Increase In Clinical Symptoms Research Articles

Assessment of clinical functional changes and quality of life in bronchial asthma

Our research was conducted at the multidisciplinary clinic of the Tashkent Medical Academy.Clinical functional changes were conducted among 46 patients with bronchial asthma.The average duration of the disease is 24,2 years.When we analyzed the patients with bronchial asthma, the degree of clinical functional changes in patients increased with the increase of disease. Indicators of obstructive disorders a significant decrease in peak expiratory flow rate ( PEFR) up to 55,6±6.9% and Lung capacities up to 69.7±6.4% confirms the nature of clinical signs and obstructive disorders.PEFR showed a significant decrease from 78% to 35% with the severity of the disease stage in BA patients and an increase in clinical symptoms depending on the level of the disease

Novel three-way decision model in medical diagnosis based on inexact reasoning

According to the clinical symptoms, a patient exhibits and medical domain knowledge, determining the type of disease the patient has is essential for medical diagnosis. Uncertainty is the nature of medical diagnosis. The intuitionistic fuzzy set (IFS) is one of the effective tools to deal with uncertainty problems. In recent years, IFS has been widely used to deal with medical diagnosis problems. The existing mainstream approach is to rank the underlying diseases and then assign the first-ranked disease to the patient. These methods cannot deal with situations where patients have multiple diseases at the same time or no disease at all. In addition, these methods may generate unreasonable diagnostic results in some cases. Consider clinical symptoms as evidence that a patient has or does not have the disease. With the increase in clinical symptoms, physicians will increase their belief or disbelief that the patient has the disease. Therefore, based on the method of inexact reasoning, this paper proposed an inexact reasoning model in medical diagnosis, namely IRM-MD, which can rank the underlying diseases and avoid generating unreasonable diagnostic results. Furthermore, a three-way decision model for medical diagnosis based on IRM-MD, namely 3WDM-IRM, is proposed. This model can effectively deal with cases where patients have multiple conditions at the same time or none at all, and prevent missed diagnoses and misdiagnoses. Finally, the numerical experiment results show that (a)the results generated by the IRM-MD model are similar to those of other existing models, and (b)the 3WDM-IRM model can effectively identify whether a patient has a disease or not, and identify multiple diseases that the patient has at the same time.

DYNAMICS OF INTESTINAL CONTENT FLUCTUATIONS ANASTOMOSED SMALL INTESTINE LOOPS AS MARKER IN DIAGNOSIS OF DUMPING SYNDROME OF DIFFERENT SEVERITY IN GASTRIC CANCER PATIENTS AFTER GASTRECTOMY

The aim: to study the effectiveness of the method of daily fibroesophagoejunoscopy in determining the number of pellets of intestinal contents in the newly created anatomical-physiological complex and related functional disorders, accompanied by the manifestation of clinical symptoms of dumping syndrome of varying severity. Materials and methods. The method of fibrogastroscopic examination was by 190 patients with gastric tract after gastrectomy carried out. All patients were diagnosed with dumping syndrome of varying severity. The study showed that the severity of clinical manifestations of dumping syndrome depends on the number of intestinal contents in the newly created anatomical-physiological complex depending on the time of day. For proof of body, observing the stage, 30 patients underwent a modified esophagogastroscopic examination method, which was proposed by us – daily fibroeophagoeunoscopy, as well as histological and histochemical studies to detect inflammatory changes in anastomosed loops of the small intestine. To determine the dependence of clinical manifestations of dumping syndrome on the number of intestinal pellets, all patients underwent intracavitary intestinal laser therapy with helium-neon laser ULF-01. Results. When analyzing and comparing the data obtained during daily fibroesoeunoscopy with the clinical manifestations of dumping syndrome of varying severity, it was found, that at different periods of the day the intensity of intestinal casting in anastomosed loops of the small intestine and clinical manifestations of the disease differ significantly. It was established, that in the morning hours, at all degrees of severity of dumping syndrome, there was a minimum number of pellets of intestinal contents in the newly created anatomical complex and, accordingly, there were minimal clinical manifestations of the disease. The study also showed that the increase in clinical symptoms in patients with dumping syndrome is clearly precisely in the daytime manifested. Conclusions. The findings suggest that daily fibroesophagoeunoscopy is a pathognomonic method for diagnosing dumping syndrome in gastric cancer patients after gastrectomy. The method made it possible to establish that the severity of clinical manifestations depends on the number of casts of intestinal content and the time of its exposure in the newly created anatomical complex. The clinical symptoms of dumping syndrome are most in the daytime pronounced. The method also made it possible to determine that the most effective time for laser therapy is the morning period.

