ACUTE EFFECTS OF MOVEMENT VELOCITY ON BLOOD LACTATE AND GROWTH HORMONE RESPONSES AFTER ECCENTRIC BENCH PRESS EXERCISE IN RESISTANCE-TRAINED MEN

This study aimed to compare the effects of different velocities of eccentric muscle actions on acute blood lactate and serum growth hormone (GH) concentrations following free weight bench press exercises performed by resistance-trained men. Sixteen healthy men were divided into two groups: slow eccentric velocity (SEV; n = 8) and fast eccentric velocity (FEV; n = 8). Both groups performed four sets of eight eccentric repetitions at an intensity of 70% of their one repetition maximum eccentric (1RMecc) test, with 2-minute rest intervals between sets. The eccentric velocity was controlled to 3 seconds per range of motion for SEV and 0.5 seconds for the FEV group. There was a significant difference (P < 0.001) in the kinetics of blood lactate removal (at 3, 6, 9, 15, and 20 min) and higher mean values for peak blood lactate (P = 0.001) for the SEV group (9.1 ± 0.5 mM) compared to the FEV group (6.1 ± 0.4 mM). Additionally, serum GH concentrations were significantly higher (P < 0.001) at 15 minutes after bench press exercise in the SEV group (1.7 ± 0.6 ng · mL⁻¹) relative to the FEV group (0.1 ± 0.0 ng · mL⁻¹). In conclusion, the velocity of eccentric muscle action influences acute responses following bench press exercises performed by resistance-trained men using a slow velocity resulting in a greater metabolic stress and hormone response.     

Acute responses of muscle oxygen saturation during different cluster training configurations in resistance-trained individuals

This study compared the perceptual responses, physiological indicators and technical parameters between different training protocols focused on upper body exercises. A randomized crossover design was performed, and 12 trained individuals (age: 27.1 ± 5.7 years; height: 173.7 ± 10.7 cm; BMI: 23.9 ± 2.3) completed three resistance training sessions under different protocols separated by at least 72 h: traditional training (TT) (4 x 6 repetitions at 85% of 1RM with 120 s of rest between sets), cluster 1 (CL1) (4 x 2+2+2 repetitions at 85% of 1RM with 15 s of intra-rep rest and 80 s between sets), and cluster 2 (CL2) (24 repetitions at 85% of 1RM with 15 s of inter-set recovery). Before training, arterial blood pressure (BP) and repetitions to failure of pull-up and push-up (FT) were collected. Muscle oxygen saturation (SmO₂) in the chest and movement velocity were evaluated in barbell bench press during the training session. After finishing, lactate, BP, rate of perceived exertion and FT were assessed. The percentage of velocity loss (TT: 19.24%; CL1: 5.02% and CL2: 7.30%) in the bench press and lactate concentration (TT: 8.90 mmol·l^-1; CL1: 6.13 mmol·l^-1 and CL2: 5.48 mmol·l^-1) were significantly higher (p < 0.05) for TT compared to both CLs. RPE values were higher (p < 0.05) in TT compared to CL1 (7.95 a.u. vs. 6.91 a.u., respectively). No differences (p > 0.05) were found between protocols for SmO₂, BP, FT, pain or heart rate between set configurations. Cluster configurations allow one to maintain higher movement velocity and lower lactate and RPE values compared to a traditional configuration, but with similar concentrations of SmO₂.     

The effect of breathing technique on sticking region during maximal bench press

The intrathoracic pressure and breathing strategy on bench press (BP) performance is highly discussed in strength competition practice. Therefore, the purpose of this study was to analyze whether different breathing techniques can influence the time and track characteristics of the sticking region (SR) during the 1RM BP exercise. 24 healthy, male adults (age 23 ± 2.4 yrs., body mass 85 ± 9.2 kg, height 181 ± 5.4 cm) performed a 1 repetition BP using the breathing technique of Valsalva maneuver (VM), hold breath, lung packing (PAC), and reverse breathing (REVB), while maximum lifted load and concentric phase kinematics were recorded. The results of ANOVA showed that the REVB breathing decreased absolute (p < 0.04) and relative lifted load (p < 0.01). The VM showed lower (p = 0.01) concentric time of the lift than the other breathing techniques. The VM and PAC showed lower SR time than other breathing techniques, where PAC showed a lower SR time than VM (p = 0.02). The PAC techniques resulted in shorter SR and pre-SR track than other breathing techniques and the REVB showed longer SR track than the other considered breathing techniques (p = 0.04). Thus, PAC or VM should be used for 1RM BP lifting according to preferences, experiences and lifting comfort of an athlete. The hold breath technique does not seem to excessively decrease the lifting load, but this method will increase the lifting time and the time spend in the sticking region, therefore its use does not provide any lifting benefit. The authors suggest that the REVB should not be used during 1 RM lifts.     

