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/VT) and dynamic hyperinflation to alterations in exercise limitation. We utilized a unique noninvasive method to assess VD/VT (transcutaneous carbon dioxide, Tc[Formula see text]) and found that dual bronchodilators yielded a moderate improvement in exercise tolerance. Importantly, attenuation of dynamic hyperinflation rather than change in dead space ventilation was the most important contributor to exercise tolerance improvement.Classic in vitro experiments (Severin's phenomenon) demonstrated that acute carnosine supplementation may potentiate muscle contractility. However, upon oral ingestion, carnosine is readily degraded in human plasma by the highly active serum carnosinase-1 (CN1). We developed a novel strategy to circumvent CN1 by preexercise ingestion of combined carnosine (CARN) and anserine (ANS), the methylated analog with similar biochemical properties but more resistant to CN1. First, in vitro hydrolysis was tested by adding carnosine and anserine to human plasma, alone or in combination. Second, five subjects were supplemented with 25 mg/kg anserine or 25 mg/kg of each anserine and carnosine to test in vivo bioavailability. Third, two double-blind, placebo-controlled, crossover studies investigated the effect of preexercise ANS + CARN (20 mg/kg body wt of each) supplementation on performance during a single all-out Wingate test following 6-min high-intensity cycling (study A) or three repeated Wingate tests (study B). Inlasma. Acute combined carnosine and anserine supplementation is therefore described as novel strategy to raise plasma anserine and carnosine. We report that indices of maximal exercise/muscle power during the initial stage of a Wingate test were significantly improved by preexercise 20-25mg/kg body wt anserine and carnosine supplementation, pointing toward a novel acute nutritional strategy to improve high-intensity exercise performance.Previous research suggests individuals with intellectual disabilities (ID) may experience autonomic dysfunction, however, this has not been thoroughly investigated. The aim of this study was to compare the autonomic response to standing up (active orthostasis) and head-up tilt (passive orthostasis) in individuals with ID to a control group without ID. Eighteen individuals with and 18 individuals without ID were instrumented with an ECG-lead and finger-photoplethysmography for continuous heart rate and blood pressure recordings. The active and passive orthostasis protocol consisted of 10-min supine rest, 10-min standing, 10-min supine recovery, 5-min head-up tilt at 70°, followed by 10-min supine recovery. The last 5 min of each position was used to calculate hemodynamic and autonomic function (time- and frequency-domain heart rate and blood pressure variability measures and baroreflex sensitivity). Individuals with ID had higher heart rate during baseline and recovery (P less then 0.05), and an attenuated hemodynamic (stroke volume, heart rate) and heart rate variability response to active and passive orthostasis (interaction effect P less then 0.05) compared with individuals without ID. Mean arterial pressure (MAP) was higher in individuals with ID at all timepoints. Individuals with ID demonstrated altered hemodynamic and autonomic regulation compared with a sex- and age-matched control group, evidenced by a higher mean arterial pressure and a reduced response in parasympathetic modulation to active and passive orthostasis.NEW & NOTEWORTHY Individuals with ID demonstrated altered hemodynamic and autonomic regulation to the clinical autonomic function tasks standing up and head-up tilt (active and passive orthostasis). Higher resting heart rate and higher MAP throughout the protocol suggest a higher arousal level, and individuals with ID showed a blunted response in parasympathetic modulation. Further research should investigate the relationship of these findings with clinical outcomes.Neuromuscular fatigue (NMF) and exercise performance are affected by exercise intensity and sex differences. However, whether slight changes in power output (PO) below and above the maximal lactate steady state (MLSS) impact NMF and subsequent performance (time to task failure, TTF) is unknown. This study compared NMF and TTF in females and males in response to exercise performed at MLSS, 10 W below (MLSS-10) and above (MLSS+10). Twenty participants (9 females) performed three 30-min constant-PO exercise bouts followed (1-min delay) by a TTF at 80% of the peak-PO. NMF was characterized by isometric maximal voluntary contractions (IMVC) and femoral nerve electrical stimulation of knee extensors [e.g., peak torque of potentiated high-frequency (Db100) and single twitch (TwPt)] before and immediately after the constant-PO and TTF bouts. IMVC declined less after MLSS-10 (-18 ± 10%) compared to MLSS (-26 ± 14%) and MLSS+10 (-31 ± 11%; all P 0.05). Slight manipulations in PO around MLSS elicited great changes in the reduction of maximal voluntary force and impairments in contractile function. Although NMF was lower in females compared to males, the changes in PO around the MLSS impacted both sexes similarly.NEW & NOTEWORTHY It is unknown whether minimum changes in power output (PO) below and above the maximal lactate steady state (MLSS) affect neuromuscular fatigue (NMF) development in females and males. DX600 ACE inhibitor The present data showed that a decrease or increase of 10 W in PO in relation to MLSS elicited lower and greater impairments in contractile function, respectively. Even though females had less of an overall decline in NMF than males, similar exercise intensity-dependent response occurred independently of sex.The human cardiovascular (CV) system elicits a physiological response to gravitational