Biological Markers of Training Level among Qualified Greco-Roman Wrestlers

BACKGROUND: The article presents the dynamics of biochemical indicators showing the tension of body functional systems in qualified Greco-Roman wrestlers at the pre-competition stage. Biochemical indicators can be regarded as the markers of training level, as a reflection of adaptive changes during performing training loads. AIM: The study aims to examine the adaptive reactions of body internal systems in wrestlers to the load performed at the stage of pre-competition training. METHODS: The methodological basis of the study is the examination of the reaction of body functional systems in wrestlers (n = 24) in response to the load performed at the stage of pre-competition training. The basis of the studied indicators of wrestlers’ organisms is the dynamics of the enzymatic activity (ALT and AST), the activity of creatine phosphokinase, and the balance of anabolic and catabolic processes in the course of a 2-week macrocycle of the pre-competition training. RESULTS: A high level of enzymatic activity (ALT and AST) was noted as the response to shock training load in the first and the second training macrocycles against the background of a negative trend during the entire sports event, which indicates a directed decrease in the heart’s tension muscle, being an indicator of adaptive changes occurring in wrestlers’ body energy. The high variability of AST indicators on the first day and creatine phosphokinase throughout the entire pre-competition training pointed out an individual level of adaptive reactions of the athletes’ bodies in response to the training load taken. CONCLUSIONS: The results of the study have shown notable dynamics in the indicators of the enzymatic activity of AST, creatine phosphokinase, and the hormone cortisol in a series of shock training loads, as the response to adaptive changes in body energy systems, the value of which should be considered during the pre-competition training.

Unusal Presentation of Dengue Fever as Pyomyositis

Dengue is the most common and widespread arthropod-borne arboviral infection. Symptoms include fever, headache, muscle, and joint pains, and a characteristic skin rash. Although viral myositis is common, myositis caused by the dengue virus is not commonly reported. The case of serologically confirmed dengue fever complicated by pyomyositis associated with a tenfold increase in serum creatine phosphokinase is presented.

Spinal Muscular Atrophy 5q under the Mask of Myopathy: 10 Clinical Cases

Background. Spinal muscular atrophy 5q (5q SMA) is the most frequent autosomal recessive hereditary neuromuscular disease. Molecular genetic testing is used for SMA diagnosis, and it can confirm only 5q SMA. The clinical findings and results of paraclinical studies may overlap with hereditary primary-muscular diseases making the diagnosis difficult and delaying the administration of pathogenetic treatment for 5q SMA.Clinical case description. Clinical description of 10 patients with 5q SMA aged from 3 months to 25 years with different severity of proximal tetraparesis, skeletal muscular atrophy and tendon reflexes depression is given. 3 patients under 2 years of age with myogenic pattern at needle electromyography (nEMG) in lateral vastus muscle and 7 patients over 2 years of age with increased levels of creatine phosphokinase (CPK) in blood serum were mistakenly diagnosed for inherited primary-muscular diseases for the period from 1 month to 12 years. After the genetic counselling based on the disease course and clinical findings we suspected and later confirmed 5q SMA.Conclusion. In case of flaccid proximal tetraparesis associated with myogenic pattern at nEMG in young children or with increased CPK levels at late manifestation it is crucial to perform differential diagnosis of 5q SMA since there are options of pathogenetic therapy.

Dynamics of laboratory indicators against the background of antibacterial therapy regimens that included fluoroquinolones in the treatment of critically ill COVID-19 patients depending on their age and doses of hormonal drugs

