Heavy Exercise Research Articles

PSAT339 Long-term Follow Up of Three Cases of Periodic Paralysis

Abstract Introduction Periodic paralysis (PP) is a disorder of muscle ion channels. It is clinically manifested by episodes of painless muscle weakness and often precipitated by heavy exercise, fasting, or high-carbohydrate meals. Although first described in 1951, there is limited information for its long term course. We describe long term follow up of 3 cases of PP. Case 1 A 28-year-old male presented to the emergency room for abnormal sensations of lower extremities and inability to move his legs. Symptoms progressed to upper extremities with serum potassium of 1.7 mmol/L. He was treated with potassium chloride and discharged the next day with diagnosis of PP. He reported high intensity exercise precipitating these episodes and milder symptoms two years previously. Patient also had symptoms of hyperthyroidism, confirmed by thyroid functions tests. Physical examination showed normal vitals, small but palpable thyroid, and no neurological deficit. He was treated with methimazole, propranolol and KCl 20meq. Serum potassium normalized in 4 weeks and KCl was stopped. Following 3 months of treatment, patient developed hypothyroidism and was prescribed levothyroxine. Patient is currently euthyroid and able to perform daily activities without episodes of PP for the next 6 years of follow up. Case 2 A 29-year-old male presented with severe exertional muscle weakness for 1.5 years. Symptoms worsened with exercise. He had no family history of any neurologic diseases. Physical examination: normal vitals, thyroid, muscle, and neurologic exam. Laboratory values: normal thyroid function, serum potassium, liver function, and creatine kinase. EMG showed decreased amplitude of the compound muscle action potential (CMAP), with reduced motor unit recruitment or electrical silence. Patient was prescribed propranolol 20mg. Genetic testing revealed CACNA1S mutation consistent with hypokalemic periodic paralysis. He was prescribed eplerenone and acetazolamide. He has displayed no new symptoms from exertion and continues to perform normal daily activities on the current regimen. Case 3 A 72-year-old male presented with episodes of flaccid paralysis that lasted several minutes. Patient reported each episode started about an hour after eating dinner. During one episode serum potassium was 3.2 mmol/L and his symptoms slowly resolved after receiving potassium. His medical history was notable for hyperlipidemia, hypertension and pre-diabetes. Vital signs revealed stage-1 hypertension. Physical examination during the episode was notable for weakness greater in the proximal muscles and hyporeflexia. Laboratory values with TSH 2.03 mcIU/mL and follow-up potassium level 4.3 mmol/L. He continues to perform normal daily activities without any PP symptoms for the next 9 years following the initial episode. Conclusion Limited information is available regarding the long-term follow up of patients diagnosed with PP. Our 3 patients illustrate a relatively benign long-term course with appropriate treatment. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

Open aortic reconstruction for middle aortic syndrome associated with right renal artery poststenotic aneurysm.

A 24-year-old woman was diagnosed with high blood pressure when she was 14 years old. During the last 4 years, she has experienced progressive symptoms of lower extremity weakness and fatigue and cannot do any heavy exercise. On physical examination, she presented with absent bilateral femoral pulses. Ultrasound ankle-brachial index (ABI) with Doppler of the lower extremities showed diffuse monophasic waveforms and diminished ABI bilaterally (right ABI = 0.68, left ABI = 0.65). A computed tomography angiography confirmed a severe narrowing of the aorta just distal to the origin of the left renal artery consistent with the diagnosis of middle aortic syndrome.

