Effects of resistance training protocols on nonlinear analysis of heart rate variability in metabolic syndrome.

Despite the various standard non-linear measurements used in autonomic modulation (AM) assessments usually being applied to long time-series, such analyses can sometimes be applied to shorter term series. To overcome this disadvantage, chaotic global methods were formulated by putting together heart rate variability (HRV) linear methods. Chaos provides information about vegetative function control related to cardiovascular risks. Applying this method can be useful to investigate the complexity of the health condition after resistance training protocols, as a therapeutic intervention in AM in metabolic syndrome individuals (MetS). This study aimed to compare the effects of two resistance training programs (conventional vs functional) in MetS using nonlinear analysis of AM. MetS subjects (n=50) of both sexes aged 40 to 60 years were randomly divided into two programs; a group of 12 people served as a control group. Both groups performed 30 sessions of training. AM was assessed in the chaos domain by chaotic global techniques. The main results showed that both resistance training, functional and conventional, increased chaos when compared to the control group, respectively, observed by chaotic forward parameter (CFP)1 (13.9±17.9 vs 12.8±14.4 vs -2.23±7.96; P≤0.05) and CFP3 (15.4±19.8 vs 21.9±13.2 vs -4.82±11.4; P≤0.05). In addition, 30 sessions of both resistance programs increased chaos, and non-linear analysis enabled discrimination of AM after interventions when compared to the control group.

Effects of resistance training protocols on nonlinear analysis of heart rate variability in metabolic syndrome

Despite the various standard non-linear measurements used in autonomic modulation (AM) assessments usually being applied to long time-series, such analyses can sometimes be applied to shorter term series. To overcome this disadvantage, chaotic global methods were formulated by putting together heart rate variability (HRV) linear methods. Chaos provides information about vegetative function control related to cardiovascular risks. Applying this method can be useful to investigate the complexity of the health condition after resistance training protocols, as a therapeutic intervention in AM in metabolic syndrome individuals (MetS). This study aimed to compare the effects of two resistance training programs (conventional vs functional) in MetS using nonlinear analysis of AM. MetS subjects (n=50) of both sexes aged 40 to 60 years were randomly divided into two programs; a group of 12 people served as a control group. Both groups performed 30 sessions of training. AM was assessed in the chaos domain by chaotic global techniques. The main results showed that both resistance training, functional and conventional, increased chaos when compared to the control group, respectively, observed by chaotic forward parameter (CFP)1 (13.9±17.9 vs 12.8±14.4 vs -2.23±7.96; P≤0.05) and CFP3 (15.4±19.8 vs 21.9±13.2 vs -4.82±11.4; P≤0.05). In addition, 30 sessions of both resistance programs increased chaos, and non-linear analysis enabled discrimination of AM after interventions when compared to the control group.

Metabolic and psychological changes during refeeding in anorexia nervosa.

OBJECTIVE: This study aimed to examine resting metabolic rate (RMR) and psychological changes during refeeding in 10 women with anorexia nervosa participating in a partial hospitalization eating disorder program. RESULTS: Participants' admission RMRs, as assessed by the MedGem Analyzer, were below their RMRs predicted by the Harris- Benedict equation, t(1,9)=5.77, p<0.01. Correlational analyses revealed a trend toward smaller increases in RMR being associated with higher admission BMI (r=-0.49, p=0.08), but not with highest lifetime BMI. Over the course of treatment, RMR per pound of Fat-Free Mass (FFM) increased from the beginning to the middle, t(1,9)=-3.02, p<0.05, and to the end stage of treatment, t(1,9)=-2.53, p<0.05. Scores on the Eating Attitudes Test-26, Eating Disorder Inventory-2, Brief Symptom Inventory (BSI), BSI Depression subscale, and Mizes Anorectic Cognitions scale significantly improved throughout treatment (all p<0.05); however, body dissatisfaction did not improve. DISCUSSION: Results suggest that weight restoration programs for anorexia nervosa cannot rely on FFM or standard formulas to predict caloric needs throughout refeeding, and that admission BMI is one factor to be considered in predicting caloric needs during refeeding. Furthermore, ways to improve body dissatisfaction during refeeding needs to be more of a treatment focus.

Eating concerns in East Asian immigrants: relationships between acculturation, self-construal, ethnic identity, gender, psychological functioning and eating concerns.

