Bone mineral density in postmenopausal women with and without breast cancer

OBJECTIVE: The values of bone mineral density (BMD) were compared in postmenopausal women with and without breast cancer. METHODS: A cross-sectional study was conducted, including 51 breast cancer survivors (BCS) and 71 women without breast cancer, who were non-users of hormone therapy, tamoxifen, or aromatase inhibitors. BMD T-scores and measurements in grams per centimeter squared (g/cm²) were obtained at the femoral neck, trochanter, Ward's triangle, and lumbar spine. Osteopenia and osteoporosis were grouped and categorized as abnormal BMD. Unconditional logistic regression analysis was used to estimate the odds ratios (OR) of abnormal BMD values as measures of association, with 95% confidence intervals (CIs), adjusting for age, years since menopause, parity, and body mass index (BMI). RESULTS: The mean age of the women with and without breast cancer was 54.7 ± 5.8 years and 58.2 ± 4.8 years (p < 0.01), respectively. After adjusting for age, parity and BMI, abnormal BMD at the femoral neck (adjusted OR: 4.8; 95% CI: 1.5-15.4), trochanter (adjusted OR: 4.6; 95% CI: 1.4-15.5), and Ward's triangle (adjusted OR: 4.5; 95% CI: 1.5-12.9) were significantly more frequent in postmenopausal BCS than in women without breast cancer. Postmenopausal BCS had a significantly lower mean BMD at the trochanter (0.719 vs. 0.809 g/cm², p < 0.01) and at the Ward's triangle (0.751 vs. 0.805 g/cm², p = 0.03). CONCLUSION: The prevalence of abnormal BMD was higher in postmenopausal BCS than in postmenopausal women without breast cancer. Bone health requires special vigilance and the adoption of interventions should be instituted early to minimize bone loss in BCS.

Estudo da estabilidade dos componentes na artroplastia total do joelho sem cimento

OBJETIVO: Comparar dois métodos de avaliação da estabilidade dos componentes tibial e femoral nas artroplastias de joelho não cimentadas com plataforma rotatória. MÉTODOS: Para isso foram avaliados 20 pacientes (20 joelhos) através de uma análise de radiografias dinâmicas com intensificador de imagem e manobras de estresse em varo e valgo, que foram comparadas com radiografias estáticas em frente e perfil dos joelhos, analisadas por dois cirurgiões experientes, cegos um em relação ao outro. RESULTADOS: Os resultados das análises estáticas e dinâmicas foram comparados e demonstraram forte correlação estatística (p<0,001), utilizando-se o método Kappa de comparação. CONCLUSÃO: O componente tibial mostrou-se mais instável quando comparado com o componente femoral, tanto na análise estática, quanto na dinâmica. Nível de evidência IV, Série de Casos.

Comparação do sinal EMG e das características da passada em diferentes protocolos de corrida incremental

O objetivo do presente estudo foi comparar o sinal eletromiográfi co, a frequência e a amplitude de passada entre diferentes intensidades de corrida: 60%, 80% e 100% da velocidade máxima em dois protocolos incrementais. Participaram deste estudo 11 corredores do sexo masculino. Os protocolos de corrida foram realizados com velocidades iniciais de 10 km.hr-1, com incrementos de 1 km.hr-1 a cada três minutos até a exaustão, que diferiram em relação ao intervalo entre cada estágio incremental: 30 e 120 segundos. Foram analisados valores RMS dos músculos iliocostal lombar, reto femoral, vasto lateral, vasto medial, bíceps femoral, tibial anterior, e gastrocnêmio, e a amplitude e frequência de passada. Os valores RMS mostraram aumento entre as intensidades para quase todos os músculos, e não foram influenciados pelo tipo de protocolo utilizado para maioria dos músculos. A frequência e amplitude de passada apresentaram contribuições percentuais diferenciadas para o aumento da velocidade de corrida.