ODP208 Hypoglycemia as a Presenting Feature of McArdle's Disease

Abstract Introduction McArdle's disease (glycogen storage disease type V) is an autosomal recessive disease caused by mutations in the gene encoding for the muscle isoform of glycogen phosphorylase (PYGM). Characteristic symptoms include exercise intolerance, myalgia, muscle stiffness. Approximately half develop rhabdomyolysis, myoglobinuria, and renal failure. Hypoglycemia is an uncommon presenting symptom. Case report A 36-year-old male, previous college football athlete presented with jitteriness and blurry vision while exercising over the last one year. Symptoms occur 12-15 minutes into aerobic exercise. Fingerstick blood sugar during these episodes were as low as 30 mg/dl and afterwards the patient reported fatigue all day long. Consuming high carbohydrate foods and fluids supplemented with dextrose prior to exercise mitigate his symptoms. He reported no fasting hypoglycemia. Retrospectively, the patient reports that for years he noticed feeling fatigued a few minutes into starting exerice which improves after short periods of rest "second wind phenomenon." He can perform heavy resistance exercise like weightlifting but struggles with sustained aerobic activity. Past medical history is significant for HLA B27 positivity, alopecia areata and uveitis. Medications include multivitamin and creatine supplements. Physical exam revealed a healthy, well developed muscular individual with no other remarkable findings. Family history is significant for McArdle's disease in his brother, diagnosed at age 20 based on a muscle biopsy after multiple episodes of rhabdomyolysis. Grandfather had diabetes mellitus and pancreatic carcinoma. Labs revealed a creatine kinase (CK) level of 1638.7 U/L (49-397 U/L), CK-MB 49.1 ((0.1-5.9 ng/ml), 8 AM morning cortisol of 12.3 ug/dl (4.2-22.4 ug/dl), A1c 5.3%. There was no myoglobinuria. Thyroid function tests were within normal limits. Investigations done during an episode of exercise induced hypoglycemia - fingerstick blood sugar 44 mg/dl, plasma blood glucose 56 mg/dl(65-99 mg/dl), Insulin <0.5 mU/L(3-25mU/l), C-Peptide 0.5ng/ml(1.1-4.4ng/ml), Proinsulin 1.1 pmol/L(0-10. 0 pmol/L). Insulin autoantibody was negative. This ruled out exercise induced hyperinsulinemia. IGF-1 and IGF-2 levels were normal. Genetic study performed by the Glycogen Storage Disease Panel showed PYGM c.2262del (p. Lys754Asnfs*49), Pathogenic, PYGM c.1537A>G (p. Ile513Val), Uncertain Significance, PYGM c.833G>C (p. Arg278Pro), Uncertain Significance. Subsequently, the patient's brother underwent genetic testing, which confirmed the presence of all three before-mentioned PYGM variants. His father was found to carry the two variants of undetermined significance, suggesting that the patient and his brother inherited the pathogenic variant from their deceased mother. Discussion The patient's medical history, along with his personal and family's genetic findings were found to be consistent with McArdle's disease. Our patient's presentation is unique in that his exercise tolerance is much higher as compared to most individuals with McArdle's and his presenting complaint was hypoglycemia. Additionally, one of the variants of uncertain significance is likely to be recognized as pathogenic in the future. Presentation: No date and time listed

Getting Ready for Wound Certification: Factors Impeding Wound Healing.

Getting Ready for Wound Certification: Factors Impeding Wound Healing.

Neuromuscular and acute symptoms responses to progressive elastic resistance exercise in patients with chronic obstructive pulmonary disease: Cross-sectional study.

Quadriceps muscle training is a key part in the rehabilitation of chronic obstructive pulmonary disease (COPD) patients. However, exercise intensity prescription and progression with the typically used elastic bands is challenging. We aimed to evaluate neuromuscular, acute symptoms and cardiorespiratory responses (heart rate and dyspnea) during progressive elastic resistance exercise in patients with COPD. Fourteen patients diagnosed with moderate-very severe COPD performed knee extensions at different elastic resistance levels (i.e., colors). The neuromuscular activity was recorded using surface electromyography for the rectus femoris, vastus lateralis and vastus medialis, together with rate of perceived exertion, perceived quadriceps fatigue, dyspnea, oxygen saturation and heart rate. For the vastus lateralis and rectus femoris, increase of muscle activity was evident from a two-level increment when using the red color. For the vastus medialis, there were no muscle activity progressions. Dyspnea, quadriceps fatigue and especially rate of perceived exertion increased in a dose-response fashion and were correlated with the resistance level and muscle activity at the three muscles. Heavy elastic resistance exercise is feasible in COPD patients without excessive dyspnea and a stable cardiorespiratory response. In general, at least two elastic resistance increments are needed to enhance muscle activity for the vastus lateralis and rectus femoris, while there is no increase for the vastus medialis. These results may help to individualize exercise dosing during elastic resistance training in patients with COPD.

