Massage enhances recovery following exercise-induced muscle damage in older adults.

To examine efficacy of cold water immersion (CWI) and massage as recovery techniques on joint position sense, balance, and fear of falling following exercise-induced muscle damage in older adults. Seventy-eight older men and women performed a single bout of strength training on the calf muscles (3 exercises with 4 sets of 10 reps with 75% of 1RM) to induce muscle damage. After the damaging exercise, participants received either a 15-minute massage on calf muscles, or a CWI of the lower limb in cold water (15 ± 1°C) for 15 minute, or passive rest. Interventions were applied immediately after the exercise protocol and at 24, 48, and 72 hours post-exercise. Muscle pain, calf muscle strength, joint position sense, dynamic balance, postural sway, and fear of falling were measured at each time point. Repeated application of massage after EIMD relieved muscle pain, attenuated the loss of muscle strength and joint position senses, reduce balance impairments, and fear of falling in older adults (P ≤ .05). However, repeated applications of CWI, despite relieving muscle pain (P ≤ .05), did not attenuate the loss of muscle strength, joint position senses, balance impairments, and fear of falling. CWI had only some modest effects on muscle pain, but massage attenuated EIMD symptoms and the related impairments in muscle strength, joint position sense, balance, and postural sway in untrained older individuals. Therefore, older exercisers who plan to participate in strength training can benefit from massage for recovery from muscle damage indices and balance to decrease falling risk during the days following strength training.

Effect of exercise training on glycemic control in diabetic peripheral neuropathy: A GRADE assessed systematic review and meta-analysis of randomized-controlled trials.

AIMS: We conducted a systematic review and meta-analysis to investigate the effect of exercise training on HbA1c, and on fasting and postprandial plasma glucose concentrations in patients with diabetic peripheral neuropathy (DPN). METHODS: Two independent researchers performed a systematic search in the electronic databases of PubMed, Web of Science and Scopus. Studies investigating the effect of exercise training on patients diagnosed with DPN using a randomized-controlled design were included in the meta-analysis. RESULTS: Of 1254 retrieved studies, 68 studies were identified to undergo full-text review; out of these a total of 13 randomized trials met the inclusion criteria. Eleven studies assessed HbA1c, 8 fasting plasma-glucose concentration, and 3 postprandial plasma-glucose concentration. Overall, exercise training significantly decreased HbA1c [-0.54% (95% CI -0.78 to -0.31%)], fasting plasma glucose [-32.6 mg/dl [-1.8 mmol/L] (-44.2 to -20.9 mg/dl [-2.4 to -1.1 mmol/L])] and postprandial plasma glucose [-67.5 mg/dl [-3.7 mmol/L] (-129.5 to -5.4 mg/dl [-7.1 to -0.3 mmol/L])]. Studies with aerobic training intervention yielded the largest significant mean reduction in HbA1c (-0.75%) and fasting plasma glucose concertation (34.0 mg/dl). CONCLUSIONS: aerobic training is the most effective modality to reduces HbA1c, fasting and postprandial plasma glucose concentration in patients with DPN. From a metabolic perspective, the magnitude precision range of the reduction in HbA1c is of clinical importance for patients with DPN. This area of research warrants further attention to investigate the impact of various exercise modalities on glycemic control. Registration number CRD42023413687.

Natural wetlands efficiency assessment in removing sugarcane fields' drainage contaminants: a case study in Khuzestan, Southwest Province of Iran.

The present study investigated the efficiency of a real-scale natural wetland (Naseri Wetland) in the qualitative treatment of agricultural drainage of Khuzestan sugarcane for 1 year (2019-2020). This study divides the wetland length into three equal parts in W1, W2, and W3 stations. The efficiency of the wetland in removing contaminants such as Cr, Cd, BOD5, TDS, TN, and TP is evaluated by field sampling, laboratory analysis, and t-test. Results indicate that the highest mean difference in Cr, Cd, BOD, TDS, TN, and TP are observed between W0 and W3. At W3, the farthest station from the entry point, the highest removal efficiency is obtained for each factor. Removal percentage of Cd, Cr, and TP in all seasons is equal to 100% up to station 3 (W3), and BOD5 and TN are 75% and 65%, respectively. Also, the results show a gradual rise in TDS along the wetland's length due to high evaporation and transpiration in the area. Naseri Wetland reduces the Cr, Cd, BOD, TN, and TP compared to the initial level. This decrease is more significant at W2 and W3, and it is worth mentioning that W3 has the most considerable reduction. With increasing distance from the entry point, the effect of timing of 1.10, 1.26, 1.30, and 1.60 on removing heavy metals and nutrients is high. The highest efficiency is observed for each retention time at W3.

