Relationships of isometric mid-thigh pull variables to weightlifting performance.

AIM: The purpose of this study was to evaluate the relationship between weightlifting performance (snatch, clean and jerk, and total) and variables obtained from the isometric mid-thigh pull (IMTP). METHODS: Twelve weightlifters, ranging from novice to advanced, performed the IMTP 10 days after a competition. Correlations were used to evaluate relationships between variables of the IMTP and absolute and scaled competition results. RESULTS: Unscaled competition results correlated strongly with IRFD (0-200ms: r=0.567-0.645, 0-250ms: r=0.722-0.781) while results correlated weakly with Peak IRFD (5ms window, r=0.360-0.426). Absolute peak force values correlated very strongly with absolute values for the competition performance (r=0.830-0.838). Force at 100ms, 150ms, 200ms and 250ms also correlated strongly with competition results (r=0.643-0.647, r=0.605-0.636, r=0.714-0.732, r=0.801-0.804). Similar findings were noted for allometrically scaled values. CONCLUSION: Measures of average IRFD probably represent a more relevant variable to dynamic performance than does Peak IRFD (5ms). Maximum isometric strength also is likely to have a strong role in weightlifting performance.

Audit of a change in otolaryngology discharge letters using the Scottish Intercollegiate Guidelines Network (SIGN) recommendations.

Hospital and general practitioners should establish good communications so that continuity of care can be maintained when patients are discharged from hospital. A discharge letter was routinely prepared utilizing the standardized morbidity registration forms by the house surgeon for delivery to the patients general practitioner. The authors developed a new discharge letter, which was sent under separate cover to the general practitioner. The two discharge letters were assessed utilising data fields recommended by the Scottish Intercollegiate Guidelines Network (SIGN). A total of 162 consecutive paediatric patient discharges were identified. The mean number of items present in the existing and the new discharge letters were 13.7 + 1.8 and 12.2 + 3 respectively. The new discharge letter met the SIGN guidelines more closely than the existing discharge letter.

The effect of dosing time on the pharmacokinetics and pharmacodynamics of a 'once-a-day' sustained release theophylline preparation.

1. The pharmacokinetics and the bronchodilating effect of theophylline were studied during 1 week of morning dosing and 1 week of evening dosing in a randomized cross-over design in thirteen patients with reversible airways obstruction, treated with a new 'once-a-day' theophylline capsule formulation. 2. There were no differences between the mean pre-dose trough plasma concentration, maximal plasma concentration, trough-to-peak variation, tmax, area under the plasma drug concentration time-curve after morning or evening dosage. There was only a slightly but significantly higher plasma theophylline concentration between 16 and 20 h after evening dosing. 3. The mean plasma drug concentration time-curves were relatively flat with a mean trough to peak variation of 73.9% after morning dosing and 66.7% after evening dosing. Both sets of mean data were within the 10-20 mg l-1 therapeutic range. 4. The variations in FEV1 and PEFR throughout the 24 h after either morning or evening dosing were similar and followed the normal pattern of diurnal variation. 5. Adverse effects were mild and occurred in three patients without causing discontinuation of the study. 6. The theophylline preparation used appears suitable for once a day administration either in the morning or in the evening.

Intravenous versus nebulized terbutaline in patients with acute severe asthma; a double-blind randomized study.

Twenty-three patients with acute severe asthma were treated in a randomized double-blind way by either intravenous terbutaline two times at an hour interval 6 micrograms/kg or inhaled terbutaline two times 0.1 mg/kg. Peak expiratory flow rate in percent of expected value rose from 89 L/min to 128 L/min (P less than .01) in the intravenous group and from 97 L/min to 122 L/min (P less than .02) in the inhalation group; this was comparable for both groups. PaO2 initially was 7.55 kPa in the intravenous group and rose by 1.4 after 60 minutes (P less than .02) and by 1.33 after 120 minutes (P less than .01). The mean PaO2 did not change in the inhalation group. The pulse rate and blood pressure did not vary significantly in either of the two groups. We conclude that both the intravenous and inhalational administration of terbutaline are effective in acute severe asthma, but that the intravenous route is possibly better for increasing PaO2.

Cuprophan reuse and intradialytic changes of lung diffusion capacity and blood gases.

