Alterations in Exercise-Induced Plasma Adenosine Triphosphate Concentration in Highly Trained Athletes in a One-Year Training Cycle

This study aimed to assess the effect of training loads on plasma adenosine triphosphate responsiveness in highly trained athletes in a 1 y cycle. Highly trained futsal players (11 men, age range 20–31 y), endurance athletes (11 men, age range 18–31 y), sprinters (11 men, age range 21–30 y), and control group (11 men, age range 22–34 y) were examined across four characteristic training phases in response to an incremental treadmill test until exhaustion. A considerably higher exercise and post-exercise plasma adenosine triphosphate concentrations were observed in consecutive training phases in highly trained athletes, with the highest values reached after the competitive period. No differences in plasma adenosine triphosphate concentrations were found in the control group during the 1 y cycle. Sprinters showed a higher absolute and net increase in plasma adenosine triphosphate concentration by 60–114% during exercise in consecutive training phases than futsal players (63–101%) and endurance athletes (64–95%). In this study, we demonstrated that exercise-induced adenosine triphosphate concentration significantly changes in highly trained athletes over an annual training cycle. The obtained results showed that high-intensity but not low- to moderate-intensity training leads to an increased adenosine triphosphate response to exercise, suggesting an important role of ATP for vascular plasticity.

Download Full-text

Screening for Atrial Fibrillation in Older Adults at Primary Care Visits: the VITAL-AF Randomized Controlled Trial

10.1101/2021.08.13.21261969 ◽

2021 ◽

Author(s):

Steven Lubitz ◽

Steven J. Atlas ◽

Jeffrey M. Ashburner ◽

Ana Lipsanopoulos ◽

Leila Borowsky ◽

...

Keyword(s):

Atrial Fibrillation ◽

Primary Care ◽

Usual Care ◽

Controlled Trial ◽

Oral Anticoagulants ◽

Care Practice ◽

Control Group ◽

Newly Diagnosed ◽

One Year ◽

And Control

Background: Undiagnosed atrial fibrillation (AF) may cause preventable strokes. Guidelines differ regarding AF screening recommendations. We tested whether point-of-care screening with a handheld single lead electrocardiogram (ECG) at primary care practice visits increases diagnoses of AF. Methods: We randomized 16 primary care clinics 1:1 to AF screening using a handheld single-lead ECG (AliveCor KardiaMobile) during vital sign assessments, or usual care. Patients included were aged ≥ 65 years. Screening results were provided to primary care clinicians at the encounter. All confirmatory diagnostic testing and treatment decisions were made by the primary care clinician. New AF diagnoses over one-year follow-up were ascertained electronically and manually adjudicated. Proportions and incidence rates were calculated. Effect heterogeneity was assessed. Results: Of 30,715 patients without prevalent AF (n=15,393 screening [91% screened], n=15,322 control), 1.72% of individuals in the screening group had new AF diagnosed at one year versus 1.59% in the control group (risk difference [RD] 0.13%, 95% confidence interval [CI] -0.16,0.42, P=0.38). New AF diagnoses in the screening and control groups differed by age with the greatest effect observed for those aged ≥ 85 years (5.56% versus 3.76%, respectively, RD 1.80%, 95% CI 0.18,3.30). The difference in newly diagnosed AF between the screening period and the prior year was marginally greater in the screening versus control group (0.32% versus -0.12%, RD 0.43%, 95% CI -0.01,0.84). The proportion of individuals with newly diagnosed AF who were initiated on oral anticoagulants was similar in the screening (n=194, 73.5%) and control (n=172, 70.8%) arms (RD 2.7%, 95% CI -5.5,10.4). Conclusions: Screening for AF using a single-lead ECG at primary care visits was not associated with a significant increase in new AF diagnoses among individuals aged 65 years or older compared to usual care. However, screening may be associated with an increased likelihood of diagnosing AF among individuals aged 85 years or older and warrants further evaluation.

