Themes in Literature Related to Incidence, Risk, and Prevention of Cancer in Solid-Organ Transplantation Recipients on Immunosuppressive Therapy.

BACKGROUND: Solid-organ transplants provide a second chance to thousands of critically ill patients with end-organ failure each year. Immunosuppressants are administered to patients to prevent graft rejection of a transplanted organ, such as a heart, kidney, or liver, while placing the recipient at greater risk for infection and cancer. OBJECTIVE: The literature provides evidence of various cancers that have been found to develop in patients' posttransplantation. The purpose of this comprehensive review is to investigate the incidence, risk, and prevention of cancer in solid-organ transplantation recipients on immunosuppressive therapy. METHODS: Google Scholar, Cumulative Index to Nursing and Allied Health Literature and Ovid databases were searched to identify research articles in peer-reviewed journals from 2011 to 2016. Variables under examination included cancer risk, cancer type, incidence, demographic characteristics, prevention, screening modalities, and education tools. RESULTS: Six articles met the inclusion criteria. Results indicate that malignancy is a prominent postoperative finding in at least 4% to 5% of solid-organ transplant recipients, with evidence of various cancer types. Risk factors include male sex, increased age, number of years posttransplant, fair skin, white race, and UV exposure. Screening intervals and educational tools have been found to increase awareness and target those at greater risk. CONCLUSION: Skin cancer and non-Hodgkin lymphoma were the most commonly diagnosed cancers in transplant recipients. IMPLICATIONS FOR PRACTICE: Practitioners may find utility in screening tools, self-examination education for patients, and follow-up protocols to prevent further complications in this patient population. Early detection of cancer and those at risk may help decrease morbidity and mortality rates in organ recipients.

Effects of a competitive wrestling season on body composition, endocrine markers, and anaerobic exercise performance in NCAA collegiate wrestlers.

Few data exist examining the body composition, endocrine, and anaerobic exercise performance changes over a competitive wrestling season. Eighteen NCAA wrestlers were tested for endocrine markers, body composition, hydration, grip strength, and power on four occasions: prior to pre-season training (T1); after pre-season training 3 days prior to the first seasonal meet (T2); mid-season one day prior to a meet (T3); and at the end of the season 2-3 days following the last meet (T4). Body mass, percent body fat (BF %), and fat mass were significantly lower (P ≤ 0.05) at T2 and T3 compared to T1 but were not different between T1 and T4. Lean body mass was significantly reduced at T2 only. Urine specific gravity was significantly elevated at T3 compared to T1, T2, and T4. Resting cortisol concentrations did not change but resting testosterone concentrations were significantly reduced at T2, T3, and T4. Maximal grip strength was significantly reduced at T2. Vertical jump peak power was significantly reduced at T2, T3, and T4. Wingate peak power was significantly reduced at T2 and T3. However, Wingate average power and total work did not significantly change. Fatigue rate during the Wingate test was significantly improved at T2, T3, and T4 compared to T1. In conclusion, body mass, BF %, and measures of peak force and power were reduced for most of the competitive wrestling season. Competitive wrestling reduces resting total testosterone concentrations throughout the entire season.

Effect of a proprietary protein supplement on recovery indices following resistance exercise in strength/power athletes.

The effect of 42 g of protein ingested pre- and post-exercise on recovery from an acute resistance exercise session was examined in 15 male strength/power athletes who were randomly divided into a supplement (SUP) or placebo (PL) group. Subjects reported to the Human Performance Laboratory (HPL) on four separate occasions (T1-T4). Maximal strength [one repetition-maximum (1-RM)] testing was performed during T1. During T2 subjects performed four sets of ten repetitions at 80% of their 1-RM in the squat, dead lift and barbell lunge exercises with 90 s of rest between each set. Blood draws occurred at baseline (BL), immediate and 15 min post-exercise to determine testosterone, cortisol and creatine kinase (CK) concentrations. Subjects reported back to the HPL 24 (T3) and 48 h (T4) post-exercise for a BL blood draw and to perform four sets of ten repetitions with 80% of 1-RM for the squat exercise only. No differences in the number of repetitions performed in the squat exercise were seen between the groups at T2. Relative to T2, PL performed significantly (P < 0.05) fewer repetitions than SUP at T3 and T4 (-9.5 +/- 5.5 repetitions vs. -3.3 +/- 3.6 during T3, respectively, and -10.5 +/- 8.2 repetitions vs. -2.3 +/- 2.9 repetitions during T4, respectively). No differences in hormonal measures were seen between the groups. CK concentrations were significantly (P < 0.05) elevated at T3 for both groups, but continued to elevate (P < 0.05) at T4 for PL only. No significant group differences were noted for CK at any time point. Results indicate that a proprietary protein SUP consumed before and after a resistance training session significantly contributes to improvements in exercise recovery 24 and 48 h post-exercise.

