Early-phase adaptations of traditional-speed vs. superslow resistance training on strength and aerobic capacity in sedentary individuals.

We performed a randomized exercise training study to assess the effects of traditional Nautilus-style (TR) or superslow (SS) strength training on muscular strength, body composition, aerobic capacity, and cardiovascular endurance. Subjects were 14 healthy, sedentary women, 19-45 years of age (mean +/- SD age, 32.7 +/- 8.9 years), randomized to either the SS or TR training protocols and trained 3 times per week for 10 weeks. Measurements were taken both before and after training, which included a maximal incremental exercise test on a cycle ergometer, body composition, and 1 repetition maximum (1RM) tests on 8 Nautilus machines. Both groups increased their strength significantly on all 8 exercises, whereas the TR group increased significantly more than the SS group on bench press (34% vs. 11%), torso arm (anterior lateral pull-down) (27% vs. 12%), leg press (33% vs. 7%), leg extension (56% vs. 24%), and leg curl (40% vs. 15%). Thus, the TR group's improvement in total exercise weight lifted was significantly greater than that of the SS group after testing (39% vs. 15%). Exercise duration on the cycle ergometer and work rate significantly improved for both groups, but there was no group-by-training interaction. No significant differences were found for body composition or additional aerobic variables measured. Both strength training protocols produced a significant improvement in strength during a 10-week training period, but the TR protocol produced better gains in the absence of changes in percentage of body fat, body mass index, lean body mass, and body weight. In addition, strength training alone did not improve Vo2max, yet short-term endurance increased.

Carotenoid content, physicochemical, and sensory qualities of deep-fried carrot chips as affected by dehydration/rehydration, antioxidant, and fermentation.

Carrot slices were subjected to one of the following experiments prior to deep-frying: (A) dehydration/rehydration, (B) soaking in different antioxidants, and (C) fermentation with/without blanching. There were no significant differences (P > or = 0.05) in carotenoid contents among carrot chips treated with/without dehydration. Soaking in sodium metabisulfite resulted in the highest carotenoid content and lightness (L), redness (a), and yellowness (b) values among the antioxidant treatments. Fermentation without blanching significantly decreased (P < 0.05) carotenoid content, vitamin A activity, and fat content. Dehydration and fermentation with blanching significantly increased (P < 0.05) the lightness (L), redness (a), and yellowness (b) values of the chips. Dehydration/rehydration, but not antioxidant and fermentation, significantly decreased (P < 0.05) the water activity of the chips. The textural values of carrot chips prepared using sodium metabisulfite, without dehydration and without fermentation, were the lowest among other treatments which suggests the crispiest. Carrot chips prepared using sodium metabisulfite, without dehydration and without fermentation, had the highest carotenoid content and retention, and the highest overall acceptability score.

Creating healing relationships for couples dealing with trauma: the use of emotionally focused marital therapy.

Emotionally focused marital therapy (EFT), a marital therapy that particularly focuses on the creation of secure attachment, has proven in empirical studies to be effective for distressed couples. This paper discusses the application of EFT in couples where one or both of the partners have experienced significant trauma. EFT, in this context of trauma, incorporates the nine steps of conventional EFT and also encompasses the three stages of the "constructivist" self development theory of trauma treatment. This paper illustrates how the integration of EFT and trauma treatment can prove effective in treating not only relationship distress but also the individual symptoms of posttraumatic stress disorder (PTSD).

Outcome assessment of double-J stents during extracorporeal shockwave lithotripsy of small solitary renal calculi.

The utility of indwelling double-J ureteral stents during extracorporeal shockwave lithotripsy (SWL) of renal calculi is ill defined. We evaluated 179 patients treated with SWL for small (< 20 mm in diameter) solitary renal calculi with (N = 27) or without (N = 152) indwelling ureteral stents. There was no significant difference in the stone-free rates at 1 month (both 52%) and 3 months (61% nonstented group v 67% stented group; P = 0.45) or in the retreatment rates (13.3% nonstented group v 14.8% stented group; P = 0.60). The incidence and severity of pain/renal colic were similar for the two treatment groups. There was minimal morbidity associated with SWL in either group. Placement of double-J stents for the purpose of improving stone-free rates, alleviating pain, or preventing ureteral obstruction in conjunction with SWL of solitary renal calculi < 20 mm in diameter is unnecessary.

Effectiveness and safety of the Dornier compact lithotriptor: an evaluative multicenter study.

