How exercise affects lipid profiles in women: what to recommend for patients.

After menopause, women have less favorable lipid profiles than before menopause. While regular exercise improves lipid metabolism in men, the specifics for doing so in pre- and postmenopausal women are not fully understood. Literature review suggests that higher-volume aerobic exercise programs increase high-density lipoprotein cholesterol (HDL-C) levels in both pre- and postmenopausal women. Although longitudinal studies of resistance training did not reveal increases in HDL-C levels in women, other favorable benefits observed included decreases in low-density lipoprotein-cholesterol, total cholesterol, and body fat. Cross-sectional studies, however, seem to favor high-volume exercise for increasing HDL-C levels.

Effect of 14 weeks of resistance training on lipid profile and body fat percentage in premenopausal women.

OBJECTIVES: To study the effects of a supervised, intensive (85% of one repetition maximum (1-RM)) 14 week resistance training programme on lipid profile and body fat percentage in healthy, sedentary, premenopausal women. SUBJECTS: Twenty four women (mean (SD) age 27 (7) years) took part in the study. Subjects were randomly assigned to either a non-exercising control group or a resistance exercise training group. The resistance exercise training group took part in supervised 45-50 minute resistance training sessions (85% of 1-RM), three days a week on non-consecutive days for 14 weeks. The control group did not take part in any structured physical activity. RESULTS: Two way analysis of variance with repeated measures showed significant (p < 0.05) increases in strength (1-RM) in the exercising group. There were significant (p < 0.05) decreases in total cholesterol (mean (SE) 4.68 (0.31) v 4.26 (0.23) mmol/1 (180 (12) v 164 (9) mg/dl)), low density lipoprotein (LDL) cholesterol (2.99 (0.29) v 2.57 (0.21) mmol/l (115 (11) v 99 (8) mg/dl), the total to high density lipoprotein (HDL) cholesterol ratio (4.2 (0.42) v 3.6 (0.42)), and body fat percentage (27.9 (2.09) v 26.5 (2.15)), as well as a strong trend towards a significant decrease in the LDL to HDL cholesterol ratio (p = 0.057) in the resistance exercise training group compared with their baseline values. No differences were seen in triglycerides and HDL cholesterol. No changes were found in any of the measured variables in the control group. CONCLUSIONS: These findings suggest that resistance training has a favourable effect on lipid profile and body fat percentage in healthy, sedentary, premenopausal women.

The effect of oral creatine monohydrate supplementation on running velocity.

Creatine supplementation has been shown to augment muscle PCr content and increase the rate of ATP resynthesis. Thus, we hypothesized that creatine supplementation might enhance sprinting performance. Eighteen subjects completed both of two testing sessions (control and postsupplement) 1 week apart, wherein they sprinted three 60-m distance trials that were recorded with videotape. Following the control session, for 7 days, subjects in the treatment group ingested a creatine-glucose mixture, while the placebo group consumed a glucose powder, followed by the postsupplementation session. Velocities of the subjects through three testing zones within the 60-m sprint were calculated from the videotape. Resultant velocities were analyzed using a MANOVA with a 2 x 2 x 3 x 3 (Group x Session x Trial x Zone) design. Results indicated that there were no statistically significant main or interaction effects on velocity between groups for session, trial, or zone. These data do not support the hypothesis that supplementary creatine ingestion will enhance velocity during the early or latter segments of a 60-m sprint.

Effect of Eleutherococcus senticosus on submaximal and maximal exercise performance.

We investigated the effect of Eleutherococcus senticosus Maxim L (ESML) on performance during submaximal and maximal aerobic exercise. Twenty highly trained distance runners randomly assigned in matched pairs to either an experimental (ESML) or placebo (PL) group, participated in an 8-wk double-blind study during which they completed five trails of a 10-min treadmill run at their 10 km (10K) race pace and a maximal treadmill test (T(max)). Following a baseline trail, ESML and PL consumed, respectively, 3.4 ml of ESML extract or placebo daily for 6 wk. Subjects were tested every 2 wk during supplementation and 2 wk following withdrawal. Heart rate (HR), oxygen consumption (VO2), expired minute volume (VE), ventilatory equivalent for oxygen (VE/VO2), respiratory exchange ratio (RER), and rating of perceived exertion (RPE) were measured during the 10K and T(max) tests. Resting, post-10K and post-T(max) blood samples were analyzed for serum lactate. No significant differences were observed between ESML and PL for: HR, VO2, VE, VE/VO2, RER, or RPE; T(max) time to exhaustion; or serum lactate. The data do not support an ergogenic effect of ESML supplementation on selected metabolic, performance, or psychologic parameters associated with submaximal and maximal aerobic exercise tasks.