The article provides a review of the literature on the dynamics of blood counts in patients with the new coronavirus di­sease 19 and provides data from our own researches. It was found that patients of all age groups on the background of fluoroquinolone and dexamethasone treatment demonstrated an increase in leukocyte count, and in people over 60 years of age, its increase to the highest levels was observed. Individuals under 60 compared to patients over 60 years who received only antibiotics with the inclusion of fluoroquinolones, without the use of dexamethasone, had a slightly lower level of lymphocytes (р > 0.05) at the beginning of hospitalization, but already from day 4 their growth was observed. At the same time, in people over 60 years old, on the contrary, indicators decreased. In patients under 60 years of age who received antibiotics with the inclusion of fluoroquinolones and 16 mg of dexamethasone during treatment, their gra­dual increase with normalization was observed; this did not happen when 8 mg were used. In patients over 60 years of age who received antibiotics with the inclusion of fluoroquinolones, 8 and 16 mg dexamethasone and who recovered, fluctuations were observed at reduced numbers with a slight tendency towards normalization, as it was observed in younger people. In patients over 60 who received antibiotics without the use of dexamethasone and died, there was a decrease in lymphocyte level during treatment. In people over 60 who recovered, greater fluctuations in the level of lymphocytes to normal values were observed when using 8 mg of dexamethasone, while against the background of 16 mg of dexamethasone, the former showed a decrease in their level with a tendency to increase. At the same time, those who died, on the contrary, had a more significant decrease without a tendency towards normalization. Among patients under 60 and over 60 who have recovered, the former have a more rapid decrease in the le­vel of granulocytes with a tendency to normalize. In people under 60 years of age, when 16 mg of dexamethasone were prescribed, a slightly faster decrease in granulocyte level was observed. Also, a tendency to a more rapid decrease in the level of granulocytes was observed in patients older than 60 years against the background of the use of 16 mg of dexamethasone. In the age group over 60 years old against the background of 16 mg of dexamethasone, those who recovered demonstrated a decrease in granulocytes, and those who died, on the contrary, their increase. In people older than 60 years who recovered, when using 8 mg of dexamethasone and antibiotics with the inclusion of fluoroquinolones in the treatment regimen, the level of band neutrophils was slightly higher than in people younger than 60 years, and a period of its normalization was longer. Against the background of 16 mg of dexamethasone, people over 60 years of age who recovered, had lower indicators of band neutrophils in the first three days and a longer period of their normalization compared to those under 60 years of age. Patients over 60 years old who died, in comparison with those who reco­vered, already from the beginning of hospitalization demonstrated higher levels of band neutrophils and their gradual increase, while those who recovered, on the contrary, had a decrease. In patients under 60 years of age who, in addition to antibiotics, received 8 mg of dexamethasone, in the first three days after hospitalization the level of C-reactive protein (CRP) was lower than in people over 60 years of age who recovered. In both groups of patients, a tendency towards a decrease in the level of CRP was observed. Recovered patients over 60 years of age who received fluoroquinolones and 16 mg of dexamethasone had hig­her CRP content in the first three days than younger patients, and almost the same rates as those who died at the age of 60 years and older. Patients over 60 years old and those who recovered against the background of the use of 16 mg dexamethasone, had a more rapid decrease in the level of CRP; at the same time, in those who died, its slower decrease was observed. Also, the dynamics of ala­nine aminotransferase, aspartate aminotransferase, urea, creatinine, glucose, creatine phosphokinase, lactate dehydrogenase was established depending on the doses of hormones, age and the consequences of the disease course.

SERUM CREATINE PHOSPHOKINASE ACTIVITY IN RABBIT DURING REGENERATION OF EXPERIMENTALLY DAMAGED MUSCLE TISSUE AND AFTER ITS STIMULATION BY TRANSPLANTED MSC

According to statistics, in modern veterinary practice, the percentage of muscle injuries among sport and working animals ranges from 40–70% of sports injuries. Quite often there are cases with muscle injuries of skeletal muscles, namely extremities. This scientific work describes the research methodology, stages of research step-by-step, and studies the relationship of dynamics of the activity of a single biochemical blood indicator. The essence of the method was to model the injury of muscle tissue performed by the skin and fascia dissection and cutting off in the area of midplane of the pelvic head of the biceps femoris muscle, measuring 1.5 x 1.5 cm to a depth of 1.5 cm of muscle tissue on 105 laboratory animals, divided into 4 groups with the use of various treatment methods. We analyze the results of one of the most effective biochemical methods for diagnosing muscle fiber of skeletal system damage and compare the activity of the enzyme creatine phosphokinase iso-enzyme depending on the stage of the study. Other research methods such as clinical, biochemical, ultrasonographic, histological research methods were recorded on 4, 7, 10, 14, 21, and 28 days. We analyzed the latest literature sources and concluded that on the 4th and 7th days, the level of creatine phosphokinase in the groups with intravenous administration, intramuscular administration of allogeneic mesenchymal stem cells is higher than the reference values but significantly lower compared to the control groups and the traditional method of treatment. But we observe a significant decrease in serum creatine phosphokinase levels in crawls on 10th day in the intravenous administration group compared to the control group of animals in 2 times, compared to traditional treatment in 1.6 times. The group of animals with intramuscular administration has reference values on the 14th day, compared with the control in 1.3 times lower, traditional treatment in 1.2 times. And on 21th day, we get reference values for a group of animals with traditional treatment. The level of creatine phosphokinase activity decreases in the control group of animals on 28th day of the research, which indicates a complete muscle rupture. The results of studies showed that the highest activity of the creatine phosphokinase enzyme during the study was shown by groups of animals with control and traditional treatment, which indicated significant structural, functional and destructive disorders of the muscle fibers of skeletal tissues with severe trauma. Thus, it is noted that the activity of the enzyme in conditions of damage of skeletal muscle tends to increase in accordance with the severity of the injury.

