrs":{"text":"NCT03252821","term_id":"NCT03252821"}}NCT03252821 (date of registration: March 30, 2017)     

Effects of downhill or uphill training prior to a downhill run

Nine men volunteered to undergo 10% downhill (DT) or 10% uphill (UT) treadmill training at 60% VO2max for 12 minutes on two consecutive days. Four days later the downhill run (DR) was repeated. All subjects reported considerable muscular soreness following DT but not UT. When DR followed UT muscular soreness was again reported but not when DR followed DT. Peak knee flexion and extension moment of force data at five angular velocities, ranging from 0.52-4.71 rad s-1, were reduced following DR regardless of whether soreness was present. During each run VO2 was stable during UT but drifted upwards during DT and DR. This increase in VO2 was not due to changes in the stride frequency since the stride frequency remained nearly constant on all days except for the second day of the DT when an increase of 20 strides per minute occurred; this was the only day the subjects ran while sore. It was concluded that two 12 minute bouts of downhill running were sufficient to protect against the occurrence of muscular soreness in subsequent downhill run. However, this training was insufficient to prevent a 2-3 day loss of muscular strength. These results support the hypothesis that the sensation of delayed onset muscle soreness and the temporary strength loss associated with eccentric contraction have different physiological causes.     

Research ethics training in Peru: a case study

With the rapidly increasing number of health care professionals seeking international research experience, comes an urgent need for enhanced capacity of host country institutional review boards (IRB) to review research proposals and ensure research activities are both ethical and relevant to the host country customs and needs. A successful combination of distance learning, interactive courses and expert course instructors has been applied in Peru since 2004 through collaborations between the U.S. Naval Medical Research Center Detachment, the University of Washington and the Department of Clinical Bioethics of the National Institutes of Health to provide training in ethical conduct of research to IRB members and researchers from Peru and other Latin American countries. All training activities were conducted under the auspices of the Peruvian National Institute of Health (INS), Ministry of Health. To date, 927 people from 12 different Latin American countries have participated in several of these training activities. In this article we describe our training model.     

The effects of EMG feedback training during problem solving: a case study.

The present case study investigated the effects of competing task demands on biofeedback training to reduce frontalis muscle tension. Baseline levels of frontalis muscle tension were recorded for relaxation and problem solving. The subject was trained to decrease muscle tension with biofeedback for the problem-solving task alone. The results indicated that EMG training during problem-solving was successfully accomplished. Frontalis muscle tension during relaxation baseline did not change as a result of reductions in muscle tension during problem-solving feedback training. This suggests that the decrease of muscle tension cannot be attributed to reductions in overall muscle tension levels. Instead, training was specific to the problem-solving feedback phases. Additionally, it was found that accuracy in problem-solving did not decline as a result of simultaneous feedback training. Thus EMG biofeedback training can be accomplished and exercised without disruption of ongoing mental activity.     

A case of radiation-induced bullous morphea/lichen sclerosus overlap in a breast cancer patient

Radiation induced morphea (RIM) is an increasingly common complication of radiation treatment for malignancy as early detection has made more patients eligible for non-surgical treatment options. In many cases, the radiation oncologist is the first person to learn of the initial skin changes, often months before a dermatologist sees them. In this paper we present a breast cancer patient who developed a rare bullous variant of RIM, which delayed her diagnosis and subsequent treatment. It is imperative to diagnose RIM early as it carries significant morbidity and permanent deformity if left untreated. The lesions typically present within 1 year of radiation therapy and extend beyond the radiated field. RIM is often mistaken for radiation dermatitis or cellulitis. Bullae, when present, are often hemorrhagic in appearance, which can serve as another clinical clue. It is important to refer these patients for a full gynecologic exam as there can be concurrent anogenital lichen sclerosus et atrophicus which is both debilitating and carries a long term risk for squamous cell carcinoma. Treatment with systemic agents is often necessary, and can be managed by a dermatologist. The most proven regimen in the literature appears to be methotrexate, with our without concurrent narrow band UVB phototherapy.     

