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The Journal of Infection Dec 2019Antibiotics change the composition of the intestinal microbiota. The magnitude of the effect of antibiotics on the microbiota and whether the effects are short-term or...
OBJECTIVE
Antibiotics change the composition of the intestinal microbiota. The magnitude of the effect of antibiotics on the microbiota and whether the effects are short-term or persist long-term remain uncertain. In this review, we summarise studies that have investigated the effect of antibiotics on the composition of the human intestinal microbiota.
METHODS
A systematic search was done to identify original studies that have investigated the effect of systemic antibiotics on the intestinal microbiota in humans.
RESULTS
We identified 129 studies investigating 2076 participants and 301 controls. Many studies reported a decrease in bacterial diversity with antibiotic treatment. Penicillin only had minor effects on the intestinal microbiota. Amoxicillin, amoxcillin/clavulanate, cephalosporins, lipopolyglycopeptides, macrolides, ketolides, clindamycin, tigecycline, quinolones and fosfomycin all increased abundance of Enterobacteriaea other than E. coli (mainly Citrobacter spp., Enterobacter spp. and Klebsiella spp.). Amoxcillin, cephalosporins, macrolides, clindamycin, quinolones and sulphonamides decreased abundance of E. coli, while amoxcillin/clavulante, in contrast to other penicillins, increased abundance of E. coli. Amoxicllin, piperacillin and ticarcillin, cephalosporins (except fifth generation cephalosporins), carbapenems and lipoglycopeptides were associated with increased abundance of Enterococcus spp., while macrolides and doxycycline decreased its abundance. Piperacillin and ticarcillin, carbapenems, macrolides, clindamycin and quinolones strongly decreased the abundance of anaerobic bacteria. In the studies that investigated persistence, the longest duration of changes was reported after treatment with ciprofloxacin (one year), clindamycin (two years) and clarithromycin plus metronidazole (four years). Many antibiotics were associated with a decrease in butyrate or butryrate-producing bacteria.
CONCLUSION
Antibiotics have profound and sometimes persisting effects on the intestinal microbiota, characterised by diminished abundance of beneficial commensals and increased abundance of potentially detrimental microorganisms. Understanding these effects will help tailor antibiotic treatment and the use of probiotics to minimise this 'collateral damage'.
Topics: Anti-Bacterial Agents; Gastrointestinal Microbiome; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Microbiota
PubMed: 31629863
DOI: 10.1016/j.jinf.2019.10.008 -
Journal of Sports Sciences Jun 2023Understanding the reliability and validity of field-based mobility and performance tests used within the wheelchair sports of basketball (WCB), rugby (WCR) and tennis... (Review)
Review
BACKGROUND
Understanding the reliability and validity of field-based mobility and performance tests used within the wheelchair sports of basketball (WCB), rugby (WCR) and tennis (WCT) can assist in understanding an athletes' physiological state, training effects, and/or assist with optimising their wheelchair-user interface.
PURPOSE
To examine, evaluate and synthesize current aerobic and anaerobic field-based mobility and performance tests used in WCB, WCR and WCT.
METHODS
A systematic search was performed according to PRISMA guidelines. Studies were included if they investigated performance tests in WCB, WCR and WCT and reported reliability.
RESULTS
Twenty-one studies covering 45 mobility/performance tests were included (anaerobic, = 35; aerobic, = 10), with agility and repeated sprints ( = 13) being the most common, followed by linear-sprints ( = 11). Repeated sprint ability ( = 2) and submaximal field-tests ( = 2) were the least frequent. Intra-class correlations among all tests ranged from 0.62 to 0.99, with agility and repeated sprints being 0.65-0.98, followed by values of 0.62-0.99 for linear-sprint, 0.96-0.99 for repeated sprints and 0.85-0.97 for submaximal field-tests.
CONCLUSION
The most frequently measured performance tests were anaerobic tests focusing on agility and repeated sprints. Given the low number of aerobic tests in WCB, WCR and WCT, future research should focus on reliable and valid ways to measure and track performance.
