In light-chain (AL) amyloidosis, prognosis is dictated by cardiac dysfunction. N-terminal natriuretic peptide type B (NT-proBNP) and cardiac troponins (cTn) are used to assess the severity of cardiac damage. We evaluated the prognostic relevance of a high-sensitivity (hs) cTnT assay, NT-proBNP, and cardiac troponin I in 171 consecutive patients with AL amyloidosis at presentation and 6 months after treatment. Response and progression of NT-proBNP were defined as more than 30% and more than 300 ng/L changes. All 3 markers predicted survival, but the best multivariable model included hs-cTnT. The hs-cTnT prognostic cutoff was 77 ng/L (median survival 10.6 months for patients with hs-cTnT above the cutoff). After treatment, response and progression of NT-proBNP and a more than 75% increase of hs-cTnT were independent prognostic determinant. In AL amyloidosis, hs-cTnT is the best baseline prognostic marker. Therapy should be aimed at preventing progression of cardiac biomarkers, whereas NT-proBNP response confers an additional survival benefit. (Blood. 2010; 116(18):3426-3430)

a b s t r a c tWhole-body cryotherapy (WBC) covers a wide range of therapeutic applications and consists of briefly exposing the body to extremely cold air. In sports medicine, WBC is used to improve recovery from muscle injury; however, empirical studies on its application to this area are lacking. To fill this gap, we compared changes in immunological parameters (C3, IgA, IgM, IgG, C-reactive protein, PGE2), cytokines (IL-2, IL-8, IL-10), adhesion molecules (sICAM-1), and muscle enzymes (creatine kinase [CK], lactate dehydrogenase [LAD]) before and after WBC in 10 top-level Italian National team rugby players. The subjects underwent five sessions on alternate days once daily for 1 week. During the study period, the training workload was the same as that of the previous weeks. Compared to baseline values, immunological parameters remained unchanged, while CK and LAD levels significantly decreased after treatment. No alterations in immunological function were observed but there is a decrease in proinflammatory cytokine/chemokine and an increase in anti-inflammatory cytokine.As measured by changes in serum CK and LAD concentrations, and cytokines pathway, short-term cold air exposure was found to improve recovery from exercise-induced muscle injury and/or damage associated with intense physical training.

Background COVID-19 is an infectious disease caused by a novel coronavirus (SARS-CoV-2). The immunopathogenesis of the infection is currently unknown. Healthcare workers (HCWs) are at highest risk of infection and disease. Aim of the study was to assess the sero-prevalence of SARS-CoV-2 in an Italian cohort of HCWs exposed to COVID-19 patients. Methods A point-of-care lateral flow immunoassay (BioMedomics IgM-IgG Combined Antibody Rapid Test) was adopted to assess the prevalence of IgG and IgM against SARS-CoV-2. It was ethically approved (“Milano Area 1” Ethical Committee prot. n. 2020/ST/057). Results A total of 202 individuals (median age 45 years; 34.7% males) were retrospectively recruited in an Italian hospital (Milan, Italy). The percentage (95% CI) of recruited individuals with IgM and IgG were 14.4% (9.6–19.2%) and 7.4% (3.8–11.0%), respectively. IgM were more frequently found in males (24.3%), and in individuals aged 20–29 (25.9%) and 60–69 (30.4%) years. No relationship was found between exposure to COVID-19 patients and IgM and IgG positivity. Conclusions The present study did show a low prevalence of SARS-CoV-2 IgM in Italian HCWs. New studies are needed to assess the prevalence of SARS-CoV-2 antibodies in HCWs exposed to COVID-19 patients, as well the role of neutralizing antibodies.

