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Background Exercise training (ET) with blood flow restriction (BFR) is becoming increasingly popular, but the majority of BFR ET studies have evaluated skeletal muscle strength and hypertrophy. The favorable effect of BFR ET on skeletal muscle and the vasculature appears to improve aerobic capacity (AC) although conflicting results have been observed.Purpose: The purposes of this systematic review with meta- analysis were to examine the effects of aerobic ET with and without BFR on AC and to compare the effect of low-to-moderate aerobic ET with and without BFR to high-intensity aerobic ET with and without BFR on AC. Study design Systematic Review with Meta-analysis. Methods A comprehensive search for studies examining the effects of aerobic ET with and without BFR on AC was performed. Inclusion criteria were: (a) the study was conducted in healthy individuals, (b) there was random allocation of study participants to training and control groups, (c) BFR was the sole intervention difference between the groups. Results A total of seven studies (5 low-to-moderate ET and 2 high-intensity ET) were included in the meta-analysis providing data from 121 subjects. There was a significant standardized mean difference (SMD) of 0.38 (95% CI = 0.01, 0.75) in AC between the BFR and non-BFR groups of all seven studies (z = 2.01; p = 0.04). Separate analyses of the five low-to-moderate aerobic ET studies found similar results with aerobic ET with BFR eliciting a significantly greater AC (z = 2.47; p=0.01) than aerobic ET without BFR (SMD of 0.57; 95% CI = 0.12, 1.01). Separate analyses of the two high-intensity aerobic ET studies with and without BFR found no significant difference in AC between the groups (SMD of - 0.01; 95% CI = - 0.67, 0.64). Conclusion Aerobic ET with BFR elicits a significantly greater AC than aerobic ET without BFR in healthy young adults. However, low-to-moderate intensity aerobic ET with BFR elicited a greater improvement in AC than aerobic ET without BFR while high-intensity aerobic ET with BFR did not elicit an improvement in AC over high-intensity aerobic ET without BFR. Level of evidence 1a.

Evidence informed management of individuals presenting with subacromial impingement syndrome (SAIS) includes strengthening exercises directed at the shoulder musculature. Patients with subacromial impingement syndrome (SAIS) can present with pain during and after completion of heavy resistance training limiting the applicability of this recommended treatment approach. Blood flow restriction (BFR) training is indicated for patients who have pain while completing heavy resistance training and may represent an important treatment modification for patients with SAIS unable to fully participate in a strengthening exercise program. The purpose of this case series is to describe the inclusion of BFR in the treatment of two patients with SAIS.Two middle aged, non-operative patients with signs and symptoms consistent with SAIS and high levels of irritability were included. Treatment over one month consisted of three commonly used exercises in the treatment of SAIS in conjunction with a standard BFR protocol: 75 reps broken up into sets of 30,15,15,15 with the BFR cuff placed over proximal humerus.Immediate within session improvements beyond measurement error were observed in resting pain and pain pressure thresholds at three sites. At the end of the course of treatment, clinically meaningful improvements were observed in patient reported outcomes including the PENN Score, ASES score, and the patient-specific functional scale. Clinically meaningful improvements and change beyond measurement error were also observed in range of motion and strength which (assessed via a handheld dynamometer).The incorporation of low load resistance training with BFR may be a useful adjunct for treating patients with SAIS to promote exercise-induced hypoalgesia, decrease pain, and increase function in the upper extremity.5.