Assessment of estrogenic recruitment before chemotherapy in advanced breast cancer: Preliminary results of a double-blind randomized study of the eortic breast cancer cooperative group

We investigated whether estrogenic recruitment could enhance the antitumor effect of chemotherapy in 165 patients with advanced breast cancer, presumably sensitive to hormonal treatments (ER + and/or PgR + lesions). The therapeutic regimen consisted of: (a) estrogenic suppression by aminoglutethimide 1 g/day + hydrocortisone 40 mg/day; surgical castration in premenopausal patients only; (b) FAC (5FU 500 mg/m²; ADM 50 mg/m²; CPA 500 mg/m²) for 3 weeks; (c) following randomization, exactly 24h prior to chemotherapy, patients had to take 1 tablet of either placebo (PL) or 50 μg ethinylestradiol (EE2). Tolerance, responses, time to progression and median survival were identical in both groups. Thus, EE2 before chemotherapy did not contribute to the efficacy of this particular therapeutic regimen, which yielded an overall response rate of 64%. We conclude that the validity of the hormonal recruitment concept has not yet been established in clinical practice, so that this approach remains experimental.     

Versican G3 domain modulates breast cancer cell apoptosis: a mechanism for breast cancer cell response to chemotherapy and EGFR therapy

Overexpression of EGFR and versican has been reported in association with breast cancers. Considered oncogenic, these molecules may be attractive therapeutic targets. Possessing anti-apoptotic and drug resistant properties, overexpression of these molecules is accompanied by selective sensitization to the process of apoptosis. In this study, we exogenously expressed a versican G3 construct in breast cancer cell lines and analyzed the effects of G3 on cell viability in fetal bovine serum free conditioned media and evaluated the effects of apoptotic agent C2-ceramide, and chemotherapeutic agents including Docetaxel, Doxorubicin, and Epirubicin. Versican G3 domain enhanced tumor cell resistance to apoptosis when cultured in serum free medium, Doxorubicin, or Epirubicin by up-regulating pERK and GSK-3β (S9P). However, it could be prevented by selective EGFR inhibitor AG 1478 and selective MEK inhibitor PD 98059. Both AG 1478 and PD 98059 enhanced expression of pSAPK/JNK, while selective JNK inhibitor SP 600125 enhanced expression of GSK-3β (S9P). Versican G3 promoted cell apoptosis induced by C2-ceramide or Docetaxel by enhancing expression of pSAPK/JNK and decreasing expression of GSK-3β (S9P), an observation blocked by AG 1478 or SP 6000125. Inhibition of endogenous versican expression by siRNA or reduction of versican G3's expression by linking G3 with 3'UTR prevented G3 modulated cell apoptosis. The dual roles of G3 in modulating breast cancer cell resistance to chemotherapeutic agents may in part explain a potential mechanism for breast cancer cell resistance to chemotherapy and EGFR therapy. The apoptotic effects of chemotherapeutics depend upon the activation and balance of down stream signals in the EGFR pathway. GSK-3β (S9P) appears to function as a key checkpoint in this balance of apoptosis and anti-apoptosis. Investigation and potential consideration of targeting GSK-3β (S9P) merits further study.     

Reproductive factors and breast cancer risk in Palestine: A case control study

BackgroundEarly age at menarche, late age at menopause, and late age at first full-term pregnancy are linked to a modest increase in the risk of developing breast cancer (breast ca). This study aims to investigate the reproductive determinants of breast cancer among women in the West Bank of Palestine.A structured questionnaire was used to collect data in a case-control study (237 registered cases and 237 controls). A multivariate analysis model was used to adjust for the association between women’s reproductive factors and breast ca risk. This study was approved by Al Quds University Ethical Research Committee and the Ministry of Health research unit.ResultsIn the multivariate analysis, menarche after 13 years of age, use of oral contraceptives for more than two months, and hormonal contraceptives use significantly doubled the risk for breast ca (Adjusted Odds Ratio (AOR) = 2.03, 95 % CI: 1.21–4.37, p < 0.011 and AOR = 2.2, 95 % CI: 1.24–4.01, p = 0.008, respectively). Women who used hormone replacement therapy (HRT) were significantly associated with higher odds (5 folds) of having breast ca versus those who did not use them (AOR 5.02, 95 % CI: 1.93–13.06, p = 0.001). Similarly, nulliparous women showed 6 times the odds of breast ca compared with women with one or more children (p = 0.005). Also, parental consanguinity marriage (AOR 2.59, 95 % CI: 1.53–4.36, p = 0.001) and positive family history (AOR 3.88, 95 % CI: 2.19–6.87, p = 0.001) of the condition can be strong determinants for breast ca in this study.ConclusionThis study provides clear evidence that the use of reproductive hormones, whether as a birth control tool or for therapeutic purposes, must be rationalized worldwide and in Palestine in particular.     

