Antioxidant-rich foods and response to altitude training: A randomized controlled trial in elite endurance athletes.

High doses of isolated antioxidant supplements such as vitamin C and E have demonstrated the potential to blunt cellular adaptations to training. It is, however, unknown whether intake of high doses of antioxidants from foods has similar effects. Hence, the aim of the study was to investigate whether intake of antioxidant-rich foods affects adaptations to altitude training in elite athletes. In a randomized controlled trial, 31 national team endurance athletes (23 ± 5 years) ingested antioxidant-rich foods (n = 16) or eucaloric control foods (n = 15) daily during a 3-week altitude training camp (2320 m). Changes from baseline to post-altitude in hemoglobin mass (Hbmass ; optimized CO rebreathing), maximal oxygen uptake (VO2max ; n = 16) or 100 m swimming performance (n = 10), and blood parameters were compared between the groups. The antioxidant group significantly increased total intake of antioxidant-rich foods (~118%) compared to the control group during the intervention. The total study population improved VO2max by 2.5% (1.7 mL/kg/min, P = .006) and Hbmass by 4.7% (48 g, P < .001), but not 100 m swimming performance. No difference was found between the groups regarding changes in Hbmass , VO2max or swimming performance. However, hemoglobin concentration increased more in the antioxidant group (effect size = 0.7; P = .045) with a concomitantly larger decrease in plasma and blood volumes compared to control group. Changes in ferritin and erythropoietin from pre- to post-altitude did not differ between the groups. Doubling the intake of antioxidant-rich foods was well tolerated and did not negatively influence the adaptive response to altitude training in elite endurance athletes.

Upper body heavy strength training does not affect performance in junior female cross-country skiers.

We investigated the effects of adding heavy strength training to a high volume of endurance training on performance and related physiological determinants in junior female cross-country skiers. Sixteen well-trained athletes (17 ± 1 years, 60 ± 6 kg, 169 ± 6 cm, VO2max running: 60 ± 5 mL/kg/min) were assigned either to an intervention group (INT; n = 9) or a control group (CON; n = 7). INT completed two weekly sessions of upper body heavy strength training in a linear periodized fashion for 10 weeks. Both groups continued their normal aerobic endurance and muscular endurance training. One repetition maximum in seated pull-down increased significantly more in INT than in CON, with a group difference of 15 ± 8% (P < 0.01). Performance, expressed as average power output on a double poling ergometer over 20 s and as 3 min with maximal effort in both rested (sprint-test) and fatigued states (finishing-test), showed similar changes in both groups. Submaximal O2 -cost and VO2peak in double poling showed similar changes or were unchanged in both groups. In conclusion, 10 weeks of heavy strength training increased upper body strength but had trivial effects on performance in a double poling ergometer in junior female cross-country skiers.

Differences in V1 and V2 ski skating techniques described by accelerometers.

The aims of the study were to describe the differences between the ski skating techniques V1 and V2 and evaluate reproducibility in complex cyclic hip movements measured by accelerometers. Fourteen elite senior male cross-country skiers rollerskied twice for 1 min (V1 and V2) at 4° inclination and 3 m/s. Tests were repeated after 20 min and again 4 months later. Five triaxial accelerometers were attached to the subject's hip (os sacrum), poles, and ski boots. Post-processing included transforming to an approximately global coordinate system, normalization for cycle time, double integration for displacement, and revealing temporal patterns. Different acceleration patterns between techniques and large correlation coefficients (Pearson's r = 0.6-0.9) between repeated trials were seen for most parameters. In V2, the hip was lowered [-10.9 (1.2) cm], whereas in V1, the hip was elevated [4.8 (1.5) cm] during the pole thrust. In conclusion, V2 but not V1 showed similarities to double poling in the way that potential energy is gained between poling strokes and transferred to propulsion during the poling action. Elite skiers reproduce their own individual patterns. One triaxial accelerometer on the lower back can distinguish techniques and might be useful in field research as well as in providing individual feedback on daily technique training.

Metabolic and mechanical involvement of arms and legs in simulated double pole skiing.

