Neuromuscular, hormonal and cardiovascular adaptations to eight-week HIIT and continuous aerobic training combined with neuromuscular electrical stimulation.

BACKGROUND: Whether high-or-low intensity exercise coupled with neuromuscular electrostimulation (NMES) affect IGF-1 and IGFBP-1 is unknown. The scope of this study was to test whether 8-week high-intensity interval training (HIIT) and continuous aerobic training (CA) combined with/without NMES performed at 65% and 120% of VO2max on a cycle ergometer induce different metabolic adaptations. METHODS: A randomized controlled trial with a parallel groups study design was used. Thirty healthy untrained male participants (age: 21.33±1.24 years, height: 177.80±5.97 cm, weight: 73.74±7.90 kg, lean body mass: 64.29±5.11 kg, percent body fat: 12.43±5.34%) voluntarily participated in this study. Six participants were allocated to Control, six to HIIT, six to HIIT+NMES, six to CA, and six to CA+NMES. RESULTS: Pre- to post-test IVO2max, blood lactate concentrations, O2 kinetics, peak torques at 60o/s and 180o/s were found statistically significant (P<0.05, P<0.001). IGF-1 pre 15 min in CA and IGF-1 post 30 min in HIIT group was found significantly higher compared to control group (16.93±8.40 vs. 6.05±4.25, P=0.024; 10.80±3.94 vs. 6.15±2.56, P=0.037), respectively. Additionally, IGFBP-1 were found significantly higher in CA+NMES group than HIIT group (0.95±0.67 vs. 1.23±0.56). Eight week post IGF-1/IGFBP-1 ratios were found higher in pre 15 min, post 30 min and post 24 h compared to baseline pre 15 min, post 30 min and post 24 h measurements in all groups (8.92±4.72 vs. 3.93±3.14; 9.41±3.72 vs. 3.99±1.76; 8.63±3.01 vs. 5.89±3.01, respectively). Also, IGFBP-1 post 30 min was significantly lower in HIIT+NMES while CA group showed significantly lower baseline and 24 h post IGFBP-1 compared to pre-test measurements (Z=-3.20, P=0.001; Z=-3.72, P=0.000; Z=-2.93, P=0.000). CONCLUSIONS: HIIT and CA training induce different stimuli on IGF-1 and IGFBP-1 and NMES application combined with high-and-low intensity exercise is highly effective in improving athletic performance.

Development of a self-administered psychosocial cancer screening tool.

Among patients with cancer, psychosocial issues and problems are common, yet they often go unnoticed and thus untreated until they become severe and significantly interfere with the patient's comfort, quality of life, and potentially survival. Given the increasing complexity of cancer care, psychosocial support must assume a more prominent role in the care of individuals with cancer. Routine use of a screening tool for psychosocial assessment may help facilitate early identification and intervention for individuals who are at risk for psychosocial problems. Based on the prevalence of psychosocial problems described in the literature and the paucity of psychosocial screening instruments that can be applied practically in the clinical setting, the development of a new instrument to identify patients with cancer who have psychosocial problems in multiple domains and who thus are at risk for excessive psychosocial distress throughout the course of treatment is presented. This article provides background information, reviews the literature, including instruments that have been used to screen patients in the oncology setting for psychosocial problems, and presents a new instrument based on current deficiencies in this area. Pilot testing of the instrument demonstrates its feasibility for use in the clinical setting.

Spontaneous subcapsular renal hematoma: diagnosis and management.

Spontaneous subcapsular or perinephric hematoma in the absence of anticoagulation, arteritis or trauma is most likely due to an underlying renal tumor. Eight such patients recently have been evaluated and after nephrectomy 5 had small tumors undetectable by imaging techniques, including computerized tomography or angiography. In 1 patient a tumor was demonstrated preoperatively by angiography and in only 2 was a tumor not found. In the absence of an apparent etiology, patients with spontaneous renal bleeding and a normal contralateral kidney should undergo radical nephrectomy because of the extremely high incidence of small undetectable occult tumors, often less than 2 cm. in size.

Testicular neoplasm diagnosed by ultrasound.

The diagnosis of testicular cancer is usually made by the findings of a testicular mass on physical examination. In rare cases a young man will present with retroperitoneal nodes and a normal testicular examination. In such cases a testicular ultrasound may localize the testis which harbors a subclinical neoplasm. In addition serum markers of B-HCG and AFP are essential. As a screening procedure a urine pregnancy test is helpful, since it can be obtained quickly while quantitative B-HCG and APF results are delayed.