Joynermaher1729

The authors present a case of delayed radiation myelopathy in a 12-year-old girl with Hodgkin lymphoma and Artemis mutation. This is the first of such a case presented in the literature.Congenital afibrinogenemia is a rare disorder characterized by a lack of detectable fibrinogen. The mainstay of treatment for acute bleeding episodes or perioperative management is replacement with fibrinogen concentrate or fibrinogen-containing blood products. The development of neutralizing antibodies and severe allergic reactions to fibrinogen replacement is rarely reported in afibrinogenemia patients. Here the treatment regimen is described for a 6-year-old girl with a severe allergic reaction to multiple fibrinogen-containing products who became refractory to treatment because of a presumed inhibitor to fibrinogen.BACKGROUND Thrombopoietin receptor agonists are emerging as a therapeutic option for patients with aplastic anemia (AA) and myelodysplastic syndrome (MDS). We report our experience of treating children with AA/MDS with romiplostim, thrombopoietin receptor agonist. OBSERVATIONS Three children (AA, 2; MDS, 1) received romiplostim treatment at a median dose of 10 μg/kg/week (starting dose 5 μg/kg/wk; 2.5 μg/kg/wk increment). Trilineage hematopoietic recovery occurred at a median of 13 weeks (range 13 to 16 wk) without adverse events. Hematopoiesis continued to improve after therapy discontinuation (median follow-up 2.8 y; range 0.5 to 3.0). CONCLUSION Our experience supports the short-term safety and efficacy of romiplostim in children with AA/MDS.BACKGROUND Community-based interventions are vital for facilitating poststroke recovery, increasing community participation, and raising awareness about stroke survivors. To optimize recovery and community reintegration, there is a need to understand research findings on community-based interventions that focus on stroke survivors and their caregivers. Although nurses and community health workers (CHWs) are commonly involved in community-based interventions, less is known about their roles relative to other poststroke rehabilitation professionals (physical therapists, occupational therapists, and speech-language pathologists). Thus, the purpose of this review is to explore research focused on improving community-based stroke recovery for adult stroke survivors, caregivers, or both when delivered by nurses or CHWs. METHODS A systematic review using Scopus, PubMed, EBSCOhost, MEDLINE, CINAHL Complete, and PsycInfo was completed to identify community-based poststroke intervention studies using nurses or CHWs through August 2018. RESULTS Eighteen studies meeting inclusion criteria from 9 countries were identified. Details regarding nurses' and CHWs' roles were limited or not discussed. Interventions emphasized stroke survivor self-care and caregiver support and were offered face-to-face and in group sessions in the community and home. A wide range of instruments were used to measure outcomes. The results of the interventions provided were mixed. Improvements were observed in perceptions of health, quality of life, knowledge, self-efficacy, self-management, and caregiver support. CONCLUSION Nurses and CHWs play a pivotal role in community-based care. Evidence suggests community-based interventions facilitate the necessary support for stroke survivors, caregivers, families, and communities to optimize stroke recovery. VX970 Data from this review illustrate a continued need for comprehensive programs designed to address the complex needs of stroke survivors and families when they return to their homes and communities.PURPOSE Peripartum cardiomyopathy, a traumatic life-threatening type of heart failure, occurs in the last trimester of pregnancy or shortly after childbirth. Little is known about psychological or emotional conditions women experience with peripartum cardiomyopathy. The purpose of this study was to examine relationships among post-traumatic stress, depression, and quality of life in women with peripartum cardiomyopathy. DESIGN AND METHODS This cross-sectional, correlational survey study included 28 participants recruited via public notice on Facebook. link2 Participants completed the Horowitz Impact of Events Scale, the Center for Epidemiology Scale-Depression 20, and the Ferrans & Powers Quality of Life Index-Cardiac Version-IV. RESULTS Post-traumatic stress correlated significantly and positively with depression (r = .809, p less then .001). Post-traumatic stress and depression correlated significantly and inversely with quality of life (r = -.455, p = .015), (r = -.544, p = .003), respectively. All participants measured positive for depression. Participants with lower education scored higher on post-traumatic stress and depression, whereas those unemployed or disabled registered a lower quality of life. CLINICAL IMPLICATIONS Nurses, midwives, and physicians caring for women with cardiomyopathies must be vigilant for evidence of post-traumatic stress, depression, and poor quality of life. Targeted antenatal and postnatal support could be vital to emotional and psychological recovery.Hebisz, R, Hebisz, P, Danek, N, Michalik, K, and Zatoń, M. Predicting changes in maximal oxygen uptake in response to polarized training (sprint interval training, high-intensity interval training, and endurance training) in mountain bike cyclists. J Strength Cond Res XX(X) 000-000, 2020-The aim of this study was to determine the predictors of change in maximal oxygen uptake (ΔV[Combining Dot Above]O2max) in response to a polarized training program. Twenty well-trained mountain bike cyclists completed an 8-week intervention of sprint interval training (SIT) (8-16 30-second maximal sprints), high-intensity interval training (4-6 