We evaluated arm and leg work rate and metabolism during double pole ergometer skiing. Thermodilution arm and leg blood flow was determined together with the arterial to venous difference for oxygen, while the work rate was assessed in eight male recreational skiers [24 (SD 7) years]. When work rate increased from 82 (SE 4) to 117 (7) W, leg power increased by 43% (enhanced vertical force and displacement of the body). The elbow angle tended to increase [from 71 (11.3)° to 75 (10.9)°; P = 0.07] and arm oxygen uptake increased by 20 (5)% [from 0.65 (0.07) to 0.78 (0.08) L/min; P < 0.05] because two-arm blood flow increased [from 5.4 (0.6) to 6.3 (0.7) L/min; P < 0.05] with no significant change in oxygen extraction [from 59 (2.3)% to 60 (1.9)%] accompanied with net arm lactate and potassium release. In contrast, two-leg blood flow [from 5.8 (0.5) to 8.0 (0.5) L/min] and oxygen extraction [from 67 (1.3)% to 75 (1.5)%] increased (P < 0.05), resulting in a 53 (8)% increase in leg oxygen uptake [from 0.82 (0.06) to 1.24 (0.07) L/min; P < 0.05]. In conclusion, during double poling on an ergometer, arm muscle metabolism and work rate increase only marginally and an increase in work intensity is covered mainly by the leg muscles.

Effects of 12 weeks of block periodization on performance and performance indices in well-trained cyclists.

The purpose of this study was to compare the effects of two different methods of organizing endurance training in trained cyclists during a 12-week preparation period. One group of cyclists performed block periodization (BP; n = 8), wherein every fourth week constituted five sessions of high-intensity aerobic training (HIT), followed by 3 weeks of one HIT session. Another group performed a more traditional organization (TRAD; n = 7), with 12 weeks of two weekly HIT sessions. The HIT was interspersed with low-intensity training (LIT) so that similar total volumes of both HIT and LIT were performed in the two groups. BP achieved a larger relative improvement in VO2max than TRAD (8.8 ± 5.9% vs 3.7 ± 2.9%, respectively, < 0.05) and a tendency toward larger increase in power output at 2 mmol/L [la(-)] (22 ± 14% vs 10 ± 7%, respectively, P = 0.054). Mean effect size (ES) of the relative improvement in VO2max , power output at 2 mmol/L [la(-)], hemoglobin mass, and mean power output during 40-min all-out trial revealed moderate superior effects of BP compared with TRAD training (ES range was 0.62-1.12). The present study suggests that BP of endurance training has superior effects on several endurance and performance indices compared with TRAD.

Elite cross-country skiers do not reach their running VO2max during roller ski skating.

AIM: Cross-country skiers' VO2max is often measured during treadmill running. However, VO2max during treadmill skiing with the diagonal stride technique is higher, whereas it is lower during double poling, another classical style technique. How these values compare to VO2max during ski skating in elite cross country skiers is not known. Therefore, this study compared VO2max during treadmill uphill running and treadmill roller ski skating. METHODS: Twenty-two males (21±2 years, 182±6 cm, 77±7 kg, VO2max running; 72.4±4.4 mL·kg-1·min-1) elite cross-country skiers and biathlon athletes underwent testing in both running and roller ski skating before (May) and at the end (October) of the preseason training. RESULTS: From May to October VO2max increased during running (3.1±4.5%, P=0.003, Effect size; ES=0.44, small) but not during roller ski skating (1.8±5.6%, P=0.13, ES=0.24, small). In May the subjects' VO2max during running was 1.7±4.7% higher compared to during roller ski skating (P=0.08, ES=0.24, small) while in October this difference was 3.0±5.0 % (P<0.001, ES=0.49, small). CONCLUSION: Elite cross-country skiers do not elicit higher VO2max during roller ski skating than during running and this relationship does not change during the pre-season training period.

The effect of strength training volume on satellite cells, myogenic regulatory factors, and growth factors.

