The Effect of Acute Aerobic Exercise on Biomarkers of Renal Health and Filtration in Moderate-CKD.

Purpose: Efficacy of exercise to improve renal health and filtration remains understudied in adults with moderate-stages (stages G3a-b) of chronic kidney disease (CKD). Acute exercise may contribute clinically relevant information for exercise-related augmentation of renal health and filtration in CKD. Urine epidermal growth factor (uEGF) and cystatin C (CyC) are proposed to be more direct biomarkers of renal health and filtration. This study aimed to determine the influence of continuous moderate-intensity exercise (CMIE) and high-intensity interval exercise (HIIE) on traditional and novel biomarkers of renal health and filtration in moderate-stages of CKD. Methods: Twenty CKD participants completed 30 minutes of both CMIE and HIIE. Blood and urine samples were obtained pre, 1-hour, and 24-hours post-exercise. Traditional-serum creatinine (sCr) urine creatinine, novel-uEGF, uEGF ratio (uEGFr), and CyC. Estimates of glomerular filtration rate (eGFR)-modification of diet in renal disease (MDRD) and the CKD-Epidemiology (CKD-EPI)-responses were compared pre, 1 hr, and 24 hr post-exercise. Results: Relative to pre-exercise measures, uEGF remained unchanged in both exercise conditions. However, uEGFr was 5.4% greater 24-hours after HIIE (P = .05), while uEGFr remained unchanged with CMIE. sCr decreased 6 to 19% 1-hour post-exercise in both conditions (P = .009). On average renal filtration increased in eGFR-MDRD (7.2 ± 2.0 ml/min/1.73 m2) (P = .007) and eGFR-CKD-EPI (8.6 ± 2.3 ml/min/1.73 m2) 1-hour post-exercise (P = .009). Conclusion: By clinical estimates, renal filtration in CKD was not normalized but transiently improved regardless of exercise condition, with HIIE eliciting transient improvements in renal health.

The effect of exercise intensity and excess postexercise oxygen consumption on postprandial blood lipids in physically inactive men.

Reductions in postprandial lipemia have been observed following aerobic exercise of sufficient energy expenditure. Increased excess postexercise oxygen consumption (EPOC) has been documented when comparing high- versus low-intensity exercise. The contribution of EPOC energy expenditure to alterations in postprandial lipemia has not been determined. The purpose of this study was to evaluate the effects of low- and high-intensity exercise on postprandial lipemia in healthy, sedentary, overweight and obese men (age, 43 ± 10 years; peak oxygen consumption, 31.1 ± 7.5 mL·kg-1·min-1; body mass index, 31.8 ± 4.5 kg/m2) and to determine the contribution of EPOC to reductions in postprandial lipemia. Participants completed 4 conditions: nonexercise control, low-intensity exercise at 40%-50% oxygen uptake reserve (LI), high-intensity exercise at 70%-80% oxygen uptake reserve (HI), and HI plus EPOC re-feeding (HI+EERM), where the difference in EPOC energy expenditure between LI and HI was re-fed in the form of a sports nutrition bar (Premier Nutrition Corp., Emeryville, Calif., USA). Two hours following exercise participants ingested a high-fat (1010 kcals, 99 g sat fat) test meal. Blood samples were obtained before exercise, before the test meal, and at 2, 4, and 6 h postprandially. Triglyceride incremental area under the curve was significantly reduced following LI, HI, and HI+EERM when compared with nonexercise control (p < 0.05) with no differences between the exercise conditions (p > 0.05). In conclusions, prior LI and HI exercise equally attenuated postprandial triglyceride responses to the test meal. The extra energy expended during EPOC does not contribute significantly to exercise energy expenditure or to reductions in postprandial lipemia in overweight men.

Acute Exercise and Oxidative Stress: CrossFit(™) vs. Treadmill Bout.