Декомпенсация хронической сердечной недостаточности после COVID-19: клиническое наблюдение

Chronic heart failure is a clinical syndrome that develops as a result of various diseases of both the cardiovascular and other systems, aggravates the course of the underlying disease, and increases the risk of an unfavorable outcome. The development of coronavirus infection in patients with CHF implies both the likelihood of symptom manifestation and the development of decompensation of the condition as a result of their mutual aggravation, which requires additional efforts from the doctor in their treatment to prevent disability and mortality. A case of dynamic follow-up of a patient with chronic heart failure that developed as a result of myocarditis is presented. After a COVID-19 infection, a progressive increase in clinical symptoms, loss of control, and decompensation of the condition were observed for six months, which required correction of drug and non-drug therapy to improve the prognosis for life.

SPONTANEOUS OCCLUSION OF THE CAROTID-CAVERNOUS FISTULAS. CASE SERIES AND LITERATURE REVIEW

Carotid-cavernous fistulas (CCF) is a pathological connection between the arteries and the cavernous sinus, which can be direct or indirect (dural). Direct CCS are characterized by the presence of a direct fistula between the internal carotid artery and the cavernous sinus, while indirect (low-flow) CCS are the result of a pathological connection between the branches of the carotid artery and the cavernous sinus. For more than a century (from the end of the 19th century to the beginning of the 20th century), clinical manifestations and surgical methods of treatment of CCF were discussed. The treatment of patients with indirect shunts and minimal clinical manifestations is not well defined, especially in case where endovascular embolization is associated with technical difficulties considering device selection and difficulties in access to the fistulas, both transarterial and transvenous. Few articles has been studied the tendency of spontaneous occlusion of the CCF ‒ a natural process of recovery. The study of the tendency of the CCS to spontaneous occlusion is promising for optimizing the treatment of this specific group of patients and improving the results of their treatment.Objective ‒ to analyze the cases of spontaneous occlusion of the CCF and data from the literature for optimizing the management of patients with this pathology.Materials and methods. A retrospective analysis of the database of 63 patients with a diagnosis of CCF confirmed by angiography who were treated at the SO «Scientific-Practical Center of Endovascular Neuroradiology NAMS of Ukraine» during the period from 2014 to 2022, was conducted. There were 67 (in 4 patients they were bilateral) patients with CCF. In 7 (11.1 %) cases, their spontaneous occlusion was detected, which was confirmed with follow-up examinations.Results. Among 7 patients with documented spontaneous CCS occlusion, 2 were male and 5 were female. The average age of patients was (56.31 ± 10.39) years. In all cases, CCF were unilateral, dural, low-flow, and occlusion occurred within 3 – 4 months after the manifestation (appearance of clinical symptoms). In 2 (28.6 %) cases, CCF occurred as a result of trauma, in 5 (71.4 %) ‒ they were spontaneous. In 3 (42.8 %) patients, the occlusion occurred before the planned endovascular embolization. In 1 (14.3 %) case, the endovascular treatment was technically unsuccessful, but the CCF regressed after 4 months, which was confirmed by control cerebral angiography. Three (42.8 %) patients refused the procedure and received conservative treatment. Ocular manifestations of the CCF prevailed in all patients (conjunctival injection ‒ in 7 (100 %), diplopia ‒ in 5 (71.4 %), proptosis ‒ in 4 (57.1 %), retro-orbital pain ‒ in 3 (42.8 %), visual impairment in 1 (14.3%). Five (71.4 %) patients complained of headache, 1 (14.3 %) ‒ tinnitus. In 2 (28.6 %) patients spontaneous occlusion was accompanied by an increase in clinical symptoms and their subsequent regression, in 5 (71.4 %) patients there ware a clinical improvement (in 2 (28.6 %) ‒ gradual over several months).Conclusions. Spontaneous occlusion of direct CCF is rare. In order to determine clear predictors regarding the prognosis of this disease and indications for surgical treatment or observation, it is necessary to compare angiographic features, clinical features, and manifestations of the disease.
 
