Wearing face masks reduce the maximum physical performance. Sports and occupational activities are often associated with submaximal constant intensities. This prospective crossover study examined the effects of medical face masks during constant-load exercise. Fourteen healthy men (age 25.7 ± 3.5 years; height 183.8 ± 8.4 cm; weight 83.6 ± 8.4 kg) performed a lactate minimum test and a body plethysmography with and without masks. They were randomly assigned to two constant load tests at maximal lactate steady state with and without masks. The cardiopulmonary and metabolic responses were monitored using impedance cardiography and ergo-spirometry. The airway resistance was two-fold higher with the surgical mask (SM) than without the mask (SM 0.58 ± 0.16 kPa l−1 vs. control [Co] 0.32 ± 0.08 kPa l−1; p < 0.01). The constant load tests with masks compared with those without masks resulted in a significantly different ventilation (77.1 ± 9.3 l min−1 vs. 82.4 ± 10.7 l min−1; p < 0.01), oxygen uptake (33.1 ± 5 ml min−1 kg−1 vs. 34.5 ± 6 ml min−1 kg−1; p = 0.04), and heart rate (160.1 ± 11.2 bpm vs. 154.5 ± 11.4 bpm; p < 0.01). The mean cardiac output tended to be higher with a mask (28.6 ± 3.9 l min−1 vs. 25.9 ± 4.0 l min−1; p = 0.06). Similar blood pressure (177.2 ± 17.6 mmHg vs. 172.3 ± 15.8 mmHg; p = 0.33), delta lactate (4.7 ± 1.5 mmol l−1 vs. 4.3 ± 1.5 mmol l−1; p = 0.15), and rating of perceived exertion (6.9 ± 1.1 vs. 6.6 ± 1.1; p = 0.16) were observed with and without masks. Surgical face masks increase airway resistance and heart rate during steady state exercise in healthy volunteers. The perceived exertion and endurance performance were unchanged. These results may improve the assessment of wearing face masks during work and physical training.

BP is superior to MP with respect to complete remission rate, TTF, cycles needed to achieve maximum remission and quality of life and should be considered the new standard in first-line treatment of MM patients not eligible for transplantation.

Bendamustine can efficaciously and safely replace cyclophosphamide, as used in standard COP therapy, for the treatment of patients with indolent NHL and mantle cell lymphoma. Long-term survival data suggest a clinically significant benefit for patients treated with BOP.

Between 1996 and 2004, a total of 708 patients were enrolled in the acute myeloid leukaemia (AML) '96 and '02 studies of the East German Study Group (OSHO). Of these, 138 patients (19.5%) had unfavourable cytogenetics defined as complex karyotype, del (5q)/-5, del (7q)/-7, abn (3q26) and abn (11q23). In all, 77 (56%) achieved complete remission 1 (CR1) after induction chemotherapy and were eligible for haematopoietic cell transplantation (HCT). HCT was performed after a median of two cycles of consolidation chemotherapy (CT) in the AML '96 and one cycle in the AML '02 study (P ¼ 0.03). After a median follow-up of 19 months, overall survival (OS) at two years was significantly better in the donor group (52 ± 9%) versus the no-donor group (24±8%; P ¼ 0.005). Differences in outcomes were mainly because of a lower relapse incidence in patients after HCT (39±11%) compared with a higher relapse incidence in patients undergoing CT (77 ± 10%; P ¼ 0.0005). Treatment-related mortality was low and not statistically significantly different between the two treatment groups (15 ± 7 and 5 ± 5% for HCT and chemotherapy, respectively; P ¼ 0.49).We conclude that early HCT from related or unrelated donors led to significantly better OS and leukaemia-free survival compared with chemotherapy in patients with unfavourable karyotype.