A comparative radiographic investigation of femoroacetabular impingement in young patients with and without hip pain

OBJECTIVE: To compare the existence of radiographic abnormalities in two groups of patients, those with and without hip pain. METHODS: A total 222 patients were evaluated between March 2007 and April 2009; 122 complained of groin pain, and 100 had no symptoms. The individuals in both groups underwent radiographic examinations of the hip using the following views: anteroposterior, Lequesne false profile, Dunn, Dunn 45º, and Ducroquet. RESULTS: A total of 1110 radiographs were evaluated. Female patients were prevalent in both groups (52% symptomatic, 58% asymptomatic). There were statistically significant differences between the groups in age (p<0.0001), weight (p = 0.002) and BMI (p = 0.006). The positive findings in the group with groin pain consisted of the presence of a bump on the femoral head in the anteroposterior view (p<0.0001) or in the Dunn 45º view (p = 0.008). The difference in the a angle in the anteroposterior, Dunn, Dunn 45º, and Ducroquet views for all of the cases studied was p,0.0001. The joint space measurement differed significantly between groups in the Lequesne view (p = 0.007). The Lequesne anteversion angle (ρ) and the femoral offset measurement also differed significantly (p = 0.005 and p = 0.0001, respectively). CONCLUSIONS: We conclude that the best views for diagnosing a femoroacetabular impingement are the anteroposterior pelvic orthostatic, the Dunn 45º, and the Ducroquet views. The following findings correlated with hip pain: a decrease in the femoral offset, an increase in the α angle, an increase in the Lequesne ρ angle, a decrease in the CE angle of Wiberg, a thinner articular space and the presence of a bump on the femoral head-neck transition.

Post-surgical follow-up of primary hyperparathyroidism associated with multiple endocrine neoplasia type 1

The bone mineral density increments in patients with sporadic primary hyperparathyroidism after parathyroidectomy have been studied by several investigators, but few have investigated this topic in primary hyperparathyroidism associated with multiple endocrine neoplasia type 1. Further, as far as we know, only two studies have consistently evaluated bone mineral density values after parathyroidectomy in cases of primary hyperparathyroidism associated with multiple endocrine neoplasia type 1. Here we revised the impact of parathyroidectomy (particularly total parathyroidectomy followed by autologous parathyroid implant into the forearm) on bone mineral density values in patients with primary hyperparathyroidism associated with multiple endocrine neoplasia type 1. Significant increases in bone mineral density in the lumbar spine and femoral neck values were found, although no short-term (15 months) improvement in bone mineral density at the proximal third of the distal radius was observed. Additionally, short-term and medium-term calcium and parathyroid hormone values after parathyroidectomy in patients with primary hyperparathyroidism associated with multiple endocrine neoplasia type 1 are discussed. In most cases, this surgical approach was able to restore normal calcium/parathyroid hormone levels and ultimately lead to discontinuation of calcium and calcitriol supplementation.

Efeito do precondicionamento isquêmico remoto no transplante de intestino fetal em camundongos