PubMed: 37748031
DOI: 10.1080/02640414.2023.2259726 -
Diseases of the Colon and Rectum Mar 2018Gas exchange-derived variables obtained from cardiopulmonary exercise testing allow objective assessment of functional capacity and hence physiological reserve to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Gas exchange-derived variables obtained from cardiopulmonary exercise testing allow objective assessment of functional capacity and hence physiological reserve to withstand the stressors of major surgery. Field walk tests provide an alternate means for objective assessment of functional capacity that may be cheaper and have greater acceptability, in particular, in elderly patients.
OBJECTIVE
This systematic review evaluated the predictive value of cardiopulmonary exercise testing and field walk tests in surgical outcomes after colorectal surgery.
DATA SOURCE
A systematic search was undertaken using Medline, PubMed, Embase, CINAHL, and PEDro.
STUDY SELECTION
Adult patients who had cardiopulmonary exercise testing and/or field walk test before colorectal surgery were included.
MAIN OUTCOME MEASURE
The primary outcomes measured were hospital length of stay and postoperative morbidity and mortality.
RESULTS
A total of 7 studies with a cohort of 1418 patients who underwent colorectal surgery were identified for inclusion in a qualitative analysis. Both pooled oxygen consumption at anaerobic threshold (range, 10.1-11.1 mL·kg·min) and peak oxygen consumption (range, 16.7-18.6 mL·kg·min) were predictive of complications (OR for anaerobic threshold, 0.76; 95% CI, 0.66-0.85, p<0.0001; OR for peak oxygen consumption, 0.76; 95% CI, 0.67-0.85, p<0.0001). Patients had significant increased risk of developing postoperative complications if their anaerobic threshold was below this cut point (p<0.001). However, it was not predictive of anastomotic leak (p = 0.644). Shorter distance (<250 m) walked in incremental shuttle walk test, lower anaerobic threshold, and lower peak oxygen consumption were associated with prolonged hospital length of stay, which was closely related to the development of complications.
CONCLUSIONS
Variables derived from cardiopulmonary exercise testing are predictive of postoperative complications and hospital length of stay. Currently, there are insufficient data to support the predictive role of the field walk test in colorectal surgery.
Topics: Adult; Colorectal Neoplasms; Colorectal Surgery; Exercise Test; Humans; Kaplan-Meier Estimate; Length of Stay; Physical Fitness; Postoperative Complications; Risk Assessment
PubMed: 29377872
DOI: 10.1097/DCR.0000000000001017 -
Research in Developmental Disabilities 2015To analyze the clinimetric properties of maximal aerobic and anaerobic fitness measurement protocols in adults with cerebral palsy (CP). (Review)
Review
OBJECTIVE
To analyze the clinimetric properties of maximal aerobic and anaerobic fitness measurement protocols in adults with cerebral palsy (CP).
DATA SOURCES
A systematic search through March 2015 of databases PubMed, Embase, SPORTDiscus and PsycINFO was performed with medical subject heading terms for 'cerebral palsy' combined with search terms adults or adolescents and multiple text words for fitness and exercise tests that yielded 864 articles.
STUDY SELECTION
Abstracts were screened by two reviewers to identify use of maximal fitness measurements in adolescents (14-18yrs) or adults (>18yrs) with CP of all abilities. Ninety-four articles were reviewed. No studies of adolescent (14-18yrs) qualified. Eight articles reported clinimetric properties for adults with CP who walk or propel a wheelchair independently. Five articles reported on aerobic capacity, one reported on anaerobic capacity and two reported on both.
DATA EXTRACTION
Methodological quality of the studies was rated using portions of the COSMIN (COnsensus-based Standards for the selection of health status Measurement INstruments) checklist. Quality of the measurement protocols was evaluated based on statistical strength of the clinimetrics. Synthesis of the overall evidence was based on the Cochrane review group guidelines which combine methodological quality and statistical strength.
DATA SYNTHESIS
Eight articles reported on 4 aerobic and 1 anaerobic protocols. Overall synthesis revealed that for ambulatory adults with CP there is (i) moderate evidence for good reliability and good construct validity of maximal aerobic and anaerobic cycle tests, (ii) moderate evidence for good criterion validity of sub-maximal aerobic cycle tests, and (iii) strong evidence for poor criterion validity of the six-minute walk test as a maximal aerobic test. And for adults who propel a wheelchair there is limited evidence of good reliability for maximal aerobic wheelchair ergometer tests.