Introduction: Little evidence appears to exists for the use of anakinra, a recombinant interleukin-1 receptor antagonist, after non-response to treatment with corticosteroids alone or combined with tocilizumab in patients with severe COVID-19 pneumonia and moderate hyperinflammatory state. Patients and Methods: A retrospective observational cohort study was carried out involving 143 patients with severe COVID-19 pneumonia and moderate hyperinflammation. They received standard therapy along with pulses of methylprednisolone (group 1) or methylprednisolone plus tocilizumab (group 2), with the possibility of receiving anakinra (group 3) according to protocol. The aim of this study was to assess the role of anakinra in the clinical course (death, admission to the intensive care ward) during the first 60 days after the first corticosteroid pulse. Clinical, laboratory, and imaging characteristics as well as infectious complications were also analyzed.Results: 74 patients (51.7%) in group 1, 59 (41.3%) patients in group 2, and 10 patients (7%) in group 3 were included. 8 patients (10.8%) in group 1 died, 6 (10.2%) in group 2, and 0 (0%) in group 3. After adjustment for age and clinical severity indices, treatment with anakinra was associated with a reduced risk of mortality (adjusted hazard ratio 0.518, 95% CI 0.265-0.910; p=0.0437). Patients in group 3 had a lower mean CD4 count after 3 days of treatment. No patients in this group presented infectious complications.Conclusions: In patients with moderate hyperinflammatory state associated with severe COVID-19 pneumonia, treatment with anakinra after non-response to corticosteroids or corticosteroids plus tocilizumab therapy may be an option for the management of these patients, and may improve their prognosis.

El artículo constituye una reflexión sobre la relevancia antropológica de la acción moral sobre su propio sujeto, más allá de los criterios al uso basados en modelos interpretativos orientados a dilucidar la validez ética de las acciones externas. En este caso, el interés se centra en los efectos que las acciones tienen en el propio sujeto que las realiza, como base para una justificación de la ética desde su propio sujeto. Para ello se toma como referencia de partida un contexto profesional concreto, como es el área financiera.

Hereditary angioedema (HAE) is an infrequent, recurrent, and potentially lethal disorder caused by a deficiency of C(1) inhibitor or its activity. Abdominal pain secondary to bowel edema is common in these patients. However, a thorough literature search yielded only six previously reported cases of pancreatitis associated with this entity.

El aceite de mora es un ingrediente natural con potencial en la industria cosmética y alimentaria, a su vez puede experimentar degradación oxidativa en condiciones ambientales. Por ello, se extrajo aceite a partir de semillas de mora empleando fluidos supercríticos y, posteriormente, se microencapsuló mediante secado por aspersión y se evaluó la influencia de diferentes condiciones de operación en el rendimiento, y la eficiencia del proceso. Se emplearon como materiales encapsulantes: masterdry, goma arábiga y maltodextrina. Se estudió el tamaño y morfología de las microcápsulas. Se determinó que en el proceso de microencapsulación la temperatura de entrada fue la única variable estadísticamente significativa que afectó el rendimiento y la eficiencia, cuando se usaron como encapsulantes masterdry y goma arábiga. El caudal de alimentación fue estadísticamente significativo sólo para el rendimiento del proceso y lo influenció negativamente cuando se usó maltodextrina. La goma arábiga resultó ser el mejor encapsulante entre los tres estudiados. Se obtuvieron microcápsulas con tamaños entre 8,2 y 14 μm, con superficie continua en las paredes y ausencia de poros. Se comprobó que la microencapsulación con los tres encapsulantes permitió proteger el aceite y conservar mayoritariamente su perfil de ácidos grasos. Blackberry oil is a natural ingredient with potential in cosmetics and food industry, however, it experiences oxidative degradation at ambient conditions. Therefore, oil was obtained from blackberry seeds by supercritical fluid extraction and then was microcapsulated by spray drying. The influence of different operating conditions during freeze-drying towards yield and encapsulation was evaluated. Masterdry, gum arabic and maltodextrin were used as wall materials. Morphology and size of the microcapsules were also studied. Inlet temperature was the only statistically significant variable in process yield and efficiency when gum arabic and masterdry were used. Feed flow rate was statistically significant only for process yield and it was influenced negatively when maltodextrin was used. Gum arabic was the best wall material among the three studied. Microcapsules with sizes between 8.2 and 14 µm were obtained; continuous wall and no apparent cracks were observed. It was also seen that the fatty acid profile was mostly conserved after microencapsulation process carried out with the three wall materials

Hereditary angioedema (HAE) is an infrequent, recurrent, and potentially lethal disorder caused by a deficiency of C(1) inhibitor or its activity. Abdominal pain secondary to bowel edema is common in these patients. However, a thorough literature search yielded only six previously reported cases of pancreatitis associated with this entity.