The changes in arterial blood gas, pulmonary function tests, leukocyte counts and complement activation were evaluated during first use and subsequent reuse of cuprophan dialyzers. The dialysate buffer was bicarbonate. Reuse of cuprophan dialyzers significantly attenuated the fall in leukocyte counts and the rise in C3a des Arg seen during first use dialysis. First use dialysis also caused a drop in arterial paO2 from 93.0 +/- 12.4 mm Hg to a nadir of 82.8 +/- 12.6 mm Hg at 60 minutes (P less than 0.01). PaO2 levels did not change when reused dialyzers were employed (93.7 +/- 12.2 before dialysis and 96.4 +/- 15.2 mm Hg at 60 minutes, P greater than 0.05). Intradialytic paO2 curves obtained during first use and reuse were significantly different by variance analysis (P less than 0.001). There was also a significant decline in lung diffusion capacity (DLCO, from 30.70 +/- 8.89 to 23.77 +/- 7.76 ml/min X mm Hg, P less than 0.01) and transfer factor (KCO, from 6.07 +/- 1.97 to 5.65 +/- 2.13 ml/min X mm Hg, P less than 0.01), during first use at one hour after initiation of dialysis. This decrease was entirely prevented during reuse, (P less than 0.001 vs. first use by variance analysis). Percentual changes in leukocyte counts and C3a des Arg concentration on one hand, and in paO2, DLCO and KCO on the other were significantly correlated to each other. Other factors with a possible influence on intradialytic pulmonary function such as ultrafiltration volume, dialysate buffer composition, evolution of intradialytic blood pH and cardiac output, were all identical under both experimental conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

A comparison of the clinical and bronchodilating effects of plain and slow-release tablets of terbutaline at steady state.

The clinical efficacy, the bronchodilating effect and the side effects of two oral forms of terbutaline were compared in a double-blind, cross-over study involving ten patients with chronic reversible airways obstruction. The administration of plain-tablets, containing 2.5 mg terbutaline sulphate, three times daily at 6 h intervals was compared to the administration of slow-release (SR) tablets, containing 5 mg terbutaline sulphate, every 12 h. Each course of treatment lasted for 7 days. Treatment with SR-tablets resulted in significantly higher lung function values in the morning (PEFR at home and FEV1 at the lung function laboratory on day 7). There were no significant differences between the two forms with regard to symptom score, extra use of rimiterol aerosol, heart rate or blood pressure. The plasma terbutaline concentration in the morning of the seventh treatment day was significantly higher during SR-tablet treatment. The plasma terbutaline concentration curve showed a smaller peak/trough ratio for the SR-tablets.

Wegener's granulomatosis: radiographic and clinical pattern. Report of six cases.

The clinical, radiological and histological features of 6 patients with Wegener's granulomatosis are presented. Because of the frequent finding of "atypical" radiographic features on chest X-rays in our patients, we also reviewed the literature.

Influence of an extension tube on the bronchodilator efficacy of terbutaline delivered from a metered dose inhaler.

Pressurized aerosols of sympathomimetic drugs are widely used in the treatment of bronchial asthma. The efficacy of this form of treatment is diminished in a number of patients by difficulties in coordination between the aerosol actuation and the inhalation. In order to improve the intrapulmonary deposition of terbutaline, an extension tube has been adapted to the regular pressurized aerosol device. In a cross-over randomized study we compared the bronchodilatory effect of increasing doses of terbutaline (250, 500 and 750 micrograms at 25-min intervals) either delivered by the regular pressurized aerosol device or by the device with the extension tube. The study was performed on 11 adult patients with reversible airways obstruction. Spirometry, body plethysmography and flow volume curves were performed. The onset of the bronchodilatory effect of a single dose of 250 micrograms terbutaline was more rapid after delivery via the extension tube. The addition of the extension tube caused a significantly higher bronchodilator efficacy of aerosolized terbutaline on the small airways. Our results show that the addition of an extension tube improves the bronchodilator efficacy of terbutaline delivered from a pressurized aerosol.

The combined effect of theophylline and terbutaline in patients with chronic obstructive airway diseases.

Using a double-blind, cross-over design the acute bronchodilating effect of 375 mg microcrystalline theophylline, 5 mg terbutaline, a combination of both drugs and placebo was studied in 11 patients suffering from moderate to severe chronic obstructive lung disease with partially reversible airway obstruction. Plasma concentrations both theophylline and terbutaline were measured. The bronchodilation produced by oral intake of 5 mg terbutaline and 375 mg theophylline was comparable. The maximal median value of terbutaline in plasma was 4.6 ng/ml 2 h after intake of medication, followed by a decline with a double peak in some patients. The maximal median increase of FEV1 was 37% 3 h after intake of medication. The maximal median plasma level of theophylline reached 12.5 ng/ml 30 min after intake of the medication. The median maximal increase of FEV1 was 24%. One hour after intake of medication and throughout the whole test period up to 7 h, the combination of 5 mg terbutaline and 375 mg theophylline produced a significantly greater bronchodilation than each drug alone. It is concluded that 375 mg microcrystalline theophylline produced a significantly greater bronchodilation than each drug alone. It is concluded that 375 mg microcrystalline theophylline and 5 mg terbutaline produces almost equal bronchodilating activity: a combination of both drugs, however, results in further bronchodilation.

Plasma theophylline level and effect on lung function after oral and rectal administration of aminophylline.

