Τετάρτη, 9 Νοεμβρίου 2016

Raw: London Tram Derails, Multiple Injured



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An evaluation of knowledge, attitude and practice of pharmacovigilance among interns in a tertiary care teaching hospital of North Maharashtra

2016-11-09T07-12-32Z
Source: International Journal of Basic & Clinical Pharmacology
Kiran Prabhakar Vakade, Vijayaprasad M. Sangisetti, Mitali V. Binayke, Vijaykumar N. Abhavathi, Bana Bihari Nayak.
Background: Adverse Drug Reactions (ADRs) are considered as one of the leading cause throughout the world resulting in significant increase in mortality and morbidity, therefore its monitoring is very essential in today's practice of medicine. Spontaneous reporting of ADRs have played a major role in the detection of unsuspected, serious and unusual ADRs previously undetected during the phases of clinical trials. Under-reporting of ADRs is considered as one of the major hurdle for the success of pharmacovigilance. Aims and objectives were to assess the knowledge, attitude and practice of pharmacovigilance among interns in a tertiary care teaching hospital. Methods: A cross sectional, observational, questionnaire based study was carried out using a predesigned Knowledge Attitude Practice (KAP) questionnaire. Study was conducted after the permission of Institutional Ethical Committee (IEC). The study included 100 interns who had completed at least ten months of their internship. The KAP questionnaire was assessed and analyzed and data was presented as percentages. Results: On an average only 31.17% interns answered correctly related with knowledge about pharmacovigilance. 88.63% interns agreed that ADRs reporting is necessary. According to 85.22% interns, pharmacovigilance must be taught in details to healthcare professionals. Only 34.09% had ever seen the ADR reporting form. Only 17.04% interns had knowledge about how to report ADR? Conclusions: Our study revealed that there was lack of awareness related with knowledge, attitude and practice of pharmacovigilance among the interns. There is need of implementation of pharmacovigilance awareness programs for undergraduates.


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Vomiting, Rifampicin And Collapse

2016-11-09T05-22-34Z
Source: The Southeast Asian Journal of Case Report and Review
Jatinder Mokta, Kiran Mokta, Asha Ranjan.
Adrenal insufficiency is an important life threatening manifestation of tuberculosis. Patient can have insidious onset of symptoms, or acute adrenal crisis depending upon the acute of adrenal deficit. Here we report a patient of tuberculosis who developed acute adrenal insufficiency after initiation of anti tubercular therapy.


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Hydatid Cyst Presenting With Inferior Vena Cava Obstruction

2016-11-09T05-22-34Z
Source: The Southeast Asian Journal of Case Report and Review
Jatinder Kumar Mokta, Kiran Mokta, Asha Ranjan.
Hydatid cyst disease is caused by echinnococcus species in humans. Humans are accidental hosts. Here, we present a case report of male with disseminated hydatid cyst disease secondary to spillage of peritoneum with cysts during the previous surgery. He presented with features of inferior vena cava obstruction. We report this case as inferior vena cava (IVC) obstruction is a rare presentation of this common disease of Himalayan area like ours where animals stay at close proximity to humans.


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Respiratory Bronchiolitis With Christ-Siemens-Taurine Syndrome

2016-11-09T05-22-34Z
Source: The Southeast Asian Journal of Case Report and Review
Harsha Vardhana Varma, Jayasree Helen, Aruna Kumari Badam, Somnath Dash.
We the present the case of Respiratory Bronchiolitis in whom Christ Siemens Taurine syndrome was also diagnosed after stepwise approach, such kind of rare entity found in this part of the world should be an eye opener for every one.


