Outbreak of Oropouche virus in frontier regions in western Amazon.

Oropouche virus (OROV) is characterized as a re-emerging arbovirus of great concern for public health, being responsible for several outbreaks of acute fever identified in Latin American countries, registering more than half a million reported cases. The incidence of reports of this virus is intrinsically favored by environmental conditions, in which such characteristics are related to the increase and distribution of the vector population to areas of human traffic. Moreover, there is a problem regarding the lack of diagnosis in Brazil that aggregates the success of the etiologic agent. Thus, by means of molecular techniques, we identified 27 positive cases of the OROV circulating in border locations in western Amazon, with 44.44% (12/27) of the cohort characterized as infected individuals with reported symptoms, mainly ranging from fever, myalgia, and back pain. Among the positive samples, it was possible to obtain a total of 48.14% (13/27) samples to analyze the S and M segments of Oropouche, which showed similarities among the Brazilian sequences. Thus, it was possible to verify the circulation of the OROV in Rondonia and border areas, in which the tracking of neglected arboviruses is necessary for the genomic surveillance of emerging and re-emerging viruses.IMPORTANCEThe western Amazon region is known for outbreaks of acute febrile illnesses, to which the lack of specific diagnostics for different pathogens hinders the management of patients in healthcare units. The Oropouche virus has already been recorded in the region in the 1990s. However, this is the first study, after this record, to perform the detection of individuals with acute febrile illness using a screening test to exclude Zika, dengue, and chikungunya, confirmed by sequencing the circulation of the virus in the state of Rondonia and border areas. We emphasize the importance of including diagnostics for viruses such as Oropouche, which suffers underreporting for years and is related to seasonal periods in Western Amazon locations, a factor that has a direct influence on public health in the region. In addition, we emphasize the importance of genomic surveillance in the elucidation of outbreaks that affect the resident population of these locations.

The emergence of Omicron VOC and its rapid spread and persistence in the Western Amazon.

Genomic surveillance represents a strategy to understanding the evolutionary mechanisms, transmission, and infectivity of different SARS-CoV-2 variants. We evaluated 603 individuals positive for SARS-CoV-2 from 34 municipalities of Rondônia between December 2021 to December 2022. Nasopharyngeal samples were collected, RNA was extracted and screened using RT-qPCR for VOCs. RNA of the samples were sequenced and further analyzed for phylogeny, mutations, and lineages, totaling 96.19% of samples positive for Omicron VOC in this cohort. We observed that most individuals had at least two doses, however 18.97% were not vaccinated with any dose. 554 sequences were amenable to analysis for alignment and phylogenetic characterization; this group corresponded to the 27 subvariants of the Omicron VOC; a total of 100 mutations were identified, 48% of which were found in the S gene. In conclusion, the data demonstrated the rapid spread and persistence of Omicron VOC in Rondônia during the 12-month study period. Although high frequency of mutations was found in the analyzed samples, there were no individuals with a severe clinical profile, demonstrating that vaccination had a positive effect in those cases.

Experience of Definitive Chemoradiation for Oesophageal Cancer Within a Large Regional Cancer Treatment Centre: Improving Outcomes and Tolerability.