CrossFit(™), a popular high-intensity training modality, has been the subject of scrutiny, with concerns of elevated risk of injury and health. Despite these concerns empirical evidence regarding physiologic stresses including acute oxidative stress is lacking. Therefore, the purpose of this investigation was to examine the acute redox response to a CrossFit(™) bout. Furthermore, these findings were compared to a high-intensity treadmill bout as a point of reference. Ten males 26.4 ± 2.7 yrs having three or more months of CrossFit(™) experience participated in the present study. Blood plasma was collected at four time points: Pre-exercise (PRE), immediately-post-exercise (IPE), 1 hr-post (1-HP) and 2 hr-post (2-HP), to examine oxidative damage and antioxidant capacity. Regarding plasma oxidative damage, CrossFit(™) and Treadmill elicited a time-dependent increase of lipid peroxides 1-HP (CrossFit(™)=+143%, Treadmill=+115%) and 2-HP (CrossFit(™)=+256%, Treadmill+167%). Protein Carbonyls were increased IPE in CF only (+5%), while a time-dependent decrease occurred 1-HP (CrossFit(™)=-16%, Treadmill=-8%) and 2-HP (CF=-16%, TM=-1%) compared to IPE. Regarding antioxidant capacity, Ferric Reducing Antioxidant Power also demonstrated a time-dependent increase within CrossFit(™) and Treadmill: IPE (CrossFit(™)=+25%, Treadmill=+17%), 1-HP (CrossFit(™)=+26%, Treadmill=+4.8%), 2-HP (CrossFit(™)=+20%, Treadmill=+12%). Total Enzymatic Antioxidant Capacity showed a time-dependent decrease in IPE (CrossFit(™)=-10%, Treadmill=-12%), 1-HP (CrossFit(™)=-12%, Treadmill=-6%), 2-HP (CrossFit(™)=-7%, Treadmill=-11%). No trial-dependent differences were observed in any biomarker of oxidative stress. The CrossFit(™) bout elicited an acute blood oxidative stress response comparable to a traditional bout of high-intensity treadmill running. Results also confirm that exercise intensity and the time course of exercise recovery influence oxidative responses.

Microbial uropathogens and their antibiotic resistance profile from hospitalized patients in Central Alabama.

Urinary tract infections remain a common problem in inpatient care. They are highly challenging to provide effective initial therapy without sensitivity data. The purpose of this study was to survey the uropathogens and their sensitivity profile at a hospital in Central Alabama and to guide experiential antibiotic selection. This was the first reported study on bacterial uropathogens and their antibiotic resistance profile at this Central Alabama hospital. The survey period was between July 2009 and June 2010, a total of 473 urine cultures were reviewed and susceptibility testing was determined using the Clinical and Laboratory Standards Institute (CLSI) microdilution method. The results indicated that Escherichia coli (45.5%) was the most common organism, followed by Klebsiella pneumoniae (18.2%), Pseudomonas aeruginosa (10.1%), Proteus mirabilis (7.8%), Enterobacter cloacae (4.2%), methicillin-resistant Staphylococcus aureus (3.0%), Klebsiella oxytoca and Citrobacter freundii (1.5%), Morganella morganii (1.3%), and the other species (7.0%). For the 215 E. coli isolates, imipenem and cephalosporins (except for cefazolin) had the highest sensitivity (99-100%, P < 0.05). In contrast, ampicillin had the highest resistance (57%, P < 0.05) as compared to other antibiotics (about 30%) including ampicillin/ sulbactam, ciprofloxacin, levofloxacin, tetracycline, and trimethoprim/sulfamethoxazole. The major finding of this study was that ciprofloxacin, levofloxacin and trimethoprim/sulfamethoxazole had comparable sensitivity patterns for Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Enterobacter cloacae, the most common uropathogens at this Central Alabama hospital. Additionally, this study found that E. coli had a resistant rate of 31% to ciprofloxacin and levofloxacin compared to the resistance rate of 28.4% and 15.8% in earlier reports (Lee et al. 2010; Rattanaumpawan et al. 2010), likely indicating the continuing evolution of resistance due to antibiotic exposure. It is imperative to monitor the resistance of P. aeruginosa considering their high resistance to imipenem found in this study.

Hand hygiene knowledge of college students.

An observational study was conducted to evaluate hygiene habits of students with fields of study, gender, and understanding of hygiene at a university in Alabama. One hundred students were randomly observed in ten restrooms on campus to determine whether or not students washed their hands. The study was divided into an observational stage, a quiz to ascertain student's knowledge of hygiene and the spread of pathogens, and a survey of self-reported illness rates. Females had a tendency to wash their hands more often than males while visiting the bathroom (p = 0.02, chi2 = 11.6). Science majors were more likely to wash their hands than non-science majors (p < or = 0.001, chi2 = 5.2). Females (p < or = 0.0001, df = 98, F = 21.5) and science majors (p < or = 0.0001, df = 98, F = 81.4) scored significantly higher on the survey than males and nonscience majors, and that those observed not washing their hands reported being sick more often than those observed washing their hands (chi2 = 155.0, df= 3, p < 0.001, Fisher's exact p < 0.001).

The influence of sex, body composition, and nonesterified fatty acids on serum adipokine concentrations.

