The Ontario cohort study of running-related injuries.

A cohort of 1680 runners was enrolled through two community road race events and monitored during a 12-month follow-up period for the occurrence of musculoskeletal injuries. Forty-eight percent of the runners experienced at least one injury, and 54% of these injuries were new; the remainder were recurrences of previous injuries. The risk of injury was associated with increased running mileage but was relatively unassociated with other aspects of training, such as usual pace, usual running surface, hill running, or intense training. Injury rates were equal for all age-sex groups and were independent of years of running experience. Runners injured in the previous year had approximately a 50% higher risk for a new injury during follow-up.

The M.D.R. index of function in rheumatoid arthritis.

The M.D.R. index is a new instrument which has been designed to give a measurement of physical function in inflammatory joint disease. It is very easy to apply and is not time-consuming. In preliminary assessment, the index has proven to be highly reliable. It has also been sufficiently sensitive to detect short-term changes in functional capacity which were unrelated to changes in the severity of joint inflammation. The application of the index is inexpensive and does not require extensive training of personnel for its accurate use. It is expected that the M.D.R. index will prove to be suitable for widespread use as a clinical assessment of physical function.

Environmental considerations for exercise.

Physical activity, whether at a competitive or a recreational level, is frequently affected by environmental conditions. With changes in the natural environment, the exercising individual invokes a series of complex physiologic responses that are directed at maintaining homeostasis. This article will focus on the nature of these responses, with special reference to their influence on cardiorespiratory function. Because alterations in ambient temperature and ascent to altitude are the most common and are the most extensively studied of man's adaptational abilities, these will provide the basis for this discussion.

Suspected sodium toxicity in hand-reared great blue heron (Ardea herodias) chicks.

Sodium toxicity was suspected in hand-reared great blue heron (Ardea herodias) chicks fed herring frozen in brine (seawater). Affected chicks were lethargic with stiff legs that extended to the posterior, and breathing was labored. Chicks regurgitated food or refused to eat. All chicks that were fed herring exclusively and eight of the 10 chicks fed a mixed diet (herring and salmonids) died, whereas all chicks fed only salmonids survived. Renal lesions ranged from mild to marked generalized nephrosis, which was characterized by degeneration and necrosis of the proximal convoluted tubular epithelium and dilation of the distal convoluted tubules and collecting ducts. These observations suggest that fish frozen in brine is unsuitable food for hand-rearing of young herons.

Ionic and endocrine characteristics of reproductive failure in calcium-deficient and vitamin D-deficient laying hens.

Whole blood ionized calcium and plasma total calcium, inorganic phosphorus, estradiol-17 beta, progesterone, and 1,25-di-hydroxycholecalciferol concentrations were measured in calcium- or vitamin D-deficient Single Comb White Leghorn hens. Control birds were serially sampled every 2 h for 26 h immediately following oviposition until the next oviposition. Deficient birds, which had ceased laying 10 to 14 days prior to sampling, were sampled at the same times. The control birds had significantly higher mean total and bound plasma calcium and inorganic phosphorus concentrations than the deficient hens. Control and vitamin D-deficient hens had similar mean ionized calcium concentrations. Control hens exhibited a cyclic pattern in ionized calcium and inorganic phosphorus concentrations over the sampling period that was related to shell calcification. Deficient hens showed no changes in ionized calcium concentration during this time. Plasma 1,25-dihydroxycholecalciferol concentrations were significantly higher in the calcium-deficient birds than the control or vitamin D-deficient hens. Mean plasma estradiol-17 beta and progesterone concentrations were consistently higher in the control hens than the deficient hens. Consistent with this observation were decreases in ovary and oviduct weights, which occurred in the nonlaying deficient hens.

The effect of taurine transport antagonists on cardiac taurine concentration and the incidence of sudden death syndrome in male broiler chickens.

Two experiments were conducted in which 540 day-old male broiler chickens were raised in heated battery brooders to 4 wk of age. Diets contained taurine antagonists to test effects on cardiac taurine content and the incidence of Sudden Death Syndrome (SDS). In Experiment 1 treatments during Weeks 2 to 4 were A) basal diet; B) basal diet supplemented with .25% guanidinoethyl sulfonate (GES) in Week 2 and 1.5% GES in Weeks 3 and 4; and C) basal diet supplemented with .5% GES in Weeks 2 to 4. The taurine content of heart was significantly reduced (P less than .05) with GES supplementation, but no effects on SDS mortality rates were noted. In Experiment 2 birds received diets containing 0. 2.5, or 5% beta-alanine. Supplementation with this compound decreased cardiac taurine concentration to extremely low levels (P less than .05). No significant effects on SDS mortality rates were noted. The results are interpreted as suggesting that taurine does not play a major role in the etiology of SDS.