OBJECTIVE: Eating concerns in East Asian immigrants were assessed and their association with acculturation status, self-construal, ethnic identity, gender and psychological functioning was examined. METHOD: One-hundred and fifty non-clinical East Asian immigrants (75 males, 75 females) were administered a battery of psychometrically established measures with satisfactory reliability and validity. RESULTS: Females were more prone to eating concerns and these were positively related to symptoms of psychological distress. Acculturation, self-construal, ethnic identity and psychological functioning were not related to desire to be thinner, feeling guilt after eating, fear of being overweight nor preoccupation with the thought of having fat on one's body. Collective self-esteem and symptoms of psychological distress were positively related to feeling discomfort after eating sweets, while interdependent self-construal and assimilation were negatively related. DISCUSSION: Culturally relevant variables, namely acculturation, self-construal and ethnic identity, were related to only certain facets of eating concerns. The findings suggest the importance of assessing discrete, psychologically-relevant facets of culture rather than more global constructs such as westernization when examining eating concerns in immigrant populations.

Determination of bisnafide, a novel bis-naphthalimide anticancer agent, in human plasma by high-performance liquid chromatography with UV detection.

A simple, specific, and sensitive high-performance liquid chromatographic (HPLC) assay utilizing ultraviolet (UV) detection for the determination of bisnafide in human plasma was developed, validated, and applied to plasma samples from patients undergoing cancer therapy. Plasma samples, containing an internal standard, XE842, were first deproteinized with 2.0 ml acetonitrile, and subsequently, 1.0 ml and pH 9 boric acid-potassium chloride-sodium hydroxide buffer (0.1 M) was added. To this mixture, 9.0 ml of ethyl ether was added then vortex mixed. Following centrifugation, the ether layer was back-extracted into 250 microliters of 0.1 M phosphoric acid, then removed by vacuum aspiration. A portion of the remaining acid layer was directly injected onto the HPLC. Bisnafide was quantified using a Shiseido Capcell Pak C8 HPLC column and ultraviolet detection (274 nm). The lower limit of quantification was 10 ng ml-1 using 1.0 ml plasma. The intraday precision (RSD) ranged from 2.7 to 8.6% over a concentration range of 10-1000 ng ml-1. The interday precision (RSD) ranged from 5.6 to 11.5%. Overall mean accuracy was +/- 5.2%. The drug was stable in frozen heparinized human plasma stored at -20 degrees C for at least 1 year and stable throughout at least two freeze-thaw cycles. This method was successfully utilized for quantifying plasma concentrations needed to study the clinical pharmacokinetics of bisnafide in patients undergoing cancer therapy.

Eating disorders among athletes. Research and recommendations.

Research indicates that certain athletes, particularly those in sports that emphasize leanness to enhance performance or appearance (e.g., gymnastics, wrestling, figure skating, diving, and ballet), are at risk for eating disorders. Little is known about the risk for eating disorder symptoms in weight and strength training. It is concluded that, even when mild variants of eating disorders are observed in athletes, they should be given immediate attention because they may severely compromise health and performance. Practical recommendations are made for coaches and trainers to identify the physical, psychological, and behavioral symptoms of eating disorders. Finally, suggestions are made for addressing eating disorders in athletes.

A simple and reliable method to calibrate respiratory magnetometers and Respitrace.

We present a simple and reliable method to calibrate respiratory magnetometers and Respitrace to infer respiratory volume changes. As in earlier methods, we assume two degrees of freedom in the chest wall and that volume displacement depends linearly on surface motion at the rib cage and abdomen. Because the area of the rib cage is larger, a given motion of its surface produces a greater lung volume change; therefore, the rib cage motion signal is given a larger gain before the two signals are added to estimate volume. In contrast to earlier methods, we use a "standard ratio" to weight relative gains of the rib cage and abdominal signals for all subjects rather than determining a gain ratio for each individual subject. Our procedure does not require subjects to perform the sometimes difficult isovolume maneuvers used in the calibration method of Konno and Mead (J. Appl. Physiol. 22: 407-422, 1967), does not require statistical computation used in the multiple-breath linear regression method, and does not produce the occasional substantial errors in gain ratio that may occur with the other methods. When magnetometers are used, the standard ratio is 4:1 (rib cage-to-abdomen); when Respitrace is used, the standard ratio is 2:1. In 11 subjects, calibration with standard ratios was as accurate as the isovolume and linear regression techniques. Accuracy during normal breathing was nearly always within 10% (median 2%), but occasional large errors occurred with both instruments.

Use of high-resolution cytometry in predicting the biologic behavior of T1 adenocarcinoma of the lung.