 

A clinical case of the debut of pemphigus foliaceus against the background of vaccination against coronavirus infection (COVID-19)

The article describes the onset of pemphigus foliaceus against the background of vaccination with the combined vector vaccine "Gam-COVID-Vac" ("Sputnik V"). A feature of this clinical case is the duration of the period from the moment of development of the first symptoms of the disease to clinical and immunohistochemical confirmation of the diagnosis, which, in fact, indicates a low availability of specialized medical care for rare dermatoses. In particular, the waiting period for taking material for histological examination lasted for several months, which, in fact, is not an isolated case. At the same time, against the background of an increase in clinical symptoms, this became an additional factor in the patient's self-referral to a specialized federal state medical institution, where, within two weeks, the diagnosis was confirmed by immunohistochemical analysis methods and inpatient treatment was carried out with a pronounced positive effect. In addition, the analysis of the medical care provided to the patient showed insufficient alertness and the level of training of dermatovenereologists in diagnosing rare dermatoses accompanied by blistering rashes. In particular, the patient initially underwent several courses of antifungal therapy in combination with intravenous infusion of systemic glucocorticosteroids. The article also presents an analysis of the frequency of occurrence of this disease in different countries for more than 100 years.

It’s all about beliefs: Believing emotions are uncontrollable is linked to symptoms of anxiety and depression through cognitive reappraisal and expressive suppression

The aim of this study was to examine the link between personal beliefs about emotion controllability and symptoms of anxiety and depression, with a particular focus on the mediating role of emotion regulation. To date, there has been little research examining the mediating role of cognitive reappraisal or expressive suppression in the link between beliefs about emotion controllability and symptoms of anxiety. Online questionnaires measuring emotion regulation, beliefs about emotion controllability, and depression and anxiety, were completed by 1227 participants (n = 336 males; Mage = 25.3, SD = 10.1; range = 16 to 83 years). The results indicated that perceived control over one’s own emotions predicted better psychological health (fewer symptoms of anxiety and depression). This link between beliefs about emotion controllability and psychological heath was partially mediated by cognitive reappraisal and expressive suppression, with cognitive reappraisal predicting a reduction in clinical symptoms and expressive suppression predicting an increase in clinical symptoms. These findings suggest that individuals’ beliefs about emotion controllability, leads to the use of certain emotion regulation strategies which in turn, have important consequences for psychological health.

Tick-transmitted co-infections among erythema migrans patients in a general practice setting in Norway: a clinical and laboratory follow-up study

BackgroundErythema migrans (EM) is the most common manifestation of Lyme borreliosis. Here, we examined EM patients in Norwegian general practice to find the proportion exposed to tick-transmitted microorganisms other than Borrelia, and the impact of co-infection on the clinical manifestations and disease duration.MethodsSkin biopsies from 139/188 EM patients were analyzed using PCR for Neoehrlichia mikurensis, Rickettsia spp., Anaplasma phagocytophilum and Babesia spp. Follow-up sera from 135/188 patients were analyzed for spotted fever group (SFG) Rickettsia, A. phagocytophilum and Babesia microti antibodies, and tested with PCR if positive. Day 0 sera from patients with fever (8/188) or EM duration of ≥ 21 days (69/188) were analyzed, using PCR, for A. phagocytophilum, Rickettsia spp., Babesia spp. and N. mikurensis. Day 14 sera were tested for TBEV IgG.ResultsWe detected no microorganisms in the skin biopsies nor in the sera of patients with fever or prolonged EM duration. Serological signs of exposure against SFG Rickettsia and A. phagocytophilum were detected in 11/135 and 8/135, respectively. Three patients exhibited both SFG Rickettsia and A. phagocytophilum antibodies, albeit negative PCR. No antibodies were detected against B. microti. 2/187 had TBEV antibodies without prior immunization. There was no significant increase in clinical symptoms or disease duration in patients with possible co-infection.ConclusionsCo-infection with N. mikurensis, A. phagocytophilum, SFG Rickettsia, Babesia spp. and TBEV is uncommon in Norwegian EM patients. Despite detecting antibodies against SFG Rickettsia and A. phagocytophilum in some patients, no clinical implications could be demonstrated.