Comparison of two multiple blood sampling regimens using an indwelling vascular access device for investigations of the hen's ovulatory cycle and calcium metabolism.

The objectives of the present study were to compare the effects of two regimens of serial blood sampling on the concentrations of hormones and ions during the ovulatory cycle of the domestic hen, and to examine the effectiveness of an indwelling vascular access device for repeated collection of blood samples. Single Comb White Leghorn hens were bled every 2 h over a period of 24 to 26 h, either from one oviposition to the next oviposition (OVIP-OVIP), or from 10 h prior to ovulation until the same time 24 h later (AFTN-AFTN). Whole blood was analyzed for ionized calcium concentration. Plasma was analyzed for total calcium, inorganic phosphorus, 1,25-dihydroxycholecalciferol, estradiol-17beta, and progesterone concentrations. The OVIP-OVIP regimen, using oviposition as a reference point, provided more accurate measurements of ionized calcium, inorganic phosphorus, and estradiol-17beta than did the AFTN-AFTN regimen. Either bleeding regimen was suitable for observing the patterns of 1,25-dihydroxycholecalciferol and progesterone concentrations. The decrease in bound calcium concentration observed with both regimens appeared to be an artifact of repeated blood sampling. The chance of a bird laying an egg following her second oviposition was lower following the OVIP-OVIP regimen than the AFTN-AFTN regimen. The vascular access device was a helpful tool in procuring multiple blood samples for measurement of ions and hormones during the ovulatory cycle of the domestic fowl.

Aerobic fitness and hormonal responses to prolonged sleep deprivation and sustained mental work.

This study examined the influence of aerobic fitness on the responses of selected hormones to the combined stressors of sleep deprivation (SD) and sustained mental work. Six aerobically high fit (HF) (VO2max greater than 50 ml.kg-1.min-1) and six average fit (AF) (VO2max less than 40 ml.kg-1.min-1) female subjects were subjected to a period of sleep loss of 60 h during which time they performed sustained mental tasks with no physical activity component. Venous blood samples were drawn every 12 h at 1330 hours and 0130 hours and plasmas analyzed for cortisol, growth hormone (hGH), prolactin, thyroxine (T4), triiodothyronine (T3), and reverse-triiodothyronine (rT3). For cortisol, both the HF and AF groups exhibited the normal high-daytime and low-nighttime pattern of secretion, with levels increasing significantly as the duration of SD increased. The normal elevations of hGH and prolactin levels during normal sleep were suppressed during SD. No significant fitness effects were found for cortisol, hGH, and prolactin responses. Plasma levels of T4, T3, and rT3 increased significantly during SD, with highly fit subjects exhibiting higher levels of these hormones than those of average fitness. We suggest that aerobic fitness may influence the peripheral metabolism of T4 during SD, but that aerobic fitness does not influence the regulation of the classical stress hormones during SD.

Moderate exercise and hemodilution during sleep deprivation.

The effect of 52 h of sleep deprivation (SD) upon blood constituents was studied in 12 young women aged 21.5 +/- 0.4 years. Subjects were individually isolated without time cues, performing a sequence of cognitive tasks. Significant decreases in hematocrit (p less than 0.002) and red cell count (p less than 0.04) developed, mainly over the first 28 h of SD, reaching a subsequent plateau or partial recovery. The calculated plasma volume also increased by 10.7 +/- 3.1% at 52 h, with recovery to a 6.9 +/- 3.2% increase the following day. About 1 L of water was retained over the first 30 h of SD, with a subsequent partial elimination of this excess. Plasma albumin and total protein concentrations were largely sustained in the face of the plasma expansion. The plasma pH showed a progressive fall from a baseline value of 7.381 +/- 0.014 to 7.332 +/- 0.006 at 52 h, while plasma bicarbonate decreased from a baseline figure of 31.2 +/- 0.7 to 26-27 mM/L (p less than 0.05). After 8 weeks, all subjects repeated the experiment, with the introduction of 30 min of exercise in the 40th h of wakefulness. Hematocrit and plasma volume changes were similar to those of the first experiment up to the time of exercise, but hematocrit decreased and plasma volume increased after the exercise bout, rather than reaching a plateau. Plasma pH increased with exercise, but returned to the previous low level at 52 h. Any arousing effect of the exercise bout was transient. The plasma expansion reflects metabolic and/or respiratory acidosis, plus possible effects of a prolonged period without recumbency.