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Gestational Trophoblastic Disease And Its Complications:Review Of Patient Profiles And Management At A Tertiary Care Centre

2016-11-09T05-22-34Z
Source: The Southeast Asian Journal of Case Report and Review
Rajshree Dayanand Katke .
Gestational trophoblastic Disease refers to a spectrum of pregnancy related placental tumors, which is Classified into Hydatidiform Mole and Gestational Trophoblastic Neoplasia. This disease is characterized by abnormalities of chorionic villi in the form of excessive trophoblastic proliferation, oedema of villous stroma, invasion and metastasis. The incidence of Hydatiform mole is 1-2 per 1000 pregnancies. The risk factors are Adolescent and elderly women, Prior molar pregnancy, OC pill use, Smoking, various vitamin deficiency and increase paternal age. Clinical presentation is usually of varing duration of amenorrhea followed by irregular bleeding. Ultrasound appearance is characteristic snow storm pattern i.e a complex echogenic mass with numerous cystic Spaces with no fetus or amniotic sac in complete mole. The two basic tenets for management is Suction Evacuation and regular follow up to detect trophoblastic disease. Most clinicians obtain pre operative x-ray chest hemogram , baseline beta HCG, blood grouping, liver enzymes routinely before suction Evacuation. Prophylactic chemotherapy is routinely not recommended. If no further pregnancy is required, hysterectomy preferred over suction curettage ion women aged more than 40 years. It is also an important adjunct to treatment of chemo resistant tumors. Post evacuation Surveillance is done for a minimum of 6 months using hormonal contraception with beta HCG follow up 48 hours after evacuation and every 1-2 weeks, while still elevated and every month for another 6 months after it falls to normal levels. Gestationla trophoblastic neoplasia almost always develops with or follow some form of recognized pregnancy. Most follow a hydatidiform mole. Invasive mole are localy invasive but generally lack the pronounced tendency to wide spread metastasis. Choriocarcinoma is extremely malignant tumor. Metastasis often develop early in choriocarcinoma and are generally blood borne and most common sites are lungs and vagina. Placental site trophoblastic tumors are rare variant characterized by prolactin producing intermediate trophoblast with relatively low beta HCG, a high proportion of free beta HCG, chemo resistant and hysterectomy being the best treatment. Epitheliod tumors are rare characterized by non conformation of preceding pregnancy, nodular growth and microscopically resembles placental site tumors but the cells are smaller and display less pleomorphism. Risk assessment is done by using modified WHO prognostic scoring system. Score 0-6 generally include low risk neoplasia. In general methotrexate is given for non meta static or low risk metastatitic neoplasia. High risk GTN{score more then 7}usually requires EMA-CO regimen, surgery, radiotherapy. Survillence is one year for GTN and upto 2 years if there is metastasis. The purpose of this study was to study the incidence, epidemiological correlates of GTN, the clinical behavior, the complications and management of this disease in our hospital, and to review the literature on this uncommon disease.


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An assessment of antihypertensive drug prescription patterns and adherence to joint national committee-8 hypertension treatment guidelines among hypertensive patients attending a tertiary care teaching hospital

2016-11-09T05-16-18Z
Source: International Journal of Research in Medical Sciences
Rakesh Romday, Ajay Kumar Gupta, Pawan Bhambani.
Background: The new guidelines issued by the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure (JNC-8) emphasize that aggressive blood pressure (BP) control is essential to reducing morbidity and mortality. Patient non-adherence is a serious obstacle to the effective treatment of many acute and chronic disorders. Successful treatment and outcome of a chronic disease such as hypertension depend on many factors, including resources (e.g., funds, space, and people), avoidance of serious adverse events, patient adherence with treatment plans, and the availability of effective therapies. The aim of this study is to assess the antihypertensive drug prescription patterns and adherence to joint national committee (JNC-8) hypertension (HT) treatment recommendations among hypertensive patients attending a tertiary care teaching hospital. Methods: An observational and cross-sectional prospective prescription audit study was carried over a period of 1 year in ambulatory patients attending medicine OPD. A total of 500 prescriptions prescribed to diagnose HT were analyzed. Drug prescription patterns, and their adherence to JNC-8 report was assessed. Results: Out of 500 patients, 299 (59.8%) were male and 201 (40.2%) were female. Mean age of male and female patients were found to be 57.68±15.32 and 61.29±12.65 years respectively. As per present study, most of the physicians prescribed single drug (monotherapy, 34.6%) to control BP followed by two-drug combination (18.4%), three-drug combination (11.8%) and four-drug combination (3%). Two drugs regimen was prescribed in 18.4% of the hypertensive patients. Angiotensin receptor blocker + diuretic combination (4.4%) was mostly used in two drug combination therapy followed by Angiotensin receptor blockers + Diuretics (3.6%) and Calcium channel blocker + ACEIs combination (2.6%). No combination of ACEIs + ARBs was prescribed in any prescription. The overall rate of adherence was 16.5 % (Pre-hypertension); 87.90% (Stage 1 hypertension); and 68.20% (Stage 2 hypertension). Conclusions: In conclusion, present study demonstrated that physicians are not completely adhering to standard guidelines while treating hypertension with comorbid conditions.


