High physical fitness is associated with reduction in basal- and exercise-induced inflammation.

C-reactive protein (CRP) increases after strenuous exercise. It has been a concern that prolonged strenuous exercise may be harmful and induce a deleterious inflammatory response. The purpose of this study was to (a) assess and quantify the magnitude of CRP response following an endurance cycling competition in healthy middle-aged recreational cyclists. (b) Identify important determinants of this response. (c) Identify the relationship between CRP, myocardial damage (cardiac Troponin I (cTnI)), and myocardial strain (B-type natriuretic peptide [BNP]). (d) Identify the relationship between CRP and clinical events, defined as utilization of healthcare services or self-reported unusual discomfort. Race time was used as a measure of physical fitness. A total of 97 individuals (43±10 years of age, 74 [76%] males) were assessed prior to and 0, 3, and 24 hours following the 91-km mountain bike race "Nordsjørittet" (Sandnes, Norway, June 2013). There was a highly significant increase in CRP from baseline to 24 hours (0.9 (0.5-1.8) mg/L vs. 11.6 (6.0-17.5) mg/L (median[IQR]), P<.001), with no correlation of CRP to cTnI and BNP at any time-point. CRP was strongly correlated to race time at baseline (r=.38, P<.001) and at 24 hours following the race (r=.43, P<.001), In multivariate models, race time was an independent predictor of CRP both at baseline and at 24 hours (P<.01). There was no relationship between CRP levels and clinical events. In conclusion, high physical fitness was associated with reduction in both basal- and exercise-induced CRP. No adverse relationship was found between high intensity physical exercise, CRP levels, and outcomes.

Absorption of bismuth from two bismuth compounds before and after healing of peptic ulcers.

BACKGROUND/AIMS: Previous reports state that there is absorption of bismuth through active peptic ulcers. It was therefore of interest to investigate the extent of absorption in patients at the ulcer and post-ulcer stages. METHODOLOGY: Twenty H. pylori-positive patients with gastroscopically verified gastric or duodenal ulcers were randomly allocated to ingest 3000 mg bismuth subnitrate (BSN) (10 patients) or 480 mg colloidal bismuth subcitrate (CBS) (10 patients). Bismuth serum concentration in 12 samples drawn during the first 4 hours after drug intake was analyzed and the area under the curve (Bi-AUC) was calculated. Anti-H. pylori therapy with amoxicillin and lanzoprazole eradicated H. pylori in 10 patients and healed the ulcers in all patients 4 weeks after therapy ended, then the bismuth absorption test was repeated. RESULTS: There was no significant difference between ulcer- and post-ulcer Bi-AUC for patients receiving BSN or for patients receiving CBS. On a molar basis, CBS gave a 17.4-fold greater absorption of bismuth compared to BSN. CONCLUSIONS: The presence of an active ulcer does not significantly influence the absorption of bismuth from CBS or BSN.

Bismuth therapy for Helicobacter pylori infection. A review of five years experience at a university hospital in Norway.

BACKGROUND: Eradication of H. pylori cures peptic ulcer disease. Bismuth and antibiotics in various combinations were tested at a single university hospital. METHODS: The standard treatment was bismuth subnitrate, metronidazole and oxytetracycline. A positive biopsy urease test was the main inclusion criterium, whereas a negative 14C-urea breath test performed at least four weeks after cessation of therapy was the main indicator of cured infection, and performed later for reinfection. In separate studies we tested the absorption of bismuth subnitrate compared to other bismuth preparations, what aspects of bismuth-based triple therapy are most important to obtain maximum eradication, what can be done to decrease side effects, and the reliability of diagnostic methods. RESULTS: The absorption of bismuth from bismuth subnitrate was very low. More than 90% cure rates were usually obtained. Including metronidazole in the regimen increased side effects but was crucial for effectiveness. Spiramycine could replaced oxytetracycline without substantial loss of effectiveness. Effectiveness was decreased if the patients had recently used metronidazole. Aluminium containing antacids and chlorhexidine were not very useful. Side effects were frequent, up to 60%, but usually mild and very few patients withdrew from treatment. Adding ranitidine to the regimen reduced abdominal pain. 14C-urea breath test was the "gold standard" and the specificity of the biopsy urease test in diagnosing H. pylori infection was high. CONCLUSIONS: Bismuth combination therapy combines high effectiveness with acceptable side effects and low cost. Biopsy urease test and urea breath test are reliable indicators of H. pylori infection.

