Percentage Of Baseline Values Research Articles

The Amplitude of Diaphragm Compound Muscle Action Potential Correlates With Diaphragmatic Excursion on Ultrasound and Pulmonary Function After Supraclavicular Brachial Plexus Block.

ObjectiveThis prospective, double-blind, randomized study assessed (1) the associations between diaphragm compound muscle action potential (CMAP), hemidiaphragmatic excursion, and pulmonary function after supraclavicular brachial plexus block (SCBPB) and (2) diagnostic efficacy of pulmonary function for hemidiaphragmatic paralysis evidenced by diaphragm CMAP as an assessment of diaphragm strength was evaluated.MethodsEighty-six patients were scheduled for the removal of hardware after healing of a right upper limb fracture distal to the shoulder who were randomly assigned in a 1:1 ratio to two groups: Group A (diaphragmatic excursion), or Group B (pulmonary function). Phrenic nerve conduction studies (PNCSs), M-mode ultrasonography of the diaphragm, and pulmonary function tests (PFTs) were performed before and 30 min after SCBPB. PNCSs were used to determine the latency and amplitude of diaphragm CMAP. Ultrasonography of the diaphragm was performed with patients in a supine position using a low-frequency probe over the subcostal space at the midclavicular line. The diaphragmatic excursion was measured during quiet breathing and deep breathing. Pulmonary function, i.e., forced vital capacity (FVC), predicted value of FVC, and forced expiratory flow in the first second (FEV1), was measured with spirometry. Receiver Operating Characteristic (ROC) curve analysis was used to assess the diagnostic efficacy of pulmonary function for hemidiaphragmatic paralysis evidenced by diaphragm CMAP as an assessment of diaphragm strength.ResultsThere were significant associations between the reduction in amplitude of diaphragm CMAP and reductions in diaphragmatic excursion during quiet breathing (r = 0.70, p < 0.01) and deep breathing (r = 0.63, p < 0.01) when expressed as a percentage of baseline values. There were significant associations between the reduction in amplitude of diaphragm CMAP and reductions in FVC (r = 0.67, p < 0.01), FVC% (r = 0.67, p < 0.01), and FEV1 (r = 0.62, p < 0.01), when expressed as percentage of baseline values. The area under the ROC curve for FVC was 0.86. A decrease of >8.4% in FVC compared to pre-block predicted hemidiaphragmatic paralysis (determined by diaphragm CMAP) with sensitivity and specificity of 79.2 and 100%, respectively.ConclusionsThe relative reduction in diaphragm CMAP amplitude after SCBPB was correlated with relative reductions in diaphragmatic excursion and pulmonary function. FVC has potential as a useful diagnostic indicator of hemidiaphragmatic paralysis, evidenced by diaphragm CMAP, after SCBPB. These data establish diaphragm CMAP as a direct and objective index of diaphragmatic paralysis after SCBPB.

Low-dose Droperidol Reduces the Amplitude of Transcranial Electrical Motor-evoked Potential: A Randomized, Double-blind, Placebo-controlled Trial.

Low-dose droperidol has been reported to suppress the amplitude of transcranial electrical motor-evoked potentials (TCE-MEPs), but no randomized controlled trials have been conducted to assess this. This randomized, double-blinded, placebo-controlled trial aimed to test the hypothesis that low-dose droperidol reduced TCE-MEP amplitudes. Twenty female patients with adolescent idiopathic scoliosis, aged between 12 and 20 years, and scheduled to undergo corrective surgery were randomly allocated to receive droperidol (20 µg/kg) or 0.9% saline. After recording baseline TCE-MEPs, the test drug was administered, following which TCE-MEP recordings were carried out every 2 minutes for up to 10 minutes. The primary outcome was the minimum relative TCE-MEP amplitude (peak-to-peak amplitude, percentage of baseline value) recorded in the left tibialis anterior muscle. Secondary outcomes included minimum relative MEP amplitudes recorded from all other muscle groups monitored in the study. Data are expressed as medians (interquartile range). The TCE-MEP amplitude of the left tibialis anterior muscle was significantly reduced following droperidol administration compared with saline (37% [30% to 55%] vs. 76% [58% to 93%], respectively, P <0.01). In the other muscles, the amplitudes were reduced in the droperidol group, except for the bilateral abductor pollicis brevis and the left quadriceps femoris muscles. The relative amplitude of the bilateral F waves recorded from the gastrocnemius was decreased in the droperidol group. Low-dose droperidol (20 µg/kg) reduced TCE-MEP amplitudes. Anesthesiologists should pay attention to the timing of droperidol administration during intraoperative TCE-MEP recordings, even if used in a low dose.

The Impact Of Head And Neck Cancer Radiotherapy On Salivary Flow And Quality Of Life: Results Of The OraRad Study