The relationship between nutrition, inflammation and colchicine resistance in familial Mediterranean fever

Aim: Familial Mediterranean fever (FMF) is an autoinflammatory and genetic disease associated with chronic inflammation. Colchicine is the gold standard treatment for FMF, although some patients respond partially. Factors such as heavy exercise, cold exposure, stress, recent infection or surgery have been associated with the occurrence of attacks. Recently, nutrition is thought to be involved in the pathogenesis of autoimmune and autoinflammatory diseases. Therefore, we aimed to investigate the relationship between nutrition, inflammation and colchicine resistance by considering the nutritional status of FMF patients.
 Material and Method: The study included 59 patients and 67 healthy individuals who were matched for gender, age and body mass index (BMI). Clinical, anthropometric, and biochemical measurements were obtained. Three-days, 24-hour diet records were recorded in the nutrient database program (BeBiS software program), the amounts of macro and micronutrient contents were determined and the Diet Inflammatory Index (DII) score was calculated and compared between groups.
 Results: Statistically, the diets of FMF patients were found to be higher in omega-6, carbohydrate percentage and salt content, and lower in terms of lactose, fat percentage, monounsaturated fatty acids, retinol and biotin compared to controls. There was no correlation between DII and acute phase reactants and colchicine dose.
 Conclusion: The course of FMF can be affected by environmental factors, as well as its genetic background. Nutrition is a new and interesting topic in this regard and may contribute to inflammation and disease activity in FMF patients.

A RARE CASE: CHEMOPORT TIP DISPLACEMENT FROM PERSISTENT VOMITING AND RETCHING

A RARE CASE: CHEMOPORT TIP DISPLACEMENT FROM PERSISTENT VOMITING AND RETCHING

S2032 Epiploic Appendagitis as an Uncommon Cause of Abdominal Pain

Introduction: Acute epiploic appendagitis (EA) is a self-limited inflammation of the appendices epiploicae. Epiploic, also known as omental, appendages are pouches that derive from the peritoneum. These appendages are made of adipose tissue and each appendage contains a venous and arterial supply. If torsion of the appendage occurs, occlusion of the vascular supply can lead to ischemia and may cause EA. Acute EA is associated with obesity, abdominal hernias, and heavy or unaccustomed exercise. EA management is supportive. The increased utilization of CT imaging for acute abdomen visits to emergency rooms nationwide has led to increased identification of this condition. Such radiographic diagnosis has obviated the need for unproven therapies such as antibiotics and surgery. Case Description/Methods: A 66-year-old male with past medical history of gastrointestinal stromal tumor status post small bowel resection presented to the emergency room complaining of epigastric abdominal pain of one day duration. The pain was constant, non-radiating, cramping, and awakened him from sleep. The patient rated the pain as 7/10 in intensity. The pain was not alleviated by acetaminophen use and was associated with 3 loose, non-bloody, non-mucoid bowel movements. A CT of the abdomen/pelvis showed an ovoid fat density area adjacent to the descending colon with a high-density rim and mild surrounding inflammatory fat stranding, suggestive of EA (Figure). He was treated with oral anti-inflammatory medications and discharged home. At follow-up one week later his abdominal pain had completely resolved. Discussion: This case illustrates that EA is not commonly considered in the differential for abdominal pain. Fortunately, this condition is easily diagnosed on CT imaging. With the rise of CT scan use in the work-up of acute abdominal pain, EA is easily identified and can be appropriately managed. Radiographically, acute EA is described as an oval-shaped mass lesion of fat density with a hyper-attenuating dense rim. EA is a self-limited and self-resolving condition. The treatment is oral anti-inflammatory medication with recovery expected within 10 days. There is no indication for antibiotics in acute EA. Correct diagnosis is meaningful to avoid unnecessary hospital stay. The importance in highlighting this case is that EA diagnosis is very unlikely in the absence of CT scanning due to lack of clinician awareness and uncommon nature of the disease. This case highlights the radiologic assessment of EA and its appropriate treatment.Figure 1.: Yellow arrow points to the hyper-enhancing dense rim of an oval-shaped lesion with fat density, indicative of acute EA.

