Non-Ketotic Hyperglycemic Hemichorea-Hemiballismus in the Setting of Antipsychotics and Methamphetamine.

The management of common chronic conditions presenting in uncommon ways is an important facet of medical education and patient care. We report a 54-year-old patient who developed left arm dystonia precipitated by several potential factors. These include laboratory findings notable for significant hyperglycemia, methamphetamine positive on urine drug testing and patient history consistent with bipolar II managed with Lurasidone, a second-generation antipsychotic medication. The potential etiology of this uncommon presentation is discussed below.

Net energy expenditure of gravity-independent high-speed resistive exercise done by women.

INTRODUCTION: Elevated metabolism is common to spaceflight while exercise in microgravity exacerbates energy costs. Thus in-flight exercise countermeasures must be devised that minimize energy costs as they are performed on hardware operable in microgravity. METHODS: Female subjects (N = 28), subdivided into athletic and sedentary groups, each performed two workouts on a resistive exercise device (Impulse Training Systems; Newnan, GA). Comprised exclusively of either tonic or phasic repetitions, each exercise bout entailed two 1 -min sets interspersed by a 90-s rest from which the work volume was determined. Oxygen consumption was measured before, during, and after workouts until gas uptake returned to pre-exercise levels. Net oxygen consumption was converted to net energy expenditures via indirect calorimetry. Mean net energy expenditure and work volume values were each compared with 2 (athletes, sedentaries) x 2 (tonic, phasic) ANOVAs, with repeated measures for workout. In addition, multivariate regression employed three predictor (body mass, body fat percentage, work volume) variables to account for the net energy expenditure variance. RESULTS: Workouts yielded a metabolic cost of approximately 14 kcal, yet the data produced no significant intergroup or workout differences. However, work volume analysis yielded a significant (tonic > phasic) effect. The multivariate analysis explained small yet significant amounts of net energy expenditure variance. DISCUSSION: Current results: 1) are partly attributable to higher series elastic element activity seen with Impulse repetitions; and 2) offer new information with respect to in-flight exercise protocols for female astronauts.