1. Initial observations on sexual dysfunction as a symptom of chemotherapy-induced peripheral neuropathyNadine Reimer, Dominik Ratiu, Damir Zubac, Helmar C. Lehmann, Freerk T. Baumann, 2023, drugi znanstveni članki Povzetek: Introduction: Peripheral neuropathy (PNP) in feet and/or hands and sexual dysfunction are common side effects of cancer therapies. In Nadine Reimer1 Dirk Brodesser1 patients with other diseases, there is evidence of an association Dominik Ratiu2 between peripheral nervous system disorders and sexual dysfunction due to the impact of impaired neuronal control on genital organ sensi- Damir Zubac1 tivity. In cancer patient interviews, it has now been observed that PNP Helmar C. Lehmann3 and sexual dysfunction may be related. The aim of the study was to Freerk T. Baumann1 investigate the potential association between PNP, sexual dysfunction, and physical activity behavior. Methods: Ninety-three patients with PNP of the feet and/or hands were interviewed in August/September 2020 in a cross-sectional study re- 1 University of Cologne, Department I of Internal garding medical history, sexual dysfunction and functionality of the genital organs. Medicine, Center for Integrated Oncology Aachen Results: Thirty-one persons who participated in the survey provided Bonn Cologne Dusseldorf, seventeen evaluable questionnaires (four men, thirteen women). Nine University Hospital of women (69%) and three men (75%) reported sensory disorders of the Cologne, Germany genital organs. Three men (75%) had erectile dysfunction. All men who 2 University of Cologne, Clinic had sensory symptoms of the genital organs received chemotherapy, and Polyclinic for Gynecology and Obstetrics, University Hospital Cologne, Germany and one man also received immunotherapy. Eight women were sexually active. Five (63%) of them reported genital organ symptoms and mainly lubrication disorders. Four (80%) of the five sexually inactive women 3 University of Cologne, Clinic reported genital organ symptoms. Eight of the nine women with sensory and Polyclinic for Neurology, University Hospital Cologne, Germany symptoms of the genital organs received chemotherapy, and one woman received immunotherapy. Discussion: Our limited data suggest genital organ sensory symptoms in chemotherapy and immunotherapy patients. Genital organ symptoms do not appear to be directly related to sexual dysfunction, and the association between PNP and genital organ symptoms appears to be more pronounced in sexually inactive women. Chemotherapy could cause sensory symptoms of the genital organs and sexual dysfunction by damaging genital organ nerve fibers. Chemotherapy and anti-hormone therapy (AHT) could trigger a disturbance of the hormone balance, which in turn could be causative for sexual dysfunction. It remains open whether the cause of these disorders is the symptomatology of the genital organs or the altered hormone balance. The significance of the results is limited due to the small number of cases. To our knowledge, this study is the first of its kind in cancer patients and allows a better understanding of the association between PNP, sensory symptoms of the genital organs, and sexual dysfunction. Conclusion: In order to be able to narrow down the cause of these initial observations in cancer patients more precisely, larger studies are needed that can relate the influence of cancer therapy-induced PNP, physical activity level and hormone balance to sensory symptoms of the genital organs and sexual dysfunction. The methodology of further studies should take into account the frequent problem of low response rates in surveys on sexuality.
Ključne besede: peripheral neuropathy, genital organs, sexual disfunction, oncology, exercise therapy, physical activity
Objavljeno v DiRROS: 05.11.2025; Ogledov: 37; Prenosov: 11
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2. Feasibility and safety of impact‑loading exercise in patients with multiple myeloma—a pilot studyAnne Kollikowski, Marei Schallock, Ruben Ringeisen, Dirk Hasenclever, Lothar Seefried, Jan-Peter Grunz, Damir Zubac, Claudia Löffler, Freerk T. Baumann, Franziska Jundt, 2025, izvirni znanstveni članek Povzetek: Purpose Patients with multiple myeloma (MM) develop osteolytic lesions with fractures, pain, and impaired quality of life. Preclinical data show an anabolic effect of loading exercise in osteolytic lesions of MM. This 6-month pilot study evaluated feasibility and safety of impact-loading exercise in patients with MM after assessment of spinal stability. Methods We assigned 20 patients to perform 45 min of guided impact-loading exercise twice a week and home-based training once a week or stretching exercise twice a week. Primary endpoint was assessment of feasibility and safety. Secondary endpoints were assessments of physical performance, quality of life, and bone remineralization. Results Of 77 eligible patients with MM, 26% accepted participation. In the impact group, 9/12 and in the stretching group 7/8 patients completed training with adherence rates of 65.8 and 81.1%. Ninety percent of the stamping and jumping exercises were performed with increasing intensity from the prescribed training volume of ≥ 100%. Low severity pain events were reported after 32.9% of impact sessions. No serious adverse events were observed. After 6 months, 6-minute walk distance increased in the impact group by 35 m and in the stretching group by 46 m, and chair-rise test improved in the stretching group by 1.7 s. Global health status increased by 24.9% in the impact group, and functional scale by 31.9% in the stretching group based upon EORTC QLQ-C30. No signs of bone remineralization were observed in computed tomography. Conclusion Impact training is feasible and appears to be safe in selected MM patients.