AIMS: To review delivery of definitive chemoradiation (dCRT) for patients with oesophageal cancer within a large regional cancer centre. To assess toxicity, tolerability and outcomes and compare with published data. MATERIALS AND METHODS: A retrospective review of patients undergoing dCRT between November 2009 and November 2014 was carried out. Data were collected regarding treatment completion, radiotherapy plans, toxicity, failure and death. Kaplan-Meier survival curves with a Log-rank test for significance were used for survival analysis. RESULTS: In total, 179 patients were analysed. The median age at diagnosis was 70 years. Forty-four (24.6%) patients had T1 or T2 tumours, 113 (63.1%) T3 and 18 (10.1%) T4; 117 (65.4%) patients were node positive on initial staging. One hundred and forty patients were treated before 2012 with CRT and two adjuvant cycles of cisplatin and capecitabine. Of these, only 50% completed both adjuvant cycles of chemotherapy. Thirty-nine patients were treated after 2012 with neoadjuvant cisplatin and capecitabine followed by CRT. Of these, 92% completed all planned chemotherapy. Ninety-five per cent of patients completed radiotherapy without interruption, but only 46% completed concurrent capecitabine. The mean planning target volume (PTV) length was 13 cm (range 6.9-22.2 cm) and 27 (15%) patients had a PTV length greater than 16 cm. After a median follow-up of 19.6 months (range 3.0-71.9), 83 patients (46%) had relapsed, with 43 (24%) patients having isolated locoregional recurrence. The median overall survival was 26 months (95% confidence interval 20.2-31.8) with a 5 year overall survival rate of 19.7% (95% confidence interval 10.4-31.2). CONCLUSIONS: Our series shows comparable survival rates with published data despite an unselected population. The transition to neoadjuvant chemotherapy before CRT has improved tolerability and increased rates of completion of treatment. The locoregional failure rate remains significant and strategies for improving this, such as changing the chemotherapy back bone and radiation dose escalation, are eagerly awaited within the SCOPE-2 study.

Distribution of lymph nodes in men with prostatic adenocarcinoma and lymphadenopathy at presentation: a retrospective radiological review and implications for prostate and pelvis radiotherapy.

AIMS: To describe the distribution of enlarged lymph nodes by nodal group found radiologically in patients presenting with adenocarcinoma of the prostate. This will help to define which nodal groups should be treated during the pelvic radiotherapy of patients with less advanced disease. MATERIALS AND METHODS: The scans of 55 men presenting with prostate cancer and metastases to lymph nodes only were reviewed. Lymph nodes of 8 mm or more in size were considered to be enlarged. RESULTS: The medial external iliac (obturator) nodes were most commonly enlarged (75% of patients) followed by nodes in the para-aortic region (26%) and anterior internal iliac region (24%). Para-aortic lymph-node enlargement was uncommon in the absence of pelvic lymphadenopathy. Midline pre-sacral lymph-node enlargement was not observed. Incidence of enlarged lymph nodes in the lateral external iliac group was 18%, an area which may not be routinely included during radiotherapy. CONCLUSION: There is a case for studying further the role of including lateral external iliac lymph nodes in the pelvic radiotherapy volume, as there may be an appreciable risk of lymph-node spread to this area.

Tumour staging using magnetic resonance imaging in clinically localised prostate cancer: relationship to biochemical outcome after neo-adjuvant androgen deprivation and radical radiotherapy.

AIMS: To evaluate the prognostic significance of magnetic resonance imaging (MRI) tumour stage in clinically localised prostate cancer. MATERIALS AND METHODS: Between 1988 and 1999, 199 men with clinically localised prostate cancer (T -T4, N0/Nx, M0) were treated with neo-adjuvant androgen deprivation and radical radiotherapy, and were staged using MRI. Concordance between clinical tumour (cT) stage, as determined by digital rectal examination, and MRI tumour (mT) stage was assessed. Univariate and multivariate analyses using the Cox proportional hazards model were used to study the prognostic role of cT stage and mT stage in addition to established prognostic factors. RESULTS: Of these 199 patients, 103 (52%) were upstaged on MRI, seven (3%) were downstaged, and in 89 (45%) cT and mT stages were concordant. With median follow-up of 3.8 years, 5-year freedom from prostate-specific antigen (PSA) failure was 48% (95% confidence interval (CI) 39-56%). On univariate analysis, freedom from PSA failure was associated with mT stage (P = 0.009) as well as Gleason score (P < 0.001) and initial PSA (P < 0.001), but not cT stage (P = 0.449). On multivariate analysis, Gleason score (P = 0.001), initial PSA (P < 0.001), but not mT stage (P = 0.112) remained independent determinants of freedom from PSA failure. For the subgroup of 149 patients with cT1-2 disease, mT stage was a significant predictor of increased risk of PSA failure on univariate analysis (P = 0.005), but not multivariate analysis (P = 0.19). CONCLUSION: Freedom from PSA failure was more closely associated with mT stage than cT stage. Future studies are warranted to determine whether mT stage is an independent determinant of treatment outcome.

Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men.

BACKGROUND: Cardiorespiratory fitness and body fatness are both related to health, but their interrelation to all-cause and cardiovascular disease (CVD) mortality is unknown. OBJECTIVE: We examined the health benefits of leanness and the hazards of obesity while simultaneously considering cardiorespiratory fitness. DESIGN: This was an observational cohort study. We followed 21925 men, aged 30-83 y, who had a body-composition assessment and a maximal treadmill exercise test. There were 428 deaths (144 from CVD, 143 from cancer, and 141 from other causes) in an average of 8 y of follow-up (176742 man-years). RESULTS: After adjustment for age, examination year, cigarette smoking, alcohol intake, and parental history of ischemic heart disease, unfit (low cardiorespiratory fitness as determined by maximal exercise testing), lean men had double the risk of all-cause mortality of fit, lean men (relative risk: 2.07; 95% CI: 1.16, 3.69; P = 0.01). Unfit, lean men also had a higher risk of all-cause and CVD mortality than did men who were fit and obese. We observed similar results for fat and fat-free mass in relation to mortality. Unfit men had a higher risk of all-cause and CVD mortality than did fit men in all fat and fat-free mass categories. Similarly, unfit men with low waist girths (<87 cm) had greater risk of all-cause mortality than did fit men with high waist girths (> or =99 cm). CONCLUSIONS: The health benefits of leanness are limited to fit men, and being fit may reduce the hazards of obesity.

Reliability and validity of bioelectrical impedance in determining body composition.

This study was designed to examine the reliability and validity of the bioelectrical impedance method (BIA) of measuring body composition and compare its accuracy with the results obtained by standard anthropometric methods BIA, skinfold fat, and hydrostatically measured percent fat (% fat) were obtained on 44 women and 24 men. Each subject was tested four times by two testers on two different days. Generalizability theory was used to estimate reliability and measurement error that considered both day-to-day and intertester error. The BIA, skinfold fat, and hydrostatic methods were all found to be reliable (Rxx = 0.957-0.987) with standard errors ranging from 0.9 to 1.5% fat. An additional 26 men (n = 50) and 38 women (n = 82) were tested once and combined with the data used for the reliability analysis to cross-validate BIA estimates of % fat with hydrostatically determined % fat. The cross-validation correlations for the BIA determinations of % fat ranged from 0.71 to 0.76, which were significantly lower than that obtained with the sum of seven (sigma 7) skinfolds equations (rxy = 0.92 for men and 0.88 for women). The correlations between the weight-to-height ratio body mass index (BMI) and hydrostatically determined % fat were 0.75 and 0.74 for men and women, respectively. The standard errors of estimate for the two BIA models ranged from 4.6 to 6.4% fat compared with 2.6 and 3.6% fat for the sigma 7 equations. The BIA method for measuring body composition was comparable to the BMI method, with height and weight accounting for most of the variance in the BIA equation.

Modeling the influence of body size on V(O2) peak: effects of model choice and body composition.

