Short-term aerobic exercise prevents development of glucocorticoid myopathic features in aged skeletal muscle in a sex-dependent manner.

Older adults are vulnerable to glucocorticoid-induced muscle atrophy and weakness, with sex potentially influencing their susceptibility to those effects. Aerobic exercise can reduce glucocorticoid-induced muscle atrophy in young rodents. However, it is unknown whether aerobic exercise can prevent glucocorticoid myopathy in aged muscle. The objectives of this study were to define the extent to which sex influences the development of glucocorticoid myopathy in aged muscle, and to determine the extent to which aerobic exercise training protects against myopathy development. Twenty-four-month-old female (n = 30) and male (n = 33) mice were randomized to either sedentary or aerobic exercise groups. Within their respective groups, mice were randomized to either daily treatment with dexamethasone (DEX) or saline. Upon completing treatments, the contractile properties of the triceps surae complex were assessed in situ. DEX marginally lowered muscle mass and soluble protein content in both sexes, which was attenuated by aerobic exercise only in females. DEX increased sub-tetanic force and rate of force development only in females, which was not influenced by aerobic exercise. Muscle fatigue was higher in both sexes following DEX, but aerobic exercise prevented fatigue induction only in females. The sex-specific differences to muscle function in response to DEX treatment coincided with sex-specific changes to the content of proteins related to calcium handling, mitochondrial quality control, reactive oxygen species production, and glucocorticoid receptor in muscle. These findings define several important sexually dimorphic changes to aged skeletal muscle physiology in response to glucocorticoid treatment and define the capacity of short-term aerobic exercise to protect against those changes. KEY POINTS: There are sexually dimorphic effects of glucocorticoids on aged skeletal muscle physiology. Glucocorticoid-induced changes to aged muscle contractile properties coincide with sex-specific differences in the content of calcium handling proteins. Aerobic exercise prevents glucocorticoid-induced fatigue only in aged females and coincides with differences in the content of mitochondrial quality control proteins and glucocorticoid receptors.

Oral anticoagulants and concurrent rifampin administration in tuberculosis patients with non-valvular atrial fibrillation.

BACKGROUND: Evidence and guidelines for Non-vitamin K antagonist oral anticoagulants (NOACs) use when prescribing concurrent rifampin for tuberculosis treatment in patients with non-valvular atrial fibrillation (NVAF) are limited. METHODS: Using the Korean National Health Insurance Service database from January 2009 to December 2018, we performed a population-based retrospective cohort study to assess the net adverse clinical events (NACE), a composite of ischemic stroke or systemic embolism and major bleeding, of NOACs compared with warfarin among NVAF patients taking concurrent rifampin administration for tuberculosis treatment. After a propensity matching score (PSM) analysis, Cox proportional hazards regression was performed in matched cohorts to investigate the clinical outcomes. RESULTS: Of the 735 consecutive patients selected, 465 (63.3%) received warfarin and 270 (36.7%) received NOACs. Among 254 pairs of patients after PSM, the crude incidence rate of NACE was 25.6 in NOAC group and 32.8 per 100 person-years in warfarin group. There was no significant difference between NOAC and warfarin use in NACE (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.48-1.14; P = 0.172). Major bleeding was the main driver of NACE, and NOAC use was associated with a statistically significantly lower risk of major bleeding than that with warfarin use (HR, 0.63; 95% CI, 0.40-1.00; P = 0.0499). CONCLUSIONS: In our population-based study, there was no statically significant difference in the occurrence of NACE between NOAC and warfarin use. NOAC use may be associated with a lower risk of major bleeding than that with warfarin use.

Safety and efficacy of immediate heparin reversal with protamine after complex percutaneous coronary intervention.

