PMID: 

Eur Rev Aging Phys Act. 2015 ;12:8. Epub 2015 Nov 2. PMID: 26865872

Abstract Title: 

Health benefits of cycle ergometer training for older adults over 70: a review.

Abstract: 

As the number of older adults continues to increase worldwide, more attention is being paid to geriatric health care needs, and successful ageing is becoming an important topic in the medical literature. A preventive approach to the care of older adults is thus a priority in our aging societies. The purpose of this study was to update evidence for the health benefits of cycle ergometer training for older adults over 70. We searched online electronic databases up to September 2014 for original observational and intervention studies on the relationship between cycle ergometer training and health among older patients over 70. Twenty-five studies examined interventions aimed specifically at promoting cycling for older adults over 70. These studies reported a positive effect on the prevention of cardiovascular disease, and a significant improvement in metabolic responses. Improving functional status, muscle strength and cognitive performance are also well established. Overall, this review demonstrates a positive effect of cycle ergometer training with functional benefits and positive health outcomes for older adults over 70. Based on this evidence, clinicians can now encourage older adults to profit from the health benefits of cycle ergometer training to be able to pursue their daily activities independently.

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PMID: 

Exp Gerontol. 2019 Dec 31 ;131:110799. Epub 2019 Dec 31. PMID: 31899340

Abstract Title: 

Cycle Training improves vascular function and neuropathic symptoms in patients with type 2 diabetes and peripheral neuropathy: A randomized controlled trial.

Abstract: 

Diabetic peripheral neuropathy (DPN) is associated with peripheral arterial disease and endothelial dysfunction. We investigated the effect of exercise training on the measures of superficial femoral artery (SFA) and neuropathic symptoms in patients with DPN. In a randomized-controlled trial, 31 volunteers with established DPN were randomly assigned to experimental or control groups. Experimental group performed cycling exercise training (50%-70% of heart rate reserve, 30-45 min, 3 sessions/week) over 12 weeks. Before and 48 h after the experimental period a 5-min flow mediated dilation (FMD) response in SFA using Color Doppler Ultrasonography, fasting glucose level, HbA1c and neuropathic score were assessed. FMD% significantly increased in the experimental group (from 3.2 ± 1.1% to 5.7 ± 1.2%) compared to the control condition (P = 0.0001). However, no significant alteration occurred in baseline membrane diameter and intima media thickness (P > 0.05). We also observed a significant improvement in fasting glucose, HbA1c and Michigan Diabetic Neuropathy Score (MDNS) following exercise intervention (all P 

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PMID: 

Med Sci Sports Exerc. 2019 Dec 23. Epub 2019 Dec 23. PMID: 31876670

Abstract Title: 

Exercise Effects on Multiple Sclerosis Quality of Life and Clinical-Motor Symptoms.

Abstract: 

INTRODUCTION: Different therapies can improve clinical and motor symptoms of multiple sclerosis (MS) similarly but studies comparing the effects of different exercise therapies on clinical and motor outcomes are scant. We compared the effects of exergaming (EXE), balance (BAL), cycling (CYC), proprioceptive neuromuscular facilitation (PNF), and a standard care wait-listed control group (CON) on clinical and motor symptoms and quality of life (QoL) in people with MS (PwMS).METHODS: PwMS (n=68, 90% females; age: 47.0y, Expanded Disability Status Scale: 5 to 6) were randomized to 5 groups. Before and after the interventions (5x/week for 5 weeks) PwMS were tested for: MS-related clinical and motor symptoms (Multiple Sclerosis Impact Scale-29; MSIS-29, primary outcome), QoL (EQ-5D), symptoms of depression, gait and balance ability (Tinetti Assessment Tool, TAT), static and dynamic balance and fall risk (Berg Balance Scale (BBS), walking capacity (six-minute walk test, 6MWT), and standing posturography on a force platform.RESULTS: EXE, BAL, and CYC improved MSIS-29 scores similarly. EXE and CYC improved QoL and walking capacity similarly but more than BAL. Only EXE improved gait and balance scores (TAT). EXE and BAL improved fall risk and standing balance similarly but more than CYC. PNF and CON revealed no changes. EQ-5D moderated the exercise effects on MSIS-29 scores only in EXE. Changes in QoL and changes in MSIS-29 scores correlated R=0.73 only in EXE.CONCLUSION: In conclusion, BAL and CYC but EXE in particular, but not PNF, can improve clinical and motor symptoms and QoL in PwMS (EDSS: 5 to 6), expanding the evidence-based exercise options to reduce mobility limitations in PwMS.