Postsurgical timing of restorative therapy: a review.

Knowledge of wound healing is necessary for the clinician when determining the time of prosthodontic treatment after periodontal surgery. Wound healing and longitudinal clinical studies indicate that the clinician should wait approximately 8 weeks before proceeding with the final restoration. Restorative procedures could be considered as early as 6 weeks if (1) the patient shows good systemic health; (2) injury is not inflicted on the gingiva by the restorative technique; (3) restorative margins are supragingival; and (4) esthetics are not critical. With a thick periodontium, more common in posterior areas, the gingiva often will move coronally as the tissue matures. Thin periodontal tissues may recede postsurgically, and in areas of esthetic concern, postponement of final restoration for up to 5 to 6 months may be desirable to assure gingival margin stability. Modifiers that may affect time and quality of healing, such as the patient's smoking frequency and age, should be considered when scheduling restorative treatment after periodontal surgery.

Chondromyxoid fibroma.

Chondromyxoid fibroma (CMF) is the least common cartilage-producing tumor. In Dahlin and Unni's series of 8,542 bone tumors, 39 of which were CMF, none were found in the femoral shaft. In this case, a CMF in the femoral shaft presented initially as a pathologic fracture. Attempts at curettage and autogenous bone graft failed, and en bloc resection and segmented allograft reconstruction were eventually required.

Reproductive hormones and bone mineral density in women runners.

We examined the relationships among reproductive hormone concentrations and bone mineral density (BMD) in 43 women runners classified as eumenorrheic (n = 24), oligomenorrheic (n = 8), or amenorrheic (n = 11). Results were compared with a eumenorrheic nonrunner control group (n = 11). Serum 17 beta-estradiol, progesterone, and dehydroepiandrosterone sulfate concentrations were determined in daily blood samples for 21 days, and integrated concentrations (areas under the curve) were calculated. BMD was assessed at the lumbar spine and proximal femur by dual-photon absorptiometry. As expected, 17 beta-estradiol, progesterone, and lumbar spine BMD were higher in the control and eumenorrheic runner groups than in the oligomenorrheic and amenorrheic runner groups (P less than 0.05). Progesterone concentration was significantly correlated with lumbar spine BMD in the eumenorrheic runners (r = 0.61). None of the steroid hormones was significantly related to BMD in the oligomenorrheic/amenorrheic group. The present data suggest that circulating levels of gonadal steroid hormones affect axial BMD in eumenorrheic runners.

Endometrial morphology in asymptomatic postmenopausal women.

Few data are available regarding endometrial histologic features in asymptomatic perimenopausal and postmenopausal women. This study encompasses endometrial biopsy specimens obtained from 801 such women before enrollment in a multicenter study of estrogen-progestin replacement. One endometrial cancer was found (0.13%); four additional biopsy specimens showed atypia (total 0.63%). The endometrium was atrophic in 373 (46.9%), proliferative in 133 (16.7%), secretory in 54 (6.8%), and hyperplastic in 41 (5.2%). Insufficient tissue for diagnosis was obtained in 195 (24.5%). We conclude that the yield for neoplasia is so low that screening endometrial biopsy is not justified in asymptomatic perimenopausal and postmenopausal women.

Cardiovascular effects of H2-receptor antagonists.

The type II histamine receptor antagonists, cimetidine and ranitidine, widely used in treatment of peptic ulcer disease have been reported to cause bradycardia. To evaluate the cardiovascular effects of H2 antagonists nineteen healthy volunteers were entered into a double-blind crossover comparison of cimetidine 300 mg qid, ranitidine 150 mg bid, and placebo. Subjects ingested study medicine for 7 days prior to being tested by the Bruce Exercise Test. Heart rate, blood pressure, oxygen consumption, expiratory volume, and fractional expiration of CO2 and O2 were measured at rest, exercise and recovery. A plasma sample for determination of cimetidine and ranitidine levels were obtained prior to the exercise period. Multivariate analysis and paired t test revealed no significant differences for the cardiovascular or pulmonary variables. However, in 5 subjects, the heart rate at 25% maximum VO2 was depressed 8% (P less than or equal to 0.03). This effect in a small percentage of the population suggests that further studies are needed to determine if subpopulations are affected.

