Coronary CT angiography in asymptomatic middle-aged athletes with ST segment anomalies during maximal exercise test.

The clinical significance of ST segment anomalies occurring during exercise test in asymptomatic subjects is still debated. We designed a cross-sectional study to evaluate if the presence of these exercise test abnormalities were related with coronary CT angiography findings. Nine hundred forty athletes (range 30 to 60 years old), performed a maximal exercise test for sport eligibility. Forty-six subjects (4.9%) showing ST abnormalities during exercise and/or the recovery phase were referred to a 64-slice coronary computed tomography (CT) angiography. Among 44 subjects who underwent coronary CT angiography, 23 had an equivocal while 21 had a positive exercise test. Coronary CT angiography found, six and eight subjects with significant and not significant coronary artery disease, respectively. Further, seven patients demonstrated origin and course coronary anomalies. The positive predictive value for significant coronary artery disease of the exercise test was 13.6%. Our data suggest the referral to coronary CT angiography even of patients with equivocal repolarization anomalies during exercise and its recovery phase. Although the positive predictive value of a maximal exercise test in asymptomatic athletes appears lower than what observed in patients at high risk for coronary artery disease, about half of athletes with equivocal or positive exercise test demonstrated some coronary abnormalities.

The effects of Pilates exercise training on physical fitness and wellbeing in the elderly: A systematic review for future exercise prescription.

UNLABELLED: This systematic review aims to summarize the effects of Pilates exercise training (PET) in elderly population on physical fitness, balance and fall prevention, and its effects on mood states, quality of life and independence in the daily living activities. METHODS: Keyword "Pilates" associated with "elderly", "aging" and "old subjects" were identified as terms for the literature research in MEDLINE, Embase, PubMed, Scopus, PsycINFO and SPORTDiscus. Only studies published in peer-reviewed journals written in English language were considered. A meta-analysis was performed and effect sizes (ES) calculated. RESULTS: 10 studies were identified (6 RCTs and 4 uncontrolled trials); age ranged from 60 to 80years. Overall, PET showed large ES to improve muscle strength (ES=1.23), walking and gait performances (ES=1.39), activities of daily living, mood states and quality of life (ES=0.94), moderate to high effect on dynamic balance (ES=0.77), small effects on static balance (ES=0.34) and flexibility (ES=0.31), while a small effect on cardio-metabolic outcomes (ES=0.07). CONCLUSIONS: PET should be taken into account as a way to improve quality of life in the elderly, due to the imparted benefits of fall prevention, physical fitness, and mood states. In this context, physicians might include PET as a tool for exercise prescriptions for the elderly.

Comparative ultrasonographic evaluation of the Achilles paratenon in symptomatic and asymptomatic subjects: an imaging study.

Achilles tendon analysis represents one of the most frequently requested ultrasonographic evaluations, due to the high incidence of tendinopathy. Various authors have described inflammatory features of the paratenon recruited 22 subjects complaining of pain in the mid-portion of the Achilles tendon and 22 healthy subjects. Both groups underwent ultrasonographic examination and Victorian Institute of Sport Assessment-Achilles questionnaire administration. It was found statistically significant inter-group differences of the paratenon (p = 0.0001) as well as tendon thickness (p < 0.0001). Our results show that Achilles symptoms could also be associated with an increase in the paratenon thickness. We suggest that clinicians should carefully analyze paratenon thickness when evaluating patients with Achillodynia using ultrasound. It may be that the paratenon, when thickened, may explain some of the painful symptoms reported by patients and it is associated with a tendinopathy process, hence we suggest careful analysis in patients with Achillodynia.

Effects of consumption of whole grain foods rich in lignans in healthy postmenopausal women with moderate serum cholesterol: a pilot study.

This study aims at investigating the effect of an experimental period of intake of whole grain foods rich in lignans as part of an habitual diet on the plasma and urinary excretion of enterolignans, the biomarkers of lipid metabolism and the immunological and antioxidant status in a group of postmenopausal women with moderate serum cholesterol. A randomized double-blind crossover study was completed on 13 subjects in 12-weeks after protocol approval of an ethical committee. The subjects consumed whole grain foods high in lignans (30 g/d of breakfast cereals or biscuits, etc., 80 g/d of whole grain pasta) or refined grain foods for 4 weeks, separated by a 2-weeks wash-out period. A modest hypocholesterolemic effect (p < 0.05) of the whole grain diet was observed and the intake of whole grain products rich in lignans was also associated with an increase in urinary enterodiol excretion (p < 0.05).

