Differences in the pressures of canal anal and rectal sensitivity in patients with fecal incontinence, chronic constipation and healthy subjects.

INTRODUCTION: There exists a great variability in the manometric findings between patients with anal incontinence (AI) and healthy subjects. The correlation between the pressures of the anal canal and the AI is not exact by the wide rank of normal values. OBJECTIVES: Prospective study to evaluate differences in the pressures of the anal canal and in rectal sensitivity in patients with AI, chronic constipation (CC) and healthy subjects. MATERIAL AND METHODS: Ninety four patients with AI, 36 patients with CC and 15 healthy subjects were included. The following data were obtained: age, sex, resting pressure, anal canal length (ACL), squeeze maximum pressure (SMP), squeeze pressure duration (SPD), first sensation, urge and maximum tolerated volume (MTV). Statistical study: test of Kruskal-Wallis, test of Mann-Whitney, and multinomial logistic regression test. RESULTS: There were significant differences in the resting pressure (p < 0.001), the ACL (p < 0.001) and the SMP (p < 0.01) in the group of AI with respect to the other two groups. The volume for the first sensation was significantly lower in the healthy subjects than that in the other two groups (p < 0.05). The urge volume and the MVT were smaller in the group with AI with respect to the other groups (p < 0.001). In multivariate analysis the age, the resting pressure and the volume for the first sensation and urge increase the relative risk for AI. CONCLUSIONS: The greater age, the decrease in anal canal resting pressure and the alteration of rectal sensation increase the risk for AI.

Effects of caffeine supplementation on physical performance and mood dimensions in elite and trained-recreational athletes.

BACKGROUND: Caffeine supplementation (CAFF) has an established ergogenic effect on physical performance and the psychological response to exercise. However, few studies have compared the response to CAFF intake among athletes of different competition level. This study compares the acute effects of CAFF on anaerobic performance, mood and perceived effort in elite and moderately-trained recreational athletes. METHODS: Participants for this randomized, controlled, crossover study were 8 elite athletes (in the senior boxing national team) and 10 trained-recreational athletes. Under two experimental conditions, CAFF supplementation (6 mg/kg) or placebo (PLAC), the athletes completed a Wingate test. Subjective exertion during the test was recorded as the rating of perceived exertion (RPE) both at the general level (RPEgeneral) and at the levels muscular (RPEmuscular) and cardiorespiratory (RPEcardio). Before the Wingate test, participants completed the questionnaires Profiles of Moods States (POMS) and Subjective Vitality Scale (SVS). RESULTS: In response to CAFF intake, improvements were noted in Wpeak (11.22 ± 0.65 vs 10.70 ± 0.84; p = 0.003; [Formula: see text] =0.44), Wavg (8.75 ± 0.55 vs 8.41 0.46; p = 0.001; [Formula: see text] =0.53) and time taken to reach Wpeak (7.56 ± 1.58 vs 9.11 ± 1.53; p <  0.001; [Formula: see text] =0.57) both in the elite and trained-recreational athletes. However, only the elite athletes showed significant increases in tension (+ 325%), vigor (+ 31%) and SVS (+ 28%) scores after the intake of CAFF compared to levels recorded under the condition PLAC (p <  0.05). Similarly, levels of vigor after consuming CAFF were significantly higher in the elite than the trained-recreational athletes (+ 5.8%). CONCLUSIONS: CAFF supplementation improved anaerobic performance in both the elite and recreational athletes. However, the ergogenic effect of CAFF on several mood dimensions and subjective vitality was greater in the elite athletes.

Does complete deficiency of muscle alpha actinin 3 alter functional capacity in elderly women? A preliminary report.

The sarcomeric protein alpha actinin 3 is localised to the Z line of fast fibres, which are responsible for generating forceful muscle contractions at high velocity. However, a substantial proportion of healthy humans are totally deficient in this protein as they are homozygous for a premature stop codon polymorphism (R577X) in the ACTN3 gene. The purpose of this preliminary study was to assess if the presence or absence of alpha actinin 3 influences the deleterious effects of ageing on muscle output and functional capacity.

Serum concentrations of C reactive protein, alpha1 antitrypsin, and complement (C3, C4, C1 esterase inhibitor) before and during the Vuelta a Espana.