This study examined the bivariate relationship between peak oxygen uptake (V(O2) peak); l/min) and body size in adult men (n = 1,314, age 17-66 yr), using both "simple" and "full" iterative nonlinear allometric models. The simple model was described by V(O2) peak = M(b) (or FFM(b)) exp(c SR-PA) exp(a + d age) epsilon (where M is body mass in kg; FFM is fat-free mass in kg; SR-PA is self-reported physical activity; epsilon is a multiplicative error term; and exp indicates natural antilogarithms). The full model was described by V(O2) peak = M(b) (or FFM(b)) exp(c SR-PA) exp(a + d age) + e (epsilon), where e is a permitted Y-intercept term. The M exponent obtained from simple allometry was 0.65 [95% confidence interval (CI), 0.59-0.71], suggestive of a curvilinear relationship constrained to pass through the origin. This "zero Y-intercept" assumption was examined via the full allometric model, which revealed an M exponent of 1.00 (95% CI, 0.7-1.31), together with a positive Y-intercept term (e) of 1.13 (95% CI, 0.54-1.73). The FFM exponents were not significantly different from unity in either the simple or full allometric models. It appears that the curvilinearity of the simple allometric model (using total M) is fictitious and is due to the inappropriate forcing of the regression line through the origin. Utilizing FFM as the body-size variable revealed a linear relationship between body size and V(O2) peak, irrespective of model choice. We conclude that the population mass exponent for V(O2) peak is close to unity.

Research design and analysis of data procedures for predicting body density.

Statistical methods used to develop body composition prediction equations were examined. Equations published in the 1960s and early 1970s have been called "population-specific" equations because they were developed on homogeneous samples. A major limitation of population-specific equations was a low ratio of subjects per variable, which reduces validity. The more recent method has been to develop "generalized" equations with large samples varying greatly in age and body fatness. The statistical models used for generalized equations were nonlinear regression analysis to account for the quadratic relation between body density and skinfold fat. Age was used as an independent variable to adjust for aging. Generalized equations exhibit accuracy consistent with population-specific equations and increase the generalizability of prediction. Future body composition research should focus on the cross-validation of published equations to define the limits of equation accuracy.

Research progress in validation of clinical methods of assessing body composition.

Anthropometry is the method of choice for estimating body composition in the clinical setting. The method can be accurate, and requires little time, space, equipment, or financial outlay. Although used extensively in epidemiological research, height/weight indices are not as accurate as skinfold and circumference measures for estimating body composition. The validity of estimating body density is enhanced by using a combination of skin-fold and circumference measures in a multiple-regression model. Some recently developed generalized equations may have a broader application for use in varied populations than several population-specific equations. The newer equations take into account the potential change in ratio of internal to external fat and bone density with age, and the nonlinear relationship between skinfold fat and body density. The validity of using skinfolds for estimating body density can be significantly affected by caliper selection and measurement procedures. Inter-observer errors appear to be the most problematic, with improper skinfold site selection causing the greatest variation among observers. To improve the validity of the anthropometric technique for use in the clinical setting, more precise standards and description of methods need to be developed.

Generalized equations for predicting body density of women.

Previous research with women has shown that body composition regression equations derived from anthropometric variables were population specific. This study sought to derive generalized equations for women differing in age and body composition. The hydrostatic method was used to determine body density (BD) and percent fat (%F) on 249 women in 18 to 55 years (X = 31.4 +/- 10.8 yrs) and 4 to 44 %F (X = 24.1 +/-7.2 %F). Skinfold fat (S), gluteal circumference (C) and age were independent variables. The quadratic form of the sum of three, four and seven S in combination with age and gluteal C produced multiple correlations that ranged from 0.842 to 0.867 with standard errors of 3.6 to 3.8 %F. The equations were cross-validated on a different sample of 82 women with similar age and %F characteristics. The correlations between predicted and hydrostatically determined %F ranged from 0.815 to 0.820 with standard errors of 3.7 to 4.0 %F. This study showed that valid generalized body composition equations could be derived for women varying in age and body composition, but care need to be exercised with women over an age of forty.

Development of normative values for resting and exercise rate pressure product.