Effect of Beta-Alanine Supplementation on Exercise-Induced Cell Damage and Lactate Accumulation in Female Basketball Players: A Randomized, Double-Blind Study.

Beta-alanine (BA) is a supplement that has received attention for its buffering potential among athletes. The aim of this study was to investigate the effects of BA supplementation on exercise performance and exercise-induced cell damage in female basketball players. Twenty-two female basketball players participated in a randomized, double-blind study. They ingested 6.4 g·day-1 of BA or an isocaloric placebo (dextrose) over 4 weeks. Exercise performance including aerobic (Bruce test), anaerobic (Wingate test), intermittent (Yo-Yo test) and basketball performance (countermovement jump and free throw shots) was measured before and following the intervention. Exercise measures were performed at the lab and free throw shots were undertaken on a wooden indoor basketball court. Blood samples were also collected before and after the exhaustive exercise to assess lactate concentration, creatine kinase (CK), lactate dehydrogenase (LDH) and malondialdehyde (MDA) activity. The exhaustive exercise test induced an increase in lactate concentration and MDA, CK and LDH activity (all p < 0.05). BA supplementation significantly reduced the lactate response to exhaustive exercise (p = 0.001); however, it had no significant effect on exercise-induced MDA, CK and LDH activity (all p > 0.05). Furthermore, exercise performance measures improved from pre- to post-test regardless of supplement/placebo ingestion (all p < 0.05). BA consumption over 4 weeks significantly reduced lactate accumulation following exhaustive exercise, but had no ergogenic effect in female basketball players. Usual dosing of BA does not seem to exhibit protective effect against oxidative damage.

Bilateral Wrist Drop Due to Lead Poisoning in a Young Woman With Opium Addiction.

Opium addiction can cause symptoms in the central or peripheral neurological systems, as well as gastrointestinal disorders and anemia; in such situations, lead poisoning should be considered and chelation therapy should be started as soon as possible. In adults, lead poisoning is an unusual cause of abdominal pain. A common form of lead neuropathy includes weakness of the wrist and finger extensors. We describe a 24-year-old female who developed severe lead poisoning after 3 years of opium consumption, leading to gastrointestinal complaints and bilateral wrist drops.

Rhabdomyolysis and acute kidney injury due to suicide attempt with tramadol: A rare case report.

Although acute kidney injury (AKI) is a very rare complication of tramadol (TR) poisoning, overdose use in recent years should be considered. We present a 21-year-old man with metabolic acidosis, seizures, elevated serum creatine phosphokinase (CPK), creatinine, and rhabdomyolysis due to tramadol poisoning.

Resistance training improves nerve conduction and arterial stiffness in older adults with diabetic distal symmetrical polyneuropathy: A randomized controlled trial.

Diabetes is the main cause of peripheral neuropathy where older patients are at increased risk of diabetic distal symmetrical polyneuropathy (DSPN) due to age-related nerve degeneration and vascular changes. The aim of the study was to investigate the effect of resistance training on nerve conduction, measures of neuropathy and arterial stiffness in older patients with DSPN. In a randomized controlled trial, thirty-four older adults with type-2 diabetes and peripheral neuropathy were enrolled and randomly assigned to experimental and control groups. The experimental group carried out circuit resistance training (1-3 rounds, 11 exercises, 10-15 reps, 50%-60% of 1RM, 3 times per week) for 12 weeks. Measurements were performed at baseline and 48 h after the intervention. Measures of DSPN including Michigan neuropathy screening instrument (MNSI), Michigan diabetic neuropathy score (MDNS), motor nerve action potential amplitude (APA), sensory and motor nerve conduction velocity (NCV) improved following intervention (p < 0.001, p = 0.001, p = 0.034, p = 0.001, and p = 0.001, respectively). Sensory APA did not change after the intervention (p = 0.139). Cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) improved in the experimental group compared with the control group (p = 0.014 and p = 0.033, respectively). In addition, HbA1C decreased following the 12-week resistance training program (p = 0.002). Older adults with DSPN respond positively to resistance training by improved neuropathy symptoms, nerve conduction, arterial stiffness and glucose regulation. Resistance training offers a positive intervention that can abate the progression of DSPN in older adults.