Xerostomia is a common long-term side effect of head and neck cancer (HNC) radiotherapy (RT) and can negatively impact patient quality of life (QOL). The OraRad study (NCT02057510) is the largest prospective study to date examining dental and other outcomes in patients receiving HNC RT. Here, we present our results on the longitudinal impact of RT on salivary flow and its association with patient-reported outcomes. Prospective cohort study of 572 patients receiving curative intent (definitive or postoperative) RT for head and neck cancer. Stimulated whole salivary flow rates and patient-reported outcomes (subset of EORTC HN35) were measured prior to RT and at 6- and 18-months post-RT. Linear mixed effects models with subject specific intercepts were used to examine the relationship between change in salivary flow, expressed as percentage of baseline value, and change in patient-reported outcomes. 422 patients completed salivary flow measurements at all 3 timepoints. Baseline median stimulated salivary flow rate (interquartile range, IQR) was 0.975 (0.769) g/min. Diminished flow was observed at 6 months post-RT (0.357 g/min, IQR = 0.450 g/min) with subsequent partial recovery at 18 months (0.575 g/min, IQR = 0.545 g/min). Diminished salivary flow was associated with patient-reported dysphagia with liquids (p = 0.04), pureed (p = 0.005) and solid foods (p≤0.001), and problems with taste (p = 0.006). Head and neck radiotherapy diminishes salivary flow with resultant negative impact on patient quality of life. Salivary flow nadirs after RT, with subsequent improvement over time (but only to about 40% of baseline). Future efforts to lower doses to salivary glands, whether via novel methods of conformal RT delivery or via dose and volume reduction, need to be considered as a means to improve long-term outcomes and quality of life.

Baroreflex Control of Renal Sympathetic Nerve Activity and Renal Responses to Volume Expansion Following Intermittent Hypoxia in Rats

The baroreceptor reflex provides negative‐feedback control to reduce blood pressure fluctuations. Dysfunction of the baroreflex was reported in hypertension disease models that involve kidney injury. This study investigated the high‐ and low‐pressure baroreflex control of renal sympathetic nerve activity (RSNA), in addition to renal diuretic and natriuretic responses to volume expansion (VE) in rats exposed to intermittent hypoxia (IH). Wistar rats were exposed to IH (210 sec at 21% O2 and 90 sec at 6% O2, 12 cycles/hr, n=9) or to normoxia (sham, 21% O2, n=8) for 14 days. On day 15, rats were anaesthetized (induction: urethane, α‐chloralose and sodium pentobarbitone mixture i.p. (416, 27 and 33mg/kg), maintenance: urethane and α‐chloralose mixture i.v.) and prepared to record cardiovascular parameters and RSNA, and measure renal sodium and water excretory function. High‐pressure baroreflex was assessed using i.v. injections of phenylephrine and sodium nitroprusside (50μg/kg/min) to induce blood pressure changes. RSNA was calculated as a percentage of baseline values and plotted against mean arterial blood pressure. Low‐pressure baroreflex was studied using two successive VE challenges (0.25ml saline/100g body weight/min for 30min i.v.) during which saline or capsaizepine (CPZ, 5μg/ml/hr), a TRPV1 blocker were infused intra‐renally and the RSNA sympatho‐inhibitory response was recorded. Urine samples were collected to measure urine flow rate (UFR) and absolute Na + excretion (UNa+). Data are expressed as mean±SD and analyzed using t‐test or ANOVA where relevant. IH rats had higher blood pressure (97±11 vs. 84±9 mmHg) and RSNA to maximum RSNA ratio (0.36±0.15 vs. 0.17±0.07, all p&lt;0.05), compared with sham. The slope (sensitivity) of the baroreflex gain curve of RSNA was smaller (0.09±0.05 vs. 0.29±0.27 a.u./mmHg, p=0.016) while the operating pressure was greater (129±14 vs. 109±6 mmHg, p=0.005) in IH rats compared with sham. VE decreased RSNA during the 30 min period from baseline to an equivalent extent (−35%) in sham and IH groups. However, VE‐induced increase in UFR (p=0.015) and UNa+ (p=0.02) was blunted after 30 min of VE challenge in IH rats compared with sham. This was revealed by a decrease in the area under UFR (5875±1574 vs. 9785±2714 ml/kg, p=0.002) and UNa+ (467±120 vs. 655±249 μmol, p=0.062) curves of IH rats compared with sham. Intra‐renal CPZ increased UFR (AUC; IH, 9868±4098 vs. sham, 10157±4081 ml/kg) and UNa+ (AUC, IH, 612±217 vs. sham, 721±223 μmol) in the IH group to comparable levels of sham. This was associated with potentiation of RSNA sympatho‐inhibition response to VE by 54% (p&lt;0.05) in both groups. There was no evidence of oxidative stress or inflammation in IH kidneys. These findings suggest that moderate IH exposure blunts baroreflex regulation of RSNA. Renal diuretic and natriuretic responses to VE were perturbed by IH exposure although low‐pressure baroreflex control of RSNA was preserved. TRPV1 blockade restored the blunted excretory response to VE in IH rats.

Оцінка посухостійкості сортів порічок (Ribes vulgare L.) методом визначення електропровідності тканин

Red and white currants are characterized with the high adaptability to growing conditions such as soils, temperatures in the cold season, insolation. However, the important factor influencing the formation of high quality crop is the water regime. The climate of Ukraine is changing, that causes an uneven distribution of temperatures and precipitations during the growing season. As a result, there are periods of prolonged droughts with temperatures above +35 °С. In such periods, are observed the appearance of the sun-burn spots on the leaves and berries mass loss and as well loss of 50 % of the crop due to fruit falling. Therefore, it is important to establish experimentally the level of the red and white currants drought-resistance in order to create industrial plantations in the Western Lisosteppe of Ukraine. The research was conducted at the Institute of Horticulture (NAAS) in the red and white currants plantations in 2010-2012 and 2018. The objects of the investigation were 18 varieties and 4 promising hybrid forms. For studying the vs drought-resistance, leaves were selected from the annual shoots in the most drought periods of June and July. The relative electrical conductivity and its change were determined by means of the conductivity meter E 7-13. The measurements were carried out after 1 and 4 hours of exposure of the diffused sunlight. The electrical conductivity changes were determined as a percentage of baseline values. The analysis of the obtained data shows that electrical conductivity level of the red and white currant leaf apparatus at the beginning of the exposure and dynamics reduction of this indicator has a clear varietal specificity and can be used successfully to diagnose the plants` state in the plantations in droughty periods. The results of the stimulated drought enable to divide the 22 studied objects according to the results into several groups that differ concerning the drought resistance level. Thus, the significant resistance to drought potential is characteristic of the variety Svyatomykhailivska and hybrid form 85-1-5. The vs and hybrid forms Baiana, Dar Orla, Darnytsia, Rosynka, Uliublena, Svitlytsia, Uralskaia Belaia, 85-6-25, 83-28-9, 85-1-5 are drought-resistant. Bielka, Vatra, Gazelle, Dana, Orlovskaia Zviezda, Vyborova, Lasunia and Asia are medium drought-resistant.

