The Effects of Tai Chi on Lower Limb Proprioception in Adults Aged Over 55: A Systematic Review and Meta-Analysis

Publication date: Available online 18 August 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Liye Zou, Jia Han, Chunxiao Li, Albert Yeung, Stanley Sai-chuen Hui, William W.N. Tsang, Zhanbing Ren, Lin Wang

Abstract

Objective

To summarize and critically evaluate the effects of Tai Chi on lower limb proprioception in adults aged over 55.

Data Sources

Seven databases (Scopus, PubMed, Web of Science, SPORTDiscus, Cochrane Library, Wanfang, and CNKI) were searched from inception until April 14, 2018.

Study Selection

Eleven randomized controlled trials were included for meta-analysis.

Data Extraction

Two independent reviewers screened potentially relevant studies based on the inclusion criteria, extracted data, and assessed methodological quality of the eligible studies using the Physiotherapy Evidence Database (PEDro).

Data Synthesis

The pooled effect size (standardized mean difference, SMD) was calculated while the random-effects model was selected. PEDro scores ranged from 5 to 8 points (mean = 6.7). The study results showed that Tai Chi had significantly positive effects on lower limb joint proprioception. Effect sizes were moderate to large, including ankle plantar flexion (SMD = -0.55, 95% CI -0.9 to -0.2, p = 0.002, I² = 0%, N = 162), dorsiflexion (SMD = -0.75, 95% CI -1.11 to -0.39, p < 0.001, I² =0%, N = 162), non-dominant/left knee flexion (SMD = -0.71, 95% CI -1.10 to - 0.41, p< 0.001, I² = 25.1%, N = 266), dominant/right knee-flexion (SMD = -0.82, 95% CI -1.06 to - 0.58, p < 0.001, I² = 33.8%, N = 464).

Conclusions

There is moderate to strong evidence suggests that Tai Chi is an effective intervention to maintain and improve lower limb proprioception in adults aged over 55. More robust multi-center studies including oldest-old participants, with longer follow-ups and validated outcome measures are needed before a definitive conclusion is drawn.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2N1wOWw
via IFTTT

Postoperative pain management — 2018 consensus statement

brak

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2BlUNOY
via IFTTT

Spatiotemporal expression of the cocaine- and amphetamine-regulated transcript-like (cart-like) gene during zebrafish embryogenesis

Publication date: Available online 17 August 2018

Source: Gene Expression Patterns

Author(s): Atsuo Kawahara, Hitoshi Morita, Kanoko Yanagi, Hiroaki Suzuki, Takaaki Mori, Rie Ohga, Kiyohito Taimatsu

Abstract

The cocaine- and amphetamine-regulated transcript (CART) genes are involved in the neural regulation of energy homeostasis; however, their developmental expressions and functions are not fully understood in vertebrates. We have identified a novel zebrafish cart-like gene that encodes a protein of 105 amino acids possessing sequence similarity to zebrafish and mammalian CART proteins. RT-PCR analysis revealed that the cart-like transcripts were maternally supplied and gradually decreased during the cleavage, blastula and gastrula stages; then, transcripts subsequently reaccumulated at the segmentation, pharyngula and hatching stages. Based on a whole-mount in situ hybridization analysis using an antisense cart-like RNA probe, we found that the cart-like transcript was predominantly expressed in both the Rohon-Beard neurons and trigeminal ganglia, suggesting the involvement of the cart-like gene in zebrafish neural development.

from Genetics via xlomafota13 on Inoreader https://ift.tt/2vSMHrR
via IFTTT

A motivational phone call improves participation to screening colonoscopy for those with a positive FIT in a national screening programme (NCT 03276091)

A large proportion of individuals with a positive faecal immunologic test (FIT) will never undergo the recommended colonoscopy despite a full sequence of reminders.

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2MzutFi
via IFTTT

DNA damage in obesity: Initiator, promoter and predictor of cancer

Publication date: Available online 17 August 2018

Source: Mutation Research/Reviews in Mutation Research

Author(s): Moonisah Usman, Emanuela V. Volpi

Abstract

Epidemiological evidence linking obesity with increased risk of cancer is steadily growing, although the causative aspects underpinning this association are only partially understood. Obesity leads to a physiological imbalance in the regulation of adipose tissue and its normal functioning, resulting in hyperglycaemia, dyslipidaemia and inflammation. These states promote the generation of oxidative stress, which is exacerbated in obesity by a decline in anti-oxidant defence systems. Oxidative stress can have a marked impact on DNA, producing mutagenic lesions that could prove carcinogenic. Here we review the current evidence for genomic instability, sustained DNA damage and accelerated genome ageing in obesity. We explore the notion of genotoxicity, ensuing from systemic oxidative stress, as a key oncogenic factor in obesity. Finally, we advocate for early, pre-malignant assessment of genome integrity and stability to inform surveillance strategies and interventions.

from Genetics via xlomafota13 on Inoreader https://ift.tt/2weHOZL
via IFTTT

Radiation-induced bystander and systemic effects serve as a unifying model system for genotoxic stress responses

Publication date: Available online 17 August 2018

Source: Mutation Research/Reviews in Mutation Research

Author(s): Susanne Burdak-Rothkamm, Kai Rothkamm

Abstract

This review summarises our current understanding of the radiation-induced bystander/systemic effect (RIBE) as well as other types of intercellular reactions induced by malignant tumours, chemotherapy, photodynamic stress and the microbiome. On the basis of striking similarities between these different types of responses RIBE is proposed as a prototype model of a unifying genotoxic stress response system.

The early bystander response is initiated by a mitochondria-dependent increase of reactive oxygen species (ROS) and triggers a complex intercellular signalling cascade leading to a sustained increase of cellular DNA damage. The susceptibility to this DNA damage-inducing signal depends on the genetic make-up of the recipient cell population where ATR/ATM- and FA/BRCA-dependent DNA damage response pathways are key players. Long distance bystander/systemic effects observed in in vivo-models are sustained by macrophage-mediated inflammation.

Of clinical importance is the potential contribution of bystander DNA damage to an increased risk of malignancies. Defects in DNA damage repair pathways are frequently observed in tumours, which may affect their susceptibility to bystander DNA damage. The potential role for molecular targeted inhibitors in the therapeutic exploitation of bystander responses as well as their differential modulation of targeted and non-targeted effects is also discussed in this context.

from Genetics via xlomafota13 on Inoreader https://ift.tt/2nL4Wel
via IFTTT

A motivational phone call improves participation to screening colonoscopy for those with a positive FIT in a national screening programme (NCT 03276091)

A large proportion of individuals with a positive faecal immunologic test (FIT) will never undergo the recommended colonoscopy despite a full sequence of reminders.

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2MzutFi
via IFTTT

Bilateral reaching deficits after unilateral perinatal ischemic stroke: a population-based case-control study

Detailed kinematics of motor impairment of the contralesional ("affected") and ipsilesional ("unaffected") limbs in children with hemiparetic cerebral palsy are not well understood. We aimed to 1) quantify the...

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2vTMdSp
via IFTTT

Genetic polymorphisms in candidate genes are not associated with increased vincristine-related peripheral neuropathy in Arab children treated for acute childhood leukemia: a single institution study

Objective The aim of this study was to evaluate the potential association between candidate genetic polymorphisms and vincristine-related peripheral neuropathy in Arab children with acute lymphoblastic leukemia (ALL). Patients and methods This is a retrospective evaluation of 133 Arab children treated for ALL at the Children's Cancer Center of Lebanon. Incidence and severity of, as well as the timing (in weeks) at which grade 2 or higher peripheral neuropathy occurred were recorded. Genotyping for ABCB1 (rs1045642), ABCB1 (rs1128503), ABCC2 (rs717620), CEP72 (rs924607), ETAA1 (rs17032980), and MTNR1B (rs12786200) was performed. Results A total of 26 (19.5%) individuals developed peripheral neuropathy, three of which occurred during the induction phase. No statistically significant associations were revealed for any of the polymorphisms with either incidence of vincristine-related toxicity, toxicity severity, or time to the first episode of grade 2 or higher vincristine-related peripheral neuropathy. Conclusion This study presents the first pharmacogenetic analysis of vincristine-related peripheral neuropathy in children with ALL in an Arab country. We have shown that genetic polymorphisms in candidate genes are not associated with peripheral neuropathy secondary to chronic therapy with high-dose vincristine (2 mg/m2) during the continuation phase. Concerning CEP72, our results are in line with the findings from the St Jude cohort of children treated for ALL with higher vincristine doses during chronic treatment. Larger high-throughput genetic analyses may be warranted to evaluate variants in other candidate genes such as CYP3A5 and reveal new nonpreviously reported alleles that may be peculiar to this region of the world. Correspondence to Samar A. Muwakkit, MD, Department of Pediatrics and Adolescent Medicine, Children's Cancer Center of Lebanon, PO Box 113-5067, Clemenceau Street, Beirut, Lebanon Tel: +961 1 350 000; fax: +961 1 360 496; e-mail: sm03@aub.edu.lb Received April 9, 2018 Accepted July 27, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

from Genetics via xlomafota13 on Inoreader https://ift.tt/2nNsi30
via IFTTT

Unique Factors Affecting the Management and Prevention of Caries in the Childhood Cancer Survivor