Download Full-text

PO-055 Changes of trace elements in skeletal muscle and serum of rats after exercise-induced injury

Exercise Biochemistry Review ◽

10.14428/ebr.v1i3.10753 ◽

2018 ◽

Vol 1 (3) ◽

Author(s):

Jingyun Liu ◽

Qun Zuo

Keyword(s):

Skeletal Muscle ◽

Trace Elements ◽

Nitric Acid ◽

Vena Cava ◽

The Body ◽

Emission Spectrometry ◽

Control Group ◽

Exercise Induced ◽

And Control ◽

Cu And Zn

Objective This study is to investigate the changes of trace elements (Cu, Fe, Zn, Se, Mg) in serum and skeletal muscle of rats after skeletal muscle injury induced by downhill running, and to find out the change regularity of trace elements in the body after exercise injury. To provide experimental basis for how to use trace elements supplements reasonably. Methods Fifty-four healthy male Sprague-Dawley rats aged 8 weeks were randomly divided into two groups: control group (C, N=6) and exercise group (E, N=48, include: 0 h group, 6 h group, 12 h group, 24 h group, 48 h group, 72 h group, 1- week group and 2- week group). The rats in exercise groups run down a 16°incline at 16m/min for 90 minutes. At the end of the exercise, the rats were killed at 0 h, 6 h, 12 h, 24 h, 48 h, 72 h, 1 week and 2 weeks, respectively. The serum was got from the inferior vena cava blood and diluted by 1% nitric acid. The muscle was got from the right side of the rat's sural which were digested by concentrated nitric acid and 30% hydrogen peroxide in 75℃water bath for 20mins. The content of trace elements in muscle and serum were measured by inductively coupled plasma atomic emission spectrometry (ICP-MS). All the data are analyzed and processed by SPSS22.0 statistical software. Results (1) The contents of trace elements in serum showed: Cu, Zn, Mg, Se decreased immediately after exercise, but the Cu still increased to reach a peak at 24h after decreasing, and after 2 weeks the content of Cu was slightly lower than pre-exercise level. However, the content of Zn did not elevate again, it continued declined to the lowest at 24h which was significantly lower than control group (P < 0.05). And after 2 weeks, Zn did not return to the pre-exercise level. The changes of Mg, Se in serum was not statistically significant. There is no difference between 0h and control groups in content of Fe, after that Fe decreased continually and appeared the least value at 24h, the differences between immediate group and control group were statistically significant (P < 0.05). Fe returned to the pre-exercise level after 2 weeks. (2) The contents of trace elements in muscle showed: Most of trace elements increased to the maximum level at 6 h, after that Mg, Fe, Cu decreased to the lowest value at 72 h which were significant lower than 0h group or 6h group (P < 0. 05). ALL the trace elements were lower than pre-exercise level. There was no statistical difference in the content of Se in muscle. Conclusions (1) The different changes of trace elements in skeletal muscle and serum after exercise injury may be due to the redistribution of trace elements caused by the body adaptability. (2) The most obviously changes of trace element in serum and muscle are Cu and Zn. Both of them did not return to the pre-exercise level after 2 weeks, it suggests that the supplement include Cu and Zn may play an important role in recovering after exercise-induced injury.

Download Full-text

Role of Extracorporeal Photopheresis in Prevention of Graft-Versus-Host Disease in Patients Treated with Allogeneic Hematopoietic Stem Cell Transplantation: A Randomized Controlled Trial

Blood ◽

10.1182/blood-2021-147243 ◽

2021 ◽

Vol 138 (Supplement 1) ◽

pp. 102-102

Author(s):

Maryan M Ali ◽

Tobias Gedde-Dahl ◽

Marit B Veierød ◽

Geir E Tjønnfjord ◽

Per Ole Iversen

Keyword(s):