Transient responses of melatonin to stress

Melatonin and its metabolites are ubiquitous antioxidants that are produced
 in response to reactive oxygen species (ROS) in virtually all cells of the
 body. The highest reported melatonin values in plasma and sweat occur during
 heavy exercise both indoors and outdoors during the day. The advent of sweat
 biosensors with sufficient melatonin sensitivity provides pseudo real-time
 evidence that melatonin is produced throughout the body not just in the pineal
 gland. The role of the pineal gland appears to be to provide cyclic production
 of melatonin for the regulation of circadian rhythms as well as supplemental melatonin
 during periods of low cellular activity. 
 Melatonin from the pineal gland represents only a small fraction of the
 body’s production capacity. Greater than 5 pg/ml min ramp rates for plasma and
 sweat melatonin have been reported during strenuous exercise in sunlight as
 compared to 0.15 pg/ml min ramp rates for plasma melatonin under dim light
 melatonin onset (DLMO) conditions. Sunlight
 and exercise, like fever, generates transient elevated levels of ROS in tissues
 with time constants measured in minutes or even seconds making this systemic
 antioxidant response potentially protective. Based on a simple accounting of
 ROS generated by sunlight, ROS we breathe, ROS we drink, and exercise, it
 appears that the body maintains a heightened basal level of ROS as part of its
 pathogen defense mechanisms. Current
 human lifestyles and modern enclosed spaces have substantially eliminated over
 90% of the ROS which undermines one of the body’s primary defenses. With
 advanced age, the inability to maintain this protective barrier appears to make
 us more susceptible to disease.

The Effect of Heavy Exercise on Plasma Lipid Levels in Elite Volleyball Male Athletes

It is known that physical activity plays a cardioprotective role. Various types of physical exercise have positive effects on the plasma lipid panel, which generally indicates the risk of cardiovascular disease. The aim of this study is to examine the plasma lipid levels of elite volleyball players who trained heavily for 10 weeks. Male elite volleyball athletes voluntarily participated in the study, who are healthy and between the ages of 18-35 (n=18). Body mass index (BMI) values were calculated by measuring the weight and height of all athletes participating in the study before and after heavy exercise. Before and after the heavy exercise program, blood plasma samples were taken from the athletes for biochemical and hematological analyzes. When the plasma values of the athletes were compared before and after exercise, no statistically significant difference was found (p>0.05). It was determined that the total cholesterol (TC) value in the plasma lipid panel of the athletes after heavy exercise decreased (p

Cold air exposure at − 15 °C induces more airway symptoms and epithelial stress during heavy exercise than rest without aggravated airway constriction

PurposeExposure to cold air may harm the airways. It is unclear to what extent heavy exercise adds to the cold-induced effects on peripheral airways, airway epithelium, and systemic immunity among healthy individuals. We investigated acute effects of heavy exercise in sub-zero temperatures on the healthy airways.MethodsTwenty-nine healthy individuals underwent whole body exposures to cold air in an environmental chamber at − 15 °C for 50 min on two occasions; a 35-min exercise protocol consisting of a 5-min warm-up followed by 2 × 15 min of running at 85% of VO2max vs. 50 min at rest. Lung function was measured by impulse oscillometry (IOS) and spirometry before and immediately after exposures. CC16 in plasma and urine, and cytokines in plasma were measured before and 60 min after exposures. Symptoms were surveyed pre-, during and post-trials.ResultsFEV1 decreased after rest (− 0.10 ± 0.03 L, p < 0.001) and after exercise (− 0.06 ± 0.02 L, p = 0.012), with no difference between trials. Exercise in − 15 °C induced greater increases in lung reactance (X5; p = 0.023), plasma CC16 (p < 0.001) as well as plasma IL-8 (p < 0.001), compared to rest. Exercise induced more intense symptoms from the lower airways, whereas rest gave rise to more general symptoms.ConclusionHeavy exercise during cold air exposure at − 15 °C induced signs of an airway constriction to a similar extent as rest in the same environment. However, biochemical signs of airway epithelial stress, cytokine responses, and symptoms from the lower airways were more pronounced after the exercise trial.