Childhood cancer survivors are at high risk for a myriad of complications secondary to oncologic treatment regimens. Caries is one of the major sequela of oncologic treatment that place the childhood cancer survivor at risk for complications in adulthood. Dental caries can be prevented with optimum dental care, early identification, and patient education. A barrier to their prevention is the lack of routine dental care received by this population. Health care providers are in a prime position to remedy this problem through their frequent contact with the childhood cancer survivor during sick and well-child office visits.

from Health via xlomafota13 on Inoreader https://ift.tt/2BjM9QW
via IFTTT

Kodiak Emergency Vehicles joins the fast-growing distribution network of Technimount System

Technimount System keeps adding new players to its distribution network

from EMS via xlomafota13 on Inoreader https://ift.tt/2nNyzfm
via IFTTT

ESPGHAN Distinguished Service Award 2018 to Professor Markku Mäki

No abstract available

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2PitZly
via IFTTT

Use of Breast Milk and Other Feeding Practices Following Gastrointestinal Surgery in Infants

Objectives: To characterize the enteral feeding practices in infants following gastrointestinal surgery. Methods: We performed a retrospective analysis of infants who underwent intestinal surgery at age

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2MVRob3
via IFTTT

Weight Gain Trajectory Predicts Long-Term Overweight and Obesity After Pediatric Liver Transplant

Objective: To identify early predictors of long-term overweight and obesity in pediatric liver transplant recipients. Methods: Single-center, retrospective review of children who underwent liver transplant before age 6 years. Body Mass Index (BMI), weight, and height percentiles at transplant and post-transplant were calculated. BMI, weight gain trajectories, and failure-to-thrive (FTT) were examined as predictors of overweight/obesity at 3 and 5 years post-transplant. Results: Children (n = 70) were median 0.9 years at transplant. Median BMI percentile increased from 37 (IQR 12–73) at transplant to 83 (IQR 64–97) at 12 months, with median weight percentile 47 (IQR 26 - 67) and height percentile 9 (IQR 2- 32). Overweight/obesity prevalence peaked at 3 years post-transplant (44%). Children who were overweight/obese at 3 years post-transplant were more likely to be overweight/obese at transplant, and at 6 and 12 months post-transplant (OR: 9.4, p = 0.02, OR: 6.7 p = 0.013, OR: 6.4 p = 0.007, respectively). The prevalence of overweight/obesity decreased to 26% at 5 years. Rapid weight gain post-transplant did not predict overweight/obesity at 3 or 5 years. Over 1/3 of children who were FTT at transplant were overweight/obese at 3 or 5 years, but FTT at transplant did not increase later obesity risk. Conclusions: Most children gain weight rapidly after liver transplant. Nearly half of transplant recipients are overweight/obese at 3 years, but the prevalence decreases by 5 years. Those who become overweight/obese tend to do so within one year post-transplant, making this an important time to identify high-risk children and provide counseling. Address correspondence and reprint requests to Sonja Marie Swenson, BA, 724 Parnassus Avenue, San Francisco, CA 94122 (E-mail: Sonja.Swenson@ucsf.edu) Received 7 April, 2018 Accepted 30 July, 2018 Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org). Disclosure of funding: This work was supported by grants from the University of California San Francisco Resource Allocation Program for Trainees (RAPTr, Swenson) and by the NIH-NIDDK (K23 DK0990253-A101, Perito). Conflicts of Interests: none © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2MDyclC
via IFTTT

Contribution of Oral Hygiene and Cosmetics on Contamination of Gluten-Free Diet: Do Celiac Customers Need to Worry About?

Objectives: The only available treatment for celiac disease (CD) is the gluten-free diet. It is unclear whether the presence of gluten in oral hygiene products and cosmetics that are applied on the mouth is a reason of concern for CD patients. The aim of this study was to test the level of gluten contamination in oral hygiene and cosmetic products available in the Italian market. Methods: A total of 66 products (toothpastes = 37; dental tablets = 2; mouthwashes = 5; lip-balms = 10; lipsticks = 12) labelled gluten-free or with unknown gluten content were randomly collected from different supermarkets and pharmacies. The gluten quantification was determined by the R5 ELISA method approved by EU regulations. Results: Out of 66 oral hygiene and cosmetics, 62 products (94%) were found to be gluten-free (gluten level 20 ppm (toothpastes: 20.7 ppm, 31.4 ppm, and 35 ppm; lipstick: 27.4 ppm). None of the selected products had ingredient derived from wheat, barley, or rye. Conclusions: Gluten contamination is currently not an issue in a wide array of cosmetic and oral hygiene products that are commonly on the market. Address correspondence and reprint requests to Anil K. Verma, M.Sc., Celiac Disease Research Laboratory, Department of Pediatrics, Marche Polytechnic University, Ancona, 60123, Italy (e-mail: anilkrvermaa@gmail.com, a.k.verma@pm.univpm.it) Received 6 June, 2018 Accepted 19 July, 2018 Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org). Source of Funding and conflict of interest: This study has not received any fund for any funding body. Carlo Catassi and Elena Lionetti are scientific consultants to Dr Schär's, all other authors declare no conflict of interest. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2OJUeQK
via IFTTT

Effectiveness of robot-assisted gait training on motor impairments in people with Parkinson’s disease: a systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to evaluate the effectiveness of robot-assisted gait training (RAGT) on motor impairments in people with Parkinson's disease (PD). A computer-based systematic literature search was performed in six databases according to PRISMA guidelines. Randomized controlled trials (RCTs) that assessed the effects of RAGT on motor impairments in people with PD were included. GRADE approach and PEDro scale were used to determine the studies' quality of evidence. Meta-analyses were performed by calculating the weighted mean difference (WMD) at 95% confidence interval. Seven RCTs (PEDro: 5–8) met the inclusion criteria for systematic review and meta-analyses. The meta-analysis showed significant improvement on Unified Parkinson Disease Rating Scale Part III after intervention [WMD=3.292; 95% confidence interval (CI)=1.378–5.207; P=0.000], and after 1-month follow-up (WMD=5.512; 95% CI=2.396–8.629; P=0.001). Stride length (WMD=9.283; 95% CI=7.153–11.414; P=0.00) and gait speed (WMD=0.166; 95% CI=−0.090 to 0.243; P=0.000) showed significant improvements after RAGT. Balance as measured by Berg Balance Scale was improved significantly after intervention (WMD=3.87; 95% CI=0.374–6.735; P=0.029) and at 1-month follow-up (WMD=3.87; 95% CI=1.324–6.413; P=0.002). The pooled analysis did not detect any significant changes regarding stride time, cadence and functional balance scales. GRADE level of evidence ranged between high and low. The RAGT showed better outcomes than conventional interventions on some motor aspects in PD. However, RAGT did not seem superior to control interventions. Further RCTs that examine the effect of RAGT on more specific outcomes and at different medication statuses are required. Correspondence to Mohammad Alwardat, PT, PhD, Neuroscience PhD School, Faculty of Medicine and Surgery, University of Rome 'Tor Vergata', Via Montpellier, 1, 00133 Rome, Italy Tel: +39 329 642 3074; fax: +39 062 090 2106; e-mail: wardatm1@gmail.com Received June 27, 2018 Accepted July 30, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2MTjd3z
via IFTTT

Survival Analysis and Interpretation of Time-to-Event Data: The Tortoise and the Hare

Survival analysis, or more generally, time-to-event analysis, refers to a set of methods for analyzing the length of time until the occurrence of a well-defined end point of interest. A unique feature of survival data is that typically not all patients experience the event (eg, death) by the end of the observation period, so the actual survival times for some patients are unknown. This phenomenon, referred to as censoring, must be accounted for in the analysis to allow for valid inferences. Moreover, survival times are usually skewed, limiting the usefulness of analysis methods that assume a normal data distribution. As part of the ongoing series in Anesthesia & Analgesia, this tutorial reviews statistical methods for the appropriate analysis of time-to-event data, including nonparametric and semiparametric methods—specifically the Kaplan-Meier estimator, log-rank test, and Cox proportional hazards model. These methods are by far the most commonly used techniques for such data in medical literature. Illustrative examples from studies published in Anesthesia & Analgesia demonstrate how these techniques are used in practice. Full parametric models and models to deal with special circumstances, such as recurrent events models, competing risks models, and frailty models, are briefly discussed.

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2L37FJh
via IFTTT

Critically Ill, Then Chronically Painful: Pain and Interference With Everyday Life

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2PkITIi
via IFTTT

Informed Consent for Sugammadex and Oral Contraceptives: Through the Looking Glass

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2MVKv9H
via IFTTT

Another Win for Lidocaine, Another Loss for Magnesium?

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2vSWTkm
via IFTTT

Caution When Dosing Anesthetic Medications: Are We Putting Too Much Weight on Patient Weight?

