Sensory system-specific associations between brain structure and balance.

Nearly 75% of older adults in the US report balance problems. Although it is known that aging results in widespread brain atrophy, less is known about how brain structure relates to balance in aging. We collected T1- and diffusion-weighted MRI scans and measured postural sway of 36 young (18-34 years) and 22 older (66-84 years) adults during eyes open, eyes closed, eyes open-foam, and eyes closed-foam conditions. We calculated summary measures indicating visual, proprioceptive, and vestibular contributions to balance. Across both age groups, thinner cortex in multisensory integration regions was associated with greater reliance on visual inputs for balance. Greater gyrification within sensorimotor and parietal cortices was associated with greater reliance on proprioceptive inputs. Poorer vestibular function was correlated with thinner vestibular cortex, greater gyrification within sensorimotor, parietal, and frontal cortices, and lower free water-corrected axial diffusivity across the corona radiata and corpus callosum. These results expand scientific understanding of how individual differences in brain structure relate to balance and have implications for developing brain stimulation interventions to improve balance.

Differential Relationships Between Brain Structure and Dual Task Walking in Young and Older Adults.

Almost 25% of all older adults experience difficulty walking. Mobility difficulties for older adults are more pronounced when they perform a simultaneous cognitive task while walking (i.e., dual task walking). Although it is known that aging results in widespread brain atrophy, few studies have integrated across more than one neuroimaging modality to comprehensively examine the structural neural correlates that may underlie dual task walking in older age. We collected spatiotemporal gait data during single and dual task walking for 37 young (18-34 years) and 23 older adults (66-86 years). We also collected T 1-weighted and diffusion-weighted MRI scans to determine how brain structure differs in older age and relates to dual task walking. We addressed two aims: (1) to characterize age differences in brain structure across a range of metrics including volumetric, surface, and white matter microstructure; and (2) to test for age group differences in the relationship between brain structure and the dual task cost (DTcost) of gait speed and variability. Key findings included widespread brain atrophy for the older adults, with the most pronounced age differences in brain regions related to sensorimotor processing. We also found multiple associations between regional brain atrophy and greater DTcost of gait speed and variability for the older adults. The older adults showed a relationship of both thinner temporal cortex and shallower sulcal depth in the frontal, sensorimotor, and parietal cortices with greater DTcost of gait. Additionally, the older adults showed a relationship of ventricular volume and superior longitudinal fasciculus free-water corrected axial and radial diffusivity with greater DTcost of gait. These relationships were not present for the young adults. Stepwise multiple regression found sulcal depth in the left precentral gyrus, axial diffusivity in the superior longitudinal fasciculus, and sex to best predict DTcost of gait speed, and cortical thickness in the superior temporal gyrus to best predict DTcost of gait variability for older adults. These results contribute to scientific understanding of how individual variations in brain structure are associated with mobility function in aging. This has implications for uncovering mechanisms of brain aging and for identifying target regions for mobility interventions for aging populations.

In Vivo Brain Glutathione is Higher in Older Age and Correlates with Mobility.

Brain markers of oxidative damage increase with advancing age. In response, brain antioxidant levels may also increase with age, although this has not been well investigated. Here, we used edited magnetic resonance spectroscopy to quantify endogenous levels of glutathione (GSH, one of the most abundant brain antioxidants) in 37 young [mean: 21.8 (2.5) years; 19 female] and 23 older adults [mean: 72.8 (8.9) years; 19 female]. Accounting for age-related atrophy, we identified higher frontal and sensorimotor GSH levels for the older compared with the younger adults. For the older adults only, higher sensorimotor (but not frontal) GSH was correlated with poorer balance and gait. This suggests a regionally specific relationship between higher brain oxidative stress levels and motor performance declines with age. We suggest these findings reflect an upregulation of GSH in response to increasing brain oxidative stress with normal aging. Together, these results provide insight into age differences in brain antioxidant levels and implications for motor function.

Histamine H3 Receptor Agonist Imetit Attenuated Isoproterenol Induced Renin Angiotensin System and Sympathetic Nervous System Overactivity in Myocardial Infarction of Rats.