Touch preparations from 60 cases of T1 adenocarcinoma were analyzed using a high-resolution, automated image cytometer. These cases were divided according to pathologic stage: stage I, 31; stage II, 3; stage III, 19; and stage IV, 7. For each nucleus 57 features were analyzed, and using a linear combination of three texture features describing the DNA distribution in the cell nucleus (TARL, ODMAX and FAREA1), aggressive cancer cells belonging to stage III/IV could be identified. The best discrimination between the stages was achieved when the frequency of aggressive cancer cells was 48%; the correct classification rate was 77%. Using this criterion, 22 of 27 patients (81%) who died of cancer within five years after surgery were correctly predicted. These results suggest that high-resolution cytometry may be of value in predicting the biologic behavior of adenocarcinoma cases, especially in stage I/II.

Single-dose pharmacokinetics, safety, and tolerance of linopirdine (DuP 996) in healthy young adults and elderly volunteers.

The pharmacokinetics, safety, and tolerance of linopiridine ([3,3-bis(4-pyridinylmethyl)-1-phenylindolin-2-one]; DuP 996) a potential therapeutic agent for Alzheimer's disease, were assessed in double-blind, placebo-controlled, randomized studies in which single oral doses were given to 64 healthy young or elderly males. Young subjects received escalating doses of 0.5 to 55 mg, whereas elderly subjects were given doses of 20 to 45 mg. Linopirdine plasma and urine samples were quantified after liquid extraction by a specific HPLC method using UV detection. In both groups, linopirdine disposition was characterized by rapid absorption (mean Tmax, < 1 hr) and elimination (mean t1/2, 0.4-3.2 hr). Urinary excretion of unchanged drug was negligible. The pharmacokinetic parameters showed large inter- and intrasubject variability. Linopirdine was well-tolerated in both young and elderly volunteers. The most frequently reported adverse event was headache. The subjects who received linopirdine did not experience clinically important changes in vital signs, electrocardiograms (ECGs), electroencephalograms (EEGs), or clinical laboratory evaluations.

Image cytometry and chemoprevention in cervical cancer.

Of the approximately 60 million Pap smears performed in the United States in 1995, about 8% or 5 million will show cytology that is "not negative" (ASCUS, AGCUS, LSIL, HSIL, etc.). Possibly 15% or about 0.7 million of these cases will have positive follow-up by repeated Pap smears, colposcopy or biopsy. More than 4 million will be false-positive smears based on the reference standard of biopsy or repeated smears. If no treatment or medical intervention was offered to the 0.7 million cytologically and histologically positive cases, perhaps 20,000 (3%) would develop into invasive cancer. Of the original 5 million cytologically "not negative" cases, fewer than 0.5% have the potential to develop into invasive cancer. While considerable attention has been paid to false-negatives in Pap screening, the above considerations indicate that the cytological and histological criteria for assessing the malignant potential of "not negative" samples might benefit from some refinement. Until such refinement occurs, any chemoprevention studies in cervix face a formidable signal-to-noise problem--worse than 1:30. This paper presents data from quantitative image cytometry of cervical smears for assessing the malignant potential of various "not negative" cases. We have approached this in two ways--by analyzing dysplastic cell nuclei and by analyzing the nuclei of cytologically normal cells growing in the vicinity of the neoplastic lesion. In both cases, nuclear features describing the distribution of the DNA in the cell nuclei (especially texture features) are the discriminating factors. Future research into the objective assessment of malignant potential of "not negative" cases is outlined.

Diagnoses of eating or dieting disorders: what may we learn from past mistakes?

A brief history of a patient is given and an attempt is made to reconcile the clinical realities she presents with the various diagnostic criteria that have been proposed for eating disorders. Despite much deliberation and many formulations, no scheme fully encompasses her not-uncommon problem. Rather than tinker yet again with the criteria for the syndromes of anorexia and bulimia nervosa, or introduce yet another new condition such as binge eating disorder, the authors suggest a unitary approach to diagnosis. Emphasis should be placed on the preoccupation with weight loss, the illness should be conceptualized as a dieting disorder rather than an eating disorder, and patient status should be accorded only when the disturbance results in significant psychological or physical ill-effects. The term anorexia nervosa should be retained for such cases, and all anorexia nervosa patients should be categorized on three parameters, viz: their current state of nutrition; the presence or absence of significant purging behaviors; and whether or not they have binge eating episodes.

Anorexia nervosa "restricters" who purge: implications for subtyping anorexia nervosa.