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2MUHKFE
via IFTTT

Dyeing to Find Out How an “AWEsim” Bundle Can Impact Anesthesia Work Environment Contamination

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2vSWKgO
via IFTTT

Readiness for Discharge After Foot and Ankle Surgery Using Peripheral Nerve Blocks: A Randomized Controlled Trial Comparing Spinal and General Anesthesia as Supplements to Nerve Blocks

BACKGROUND: Neuraxial anesthesia is often viewed as superior to general anesthesia but may delay discharge. Comparisons do not typically use multimodal analgesics and nerve blockade. Combining nerve blockade with general anesthesia may reduce pain, opioid consumption, and nausea. We hypothesized that general anesthesia (with nerve blocks) would lead to earlier readiness for discharge, compared to spinal anesthesia (with nerve blocks). METHODS: All patients underwent ambulatory foot and ankle surgery, with a predicted case duration of 1–3 hours. All patients received popliteal and adductor canal nerve blocks using bupivacaine and dexamethasone. No intraoperative opioids were administered. All patients received ondansetron, dexamethasone, ketamine, and ketorolac. Patients, data collectors, and the data analyst were not informed of group assignment. Patients were randomized to spinal or general anesthesia with concealed allocation. Spinal anesthesia was performed with mepivacaine and accompanied with propofol sedation. After general anesthesia was induced with propofol, a laryngeal mask airway was inserted, followed by sevoflurane and propofol. Time until ready for discharge, the primary outcome, was compared between groups after adjusting for age and surgery time using multivariable unconditional quantile regression. Secondary outcomes compared at multiple timepoints were adjusted for multiple comparisons using the Holm–Bonferroni step-down procedure. RESULTS: General anesthesia patients were ready for discharge at a median of 39 minutes earlier (95% confidence interval, 2–75; P = .038) versus spinal anesthesia patients. Patients in both groups met readiness criteria for discharge substantially before actual discharge. Pain scores at rest were higher among general anesthesia patients 1 hour after leaving the operating room (adjusted difference in means, 2.1 [95% confidence interval, 1.0–3.2]; P

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2MVKa6S
via IFTTT

Intraoperative Transfusion Guidelines: Promoting Clinician Adherence in the Operating Room

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2vSWDSq
via IFTTT

Pediatric Intensive Care, 1st ed

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2MUHJBA
via IFTTT

Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers Before Elective Noncardiac Surgery: An Ongoing Dilemma

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2vSWyy6
via IFTTT

Cardiac Arrest in the Operating Room: Resuscitation and Management for the Anesthesiologist Part 1

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2L1RUSQ
via IFTTT

Local Anesthetics as…Cancer Therapy?

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2PhSmQg
via IFTTT

Promoting a Restrictive Intraoperative Transfusion Strategy: The Influence of a Transfusion Guideline and a Novel Software Tool

BACKGROUND: The effect of neither transfusion guidelines nor decision support tools on intraoperative transfusion has been previously evaluated. The University of Michigan introduced a transfusion guideline in 2009, and in 2011, the Department of Anesthesiology developed a transfusion decision support tool. The primary aim of this study was to assess the associations of the transfusion guideline and the optional use of the software transfusion tool with intraoperative behaviors; pretransfusion hematocrit assessment (whether or not a hematocrit was checked before each red cell unit) and restrictive red cell use (withholding transfusion unless the hematocrit was ≤21%). METHODS: This was a before–after retrospective study without a concurrent control group of patients transfused 1–3 units of red cells intraoperatively. Three phases were studied to provide data both before and after the implementation of the transfusion guideline and the intraoperative software tool. Within each phase, trends of checking hematocrits before transfusion and restrictive transfusion were charted against time. F tests were used to measure differences of slopes. The difference between means of each phase was measured using Mann-Whitney U tests. Independent associations were measured using mixed-effects multivariable logistic regression. A secondary outcome analysis was conducted for 30-day mortality, myocardial infarction, renal injury, and their combination. RESULTS: The transfusion guideline was associated with increased pretransfusion hematocrit evaluation (67.4%, standard deviation [SD] 3.9 vs 76.5%, SD 2.7; P

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2L1ROdW
via IFTTT

Fibrinogen Concentrate: Is It Standard Currency or Bitcoin in Bleeding Management?

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2vOStLa
via IFTTT

α-Asarone Alleviated Chronic Constriction Injury–Induced Neuropathic Pain Through Inhibition of Spinal Endoplasmic Reticulum Stress in an Liver X Receptor–Dependent Manner

BACKGROUND: Neuropathic pain is an intractable and complex disease. Recent studies have shown a close relationship between endoplasmic reticulum (ER) stress and neuropathic pain. Here, we investigated the effect of α-asarone, an ER stress inhibitor, on chronic constriction injury (CCI)–induced neuropathic pain. METHODS: Two parts were included in this study. In part 1, rats were assigned to 7 groups: the sham group, the sham + α-asarone 20 mg/kg group, the CCI group, the CCI + vehicle group, the CCI + α-asarone 5 mg/kg group, the CCI + α-asarone 10 mg/kg group, and the CCI + α-asarone 20 mg/kg group. After surgery, the rats were treated with α-asarone or normal saline daily. Pain thresholds were measured, and samples of the L3–6 spinal cord were taken for western blotting and immunofluorescence on day 7. In part 2, rats were intrathecally implanted with PE-10 tubes and divided into 4 groups: the CCI + α-asarone 20 mg/kg group, the CCI + α-asarone 20 mg/kg + vehicle group, the CCI + α-asarone 20 mg/kg + SR9243 group, and the CCI group. Five rats in each group were separated for behavioral tests 1 hour after intrathecal injection. The rest of them were killed for western blotting on day 7. RESULTS: In this study, CCI surgery significantly induced mechanical allodynia and thermal hyperalgesia. CCI surgery significantly induced activation of ER stress (PERK-eIF2α, IRE1α, CHOP, and XBP-1s) in rats. However, treatment with 20 mg/kg of α-asarone significantly alleviated CCI-induced activation of ER stress. Behavioral results showed that daily treatment with 20 mg/kg of α-asarone significantly alleviated CCI-induced nociceptive behaviors, on day 7 (mechanical allodynia, P = .016, 95% confidence interval, 0.645–5.811; thermal hyperalgesia, P = .012, 95% confidence interval, 0.860–6.507). Furthermore, α-asarone induced upregulated expression of liver X receptor β (LXRβ) and downstream proteins in the spinal cord. The LXR antagonist SR9243 completely inhibited the anti-ER stress and antinociceptive effects of α-asarone in rats. CONCLUSIONS: α-Asarone relieved CCI-induced neuropathic pain in an LXR-dependent manner. α-Asarone may be a potential agent for treatment of neuropathic pain.

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2MZQcDG
via IFTTT

Surveying the Literature: Synopsis of Recent Key Publications

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2Piru2E
via IFTTT

Perioperative Care of the Elderly Patient

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2MT54DK
via IFTTT

Description of a Novel Set-up for Functional Echocardiographic Assessment of Left Ventricular Performance During Ex Vivo Heart Perfusion

Ex vivo heart perfusion (EVHP) is a new technology aimed at decreasing cold ischemia time and evaluating cardiac function before transplanting a donor heart. In an experimental EVHP swine model, we tested a 3D-printed custom-made set-up to perform surface echocardiography on an isolated beating heart during left ventricular loading. The views obtained at any time point were equivalent to standard transesophageal and transthoracic views. A decrease in left ventricular function during EVHP was observed in all experiments.

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2PkvKyX
via IFTTT

Observation and Experiment: An Introduction to Causal Inference

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2L2GSwO
via IFTTT

Fibrinogen Concentrate in Cardiovascular Surgery: A Meta-analysis of Randomized Controlled Trials

BACKGROUND: Postoperative bleeding remains a frequent complication after cardiovascular surgery and may contribute to serious morbidity and mortality. Observational studies have suggested a relationship between low endogenous plasma fibrinogen concentration and increased risk of postoperative blood loss in cardiac surgery. Although the transfusion of fibrinogen concentrate has been increasing, potential benefits and risks associated with perioperative fibrinogen supplementation in cardiovascular surgery are not fully understood. METHODS: PubMed, Cochrane Library, Ovid MEDLINE, Embase, Web of Science, and China National Knowledge Infrastructure were searched on January 15, 2017, with automated updates searched until February 15, 2018, to identify all randomized controlled trials (RCTs) of fibrinogen concentrate, whether for prophylaxis or treatment of bleeding, in adults undergoing cardiovascular surgery. All RCTs comparing fibrinogen infusion versus any other comparator (placebo/standard of care or another active comparator) in adult cardiovascular surgery and reporting at least 1 predefined clinical outcome were included. The random-effects model was used to calculate risk ratios and weighted mean differences (95% confidence interval [CI]) for dichotomous and continuous variables, respectively. Subgroup analyses by fibrinogen dose and by baseline risk for bleeding were preplanned. RESULTS: A total of 8 RCTs of fibrinogen concentrate in adults (n = 597) of mixed risk or high risk undergoing cardiovascular surgery were included. Compared to placebo or inactive control, perioperative fibrinogen concentrate did not significantly impact risk of all-cause mortality (risk ratio, 0.41; 95% CI, 0.12–1.38; I2 = 10%; P = .15). Fibrinogen significantly reduced incidence of allogeneic red blood cell transfusion (risk ratio, 0.64; 95% CI, 0.49–0.83; I2 = 0%; P = .001). No significant differences were found for other clinical outcomes. Subgroup analyses were unremarkable when analyzed according to fibrinogen dose, time of infusion initiation, mean cardiopulmonary bypass time, and rotational thromboelastometry/fibrinogen temogram use (all P values for subgroup interaction were nonsignificant). CONCLUSIONS: Current evidence remains insufficient to support or refute routine perioperative administration of fibrinogen concentrate in patients undergoing cardiovascular surgery. Fibrinogen concentrate may reduce the need for additional allogeneic blood product transfusion in cardiovascular surgery patients at high risk or with evidence of bleeding. However, no definitive advantage was found for reduction in risk of mortality or other clinically relevant outcomes. The small number of clinical events within existing randomized trials suggests that further well-designed studies of adequate power and duration to measure all-cause mortality, stroke, myocardial infarction, reoperation, and thromboembolic events should be conducted. Future studies should also address cost-effectiveness relative to standard of care.