Physical activity attenuates the negative effect of low birth weight on leptin levels in European adolescents; the HELENA study.

We examined whether physical activity (PA) influences the association between birth weight and serum leptin in adolescents. The study comprised a total of 538 adolescents (315 girls), aged 12.5-17.49 years, born at term (≥ 37 weeks of gestation). We measured serum leptin levels and time engaged in moderate-vigorous PA (MVPA) by accelerometry. There was an interaction effect between birth weight and meeting the PA recommendations (60 min/day MVPA) on leptin levels in girls (P = 0.023) but not in boys (P = 0.809). Birth weight was negatively associated with leptin levels in girls not meeting the PA recommendations (i.e. more than 60 min/day of MVPA) (ß = -0.096, P = 0.009), whereas no significant association was observed in those meeting the PA recommendations (ß = -0.061, P = 0.433). In conclusion, meeting the PA recommendations may attenuate the negative effect of low birth weight on serum leptin levels in European female adolescents.

Plasma leptin and energy expenditure during prolonged, moderate intensity, treadmill exercise.

BACKGROUND: Current literature shows conflicting results regarding the possible direct role of exercise on leptin concentrations, mainly because of a non-homogeneous level of energy expenditure (EE) and the lack of standardization of energy balance. AIM: The aim of the study was to evaluate the effect of exercise duration and its corresponding EE on leptin levels, during prolonged treadmill exercise, in a well-controlled laboratory setting. MATERIALS AND METHODS: Seven young trained males underwent a 4-h treadmill exercise. The starting intensity was set at 65% of maximal oxygen consumption. At the start of the test and throughout the exercise, venous blood samples were drawn for the assays of leptin, glucose, free fatty acids (FFA), cortisol, epinephrine (E) and norepinephrine (NE). Hourly and total EE was monitored with gas analysis. RESULTS: Plasma leptin levels decreased from 1.10±0.15 to 0.85±0.26 µg/l (p<0.01) at the end of the exercise, reaching a significant reduction already after the second hour. FFA and cortisol showed a progressive significant increase, while glucose did not significantly change throughout the test. Plasma E and NE significantly increased at all sampling times compared to basal values (48.1±30.3 to 352.3±187.7 pg/ml, p<0.001 and 238.1±118.9 to 1798.7±413.5 pg/ml, p<0.001). The random-effects model for panel data analysis showed negative correlation between leptin, NE and the values of progressive EE (r2=0.745, p<0.05). CONCLUSIONS: Our data demonstrate that, during a prolonged moderate intensity exercise, leptin decrease is significantly related to the total EE. Further, NE concentrations seem to play an important role in the inhibition of leptin secretion.

Muscular strength and markers of insulin resistance in European adolescents: the HELENA Study.

The aim of the study was to examine the association of muscular strength with markers of insulin resistance in European adolescents. The study comprised a total of 1,053 adolescents (499 males; 12.5-17.5 years) from ten European cities participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Cross-Sectional Study. Muscular strength was measured by the handgrip strength and standing long jump tests. Cardiorespiratory fitness was measured by the 20-m shuttle run test. Fasting insulin and glucose were measured and the homeostasis model assessment (HOMA) and quantitative insulin sensitivity check index (QUICKI) indices were calculated. Weight, height, waist circumference and skinfold thickness were measured, and body mass index (BMI) was calculated. In males, the handgrip strength and standing long jump tests were negatively associated with fasting insulin and HOMA (all P < 0.05) after controlling for pubertal status, country and BMI or waist circumference. When skinfold thickness was included in the model, the association became non-significant. In females, the standing long jump test was negatively associated with fasting insulin and HOMA (all P < 0.001) after controlling for pubertal status, country and surrogate markers of total or central body fat (BMI, waist circumference or skinfold thickness). Findings were retained in males, but not in females after controlling for cardiorespiratory fitness. The findings of the present study suggest that preventive strategies should focus not only on decreasing fatness and increasing cardiorespiratory fitness but also on enhancing muscular strength.

