Antimicrobial potential of Ericaria selaginoides extracts against Listeria monocytogenes in “mató”, a Catalan fresh cheese

The objective of this work was to assess the antimicrobial effect of crude extracts and non-polar and mid-polar subfractions of the brown macroalga Ericaria selaginoides, using a mid-polarity extraction medium. The activity was evaluated through challenge testing against Listeria monocytogenes in Catalan “mató” (fresh cheese) selected as a food matrix. Three concentrations were tested, representing 2 ×, 4 × and 10 × Minimum Bactericidal Concentration values obtained for crude extract in previous in vitro assays. Ericaria selaginoides extracts inhibited L. monocytogenes growth in a dose-dependent manner. Intermediate concentrations of the three extracts were able to notably reduce the growth rate of the pathogen. Highest concentration of crude extract and non-polar subfraction were able to completely inhibit the growth of L. monocytogenes during the 10 days of storage at 8 °C. Moreover, a slight listericidal effect was observed in presence of the non-polar subfraction, reducing the L. monocytogenes level by ca. 3 log after 10 days of refrigerated storage. These results prove the potential of E. selaginoides extracts as a source of valuable antimicrobial compounds that can be used as natural food ingredients to develop safer fresh dairy food.info:eu-repo/semantics/publishedVersio

A FENCING KINEMATIC ANALYSIS BASED ON COACH’S CRITERIA

The purpose of this study was to identify, based on coach's criteria, upper body and center of mass kinematic variables that lead to a good performance in epee fencing. We used an Optitrack motion capture system to evaluate one skilled amateur fencing athlete performing a lunge in the presence or not of a static opponent. In the presence of a static opponent (target), the individual developed a lower centre of mass forward velocity, a higher epee’s tip forward velocity and improved synchronization between the upper and the lower limbs. The best-performed trials according to coach criteria showed differences in the elbow movement in both the armed and unarmed arm compared to the other trials. Our results highlights the importance of the unarmed arm to lunge performance and corroborate the idea that training with and without the use of a target improve different motor abilities

Differences between Portuguese and Brazilian Patients with Fibromyalgia Syndrome: Exploring the Associations across Age, Time of Diagnosis, and Fatigue-Related Symptoms

The aim of the study was to explore the differences between Brazilian and Portuguese patients with fibromyalgia (FM) syndrome in their experience of fatigue, and to measure differences in the perception of fatigue as a function of age and duration of the diagnosis. In total, 209 Portuguese women aged between 21 and 75 years (M = 47.44; SD = 10.73) and 429 Brazilian women aged between 18 and 77 years (M = 46.51; SD = 9.24) were recruited to participate in the present study. Participants completed the Multidimensional Daily Diary of Fatigue-Fibromyalgia-17 items (MDF-Fibro-17), a specific tool to measure the level of five components of FM-related fatigue. Results showed greater perception of all the components of fatigue in the Brazilian sample. No significant differences were found related to age and duration of FM diagnosis. The multifaceted nature of FM and cultural differences suggests that individualized treatment programs may be necessary to reduce fatigue-related symptoms in patients with this syndrome.info:eu-repo/semantics/publishedVersio

The COVID-19 pandemic and ANCA-associated vasculitis - reports from the EUVAS meeting and EUVAS education forum.

The Coronavirus Disease 2019 (COVID-19) pandemic influenced the management of patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis. A paucity of data exists on outcome of patients with vasculitis following COVID-19, but mortality is higher than in the general population and comparable to patients undergoing haemodialysis or kidney transplant recipients (reported mortality rates of 20-25%). Delays in diagnosis have been reported, which are associated with sequelae such as dialysis-dependency. Management of ANCA-associated vasculitis has not changed with the aim to suppress disease activity and reduce burden of disease. The use of rituximab, an important and widely used agent, is associated with a more severe hospital course of COVID-19 and absence of antibodies following severe acute respiratory syndrome (SARS)-CoV-2 infections, which prone patients to re-infection. Reports on vaccine antibody response are scarce at the moment, but preliminary findings point towards an impaired immune response, especially when patients receive rituximab as part of their treatment. Seropositivity was reported in less than 20% of patients when rituximab was administered within the prior six months, and the antibody response correlated with CD19+ B-cell repopulation. A delay in maintenance doses, if disease activity allows, has been suggested using a CD19+ B-cell guided strategy. Other immunosuppressive measures, which are used in ANCA-associated vasculitis, also impair humoral and cellular vaccine responses. Regular measurements of vaccine response or a healthcare-policy time-based strategy are indicated to provide additional doses ("booster") of COVID-19 vaccines. This review summarizes a recent educational forum and a recent virtual meeting of the European Vasculitis Society (EUVAS) focusing on COVID-19