EFFECTS OF WHOLE BODY VIBRATION ON STRENGTH AND JUMPING PERFORMANCE IN VOLLEYBALL AND BEACH VOLLEYBALL PLAYERS

The primary aim of this study was to examine the effects of 6-week strength training with whole body vibration (WBV) on leg strength and jumping performance in volleyball and beach volleyball players. Twenty-three sub-elite male volleyball (VB; n=12) and beach volleyball players (BVB; n=11) aged 21.2±3.0 years were divided into two groups and subjected to 6 weeks of strength training (three one-hour sessions per week): (I) 12 players (6 VB and 6 BVB players) underwent training with WBV (30-40 Hz, 1.7-2.5 mm, 3.0-5.7 g), and (II) 11 players (6 VB and 5 BVB players) underwent traditional strength training. Squat jump (SJ) and countermovement squat jump (CMJ) measurements by the Ergo Tester contact platform and maximum leg press test (1RM) were conducted. Three-factor (2 time x 2 WBV use x 2 discipline) analysis of variance for SJ, CMJ and 1RM revealed a significant time main effect (p<0.001), a WBV use effect (p<0.001) and a discipline effect (p<0.001). Significantly greater improvements in the SJ (p<0.001) and CMJ (p<0.001) and in 1RM (p<0.001) were found in the WBV training groups than in traditional training groups. Significant 3-way interaction effects (training, WBV use, discipline kind) were also found for SJ, CMJ and 1RM (p=0.001, p<0.001, p=0.001, respectively). It can be concluded that implementation of 6-week WBV training in routine practice in volleyball and beach volleyball players increases leg strength more and leads to greater improvement in jump performance than traditional strength training, but greater improvements can be expected in beach volleyball players than in volleyball players.     

Short-term in-season ballistic training improves power,muscle volume and throwing velocity in junior handball players. A randomized control trial

This study investigated the effects of a ballistic training programme using an arm/shoulder specific strength device (ASSSD) on the upper body peak power (PP), muscle volume (MV) of the dominant arm and throwing velocity in junior handball players. Twenty-six players were randomly assigned to an experimental (EG = 15, age 17.6 ± 0.51 years) and control (CG = 11, age 17.36 ± 0.50 years) group. Over an 8-week in-season period, the EG performed a ballistic training programme (2 sessions/week) immediately before their normal team handball training. Both groups underwent tests on the ASSSD, which operates in consecutive accelerative and decelerative actions, for throwing characteristics determination. Peak power (PP), peak force (PF), peak velocity (PV), peak rate of power development (PRPD), muscle volume (MV), throwing velocity with runup, standing throw, and jump throw were also assessed before/after the training programme. The EG group showed significant post-training improvements in PP (52.50% – p < 0.001), PF (26.45% – p < 0.01) and PRPD (78.47% – p < 0.001) better than the CG (1.81, 0.67 and 1.64%, p > 0.05, respectively). There was also a post-training improvement in the velocity at PP (22.82% – p < 0.001) and PF (42.45% – p < 0.001) in the EG compared to the CG (4.18 and 8.53%, p > 0.05 respectively). There was a significant increase in acceleration at PP (51.50% – p < 0.01) and PF (69.67% – p < 0.001). MV increased (19.11% – p < 0.001) in the EG, with no significant change (3.34% – p = 0.84) in the CG. Finally, significant increases were obtained in the three throw types (3.1–6.21%, p < 0.05- < 0.001) in the EG compared to the CG. The additional ASSSD training protocol was able to improve muscle strength/volume and ball throwing velocity in junior handball players.     

Assessment of Clinical Signs of Liver Cirrhosis Using T1 Mapping on Gd-EOB-DTPA-Enhanced 3T MRI

Objectives

To assess the differences between normal and cirrhotic livers by means of T1 mapping of liver parenchyma on gadoxetic acid (Gd-EOB-DTPA)-enhanced 3 Tesla (3T) MR imaging (MRI).

