Treating gout - can hypouricemia produced by moderate doses of combined oral treatment give early treatment success? Preliminary observations.

Six male patients with gout were treated with combined oral medication (febuxostat, 120 mg/d, and benzbromarone, 50 or 100 mg/d), aiming at a more rapid success of uric acid lowering treatment (ULT) compared to guideline suggestions. By combined oral medication in moderate dosage, the sUA was reduced to <2 mg/dl in all cases. We conclude that, by the treatment schedule outlined, the majority of patients with gout can be cured within 1 - 2 years, with uricase treatment being necessary very rarely only.

Reflective practitioners: The importance of critical thought for change agents.

Investment of resources in international development continues to grow, but evidence suggests that progress is patchy and that parameters such as losses resulting from disasters of all scales continue to grow. It is suggested that critical thought and reflection, as an adjunct to action, is vital for both individuals and organisations concerned for social development. It is further argued that disruption is often required in order to dynamically pursue transformation of structures and institutions in order to secure progress towards sustainable livelihoods.

Detraining in the older adult: effects of prior training intensity on strength retention.

In this study, we assessed the influence of training intensity on strength retention and loss incurred during detraining in older adults. In a previous study, untrained seniors (age = 71.0 +/- 5.0; n = 61) were randomly divided into 3 exercise groups and 1 control group. Exercise groups trained 2 days per week for 18 weeks with equivalent volumes and acute program variables but intensities of 2 x 15 repetitions maximum (RM), 3 x 9RM, or 4 x 6RM. Thirty of the original training subjects (age 71.5 +/- 5.2 years) participated in a 20-week detraining period. A 1RM for 8 exercises was obtained pre- and posttraining and at 6 and 20 weeks of detraining. The total of 1RM for the 8 exercises served as the dependent variable. Analysis of variance procedures demonstrated significant increases in strength with training (44-51%; p < 0.05), but no group effect. All training groups demonstrated significant strength decreases at both 6 and 20 weeks of detraining independent of prior training intensity (all group average 4.5% at 6 weeks and 13.5% at 20 weeks; p < 0.04). However, total-body strength was significantly greater than pretraining values after the detraining period (all group average 82% at 6 weeks and 49% at 20 weeks; p < 0.001). The results suggest that when older adults participate in progressive resistance exercise for 18 weeks, then stop resistance training (i.e., detrain), strength losses occur at both 6 and 20 weeks of detraining independent of prior resistance training intensity. However, despite the strength losses, significant levels of strength are retained even after 20 weeks of detraining. The results have important implications for resistance-trained older adults who could undergo planned or unplanned training interruptions of up to 5 months.

The effect of resistance-training intensity on strength-gain response in the older adult.

UNLABELLED: This study examined how training intensity affects strength gains in older adults over an 18-week training period using nonperiodized, progressive resistance-training protocols. Untrained men and women participants were separated into 4 groups: group A (n = 17, 71.4 +/- 4.6 years) performed 2 sets of 15 repetitions maximum (RM), group B (n = 13, 71.5 +/- 5.2 years) performed 3 sets of 9 RM, group C (n = 17, 69.4 +/- 4.4 years) performed 4 sets of 6 RM, group D (n = 14, 72.3 +/- 5.9 years) served as controls. Training groups exercised 2 days/week performing 8 resistance exercises. Except for training intensity, the acute program variables were equated between groups. A 1RM for 8 exercises was obtained every 6 weeks. The total of 1RM for the 8 exercises served as the dependent variable. RESULTS: repeated measures analysis of variance (ANOVA) and Scheffe post hoc revealed that, at 6 weeks, only groups B and C were significantly stronger than group D (p < 0.01). By weeks 12 and 18, all training groups were significantly stronger than controls (p < 0.01). However, no difference existed between groups A, B, and C at any time. The data suggests that, for protocols with equated acute program variables, strength gain is similar over 18 weeks for training intensities ranging from 6 to 15 RM in previously untrained older adults. When programming nonperiodized, progressive resistance exercise for novice senior lifters, in the initial phases of the program, a wide range of intensities may be employed with similar strength gain.