The aim of this work was to study the effect of training volume on activation of satellite cells. Healthy untrained men were randomly assigned into two groups. The 3L-1UB group (n = 10) performed three-set leg exercises and single-set upper body exercises, and the 1L-3UB group (n = 11) performed single-set leg exercises and three-set upper body exercises. Both groups performed three sessions (80-90 min) per week for 11 weeks. Biopsies were taken from m. vastus lateralis and m. trapezius. The number of satellite cells, satellite cells positive for myogenin and MyoD, and the number of myonuclei were counted. Homogenized muscle was analyzed for myogenin and MyoD, and extracted ribonucleic acid (RNA) was monitored for selected growth factor transcripts. Knee extensor strength increased more in the 3L-1UB group than in the 1L-3UB group (48 ± 4% vs 29 ± 4%), whereas the strength gain in shoulder press was similar in both training groups. The number of satellite cells in m. vastus lateralis increased more in the 3L-1UB group than in the 1L-3UB group. The number of myonuclei increased similarly in both groups. The messenger RNA expression of growth factors peaked after 2 weeks of training. In conclusion, increasing training volume enhanced satellite cell numbers in the leg muscle, but not in the upper body muscle.

High-intensity interval training improves peak oxygen uptake and muscular exercise capacity in heart transplant recipients.

Heart transplant (HTx) recipients usually have reduced exercise capacity with reported VO(2peak) levels of 50-70% predicted value. Our hypothesis was that high-intensity interval training (HIIT) is an applicable and safe form of exercise in HTx recipients and that it would markedly improve VO(2peak.) Secondarily, we wanted to evaluate central and peripheral mechanisms behind a potential VO(2peak) increase. Forty-eight clinically stable HTx recipients >18 years old and 1-8 years after HTx underwent maximal exercise testing on a treadmill and were randomized to either exercise group (a 1-year HIIT-program) or control group (usual care). The mean ± SD age was 51 ± 16 years, 71% were male and time from HTx was 4.1 ± 2.2 years. The mean VO(2peak) difference between groups at follow-up was 3.6 [2.0, 5.2] mL/kg/min (p < 0.001). The exercise group had 89.0 ± 17.5% of predicted VO(2peak) versus 82.5 ± 20.0 in the control group (p < 0.001). There were no changes in cardiac function measured by echocardiography. We have demonstrated that a long-term, partly supervised and community-based HIIT-program is an applicable, effective and safe way to improve VO(2peak) , muscular exercise capacity and general health in HTx recipients. The results indicate that HIIT should be more frequently used among stable HTx recipients in the future.

Preserved metabolic reserve capacity in skeletal muscle of post-infarction heart failure patients.

It has been proposed that exercise capacity during whole body exercise in post-infarction congestive heart failure (CHF) patients is limited by skeletal muscle function. We therefore investigated the balance between cardiopulmonary and muscular metabolic capacity. CHF patients (n=8) and healthy subjects (HS, n=12) were included. Patients with coronary artery disease (CAD, n=8) were included as a control for medication. All subjects performed a stepwise incremental load test during bicycling (∼24 kg muscle mass), two-legged knee extensor (2-KE) exercise (∼4 kg muscle mass) and one-legged knee extensor (1-KE) exercise (∼2 kg muscle mass). Peak power and peak pulmonary oxygen uptake (VO(2peak) ) increased and muscle-specific VO(2peak) decreased with an increasing muscle mass involved in the exercise. Peak power and VO(2peak) were lower for CHF patients than HS, with values for CAD patients falling between CHF patients and HS. During bicycling, all groups utilized 24-29% of the muscle-specific VO(2peak) as measured during 1-KE exercise, with no difference between the groups. Hence, the muscle metabolic reserve capacity during whole body exercise is not different between CHF patients and HS, indicating that appropriately medicated and stable post-infarction CHF patients are not more limited by intrinsic skeletal muscle properties during whole body exercise than HS.

Using a dynamic mass balance model to predict fate and transport of PCBs in a polluted boreal lake in Sweden.

