Reliability of Trunk Muscle Electromyography in the Loaded Back Squat Exercise.

Trunk muscle activation (TMA) has been reported during back squat exercise, however reliability and sensitivity to different loads alongside kinematic measures has not. Hence the aim was to determine the interday reliability and load sensitivity of TMA and kinematics during back squats. 10 males performed 3 test sessions: 1) back squat 1RM, 2) and 3) 3 reps at 65, 75, 85 and 95% of system mass max (SMmax). Kinematics were measured from an electrogoniometer and linear transducer, and surface electromyography (sEMG) recorded 4 muscles of the trunk: rectus abdominis (RA), external oblique (EO), upper lumbar erector spinae (ULES) and lumbar sacral erector spinae (LSES), and a reference leg muscle, the vastus lateralus (VL). sEMG amplitude was root mean squared (RMS). No differences (p>0.05) found between tests for any kinematic and RMS data. CV demonstrated moderate interday reliability (~16.1%) for EO, LSES and ULES but not RA (29.4%) during the velocity-controlled eccentric phase; whereas it was moderately acceptable for just LSES and ULES (~17.8%) but not RA and EO (27.9%) during the uncontrolled concentric phase. This study demonstrated acceptable interday reliability for kinematic data while sEMG for most trunk muscle sites was moderately acceptable during controlled contraction. sEMG responded significantly to load.

Cognitive rehabilitation group intervention for breast cancer survivors: results of a randomized clinical trial.

PURPOSE: We conducted a randomized clinical trial evaluating the efficacy of a cognitive rehabilitation (CR) intervention compared with a wait list (WL) control condition on cognitive complaints, neuropsychological and brain functioning in breast cancer survivors (BCS). METHODS: The small group intervention of five sessions included psychoeducation and cognitive exercises. ELIGIBILITY: Disease-free BCS with cognitive complaints, diagnosed with stage I, II or III breast cancer, completed primary treatment 18 months to 5 years earlier. Neurocognitive test data and cognitive complaints on the Patient's Assessment of Own Functioning Inventory (PAOFI) were assessed at baseline (T1), immediately post-intervention (T2), and 2 months later (T3). A subgroup of participants underwent resting state quantitative electroencephalography (qEEG) at all three assessment time points. RESULTS: Forty-eight participants [mean age (SD) 53.8 (8.2)] completed T1 assessments, and 29 participants had analyzable qEEG data. The CR group improved significantly over time compared with the WL group on PAOFI total and memory scores (both p = .01) and on Rey Auditory Verbal Learning Test (RAVLT) total (trials I-V) (p = .02) and RAVLT delayed recall (p = .007) scores. On qEEG, the CR group showed a significant decrease in delta 'slow wave' power (p = .02) and an increase in the frontal distribution of alpha power (p = .04) from T1 to T2. CONCLUSIONS: BCS in the CR group showed immediate and sustained improvements in self-reported cognitive complaints and memory functioning on neurocognitive testing. Results of the qEEG substudy provide some support for neurophysiological changes underlying the intervention. Copyright © 2015 John Wiley & Sons, Ltd.

Neuromuscular response differences to power vs strength back squat exercise in elite athletes.

The study's aim was to establish the neuromuscular responses in elite athletes during and following maximal 'explosive' regular back squat exercise at heavy, moderate, and light loads. Ten elite track and field athletes completed 10 sets of five maximal squat repetitions on three separate days. Knee extension maximal isometric voluntary contraction (MIVC), rate of force development (RFD) and evoked peak twitch force (Pt) assessments were made pre- and post-session. Surface electromyography [root mean square (RMS)] and mechanical measurements were recorded during repetitions. The heavy session resulted in the greatest repetition impulse in comparison to moderate and light sessions (P < 0.001), while the latter showed highest repetition power (P < 0.001). MIVC, RFD, and Pt were significantly reduced post-session (P < 0.01), with greatest reduction observed after the heavy, followed by the moderate and light sessions accordingly. Power significantly reduced during the heavy session only (P < 0.001), and greater increases in RMS occurred during heavy session (P < 0.001), followed by moderate, with no change during light session. In conclusion, this study has shown in elite athletes that the moderate load is optimal for providing a neuromuscular stimulus but with limited fatigue. This type of intervention could be potentially used in the development of both strength and power in elite athletic populations.