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PMID: 

Behav Neurol. 2019 ;2019:4829572. Epub 2019 Dec 5. PMID: 31885725

Abstract Title: 

Long-Term Voluntary Physical Exercise Exerts Neuroprotective Effects and Motor Disturbance Alleviation in a Rat Model of Parkinson's Disease.

Abstract: 

Background: Parkinson's disease (PD) is the second most prevalent neurodegenerative disorder affecting 7-10 million individuals. The pathologic hallmark of PD is nigrostriatal dopaminergic neuron loss, leading to several motor and nonmotor disturbances, such as akinesia, gait disturbance, depression, and anxiety. Recent animal studies have demonstrated that physical exercise improves behavioral and neuropathological deficits in PD. However, the exact underlying mechanism underlying this effect remains unclear. In this study, we investigated whether long-term exercise has neuroprotective effects on dopaminergic nigrostriatal neurons and whether it further alleviates impairment of the gait pattern, locomotor activity, akinesia, and anxiety-like behavior in PD rats.Methods: A hemiparkinsonian rat model, generated by unilateral injection of 6-hydroxydopamine (6-OHDA) into the medial forebrain bundle, was applied to evaluate neuroprotective effects and motor behaviors. Comprehensive spatiotemporal gait analysis, open-field locomotor activity, akinesia, apomorphine-induced rotational analysis, and dopaminergic neuron degeneration level were assessed every week and up to 8 weeks after daily voluntary running wheel exercise.Results: Compared with the sham-treated group, we found that 10 weeks of voluntary exercise (i.e., 2-week exercise before PD lesion and 8-week exercise post-PD lesion) significantly reduced 6-OHDA-induced motor deficits in the gait pattern, akinesia, and rotational behavior in the exercise group. Immunohistochemically, a tyrosine hydroxylase-positive neuron in the substantia nigra was significantly preserved in the exercise group.Conclusions: Our results demonstrated that long-term exercise training is effective for neuroprotection and further attenuates motor declines induced by 6-OHDA in an experimental model of PD. Our data further highlighted potential therapeutic effects of long-term physical exercise relevant to clinical effects for further potential application on human PD subjects.

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PMID: 

Biomed Res Int. 2019 ;2019:2308475. Epub 2019 Nov 22. PMID: 31886182

Abstract Title: 

Effectiveness of Exercise Programs on Patients with Dementia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Abstract: 

Exercise programs have been introduced to improve cognitive function, whereas studies showed inconsistent results regarding the effectiveness of exercise programs on patients with dementia. This study aimed to summarize randomized controlled trials (RCTs) to assess the effect of exercise programs on cognition, activities of daily living (ADL), and depression in elderly with dementia. We systematically screened PubMed, Embase, and the Cochrane library for relevant studies throughout November 21, 2018. The pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were employed to calculate cognition, ADL, and depression by using random-effects model. A total of 20 RCTs with 2,051 dementia patients were included in final quantitative meta-analysis. There were no significant differences between exercise programs and control regarding cognition (SMD: 0.44; 95% CI: -0.21-1.09;=0.183), ADL (SMD: 0.50; 95% CI: -0.03-1.02;=0.066), and depression (SMD: -0.43; 95% CI: -0.90-0.05;=0.077). Sensitivity analysis results indicated that exercise programs might play an important role in cognition and ADL, whereas the depression level was unaltered by the exclusion of any particular study. Subgroup analyses indicated that exercise programs were associated with increased cognitive levels if the mean age of patients was

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PMID: 

Arch Pediatr. 2006 Feb ;13(2):175-80. Epub 2005 Dec 15. PMID: 16343870

Abstract Title: 

[Pharmacovigilance of vaccines].