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2vRzEa3
via IFTTT

Sonographically Detected Transligamentous Median Nerve Branch

No abstract available

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2Btx8wi
via IFTTT

Trajectories of Quality of Life and Associated Risk Factors in Patients With Knee Osteoarthritis: Findings From the Osteoarthritis Initiative

Objective Knee osteoarthritis (OA) has a significant impact on quality of life (QOL). Although QOL is generally thought to diminish over time, it is unknown whether different patient groups demonstrate unique patterns of change in QOL. We sought to identify and characterize QOL trajectories in knee OA. Design This prospective cohort study included 1013 individuals with symptomatic knee OA from the osteoarthritis initiative. We used group-based trajectory modeling to identify distinct temporal patterns of change in the Knee Injury and Osteoarthritis Outcome Score QOL subscale for 8 yrs. Baseline covariates included age, sex, ethnicity, education, co-morbidities, body mass index, substance use, depression, knee pain, and functional tests. Results Group-based trajectory modeling revealed the following three distinct QOL trajectories: a high QOL trajectory (32% of the cohort) experiencing improvement for 8 yrs as well as moderate (49%) and low QOL (20%) trajectories maintaining similar levels over time. Low QOL trajectory membership was significantly associated with younger age (P

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2MwBLtC
via IFTTT

Second-Order Peer Reviews of Clinically Relevant Articles for the Physiatrist: Is Pregabalin Effective in the Treatment of Radiating Low Back Pain Into the Leg?

No abstract available

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2MVSQKk
via IFTTT

The Efficiency of a Multicomponent Training for Prospective Memory Among Healthy Older Adults: A Single-Blind, Randomized Controlled Within-Participants Cross-Over Trial

Objective The main objective of the present trial was to evaluate the efficiency of a preventative multicomponent prospective memory training among healthy older adults. Design This study was a two-arm within-participants trial with 4- and 12-wk follow-ups. Allocation ratio was 1:1, and pretraining and posttraining measurements were included. A total number of 25 healthy older adults were enrolled (mean = 63.32, SD = 4.44). Participants were randomly allocated into two conditions: (a) prospective memory training: participants underwent a multicomponent prospective memory training, and (b) control: participants were not contacted during the training phase. After the training phase was finished, participants crossed over to undergo the condition they did not experience before. The differences between pretraining and posttraining measures of prospective memory, activities of daily living, negative mood (depression), and anxiety were assessed. All changes in the measurements were analyzed using general linear method. This trial is registered at https://www.isrctn.com (#ISRCTN57600070). Results Multicomponent prospective memory training program was significantly effective on both subjective and objective prospective memory performances among healthy older adults. Moreover, the training had significant positive effects on activities of daily living (independence) among participants. In addition, negative mood and anxiety levels were reduced after the training was finished. Conclusions This multicomponent prospective memory training improved prospective memory performance and activities of daily living and reduce negative mood (depression) and anxiety levels among healthy older adults.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2MwBHdm
via IFTTT

Evidence-Based Physiatry: Key Role of Rehabilitation in New CDC Guidelines for the Management of Duchenne Muscular Dystrophy

No abstract available

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2MTq7WF
via IFTTT

Discharge Patterns for Ischemic and Hemorrhagic Stroke Patients Going From Acute Care Hospitals to Inpatient and Skilled Nursing Rehabilitation

Objective The aim of the study was to explore variation in acute care use of inpatient rehabilitation facilities and skilled nursing facilities rehabilitation after ischemic and hemorrhagic stroke. Design A secondary analysis of Medicare claims data linked to inpatient rehabilitation facilities and skilled nursing facilities assessment files (2013–2014) was performed. Results The sample included 122,084 stroke patients discharged to inpatient or skilled nursing facilities from 3677 acute hospitals. Of the acute hospitals, 3649 discharged patients with an ischemic stroke (range = 1–402 patients/hospital, median = 15) compared with 1832 acute hospitals that discharged patients with hemorrhagic events (range = 1–73 patients/hospital, median = 4). The intraclass correlation coefficient examined variation in discharge settings attributed to acute hospitals (ischemic intraclass correlation coefficient = 0.318, hemorrhagic intraclass correlation coefficient = 0.176). Patients older than 85 yrs and those with greater numbers of co-morbid conditions were more likely to discharge to skilled nursing facilities. Comparison of self-care and mobility across stroke type suggests that patients with ischemic stroke have higher functional abilities at admission. Conclusions This study suggests demographic and clinical differences among stroke patients admitted for postacute rehabilitation at inpatient rehabilitation facilities and skilled nursing facilities settings. Furthermore, examination of variation in ischemic and hemorrhagic stroke discharges suggests acute facility-level differences and indicates a need for careful consideration of patient and facility factors when comparing the effectiveness of inpatient rehabilitation facilities and skilled nursing facilities rehabilitation.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2MzgG1u
via IFTTT

Letter to the Editor Involving the Article “Comparison Between Corticosteroids and Lidocaine Injection in the Treatment of Tennis Elbow: A Randomized, Double-Blinded, Controlled Trial”

No abstract available

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2Blv89c
via IFTTT

Gait Variability and Energy Cost of Oveground Walking in Persons With Multiple Sclerosis: A Cross-Sectional Study

Objective This study examined the associations between gait variability based on common spatiotemporal parameters and energetic cost of walking in persons with multiple sclerosis. Design Eighty-six persons with multiple sclerosis underwent the 6-min walk while wearing a portable metabolic unit. The cost of walking was generated by dividing the net steady-state VO2 (milliliter per kilogram per minute) by walking speed during the 6-min walk. Participants further completed two trials of walking on the GAITRite mat at a self-selected pace for measuring spatiotemporal parameters. Variability of step length, step time, stride length, swing time, stance time, stride velocity, and single- and double-support time was indexed by the coefficient of variation. Results Variability in the spatiotemporal variables and Expanded Disability Status Scale scores were significantly correlated with cost of walking (i.e., ρ = 0.25–0.36). Multivariate analysis revealed that disability (Expanded Disability Status Scale: β = 0.186), stance time variability (β = 1.446), and step length variability (β = −1.216) explained significant variance (R2 = 0.38, P

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2MzgvmQ
via IFTTT

Efficacy of Extracorporeal Shock Wave Therapy for Lower-Limb Tendinopathy: A Meta-analysis of Randomized Controlled Trials

Objective Extracorporeal shock wave therapy, including radial shock wave and focused shock wave types, is widely used for managing tendinopathies. The difference in efficacy between the 2 shock wave characteristics with different dosage levels remains controversial, and the purpose of this meta-analysis was to examine it for patients with lower-limb tendinopathy. Design A comprehensive search of online databases and search engines was performed. This study included randomized controlled trials reporting the efficacy of extracorporeal shock wave therapy in treating lower-limb tendinopathy. The included randomized controlled trials were subjected to a meta-analysis and risk of bias assessment. Results In total, 29 randomized controlled trials were included, all of which had a good methodological quality, with a PEDro score of ≥6/10. General extracorporeal shock wave therapy showed significant effects at the immediate follow-up [pain score: standardized mean difference = −1.41, 95% confidence interval = −2.01 to −0.82, P

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2BtwVt0
via IFTTT

Long-Term Course of Shoulders After Ultrasound Therapy for Calcific Tendinitis: Results of the 10-Year Follow-Up of a Randomized Controlled Trial

Objective The aim of the study was to follow both the structure- and function-related long-term course of shoulders that had been treated with therapeutic ultrasound for symptomatic calcific tendinitis. Design This is a long-term follow-up of 45 shoulders (37 patients) that had been treated for symptomatic calcific tendinitis with either a series of ultrasound or sham ultrasound 10 yrs ago. The main outcome variables were presence of calcium deposits and subacromial impingement on standardized x-ray imaging, shoulder symptoms (Binder score), and function (Constant score). Results At 10 yrs, a similar proportion of calcium deposits had resolved in 78% of the originally ultrasound treated compared with 83% of sham-treated shoulders, whereas at 9 mos, significantly more calcium deposits had been resolved in the ultrasound group (P = 0.045). Relative to baseline, shoulder symptoms and function had significantly improved at both the 10-yr and 9-mo follow-up examinations with no significant differences between groups. Regular sports performance at baseline predicted a favorable long-term outcome. Conclusions Symptomatic calcific tendinitis of the shoulder has a good likelihood to completely resolve in the long term. Treating the calcium deposit effectively, however, may not be causal to the recovery from symptoms and function in calcific tendinitis.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2PkJWbc
via IFTTT