Thermogenic effect of meltdown RTD energy drink in young healthy women: a double blind, cross-over design study.

BACKGROUND: The purpose of this study was to examine the acute metabolic effects of a high-energy drink in healthy, physically-active women. METHODS: Ten women (20.4 +/- 0.70 y; 166.9 +/- 7.2 cm; 67.0 +/- 7.0 kg; 29.6 +/- 6.5% body fat) underwent two testing sessions administered in a randomized and double-blind fashion. Subjects reported to the laboratory in a 3-hr post-absorptive state and were provided either 140 ml of the high-energy drink (SUP; commercially marketed as Meltdown RTD) or placebo (P). Subjects consumed two 70 ml doses of SUP or P, separated by 30 min and rested in a semi-recumbent position for 3 hours. Resting oxygen consumption (VO2) and heart rate (HR) were determined every 5 min during the first 30 min and every 10 min during the next 150 min. Blood pressure (BP) was determined every 15 min during the first 30 min and every 30 min thereafter. Area under the curve (AUC) analysis was computed for VO2, whereas a 3-hour average and hourly averages were calculated for respiratory quotient (RQ), total kcal, HR, BP, and profile of mood states (POMS). RESULTS: AUC analysis revealed a 10.8% difference (p = 0.03) in VO2 between SUP and P. No difference in VO2 was seen between the groups in the first hour, but VO2 in SUP was significantly greater than P in the second (13.9%, p = 0.01) and third hours (11.9%, p = 0.03). A difference (p = 0.03) in energy expenditure was seen between SUP (1.09 +/- 0.10 kcal x min-1) and P (0.99 +/- 0.09 kcal x min-1) for the 3-hour period. Although no difference in energy expenditure was seen in the first hour, significant differences between SUP and P were observed in the second (1.10 +/- 0.11 kcal x min-1 and 0.99 +/- 0.09 kcal x min-1, respectively; p = 0.02) and third hour (1.08 +/- 0.11 kcal x min-1 and 0.99 +/- 0.09 kcal x min-1, respectively; p = 0.05). Average systolic BP was significantly higher (p = 0.007) for SUP (110.0 +/- 3.9 mmHg) compared to P (107.3 +/- 4.4 mmHg). No differences were seen in HR, diastolic BP, or POMS at any time point. CONCLUSIONS: Results showed a significant increase in energy expenditure in young, healthy women following an acute ingestion of a high-energy drink.

Effect of preceding resistance exercise on metabolism during subsequent aerobic session.

The present study was undertaken to evaluate the acute effect of prior resistance training of varying intensities on energy expenditure and substrate utilization during subsequent aerobic exercise. Eleven males and 21 females completed three experimental trials consisting of (1) aerobic exercise only (C), (2) aerobic exercise preceded by a high-intensity resistance training (HI), and (3) aerobic exercise preceded by a low-intensity resistance training (LO). Resistance training produced an equal volume between HI and LO and consisted of six exercises with each performed for three sets of eight repetitions at 90% of 8-RM in HI and three sets of 12 repetitions at 60% of 8-RM in LO. Aerobic exercise was performed on a cycle ergometer at 50% VO(2)peak for 20 min in all trials. Oxygen uptake (VO2), and carbohydrate and fat oxidation were determined throughout each aerobic exercise session. Fat oxidation rate was higher (P < 0.05) in HI than either LO or C in both males and females. VO2 was also higher (P < 0.05) in HI than either LO or C in females. In males, although between-trial differences in VO2 did not reach statistical significance, they were consistent with the trend seen in females. No differences in carbohydrate oxidation rates were observed across the three trials in either gender group. It appears that in training that combines both aerobic and resistance exercises, performing a comparatively higher intensity resistance exercise first would augment fat utilization and energy expenditure during subsequent aerobic exercise.

Effect of protein-supplement timing on strength, power, and body-composition changes in resistance-trained men.