Nasal dysfunction induced by chlorinate water in competitive swimmers.

AIMS: Swimmers commonly complain of nasal symptoms probably due to mucosal irritation caused by chlorinated water. The aim of the present prospective study was to investigate changes in nasal function and cytology in a cohort of 15 volunteer competitive swimmers, as compared with a control group of 15 competitive athletes practicing other sports. METHODS: Olfactory threshold for n-butanol was measured in a population of competitive swimmers. Changes in nasal function and cytology were compared between the two groups of volunteer competitive athletes. RESULTS: There were no significant differences between the two groups in terms of mean 20-Item Sino-Nasal Outcome Test scores, peak nasal inspiratory flow, pulmonary peak expiratory flow, or total nasal resistance on anterior active rhinomanometry. Nasal mucociliary transport time (MCTt) was significantly shorter for the non-swimmers than for the swimmers. The mean olfactory threshold for n-butanol in the swimmers was significantly lower than in the other group of athletes. CONCLUSIONS: Data seem to confirm the utility of MCTt in studying nasal mucosa damage caused by chlorinated water. The present results also support the hypothesis of a role for the olfactory threshold in evaluating damage to the olfactory mucosa exposed to chlorinated water.

Aflatoxins are natural scavengers of reactive oxygen species.

The role of aflatoxins (AFs) in the biology of producing strains, Aspergillus sect. Flavi, is still a matter of debate. Over recent years, research has pointed to how environmental factors altering the redox balance in the fungal cell can switch on the synthesis of AF. Notably, it has been known for decades that oxidants promote AF synthesis. More recent evidence has indicated that AF synthesis is controlled at the transcriptional level: reactive species that accumulate in fungal cells in the stationary growth phase modulate the expression of aflR, the main regulator of AF synthesis-through the oxidative stress related transcription factor AP-1. Thus, AFs are largely synthesized and secreted when (i) the fungus has exploited most nutritional resources; (ii) the hyphal density is high; and (iii) reactive species are abundant in the environment. In this study, we show that AFs efficiently scavenge peroxides and extend the lifespan of E. coli grown under oxidative stress conditions. We hypothesize a novel role for AF as an antioxidant and suggest its biological purpose is to extend the lifespan of AFs-producing strains of Aspergillus sect. Flavi under highly oxidizing conditions such as when substrate resources are depleted, or within a host.

Nasal functional modifications after physical exercise: olfactory threshold and peak nasal inspiratory flow.

STATEMENT OF PROBLEM: The respiratory nasal effects of physical exercise have been extensively investigated; on the other hand there are no data regarding olfactory threshold modification after aerobic physical exercise. METHODS: The present prospective study investigated the modifications in nasal respiratory flows and olfactory thresholds after controlled aerobic physical exercise in a cohort of 15 adult, healthy volunteers. The Peak Nasal Inspiratory Flow (PNIF), and the Sniffin' Sticks olfactory threshold test were used for our determinations. MAIN RESULTS: The mean PNIF after physical exercise was significantly higher than the mean PNIF value found before physical exercise. Statistical analysis ruled out any significant difference between mean olfactory thresholds pre vs post physical exercise. PRINCIPAL CONCLUSIONS: These outcomes confirmed PNIF sensitivity and reliability also in determining the changes in nasal patency occurring after physical exercise. The active vasoconstriction of nasal mucosa associated with the reduction of blood flow to the olfactory epithelium due to physical exercise may be compensated for by the increase of olfactory molecules that reach the olfactory mucosa because of nasal mucosal shrinkage: this mechanism could explain the stability of mean olfactory threshold after physical exercise.

Validity of self-reported body weight and height among women including patients with eating disorders.

