PHYSICAL ACTIVITY DURING PREGNANCY AND AFTER DELIVERY

It is well known that physical activity and proper diet can have beneficial effects on health improvement, as a prevention and as a therapy of chronic non-communicable diseases. Pregnancy is a special period in the life of every woman. Therefore, you often ask yourself whether it is advisable to exercise during pregnancy, when and how much? This review article, by analyzing the available literature data, has tried to explain what form of physical activity is recommended during pregnancy, depending on the period of pregnancy, under what conditions pregnant women should exercise, what forms of physical activity they should avoid and when they should not to practice it. In addition, we analyzed the role of physical activity in the prevention of gestational diabetes, the most common metabolic disorder that occurs during pregnancy. Following the recommendations of the FITT principle outlined in this paper, controlled exercise conditions with a specialized trainer and nutritionist, regular moderate physical activity adapted to different periods of pregnancy, undoubtedly contributes to the maintenance and improvement of the musculoskeletal and cardiovascular system of the pregnant woman, better control of her body weight and improvement of her psychological state

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 Poincare´ 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. © 2019 Platiša et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Survey on coaching philosophies and training methodologies of water polo head coaches from three different European national schools

The ability to change swimming styles and body positions, involving continuous shifting from horizontal to vertical posture and performing jumps, as well as technical skills play a fundamental role in water polo performance. To face with these demands, the coaching staff of elite and sub-elite water polo clubs might adopt a variety of training methods, also based on their specific coaching philosophies. This point has led to an enlargement of the staff, with higher head coaches’ responsibilities, who may interpret their professional activity according to their own coaching philosophy, education, and their respective national water polo schools. In fact, based on their international sports achievements, some countries can be identified as recognised water polo national schools. For this reason, the purpose of this study was to survey 40 head coaches of three important national water polo schools (Italy, Greece, and Serbia) to identify and compare their coaching philosophies and training methodologies. The survey was based on five sections (Technical staff composition, Team roster, Weekly periodization, Testing and monitoring, Tactics and strategies). Furthermore, using a detailed descriptive statistic, the current study gives interesting information on how 40 high-ranking elite and sub-elite teams of different national championships organize their training during a typical week of the competitive season. A further improvement of this research line could include more national schools, expanding the sample to more countries from all over the world

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

PHYSICAL ACTIVITY AS A PRE-ANALYTICAL FACTOR AFFECTING LABORATORY TEST RESULTS

It is known that physical activity undoubtedly exhibits positive effects, decreasing the incidence of many chronic diseases. But, at present, physical activity is consider a pre-analytical factor/error related to the sampling process. Namely, different types of physical activity as well as its different intensity may influence a broad array of laboratory variables. The amount of extracellular release and clearance from blood of most of these biomarkers is markedly influenced by the biological characteristics of the molecule(s), level of training, type, intensity and duration of exercise, and time of recovery after training. It is therefore noteworthy to have the anamnestic information about these specific characteristics of physical activity and to understand the "physiologic" effects of exercise on laboratory results and when the threshold to pathological effects has been crossed. There are a lot of research data about the influence of physical activity on laboratory test results, but the accessible results are scattered and inconsistent since variations in type, duration, and intensity of exercise, sample size, and biological, behavioral, and experimental variables are not always adequately controlled. In this study we put an effort to summarize the most often changes in laboratory results that occur as a result of physical activity and to explain these changes in accordance with their biochemical, physiological and metabolic features

Effect of acute exercise on serum growth hormone and fatty acid levels in elite male water polo players

The aim of study was to estimate the effect of acute exercise on serum growth hormone (GH) and fatty acid (FFA) levels in elite water polo players. Twelve male water polo players (20.50 ± 2.02 years) and eleven non-athletic male subjects (20.55 ± 1.04 years) participated in this study. In order to determine GH and FFA responses to acute exercise, a treadmill-running test was performed following an incremental protocol. Pre-exercise blood samples for both athletes and non-athletes were taken at 9 AM. Post-exercise samples were taken immediately after and 30 min after the treadmill running test. Water polo players had significantly lower baseline values of serum GH concentration compared to controls, whereas serum FFA concentration was significantly higher in water polo players compared to controls (p<0.01; p<0.05, respectively). In both groups, concentration of GH was significantly higher immediately after and after the 30-min of recovery compared to baseline levels (p<0.05). In water polo players, the concentration of FFA was significantly decreased immediately after and after the 30-min of recovery compared to baseline levels (p<0.05). No significant response to maximal exercise test was observed in the control group for serum FFA concentration. Our research indicates that acute exercise resulted in a significant increase in serum GH and reduction in fatty acid levels in elite water polo players. [Projekat Ministarstva nauke Republike Srbije, br. OI 175067

Collection and composition of autologous peripheral blood stem cells graft in patients with acute myeloid leukemia: influence on hematopoietic recovery and outcome [Skupljanje i sastav transplantata autolognih krvotvornih matičnih stanica periferne krvi u bolesnika s akutnom mijeloičnom leukemijom: utjecaj na hematološki oporavak i ishod]