PURPOSE: We evaluated the efficacy and safety of the Dornier compact lithotriptor for management of renal stones. MATERIALS AND METHODS: We administered 191 treatments to 169 patients with renal stones on 176 occasions with the patient under combined parental sedation and analgesia. The Dornier Compact lithotriptor is mobile and ultrasound guided, and uses an electromagnetic energy source. RESULTS: A total of 22 patients required a second treatment (13%), 123 (72.8%) were stone-free, 26 (15.4%) had fragments less than 4 mm. large, 16 (9.5%) had stone fragments larger than 4 mm, and 4 (2.4%) required auxiliary therapy (treatment failures). The side effects were mostly mild to moderate, with nausea and/or vomiting reported in 26 patients (14%), colic or pain in 66 (39%), ureteral obstruction in 2, steinstrasse in 7 (4%) and fever in 1. Our clinical results indicate that extracorporeal shock wave lithotripsy was effective for treatment of stones in the kidney, with a low incidence of complications and adverse effects. The lithotriptor used is much smaller, less expensive and user friendly with no installation requirements, rendering it mobile. CONCLUSIONS: The success rate with newer generation devices compares well with results obtained using other stationary and larger versions.

Toward tougher oversight of managed care: MSNJ proposals.

The Medical Society of New Jersey has developed a detailed position statement on the regulation of health maintenance organizations (HMO). This statement has been presented to an advisory committee of the New Jersey State Department of Health, which is preparing new HMO regulations.

Psychosis as precipitating trauma for PTSD: a treatment strategy.

Parallels between the experience of living with a psychotic illness and that of PTSD as a response to combat stress are explored, and similarities with respect to a loss of a sense of self are examined. Therapeutic implications of the possible connection between the two disorders are delineated in terms of a three-stage psychosocial recovery model.

Von Hippel-Lindau disease and renal cell carcinoma in a 16-year-old boy.

Von Hippel-Lindau disease is a rare autosomal dominant disorder. Kidney lesions occur in the majority of cases, with renal cell carcinoma noted in 40% and renal cysts in 60%. Renal cell carcinoma in von Hippel-Lindau disease is usually bilateral and occurs at an earlier age than in patients with sporadic renal cell carcinoma. We report on a 16-year-old boy who, to our knowledge, is the youngest patient to present with von Hippel-Lindau disease and renal cell carcinoma. Controversy currently exists regarding the nature of renal cysts in von Hippel-Lindau disease and the optimal therapeutic approach (that is radical versus parenchymal sparing surgery). We review the histology of renal cysts and carcinoma, and discuss the rationale for selecting parenchymal sparing surgery.

Treatment in the prone position of calculi in the midureter overlying the bony sacrum with extracorporeal shock wave lithotripsy.

Thirty-six patients with radiopaque calculi in the segment of the ureter overlying the sacrum, were treated in the prone position with an unmodified Dornier HM-3 lithotripter. Thirty-one treatments were successful and five failed for a success rate of 86%. Success is defined as the absence of fragments on KUB. The five failures were all removed ureteroscopically. Epidural anesthesia was used for all cases. A post-extracorporeal shock wave lithotripter (post-ESWL) gastrointestinal (GI) bleeding episode, and an upper ureteral extravasation post-ESWL, as well as two patients who could not tolerate the position are discussed.

Spontaneous rupture of a bladder diverticulum.

A case of spontaneous rupture of an acquired bladder diverticulum is presented. Diagnosis was made preoperatively and full recovery followed surgical treatment. A review of the literature revealed 9 other cases of spontaneous rupture. Bladder outlet obstruction and urinary tract infection were present in the majority of cases. In the past misdiagnosis and delayed treatment led to significant mortality. However, the prognosis currently is better due to the use of broad-spectrum antibiotics, better radiological imaging studies, and earlier diagnosis and treatment.

Pain control: comparison of percutaneous and operative nephrolithotomy.

Percutaneous removal of renal calculi is an effective form of therapy with less morbidity than some other operative procedures. The narcotic requirements of 21 patients treated percutaneously were compared with a comparable group of patients treated by open nephrolithotomy. Patients treated percutaneously stayed in the hospital for 8.9 days and required 6.5 doses of narcotics. Patients treated by open surgical lithotomy remained in the hospital for 11.0 days and required 21 doses of narcotics. When compared on a daily basis, patients in the open operative group required 2.7 times more doses of narcotics than patients treated percutaneously. Percutaneous nephrolithotomy appears to be significantly less painful than operative nephrolithotomy utilizing a standard flank incision as indicated by narcotic analgesic usage.

Is colony count necessary?

Evidence presented herein suggests that: (1) If the Gram stain of the spun urinary sediment is negative, there is no need to do a culture, sensitivity test, and colony count since significant bacteriuria and urinary infection are not present. There are very few false negative results. (2) Since there are many false positive Gram stains, the test is not specific. A positive Gram stain of the spun urinary sediment does not mean that bacteriuria is present. (3) The test is very sensitive in that practically all bacteriuric subjects had a positive Gram stain. (4) Because the Gram stain of the spun urinary sediment is so sensitive, a positive spun urinary sediment and culture should be treated regardless of the colony count.