CONCLUSIONS
Limited quality research exists on the clinimetric properties of aerobic and anaerobic capacity measures for adults with CP who have independent mobility. Quality aerobic and anaerobic measures for adults with more severe mobility impairments are absent.
Topics: Adolescent; Adult; Anaerobic Threshold; Cerebral Palsy; Exercise Test; Exercise Tolerance; Humans; Oxygen Consumption; Physical Endurance; Physical Fitness; Reproducibility of Results; Young Adult
PubMed: 26296079
DOI: 10.1016/j.ridd.2015.08.002 -
Journal of Rehabilitation Medicine Apr 2017Anaerobic capacity assessment in rehabilitation has received increasing scientific attention in recent years. However, anaerobic capacity is not tested consistently in...
OBJECTIVE
Anaerobic capacity assessment in rehabilitation has received increasing scientific attention in recent years. However, anaerobic capacity is not tested consistently in clinical rehabilitation practice. This study reviews tests and protocols for anaerobic capacity in adults with various disabilities (spinal cord injury, cerebral palsy, cerebral vascular accident, lower-limb amputation(s)) and (able-bodied) wheelchair users.
DATA SOURCES
PubMed, CINAHL and Web of Science.
STUDY SELECTION
Papers were screened by 2 independent assessors, and were included when anaerobic exercise tests were performed on the above-selected subject groups.
DATA EXTRACTION
Included articles were checked for methodological quality.
DATA SYNTHESIS
A total of 57 papers was included. Upper-body testing [56 protocols] was conducted with arm crank [16] and wheelchair tests [40]. With a few [2] exceptions, modified Wingate (Wingate) protocols and wheelchair sprint tests dominated upper-body anaerobic testing. In lower-body anaerobic work [11], bicycle [3] and recumbent [1], and overground tests [7] were used, in which Wingate, sprint or jump protocols were employed.
CONCLUSION
When equipment is available a Wingate protocol is advised for assessment of anaerobic capacity in rehabilitation. When equipment is not avail-able a 20-45 s sprint test is a good alternative. Future research should focus on standardized tests and protocols specific to different disability groups.
Topics: Adult; Anaerobiosis; Exercise; Exercise Test; Humans; Male; Rehabilitation
PubMed: 28350415
DOI: 10.2340/16501977-2213 -
Journal of Strength and Conditioning... Jul 2016Ferreira, MI, Barbosa, TM, Costa, MJ, Neiva, HP, and Marinho, DA. Energetics, biomechanics, and performance in masters' swimmers: a systematic review. J Strength Cond... (Review)
Review
Ferreira, MI, Barbosa, TM, Costa, MJ, Neiva, HP, and Marinho, DA. Energetics, biomechanics, and performance in masters' swimmers: a systematic review. J Strength Cond Res 30(7): 2069-2081, 2016-This study aimed to summarize evidence on masters' swimmers energetics, biomechanics, and performance gathered in selected studies. An expanded search was conducted on 6 databases, conference proceedings, and department files. Fifteen studies were selected for further analysis. A qualitative evaluation of the studies based on the Quality Index (QI) was performed by 2 independent reviewers. The studies were thereafter classified into 3 domains according to the reported data: performance (10 studies), energetics (4 studies), and biomechanics (6 studies). The selected 15 articles included in this review presented low QI scores (mean score, 10.47 points). The biomechanics domain obtained higher QI (11.5 points), followed by energetics and performance (10.6 and 9.9 points, respectively). Stroke frequency (SF) and stroke length (SL) were both influenced by aging, although SF is more affected than SL. Propelling efficiency (ηp) decreased with age. Swimming performance declined with age. The performance declines with age having male swimmers deliver better performances than female counterparts, although this difference tends to be narrow in long-distance events. One single longitudinal study is found in the literature reporting the changes in performance over time. The remaining studies are cross-sectional designs focusing on the energetics and biomechanics. Overall, biomechanics parameters, such as SF, SL, and ηp, tend to decrease with age. This review shows the lack of a solid body of knowledge (reflected in the amount and quality of the articles published) on the changes in biomechanics, energetics, and performance of master swimmers over time. The training programs for this age-group should aim to preserve the energetics as much as possible and, concurrently, improve the technique. Training sessions should feature a higher percentage of technical drills with the goal of enhancing the swim technique. Another goal should be the association of technique enhancement with aerobic and anaerobic sets, enabling the swimmer to improve the swimming efficiency.