Dissociated time course between peak torque and total work recovery following bench press training in resistance trained men

ObjectiveTo evaluate the time course of peak torque and total work recovery after a resistance training session involving the bench press exercise. DesignRepeated measures with a within subject design. MethodsTwenty-six resistance-trained men (age: 23.7±3.7years; height: 176.0±5.7cm; mass: 79.65±7.61kg) performed one session involving eight sets of the bench press exercise performed to momentary muscle failure with 2-min rest between sets. Shoulder horizontal adductors peak torque (PT), total work (TW), delayed onset muscle soreness (DOMS) and subjective physical fitness were measured pre, immediately post, 24, 48, 72 and 96h following exercise. ResultsThe exercise protocol resulted in significant pectoralis major DOMS that lasted for 72h. Immediately after exercise, the reduction in shoulder horizontal adductors TW (25%) was greater than PT (17%). TW, as a percentage of baseline values, was also less than PT at 24, 48 and 96h after exercise. Additionally, PT returned to baseline at 96h, while TW did not. ConclusionsResistance trained men presented dissimilar PT and TW recovery following free weight bench press exercise. This indicates that recovery of maximal voluntary contraction does not reflect the capability to perform multiple contractions. Strength and conditioning professionals should be cautious when evaluating muscle recovery by peak torque, since it can lead to the repetition of a training session sooner than recommended.

Postoperative Edema Resolution following Rhinoplasty: A Three-Dimensional Morphometric Assessment.

The final result of rhinoplasty may be masked for several months after surgery because of postoperative edema; however, no objective evidence supports this time estimate. The purpose of this study was to three-dimensionally quantify the decrease in postsurgical nasal edema following rhinoplasty over the first postoperative year. This was a retrospective, three-dimensional, morphometric study of primary, open rhinoplasty patients. Subjects with at least three postoperative three-dimensional images up to 1 year were included. Patients were excluded for closed or secondary procedures or cleft deformities. Images were assessed using three-dimensional stereophotogrammetry (Vectra) and volumetric analysis (Geomagic). Baseline nasal volume (time 0) occurred at the first postoperative visit at 1 to 2 weeks. All subsequent nasal volume measurements were calculated as a percentage of baseline values. Data points from all patients were pooled, and a six-point moving average was used to create an inverse function line of best fit. Forty patients were included, with 146 three-dimensional photographs quantified. The equation for the inverse function line of best fit of the six-point moving average was y = 1.484 (1/x) + 0.844 (R = 0.85, p < 0.01). According to this equation, approximately two-thirds of edema resolves within the first month, 95 percent after 6 months, and 97.5 percent after 1 year. A plateau is reached at 84.4 percent of the original postoperative volume. This study provides quantitative evidence to predict decrement of rhinoplasty edema with time. Three-dimensional morphometric assessment demonstrated a two-thirds decrease in edema at 1 month, a 95 percent decrease at 6 months, and a 97.5 percent decrease at 1 year. Therapeutic, IV.

Overexpression of cyclic adenosine monophosphate effluent protein MRP4 induces an altered response to β-adrenergic stimulation in the senescent rat heart.

In the senescent heart, the positive inotropic response to β-adrenoceptor stimulation is reduced, partly by dysregulation of β1- and β3-adrenoceptors. The multidrug resistance protein 4 (MRP4) takes part in the control of intracellular cyclic adenosine monophosphate concentration by controlling its efflux but the role of MRP4 in the β-adrenergic dysfunction of the senescent heart remains unknown. The β-adrenergic responses to isoproterenol were investigated in vivo (stress echocardiography) and in vitro (isolated cardiomyocyte by Ionoptix with sarcomere shortening and calcium transient) in young (3 months old) and senescent (24 months old) rats pretreated or not with MK571, a specific MRP4 inhibitor. MRP4 was quantified in left ventricular homogenates by Western blotting. Data are mean ± SD expressed as percent of baseline value. The positive inotropic effect of isoproterenol was reduced in senescent rats in vivo (left ventricular shortening fraction 120 ± 16% vs. 158 ± 20%, P < 0.001, n = 16 rats) and in vitro (sarcomere shortening 129 ± 37% vs. 148 ± 35%, P = 0.004, n = 41 or 43 cells) as compared to young rats. MRP4 expression increased 3.6-fold in senescent compared to young rat myocardium (P = 0.012, n = 8 rats per group). In senescent rats, inhibition of MRP4 by MK571 restored the positive inotropic effect of isoproterenol in vivo (143 ± 11%, n = 8 rats). In vitro in senescent cardiomyocytes pretreated with MK571, both sarcomere shortening (161 ± 45% vs. 129 ± 37%, P = 0.007, n = 41 cells per group) and calcium transient amplitude (132 ± 25% vs. 113 ± 27%, P = 0.007) increased significantly. MRP4 overexpression contributes to the reduction of the positive inotropic response to β-adrenoceptor stimulation in the senescent heart.

