Cerebral Microembolization During Aortic Valve Replacement Using Minimally Invasive or Conventional Extracorporeal Circulation: A Randomized Trial.

To compare intraoperative cerebral microembolic load between minimally invasive extracorporeal circulation (MiECC) and conventional extracorporeal circulation (CECC) during isolated surgical aortic valve replacement (SAVR), we conducted a randomized trial in patients undergoing primary elective SAVR at a tertiary referral hospital. The primary outcome was the procedural phase-related rate of high-intensity transient signals (HITS) on transcranial Doppler ultrasound. HITS rate was used as a surrogate of cerebral microembolism in pre-defined procedural phases in SAVR using MiECC or CECC with (+F) or without (-F) an oxygenator with integrated arterial filter. Forty-eight patients were randomized in a 1:1 ratio to MiECC or CECC. Due to intraprocedural Doppler signal loss (n = 3), 45 patients were included in final analysis. MiECC perfusion regimen showed a significantly increased HITS rate compared to CECC (by a factor of 1.75; 95% confidence interval, 1.19-2.56). This was due to different HITS rates in procedural phases from aortic cross-clamping until declamping [phase 4] (P = 0.01), and from aortic declamping until stop of extracorporeal perfusion [phase 5] (P = 0.05). Post hoc analysis revealed that MiECC-F generated a higher HITS rate than CECC+F (P = 0.005), CECC-F (P = 0.05) in phase 4, and CECC-F (P = 0.03) in phase 5, respectively. In open-heart surgery, MiECC is not superior to CECC with regard to gaseous cerebral microembolism. When using MiECC for SAVR, the use of oxygenators with integrated arterial line filter appears highly advisable. Only with this precaution, MiECC confers a cerebral microembolic load comparable to CECC during this type of open heart surgery.

National drug control strategy.

Some vols. have also a distinctive title.

The independent effects of attention and lead stimulus properties on the acoustic blink reflex

The effects of attention to a lead stimulus and of its sensory properties on modulation of the acoustic blink reflex were investigated. Participants performed a reaction time task cued by an acoustic or a visual lead stimulus. In Experiment 1, half the participants were presented with sustained lead stimuli. For the remainder, the lead stimulus was discrete and consisted of two brief presentations that marked the onset and offset of a stimulus-free interval. In Experiment 2, sustained lead stimuli were presented at a low or high intensity. The attentional demands of the task enhanced blink latency and magnitude modulation during acoustic and visual lead stimuli, with blink modulation being largest at a late point during the lead stimulus. Independent of the attentional effects, blink latency and magnitude modulation were larger during sustained than during discrete acoustic lead stimuli, whereas there was no difference for visual lead stimuli. Increases in the intensity of the lead stimulus enhanced blink modulation regardless of lead stimulus modality. Attention to a lead stimulus and the properties of the lead stimulus appear to have independent effects on blink reflex modulation.

Tennis, incidence of URTI and salivary IgA

Tennis played at an elite level requires intensive training characterized by repeated bouts of brief intermittent high intensity exercise over relatively long periods of time (1 - 3 h or more). Competition can place additional stress on players. The purpose of this study was to investigate the temporal association between specific components of tennis training and competition, the incidence of upper respiratory tract infections (URT1), and salivary IgA, in a cohort of seventeen elite female tennis players. Timed, whole unstimulated saliva samples were collected before and after selected 1-h training sessions at 2 weekly intervals, over 12 weeks. Salivary IgA concentration was measured by ELISA and IgA secretion rate calculated (mug IgA x ml(-1) x ml saliva x min(-1)). Players reported URTI symptoms and recorded training and competition in daily logs. Data analysis showed that higher incidence of URTI was significantly associated with increased training duration and load, and competition level, on a weekly basis. Salivary IgA secretion rate (S-IgA) dropped significantly after 1 hour of tennis play. Over the 12-week period, pre-exercise salivary IgA concentration and secretion rate were directly associated with the amount of training undertaken during the previous day and week (p < 0.05). However, the decline in S-IgA after 1 h of intense tennis play was also positively related to the duration and load of training undertaken during the previous day and week (p < 0.05). Although exercise-induced suppression of salivary IgA may be a risk factor, it could not accurately predict the occurrence of URTI in this cohort of athletes.