Hematological Malignancy ◽

Intervention Group ◽

Study Groups ◽

Control Group ◽

Hematopoietic Stem ◽

Graft Versus Host ◽

Randomized Controlled ◽

Gvhd Prophylaxis ◽

One Year ◽

And Control

Abstract Introduction In many patients diagnosed with a hematological malignancy, the disease cannot be totally eradicated by conventional therapeutic approaches, and for them allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only curative option. A major complication of allo-HSCT is graft-versus-host disease (GvHD), affecting about 50% of transplant recipients. In addition to increased risk of death and long-lasting debilitating conditions, severe GvHD also impairs health-related quality of life. High-dose systemic steroids is the first line treatment for GvHD, but treatment failure is common, and steroid-refractoriness is a major cause of non-relapse mortality after allo-HSCT. While there is no established second line GvHD-treatment, extracorporeal photophoresis (ECP) has emerged as an attractive and increasingly applied alternative, partly due to its favourable safety profile. However, the use of ECP in preventing GvHD is sparse and data are inconclusive due to lack of randomized controlled trials (RCT). We therefore conducted a RCT to study if ECP given post transplantation could prevent the development of GvHD. Methods Between June 2017 and February 2020, we enrolled 157 patients (> 18 years) diagnosed with a hematological malignancy and treated with an allo-HSCT in first remission into an intention-to-treat open RCT. Ethical and IRB approvals were granted, and the RCT was registered with Clinical Trials (ID NCT03204721). The sample size (76 in intervention group and 81 controls) was calculated based on a reduction of 25% in the total number of patients diagnosed with any form of GvHD within the first year of allo-HCST (primary end-point) as clinically relevant. The patients were stratified according to whether they received myeloablative or reduced intensity conditioning (Table 1), and they were given GvHD prophylaxis as shown in Table 1. ECP (Therakos Cellex ®, Mallinckrodt Pharm., NJ) was initiated when patients had engrafted (i.e. leukocytes > 1 x 10 9/L and platelets > 20 x 10 9/L), and, according to the study protocol, we planned for ECP on two consecutive days/week for two weeks, then weekly for four weeks to a total eight treatments for each patient in the intervention group. Chi-square test was used to test differences between the two study groups. Results Table 1 shows that patient characteristics were well balanced among the two study groups. Four patients did not receive ECP while 39 received all the eight treatments. One year after allo-HCST, the proportion of GvHD was 45/76 (59%) in the intervention group and 52/81 (64%) in the controls (p=0.52). There were no significant differences between the intervention and control group regarding development of acute (45% vs. 48%) or chronic (39% vs. 40%) GvHD. Neither did we detect any statistical differences between the two study groups regarding organ involvement or severity of the GvHD manifestations (data not shown). During the one-year observation period, 16/76 (21%) and 10/81 (12%) relapsed in the intervention and control group, respectively (p=0.14). The corresponding numbers of deaths were 12/76 (16%) and 16/81 (20%), respectively (p=0.52). Six patients in the intervention group experienced mild to moderate temporary, adverse events that could possibly be related to the ECP-procedure. Conclusion In this first RCT addressing ECP as GvHD prophylaxis in allo-HSCT for hematological malignancy, we found no significant difference in the numbers, types, organ involvement, or severity of GvHD between the intervention and the control group. Thus, our study does not support the use of ECP as an adjunct to GvHD-prophylaxis based on cyclosporine and methotrexate, mycophenolate mofetil, or sirolimus. However, ECP did not seem to be harmful in this setting. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Download Full-text

Immediate Loading of Implant-Supported Single Crowns after Conventional and Ultrasonic Implant Site Preparation: A Multicenter Randomized Controlled Clinical Trial

BioMed Research International ◽

10.1155/2018/6817154 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 11

Author(s):

Claudio Stacchi ◽

Teresa Lombardi ◽

Domenico Baldi ◽

Calogero Bugea ◽

Antonio Rapani ◽

...

Keyword(s):