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Maximal intermittent contractions of the first dorsal interosseous inhibits voluntary activation of the contralateral homologous muscle

The aim of this study was to investigate how maximal intermittent contractions for a hand muscle influence cortical and reflex activity, as well as the ability to voluntarily activate the homologous muscle in the opposite limb. Twelve healthy subjects (age 24 ± 3 yr, all right-hand dominant) performed maximal contractions of the dominant limb first dorsal interosseous (FDI), and activity of the contralateral FDI was examined in a series of experiments. Index finger abduction force, FDI electromyography (EMG), motor evoked potentials, and heteronomous reflexes were obtained from the contralateral limb during brief, nonfatiguing contractions. The same measures, as well as the ability to voluntarily activate the contralateral FDI, were then assessed in an extended intermittent contraction protocol that elicited fatigue. Brief contractions under nonfatigued conditions increased index finger abduction force, FDI EMG, and motor evoked potential amplitude of the contralateral limb. However, when intermittent maximal contractions were continued until fatigue, there was an inability to produce maximal force with the contralateral limb (~30%), which was coupled to a decrease in the level of voluntary activation (~20%). These declines were present without changes in reflex activity and regardless of whether cortical or motor point stimulation was used to assess voluntary activation. It is concluded that performing maximal intermittent contractions with a single limb causes an inability of the central nervous system to maximally drive the homologous muscle of the contralateral limb. This is, in part, mediated by mechanisms that involve the motor cortex ipsilateral to the contracting limb.



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Experience-dependent plasticity of excitatory and inhibitory intertectal inputs in Xenopus tadpoles

Communication between optic tecta/superior colliculi is thought to be required for sensorimotor behaviors by comparing inputs across the midline; however, the development of and the role of visual experience in the function and plasticity of intertectal connections are unclear. We combined neuronal labeling, in vivo time-lapse imaging, and electrophysiology to characterize the structural and functional development of intertectal axons and synapses in Xenopus tadpole optic tectum. We find that intertectal connections are established early during optic tectal circuit development. We determined the neurotransmitter identity of intertectal neurons using both rabies virus-mediated tracing combined with post hoc immunohistochemistry and electrophysiology. Excitatory and inhibitory intertectal neuronal somata are similarly distributed throughout the tectum. Excitatory and inhibitory intertectal axons are structurally similar and elaborate broadly in the contralateral tectum. We demonstrate that intertectal and retinotectal axons converge onto tectal neurons by recording postsynaptic currents after stimulating intertectal and retinotectal inputs. Cutting the intertectal commissure removes synaptic responses to contralateral tectal stimulation. In vivo time-lapse imaging demonstrated that visual experience drives plasticity in intertectal bouton size and dynamics. Finally, visual experience drives the maturation of excitatory intertectal inputs by increasing AMPA-to-N-methyl-d-aspartate (NMDA) ratios, comparable to experience-dependent maturation of retinotectal inputs, and coordinately increases intertectal GABA receptor-mediated currents. These data indicate that visual experience regulates plasticity of excitatory and inhibitory intertectal inputs, maintaining the balance of excitatory to inhibitory intertectal input. These studies place intertectal inputs as key players in tectal circuit development and suggest that they may play a role in sensory information processing critical to sensorimotor behaviors.