Topics: Aged; Aging; Athletic Performance; Biomechanical Phenomena; Energy Metabolism; Female; Humans; Male; Swimming
PubMed: 27331916
DOI: 10.1519/JSC.0000000000001279 -
Archives of Physical Medicine and... Feb 2013To systematically evaluate the level of evidence of the clinimetric properties of measures of aerobic and anaerobic capacity used for children with cerebral palsy (CP). (Review)
Review
OBJECTIVE
To systematically evaluate the level of evidence of the clinimetric properties of measures of aerobic and anaerobic capacity used for children with cerebral palsy (CP).
DATA SOURCES
A systematic search of databases PubMed, Embase, SPORTDiscus, and PsycINFO through April 2011 was performed.
STUDY SELECTION
Two independent raters identified and examined studies that reported laboratory- or field-based measures of maximal aerobic or anaerobic capacity in children with CP aged 5 to 14 years.
DATA EXTRACTION
The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist was used by 2 independent raters to evaluate the methodologic quality of the included clinimetric studies and to identify measures used in these studies.
DATA SYNTHESIS
Twenty-four studies that used a maximal aerobic or anaerobic capacity measure were identified. Five studies reported clinimetric properties for 5 measures (2 aerobic and 3 anaerobic measures). Methodologic quality was excellent in 3 studies, showing good validity and reliability of field-based aerobic (Shuttle Run Test) and anaerobic (Muscle Power Sprint Test) measures. The studies on laboratory-based measures were rated fair, mainly because of inadequate statistics. The level of evidence was strong for good validity and reliability of the field-based tests. The level of evidence was unknown for validity and low to moderate for good reliability of laboratory-based tests.
CONCLUSIONS
There is a paucity of research on the clinimetric properties of measurement instruments to assess aerobic and anaerobic capacity for children with CP. Further clinimetric studies of laboratory-based measures in children with CP at all Gross Motor Function Classification System (GMFCS) levels, and clinimetric studies of field-based measures in children who are classified as GMFCS levels III to V are required.
Topics: Cerebral Palsy; Child; Exercise Test; Humans; Oxygen Consumption; Physical Fitness
PubMed: 23022091
DOI: 10.1016/j.apmr.2012.09.012 -
British Journal of Sports Medicine Jun 2020To systematically review, summarise and appraise findings of published meta-analyses that examined the effects of caffeine on exercise performance. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To systematically review, summarise and appraise findings of published meta-analyses that examined the effects of caffeine on exercise performance.
DESIGN
Umbrella review.
DATA SOURCES
Twelve databases.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
Meta-analyses that examined the effects of caffeine ingestion on exercise performance.
RESULTS
Eleven reviews (with a total of 21 meta-analyses) were included, all being of moderate or high methodological quality (assessed using the Assessing the Methodological Quality of Systematic Reviews 2 checklist). In the meta-analyses, caffeine was ergogenic for aerobic endurance, muscle strength, muscle endurance, power, jumping performance and exercise speed. However, not all analyses provided a definite direction for the effect of caffeine when considering the 95% prediction interval. Using the Grading of Recommendations Assessment, Development and Evaluation criteria the quality of evidence was generally categorised as moderate (with some low to very low quality of evidence). Most individual studies included in the published meta-analyses were conducted among young men.
SUMMARY/CONCLUSION
Synthesis of the currently available meta-analyses suggest that caffeine ingestion improves exercise performance in a broad range of exercise tasks. Ergogenic effects of caffeine on muscle endurance, muscle strength, anaerobic power and aerobic endurance were substantiated by moderate quality of evidence coming from moderate-to-high quality systematic reviews. For other outcomes, we found moderate quality reviews that presented evidence of very low or low quality. It seems that the magnitude of the effect of caffeine is generally greater for aerobic as compared with anaerobic exercise. More primary studies should be conducted among women, middle-aged and older adults to improve the generalisability of these findings.