Objetivo: avaliar os efeitos de precondicionamento isquêmico remoto (PCI-R) no modelo de transplante de intestino delgado fetal. Métodos: foram constituídos dois grupos: transplante isogênico (Iso, camundongos C57BL/6, n=24) e transplante alogênico (Alo, camundongos BALB/c, n=24). Em cada grupo, distribuíram-se os animais com e sem PCI-R, que foi realizado por oclusão da artéria femoral esquerda da fêmea prenhe durante 10 minutos, seguida por tempo igual de reperfusão. O imunossupressor utilizado foi Tacrolimo (Fk, 5 mg/kg/dia v.o.). Ao final obteve-se os seguintes subgrupos: Alo-Tx, Alo-Pci, Alo-Fk, Alo-Pci-Fk, Iso-Tx, Iso-Pci, Iso-Fk e Iso-Pci-Fk. O enxerto foi transplantado no espaço entre o músculo reto-abdominal e pré- peritoneal dos receptores a meio centímetro do apêndice xifóide, à esquerda da linha mediana. Após o sétimo dia de seguimento, o enxerto foi removido, fixado e embebido em parafina para avaliação histomorfológica (desenvolvimento e rejeição) e análise imunohistoquímica (anti-PCNA e anti-caspase-3 clivada). Os dados foram analisados usando ANOVA e testes complementares e foi considerado significante quando p <0.05. Resultados: A avaliação do desenvolvimento do enxerto no grupo de Iso mostrou que o PCI-R reduziu o desenvolvimento comparado com Iso-Tx (5,2±0,4 vs 9,0±0,8), o Fk e sua associação com PCI-R aumentaram o desenvolvimento do enxerto comparado com PCI-R (11,2±0,7 e 10,2±0,8, respectivamente). No grupo Alo, o Fk e/ou sua associação com PCI-R aumentaram o desenvolvimento comparado com Alo-Tx e Alo com PCI-R (6,0±0,8, 9,0±1,2, 0,0±0,0, 0,5±0,3, respectivamente). A expressão de PCNA foi maior no grupo ISO em animais tratados com Fk e PCI-R comparados a outros grupos (12,2±0,8 vs Tx: 8,8±0,9, PCI-R: 8,0±0,4 e Fk: 9,0±0,6). No grupo Alo, a expressão de PCNA não diferiu entre grupos. A rejeição do enxerto foi menor nos grupos tratados com PCI-R (-18%), Fk (- 68%) ou ambos (-61%) comparados com Alo-Tx. A expressão de caspase-3 clivada foi menor no grupo Iso em animais tratados com associação de PCI-R e Fk (6,2 ±0,9 vs Tx: 8,6±0,5; PCI-R: 5,8 ±0,9 e Fk: 6,0 ±0,3). Conclusão: O PCIR mostrou efeito benéfico sobre a lesão de isquemia e reperfusão do enxerto intestinal fetal nos transplantes isogênico e alogênico, aumentando o número de células caliciformes e a proliferação celular. No transplante alogênico, aumentou o desenvolvimento do enxerto, diminuiu o grau de rejeição aguda na ausência de imunossupressão, porém não apresentou efeito sinérgico com o imunossupressor. No transplante isogênico houve diminuição do grau de desenvolvimento do enxerto, porém foi efetivo na redução da apoptose.

Efeitos da oxigenoterapia hiperbárica e do sulfato de condroitina-A associado ao sulfato de glucosamina na reparação óssea de coelhos

Objetivo: Estudar o hemograma e avaliar radiológica e morfológicamente a reparação do calo ósseo após a lesão na diáfise femural de coelhos. Métodos: foram utilizados 48 coelhos independentes do sexo, Nova Zelândia, onde estes foram anestesiados e submetidos à ostectomia do côndilo femoral medial direito e osteossíntese, randomizados e distribuídos em 4 grupos (n = 12 em cada): Grupo Controle (I), Grupo Sulfato de Condroitina-A associado ao Sulfato de Glucosamina (II), sendo que a aplicação de Sulfato de Condroitina-A associado ao Sulfato de Glucosamina (2mL.10Kg -1 ) iniciou no pós-operatório imediato seguido de aplicações a cada 3 dias; Grupo Oxigenoterapia Hiperbárica (III): com sessões diárias (3 ATA durante 130 minutos, sendo 90 minutos de pressão absoluta) iniciadas no primeiro dia de pós-operatório; Grupo Sulfato de Condroitina-A associado ao Sulfato de Glucosamina e Oxigenoterapia Hiperbárica (IV). Os animais foram eutanasiados após 2 (n=6 de cada grupo) e 6 semanas (n=6 de cada grupo) de pós-operatório. Resultados: Diferenças significantes foram encontradas entre os grupos de 2 e 6 semanas de pós-operatório, quanto à média do comprimento do calo ósseo nos grupos: I (p = 0,001), II (p = 0,012) e IV (p = 0,001). A comparação entre os quatro grupos após 2 semanas mostrou diferença significante (p < 0,001), onde o grupo I apresentou média de comprimento caloso menor que os grupos II (p = 0,001), III (p = 0,001) e IV (p = 0,008), de maneira significante. Os demais grupos não se diferenciaram de forma significante (p > 0,05) nas demais comparações. Entretanto, após 6 semanas a comparação entre os quatro grupos mostrou diferença significante onde: o grupo I apresentou média de comprimento menor que os grupos III (p = 0,006) e IV (p < 0,001); o grupo II apresentou média de comprimento menor que os grupos III (p = 0,001) e IV (p < 0,001). Os demais grupos não se diferenciaram de forma significante (p > 0,05) nas demais comparações. Nos achados radiológicos de até duas semanas encontramos uma formação calosa rápida nos grupos que receberam oxigenoterapia hiperbárica (83% dos animais do grupo III) isoladamente ou em associação com o sulfato de condroitina-a associado ao sulfato de glucosamina (33% dos animais do grupo IV) quando comparados ao grupo controle. Já com seis semanas esta diferença diminui, mas ainda o grupo III (83%) apresenta um maior número de animais com formação calosa do que no grupo IV (67%). Sendo que os resultados radiológicos mostram a possibilidade de uma melhor ação da oxigenoterapia hiperbárica (83% dos animais) de forma isolada, pois quando comparada com o grupo II isolado (67% dos animais) ainda sugere uma superioridade na formação calosa mais rápida ao término do período precoce. Não foram encontradas alterações nos parâmetros hematológicos com as intervenções utilizadas. Conclusões: A oxigenoterapia hiperbárica e o sulfato de condroitina-a associado ao sulfato de glucosamina, isoladas ou em associação promovem aumento do calo ósseo e não promovem alterações nos parâmetros hematológicos dos animais nos tempos estudados.