BACKGROUND: Myocardial infarction is an alarming health issue, needs great attention. The present study investigated the role of histamine-H3 receptor (H3R) agonist imetit in relationship to sympathetic and renin angiotensin system in Wistar rats. MATERIALS AND METHODS: Subcutaneous injection of isoproterenol (85 mg/kg) on last 2 consecutive days in per se group and 7 days treatment of different groups at 24 h interval induced myocardial infarction in Wistar rats. H3R agonist imetit (10 mg/kg), H3R antagonist thioperamide (5 mg/kg), losartan (10 mg/kg) were administered orally to evaluate imetit's cardioprotective potential effect by measuring plasma cardiac antioxidant markers, angiotensin II, norepinephrine levels and histopathological analysis. RESULTS: Isoproterenol significantly elevated the angiotensin II and norepinephrine levels in rat plasma. This study revealed that pre-treatment with imetit similar to losartan attenuated norepinephrine and angiotensin II levels whereas thioperamide showed its antagonistic effect by diminishing imetit's effects. Furthermore, its protective effect was confirmed by restoration of cardiac antioxidant markers and histopathological improvement of myocardium integrity. CONCLUSION: This study confirm imetit's cardioprotective potential and also reveals renin angiotensin system, sympathetic system and H3R correlation in isoproterenol induced toxicity in rats. However, molecular studies must be warranted to prove the role of H3R in myocardial infarction.

Anticoagulant prescribing practices and anesthetic interventions among anticoagulated pregnant patients: a retrospective study.

BACKGROUND: The peripartum management of anticoagulated patients poses important challenges for obstetric anesthesiologists, especially when deciding to perform neuraxial block. However, there is limited evidence evaluating anticoagulant prescribing practices and neuraxial block utilization in this setting. Our objective was to examine peripartum anticoagulant prescribing and anesthetic practices in a cohort of anticoagulated patients receiving subcutaneous enoxaparin, and subcutaneous or intravenous unfractionated heparin. METHODS: We performed a retrospective study of anticoagulant prescribing patterns and anesthetic interventions among patients receiving enoxaparin and/or unfractionated heparin who delivered at a USA obstetric center over a seven-year period. RESULTS: We identified 101 patients who received enoxaparin and/or unfractionated heparin before delivery. Thirty-nine (38.6%) patients received enoxaparin only, 41 (40.6%) patients received enoxaparin bridged to subcutaneous unfractionated heparin, 11 (10.9%) patients received enoxaparin and were converted to intravenous unfractionated heparin and 10 (9.9%) patients received only subcutaneous unfractionated heparin. The overall rate of neuraxial block utilization was 80.2%. The median [IQR] time-period between the last dose of enoxaparin and neuraxial block was significantly shorter for patients who received only enoxaparin vs. enoxaparin with subcutaneous unfractionated heparin (54h [12-192h] (n=26) vs. 216h [39-504h] (n=23), P=0.04). Among patients who received only subcutaneous unfractionated heparin, the time period between unfractionated heparin and neuraxial block was 24h [19-51h]. CONCLUSION: In this study, the neuraxial block rate was high among patients receiving enoxaparin and/or subcutaneous unfractionated heparin with patients undergoing relatively long periods off anticoagulation. Careful multidisciplinary planning is recommended for the peripartum management of anticoagulated pregnant patients.

Relationship between postural control and restricted, repetitive behaviors in autism spectrum disorders.

Restricted, repetitive behaviors (RRBs) are one of the core diagnostic criteria of autism spectrum disorders (ASD), and include simple repetitive motor behaviors and more complex cognitive behaviors, such as compulsions and restricted interests. In addition to the core symptoms, impaired movement is often observed in ASD. Research suggests that the postural system in individuals with ASD is immature and may never reach adult levels. RRBs have been related to postural sway in individuals with mental retardation. Our goals were to determine whether subjects with ASD had greater postural sway and whether RBS-R scores were related to the magnitude of postural sway. We compared the center of pressure (COP) sway area during quiet stance with scores on the Repetitive Behavior Scale-Revised (RBS-R) in children with ASD and typically developing (TD) controls ages 3-16. All subjects had Non-verbal IQ > 70. Subjects performed four quiet stance trials at a self-selected stance width for 20 s. Subjects with ASD had greater postural sway area compared to controls. Not surprisingly, subjects with ASD exhibited greater frequencies and intensities of RRBs overall and on all six subscales. Further, there was a positive correlation between postural sway area and presence of RRBs. Interestingly, results of the postural sway area for the ASD group suggests that roughly half of the ASD subjects scored comparable to TD controls, whereas the other half scored >2 SD worse. Motor impaired children did not have significantly worse IQ scores, but were younger and had more RRBs. Results support previous findings of relationships between RRBs and postural control. It appears that motor control impairments may characterize a subset of individuals with ASD. Better delineation of motor control abilities in individuals with ASD will be important to help explain variations of abilities in ASD, inform treatment, and guide examination of underlying neural involvement in this very diverse disorder.

Brain penetration effects of microelectrodes and DBS leads in STN or GPi.

