Effects of a highly intensive clean and jerk exercise on blood pressure and arterial stiffness in experienced non-professional weight lifters

Abstract

Purpose

Weight lifting training has gained much popularity in recent years and is frequently used in non-professional and professional settings. However, little is known about the acute effects of a highly intensive weight lifting exercise (clean and jerk) on the hemodynamic reaction.

Methods

18 non-professional experienced weight lifters were recruited. Hemodynamic parameters were obtained and measured at baseline (T1), after warming up (T2), and after a highly intensive clean and jerk exercise (90–95% of personal best; T3). Further, 15 (T4), and 30 min (T5) post-exercise measurements were conducted. Evaluated parameters were heart rate (HR) (b/min), peripheral and central systolic and diastolic blood pressure (pSysBP, pDiaBP, cSysBP, cDiaBP) (mmHg), pulse wave velocity (PWV) (m/s), and double product (DP).

Results

All hemodynamic values increased from T1 up to T3 with significantly higher values measured at T3 compared to T1 and T2. Values of measured parameters at T3 were as follows: HR: 94.4 ± 15.6 b/min, pSysBP: 147.1 ± 15.9 mmHg, pDiaBP: 87.4 ± 12.2 mmHg, cSysBP: 129.3 ± 13.8 mmHg, cDiaBP: 89.9 ± 12.8 mmHg, and: 5.8 ± 0.5 m/s, DP: 14053 ± 3669. Post-exercise (T4, T5), all values returned to baseline levels.

Conclusions

Results indicate that a highly intensive weight lifting exercise led to an acute increase of blood pressure and an acute stiffening of the arteries. Yet, increases were moderate and did not reach disproportionately high levels and returned to baseline levels within 15 min post-exercise. Hence, no negative acute effects of a maximum weight lifting exercise on the hemodynamic system are observed.

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Medical Emergency Department attendance of under‐16‐year‐olds with dental problems

Abstract

Background

Medical Emergency Departments (MED) are under increasing pressure in the UK with suggestions that unnecessary attendances to MED, which may include dental problems, are to blame.

Objectives

The aim of this cross‐sectional study was to examine the period prevalence of under 16‐year‐olds attendance to Medical Emergency Departments (MED) with oral and dental problems over a 5‐year period and investigate reason for attendance. This cross‐sectional study was carried out as part of a service evaluation at the Newcastle upon Tyne Hospitals NHS Foundation Trust.

Methods

Retrospective data were collected between 1 January 2012 and 31 December 2016 from the MED database using coding and a free text search of all paediatric attendances. The data were then analysed using descriptive statistics.

Results

Over the 5‐year period 135,760 under 16s attended the MED. Of these 868 (0.6%) attended for dental problems. The most common dental reason for attendance were as follows: Candida accounted for 22.6% of the 0‐5‐year‐olds; dental trauma accounted for 29.5% of 6‐11‐year‐olds; and mandibular fractures accounted for 18.9% of the 12‐16‐year‐olds. Of those who attended the MED for dental problems 28.5% resided in areas with an Index of Multiple Deprivation decile of 1, the areas of highest deprivation in the UK.

Conclusion

Many of the diagnoses may have been appropriately managed elsewhere in the community, which may result in improved treatment provision and tailored care pathways, as well as reducing strain on the MED. Further research is needed to investigate why patients attend MED with dental problems.

This article is protected by copyright. All rights reserved.

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Exome sequencing in genomic regions related to racing performance of Quarter Horses

Abstract

Among horses selected for speed, the racing line of Quarter Horses is characterized by high performance in sprint races, with these animals being considered the fastest horses in the world. However, few studies have investigated in more detail the polymorphisms and genes that act on this trait. The objective of this study was to analyze exomes and UTRs in regions previously associated with this trait by GWAS in Quarter Horse racehorses with contrasting maximum speed index (SImax), prospecting causal gene polymorphisms that are related to or are in strong linkage disequilibrium with racing performance. Genotypic and phenotypic records from 360 animals of the racing line of Quarter Horses, previously genotyped with an SNP chip to obtain individual genomic estimated breeding values for performance, were used for the formation and sequencing of two groups of animals with contrasting racing performance (20 animals with superior SImax and 20 with inferior SImax). Two rapid runs were performed using two pools of libraries containing 20 and 19 samples randomly chosen among the 40 samples with contrasting SIs. A total of 1203 variants (1105 SNPs and 93 InDels) were identified in 33 regions of interest obtained previously by GWAS. Twenty-nine of the polymorphisms (24 SNPs and 5 InDels) were considered to be important based on three different and independent approaches: SIFT scores classified as deleterious (< 0.05), degree of impact on the consensus region of each polymorphism, and different allele frequencies identified by Fisher's exact test (p < 0.01) between the groups of horses with contrasting SImax. Thus, eight genes described as functional and positional candidates in previous studies (ABCG5, COL11A1, GEN1, SOCS3, MICAL1, SPTBN1, EPB41L3, and SHQ1) and nine new candidate genes (AKNA, ARMC2, FKBP15, LHX1, NOL10, TMEM192, ZFP37, FIG4, and HNRNPU), some of them with known function, were related to racing performance in Quarter Horses.

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The impact of a quality improvement project to standardize pain, agitation, and withdrawal assessments on the use of morphine and midazolam in the Pediatric Intensive Care Unit

Abstract

Objectives

This study aims to assess the impact of a quality improvement initiative to increase assessments of pain, agitation, and iatrogenic withdrawal syndrome, on the use of sedative and analgesic medication in a pediatric intensive care unit.

Design and setting

This is a retrospective pre‐ and post, observational, quality improvement study conducted in an eighteen‐bed medical‐surgical‐cardiac, tertiary intensive care unit.