BACKGROUND: Compared to simple percutaneous coronary intervention (PCI), complex PCI is associated with higher bleeding and thrombotic risk. No previous study has evaluated the use of protamine after PCI with contemporary technologies. This study aimed to evaluate the safety and efficacy of manual compression with and without protamine after transfemoral complex PCI. METHODS: We retrospectively analyzed 160 patients (protamine group, n = 92; non-protamine group, n = 68) who underwent complex PCI via the femoral artery. The primary outcome was a composite of in-hospital death, myocardial infarction, stent thrombosis, stroke/systemic embolism, bleeding requiring blood transfusion, and vascular access complications. RESULTS: The primary outcome was significantly lower in the protamine group than in the non-protamine group (4.3% vs. 17.6%; p = 0.006). This was driven mainly by the lower incidences of hematoma in the protamine group (3.3% vs. 13.2%, p = 0.020). Furthermore, the protamine group had a significantly shorter hospital stay than the non-protamine group (4.8 ± 3.7 days vs. 8.4 ± 8.3 days, p = 0.001). While > 90% of the patients had acute coronary syndrome, there were no incidences of myocardial infarction or stent thrombosis in either group. CONCLUSIONS: Among patients who underwent complex PCI via transfemoral access, immediate protamine administration was associated with a significantly lower rate of vascular access complications, especially hematoma, and shorter hospital stay than no protamine administration.

Incidence and clinical impact of early recurrence of atrial tachyarrhythmia after surgical ablation for atrial fibrillation.

BACKGROUND: Atrial tachyarrhythmias (ATAs) are common within the 3-month blanking period after catheter ablation of atrial fibrillation (AF). However, little evidence is available regarding the current guidelines on the blanking period after surgical AF ablation. We investigate the incidence and significance of early recurrence of atrial tachyarrhythmia (ERAT) and evaluate the optimal blanking period after surgical AF ablation. METHODS: Data from 259 patients who underwent surgical AF ablation from 2009 to 2016 were collected. ERAT was defined as documented ATA episodes lasting for 30 s. A multivariate Cox proportional hazard model was constructed to evaluate the role of ERAT as a predictor of late recurrences (LR) for AF. RESULTS: In total, 127 patients (49.0%) experienced their last episodes of ERAT during the first (n = 65), second (n = 14), or third (n = 48) month of the 3-month blanking period (p < .001). One year freedom from ATAs was 97.8% in patients without ERAT compared with 95.4%, 64.3%, and 8.3% in patients with ERAT in the first, second, and third months after the index procedure, respectively (p < .001). Hazard ratios of LR according to the timing of the last episode of ERAT first, second, and third months after the procedure were 2.84, 16.70, and 119.75, respectively. CONCLUSIONS: The ERAT occurred in 49.0% of patients within the first 3 months after surgical ablation. The occurrence of ERAT within 3 months after surgical AF ablation was a significant independent predictor of LR. Hence, the currently accepted 3-month blanking period may be considered for redefining in patients with AF surgical ablation.

Lipolysis and Fat Oxidation Are Not Altered with Presleep Compared with Daytime Casein Protein Intake in Resistance-Trained Women.

BACKGROUND: To date, no studies have directly compared the differences between presleep and daytime protein (PRO) consumption on localized and systemic fat metabolism in active women. OBJECTIVE: The purpose of this study was to assess the effects of presleep compared with daytime PRO supplementation on subcutaneous abdominal adipose tissue (SCAAT) lipolysis and whole-body substrate utilization in women. METHODS: Thirteen young (mean ± SE age: 22 ± 1 y; BMI: 24.3 ± 0.8 kg/m2), resistance-trained [1 repetition maximum (1RM) squat percentage of body weight: 135% ± 6%; 1RM bench press percentage of body weight: 82% ± 4%] women volunteered. On overnight experimental visits, participants performed full-body resistance exercise (RE; 65% 1RM) and were randomly assigned to consume either daytime PRO (PRO, 30 g casein) 30 min post-RE and presleep (30 min before bed) noncaloric, sensory-matched placebo (PLA, 0 g casein) (PRO-PLA), or the opposite (PLA-PRO), switching the order of the supplements on the following visit. SCAAT lipolysis, resting metabolism (indirect calorimetry), and plasma biomarkers (glucose, insulin, nonesterified fatty acids, glycerol) were measured at baseline, overnight, and the next morning. RESULTS: There were no differences in overnight SCAAT lipolysis between conditions indicated by interstitial glycerol concentrations (PRO-PLA: baseline, 669 ± 137; next morning, 321 ± 77.1; PLA-PRO: baseline, 524 ± 109; next morning, 333 ± 68.0 µM), fat oxidation (PRO-PLA: baseline, 5.70 ± 0.35; next morning, 5.00 ± 0.28; PLA-PRO: baseline, 6.59 ± 0.32; next morning, 5.44 ± 0.27 g/min), or any other measure. CONCLUSIONS: There was no difference between the effects of daytime and presleep PRO supplementation on SCAAT lipolysis or whole-body substrate utilization in resistance-trained women. Presleep PRO is a viable option for increasing PRO consumption in resistance-trained women because it does not blunt overnight lipolysis, and will therefore likely not lead to increases in subcutaneous abdominal fat.This trial was registered at clinicaltrials.gov as NCT03573687.