Topics: Athletic Performance; Caffeine; Coffee; Dietary Supplements; Exercise; Female; Humans; Male; Muscle Strength; Muscle, Skeletal; Performance-Enhancing Substances; Sex Factors
PubMed: 30926628
DOI: 10.1136/bjsports-2018-100278 -
Heart (British Cardiac Society) Mar 2024In Fontan circulation, pulmonary arterial hypertension (PAH)-targeted therapies could improve the patients' exercise capacity. This study aimed to investigate the... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
In Fontan circulation, pulmonary arterial hypertension (PAH)-targeted therapies could improve the patients' exercise capacity. This study aimed to investigate the effects of PAH agents on different exercise parameters in stable Fontan patients by synthesising evidence of randomised controlled trials (RCTs).
METHODS
A systematic search of PubMed, Cochrane Central Register of Controlled Trials and Web of Science databases, as well as of ClinicalTrials.gov, was performed. Primary outcomes were specific cardiopulmonary exercise test parameters: peak oxygen uptake (peak VO), peak heart rate (peak HR), the minute ventilation/produced carbon dioxide (VE/VCO) slope and the oxygen uptake, both measured at the anaerobic threshold (VO@AT).
RESULTS
Five RCTs were included in the analysis including 573 Fontan patients (mean age 21.2 years, 60% male). PAH-targeted therapies did not affect peak VO (mean difference (MD) 0.72, 95% CI -0.25 to 1.70) or peak HR (MD -0.67, 95% CI -3.81 to 2.47), but resulted in a small, significant improvement in VO@AT (standardised MD 0.24, 95% CI 0.02 to 0.47). VE/VCO slope at the anaerobic threshold was also reduced (MD -1.13, 95% CI -2.25 to -0.01).
CONCLUSIONS
Although PAH-targeted therapies did not affect exercise parameters at maximal effort, they induced slight improvements in indices of submaximal effort, measured at the anaerobic threshold. Pharmacological improvement of submaximal exercise seems to be a more suitable indicator of Fontan individuals' exercise capacity. Larger RCTs, recruiting specific subpopulations and focusing also on the anaerobic threshold, are warranted to draw more robust conclusions.
PROSPERO REGISTRATION NUMBER
CRD42022306674.
Topics: Male; Humans; Young Adult; Adult; Female; Fontan Procedure; Vasodilator Agents; Lung; Exercise Test; Familial Primary Pulmonary Hypertension; Oxygen; Oxygen Consumption; Randomized Controlled Trials as Topic
PubMed: 37918902
DOI: 10.1136/heartjnl-2023-323166 -
International Journal of Environmental... Apr 2021Municipal solid waste (MSW) can pose a threat to public health if it is not safely managed. Despite prior research, uncertainties remain and refurbished evidence is... (Review)
Review
Municipal solid waste (MSW) can pose a threat to public health if it is not safely managed. Despite prior research, uncertainties remain and refurbished evidence is needed along with new approaches. We conducted a systematic review of recently published literature to update and expand the epidemiological evidence on the association between MSW management practices and resident populations' health risks. Studies published from January 2005 to January 2020 were searched and reviewed following PRISMA guidelines. Eligible MSW treatment or disposal sites were defined as landfills, dumpsites, incinerators, waste open burning, transfer stations, recycling sites, composting plants, and anaerobic digesters. Occupational risks were not assessed. Health effects investigated included mortality, adverse birth and neonatal outcomes, cancer, respiratory conditions, gastroenteritis, vector-borne diseases, mental health conditions, and cardiovascular diseases. Studies reporting on human biomonitoring for exposure were eligible as well. Twenty-nine studies were identified that met the inclusion criteria of our protocol, assessing health effects only associated with proximity to landfills, incinerators, and dumpsites/open burning sites. There was some evidence of an increased risk of adverse birth and neonatal outcomes for residents near each type of MSW site. There was also some evidence of an increased risk of mortality, respiratory diseases, and negative mental health effects associated with residing near landfills. Additionally, there was some evidence of increased risk of mortality associated with residing near incinerators. However, in many cases, the evidence was inadequate to establish a strong relationship between a specific exposure and outcomes, and the studies rarely assessed new generation technologies. Evidence gaps remain, and recommendations for future research are discussed.
Topics: Humans; Incineration; Infant, Newborn; Recycling; Refuse Disposal; Solid Waste; Waste Disposal Facilities; Waste Management
PubMed: 33921868
DOI: 10.3390/ijerph18084331