Helicobacter pylori, clinical, laboratory, and noninvasive biomarkers suggestive of gastric damage in healthy school-aged children: A case-control study

BackgroundHelicobacter pylori is acquired largely in early childhood, but its association with symptoms and indirect biomarkers of gastric damage in apparently healthy children remains controversial. We aimed to relate persistent H. pylori infection in apparently healthy school-aged children with clinical, laboratory, and noninvasive biomarkers suggestive of gastric damage using a case-control design. Materials and methodsWe followed up 83 children aged 4–5 years with persistent H. pylori infection determined by stool antigen detection and/or a urea breath test and 80 noninfected matched controls from a low-income to middle-income, periurban city in Chile for at least 3 years. Monitoring included clinical visits every 4 months and annual assessment by a pediatric gastroenterologist. A blood sample was obtained to determine laboratory parameters potentially associated with gastric damage (hemogram and serum iron and ferritin levels), biomarkers of inflammation (cytokines, pepsinogens I and II, and tissue inhibitor metalloproteinase 1), and expression of cancer-related genes KLK1, BTG3, and SLC5A8. ResultsPersistently infected children had higher frequency of epigastric pain on physical examination (40% versus 16%; P = 0.001), especially from 8 to 10 years of age. No differences in anthropometric measurements or iron-deficiency parameters were found. Persistent infection was associated with higher levels of pepsinogen II (median 12.7 ng/mL versus 9.0 ng/mL; P < 0.001); no difference was observed in other biomarkers or gene expression profiles. ConclusionsH. pylori infection in apparently asymptomatic school-aged children is associated with an increase in clinical symptoms and in the level of one significant biomarker, pepsinogen II, suggesting early gastric involvement.

Platelet-rich plasma use for shoulder epicondylitis treatment

Epicondylitis is the most common cause of elbow pain, affecting up to 3,0% of the adult population. A comparative study of platelet-rich plasma (BTP) and betamethasone (diprospan) in the treatment of epicondylitis of the shoulder. 50 patients received injections of betamethasone 2-fold with an interval of 14 days. The main group-50 patients received 2 injections of BTP with an interval of 14 days. The results were evaluated using the psychometric scale Patient-Rated Tennis Elbow Evaluation (PRTEE) after 1, 6 and 12 months. Patients receiving Betamethasone showed the lowest level of pain after 1 month, with a gradual tendency to reduce the clinical effect after 6 months and the increase in clinical symptoms of the disease after 12 months. after treatment. The clinical effect after the use of BTP increases to 6 months with a slight tendency to reduce the effect to 12 months. Our studies have shown a high, up to 86,0% effectiveness of the applied methods of treatment of internal and external epicondylitis of the shoulder using PRP in comparison with glucorticosteroids.

Клиническая оценка тяжести течения хронического цистита у женщин разных возрастных групп

The aim of the study was to estimate course the peculiarities of chronic cystitis in women of different ages. The study included 334 women with chronic cystitis (CC). The patients were divided into 3 age groups: group 1 — 20 to 39 years old; group 2 — 40 to 59 years old; group 3 — elderly age (60 years old and older). Cystoscopy was performed, the frequency of cystitis exacerbations was estimated, a survey was carried out using the PUF Scale (Pelvic Pain and Urgency/Frequency Patient Symptom Scale) questionnaire, and urination diaries were evaluated. A higher severity of symptoms was revealed in patients with leukoplakia in all age groups. However, the incidence of leukoplakia signifi cantly decreased with age. In this regard, the observed age-related increase in clinical symptoms of CC is most likely associated with the emergence of age-related pathogenesis factors. An inverse correlation between the presence of leukoplakia and mucosal edema was detected in women with the same symptoms. The two-way analysis of variance revealed two factors associated with increasing severity of chronic cystitis symptoms: age and the presence of squamous metaplasia (leukoplakia).

IFNG +874A/T Polymorphism Among Asymptomatic HTLV-1-Infected Individuals Is Potentially Related to a Worse Prognosis.