Association of Academic Physiatrists Women’s Task Force Report

The Association of Academic Physiatrists (AAP) convened a women's task force in 2016, and the members agreed on a list of metrics that would permit retrospective data review pertaining to the representation and inclusion of women physicians in the society. Examples of categories examined included leadership positions (i.e., board membership, board presidents, committee membership, committee chairs, and resident fellow physician chairs), conference presentations (i.e., annual meeting session proposals, annual meeting faculty, annual meeting plenary speakers), and recognition awards (i.e., recognition award nominations and recipients). The findings highlight areas in which the Association of Academic Physiatrists has been successful in supporting gender equity and other areas in which women physiatrists have been underrepresented. The task force worked with the Board of Trustees to construct an action plan, asking the respective committees to address areas of underrepresentation. A volunteer from each committee was deemed a "diversity steward" and going forward will work directly with the task force as a liaison to document an action plan and collect data. The board plans to transparently report progress to members and other stakeholders, and the task force aims to publish a follow-up report within the next 5 years.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2BtwL4S
via IFTTT

In Vivo Evaluation of Subacromial and Internal Impingement Risk in Asymptomatic Individuals

Objective The study aim was to evaluate subacromial and internal impingement risk between shoulders (dominant/nondominant) during dynamic motion using subject-specific anatomy and precise in vivo kinematics. Design In a prospective cross-sectional study, nine subjects underwent bilateral magnetic resonance (N = 18 shoulders) and fluoroscopic imaging during elevation and external rotation at 90 degrees of abduction. Subject-specific bone models were created and distances from footprint to (a) acromion and (b) glenoid were measured to evaluate risk. Results Throughout elevation, subacromial impingement risk was greater in the dominant shoulder (P = 0.0178). Regardless of side, high subacromial impingement risk occurred at 30% (78 degrees), 50% (101 degrees), and 70% (57 degrees) of the elevation cycle (P

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2Mtpkil
via IFTTT

New Swallowing Method to Improve Pharyngeal Passage of a Bolus by Creating Negative Pressure in the Esophagus—Vacuum Swallowing

Herein, we present a case of a patient with Wallenberg syndrome with severe bulbar dysphagia who discovered a unique swallowing method: creating strong negative pressure in the esophagus to improve pharyngeal passage of a bolus. A 47-yr-old man presented with a subarachnoid hemorrhage secondary to a ruptured aneurysm in the right vertebral artery. After coil embolization, he experienced severe dysphagia due to Wallenberg syndrome and required tube feeding. Eighty-one days after the onset of the stroke, a videofluoroscopic swallowing evaluation revealed that the bolus was rapidly sucked into the esophagus. High-resolution manometry showed weak constriction of the pharynx simultaneous with forced, voluntary constriction of the diaphragm before swallowing; this created negative pressure in the esophagus. The authors named this unique swallowing method "vacuum swallowing." Ultimately, the patient was able to eat an ordinary diet via the use of this technique. Vacuum swallowing is a unique method of improving pharyngeal passage of a bolus by creating strong negative pressure in the esophagus. Additional studies are necessary to determine whether vacuum swallowing can be successfully used for other forms of dysphagia.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2MVmDD5
via IFTTT

Hamstring Co-Contraction in the Early Stage of Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Longitudinal Study

Objective Hamstring co-contraction may affect recovery from anterior cruciate ligament reconstruction. The aim of the study was to evaluate the changes in hamstring co-contraction during the early postoperative stages. Design Twenty-five patients with anterior cruciate ligament reconstruction were followed up for 1–3 mos postoperatively, during which the Lysholm and International Knee Documentation Committee questionnaires were completed and surface electromyograms were assessed during terminal knee extension maximum voluntary contraction and step-up tests. The integrated electromyogram of the tested muscles and co-contraction ratio were analyzed. Results Co-contraction ratio during terminal knee extension maximum voluntary contraction at 3 mos postoperatively was significantly less than that at 1 mo postoperatively (P

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2MuY8zv
via IFTTT

Comparison Between Corticosteroid and Lidocaine Injection in the Treatment of Tennis Elbow: A Randomized, Double-Blinded, Controlled Trial

No abstract available

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2MWsJDl
via IFTTT

Quality Improvement Education in Residency Training: A Review

Hospitals and healthcare institutions have strong external and internal pressures to improve patient safety and healthcare quality. Quality improvement education has been mandated for resident physicians by the Accreditation Council for Graduate Medical Education. This review describes didactic and experiential curricula for residents in quality improvement interventions as well as factors that create challenges to implementing such a curriculum and those that foster it. Resident attitudes, faculty capacity, institutional resources, and dedicated time are critical elements influencing the success of quality improvement curricula. Faculty interest in quality improvement could be enhanced by academic recognition of their work. Recommendations to facilitate publication of quality improvement efforts are described.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2PjSIWT
via IFTTT

Intersection Syndrome Revisited: Let’s Talk Much More About It Using Ultrasound

No abstract available

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2BkQC5V
via IFTTT

Authors’ Reply to Webster and Smith: Comment on: “Substrate Metabolism During Ironman Triathlon: Different Horses on the Same Courses”

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2L4tE2G
via IFTTT

Comment on: Substrate Metabolism During Ironman Triathlon: Different Horses on the Same Courses

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2nKIuSI
via IFTTT

A tale of confusion from overlapping confidence intervals: brief report

In clinical research presentations, study results are commonly reported in the form of p-values and confidence intervals as an estimate of association and treatment effect. The interpretation of confidence intervals that overlap can be confusing and difficult for the reader to draw clinically meaningful conclusions. In this brief report, we describe the basics of confidence intervals and present an example from a recently published randomized control trial (RCT) to illustrate a common confusion that overlapping confidence intervals between the means of two independent groups may not necessarily reject the true significant difference of effect. It is recommended that investigators use the direct difference of means between groups for confidence interval estimation to reduce Type II errors. Clinicians should interpret overlapping confidence intervals with caution, and avoid the assumption that overlapping confidence intervals always implies a lack of difference of treatment effect to decide application of treatment. Corresponding Author: Dinesh Kumbhare MD, PhD, FRCPC, FAAPMR, Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, dinesh.kumbhare@uhn.ca, Telephone: 416-597-3422 x 4612 Author Disclosures: All the authors report no conflict of interest for the completion of this manuscript. Also, no funding was received. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2BlVacm
via IFTTT

Complete Restoration of Respiratory Muscle Function in Three Subjects with Spinal Cord Injury Pilot Interventional Clinical Trial

Objectives To assess the safety and efficacy of complete restoration of respiratory muscle function in subjects with Spinal Cord Injury (SCI). Methods This was an interventional study investigating three subjects maintained on a diaphragm pacing system who were implanted with the spinal cord stimulation (SCS) system to restore cough. Peak expiratory airflow and airway pressure generation were the primary physiologic outcome measures; an assessment of the degree of difficulty in raising secretions was the primary clinical outcome measure. Results Mean peak expiratory airflow and airway pressure generation during spontaneous efforts were 1.7±0.2L/s and 31±7cmH2O respectively. When SCS was applied following pacing volume associated with the subject's maximum inspiratory effort and synchronized with the subject's maximum expiratory effort, peak expiratory airflow and airway pressure generation were 9.0±1.9 and 90±6cmH2O, respectively (p

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2MnaYRh
via IFTTT

Integrated Rehabilitation for Breast Cancer Survivors

The physical and psychological side effects of breast cancer therapies can have substantial impact on survivors' physical and social functioning. Roughly half of the more than 3 million Americans alive with a history of breast cancer report adverse, function-degrading sequelae related to their oncologic treatments. Care delivery models for the timely delivery of rehabilitation services have been proposed yet limitedly vetted or implemented. These include the prospective surveillance model, procedure-linked referrals, survivorship care plans and risk stratification. Patients' capacity to engage in the rehabilitative process varies over the course of cancer therapy and into survivorship. Perioperative attention generally focuses on managing premorbid impairments and normalizing shoulder function. In contrast, during chemo- and radiation therapies, symptom control, constructive coping, and role preservation may become more salient. Risk-stratified, individualized screening and prevention activities for specific impairments have become increasingly feasible through predictive models and analytics. Impairments' severity deleterious impact can be mitigated, as has been established for lymphedema, shoulder dysfunction, chemotherapy-induced peripheral neuropathy, cognitive dysfunction, fatigue, and sexual side effects. Integrated rehabilitative programs, often initiated following the completion of cancer treatment, are available in some countries outside of the United States and may offer survivors vital vocation- and avocation-directed services. Corresponding Author: Andrea L. Cheville, MD, MSCE, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN 55905, Tel: (507) 284-2747, Fax: (507) 284-3431, Cheville.andrea@mayo.edu Funding: No funding was received to support the effort involved in preparing this manuscript. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2OJBNMc
via IFTTT

Molecular characterization of wdr68 gene in embryonic development of Xenopus laevis

