Preventive Effects of Bioabsorbable Anti-Adhesion Barriers on Bowel Obstruction After Colectomy in Colon Cancer Patients: A Retrospective Cohort Study Using an Insurance Claims Database.

PURPOSE: Postoperative adhesions can be prevented by the use of bioabsorbable anti-adhesion barriers. Although the occurrence of postoperative bowel obstruction is an important concern for patients, at the time of approval of anti-adhesion barriers, its effectiveness in preventing postoperative bowel obstruction had not been evaluated. We aimed to retrospectively evaluate the incidence of bowel obstruction after colectomy in patients with colon cancer using an insurance claims database. METHODS: This retrospective cohort study analyzed the data of colon cancer patients (between 2005 and 2017 from a national insurance claims database) who underwent colectomies to compare the proportion of individuals with postoperative bowel obstruction between the barrier and no barrier groups. RESULTS: Of the 587 patients who met the inclusion criteria, 308 and 279 patients were identified as the barrier and no barrier groups, respectively. The incidence of postoperative bowel obstruction was significantly lower in the barrier group (log-rank test, P = 0.0483). The cumulative incidence of postoperative bowel obstruction 37 months after the initial colectomy was 6.1% and 10.9% in the barrier and no barrier groups, respectively. Moreover, consistent results were obtained in the matched cohort. CONCLUSION: In colectomies for patients with colon cancer, the use of anti-adhesion barriers could significantly reduce the incidence of postoperative bowel obstruction. Evaluations using insurance claims databases could provide important information on outcomes following implementation of medical devices.

Effects of palm cooling on thermoregulatory-related and subjective indicators during exercise in a hot environment.

Palm cooling is a simple and easily implemented intervention strategy during exercise. We aimed to examine the effects of bilateral palm cooling before and during exercise on thermoregulatory-related and subjective indicators in a hot environment. Ten active men (age: 21 ± 1 years; height 172.2 ± 5.7 cm; weight 67.4 ± 7.2 kg) underwent three experimental trials at the same time of the day, consisting of palm cooling with 12°C (ICE12°C), palm cooling with 0°C (ICE0°C) where vasoconstriction is supposed to occur, and control (CON) trials. After 30 min rest at ambient temperature, participants performed 20 min exercise at 33°C, 60% relative humidity. Rectal temperature, skin temperature, rate of perceived exertion, heart rate, local sweat rate, oxygen uptake, carbon dioxide production, and respiratory exchange ratio did not differ between the trials. Thermal sensation and comfort were lower in the ICE12°C and ICE0°C trials than in the CON trial, but the ICE0°C trial showed a longer duration of cold sensation than the ICE12°C trial. Palm cooling at 12°C and 0°C improved thermal sensation and thermal comfort during exercise in a hot environment, although there was no effect on core body temperature, sweating, and cardiorespiratory function. Bilateral palm cooling at 12°C and 0°C improve subjective indicators during exercise in a hot environment and these effects are slightly greater at 0°C than at 12°C cooling, while having no effect on thermoregulatory-related indicators. These results suggest that bilateral palm cooling at lower temperatures may safely reduce the perception of warmth during exercise in a hot environment.

Comparison of the effect of post-exercise cooling with ice slurry ingestion between males and females.

This study aimed to compare the effects of ice slurry ingestion on post-exercise cooling in males and females. Twenty-four healthy adults (male n = 12; body weight [BW], 65.8 ± 10.3 kg; female, n = 12; BW, 58.2 ± 10.0 kg) participated in this study. Participants ingested 7.5 g/kg of either ice slurry at -1 °C (ICE) or control fluid at 20 °C (CON) during recovery after cycling at 55% VO2max until the rectal temperature reached 38.5 °C or exhaustion in a hot environment (controlled at 38 °C, 40% relative humidity). Rectal (Tre) and skin (Tsk) temperature, ratings of thermal sensation (TS), thermal comfort (TC), heart rate (HR), mean arterial pressure (MAP), and whole body sweat loss (WBSL) were measured 60 min after exercise. Ice slurry ingestion reduced Tre and TS and improved post-exercise hypotension only in females (p < 0.05). In comparison, males did not receive cooling effect from post- exercise cooling with ice slurry ingestion. WBSL tended to be lower in ICE than CON in males (ICE, 454.3 ± 172.3 g; CON, 539.7 ± 157.2 g; p = 0.065). In conclusion, sex differences were observed in the effects of post-exercise cooling with ice slurry ingestion.