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Medical myth busting to engage physiology students in scientific literature

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The inclusion of undergraduate students in physiology outreach activities improves their physiology learning and understanding skills

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The flipped classroom allows for more class time devoted to critical thinking

The flipped classroom was utilized in a two-semester, high-content science course that enrolled between 50 and 80 students at a small liberal arts college. With the flipped model, students watched ~20-min lectures 2 days/wk outside of class. These videos were recorded via screen capture and included a detailed note outline, PowerPoint slides, and review questions. The traditional format included the same materials, except that lectures were delivered in class each week and spanned the entire period. During the flipped course, the instructor reviewed common misconceptions and asked questions requiring higher-order thinking, and five graded case studies were performed each semester. To determine whether assessments included additional higher-order thinking skills in the flipped vs. traditional model, questions across course formats were compared via Blooms Taxonomy. Application-level questions that required prediction of an outcome in a new scenario comprised 38 ± 3 vs. 12 ± 1% of summative assessment questions (<0.01): flipped vs. traditional. Final letter grades in both formats of the course were compared with major GPA. Students in the flipped model performed better than their GPA predicted, as 85.5% earned a higher grade (vs. 42.2% in the traditional classroom) compared with their major GPA. These data demonstrate that assessments transitioned to more application-level compared with factual knowledge-based questions with this particular flipped model, and students performed better in their final letter grade compared with the traditional lecture format. Although the benefits to a flipped classroom are highlighted, student evaluations did suffer. More detailed studies comparing the traditional and flipped formats are warranted.



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Medical students perceptions of the effectiveness of integrated clinical skills sessions using different simulation adjuncts

Simulation-based integrated clinical skills sessions have great potential for use in medical curricula. Integration is central to simulation efficacy. The aim of this study was to obtain medical students' perceptions toward effectiveness of integrated clinical skills sessions by using different simulation adjuncts and to know the challenges/obstacles encountered toward the implementation of such sessions. A study was conducted to obtain anonymous feedback from male (n = 156) and female (n = 179) medical students in years 2 and 3 during the 2014–2015 academic sessions at Alfaisal University about their perceptions of the effectiveness of integrated clinical skills sessions, uses of simulation adjuncts, and obstacles encountered toward the effective implementation of such sessions. The response rate was 93.4. Factor analysis showed data being valid and reliable. Cronbach's α-values for effectiveness of sessions, use of simulation adjunct, and obstacles encountered were 0.97, 0.95, and 0.95, respectively. We conclude that students perceived positively the effectiveness of integrated clinical skills sessions as well as the use of simulation adjuncts, especially SPs. They suggested overcoming the obstacles and limitations of simulation. They highly valued the role of the facilitators in achieving effective sessions.



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Attention span during lectures: 8 seconds, 10 minutes, or more?

In the current climate of curriculum reform, the traditional lecture has come under fire for its perceived lack of effectiveness. Indeed, several institutions have reduced their lectures to 15 min in length based upon the "common knowledge" and "consensus" that there is a decline in students' attention 10–15 min into lectures. A review of the literature on this topic reveals many discussions referring to prior studies but scant few primary investigations. Alarmingly, the most often cited source for a rapid decline in student attention during a lecture barely discusses student attention at all. Of the studies that do attempt to measure attention, many suffer from methodological flaws and subjectivity in data collection. Thus, the available primary data do not support the concept of a 10- to 15-min attention limit. Interestingly, the most consistent finding from a literature review is that the greatest variability in student attention arises from differences between teachers and not from the teaching format itself. Certainly, even the most interesting material can be presented in a dull and dry fashion, and it is the job of the instructor to enhance their teaching skills to provide not only rich content but also a satisfying lecture experience for the students.



