Exercise intolerance in chronic heart failure : mechanisms and therapies. Part I

Muscular fatigue and dyspnoea on exertion are among the most common symptoms in chronic heart failure; however their origin is still poorly understood. Several studies have shown that cardiac dysfunction alone cannot fully explain their origin, but the contribution of the multiorgan failure present in this syndrome must be highlighted. In this study, divided in two parts (see part II: pp. 643-648), we aimed to summarize the existing evidence and the most controversial aspects of the complex interplay of different factors involved in symptom generation. In this first part of the review, six key factors are revised: the heart, the lung, the skeletal muscle, the hormonal changes, the O-2 delivery to the periphery, the endothelium. In the second part, the role of the excitatory reflexes and the cardiac cachexia will be presented, and finally, the potential therapeutic implications are discussed. We believe that a better knowledge of the pathophysiology of this syndrome may contribute to the management of the patients and to the improvement in their stress tolerance and quality of life. Eur J Cardiovasc Prev Rehabil 17:637-642 (C) 2010 The European Society of Cardiolog

Future directions for early career researchers in planetary health equity

Achieving social and health equity on a healthy planet requires attending to the structural drivers of intersecting crises of global environmental change, social inequities, and health inequities. A diverse group of early career researchers have formed a new network aligned in advancing work that promotes planetary health equity. This Perspective articulates proposed future research directions emerging from shared understandings of intersecting governance and policy challenges, including sections on transdisciplinary and co-productive knowledge paradigms; political economy and governance; policy integration; and opportunities to advance planetary health equity. We present this agenda with reference to a range of substantive environmental- and health-related domains, including food systems governance, trade policy, energy policy, urban planning, and education. As early career researchers in the emerging field of planetary health equity, these future directions for research are intended to offer novel avenues towards the goals of social and health equity in a stable Earth system

Functional overload attenuates plantaris atrophy in tumor-bearing rats

Background Late stage cancer malignancies may result in severe skeletal muscle wasting, fatigue and reduced quality of life. Resistance training may attenuate these derangements in cancer patients, but how this hypertrophic response relates to normal muscle adaptations in healthy subjects is unknown. Here, we determined the effect of resistance training on muscle mass and myosin heavy chain (MHC) isoform composition in plantaris muscles from tumor-bearing (TB) rats. Methods Age- and gender-matched Buffalo rats were used for all studies (n = 6/group). Suspensions of Morris Hepatoma MH7777 cells or normal saline were injected subcutaneously into the dorsum. Six weeks after cell implantation, muscles from TB rats were harvested, weighed and processed for ATP-independent proteasome activity assays. Once tumor-induced atrophy had been established, subgroups of TB rats underwent unilateral, functional overload (FO). Healthy, sham-operated rats served as controls. After six weeks, the extent of plantaris hypertrophy was calculated and MHC isoform compositions were determined by gel electrophoresis. Results Six weeks of tumor growth reduced body mass and the relative masses of gastrocnemius, plantaris, tibialis anterior, extensor digitorum longus, and diaphragm muscles (p ≤ 0.05). Percent reductions in body mass had a strong, negative correlation to final tumor size (r = -0.78). ATP-independent proteasome activity was increased in plantaris muscles from TB rats (p ≤ 0.05). In healthy rats, functional overload (FO) increased plantaris mass ~44% compared to the contralateral control muscle, and increased the relative percentage of MHC type I and decreased the relative percentage of MHC type IIb compared to the sham-operated controls (p ≤ 0.05). Importantly, plantaris mass was increased ~24% in TB-FO rats and adaptations to MHC isoform composition were consistent with normal, resistance-trained muscles. Conclusion Despite significant skeletal muscle derangements due to cancer, muscle retains the capacity to respond normally to hypertrophic stimuli. Specifically, when challenged with functional overload, plantaris muscles from TB rats displayed greater relative mass, increased percentages of MHC type I and decreased percentages of MHC type IIb. Therefore, resistance training paradigms should provide relative morphological and functional benefits to cancer patients suffering from muscle wasting.Published versio

T Regulatory Cells Are Markers of Disease Activity in Multiple Sclerosis Patients

FoxP3+ Treg cells are believed to play a role in the occurrence of autoimmunity and in the determination of clinical recurrences. Contradictory reports are, however, available describing frequency and function of Treg cells during autoimmune diseases. We examined, by both polychromatic flow cytometry, and real-time RT-PCR, several Treg markers in peripheral blood mononuclear cells from patients with multiple sclerosis (MS), an autoimmune disease affecting the central nervous system. We found that Tregs, as defined by CD25, CD39, FoxP3, CTLA4, and GITR expression, were significantly decreased in stable MS patients as compared to healthy donors, but, surprisingly, restored to normal levels during an acute clinical attack. We conclude that Treg cells are not involved in causing clinical relapses, but rather react to inflammation in the attempt to restore homeostasis

Sequele psicosessuali delle neoplasie ginecologiche. Revisione della letteratura

Questo lavoro intende valutare l\u2019impatto del cancro ginecologico sulla qualit\ue0 della vita delle pazienti e pi\uf9 in generale della coppia, analizzando, attraverso un\u2019analisi critica della letteratura pi\uf9 recente, le conseguenze sul piano psicologico e su quello del funzionamento sessuale. Avendo come obiettivo il miglioramento dello stato di salute della donna, e non pi\uf9 meramente la sua guarigione \u2013 l\ue0 dove possibile - da uno stato di malattia, siamo interessati a tutto ci\uf2 che pu\uf2 contribuire a innalzare il livello di benessere della donna, attraverso una adeguata prevenzione delle possibili sequele negative