Anastassios Philippou

Background/Aim: To investigate the effects of an exercise training program on physical and cognitive function in older patients with dementia. Patients and Methods: Thirtyeight patients with early-middle dementia (31 females and seven males), aged 80.6±6.9 years, residents in an Elderly Care Unit, either completed a 36-week structured exercise program (Intervention Group, IG; n=19), or received the usual medical care (Control Group, CG; n=19). Before and after the 36-week intervention, cognitive function was evaluated in both groups by Mini-Mental State Examination (MMSE) and depression by Geriatric Depression Scale (GDS); physical function was assessed using handgrip test, Timed Up to Go (TUG), Berg Balance Scale (BBS) and Chair-Stand Test (CST), and daily living functionality by Functional Rating Scale for Symptoms of Dementia (FRSSD). Results: As a result of exercise intervention, participants scored better in all functional and cognitive test assessments compared to the control group, as reflected by absolute and relative (%) differences in all metrics after the 36-week exercise program (p<0.001). Conclusion: A 36-week supervised exercise training program was found to result in significant improvements in physical and cognitive function of elderly patients in early to middle stages of dementia at an Elderly Care Unit. The promising results of this study shed more light on the adaptability of elderly patients with early and mild dementia to long-term exercise training and verified the feasibility of applying such programs in this clinical population.

Background: The benefits derived from supervised aerobic exercise in people living with human immunofeficiency virus-HIV (PLWH) have not yet been clearly identified. Objective: To evaluate the impact of supervised aerobic exercise on immunological, cardiorespiratory, pulmonary, hemodynamic and mental parameters of PLWH. Methods: A systematic review was carried out in accordance to PRISMA guidelines. PubMed, Physiotherapy Evidence Database (PEDro) and Cochrane Central Register of Controlled Trials (CENTRAL) were screened up to August 2021, for the identification of English written randomized trials, with participants aged 18 years and older, at any stage of the disease, with or without co-morbidities. The risk of bias assessment was conducted according to the Cochrane Collaboration's tool for assessing risk of bias. Meta-analyses were conducted using continuous, inverse variance, random-effects model. Results: Ten studies were suitable for meta-analysis based on inclusion criteria. Supervised aerobic exercise appeared to have beneficial effects on depressive symptoms [mean difference (MD)¼ À4.18 (confidence interval (CI)¼ (À6.55)-(À1.81), Z ¼ 3.46, p ¼ 0.0005, I 2 ¼0%, n ¼ 2], forced expiratory volume in 1 sec [MD ¼ 0.70, CI ¼ 0.39-1.00, Z ¼ 4.41, p < 0.0001, I 2 ¼0%, n ¼ 2], and on the maximum oxygen uptake [MD ¼ 1.38, CI ¼ À0.02-2.78, Z ¼ 1.94, p ¼ 0.05, I 2 ¼94%, n ¼ 4] of PLWH. No exercise effect was found for CD4 T-cell count (p ¼ 0.16, n ¼ 5), systolic blood pressure (p ¼ 0.91, n ¼ 2) and diastolic blood pressure (p ¼ 0.72, n ¼ 2). Conclusions: Supervised continuous aerobic exercise may improve lung function, depressive symptomatology and aerobic capacity of PLWH, however, the small number of available studies and the high heterogeneity concerning VO2max demonstrate the need for more research in this area.

There is increasing evidence to indicate that insulin-like growth factor (IGF)-1 plays a crucial role in the regeneration of different tissues following injury. Notably, despite the escalating number of animal studies, studies investigating the role of IGF-1 in the wound healing process in humans are fewer. In this context, the aim of the present study was to evaluate the variations in the expression IGF-1 isoforms (IGF1-Ea, IGF1-Eb and IGF1-Ec), as well as its binding protein and receptor (IGF-BP3 and IGF-1R) during wound healing in patients. The study population comprised of 21 patients presenting with the first episode of sacrococcygeal pilonidal disease. Samples were obtained during surgery, as well as on days 2, 7 and 14 post-operatively. The expression levels of IGF-1 isoforms, as well as that of its binding protein and receptor were evaluated using reverse transcription-quantitative PCR. Statistical analyses were performed using GraphPad Prism software. The Kruskal-Wallis test and Dunn's post hoc test were utilized. The results revealed a statistically significant difference in the expression of IGF-BP3 and IGF-1R during wound healing (P=0.014 and P=0.018, respectively). Specifically, the pairwise post-hoc Dunn test indicated that IGF-BP3 expression was significantly decreased on the 2nd post-operative day compared to the day of surgery, while IGF-1R expression was significantly increased at 14 days post-operatively. The expression of the remaining IGF-1 isoforms was not significantly altered during wound healing. On the whole, as demonstrated herein, IGF-BP3 and IGF-1R appear to play a crucial role during the wound healing process, particularly in patients with large open wounds following pilonidal disease treatment. Further studies are warranted to evaluate the exact role, as well as the possible use of these proteins as enhancers of wound healing.