Effects of Wild Blueberries on Fat Oxidation Rates in Aerobically Trained Males.

Wild blueberries (WBs) have been documented to decrease oxidative stress in active and sedentary populations as well as influence lipolytic enzymes and increase the rate of fat oxidation (FAT-ox) during rest. To examine the effect of WBs on the rate of FAT-ox and lipid peroxidation during submaximal exercise, 11 healthy, aerobically trained males (26 ± 7.5 years, 74.9 ± 7.54 kg, 10.5 ± 3.2% BF) completed a 2-week washout avoiding foods high in anthocyanins, then completed a control exercise protocol cycling at 65% of VO2peak for 40 min. Participants then consumed 375 g/d of anthocyanins for two weeks before repeating the exercise protocol. WBs increased FAT-ox when cycling at 65% of VO2peak by 19.7% at 20, 43.2% at 30, and 31.1% at 40 min, and carbohydrate oxidation (CHO-ox) decreased by 10.1% at 20, 19.2% at 30, and 14.8% at 40 min of cycling at 65% of VO2peak. Lactate was lower with WBs at 20 (WB: 2.6 ± 1.0, C: 3.0 ± 1.1), 30 (WB: 2.2 ± 0.9, C: 2.9 ± 1.0), and 40 min (WB: 1.9 ± 0.8, C: 2.5 ± 0.9). Results indicate that WBs may increase the rate of FAT-ox during moderate-intensity activity in healthy, active males.

Cycling with Short Crank Lengths Improved Economy in Novices.

Novice endurance athletes utilize slower movements and smaller ranges of motion compared to trained endurance athletes. Novice cyclists have been shown to follow this paradigm via the use of slower cadences but may further benefit by utilizing shorter crank lengths to affect speed of movement and range of motion. The purpose of the study was to determine the impact of shorter than traditional crank lengths on the physiological response and performance of novice cyclists exercising at 60% of VO2peak. A total of 14 male novice cyclists (25.9 ± 6.9 yrs.) participated in the study. Participants completed an incremental cycle test to determine VO2peak. Experimental trials consisted of 30 min cycling bouts at 60% of VO2peak; one session using a traditional crank length (175 mm), the other used a short crank length (145 mm). Experimental trials were randomized. Repeated Measures ANOVAs were used to compare power output, cycling economy, RER, VE, HR, RPE, pedal speed and cadence between crank length conditions. Power output (p = 0.002) and cycling economy (p = 0.002) were significantly higher at all time points during the short crank length condition. Pedal speed (p = 0.001) was significantly lower at all time points during the short crank length condition. Novice cyclists were able to ride with improved economy and higher power output while using short crank lengths. These improvements may be related to the slower pedal speeds, slower muscle contraction velocities and more extended hip and knee joints that a short crank length affords.

The Effect of Acute L-carnitine and Carbohydrate Intake on Cycling Performance.

Chronic supplementation of L-carnitine and carbohydrate has been reported to increase L-carnitine content in skeletal muscle and have positive influences on exercise variables and performance. This study investigated the acute intake of L-carnitine and carbohydrate on the exercise parameters of cycling. A total of 10 males (27.0 ± 4 years) completed two exercise sessions consisting of 40 min of cycling at 65% of VO2peak, followed by cycling to exhaustion at 85% of VO2peak. L-carnitine or a placebo was consumed 3 hours prior to exercise, and beverages consisting of 94 g of carbohydrate were consumed at both 2 hours, and 30 minutes prior to exercise. Repeated measures ANOVAs were used to compare respiratory exchange ratio (RER), blood lactate, and power output across experimental trials and time. A repeated measures t-test was used to analyze differences between conditions and time to exhaustion. RER was significantly lower (p=0.01) at baseline with L-carnitine ingestion (.83 ± .05) compared to the placebo ingestion (.86 ± .06). Blood lactate was significantly lower (p=0.02) after 10 minutes of cycling at 65% of VO2peak with ingestion of L-carnitine (35% change from baseline) compared to placebo ingestion (53% change from baseline). No differences were found for power output or time to exhaustion at 85% of VO2peak. Despite mentioned differences, acute intake of L-carnitine and carbohydrate does not appear to influence exercise parameters, likely due to a lack of sufficient change in the content of L-carnitine in skeletal muscle.

Organizational changes aiming to reduce iv tPA door-to-needle time.