bouts at 85-95% maximal aerobic power), and endurance training (2-3 hours cycling at 70-80% power at the ventilatory threshold). An incremental exercise test was performed to determine preintervention and postintervention maximal oxygen uptake (V[Combining Dot Above]O2max) and maximal pulmonary ventilation (VEmax) normalized to lean body mass (LBM). The frequency and time domain of heart rate variability (HRV) was also determined during recovery after moderate warm-up in the first and last SIT. Training status was quantified as the total distance cycled in the previous year. V[Combining Dot Above]O2max, VEmax, and the root mean square of the successive differences of normal-to-normal time interval between heartbeats (RMSSD), which is the time domain of HRV all increased significantly. Multiple significant correlations were observed between ΔV[Combining Dot Above]O2max and training status and baseline measures of VEmax·LBM, RMSSD, and V[Combining Dot Above]O2max·LBM and a regression equation was developed (r = 0.87, r = 0.76; p = 0.0001). The change in V[Combining Dot Above]O2max in response to polarized training can be predicted with high accuracy based on several measurable variables.ter Beek, F, Jokumsen, PS, Sloth, BN, Thomas Stevenson, AJ, and Larsen, RG. Ischemic preconditioning attenuates rating of perceived exertion but does not improve maximal oxygen consumption or maximal power output. J Strength Cond Res XX(X) 000-000, 2020-Brief consecutive periods of limb ischemia and reperfusion, known as ischemic preconditioning (IPC), have been reported to increase maximal power output (MPO) during cycling. However, the underlying mechanisms are unclear. Therefore, the purpose of the study was to investigate the effects of IPC on MPO, maximal oxygen consumption (V[Combining Dot Above]O2max), muscle oxygenation, and rating of perceived exertion (RPE) during an incremental cycling test. Fourteen healthy young men participated in this double-blinded, randomized crossover study, involving IPC (250 mm Hg; four 5-minute cycles of ischemia) and sham (20 mm Hg) treatment followed by an incremental cycling test to exhaustion. During the cycling test, V[Combining Dot Above]O2, RPE, heart rate (HR), blood lactate (BL), and muscle oxygenation and deoxygenation (near-infrared spectroscopy) were measured. MPO, V[Combining Dot Above]O2max, HRmax, and muscle deoxygenation did not change with IPC (all p-values > 0.13). Furthermore, IPC had no significant effect on V[Combining Dot Above]O2, HR, or muscle oxygenation during the incremental cycling test (all p-values > 0.18). However, IPC attenuated RPE during cycling at 210 W (IPC median 17.0 [interquartile range 15.3-19.0]; sham 17.5 [17.0-19.0]; p = 0.007) and 245 W (IPC 18.0 [17.0-18.8]; sham 19.0 [18.0-19.8]; p = 0.011). A single session of IPC did not improve MPO, V[Combining Dot Above]O2max, or measures of oxygen consumption during the cycling test. However, IPC lowered RPE at 210 and 245 W, suggesting that IPC may attenuate the perception of effort at higher submaximal exercise intensities.Rothschild, J, Sheard, AC, and Crocker, GH. Influence of a 2-km swim on the cycling power-duration relationship in triathletes. J Strength Cond Res XX(X) 000-000, 2020-Triathletes must cycle after swimming, and so, it is important to understand how cycling performance may be affected by prior swimming. Therefore, the purpose of this study was to determine the effects of a 2-km swim at a self-selected race-pace intensity on the cycling power-duration relationship. Eighteen trained triathletes (12 M, 6 F; 37.1 ± 10.6 years, V[Combining Dot Above]O2max 54.8 ± 10.1 ml·kg·min) performed two 3-minute all-out cycling tests (3MTs) on separate days with one 3 MT immediately after a 2-km swim (swim-bike [SB]) and one without prior swimming (bike-only [BO]). The power-duration relationship was expressed as the total work done (TWD) and subdivided into end-test power (EP) and work done above EP. To assess swimming intensity, heart rate (HR) was continuously monitored during the 2-km swim and blood lactate was assessed on completion of the swim. End-swim lactate was 4.2 ± 1.8 mM, and mean swimming HR was 147 ± 18 b·min. The 2-km swim decreased TWD during the 3MT by 6% (BO 62.8 ± 12.7 kJ; SB 58.9 ± 13.4 kJ; p = 0.001) though neither EP (BO 281 ± 65 W; SB 269 ± 68 W; p = 0.102) nor work done above EP (BO 12.1 ± 3.8 kJ; SB 10.5 ± 4.2 kJ; p = 0.096) differed between trials. In conclusion, TWD while cycling decreases after a 2-km race-pace swim. Results from this study suggest that triathletes should determine racing cycling power following a simulated race-pace swim.Nunes, GS, Barton, CJ, and Serrão, FV. Impaired knee muscle capacity is correlated with impaired sagittal kinematics during jump landing in women with patellofemoral pain. link3 J Strength Cond Res XX(X) 000-000, 2020-Knee and hip muscle capacity is impaired in women with patellofemoral pain (PFP), but little is known about the rate of force development (RFD) at the knee. Impaired muscle capacity may contribute to reduced sagittal plane movement at the knee and hip during jump landing in women with PFP. This study aimed to (a) compare knee extensor muscle capacity (including RFD), and hip abductor and extensor muscle capacity between women with and without PFP; and (b) evaluate the relationship between hip/knee muscle capacity and sagittal kinematics during single-legged drop jump landing in women with PFP. Fifty-two physically active women (26 with PFP and 26 controls) participated. Rate of force development (in %/ms), isometric, concentric, and eccentric torque (in N·m·kg × 100) were evaluated using isokinetic dynamometry, and knee and hip kinematics were evaluated using three-dimensional motion capture.