ZusammenfassungHintergrund: Pankreas-Agenesie ist eine seltene Ursache des neonatalen Diabetes mellitus. Pankreas-Agenesie wurde in einzelnen Fallberichten beschrieben, und Informationen zur Klinik und Prognose sind spärlich. Wir berichten über einen Patienten mit Pankreas-Agenesie und double outlet right ventricle, eine bisher nicht beschriebene Assoziation. Zusätzlich geben wir einen Überblick über insgesamt 14 Patienten mit Pankreas-Agenesie, die bisher berichtet wurden. Methode: Wir berichten über einen Patienten und fanden 13 weitere Patienten durch Medlineund OMIM-Recherche. Ergebnisse: Bei einem Kind wurde die Schwangerschaft in der 19. Woche abgebrochen. 31 % (4/13) der Kindern starben in der ersten Woche und 69 % (9/13) in den ersten sechs Lebenswochen, 17 % (2/12) waren Frühgeborene, 83 % (10/12) Reifgeborene, 93 % (13/14) hatten eine schwere intrauterine Wachstumsretardierung, Manifestation des Diabetes mellitus war bei 60 % (6/10) während der ersten zwei Lebenstage, Ketonurie ist selten und wurde nur einmal berichtet. 64 % (9/14) der Kinder mit Pankreas-Agenesie hatten zusätzliche Fehlbildungen, überwiegend des Gallengangssystems (50 %) und/oder des Herzens (36 %), 31 % (4/13) überlebten die Neonatalperiode und zeigten eine gute Entwicklung. Nach Substitution der Pankreasenzyme kam es zum Aufholwachstum. Schlussfolgerung: Pankreas-Agenesie ist eine klinische Entität, charakterisiert durch schwere intrauterine Wachstumsretardierung, frühe Manifestation eines persistierenden Diabetes mellitus ohne Ketoazidose, Gedeihstörung infolge exokriner Pankreasinsuffizienz und assoziierter Fehlbildungen, vorwiegend des Gallengangssystems Abstract Background: Pancreatic agenesis is a rare cause of neonatal diabetes mellitus and the knowledge about the clinical features is sparse. A patient with pancreatic agenesis and double outlet right ventricle is reported. This association has not previously been reported. In addition a synopsis of the patients (n = 14) with pancreatic agenesis who have hitherto been described is given. Method: We studied one patient and obtained information on 13 additional patients with pancreatic agenesis by reviewing literature. Results: Literature review: In one patient the pregnancy was terminated at 19 weeks. 31 % (4/13) of the infants died in the first week and 69 % (9/13) in the first six weeks of live, 17 % (2/12) were born preterm and 83 % (10/12) at term, 93 % (13/ 14) had severe intrauterine growth restriction, onset of diabetes was in 6 out of 10 infants during the first two days of live, ketonuria is rare and has been reported only once. 64 % (9/14) of the infants with pancreatic agenesis had additional malformations mainly of the biliary system (50 %) and/or the heart (36 %). 31 % (4/13) of the infants survived the neonatal period and developed normally. Failure to thrive was compensated by catch-up growth after replacement of pancreatic enzymes and surgical correction of the cardiac malformation. Conclusions: Pancreatic agenesis is a clinical entity characterized by severe intr...

Mouthguards (MGs) are highly recommended in rugby. Airway obstruction and a resulting decrease in power output are potential disadvantages of their usage. The aim of the study was to assess possible limitations of “vented” (MGV) and custom-made mouthguards (MGC) on rugby players’ performance. The MG effects were investigated in 13 male first-league rugby players ranging from 18–34 years old. First a lung function test was completed. Then a double incremental treadmill test was performed to measure maximum aerobic performance, ventilation, VO2, VCO2, heart rate, and lactate. Effects on sprint times (10 and 40 m) and countermovement jumps were also investigated. Peak flow values were significantly decreased with MGV by about 0.9 l/s. Neither ventilatory parameters nor oxygen uptake were affected by either of the mouthguards. Maximum lactate was significantly decreased in both MG types vs. no MG use. The maximum running velocity was similar in all tests. The aerobic energy turnover was moderately increased with the MGC and MGV. No effects were seen on sprint times or jump tests. Although neither type of mouthguard had a significant impact on maximum performance in treadmill running, the anaerobic energy turnover was decreased.

In conclusion, treatment of older AML pts with dose-intense AraC is feasible in the majority of pts and induces high rates of CR. Nevertheless, except for favourable karyotype, OS and event-free survival remain low. These results need to be viewed in relation to the new modalities including stem cell transplantation following non-myeloablative conditioning, epigenetic and molecular therapies.

This clinical case revealed a highly relevant correlation between insulin resistance and a local dental inflammation. To avoid an increase in insulin resistance, it seems important to attend to radically non-vital teeth as well as any other dental inflammation in diabetic patients.