The main objective of this study was to evaluate the accuracy of self-reported weight and height among women with eating disorders. The study sample consisted of 271 women aged 18-50 yrs: 73 anorexic patients (AN) with a body mass index (BMI) of <18.50 kg/m2, 54 normal weight bulimic or rehabilitated patients (BU/RE: 18.5 or =25 kg/m2) and 106 normal weight women without an eating disorder (NW: 18.5

Relationship between stress hormones and immune response during high-altitude exposure in women.

We previously confirmed that high altitude (HA) exposure can modify the number and function of immune cells, leading to a disruption in the homeostatic regulation of T helper1 (Th1)/T helper2 (Th2) immune responses. Our aim was to evaluate possible relationships between the stress response and immunological parameters during HA exposure. Thirteen healthy women spent 21 days at 5050 m. Before (SL1), the first and the 21st day at HA (HA1 and HA2, respectively), and the day after returning at sea level (SL2), we collected blood samples for immunologic parameters, and 24-h urine samples for norepinephrine, epinephrine, and cortisol. Norepinephrine and cortisol significantly increased (p<0.01) at HA1 and HA2 compared to SL1, while epinephrine did not change. At HA1, CD3+ T-cell fell significantly (p<0.001) with respect to SL1, owing to a significant (p<0.001) CD4+ T-cell reduction, while CD16+ and CD56+ increased (p<0.001) at HA2 compared to SL1. The expression of interferon-gamma (IFN-gamma) decreased (p<0.0005) at HA1 and HA2 with respect to SL1. At HA1 different lymphocyte subset (CD3+, CD4+, CD19+) were well correlated with epinephrine (p<0.05), whereas in analyzing the combined data (SL1-HA1-HA2-SL2), CD3+ (r=-0.310), CD4+ (r=-0.332), CD16+ (r=0.404), and CD56+ (r=0.373) demonstrated moderate but significant correlations (p<0.05) with norepinephrine. Moreover, norepinephrine levels were inversely correlated (r=-0.591; p<0.001) with IFN-gamma expression, a typical Th1 cytokine. We suggest that the sympatho-adrenal axis may have a role on the immunologic adaptations observed during HA exposure, and specifically on the observed impairment of the Th1/Th2 immune balance.

Effect of zinc supplementation on vitamin status of middle-aged and older European adults: the ZENITH study.

OBJECTIVE: To assess the effects of zinc supplementation on vitamin status in middle-aged and older volunteers. SUBJECTS/METHODS: Three hundred and eighty-seven healthy middle-aged (55-70 years) and older (70-85 years) men and women, randomly allocated to three groups to receive 15 or 30 mg Zn/day or placebo for 6 months. Dietary intake was assessed by means of a validated 4-day recall record. Fasting blood samples were simultaneously analysed for levels of plasma retinol and alpha-tocopherol by high-performance liquid chromatography. Erythrocyte folates were measured by a competitive immunoassay with direct chemiluminescence detection on an automatized immunoanalyser. Biochemical measurements were performed at baseline and after 3 and 6 months of zinc supplementation. RESULTS: Plasma vitamin A levels were significantly increased proportionally with zinc dose and period of treatment, particularly at 6 months (for 15 mg Zn/day, P<0.05; for 30 mg Zn/day, P<0.0001); no significant changes were observed in the placebo group. There was no effect of zinc supplementation on vitamin E/cholesterol ratio and erythrocyte folates. CONCLUSIONS: Our results show that a long-term zinc supplementation increases plasma vitamin A levels in middle-aged and older people of similar characteristics to those involved in this study. Moreover, supplementation influences serum zinc levels but does not affect erythrocyte zinc concentration and both plasma vitamin E and erythrocyte folate status.

Descriptive data on lifestyle, anthropometric status and mental health in italian elderly people.