Markers of myocardial injury and inflammation after radiofrequency ablation in children and adolescents

Aim. To assess the severity of myocardial damage and inflammation after radiofrequency ablation in children and adolescents using biochemical markers.Material and methods. The study included 58 children with tachyarrhythmias (Wolff-Parkinson-White (WPW) syndrome, WPW phenomenon, atrial tachycardia, paroxysmal atrioventricular reciprocating tachycardia, ventricular tachycardia) who underwent catheter ablation from July to October 2019. Before and after surgical treatment (after 2 hours and 5 days), the blood concentrations of myocardial damage and inflammation biomarkers (myoglobin, creatine phosphokinase-MB, interleukin-8, C-reactive protein, tumor necrosis factor alpha, metalloproteinase (MMP)-2, MMP-9, heart-type fatty acid binding protein). During the operation, catheter ablation parameters (power, temperature, application duration), the localization of arrhythmogenic focus and the type of ablation catheter were recorded. Their relationship with changes in the concentration of biochemical markers before and after intervention was studied.Results. Two hours after the operation, the concentrations of myoglobin, creatine phosphokinase-MB, MMP-9, heart-type fatty acid binding protein were increased several times (p<0,05). Changes in concentrations of interleukin-8, tumor necrosis factor alpha after the operation was not revealed. On the 5th day, elevated levels of cardiac markers returned to baseline values. MMP-9 level also decreased, but was higher than the preoperative level. Using Spearman’s correlation analysis, a direct relationship was revealed between the application duration and heart-type fatty acid binding protein level.Conclusion. Radiofrequency ablation is a safe method of treating arrhythmias in children and adolescents, since there is low volume of damaged myocardium. There was a slight increase in the level of biochemical markers after ablation (myoglobin, creatine phosphokinase-MB, fatty acid binding protein, MMP-9), incomparable with their rise in acute coronary syndrome, as well as the rapid decrease in the early postoperative period.

Identification of risk factors for daptomycin-associated creatine phosphokinase elevation and development of a risk prediction model for incidence probability

Background In this study, we investigated the risk factors for daptomycin-associated creatine phosphokinase (CPK) elevation and established a risk score for CPK elevation. Methods Patients who received daptomycin at our hospital were classified into the normal or elevated CPK group based on their peak CPK levels during daptomycin therapy. Univariable and multivariable analyses were performed, and a risk score and prediction model for the incidence probability of CPK elevation were calculated based on logistic regression analysis. Results The normal and elevated CPK groups included 181 and 17 patients, respectively. Logistic regression analysis revealed that concomitant statin use (odds ratio [OR] 4.45, 95% confidence interval [CI] 1.40–14.47, risk score 4), concomitant antihistamine use (OR 5.66, 95% CI 1.58–20.75, risk score 4), and trough concentration (Cmin) between 20 and &lt;30 µg/mL (OR 14.48, 95% CI 2.90–87.13, risk score 5) and ≥30.0 µg/mL (OR 24.64, 95% CI 3.21–204.53, risk score 5) were risk factors for daptomycin-associated CPK elevation. The predicted incidence probabilities of CPK elevation were &lt;10% (low risk), 10%–&lt;25% (moderate risk), and ≥25% (high risk) with the total risk scores of ≤4, 5–6, and ≥8, respectively. The risk prediction model exhibited a good fit (area under the receiving-operating characteristic curve 0.85, 95% CI 0.74–0.95). Conclusions These results suggested that concomitant use of statins with antihistamines and Cmin ≥20 µg/mL were risk factors for daptomycin-associated CPK elevation. Our prediction model might aid in reducing the incidence of daptomycin-associated CPK elevation.

Ropivacaine: An Unusual Cause of Neuroleptic Malignant-Like Syndrome

Ropivacaine is commonly used for post-operative pain management. We describe a case of neuroleptic malignant-like syndrome in a woman administered ropivacaine delivered using a drug infusion balloon. The presenting symptoms were confusion, agitation and fever. Blood analysis showed elevated C-reactive protein, leucocytosis and increased creatine phosphokinase. As intoxication was suspected, ropivacaine was suspended and the patient gradually improved. Possible leakage of ropivacaine into the intrathecal space may have resulted in central nervous system toxicity.