Publication date: Available online 17 August 2018

Source: Gene Expression Patterns

Author(s): M. Bonano, E. Martín, M.M. Moreno Ruiz Holgado, G.M. Silenzi Usandivaras, G. Ruiz De Bigliardo, M.J. Aybar

Abstract

WDR68, also known as DCAF7, is a WD40 repeated domain protein highly conserved in eukaryotic organisms in both plants and animals. This protein participates in numerous cellular processes and exerts its function through interaction with other proteins. In the present work, we isolated, sequenced and characterized cDNA corresponding to the wdr68 gene in embryos of the amphibian Xenopus laevis. Syntenic analysis revealed high conservation of the genomic region containing the WDR68 locus in amniotes. Nevertheless, in fishes and amphibians, we observed that the tandem genes surrounding wdr68 undergoes certain rearrangements with respect to the organization found in amniotes. We also defined the temporal and spatial expression pattern of the wdr68 gene in the development of Xenopus laevis through whole mount in situ hybridization and RT-PCR techniques. We observed that wdr68 is ubiquitously expressed during early embryonic development but, during the neurula stage, it undergoes a strong expression in the neural tube and in the migratory cephalic streams of the neural crest. At the tailbud stages, it is strongly expressed in the cephalic region, particularly in otic and optic vesicles, in addition to branchial arches. In contrast, wdr68 transcripts are localized in the somitic mesoderm in the trunk. The expression area that includes the migratory neural crest of the head and the branchial arches suggest that this gene would be involved in jaws formation, probably through a hierarchical relationship with the component genes of the endothelin-1/endothelin receptor type A cell signaling pathway.

from Genetics via xlomafota13 on Inoreader https://ift.tt/2MWfCC7
via IFTTT

Correction to: China: concurring regulation of cross-border genomic data sharing for statist control and individual protection

The article China: concurring regulation of cross-border genomic data sharing for statist control and individual protection, written by Yongxi Chen and Lingqiao Song, was originally published electronically on the publisher's internet portal (currently SpringerLink) on 16 July 2018 without open access. With the author(s)' decision to opt for Open Choice the copyright of the article changed on 16 August 2018 to © The Author(s) 2018 and the article is forthwith distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits use, duplication, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

from Genetics via xlomafota13 on Inoreader https://ift.tt/2nKEzW0
via IFTTT

How to help an emotional partner

Our co-hosts answer an email from a listener asking for help in dealing with a partner who is going through an emotional time

from EMS via xlomafota13 on Inoreader https://ift.tt/2L2GvSO
via IFTTT

How to help an emotional partner

Our co-hosts answer an email from a listener asking for help in dealing with a partner who is going through an emotional time

from EMS via xlomafota13 on Inoreader https://ift.tt/2ODjjg8
via IFTTT

A Simple and Reliable Submental Intubation Technique for Maxillofacial Fractures.

Related Articles

A Simple and Reliable Submental Intubation Technique for Maxillofacial Fractures.

J Craniofac Surg. 2018 Aug 11;:

Authors: Oshima N, Shiraishi T, Kawauchi T, Oba J, Sato D, Fujiki M, Ozaki M, Takushima A, Harii K

Abstract
In 1986, Altemir first reported the use of submental intubation to avoid tracheotomy in patients with panfacial and midfacial fractures for whom intermaxillary fixation is necessary, but orotracheal and nasotracheal intubations are not recommended. This novel technique allowed intraoperative access to perform dental occlusion and reconstruction of the nasal pyramid in patients with skull base fractures. Herein, we describe a refined technique based on Altemir's original procedure. Seven male patients with panfacial fractures underwent submental intubation using our refined technique. The technique was developed after encountering a technical error with Altemir's original procedure. In this new technique, we employed a 2-0 silk suture guide to allow the passage of both the endotracheal and cuff-inflation tubes through the same tunnel created from the oral cavity to the submental area. The success rate of the refined technique was 100%, and there were no intraoperative or postoperative complications. There was 20 seconds of ventilation outage time in total. Endotracheal and cuff-inflation tubes were easily and quickly passed through the same submental tunnel. Our refined technique is simple, easy, safe, fast, inexpensive, and does not require specific materials. Submental scars were smaller and relatively inconspicuous in this study, compared to those reportedly associated with other modified techniques.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. https://ift.tt/OBJ4xP.

PMID: 30113420 [PubMed - as supplied by publisher]

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2MUdz1i
via IFTTT

Arab Men and Women’s Conceptualization of Mental Health and Depression: A Qualitative Study from the Middle East

Abstract

Cardiovascular diseases are the leading cause of death worldwide. Among cardiovascular patients, depression is associated with an increased morbidity and mortality. Understanding how depression is conceptualized from cardiovascular patients' perspective can help with prevention, early detection, and treatment for depression. This might reduce cardiovascular morbidity and mortality, and save health care costs. To the best of our knowledge, there is no study in the Gulf region exploring depression among Arab cardiovascular patients. The purpose of this exploratory ethnographic qualitative research is to investigate how Arab male and female patients with cardiovascular disease conceptualize mental health and depression. Two theoretical frameworks guided this research: (1) The Ecological Perspective, and (2) Kleinman's Explanatory Model of Health and Illness. Using maximum variation purposive sampling, thirty (30) male and twenty-five (25) female, self-identified, Arab cardiovascular patients were recruited as research participants. Individual in-depth interviews were conducted using a semi-structured questionnaire. Thematic analysis was performed to generate themes. Nvivo 10, a qualitative data analysis software, was used to organize the narrative data. The participants in this study placed great emphasis on the manifestations of mental illness and their impact on both themselves and their families. Four major themes were identified from their narratives: psychological and physical disturbances; unfavorable personal characteristics; work issues and financial constraints; lack of family and social support. The knowledge generated in this study might help increase awareness, prevention of and treatment for depression among cardiovascular patients in Qatar. The findings from this study can also be used to inform a multi-disciplinary and multi-sectoral intervention approach that is contextualized to meet the mental health care needs of Arab cardiovascular patients, thus reducing cardiovascular diseases morbidity and mortality in Qatar and the Gulf region.

from Health via xlomafota13 on Inoreader https://ift.tt/2nIBN3B
via IFTTT

Infliximab and adalimumab concentrations and anti-drug antibodies in inflammatory bowel disease control using New Zealand assays

Internal Medicine Journal

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2vSdqEZ
via IFTTT

Outcome of hospital outpatient treatment of functional gastrointestinal disorders

Internal Medicine Journal

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2OI09po
via IFTTT

Laminin 511 is a target antigen in autoimmune pancreatitis

Science Translational Medicine

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2vSnyh5
via IFTTT

The Old and the New: An Enhanced Vision for JNA

No abstract available

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2MWvHaW
via IFTTT

High and Intensive Care in Psychiatry: Validating the HIC Monitor as a Tool for Assessing the Quality of Psychiatric Intensive Care Units

Abstract

This study aims to validate the HIC monitor as a model-fidelity scale to the High and Intensive Care (HIC) model, a recently developed model for acute psychiatric wards. To assess the psychometric properties of the HIC monitor, 37 audits were held on closed inpatient wards at 20 psychiatric hospitals in the Netherlands. Interrater reliability, construct validity and content validity were examined. Our results suggest that the HIC monitor has good psychometric properties. It can be used as a tool for assessing the implementation of the HIC model on acute psychiatric wards in the Netherlands, and for quality assessment and improvement.

from Health via xlomafota13 on Inoreader https://ift.tt/2KZJ4Fv
via IFTTT

Correction to: Canada: will privacy rules continue to favour open science

This article was inadvertently published under a draft title.

from Genetics via xlomafota13 on Inoreader https://ift.tt/2MTTUi0
via IFTTT

Conclusion: harmonisation in genomic and health data sharing for research: an impossible dream?

Abstract

There are clear benefits from genomics and health data sharing in research and in therapy for individuals across societies. At the same time, citizens have different expectations and fears about that data sharing. International legislation in relation with research ethics and practice and, particularly, data protection create a particular environment that, as is seen in the articles in part two of this special issue, are crying out for harmonisation both at a procedural but at fundamental conceptual levels. The law of data sharing is pulling in different directions. This paper poses the question, 'harmonisation, an impossible dream?' and the answer is a qualified 'no'. The paper reflects on what can be seen in the papers in part two of the special issue. It then identifies three major areas of conceptual uncertainty in the new EU General Data Protection Regulation (not because it has superiority over other jurisdictions, but because it is a recent revision of data protection law that leaves universal conceptual questions unclear). Thereafter, the potential for Artificial Intelligence to meet some of the shortcomings is discussed. The paper ends with a consideration of the conditions under which data sharing harmonisation might be achieved: an understanding of a human rights approach and citizen sensitivities in considering the 'public interest'; social liberalism as a basis of solidarity; and the profession of 'researcher'.

from Genetics via xlomafota13 on Inoreader https://ift.tt/2Pj8d1l
via IFTTT

Is Exercise the Right Medicine for Dystrophic Muscle?