Survival Rate ◽

Test Group ◽

Site Preparation ◽

Control Group ◽

Controlled Clinical Trial ◽

Marginal Bone Loss ◽

One Year ◽

And Control ◽

Implant Site Preparation ◽

Single Crowns

Aim. To compare implant survival rate and marginal bone loss (MBL) of immediately loaded single implants inserted by using ultrasonic implant site preparation (UISP) (test) and conventional rotary instrumentation (control). Methods. Two single implants were inserted for each patient: after randomization, test site was prepared by using an ultrasonic device (Piezosurgery Touch, Mectron, Italy) and control site was prepared by using the drills of the selected implant system (Premium AZT, Sweden & Martina, Italy), until reaching a final diameter of 3 mm in both groups. Identical implants (3.8x11.5 mm) were inserted in all sites at crestal level. Impressions were taken and screwed resin single crowns with platform-switched provisional abutments were delivered with 48 hours. Periapical radiographs were taken at provisional crown insertion (T0), 6 months (T1) and one year (T2) after prosthetic loading to measure MBL. All data were tested for normality and subsequently analyzed by paired samples t-test and forward multiple linear regression. Results. Forty-eight patients were treated in six centers with the insertion of ninety-six implants (48 test; 48 control). Four implants in four patients failed within the first six months of healing (two in test group; two in control group; no difference between groups). Forty patients (age 60.1±10.7 years; 22 female, 18 male) were included in the final analysis. Mean MBL after six months of loading was 1.39±1.03 mm in the test group and 1.42±1.16 mm in the control group (p>0.05) and after one year was 1.92±1.14 mm and 2.14±1.55 mm in test and control, respectively (p>0.05). Conclusions. No differences in survival rate and MBL were demonstrated between UISP and conventional site preparation with rotary instruments in immediately loaded dental implants: UISP, with its characteristics of enhanced surgical control and safety in proximity of delicate structures, may be used as a reliable alternative to the traditional drilling systems.

Download Full-text

Mammary Tumors in a Colony of Beagle Dogs

Veterinary Pathology ◽

10.1177/030098588602300613 ◽

1986 ◽

Vol 23 (6) ◽

pp. 741-749 ◽

Cited By ~ 30

Author(s):

J. E. Moulton ◽

L. S. Rosenblatt ◽

M. Goldman

Keyword(s):

Morphological Type ◽

Control Group ◽

Beagle Dogs ◽

Control Groups ◽

First Occurrence ◽

Closed Colony ◽

Benign Mixed Tumor ◽

Age Range ◽

And Control ◽

Mixed Tumors

In a lifetime study, female beagle dogs in a closed colony were administered 226radium and 90strontium. An unirradiated control group was included in the study. A total of 223 of 356 dogs at risk developed 1,112 mammary proliferative growths (hyperplastic nodules and neoplasms). There was no correlation between occurrence and types of lesions in radiation and control groups. The age range for first occurrence of lesions was 10.4 to 13.9 years; hyperplastic nodule and benign mixed tumor occurred 1 to 2 years earlier than other lesions. A multiplicity of growths of similar or different morphological type were common throughout the lifetime of the dog. The female beagles, collectively, developed 244 hyperplastic nodules, 78 adenomas, 694 benign mixed tumors, 78 carcinomas, 14 malignant mixed tumors, and four myoepitheliomas. Proliferations occurred with increasing frequency from the cranial to caudal mammary glands. Metastasis was found in 77% of the dogs with carcinoma. The median time from diagnosis to metastasis was 10 months, but was shorter in dogs with infiltrative carcinoma.

Download Full-text

Abstract 100: Delta Opioid Receptor Blockade Abolishes Exercise-Induced Cardioprotection Against Ischemia-Reperfusion Injury In Vivo

Circulation Research ◽

10.1161/res.113.suppl_1.a100 ◽

2013 ◽

Vol 113 (suppl_1) ◽

Author(s):

Juliana P Borges ◽

Marina Tristao ◽

Eduardo V Tibiriçá ◽

Marcos A Lessa

Keyword(s):

Receptor Antagonist ◽

Opioid Receptor ◽

Acute Exercise ◽

Ischemia Reperfusion ◽

Control Group ◽

Receptor Subtype ◽

Kappa Receptor ◽

Exercise Induced ◽

Delta Receptor ◽

And Control

Introduction: Recent studies showed that exercise enhances myocardial tolerance to ischemia-reperfusion (I-R) injury via an opioid receptor-dependent mechanism. However, the specific subtype of opioid receptor involved in this response remains to be determined. Methods: Male Wistar rats were first divided into 2 groups: exercised and control. The exercised group underwent 4 consecutive days of treadmill training (60 min at 70% of maximal oxygen consumption). The exercised group was then divided into 4 subgroups: exercised (Exe; n = 10); exercised + kappa receptor antagonist (Exe + K; n=4); exercised + delta receptor antagonist (Exe + D; n=4); exercised + mu receptor antagonist (Exe + M; n=4). Control group was also divided into 2 groups: control (Ctr; n = 10) and control sham (Sham; n = 10). To induce I-R injury, anesthetized animals were submitted to a left thoracotomy and a 30 min interventricular coronary occlusion followed by 60 min of reperfusion. The hemodynamic parameters were recorded and infarct size was post-mortem determined by double staining using TTC/Evans blue and expressed as a percentage of the area at risk. Results: As shown in the figure, Sham group showed no infarct, Exe group showed a significant reduction in the infarcted area (27.6%) when compared to Ctr group (42.0%). The pretreatment with mu and kappa receptor antagonist did not alter the cardioprotective effect of exercise. However, the pretreatment with delta receptor antagonist prevented the exercise-induced cardioprotection. Conclusions: Endogenous opioid system is involved in cardioprotection conferred by acute exercise, and delta receptor subtype seems to play an important role in this response.