Training Habits and Injury Experience in Distance Runners: Age-and Sex-Related Factors.

In brief: An 80-item questionnaire was used to study the variations by age and sex in the training habits and injury experience of 688 adult entrants in a 10-mile road race in southern Ontario. The results showed that runners over the age of 30 years tend to train at a slower pace than younger runners. On the average, men trained over somewhat longer distances and at a faster pace than women of the same age, but women ran more times per week. Older athletes tended toward a higher weekly mileage and entered the longer distance races. While 57% of all respondents reported at least one injury during the 12 months preceding our study, there was no significant variation by age or sex.

Exercise and soft tissue injury.

Once the almost exclusive domain of the orthopaedic surgeon, sports injuries are now being seen with increasing frequency by other specialists, including rheumatologists. It is therefore important for rheumatologists to be able to diagnose and manage the various musculoskeletal conditions that are associated with physical activity. Soft tissue injuries are a very common cause of morbidity in both competitive and recreational athletes. Most of these conditions are provoked by muscle-tendon overload (or overuse) that is usually the result of excessive training or improper training techniques. However, despite an emerging literature on the natural history of soft tissue overuse syndromes, relatively little is known about the causes, incidence and outcome of many of these injuries. Of the methodologically robust epidemiological studies that have been done, most have focused on habitual distance runners. In this population, it has been reported that the incidence of injury can be as high as 50% or more, and that overtraining and the presence of previous injury are the most significant predictors of future injury. In other popular forms of exercise, such as walking, swimming, cycling, aerobics and racquet sports, injuries are also reported with high frequency but, to date, no prospective studies have examined actual incidences in these populations, and risk factors for injury in these activities remain speculative. Several of the more commonly occurring soft tissue injuries (such as rotator cuff tendinitis, lateral and medial epicondylitis, patellar tendinitis, the iliotibial band friction syndrome, Achilles tendinitis and plantar fasciitis) exemplify the overuse concept and are therefore highlighted in this review. The management of these, and most other, exercise-related soft tissue injuries is directed towards promptly restoring normal function and preventing re-injury.

Effect of vitamin D3 metabolites on calcium and phosphorus metabolism in chick embryos.

The biochemical nature of the physiological defect found in chick embryos from hens supported on 1,25-dihydroxyvitamin D3 as their sole source of vitamin D is described. Vitamin D-deficient hens (44-wk-old) were divided into six groups of five and dosed daily for 19 wk with either 2.0 micrograms of 25-hydroxyvitamin D3, 2.0 micrograms of 24,24-difluoro-25-hydroxy-vitamin D3, 0.4 micrograms of 1,25-dihydroxyvitamin D3, 2.0 micrograms of 24,25-dihydroxyvitamin D3, 0.4 micrograms of 1,25-dihydroxyvitamin D3 plus 2.0 micrograms of 24,25-dihydroxyvitamin D3, or vehicle only. Normal embryonic development was found in eggs from hens given 25-hydroxyvitamin D3 or 24,24-difluoro-25-hydroxyvitamin D3, whereas embryos from hens given 1,25-dihydroxyvitamin D3, 24,25-dihydroxyvitamin D3, or their combination were abnormal and failed to hatch. Embryos from hens fed 1,25-dihydroxyvitamin D3 and/or 24,25-dihydroxyvitamin D3 had vitamin D deficiency: low bone ash, low plasma calcium, low total body calcium, and extremely high plasma phosphorus. Because the shell is the major source of calcium for the developing embryo, calcium transport from the shell to the embryos across the chorioallantoic membrane apparently fails, giving rise to the observed defects in embryonic development.

The action of various vitamin D3 metabolites on calcium and phosphorus metabolism in chick embryo calvariae.

Chick embryos from vitamin D-deficient hens given physiological doses of 1,25-dihydroxyvitamin D3 or 24,25-dihydroxyvitamin D3 or both become severely hypocalcemic, hyperphosphatemic and fail to hatch as compared to those derived from hens given 25-hydroxyvitamin D3 or 24,25-difluoro-25-hydroxyvitamin D3. Calvariae from the former contain less mineral and on incubation in vitro produce significantly lower calcium and higher phosphate concentration in the medium than do the calvariae derived from the embryos of hens supported on 25-hydroxyvitamin D3 or 24,24-difluoro-25-hydroxyvitamin D3.