Understanding the Associations across Fibromyalgia-Related Fatigue, Depression, Anxiety, Self-Esteem Satisfaction with Life and Physical Activity in Portuguese and Brazilian Patients: A Structural Equation Modeling Analysis

Background and Objectives: Fibromyalgia are heterogeneous and differ from patient to patient; however, the most reported are general myalgia and at specific points associated with fatigue and certain psychological adversities. Physical activity can mitigate the effects of the symptoms. However, the associations between fibromyalgia-related fatigue, self-esteem, anxiety, depression, satisfaction with life and physical activity are unclear. Therefore, the aim of the present study was to understand the associations between these symptoms and whether there are differences between these associations across two distinct cultures. Materials and Methods: A total of 473 women aged between 28 and 75 years (M = 49.27; SD ± 8.28) completed five questionnaires about fibromyalgia-related fatigue, physical activity, anxiety, depression, self-esteem, and satisfaction with life. Results: Fibromyalgia-related fatigue was positively associated with depression and anxiety, depression and anxiety were negatively associated with self-esteem, self-esteem was positively associated with satisfaction with life, satisfaction with life was positively associated with physical activity and there were no differences in terms of the perceptions and associations of these variables between Portuguese and Brazilian patients. Conclusions: Our results showed the significant role of associations between these variables and a similarity in the perception and relationship of the variables between the two cultures.info:eu-repo/semantics/publishedVersio

Exploring the Relationship between Fibromyalgia-Related Fatigue, Physical Activity, and Quality of Life

The symptoms of fibromyalgia are varied, including general muscle pain and pain at specific points (also called tender points), excessive fatigue, anxiety, depression, and some psychological problems that can have a negative impact on quality of life. Physical activity is a widely used option by health professionals to alleviate the effects of this syndrome. However, there is no clear information on the possible mediating role of physical activity in the relationship between fibromyalgia-related fatigue and quality of life. Therefore, this study aims to evaluate the relationship between fibromyalgia-related fatigue and quality of life, and to investigate the mediating role of physical activity in patients with this syndrome. Methods: In a cross-sectional study, 237 Portuguese women aged 28 to 75 years (M = 49.12; SD ± 8.87) and 117 Brazilian women aged 20 to 69 years (M = 46.72; SD ± 8.38) were recruited to participate in this study. These patients completed three valid and reliable questionnaires related to the assessment of fibromyalgia-related fatigue (MDF-Fibro-17), physical activity (IPAQ), and quality of life (SF-36). Results: Both samples had scores above the midpoint for all dimensions of fibromyalgia-related fatigue and scores below the midpoint for quality of life. Physical activity had no mediating effect in either sample, as the total indirect effect was not significant. Conclusions: Physical activity does not mediate the relationship between fatigue and quality of life. However, the results also show that the fatigue dimensions associated with fibromyalgia had a negative and significant association with physical and mental health indicators in both samples. Thus, patients with FM with higher scores on fatigue-related symptoms might suffer more from physical and mental health, both of which are related to quality of lifeinfo:eu-repo/semantics/publishedVersio

Long-term effect of tocilizumab in patients with giant cell arteritis:open-label extension phase of the Giant Cell Arteritis Actemra (GiACTA) trial

Background: The combination of tocilizumab plus a glucocorticoid taper is effective in maintaining clinical remission without requiring additional glucocorticoid therapy in patients with giant cell arteritis, as shown in part one of the Giant Cell Arteritis Actemra (GiACTA) trial. However, the duration of the tocilizumab effect after discontinuation is unknown. Here, we explored the maintenance of efficacy 1 year after discontinuation of tocilizumab treatment, the effectiveness of retreatment with tocilizumab after relapse, and the long-term glucocorticoid-sparing effect of tocilizumab. Methods: In part one of the GiACTA trial, 251 patients were randomly assigned (2:1:1:1) to receive subcutaneous tocilizumab (162 mg) once a week or every other week, combined with a 26-week prednisone taper, or placebo combined with a prednisone taper over a period of either 26 weeks or 52 weeks. Patients in clinical remission stopped masked injections at 1 year (the conclusion of part one). In part two, treatment was at the investigators' discretion and could consist of no treatment, tocilizumab, glucocorticoids, methotrexate, or combinations of these, for two years. Maintenance of efficacy as assessed by clinical remission (defined as absence of relapse determined by the investigator), cumulative glucocorticoid dose, and long-term safety were exploratory objectives in part two of the trial. This trial is registered at ClinicalTrials.gov, NCT01791153. Findings: 215 patients participated in part two of the trial; 81 patients who were randomly assigned to tocilizumab once a week in part one were in clinical remission after 1 year, of whom 59 started part two on no treatment. 25 of these 59 patients (42%) maintained tocilizumab-free and glucocorticoid-free clinical remission throughout part two. Median (95% CI) cumulative glucocorticoid doses over 3 years were 2647 mg (1987\u20133507) for tocilizumab once a week, 3948 mg (2352\u20135186) for tocilizumab-every-other-week, 5277 mg (3944\u20136685) for placebo with a 26-week prednisone taper, and 5323 mg (3900\u20136951) for placebo with a 52-week prednisone taper (van Elteren p 640\ub7001, tocilizumab once a week vs placebo groups; p<0\ub705, tocilizumab-every-other-week vs placebo groups). Tocilizumab-based regimens restored clinical remission among patients who experienced relapse in part two and were treated (median time to remission: 15 days for tocilizumab alone [n=17]; 16 days for tocilizumab plus glucocorticoids [n=36]; and 54 days for glucocorticoids alone [n=27]). No new or unexpected safety findings were reported over the full 3 years of the study. Interpretation: Giant cell arteritis remains a chronic disease that entails ongoing management and careful vigilance for disease relapse, but continuous indefinite treatment with immunosuppressive drugs is not required for all patients. A substantial proportion of patients treated with tocilizumab for one year maintain drug-free remission during the two years after tocilizumab cessation. For patients who experience relapse, tocilizumab can be used to manage relapses, but it remains prudent to include prednisone for patients who experience relapse because of the risk for vision loss. Funding: F Hoffmann-La Roche