Urinary proteins in a patient with Tangier disease.

We have investigated the possibility that the mild proteinuria in a patient with Tangier disease is directly related to the plasma HDL-deficiency through excretion of apolipoprotein A-I (Mr 28,300). An increased urinary excretion of a 29,000 polypeptide was observed in this patient. However, western blot analysis of the urine showed that this protein was not apolipoprotein A-1 or its precursor form. Subsequent investigations identified the urinary protein as immunoglobulin light chains. The elevated excretion may be a consequence of the patient's plasma polyclonal gammopathy which had resulted from a chronic infection.

Preparative isoelectric focussing of apolipoproteins C and E from human very low density lipoproteins.

The application of isoelectric focussing on a gel-stabilized layer for the separation of the Tris-urea-soluble apolipoproteins of very low density lipoproteins has been described. This method in one step, allows the separation of most apolipoproteins, which were then analyzed and characterized. Apolipoproteins CII and CI were isolated as single protein bands with apparent pI of 5.0 and 6.5, respectively. Apolipoprotein CII was biologically active and could activate lipoprotein lipase. Apolipoprotein CIII was separated into several protein bands with pI ranging from 4.7 to 5.1 as a function of their number of sialic acid residues. Apolipoprotein E was isolated and characterized into five polymorphic bands with pI of 5.7, 5.8, 5.9, 6.0, and 6.2, respectively.

Low density lipoprotein turnover in swine.

The catabolism of intravenously injected 125I-labelled low density lipoproteins (LDL) was followed in normal miniature swine for 2 weeks. When compared with the two-exponential model, the decay curve of the plasma radioactivity associated with the LDL fraction was best described by a three-exponential model. In this system, the half-lives were 4.5 +/- 3.7, 19.7 +/- 6.6, and 127 +/- 70 h (mean of four studies). Assuming a kinetic model with metabolism of LDL in the rapidly equilibrating compartment and two slower equilibrating compartments (a model requiring three exponentials), the mean fractional catabolic rate for apo-LDL was calculated to be 0.015 h-1. Therefore, if at steady state, the synthetic rate for apo-LDL in the same pigs would be 5.6 +/- 4.1 mg/h. Different kinetic models using two or three exponentials would provide different values for the synthetic rate of apo-LDL. However, in view of the known existence of at least three major equilibrating pools for LDL in plasma, liver, and lymph, and in view of the present results, the kinetic model for LDL metabolism should be better represented by a three-exponential system.

Lipid and lipoprotein secretion following portacaval shunt in swine.

Lipid and lipoprotein secretion were studied over 24 h in normal and portacaval shunted (PCS) fasting miniature swine after an infusion of Triton WR-1339 and [3H]amino acid mixture. The plasma triglyceride secretion rate and the secretion of triglyceride, total cholesterol and protein in the very low density lipoprotein fraction (VLDL) were linear for about 9 h after Triton. No net catabolism of the VLDL appeared to take place over the 24 h. Due to large variation, differences in the absolute secretion rates of plasma triglyceride and of the VLDL constituents could not be shown. However, the secretion of VLDL cholesterol in the PCS group appeared to be lower than that of the sham group when corrected for metabolic body size and plasma volume.

The effect of portacaval shunt on plasma lipids and lipoproteins in swine.

Plasma lipids and lipoprotein composition and distribution were studied in fasted miniature swine prior to and at 5 and 19 weeks following portacaval shunt surgery or a sham operation. Plasma triacylglycerol and cholesterol levels were significantly reduced in the portacaval shunt swine at 5 weeks. These reductions were accompanied by significant decreases in the plasma very low density lipoprotein (d less than 1.006), low density lipoprotein (d = 1.02-1.07) and high density lipoprotein (d = 1.09-1.21) levels. The very low density lipoprotein were shown depleted in lipids and the low density lipoprotein was a cholesterol-depleted, triacylglycerol-enriched particle. No changes in the composition of the high density lipoprotein were observed. These reductions and changes in composition were maintained until killing at 19 weeks post-surgery.