Effects of sex differences on breath-hold diving performance.

PURPOSE: The present study aimed to measure diving response, CO2 sensitivity and forced vital capacity in male and female breath-hold divers (BHDs), and to determine their effect on breath-hold diving performance. METHODS: This study included 8 non-divers (NDs, 4 males and 4 females) and 15 BHDs (7 males and 8 females). For NDs, diving response was measured during breath-holding with facial immersion, whereas for BHDs CO2 sensitivity was also measured. RESULTS: Compared to NDs, BHDs showed a prominent diving response. In BHDs, no statistically significant sex differences were observed in diving response and CO2 sensitivity. Furthermore, a positive correlation was found between performance and the % forced vital capacity in BHDs. CONCLUSION: It was suggested that % forced vital capacity contributed more significantly to performance than diving response and CO2 sensitivity. Furthermore, the higher performance of male divers compared to female divers may be due to the % forced vital capacity rather than the diving response and CO2 sensitivity.

The effect of foam rollers of varying densities on range of motion recovery.

OBJECTIVE: This study aimed to compare the effect of different density foam rollers on range of motion recovery. METHOD: Ten active men completed two, 3-day trials in random order. During the experimental trials, all participants performed 2 min of foam rolling (FR) using a medium-density (medium trial) or hard-density (hard trial) foam roller on the right posterior thigh after completing the 90-min Loughborough Intermittent Shuttle Test (LIST). The hip joint range of motion (ROM), muscle hardness, and muscle soreness were assessed before and after the LIST and at 0 min, 20 min, 60 min, 24 h, and 48 h after FR intervention. Serum creatine kinase (CK) concentrations were assessed before the LIST and at 60 min, 24 h, and 48 h after FR intervention. The contralateral leg in each trial was used as a control. RESULTS: The ROM at 0 min, 20 min, 60 min, 24 h, and 48 h after FR intervention were higher in the right leg (the massage leg) than in the left leg (the contralateral leg) (p < 0.05). In the right leg, the ROM at 0 min after FR intervention was higher than after the LIST (p < 0.05). There were no significant differences between the medium and hard trials for ROM. Muscle hardness, muscle soreness, and serum CK concentration were not affected by FR. CONCLUSION: FR has a positive effect on ROM recovery. Moreover, the two roller densities provided similar ROM recovery.

Estimation of absolute oral bioavailability without performing an intravenous clinical study.

The absolute oral bioavailability (BA) of drugs are yet to be determined, and intravenous pharmacokinetic studies are currently considered indispensable for determining the BA values of oral drugs. The aim of this study was to develop and validate a novel approach to estimating BA values without intravenous pharmacokinetic data. Based on the drug inclusion criteria, such as exhibiting a urinary recovery rate of (Ru) of ≥20% in a clinical study, 13 drugs were included in the present study, and pharmacokinetic data for them were collected from the literature. The fraction excreted unchanged into urine (fe) was calculated for healthy subjects by dividing the Ru value by the total recovery rate. The contribution of renal excretion to total clearance from the systemic circulation (Rren) was estimated by subjecting oral clearance and creatinine clearance to regression in subjects with normal and impaired renal function. BA was estimated as fe/Rren and compared with the observed BA (BAobs). The predicted BA values for 9 drugs fell within ±20% of their BAobs. The examined approach makes it possible to estimate BA values for drugs with mean renal excretion values in healthy subjects and oral clearance in subjects with various renal function, without intravenous pharmacokinetic data.

Differences between sexes in thermoregulatory responses and exercise time during endurance exercise in a hot environment following pre-cooling with ice slurry ingestion.

This study aimed to examine differences between sexes in thermoregulatory responses and exercise time after ice slurry ingestion in a hot environment. Twenty-four healthy adults (male n = 12, body weight (BW) = 65.8 ± 10.3; female n = 12, BW = 58.2 ± 10.0) ingested 7.5 g/kg of either ice slurry at -1 °C (ICE) or control water at 20 °C (CON) before cycling at 55%VO2 max in a hot environment (controlled at 38 °C, 40% relative humidity). Rectal (Tre) and skin (Tsk) temperature, heart rate, sweat rate, respiratory gases, ratings of thermal sensation (TS), thermal comfort (TC), and rating of perceived exertion (RPE) were measured. Ice slurry did not improve exercise time in both sexes despite Tre was significantly lower in ICE than CON in both sexes. Tre, Tsk, HR, sweat rate and TS did not differ between sexes. TC and RPE in ICE were significantly higher during exercise in males than in females. In conclusion, there were no sex differences in the effects of pre-cooling with ice slurry ingestion; however, pre-cooling with ice slurry may be more effective in mitigating ratings of TC and RPE in females than males.