Depth of cure and surface microhardness of composite resin cured with blue LED curing lights

Objectives. This study examined the depth of cure and surface microhardness of Filtek Z250 composite resin (3M-Espe) (shades B1, A3, and C4) when cured with three commercially available tight emitting diode (LED) curing lights [E-light (GC), Elipar Freelight (3M-ESPE), 475H (RF Lab Systems)], compared with a high intensity quartz tungsten halogen (HQTH) light (Kerr Demetron Optilux 501) and a conventional quartz tungsten halogen (QTH) lamp (Sirona S1 dental unit). Methods. The effects of light source and resin shade were evaluated as independent variables. Depth of cure after 40 s of exposure was determined using the ISO 4049:2000 method, and Vickers hardness determined at 1.0 mm intervals. Results. HQTH and QTH lamps gave the greatest depth of cure. The three LED lights showed similar performances across all parameters, and each unit exceeded the ISO standard for depth of cure except GC ELight for shade B1. In terms of shade, LED lights gave greater curing depths with A3 shade, while QTH and HQTH tights gave greater curing depths with C4 shade. Hardness at the resin surface was not significantly different between LED and conventional curing lights, however, below the surface, hardness reduced more rapidly for the LED lights, especially at depths beyond 3 mm. Significance. Since the performance of the three LED lights meets the ISO standard for depth of cure, these systems appear suitable for routine clinical application for resin curing. (C) 2003 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Single- vs. multiple-set resistance training: Recent developments in the controversy

Galvao, D.A., and D.R. Taaffe. Single- vs. multiple-set resistance training: recent developments in the controversy. J. Strength Cond. Res. 18(3):660-667. 2004.-The number of sets in a resistance training program remains a major point of discussion and controversy. Studies prior to 1998 demonstrated inconsistent findings between single-set and multiple-set programs; however, recent evidence suggests that multiple sets promote additional benefits following short- and long-term training. The rationale supporting multiple sets is that the number of sets is part of the exercise volume equation, and the volume of exercise is crucial in producing the stimulus necessary to elicit specific physiological adaptations. The purpose of this paper is to present an overview of recent resistance training studies comparing single and multiple sets. However, it should be noted that studies to date have been conducted in young and middle-aged adults, and it remains to be determined if the additional benefits accrued with multiple-set training also occurs for older adults, especially the frail elderly.

Temporal aspects of the VO2 response at the power output associated with VO2peak in well trained cyclists: Implications for interval training prescription

The power output achieved at peak oxygen consumption (VO2 peak) and the time this power can be maintained (i.e., Tmax) have been used in prescribing high-intensity interval training. In this context, the present study examined temporal aspects of the VO2 response to exercise at the cycling power that output well trained cyclists achieve their VO2 peak (i.e., Pmax). Following a progressive exercise test to determine VO2 peak, 43 well trained male cyclists (M age = 25 years, SD = 6; M mass = 75 kg SD = 7; M VO2 peak = 64.8 ml(.)kg(1.)min(-1), SD = 5.2) performed two Tmax tests 1 week apart.1. Values expressed for each participant are means and standard deviations of these two tests. Participants achieved a mean VO2 peak during the Tmax test after 176 s (SD = 40; = 74% of Tmax, SD = 12) and maintained it for 66 s (SD = 39; M = 26% of Tmax, SD = 12). Additionally they obtained mean 95 % of VO2 peak after 147 s (SD = 31; M = 62 % of Tmax, SD = 8) and maintained it for 95 s (SD = 38; M = 38 % of Tmax, SD = 8). These results suggest that 60-70% of Tmax is an appropriate exercise duration for a population of well trained cyclists to attain VO2 peak during exercise at Pmax. However due to intraparticipant variability in the temporal aspects of the VO2 response to exercise at Pmax, future research is needed to examine whether individual high-intensity interval training programs for well trained endurance athletes might best be prescribed according to an athlete's individual VO2 response to exercise at Pmax.

Anabolic responses to resistance training in older men and women: A brief review

Resistance training has been shown to be the most effective exercise mode to induce anabolic adaptations in older men and women. Advances in imaging techniques and histochemistry have increased the ability to detect such changes, confirming the high level of adaptability that remains in aging skeletal muscle. This brief review presents a summary of the resistance-training studies that directly compare chronic anabolic responses to training in older (> 60 years) men and women. Sixteen studies are summarized, most of which indicate similar relative anabolic responses between older men and women after resistance training. Relatively small sample sizes in most of the interventions limited their ability to detect significant sex differences and should be considered when interpreting these studies. Future research should incorporate larger sample sizes with multiple measurement time points for anabolic responses.

Physiological role of carnosine in contracting muscle

High-intensity exercise leads to reductions in muscle substrates (ATP, PCr, and glycogen) and a subsequent accumulation of metabolites (ADP, Pi, H+, and M2+) with a possible increase in free radical production. These factors independently and collectively have deleterious effects on muscle, with significant repercussions on high-intensity performance or training sessions. The effect of carnosine on overcoming muscle fatigue appears to be related to its ability to buffer the increased H+ concentration following high-intensity work. Carnosine, however, has other roles such as an antioxidant, a metal chelator, a Ca2+ and enzyme regulator, an inhibitor of protein glycosylation and protein-protein cross-linking. To date, only 1 study has investigated the effects of carnosine supplementation (not in pure form) on exercise performance in human subjects and found no improvement in repetitive high-intensity work. Much data has come from in vitro work on animal skeletal muscle fibers or other components of muscle contractile mechanisms. Thus further research needs to be carried out on humans to provide additional understanding on the effects of carnosine in vivo.