OBJECTIVES: To determine serum concentrations of proinflammatory (C reactive protein, complement C3 and C4) and anti-inflammatory (alpha(1) antitrypsin, C1 esterase inhibitor (C1-INH)) acute phase proteins in elite cyclists before and during a three week cycle tour. METHODS: Seventeen professional cyclists participating in the Vuelta a Espana volunteered for the study. Their mean (SD) physical characteristics were: age 28 (1) years; height 1.7 (0.06) m; weight 65 (7) kg; body fat 7.6 (0.8)%; Vo(2)max 75.3 (2.3) ml/kg/min. Venepuncture was performed on each subject 24 hours before the tour began (T0), on day 11 (the first rest day; T1) and day 21 (the second to last stage of the tour; T2). Samples at T1 and T2 were taken about 17 hours after the previous stage. Analysis of variance was used to determine changes over time. Where significance was found, a Tukey post hoc test was performed. RESULTS: C reactive protein concentrations were consistently within the normal range, although there was a 228%, non-significant increase at T1. C3 concentrations fell within the normal range at all times assessed. C4 concentrations before the race were within the normal range and were significantly increased 10 days (T1) into the race. C1-INH concentrations did not change significantly throughout the race. alpha(1) Antitrypsin concentration before the race was at the lower end of the normal range and was only significantly raised at T2. CONCLUSIONS: Although not as pronounced as those reported in marathon/ultramarathon runners, elite cyclists participating in a three week cycle tour experienced increases in selected proinflammatory and anti-inflammatory acute phase proteins, indicating an acute phase/inflammatory response. It is tenable that the increase in alpha(1) antitrypsin and C1-INH (anti-inflammatory mediators) at T2 served to attenuate the acute phase/inflammatory response. The lower than normal resting concentrations of the acute phase proteins supports the notion that chronic aerobic exercise induces an anti-inflammatory state.

C34T mutation of the AMPD1 gene in an elite white runner.

The case is reported of an elite, male, white endurance runner (28 years of age), who is one of the best non-African runners in the world despite carrying the C34T mutation in the gene (AMPD1) that encodes the skeletal muscle specific isoform of AMP deaminase, an enzyme that plays an important role in muscle metabolism. The frequency of the mutant allele in sedentary white people is 8-11%. Previous research has shown that this mutation, at least in homozygotes, can impair the exercise capacity of untrained people and their trainability. The maximum oxygen uptake of the study subject was exceptionally high (83.6 ml/kg/min), whereas his ammonia and lactate concentrations at high submaximal running speeds were lower than those of other world class runners who are not carriers of the mutation. The partial metabolic deficiency of the study subject is possibly compensated for by his exceptionally favourable anthropometric characteristics (body mass index 18.2 kg/m2).

Evidence of a dual function in fl(2)d, a gene needed for Sex-lethal expression in Drosophila melanogaster.

In Drosophila melanogaster, the female sexual development of the soma and the germline requires the activity of the gene Sxl. The somatic cells need the function of the gene fl(2)d to follow the female developmental pathway, due to its involvement in the female-specific splicing of Sxl RNA. Here we report the analysis of both fl(2)d1 and fl(2)d2 mutations: (1) fl(2)d1 is a temperature-sensitive mutation lethal in females and semilethal in males; (2) fl(2)d2 is lethal in both sexes; (3) the fl(2)d1/fl(2)d2 constitution is temperature-sensitive and lethal in females, while semilethal in males. The temperature-sensitive period of fl(2)d1 in females expands the whole development. SxlM1 partially suppresses the lethality of fl(2)d1 homozygous females and that of fl(2)d1/fl(2)d2 constitution, whereas it does not suppress the lethality of fl(2)d2 homozygous females. The addition of extra Sxl+ copies does not increase the suppression effect of SxlM1. The fl(2)d1 mutation in homozygosis and the fl(2)d1/fl(2)d2 constitution, but not the fl(2)d2 in homozygosis, partially suppress the lethality of SxlM1 males. This suppression is not prevented by the addition of extra Sxl+ copies. The semilethality of both fl(2)d1 and fl(2)d1/fl(2)d2 males, and the lethality of fl(2)d2 males, is independent of Sxl function. There is no female synergistic lethality between mutations at fl(2)d and neither at sc or da. However, the female synergistic lethality between mutations at Sxl and either sc or da is increased by fl(2)d mutations. We have analyzed the effect of the fl(2)d mutations on the germline development of both females and males. For that purpose, we carried out the clonal analysis of fl(2)d1 in the germline. In addition, pole cells homozygous for fl(2)d2 were transplanted into wild-type host embryos, and we checked whether the mutant pole cells were capable of forming functional gametes. The results indicated that fl(2)d mutant germ cells cannot give rise to functional oocytes, while they can form functional sperm. Moreover, SxlM1 suppresses the sterility of the fl(2)d1 homozygous females developing at the permissive temperature. Thus, with respect to the development of the germline the fl(2)d mutations mimic the behavior of loss-of-function mutations at the gene Sxl. Females double heterozygous for fl(2)d and snf1621 are fully viable and fertile. fl(2)d2 in heterozygosis partially suppresses the phenotype of female germ cells homozygous for snf1621; however, this is not the case with the fl(2)d1 mutation. The fl(2)d mutations partially suppress the phenotype of the female germ cells homozygous for ovoDIrSI.(ABSTRACT TRUNCATED AT 400 WORDS)

Degradation of human factor XIII by lonomin V, a purified fraction of Lonomia achelous caterpillar venom.