Patients

We included patients consecutively admitted from October 1‐ March 31 (pre period 2015‐2016, post period 2016‐2017) who were mechanically ventilated beyond 48 hours.

Intervention

A multidisciplinary team, including a family advisor, implemented the following interventions using rapid "Plan‐Do‐Study‐Act cycles:" 1) standardized pain and sedation assessments, 2) standardized sedation goal setting, and 3) non‐pharmacological strategies to manage pain and agitation. We did not implement any specific sedation protocol. We used audit and feedback to reinforce change.

Measurements and main results

The post‐intervention phase started once sedation scores were documented q12h for > 60% of patients. The groups (n=45 per group) were similar regarding demographics, severity of illness, and mechanical ventilation duration, but different in length of intensive care stay. The cumulative dose of midazolam equivalent was significantly lower in the post‐intervention period (3.71 vs 2.65 mg/kg/mechanical ventilation day, p 0.009, 95%CI ‐1.12 (‐1.89, ‐0.31)). Morphine equivalent usage went from 3.51 vs 2.57 mg/kg/mechanical ventilation day (p 0.066, 95%CI ‐0.67 (‐1.44, 0.05)). There were no significant pre‐post differences in the use of other sedative agents, rates of iatrogenic withdrawal syndrome or severe pain, nor medication cost.

Conclusions

Implementation of a multi‐faceted QI project was successful at increasing standardized assessments of pain and agitation, and was associated with a significant reduction in midazolam use. We also observed a decrease in morphine use without increasing rates of severe pain. Incidence of iatrogenic withdrawal syndrome and cost were unchanged.

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Fruits and vegetables (FVs)

Nature's bountiful gift to humankind: Vegetables & fruits & their role in cardiovascular disease & diabetes p. 569

Kamala Krishnaswamy, Rajagopal Gayathri

DOI:10.4103/ijmr.IJMR_1780_18  

Fruits and vegetables (FVs) are recognized as healthy constituents of diet and a sustainable solution to the existing twin burden of micronutrient deficiencies and non-communicable diseases in developing and developed countries. In general, FVs are nutrient dense foods low in energy, containing varying amounts of vitamins and minerals including carotenoids, B vitamins, vitamin C, iron, zinc, potassium, calcium, magnesium and fibre. These are abundantly rich in phytochemicals that function as antioxidants, anti-atherosclerotic and anti-inflammatory agents. This review summarizes some epidemiological, prospective cohort and intervention studies on the health benefits of FVs in relation to cardiovascular disease, obesity and diabetes. The rich varieties of FVs available, their composition, production scenario in India, dietary intake and trends over time, barriers to sufficient intake mainly sociocultural, economic and horticulture environment, policies for promotion and prevention of diseases are considered.

The application of repeated testing and monoexponential regressions to classify individual cardiorespiratory fitness responses to exercise training

Abstract

Purpose

We tested the hypothesis that monoexponential regressions will increase the certainty in response estimates and confidence in classification of cardiorespiratory fitness (CRF) responses compared to a recently proposed linear regression approach.

Methods

We used data from a previously published RCT that involved 24 weeks of training at high amount–high intensity (HAHI; N = 28), high amount–low intensity (HALI; N = 48), or low amount–low intensity (LALI; N = 33). CRF was measured at 0, 4, 8, 16, and 24 weeks. We fit the repeated CRF measures with monoexponential and linear regressions, and calculated individual response estimates, the error in these estimates (TE_MONOEXP and TE_SLOPE, respectively), and 95% confidence intervals (CIs). Individuals were classified as responders, uncertain, or non-responders based on where their CI lay relative to a minimum clinically important difference. Additionally, responses were classified using observed pre–post-changes and the typical error of measurement.

Results

Comparing the error in response estimates revealed that monoexponential regressions were a better fit than linear regressions for the majority of individual responses (N = 81/109) and mean CRF data (mean TE_MONOEXP:TE_SLOPE; HAHI = 2.00:2.58, HALI = 1.91:2.46, LALI = 1.63:2.18; all p < 0.01). Fewer individuals were confidently classified as responders with linear regressions (N = 29/109) compared to monoexponential (N = 55/109). Additionally, response estimates were highly correlated across all three approaches (all r > 0.92).

Conclusions

Future studies should determine the type of regression that best fits their data prior to classifying responses. The similarity in response estimates and classification from regressions and observed pre–post-changes questions the purported benefit of using repeated measures to characterize CRF responses to training.

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Early demise of twins in a cohort of stillbirths and second trimester miscarriages

Twins, particularly monochorionic (MC) pairs, are at increased risk for fetal death. Whereas previous work has sought to understand the mechanisms for this increased mortality, most studies analyze viable twin pregnancies or liveborn twin cohorts. In the Wisconsin Stillbirth Service Program cohort of 3,137 stillbirths and second trimester miscarriages, we identified 175 twin pregnancies for a twinning rate of 56/1,000, which is approximately double the general population. The excess of twins among miscarriages and stillbirths was attributable to MC pairs as the incidence of dizygotic (DZ) twinning was not increased compared to livebirth data. The leading causes of fetal demise among twins were twin–twin transfusion, acardia, and twin–twin disruption. Maternal causes of death, primarily premature rupture of membranes, were moderately increased in both MC and DZ twins relative to singletons. Although deceased twins were smaller than expected for viable twins at comparable gestational ages, placenta weights of deceased MC pairs were large compared to combined fetal weight, which indicates placental inefficiency likely due to vascular shunting. Co‐twin survival was much lower for MC than for DZ pairs. Therefore, earlier diagnosis and treatment of MC twinning complications may decrease prenatal mortality.

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