More on Current Evidences on Probiotics as a Novel Treatment for Non-Alcoholic Fatty Liver Disease

Dear Editor, In their recent article Kelishadi et al. (1) analyzed in a clear and concise way a number of key aspects of obesity-related NAFLD, deepening in particular the role of gut microflora and its potential therapeutic modulation by probiotics. From their paper it is apparent that most promises still derive from a relevant number of studies conducted in different NAFLD animal models. When interpreting data obtained in these models one should however remind that other factors like physical activity, social and chemical environment, psychological stress factors and genetics are also important contributors to the development of human NAFLD and to its incredible resistance to treatments as well (2). In this respect Dr. Kelishadi and colleagues' review of four available clinical trials on human population is therefore particularly welcomed. In three studies probiotic treatments appear to improve somehow NAFLD related parameters. The fourth study, published in 2008 by doctor Diehl’s group, instead warned versus probiotics treatment of NAFLD, reporting that steatosis measured by proton magnetic resonance spectroscopy increased in three out of four patients treated with VSL#3 for 4 months (3). In addition to these meagre evidences, in recent times, Malguarnera et al. showed in histologically monitored NAFLD patients that Bifidobacterium longum + fructo-oligosaccharides (FOS) treatment and lifestyle modification, when compared to lifestyle modification alone, significantly reduced a number of serum inflammatory, metabolic, toxinic and cytolitic parameters, along with improved histological steatosis, and NASH activity index (4). Even more recently, a further open label randomized controlled trial in 20 obese adult patients with biopsy proven NAFLD appeared fairly promising. Patients received a six month formula containing five strains of bacteria (4 lactobacilli + Bifidobacterium bifidum) + FOS. Treatment resulted in reduction of liver fat (P = 0.034) and AST level (absolute change P = 0.021; percentage of baseline value P = 0.008) (5). In all cases, it should be emphasized that the hitherto available study designs are not homogeneous and data results cannot be easily compared. Study population of two examined series by dr Kelishadi and colleagues for example included different chronic liver diseases in addition to NAFLD (6, 7); probiotics preparations often contained different bacteria strains, and sometimes confounding prebiotics (FOS) and/or vitamins cocktails (4-6); study duration was quite different, and it is still not clear if longer study may be affected by a number of biases like concurrent unpredictable major life style modifications, and at which extent. Last, but not least, although the Authors reminded the seriousness of epidemiologic data of pediatric NAFLD, they do not refer further to pediatric therapeutic studies targeting gut microbiota. In this regard we think therefore it might be valuable to the discussion completeness also the inclusion of our 2011 study published in Journal of Pediatric Gastroenterology and Nutrition (8). In that double-blind, placebo-controlled pilot study the effects of a short-term (8 weeks) probiotic treatment in 20 children with obesity-related liver disease were evaluated. Patients received Lactobacillus Rhamnosus strain GG (12 billion CFU/day): this probiotic strain was chosen because of the proven safety and efficacy profile in previous pediatric studies. Consistently with available adult data, in our population a multivariate analysis after probiotic treatment revealed a significant decrease in alanine aminotransferase (average variation vs. placebo P = 0.03), with normalization in most (80%) cases, irrespective of changes in BMI z score and visceral fat. We measured anti peptidoglycan-polysaccharide (PGPS) antibodies, an indirect indicator of intestinal bacterial overgrowth. PGPS is a ubiquitous bacterial antigen found in both gram-positive and gram-negative bacteria wall, and anti PGPS production is a sign of bacteria or bacterial membrane translocation through intestine barrier. Interestingly PGPS antibodies were significantly reduced after probiotic treatment (average variation vs. placebo P = 0.03). Serum levels of tumor necrosis factor-alpha, and US bright liver parameters remained stable during the study frame. Summing up, taking into account also the above additional evidences, we agree with Dr. Kelishadi and colleagues that available animal and human studies altogether may authorize to further support the view of a reasonable therapeutic role of probiotics in adult and also pediatric NAFLD patients not compliant to lifestyle changes, also because of minimal adverse effects and low cost (9). For better clarifying these aspects, future studies still need to be planned on well characterized larger populations, possibly with single probiotic agents, followed by a wash out period, and/or with gut microbiota characterization. The latter, much interestingly, has been defined only very recently both in adult (10)and in pediatric NAFLD (11).

The Effects of Bile Duct Obstruction on Liver Volume: An Experimental Study

Objectives. This study is aimed at investigating alterations in liver volume during obstructive jaundice in rat liver. Materials and Methods. Thirty-six rats were divided into four groups. Abdominal tomography was performed for baseline volumetric analyses. The main bile ducts were ligated (BDL). Volumetric analyses were repeated 3 days after BDL in group 1, 7 days after BDL in group 2, 15 days after BDL in group 3, and 25 days after BDL in group 4, and total hepatectomy was performed in all animals. Control group (n = 4) was created with the rats that died before bile duct ligation. Results. There was no difference found in liver volume in group 1 compared to control animals. The liver volume was increased 7 days after BDL (P = 0.01). It was increased up to 60% of baseline values 25 days after BDL (P = 0.002). Wet liver weights of animals were also increased compared to control group. Liver weights were increased up to 40% percent of baseline values in group 4 (P = 0.002). Conclusions. Liver volume and weight were increased after BDL. Liver surgery in patients with huge liver mass is generally associated with significant difficulty. The surgeon should be aware of the time-dependent alteration in liver volume after obstructive jaundice.