Moderate Intensity Arm Cycling As A Viable Exercise Alternative For Overfat And Obese Individuals

The prescription of aerobic exercise engaging the arms may extend the reach of physical activity and improve cardiorespiratory fitness in individuals with obesity. PURPOSE: This study compared the acute cardiopulmonary responses obtained during isocaloric arm and leg cycling trials performed at different intensities among individual’s with and without excess body fat. METHODS: Participants were 37 young adults divided into two groups based on their fat mass index, lean and average (LA) and overfat and obese (OFO). They were tested for mode-specific work rate at the ventilatory threshold (VT) and volitional fatigue (VF) during two randomized ramp tests. The main experiments consisted of four randomized constant work rate isocaloric trials for arm and leg cycling performed at moderate (i.e., work rate equivalent to 80% of VT obtained during the ramp tests) and heavy (i.e., work rate equivalent to 30% of the difference between VT and VF obtained during the ramp tests). The time to expend 100 kcal (Tkcal100) was recorded, and oxygen uptake (V̇O2) was averaged for the duration of the tests. A two-way mixed factorial ANCOVA with physical activity level as a covariate determined work rate at VT, and V̇O2 peak responses to the ramp tests. A three-way mixed factorial ANCOVA with the mode-specific fitness difference and physical activity level as covariates were run for Tkcal100 and V̇O2 obtained during isocaloric trials. Cohen’s d were calculated and interpreted with magnitude thresholds and significance level was set at p ≤ 0.05. RESULTS: Significantly lower work rates at VT and V̇O2 peak were shown for the OFO during ramp tests (LA: 43.4 ± 1.9%, OFO: 37.6 ± 1.9%). Tkcal100 was significantly longer for OFO (25 ± 2 min) in comparison to LA (21 ± 1 min) during isocaloric trials (d = 0.36). The V̇O2 responses were significantly greater in leg cycling (20.4 ± 1.3 mL/min/kg) than arm cycling (15.5 ± 1.3 mL/min/kg), while effect sizes were larger during heavy exercise (d = 1.45) compared to moderate (d = 1.13). CONCLUSION: Arm cycling performed at moderate intensity could be an alternative for young adults with excess body fat and poor cardiorespiratory fitness since this exercise modality elicited a sufficient metabolic response above three metabolic equivalents, which is within the moderate intensity domain suggested by current guidelines.

Effect Of Exercise-specific Mask On Respiratory Function In Athletes With And Without Exercise Induced Bronchoconstriction

PURPOSE: Heavy ventilation is a known factor in exercise induced bronchoconstriction (EIB), leading to airway hyperresponsiveness in endurance athletes over time. How an exercise-specific mask designed for heavy ventilation affects EIB status and overall respiratory function following intense exercise is not well studied. Thus, we aimed to determine the effect of an exercise-specific facemask on airway function post-exercise in athletes with and without EIB at a normal indoor temperature. METHODS: Male (n=13) and female (n=7) athletes underwent two separate graded exercise tests to fatigue on a treadmill at 20 °C (20-40 % RH) while wearing an exercise-specific mask in one test (M) and unmasked (UM) in the other. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), forced expiratory flow at 25-75% (FEF25-75), and forced expiratory flow at 50% (FEF50) were measured pre and at 3,6,10,15, 20, & 30 min post-exercise. Participants with a >10% reduction in FEV1 post-exercise (EIB+), those with an FEV1 reduction not meeting the threshold for EIB+ (EIB suspect), and participants without EIB (EIB-) were compared. RESULTS: Overall (n = 20) percentage of baseline post-exercise was improved (p>0.05) in the M condition compared to the UM condition for FEV1 (92.8 vs 92.1), FVC (91.4 vs 90.6), PEF (93.3 vs 87.2), FEF25-75 (93.5 vs 88.3) and FEF50 (93.3 vs 87.7). When EIB+ (n=3) and EIB- (n=12) subjects were compared, the magnitude of the difference in the M condition was smaller than that of the UM condition for all spirometry measures except for PEF. The magnitude of these differences between EIB+ and EIB- in the UM condition was reduced the most in the M condition for FEF50 (26.6% UM vs 11.0% M) and FEF25-75 (30.0% UM vs 20.4% M). The face mask reduced the absolute drop in FEV1 post-exercise in 67% of EIB+ subjects, 40% of EIB suspect subjects, and 42% of EIB- subjects. CONCLUSIONS: Wearing an exercise-specific mask attenuates reductions in respiratory function post-exercise in EIB+ participants. However, EIB suspect and EIB- athletes may also benefit from wearing a mask designed for heavy ventilation exercise. To fully understand the protective benefits of a mask in high ventilation athletes, provocation tests with post-exercise spirometry in both M and UM conditions should be performed.