environments, with significant variation between different individuals. Computational modeling can predict CV response, however model complexity and variation of physiological parameters in a normal population makes it challenging to capture individual responses. We conducted a sensitivity analysis on an existing 21-compartment lumped-parameter hemodynamic model in a range of gravitational conditions to 1) investigate the influence of model parameters on a tilt test CV response and 2) to determine the subset of those parameters with the most influence on systemic physiological outcomes. A supine virtual subject was tilted to upright under the influence of a constant gravitational field ranging from 0 g to 1 g. The sensitivity analysis was conducted using a Latin hypercube sampling/partial rank correlation coefficient methodology with subsets of model parameters varied across a normal physiological range. Sensitivity was dett for individuals challenging. This computational effort studies sensitivity in cardiovascular model outcomes due to varying parameters across a normal physiological range. This allows determination of which parameters have the largest influence on outcomes, i.e., which parameters must be most carefully selected to give accurate predictions of individual responses.Motor unit (MU) firing rates (FRs) are lower in aged adults, compared with young, at relative voluntary contraction intensities. However, from a variety of independent studies of disparate muscles, the age-related degree of difference in FR among muscles is unclear. Using a standardized statistical approach with data derived from primary studies, we quantified differences in FRs across several muscles between younger and older adults. The data set included 12 different muscles in young (18-35 yr) and older adults (62-93 yr) from 18 published and one unpublished study. Experiments recorded single MU activity from intramuscular electromyography during constant isometric contraction at different (step-like) voluntary intensities. For each muscle, FR ranges and FR variance explained by voluntary contraction intensity were determined using bootstrapping. Dissimilarity of FR variance among muscles was calculated by Euclidean distances. There were threefold differences in the absolute frequency of FR ranges across mntary contraction intensity were muscle dependent and more dissimilar among muscles in the older than young adults.Background Endoscopic treatment can represent a technical challenge for several special situations, such as resecting gastric tumors with larger size or in unfavorable sites and performing endoscopic retrograde cholangiopancreatography (ERCP) after Roux-en-Y gastric bypass (RYGB). This study aims to describe an innovative and multipurpose technique, intragastric single-port surgery (IGS), which can be applied for abovementioned special situations and for assessing its safety, feasibility, and efficacy. Methods IGS technique was performed through a 2-3 cm skin incision, where the stomach wall is exteriorized and fixed to the skin. The single-port device is inserted and intragastric access is gained for laparoscopic or endoscopic instruments. Three purposes of IGS were performed (1). gastric intraluminal lesions resection; (2). to perform ERCP after RYGB; and (3). revision of pancreaticogastric anastomosis after pylorus-preserving pancreaticoduodenectomy. Results IGS was performed successfully in 20 patients. Ten patients underwent gastric intraluminal lesion resection, mostly for gastric gastrointestinal stromal tumors (n = 7, 70%); all pathological specimens were with negative margin, mean operation time was 102.3 ± 43.5 minutes, and mean postoperative hospital stay was 4.6 ± 1.5 days. Nine patients underwent ERCP after RYGB, cleaning of the bile duct was successful in all patients (100%), and mean operation time and mean postoperative hospital stay were 140.6 ± 46.3 minutes and 4.4 ± 2.6 days, respectively. One patient underwent pancreaticogastric anastomosis revision. There were no mortalities in our series. Conclusions IGS is a safe, feasible, and effective technique for gastric intraluminal lesion resection and for performing ERCP after RYGB, while it has the potential for other future applications.
Inguinal disruption and femoroacetabular impingement (FAI) are well-recognized sources of groin pain in athletes; however, the relationship between inguinal disruption and FAI remains unclear. In cases of dual pathology, where both entities coexist, there is no definitive consensus regarding which pathology should be prioritized for treatment in the first instance.
(1) To examine the 2-year effectiveness and clinical outcome in athletes presenting with dual pathology in which the FAI component alone was treated with arthroscopic deformity correction. (2) To compare 2-year patient-reported outcome measures between athletes undergoing only hip arthroscopy (HA) and athletes undergoing groin repair and HA.
Cohort study; Level of evidence, 3.
All patients undergoing HA for the treatment of FAI with concomitant clinical signs of inguinal disruption at initial consultation were between 2010 and 2016 were included in this study. Inclusion criteria were male sex, age <40 years, and involvement in competitivone) and those undergoing 2 procedures (HA and groin repair at any stage).
In patients with dual pathology, treatment of the FAI component alone using arthroscopic hip surgery results in a successful outcome without need for groin repair in 89.2% of cases. No statistical difference in clinical outcome 2 years after surgery was observed between athletes undergoing 1 procedure (HA alone) and those undergoing 2 procedures (HA and groin repair at any stage).
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