Splenic abscess caused by Blastomyces dermatitidis.

We have reported a case of fungal splenic abscess caused by Blastomyces dermatitidis. Splenic abscess is an uncommon disorder, and fungus as the causative organism is rare. The diagnosis of splenic abscess can be rapidly made with radionuclide and CT scanning and ultrasonography. Splenectomy with appropriate antifungal chemotherapy is the currently recommended therapy.

Flank mass and pain in a 72-year-old man.

This patient had retroperitoneal multiseptated masses, which extensively invaded the right flank and thigh musculature. The radiologic, pathologic, and clinical findings were consistent with a retroperitoneal pseudomyxoma from an appendiceal mucocele.

Osteoclastic giant cell tumor of the pancreas. Aspiration cytology, light microscopy, and ultrastructure with review of the literature.

The osteoclastic giant cell tumor of the pancreas is a rare primary neoplasm that by light and electron microscopy mimics giant cell tumor of bone. In the proper clinical setting, this lesion can be diagnosed by fine needle aspiration. Review of 10 cases reveals a female predominance, a median survival of 12 months, and a tendency for local invasion, rather than lymphatic or distant metastasis, and for invasion of large veins. An epithelial origin is favored for this malignant neoplasm, which expresses varying degrees of mesenchymal differentiation.

The prevalence of actinomycetes-like organisms found in cervicovaginal smears of 300 IUD wearers.

The association of Actinomyces with IUD wearers has been widely documented and the possibility of the recognition of actinomycetes-like organisms in routine Papanicolaou-stained cervicovaginal smears has been reported. We conducted a retrospective study of IUD wearers to determine the prevalence and significance of actinomycetes-like organisms found in such smears. Three hundred smears from current IUD wearers were rescreened for actinomycetes-like organisms. Of this group, 200 patients were from a public health family planning clinic, and 100 were private patients. The incidence for the public health group was 25.5% and for the private patient group, 8%. A case history of actinomycosis is included. Findings such as other infectious agents, abnormal cytology and symptoms are also discussed. Although the presence of Actinomyces probably represents an opportunistic infection, the threat of pelvic actinomycosis with serious complications poses a management problem to the clinician when Actinomyces is reported in a routine Papanicolaou smear. Our findings lead us to question the practicality of the earlier recommendations of IUD removal and antibiotic therapy.

PIP: 300 Papanicolaou smears from current IUD wearers were rescreened to determine the prevalence of actinomycetes. Of the 300 patients, 59 showed actinomycetes-like organisms in cervicovaginal smears. Of the 59 positive cases, 51 (of 200, 25%) were from public health clinics and 8 (of 100, 8%) were from private patients. Of 21 patients complaining of irregular bleeding, only 4 had positive actinomycete cultures. In cases positive for the organisms there was no correlation of prevalence found with the phase of the menstrual cycle or with menstruation itself. A case history of actinomycosis is included. Although the presence of Actinomyces probably represents an opportunitistic pathogenic infection, management of this infection is important to eradicate the threat of pelvic actinomycosis. In the case history described, however, antibiotic therapy failed, and a complete abdominal hysterectomy was performed.

Massive orbital invasion by small malignant lesions.

In diagnosing and treating small malignant lesions of the eyelids, physicians should be alert for possible extension of the cancer into the orbit, endangering not only the patient's sight but his life as well. Important signs and symptoms include bone thickening, disturbances of ocular motility, intermittent epiphora, and positive results of radiologic studies. From histopathologic study of the resected carcinomatous tissues, it is apparent that the creeping, cicatrizing, ulcerated, and invasive patterns of basal cell carcinoma predominate in this group of eyelid tumors, all of which are aggressive lesions; however, the histologic type is quite variable and no definite trends can be established.

The pathologic behavior of primary vaginal carcinoma and its relationship to cervical cancer.

The surgical pathology files at the University of Alabama Medical Center for 1958 through 1973 contain records of 157 cases of vaginal carcinoma. Of the 141 patients on whom complete records are available, 37 had primary and 104 secondary vaginal carcinoma. Only 3 of the primary vaginal malignancies were adenocarcinoma; the rest were epidermoid. The microscopic appearance of these carcinomas was frequently lateral spreading or papillary, but in a few instances the growth pattern was submucosal. Prognosis appeared to be related to the stage of the disease. Vaginal carcinomas associated with cervical cancer clustered either within 1 year or 5 years after the therapeutic treatment. In this paper, the relationship between primary vaginal cancer and cervical cancer is discussed.