Incidence of Cardiovascular Events and Safety Profile of Prasugrel in Korean Patients With Acute Coronary Syndrome.

BACKGROUND: Dual antiplatelet therapy is commonly used for patients with acute coronary syndrome (ACS). This study aimed to evaluate the safety and efficacy of aspirin and prasugrel at standard dosages in Korean patients using clinical outcome data.Methods and Results:For this prospective multicenter phase IV post-marketing surveillance (PMS) study, ACS patients from 29 July 2012 to 28 July 2016 were recruited. Patients received aspirin at a dose of 75-150 mg daily and a standard dose of prasugrel. Bleeding events were recorded and summarized to evaluate safety. Data on adverse events (AEs) and composite events such as cardiovascular (CV) death, myocardial infarction (MI), and stroke were recorded and summarized to assess efficacy. Of the 3,283 patients recruited, data from 3,110 and 3,044 patients were included in the safety and efficacy analyses, respectively (median treatment duration, 172 days). The most frequently reported AE was ecchymosis (2.8%). The number of patients with major bleeding was 29/3,110 (0.93%). The discontinuation rate for any reason was 12.6%. The number of cases that ended in CV death, MI, stroke, stent thrombosis, or unplanned coronary revascularization was 26/3,044 (0.85%). CONCLUSIONS: The present results are similar to those observed in clinical trials where administration of low-dose aspirin plus prasugrel was associated with a low rate of major bleeding and CV events.

Heart-lung transplantation for refractory diffuse alveolar hemorrhage supported by prolonged extracorporeal membrane oxygenation after cardiogenic shock from ST segment elevation myocardial infarction: a case report.

Diffuse alveolar hemorrhage after percutaneous coronary intervention is a rare but fatal complication. Although timely application of extracorporeal membrane oxygenator and discontinuation of antiplatelet/anticoagulation is the treatment of choice, bleeding is often irreversible. Herein, we introduce a patient with refractory diffuse alveolar hemorrhage after prolonged extracorporeal membrane oxygenator and percutaneous coronary intervention, who was eventually rescued with heart-lung transplantation.

Value of Coronary Angiography in the Cardiac Myxoma.

Preoperative coronary angiography for cardiac myxoma not only excludes coronary artery disease but also detects the artery feeding the cardiac myxoma, which has several clinical implications. In this study, we examined cardiac myxoma cases in two tertiary hospitals using coronary angiography to identify the artery feeding the myxoma. We retrospectively reviewed 42 patients with cardiac myxoma who had undergone surgical removal between July 2008 and December 2015 in two tertiary hospitals, and recorded their baseline characteristics, echocardiographic findings, and coronary angiography. Among those 42 patients, 23 (55%) had coronary angiography before surgery and in no case was significant luminal narrowing observed. In 21 of the coronary angiograms, the artery feeding the cardiac myxoma had a vascular branch (100%), clusters of tortuous vessels with contrast medium pooling (67%), an arteriocavity fistula (33%), and a mobile feeding artery (67%). No significant relationship was found between coronary artery dominance type and the origin of the artery feeding the cardiac myxoma (P = 0.362). Identification of the artery feeding the cardiac myxoma, with a distinctive vascular appearance in coronary angiography, is important for several clinical applications such as helping to diagnose cardiac myxoma and to plan the surgical approach. Clin. Anat. 33:833-838, 2020. © 2019 Wiley Periodicals, Inc.