Long-term Heavy Exercise Impairs The Self-renewal Ability Of Muscle Stem Cells

Long-term Heavy Exercise Impairs The Self-renewal Ability Of Muscle Stem Cells

ENJOYMENT AND PLEASURE RESPONSES FOR VARIED COOL-DOWN DURATIONS

PURPOSE: Assess the impact of cool-down duration with and without autonomy for selecting duration on perceptions of pleasure and enjoyment both immediately and 24 hours after exercise. METHODS: 12 participants (6 females, 6 males; BMI = 24 + 4; age = 23 + 6) completed 4 continuous, intense exercise trials after maximal exercise testing. All trials included a 2-minute warm-up followed by 20 minutes of continuous heavy exercise 10% above ventilatory threshold. Sessions were identical except for cool-down duration (1-minute, 5-minutes, 10-minutes), with an additional session allowing for self-selection of cool-down duration. Variables of interest were remembered pleasure, forecasted pleasure, and enjoyment. RESULTS: Repeated measures ANOVA revealed no differences in remembered pleasure, forecasted pleasure post exercise and forecasted pleasure 24 hours post exercise between trials (p = .883, .675, and .540). There also were no differences in enjoyment post exercise (p = .849). Exploratory analysis of effect size differences revealed relatively small differences (Cohen’s d < .2). CONCLUSIONS: Findings suggest pleasure-related responses are not significantly impacted by cool-down duration or the provision of autonomy. These preliminary findings support the perspective that responses during the recovery are secondary to the experiences of the main session of exercise. Data collection is ongoing and analysis of a larger sample may yield different outcomes, but findings at this point suggest cool-down duration is not an important consideration from a psychological perspective in the construction of exercise recovery.

Changes In Splanchnic Blood Flow And Blood Pressure During Inspiratory Resistive Breathing

PURPOSE: The hyperpnea during whole-body heavy exercise leads to an increase in respiratory muscle work, which is associated with cardiovascular regulations during exercise (i.e., respiratory muscle metaboreflex). In resting condition, blood flow to inactive limbs is reduced with inspiratory resistive breathing. Furthermore, increasing the work of breathing during dynamic exercise influences inactive limb blood flow. Therefore, it is conceivable that the respiratory muscle-induced metaboreflex is associated with blood flow redistribution during exercise. Redistribution of blood flow is also associated with splanchnic blood flow as well as inactive blood flow. However, influence of respiratory muscle metaboreflex on splanchnic blood flow in humans remains unknown. We hypothesized that blood flow to splanchnic organs would reduce via respiratory muscle-induced metaboreflex. METHODS: Ten healthy young men (20.2 ± 0.4 yrs, mean ± SE) performed two voluntary hyperventilation tests (tidal volume of 40% of vital capacity, a breathing frequency of 40 breaths/min and inspiratory duty cycle of 50%). One trial was voluntary hyperventilation with inspiratory resistance (about 40% of maximal inspiratory pressure), and the trial was terminated when the subject could not maintain the target ventilation (the resistance trial), and the other one was voluntary hyperventilation without inspiratory resistance until the same time as the resistance trial (the non-resistance trial). During trials, mean arterial blood pressure (MAP) was measured using finger photoplethysmography, and celiac artery blood flow was recorded by Doppler ultrasonography. RESULTS: MAP increased progressively and was higher (P < 0.05) in the resistance trial (100.5 ± 4.4 mmHg) than in the non-resistance trial (92.8 ± 2.0 mmHg) at the end of trial. Celiac artery blood flow decreased gradually from baseline value in the resistance trial (469.3 ± 47.6 mL/min), whereas did not change in the non-resistance trial (605.7 ± 56.2 mL/min). Celiac artery vascular conductance was lower in the resistance trial (4.8 ± 0.6 mL/min/mmHg) than in the non-resistance trial (6.6 ± 0.6 mL/min/mmHg, P < 0.05). CONCLUSIONS: These results suggest that increasing work of breathing affects the splanchnic circulation, via respiratory muscle-induced metaboreflex.