Studies on the role of 1,25-dihydroxyvitamin D in chick embryonic development.

Vitamin D-deficient laying hens were repleted with 25-hydroxy[26,27-3H]vitamin D3 or 1,25-dihydroxy[26,27-3H]vitamin D3. Egg production returned to normal for both groups of hens by the third week. Eggs from hens fed either 25-hydroxy[26,27-3H]vitamin D3 or 1,25-dihydroxy[26,27-3H]vitamin D3 contained 1,25-dihydroxy[26,27-3H]vitamin D3. Eggs from hens fed 25-hydroxy[26,27-3H]vitamin D3 contained substantial amounts of 25-hydroxy[26,27-3H]vitamin D3, while those from hens fed 1,25-dihydroxy[26,27-3H]vitamin D3 contained none. Plasma from 18-day embryos from hens fed 1,25-dihydroxy[26,27-3H]vitamin D3 contained little or no 1,25-dihydroxy[26,27-3H]vitamin D3, while that from 18-day embryos from hens given 25-hydroxy[26,27-3H]vitamin D3 had normal levels of 1,25-dihydroxy[26,27-3H]vitamin D3. No eggs from hens fed 1,25-dihydroxy[26,27-3H]vitamin D3 hatched, while eggs from hens fed 25-hydroxy[26,27-3H]vitamin D3 achieved a hatchability of 90%. It appears that embryos from hens maintained on 1,25-dihydroxyvitamin D3 as their sole source of vitamin D are essentially vitamin D deficient.

Effects of sexual and physical abuse: a comparison of adolescent inpatients.

The present study was designed to collect descriptive data on a sample of hospitalized adolescents who were victims of sexual and/or physical abuse and to compare these groups to patients without a history of abuse. A questionnaire was administered to 51 inpatient teenagers at Fort Logan Mental Health Center, a state psychiatric hospital in Denver, Colorado. Information was obtained about family background, type, extent and duration of abuse, drug and alcohol abuse and self-reported mental health and general adjustment problems. In addition, clinical staff completed the Revised Behavior Problem Checklist (1) for the subjects. The results indicated statistically significant differences (p less than .05) between groups with adolescents who were both physically and sexually abused reporting the most problems. The implications for the findings for treatment are discussed.

Endocrinology of the avian embryo: an overview.

The full endocrine system is developed during the embryonic stages of the domestic fowl and probably in all avian species. This involves the genesis and differentiation of endocrine cells and progressive acquisition of interactions between endocrine tissues leading to integrated series of control systems. The embryonic endocrine organs produce hormones with a variety of physiological roles (including homeostatic, homeorhetic, and anticipatory). The present chapter provides an overview of the recent advances in the endocrinology of the avian embryo. Particular attention is focused on the general phenomenon of endocrine development and on the ontogeny of the hypothalamo-pituitary (growth hormone)-somatomedin-growth axis, the hypothalamo-pituitary-thyroid axis, and the hormones of calcium homeostasis.

Hydroxylation of carbon-24 of 25-hydroxycholecalciferol is not necessary for normal embryonic development in chickens.

Laying hens fed 25-hydroxycholecalciferol, 24,24-difluoro-25-hydroxycholecalciferol, 1,25-dihydroxycholecalciferol or 24,25-dihydroxycholecalciferol were used to investigate whether hydroxylation of C-24 of cholecalciferol is necessary for normal embryonic development in chickens. Laying hens were fed a rachitogenic diet and 25-hydroxycholecalciferol from hatching until normal egg production, fertility and hatchability were achieved. When the hens were 40 weeks old, 25-hydroxycholecalciferol was withdrawn and egg production ceased in 4 weeks. The hens were divided into 6 groups of 5 and dosed daily for 19 weeks with either 2.0 micrograms of 25-hydroxycholecalciferol, 2.0 micrograms of 24,24-difluoro-25-hydroxycholecalciferol, 0.4 microgram of 1,25-dihydroxycholecalciferol, 2.0 micrograms of 24,25-dihydroxycholecalciferol, both 1,25-dihydroxycholecalciferol and 24,25-dihydroxycholecalciferol or vehicle only. Egg production during this period was high for all hens fed the cholecalciferol compounds. Egg production of 3% occurred in hens given vehicle only. Fertility was over 90% for all groups of cholecalciferol compound-fed hens. Hatchability of over 90% was achieved with the eggs from hens given 25-hydroxycholecalciferol or 24,24-difluoro-25-hydroxycholecalciferol and 6% with eggs from hens fed both 1,25-dihydroxycholecalciferol and 24,25-dihydroxycholecalciferol. No eggs from hens fed 1,25-dihydroxycholecalciferol or 24,25-dihydroxycholecalciferol alone hatched (over 140 eggs in each group.