It has not been clear from earlier studies whether it is binge eating per se or the compensatory behaviors frequently associated with binge eating (i.e., self-induced vomiting and/or laxative abuse) that provide the most relevant marker for subclassifying anorexia nervosa. The current study addressed this question by comparing the clinical and psychological features of three groups of anorexia nervosa patients: "pure restricting" patients who do not binge (by definition) and who also do not purge (AN-R, N = 116); "restricting-purging" patients who engage in purging behavior (AN-RP, N = 74); and anorexia nervosa "bulimics" who binge eat as defined in earlier studies (AN-B, N = 190). While all three groups displayed similar levels of psychological disturbance on many variables, the overall pattern of findings indicates that the AN-RP group displays significantly more psychopathology than the AN-R group and their profile of disturbance is very similar to that observed with the AN-B group. Thus, anorexia nervosa patients who purge, regardless of whether or not they report objective binge episodes, may be meaningfully distinguished from nonpurging patients. These results, combined with the medical risks associated with purging behaviors and the formidable problems associated with the definition of binge eating, support a sub-typing system for anorexia nervosa based on the presence or absence of purging rather than binge eating.

Comparison of cognitive-behavioral and supportive-expressive therapy for bulimia nervosa.

OBJECTIVE: The authors compared the effectiveness of 4 months (18 sessions) of cognitive-behavioral and supportive-expressive therapy for bulimia. METHOD: Sixty patients obtained from clinical referrals to an eating disorders program who met modified DSM-III-R criteria for bulimia nervosa were randomly assigned to the two conditions. Treatments were delivered in an individual format, on an outpatient basis, by experienced therapists using treatment manuals. The primary outcome measures were self-induced vomiting, binge eating, and attitudes toward body weight and shape, which were assessed by self-report and structured interview. RESULTS: Fifty patients completed treatment, 25 in each condition. Both treatments led to significant improvements in specific eating disorder symptoms and in psychosocial disturbances. Supportive-expressive therapy was just as effective as cognitive-behavioral therapy in reducing binge eating. Where treatment differences were found, they favored cognitive-behavioral therapy. Cognitive-behavioral therapy was marginally superior in reducing the frequency of self-induced vomiting; 36% of the patients who received cognitive-behavioral therapy and 12% of those who received supportive-expressive therapy abstained from vomiting in the last month of treatment. Cognitive-behavioral therapy was significantly more effective in ameloriating disturbed attitudes toward eating and weight, depression, poor self-esteem, general psychological distress, and certain personality traits. CONCLUSIONS: These results moderately favor cognitive-behavioral therapy over supportive-expressive therapy for bulimia nervosa, but follow-up is required to determine the durability of outcome with both modalities. The findings must be interpreted with caution since the selected clinical sample in this study may not represent the bulimia nervosa population.

Cross-cultural patterns in eating disorders: a review.

Eating disorders were previously thought to be isolated to achievement-oriented, upper and middle class individuals in Western countries. It now appears that these disorders may be increasing in other sectors of society and in a number of diverse cultural settings. We review the studies that comprise the relevant cross-cultural research literature on eating disorders. We also discuss the changing cultural factors that may be contributing to the apparent increase in these disorders around the world and directions for future research on such factors.

Obesity treatment: the high cost of false hope.

Although millions seek treatments for obesity, the benefits of treatment have been overstated. For most people, treatment is not effective; the majority of the obese struggle in vain to lose weight and blame themselves for relapses. Repeated experiences of failure add to the psychologic burden caused by the social stigma and the presumption of psychopathologic conditions attached to obesity. Many therapists may be contributing to this psychologic damage by giving their patients false hope for success and by failing to recognize that seeking treatment for obesity may be triggered by psychologic problems that are not addressed in obesity treatment.

Prevalence of Type A behavior in untreated hypertensive individuals.

Type A behavior has been associated with coronary heart disease as well as high cholesterol and smoking, major risk factors for coronary heart disease, but the data indicating a similar association with hypertension are inconsistent. Since past studies have usually based hypertension on a single blood pressure assessment or have often included treated hypertensive patients, this inconsistency is not surprising. The current study compared the prevalence of Type A behavior (assessed by Rosenman's structured interview) between 109 untreated hypertensive subjects and 109 age-, sex-, ethnic-, and occupation-matched normotensive subjects. Hypertension status was based on five repeated assessments over a 5-month period. Results indicated that Type A behavior is more prevalent in untreated, mildly hypertensive employed individuals than occupationally matched normotensive subjects. Type A component analysis confirmed the importance of hostility and certain vigorous voice stylistics in predicting cardiovascular conditions. These findings, taken together with the evidence linking Type A behavior with high cholesterol and cigarette smoking, further support the view that this behavior pattern is associated with increased risk of coronary heart disease.