The severity of coronavirus disease 2019 (COVID‐19) is a crucial problem in patient treatment and outcome. The aim of this study is to evaluate circulating level of sphingosine‐1‐phosphate (S1P) along with severity markers, in COVID‐19 patients. One hundred eleven COVID‐19 patients and forty‐seven healthy subjects were included. The severity of COVID‐19 was found significantly associated with anemia, lymphocytopenia, and significant increase of neutrophil‐to‐lymphocyte ratio, ferritin, fibrinogen, aminotransferases, lactate dehydrogenase (LDH), C‐reactive protein (CRP), and D‐dimer. Serum S1P level was inversely associated with COVID‐19 severity, being significantly correlated with CRP, LDH, ferritin, and D‐dimer. The decrease in S1P was strongly associated with the number of erythrocytes, the major source of plasma S1P, and both apolipoprotein M and albumin, the major transporters of blood S1P. Not last, S1P was found to be a relevant predictor of admission to an intensive care unit, and patient’s outcome. Circulating S1P emerged as negative biomarker of severity/mortality of COVID‐19 patients. Restoring abnormal S1P levels to a normal range may have the potential to be a therapeutic target in patients with COVID‐19.

a b s t r a c tSystemic cryostimulation is useful treatment, both in sport and medicine, during which human body is exposed to very low, cryogenic temperature (below À100°C). Although there exists some evidence of its beneficial effect in biological regeneration, so far it has not been unequivocally determined if the positive effect of repeated stimulations depends on their number in a series. The aim of this research was to estimate the influence of 5, 10 and 20 sessions of 3 min-long exposures to cryogenic temperature (À130°C) on the lipid profile in physically active men. Sixty-nine healthy volunteers participated in the study. The blood samples were taken in the morning, after overnight fasting, before the first cryostimulation session, and the following morning after the last one (5th,10th, 20th).In serum specimens the concentration of total cholesterol (TCh), HDL cholesterol and triglicerydes were determined using enzymatic methods. LDL cholesterol level was calculated using Friedewald formula. The changes in lipid profile (LDL decrease with simultaneously HDL increase) occurred after at least 10 sessions of cryostimulation.Ó 2010 Elsevier Inc. All rights reserved. IntroductionWhole-body cryostimulation in a cryogenic chamber uses very low temperatures (ranging from À100 to À160°C) over a short time span (1-3 min) to induce systemic physiological responses. It is based on the heat exchange between surfaces with different temperatures [30]. Heat is absorbed by cooled surface tissues from deeper situated tissues at the rate proportional to their difference in temperature.A desired response to a systemic effect of cryogenic temperatures (below À100°C) is a hyperaemic reaction (rebound effect), stimulatory in character. Exposure in cryogenic chamber, under a supervision of a physician and in compliance to commonly accepted rules concerning cryostimulation, is not harmful or dangerous to healthy individuals, although there exist several contraindications. Banfi et al. reported that whole-body cryotherapy is not deleterious to cardiac function in healthy individuals [1]. Documented analgesic, anti-inflammatory and antioedematous action reduces increased muscle tension and therefore cryotherapy has been increasingly often applied in sport and medicine, in combination with additional forms of treatment [13,14,25,34,36].It is postulated that cryostimulation mobilizes the white blood cells, particularly immunocompetent lymphocytes [4,15,21,22]. The effect on red blood cells has not been positively confirmed. Banfi et al. did not observe changes in the level of hematocrit, whereas red blood cells and mean corpuscular hemoglobin decreased after 5 cryostimulation sessions [2,3]. On the contrary, significant increase in erythrocytes count, hemoglobin concentration, hematocrit value and the mean corpuscular value (MCV) were reported by Stanek et al. [33].It is unclear how repeated cryostimulation influences the level of pro-inflammatory and anti-inflammatory mechanisms. There is a report of increased anti-inflammatory cy...

These observations establish gut damage and the size of the HIV reservoir as features of deficient immunological response to cART and provide new elements for interventional strategies in this setting.

PCT may be a useful marker to predict which patients subsequently have early VAP. The CPIS could help as an early way to detect the patients with early VAP and who need further diagnostic testing.

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