Lowering the alcohol content of red wine does not alter its cardioprotective properties

Many epidemiological, clinical and laboratory studies suggest that chronic and moderate consumption of red wine benefits cardiovascular health, because of the alcoholic content or the polyphenols/flavonoids. The antioxidant and cardioprotective properties of a French red wine (cabernet sauvignon, 12% alcohol by volume) were compared with those of the same wine subjected to reverse osmosis for partial removal of alcohol (6% alcohol by volume). Antioxidant capacity was assessed in vitro using the oxygen radical absorbance capacity (ORAC) assay. To test the cardioprotective effect of 12% v. 6% wine, the drinking water of rats used for controls was supplemented with red wine (12% or 6%). After 10 days, hearts were isolated on a Langendorff system and subjected to 30 minutes of global ischaemia plus 30 minutes of reperfusion (I/R). No differences in antioxidant capacity were observed between wine of 12% and 6% alcohol content (n=8 per group). Control hearts subjected to I/R presented a rate pressure product (heart rate x left ventricular developed pressure, expressed as a percentage of baseline value) of 16±4% (mean±standard error). Pretreatment with wine 12% or 6% improved the rate pressure product to 40±6% and 43±6%, respectively (p<0.05 v. control). Our findings suggest that the reduction of alcohol content from 12% to 6% in wine did not alter its antioxidant and cardioprotective properties. Moderate and regular consumption of lower alcohol content wines may confer beneficial effects without the risks associated with traditional wines of higher alcohol content.

Nimodipine Reverses the Elevation of Synaptic Striatal Dopamine and Serotonin During In Vivo Hypoxia

Introduction: Moderate hypoxia has been implicated in the development of delirium. One mechanism may be an increase of Dopamine (DA) and Serotonin (5-HT) levels. Our previous studies indicated that hypoxia increased levels of both neurotransmitters (NT) and that nimodipine (NIMO) administered immediately after hypoxia preserved short term memory. We tested the hypothesis that these observations may be related to a NIMO dependent reduction of hypoxia in- duced NT elevation. Methods: Following IACUC approval, In Vivo microvoltammetry sensors (BRODERICK PROBE ® ) were implanted in the dorsal striatum of Na Pentobarbital anesthetized adult Sprague-Dawley rats. Extracellular NT levels were recorded for 15m during the establishment of baseline values in room air (N=6). Three sequential thirty-minute periods under hypoxia (10% O2) followed. First: under hypoxia alone; second after i.p. injection of NIMO (0.1mg/kg); and third following i.p. injection of NIMO (1.0mg/kg). Measurements were analyzed with ANOVA with post hoc Tukeys test. P-values less than 0.05 were considered significant. Results: NT levels are expressed as percentages of baseline values. Treatment values were averaged over each sequential thirty-minute period following each intervention. Moderate hypoxia resulted in the increase of DA to 172% (SEM=18) and 5-HT to 68% (SEM=4) above baseline. Under continuing hypoxia, NIMO (0.1mg/kg) caused DA levels to fall to 112% (SEM=14) and 5-HT to 13% (SEM=5) above baseline. NIMO (1.0mg/kg) caused DA levels to fall to 34% (SEM=6) above baseline and 5-HT to 20% (SEM=2) below baseline. Conclusion: Moderate hypoxia increased levels of DA and 5-HT in the striatum of rats. NIMO administration during on- going hypoxia caused the levels of both neurotransmitters to fall towards baseline. The results may have implications for understanding and treating cognitive decline due to hypoxia.

Bronchial reversibility with a short-acting β2-agonist predicts the FEV1 response to administration of a long-acting β2-agonist with inhaled corticosteroids in patients with bronchial asthma

A long-acting β2-agonist (LABA) combined with an inhaled corticosteroid (ICS) is frequently prescribed as initial therapy in steroid-naïve asthma patients because of its effective control of symptoms and improvement of pulmonary function. However, it is unclear which patients will be responsive to LABAs and whether bronchial responsiveness to LABAs is similar to that to short-acting β2-agonists (SABAs) in a clinical setting. Therefore, the goal of the present study was to compare the changes in spirometric parameters after SABA (salbutamol) inhalation to those after 1-month LABA/ICS (salmeterol/fluticasone propionate) therapy. Spirometric changes were evaluated as absolute values, as the percentage of predicted normal values and as the percentage of baseline values after salbutamol inhalation or 1-month LABA/ICS therapy in 45 patients with asthma. Compared to SABA inhalation, LABA/ICS therapy produced significant improvements in forced expiratory volume in 1 sec (FEV1), peak expiratory flow (PEF), forced expiratory flow at 50% of vital capacity expired (FEF50%) from baseline (expressed as the percentage predicted) in all patients. FEV1 and the FEV1/forced vital capacity (FVC) ratio after SABA or LABA/ICS therapy were inversely related to the corresponding baseline values. Analysis of spirometric changes after SABA inhalation showed that FEV1 was the best among spirometric parameters, such as PEF, correlated with responsiveness to LABA/ICS therapy. Reversibility of FEV1 with SABA inhalation predicts the spirometric response to LABA/ICS as initial therapy in patients with bronchial asthma. LABA/ICS therapy had a greater effect on bronchial reversibility in asthmatic patients, compared to SABA inhalation. This suggested that evaluation of bronchial reversibility after LABA/ICS therapy would be superior to that after SABA inhalation.