HTLV-1 infections are persistent and frequently latent; however, productive infections trigger different types of immunological responses that utilize cytokines to control infection. The present study investigated the role of IFNG +874A/T polymorphisms among 153 HTLV-1-infected individuals (33 clinically diagnosed with TSP/HAM, 22 with rheumatologic manifestations, 2 with dermatitis, 1 with uveitis, and 95 asymptomatic patients) and 300 healthy control individuals. Genotyping and proviral HTLV-1 load assessment were performed using real-time PCR assays, and the plasma levels of IFN-γ were measured using an enzyme immunoassay (ELISA). Genotype frequencies were not significantly different, but the presence of the T allele was higher (p < 0.0142) among the asymptomatic patients. Plasma levels of IFN-γ were significantly higher (p < 0.0137) among those with the TT genotype. Their proviral load was also higher, although this elevation did not reach statistical significance. There was no difference in the IFN-γ plasma levels among the symptomatic patients, even when ranked according to disease severity (TSP/HAM or rheumatologic manifestations). However, the difference among asymptomatic patients with the T allele was significantly higher (p < 0.0016) and similar to the plasma levels observed among symptomatic individuals. These results suggest that the IFNG +874A/T polymorphism may modulate the plasma levels of IFN-γ during HTLV-1 infection. Asymptomatic carriers of the polymorphic genotypes appear to develop an inflammatory response in a shorter timeframe, triggering progression to HTLV-1-related symptoms and disorders. These results further suggest that HTLV-1-infected asymptomatic individuals expressing the IFNG +874A/T polymorphism should be monitored more closely in order to readily detect the increase in clinical symptoms, as these patients are potentially at risk of a poor prognosis and should therefore start available treatment procedures earlier.

Oxytocin Receptor Genotype Modulates Ventral Striatal Activity to Social Cues and Response to Stressful Life Events

Common variants in the oxytocin receptor gene (OXTR) have been shown to influence social and affective behavior and to moderate the effect of adverse experiences on risk for social-affective problems. However, the intermediate neurobiological mechanisms are not fully understood. Although human functional neuroimaging studies have reported that oxytocin effects on social behavior and emotional states are mediated by amygdala function, animal models indicate that oxytocin receptors in the ventral striatum (VS) modulate sensitivity to social reinforcers. This study aimed to comprehensively investigate OXTR-dependent brain mechanisms associated with social-affective problems. In a sample of 1445 adolescents we tested the effect of 23-tagging single nucleotide polymorphisms across the OXTR region and stressful life events (SLEs) on functional magnetic resonance imaging blood oxygen level-dependent activity in the VS and amygdala to animated angry faces. Single nucleotide polymorphisms for which gene-wide significant effects on brain function were found were then carried forward to examine associations with social-affective problems. A gene-wide significant effect of rs237915 showed that adolescents with minor CC-genotype had significantly lower VS activity than CT/TT-carriers. Significant or nominally significant gene × environment effects on emotional problems (in girls) and peer problems (in boys) revealed a strong increase in clinical symptoms as a function of SLEs in CT/TT-carriers but not CC-homozygotes. However, in low-SLE environments, CC-homozygotes had more emotional problems (girls) and peer problems (boys). Moreover, among CC-homozygotes, reduced VS activity was related to more peer problems. These findings suggest that a common OXTR-variant affects brain responsiveness to negative social cues and that in "risk-carriers" reduced sensitivity is simultaneously associated with more social-affective problems in "favorable environments" and greater resilience against stressful experiences.

Major increase in allergic sensitization in schoolchildren from 1996 to 2006 in northern Sweden

Time trends for allergic sensitization are poorly known. To compare the trends in prevalence of allergic sensitization and associated risk factors in children. Two cohorts of children (age 7-8 years) were invited for skin prick tests (SPTs) 10 years apart, 1996 and 2006. The participation rates were 2148 (88%) and 1700 (90%), respectively. The methods were identical, and 10 common airborne allergens were used. An expanded International Study of Allergy and Asthma in Children questionnaire about symptoms and possible risk factors for allergic conditions was completed by the parents. The prevalence of any positive SPT increased from 21% in 1996 to 30% in 2006 (P < .001). The pattern of sensitization remained similar, and sensitization to cat was most common both years, 13% and 19%, respectively. Sensitization to mites and mold was uncommon in both surveys. A family history of allergy was a significant risk factor for a positive SPT both years (odds ratio, 1.7). Factors that in 1996 had a protective effect, such as rural living and having several siblings, had lost this effect in 2006. The prevalence of most risk factors remained similar, but respiratory infections and smoking among parents decreased significantly. During the same period, there was no significant increase in the prevalence of current wheeze (11.9% to 12.4%, P = .636) or symptoms of rhinitis or eczema. The prevalence of allergic sensitization increased significantly from 1996 to 2006, whereas no increase in clinical symptoms was found. The parallel decrease in parental smoking and respiratory infections indicate a different influence of environmental factors on allergic sensitization and clinical symptoms, respectively.