Serum adiponectin concentrations are higher in women than men. The sexual dimorphism for adiponectin has been attributed to the direct effects of testosterone on adipose tissue adiponectin secretion. However, serum testosterone and adiponectin concentrations are generally lower in obese men than lean men, suggesting that sex steroids may not be the only factor that contributes to sex differences in serum adiponectin. The primary objective of this study was to examine the influence of sex, body composition, and nonesterified fatty acids (NEFAs) on serum adiponectin concentrations. Women and men between the ages of 18 and 35 years were consecutively accrued into the study. Sixty-one participants were partitioned into normal-weight (15 female and 16 male) or obese (14 female and 16 male) groups. Blood samples were obtained after a 12-hour fast. Differences between groups were determined by analysis of variance with Tukey-Kramer post hoc testing. Serum adiponectin was 26% higher in women compared with men. Body mass index was associated with total serum adiponectin in men (r = -0.63, P < .05) but not women. Adiponectin was correlated with the homeostasis model assessment index in women (r = -0.56, P < .05) and men (r = -0.58, P < .05) and with NEFAs (r = -0.68, P < .05) in men only. After partitioning men and women into normal-weight and obese groups, serum adiponectin was lower and NEFAs were higher in obese men only. Homeostasis model assessment was similar between obese women and men despite higher NEFAs in the obese men. Leptin and plasminogen activator inhibitor-1 were higher in obese participants but were not associated with serum NEFAs. These results suggest that serum NEFAs may reduce adiponectin concentrations independent of their effects on insulin sensitivity in obese young men.

Postprandial triglyceride responses to aerobic exercise and extended-release niacin.

BACKGROUND: Aerobic exercise and niacin are frequently used strategies for reducing serum triglycerides, and, yet, there is no information regarding the combined effects of these strategies on postprandial triglycerides. OBJECTIVE: We compared the effects of aerobic exercise and 6 wk of extended-release niacin on postprandial triglycerides in men with the metabolic syndrome. DESIGN: Fifteen participants underwent each of 4 conditions: control--high-fat meal only (100 g fat); exercise--aerobic exercise performed 1 h before a high-fat meal; niacin--high-fat meal consumed after 6 wk of niacin; and niacin + exercise--high-fat meal consumed after 6 wk of niacin and 1 h after aerobic exercise. Temporal responses for triglyceride and insulin concentrations were measured and total (AUC(T)) and incremental (AUC(I)) areas under the curve were calculated. Differences were determined by using a 2-factor repeated-measures analysis of variance (P < 0.05 for all). RESULTS: Exercise lowered the triglyceride AUC(I) by 32% compared with control (724 +/- 118 and 1058 +/- 137, respectively). Niacin had no influence on the triglyceride AUC(I) and attenuated the triglyceride-lowering effect of exercise when combined. Niacin + exercise had no effect on the triglyceride AUC(I) but decreased the insulin AUC(I) after niacin administration. CONCLUSIONS: Aerobic exercise lowers the postprandial triglyceride response to a high-fat meal. Niacin lowers fasting but not postprandial triglycerides and appears to influence the triglyceride-lowering effect of aerobic exercise when combined. However, exercise decreases postprandial insulin concentrations after niacin administration, which illustrates the potential metabolic benefits of exercise in persons taking niacin.

Cardiovascular fitness and vascular inflammatory markers after acute aerobic exercise.

Inflammatory markers such as C-reactive protein (CRP), fibrinogen, and white-blood-cell (WBC) count are strongly associated with cardiovascular disease. The authors' purpose was to compare the inflammatory response to a single aerobic-exercise session between individuals of high and moderate fitness. Ten apparently healthy highly fit and 11 moderately fit men expended 500 kcal at 70% of VO2peak. Fasting blood samples were obtained on 2 consecutive days before and again at 24, 72, and 120 h postexercise. Blood samples were analyzed for CRP, fibrinogen, and WBC count. CRP was 76% lower at baseline in the highly fit group than in the moderately fit group (P = 0.03). CRP, fibrinogen, and WBC count remained unaltered, however, in the days after exercise (P > 0.05 for all). These findings suggest that markers of inflammation are stable in the days after a single session of moderate-intensity aerobic exercise in apparently healthy men of at least average fitness.

The incidence of group B streptococcus in the vaginal tracts of pregnant women in central Alabama.

Group B streptococcus (Streptococcus agalactiae) or GBS is the most common cause of neonatal sepsis and meningitis in the United States. One important risk factor for infants who acquire GBS is maternal colonization. Colonization rates have been estimated in various studies to be between 15% and 35% of pregnant women. Colonization rates for black women have also been shown to be higher than for non-blacks. Local data were collected and compared to those of other studies. Of the pregnant women in this study overall, 22.76% tested positive for GBS. Black women were colonized by GBS (35.71%) significantly more often than non-black women (19.84%; G = 8.9729, p < 0.00274). Generalized linear models were used to examine age and race. Both maternal age and the interaction of maternal race and age as predictors of infection were ruled out, leaving only race as a significant predictor of colonization.