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Biomedical subjects

A Gombacci

Publications and source records attributed to A Gombacci.

4 recordsLinked to original sources

Coagulation parameters in senior athletes practicing endurance sporting activity.

AIM: Physical activity is practiced more and more by middle-aged people. We studied the behavior of the coagulation system before and after near-maximum, specific and standardized exercise tests in 2 groups of senior athletes. METHODS: The subjects of the study were 2 groups of athletes over 40 years of age (ranging 41 to 60 years): 10 rowers and 10 marathon runners. The data were compared with 10 controls (ranging in age from 40 to 71 years) tested on the cycle ergometer. The first group (rowers) was tested on a rowing machine; the second group (marathon runners) performed a maximal exercise on the treadmill. All subjects were tested to a maximal level of cardiovascular and muscular exertion and cardiac and respiratory parameters were monitored. The following coagulation tests were performed before and after maximal exercise: prothrombin time (PT), partial activated thromboplastin time (PTT), fibrinogen (FBG), antithrombin III (ATIII), protein C (PC), protein S (PS), prothrombin fragment 1+2 (F1+2), tissue activator of plasminogen (t-PA) and its inhibitor (PAI). All subjects performed a complete maximal specific test. RESULTS: The results showed all individuals produced a significant increase of FBG, PT and PTT activities and a lowering trend for PC and PS inhibitors after maximal exercise testing. ATIII levels increased significantly in trained subjects. After the test, data regarding fibrinolysis showed higher t-PA levels in athletes as compared with controls. PAI levels indicated a more marked decrease in athletes. The F1+2 showed a moderate but significant increase in the control group. CONCLUSIONS: Coagulative tests showed an increase in procoagulant and fibrinolysis parameters in all the groups but the increased fibrinolytic activity in trained athletes indicates a protective factor and greater vascular efficiency. The results demonstrate that sporting activity practiced by middle-aged people accelerates fibrinolytic activity in conditioned subjects. In conclusion, physical activity benefits the coagulation system particularly as regards fibrinolysis.

Adult↗

Efficacy of multidisciplinary approach in the treatment of two cases of nonclassical infantile glycogenosis type II.

Glycogenosis type II (GSD II) is a lysosomal storage disorder due to acid alpha-glucosidase deficiency. We report the results of a clinical multidisciplinary approach in two cases of nonclassical infantile GSD II. The patients received a high-protein diet by percutaneous enteral gastrostomy (PEG), mechanical ventilatory support by tracheostomy and a physiotherapy programme. After 12 months of treatment, the patients showed significant improvement in muscular strength, nutritional state and respiratory function. Electrocardiography (ECG) and echocardiography improved in both patients. They maintained good clinical conditions for a period of 18 and 20 months, respectively; thereafter they presented with an elevated and persistent fever that was not correlated to a septic status and was not responsive to any antipyretic treatment. They deteriorated progressively and died. This study shows how a multidisciplinary approach may be useful to improve, even if temporarily, the clinical course of nonclassical infantile GSD II.

Child, Preschool↗

Variations in hemostatic parameters after near-maximum exercise and specific tests in athletes.

BACKGROUND: The clotting state of the blood changes according to the type of physical exercise to which a group of healthy subjects are subjected. We studied the behaviour of the coagulation system before and after near-maximum, specific and standardized exercise tests in three groups of males practising sports defined as demanding in terms of cardiovascular output. METHODS: The study was a comparative investigation between athletes and the group of controls composed of presumably healthy males. SETTING: athletes training for competitions such as marathon, rowing and weightlifting. PARTICIPANTS AND INTERVENTIONS: we tested 7 rowers using the rowing machine, 12 marathon runners using the treadmill, 7 weightlifters using their own exercise equipment, and 7 healthy subjects (controls) using the cycle ergometer. MEASURES: during the tests we monitored heart rates, maximal oxygen intake, anaerobic threshold, respiratory quotient, maximum ventilation, and lactic acid. The following coagulation tests were performed before and after near-maximum exercise: prothrombin time (PT), partial activated thromboplastin time (PTT), fibrinogen (FBG), antithrombin III (ATIII), protein C (PC), protein S (PS), prothrombin fragment 1 + 2 (F1 + 2), tissue activator of plasminogen (t-PA) and its inhibitor (PAI). RESULTS: The most significant results showed a low basal PC in the rowers which decreased further after near-maximum exercise; significantly higher basal activities of ATIII, PC and PS in the marathon runners compared to the rowers; a high proportion of weightlifters showed a reduction in t-PA after exercise and an increase of PAI; the controls were the only group in which fibrinolytic activity and all the circulating anticoagulants increased after near-maximum exercise. Thus subjects who practise aerobic sports differ principally in terms of variations in inhibitors (low PC in rowers and marathon runners, increased presence of inhibitors in controls). The weightlifters did not show any significant variations, and so the kind of exercise involved (training to increase resistance and maximum strength) and the recovery times between the exercises do not seem to trigger changes in coagulation/fibrinolysis. CONCLUSIONS: We can therefore confirm that only relatively prolonged effort can trigger a mechanism beneficial to the cardiovascular system. In conclusion, physical activity benefits the coagulation system particularly as regards fibrinolysis, but certain subjects may be at risk of thrombosis and these must be identified and followed. We suggest that fibrinolytic activity be studied in athletes who practise weightlifting and have a history of cardiovascular disease, and that inhibitors (protein C in particular) be studied in rowers with a family history of thromboembolism.

Adolescent↗