Mycophenolate mofetil-induced peripheral neuropathy in the treatment of membranous glomerulonephropathy: A case report.

Mycophenolate mofetil (MMF) as an immunosuppressive agent is widely used in the management of Membranous Glomerulonephropathy (MGN). In this report, we described a 66-year-old male MGN case treated with MMF and revealed acquired sensory-motor axonal polyneuropathy, which is rare and has not been reported before.

Roux-en-Y gastric bypass surgery induced oxalosis and acute kidney injury: A case report.

INTRODUCTION AND IMPORTANCE: Diabetes mellitus and hypertension are two conditions that can coexist in obese individuals. Roux-en-Y gastric bypass (RYGB) surgery, are used to control obesity. Complications such as steatorrhea, hyperoxaluria, and decreased bone mineral density, may occur after RYGB. CASE PRESENTATION: A 58-year-old woman referred to the emergency department complaining of pain on the right side of her lower abdomen. Her past medical history was RYGB surgery, COVID-19 with 40% pulmonary involvement, and Chronic Kidney Disease (CKD). Rapid progressive glomerulonephritis (RPGN) was predicted based on extensive laboratory test results. A kidney biopsy demonstrated oxalate nephropathy. Along with the findings from the kidney biopsy, acute tubulointerstitial nephritis with tubular injury secondary oxalosis was diagnosed. CLINICAL DISCUSSION: RYGB surgery and chronic kidney disease, can increase the risk of secondary oxalosis. Recent studies introduce enteric hyperoxaluria as an important marker for diagnosing end-stage kidney disease. Renal biopsy is often prescribed for absolute recognition of oxalosis. On the other hand, our patient has a recent history of COVID-19 infection. The use of anti-Covid-19 drugs in patients with renal insufficiency should be considered with caution. CONCLUSION: It is important to monitor kidney function following RYGB surgery, particularly in patients with underlying diseases such as diabetes or hypertension.

Tomato powder is more effective than lycopene to alleviate exercise-induced lipid peroxidation in well-trained male athletes: randomized, double-blinded cross-over study.

BACKGROUND: Consumption of nutritional supplements to optimize recovery is gaining popularity among athletes. Tomatoes contain micronutrients and various bioactive components with antioxidant properties. Many of the health benefits of tomatoes have been attributed to lycopene encouraging athletes to consume pure lycopene supplements. The aim of this study was to compare the effect of tomato powder and lycopene supplement on lipid peroxidation induced by exhaustive exercise in well-trained male athletes. METHODS: Eleven well-trained male athletes participated in a randomized, double-blinded, crossover study. Each subject underwent three exhaustive exercise tests after 1-week supplementation of tomato powder (each serving contained 30 mg lycopene, 5.38 mg beta-carotene, 22.32 mg phytoene, 9.84 mg phytofluene), manufactured lycopene supplement (30 mg lycopene), or placebo. Three blood samples (baseline, post-ingestion and post-exercise) were collected to assess total anti-oxidant capacity (TAC) and variables of lipid peroxidation including malondialdehyde (MDA) and 8-isoprostane. Data were analyzed using repeated-measures of ANOVA at P < 0.05. RESULTS: Tomato powder enhanced total antioxidant capacity (12% increase, P = 0.04). Exhaustive exercise, regardless of supplement/ placebo, elevated MDA and 8-isoprostane levels (P < 0.001). The elevation of 8-isoprostane following exhaustive exercise was lower in the tomato powder treatment compared to the placebo (9% versus 24%, p = 0.01). Furthermore, following exhaustive exercise MDA elevated to a lower extent in tomatoe powder treatment compared to the placebo (20% versus 51%, p = 0.009). However, such differences were not indicated between lycopene and placebo treatments (p > 0.05). CONCLUSION: Beneficial effects of tomato powder on antioxidant capacity and exercise-induced lipid peroxidation may be brought about by a synergistic interaction of lycopene with other bioactive nutrients rather than single lycopene.

