Sports supplements. Can dietary additives boost athletic performance and potential?

Nutritional sports supplements, many of which are endorsed by professional athletes, are increasing in popularity among casual and adolescent sports enthusiasts, bodybuilders, and weight lifters. Because many people consider nutritional additives to be "natural" and therefore "safe," patients may not consider the possible effects of those substances when taken in high doses or in combination with medications. Drs Rubinstein and Federman present an interesting overview of several sports supplements and examine the consequences and caveats of their use, as well as the reasons for their popularity.

High prevalence of insomnia in an outpatient population with HIV infection.

OBJECTIVE: To determine the prevalence, characteristics, and clinical recognition of insomnia in HIV-seropositive outpatients. DESIGN: Systematic sample of patients attending an outpatient HIV/AIDS clinic at an urban teaching hospital. METHODS: Patients were recruited for standard interviews including Pittsburgh Sleep Quality Index (PSQI); Mini Mental State Exam (MMSE); Trail Making Test A and B, and Hospital Anxiety and Depression Scale. Abstraction of medical records was used to assess clinician identification of insomnia. RESULTS: 115 of 127 (91%) patients who were approached agreed to be interviewed for the study. Of these, 79 (69%) were male, 36 (31%) female; 38 (33%) black, 64 (56%) white, 12 (10%) Hispanic, 1 (1%) native American; 45 (39%) were injection drug users. Eighty-four (73%) respondents were classified as having a sleep disturbance according to the PSQI. Patients with cognitive impairment had a higher prevalence of insomnia (100% versus 70%; p = .034). A trend was shown for drug-using patients to report a higher prevalence of insomnia than nondrug users (86% versus 69%; p < .07). Using multivariate analysis, cognitive impairment (odds ratio [OR] = 1.4) as defined by the neuropsychiatric test battery and depression (OR = 1.2) were the best predictors of insomnia (p < .05). Only 28 (33%) patients with insomnia had any documentation of sleep disturbance in their clinical medical records. CONCLUSIONS: Insomnia is widespread and underdiagnosed in HIV-seropositive ambulatory patients. Insomnia is especially prevalent among those with cognitive impairment. These findings suggest the importance for clinicians to inquire specifically about sleep disorders in HIV-seropositive patients. Prompt diagnosis and treatment may improve the quality of life in patients living with HIV.

Improved signal processor for the ultrasonic dimension gauge.

Inexpensive modifications and additions to improve the performance of a widely used ultrasonic dimension gauge are presented in detail. These include a pulse width demodulator, averaging peak detector, and improved signal processing circuits. Benefits of the modifications are improved frequency response (to 1 kHz), lowered drift, increased sensitivity (to 128 mV/mm), rational gain calibration, calibrated zero suppression, and improved recovery from signal dropout. The modifications result in the ability to take the derivatives of ventricular wall motion with greater reliability.