PURPOSE: The purpose of this study was to develop multivariate models to quantify resting, submaximal, and maximal rate pressure products (RPP). METHODS: A validation sample (N = 1623) was randomly selected from a clinically healthy population, and four cross-validation samples were randomly selected from a clinical cohort. The cross-validation samples were patients who had a negative exercise ECG with (Neg-Med, N = 179) and without cardiovascular drug (Neg-NoMed, N = 350), and patients who had a positive exercise ECG with (Pos-Med, N = 60) and without cardiovascular drug (Pos-NoMed, N = 75). Men made up 83% of the validation sample (mean age = 44.2+/-8.7) and women 17% (mean age = 39.7+/-10.1). The validation sample was used to develop multiple regression equations to quantify resting, submaximal, and maximal RPP. RESULTS: Results indicated that gender, body mass index (BMI), and physical activity level (Ex-code) were significantly related with resting RPP. Gender, age, BMI, and Ex-code were significantly related with maximal RPP. Gender, age, BMI, Ex-code, and percent of maximal heart rate at submaximal exercise (%HRmax) were significantly related with submaximal RPP. The multiple correlations for the resting, submaximal, and maximal models were 0.29 (SE = 16.75 beats x min(-1) x mm Hg), 0.87 (SE = 29.04 beats x min(-1) x mm Hg), and 0.31 (SE = 42.41 beats x min(-1) x mm Hg), respectively. The accuracy of the models was confirmed when applied to the Neg-NoMed and Pos-NoMed samples but not the Neg-Med and Pos-Med samples. This result suggest that the regression models developed from this study can be generalized to other populations where patients were not taking cardiovascular medication. Microcomputer programs were suggested to evaluate RPP at rest, maximal exercise, and submaximal exercise. CONCLUSION: Normative RPP for resting and exercise relies on multiple fitness parameters. Practical regression models are developed and can be applied to patients without cardiovascular medication.

The effect of hand-held weights on the physiological responses to walking exercise.

To study the physiological responses to walking with hand-held weights (HWs), 12 untrained men completed three sub-maximal and two maximal treadmill tests. Heart rate, oxygen uptake, respiratory exchange ratio, ventilation, systolic blood pressure (BP), diastolic BP, rate pressure product, and rating of perceived exertion were significantly greater (P less than 0.01) when HWs were added to walking exercise performed at constant treadmill speed and grade. To evaluate whether the evaluated BP response was caused by HWs independent of exercise load, heart rate was held constant at 75% maximum heart rate reserve during the third submaximal test. Systolic BP (151.1 +/- 15.3 mm Hg vs 160.1 +/- 16.9 mm Hg) and rate pressure product (252.1 +/- 27.0 vs 237.3 +/- 25.1) were significantly greater (P less than 0.05) during exercise with HWs. Physiological responses to maximal exercise with and without 3 lb HWs were similar. The time to exhaustion, however, was reduced (P less than 0.01) with HWs. (719.3 +/- 98.1 s with HWs vs 784.4 +/- 118.9 s without HWs). These data indicate that 3-lb HWs can increase the metabolic cost of training (1 MET, 7 to 13 b X min-1) and may be useful in exercise prescription for individuals who do not want to run or are limited in the speed at which they can walk. Due to the exaggerated BP response, caution should be used when prescribing HW exercise for patients where increasing afterload may be a problem.

Accuracy of measured and predicted residual lung volume on body density measurement.

The effects of measured and predicted residual lung volume on the accuracy of body density and percent fat (%Fat) were investigated. Adult fitness subjects (N = 46) had residual lung volume measured with the oxygen dilution method while those from an athlete sample (N = 134) utilized the nitrogen washout technique. Residual lung volume was also predicted with gender-specific regression equations using height and age and from 24% of vital capacity (%FVC). Residual lung volume alpha reliability for the average of four residual lung volume trials exceeded 0.90 (SEM less than = 161 ml) for the oxygen dilution method and 0.99 (SEM = 30 ml) for the average of two nitrogen washout measures. The standard errors for predicted residual lung volume were 579 and 355 ml, respectively, for the men and women in the adult sample and 288 ml for the trained athlete sample. Estimating residual lung volume from %FVC yielded a SEE of 318 ml for the trained athlete sample. Measured residual lung volume errors resulted in errors of 1.04%Fat, 0.87%Fat, and 0.21%Fat for the men, women, and trained athlete samples, respectively. In contrast, predicted residual lung volume measurement errors resulted in errors of 3.70%Fat, 2.85%Fat, and 1.98%Fat for the respective samples and 2.18%Fat when using %FVC with the trained athletes. Measured residual lung volume introduces little %Fat error while predicted residual lung volume introduces a substantial source of measurement error.

