Effects of slow- v. fast-digested protein supplementation combined with mixed power training on muscle function and functional capacities in older men.

Ageing leads to a progressive loss of muscle function (MF) and quality (MQ: muscle strength (MS)/lean muscle mass (LM)). Power training and protein (PROT) supplementation have been proposed as efficient interventions to improve MF and MQ. Discrepancies between results appear to be mainly related to the type and/or dose of proteins used. The present study aimed at determining whether or not mixed power training (MPT) combined with fast-digested PROT (F-PROT) leads to greater improvements in MF and MQ in elderly men than MPT combined with slow-digested PROT (S-PROT) or MPT alone. Sixty elderly men (age 69 (sd 7) years; BMI 18-30 kg/m2) were randomised into three groups: (1) placebo + MPT (PLA; n 19); (2) F-PROT + MPT (n 21) and (3) S-PROT + MPT (n 20) completed the intervention. LM, handgrip and knee extensor MS and MQ, functional capacity, serum metabolic markers, skeletal muscle characteristics, dietary intake and total energy expenditure were measured. The interventions consisted in 12 weeks of MPT (3 times/week; 1 h/session) combined with a supplement (30 g:10 g per meal) of F-PROT (whey) or S-PROT (casein) or a placebo. No difference was observed among groups for age, BMI, number of steps and dietary intake pre- and post-intervention. All groups improved significantly their LM, lower limb MS/MQ, functional capacity, muscle characteristics and serum parameters following the MPT. Importantly, no difference between groups was observed following the MPT. Altogether, adding 30 g PROT/d to MPT, regardless of the type, does not provide additional benefits to MPT alone in older men ingesting an adequate (i.e. above RDA) amount of protein per d.

Muscle adaptation in response to a high-intensity interval training in obese older adults: effect of daily protein intake distribution.

BACKGROUND: Aging is associated with declines in muscle mass, strength and quality, leading to physical impairments. An even protein distribution in daily meals has recently been proposed along with adequate total protein intake as important modulators of muscle mass. In addition, due to its short duration, high-intensity interval training (HIIT) has been highlighted as a promising intervention to prevent physical deterioration. However, the interaction between daily protein intake distribution and HIIT intervention in elderlies remain unknown. OBJECTIVE: To investigate muscle adaptation following HIIT in older adults according to daily protein intake distribution. METHODS: Thirty sedentary obese subjects who completed a 12-week elliptical HIIT program were matched [criteria: age (± 2 years), sex, BMI (± 2 kg/m2)] and divided a posteriori into 2 groups according to the amount of protein ingested at each meal: < 20 g in at least one meal (P20-, n = 15, 66.8 ± 3.7 years) and ≥ 20 g in each meal (P20+, n = 15, 68.1 ± 4.1 years). Body composition, functional capacity, muscle strength, muscle power, physical activity level, and nutritional intakes were measured pre- and post-intervention. A two way repeated ANOVA was used to determine the effect of the intervention (HIIT) and protein distribution (P20- vs P20+, p < 0.05). RESULTS: No difference was observed at baseline between groups. Following the HIIT intervention, we observed a significant decrease in waist and hip circumferences and improvements in functional capacities in both P20- and P20 + group (p < 0.05). However, no protein distribution effect was observed. CONCLUSION: A 12-week HIIT program is achievable and efficient to improve functional capacities as well as body composition in obese older adults. However, consuming at least 20 g of proteins in every meal does not further enhance muscle performance in response to a 12-week HIIT intervention.

Primary surgical repair of severe peripheral marginal ectasia in Terrien's marginal degeneration.

We have developed a safe, successful, and simple procedure for repairing the severe peripheral marginal ectasia in Terrien's marginal degeneration. The area of ectasia is incised along its thinnest paralimbal dimension down to Descemet's membrane. Ectatic stroma along both sides of the incision is then undermined until normal-thickness stroma is reached. After excision of excess ectatic stroma, if necessary, the normal-thickness stroma is then sutured together, primarily with 9-0 Prolene. The sutures are left in place permanently, and the remaining refractive error is corrected with spectacles or contact lenses. This technique substantially improved visual acuity in three of four patients and decreased corneal astigmatism in all four. Although one eye required resuturing, there were no complications in any case.

A retrospective study of laser in situ keratomileusis after radial keratotomy.