In 2013, a screening survey including fish (European perch, Perca fluviatilis) from 20 locations in the Stockholm region of Sweden indicated exceptionally high levels of PCBs (>450 ng ΣPCB7/g ww) in Lake Oxundasjön. An extensive sampling program was launched to define the magnitude and area of impact of PCBs. Moreover, a dynamic mass balance model approach was applied to identify and quantify key transport processes and predict the long-term turnover of PCBs given various remediation scenarios. Based on the dating of sediment profiles, primary emissions of PCBs to Lake Oxundasjön have likely occurred from the end of the 1940s until 1980, reaching the lake via one of its tributaries. Presently, the main source of PCBs is diffusion from the lake sediments. From the lake outlet, >400 g ΣPCB7/yr are transported to Lake Mälaren (the third largest lake in Sweden), supplying drinking water for parts of the Stockholm area. Remediation actions are necessary to reduce the PCB levels in fish below today's marketing limits and environmental quality standards. With natural recovery, our results indicate that the PCB levels in non-migratory fish from Lake Oxundasjön will be elevated for decades to come. The mass of PCBs stored in the lake sediments was estimated, and to our knowledge, Lake Oxundasjön is the most heavily PCB contaminated lake in Sweden. The system constitutes a unique opportunity to test and develop a mathematical mass balance model for PCBs, with substantial data acquired from different aquatic matrices. The model presented in the paper is applicable for risk assessments of PCBs, and the results contribute to the general understanding of the transport and turnover dynamics of PCBs in aquatic ecosystems.

The effect of heavy strength training on muscle mass and physical performance in elite cross country skiers.

AIM: To investigate the effect of supplementing high-volume endurance training with heavy strength training on muscle adaptations and physical performance in elite cross country skiers. Eleven male (18-26 years) and eight female (18-27 years) were assigned to either a strength group (STR) (n=9) or a control group (CON) (n=10). STR performed strength training twice a week for 12 weeks in addition to their normal endurance training. STR improved 1 repetition maximum (RM) for seated pull-down and half squat (19 ± 2% and 12 ± 2%, respectively), while no change was observed in CON. Cross-sectional area (CSA) increased in m. triceps brachii for both STR and CON, while there was no change in the m. quadriceps CSA. VO(2max) during skate-rollerskiing increased in STR (7 ± 1%), while VO(2max) during running was unchanged. No change was observed in energy consumption during rollerskiing at submaximal intensities. Double-poling performance improved more for STR than for CON. Both groups showed a similar improvement in rollerski time-trial performance. In conclusion, 12 weeks of supplemental heavy strength training improved the strength in leg and upper body muscles, but had little effect on the muscle CSA in thigh muscles. The supplemental strength training improved both VO(2max) during skate-rollerskiing and double-poling performance.

A COX-2 inhibitor reduces muscle soreness, but does not influence recovery and adaptation after eccentric exercise.

The aim of this study was to investigate the effect of a cyclooxygenase (COX)-2 inhibitor on the recovery of muscle function, inflammation, regeneration after, and adaptation to, unaccustomed eccentric exercise. Thirty-three young males and females participated in a double-blind, placebo-controlled experiment. Seventy unilateral, voluntary, maximal eccentric actions with the elbow flexors were performed twice (bouts 1 and 2) with the same arm, separated by 3 weeks. The test group participants were administered 400 mg/day of celecoxib for 9 days after bout 1. After both bouts 1 and 2, concentric and isometric force-generating capacity was immediately reduced (approximately 40-50%), followed by the later appearance of muscle soreness and increased serum creatine kinase levels. Radiolabelled autologous leukocytes (detected by scintigraphy) and monocytes/macrophages (histology) accumulated in the exercised muscles, simultaneously with increased satellite cell activity. These responses were reduced and recovery was faster after bout 2 than 1, demonstrating a repeated-bout effect. No differences between the celecoxib and placebo groups were detected, except for muscle soreness, which was attenuated by celecoxib. In summary, celecoxib, a COX-2 inhibitor, did not detectably affect recovery of muscle function or markers of inflammation and regeneration after unaccustomed eccentric exercise, nor did the drug influence the repeated-bout effect. However, it alleviated muscle soreness.

Subcellular movement and expression of HSP27, alphaB-crystallin, and HSP70 after two bouts of eccentric exercise in humans.