Hematopoietic stem cell (HSC) transplantation is a standard approach in the treatment of hematological malignant diseases. For the last 15 years the main source of cells for trasplantation have been peripheral blood stem cells (PBSC). With the availability of hematopoietic growth factors and understanding the advantages of treatment with PBSC, the application of bone marrow (BM) was supplanted. The aim of this survey was to explore the success of PBSC collection, the factors which influence the success of PBSC collection, the composition and the quality of graft and their infuence on hematopoietic recovery and outcome after transplantation in patients with acute myeloid leukemia (AML). PBSC were collected by the method of leukapheresis after applying a combination of chemotherapy and growth factors or only growth factors. The quality of graft was determined with the clonogenic progenitor cell assay and with the flow citometry analysis. Of the total 134 patients with AML, who were submitted to HSC mobilization, the collection was successful in 78 (58.2%) patients. The collection was more successful after the first than after the second attempt of HSC mobilization (49% vs. 11%). The criteria for effective mobilization were the number of leukocytes >3´109/L and the concentration of CD34+ cells >20´103/mL in the peripheral blood on the first day of leukapheresis. The number of CD34+ cells infused had the strongest impact on hematopoietic recovery. We noted significantly faster hematological recovery of neutrophils and platelets, fewer number of transfused units of red blood cells and platelets, shorter duration of the tranfusion support, shorter treatment with intravenous antibiotic therapy and shorter hospitalization after PBSC compared to BM transplantation. These advantages could provide their standard application in the treatment of patients with AML

PHYSICAL ACTIVITY AND DIETARY HABITS AMONG SECOND YEAR STUDENTS OF THE SCHOOL OF MEDICINE, UNIVERSITY OF BELGRADE

The aim of this study was to investigate the physical activity and dietary habits of second year medical students of the School of Medicine, University of Belgrade. The level of physical activity and dietary habits were also investigated according to other factors: gender, sports activity before and after attending college and students’ self-assessment related to their physical activity level. All second year medical students (490 students: 155 male and 355 female) were asked to participate in the study by filling out questionnaires during one week in the 2016/17 school year. They filled out a demographic questionnaire, a shorter version of International Physical Activity Questionnaire (IPAQ) as well as a food frequency questionnaire comprising 13 indicator variables. The Mann-Whitney U test was used to test the overall differences between male and female students, while a Correlation Analysis was investigated using the Spearman correlation coefficient. There is a statistically significant difference in sport habits between both male and female students, before and after enrolling in college. The Spearman correlation coefficient analysis showed that there is a moderate positive correlation between the levels of physical activity calculated from the IPAQ questionnaire with sports activity habits of the students after enrolling in college (0.344) as well as with self-assessment of the level of physical activity by the students (0.440). Second year medical students have good dietary habits that could be responsible for their adequate body composition

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

EXTRACORPOREAL PHOTOPHERESIS IN TREATMENT OF CHRONIC GRAFT VERSUS HOST DISEASE

Ekstrakorporalna fotofereza (EF) jest imunomodulatorna terapija koja se rabi u liječenju kronične reakcije transplantata protiv primatelja (engl. chronic graft versus host disease, cGVHD). Tijekom EF-a leukaferezom se iz krvi izdvajaju mononuklearne stanice, ex vivo im se dodaje 8-metoksipsoralen, stanice se ozrače UVA-zrakama i potom reinfundiraju bolesniku. Cilj istraživanja bio je procijeniti klinički i imunomodulatorni učinak postupka EF-a u bolesnika s cGVHD-om. Analiziran je 341 postupak EF-a u 7 bolesnika s cGVHD-om s medijanom EF-a po bolesniku 37 (raspon 13–131). U svih bolesnika cGVHD se manifestirao kožnim promjenama u kombinaciji sa simptomima drugih organskih sustava. EF su provođene dva dana za redom: prvih mjesec dana svaki tjedan, sljedeća 2 mjeseca svaki drugi tjedan, a potom jednom na mjesec. Medijan trajanja liječenja postupkom EF-a iznosio je 10 mjeseci (raspon 2 do 58). EF je većinom povoljno utjecao na simptome cGVHD-a pa je u 6 bolesnika došlo do poboljšanja i/ili stabilizacije promjena kože te bolje pokretljivosti zglobova, a u 2 bolesnika s ulceracijama sluznice usne šupljine promjene su se u cijelosti povukle. Do kliničkog poboljšanja došlo je 2 do 3 mjeseca nakon početka EF-a, što je omogućilo značajno smanjenje ili prestanak primjene glukokortikoida. Neželjene reakcije javile su se tijekom 4,9% postupaka. U bolesnika u kojih je došlo do poboljšanja kliničkog stanja normalizirale su se vrijednosti omjera CD4+/CD8+ stanica, kao i broj NK-stanica. Rezultati našeg istraživanja pokazuju da primjena EF-a povoljno utječe na simptome cGVHD-a i omogućuje sniženje doze kortikosteroida uz poboljšanje kvalitete života bolesnika pa se stoga može preporučiti za bolesnike koji ne odgovaraju na standardno liječenje.Extracorporeal photopheresis (ECP) is an immunomodulatory therapy which has been used in the treatment of chronic GVHD (cGVHD). ECP involves separation of the mononuclear cells with leukapheresis, followed by ex vivo administration of 8-methoxypsoralen and UV-A radiation and reinfusion to the patient. Aim of the study was to evaluate clinical and immunomodulatory effect of ECP procedures in patients with cGVHD. We analyzed 341 ECP procedures performed in 7 patients with cGVHD; median ECP per patient was 37 (range 13–131). All patients suffered from skin changes in combination with impaired joint mobility and symptoms of oral disease. ECP procedures were performed for two consecutive days: in initial phase weekly, followed by every two weeks and than monthly according to clinical response. Median of ECP treatment duration was 10 months (range 2–58). The effect of ECP in patients with cGVHD with skin and joint involvement was mostly beneficial: 6 patients experienced either improvement or stabilization in skin changes and joint mobility. In 2 patients who suffered from oral disease, the total recovery was observed. Clinical response was typically delayed until 2 to 3 months, and reduction in glucocorticoid dose was observed. Adverse reactions were observed in 4.9% procedures. In patients who responded to ECP treatment, CD4+/CD8+ ratio and number of NK cells were normalized. ECP proved to be an efficient and safe procedure that may be recommended for patients with cGVHD who do not respond to conventional therap