Introduction Duchenne muscular dystrophy (DMD) is a neuromuscular disease caused by a dystrophin protein deficiency. Dystrophin functions to stabilize and protect the muscle fiber during muscle contraction; thus, the absence of functional dystrophin protein leads to muscle injury. DMD patients experience progressive muscle necrosis, loss of function, and ultimately succumb to respiratory failure or cardiomyopathy. Exercise is known to improve muscle health and strength in healthy individuals as well as positively affect other systems. Because of this, exercise has been investigated as a potential therapeutic approach for DMD. Methods This review aims to provide a concise presentation of the exercise literature with a focus on dystrophin-deficient muscle. Our intent was to identify trends and gaps in knowledge with an appreciation of exercise modality. Results After compiling data from mouse and human studies, it became apparent that endurance exercises such as a swimming and voluntary wheel running have therapeutic potential in limb muscles of mice and respiratory training was beneficial in humans. However, in the comparatively few long-term investigations, the effect of low-intensity training on cardiac and respiratory muscles was contradictory. In addition, the effect of exercise on other systems is largely unknown. Conclusions To safely prescribe exercise as a therapy to DMD patients, multisystemic investigations are needed including the evaluation of respiratory and cardiac muscle.

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2MREP0d
via IFTTT

Effects of Neuromuscular Electrical Stimulation in People with Spinal Cord Injury

Introduction Muscle force production is usually impaired in people with spinal cord injury (SCI). The use of high-intensity neuromuscular electrical stimulation (NMES) strength training can help promote metabolically active lean muscle mass and, thus, increase muscle mass and improve physical health and quality of life (QoL). Nonetheless, NMES is usually used at low-stimulation intensities, and there is limited evidence on the effects of high-intensity NMES strength training into improving muscle force and mass, symptoms of spasticity, or physical health and QoL in people with SCI. Methods Five individuals with chronic SCI completed five 10-repetition sets of high-intensity knee extension NMES strength training sessions for 12 wk in both quadriceps muscles. Quadriceps femoris (QF) knee extensor torque was measured on a dynamometer, and cross-sectional area (CSAQF) was measured with extended field-of-view ultrasonography. Venous blood samples were collected for blood lipid profiling and C-reactive protein analyses. The Spinal Cord Injury Spasticity Evaluation Tool was used to assess symptoms of spasticity, and the QoL index SCI version III was used for QoL measures. Results QF tetanic knee extensor torque increased on average by 35% (2%–92%), and CSAQF increased by 47% (14%–145%). A significant increase in the HDL/LDL cholesterol ratio (P

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2nHyJVs
via IFTTT

Overview of the NASA 70-day Bed Rest Study

Purpose The purpose of this article was to provide an overview of the National Aeronautics and Space Administration (NASA) 70-day Bed Rest Study. The integrated complement of investigations and the standardized bed rest environment that served as the platform for this study complement are described. Outcomes of the studies will not be presented here but will be reported in separate publications. Methods A set of studies running in an integrated fashion along the entire period (pre–, in–, and post–bed rest) and using the same subjects is referred in this article as "the campaign" or "complement." NASA selected eight individual studies to participate in the 70-d bed rest campaign. These studies were integrated to increase efficiency in the utilization of resources and to share common measures among the investigations. In addition to the individual studies addressing specific aims, a battery of standardized measures was included. Standard measures target a wide range of physiologic systems and represent some of the testing routinely done on astronauts. Bed rest subjects underwent rigorous medical and psychological screening. Standardized conditions included 70 d of bed rest in a 6° head-down tilt position. Subjects' vital signs, body weight, and fluid intake and output were measured daily. A standardized diet was provided to ensure consistent nutritional intake across subjects. Exercising subjects were prescribed individualized aerobic and resistance training 6 d·wk−1 performed in a horizontal body position. Subjects in the testosterone supplementation countermeasure group received testosterone enanthate injections at 2-wk intervals during bed rest. Conclusion Long-duration head-down tilt bed rest provided a suitable platform for examining physiologic effects of spaceflight and testing countermeasures in a ground-based model. Integrating studies into a complement is an effective way to support multiple investigations while minimizing the number of subjects to answer many research questions.

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2war6KN
via IFTTT

Short-Term (<8 wk) High-Intensity Interval Training in Diseased Cohorts

Background and Aim Exercise training regimes can lead to improvements in measures of cardiorespiratory fitness (CRF), improved general health, and reduced morbidity and overall mortality risk. High-intensity interval training (HIIT) offers a time-efficient approach to improve CRF in healthy individuals, but the relative benefits of HIIT compared with traditional training methods are unknown in across different disease cohorts. Methods This systematic review and meta-analysis compares CRF gains in randomized controlled trials of short-term (

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2nIx5mr
via IFTTT

Effects of Age and Sex on Inspiratory Muscle Activation Patterns during Exercise

Purpose To characterize the effects of age, sex, and their interaction on inspiratory muscle activation patterns during exercise. Methods Twenty younger (20–30 yr, n = 10 women) and 20 older (60–80 yr, n = 10 women) subjects performed an incremental cycle exercise test. Electromyography (EMG) of the scalene (EMGsca) and EMG of the sternocleidomastoid (EMGscm) muscles were measured using skin surface electrodes, whereas diaphragm EMG (EMGdi) and esophageal and transdiaphragmatic pressures were measured using an esophageal catheter. Electromyography data were transformed into root mean square with a 100-ms time constant. Esophageal and diaphragmatic pressure–time products were used as indices of total inspiratory muscle pressure production and diaphragmatic pressure production, respectively. Results At absolute minute ventilations (V˙E), women and older subjects had greater EMGdi than men and younger subjects, respectively (all P 0.05). Women had greater EMGsca activity than men at absolute and relative levels of V˙E (all P 0.05). At absolute and relative levels of V˙E, women and older subjects had greater EMGscm than men and younger subjects, respectively (all P 0.05). No significant interactions between age and sex were noted (all P > 0.05). Conclusions Age and sex significantly affect inspiratory muscle activation patterns during exercise; however, the extent of the effects depends on whether comparisons are made at absolute or relative V˙E.

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2MSbl2k
via IFTTT

Detection of Persisting Concussion Effects on Neuromechanical Responsiveness

Purpose Assessment of various indices of neuromechanical responsiveness for association with concussion history. Methods An observational cohort study included 48 elite athletes (34 males: 23.8 ± 4.4 yr; 14 females: 25.4 ± 4.5 yr) who performed visuomotor reaction time (VMRT) tests involving rapid manual contact with illuminated target buttons that included two dual-task conditions: 1) simultaneous oral recitation of scrolling text (VMRT+ST) and 2) simultaneous verbal responses to identify the right or left direction indicated by the center arrow of the Eriksen flanker test (VMRT+FT). A whole-body reactive agility (WBRA) test requiring side-shuffle movements in response to visual targets was used to assess reaction time, speed, acceleration, and deceleration. Results Concussion occurrence at 2.0 ± 2.3 yr before testing was reported by 21 athletes. Strong univariable associations were found for VMRT+FT left minus right difference ≥15 ms (odds ratio [OR], 7.14), VMRT+ST outer two-ring to inner three-ring ratio ≥1.28 (OR, 4.58), and WBRA speed asymmetry ≥7.7% (OR, 4.67). A large VMRT+FT by VMRT+ST interaction effect was identified (OR, 25.00). Recursive partitioning identified a three-way VMRT+FT by VMRT+ST by WBRA interaction that had 100% positive predictive value for identification of athletes with concussion history, whereas negative status on all three factors had 90% negative predictive value. Conclusions Performance on dual-task VMRT tests and the WBRA test identified neuromechanical responsiveness deficiencies among elite athletes who reported a history of concussion.

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2nJg1N5
via IFTTT

Myocellular Responses to Concurrent Flywheel Training during 70 Days of Bed Rest

Purpose This investigation evaluated myocellular responses to an integrated resistance and aerobic training program during 70 d of bed rest. Methods Training was 6 d·wk−1 on a small-footprint gravity-independent flywheel resistance and aerobic device; 3 d of maximal flywheel supine quadriceps and calf exercises with continuous rowing separated by 4 to 6 h, and 3 d of interval rowing. Vastus lateralis (VL) and soleus (SOL) muscle biopsies were obtained from eight healthy males (age, 28 ± 4 yr; BMI, 25 ± 3 kg·m−2; V˙O2max, 42 ± 6 mL·kg−1·min−1) before and after 6° head-down tilt bed rest. Vastus lateralis and SOL myosin heavy chain (MHC) I and IIa single muscle fiber size and functional characteristics, as well as overall fiber type distribution, capillarization, and metabolic enzyme activities were evaluated. Results In the VL, MHC I size and power (absolute and normalized) were preserved. The MHC IIa fibers hypertrophied (+6%, P