Lonomia achelous caterpillar venom (LACV) causes a severe bleeding diathesis in humans. A constant finding in these cases is a profound depression of blood clotting Factor XIII (FXIII) activity. The molecular mechanisms by which LONOMIN V (a chromatographically purified fraction from LACV) alters the FXIII complex is the subject of the present study. Incubation of human purified FXIII with Lonomin V shows that both the zymogen and the activated forms of FXIII were proteolytically degraded, with the generation of peptidic fragments of low molecular weight. Both the A and B subunits of FXIII were degraded in a progressive, dose dependent manner. The B subunit was more resistant to the action of Lonomin V, requiring higher concentrations in order to achieve complete degradation. On the basis of these findings we postulate that the proteolysis of FXIII in vivo is one of the pathophysiological factors behind this bleeding syndrome.

Lonomia achelous caterpillar venom (LACV) selectively inactivates blood clotting factor XIII.

Lonomia Achelous Caterpillar Venom (LACV) causes a severe acquired bleeding diathesis in exposed persons. The condition is characterized by prolonged bleeding from superficial wounds and mucous membranes. Intracranial or intra-abdominal hemorrhage is a common and often fatal complication. A constant finding in these cases is a profound decrease of clotting Factor XIII (FXIII) activity. In the present study, the effects of LACV on plasmatic and purified human FXIII has been evaluated. The results show that native LACV and one of its chromatographically purified fractions (termed FIID) produce a dose dependent decrease of FXIII activity accompanied with an impairment of fibrin(ogen) crosslinking. We conclude that the inactivation of FXIII by fraction FIID (which will be named Lonomin V), is one of the principal patho-physiological mechanisms behind the acquired bleeding diathesis seen in these cases.

Thrombolytic effect of lonomin V in a rabbit jugular vein thrombosis model.

Thrombolytic efficacy of lonomin V (LV), a protein isolated from Lonomia achelous caterpillars haemolymph, administered either as a single intravenous bolus or as a continuous infusion, was evaluated in a rabbit jugular vein thrombosis model, and compared with those of single-chain tissue-type plasminogen activator (sct-PA) and two-chain urokinase-type plasminogen activator (tcu-PA). As a bolus LV, at doses of 100 000 IU/kg body weight (bw) produced an activator-induced thrombolysis (AIL) of 50.94% +/- 12.4 compared with 14.4% +/- 10.8 for tcu-PA at the same dose. As a continuous infusion at doses of 200 000 IU/kg bw LV produced an AIL of 45.8%, whereas sct-PA and tcu-PA produced an AIL of 69.9 and 33.7%, respectively. Fibrinogen, plasminogen and alpha-2-antiplasmin levels decreased significantly with the higher doses of LV, sct-PA, and tcu-PA. Factor XIII levels were significantly reduced in a dose-dependent manner only with LV. In conclusion, LV produces a dose-dependent thrombolysis in combination with a decrease in factor XIII activity.

Normal values and influence of anthropometric and demographic factors on ambulatory cutaneous electrogastrography in healthy volunteers.

INTRODUCTION: Cutaneous Electrogastrography (EGGc) is a technique used for recording the Gastric Electrical Activity by means of electrodes placed on the abdominal skin. The aim of the present study was to determine normal values in healthy volunteers as well as the influence of factors such as age, gender, Body Mass Index (BMI) and echographic location of the gastric antrum. METHODS: An abdominal echography was initially performed in 35 of the 44 healthy volunteers in order to locate the gastric antrum and to place along its axis the skin electrodes, whereas in the other 9, the electrodes were placed according to anatomical references. Afterwards, the echography was also performed in those 9 volunteers in order to have all the 44 baseline echographic records. In every case, a record of ambulatory EGGc over 60 minutes was obtained, along with other record over the same period after eating a standard meal. The analysis of data was conducted through visual inspection and combined computer analysis. RESULTS: Eighty per cent of the study subjects showed a dominant frequency ranging from 2 to 4 cpm during both periods. After the meal, the parameters showed a characteristic variation. A significant difference was found when comparing subjects under 40 years of age versus subjects between 40 and 60 years of age in terms of preprandial dominant frequency instability coefficient (DFIC) (p = 0.002) and bradygastria (p = 0.03). Subjects with BMI < 25 kg/m2 showed preprandially a smaller dominant power instability coefficient (DPIC) (p = 0.035) and a greater Dominant Power (DP) (p = 0.045). In subjects without echographic control, DFIC (p = 0.001), bradygastria (p = 0.016) and tachygastria (p = 0.02) were more frequent, with a shorter period of normogastria (p = 0.001) during the postprandial period. CONCLUSIONS: Normogastria is the predominant rhythm in healthy people, although brief dysarrhythmias can be recorded that do not have any pathological meaning. Age and BMI, but not sex, seem to influence the Gastric Electrical Activity. The percentage of gastric dysarrhythmias decreases when the electrodes are placed along the longitudinal axis of the gastric antrum through echographic control.