The effect of 10 wk of protein-supplement timing on strength, power, and body composition was examined in 33 resistance-trained men. Participants were randomly assigned to a protein supplement either provided in the morning and evening (n = 13) or provided immediately before and immediately after workouts (n = 13). In addition, 7 participants agreed to serve as a control group and did not use any protein or other nutritional supplement. During each testing session participants were assessed for strength (one-repetition-maximum [1RM] bench press and squat), power (5 repetitions performed at 80% of 1RM in both the bench press and the squat), and body composition. A significant main effect for all 3 groups in strength improvement was seen in 1RM bench press (120.6 +/- 20.5 kg vs. 125.4 +/- 16.7 at Week 0 and Week 10 testing, respectively) and 1RM squat (154.5 +/- 28.4 kg vs. 169.0 +/- 25.5 at Week 0 and Week 10 testing, respectively). However, no significant between-groups interactions were seen in 1RM squat or 1RM bench press. Significant main effects were also seen in both upper and lower body peak and mean power, but no significant differences were seen between groups. No changes in body mass or percent body fat were seen in any of the groups. Results indicate that the time of protein-supplement ingestion in resistance-trained athletes during a 10-wk training program does not provide any added benefit to strength, power, or body-composition changes.

Effect of betaine supplementation on power performance and fatigue.

BACKGROUND: The purpose of this study was to examine the efficacy of 15 days of betaine supplementation on muscle endurance, power performance and rate of fatigue in active college-aged men. METHODS: Twenty-four male subjects were randomly assigned to one of two groups. The first group (BET; 20.4 +/- 1.3 years; height: 176.8 +/- 6.6 cm; body mass: 77.8 +/- 13.4 kg) consumed the supplement daily, and the second group (PL; 21.4 +/- 4.7 years; height: 181.3 +/- 5.9 cm; body mass: 83.3 +/- 5.2 kg) consumed a placebo. Subjects were tested prior to the onset of supplementation (T1) and 7 (T2) and 14 days (T3) following supplementation. Each testing period occurred over a 2-day period. During day one of testing subjects performed a vertical jump power (VJP) and a bench press throw (BPT) power test. In addition, subjects were required to perform as many repetitions as possible with 75% of their 1-RM in both the squat and bench press exercises. Both peak and mean power was assessed on each repetition. On day two of testing subjects performed two 30-sec Wingate anaerobic power tests (WAnT), each test separated by a 5-min active rest. RESULTS: No differences were seen at T2 or T3 in the repetitions performed to exhaustion or in the number of repetitions performed at 90% of both peak and mean power between the groups in the bench press exercise. The number of repetitions performed in the squat exercise for BET was significantly greater (p < 0.05) than that seen for PL at T2. The number of repetitions performed at 90% or greater of peak power in the squat exercise was significantly greater for BET at both T2 and T3 than PL. No differences in any power assessment (VJP, BPT, WAnT) was seen between the groups CONCLUSION: Two-weeks of betaine supplementation in active, college males appeared to improve muscle endurance of the squat exercise, and increase the quality of repetitions performed.

Thermogenic effect of an acute ingestion of a weight loss supplement.

BACKGROUND: The purpose of this study was to examine the acute effects of a weight loss supplement on resting oxygen uptake (VO2), respiratory quotient (RQ), caloric expenditure (kcal), heart rate (HR), and blood pressure (BP) in healthy and physically active individuals. METHODS: Ten subjects (5 male, 5 female; 20.2 +/- 1.2 y; 172.2 +/- 8.9 cm; 71.5 +/- 17.2 kg; 17.3 +/- 2.6% body fat) underwent two testing sessions administered in a randomized and double-blind fashion. During each session, subjects reported to the Human Performance Laboratory after at least 3-h post-absorptive state and were provided either 3 capsules of the weight loss supplement (SUP), commercially marketed as Meltdown(R) or 3 capsules of a placebo (P). Subjects then rested in a semi-recumbent position for three hours. VO2 and HR were determined every 5 min during the first 30 min and every 10 min during the next 150 min. BP was determined every 15 min during the first 30 min and every 30 min thereafter. The profile of mood states was assessed every 30 min. RESULTS: Area under the curve analysis revealed a significant 28.9% difference in VO2 between SUP and P for the three hour study period. In addition, a significant difference in energy expenditure was also seen between SUP (1.28 +/- 0.33 kcal.min-1) and P (1.00 +/- 0.32 kcal.min-1). A trend (p = 0.06) towards a greater utilization of stored fat as an energy source was also demonstrated (0.78 +/- 0.23 kcal.min-1 and 0.50 +/- 0.38 kcal.min-1 in P and SUP, respectively). Significant elevations in HR were seen during hours two and three of the study, and significantly higher average systolic BP was observed between SUP (118.0 +/- 7.3 mmHg) and P (111.4 +/- 8.2 mmHg). No significant differences were seen in diastolic blood pressure at any time point. Significant increases in tension and confusion were seen in SUP. CONCLUSION: Results indicate a significant increase in energy expenditure in young, healthy individuals following an acute ingestion of a weight loss supplement. In addition, ingestion of this supplement appears modify mood and elevate HR and systolic BP following ingestion.