OBJECTIVE: To determine how intraoperative microelectrode recordings (MER) and intraoperative lead placement acutely influence tremor, rigidity, and bradykinesia. Secondarily, to evaluate whether the longevity of the MER and lead placement effects were influenced by target location (subthalamic nucleus (STN) or globus pallidus interna (GPi)). BACKGROUND: Currently most groups who perform deep brain stimulation (DBS) for Parkinson disease (PD) use MER, as well as macrostimulation (test stimulation), to refine DBS lead position. Following MER and/or test stimulation, however, there may be a resultant "collision/implantation" or "microlesion" effect, thought to result from disruption of cells and/or fibres within the penetrated region. These effects have not been carefully quantified. METHODS: 47 consecutive patients with PD undergoing unilateral DBS for PD (STN or GPi DBS) were evaluated. Motor function was measured at six time points with a modified motor Unified Parkinson Disease Rating Scale (UPDRS): (1) preoperatively, (2) immediately after MER, (3) immediately after lead implantation/collision, (4) 4 months following surgery-off medications, on DBS (12 h medication washout), (5) 6 months postoperatively-off medication and off DBS (12 h washout) and (6) 6 months-on medication and off DBS (12 h washout). RESULTS: Significant improvements in motor scores (p<0.05) (tremor, rigidity, bradykinesia) were observed as a result of MER and lead placement. The improvements were similar in magnitude to what was observed at 4 and 6 months post-DBS following programming and medication optimisation. When washed out (medications and DBS) for 12 h, UPDRS motor scores were still improved compared with preoperative testing. There was a larger improvement in STN compared with GPi following MER (p<0.05) and a trend for significance following lead placement (p<0.08) but long term outcome was similar. CONCLUSION: This study demonstrated significant acute intraoperative penetration effects resulting from MER and lead placement/collision in PD. Clinicians rating patients in the operating suite should be aware of these effects, and should consider pre- and post-lead placement rating scales prior to activating DBS. The collision/implantation effects were greater intraoperatively with STN compared with GPi, and with greater disease duration there was a larger effect.

Prescription of resistance training for healthy populations.

Although there are well documented protective health benefits conferred by regular physical activity, most individuals of all ages are not physically active at a level for sufficient maintenance of health. Consequently, a major public health goal is to improve the collective health and fitness levels of all individuals. The American College of Sports Medicine (ACSM) and other international organisations have established guidelines for comprehensive exercise programmes composed of aerobic, flexibility and resistance-exercise training. Resistance training is the most effective method available for maintaining and increasing lean body mass and improving muscular strength and endurance. Furthermore, there is an increasing amount of evidence suggesting that resistance training may significantly improve many health factors associated with the prevention of chronic diseases. These health benefits can be safely obtained by most segments of the population when prescribed appropriate resistance-exercise programmes. Resistance-training programmes should be tailored to meet the needs and goals of the individual and should incorporate a variety of exercises performed at a sufficient intensity to enhance the development and maintenance of muscular strength and endurance, and lean body mass. A minimum of 1 set of 8 to 10 exercises (multi-joint and single joint) that involve the major muscle groups should be performed 2 to 3 times a week for healthy participants of all ages. More technical and advanced training including periodised multiple set regimens and/or advanced exercises may be more appropriate for individuals whose goals include maximum gains in strength and lean body mass. However, the existing literature supports the guidelines as outlined in this paper for children and adults of all ages seeking the health and fitness benefits associated with resistance training.

Concurrent improvements in cardiorespiratory and muscle fitness in response to total body recumbent stepping in humans.

A group of 26 sedentary adults [mean age 48.4 (SD 6.4) years] were allocated randomly into either a non-exercising control group (CON, n =9) or an exercise group (EX, n = 17) that trained 3 days a week for 12 weeks using a total body recumbent stepper (TBRS). Training intensity and duration progressed from 50% of heart rate reserve maximum (HRRmax) for 20 min to 75% HRRmax for 40 min. Maximal exercise responses were measured during incremental treadmill (TM) and TBRS tests to examine the specificity of the adaptations to training. Muscle strength was measured using a one repetition maximum (1 RM) test for the leg press (LP), chest press (CP), and seated row (SR). Muscle endurance (END) was evaluated for LP, CP, and SR as the number of repetitions achieved before failure when exercising at an intensity of 60% of baseline 1 RM. Body composition was estimated using the sum of seven skinfolds. After training, significant increases (P < 0.05) in maximal oxygen uptake and exercise time were observed in the EX group on both the TM (9.3% and 4.8%, respectively) and TBRS (18.2% and 70.5%, respectively). The TBRS training resulted in significant increases (P < 0.01) in 1 RM and END of the legs, chest, and back, with greater magnitude of improvements observed for END. Furthermore, TBRS training resulted in a significant increase in lean body mass and significant reductions in fat mass and percentage body fat (P<0.01). The CON did not show changes in any measurement (P>0.05). These data indicated concurrent improvements in both cardiovascular and muscle fitness. The greater improvements observed on the TBRS test and in muscle endurance suggest the adaptations are specific to the mode of training.