Aerobic fitness does not influence the biventricular response to whole body passive heat stress

We examined biventricular function during passive heat stress in endurance trained (ET) and untrained (UT) men to evaluate whether aerobic fitness alters the volumetric response. Body temperature was elevated ~0.8°C above baseline in 20 healthy men (10 ET, 64.4 ± 3.0 ml·kg(-1)·min(-1); and 10 UT, 46.3 ± 6.2 ml·kg(-1)·min(-1)) by circulating warm water (50°C) throughout a tube-lined suit. Cardiac magnetic resonance imaging was used to measure biventricular volumes, function, filling velocities, volumetric flow rates, and left ventricular (LV) twist and circumferential strain at baseline (BL) and after 45 min of heat stress. In both groups, passive heat stress reduced biventricular end-diastolic (ET, -19.5 ± 24.0 ml; UT, -25.1 ± 23.8 ml) and end-systolic (ET, -15.9 ± 8.8 ml; UT, -17.6 ± 7.9 ml) volumes and left atrial volume (ET, -19.2 ± 11.6 ml; UT, -15.0 ± 12.7 ml) and significantly increased heart rate (ET, 29.3 ± 9.0 beats/min; UT, 31.7 ± 10.4 beats/min) and cardiac output (ET, 3.8 ± 2.2 l/min; UT, 3.2 ± 1.4 l/min) similarly, while biventricular stroke volume was unchanged. There were no between-group differences in any parameter. Heat stress increased (P < 0.05), as a percentage of baseline values, biventricular ejection fraction (ET, 3.4 ± 5.3%; UT, 4.4 ± 3.7%), annular systolic tissue velocities (ET, 32.5 ± 34.9%; UT, 44.0 ± 38.1%), and peak LV twist (ET, 51.6 ± 59.7%; UT, 59.7 ± 54.2%) and untwisting rates (ET, 45.5 ± 42.3%; UT, 51.8 ± 55.0%) similarly in both groups. Early LV diastolic tissue and blood velocities, volumetric flow rates, and strain rates (diastole) were unchanged with heat stress in both groups. The present findings indicate that aerobic fitness does not influence the biventricular response to passive heat stress.

194 RHO-KINASE INHIBITION IMPACTS NEUROGENIC DETRUSOR OVERACTIVITY IN CHRONIC SPINALIZED RATS

You have accessJournal of UrologyBladder and Urethra: Anatomy, Physiology and Pharmacology I1 Apr 2010194 RHO-KINASE INHIBITION IMPACTS NEUROGENIC DETRUSOR OVERACTIVITY IN CHRONIC SPINALIZED RATS Dong Broqueres-You, Stephanie Oger, Delphine Behr-Roussel, Sandrine Compagnie, Stephanie Caisey, Pierre Denys, Emmanuel Chartier-Kastler, and Francois Giuliano Dong Broqueres-YouDong Broqueres-You Orsay, France More articles by this author , Stephanie OgerStephanie Oger Orsay, France More articles by this author , Delphine Behr-RousselDelphine Behr-Roussel Orsay, France More articles by this author , Sandrine CompagnieSandrine Compagnie Orsay, France More articles by this author , Stephanie CaiseyStephanie Caisey Orsay, France More articles by this author , Pierre DenysPierre Denys Garches, France More articles by this author , Emmanuel Chartier-KastlerEmmanuel Chartier-Kastler Paris, France More articles by this author , and Francois GiulianoFrancois Giuliano Garches, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.250AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Spinal cord injury (SCI) severely disrupts normal bladder function by inducing neurogenic detrusor overactivity (NDO). First line SCI-induced NDO treatments i.e. antimuscarinics often associated with intermittent catheterization are somewhat limited by a mild to moderate clinical efficacy and a significant incidence of side effects. Thus the development of new effective drugs for the treatment of NDO is of crucial importance. Rho-kinase has a central role in the regulation of detrusor smooth muscle contraction since components of the rhoA/rho-kinase signalling pathway are involved in the Ca2+-sensitization of the smooth muscle. Moreover, in vitro and in vivo data from animal models of overactive bladder (OAB) indicate that rho-kinases are involved in pathophysiological mechanisms responsible for OAB. Thus, we aimed to evaluate the effects of a rho-kinase inhibitor (Y-27632) on urodynamic parameters in rats with chronic SCI. METHODS Complete T7-T8 spinal cord transection was performed in 17 female adult Sprague-Dawley rats. At 3-4 weeks post-SCI, cystometry was performed in conscious rats to determine the effects of Y-27632 (150μg/kg, intravenous injection, iv, n=7) and vehicle (saline, iv, n=10) on the following urodynamic parameters: maximal amplitude of micturition pressure (MP); baseline intravesical pressure (BP); delta pressure threshold for inducing micturition (delta PT); intercontraction interval, (ICI); voided volume; amplitude of non-voiding contractions (NVC) and the volume threshold necessary to initiate NVC. The effects of Y-27632 or vehicle were observed during a treatment period of 60 min. The results were expressed as percentage of baseline value during the control period i.e before Y-27632 or saline injection. RESULTS Y-27632 significantly increased voided volume whereas it did not modify MP, BP, delta PT and ICI. Voided volume reached 117±9% of baseline at 60 min after Y-27632 injection versus 96±4% of baseline for vehicle. The amplitude of NVC was significantly decreased by 43.1% and 17.6% at 30 min and 60 min after Y-27632 administration, respectively when compared to vehicle. In addition, Y-27632 significantly increased the volume threshold of NVC. At 30 min and 60 min after Y-27632 injection, it was increased by 117.4% and by 166.3% when compared with vehicle. CONCLUSIONS The present study demonstrates that inhibition of rho-kinase alters the urodynamic parameters related to NVC and enables a better bladder emptying in SCI-induced NDO rats. This supports the potential development of rho-kinase inhibitors for the treatment of NDO. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e76-e77 Peer Review Report Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dong Broqueres-You Orsay, France More articles by this author Stephanie Oger Orsay, France More articles by this author Delphine Behr-Roussel Orsay, France More articles by this author Sandrine Compagnie Orsay, France More articles by this author Stephanie Caisey Orsay, France More articles by this author Pierre Denys Garches, France More articles by this author Emmanuel Chartier-Kastler Paris, France More articles by this author Francois Giuliano Garches, France More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Safety and Efficacy of Dietary Agmatine Sulfate in Lumbar Disc-associated Radiculopathy. An Open-label, Dose-escalating Study Followed by a Randomized, Double-blind, Placebo-controlled Trial