The aims of this study were to investigate the sarcomeric accumulation and expression of heat shock proteins (HSPs) after two bouts of maximal eccentric exercise. Twenty-four subjects performed two bouts of 70 maximal voluntary eccentric actions using the elbow flexors in one arm. The bouts were separated by 3 wk. The changes in concentric (60 degrees/s) and isometric (90 degrees) force-generating capacity were monitored for 9 days after each bout, and biopsies were taken 1 and 48 h and 4 and 7 days after bout 1 and 1 and 48 h after bout 2. The content of HSP27, alphaB-crystallin, HSP70, and desmin in the cytosolic and cytoskeleton/myofibrillar fractions of homogenized muscle samples was determined by immunoassays, and the cellular and subcellular localization of the HSPs in the myofibrillar structure was analyzed by conventional and confocal immunofluorescence microscopy and quantitative electron microscopy. The force-generating capacity was reduced by approximately 50% and did not recover completely during the 3 wk following bout 1. After bout 2, the subjects recovered within 4 days. The HSP levels increased in the cytosolic fraction after bout 1, especially HSP70 (approximately 300% 2-7 days after exercise). Increased levels of HSP27, alphaB-crystallin, and HSP70 were found in the cytoskeletal/myofibrillar fraction after both bouts, despite reduced damage after bout 2. At the ultrastructural level, HSP27 and alphaB-crystallin accumulated in Z-disks, in intermediate desmin-like structures (alphaB-crystallin), and in areas of myofibrillar disruption. In conclusion, HSP27 and alphaB-crystallin accumulated in myofibrillar structures, especially in the Z-disks and the intermediate structures (desmin). The function of the small HSPs is possibly to stabilize and protect the myofibrillar structures during and after unaccustomed eccentric exercise. The large amount of HSP27, alphaB-crystallin, and HSP70 in the cytoskeletal/myofibrillar fraction after a repeated bout of exercise suggests a protective role as part of the repeated-bout effect.

Higher skeletal muscular metabolic reserve capacity in COPD patients than healthy subjects.

We investigated the interaction between skeletal muscle exercise capacity and central restrictions using exercise modalities, which recruit differing levels of muscle mass in eight patients chronic obstructive lung disease (COPD) (FEV(1)% of predicted; 35 [SE 4%]) and eight healthy controls. Subjects performed conventional bicycling, two-leg knee extensor (2-KE) and single-leg knee extensor (1-KE) exercises. Maximal values for pulmonary VO(2) (VO(2max)), power output, blood lactate, heart rate, blood pressure, and arterial oxygen saturation of hemoglobin were registered. VO(2max) in controls was 2453 (210), 1468 (124), and 976 (76) mL/min during bicycling, 2-KE and 1-KE, respectively. The COPD patients achieved 48% (P<0.05), 62% (P<0.05), and 81% (P=0.10) of the control values. The mass-specific VO(2max) (VO(2max)/exercising muscle mass) during 1-KE was 345 (25) and 263 (30) mL/kg/min (P<0.05) in controls and COPD patients, respectively. During 2-KE the controls and COPD patients achieved 85% (4%) and 67% (5%) (P=0.06) of the mass-specific VO(2) during 1-KE, while during bicycling they achieved 31% (2%) and 17% (1%) (P<0.05), respectively. The COPD patients have central restrictions when exercising with a relatively small muscle mass (2-KE) and have a higher muscular metabolic reserve capacity than controls during whole body exercise.

Effect of beta-adrenoceptor blockade on post-exercise oxygen consumption.

In the recovery period after strenuous exercise, there is an increase in O2 uptake termed the excess post-exercise O2 consumption (EPOC), consisting of a rapid and a prolonged component. Mechanisms regulating the prolonged component of EPOC are not completely understood, but an effect of catecholamines has been suggested. The purpose of this study was to investigate the effect of beta-adrenoceptor blockade on EPOC. Six healthy young men were randomized to one control experiment and two exercise experiments, one with and one without nonselective beta-adrenoceptor blockade. In the exercise experiments, they exercised for 60 minutes at 78% +/- 3% (mean +/- SD) of maximal O2 uptake (VO2max) on a cycle ergometer followed by 6.5 hours' bedrest. In the beta-adrenoceptor blockade experiment, propranolol (0.1 mg.kg-1 body weight [BW]) was administered intravenously immediately after the exercise bout and again 3.5 hours after exercise. The control experiment was performed without exercise or beta-adrenoceptor blockade. EPOC was calculated as the difference in O2 uptake between the exercise and control experiments. A supplementary study on 15 subjects showed resting O2 uptake to be unaffected by propranolol. O2 uptake was significantly increased during the recovery period after exercise when no beta-adrenoceptor blocker was administered. After 6.5 hours of bedrest, the mean increase (+/- SE) in O2 uptake was 19 +/- 4 mL.min-1. In contrast, when propranolol was administered during recovery from exercise, O2 uptake was significantly increased for only the first 2 hours. Propranolol decreased total EPOC (+/- SE) by about one third, from 14.4 +/- 1.9 to 9.5 +/- 2.5 L.(ABSTRACT TRUNCATED AT 250 WORDS)

