ADIR Association

Sex hormone fluctuations across the normal menstrual cycle (NMC) may affect women's performance and health, but literature is sparse on the estradiol (E2) impact on anabolic and catabolic hormones and well‐being in female athletes. We therefore measured in 21 NMC anaerobically trained female athletes: 12 highly (HT) and nine recreationally (RT) during late luteal/early follicular (Low E2) and late follicular/peri‐ovulatory (High E2) phases: DHEAS, DHEA, androstenedione (A4), testosterone (T), sex hormone‐binding globulin (SHBG), cortisol, free androgen index (FAI = T/SHBG), and their relative ratios. Body composition and well‐being, assessed by positive and negative affects (PANAS), were determined in parallel. In High versus Low E2, subjects showed a significant percentage increase in T, A4 (p < 0.001) and FAI (p < 0.05), with high A4/T correlation (r = 0.78), without any change in the other parameters. While no group difference was detected in hormone concentrations, HT versus RT subjects presented higher muscle mass and positive affects and lower FAI (p < 0.05). In conclusion, T and A4 were modulated across NMC, probably resulting from a variable ovarian contribution, but without inducing any change in the anabolic/catabolic balance, regardless of the physical training level. However, high anaerobic training may enhance T sensitivity in view of the FAI, body composition and well‐being outcomes.

<bold>Background:</bold> Urinary incontinence (UI) is common in the general population of individuals with chronic respiratory disease (CRD). It may represent a significant barrier to participation, completion, and response to pulmonary rehabilitation (PR). However, data on this topic are scarce. <bold>Aim:</bold> To assess the prevalence of urinary incontinence and its impact on adherence and response to an 8-week PR program. <bold>Method:</bold> We conducted a multicenter cross-sectional study during which UI was prospectively assessed at the start of the PR program using the ICIQ-UI questionnaire (score ≥ 1). Adherence was defined as attending at least 70% of the 24 scheduled sessions. PR responders were identified as individuals who achieved clinically meaningful improvements in at least one outcome among exercise capacity (6MWT, 1STS or CWRET), quality of life (SGRQ) or mood status (HAD). <bold>Results:</bold> A total of 341 individuals with CRD were recruited, with chronic obstructive pulmonary disease being the most common condition (41%). Of the participants, 48% were female, with a mean age of 63 (SD 10) years, and a mean peak oxygen uptake of 13.9 (SD 3.4) ml/kg/min. UI was reported by 130 participants (38%, 95% CI 32 to 44). This symptom was associated with lower adherence (adjusted OR 0.45), thought this estimate came with uncertainty, ranging from a strong reduction to no reduction (95% CI 0.18 to 1.05). The impact of UI on PR response was uncertain due to imprecise estimate (adjusted OR 0.71, 95% CI 0.21 to 2.61). <bold>Conclusion:</bold> UI is common among people attending PR. Further research is warranted to confirm its impact on adherence and response to PR.

BackgroundMultiple studies have evaluated fecal microbiota transfer (FMT) in patients with ulcerative colitis (UC) using single-donor (SDN) and multidonor (MDN) products. Systematic review and meta-analysis were performed to compare the safety of SDN and MDN products.MethodsSystematic searches were performed in Web of Science, Scopus, PubMed, and Orbit Intelligence to identify studies that compared FMT products manufactured using SDN or MDN strategies against control treatment in patients with UC. Fifteen controlled studies were selected for meta-analysis (11 randomized controlled trials and 4 controlled cohort trials). Safety of each treatment type was assessed using the counts of adverse events and serious adverse events using fixed- and random-effects models. Significance of the indirect difference between FMT preparations was assessed using a network approach. Benefit-risk ratios were calculated by multiplicative utility model, incorporating geometric mean of risk ratios (RRs) of efficacy and safety.ResultsSafety data was collected for a total of 587 patients (193 exposed to SDN products, 114 exposed to MDN products and 280 exposed to control treatment). The 12 studies showed similar overall safety event counts for MDN and SDN versus placebo (RRs: 0.90 and 1.09, respectively [P = 0.206 and P = 0.420, respectively]). Results indicated similar risk of safety events for MDN compared to SDN (RR: 0.83, P = 0.159). Positive benefit-risk ratios were demonstrated for MDN and SDN versus placebo (RRs: 1.70 and 1.16, respectively [P = 0.003 and P = 0.173, respectively]). MDN had a greater benefit-risk ratio compared to SDN (RR: 1.46, P = 0.072).ConclusionSimilar safety profiles were observed for MDN and SDN strategies. Alongside previously described superior efficacy, treatment with MDN has greater benefit-risk ratio than SDN in patients with UC. Further development of MDN FMT treatment for UC should be considered.

BackgroundRecurrent infections of the nose, sinuses and ears are common problems for people with primary ciliary dyskinesia. While pulmonary exacerbations in primary ciliary dyskinesia are defined, there is no definition for ear-nose-throat exacerbations, a potential outcome for research and clinical trials.MethodsWe set up an expert panel of 24 ear-nose-throat specialists, respiratory physicians, other healthcare professionals and patients to develop consensus definitions of sinonasal and otological exacerbations in children and adults with primary ciliary dyskinesia for research settings. We reviewed the literature and used a modified Delphi approach with four electronic surveys.ResultsDefinitions for both sinonasal and otological exacerbations are based on a combination of major and minor criteria, requiring three major or two major and at least two minor criteria each. Major criteria for a sinonasal exacerbation are 1) reported acute increase in nasal discharge or change in colour, 2) reported acute pain or sensitivity in the sinus regions and 3) mucopurulent discharge on examination. Minor criteria include reported symptoms, examination signs, doctor's decision to treat and improvement after at least 14 days. Major criteria for the otological exacerbation are 1) reported acute ear pain or sensitivity, 2) reported acute ear discharge, 3) ear discharge on examination and 4) signs of otitis media in otoscopy. Minor criteria are reported acute hearing problems, signs of acute complication, and doctor's decision to treat.ConclusionThese definitions might offer a useful outcome measure for primary ciliary dyskinesia research in different settings. They should be validated in future studies and trials together with other potential outcomes, to assess their usability.