Beyond the mechanical lens: Systemic inflammatory responses to repetitive lifting under varying loads and frequencies
APPLIED ERGONOMICS
Authors: Beharriell, Tianna H.; Mavor, Matthew P.; Ramos, Wantuir, Jr.; Mauger, Jean-Francois; Imbeault, Pascal; Graham, Ryan B.
Abstract
Objective: Currently, low back disorder (LBD) research focuses primarily on mechanical variables to assess whether task demands exceed tissue capacity; however, it is important to assess how other nonmechanical variables affect tissue capacity in a time-dependent manner. The current investigation sought to explore physiological responses to an acute lifting task, as lifting has been implicated as a risk factor in the development of LBDs. Methods: Twelve participants completed two sessions of 2 h of repetitive symmetrical lifting from floor to knuckle height under two conditions, matched for total external work (Low Force High Repetition (LFHR) and High Force Low Repetition (HFLR)). Full-body kinematics and ground reaction forces were measured throughout. Interleukin 6 (IL-6) and interleukin 8 (IL-8), markers of systemic inflammation, were assessed from blood sampling at Baseline, 0, 4 and 24 h post-lifting on both days. Dual x-ray absorptiometry (DEXA) scans were also performed on participants to quantify body composition. Results: Significant load (HFLR and LFHR) * time (Baseline, 0, 4, 24 h) interaction effects were found for both IL-6 and IL-8, where the LFHR condition resulted in greater responses at 0 and 4 h post-lifting. Conclusions: This was the first study of its kind to concurrently measure peak and cumulative spinal moments and their relationship to systemic inflammation in both sexes, while strictly controlling for confounding variables (e. g. physical activity, caloric intake, body composition, etc.). Greater levels of IL-6 and IL-8 were seen in the LFHR condition, likely due to the greater cumulative spinal moments in this condition.
Current treatment options and safety considerations when treating adult-onset Still's disease
EXPERT OPINION ON DRUG SAFETY
Authors: Cavalli, Giulio; Farina, Nicola; Campochiaro, Corrado; Baldissera, Elena; Dagna, Lorenzo
Abstract
Introduction Growth hormone (GH) deficiency (GHD) in adults is characterized by abnormal body composition, unfavorable cardiovascular risk factors, and poor quality of life. The diagnosis is made within appropriate clinical settings and according to established guidelines. Numerous studies have shown that GH treatment improves body composition, cardiovascular risk factors, physical capacity, and quality of life while issues on safety, in particular long-term safety, remain. Areas covered Short- and long-term safety of GH replacement in adults with GHD. Expert opinion Adults with GHD are an inhomogeneous group of patients and GH replacement requires individual considerations. Most adverse effects are mild and transient and related to fluid retention and GH dose. In patients without comorbidities long-term GH treatment is safe and development of diabetes, cardiovascular disease, tumors or mortality are not increased. Patients with risk factors should be identified before GH treatment is initiated and an optimal balance between benefit and risk established. Studies with sufficient duration and power to identify the development of cardiovascular diseases and cancers are still awaited. Effective management of comorbidities can be expected to decrease morbidity and mortality and improve quality of life. Studies with long-acting GH formulations are ongoing and available data indicate similar effects and short-time safety.