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"The House I Live In": New Film Exposes Economic, Moral Failure of U.S. War on Drugs. 1 of 2

Land of the free..: 5% Of the worlds Population, 25 % Of the worlds Prisoners ..! FACT ! https://youtube/IAKiCdD0hkE https://youtube/OmnDEUD9NyI WTF ..? ExEMTNor

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Pancreatic duct stenosis: Differential diagnosis between malignant and benign conditions at secretin-enhanced MRCP

Clinical Imaging

from Gastroenterology via xlomafota13 on Inoreader http://www.mdlinx.com/gastroenterology/medical-news-article/2016/11/09/pancreas-cancer-magnetic-resonance-imaging-mrcp/6926904/
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Effects of concomitant immunomodulators on the pharmacokinetics, efficacy and safety of adalimumab in patients with Crohn's disease or ulcerative colitis who had failed conventional therapy

Alimentary Pharmacology and Therapeutics

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Interferon-free regimens improve portal hypertension and histological necroinflammation in HIV/HCV patients with advanced liver disease

Alimentary Pharmacology and Therapeutics

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Retrospective analysis of management of ingested foreign bodies and food impactions in emergency endoscopic setting in adults

BMC Emergency Medicine

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Metabolic syndrome and risk of esophageal adenocarcinoma in elderly patients in the United States: An analysis of SEER-Medicare data

Cancer

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The short-term outcomes of laparoscopic multivisceral resection for locally advanced colorectal cancer: Our experience of 39 cases

Surgery Today

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Metformin use and the risk of colorectal adenoma: A systematic review and meta-analysis

Journal of Gastroenterology and Hepatology

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18F-FDG uptake in the stomach on screening PET/CT: Value for predicting Helicobacter pylori infection and chronic atrophic gastritis

BMC Medical Imaging

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Prevention of allograft HCV recurrence with peri-transplant human monoclonal antibody MBL-HCV1 combined with a single oral direct-acting antiviral: A proof-of-concept study

Journal of Viral Hepatitis

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Study suggests link between bacterium and oesophageal cancer survival

Cancer Research UK News

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Efficacy of synbiotic, probiotic, and prebiotic treatments for irritable bowel syndrome in children: A randomized controlled trial

The Turkish Journal of Gastroenterology

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Proximal signaling responses in peripheral T cells from colorectal cancer patients are affected by high concentrations of circulating prostaglandin E2

Human Immunology

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Phase II clinical trial using novel peptide cocktail vaccine as a postoperative adjuvant treatment for surgically resected pancreatic cancer patients

International Journal of Cancer

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Intraperitoneal chemotherapy for gastric cancer with peritoneal disease: Experience from Singapore and Japan

Gastric Cancer

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Tolerability, pharmacokinetics and antiviral activity of rHSA/IFN?2a for the treatment of chronic hepatitis B infection

British Journal of Clinical Pharmacology

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Additive value of non-contrast MRA in the preoperative evaluation of potential liver donors

Clinical Imaging

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A study of thymidylate synthase expression as a biomarker for resectable colon cancer: Alliance (cancer and leukemia group B) 9581 and 89803

The Oncologist

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Biliary duct-to-duct reconstruction with a tunneled retroperitoneal T-tube during liver transplantation: A novel approach to decrease biliary leaks after T-tube removal

Journal of Gastrointestinal Surgery

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The value of cure associated with treating treatment-naive chronic hepatitis C genotype 1: Are the new all oral regimens good value to society?

Liver International

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Clinical outcomes of endoscopic submucosal dissection for high-grade dysplasia from endoscopic forceps biopsy

Gastric Cancer

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"The House I Live In": New Film Exposes Economic, Moral Failure of U.S. War on Drugs. 1 of 2

Land of the free..: 5% Of the worlds Population, 25 % Of the worlds Prisoners ..! FACT ! https://youtube/IAKiCdD0hkE https://youtube/OmnDEUD9NyI WTF ..? ExEMTNor

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"The House I Live In": New Film Exposes Economic, Moral Failure of U.S. War on Drugs. 1 of 2

Land of the free..: 5% Of the worlds Population, 25 % Of the worlds Prisoners ..! FACT ! https://youtube/IAKiCdD0hkE https://youtube/OmnDEUD9NyI WTF ..? ExEMTNor

from EMS via xlomafota13 on Inoreader http://paramedictv.ems1.com/videos/142434187-the-house-i-live-in-new-film-exposes-economic-moral-failure-of-us-war-on-drugs-1-of-2/
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"The House I Live In": New Film Exposes Economic, Moral Failure of U.S. War on Drugs. 1 of 2

Land of the free..: 5% Of the worlds Population, 25 % Of the worlds Prisoners ..! FACT ! https://youtube/IAKiCdD0hkE https://youtube/OmnDEUD9NyI WTF ..? ExEMTNor

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Hypertension during Weight Lifting Reduces Flow-Mediated Dilation in Nonathletes.