The effect of krill oil supplementation on skeletal muscle function and size in older adults: A randomised controlled trial.

BACKGROUND & AIMS: The aim of this study was to determine the effect of krill oil supplementation, on muscle function and size in healthy older adults. METHODS: Men and women, aged above 65 years, with a BMI less than 35kg/m2, who participated in less than 1h per week of structured self-reported exercise, were enrolled in the study (NCT04048096) between March 2018 and March 2020. Participants were randomised to either control or krill oil supplements (4g/day) for 6 months in this double blind randomised controlled trial. At baseline, 6 weeks and 6 months, knee extensor maximal torque was measured as the primary outcome of the study. Secondary outcomes measured were grip strength, vastus lateralis muscle thickness, short performance physical battery test, body fat, muscle mass, blood lipids, glucose, insulin, and C-Reactive Protein, neuromuscular (M-Wave, RMS and voluntary activation), and erythrocyte fatty acid composition. RESULTS: A total of 102 men and women were enrolled in the study. Ninety-four participants (krill group (26 women and 23 men) and placebo group (27 women and 18 men)) completed the study (mean (SD): age 71.2 (5.1) years and weight 71.8 (12.3) kg). Six months supplementation with krill oil resulted in, an increase in knee extensor maximal torque, grip strength and vastus lateralis muscle thickness, relative to control (p<0.05). The 6-month treatment effects were 9.3% (95%CI: 2.8, 15.8%), 10.9% (95%CI: 8.3, 13.6%) and 3.5% (95%CI: 2.1, 4.9%) respectively. Increases in erythrocyte fatty acid profile were seen with krill oil for EPA 214% (95%CI: 166, 262%), DHA 36% (95%CI: 24, 48%) and the omega-3 index 61% (95%CI: 49, 73%), relative to control (p < 0.05). Krill oil resulted in an increased, relative to control (p < 0.05), M-Wave of 17% (95%CI: 12.7, 38.1%) but there was no effect of krill oil on RMS, voluntary activation, or on any other secondary outcomes such as performance of the short performance physical battery test or quality of life. CONCLUSION: Krill oil supplementation for 6 months results in statistically and clinically significant increases in muscle function and size in healthy older adults. GOV IDENTIFIER: NCT04048096.

Brain functional changes (QEEG cordance) and worsening suicidal ideation and mood symptoms during antidepressant treatment.

OBJECTIVE: Antidepressant medications are efficacious overall; however, some individuals experience worsening mood symptoms and increased suicidal ideation (SI) during treatment. We examined the quantitative electroencephalographic (QEEG) cordance biomarker of brain function biomarker in relation to treatment-emergent symptom worsening. METHOD: Seventy-two major depressive disorder (MDD) subjects were treated with fluoxetine 20 mg (n = 13), venlafaxine 150 mg (n = 24), or placebo (n = 35) under double-blind conditions. Behavioral ratings determined whether each subject demonstrated worsening of depressed mood, anxiety, or SI during treatment. QEEG cordance data were analyzed to determine whether symptom worsening was associated with neurophysiological changes. RESULTS: Antidepressant treatment-emergent SI (13.5%) was associated with a large transient decrease in midline-and-right-frontal (MRF) cordance 48 h after start of medication. CONCLUSION: Hypothesis-generating results suggest a pattern of functional changes in midline and right frontal brain regions associated with antidepressant treatment-emergent SI in MDD.

Reproducibility of limb power outputs and cardiopulmonary responses to exercise using a novel swimming training machine.