High-intensity cycling re-warm up within a very short time-frame increases the subsequent intermittent sprint performance.

This study investigated the effect of high-intensity cycling re-warm up (RW) within a very short time-frame on the subsequent intermittent sprint performance. Twelve active males completed three trials in random order: control (CON); 3-min RW at 30% of maximal oxygen uptake (VO2max) (RW30); and 1-min RW at 90% of VO2max (RW90). During the experimental trials, participants performed 40-min intermittent cycling exercise followed by 15-min rest. During the rest period, participants completed CON, RW30, or RW90. After the rest period, participants performed the Cycling Intermittent-Sprint Protocol (CISP), which consisted of 10-s rest, 5-s maximal sprint, and 105-s active recovery with the cycles repeated over 10 min. The mean work during sprint for the CISP was significantly higher in both RW trials than in the CON trial (mean±standard deviation; CON: 3539±698 J; RW30: 3724±720 J; RW90: 3739±736 J; p<0.05). The mean electromyogram amplitude during the sprint for the CISP was higher in the RW30 trial than in the CON trial; however, there was no significant difference between the two trials (p=0.06). The mean median frequency during sprint for the CISP was significantly higher in the RW90 trial than in the other trials (p<0.05). Rectal temperature did not differ among the three trials. Oxygenated haemoglobin during the initial 30 s of the CISP was significantly higher in the RW90 trial than in the CON trial (p<0.05). Compared with seated rest, RW, irrespective of whether it comprised 1-min at 90% of VO2max or 3-min at 30% of VO2max, increased the subsequent intermittent sprint performance.

A 1-Minute Re-warm Up at High-Intensity Improves Sprint Performance During the Loughborough Intermittent Shuttle Test.

Although a 3- to 7-min re-warm up (RW) elicits performance and physiological benefits after half-time (HT), a time-efficient and feasible RW protocol is required for the use of an RW in the athletic setting. This study aimed to investigate the effect of a 1-min RW at high-intensity on the performance and physiological responses during the Loughborough Intermittent Shuttle Test (LIST). In a randomized and counterbalanced cross-over design, 12 male amateur intermittent team sports players (soccer, basketball, handball, and lacrosse; age, 22 ± 2 years; height, 1.70 ± 0.08 m; body mass, 65.1 ± 8.3 kg; body mass index, 22.4 ± 1.9 kg m-2; VO2max, 53.5 ± 4.5 ml kg-1 min-1) performed the LIST. The LIST comprised two 45-min halves separated by a 15-min HT. Each half comprised repetitions of exercise cycles consisting of 3 × 20-m walking, 1 × 20-m maximal sprint, 3 × 20-m jogging, and 3 × 20-m running. During the HT, the participants were assigned to a control trial (CON; 15-min seated rest) or an RW trial (1-min running at 90% of the maximal oxygen uptake after a 14-min seated rest). Compared to the CON, the RW prevents reductions in sprint performance at the fourth and sixth periods of the LIST (fourth: 2.4%, p = 0.002, d = 1.68, sixth: 3.6%, p = 0.012, d = 1.74) and a decrement of gastrointestinal temperature during HT (0.5°C, p = 0.010, d = 1.41). Moreover, the RW decreased the electromyogram amplitude of maximal voluntary contraction (MVC) after HT (12%, p = 0.017, d = 1.12) without a decrease of maximal voluntary contraction force, suggesting an increased neuromuscular efficiency (9%, p = 0.048, d = 0.58). The RW also increased the mean heart rate in the initial part of the second half (4 bpm, p = 0.016, d = 0.38). In conclusion, the RW improved sprint performance, core temperature, muscle activation, and heart rate in the second half of the LIST. The findings suggest that the RW should be recommended for intermittent team sports players when longer RWs are not possible.