Is there a relationship between the total volume of load lifted in bench press exercise and the rating of perceived exertion?

AIM: The purpose of the study was to investigate the relationship between the total volume of load lifted (TVLL) and the rating of perceived exertion (RPE) measures during different resistance training (RT) schemes using the bench press exercise. METHODS: The present study was divided into two experiments. In the first experiment, 18 healthy men performed three different RT schemes: a strength oriented scheme (SS), a muscular endurance oriented scheme (ES) and a hypertrophy oriented scheme (HS). TVLL was calculated for each scheme. Mean-RPE and session-RPE were assessed. In the second experiment, 23 men performed two resistance exercise bouts at different intensities (50%-1RM and 75%-1RM) with matched TVLL. Mean-RPE and session-RPE were also assessed. RESULTS: SS and HS showed higher TVLL and greater RPE scores as compared to ES (P<0.05). No significant difference was observed between SS and HS. It was verified significant positive correlations between TVLL and session-RPE (SS r=0.63, HS r=0.64, ES r=0.56; P<0.05), and between mean-RPE and TVLL (SS r=0.55, HS r=0.52, ES r=0.47; P<0.05) for all schemes. No differences were observed for mean-RPE, session-RPE and TVLL between the 50%-1RM and 75%-1RM. Significant positive relationships between TVLL and session-RPE (50%-1RM r=0.61, 75%-1RM r=0.66; p<0.05) and between TVLL and mean-RPE (50%-1RM r=0.51, 75%-1RM r=0.49; P<0.05) were observed. CONCLUSION: The results of this study have shown that the TVLL in RT influences RPE measures. These findings corroborates the existence of a relationship between total work performed (external training load) and perception of effort (internal training load).

Work and peak torque during eccentric exercise do not predict changes in markers of muscle damage.

OBJECTIVES: Large inter-subject variability in responses to eccentric exercise has been reported. This study investigated the hypothesis that the variability of changes in indirect markers of exercise-induced muscle damage (EIMD) would be explained by work performed and/or torque generated during eccentric exercise. METHODS: Subjects (n = 53) performed 60 maximal eccentric actions of the elbow flexors on an isokinetic dynamometer that forcibly extended the elbow joint from 60 degrees to 180 degrees at a constant velocity (90 degrees s(-1)). Markers of EIMD included maximal voluntary isometric contraction torque at 90 degrees elbow flexion (MVC), range of motion, plasma creatine kinase activity and muscle soreness. Measurements were taken 2 days before, immediately after and 1-4 days post-exercise. Pearson's correlation coefficient was used to examine relationships between exercise parameters (total work, change in total work, torque produced during exercise, change in peak torque) and markers of EIMD. RESULTS: Large inter-subject variability was evident for both work and torque during exercise, and changes in all markers of EIMD. Contrary to the hypothesis, total work (normalised for individual pre-exercise MVC) did not correlate significantly with any markers of EIMD, with the exception of MVC (r = 0.3). Total work performed and changes in total work showed higher correlations with some markers, but no r-values exceeded 0.4. Normalised exercise torque and the changes in peak torque during exercise were not correlated with changes in MVC, or other markers. CONCLUSION: These results suggest the large inter-subject variability in responses to eccentric exercise is not associated with work performed or torque generated during eccentric exercise.

Moral dilemmas in surgical training: intent and the case for ethical ambiguity.

It is often assumed that the central problem in a medical ethics issue is determining which course of action is morally correct. There are some aspects of ethical issues that will yield to such analysis. However, at the core of important medical moral problems is an irreducible dilemma in which all possible courses of action, including inaction, seem ethically unsatisfactory. When facing these issues ethical behaviour depends upon an individual's understanding and acceptance of this painful dilemma without recourse to external moral authority.

KIE: The dilemma of how inexperienced trainees are ethically to acquire professional skills when patients are owed the best available care is examined, using for illustration the training of surgical residents in ophthalmology. Newton maintains that, given the irreducible nature of this dilemma, each trainee and instructor must take personal responsibility for his or her action. Reliance on external ethical guidelines, be they codes of ethics or philosophical theories, may initially seem helpful but will ultimately interfere with the individual's development of a sense of ethical intent, which entails a painful self-awareness of the inherent dilemma.

New issues in the prevention and treatment of ophthalmia neonatorum.

We have recently seen two cases of ophthalmia neonatorum (ON) that illustrate a changing picture of this disease and raise a number of questions concerning optimal prophylaxis and treatment. Silver nitrate, which is the most widely used method for prevention of gonococcal ON, fails to prevent neonatal eye disease due to chlamydia. In addition, strains of gonococci which produce a penicillinase and are resistant to penicillin are becoming common in parts of the United States and Europe. Thus all gonococcal isolates must be tested for penicillinase production. The emergence of Chlamydia trachomatis as the most frequent cause of ON and the appearance of penicillin-resistant gonococci has led to new regimens for prophylaxis and therapy of neonatal ophthalmia. At our institution, we now use intramuscular penicillin and topical tetracycline ointment (1%) for eye prophylaxis. For initial therapy of gonococcal ON we recommend penicillin (systemic and topical) plus another antimicrobial with greater stability against the penicillinase of Neisseria gonorrhoeae.

Lack of hydrophilic lens discoloration in patients using dipivalyl epinephrine for glaucoma.

Five glaucoma patients used topical dipivalyl epinephrine for periods of up to 84 weeks without discoloration of their soft contact lenses. Thus, patients who need both soft contact lenses and antiglaucoma therapy with topical epinephrine may use the dipivalyl analogue without lens spoilage.

Evaluation of a packaged kit assay of serum ferritin and application to clinical diagnosis of selected anemias.

The reliability of a radioimmunometric assay of serum ferritin concentration by a packaged kit was evaluated. In addition, application of the serum ferritin assay to the clinical evaluation of selected anemias was assessed. When appropriate serum dilutions were utilized, this method was sufficiently reproducible and reliable for application to the clinical laboratory. Serum ferritin was found to be a valuable tool in the differential diagnosis of anemia accompanied by hypoferremia, although iron depletion coexisting with either the anemia of chronic disease or active hepatocellular disease may not be clearly appreciated. The primary advantage of the determination was to help characterize the iron status of the patient with a hypochromic microcytic anemia or hypoferremia who would ordinarly require a bone-marrow examination for iron stores.