Avaliação hemodinâmica de duas vias de reposição volêmica em um modelo de hemorragia da veia cava caudal em porcos

Introdução: A reposição volêmica em pacientes traumatizados tem sido controvérsa. O A.T.L.S. recomenda a infusão de um grande volume de fluidos na fase inicial de tratamento, enquanto outros autores recomendam a administração somente quando do controle da hemorragia. O acesso venoso femoral é contra indicado em pacientes com trauma abdominal por temor de aumento de hemorragia. A solução hipertônica de NaCl a 7,5% (SH) possui benefícios consideráveis de logística e de recuperação hemodinâmica com pequenos volumes de infusão, semelhante as vantagens das soluções padrões isotônicas na fase pré-hospitalar. Objetivos: Criar um modelo de choque hemorrágico induzido por trauma venoso. Avaliar a hemodinâmica e o volume de hemorragia abdominal nos animais submetidos a choque hemorrágico e tratados com SH via acesso femoral e jugular. Métodos: Em 18 porcos da raça landrace, divididos em 3 grupos de 6 animais (Controle, Jugular e Femoral), foi induzido um choque hipovolêmico não controlado pela ruptura da veia cava caudal. Os animais do grupo controle (GC) foram observados por 40 minutos quanto ao seu padrão hemodinâmico de Pressão de Artéria Pulmonar (PAP), Pressão Artérial Média (PAM), Débito Cardíaco (DC) e Fluxo de Veia Porta (FVP), porém sem reposição volêmica. Os animais dos grupos Femoral (GC) e Jugular (GJ) foram tratados com 4 ml/Kg de solução hipertônica de NaCl a 7,5% (SH) aos 20 minutos de experimento. Ao final do experimento, o volume de hemorragia abdominal foi mensurado.Resultados: O grupo controle (GC) apresentou queda dos valores hemodinâmicos aos 10 minutos e estes permaneceram estáveis até o final do experimento. Os animais dos grupos tratamento (GF e GJ) apresentaram melhora da hemodinâmica aos 30 minutos, sem aumento da hemorragia abdominal. Conclusão: A solução hipertônica de NaCl (SH) permitiu a melhora parcial da hemodinâmica no modelo de choque hipovolêmico, sem aumento da hemorragia, independentemente do acesso utilizada para a infusão.

Why do arms extract less oxygen than legs during exercise?

[EN] To determine whether conditions for O2 utilization and O2 off-loading from the hemoglobin are different in exercising arms and legs, six cross-country skiers participated in this study. Femoral and subclavian vein blood flow and gases were determined during skiing on a treadmill at approximately 76% maximal O2 uptake (V(O2)max) and at V(O2)max with different techniques: diagonal stride (combined arm and leg exercise), double poling (predominantly arm exercise), and leg skiing (predominantly leg exercise). The percentage of O2 extraction was always higher for the legs than for the arms. At maximal exercise (diagonal stride), the corresponding mean values were 93 and 85% (n = 3; P < 0.05). During exercise, mean arm O2 extraction correlated with the P(O2) value that causes hemoglobin to be 50% saturated (P50: r = 0.93, P < 0.05), but for a given value of P50, O2 extraction was always higher in the legs than in the arms. Mean capillary muscle O2 conductance of the arm during double poling was 14.5 (SD 2.6) ml.min(-1).mmHg(-1), and mean capillary P(O2) was 47.7 (SD 2.6) mmHg. Corresponding values for the legs during maximal exercise were 48.3 (SD 13.0) ml.min(-1).mmHg(-1) and 33.8 (SD 2.6) mmHg, respectively. Because conditions for O2 off-loading from the hemoglobin are similar in leg and arm muscles, the observed differences in maximal arm and leg O2 extraction should be attributed to other factors, such as a higher heterogeneity in blood flow distribution, shorter mean transit time, smaller diffusing area, and larger diffusing distance, in arms than in legs.