[Postsurgical family information: an improvement area. Prospective study after urologic surgery]. / Información posquirúrgica a la familia: un área de mejora. Estudio prospectivo tras cirugía urológica.

OBJECTIVES: Analyzing and quantifying the postoperative retention of information, checking if it could be improved been delivered in an organized way. MATERIAL AND METHODS: After the basic information to relatives of 50 post-surgical patients operated for bladder or prostate, we deliver a questionnaire about what has just been told. It must be completed by a family member. The information is distributed differently: group 1 (30 patients) reported to the family following a script designed by us, written in simple and natural language. In group 2 (20 patients) the doctor informed as usual, not knowing that he is participating in the research. Then the relative is interviewed by one of the researchers. RESULTS: Only 3 (6%) family members matched all the right answers, and 25 (50%) did not hit more than 70% of the issues. The best known concept was the organ involved: 46 (92%). 21(42%) of respondents did not know if the process is basically benign or malignant, getting better results in group 1 but without significance: 20/30 (66.7%) vs 9/20 (45%) (p>0.05). The only item in which there are differences in success rate depending on the group is if a catheter have been set: 29 (96.7%) of successes in group 1, 13(65%) in 2. We found no difference in success rate according to number of family members informed, education, age or number of previous interventions. CONCLUSIONS: Relatives do not retain everything that was said. Organizing the information provided may improve, but other factors have influence. We must improve issues such as personal identification. It may be useful to repeat the information later.

Benefits of intrahospital exercise training after pediatric bone marrow transplantation.

The purpose of this study was to determine if an eight-week intrahospital supervised, conditioning program improves functional capacity and quality of life (QOL) in children (4 boys, 4 girls) (mean [SD] age: 10.9 [2.8] years [range: 8-16]) who have undergone bone marrow transplantation (BMT) for leukemia treatment within the last 12 months. A group of 8 age and gender-matched healthy children served as controls. The experimental group performed 3 weekly sessions of resistance and aerobic training inside an intra-hospital gymnasium. A significant combined effect of group and time (p < 0.05) was observed for muscle functional capacity (Timed Up and Down Stairs [TUDS] test) and peak oxygen uptake (V.O(2peak)), i.e., with BMT children showing greater improvements than controls (V.O(2peak) at pre- and post-training of 25.9 (8.2) and 31.1 (7.6) mL/kg/min in diseased children). Muscle strength (6 RM test for bench and leg press and seated row) also improved after training (p < 0.05) in the BMT group. Concerning QOL, a significant combined effect of group and time (p < 0.05) was also observed for children's self-report of comfort and resilience and for parents' report of their children's satisfaction and achievement. In summary, children who have received BMT experience physical and overall health benefits after a relatively short-term (8 weeks) supervised exercise training program.

Functional capacity of children with leukemia.

The purpose of this study was to determine if the functional capacity and quality of life of children receiving treatment against acute lymphoblastic leukemia (ALL) is decreased compared to healthy age and gender-matched children. Functional capacity was assessed with a number of measurements as the peak oxygen uptake (VO2peak) and ventilatory threshold determined during a ramp treadmill test, functional mobility (Timed Up and Down Stairs test [TUDS]) and ankle dorsiflexion passive and active range of motion (passive and active DF-ROM, respectively). Quality of life (QOL) was determined with the Spanish version of the Child Report Form of the Child Health and Illness Profile-Child Edition (CHIP-CE/CRF). Fifteen children (9 boys, 6 girls; mean [SD] age: 6.8 +/- 3.1 years) receiving maintenance therapy against ALL were studied and fifteen, nonathletic healthy children (9 boys, 6 girls; 6.9 +/- 3.3 years) were selected as controls. The mean values of VO2peak and active DF-ROM were significantly (p < 0.05) lower in patients (25.3 +/- 6.5 ml . kg (-1) . min (-1) vs. 31.9 +/- 6.8 ml . kg (-1) . min (-1) in controls and 19.6 +/- 8.0 degrees vs. 24.1 +/- 5.0 degrees , respectively). Children's self report of satisfaction (with self and health) (p < 0.05), comfort (concerning emotional and physical symptoms and limitations) (p < 0.01) and resilience (positive activities that promote health) (p < 0.01) were significantly decreased in patients with ALL. In summary, children receiving treatment against ALL have overall lower functional capacity and QOL than healthy children. However, their physical condition and health status are sufficiently high to allow them to participate in physical activities and supervised exercise programs.