The purpose of this study was to determine the reproducibility of limb power outputs and cardiopulmonary responses, to incremental whole-body exercise using a novel swimming training machine. 8 swimmers with a mean age of 23.7 ± 4.6 (yrs), stature 1.77 ± 0.13 (m) and body mass of 74.7 ± 2.8 (kg) gave informed consent and participated in repeat exercise testing on the machine. All subjects performed 2 incremental exercise tests to exhaustion using front crawl movements. From these tests peak oxygen consumption (VO(2peak)), peak heart rate (HR(peak)), peak power output (W (peak)) and individual limb power outputs were determined. Results showed there were no significant differences between test 1 and 2 for any variable at exhaustion, and the CV% ranged from 2.8 to 3.4%. The pooled mean values were; VO(2peak) 3.7 ± 0.65 L.min⁻¹, HR (peak) 178.7 ± 6.6 b.min⁻¹ and W (peak) 349.7 ± 16.5 W. The mean contributions to the total power output from the legs and arms were (37.3 ± 4.1% and 62.7 ± 5.1% respectively). These results show that it is possible to measure individual limb power outputs and cardiopulmonary parameters reproducibly during whole-body exercise using this training machine, at a range of exercise intensities.

Brain functional changes during placebo lead-in and changes in specific symptoms during pharmacotherapy for major depression.

OBJECTIVE: Brain functional changes during placebo lead-in have been associated with antidepressant response in clinical trials for major depressive disorder (MDD); however, the relationship between such non-pharmacodynamic changes in brain function and changes in specific symptoms is unknown. METHOD: Fifty-eight adults with MDD completed a 1-week single-blind placebo lead-in preceding 8 weeks of double-blind randomized treatment with fluoxetine or venlafaxine (n = 30) or placebo (n = 28). Brain functional change during lead-in was assessed using quantitative electroencephalographic (qEEG) prefrontal theta-band cordance. Symptoms were assessed using the Symptom Checklist-90-Revised (SCL-90-R). RESULTS: The multiple regression model examining the qEEG parameter in relation to SCL-90-R subscales was significant [F(9,9) = 4.27, P = 0.021, R(2) = 0.81] in females, with a significant association for the interpersonal sensitivity subscale (beta coefficient = 1.94, P = 0.001). CONCLUSION: Prefrontal neurophysiologic change during placebo lead-in may indicate subsequent antidepressant-related improvement in symptoms of interpersonal sensitivity.

Effect of lower limb massage on electromyography and force production of the knee extensors.

OBJECTIVE: To evaluate the effect of massage on force production and neuromuscular recruitment. METHODS: Ten healthy male subjects performed isokinetic concentric contractions on the knee extensors at speeds of 60, 120, 180, and 240 degrees /s. These contractions were performed before and after a 30 minute intervention of either rest in the supine position or lower limb massage. Electromyography (EMG) and force data were captured during the contractions. RESULTS: The change in isokinetic mean force due to the intervention showed a significant decrease (p<0.05) at 60 degrees /s and a trend for a decrease (p = 0.08) at 120 degrees /s as a result of massage compared with passive rest. However, there were no corresponding differences in any of the EMG data. A reduction in force production was shown at 60 degrees /s with no corresponding alteration in neuromuscular activity. CONCLUSIONS: The results suggests that motor unit recruitment and muscle fibre conduction velocity are not responsible for the observed reductions in force. Although experimental confirmation is necessary, a possible explanation is that massage induced force loss by influencing "muscle architecture". However, it is possible that the differences were only found at 60 degrees /s because it was the first contraction after massage. Therefore muscle tension and architecture after massage and the duration of any massage effect need to be examined.

Nutrition management of patients with neoplastic disease of the head and neck treated with radiation therapy.

Neoplastic lesions of the head and neck are primarily squamous cell carcinomas of the aerodigestive tract mucosa. Approximately 43,000 new cases of head and neck cancer (8.5% of all malignancies) are diagnosed in the United States each year. Tumors, with a male predominance at age 50 to 60 years, generally occur on the surface of the mucosal lining of the oral cavity, oropharynx, nasopharynx, larynx, maxillary sinus, salivary glands, and the thyroid gland. Tobacco, alcohol, and the combination of tobacco and alcohol are the principle causative agents of head and neck neoplasms. The use of these carcinogenic agents often has a negative impact on lifestyle, and it is not unusual for significant nutritional deficiencies to exist in this population before diagnosis of head and neck cancer. Definitive and adjuvant cancer treatment modalities are rigorous, and sequelae associated with the therapy often further impair nutritional status and increase morbidity. Auspicious nutrition assessment and management before the initiation of therapy can have a significant impact on the course of treatment and the patient's quality of life.