Effects of ATP-induced leg vasodilation on VO2 peak and leg O2 extraction during maximal exercise in humans

[EN] During maximal whole body exercise VO2 peak is limited by O2 delivery. In turn, it is though that blood flow at near-maximal exercise must be restrained by the sympathetic nervous system to maintain mean arterial pressure. To determine whether enhancing vasodilation across the leg results in higher O2 delivery and leg VO2 during near-maximal and maximal exercise in humans, seven men performed two maximal incremental exercise tests on the cycle ergometer. In random order, one test was performed with and one without (control exercise) infusion of ATP (8 mg in 1 ml of isotonic saline solution) into the right femoral artery at a rate of 80 microg.kg body mass-1.min-1. During near-maximal exercise (92% of VO2 peak), the infusion of ATP increased leg vascular conductance (+43%, P<0.05), leg blood flow (+20%, 1.7 l/min, P<0.05), and leg O2 delivery (+20%, 0.3 l/min, P<0.05). No effects were observed on leg or systemic VO2. Leg O2 fractional extraction was decreased from 85+/-3 (control) to 78+/-4% (ATP) in the infused leg (P<0.05), while it remained unchanged in the left leg (84+/-2 and 83+/-2%; control and ATP; n=3). ATP infusion at maximal exercise increased leg vascular conductance by 17% (P<0.05), while leg blood flow tended to be elevated by 0.8 l/min (P=0.08). However, neither systemic nor leg peak VO2 values where enhanced due to a reduction of O2 extraction from 84+/-4 to 76+/-4%, in the control and ATP conditions, respectively (P<0.05). In summary, the VO2 of the skeletal muscles of the lower extremities is not enhanced by limb vasodilation at near-maximal or maximal exercise in humans. The fact that ATP infusion resulted in a reduction of O2 extraction across the exercising leg suggests a vasodilating effect of ATP on less-active muscle fibers and other noncontracting tissues and that under normal conditions these regions are under high vasoconstrictor influence to ensure the most efficient flow distribution of the available cardiac output to the most active muscle fibers of the exercising limb.

Cardiac output and leg and arm blood flow during incremental exercise to exhaustion on the cycle ergometer

[EN] To determine central and peripheral hemodynamic responses to upright leg cycling exercise, nine physically active men underwent measurements of arterial blood pressure and gases, as well as femoral and subclavian vein blood flows and gases during incremental exercise to exhaustion (Wmax). Cardiac output (CO) and leg blood flow (BF) increased in parallel with exercise intensity. In contrast, arm BF remained at 0.8 l/min during submaximal exercise, increasing to 1.2 +/- 0.2 l/min at maximal exercise (P < 0.05) when arm O(2) extraction reached 73 +/- 3%. The leg received a greater percentage of the CO with exercise intensity, reaching a value close to 70% at 64% of Wmax, which was maintained until exhaustion. The percentage of CO perfusing the trunk decreased with exercise intensity to 21% at Wmax, i.e., to approximately 5.5 l/min. For a given local Vo(2), leg vascular conductance (VC) was five- to sixfold higher than arm VC, despite marked hemoglobin deoxygenation in the subclavian vein. At peak exercise, arm VC was not significantly different than at rest. Leg Vo(2) represented approximately 84% of the whole body Vo(2) at intensities ranging from 38 to 100% of Wmax. Arm Vo(2) contributed between 7 and 10% to the whole body Vo(2). From 20 to 100% of Wmax, the trunk Vo(2) (including the gluteus muscles) represented between 14 and 15% of the whole body Vo(2). In summary, vasoconstrictor signals efficiently oppose the vasodilatory metabolites in the arms, suggesting that during whole body exercise in the upright position blood flow is differentially regulated in the upper and lower extremities.