Abstract: 

Safety of vaccines must be excellent to make vaccine's strategy acceptable, since it usually has a deferred individual benefit but immediate adverse drug reactions (ADRs). Pharmacovigilance of vaccines after their marketing is crucial because, prior to its availability on the market, the size of clinical trials is insufficient to identify rare or deferred adverse effects. The Pharmacovigilance is based on"spontaneous reporting"of ADRs to the Pharmacovigilance Regional Centre (PVRC) which establishes a relationship between each drug taken by the patient and the ADRs occurrence (imputability). This method is crucial to generate alerts, but under-estimates the real frequency of ADRs (1 to 10% of severe ADRs are reported). Thus pharmacoepidemiology studies are necessary to confirm the alerts identified by spontaneous reporting. ADRs can be specific, related to the antigen of an attenuated alive virus vaccine (lymphocyte meningitis after anti-mumps vaccine) or non-specific, related to a component different from the antigen (aluminium hydroxide involved in the"macrophagic myofasciitis", allergic reactions to neomycin, latex, egg or gelatine). Importance of Pharmacovigilance of vaccines is illustrated. Data, especially case-control studies, about the relationship between multiple sclerosis and hepatitis B vaccine are summarised. Data about the relationship between Crohn's disease or autism and MMR vaccine are analysed. As vaccines are used in healthy people, their safety must be excellent to be accepted. To monitor them after their marketing is the unique way to detect rare ADRs. This surveillance is made through reporting of ADRs to the PVRC. However, an active and intensive surveillance of ADRs as the one set up from the marketing of Prevenar should be systematic.

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PMID: 

Contact Dermatitis. 1988 Mar ;18(3):143-6. PMID: 3365966

Abstract Title: 

Allergy to non-toxoid constituents of vaccines and implications for patch testing.

Abstract: 

We report 3 patients with persistent symptoms at vaccination sites. All were allergic to aluminium and one to thiomersal and neomycin too. Aluminium allergy causes false positive patch test reactions and we propose methods of patch testing patients with symptoms at vaccination sites in order to avoid this problem. The practical relevance of allergy to non-toxoid constituents of vaccines is discussed.

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PMID: 

Curr Allergy Rep. 2001 Jan ;1(1):11-7. PMID: 11899279

Abstract Title: 

Allergenic components of vaccines and avoidance of vaccination-related adverse events.

Abstract: 

Vaccines have had a dramatic effect on the prevalence of communicable diseases, but, in selected individuals, the injection presents a risk of anaphylaxis. Fortunately, most people have no allergic reactions to vaccines. In egg-allergic individuals, care must be taken before administering specific vaccines; the algorithm provided in this article gives specific recommendations for skin testing and desensitization. This algorithm is not needed for individuals receiving the measles-mumps-rubella vaccine because the risk of anaphylaxis is extremely low, even in those with known egg-protein sensitivity. Some individuals have gelatin sensitivity, which may cause anaphylaxis. Selected vaccines contain antibiotic drugs, so it is important to note if an individual has any known drug sensitivity, especially to neomycin, polymyxin B, or amphotericin B. Lastly, vaccine preservatives may cause reactions, but this occurs very infrequently.

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PMID: 

Allergol Immunopathol (Madr). 2003 May-Jun;31(3):125-38. PMID: 12783762

Abstract Title: 

[Adverse reactions to vaccines].

Abstract: 

