AIM:To investigate the effects of exercise on healthy individuals of both genders. METHODS:This study lasted 6 years and involved about 800 healthy people. Individuals were divided into females and males and further sub-divided into two groups; in the first group individuals run (or skied in the winter time) and then rested for 3 h, whereas individuals in the second group intensely cycled for 5 min. The status of health was determined by measuring the sedimentation rate and the intensity of exercises by measuring the heart rate. Blood samples were collected before and after exercise. RESULTS:We observed that in the first group a significant increase of the total white blood cells, segmented neutrophils, band neutrophils, eosinophils and to a lesser extent lymphocytes but not monocytes in the blood circulation. However, all cell types were increased in the circulation after 5 min intense exercise. No differences in the pattern of cell increase were observed among the genders. Activated partial thromboplastin time (APTT) and D-dimer were also measured in the blood of individuals who cycled intensely for 5 min to determine the coagulation and fibrinolytic activities in the blood. APTT is reduced and D-dimer values significantly increased after intense exercise. However, APTT was statistically lower in males than females, whereas no differences in the D-dimer values were observed among the genders. CONCLUSION:Our results indicate that exercise whether leisure or strenuous affects leukocytosis and hemostasis in both genders. A major advantage of this study is the high numbers of individuals involved and the inclusion of both females and males values.
IMPORTANCEThe use of perioperative, prophylactic, intravenous antibiotics is standard practice to reduce the risk of surgical site infection after oncologic resection and complex endoprosthetic reconstruction for lower extremity bone tumors. However, evidence guiding the duration of prophylactic treatment remains limited.OBJECTIVE To assess the effect of a 5-day regimen of postoperative, prophylactic, intravenous antibiotics compared with a 1-day regimen on the rate of surgical site infections within 1 year after surgery.DESIGN, SETTING, AND PARTICIPANTS This randomized clinical superiority trial was performed at 48 clinical sites in 12 countries from January 1, 2013, to October 29, 2019. The trial included patients with a primary bone tumor or a soft tissue sarcoma that had invaded the femur or tibia or oligometastatic bone disease of the femur or tibia with expected survival of at least 1 year who required surgical management by excision and endoprosthetic reconstruction. A total of 611 patients were enrolled, and 7 were excluded for ineligibility.INTERVENTIONS A 1-or 5-day regimen of postoperative prophylactic intravenous cephalosporin (cefazolin or cefuroxime) that began within 8 hours after skin closure and was administered every 8 hours thereafter. Those randomized to the 1-day regimen received identical saline doses every 8 hours for the remaining 4 days; patients, care providers, and outcomes assessors were blinded to treatment regimen. MAIN OUTCOMES AND MEASURESThe primary outcome in this superiority trial was a surgical site infection (superficial incisional, deep incisional, or organ space) classified according to the criteria established by the Centers for Disease Control and Prevention within 1 year after surgery. Secondary outcomes included antibiotic-related complications, unplanned additional operations, oncologic and functional outcomes, and mortality. RESULTSOf the 604 patients included in the final analysis (mean [SD] age, 41.2 [21.9] years; 361 [59.8%] male; 114 [18.9%] Asian, 43 [7.1%] Black, 34 [5.6%] Hispanic, 15 [2.5%] Indigenous, 384 [63.8%] White, and 12 [2.0%] other), 293 were randomized to a 5-day regimen and 311 to a 1-day regimen. A surgical site infection occurred in 44 patients (15.0%) allocated to the 5-day regimen and in 52 patients (16.7%) allocated to the 1-day regimen (hazard ratio, 0.93; 95% CI, 0.62-1.40; P = .73). Antibiotic-related complications occurred in 15 patients (5.1%) in the 5-day regimen and in 5 patients (1.6%) allocated to the 1-day regimen (hazard ratio, 3.24; 95% CI, 1.17-8.98; P = .02). Other secondary outcomes did not differ significantly between treatment groups.CONCLUSIONS AND RELEVANCE This randomized clinical trial did not confirm the superiority of a 5-day regimen of postoperative intravenous antibiotics over a 1-day regimen in preventing surgical site infections after surgery for lower extremity bone tumors that required an endoprosthesis. The 5-day regimen group had significantly more antibiotic-related complications.
Introduction The human temperature control within the thermoneutral zone (TNZ) depends on the regulation of skin blood flow to hands and feet (acral skin) [1]. The acral skin blood flow is regulated by absolute level and fluctuations in arterio‐venous anastomoses’ vasculature resistance. We hypothesized that a change in ambient temperature would not affect the hemodynamic responses within the TNZ in healthy humans. Methods Twenty‐four young healthy human subjects were exposed to three ambient temperatures (20°C, 26°C and 32°C) while supine and lightly dressed in a climate chamber. Each temperature plateau lasted for 40 minutes. The protocol either started at 20°C or 32°C, with a subsequent increase or decrease in temperature, respectively, and the order was randomized. Beat‐by‐beat blood flux from both index fingers and the left forearm were recorded simultaneously by laser Doppler flowmetry (DRT4, Moor Instruments, Devon, UK), together with heart rate (HR, from ECG). Non‐invasive finger arterial blood pressure (Finometer, Finapres Medical System, Netherlands; calibrated at each temperature plateau) was recorded continuously from the right middle finger, providing mean arterial pressure (MAP) and estimated beat‐to‐beat cardiac stroke volume (SV). The medians and their corresponding 95% confidence intervals were calculated by Hodges‐Lehmann’s estimates. Wilcoxon signed rank sum test for paired samples tested differences between states. Preliminary results Increasing ambient temperature from 20°C to 32°C caused a five‐fold increase in left fingertip flux (p<0.003) while left forearm flux doubled (p<0.008). The fluctuations in the bilateral fingertip flux were maximum correlated at 26°C (>0.82) and significantly higher than the correlation at 32°C (0.73, p<0.01 as compared to 26°C). The hemodynamic variables changed significantly within the TNZ. MAP decreased from 74 (70,77) mmHg at 20°C to 64 (60,68) mmHg at 32°C (p<0.0001). SV decreased from 102 (93, 113) ml at 20°C to 97 (86, 106) ml at 32°C (p<0.0004). HR increased minimally from 20°C (56 bpm (52, 59) to 32°C (58 bpm (56, 61) (p=0.01). Conclusions The marked changes in acral skin blood flow within TNZ affected the central hemodynamic variables, with the vasodilation reflected in MAP decrease coinciding with an increase in ambient temperature. HR and SV showed minimal changes within TNZ. Support or Funding Information The Research Council of Norway (grant no: 230354) Responses in acral and non-acral skin vasomotion and temperature during lowering of ambient temperatureMElstadLVanggaardAHLossiusLWalløeTK.BergersenJ Therm Biol.4516874
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