On the mechanisms that limit oxygen uptake during exercise in acute and chronic hypoxia: role of muscle mass

[EN] Peak aerobic power in humans (VO2,peak) is markedly affected by inspired O2 tension (FIO2). The question to be answered in this study is what factor plays a major role in the limitation of muscle peak VO2 in hypoxia: arterial O2 partial pressure (Pa,O2) or O2 content (Ca,O2)? Thus, cardiac output (dye dilution with Cardio-green), leg blood flow (thermodilution), intra-arterial blood pressure and femoral arterial-to-venous differences in blood gases were determined in nine lowlanders studied during incremental exercise using a large (two-legged cycle ergometer exercise: Bike) and a small (one-legged knee extension exercise: Knee)muscle mass in normoxia, acute hypoxia (AH) (FIO2 = 0.105) and after 9 weeks of residence at 5260 m (CH). Reducing the size of the active muscle mass blunted by 62% the effect of hypoxia on VO2,peak in AH and abolished completely the effect of hypoxia on VO2,peak after altitude acclimatization. Acclimatization improved Bike peak exercise Pa,O2 from 34 +/- 1 in AH to 45 +/- 1 mmHg in CH(P <0.05) and Knee Pa,O2 from 38 +/- 1 to 55 +/- 2 mmHg(P <0.05). Peak cardiac output and leg blood flow were reduced in hypoxia only during Bike. Acute hypoxia resulted in reduction of systemic O2 delivery (46 and 21%) and leg O2 delivery (47 and 26%) during Bike and Knee, respectively, almost matching the corresponding reduction in VO2,peak. Altitude acclimatization restored fully peak systemic and leg O(2) delivery in CH (2.69 +/- 0.27 and 1.28 +/- 0.11 l min(-1), respectively) to sea level values (2.65 +/- 0.15 and 1.16 +/- 0.11 l min(-1), respectively) during Knee, but not during Bike. During Knee in CH, leg oxygen delivery was similar to normoxia and, therefore, also VO2,peak in spite of a Pa,O2 of 55 mmHg. Reducing the size of the active mass improves pulmonary gas exchange during hypoxic exercise, attenuates the Bohr effect on oxygen uploading at the lungs and preserves sea level convective O2 transport to the active muscles. Thus, the altitude-acclimatized human has potentially a similar exercising capacity as at sea level when the exercise model allows for an adequate oxygen delivery (blood flow x Ca,O2), with only a minor role of Pa,O2 per se, when Pa,O2 is more than 55 mmHg.

Muscular and pulmonary O2 uptake kinetics during moderate- and high-intensity sub-maximal knee-extensor exercise in humans

[EN] The purpose of this investigation was to determine the contribution of muscle O(2) consumption (mVO2) to pulmonary O(2) uptake (pVO2) during both low-intensity (LI) and high-intensity (HI) knee-extension exercise, and during subsequent recovery, in humans. Seven healthy male subjects (age 20-25 years) completed a series of LI and HI square-wave exercise tests in which mVO2 (direct Fick technique) and pVO2 (indirect calorimetry) were measured simultaneously. The mean blood transit time from the muscle capillaries to the lung (MTTc-l) was also estimated (based on measured blood transit times from femoral artery to vein and vein to artery). The kinetics of mVO2 and pVO2 were modelled using non-linear regression. The time constant (tau) describing the phase II pVO2 kinetics following the onset of exercise was not significantly different from the mean response time (initial time delay + tau) for mVO2 kinetics for LI (30 +/- 3 vs 30 +/- 3 s) but was slightly higher (P < 0.05) for HI (32 +/- 3 vs 29 +/- 4 s); the responses were closely correlated (r = 0.95 and r = 0.95; P < 0.01) for both intensities. In recovery, agreement between the responses was more limited both for LI (36 +/- 4 vs 18 +/- 4 s, P < 0.05; r = -0.01) and HI (33 +/- 3 vs 27 +/- 3 s, P > 0.05; r = -0.40). MTTc-l was approximately 17 s just before exercise and decreased to 12 and 10 s after 5 s of exercise for LI and HI, respectively. These data indicate that the phase II pVO2 kinetics reflect mVO2 kinetics during exercise but not during recovery where caution in data interpretation is advised. Increased mVO2 probably makes a small contribution to during the first 15-20 s of exercise.