Twelve patients with partly reversible, chronic airway obstruction, according to a double blind randomized cross-over design, received on three consecutive days oral aminophylline 500 mg, a 500 mg aminophylline suppository and a placebo. The effects on ventilatory function were studied and the plasma concentration of theophylline was measured. After rectal administration, the plasma concentration of theophylline rose to 5 to 10 microgram/ml, and after oral ingestion the plasma level in most patients exceeded 10 microgram/ml. Administration of the aminophylline suppository resulted in moderate improvement in ventilatory function, and although the improvement was less pronounced than after oral administration, the use of a suppository in the treatment of patients with chronic obstructive lung disease should not be rejected.

Familial diffuse interstitial pulmonary fibrosis associated with oculocutaneous albinism. Report of two cases with a family study.

Two female patients with familial diffuse fibrosing alveolitis associated with oculocutaneous albinism are presented. A family study was carried out and two other female patients with oculocutaneous albinism and pulmonary disease were detected. Clinical, radiological and histological features are highlighted and the results of treatment discussed.

Pharmacokinetics of terbutaline after subcutaneous administration.

The pharmacokinetics of terbutaline has been studied after subcutaneous adminsitration of a therapeutic dose of 250 microgram in 14 patients. Short absorption half-lives of about 7 min resulted in a fast uptake of the drug. Serum concentrations of terbutaline were measured up to 10 hr after administration, depending on the individual. An open one-compartment model appeared adequate for the mathematical description of the kinetics in most patients. Elimination constants of 0.27 +/- 0.07 hr-1 were observed. The elimination process was biphasic in 5 patients with a mean elimination constant of the second phase of 0.10 +/- 0.04 hr-1. This resulted in a comparatively high concentration of 0.7 ng/ml 10 hr after administration. Regular use of terbutaline did not influence the pharmacokinetic data in a significant way.

Comparison between ketotifen and DSCG in bronchial challenge.

A double-blind cross-over study showed that orally taken ketotifen and inhaled DSCG have a comparable protective effect on allergen-induced bronchoconstriction. Both drugs significantly inhibit the immediate bronchial reaction after a 3 day treatment with either 1 mg ketotifen or 20 mg DSCG four times daily. Late reactions, which occurred in three out of the ten patients, were inhibited in two of the three patients by ketotifen as by DSCG.

Immunity to vaginal reinfection in female guinea pigs infected sexually with Chlamydia of guinea pig inclusion conjunctivitis.

Guinea pig boars were inoculated intraurethrally with the chlamydial agent of guinea pig inclusion conjunctivitis (GPIC). At the heights of their urethral infections, they were caged with sows in estrus. Whereas some of the sows had not been previously exposed to GPIC agent, others had received an intravaginal inoculation 5 to 8 weeks earlier. Those sows for which infected boars provided the first exposure were challenged by intravaginal inoculation 5 to 8 weeks later. Vaginal and conjunctival scrapings were taken regularly and stained for chlamydial inclusions. Titers of serum anti-GPIC antibodies and of vaginal secretory IgA anti-GPIC antibodies were determined by immunofluorescence. Our results show for the first time that a sexually acquired vaginal GPIC infection induces immunity to manual reinfection of the vagina. Because of the high incidence of secondary conjunctival infections among the vaginally infected sows, we could not provide a sound statistical basis for our tentative conclusion that manual infection of the vagina induces immunity to sexual reinfection. The results of our antibody titrations confirm previous work showing that vaginal GPIC infection induces formation of both serum antibody and vaginal secretory immunoglobulin A antibody.

Studies on the effects of MJ-9184-1 in man.

A new beta 2-adrenergic receptor stimulating drug, 2-hydroxy-5-[1-hydroxy-2-(2-methyl-1-phenyl-2-propyl-amino)-ethyl]-methanesulfonanilide hydrochloride (MJ-9184-1), was found to be a potent bronchodilator in man. In double-blind cross-over study including placebo, 0.25 mg and 0.50 mg MJ-9184-1 and involving ten patients with stable chronic obstructive lung disease with reversible airways obstruction, MJ-9184-1 caused a fast-appearing and long-lasting bronchodilator effect. The oral intake of 0.50 mg MJ-9184-1, compared to 0.25 mg, caused a more rapid effect and a more pronounced bronchodilation; 0.50 mg MJ-9184-1 also caused some elevation of the pulse rate. The effect was not seen after 0.25 mg MJ-9184-1.

Further studies on the effect of oral doxantrazole on allergen-induced bronchospasm.

The protective effect of oral doxantrazole on allergen-induced bronchoconstriction in man has been tested in two different treatment schedules. A single administration of 200 mg or 400 mg doxantrazole did not result in significant protection for a group of 10 patients. Only two patients after 200 mg, and three patients after 400 mg received meaningful protection. A 14-day period of treatment with three times 400 mg doxantrazole per day had no significant different effect compared with placebo treatment on allergen-induced broncho-constriction.