Role of Transforming Growth Factor-ß in Skeletal Muscle Fibrosis: A Review.

Transforming growth factor-beta (TGF-ß) isoforms are cytokines involved in a variety of cellular processes, including myofiber repair and regulation of connective tissue formation. Activation of the TGF-ß pathway contributes to pathologic fibrosis in most organs. Here, we have focused on examining the evidence demonstrating the involvement of TGF-ß in the fibrosis of skeletal muscle particularly. The TGF-ß pathway plays a role in different skeletal muscle myopathies, and TGF-ß signaling is highly induced in these diseases. In this review, we discuss different molecular mechanisms of TGF-ß-mediated skeletal muscle fibrosis and highlight different TGF-ß-targeted treatments that target these relevant pathways.

Efficacy of the Repetitions in Reserve-Based Rating of Perceived Exertion for the Bench Press in Experienced and Novice Benchers.

Ormsbee, MJ, Carzoli, JP, Klemp, A, Allman, BR, Zourdos, MC, Kim, J-S, and Panton, LB. Efficacy of the repetitions in reserve-based rating of perceived exertion for the bench press in experienced and novice benchers. J Strength Cond Res 33(2): 337-345, 2019-Autoregulation (AR) is the practice of adjusting training variables in response to athlete feedback. One component of AR postulated to enhance resistance training adaptations involves implementing a resistance training-specific rating of perceived exertion (RPE) scale measuring repetitions in reserve (RIR). The purpose of this study was to examine the efficacy of this method using the bench press exercise. Twenty-seven college-aged men were assigned to one of 2 groups based on training age: experienced benchers (EB) (n = 14, training age: 4.7 ± 2.0 years) and novice benchers (NB) (n = 13, training age: 1.1 ± 0.6 years). Subjects performed 1 repetition maximum (1RM) followed by single-repetition sets with loads corresponding to 60, 75, and 90% of 1RM and an 8-repetition set at 70% of 1RM. Subjects reported a corresponding RPE, based on RIR, for every set. Average velocity was recorded for each single-repetition set along with the first and last repetitions of the 8-repetition set at 70% of 1RM. Average velocity at 100% of 1RM in EB was slower (0.14 ± 0.04 m·s) compared with NB (0.20 ± 0.05 m·s) (p < 0.001). Experienced benchers recorded greater RPE than NB at 1RM (EB: 9.86 ± 0.14 vs. NB: 9.35 ± 0.36) (p = 0.011). No between-group differences existed for average velocity or RPE at any other intensity. Both EB (r = 0.85, p < 0.001) and NB (r = 0.85, p < 0.001) had strong inverse significant correlations between average velocity and RPE at all intensities. Our findings suggest that the RIR-based RPE scale may be an efficacious approach for AR of bench press training load and volume in college-aged men.

Supraventricular tachyarrhythmias in patients with a persistent left superior vena cava.

Aims: A persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly. This venous anomaly can impact the evaluation and treatment of supraventricular tachyarrhythmia (SVA). The aim of this study was to assess the proportion and characteristics of PLSVC in adult SVA patients. Methods and results: From July 2002 to July 2012, clinical and procedural data from databases of 10 cardiac electrophysiology laboratories in the Yeungnam region of the Republic of Korea were reviewed. Of 6662 adult SVA patients who underwent an EP study or catheter ablation of SVA during the 10-year study period, 18 patients had PLSVC (mean age 47.6 ± 14.8 years, 10 men). The proportion of PLSVC in adult SVA patients was 0.27% (18/6662). SVA type and procedural outcomes of radiofrequency (RF) catheter ablation in these patients were investigated and the results were as follows: successful slow pathway modification in six of seven patients with atrioventricular nodal reentrant tachycardia (AVNRT), successful ablation of accessory pathway in three of four patients with atrioventricular reentrant tachycardia, and successful ablation of atrial tachycardia (cavotricuspid isthmus-dependent in two, septal macroreentry in one, focal from the PLSVC in one) in three of four patients. In one patient with junctional tachycardia, catheter ablation failed. In two patients with atrial fibrillation, catheter ablation was successful. Conclusion: Among adult SVA patients who underwent an EP study or RF catheter ablation during the 10-year study period, 0.27% had PLSVC. The most common type of SVA was AVNRT. The success rate of catheter ablation was 82% in SVA patients with PLSVC. There were no procedure-related complications.