OBJECTIVES: To assess time trends in intravenous thrombolytic (iv tPA) treatment in a general local hospital during a period with organizational changes, especially how movement of treatment start from the emergency room (ER) to the CT laboratory, and changing method of administration of acute antihypertensive medication influenced on door-to-needle time (DNT). MATERIALS AND METHODS: All stroke patients treated with iv tPA have been prospectively enrolled in the Safe Implementation of Treatments in Stroke (SITS) registry. Data from 2007 to 2011 were reviewed. Safety was evaluated by the incidence of symptomatic intracerebral hemorrhage (SICH). Predictors of DNT were assessed by multivariable regression. RESULTS: Two hundred and forty-three patients were treated with iv tPA. The annual treatment rate reached 21.9% of patients with ischemic strokes admitted to the hospital. Median DNT decreased from 36 to 28 min (P ≤ 0.001). The incidence of SICH remained low and was throughout the period 2.5%. Treatment start in the CT laboratory vs in the ER was associated with a reduction in median DNT (P = 0.007). Acute antihypertensive treatment and treatment with warfarin were associated with increased DNT (P = 0.024 and P = 0.003, respectively). Age, gender, baseline NIHSS, onset-to-door time, comorbidity, and method of administration of acute antihypertensive treatment did not influence DNT significantly. CONCLUSIONS: Streamlining of iv tPA logistics can reduce median DNT to <30 min in a general local hospital. Moving treatment start from the ER to the CT laboratory contributed to reduce DNT. Our organizational model was resistant to influence on DNT by patient age, gender, stroke severity, and time to hospital arrival. The incidence of SICH remained low.

The PI3K inhibitor GDC-0941 combines with existing clinical regimens for superior activity in multiple myeloma.

The phosphatidylinositol 3'-kinase (PI3K) pathway is dysregulated in multiple myeloma (MM); we therefore tested a highly selective class I PI3K inhibitor, GDC-0941, for anti-myeloma activity. Functional and mechanistic studies were first performed in MM cell lines, then extended to primary MM patient samples cultured in vitro. GDC-0941 was then assessed as a single agent and in various combinations in myeloma tumor xenograft models. We show p110 α and ß are the predominant PI3K catalytic subunits in MM and that a highly selective class I PI3K inhibitor, GDC-0941, has robust activity as a single agent to induce cell cycle arrest and apoptosis of both MM cell lines and patient myeloma cells. Mechanistic studies revealed an induction of cell cycle arrest at G0/G1, with decreased phospho-FoxO1/3a levels, decreased cyclin D1 and c-myc expression, and an increase in the cell cycle inhibitor, p27kip. Induction of apoptosis correlated with increased expression of the pro-apoptotic BH3-only protein BIM, cleaved caspase 3 and cleaved poly (ADP-ribose) polymerase (PARP). In vitro, GDC-0941 synergized with dexamethasone (Dex) and lenalidomide (combination index values of 0.3-0.4 and 0.4-0.8, respectively); in vivo GDC-0941 has anti-myeloma activity and significantly increases the activity of the standard of care agents in several murine xenograft tumor models (additional tumor growth inhibition of 37-53% (Dex) and 22-72% (lenalidomide)). These data provide a clear therapeutic hypothesis for the inhibition of PI3K and provide a rationale for clinical development of GDC-0941 in myeloma.

Chronic daily headache with medication overuse: predictors of outcome 1 year after withdrawal therapy.

BACKGROUND AND PURPOSE: We examined prospectively the results of withdrawal therapy in 80 patients with probable medication overuse headache. The aim was to identify baseline patient characteristics that might predict outcome after 1 year (end of study). METHODS: We classified patients according to results of withdrawal therapy measured as the improvement of headache days (HD) from baseline to end of study. RESULTS: Thirty-six per cent (29/80) had at least 50% improvement. Sixty-four per cent (51/80) had <50% improvement, and among these, 30% (24/80) had <10% improvement. The following baseline characteristics were associated with poor outcome of withdrawal therapy: use of codeine-containing drugs, low self-reported sleep quality, and high self-reported bodily pain as measured by the quality of life tool SF-36. CONCLUSION: Before suggesting withdrawal therapy, one should probably pay more close attention to sleep problems.

Chronic daily headache with medication overuse: a randomized follow-up by neurologist or PCP.

Several studies have shown the benefit of withdrawal therapy when medication overuse headache (MOH) is suspected. Our aim was to compare the effect of withdrawal therapy in patients followed by a neurologist (group A, n = 42) and a primary care physician (PCP) (group B, n = 38). Patients were randomized to A or B, and follow-up was at 3, 6 and 12 months. Calculated mean headache (MH at 6 months + MH at 12 months)/2 (primary end-point) was similar; A 1.04 (0.87, 1.21) and B 1.02 (0.82, 1.21) (P = 0.87). The number of patients with 50% improvement of headache days was also similar; 14/42 in group A vs. 12/34 in B (P = 0.86) at 3 months, 15/42 vs. 11/33 (P = 0.83) at 6 months and 15/42 vs. 14/38 (P = 0.92) at 12 months. Days without headache during the last 9 months of follow-up were 123 (96, 150) in group A and 137 (112, 161) in B (P = 0.62). After 3 months one-third were classified as MOH. Patients with MOH improved similarly in group A and B, and so did patients without MOH. Within 1 year 7/42 in A and 9/38 in B had recurrent medication overuse (P = 0.43). In summary, there were no significant differences in follow-up results between the two groups.