Download Full-text

Menopausal Status, Moderate-Intensity Walking, and Symptoms in Midlife Women

Research and Theory for Nursing Practice ◽

10.1891/rtnp.19.2.163.66799 ◽

2005 ◽

Vol 19 (2) ◽

pp. 163-180 ◽

Cited By ~ 55

Author(s):

JoEllen Wilbur ◽

Arlene Michaels Miller ◽

Judith McDevitt ◽

Edward Wang ◽

Josephine Miller

Keyword(s):

African American Women ◽

Menopausal Status ◽

Leisure Activity ◽

Physical Symptoms ◽

Midlife Women ◽

Moderate Intensity ◽

Control Group ◽

Walking Intervention ◽

Home Based ◽

And Control

The purpose of this randomized clinical trial study was to determine the effectiveness of a 24-week, home-based, moderate-intensity, walking intervention in improving symptoms (vasomotor, uro-genital/sexual, sleep, psychological, cognitive, physical) experienced by midlife women. One hundred and seventy-three Caucasian and African American women aged 45 to 65 who were not on hormone therapy, had no major signs or symptoms of cardiovascular disease, and were sedentary in their leisure activity were randomly assigned to the moderate-intensity walking group or the nonexercise control group. The exercise prescription was walking at a frequency of 4 times a week for a duration of 20 to 30 minutes. The symptom impact inventory included the frequency, intensity, and bothersomeness of 33 symptoms collected at baseline and 24 weeks. Adherence was measured with a heart rate monitor and exercise log. Average adherence to frequency of walking was 71.6% of the expected walks. After 24 weeks, there were no differences between the walking and control group on change in symptoms. However, multiple regression revealed that frequency of adherence to walking along with change in physical symptoms and menopausal status were significant predictors of change in sleep symptoms. While walking did not improve most symptoms experienced by midlife women, frequency of walking may improve sleep.

Download Full-text

Inflammatory Markers in Response to Different Intensity of Aerobic Exercise in Obese Male Wistar Rats

hormozgan medical journal ◽

10.5812/hmj.101699 ◽

2020 ◽

Vol 24 (3) ◽

Author(s):

Keyvan Hejazi ◽

Seyyed Reza Attarzadeh Hosseini ◽

Mehrdad Fathi ◽

Mohammad Mosaferi Ziaaldini

Keyword(s):

Insulin Resistance ◽

Aerobic Exercise ◽

High Intensity ◽

Inflammatory Markers ◽

Resistance Index ◽

Moderate Intensity ◽

Control Group ◽

Insulin Resistance Index ◽

Tnf Α ◽

And Control

Background: The lack of physical activity and obesity causes mild chronic inflammation that is associated with increased plasma levels of inflammatory markers. Evidence suggests that physical activity can reduce inflammatory markers. Objectives: The purpose of this study was to determine the effects of eight weeks of aerobic training with two intensities on levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and insulin resistance in obese Wistar rats. Methods: Twenty-four Wistar male rats (fourteen weeks old and weighing 250 - 300 g, body mass index > 30 g/cm2) were used. After two weeks of familiarity with the laboratory environment, the animals were randomly divided into three groups: (1) high-intensity aerobic exercise (n = 8); (2) moderate-intensity aerobic exercise (n = 8), and control (n = 8). The rats in moderate and high-intensity aerobic exercise groups were performed an increasing training for eight weeks and five days a week and one session per day for 60 minutes running at different speeds on a rodent motor-driven treadmill. Data were analyzed by paired sample t-test and repeated measures (ANOVA) for the inter-group and intra-group comparison of the variance changes. Results: Significant differences were found in serum TNF-α levels (P = 0.027 and F = 3.42), IL-6 levels (P = 0.043 and F = 2.99), and insulin resistance index (P = 0.008 and F = 4.69) between the moderate, high-intensity aerobic exercises, and control groups. The levels of TNF-α concentration was significantly different between moderate-intensity and control group (P = 0.01) and between the high-intensity and control groups (P = 0.01). The insulin resistance index in MI (P = 0.01) and HI (P = 0.01) groups significantly decreased compared to the control group. Conclusions: The results of the present study show that both types of moderate-intensity and high-intensity aerobic exercise lead to the reduction of TNF-α, interleukin-6, and insulin resistance index compared to the control group. Further studies are needed to shed light on the effects of different types of exercise on such indices, especially the use of long-term training sessions.