Gene expression and pathologic response to neoadjuvant chemotherapy in breast cancer

Pathologic complete response after neoadjuvant systemic treatment appears to be a valid surrogate for better overall survival in breast cancer patients. Currently, together with standard clinicopathologic assessment, novel molecular biomarkers are being exhaustively tested in order to look into the heterogeneity of breast cancer. The aim of our study was to examine an association between 23-gene real-time-PCR expression assay including ABCB1, ABCC1, BAX, BBC3, BCL2, CASP3, CYP2D6, ERCC1, FOXC1, GAPDH, IGF1R, IRF1, MAP2, MAPK 8, MAPK9, MKI67, MMP9, NCOA3, PARP1, PIK3CA, TGFB3, TOP2A, and YWHAZ receptor status of breast cancer core biopsies sampled before neoadjuvant chemotherapy (anthracycline and taxanes) and pathologic response. Core-needle biopsies were collected from 42 female patients with inoperable locally advanced breast cancer or resectable tumors suitable for downstaging, before any treatment. Expressions of 23 genes were determined by means of TagMan low density arrays. Analysis of variance was used to select genes with discriminatory potential between receptor subtypes. We introduced a correction for false discovery rates (presented as q values) due to multiple hypothesis testing. Statistical analysis showed that seven genes out of a 23-gene real-time-PCR expression assay differed significantly in relation to pathologic response regardless of breast cancer subtypes. Among these genes, we identified: BAX (p = 0.0146), CYP2D6 (p = 0.0063), ERCC1 (p = 0.0231), FOXC1 (p = 0.0048), IRF1 (p = 0.0022), MAP2 (p = 0.0011), and MKI67 (p = 0.0332). The assessment of core biopsy gene profiles and receptor-based subtypes, before neoadjuvant therapy seems to predict response or resistance and to define new signaling pathways to provide more powerful classifiers in breast cancer, hence the need for further research.     

Quantitative proteomics study of breast cancer cell lines isolated from a single patient: Discovery of TIMM17A as a marker for breast cancer

The proteins involved in breast cancer initiation and progression are still largely elusive. To gain insights into these processes, we conducted quantitative proteomic analyses with 21T series of breast cell lines, which include a normal, primary tumor and a metastatic tumor that were isolated from a single patient. Stable isotope labeling of amino acid in cell culture followed by LC‐MS/MS analysis was performed and deregulated proteins were identified using statistical analysis. Gene ontology analysis revealed that proteins involved in metabolic processes were the most deregulated in both tumorigenesis and metastasis. Interaction network analysis indicated that ERBB2 signaling played a critical role in tumorigenesis. In addition to known markers such as ERBB2 and E‐cadherin, novel markers, including BRP44L, MTHFD2 and TIMM17A, were found to be overexpressed in 21T breast cancer cells and verified in additional breast cell lines. mRNA expression analysis as well as immunohistochemistry analysis in breast cancer tissues indicated that expression level of TIMM17A was directly correlated with tumor progression, and survival analysis suggested that TIMM17A was a powerful prognosis factor in breast cancer. More interestingly, overexpression and siRNA knockdown experiments indicated an oncogenic activity of TIMM17A in breast cancer. Our study provides a list of potential novel markers for breast cancer tumorigenesis and metastasis using a unique cell model. Further studies on TIMM17A as well as other markers on the list may reveal mechanisms that result in more effective therapeutics for cancer treatment.     

Effects of EMG and thermal feedback training on tinnitus: A case study

This case report describes a patient who exhibited the usual complaints of frustration, annoyance, and lack of sleep associated with severe tinnitus. After 2 months of weekly biofeedback sessions along with home training with a portable thermal biofeedback unit, the patient was relieved of the psychological symptoms associated with the tinnitus. A 1-year follow-up demonstrated that the patient remained complaint-free of psychological symptoms although the subjective loudness of the rining was judged to be the same as at the onset of the tinnitus. The results indicate that biofeedback is a useful procedure in the treatment of severe tinnitus.Tallahassee Pain and Stress Management Institute