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2MYdhXm
via IFTTT

Effects of Exercise on ASC Methylation and IL-1 Cytokines in Heart Failure

Introduction/Purpose Inflammation contributes to heart failure (HF) progression and the interleukin (IL)-1 cytokine IL-1β is implicated in this process. The adaptor protein apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC) is necessary for inflammasome activation of IL-1β. Lower ASC methylation is associated with worse outcomes in HF. The purpose of this study was to examine the effects of exercise on changes in ASC methylation and activation of the IL-1 family cytokine IL-1β in persons with HF. Methods Participants (N = 54) were randomized to receive exercise intervention (n = 38) or attention control (n = 16) for 3 months. Percent methylation of the ASC gene, plasma IL-1β, and ASC mRNA and were obtained at baseline, 3 months, and 6 months. Results ASC methylation was higher in the exercise group as compared to control at 3 months (6.10% ± 0.5% vs 5.80% ± 0.4%; P = 0.04) and 6 months (6.07 ± 0.4 vs 5.82 ± 0.4; P = 0.04). Plasma IL-1β was lower in the exercise group at 3 months (1.43 ± 0.5 pg·mL−1 vs 2.09 ± 1.3 pg·mL−1; P = 0.02) and 6 months (1.49 ± 0.5 pg·mL−1 vs 2.13 ± 1.4 pg·mL−1; P = 0.004). ASC mRNA expression was negatively associated with ASC methylation at baseline (r = −0.97, P = 0.001), 3 months (r = −0.90, P = 0.001), and 6 months (r = −0.81, P = 0.001). ASC mRNA was lower than baseline at 3 months (P = 0.004) and 6 months (P = 0.002) among those in the exercise group. ASC methylation was positively associated with 6-min walk test at baseline (r = 0.517, P

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2OIsRGJ
via IFTTT

The Associations between Adiposity, Cognitive Function, and Achievement in Children

Although obesity has been related to measures of academic achievement and cognition in children, the influence of fat distribution, specifically visceral adiposity, on select aspects of achievement and cognitive function remains poorly characterized among preadolescent children. Purpose The aim of this study was to evaluate the relation of adiposity, particularly visceral adipose tissue (VAT), on achievement and cognitive function among children. Methods Children with obesity (ages 8–9 yr old, N = 55, 35 females) completed cognitive and academic tests. Normal weight children (N = 55, 35 females) were matched to this group on demographic characteristics and aerobic fitness. Covariate analyses included age, Brief Intellectual Ability, socioeconomic status, and fat-free V˙O2 (V˙O2 peak adjusted for lean mass; mL·kg lean−1·min−1). Adiposity (i.e., whole body percent fat, subcutaneous abdominal adipose tissue, and VAT) was assessed using dual-energy x-ray absorptiometry. Results The results of this study revealed that, relative to their normal weight counterparts, children with obesity had significantly lower performance on tests of reading and math. Analyses revealed that among children with obesity, %Fat and subcutaneous abdominal adipose tissue were not related to cognitive abilities. However, higher VAT was associated with poorer intellectual abilities (Ps ≤ 0.04) and cognitive performance (i.e., thinking ability and cognitive efficiency, Ps ≤ 0.04). However, among normal weight children, VAT was positively associated with intellectual abilities and cognitive efficiency. Conclusion In conclusion, the results suggest that VAT was selectively and negatively related with cognition among children with obesity. Along with the dangerous metabolic nature of VAT, its detrimental relationship with obese children's intellectual and cognitive functioning is concerning.

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2MisExf
via IFTTT

Size as an Important Determinant of Chest Blow–induced Commotio Cordis

Purpose Commotio cordis is sudden cardiac death caused by a relatively innocent blow to the left chest wall. Adolescents account for the majority of the cases; whether this is due to the higher frequency of adolescents playing ball sports or whether there is some maturational reduction of risk is not known. Methods In a swine model of commotio cordis, the effect of body weight/size (directly related to age) to the susceptibility of chest impact–induced ventricular fibrillation (VF) is examined. Methods Ball impacts were delivered at escalating velocities from 48.3 to 96.9 km·h−1 (30–60 mph) to 128 swine ranging in weight from 5 to 54 kg. Results VF occurred in 29% of impacts to the smallest animals compared with 34% in the 14- to 239-kg group, 27% in the 24- to 33.9-kg group, 30% in 34- to 43-kg group, and 15% in the 44- to 54-kg animals. The highest-weight group was associated with a significantly lower incidence of VF compared with other weights (P = 0.002). In a multivariate logistic regression analysis, controlling for repeated measures, four variables predicted VF: body weight (P = 0.0008), velocity (P

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2nR4Ulv
via IFTTT

Effects of p-Synephrine and Caffeine Ingestion on Substrate Oxidation during Exercise

Purpose Caffeine and p-synephrine are substances usually included in commercially available products for weight loss because of their purported thermogenic effects. However, scientific information is lacking about the effects of combining these substances on substrate oxidation during exercise. The purpose of this investigation was to determine the isolated and combined effects of p-synephrine and caffeine on fat oxidation rate during exercise. Methods In a double-blind randomized experiment, 13 healthy subjects participated in four experimental trials after the ingestion of a capsule containing a placebo, 3 mg·kg−1 of caffeine, 3 mg·kg−1 of p-synephrine, or the combination of these doses of caffeine and p-synephrine. Energy expenditure and substrate oxidation rates were measured by indirect calorimetry during a cycle ergometer ramp test from 30% to 90% of V˙O2max. Results In comparison with the placebo, the ingestion of caffeine, p-synephrine, or p-synephrine + caffeine did not alter total energy expenditure or heart rate during the whole exercise test. However, the ingestion of caffeine (0.44 ± 0.15 g·min−1, P = 0.03), p-synephrine (0.43 ± 0.19 g·min−1, P

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2nR4Thr
via IFTTT

A Longitudinal Study of the Effect of Organized Physical Activity on Free Active Play

Purpose The relationship between organized sport participation and positive youth development is well established. However, overinvolvement in sport and organized physical activity has been identified as having a potentially negative effect. Overscheduling and its impact on free play is one concern, given the importance of free play to overall health and development. Currently, it is not known if greater participation in organized sport has a positive or negative effect on discretionary free play in children and youth. Methods The Physical Health and Activity Study Team study was a 5-yr, longitudinal cohort study that followed 2278 fourth grade children (ages 9–10 yr). Organized sport and free play was assessed in the fall of each school year from fifth to eighth grades using self-report questionnaires. Results Using mixed-effects modeling, we found that higher participation in organized sport was associated with increased participation in free play over time (coefficient = 0.20, P

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2MXhISh
via IFTTT

Efficacy of Testosterone plus NASA Exercise Countermeasures during Head-Down Bed Rest

Introduction Prolonged confinement to head-down bed rest (HDBR) results in musculoskeletal losses similar to those observed during long-duration space flight. Exercise countermeasures by themselves have not completely prevented the deleterious losses in muscle mass or function in HDBR or space flight. Purpose The objective was to investigate the safety and efficacy of intermittent, low-dose testosterone treatment in conjunction with NASA exercise (SPRINT) countermeasures during 70 d of 6° HDBR. Methods Healthy men (35 ± 8 yr) were randomized into one of three groups that remained inactive (CON) or performed exercise 6 d·wk−1 in addition to receiving either placebo (PEX) or testosterone treatment (TEX, 100 mg·wk−1). Testosterone/placebo injections were administered once a week for 2 wk, followed by 2 wk off and so on, during HDBR. Results Total, leg, and trunk lean body mass (LBM) consistently decreased in CON, increased in TEX, and had little or no changes in PEX. Total, leg, and trunk fat mass consistently increased in CON and PEX and decreased in TEX. Leg strength decreased in CON, whereas PEX and TEX were protected against loss in strength. Changes in leg LBM correlated positively with changes in leg muscle strength. Conclusions Addition of a testosterone countermeasure enhanced the preventative actions of exercise against body composition changes during long-term HDBR in healthy eugonadal men. This is the first report to demonstrate that cycled, low-dose testosterone treatment increases LBM under conditions of strict exercise control. These results are clinically relevant to the development of safe and effective therapies against muscle atrophy during long-term bed rest, aging, and disease where loss of muscle mass and strength is a risk. The potential space flight applications of such countermeasure combinations deserve further investigations.

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2nR4LhX
via IFTTT

Older E-bike Users: Demographic, Health, Mobility Characteristics, and Cycling Levels

Purpose Electric bicycles (e-bikes) may offer an opportunity to stimulate physical activity among older adults. The current study compared Flemish (Belgian) older e-bike users with those not using an e-bike on sociodemographics, health characteristics, and access to motorized transport. In addition, it examined the association between e-bike use and levels of cycling and the moderating effects of sex, body mass index (BMI), and cycling limitations. Methods An online or interview version of the same questionnaire was completed by 1146 participants. Data were analyzed using logistic regression and hurdle models. Results Women, those with a higher BMI, and those with one (compared with no) motorized vehicle in the household had higher odds of being an e-bike user. E-bike use was related to higher odds of having cycled for transport in the past week, and this relationship was stronger among those with a higher BMI (low BMI: odds ratio, 1.89; 95% confidence interval (CI), 1.24–2.91; high BMI: odds ratio, 3.34; 95% CI, 2.26–5.00). Among those who cycled for transport in the last week, e-bike use was associated with 35% more minutes of cycling for transport (95% CI, 17%–56%). E-bike use was related to 183% higher odds of having biked for recreation (95% CI, 115%–274%). Among women and those with cycling limitations who cycled for recreation in the last week, e-bike use was also related to 57% (95% CI, 18%–109%) and 180% (95% CI, 63%–381%) more minutes of cycling for recreation, respectively. Conclusion E-bikes may provide an opportunity to promote cycling among older adults, particularly among subgroups at risk for physical inactivity.

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2wdEn5z
via IFTTT