OBJECTIVE: The objective of this paper is to provide descriptive information on anthropometric status, pathological conditions, cognitive impairment and lifestyle in apparently healthy elderly Italian people. DESIGN, SETTING AND SUBJECTS: In order to recruit the volunteers for the ZENITH study, 359 Italian participants (167 men and 192 women), aged between 70 and 85 years, free living in Rome, were selected. Volunteers underwent a full clinical examination, anthropometric measurements (height, weight), a lifestyle questionnaire and mental health assessment (cognitive impairment and depression). RESULTS: The prevalence of overweight and obesity was high (57% and 22% in men; 43% and 27% in women). Obesity was associated with low socio-economic profile in about 40% of participants. Although the sample was selected by family doctors and was apparently healthy, after medical screening the presence of several pathologies, particularly diabetes in 21% of participants was observed. There was a low prevalence of cognitive impairment in 4% of men and 7% of women and possible depression in 9% of men and 19% of women. The lifestyle questionnaire showed that most of their time was spent in light activities such as reading, watching TV or playing cards and significant differences between sex and BMI categories were observed (P=0.000). CONCLUSION: The results confirm the increasingly sedentary lifestyle of modern populations and demonstrate the need for sensitive and individualised strategies to design appropriate health promotion and disease prevention programs for older adults.

Effect of Red Orange Juice Consumption on Body Composition and Nutritional Status in Overweight/Obese Female: A Pilot Study.

The main objective of this research was to determine whether a commercial orange juice rich in anthocyanins could have an effect on body weight and on clinical parameters related to obesity including antioxidant status, lipid profile, and metabolic and inflammatory biomarkers. 11 women with an average BMI of 34.4 ± 4.8 kg/m2 were enrolled in a pilot study. Over a period of 12 weeks they received 500 mL daily dose into two doses (250 mL) of commercial red orange juice (COJ). The biochemical parameters were measured at baseline and at the end of the study (12 weeks). One month later upon free diet, a follow-up was performed measuring the same variables. The daily consumption of 500 mL of COJ had no significant effects on body weight, while there was a decrease in total cholesterol and LDL cholesterol. The grade of obesity implies different changes in inflammation biomarkers. In obese women, our data do not seem to support evidence that commercial red orange juice consumption acts as functional food preventing obesity and metabolic disorders such as insulin resistance and/or inflammatory status.

Balance impairment in kidney transplant recipients without concurrent peripheral neuropathy.

Kidney transplant recipients (KTRs) present with compromised functional capacity, low levels of physical activity, muscle atrophy, and peripheral nerve dysfunction that may result in high postural instability. This study aimed to compare the static balance control of 19 KTRs with 19 healthy adults (HA). All participants completed the Romberg test on a stabilometric platform with eyes open (EO), eyes closed (EC) and during a dual task (DT) condition. Centre of pressure (COP) measures (COP velocity (COPv) and sway area (SA)), as well as position-based outcomes such as anterior-posterior (AP) and medio-lateral (ML) ranges of COP displacements were recorded. Independent ANCOVA revealed an overall lower performance of KTRs compared to HA (p<0.05) with the EC condition exhibiting the worst relative performance for KTRs, suggesting a poorer capacity of relying on proprioceptive information when maintaining the upright posture. The addition of a cognitive task did not further worsen balance performance in KTRs. As impaired postural control is one of the main predictors of falls in elderly subjects, these data might also indicate that this constitutes an equivalent risk factor for falling in middle-aged KTRs.

Effects of sodium DL-lactate on insulin secretion in anesthetized dogs.

The effect of sodium DL-lactate administration on insulin release in anesthetized dogs has been studied. Eleven mongrel dogs were infused with sodium DL-lactate for 20 min at the rate of 20 mg/kg . min. Lactate infusion produced simultaneous increases in blood glucose and plasma insulin levels in the pancreaticoduodenal vein. To determine whether lactate stimulated insulin secretion directly, sodium DL-lactate was rapidly injected into the pancreatic artery of six dogs; this pulse induced a significant increase in insulin release from pancreatic B-cells, even in the absence of a measurable change in blood glucose. Diazoxide, when infused in six dogs, blocked lactate-induced insulin secretion. These findings indicate that lactate, as do other circulating energy fuels, may play a role in the physiologic control of insulin secretion.

Zinc intake and status in middle-aged and older European subjects: the ZENITH study.