Cycle Training improves vascular function and neuropathic symptoms in patients with type 2 diabetes and peripheral neuropathy: A randomized controlled trial.

Diabetic peripheral neuropathy (DPN) is associated with peripheral arterial disease and endothelial dysfunction. We investigated the effect of exercise training on the measures of superficial femoral artery (SFA) and neuropathic symptoms in patients with DPN. In a randomized-controlled trial, 31 volunteers with established DPN were randomly assigned to experimental or control groups. Experimental group performed cycling exercise training (50%-70% of heart rate reserve, 30-45 min, 3 sessions/week) over 12 weeks. Before and 48 h after the experimental period a 5-min flow mediated dilation (FMD) response in SFA using Color Doppler Ultrasonography, fasting glucose level, HbA1c and neuropathic score were assessed. FMD% significantly increased in the experimental group (from 3.2 ± 1.1% to 5.7 ± 1.2%) compared to the control condition (P = 0.0001). However, no significant alteration occurred in baseline membrane diameter and intima media thickness (P > 0.05). We also observed a significant improvement in fasting glucose, HbA1c and Michigan Diabetic Neuropathy Score (MDNS) following exercise intervention (all P < 0.05). Linear regression analysis indicated that the change in MDNS was significantly associated with the change in HbA1c (R Square = 0.34, standardized coefficients Beta = -0.58, P = .001) and FMD (R Square = 0.37, standardized coefficients Beta = 0.61, P = .001). This finding may be clinically of considerable importance as metabolic and vascular factors have been indicated to be involved in the development of DPN.

High doses of sodium nitrate prior to exhaustive exercise increases plasma peroxynitrite levels in well-trained subjects: randomized, double-blinded, crossover study.

The aim of this study was to investigate the effect of different doses of pre-workout sodium nitrate supplementation on nitric oxide, peroxynitrite levels, and performance parameters. Ten well-trained male subjects participated in a randomized, double-blinded, crossover study. They ingested 8, 16, and 24 mmol sodium nitrate or placebo (NaCl) dissolved in water at 2.5 h before an incremental exercise test. Respiratory gases (oxygen consumption, carbon dioxide production, respiratory exchange ratio) were measured throughout the exercise trials and 3 blood samples (pre-ingestion, 2.5 h post-ingestion and postexercise) were taken to analyze nitrate/nitrite (NOx) and peroxynitrite levels. Data were analyzed using repeated-measures ANOVA at significance level of P < 0.05. NOx levels significantly increased following sodium nitrate ingestion compared with placebo (placebo: 40.86 ± 10.7 µmol/L, 8 mmol: 203.69 ± 25.1 µmol/L, 16 mmol: 289.41 ± 30.1 µmol/L, and 24 mmol: 300.95 ± 42.4 µmol/L, respectively) (P = 0.0001). However, this did not induce any significant change in oxygen consumption (P = 0.351), blood lactate concentration (P = 0.245), and time-to-exhaustion (P = 0.147). Peroxynitrite levels were similar compared with placebo when participants ingested 8 and 16 mmol of inorganic nitrate but a significant increase was observed after exercise at maximal intensity when participants were supplemented with 24 mmol (mean = 14.60 ± 1.3 µmol/L, P = 0.001). Pre-workout ingestion of high dose of sodium nitrate (24 mmol) induced peroxynitrate formation, a marker of oxidative stress. Caution must be taken regarding administration of higher doses before benefits or adverse effects are established in this population.

Effect of aerobic training on nerve conduction in men with type 2 diabetes and peripheral neuropathy: A randomized controlled trial.