Intravasal use of pliable K(+)-selective electrodes in the femoral vein of humans during exercise.

Continuous recording of plasma K+ concentration ([K+]) during exercise would be valuable in determining K+ fluxes associated with muscle activation. Pliable polyvinyl chloride electrodes were constructed by incorporation of valinomycin into a polyvinyl chloride membrane attached to the end of a catheter with a 1 mm outer diameter. Through an outer catheter the electrode was inserted into the femoral vein of human subjects. The setup allowed easy in vivo calibration, and rapid changes of femoral venous [K+] of < 0.1 mmol/l could easily be detected. Drift over 1 h amounted to < 3 mV and was corrected for by analysis of blood samples. Rapid changes in femoral venous [K+] occurred during and after dynamic exercise, short and prolonged isometric contractions, and repetitive isometric contractions of the quadriceps muscle. Combined with arterial blood sampling and flow measurements, the electrodes will allow good approximation of 1) cellular K+ efflux rate associated with increased electrical activity, 2) rate of intramuscular reuptake of K+ mediated by the Na(+)-K+ pump, and 3) rate of K+ loss to or uptake from the circulation by the muscle.

K+ balance of the quadriceps muscle during dynamic exercise with and without beta-adrenoceptor blockade.

The effect of propranolol (0.15 mg/kg body wt) on K+ fluxes was investigated in seven healthy males performing 8-min two-legged knee-extension exercise at two different powers. K+ concentration was measured in the femoral vein by a K(+)-selective electrode, and leg blood flow was measured by the dye-dilution technique. During control bouts, rates of change in femoral venous K+ concentration were 38 +/- 10 and 53 +/- 8 mumol.l-1.s-1 at onset of exercise (K+ efflux) and -14 +/- 3 and -34 +/- 3 mumol.l-1.s-1 at cessation of exercise (K+ reuptake) at low and high powers, respectively. This mismatch between K+ efflux and reuptake rates fits with the steady-state K+ loss rate of 0.14 +/- 0.04 and 0.32 +/- 0.09 mmol/min. Propranolol raised K+ efflux rate, did not modify K+ reuptake rate or steady-state K+ loss, but caused transiently increased K+ loss rate at the onset of exercise, thus accentuating the rise of arterial K+ concentration. In conclusion, the continuous muscle K+ loss during steady-state exercise with a small muscle mass is not due to lack of catecholamine stimulation, but beta-adrenoceptor blockade increased the Na(+)-K+ pump lag so that the initial K+ loss at onset of exercise was increased.

Effect of rhEPO administration on serum levels of sTfR and cycling performance.