Bone mass and the CAG and GGN androgen receptor polymorphisms in young men

[EN] BACKGROUND: To determine whether androgen receptor (AR) CAG (polyglutamine) and GGN (polyglycine) polymorphisms influence bone mineral density (BMD), osteocalcin and free serum testosterone concentration in young men. METHODOLOGY/PRINCIPAL FINDINGS: Whole body, lumbar spine and femoral bone mineral content (BMC) and BMD, Dual X-ray Absorptiometry (DXA), AR repeat polymorphisms (PCR), osteocalcin and free testosterone (ELISA) were determined in 282 healthy men (28.6+/-7.6 years). Individuals were grouped as CAG short (CAG(S)) if harboring repeat lengths of < or = 21 or CAG long (CAG(L)) if CAG > 21, and GGN was considered short (GGN(S)) or long (GGN(L)) if GGN < or = 23 or > 23. There was an inverse association between logarithm of CAG and GGN length and Ward's Triangle BMC (r = -0.15 and -0.15, P<0.05, age and height adjusted). No associations between CAG or GGN repeat length and regional BMC or BMD were observed after adjusting for age. Whole body and regional BMC and BMD values were similar in men harboring CAG(S), CAG(L), GGN(S) or GGN(L) AR repeat polymorphisms. Men harboring the combination CAG(L)+GGN(L) had 6.3 and 4.4% higher lumbar spine BMC and BMD than men with the haplotype CAG(S)+GGN(S) (both P<0.05). Femoral neck BMD was 4.8% higher in the CAG(S)+GGN(S) compared with the CAG(L)+GGN(S) men (P<0.05). CAG(S), CAG(L), GGN(S), GGN(L) men had similar osteocalcin concentration as well as the four CAG-GGN haplotypes studied. CONCLUSION: AR polymorphisms have an influence on BMC and BMD in healthy adult humans, which cannot be explained through effects in osteoblastic activity.

Maximal muscular vascular conductances during whole body upright exercise in humans

[EN] That muscular blood flow may reach 2.5 l kg(-1) min(-1) in the quadriceps muscle has led to the suggestion that muscular vascular conductance must be restrained during whole body exercise to avoid hypotension. The main aim of this study was to determine the maximal arm and leg muscle vascular conductances (VC) during leg and arm exercise, to find out if the maximal muscular vasodilatory response is restrained during maximal combined arm and leg exercise. Six Swedish elite cross-country skiers, age (mean +/-s.e.m.) 24 +/- 2 years, height 180 +/- 2 cm, weight 74 +/- 2 kg, and maximal oxygen uptake (VO(2,max)) 5.1 +/- 0.1 l min(-1) participated in the study. Femoral and subclavian vein blood flows, intra-arterial blood pressure, cardiac output, as well as blood gases in the femoral and subclavian vein, right atrium and femoral artery were determined during skiing (roller skis) at approximately 76% of VO(2,max) and at VO(2,max) with different techniques: diagonal stride (combined arm and leg exercise), double poling (predominantly arm exercise) and leg skiing (predominantly leg exercise). During submaximal exercise cardiac output (26-27 l min(-1)), mean blood pressure (MAP) (approximately 87 mmHg), systemic VC, systemic oxygen delivery and pulmonary VO2(approximately 4 l min(-1)) attained similar values regardless of exercise mode. The distribution of cardiac output was modified depending on the musculature engaged in the exercise. There was a close relationship between VC and VO2 in arms (r= 0.99, P < 0.001) and legs (r= 0.98, P < 0.05). Peak arm VC (63.7 +/- 5.6 ml min(-1) mmHg(-1)) was attained during double poling, while peak leg VC was reached at maximal exercise with the diagonal technique (109.8 +/- 11.5 ml min(-1) mmHg(-1)) when arm VC was 38.8 +/- 5.7 ml min(-1) mmHg(-1). If during maximal exercise arms and legs had been vasodilated to the observed maximal levels then mean arterial pressure would have dropped at least to 75-77 mmHg in our experimental conditions. It is concluded that skeletal muscle vascular conductance is restrained during whole body exercise in the upright position to avoid hypotension.