Ključne besede: multiple myeloma, feasibility, safety, impact-loading exercise, bone turnover maker
Objavljeno v DiRROS: 13.10.2025; Ogledov: 126; Prenosov: 54
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3. Acute effects of high-intensity interval training on microvascular circulation : a case control study in uveal melanomaMichael Mendes Wefelnberg, Johanna Hubert, Freerk T. Baumann, Damir Zubac, 2024, izvirni znanstveni članek Povzetek: Objectives: The aim of this study was to explore the acute effects of high-intensity interval training (HIIT) on the microvascular circulation and vascular tumor microenvironment (TME) in a patient with uveal melanoma (UM). Additionally, the acceptance of the applied diagnostics and the exercise protocol in a clinical ophthalmic-oncology setting were evaluated. Methods: This case-control study included a young adult male patient with UM previously treated with radiation and an age-matched healthy control. Participants underwent a baseline assessment of dynamic retinal vessel analysis (DRVA) and cardiopulmonary exercise testing (CPET) to determine endothelial function and intensity for HIIT. Optical coherences tomography angiography (OCTA) was performed before, immediately and 30 min after one session of HIIT. The primary outcome were changes in ocular vessel parameters and whole body oxygen uptake. Results: The UM patient exhibited lower arterial dilation and constriction in the affected eye compared to his healthy eye and both eyes of the healthy control. OCTA revealed heterogeneous patterns of vascular response to HIIT in both participants. The tumor eye showed an increase followed by a significant decrease in vessel density post-exercise, while the healthy control exhibited minor increases. Conclusions: The findings of this study highlighted the potential of UM combined with OCTA and DRVA as a model for examine exercise-induced vascular effects within the TME. However, a pre-treated UM as well as detailed image analyses and further research with longitudinal, randomized controlled designs are essential to validate these findings and address methodological limitations. Such investigations could refine integrative cancer treatment.
Ključne besede: uveal melanoma, endothelial dysfunction, aerobic exercise, oxygen kinetics
Objavljeno v DiRROS: 21.11.2024; Ogledov: 618; Prenosov: 759
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4. Tensiomyography : from muscle assessment to talent identification toolDražen Čular, Matej Babić, Damir Zubac, Ana Kezić, Iva Macan, Leonardo Alexandre Peyré-Tartaruga, Francesco Ceccarini, Johnny Padulo, 2023, pregledni znanstveni članek Povzetek: Introduction: Tensiomyography (TMG) is a non-invasive and cost-effective tool that is gaining popularity in fields such as sports science, physical therapy, and medicine. In this narrative review, we examine the different applications of TMG and its strengths and limitations, including its use as a tool for sport talent identification and development. Methods: In the course of crafting this narrative review, an exhaustive literature search was carried out. Our exploration spanned several renowned scientific databases, such as PubMed, Scopus, Web of Science, and ResearchGate. The materials we sourced for our review included a broad spectrum of both experimental and non-experimental articles, all focusing on TMG. The experimental articles featured varied research designs including randomized controlled trials, quasi-experiments, as well as pre-post studies. As for the non-experimental articles, they encompassed a mix of case-control, cross-sectional, and cohort studies. Importantly, all articles included in our review were written in English and had been published in peer-reviewed journals. The assortment of studies considered provided a holistic view of the existing body of knowledge on TMG, and formed the basis of our comprehensive narrative review. Results: A total of 34 studies were included in the review, organized into three sections: 1) assessing muscle contractile properties of young athletes, 2) using TMG in the talent identification and development process and 3) Future research and perspectives. According to data presented here, the most consistent TMG parameters for determining muscle contractile properties are radial muscle belly displacement, contraction time, and delay time. Biopsy findings from the vastus lateralis (VL) confirmed TMG as a valid tool for estimating the ratio of myosin heavy chain (%MHC-I). Conclusion: TMGs ability to estimate the ratio of %MHC-I has the potential to aid in the selection of athletes with the muscle characteristics best suited for a particular sport, eliminating the need for more invasive procedures. However, more research is warranted to fully understand TMG’s potential and its reliability when used with young athletes. Importantly, the use of TMG technology in this process can positively impact health status, reducing the frequency and severity of injuries and the duration of recovery, and subsequently can reduce drop out rates among youth athletes. Future studies should look at twin youth athletes, as a model capable of discriminating between the influence of hereditary factors vs. environmental factors, in therms of muscle contractility and TMG’s potential for instance.
