SummaryThe development of neutralizing allo-antibodies against factor VIII (FVIII) or FVIII inhibitors is a severe complication in the treatment of haemophilia A. About 25% of the children with severe haemophilia A develop FVIII inhibitors. Here we report on a boy with severe haemophilia A and intron 22 inversion of the FVIII gene who was diagnosed at ten months of age. After 16 exposure days to FVIII (81 days after initial exposure) he developed a FVIII inhibitor (maximum: 9.76 BU/ml). Therapy: We started immune tolerance induction (ITI) according to the Bonn protocol with high dose plasma derived FVIII concentrate (100 IU per kg body weight) twice daily. For additional inhibitor elimination treatment the patient received intravenous immunoglobulin (ivIg) at a dose of 1–2 g/kg body weight every 4 to 6 weeks. After start of treatment a rapid decline of the inhibitor level was observed, nevertheless low FVIII inhibitor levels persisted (<5 BU/ ml). Furthermore, the FVIII half-life was still accelerated. However, after every course of ivIg the inhibitor level declined and FVIII half-life was prolonged. Currently, the FVIII half-life is approaching normal values after more than seven months of ITI duration. Conclusion: Additional application of immunoglobulin is beneficial for immune tolerance induction.
Footwear properties can influence physiological and biomechanical variables, which may lead to positive changes in distance running performance. One innovative development in running shoe technology is adding carbon fiber plates to increase midsole bending stiffness. However, there are only a few studies investigating the influence of shoe conditions on both physiological and biomechanical variables, simultaneously, when running for longer than 5 min or for distances > 1 km. Hence, the purpose of the current study was to investigate the influence of different running shoe concepts with carbon fiber plates on physiological and biomechanical parameters during a 10 km treadmill run. Twenty-three athletes participated in the study, which comprised four measurement days for each subject. On the first day, subjects performed a treadmill exhaustion test to determine maximum oxygen uptake. On the second, third, and fourth days, each subject ran 10 km at 70% of their maximum oxygen uptake in one of three shoe models. Significant differences were found between the shoe conditions for the biomechanical parameters, but not for the physiological parameters. It seems that runners adjusted their running styles to the shoe conditions during the 10 km run to reduce the load on the lower extremities without compromising their endurance performance. These results may have practical implications for runners, coaches, and shoe manufacturers.
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