Enkephalin metabolism: effect of acute exercise stress and cardiovascular fitness.

Inhibition of enkephalin hydrolysis by catecholamines in vitro suggested that local and/or humoral factors released during exercise might facilitate opiate responses by reducing the rate of opiate peptide inactivation. Several measures of enkephalin hydrolysis were determined in blood samples obtained from subjects designated as trained (VO2max, 64.3 +/- 1.6 ml.min-1.kg-1) and un-trained (VO2max, 37.4 +/- ml.min-1.kg-1) both at rest and after maximal exercise stress tests. Enkephalin hydrolyzing activity assessed under optimal conditions was equally distributed between plasma and intact red cells; however, hydrolysis by red cells increased dramatically following osmotic release of red cell contents. There were no apparent differences in enzyme concentration or its distribution between cells and plasma when comparing trained and untrained subjects; P greater than 0.05. There was also no statistical effect of maximal exercise on these measures in either group. However, when the sequential disappearance of enkephalin added to whole blood in vitro was evaluated, blood from trained subjects degraded the enkephalin more slowly than blood from untrained subjects and had half-lives in vitro 30-50% longer both before and after the exercise test; P less than 0.05. Since enzyme concentrations between the groups were similar, the longer half-lives suggest that circulating factors were responsible for moderating the rate of enkephalin metabolism in vivo and that these factors were more concentrated in trained subjects. This would facilitate opiate responses in trained subjects and perhaps provide them with added tolerance for the effort associated with elite performance levels.

The energy cost of horizontal walking and running in adolescents.

PURPOSE: This study developed and cross-validated generalized equations for predicting VO2 (mL x kg(-1) x min(-1)) and caloric expenditure (kcal x kg(-1) x min(-1)) during horizontal walking and running in adolescents. METHODS: Subjects were 47 male and 35 female adolescent volunteers, ages 12-18. Each subject underwent a submaximal treadmill exercise test to determine VO2 at randomly selected walking and jogging speeds (67-215 m x min(-1)). Caloric expenditure was estimated from VO2 and RER. Multiple regression was used to develop prediction equations for estimating VO2 and caloric expenditure from a derivation sample of 77 random observations, both walking and running. RESULTS: The group relationship between running speed and energy cost in the derivation sample was linear, whereas the relationship between walking speed and energy cost was quadratic. Gender, age, and height each failed to account for significant additional variation in energy cost after speed and mode were considered. Skinfolds accounted for a small yet significant amount of additional variation in energy cost. The derived equations were cross-validated on a sample of 76 separate random observations. The cross-validation statistics are: for VO2, R = 0.95, error = 3.58 mL x kg(-1) x min(-1), and for caloric expenditure, R = 0.94, error = 0.019 kcal x kg(-1) x min(-1). Most selected adult equations consistently underestimated both VO2 and caloric expenditure in the cross-validation sample. CONCLUSIONS: These results suggest that in adolescents, within the range of speeds tested, the relationship between speed of movement and energy cost for running is linear, but for walking is curvilinear. Also, adult models for estimating VO2 or caloric expenditure do not account for the higher relative energy cost of walking and running in adolescents.

Prediction of functional aerobic capacity without exercise testing.

