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Viral reactivations following hematopoietic stem cell transplantation in pediatric patients – A single center 11-year analysis
Viral reactivation occurs frequently in the context of immunodeficiency and immunosuppression after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and can cause severe complications. The aim of this single-center retrospective analysis was to characterize viral infections in the first year after HSCT, to investigate risk factors and to study the impact of viral infections on transplantation outcome. This will facilitate the identification of at-risk patients and the development of new preventive strategies. 107 pediatric allo-HSCT from January 2005 through December 2015 were analyzed for infections with Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), adenovirus (ADV), herpes simplex virus (HSV) and varicella zoster virus (VZV). Viral infections were detected after 68.2% of transplantations. The viruses most commonly encountered were HHV-6 (36/107) and EBV (30/107). Severe viral disease was rare (7/107) and none of the patients died as result of viral reactivation. Important risk factors for viral infections were higher age at HSCT, donor type and occurrence of acute graft-versus-host disease (aGvHD). Especially for EBV, transplant from an unrelated donor and in-vivo T-cell depletion (TCD) had a significant effect on infection rates, whereas for CMV the strongest effect was seen by donor and recipient serostatus with recipient seropositivity most predictive for reactivation. The occurrence of severe aGvHD was associated with EBV and ADV infections. For HSV, the recipient serostatus was identified as prognostic factor for HSV infections, while we found higher age at time of HSCT as risk factor for VZV infections. The overall survival of patients with or without viral infections did not differ significantly. Interestingly, when looking at the 85 patients in our cohort who had received an HSCT for a malignant disease, a tendency towards lower relapse rates was seen in patients affected by viral infections (HR 0.51, 95% CI 0.25 - 1.06, p = 0.072). Viral reactivations are common after pediatric allo-HSCT, though severe complications were rare in our collective. Determining risk factors for viral reactivations may help to identify patients in need of intensified monitoring and to individualize preventive strategies.
Journal Article
Management of herpesvirus reactivations in patients with solid tumours and hematologic malignancies: update of the Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) on herpes simplex virus type 1, herpes simplex virus type 2, and varicella zoster virus
Abstract Clinical reactivations of herpes simplex virus or varicella zoster virus occur frequently among patients with malignancies and manifest particularly as herpes simplex stomatitis in patients with acute leukaemia treated with intensive chemotherapy and as herpes zoster in patients with lymphoma or multiple myeloma. In recent years, knowledge on reactivation rates and clinical manifestations has increased for conventional chemotherapeutics as well as for many new antineoplastic agents. This guideline summarizes current evidence on herpesvirus reactivation in patients with solid tumours and hematological malignancies not undergoing allogeneic or autologous hematopoietic stem cell transplantation or other cellular therapy including diagnostic, prophylactic, and therapeutic aspects. Particularly, strategies of risk adapted pharmacological prophylaxis and vaccination are outlined for different patient groups. This guideline updates the guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) from 2015 “Antiviral prophylaxis in patients with solid tumours and haematological malignancies” focusing on herpes simplex virus and varicella zoster virus.
Journal Article
Secrets of the human body
\"206 bones. One heart. Two eyes. Ten fingers. What makes tears of joy different from tears of sadness? Why is a gut feeling so much smarter than you think? And why is 90% of you not even human? You may think you know the human body--heart, lungs, brain and bones--but our bodies are full of extraordinary mysteries that science is only just beginning to understand. This book will change forever how we think about our bodies. Thanks to cutting-edge science and cutting-edge technology we get a tantalizing glimpse beneath our skin, and there we see the secrets that make every ordinary human body ... extraordinary.\"--Page 4 of cover.
BOOK
Haemoglobin mass responses and performance outcomes among high-performance swimmers following a 3-week live-high, train-high camp at 2320 m
AimGreater quantification and characterisation of training load (TL) throughout Live-high, train-high (LHTH) altitude (ALT) training is required to identify periodisation strategies that may lead to physiological and performance improvements in swimmers.PurposeThis study aimed to examine the physiological responses and performance outcomes of 14 high-performance swimmers (FINA points: 836.0 ± 35.1) following 3 weeks of LHTH at 2320 m, while characterising the training load periodisation strategy adopted during the intervention.MethodsHaemoglobin (Hb) mass was measured pre-, 7 and 14 days post-ALT via CO rebreathing. Performance in each athlete’s primary event at national standard meets were converted to FINA points and compared from pre-to-post-ALT. TL was quantified at sea level (SL) and ALT through session rating of perceived exertion (RPE), where duration of each session was multiplied by its RPE for each athlete, with all sessions totalled to give a weekly TL. Pre-to-post-ALT changes were evaluated using repeated-measures ANOVA.ResultsHb mass increased significantly from 798 ± 182 g pre-ALT to 828 ± 187 g at 7 days post (p = 0.013) and 833 ± 205 g 14 days post-ALT (p = 0.026). Weekly TL increased from SL (3179 ± 638 au) during week one (4797 ± 1349 au, p < 0.001) and week two (4373 ± 967 au, p < 0.001), but not week three (3511 ± 730 au, p = 0.149). No evidence of improved SL swimming performance was identified.ConclusionA periodisation strategy characterised by a sharp spike in TL followed by a slight de-load towards the end of a LHTH intervention led to improved physiological characteristics but no change in the competitive performance of high-performance swimmers.