Use of High-Dose Androgens Is Associated with Reduced Brain-Derived Neurotrophic Factor in Male Weightlifters

Introduction: Use of high-dose androgens causes drastic changes in hormonal milieu and is associated with adverse medical, psychological, and cognitive effects. Brain-derived neurotrophic factor (BDNF), a member of the neurotrophin family of growth factors plays a critical role in neuroplasticity, with implications for cognitive function and mental health. The impact of long-term, high-dose androgen use on BDNF in a natural setting has not been investigated. This study examined the association between long-term androgen exposure and BDNF levels, and the links between BDNF, heavy resistance exercise, hormones, androgens, and mental health. Methods: We measured serum levels of BDNF and sex steroid hormones in male weightlifters (N = 141) with a history of current (n = 59), past (n = 29), or no (n = 52) androgen use. All participants completed questionnaires assessing maximum strength and measures of anxiety and depression. Group differences in BDNF were tested using general linear models adjusting for age and associations between BDNF and strength, anxiety, and depression using Pearson’s or Kendall’s correlations. Results: Both current (mean: 44.1 ng/mL [SD: 12.7]) and past (39.5 ng/mL [SD: 13.9]) androgen users showed lower serum BDNF levels compared to nonusing controls (51.5 [SD: 15.3], p < 0.001, ηp² = 0.10). BDNF levels were negatively related to maximal strength, and with hormonal status in past androgen users, but no significant associations were found with measures of depression and anxiety. Conclusion: Lower circulating BDNF concentrations in current and past androgen users suggest that high-dose androgen exposure triggers persistent changes in BDNF expression. Further studies are needed to verify the relationship and its potential clinical implications.

Efficacy of interval exercise training to improve vascular health in sedentary postmenopausal females.

BackgroundMenopause represents a turning point where vascular damage begins to outweigh reparative processes, leading to increased cardiovascular disease (CVD) risk. Exercise training reduces CVD risk in postmenopausal females via improvements in traditional risk factors and direct changes to the vasculature. We assessed the effect of moderate (MODERATE‐IT) versus heavy (HEAVY‐IT) intensity interval exercise training upon markers of cardiovascular health and vascular repair in postmenopausal females.MethodsTwenty‐seven healthy postmenopausal females (56 ± 4 yr) were assigned to 12 weeks of either MODERATE‐IT or HEAVY‐IT, twice per week. MODERATE‐IT consisted of 10s work, and 10s active recovery repeated for 30 min. HEAVY‐IT comprised 30s work, and 30s active recovery repeated for 21 ± 2 min. Endothelial function (flow‐mediated dilation), arterial stiffness (pulse wave velocity), and V̇O2peak were assessed pre‐training and post‐training. Blood samples were obtained pre‐training and post‐training for enumeration of circulating angiogenic cells (CACs), culture of CACs, and lipoprotein profile.ResultsV̇O2peak increased 2.4 ± 2.8 ml/kg/min following HEAVY‐IT only (p < 0.05). Brachial blood pressure and endothelial function were unchanged with exercise training (p > 0.05). Peripheral pulse wave velocity reduced 8% with exercise training, irrespective of intensity (p < 0.05). Exercise training had no effect on lipoprotein profile or endothelin‐1 (p > 0.05). CAC adhesion to vascular smooth muscle cells (VSMC) increased 30 min post plating following MODERATE‐IT only (p < 0.05).ConclusionsHEAVY‐IT was more effective at increasing V̇O2peak in postmenopausal females. The ability of CACs to adhere to VSMC improved following MODERATE‐IT but not HEAVY‐IT. Interval training had the same effect on endothelial function (no change) and arterial stiffness (reduced), regardless of exercise intensity.