The changing pattern of laryngeal tuberculosis.

Laryngeal tuberculosis is now an uncommon disease in the United Kingdom. A series of ten cases is reported. In contrast to the pre-chemotherapy era, when the disease was associated with advanced cavitated pulmonary tuberculosis and was highly infectious, it now presents in a manner similar to laryngeal carcinoma except that painful dysphagia is a prominent symptom. All such patients should have a chest X-ray carried out as part of their initial investigation. Sputum is almost always positive for tubercle bacilli on direct films. Direct laryngoscopy and biopsy are necessary if a carcinoma is suspected. The change of pattern of the disease may be due to the fact that the larynx now usually becomes involved by haematogenous spread rather than by direct spread along the airways. Laryngeal tuberculosis is now no more infectious than pulmonary tuberculosis, and responds well to antituberculous chemotherapy. Symptoms resolve completely within three weeks if corticosteroids are given in combination.

Normal radiological renal size: simple estimation from single urogram series.

A normal range of kidney size can be defined from a single, technically adequate, excretory urogram series. Relation of kidney length to distance between L1 to L3 bodies inclusive gives a better indication of normal size, than comparison between kidney length and a single vertebra. The span of the normal range of kidney length to lumbar spine ratio is such that its application to a given radiological examination will be of marginal value.

Effects of microtubule-associated protein (MAP) expression on methylmercury-induced microtubule disassembly.

The sensitivity of microtubules (MTs) to methylmercury- (MeHg) induced disassembly was compared in undifferentiated, MAP1A- and MAP2C-transfected, and neuronally differentiated P19 Embyronal Carcinoma (EC) cells. The extent of MT disassembly was examined qualitatively by immunofluorescence microscopy and Western blotting and quantitatively by dot blotting of polymer and soluble proteins extracts. Immunofluorescence microscopy showed that MeHg disassembled MTs in a time- and dose-dependent manner and that MTs in both MAP2C-transfected and neuronally differentiated cells, but not those in MAP1A-transfected cells, were significantly more resistant to MeHg-induced MT depolymerization than those in undifferentiated cells. These results suggest that MAP2C has a greater ability to stabilize MTs against MeHg-induced disassembly than MAP1A. Surprisingly, however, when the extent of MT disassembly was assessed by Western blotting and by quantitative dot blotting, no change was observed in the amounts of tubulin, MAP2, or MAP1A, in the polymer and soluble fractions in MeHg-treated samples, compared to the control cells that were not treated. These data show that, although MeHg treatment resulted in the disassembly of MTs, they were not depolymerized as detergent-soluble subunits, but rather appeared to form insoluble tubulin-MAP oligomers or aggregates.

Intrapleural immunotherapy with Corynebacterium parvum in recurrent malignant pleural effusions.

Twenty-one patients with proven recurrent malignant pleural effusions were randomly allocated to treatment groups receiving either intrapleural Corynebacterium parvum in a dose of 7 mg or intrapleural mustine (20 mg). The designated intrapleural therapy was repeated on one occasion if further pleural aspiration was required. Corynebacterium parvum (nine patients) proved superior to mustine (12 patients) in suppressing the reaccumulation of pleural fluid, and was associated with only minimal side-effects of fever and nausea in two patients. Mustine caused marked nausea and vomiting in almost all patients. Three of the four patients who were deemed "failures" after mustine therapy had complete suppression of pleural fluid reaccumulation after a single dose of C parvum, the survival of the fourth being too short to assess a response adequately. There were no failures in the C parvum treated group. Corynebacterium parvum appears to be an effective, well-tolerated agent in the management of recurrent pleural effusions. The relative contribution of its potent immunological stimulant effect to its mode of action remains uncertain.