Aluminum and acid effects on calcium and phosphorus metabolism in young growing chickens (Gallus gallus domesticus) and mallard ducks (Anas platyrhynchos).

Acidification is associated with increased mortality, reduced growth, and bone abnormalities in birds. Associated with acid deposition is an increase in aluminum availability due to solubilization from soil and other sources. (Conversely, experimental diets containing aluminum sulfate have much reduced pHs.) The present studies compare the effects of two levels of dietary acid (sulfuric acid) (0.122 and 0.56 mol H+ per kg feed; 0.056 and 0.277 mol sulfate per kg feed) and dietary aluminum (aluminum sulfate at 0.1 and 0.5%; sulfate at 0. 056 and 0.277 mol sulfate per kg feed) on bone growth, mineralization, and phosphorous/calcium homeostasis in growing birds (chickens and mallard ducks). Growth was reduced by the high acid (chicken) and aluminum (ducks and chickens) diets. A reduction in bone mineralization was observed in birds receiving aluminum-containing diets [low aluminum diet: decreased tibia ash, calcium, and phosphorus (chickens); high aluminum diet: decreased tibia dry weight, % of ash and mg; ash, calcium (chickens, ducks as % of ash), and phosphorus (chickens mg/duck, % of ash)]. Moreover, plasma concentrations of inorganic phosphate were reduced in chicks on the high aluminum diet. There were also marked decreases in bone growth and mineralization [tibia weight, ash (mg), calcium (mg), phosphorus (mg)] and plasma concentrations of 1,25-dihydroxy vitamin D3 in chicks on the high acid diet compared to those on a control diet. These changes were probably due to reduced feed intake; changes in bone indices being of a greater or similar magnitude in pairfed control. There was little change in bone indices, growth rate or feed consumption in ducklings receiving either the low or high acid diets. It is concluded that aluminum directly adversely affected bone mineralization whereas acid effects are mediated in part by changes in feed consumption.

DNA quaternary structure in the radiation sensitivity of human lymphocytes--a proposed role of copper.

On challenging with 2M NaCl, the nuclei of human lymphocytes yield an aggregate of DNA-protein material. The density of the material is less when isolated from irradiated cells than when isolated from unirradiated cells. The density of this material, designated histone-free-DNA (HF-DNA), from irradiated cells returns to that from unirradiated cells if the irradiated cells are allowed time at 37 degrees C in nutrient conditions. Lymphocyte HF-DNA from patients who have exhibited hypersensitivity to radiotherapy exhibit slower repair characteristics than lymphocyte HF-DNA from the average normal subjects. Neutrons are more effective than X-rays in producing density changes. Misonidazole and the ADPRT inhibitor 3-AAB substantially inhibit return to unirradiated densities. The oer for the initial effect is between 2 and 3. These properties of this DNA material from human lymphocytes suggest that alterations in the configuration of such material by the loss and re-establishment of relatively weak cellular bonds are closely related to the well-known changes observed in classical cell survival experiments. Where the proliferation of human lymphocytes has been observed by concanavalin A stimulation, oer, RBE and chemical modification has been of the same order as the measured density changes. Additionally, we have found that the density of HF-DNA is heavily dependent upon Cu content. This has led us to propose that cell killing or malfunction at the nuclear level caused by ionizing radiation is caused by the conversion CuII----CuI and also by specific .OH attack on DNA or proteins at a Cu site.(ABSTRACT TRUNCATED AT 250 WORDS)

Exertional heat stroke: the runner's nemesis.

Heat stroke in distance runners is increasing in frequency. A case is reported of a 41-year-old man who collapsed during a 10-km "fun run" held when the temperature was 31.6 degrees C and the humidity 80%. Acute renal failure (serum creatinine level 1530 mumol/l [17.3 mg/dl]), rhabdomyolysis, disseminated intravascular coagulation and hepatic damage complicated the clinical picture. Repeated peritoneal dialysis and one cycle of hemodialysis because of a very high serum level of uric acid (1.23 mmol/l [20.7 mg/dl]) were required. Although the illness was prolonged, recovery was almost complete, and 4 months after the man's collapse the serum creatinine level had fallen to 133 mumol/l (1.5 mg/dl).