OBJECTIVE: Peripheral neuropathy (PN) is one of the long-term complications of diabetes. Few studies have investigated the role of regular exercise on diabetic PN. We examined the effect of aerobic training on nerve conduction velocity and action potential amplitude in the lower limbs of men with type 2 diabetes and PN. METHODS: In a randomized controlled study, 24 volunteers diagnosed with diabetic PN were randomly assigned to exercise or control groups. Aerobic training consisted of 20-45min walking or running at 50-70% of heart rate reserve for three sessions per week over 12weeks. Before and 48h after the experimental period, nerve conduction studies were performed and blood samples were taken to be analyzed for HbA1c, fasting and 2h postprandial glucose concentration. Data were analyzed using repeated-measures ANOVA at significance level of P<0.05. RESULTS: Sural sensory nerve conduction velocity (NCV) in the exercise group significantly increased (from 35.2±4.3m/s to 37.3±6.2m/s) compared to the control group (P=0.007). Changes in peroneal and tibial motor NCV and nerve action potential amplitude (NAPA) in all nerves studied were not different between groups (P>0.05). Moreover, HbA1c decreased to a greater extent in the exercise group compared to the control (P=0.014). CONCLUSION: Aerobic exercise training may have the potential to hinder the progression of diabetic PN by improving NCV. Given the sparse evidence in this domain, exercise-related mechanisms need to be studied in the future.

Serum human T-lymphotropic virus 1 proviral load in patients on hemodialysis.

INTRODUCTION: Patients on hemodialysis are a high-risk group for human T-lymphotropic virus 1 (HTLV1) infection and other viruses transmitted by blood or blood products. The Razavi and South Khorasan provinces in Iran are the endemic areas for this virus. This study compares proviral load of HTLV1 in patients on hemodialysis with otherwise healthy carriers of HTLV1. MATERIALS AND METHODS: In this case-control study the proviral load of the HTLV1 virus was compared between 25 patients on long-term hemodialysis who were positive for HTLV1 and 25 healthy carriers of HTLV1, to determine The effect of uremia and chronic hemodialysis on the proviral load. virus proviral load was determined using a real-time polymerase chain reaction method. RESULTS: There was a significant difference in the proviral load between the hemodialysis patients and the control group (903 +/- 182 copies per mL versus 117 +/- 186 copies per mL, respectively; P = .008). No significant correlation was found between the proviral load and haematocrit or serum levels of urea, creatinine, parathyroid hormone, calcium , and phosphorus level in hemodialysis patients, but proviral load of HTLV1 was significantly correlated with leukocyte count (r = -0.46, P = .02), hemodialysis duration (r = 0.48, P = .02), and the numbers of blood transfusions (r = 0.71, P < .01). Conclusions. The immune deficiency related to end-stage renal disease and uremia is the probable cause of significantly higher HTLV1 proviral load in hemodialysis patients compared to healthy HTLV1 carriers. This high HTLV1 proviral load might be due to immune dysfunction in chronic hemodialysis patients.

Thyroid hormone changes in early kidney transplantation and its correlation with delayed graft function.

INTRODUCTION: Thyroid hormones affect kidney function and may alter with changes in kidney function, as well. We evaluated changes in serum levels of triiodothyronine (T3), thyroxin (T4), and thyroid-stimulating hormone (TSH) early after kidney transplantation and their relationship with delayed graft function (DGF). MATERIALS AND METHODS: Fifty-five consecutive kidney allograft recipients were enrolled in the study. Serum levels of T3, T4, and TSH were measured on the day before transplantation, and also on posttransplant days 1, 3, 7, 14, and 21. Results were compared between patients with a normal allograft function and those with DGF. RESULTS: The mean T3 level decreased from 110.41 +/- 49.79 ng/dL before transplantation to 80.78 +/- 51.42 ng/dL on the 1st day after transplantation (P = .04), while T4 reduction reached a significant level on the 3rd day after transplantation (8.27 +/- 3.27 microg/dL to 5.50 +/- 2.57 microg/dL, P = .004). Patients with DGF experienced a significantly greater decrease in the serum level of T3 at the end of the 1st week after transplantation compared with patients with normal kidney function (P = .02). This significant decrease in T3 continued until the end of the 2nd week. Serum levels of T4 reduced comparably in the two groups, until the end of the 1st week, when it showed a significantly more reduction in the patients with DGF (P = .04). CONCLUSION: Both T3 and T4 reduced early after kidney transplantation, and this reduction was significantly more prominent in those with DGF. This is compatible with a consequence rather than a cause of DGF, explained in the setting of sick euthyroid syndrome.