A community-based study of scaling assumptions and construct validity of the English (UK) and Chinese (HK) SF-36 in Singapore.

Scaling assumptions and validity of the English (UK) and Chinese (HK) short form 36 health survey (SF-36) were assessed in a community-based survey of 5,503 Chinese, Malays and Indians in Singapore using the international quality of life assessment project approach of item and scale level validation. Missing data for SF-36 items and scales occurred in less than 1.0% of subjects. Item level validation of both versions generally supported assumptions underlying Likert scoring and hypothesised item-order clustering. Item level factor analysis supported the eight-scale structure of the SF-36. In scale level validation, SF-36 scale scores showed wide variability and acceptable internal-consistency reliability (Cronbach's alpha > 0.70 for six English and seven Chinese scales), conformed to hypothesised patterns and generally varied according to hypotheses in subjects known to differ in quality of life. Scale level factor analysis of both versions yielded very similar patterns of factor correlation, comparable to that found in Japan, but differing from that seen in Western populations. Taken together, these results support the validity of the English (UK) and Chinese (HK) SF-36 versions in the multi-ethnic Asian socio-cultural context of Singapore.

[Transformed migraine--chronic daily headache]. / Transformert migrene--kronisk daglig hodepine.

Transformed migraine is probably a common cause of chronic daily headache. The International Headache Society system of diagnostic classification of headache classifies headaches, not patients, and pays no attention to the long-term evolution of the patient's headache. We support the suggestion made by Silberstein et al. that transformed migraine should be used as a diagnostic label in patients suffering from chronic daily headache with "migrainous features" and a history of migraine. Since 1994, intravenous treatment with dihydroergotamine (DHE) has been used for these patients. Among 16 patients suffering from chronic daily headache which were treated with this drug in 1996, 10 patients reported complete relief of headache at discharge from the hospital, but only four patients experienced complete relief from headache for more than two weeks. We think that the most important treatment for these patients are medicament withdrawal, information, help and support so that patients may cope with their headache. Dihydroergotamine can help patients going through a withdrawal regime.

Short term toxicity study in rats dosed with isoeugenol benzyl ether.

Isoeugenol benzyl ether was given to rats by gavage for 28 days at 0, 60, 120, and 240 mg/kg body weight/day. For both sexes at the highest dose and females at the intermediate dose statistically significantly decreased values were found for body weight, blood glucose (also for males at intermediate dose), blood urea and relative liver weights. No dose-related histopathological changes were seen in any organs. The no effect level was 60 mg/kg body weight/day.

[Toxic pneumopathy following voluntary ingestion of 1 1/2 liters of gas-oil]. / Pneumopathie toxique après ingestion volontaire d'un litre et demi de gas-oil.

Authors recall an original observation about a twenty years old young girl who ingested one and half litre of gas-oil for suicide. A severe toxic lung disease appeared in the following days. Several weeks will be necessary for complete resorption, but no heavy breathing assistance will be needed. This observation confirmates the very rare cases described in publication.

[Phosgene poisoning]. / Intoxications par le phosgène.

Phosgene, a combat gaz of the first world war is now very used in industry. Authors report a few observations about acute intoxications in the manufacture of this gaz in Toulouse. They insist about the risks of slow coming out lung oedema when safety instructions are not correctly followed. However better knowledge and observance of these instructions permitted a reduction of these intoxications in number and gravity.

A dual action of histamine on isolated human pulmonary arteries.

Isometric tension changes in 22 isolated segmental human pulmonary arteries obtained from 17 patients at thoracic surgery were studied after histamine challenge. Cumulative dose-response contraction curves were constructed. A slight potentiation could be found with the H2 antagonist cimetidine, whereas the H1 blocker mepyramine moved the log dose-response curve for histamine to the right indicating competitive antagonism at specific receptors. When mepyramine was added after maximal contraction with histamine, a relaxation occurred that could be blocked by adding cimetidine prior to mepyramine. The in vitro tests reveal a dual action of histamine with a dominating H1 receptor mediated contraction, but with the possibility of relaxation via specific H2 receptors in human pulmonary arteries.