The Effect of Endurance Training on Pulmonary V˙O2 Kinetics in Solid Organs Transplanted Recipients.

Background: We investigated the effects of single (SL-ET) and double leg (DL-ET) high-intensity interval training on O2 deficit (O2Def) and mean response time (MRT) during square-wave moderate-intensity exercise (DL-MOD), and on the amplitude of O2p slow component (SCamp), during heavy intensity exercise (DL-HVY), on 33 patients (heart transplant = 13, kidney transplanted = 11 and liver transplanted = 9). Methods: Patients performed DL incremental step exercise to exhaustion, two DL-MOD tests, and a DL-HVY trial before and after 24 sessions of SL-ET (n = 17) or DL-ET (n = 16). Results: After SL-ET, O2Def, MRT and SCamp decreased by 16.4% ± 13.7 (p = 0.008), by 15.6% ± 13.7 (p = 0.004) and by 35% ± 31 (p = 0.002), respectively. After DL-ET, they dropped by 24.9% ± 16.2 (p < 0.0001), by 25.9% ± 13.6 (p < 0.0001) and by 38% ± 52 (p = 0.0003), respectively. The magnitude of improvement of O2Def, MRT, and SCamp was not significantly different between SL-ET and DL-ET after training. Conclusions: We conclude that SL-ET is as effective as DL-ET if we aim to improve O2p kinetics in transplanted patients and suggest that the slower, O2p kinetics is mainly caused by the impairment of peripherals exchanges likely due to the immunosuppressive medications and disuse.

Mask Use for Athletes: A Systematic Review of Safety and Performance Outcomes.

With the current Centers for Disease Control and Prevention recommendations for mask use to minimize transmission of coronavirus 2019 (COVID-19) coupled with concern for future pandemics that would require mask wearing, providing data-driven guidance with respect to athletic performance is essential. The purpose of this study was to perform a systematic review of existing literature on the use of face masks while exercising to assess the physiologic effects of face masks worn during athletic activities. A systematic review was conducted of studies on face mask use during exercise according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Potential studies were identified through searches of MEDLINE, Embase, Cochrane CENTRAL and CINAHL databases. Screening was completed independently by 2 coauthors who sought to identify studies that described the effects of oronasal mask use, if any, on sports/exercise/physical activity, for any age, gender, or level of sport. Articles describing mask effects without exercise, articles published before 1980, and non-English language studies were excluded. Systematic review. Level 3. Data extraction focused on physiologic parameters measured during physical activity performed while wearing a face mask. Twenty-two articles met all inclusion criteria. Study analysis revealed that the use of masks in healthy volunteers during exercise had no significant effect on physiologic parameters measured including heart rate (HR), respiratory rate (RR), oxygen saturation, and perceived exertion. Of the studies that investigated N95 masks in the healthy adult population, 2 reported modest changes in RR and maximum power output indicative of decreased athletic performance when subjects were exercising at maximum effort. Similar findings were seen in studies of subpopulations including children and pregnant women. Available data suggest that healthy individuals can perform moderate-to-vigorous exercise while wearing a face mask without experiencing changes in HR, RR, and oxygen saturation that would compromise individual safety or athletic performance. In the specific situation in which an N95 mask is worn, maximum power generated may be impaired. To date, there has been no systematic review of the existing literature to provide a clear consensus on whether face mask use significantly impacts athletic performance. Mask use has been demonstrated safe in the workplace; however, the use of face masks during exercise has not been examined on a large scale, particularly with respect to physiologic parameters. This analysis highlights that available data suggest that healthy individuals can perform heavy exercise in face masks with minimal physiologic changes. This is the first systematic review of studies analyzing exercise use wearing masks. With the evidence presented here commonly cited concerns about both safety and performance decrements with mask use during physical activities may be allayed.