Effects of repeated long-duration water immersions on skeletal muscle performance in well-trained male divers.

PURPOSE: The objective of this study was to examine the effects of repeated long-duration water immersions (WI)s at 1.35 atmospheres absolute (ATA) on neuromuscular performance in load bearing and non-load bearing muscle groups. METHODS: During a dive week (DW), fifteen well-trained male divers completed five consecutive 6-h resting dives with 18-h surface intervals while breathing compressed air at 1.35 ATA. Skeletal muscle performance assessments occurred immediately before and after each WI, and 24 and 72 h after the final WI. Exercise assessments included maximum voluntary isometric contraction (MVIC), maximal isokinetic (IK) contraction, maximum handgrip strength (MHG). Surface electromyography measured neuromuscular activation of the quadriceps, biceps brachii (BB), and brachioradialis. RESULTS: MVIC torque of knee extensors and BB decreased by 6% (p = 0.001) and 2% (p = 0.014), respectively, by WI 3. Maximal IK torque of knee extensors increased by 11 and 5% post-WI on WIs 3 and 5 (p < 0.001) with greater neuromuscular activation post-WI than pre-WI (p < 0.001). Maximum IK elbow flexion torque did not change throughout the DW with BB neuromuscular activation greater post-WI than pre-WI (p < 0.001). MHG force output was 4% greater post-WI than pre-WI (p < 0.001) with increased brachioradialis activation through 72-h post-WI (p < 0.001). All muscle performance metrics returned baseline levels by 72-h post-WI. CONCLUSION: Our findings indicate that repeated WIs caused noticeable decrements in neuromuscular activation and performance of load bearing muscles on WI 3 while full recovery was observed by 72-h post-WI.

Reverse Left Ventricular Remodelling in ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention: Incidence, Predictors, and Impact on Outcome.

BACKGROUD: We investigated reverse left ventricular remodelling (r-LVR), defined as a reduction of >10% in left ventricular end-systolic volume (LVESV) during follow-up, in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI). METHODS: STEMI patients (n=1,237) undergoing PPCI with echocardiography at baseline and 6-month follow-up were classified into r-LVR (n=466) and no r-LVR groups (n=771). The primary outcome was composite major adverse cardiac events (MACE; all-cause death, myocardial infarction, any revascularisation). RESULTS: r-LVR occurred in 466 patients (37.7%) and was associated with maximum troponin, door-to-balloon time, direct arrival to PPCI-capable hospital, coronary disease extent, initial left ventricular ejection fraction (LVEF), and LVESV. After propensity score (PS)-matching, initial LVEF and LVESV remained significant. During a median 403-day follow-up, 2-year MACE occurred in 166 patients (13.4%); its frequency was similar between groups (entire cohort: 13.5% vs. 13.4%, p=0.247; PS-matched: 11.8% vs. 11.8%, p=0.987). Kaplan-Meier estimates showed that MACE-free survival was comparable between groups (entire cohort: 86.5% vs. 86.6%, log rank p=0.939; PS-matched: 88.2% vs. 88.2%, log rank p=0.867). In Cox proportional hazard analysis, r-LVR was not associated with MACE (entire cohort: hazard ratio [HR] 1.018, 95% confidential interval [CI] 0.675-1.534, p=0.934; PS-matched: HR 1.001, 95% CI 0.578-1.731, p=0.999). CONCLUSION: We identified independent predictors of r-LVR and showed that while r-LVR occurred in 38% of our patients, it was not associated with clinical outcomes.

Effect of conjugated linoleic acids and omega-3 fatty acids with or without resistance training on muscle mass in high-fat diet-fed middle-aged mice.

