Combining Core Training and Sensory Refinement: effects on physical performance

The concept of “the Core” describes the complex of anatomical components of the trunk, pelvis and shoulder girdle that are responsible for maintaining the stability of the spine and pelvis and are critical for the transfer of energy from larger torso to the smaller extremities, during many sport and daily-living activities (1). This concept rooted in sport science and rehabilitation and recently Core Training (CT) became very popular as a method to prevent injuries and improve sport performance and physical fitness. It consists in the progressive training of the musculature of the Core with special emphasis in posture and lumbar spine stability. This aspect requires a fine coordination and body awareness that often are poor developed or regressed after an injury. Then, it is important to include exercises of Sensorial Refinement (SR) that may stimulate the refinement of perceptually neglected areas (2). The aim of the study was to evaluate the effect of combined CT and SR on physical performance and to compare these effects with traditional core training. Furthermore, the effect on retention after 4 weeks of detraining was evaluated. Two groups of participants were recruited (age >30 < 50) and assigned to experimental (CT and SR: EXP, n = 9) or control (CT: CON, n = 9) group. Both groups trained ten weeks, with a frequency of two sessions per week. Training consisted in 10’ of warm up, 40’ of workout and 10’ of cool down. Workout of EXP group consisted in 20’ of SR and 20’ of CT whereas CON group performs 40’ of CT. Participants where tested by: Star Excursion Balance Test (SEBT) for the dynamic balance of lower body, Upper Quarter Y Balance Test (YBT-UQ) to assess upper extremities function in a closed-chain position and McGill test to evaluate muscular endurance of the core. Both groups improved core endurance after training and worsen it at follow up; moreover, both groups ameliorate upper an lower body control (SEBT and YBT-UQ) after training but only EXP group improved or maintained it at follow up. Since the information about the movements of the body are elaborated in the somatomotor cortex for fine coordination, the combination of CT and SR should better promote the consolidation of motor memory and long-term body control

VEGF response to aerobic training in postmenopause: walking training vs nordic walking

Menopausal transition leads to increased risk of non-communicable chronic diseases, which are characterized by endothelial disruption and dysfunction. Aerobic physical exercise determines an increase of vascular endothelial growth factor (VEGF), a signal protein that stimulates angiogenesis, and recent studies suggest a direct correlation between exercise intensity and VEGF production (1). However, high intensity training is often not recommended for postmenopausal women as a result of cardiovascular and orthopaedic contraindications. The aim of the study was to determine if exercising at the same intensity (i.e. moderate intensity) but involving a more extended muscle mass might induce higher circulating levels of VEGF. Nordic Walking (NW), a form of physical activity where the active use of a pair of dedicated poles is added to regular walking, was compared to walking training (WT). Thirty postmenopausal women were enrolled in the study (57.93±3.55 years old) and randomly assigned to WT (n=15) and NW (n=15). Serum VEGF levels were determined by ELISA before and after exercise training, consisting in three workouts of 40-50 minutes for 13 weeks at intensity between 11 and 13 of a 15-category scale of the ratings of the perceived exertion. The only difference was the use of poles with appropriated technique in NW group. RM-ANOVA with repeated measure for the factor time revealed an effect for time (P=.01) and an interaction effect time x group (P=.041). Post-hoc analysis, consisting in a paired sample t-test for each group, showed that NW increased VEGF whereas WT showed only a tendency (WT: T0=39.68±2.90 T1=40.22±2.56, P=.012; NW: T0=38.22±1.60 T1=42.52±5.97, P=.57). In conclusion, independently from exercise intensity, NW seems to increase VEGF more efficiently than WT, probably as a result of a larger capillary bed actively involved by exercising muscles. This outcome should be taken in consideration when programming exercise training for postmenopausal women

Clinical presentation of human monkeypox virus infection during the 2022 outbreak: descriptive case series from a large italian Research Hospital

Abstract Background In May 2022, a new case of Monkeypox Virus (MPX) was reported in a non-endemic area, the United Kingdom, and since then, the number of confirmed cases in Europe has been increasing until WHO, on May 10 2023, declared that MPOX is no longer a public health emergency of international concern. We aimed to describe the clinical and microbiological characteristics of sixteen patients with a confirmed diagnosis of MPX followed by a single Italian clinical centre, the Fondazione Policlinico Universitario Agostino Gemelli, between May 20 and August 30. Materials and methods A prospective observational study has been conducted, collecting microbiological samples during the time of the infection, as well as epidemiological and clinical data of the patients. All patients provided written informed consent. Results During clinical practice, 16 individuals presenting with consistent symptoms tested positive for MPX on a polymerase chain reaction. All patients were men having sex with men (MSM). The most frequent clinical presentation was a vesicular erythematous cutaneous rash, mainly distributed on the genital and perianal area, but also regarding limbs, face, neck, chest and back in some of the patients. Systemic symptoms, such as fever or lymphadenopathy, involved eight patients. The symptom most frequently reported by patients was pruritus in the area of the vesicles. Thirteen patients also reported pain. Nine patients were HIV-1 coinfected, but no significant differences have been observed compared to other cohort patients. The median time between the onset of symptoms and the healing was 19.5 days (IQR 14.0–20.3). Conclusions Our cohort of patients presented a mild manifestation of the disease with no complications and no need for antiviral therapy nor hospitalization. This population seems different from the ones reported in the literature during the previous outbreaks in endemic areas in epidemiological data and clinical manifestations but also from a cohort of patients described in the literature from the 2022 outbreak, suggesting the importance for healthcare workers to keep in mind the possibility of an MPX infection in the differential diagnosis of patients presenting with consistent symptoms, even in non-endemic areas, to ensure efficient isolation of the patient for infection control purposes and effective management of the infection preventing the development of MPOX-related complications