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Purpose: The purpose of this study was to determine if increased intraluminal pressure is the damaging factor which reduces flow mediated dilation (FMD) in young, healthy subjects following resistance exercise to maximal exertion. Hypothesis: Attenuating the rise in brachial artery pressure during weight lifting by placing a blood pressure cuff on the upper arm prevents post-exercise impairment of brachial artery FMD in sedentary individuals. Methods: Nine sedentary individuals who exercise =3 times/week performed leg press exercise to maximal exertion on two separate occasions. During one visit a blood pressure cuff, proximal to the site of brachial artery measurement, was inflated to 100 mmHg to protect the distal vasculature from the rise in intraluminal pressure which occurs during resistance exercise. Brachial artery FMD was determined using ultrasonography before and 30 minutes after weight lifting. Results: Without the protective cuff, brachial artery FMD in sedentary individuals was reduced after weight lifting (9.0 +/- 1.2% pre-lift vs. 6.6 +/- 0.8% post-lift; p=0.005) while in exercise-trained individuals FMD was unchanged (7.4 +/- 0.7% pre-lift vs. 8.0 +/- 0.9% post-lift; p=0.543). With the protective cuff, FMD no longer decreased, but rather increased in sedentary individuals (8.7 +/- 1.2% pre-lift vs. 10.5 +/- 1.0% post-lift, p=0.025). An increase in FMD was also seen in exercise-trained subjects when the cuff was present (6.6 +/-0.7% pre-lift vs. 10.9 +/-1.5% post-lift, p

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Exercise versus Nonexercise Activity: E-diaries Unravel Distinct Effects on Mood.

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Introduction: The association between physical activity and mood is of major importance to increase physical activity as a prevention strategy for noncommunicable diseases and to improve mental health. Unfortunately, existing studies examining how physical activity and mood wax and wane within persons over time in everyday life do show ambiguous findings. Taking a closer look at these studies reveals that the aggregation levels differ tremendously. Whereas mood is conceptualized as a three-dimensional construct, physical activity is treated as a global construct not taking into account its distinct components like exercise (such as jogging) and non-exercise activity (NEA; such as climbing stairs). Methods: To overcome these limitations, we conducted an ambulatory assessment study on the everyday life of 106 adults over 7 days continuously measuring NEA via accelerometers and repeatedly querying for mood in real time via GPS-triggered e-diaries. We used multilevel modeling to derive differential within-subject effects of exercise vs. NEA on mood and to conduct analyses on the temporal course of effects. Results: Analyses revealed that exercise increased valence (beta=0.023; p<.05 and calmness p a tendency of decreasing energetic arousal lacked significance. nea parameterized as episodes physical activity intensity in everyday life increased decreased beta="-0.080;" increasing valence using longer time intervals for revealed similar findings thus confirming our findings. conclusion: exercise differed regarding their within-subject effects on mood whereas calmness. therefore it appears necessary to clearly differentiate between mood-dimensions both research treatment. american college sports medicine>

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Long-Term Marathon Running Is Associated with Low Coronary Plaque Formation in Women.

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Introduction: Marathon running is presumed to improve cardiovascular risk, but health benefits of high volume running are unknown. High resolution coronary computed tomography angiography (CCTA) and a cardiac risk factor assessment were completed in women with long term marathon running histories to compare to sedentary women with similar risk factors. Methods: Women who had run at least one marathon per year for 10-25 years underwent CCTA, 12-lead ECG, blood pressure and heart rate measurement, lipid panel, and a demographic/health risk factor survey. Sedentary matched controls were derived from a contemporaneous clinical study database. CT scans were analyzed for calcified and non-calcified plaque prevalence, volume, stenosis severity, and calcium score. Results: Women marathon runners (n=26), age 42-82, with combined 1217 marathons (average 47) exhibited significantly lower coronary plaque prevalence and less calcific plaque volume. The marathon runners also had less risk factors (smoking, hypertension, and hyperlipidemia); significantly lower resting heart rate, body weight, body mass index, and triglyceride levels; and higher high-density lipoprotein cholesterol levels compared to controls (n=28). The five women runners with coronary plaque had run marathons for more years and were on average 12 years older (65 vs. 53) than the runners without plaque. Conclusion: Women marathon runners had minimal coronary artery calcium counts, lower coronary artery plaque prevalence, and less calcified plaque volume compared to sedentary women. Developing coronary artery plaque in long term women marathon runners appears related to older age and more cardiac risk factors, although the runners with coronary artery plaque had accumulated significantly more years running marathons. (C) 2016 American College of Sports Medicine