New-onset versus relapsing giant cell arteritis treated with tocilizumab:3-year results from a randomized controlled trial and extension

OBJECTIVE: Tocilizumab plus prednisone induces sustained glucocorticoid-free remission in patients with giant cell arteritis (GCA). However, its long-term benefits in new-onset vs relapsing disease are uncertain and the value of weekly vs every-other-week dosing has not been evaluated. METHODS: In GiACTA part 1, patients with new-onset or relapsing GCA received blinded tocilizumab weekly (TCZ QW), tocilizumab every-other-week (TCZ Q2W), or placebo for 52 weeks with a prednisone taper. In part 2 (open-label), patients were treated at investigator discretion for 104 weeks. In this analysis, patients were evaluated according to their original treatment assignments and outcomes beyond 52 weeks were assessed. Outcomes of interest included time to first flare and cumulative glucocorticoid exposure over 3 years according to baseline disease status. RESULTS: Part 1 enrolled 250 patients; 215 entered part 2. At baseline, 48% had new-onset disease and 52% had relapsing disease. In patients with new-onset and relapsing disease, median time to first flare in the TCZ QW group was 577 and 575 days, respectively, vs 479 and 428 days with TCZ Q2W and 179 and 224 days with placebo; median cumulative glucocorticoid dose was 3068 mg and 2191 mg with TCZ QW, 4080 mg and 2353 mg with TCZ Q2W, and 4639 mg and 6178 mg with placebo. CONCLUSIONS: TCZ QW delays the time to flare and reduces cumulative glucocorticoid dose in patients with relapsing GCA and new-onset GCA. These data support initiating TCZ QW as part of first-line therapy in all patients with active GCA. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov, NCT01791153

Central Nervous System Vasculitis: Still More Questions than Answers

The central nervous system (CNS) may be involved by a variety of inflammatory diseases of blood vessels. These include primary angiitis of the central nervous system (PACNS), a rare disorder specifically targeting the CNS vasculature, and the systemic vasculitides which may affect the CNS among other organs and systems. Both situations are severe and convey a guarded prognosis. PACNS usually presents with headache and cognitive impairment. Focal symptoms are infrequent at disease onset but are common in more advanced stages. The diagnosis of PACNS is difficult because, although magnetic resonance imaging is almost invariably abnormal, findings are non specific. Angiography has limited sensitivity and specificity. Brain and leptomeningeal biopsy may provide a definitive diagnosis when disclosing blood vessel inflammation and are also useful to exclude other conditions presenting with similar findings. However, since lesions are segmental, a normal biopsy does not completely exclude PACNS. Secondary CNS involvement by systemic vasculitis occurs in less than one fifth of patients but may be devastating. A prompt recognition and aggressive treatment is crucial to avoid permanent damage and dysfunction. Glucocorticoids and cyclophosphamide are recommended for patients with PACNS and for patients with secondary CNS involvement by small-medium-sized systemic vasculitis. CNS involvement in large-vessel vasculitis is usually managed with high-dose glucocorticoids (giant-cell arteritis) or glucocorticoids and immunosuppressive agents (Takayasu’s disease). However, in large vessel vasculitis, where CNS symptoms are usually due to involvement of extracranial arteries (Takayasu’s disease) or proximal portions of intracranial arteries (giant-cell arteritis), revascularization procedures may also have an important role