Adverse reactions to vaccines are highly varied, ranging from mild local reactions to fatal outcomes. In the last few years many adverse reactions have been attributed to vaccines, often without justification. In agreement with the World Health Organization, these reactions can be classified as follows, depending on the cause: vaccination-induced reactions (due to an effect of the vaccine itself or to an idiosyncrasy); reactions due to errors in storage, manipulation and/or administration; and coincidental reactions (no causal relationship with the vaccine). Hypersensitivity reactions fall into six categories, depending on the causative agent: reactions due to some component of the infectious agent or one of its products; reactions due to adjuvants: aluminium hydroxide; reactions due to stabilizers: gelatin; reactions due to preservatives: thiomersal; reactions due to antibiotics: neomycin; and reactions due to a biological culture medium: chicken embryo cells. Allergic children should not be excluded from the normal vaccine calendar. Immunologically, allergic individuals are more susceptible to infection and to microbial and viral diseases, which often play an aggravating role. Rubella, whooping cough, and influenza usually exacerbate respiratory allergies. Non-vaccination carries a marked risk of contracting serious diseases such as poliomyelitis, tetanus, and diphtheria, etc. In a not too distant future, the techniques of genetic recombination and monoclonal antibody production will allow the creation of vaccines from organisms that cannot be cultivated in the laboratory or that produce small quantities of antigen. These techniques will also lead to identification of the antigens with the greatest immunogenic power and, consequently, to extremely pure vaccines. The adverse reactions to vaccines referred to our service account for between 0.59 % and 1.27 % of first visits in the last three years. We recorded a total of 48 adverse reactions to vaccines. Of these, 44 were attributed to the tetanus vaccine (92 %), 2 to the measles-mumps-rubella vaccine (4 %) and 2 to the meningitis A and C vaccine (4 %). Clinical features consisted of urticaria (11 cases), urticaria with angioedema (7 cases), pseudo-shock (5 cases), fever and urticaria (4 cases), local reactions (4 cases), persistent crying with exanthema (3 cases), giant local reactions with angioedema of the limb (3 cases), anaphylaxis (3 cases), fever>39.5 C (2 cases), bronchospasm (1 case), and severe atopic dermatitis (1 case).A regimen of hyposensitization to tetanus toxoid was required in 20 patients (45 %); in three, this could not be completed due to generalized urticaria but all the patients presented protective titers with diluted vaccine.

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PMID: 

BMJ. 2016 Oct 13 ;355:i5170. Epub 2016 Oct 13. PMID: 27737834

Abstract Title: 

Association of BCG, DTP, and measles containing vaccines with childhood mortality: systematic review.

Abstract: 

OBJECTIVES:  To evaluate the effects on non-specific and all cause mortality, in children under 5, of Bacillus Calmette-Guérin (BCG), diphtheria-tetanus-pertussis (DTP), and standard titre measles containing vaccines (MCV); to examine internal validity of the studies; and to examine any modifying effects of sex, age, vaccine sequence, and co-administration of vitamin A.DESIGN:  Systematic review, including assessment of risk of bias, and meta-analyses of similar studies.STUDY ELIGIBILITY CRITERIA:  Clinical trials, cohort studies, and case-control studies of the effects on mortality of BCG, whole cell DTP, and standard titre MCV in children under 5.DATA SOURCES:  Searches of Medline, Embase, Global Index Medicus, and the WHO International Clinical Trials Registry Platform, supplemented by contact with experts in the field. To avoid overlap in children studied across the included articles, findings from non-overlapping birth cohorts were identified.RESULTS:  Results from 34 birth cohorts were identified. Most evidence was from observational studies, with some from short term clinical trials. Most studies reported on all cause (rather than non-specific) mortality. Receipt of BCG vaccine was associated with a reduction in all cause mortality: the average relative risks were 0.70 (95% confidence interval 0.49 to 1.01) from five clinical trials and 0.47 (0.32 to 0.69) from nine observational studies at high risk of bias. Receipt of DTP (almost always with oral polio vaccine) was associated with a possible increase in all cause mortality on average (relative risk 1.38, 0.92 to 2.08) from 10 studies at high risk of bias; this effect seemed stronger in girls than in boys. Receipt of standard titre MCV was associated with a reduction in all cause mortality (relative risks 0.74 (0.51 to 1.07) from four clinical trials and 0.51 (0.42 to 0.63) from 18 observational studies at high risk of bias); this effect seemed stronger in girls than in boys. Seven observational studies, assessed as being at high risk of bias, have compared sequences of vaccines; results of a subset of these suggest that administering DTP with or after MCV may be associatedwith higher mortality than administering it before MCV.CONCLUSIONS:  Evidence suggests that receipt of BCG and MCV reduce overall mortality by more than would be expected through their effects on the diseases they prevent, and receipt of DTP may be associated with an increase in all cause mortality. Although efforts should be made to ensure that all children are immunised on schedule with BCG, DTP, and MCV, randomised trials are needed to compare the effects of different sequences.

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