Methods

162 patients with normal (n = 96) and cirrhotic livers (n = 66; Child-Pugh class A, n = 30; B, n = 28; C, n = 8) underwent Gd-EOB-DTPA-enhanced 3T MRI. To obtain T1 maps, two TurboFLASH sequences (TI = 400 ms and 1000 ms) before and 20 min after Gd-EOB-DTPA administration were acquired. T1 relaxation times of the liver and the reduction rate between pre- and post-contrast enhancement images were measured.

Results

The T1 relaxation times for Gd-EOB-DTPA-enhanced MRI showed significant differences between patients with normal liver function and patients with Child-Pugh class A, B, and C (p < 0.001). The T1 relaxation times showed a constant significant increase from Child-Pugh class A up to class C (Child-Pugh class A, 335 ms ± 80 ms; B, 431 ms ± 75 ms; C, 557 ms ± 99 ms; Child-Pugh A to B, p < 0.001; Child-Pugh A to C, p < 0.001; Child-Pugh B to C, p < 0.001) and a constant decrease of the reduction rate of T1 relaxation times (Child-Pugh class A, 57.1% ± 8.8%; B, 44.3% ± 10.2%, C, 29.9% ± 6.9%; Child-Pugh A to B, p < 0.001; Child-Pugh A to C,p < 0.001; Child-Pugh B to C, p < 0.001).

Conclusion

Gd-EOB-DTPA-enhanced T1 mapping of the liver parenchyma may present a useful method for determining severity of liver cirrhosis.     

Nebivolol And Quinapril Reduce P-Wave Duration And Dispersion In Hypertensive Patients

We aimed to investigate the effects of nebivolol and quinapril treatments on P-wave duration and dispersion in hypertensive patients. Hypertensive patients who were in sinus rhythm were assigned to the two treatment groups and received either 20 mg quinapril/day or 5 mg nebivolol/day. P-Wave dispersion (PWD) was measured at baseline and after four weeks of treatment and defined as the difference between the maximum (Pmax) and the minimum (Pmin) P-wave duration. The study group consisted of 54 patients (Mean age: 53 ± 9 years, 46% women) with 27 patients in each group. At 4-week follow up both treatment groups showed a significant reduction (p< 0.001) in systolic (SBP) and diastolic blood pressure (DBP). Heart rate (HR) reduction was significant in patients receiving nebivolol (P=0.001). Both groups showed a similar (P=0.413 for PWD, p=0.651 for Pmax) but significant reduction in PWD (nebivolol: -16± 14, P< 0.0001 and quinapril: -13± 11, P< 0.0001) and Pmax (nebivolol: -10± 11, P=0.001 and quinapril: -9± 11, P=0.001). A 2 (Time) x 2 (Group) mixed-model repeated-measures analysis of variance revealed that the main effect of Time was significant for Pmax (P=0.002) and PWD (P=0.008) after controlling for changes in SBP, DBP and HR. However, the main effect of Group and Time x Group interaction was not significant for both variables (All p values > 0.05). In conclusion, short-term treatment with nebivolol and quinapril produces a similar but significant reduction in Pmax and PWD in hypertensive patients. This effect is independent of blood pressure and heart rate changes.     

Effects of heavy barbell hip thrust vs back squat on subsequent sprint performance in rugby players

The objective of this research was to compare the effect of Post-Activation Performance Enhancement (PAPE) exerted on the back squat (BS) versus the barbell hip thrust (HT) on the sprint performance (5- and 10-m). 17 male amateur rugby players participated in the study (age 22.14 ± 2.52 years; body mass 81.06 ± 9.6 kg; height 1.78 ± 0.05 m). All participants performed a dynamic maximum strength test (3RM) in BS and HT at maximum speed. Two randomized sessions were performed inducing PAPE using BS or HT trough three series with three repetitions at 85% 1RM eight minutes before the sprint tests. An ANOVA of repeated measurement, found no differences in the time for 5-m (F = 0.398, P = 0.537, η²p = 0.024) or 10-m (F = 2.589, P = 0.127, η²p = 0.139). There were no significant differences in the Protocol effect between HT and BS in 5-m or 10-m (F = 2.963, P = 0.104, η²p = 0.156 and F = 1.472, P = 0.243 η²p = 0.084, respectively). There were also no differences in the Time x Protocol interaction at 5-m (F = 0.001, P = 0.976, η²p < 0.001) or 10-m (F = 4.174, P = 0.058, η²p = 0.207). The effect size obtained in the results of the sprint tests was small in both exercises (ES < 0.2). None of the BS or HT exercises performed with heavy load induced a significant PAPE phenomenon on the ability to sprint in rugby players.     