'How much raltegravir do you take?' The answer may not be so obvious: an accidental finding from clinical practice

It has been over a decade since the introduction of ralte-gravir, which has a well-established efficacy and tolera-bility profile . However, until recently, raltegravir hasonly been available as twice-daily formulations with, as aresult, a lower cumulative compliance to therapy and ahigher rate of discontinuation compared with the otheragents in the class .Following encouraging results from the ONCEMRK trial, a new raltegravir formulation of 1200 mg once dailywas introduced, and has been available in our centre sinceMay 2018. The new once-daily administration appearspromising in improving the compliance to raltegravir-con-taining regimens. However, during our routine clinicalactivity, we noticed that some of the patients recentlyswitched to raltegravir 1200 mg once daily were incor-rectly taking the drug. We then decided to investigate thisissue and to determine how widespread it was and pro-ceeded to recall all patients switched to this therapy in ourclinical centre between May 2018 and December 2018. Wethen asked our patients how they were taking raltegravirand collected their opinions on the ease of administrationof the new formulation and the onset of side effects

Early use of tecovirimat in a young man with severe mpox skin lesions: a case report

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Cardiovascular Disease Risk in a Cohort of Virologically Suppressed People Living with HIV Switching to Doravirine: Preliminary Data from the Real Life

Aim of this study is to assess the impact of doravirine (DOR)-based regimens on cardiovascular risk in treatment-experienced people living with HIV (PLWHIV). We retrospectively analyzed a cohort of 40 treatment-experienced PLWHIV switching to a DOR-based three-drug regimen, evaluating 10-year risk of manifesting clinical cardiovascular diseases (CD) through the Framingham Risk Score at baseline, 12, and 24 weeks of follow-up. At baseline, median predicted 10-year risk of cardiovascular disease (10Y-CD) was 8.0% (interquartile range 4.0-13.0). After 12 weeks, we observed a significant reduction in 10Y-CD (mean decrease -2.21, p = .012); similarly, we observed a nonsignificant reduction at week 24 (p = .336). Regarding metabolic parameters, after 24 weeks we observed a significant reduction in total cholesterol (median change -8.8 mg/dL, p = .018), low-density lipoprotein cholesterol (median -9.5 mg/dL, p = .007), and triglycerides (median -19.8 mg/dL, p &lt; .001). Our results show a favorable metabolic impact of DOR-based regimens along with a promising reduction in 10-year risk of cardiovascular disease

Difference in the neurocognitive functions of WLWH and MLWH in an Italian cohort of people living with HIV

Based on the available literature, women living with HIV (WLWH) seem to show greater cognitive and emotional disadvantages than men living with HIV (MLWH). Our aim was to compare the cognitive performance of MLWH and WLWH in an Italian cohort of People Living With HIV (PLWH) and to analyse factors potentially contributing to sex differences in cognitive function. We ran a retrospective, cross-sectional analysis of a monocentric dataset of PLWH who were administered a standardized neuropsychological test battery (SNB) during routine clinical care. We enrolled 161 Italian PLWH who are on combined antiretroviral therapy (cART): 114 (70.8%) MLWH and 47 (29.2%) WLWH. Global cognitive performance (composite z score) (GCP) was significantly higher in MLWH than WLWH [mean 0.19 (SD 0.85) vs − 0.13 (SD 0.96); p = 0.039]. Moreover, WLWH obtained significantly higher scores on the Zung Depression Scale than MLWH [mean 41.8 (SD 10.9) vs 36.7 (SD 9.2); p = 0.003]. However, there was no statistically significant direct effect between male sex and better GCP (p = 0.692) in the context of a mediation model. On the contrary, the associations between male sex and better GCP were mediated by higher level of education (a*b = + 0.15, Bootstrap CI95 = 0.05 and 0.27) and a lower Zung depression score (a*b = + 0.10, Bootstrap CI95 = 0.02 and 0.21). In conclusion, the global cognitive performance of WLWH is lower than that of MLWH. However, other demographic and clinical factors besides sex might help explain differences in their neurocognitive functions and make it possible for us to monitor them and identify those patients most in need

People Living with HIV in the COVID-19 Era: A Case Report

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Is smallpox vaccination protective against human monkeypox?

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