Objective. Agmatine, decarboxylated arginine, was shown in preclinical studies to exert efficacious neuroprotection by interacting with multiple molecular targets. This study was designed to ascertain safety and efficacy of dietary agmatine sulfate in herniated lumbar disc-associated radiculopathy. Study Design. First, an open-label dose escalation study was performed to assess the safety and side-effects of agmatine sulfate. In the follow-up study, participants diagnosed with herniated lumbar disc-associated radiculopathy were randomly assigned to receive either placebo or agmatine sulfate in a double-blind fashion. Methods. Participants in the first study were recruited consecutively into four cohorts who took the following escalating regimens: 1.335 g/day agmatine sulfate for 10 days, 2.670 g/day for 10 days, 3.560 g/day for 10 days, and 3.560 g/day for 21 days. Participants in the follow-up study were assigned to receive either placebo or agmatine sulfate, 2.670 g/day for 14 days. Primary outcome measures were pain using the visual analog scale, the McGill pain questionnaire and the Oswestry disability index, sensorimotor deficits, and health-related quality of life using the 36-item short form (SF-36) questionnaire. Secondary outcomes included other treatment options, and safety and tolerability assessment. Results. Safety parameters were within normal values in all participants of the first study. Three participants in the highest dose cohort had mild-to-moderate diarrhea and mild nausea during treatment, which disappeared upon treatment cessation. No other events were observed. In the follow-up study, 51 participants were randomly enrolled in the agmatine group and 48 in the placebo. Continuous improvement of symptoms occurred in both groups, but was more pronounced in the agmatine (analyzed n = 31) as compared with the placebo group (n = 30). Expressed as percent of baseline values, significantly enhanced improvement in average pain measures and in quality of life scores occurred after treatment in the agmatine group (26.7% and 70.8%, respectively) as compared with placebo (6.0% [P </= 0.05] and 20.0% [P </= 0.05], respectively). No treatment-related adverse events were noted. Conclusions. Dietary agmatine sulfate is safe and efficacious treatment for alleviating pain and improving quality of life in lumbar disc-associated radiculopathy. Study Registration. ClinicalTrials.gov Protocol Registration System Identifier: NCT00405041.

Effect of long-term sevoflurane anesthesia on markers of myocardial damage

To investigate the effect of long-term sevoflurane anesthesia on markers of myocardial damage or toxicity. Forty adult patients scheduled for upper abdominal surgery with general anesthesia for 4 hours or more were randomly divided into Group S and PR (n=20 each). After anesthesia induction, patients of Group S were maintained with only sevoflurane, and patients of Group PR with target-controlled infusion of propofol 2-4 microg/ml and remifentanil 4-8 ng/ml. Anesthesia was titrated to control blood pressure and heart rate change at less than 20 percent of baseline values. Blood samples were draw at pre-induction, 4 h and 24 h post-induction respectively. Serum level of cardiac troponin I, creatine kinase MB and myoglobin were analyzed. There were no significant changes of troponin I, creatine kinase MB and myoglobin in Group S between pre-induction and 4 h or 24 h post-induction (P > 0.05). And there was also no significant differences as compared with Group PR (P > 0.05). At the concentration range of 1.6%-3%, long-term sevoflurane anesthesia does not cause detectable changes of markers of myocardial damage or toxicity.

Time before isolating cystinotic leukocytes affects reliability of cystine determination