Molecular phylogeny and biogeography of West Indian toads (Anura: Bufonidae).

Toads of the Bufo peltocephalus Group (Anura: Bufonidae) occur throughout the Greater Antilles (Cuba to the Virgin Islands), a geographic region of relatively high endemicity. Previous morphological and immunological studies suggested that the West Indian toads are a monophyletic lineage derived from Neotropical Bufo but were unable to clarify relationships within the group. We examined the evolutionary relationships and biogeography of this group of frogs by collecting approximately 2 kb of mitochondrial DNA sequence data from eight West Indian species and selected non-West Indian species from the New World and the Old World. Our analyses support the monophyly of native West Indian toads and a New World origin for the group. Relationships among the West Indian species are less certain, but a Cuban lineage is defined in most analyses.

Impact forces and neck muscle activity in heading by collegiate female soccer players.

Three soccer header types (shooting, clearing and passing) and two heading approaches (standing and jumping) were manipulated to quantify impact forces and neck muscle activity in elite female soccer players. The 15 participants were Division I intercollegiate soccer players. Impact forces were measured by a 15-sensor pressure array secured on the forehead. The electromyographic (EMG) activity of the left and right sternocleidomastoid and trapezius muscles was recorded using surface electrodes. Maximum impact forces and impulses as well as the EMG data were analysed with separate repeated-measures analyses of variance. Impact forces and impulses did not differ among the header types or approaches. Higher values were found for jumping versus standing headers in the mean normalized EMG for the right sternocleidomastoid. In addition, the integrated EMG was greater for the right sternocleidomastoid and right and left trapezius (P < 0.05). The sternocleidomastoid became active earlier than the trapezius and showed greater activity before ball contact. The trapezius became active just before ball contact and showed greater activity after ball contact. The increased muscle activity observed in the neck during the jumping approach appears to stabilize the connection between the head and body, thereby increasing the stability of the head-neck complex.

Single versus multiple sets in long-term recreational weightlifters.

PURPOSE: The purpose of this study was to determine the effects of increasing training volume from one set to three sets on muscular strength, muscular endurance, and body composition in adult recreational weight lifters. METHODS: Forty-two adults (age 39.7 +/- 6.2 yr; 6.2 +/- 4.6 yr weight training experience) who had been performing one set using a nine-exercise resistance training circuit (RTC) for a minimum of 1 yr participated in this study. Subjects continued to perform one set (EX-1; N = 21) or performed three sets (EX-3; N = 21) of 8-12 repetitions to muscular failure 3 d x wk(-1) for 13 wk using RTC. One repetition maximums (1-RM) were measured for leg extension (LE), leg curl (LC), chest press (CP), overhead press (OP), and biceps curl (BC). Muscular endurance was evaluated for the CP and LE as the number of repetitions to failure using 75% of pretraining 1-RM. Body composition was estimated using the sum of seven skinfold measures. RESULTS: Both groups significantly improved muscular endurance and 1 RM strength (EX-1 by: 13.6% LE; 9.2% LC; 11.9% CP; 8.7% OP; 8.3% BC; and EX-3 by: 12.8% LE; 12.0% LC; 13.5% CP; 12.4% OP; 10.3% BC) (P < 0.05). Both groups significantly improved lean body mass (P < 0.05). No significant differences between groups were found for any of the test variables (P > 0.05). CONCLUSION: Both groups significantly improved muscular fitness and body composition as a result of the 13 wk of training. The results show that one-set programs are still effective even after a year of training and that increasing training volume over 13 wk does not lead to significantly greater improvements in fitness for adult recreational weight lifters.

[Actinomycetes canaliculitis--case reports]. / Aktinomyzetenkanalikulitis--Fallberichte.

Canaliculitis is a relatively rare dacryocanal infection which occurs most unilateral. It can easily be misinterpreted and not sufficiently treated. Typical agents of the canaliculitis are actinomyces, that can cause infections of the hollow spaces with formation of concrements. The clinical courses of two patients are shown. One of them was treated for a dacryocystitis for 3 years and the other one had been referred to the eye hospital for chalazion removal. Only a microbiologic examination including cultivation of the surgically obtained dacryolithes and secretion enabled us to a reliable proof of the actinomyces and to an appropriate therapy for canaliculitis.