The purpose of this study was to develop functional aerobic capacity prediction models without using exercise tests (N-Ex) and to compare the accuracy with Astrand single-stage submaximal prediction methods. The data of 2,009 subjects (9.7% female) were randomly divided into validation (N = 1,543) and cross-validation (N = 466) samples. The validation sample was used to develop two N-Ex models to estimate VO2peak. Gender, age, body composition, and self-report activity were used to develop two N-Ex prediction models. One model estimated percent fat from skinfolds (N-Ex %fat) and the other used body mass index (N-Ex BMI) to represent body composition. The multiple correlations for the developed models were R = 0.81 (SE = 5.3 ml.kg-1.min-1) and R = 0.78 (SE = 5.6 ml.kg-1.min-1). This accuracy was confirmed when applied to the cross-validation sample. The N-Ex models were more accurate than what was obtained from VO2peak estimated from the Astrand prediction models. The SEs of the Astrand models ranged from 5.5-9.7 ml.kg-1.min-1. The N-Ex models were cross-validated on 59 men on hypertensive medication and 71 men who were found to have a positive exercise ECG. The SEs of the N-Ex models ranged from 4.6-5.4 ml.kg-1.min-1 with these subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Changes in aerobic power of women, ages 20-64 yr.

This study quantified and compared the cross-sectional and longitudinal influence of age, self-report physical activity (SR-PA), and body composition (%fat) on the decline of maximal aerobic power (VO2peak) of women. The cross-sectional sample consisted of 409 healthy women, ages 20-64 yr. The 43 women of the longitudinal sample were from the same population and examined twice, the mean time between tests was 3.7 (+/-2.2) yr. Peak oxygen uptake was determined by indirect calorimetry during a maximal treadmill test. The zero-order correlation of -0.742 between VO2peak and %fat was significantly (P < 0.05) higher then the SR-PA (r = 0.626) and age correlations (r = -0.633). Linear regression defined the cross-sectional age-related decline in VO2peak at 0.537 ml.kg-1.min-1.yr-1. Multiple regression analysis (R = 0.851) showed that adding %fat and SR-PA and their interaction to the regression model reduced the age regression weight of -0.537, to -0.265 ml.kg-1.min-1.yr-1. Statistically controlling for time differences between tests, general linear models analysis showed that longitudinal changes in aerobic power were due to independent changes in %fat and SR-PA, confirming the cross-sectional results. These findings are consistent with men's data from the same lab showing that about 50% of the cross-sectional age-related decline in VO2peak was due to %fat and SR-PA.

Changes in aerobic power of men, ages 25-70 yr.

This study quantified and compared the cross-sectional and longitudinal influence of age, self-report physical activity (SR-PA), and body composition (%fat) on the decline of maximal aerobic power (VO2peak). The cross-sectional sample consisted of 1,499 healthy men ages 25-70 yr. The 156 men of the longitudinal sample were from the same population and examined twice, the mean time between tests was 4.1 (+/- 1.2) yr. Peak oxygen uptake was determined by indirect calorimetry during a maximal treadmill exercise test. The zero-order correlations between VO2peak and %fat (r = -0.62) and SR-PA (r = 0.58) were significantly (P < 0.05) higher that the age correlation (r = -0.45). Linear regression defined the cross-sectional age-related decline in VO2peak at 0.46 ml.kg-1.min-1.yr-1. Multiple regression analysis (R = 0.79) showed that nearly 50% of this cross-sectional decline was due to %fat and SR-PA, adding these lifestyle variables to the multiple regression model reduced the age regression weight to -0.26 ml.kg-1.min-1.yr-1. Statistically controlling for time differences between tests, general linear models analysis showed that longitudinal changes in aerobic power were due to independent changes in %fat and SR-PA, confirming the cross-sectional results.

Pineal parenchymal tumours: I. Pineocytoma: a tumour responsive to platinum-based chemotherapy.

Pineocytoma and pineoblastoma are now recognised as a spectrum of the same disease. Three cases of pineocytoma (grade I-II) are presented, in which platinum-based chemotherapy was used with some success, either as part of primary therapy or at the time of relapse. With the recent reclassification of pineal parenchymal tumours into a grade I-IV continuum, the place of chemotherapy, previously only well-established in pineoblastoma, is discussed.