from Sports Medicine via xlomafota13 on Inoreader http://pdfs.journals.lww.com/acsm-msse/9000/00000/Long_Term_Marathon_Running_Is_Associated_with_Low.97356.pdf
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Aerobic Exercise Training Improves Orthostatic Tolerance in Aging Humans.

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Purpose: This study was designed to test the hypothesis that aerobic exercise training of the elderly will increase aerobic fitness without compromising orthostatic tolerance (OT). Methods: Eight healthy sedentary volunteers (67.0+/-1.7 years old, 4 women) participated in 1-year of endurance exercise training (stationary bicycle and/or treadmill) program at the individuals' 65%-75% of peak heart rate (HRpeak). Peak O2 uptake (VO2peak) and HRpeak were determined by a maximal exercise stress test using a bicycle ergometer. Carotid baroreceptor reflex (CBR) control of HR and mean arterial pressure (MAP) were assessed by a neck pressure-neck suction (NP/NS) protocol. Each subject's maximal gain (Gmax), or sensitivity, of the CBR function curves were derived from fitting their reflex HR and MAP responses to the corresponding NP/NS stimuli using a logistic function curve. The subjects' OT was assessed using lower-body negative pressure (LBNP) graded to -50 mmHg; the sum of the product of LBNP intensity and time (mmHg*min) was calculated as the cumulative stress index (CSI). Results: Training increased VO2peak (before vs after: 22.8+/-0.92 vs 27.9+/-1.33 ml/min/kg, P

from Sports Medicine via xlomafota13 on Inoreader http://pdfs.journals.lww.com/acsm-msse/9000/00000/Aerobic_Exercise_Training_Improves_Orthostatic.97357.pdf
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Gross Motor Skills and Cardiometabolic Risk in Children: A Mediation Analysis.

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Purpose: The purpose of this study was to examine the linear relationship between gross motor skills and cardiometabolic risk, with aerobic fitness as a mediator variable, in low-income children from the U.S. Methods: Participants were a convenience sample of 224 children (Mean age = 9.1 +/- 1.1 years; 129 girls, 95 boys) recruited from five low-income elementary schools from the Mountain West Region of the U.S. Gross motor skills were assessed using the Test for Gross Motor Development 3rd Edition. Gross motor skills were analyzed using a locomotor skill, ball skill, and a total gross motor skill score. Aerobic fitness was assessed using the Progressive Aerobic Cardiovascular Endurance Run that was administered during physical education class. A continuous and age- and sex-adjusted metabolic syndrome score (MetS) was calculated from health and blood marker measurements collected in a fasted state before school hours. Total effects, average direct effects, and indirect effects (Average Causal Mediation Effect; ACME) were calculated using a bootstrap mediation analysis method via a linear regression algorithm. Results: The ACME of gross locomotor skills on MetS scores, using aerobic fitness as the mediator variable, was statistically significant ([beta] = -0.055, 95%C.I. [-0.097, -0.021], p = 0.003). The model explained approximately 17.5% of the total variance in MetS with approximately 43.7% of the relationship between locomotor skills and MetS mediated through aerobic fitness. Ball skills did not significantly relate with cardiometabolic risk. Conclusion: There is a significant relationship between gross locomotor skills and cardiometabolic risk that is partially mediated through aerobic fitness in a sample low-income children from the U.S. (C) 2016 American College of Sports Medicine

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