Journal Article
How the body works : the facts simply explained
Examines \"all the complex processes that keep our bodies alive and thriving, from the basic building blocks of the body--our cells--to skin, muscles, and bones and the ways in which our many parts work together. Learn about the senses, how we read faces and body language, nutrition and immunity, the brain, sleep, memory, dreams, and much more\"--Amazon.com.
Book
Monitoring training, performance, biomarkers, and psychological state throughout a competitive season: a case study of a triathlete
IntroductionIronman triathletes undergo high workloads during competition preparation which can result in nonfunctional overreaching or overtraining syndrome if not matched with adequate recovery.PurposeThe purpose of this case study was to observe changes in physiological and psychological status over the course of a competitive season in a free-living triathlete.MethodsThe subject was a 41-year-old triathlete competing in three 113.1-km events. Over the course of a 40-week period, the participant arrived at the laboratory every 4 weeks and underwent body composition testing via air displacement plethysmography, a blood draw for analysis of various biomarkers, and a treadmill-based lactate threshold test. Workload during training and competitions was monitored via a wearable heart rate-monitoring device.ResultsThroughout the season, training volume remained high (12.5 ± 3.4 h/week) and body mass and fat-free mass (FFM) continuously decreased, while biomarkers including cortisol, testosterone, and markers of immunological status exhibited minor changes. Laboratory performance remained relatively consistent, while competition performance continually improved. Following the completion of the competitive period, training volume decreased, FFM remained below baseline levels, free cortisol increased, and both free and total testosterone decreased.ConclusionsWorkload and recovery seem to have been properly managed throughout the season, evidenced by minimal fluctuations in endocrine and immunological markers. The reason for changes observed in testosterone, cortisol, and body composition following the last competition is unclear, though it may be attributed to changes in stressors and recovery practices outside of training. It is recommended that athletes follow a structured plan during the transition period into the offseason to ensure recovery of physiological state and to set up a productive offseason.
Journal Article
What makes your body work?
\"Explains the inner workings of some of the body's major organs and systems. Readers can perform fun easy experiments that will help them measure their own lung volume or understand why the brain can decipher [letters in the wrong order in a word]. Entertaining illustrations and explanatory diagrams give details that help reveal what really makes the body work\"-- Provided by publisher.
Book
The effects of high-intensity interval training versus moderate-intensity continuous training on athletes’ aerobic endurance performance parameters
ObjectiveTo systematically evaluate and meta-analyze the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on athletes of aerobic endurance performance parameters.MethodsPubMed, Web of Science, EBSCO, Embase, and Cochrane databases were searched. The assessment of quality was conducted employing The Cochrane Risk of Bias Assessment Tool, while heterogeneity examination and subgroup analysis were performed. Moreover, regression and sensitivity analyses were executed.ResultsThere was no significant difference between the effects of HIIT and MICT on the enhancement of athletes’ running economy (RE) (P > 0.05); 1–3 weeks and 4–9 weeks of HIIT were more effective in improving athletes’ maximum oxygen uptake (VO2max) (P < 0.05), and 10 weeks and above were not significant (P > 0.05); 1–3 weeks of HIIT was more effective in improving athletes’ anaerobic threshold (AT) (P < 0.05), and 4–10 weeks was not significant (P > 0.05); 3 weeks of high-intensity interval training (HIIT) did not significantly enhance athletes’ minute ventilation (VE) (P > 0.05), whereas a duration of 6–10 weeks yielded superior results (P < 0.05); 8 weeks of moderate-intensity continuous training (MICT) did not significantly enhance athletes’ hemoglobin (Hb) level (P > 0.05), whereas a duration of 2–3 weeks yielded superior results (P < 0.05).Conclusions(1) HIIT and MICT have similar effects on enhancing athletes’ RE. (2) 6–9 weeks’ HIIT was more effective in improving athletes’ VO2max and VE, and 3 weeks’ HIIT was more effective in improving athletes’ AT. (3) Within 3 weeks, MICT was more effective in improving the Hb level of athletes.Registration number on PROSPEROCRD42024499039.
Journal Article