NEW FINDINGS: What is the central question of this study? This study examined the effects of 20 weeks of administration of conjugated linoleic acids/omega-3 fatty acids with or without programed resistance exercise training on body composition, skeletal muscle properties and functional capacity in middle-aged mice fed a high-fat diet. What is the main finding and its importance? Chronic daily administration of conjugated linoleic acids/omega-3 fatty acids with resistance exercise training can help to blunt fat gain, alleviate loss of myogenic capacity and sensorimotor function and lower tissue inflammation in middle-aged mice during chronic high-fat diet-induced catabolism. This study investigated the effects of 20 weeks of combined conjugated linoleic acid (CLA)/omega-3 fatty acid (n-3) administration independently or combined with resistance exercise training (RET) on skeletal muscle in middle-aged mice consuming a high-fat diet (HFD). Nine-month-old C57BL/6 mice were randomly assigned into four experimental groups (H, high-fat diet; HE, H + RET; HCN, H + CLA/n-3; and HECN, H + CLA/n3 + RET). Body composition and functional capacity were assessed pre- and post-intervention. Muscle tissues were collected at 14 months of age. ANOVA was used, with significance set at P ≤ 0.05. Fat mass significantly increased in H (+74%), HE (+142%) and HECN (+43%) but not in HCN. Muscle wet weights were significantly lower in H and HCN than in HE and HECN. Grip strength substantially declined in H (-15%) and HCN (-17%), whereas sensorimotor function significantly declined only in H (-11%). HECN exhibited improvement in strength (+22%) and sensorimotor coordination (+17%). In comparison to H, muscle tumour necrosis factor-α mRNA expression was significantly lower in HE (-39%), HCN (-24%) and HECN (-21%), respectively. Mean myofibre cross-sectional areas were markedly lower in H and HCN than in HE and HECN. H showed significantly lower satellite cell abundance and numbers of myonuclei than all other groups. Our findings suggest that long-term daily CLA/n-3 intake with resistance training improved sensorimotor function, ameliorated fat gain and prevented loss of myogenic capacity while lowering tumour necrosis factor-α expression during chronic HFD.

Effects of resistance exercise in women with or at risk for breast cancer-related lymphedema.

ᅟ: Breast cancer survivors (BCS) have been told in the past to avoid strenuous repetitive activities in order to decrease the risk of lymphedema development. Recent evidence suggests that exercise may be beneficial to decrease the signs/symptoms and development of lymphedema. PURPOSE/METHODS: This study assessed the arm circumferences of 27 BCS (64 ± 7 years) at baseline and every 2 weeks thereafter during a 6-month resistance exercise training (RT) intervention. RT consisted of 2 days/week of 10 exercises including two sets of 8-12 repetitions at 52-69 % of the participants' one-repetition maximum. RESULTS: A repeated measure analysis of variance revealed no significant changes in percent difference of arm circumferences at any assessment point (pre, 1.31 ± 6.21 %; post, 0.62 ± 6.55 %), nor were there any adverse lymphedema-related events reported during the study. CONCLUSIONS: These findings imply that RT can be a safe activity for women with or at risk for breast cancer-related lymphedema.

Comparisons of Bone Mineral Density Between Recreational and Trained Male Road Cyclists.

OBJECTIVE: To compare measures of training, performance, body composition, and areal bone mineral density (aBMD) between age-matched recreational and competitively trained male road cyclists. DESIGN: Cross-sectional. SETTING: Laboratory. PARTICIPANTS: Male cyclists (N = 28) aged 21-54 years riding more than 3 hours per week. ASSESSMENT OF RISK FACTORS: Men who train at high (≥8 h/wk) and moderate volumes (3-8 h/wk). MAIN OUTCOME MEASURES: Areal bone mineral density assessments by dual energy x-ray absorptiometry of the whole body, lumbar spine (L1-L4), right and left hips, maximal oxygen uptake (V[Combining Dot Above]O2max), and training history. RESULTS: Trained cyclists had higher power to weight (5.3 ± 0.4 vs 4.7 ± 0.3 W/kg, P = 0.001), V[Combining Dot Above]O2max (57.2 ± 4.5 vs 53.0 ± 6.1 mL·kg·min, P = 0.049) and training volume (10.6 ± 2.1 vs 6.3 ± 0.9 h/wk, P < 0.001) than recreational cyclists. Trained cyclists had lower right (0.898 ± 0.090 vs 0.979 ± 0.107 g/cm, P = 0.047) and left hip aBMD (0.891 ± 0.079 vs 0.973 ± 0.104 g/cm, P = 0.032). Z-scores identified lumbar (L1-L4) aBMD as osteopenic (-2.5 < Z-score < -1.0) in trained cyclists (-1.39 ± 1.09). Lumbar scans identified 12 trained and 4 recreational cyclists as osteopenic and 3 trained cyclists as osteoporotic. CONCLUSIONS: Areal bone mineral density is lower in trained male road cyclists compared with recreational, specifically at the hips. Lumbar aBMD is low in both trained and recreational cyclists. Research is needed to determine the chronic effects of cycling on aBMD and interventions that improve aBMD in this population. CLINICAL RELEVANCE: This study suggests road cycling may compromise aBMD and potentially increase the likelihood of low-trauma fractures; health care professionals should consider this exposure when exercise prescriptions are designed for patients at-risk for osteopenia/osteoporosis, for example, women and older adults.