Download Full-text

Assessing the Therapeutic Effect of 630 nm Light-Emitting Diodes Irradiation on the Recovery of Exercise-Induced Hand Muscle Fatigue with Surface Electromyogram

International Journal of Photoenergy ◽

10.1155/2012/652040 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Dandan Yang ◽

Xiaoying Wu ◽

Wensheng Hou ◽

Xiaolin Zheng ◽

Jun Zheng ◽

...

Keyword(s):

Muscle Fatigue ◽

Light Emitting Diode ◽

Voluntary Contraction ◽

Control Group ◽

Flexor Digitorum Superficialis ◽

Light Emitting ◽

Hand Muscle ◽

Exercise Induced ◽

Flexor Digitorum ◽

And Control

This paper aims to investigate the effect of light emitting diode therapy (LEDT) on exercise-induced hand muscle fatigue by measuring the surface electromyography (sEMG) of flexor digitorum superficialis. Ten healthy volunteers were randomly placed in the equal sized LEDT group and control group. All subjects performed a sustained fatiguing isometric contraction with the combination of four fingertips except thumb at 30% of maximal voluntary contraction (MVC) until exhaustion. The active LEDT or an identical passive rest therapy was then applied to flexor digitorum superficialis. Each subject was required to perform a re-fatigue task immediately after therapy which was the same as the pre-fatigue task. Average rectified value (ARV) and fractal dimension (FD) of sEMG were calculated. ARV and FD were significantly different between active LEDT and passive rest groups at 20%–50%, 70%–80%, and 100% of normalized contraction time (P<0.05). Compared to passive rest, active LEDT induced significantly smaller increase in ARV values and decrease in FD values, which shows that LEDT is effective on the recovery of muscle fatigue. Our preliminary results also suggest that ARV and FD are potential replacements of biochemical markers to assess the effects of LEDT on muscle fatigue.

Download Full-text

Effect of Moderate-Intensity Endurance Exercise on Inflammatory Cytokines in Leukocytes of Dogs

Applied Sciences ◽

10.3390/app12010215 ◽

2021 ◽

Vol 12 (1) ◽

pp. 215

Author(s):

Hae Sung Lee ◽

Hyun Ju Oh ◽

Kihae Ra ◽

Jong-Hee Kim

Keyword(s):

Mrna Expression ◽

Endurance Exercise ◽

Serum Alkaline Phosphatase ◽

Exercise Group ◽

Moderate Intensity ◽

Control Group ◽

Glucose Levels ◽

Immune Health ◽

Serum Biochemical ◽

And Control

This study aimed to investigate the effect of a treadmill exercise on hematological and serum biochemical parameters and the expression of immune-related cytokine genes in leukocytes. For the experiment, six healthy adult dogs were divided into exercise and control groups. The exercise group performed an endurance exercise three times a week for four weeks. Blood samples were collected before exercise, two weeks after exercise, and post-exercise, and hematological and serum biochemical analysis and cytokine gene analysis were conducted. In the exercise group, white blood cell count (WBC), aspartate aminotransferase, serum alkaline phosphatase, and glucose levels were significantly decreased, but there was no change in the control group. The mRNA expression of TNF-α, IFN-γ, IL-1β, and IL-4 was significantly decreased in the exercise group compared to the control group. There was no difference in IL-6, IL-8, and IL-10 mRNA expression between groups. The results in the current study demonstrate that short-term moderate-intensity endurance exercise alters WBC levels and mRNA cytokine expression in leukocytes and may have a meaningful effect on immune health in dogs.

Download Full-text