Yellow nail syndrome associated with empyema.

The yellow nail syndrome is a rare condition consisting of slow-growing dystrophic nails and oedema, usually affecting the ankles, and probably due to defective lymphatic drainage. Its association with mild chronic pulmonary disease has been recognized. We describe a case initially complicated by a recurrent pleural effusion but, more importantly, by the development of bronchiectasis and thoracic empyema.

The nutritional status of patients with chronic obstructive pulmonary disease.

The nutritional status of 38 patients with chronic obstructive pulmonary disease (COPD) was assessed by dietary intake, anthropometric measurements biochemical analysis, and immunologic testing. The mean intakes for 9 nutrients were significantly greater than the 1974 Recommended Dietary Allowances of the National Academy of Sciences. Results of the anthropometric measurements for usual weight for height, fat stores, and muscle mass were significantly less than standard. Of the 32 subjects evaluated for immunocompetence, 9 were anergic (induration, 0) on all 3 skin tests. The results of this study indicated that the marasmic type of protein calorie malnutrition is a common finding among patients with COPD, and that patients with COPD who are immunoincompetent may be more susceptible to mixed protein calorie malnutrition of the kwashiorkor-marasmus type.

Partial lipodystrophy with nephrotic syndrome.

A patient with nephrotic syndrome in association with partial lipodystrophy is reported. The features of partial lipodystrophy are well recognized and the renal lesion is a mesangiocapillary glomerulo-nephritis of a dense deposit type with an associated depression of C3. This type of kidney involvement is becoming increasingly recognized as common in the syndrome of partial lipodystrophy.

Pulmonary infection with mycobacterium xenopi: review of treatment and response.

Forty seven patients (82% male) with pulmonary infection caused by Mycobacterium xenopi have been reviewed. Pre-existing lung disease was present in 35 (75%). In 21 patients the disease was characterised by a subacute illness developing over a period of two to four months, while in another 20 patients there was a longer history of chronic respiratory problems often associated with slowly progressive changes evident from chest radiographs. Response to treatment was poor and unpredictable, and was not related to the results of in vitro sensitivity tests, pre-existing lung disease, or mode of onset of symptoms. Eleven patients (23%) were cured with chemotherapy. The best drug regimen appeared to be rifampicin and isoniazid combined with either streptomycin or ethambutol. Another 12 (26%) showed favourable responses to drug treatment initially, but eventually relapsed. Four patients had progressive disease while receiving prolonged courses of chemotherapy. Resection was performed in five patients with resultant cure in four. Since the prognosis with drug treatment alone is so unpredictable it is suggested that resection might be part of first line treatment, and that it should usually be performed if patients fail to respond to initial chemotherapy or if they relapse.

Intralesional injection of BCG using the fibreoptic bronchoscope in the treatment of bronchogenic carcinoma.

Current evidence suggests that the most effective administration of BCG immunotherapy is by the intralesional route. The new technique and complications of BCG intralesional injection of bronchogenic carcinomas via the fibreoptic bronchoscope is described. Seventeen patients with irresectable bronchogenic carcinoma have been treated with chemotherapy and BCG intralesional immunotherapy. Side-effects observed with intralesional BCG injection are: fever, hypotension and transient mild disturbances of liver function tests, and a single episode of granulomatous hepatitis. Early clinical improvement (nine patients) and radiological regression of the tumour (six patients) have been observed. Cavitation of the tumour has also been observed in three patients. Long term results are not yet available.

Treatment of pulmonary infections caused by mycobacteria of the Mycobacterium avium-intracellulare complex.

Sixty-four patients with pulmonary infection caused by mycobacteria of the M avium-intracellulare complex have been reviewed. Patients who were asymptomatic on presentation often had a benign course but some developed progressive disease. Symptomatic patients who were not treated usually deteriorated. Various treatment regimens were used. Successful treatment was achieved in the majority of patients using a combination of isoniazid, rifampicin, and either ethambutol or streptomycin given for 24 months. Other forms of treatment given including multiple drug regimens were not as effective.