PURPOSE: This is a retrospective study designed to present results of laser in situ keratomileusis (LASIK) after radial keratotomy (RK). METHODS: Eighty eyes of 56 patients underwent LASIK for residual myopia, astigmatism, and hyperopia after RK. Absolute mean preoperative spherical equivalent refraction was 2.36 +/- 1.17 D. Best spectacle-corrected visual acuity (BSCVA) was 20/20 in 56% of eyes, 20/25 in 25%, 20/30 in 13%, 20/40 in 5%, and 20/60 in 1%. Uncorrected visual acuity was better than 20/40 in four eyes. Follow-up ranged from a minimum of 1 day after surgery to a maximum of 2 years, with an average of 6 months. RESULTS: Mean final absolute spherical equivalent refraction was 0.62 +/- 0.611 D. Six eyes experienced a loss of BSCVA of one line, one eye lost two lines, and one lost more than two lines. Three eyes had one line of improvement and one eye had two lines of improvement. Uncorrected visual acuity was 20/20 in 21 eyes, 20/25 in 20 eyes, and 20/30 in 19 eyes. There was stromal opacity in two eyes, epithelial defects in two eyes, and epithelial ingrowth in four eyes. CONCLUSION: LASIK may be an effective treatment for myopia, astigmatism, and hyperopia in patients with residual refractive error after RK. Extreme caution should be exercised due to the complexity of this group of patients.

Low-power intraocular lens implantation in patients with cataracts and age-related macular degeneration.

Three patients with age-related macular degeneration for whom cataract surgery was indicated received low-power intraocular lenses (IOLs) calculated to produce an end spectacle refraction of approximately +6 diopters, producing a magnification of about 12%. Our experience with these three cases suggests that use of low-power implants in such patients may yield better results than emmetropic IOLs.

Surgical management of traumatic incision dehiscence following penetrating keratoplasty.

Three patients sustained a traumatic incision rupture of their cornea transplant; six weeks, four months, and seven months postoperatively. The cases included a phakic, aphakic, and pseudophakic keratoplasty; all did well with clear grafts following primary suture repair. Our report confirms the preferred management of such cases with primary resuturing.

Ultrasonic demonstration of xanthogranulomatous pyelonephritis.

An ultrasound examination performed on a young woman with a long history of urinary tract infection demonstrated multiple subcapsular sonolucencies suggestive of multiple abscesses. The combination of the ultrasonic appearance, the clinical history, and a large nonfunctioning kidney with calculi on intravenous pyelography allowed us to suggest the diagnosis of xanthogranulomatous pyelonephritis. Ultrasound plays an even greater role in patients who are allergic to iodinated contrast material in whom intravenous pyelograms and arteriograms may be contraindicated.

Reversible pupillary miosis during a hyperglycaemic episode: case report.

A young female patient presented with non-ketotic hyperglycaemia, pupillary miosis and clouding of consciousness. The initial blood glucose was 83.3 mmol/l; there was no metabolic acidosis. After insulin therapy and improved diabetic control, pupillary function returned to normal. There was no other associated somatic or autonomic nerve dysfunction.

Penetrating keratoplasty combined with flexible anterior chamber lens implantation.

We present an initial report on flexible anterior chamber lens implantation in 14 aphakic or pseudophakic bullous keratopathy patients undergoing penetrating keratoplasty. With a minimum follow-up of 12 months, the improvement in visual acuity and graft clarity is encouraging.

Corneal ulceration following cataract surgery in patients with rheumatoid arthritis.

A sterile corneal ulcer was observed in four cataract patients (two with intraocular lenses) during the early postoperative period. All patients had a history of rheumatoid arthritis and were on systemic antiinflammatory agents. The two patients treated medically exhibited a short recovery phase with complete healing over several days and no recurrence. Aggressive treatment of the dry eye syndrome with artificial tears, bandage lenses, punctal occlusion, tarsorrhaphy, and antibiotics resulted in immediate improvement. In this report, variabilities in corneal ulceration are stressed while emphasis is given to the role of dry eyes and exposure as the principal common factor. A discussion of risk factors, presentation, treatment, pathogenesis, and prevention is provided.

Effect of 8-methoxypsoralen on rat lens cations, membrane potential and protein levels.

Systemic application of 8-methoxypsoralen to rats, followed by u.v.-irradiation, induces a minor change in the lens membrane potential after one week, and by this time marked histological changes have already occurred. Alterations in lens sodium and potassium concentrations followed these early changes and coincided with the appearance of small light-scattering vacuoles when the lenses were examined in vivo with a slit lamp. Dramatic changes in the dry weight, soluble protein and calcium content of the lenses were apparent only after eight weeks from the start of treatment, and these changes coincided with the appearance of very large vacuoles in slit-lamp examinations of the eye.