Ključne besede: muscle assessment, muscle fiber composition, noninvasive metthod, MHC ratio, TMG
Objavljeno v DiRROS: 20.11.2024; Ogledov: 622; Prenosov: 373
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5. Setting sail for Paris 2024 : retrospective analysis ofworld-class ILCA 7 olympic sailors’ cardiorespiratory fitness (2015–2020)Damir Zubac, Zoran Valić, Vladimir Ivančev, 2024, drugi znanstveni članki Povzetek: The aim of this retrospective analysis was to provide a more comprehensive understanding of the cardiorespiratory profile of world-class ILCA-7 sailors (n = 3, all males), through a longitudinal evaluation offering real-world data on physiological profile and exercise intensity domains. The cardiopulmonary exercise testing (CPET) was performed by the same researchers using the same equipment during the study. Assessments took place twice a year, aligning with major international competition preparations. Participants trained and competed at the same sailing club in Split, Croatia, under consistent supervision from the same team throughout the study, winning a total of 21 medals at major international competitions. The recorded
ranged from 51.7 ± 1.6 to 61.9 ± 3.0 mL min−1 kg−1, respectively. Similarly, peak power output varied from 352 ± 10 to 426 ± 34 W. The changes in physiological responses at the ventilatory thresholds were proportional to the changes in peak cardiorespiratory fitness capacity. Interestingly, the oxygen pulse measured in 2015 was 25 ± 1 mL O2 beat−1. Over the subsequent 6 years, the O2 pulse marginally increased and appeared to stabilize at 27 ± 1 mL O2 beat−1 in 2020, when these athletes were 32 ± 3 years old. This work offers a broader understanding of world-class Olympic sailors’ cardiorespiratory fitness, going beyond the standard assessment of peak
to incorporate an analysis of ventilatory thresholds. While a direct link between cardiorespiratory fitness and competitive success remains ambiguous, the importance of a well-rounded aerobic capacity for excellence in ILCA-7 sailing class is evident.
Ključne besede: olypmipcs, oxygen uptake, sailing
Objavljeno v DiRROS: 31.07.2024; Ogledov: 817; Prenosov: 747
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6. Depth of SCUBA diving affects cardiac autonomic nervous systemMarina Vulić, Branislav Milovanovic, Ante Obad, Duška Glavaš, Igor Glavičič, Damir Zubac, Maja Valic, Zoran Valić, 2024, pregledni znanstveni članek Povzetek: The present study investigated the influence of SCUBA dives with compressed air at depths of 10 and 20 m on ECG-derived HRV parameters in apparently healthy individuals. We hypothesized that cardiac sympathetic activity (measured by HRV parameters) adapts proportionally to diving depth, and that both time- and frequency-domain parameters are sensitive enough to track changes in cardiac ANS function during diving activities and subsequently during the recovery period. Eleven healthy middle-aged recreational divers (nine men and two women, age 43 ± 8, all nonsmokers) volunteered to participate in the present study. The participants (all open-circuit divers) were equipped with dry suits and ECG Holter devices and were later randomly assigned to dive pairs and depths (10 m vs. 20 m), and each participant served as his or her own control. No interaction effects (diving depth x time epoch) were found for the most commonly used HRV markers. More precisely, in response to two different diving protocols, a significant post hoc effect of time was observed for HR and SDNN, as these parameters transiently decreased during the dives and returned to baseline after ascent (p < 0.001). The ULF, VLF (p < 0.003), TP, and LF parameters decreased significantly during the dives, while HF significantly increased (p < 0.003). SCUBA diving apparently challenges the cardiac ANS, even in healthy individuals. The observed changes reveal possible underwater methods of influencing the parasympathetic activity of the heart depending on the depth of the dive. These results identify autonomic nervous system markers to track the cardiovascular risk related to diving and point to the possibility of tracking cardiovascular system benefits during underwater activities in selected patients
