Summary Background : Fatigue is reported by many adults at the moment of diagnosis of coeliac disease and during follow‐up. Aim : To evaluate the prevalence, characteristics and associations of fatigue in adult coeliac disease patients. Methods : The investigated sample comprised adults from Campania, Italy. A total of 130 coeliac disease patients were consecutively recruited in both treated (59 on gluten‐free diet) and untreated conditions (71 on normal diet). The control group was made up of 80 healthy controls. Coeliac disease patients and healthy controls underwent laboratory tests, a set of questionnaires for studying fatigue: visual analogue scale for fatigue, chronic fatigue syndrome questionnaire, fatigue severity scale and a modified version of the Zung self‐rating depression scale. Results : Coeliac disease patients showed a significantly lower body mass index than controls (P = 0.0001), lower serum iron (P = 0.04). The entire cohort of coeliac disease patients reported greater modified version of the Zung self‐rating depression scale score (P = 0.001), greater visual analogue scale for fatigue score (P = 0.0001) and greater chronic fatigue syndrome questionnaire score (P = 0.0001) compared with healthy controls. Coeliac disease patients on a gluten‐free diet had a significantly higher modified version of the Zung self‐rating depression scale score than coeliacs on a normal diet (P = 0.001). The prevalence of pathological modified version of the Zung self‐rating depression scale score was 17% in all coeliac disease patients and 0% in healthy controls. A significant correlation was found between modified version of the Zung self‐rating depression scale score and fatigue scale scores in coeliacs on a normal diet. Presence/absence of gastrointestinal symptoms did not show any significant correlation with modified version of the Zung self‐rating depression scale score and fatigue scale scores. In coeliacs on a gluten‐free diet, modified version of the Zung self‐rating depression scale and fatigue scales scores did not significantly differ from coeliacs on a normal diet and were not related to dietetic compliance. Conclusion : In coeliacs, fatigue is a common finding, which ameliorates with the gluten‐free diet and is strictly correlated to depression although coeliacs on a gluten‐free diet showed more frequent and more severe depression symptoms than coeliacs on a normal diet.
Objective. We aimed to investigate the acute residual hormonal, biochemical, and neuromuscular responses to a single session of individualized whole-body vibration (WBV) while maintaining a half-squat position. Methods. Twenty male sport science students voluntarily participated in the present study and were randomly assigned to an individualized WBV group (with the acceleration load determined for each participant) or an isometric group (ISOM). A double-blind, controlled parallel study design with repeated measures was employed. Results. Testosterone and growth hormone increased significantly over time in the WBV group ( P < .05 and P < .01, respectively; effect size [ES] ranged from 1.00 to 1.23), whereas cortisol increased over time in both groups ( P < .01; ES ranged from 1.04 and 1.36). Interleukin-6 and creatine kinase increased significantly over time only in the WBV group ( P < .05; ES = 1.07). The maximal voluntary contraction decreased significantly over time in the ISOM group ( P = .019; ES = 0.42), whereas in the WBV group, the decrease did not reach a significant level ( P = .05). The ratio of electromyographic activity and power decreased significantly over time in the WBV group ( P < .01; ES ranged from 0.57 to 0.72). Conclusion. Individualized WBV increased serum hormonal concentrations, muscle damage, and inflammation to levels similar to those induced by resistance training and hypertrophy exercises.
The goal for a good clinical outcome of patients with virtual ileostomy is a strict postoperative follow-up focused on fever onset and quality of drainage discharge. In our experience virtual ileostomy is a good tool to avoid open ostomy at time of primary colorectal or coloanal anastomosis in a good number of cases.
When applying drop jump exercises, knowing the magnitude of the stimulus is fundamental to stabilize the leg joints and to generate movements with the highest power. The effects of different drop heights on leg muscles coactivation, leg stiffness and power propulsion were investigated in fifteen sport science students. Drop jumps from heights of 20, 30, 40, 50, and 60 cm in a random order were performed on a force platform. During each drop jump, the ground reaction force, knee angle displacement, and synchronized surface-electromyography root-mean-square (sEMGRMS) activity (vastus lateralis, VL; vastus medialis, VM; rectus femoris, RF; biceps femoris, BF; tibialis anterior, TA and lateral gastrocnemius, LG) were recorded. The coactivation in the pre-contact phase, between VL and BF, VM and BF as well as RF and BF, was dependent on the drop height (p < 0.01; effect size (ES) ranged from 0.45 to 0.90). Leg stiffness was dependent on the drop height (p < 0.001; ES = 0.27–0.28) and was modulated by the coactivation of VM–BF (p = 0.034) and RF–BF (p = 0.046) during the braking phase. Power propulsion was also dependent on the drop height (p < 0.001; ES = 0.34); however, it was primarily modulated by the coactivation of LG–TA during the braking phase (p = 0.002). The coactivation of thigh muscles explains leg stiffness adjustments at different drop heights. On the contrary, the coactivation of shank muscles is mostly responsible for the power propulsion.
Aneurysmal subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality. In SAH patients, plasma osteopontin (OPN) has been shown to independently predict poor outcome. The aim of the study is to investigate, in a selected population with severe SAH, OPN time course in cerebrospinal fluid (CSF) and plasma during the first week after aneurism rupture, and OPN prognostic value. We included 44 patients with the following criteria: (1) age 18 and 80 years, (2) diagnosis of SAH from cerebral aneurysm rupture, (3) insertion of external ventricular drain. Plasma and CSF were sampled at day 1, 4, and 8. OPN levels, in CSF and plasma, displayed a weak correlation on day 1 and were higher, in CSF, in all time points. Only in poor prognosis patients, OPN levels in CSF significantly increased at day 4 and day 8. Plasma OPN at day 1 and 4 was predictor of poor outcome. In conclusion, plasma and CSF OPN displays a weak correlation, on day 1. The higher levels of OPN found in the CSF compared to plasma, suggest OPN production within the CNS after SAH. Furthermore, plasma OPN, at day 1 and 4, seems to be an independent predictor of poor outcome.
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