8. Hereditary angioedema

Hereditary angioedema is an episodic swelling disorder with autosomal dominant inheritance. Attacks are characterized by brawny, self-limited, nonpruritic edema of the deep dermal layers of the skin that most often involve the hands and feet. They usually begin in childhood and become more severe after puberty. Patients also have episodic attacks of severe abdominal pain caused by edema of the gastrointestinal mucosa. Swelling attacks are life threatening when they involve the airway. Estrogens exacerbate attacks, and in some patients attacks are precipitated by trauma or psychologic stress. The disease is caused by a mutation in one of the 2 copies of the gene for the plasma protein C1 inhibitor, with the product of 1 gene unable to control generation of bradykinin. Eighty-five percent of patients have low antigenic levels of C1 inhibitor, and 15% have normal levels of poorly functioning protein. Most patients have decreased plasma complement protein C4 levels. Impeded androgens and, less frequently, epsilon-aminocaproic acid are currently the mainstays of chronic treatment. These agents or fresh frozen plasma are also used for prophylaxis. At this time, acute therapy is mostly supportive. There are currently ongoing multiple trials of new therapeutic agents. In half a century, a life-threatening disease has become one that is manageable and rarely causes death.

Mucosal IgA Response to Repeated Wingate Tests in Females

The purpose of this study was to examine the effect of repeated bouts of brief, intermittent, maximal effort exercise on the concentration of secretory IgA (S-IgA) and incidence of upper respiratory tract infection (URTI) in females. Twenty-six non-smoking, active, adult females participated in this study. The exercise intervention consisted of three consecutive, all-out 30-second Wingate leg cycling tests (0.075 kg/kg body mass), which were separated by three minutes of recovery. Unstimulated saliva was collected prior to (PRE) and five minutes after completion (POST) of the exercise testing protocol. IgA, protein and osmolality were measured, and secretory IgA (S-IgA), IgA : Protein, and IgA : Osmolality were calculated. In addition, subjects completed standard logs indicating signs and symptoms of upper respiratory tract infection (URTI) for three weeks following the test. Saliva flow rates (478.5 ± 50; 345.4 ± 50 µl/min), S-IgA (55.8 ± 4.7; 35.4 ± 3.6 µg/min), and IgA : Protein ratio (30.7 ± 3.0; 17.5 ± 1.8 µg IgA/mg protein) were significantly lower POST compared to PRE (P < 0.05). No significant differences were observed for raw IgA, protein, osmolality, and IgA : osmolality. The results of this study show that brief, intermittent, maximal effort exercise results in an acute decrease in S-IgA in healthy adult females in less than eight minutes. However, this exercise induced transient decrease did not appear to be associated with an increase in clinical symptoms of URTI in the weeks following the exercise test intervention.

Mucosal IgA response to repeated wingate tests in females.

The purpose of this study was to examine the effect of repeated bouts of brief, intermittent, maximal effort exercise on the concentration of secretory IgA (S-IgA) and incidence of upper respiratory tract infection (URTI) in females. Twenty-six non-smoking, active, adult females participated in this study. The exercise intervention consisted of three consecutive, all-out 30-second Wingate leg cycling tests (0.075 kg/kg body mass), which were separated by three minutes of recovery. Unstimulated saliva was collected prior to (PRE) and five minutes after completion (POST) of the exercise testing protocol. IgA, protein and osmolality were measured, and secretory IgA (SIgA), IgA:Protein, and IgA: Osmolality were calculated. In addition, subjects completed standard logs indicating signs and symptoms of upper respiratory tract infection (URTI) for three weeks following the test. Saliva flow rates (478.5 +/- 50; 345.4 +/- 50 microl/min), S-IgA (55.8 +/- 4.7; 35.4 +/- 3.6 microg/min), and IgA: Protein ratio (30.7 +/- 3.0; 17.5 +/- 1.8 microg IgA/mg protein) were significantly lower POST compared to PRE (P < 0.05). No significant differences were observed for raw IgA, protein, osmolality, and IgA: osmolality. The results of this study show that brief, intermittent, maximal effort exercise results in an acute decrease in S-IgA in healthy adult females in less than eight minutes. However, this exercise induced transient decrease did not appear to be associated with an increase in clinical symptoms of URTI in the weeks following the exercise test intervention.