Aerobic and resistance exercise training effects on body composition, muscular strength, and cardiovascular fitness in an HIV-1 population.

Although HIV-1 infection rates peaked in the 1980s in the United States, advanced stage HIV disease will grow by about 40% in the next 40 years. This fact has signaled the need for intervention strategies that go beyond primary prevention and into treatment of the complications associated with this chronic disease. Recently, the role of exercise in reversing the wasting process experienced by individuals with HIV-1 has received much needed attention. The purpose of this study was to examine the independent contributions of a 12-week aerobic or resistance weight training exercise regimen in improving body composition, muscle strength, and cardiovascular fitness in an HIV-1 population. Participants for this study (N = 33) were randomly assigned to an aerobic exercise training group, a resistance weight training group, or a stretching/flexibility control group. Measures of body composition, muscular strength, and cardiovascular fitness were assessed both prior to and following completion of the intervention. In general, the results revealed significant improvements in the amount of lean muscle tissue, upper and lower body muscular strength, and predicted VO(2)max for exercise participants, whereas control participants experienced declines in all physiological measures. Based on these findings, it is suggested that exercise may be one complimentary therapeutic modality capable of combating the wasting process associated with advanced HIV-1 infection.

Physical Training Effects on Acute Exercise-induced Feeling States in HIV- 1-positive Individuals.

Each year, more than one million new AIDS cases are reported worldwide, signaling an immediate need for intervention strategies to combat the physical, immunological, and psychological/emotional complications associated with the disease. In an effort to address this issue, our study contrasted an aerobic exercise intervention with a resistance weight-training intervention for a period of 12 weeks. Each week, participants seropositive for HIV-1 completed a short survey concerning their positive and negative feeling states and perceptions of fatigue immediately following exercise. Results indicated that participants in both exercise groups experienced significantly greater levels of positive well being and significantly lower levels of psychological distress and perceptions of fatigue following exercise sessions engaged in during the final week as compared to sessions engaged in during the initial week.

Silicone elastomer microshards in fluid from a painful metatarsophalangeal implant site. A case report.

Histopathologic studies have demonstrated microshards from silicone elastomer metatarsophalangeal joint implants in adjacent tissues in a setting of chronic inflammation and in inguinal lymph nodes. Cytologic smears of synovial fluid from symptomatic implanted joints should show these refractile, nonpolarizing microshards in the reactive inflammatory context. Nonspecific enzymatic inflammatory activity contributes to further destabilization of the implants, eventuating in symptoms and signs requiring prosthesis removal. Cytopathologic examination of aspirated fluid from the vicinity of a symptomatic implanted joint demonstrates foreign body reaction to silicone elastomer, predicting a need for intervention before the local damage is severe and disabling.

Esophagogastroduodenoscopy for the family physician.

Esophagogastroduodenoscopy is most commonly performed for evaluation of epigastric pain, severe heartburn, chronic nausea and other dyspepsia syndromes that are not relieved by medical therapy. It should not be performed as an in-office procedure in patients with unstable angina, respiratory failure, active upper gastrointestinal bleeding or hemodynamic instability. Although office esophagogastroduodenoscopy is safe for low-risk patients, the risks associated with anesthesia and the need for postprocedure observation may require other patients to undergo the procedure in a hospital setting. Use of a local anesthetic throat spray reduces the gag response that occurs when the endoscope is swallowed. Sedation is commonly achieved with intravenous administration of a benzodiazepine plus a narcotic, and the effects of these drugs can be rapidly reversed. Complications are rare and most frequently result from medications rather than from the procedure itself.

Analysis of antigen switching rates in Trypanosoma brucei.

Previously quoted figures for the frequency of antigen switching in Trypanosoma brucei are based on incorrect assumptions. In order to determine the correct switching frequency, an equation was derived that takes the growth rates of the newly expressed antigen types into consideration as well as the proportion of switched trypanosomes and the number of generations since the population was antigenically homogeneous. When this equation was applied to published in vitro data, variable values were obtained for the switching frequency in clonal populations originally expressing one antigen type. The calculated most likely switching frequencies ranged from 1.4 X 10(-7) to 3.5 X 10(-6). This variation was probably caused by differences in the growth rates of the new antigen types in the population and failure to detect slow growing variants. To overcome these problems, an experimental procedure was developed to analyse the switching frequency in vitro. Trypanosomes were cloned and grown in parallel cultures. After an appropriate number of generations, cells expressing the original antigen type were destroyed and, from the proportion of cultures that contained new antigen types, the switching frequency was calculated. The technique minimized subculturing or other procedures that could distort the results. Although the method was optimized for analysing switching frequency, the values differed between experiments, ranging from 2.2 X 10(-7) to 2.6 X 10(-6) for one variant. Possible causes for the variations in switching frequency are discussed.

Carcinoma of the esophagus with adenoid cystic differentiation.

Adenoid cystic carcinoma of the esophagus is a relatively rare lesion which characteristically exhibits a clinically aggressive behavior. In spite of this aggressive nature, it is most often referred to as a counterpart of the more common adenoid cystic carcinoma of salivary gland origin, a comparatively indolent tumor. In this report, the clinical and pathologic findings in a series of six cases of esophageal adenoid cystic carcinomas are contrasted with those of typical salivary gland lesions, and also compared to similar tumors exhibiting "adenoid cystic" differentiation arising in other extrasalivary gland sites. It is concluded that the esophageal tumors, as well as certain similar lesions arising in other extrasalivary gland sites, represent a class of poorly differentiated basaloid neoplasms distinct both clinically and morphologically from the common adenoid cystic carcinoma of salivary gland origin.