Modified Daily Undulating Periodization Model Produces Greater Performance Than a Traditional Configuration in Powerlifters.

The primary aim of this study was to compare 2 daily undulating periodization (DUP) models on one-repetition maximum (1RM) strength in the squat, bench press, deadlift, total volume (TV) lifted, and temporal hormone response. Eighteen male, college-aged (21.1 ± 1.9 years) powerlifters participated in this study and were assigned to one of 2 groups: (a) traditional DUP training with a weekly training order: hypertrophy-specific, strength-specific, and power-specific training (HSP, n = 9) or (b) modified DUP training with a weekly training order: hypertrophy-specific, power-specific, and strength-specific training (HPS, n = 9). Both groups trained 3 nonconsecutive days per week for 6 weeks and performed the squat, bench press, and deadlift exercises. During hypertrophy and power sessions, subjects performed a fixed number of sets and repetitions but performed repetitions until failure at a given percentage during strength sessions to compare TV. Testosterone and cortisol were measured at pretesting and posttesting and before each strength-specific day. Hypertrophy, power, and strength produced greater TV in squat and bench press (p ≤ 0.05) than HSP, but not for deadlift (p > 0.05). For squat and deadlift, there was no difference between groups for 1RM (p > 0.05); however, HPS exhibited greater increases in 1RM bench press than HSP (p ≤ 0.05). Effect sizes (ES) showed meaningful differences (ES > 0.50) in favor of HPS for squat and bench press 1RM. Testosterone decreased (p ≤ 0.05) at weeks 5 and 6 and cortisol decline at weeks 3 and 4. However, neither hormone was different at posttesting compared with pretesting (p > 0.05). Our findings suggest that an HPS configuration of DUP has enhanced performance benefits compared with HSP.

Body Composition, Strength, and Dietary Intake of Patients with Hip or Knee Osteoarthritis.

PURPOSE: To describe body composition (fat mass (FM) and fat-free mass (FFM)), strength, and nutritional characteristics of patients with hip or knee osteoarthritis undergoing total joint arthroplasty. METHODS: In this prospective pilot study, osteoarthritic patients underwent body composition assessment using bioelectrical impedance analysis, grip strength measurement, and completed a 24-h dietary recall during their pre-operative assessment. RESULTS: Fifty-five patients were included (∼66% females, age 43-89 years). Mean ± SD body mass index (BMI) was 32.79 ± 6.48 kg/m(2) and 62% were obese. Compared with hip osteoarthritis patients, knee osteoarthritis patients had a higher BMI (P = 0.018) and males with knee osteoarthritis had a lower grip strength (P = 0.028). There was a wide range in FM and FFM values across the BMI spectrum. Patients with a higher FM index (FMI, FM/height in m(2)) had higher levels of pain (P = 0.036) and females with higher FMI had a lower grip strength (P = 0.048). Dietary under-reporting was common and many patients did not meet recommendations for protein, vitamins C and E, or omega-3 fatty acids. Those who consumed less protein than the recommended dietary allowance were older (P = 0.018). CONCLUSIONS: A wide variability of body composition and dietary intake was observed which may impact strength and ultimately affect physical function. As such, patients with osteoarthritis may benefit from targeted nutrition and physical activity interventions before and after surgery.