[Morphologic changes in the lens epithelium in patients with age-induced cataract, radiation and steroid cataract and cataract following eye contusion]. / Morphologische Veränderungen des Linsenepithels bei Patienten mit altersbedingter Katarakt, Strahlen- und Steroidkatarakt und Katarakt nach Contusio bulbi.

The lens epithelium of the human eye plays a crucial role in the pathogenesis of primary and secondary cataract. Sixty hematoxylin-eosinstained lens epithelia were examined using a light microscope. Cell parameters were compared to one another in the various age groups of patients, between patients with secondary cataract (radiation cataract, steroid cataract and traumatic cataract) and patients with senile cataract, and between male and female patients. The t-test was used for statistical comparison. The median cell density was 3116.5 cells/mm2. The median nucleus-plasma ratio was 1:2.74. Patients with secondary cataract had a larger medium cell and nucleus area as well as a higher nucleus-plasma ratio and a lower cell density than patients with senile cataract. A part from degenerative and proliferative cell changes we found various cell types. The age of patients and the cause of cataract correlate with morphometric changes of lens epithelium cells. However, there was no correlation between specific cytologic changes and causes of cataract.

[Torsades de pointes during sultopride poisoning]. / Torsades de pointes lors d'une intoxication par sultopride.

A case of sultopride poisoning (ingested dose 16 g) in a 35-year-old, 65 Kg man is described. On admission myoclonus, mydriasis, vomiting and cardio-respiratory arrest were observed. Torsades de pointes were treated with potassium chloride infusion and pace maker stimulation. Plasma sultopride concentration was 25 mg/l and urinary concentration 12 g/l. A prolongation of Q-T interval may announce severe arrhythmias in sultopride poisoning.

Crocodilian evolution: insights from immunological data.

The quantitative immunological technique of microcomplement fixation was used to examine serum albumin evolution among members of the order Crocodylia. The cross-reactivity of the albumin antisera and antigens employed in this study had been examined previously using the qualitative technique of immunodiffusion. The phylogenetic conclusions derived from these two data sets are highly congruent, including support of the families Alligatoridae and Crocodylidae, with the placement of Gavialis as the sister taxon of Tomistoma. Both methods provide similar information on the relative amounts of amino acid sequence divergence between albumin molecules; however, the data obtained from microcomplement fixation comparisons are more discriminating than those derived from immunodiffusion. The estimated divergence times within the Crocodylia derived from the fossil record are examined in light of divergence times predicted by the microcomplement fixation-based albumin clock. The traditional phylogenetic placement of Gavialis outside the remaining extant crocodilians is inconsistent with all molecular data sets and we suggest that a careful reexamination of both the extant and the fossil morphological data is warranted.

Caribbean biogeography: molecular evidence for dispersal in West Indian terrestrial vertebrates.

The geological association of the Greater Antilles with North and South America in the late Cretaceous led to the hypothesis that the present Antillean biota reflects those ancient land connections. Molecular data from diverse West Indian amphibians and reptiles and their mainland relatives support a more recent derivation of the Antillean vertebrate fauna by overwater dispersal. The catastrophic bolide impact in the Caribbean region at the close of the Cretaceous provides a proximate cause for the absence of an ancient West Indian biota.

Chemical composition of bottled mineral water.

Thirty-seven brands of domestic and imported mineral waters were analyzed for the following: alkalinity, aluminum, barium, beryllium, boron, cadmium, calcium, chloride, chromium, cobalt, copper, fluoride, iron, lead, lithium, magnesium, manganese, mercury, molybdenum, nickel, nitrate, pH, phosphate, potassium, silver, sodium, specific conductance, sulfate, tin, vanadium, and zinc. Of the waters examined in this study, 24 had one or more determinands that were not in compliance with the drinking water standards in the United States.

Changes in cattle tick control practices in south eastern Queensland from 1977 to 1982.

Results of a survey of cattle producers in south eastern Queensland in 1982 concerning cattle tick control have been compared with those of a similar survey carried out in 1977-78. During the interval between these surveys the proportion of beef farms with tick resistant (Bos indicus infusion) cattle as the main breed had increased from 47.8% to 60.0%. Chemical control methods had improved but many producers were continuing to treat their cattle more often than necessary. Over the period there was an increase in the proportion of farms with small numbers of animals, and 30% of the farms had less than 50 cattle.