Ključne besede: autonomic nervous system, diving, parasympathicus, cardiovascular risk
Objavljeno v DiRROS: 09.04.2024; Ogledov: 1141; Prenosov: 628
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7. Retinal venular vessel diameters are smaller during ten days of bed restAdam Salon, Göktuğ Mert Çiftci, Damir Zubac, Boštjan Šimunič, Rado Pišot, Marco Vincenzo Narici, Per Morten Fredriksen, Benedicta Ngwenchi Nkeh-Chungag, Harald Sourij, Nandu Goswami, 2023, izvirni znanstveni članek Povzetek: Older individuals experience cardiovascular dysfunction during extended bedridden hospital or care home stays. Bed rest is also used as a model to simulate accelerated vascular deconditioning occurring during spacefight. This study investigates changes in retinal microcirculation during a tenday bed rest protocol. Ten healthy young males (22.9± 4.7 years; body mass index: 23.6± 2.5 kg·m–2) participated in a strictly controlled repeated-measures bed rest study lasting ten days. High-resolution images were obtained using a hand-held fundus camera at baseline, daily during the 10 days of bed rest, and 1 day after re-ambulation. Retinal vessel analysis was performed using a semi-automated software system to obtain metrics for retinal arteriolar and venular diameters, central retinal artery equivalent and central retinal vein equivalent, respectively. Data analysis employed a mixed linear model. At the end of the bed rest period, a signifcant decrease in retinal venular diameter was observed, indicated by a signifcantly lower central retinal vein equivalent (from 226.1 µm, CI 8.90, to 211.4 µm, CI 8.28, p= .026), while no signifcant changes in central retinal artery equivalent were noted. Prolonged bed rest confnement resulted in a signifcant (up to 6.5%) reduction in retinal venular diameter. These fndings suggest that the changes in retinal venular diameter during bedrest may be attributed to plasma volume losses and refect overall (cardio)-vascular deconditioning.
Ključne besede: eyes, retinal venular vessel, venske žile, bed rest, gibalna neaktivnost
Objavljeno v DiRROS: 23.11.2023; Ogledov: 1635; Prenosov: 698
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8. Decomposition of tensiomyogram and comparison with torque twitch responses after post-activation potentiationEnsar Abazović, Armin Paravlić, Damir Zubac, Erol Kovačević, Boštjan Šimunič, 2022, izvirni znanstveni članek Povzetek: Objectives: This study evaluates the effect of post-activation potentiation (PAP) after 5x5s maximal voluntary isometric contractions (activation stimulus, AS) on tensiomyography (TMG) and torque twitch contractile parameters of vastus lateralis (VL) and medialis (VM), respectively. Further, we validated the decomposition of TMG response to separate responses of three fiber types. Methods: 15 healthy individuals participated in this study (40% women; age 19±2.3 years). A decomposition of VL TMG response was done after optimal fitting of three exponential curves. Results: We found main effects in contraction time (Tc) for muscle, method and time. Furthermore, we found interactions between muscle*method, method*time and muscle*method*time. Compared to PRE AS, we found shorter TMG Tc in VL and VM during the first two minutes after AS. Torque Tc remained unchanged in VL, while it increased in VM within 30 seconds after AS. A decomposition of VL TMG response confirmed PAP effects being present only in decomposed type IIb muscle fibers. Conclusion: The TMG is a sensitive method to detect PAP effects with a sensor mounted directly above the muscle belly. After the decomposition of the TMG signal to three separate muscle fiber phenotypes, we provided a non-invasive insight in the contribution of each muscle fiber phenotype to the PAP of the whole muscle.
Ključne besede: skeletal muscles, fast-twitch fibers, post-activation potentiation, decomposition, tensiomyography
Objavljeno v DiRROS: 05.09.2022; Ogledov: 1793; Prenosov: 783
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