Resistance training for the older adult: Manipulating training variables to enhance muscle strength

Resistance training has been shown to reliably and substantially enhance muscle function in older adults and these improvements can be accompanied by improved functional performance. Training variables should be manipulated to enhance muscle strength and minimize injury risks in this population.

Covariation and interference between physiological reflexes: Eye-blink startle cardiac defense, and skin conductance

Comparative studies of autonomic and somatic reflexes, such as cardiac defense and motor startle, are rare. However, examination of the pattern of covariation, independence, or interference among physiological reflexes may help to clarify their functional significance and elucidate their complex modulation by psychological factors. Here we report the results of a study that examined the pattern of interference of eye-blink startle on subsequent cardiac defense. Participants were 63 students (31 women) distributed into three groups according to the sensory modality of the eliciting stimulus during the startle trials: acoustic high intensity (105 dB), acoustic low intensity (65 dB), and visual modality. Startle trials consisted of 12 presentations of the eliciting stimulus with a duration of 50 ms, instantaneous risetime, and a variable inter-stimulus interval of 16 – 20 s.Defense trials began 20 s after the last startle trial and consisted, for all groups, of 3 presentations of the high intensity acoustic stimulus with a duration of 500 ms and an inter-stimulus interval of 215 s. Results showed a clear interference of the startle trials on the subsequent defense trials when both types of trials shared identical sensory modality (acoustic) independently of intensity: the expected pattern of cardiac defense in the first trial only appeared in the visual modality. Similar interference effects were observed in the skin conductance response. Subjective reactivity to the defense stimulus did not detect differences between conditions.

The influence of bovine colostrum supplementation on exercise performance in highly trained cyclists

Purpose: The aim of this experiment was to investigate the influence of low dose bovine colostrum supplementation on exercise performance in cyclists over a 10 week period that included 5 days of high intensity training (HIT). Methods: Over 7 days of preliminary testing, 29 highly trained male road cyclists completed a VO2max test (in which their ventilatory threshold was estimated), a time to fatigue test at 110% of ventilatory threshold, and a 40 km time trial (TT40). Cyclists were then assigned to either a supplement (n = 14, 10 g/day bovine colostrum protein concentrate (CPC)) or a placebo group (n = 15, 10 g/day whey protein) and resumed their normal training. Following 5 weeks of supplementation, the cyclists returned to the laboratory to complete a second series of performance testing (week 7). They then underwent five consecutive days of HIT (week 8) followed by a further series of performance tests (week 9). Results: The influence of bovine CPC on TT40 performance during normal training was unclear (week 7: 1+/-3.1%, week 9: 0.1+/-2.1%; mean+/-90% confidence limits). However, at the end of the HIT period, bovine CPC supplementation, compared to the placebo, elicited a 1.9+/-2.2% improvement from baseline in TT40 performance and a 2.3+/-6.0% increase in time trial intensity (% VO2max), and maintained TT40 heart rate (2.5+/-3.7%). In addition, bovine CPC supplementation prevented a decrease in ventilatory threshold following the HIT period (4.6+/-4.6%). Conclusion: Low dose bovine CPC supplementation elicited improvements in TT40 performance during an HIT period and maintained ventilatory threshold following five consecutive days of HIT.

Effect of training on the response of plasma vascular endothelial growth factor to exercise in patients with peripheral arterial disease

Expansion of the capillary network, or angiogenesis, occurs following endurance training. This process, which is reliant on the presence of VEGF (vascular endothelial growth factor), is an adaptation to a chronic mismatch between oxygen demand and supply. Patients with IC (intermittent claudication) experience pain during exercise associated with an inadequate oxygen delivery to the muscles. Therefore the aims of the present study were to examine the plasma VEGF response to acute exercise, and to establish whether exercise training alters this response in patients with IC. In Part A, blood was collected from patients with IC (n = 18) before and after (+ 20 and + 60 min post-exercise) a maximal walking test to determine the plasma VEGF response to acute exercise. VEGF was present in the plasma of patients (45.11 +/- 29.96 pg/ml) and was unchanged in response to acute exercise. Part B was a training study to determine whether exercise training altered the VEGF response to acute exercise. Patients were randomly assigned to a treatment group (TMT; n = 7) that completed 6 weeks of high-intensity treadmill training, or to a control group (CON; n = 6). All patients completed a maximal walking test before and after the intervention, with blood samples drawn as for Part A. Training had no effect on plasma VEGF at rest or in response to acute exercise, despite a significant increase in maximal walking time in the TMT group (915 + 533 to 1206 + 500 s; P = 0.009) following the intervention. The absence of a change in plasma VEGF may reflect altered VEGF binding at the endothelium, although this cannot be confirmed by the present data.