PURPOSE: We assessed the possibility of using soluble transferrin receptor (sTfR) as an indicator of doping with recombinant erythropoietin (rhEPO). METHODS: A double-blind, placebo-controlled study was conducted with the administration of 5,000 U of rhEPO (N = 10) or placebo (N = 10) three times weekly (181-232 U x kg(-1) x wk-1) for 4 wk to male athletes. We measured hematocrit and the concentration of hemoglobin, sTfR, ferritin, EPO, and quantified the effects on performance by measuring time to exhaustion and maximal oxygen uptake (VO2max) on a cycle ergometer. RESULTS: Hematocrit increased from 42.7 +/- 1.6% to 50.8 +/- 2.0% in the EPO group, and peaked 1 d after treatment was stopped. In the EPO group, there was an increase in sTfR (from 3.1 +/- 0.9 to 6.3 +/- 2.3 mg x L(-1) , P < 0.001) and in the ratio between sTfR and ferritin (sTfR-ferritin(-1)) (from 3.2 +/- 1.6 to 11.8 +/- 5.1, P < 0.001). The sTfR increase was significant after 1 wk of treatment and remained so for 1 wk posttreatment. Individual values for sTfR throughout the study period showed that 8 of 10 subjects receiving rhEPO, but none receiving placebo, had sTfR levels that exceeded the 95% confidence interval for all subjects at baseline (= 4.6 mg x L(-1)). VO2max increased from 63.6 +/- 4.5 mL x kg(-1) x min(-1) before to 68.1 +/- 5.4 mL x kg(-1) x min(-1) 2 d post rhEPO administration (7% increase, P = 0.001) in the EPO group. Hematocrit, sTfR, sTfR-ferritin(-1), and VO2max did not change in the placebo group. CONCLUSION: Serum levels of sTfR may be used as an indirect marker of supranormal erythropoiesis up to 1 wk after the administration of rhEPO, but the effects on endurance performance outlast the increase in sTfR.

Postoperative recovery following outpatient pediatric myringotomy: a comparison between sevoflurane and halothane.

STUDY OBJECTIVE: To assess recovery in children undergoing myringotomy and anesthetized using sevoflurane or halothane with special reference to the phenomenon of excitation reported in previous studies. DESIGN: Prospective, randomized, single-blind study. SETTING: Regional (district general) hospital. PATIENTS: 60 healthy, physical status I children (aged 3 to 8 years) presenting for elective outpatient myringotomy. INTERVENTIONS: The children were premedicated with midazolam and paracetamol and randomly allocated to one of two groups: Group H were induced with halothane (0.5% to 5%) and Group S with sevoflurane (1% to 8%). Anesthesia was maintained with oxygen (FIO(2) = 0.33), nitrous oxide, and the study drug. No opioids were administered during surgery. Postoperatively, propofol was given (1 mg/kg) if the child was crying and uncontrollable on the excitation scale for >5 minutes. Total analgesic consumption and side effects were recorded. MEASUREMENTS AND MAIN RESULTS: Postoperatively, the following parameters were recorded: time to eye opening, excitation, pain, time to sit unaided, time to drink water, time to walk, and time to discharge home. No differences were found in the demographic data, duration of anesthesia and operation, time to loss of eyelash reflex, time to waking up, incidence of postoperative excitation (7% and 8% in the sevoflurane and halothane groups respectively), pain, or postoperative nausea and vomiting. The ability to sit and walk, and the time to discharge home (mean 60.4 min vs. 67.1 min, respectively) was similar between the groups. CONCLUSIONS: Although some studies have reported a high incidence of excitation following sevoflurane anaesthesia, we found no differences between halothane and sevoflurane. This finding could be due to the midazolam given as premedication as well as minimal postoperative pain in these children.

[Frequency of G6PD deficiency in a group of preschool-aged children in a centrally located area of Cambodia]. / Déficit en G6PD, fréquence dans un groupe d'enfants d'âge préscolaire d'une région centrale du Cambodge.

The aim of this study was to determine the frequency of G6PD deficiency and assess its impact on morbidity, especially anemia, in preschool-aged children in Cambodia. A total of 151 children including 82 boys and 69 girls from the Kandal province near Phnom Penh were studied. Ages ranged from 8 to 69 months. Blood was collected in EDTA-coated tubes. Blood counts were performed with an ABX Micros 60 system and G6PD in red blood cells was measured with a Roche Cobas Mira Plus system using Gamma reagents. G6PD deficiency was found in 14 cases (13.4% of boys and 4.3% of girls). Deficiency was complete in 7.3% of children and partial in 2%. Anemia defined as hemoglobin concentration less than 110 g/l was detected in 29.1% of children. No case of anemia could be attributed to enzyme deficiency since no sign of hemolysis was observed in any of the three children presenting both conditions. Further study is needed on G6PD deficiency in Cambodia including malaria-endemic areas and on the frequency and severity of jaundice due to enzyme deficiency in newborns.