A randomized trial was performed to compare the sequential use of 2 weeks of intravenous ganciclovir (10 mg/[kg.d]) followed by 50 weeks of high-dose oral acyclovir (800 mg/m2 four times daily) with 2 weeks of intravenous ganciclovir alone as prophylaxis for cytomegalovirus (CMV) and Epstein-Barr virus (EBV) disease after pediatric liver transplantation. CMV disease was diagnosed for seven of 24 patients treated with ganciclovir followed by high-dose oral acyclovir compared with two of 24 children treated with ganciclovir alone (P = .048). Similarly, the rate of CMV disease among high-risk patients (CMV-positive donor/CMV-negative recipient) treated with the combination regimen was higher than that among high-risk patients treated with ganciclovir alone (four [57%] of seven vs. zero of five, respectively; vs P < .05). The rate of EBV disease among patients treated with the combination regimen (eight [33%] of 24) was similar to that among patients treated with ganciclovir alone (five [21%] of 24; P = not significant). We conclude that sequential prophylaxis with 2 weeks of intravenous ganciclovir followed by 50 weeks of high-dose oral acyclovir did not decrease the frequency of CMV or EBV disease after pediatric liver transplantation when compared with 2 weeks of intravenous ganciclovir alone.

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Introduction Iron metabolism determines the oxygen transport of the blood, thereby affecting the exercise capacity and performance. In patients with heart failure iron deficiency is a major risk factor that predicts and influences patient's quality of life. In athletes diagnosing iron deficiency is also extremely important as it determines sport performance. Purpose Our aim is to study the correlation of iron metabolism parameters with exercise capacity in athletes. Methods Cardiopulmonary exercise test (CPET) was performed as part of detailed sports cardiology screening. We studied in athletes the changes of iron metabolism parameters (serum iron, transferrin, total iron-binding capacity (TIBC), ferritin) and correlation with the exercise physiology parameters. Results Our measurements were performed on 105 top athletes: swimmers (n=58,55%; male = 29; junior = 30; 20,4±4,6 y), football players (n=47, 45%; junior = 6; 23,2±5,4 y). Laboratory test verified hemoglobin (male = 153,8±9,4; female = 141,2±7,7 g/L; p&lt;0,001) and hematocrit (male = 0,45±0,03; female = 0,42±0,02 L/L; p&lt;0,001) value in a normal range for all. In women, significantly lower ferritin (67,8±76,2 vs. 98,9±48 μg/L; p&lt;0,05) and higher TIBC (78,1±14,3 vs. 66,5±9,3 μmol/L; p&lt;0,001) were observed. Young male athletes had significantly lower serum iron (16,1±6 vs. 21,2±7,5 μmol/L; p&lt;0,05), ferritin (68±42,7 vs. 109,1±45,5 μg/L; p&lt;0,01) and higher TIBC (76,1±11,0 vs. 64,3±7,4 μmol/L; p&lt;0,001) compared to adults. During CPET male athletes had higher maximal aerobic capacity (52.2±4.4 vs. 55.9±5.5 mL/kg/min; p&lt;0.001) and ventilation (115.8±16.1 vs. 153.2±26 L/min; p&lt;0.001) compared to females. Maximal aerobic capacity and ventilation showed positive correlation with ferritin (p&lt;0,0001). The ferritin cut-off value of iron supplementation was &lt;100 μg/L. Iron supplementation was required in almost half of the athletes (n=49, 47%). Conclusion Diagnosing iron deficiency in athletes, complete iron panel containing ferritin is required. According to our results iron status determines performance, therefore iron deficiency screening and iron supplementation is essential. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): - Supported by the ÚNKP-20-3-I New National Excellence Program of the Ministry for Innovation and Technology from the Source of the National Research, Development and Innovation Fund - The research was financed by the Thematic Excellence Programme (2020-4.1.1.-TKP2020) of the Ministry for Innovation and Technology in Hungary, within the framework of the Therapeutic Development and Bioimaging programmes of the Semmelweis University.

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