Fluid replacement strategy during a 27-Km trail run in hot and humid conditions.

We evaluated the effects of the fluid replacement strategy on core temperature, heart rate and urine osmolality during a 27-km trail run in tropical climate. 20 well-trained runners completed a 27-km trail race in tropical conditions. They were acclimatized to these conditions. Heart rate was monitored every 5 s, while core temperature and perceived thermal and comfort sensations were recorded before, at the 11(th) km, and just after the end of the race. Water intake, urine osmolality and body mass were measured before and after the race. Core temperature and the scores of perceived thermal and comfort sensations were significantly higher at the 11(th) km and at the end of the race compared to before the race, but not at the 11(th) km compared to the end of the race [corrected]. No participant exhibited dehydration as assessed by urine osmolality. The less the trail runners weighed, the greater the heat retention was. The less hot they felt at the end of the race, the more they lost water, and the better the performance was. The fastest runners were able to tolerate a greater variation in core temperature between the beginning and the end of the trail race with lower water intake.

High versus low training frequency in cardiac rehabilitation using a systems model of training.

No study has reported the long term effects of cardiac rehabilitation, concerning the duration of beneficial effects of training program. The present study analyzed the influence of training session frequency on long-term beneficial effects in patients with coronary artery disease (CAD) undergoing phase 2 cardiac rehabilitation. Four patients with CAD completed 20 training sessions. Two patients were assigned to low training frequency (LTF) and two to high training frequency (HTF): three and five sessions per week(-1), respectively. The method was based on the systems model of training and required training quantification and the assessment of real exercise tolerance. Convolution of training quantity with real exercise tolerance provided the model exercise tolerance for every patient. The model parameters, the magnitude factor (k), and the time constant of decay (tau), were fitted from real and model exercise tolerances by the least squares method. LTF and HTF resulted in similar increases in exercise tolerance (12-14%). A model with one-component (fitness) allowed fitting exercise tolerance in all patients with r (2) = 0.77, 0.79, 0.84, and 0.91, respectively (p < 0.05). The addition of a second component did not improve the fit in any patient (p > 0.05). The k value was about twice as high with LTF (0.13 and 0.16 AU) than with HTF (0.05 AU for the two patients), whereas the tau value was about twice as low with LTF (37 and 41 days) than with HTF (72 and 89 days). The long term beneficial effects estimated by 4tau, were twice as long with HTF (288 and 356 days) than with LTF (148 and 164 days). We concluded that exercise tolerance was similarly increased with HTF and LTF but HTF training induced beneficial effects which were sustained twice as long.

Alternative regulatory perspectives of obstetrics and gynaecology.

In addressing whether the field of obstetrics and gynaecology demands internal self-regulation or external state intervention, the authors look at the distinct yet at once interrelated notions of ethics, deontology and law. The distinctness of these concepts relates not only to their optional and/or obligatory natures, but also to the group and/or groups they influence and/or regulate. The interrelated nature of these concepts suggests that they are complimentary paradigms in as much as they collectively form a framework of individual, professional and societal norms. Given the emergence of both legal pluralism and self-regulation over the last two decades, it is believed that neither self-regulation nor state intervention is in itself appropriate. Rather, it is contended that only a pluralistic system--incorporating ethics, deontology (self-regulatory models) and law (state regulatory model) can effectively and comprehensively regulate the medical community so that it may efficaciously and appropriately respond to the continually emerging issues raised by contemporary medicine.

Ethical and legal concerns: reproductive technologies 1990-1993.

After the rapid increase in reports, bills, and regulations on assisted reproductive technologies (ART) in the 1980s, the first 3 years of the 1990s reveal a continuation of this trend notably in three major aspects. First, a certain consistency has developed in terms of the conditions of accessibility to ART, the definition of infertility, the terms of donation, and the primacy of social filiation, so that anonymity remains controversial. Second, the importance of protection of genetic material has been reaffirmed with regard to gamete and embryo conservation, embryo research, and, in particular, the acceptability of preimplantation diagnosis. Finally, the framework of practices concerning accreditation and control, organization of national data, and management of nominative information has been increasingly refined.