Sirs, We are concerned that the manner in which leukocytes are prepared for the determination of cystine levels may cause imprecise results which could adversely affect the treatment of patients with cystinosis. Leukocyte cystine levels are used to diagnose cystinosis, monitor Cystagon therapy, and for multiple purposes in research studies. The determination of cystine in leukocytes is performed only in a small number of laboratories worldwide, one of which is the Cystine Determination Laboratory at the University of California San Diego (UCSD). In the late 1970s, when the first cysteamine treatment trial was started, we evaluated ways to have blood shipped to the laboratory for the separation of leukocytes and the determination of intracellular cystine. It was determined that the leukocyte cystine level could only reliably be measured from samples that had been separated immediately after the blood was drawn. To ensure uniform preparation, our practice has been to ship reagents to point-of-care clinical laboratories, with precise instructions for sample preparation (http://biochemgen.ucsd.edu/cystinosis/), as in the published method [1]. Separated and lysed leukocyte samples are acidified, frozen and transported to our laboratory on dry ice for protein and cystine determinations. Other laboratories accept heparinized whole blood shipped on wet ice for the determination of leukocyte cystine levels. The leukocytes are separated from the sample upon arrival at the laboratory, typically 24–48 h after the blood was drawn. This frees the point-of-care laboratory from the task of preparing the leukocytes, a procedure which is not complicated but which is time consuming and may be seen as an inconvenience. Our laboratory therefore would naturally be interested in changing the procedure to accept whole blood. However, based on our experiences in the 1970s, we felt it was important to evaluate the stability of intracellular cystine in blood samples during storage and shipping. Until recently, the demanding cystine binding assay method used for the cystine assay made such an evaluation impractical, but a newer method using tandem mass spectrometry [3] has reduced sample analysis time drastically. The aim of our small study was to evaluate whether intracellular cystine levels would be reliable if leukocyte separation from heparinized whole blood were delayed for up to 24–48 h, as would be expected with express mail shipment. Three cystinotic patients were enrolled into the study. Patients on Cystagon therapy were asked to discontinue therapy 24 h before participating. Blood was drawn from each subject, with aliquots anticoagulated in Li-heparin or Na-heparin. Blood was divided into 3-mL samples, and leukocytes were prepared in triplicate by the ACD-dextran method immediately after collection (0 h, baseline) or after being stored for 24 ± 1 or 48 ± 1 h at either room temperature or 4°C. All reagents for the separation were prepared by the UCSD Cystine Determination Laboratory. Protein content was determined using the Lowry method [3], and cystine content was measured using tandem mass spectrometry [2, 4]. Leukocyte cystine content was calculated as nanomoles half-cystine per milligram protein and is presented in Table 1 as the percentage of baseline value. Samples stored for 48 h at room temperature and collected in Li- and Na-heparin, respectively, did not separate when mixed with ACD-dextran, and leukocytes could not be isolated from these samples. Leukocytes could be prepared from all other samples. Table 1 Leukocyte cystine levelsa after the storage of whole blood for 24 or 48 h in Li- and Na-heparin (results averaged together) at room temperature or 4°C before separation of leukocytes No differences were observed between Li- and Na-heparin, and the results for both anticoagulants were therefore combined. The levels determined at baseline and after storage for 24 and 48 h at 4°C and for 24 h at room temperature are shown in Table 1. Cystine levels in samples stored for 24 h at room temperature varied between 52 and 117% of baseline values. Even greater variations were measured when the samples were stored at 4°C for 24 h (37–214%). After 48 h, only samples stored at 4°C could be separated, and the cystine levels determined were between 52 and 240% of baseline values. Although we tested only a small number of samples, we believe these results clearly show that results will be imprecise if leukocytes are not prepared immediately after heparinized blood is drawn. Accordingly, we encourage nephrologists treating cystinosis patients to take into account the time involved in storing and shipping samples prior to separating leukocytes for cystine determination. We are hoping to expand this study and evaluate different agents which might stabilize leukocytes and obviate the need for immediate cell preparation, but we believe it important to share these results immediately with all pediatric nephrologists treating cystinosis patients.

Persistent Suppression of Postexercise Facilitation of Motor Evoked Potentials During Alternate Phases of Bipolar Disorder

The current study sought to longitudinally evaluate the postexercise facilitation of motor evoked potentials (MEP) in two patients during different phases of short-circle depressive-manic disorder. Each study included 50 baseline MEP elicited by transcranial magnetic stimulation, followed by 50 MEP immediately after nonfatiguing exercise of the examined muscle. Postexercise MEP facilitation, expressed as percentage of baseline value, varied from 71% to 119% and from 99% to 107% in each patient, respectively, being significantly lower than our mean normal control value (268%). No differences in MEP facilitation between phases of short-circle depressive-manic disorder were revealed. Reduced postexercise facilitation was independent of the bipolar disorder phases, suggesting an invariable underlying association of the psychiatric pathophysiological mechanisms to impaired cortical excitability.

Dietary Modulation of Plasma and Adipose Tissue n‐3:n‐6 PUFA Ratio has no Effect on Insulin Resistance and Inflammation in Obese Gambian Women

This study examined whether increasing long‐chain n‐3 polyunsaturated fatty acids (LC n‐3 PUFA) intake have benefits on glucose tolerance in obese Gambian women and on their fatty acid and lipid profiles, anthropometrics, blood pressure and inflammation status. Fifty four obese women with impaired glucose tolerance entered a 24‐week randomised intervention study. Women received LC n‐3 PUFA capsules and high n‐3 cooking oil (n = 30) or placebo capsules and high n‐6 cooking oil (n = 24). Measurements were taken at baseline, 12 and 24 weeks intervention and expressed as percentage of baseline values. In the intervention group, LC n‐3 PUFA increased in plasma (208%, p&lt;0.0001) and adipose tissue (168%, p&lt;0.0001), leading to an increase in n‐3:n‐6 PUFA ratio. There was no effect of high n‐3 PUFAs on fasting glucose, 120‐min glucose or fasting insulin, although insulin sensitivity assessed by the homeostasis model assessment improved modestly in the intervention group (p = 119%, p = 0.04 at 24 weeks). No differences were observed in weight, BMI and fat mass between the two groups, or in inflammatory markers, blood pressure or triglycerides. We conclude that although LC n‐3 PUFA supplementation modifies the fatty acid profile in obese Gambian women, there was no evidence that it had benefits on their glucose tolerance, triglycerides or inflammatory status.This work was supported by UK MRC.