OBJECTIVE: Inadequate intakes of micronutrients in elderly negatively affect the nutritional status. Zinc is an essential micronutrient in the elderly, especially in relation to its impact on immune function, bone mass, cognitive function and oxidative stress. However, data are lacking on zinc intake and status during normal ageing. In this study, we evaluate the intake and status of zinc in late middle-aged and older free-living subjects. DESIGN: Dietary zinc intake and zinc status in 188 middle-aged subjects from Clermont-Ferrand (Fr) and Coleraine (UK), and in 199 older subjects from Grenoble (Fr) and Roma (It) were assessed at the entry in the ZENITH study. RESULTS: In relation to the zinc RDA for people older than 55 y, zinc intakes in most of the middle-aged and older subjects (more than 96%) in the present study were adequate. Older people had significantly lower (P < 0.01) energy intakes as compared to middle-aged. Zinc intake expressed per MJ was also significantly (P < 0.01) higher in older people compared to middle-aged. Erythrocyte and urinary zinc concentrations were significantly (P < 0.001) higher in middle-aged subjects compared to older ones. The prevalence of biological Zn deficiency in free-living ageing European people was low (<5%). CONCLUSION: The results of the present study showed a relatively low prevalence of zinc deficiencies in healthy free-living late middle-age and older subjects. These results should be useful for health professionals to have reference data on zinc intake and status for a healthy ageing.

Effects of a Pilates exercise program on muscle strength, postural control and body composition: results from a pilot study in a group of post-menopausal women.

Participation in exercise programs is heartily recommended for older adults since the level of physical fitness directly influences functional independence. The aim of this present study was to investigate the effects of supervised Pilates exercise training on the physical function, hypothesizing that a period of Pilates exercise training (PET) can increase overall muscle strength, body composition, and balance, during single and dual-task conditions, in a group of post-menopausal women. Twenty-five subjects, aged 59 to 66 years old, were recruited. Eligible participants were assessed prior and after 3 months of PET performed twice per week. Muscular strength was evaluated with handgrip strength (HGS) test, 30-s chair sit-to-stand test (30CST), and abdominal strength (AST) test. Postural control and dual-task performance were measured through a stabilometric platform while dynamic balance with 8 ft up and go test. Finally, body composition was assessed by means of dual-energy X-ray absorptiometry. Statistically significant improvements were detected on HGS (+8.22%), 30CST (+23.41%), 8 ft up and go test (-5.95%), AST (+30.81%), medio-lateral oscillations in open eyes and dual-task condition (-22.03% and -10.37%). Pilates was effective in increasing upper body, lower body, and abdominal muscle strength. No changes on body composition were detected. Results on this investigation indicated also that 12-week of mat Pilates is not sufficient to determine a clinical meaningful improvement on static balance in single and dual-task conditions.

Disassembly of the cholinergic postsynaptic apparatus induced by axotomy in mouse sympathetic neurons: the loss of dystrophin and beta-dystroglycan immunoreactivity precedes that of the acetylcholine receptor.

In mouse sympathetic superior cervical ganglion (SCG), cortical cytoskeletal proteins such as dystrophin (Dys) and beta1sigma2 spectrin colocalize with beta-dystroglycan (beta-DG), a transmembrane dystrophin-associated protein, and the acetylcholine receptor (AChR) at the postsynaptic specialization. The function of the dystrophin-dystroglycan complex in the organization of the neuronal cholinergic postsynaptic apparatus was studied following changes in the immunoreactivity of these proteins during the disassembly and subsequent reassembly of the postsynaptic specializations induced by axotomy of the ganglionic neurons. After axotomy, a decrease in the number of intraganglionic synapses was observed (t1/2 8 h 45'), preceded by a rapid decline of postsynaptic specializations immunopositive for beta-DG, Dys, and alpha3 AChR subunit (alpha3AChR) (t1/2 3 h 45', 4 h 30' and 6 h, respectively). In contrast, the percentage of postsynaptic densities immunopositive for beta1sigma2 spectrin remained unaltered. When the axotomized neurons began to regenerate their axons, the number of intraganglionic synapses increased, as did that of postsynaptic specializations immunopositive for beta-DG, Dys, and alpha3AChR. The latter number increased more slowly than that of Dys and beta-DG. These observations suggest that in SCG neurons, the dystrophin-dystroglycan complex might play a role in the assembly-disassembly of the postsynaptic apparatus, and is probably involved in the stabilization of AChR clusters.