Could CCI or FBCI Fully Eliminate the Impact of Curve Flexibility When Evaluating the Surgery Outcome for Thoracic Curve Idiopathic Scoliosis Patient? A Retrospective Study

PurposeTo clarify if CCI or FBCI could fully eliminate the influence of curve flexibility on the coronal correction rate.MethodsWe reviewed medical record of all thoracic curve AIS cases undergoing posterior spinal fusion with all pedicle screw systems from June 2011 to July 2013. Radiographical data was collected and calculated. Student t test, Pearson correlation analysis and linear regression analysis were used to analyze the data.Results60 were included in this study. The mean age was 14.7y (10-18y) with 10 males (17%) and 50 females (83%). The average Risser sign was 2.7. The mean thoracic Cobb angle before operation was 51.9°. The mean bending Cobb angle was 27.6° and the mean fulcrum bending Cobb angle was 17.4°. The mean Cobb angle at 2 week after surgery was 16.3°. The Pearson correlation coefficient r between CCI and BFR was -0.856(P<0.001), and between FBCI and FFR was -0.728 (P<0.001). A modified FBCI (M-FBCI) = (CR-0.513)/BFR or a modified CCI (M-CCI) = (CR-0.279)/FFR was generated by curve estimation has no significant correlation with FFR (r=-0.08, p=0.950) or with BFR (r=0.123, p=0.349).ConclusionsFulcrum-bending radiographs may better predict the outcome of AIS coronal correction than bending radiographs in thoracic curveAIS patients. Neither CCI nor FBCI can fully eliminate the impact of curve flexibility on the outcome of correction. A modified CCI or FBCI can better evaluating the corrective effects of different surgical techniques or instruments.     

Effects of resistance training on hypertrophy,strength and tensiomyography parameters of elbow flexors: role of eccentric phase duration

The aim of the study was to compare the effects of two different training protocols, which differ in the duration of the eccentric phase, on the one-repetition maximum (1RM), thickness and contractile properties of elbow flexors. Twenty untrained college students were randomly divided into two experimental groups, based on the training tempo: FEG (Faster Eccentric Group: 1/0/1/0) and SEG (Slower Eccentric Group: 4/0/1/0). Training intervention was a biceps bending exercise, conducted twice a week for 7 weeks. The intensity (60–70% RM), sets (3–4) and rest intervals (120 s) were held constant, while repetitions were performed until it was not possible to maintain a set duration. In the initial and final measurements, 1RM, muscle thickness and tensiomyography parameters – contraction time (Tc) and radial deformation (Dm) – were evaluated. An ANCOVA model (using baseline outcomes as covariates) was applied to determine between-group differences at post-test, while Pearson’s product-moment correlation coefficient was used to investigate the relationship between absolute changes in muscle thickness and Dm. Muscle strength increase was greater for SEG than for FEG (6.0 ± 1.76 vs. 3.30 ± 2.26 kg, p < 0.01). In both groups muscle thickness increased equally (FEG: 3.24 ± 2.01 vs. SEG: 3.57 ± 1.17 mm, p < 0.01), while an overall reduction in Dm was observed (FEG: 1.99 ± 1.20 vs. SEG: 2.26 ± 1.03 mm, p < 0.01). Values of Tc remained unchanged. A significant negative relationship was observed between changes in muscle thickness and Dm (r = -0.763, Adj.R² = 0.560, p < 0.01). These results indicate that the duration of the eccentric phase has no effect on muscle hypertrophy in untrained subjects, but that slower eccentric movement significantly increases 1RM.     

CHANGES IN MUSCLE DAMAGE MARKERS IN FEMALE BASKETBALL PLAYERS

The aim of the present study was to investigate changes in muscle soreness, blood muscle damage markers, muscle strength and agility following an official basketball match. Eleven elite female professional basketball players (27.4 ± 4.8 years, 179.5 ± 5.5 cm, 72.0 ± 7.8 kg) of a team participated in this study. The official match was the seventh match of the season in the first phase of the Brazilian National Female Basketball Championship. Muscle soreness, plasma creatine kinase activity (CK), and myoglobin concentration (Mb) were determined before and after the match (post-match, 24 and 48 hours after the match). The 1RM strength for bench press and leg press, and the agility T test were assessed before and at 24 and 48 hours after the match. Significant increases in muscle soreness, CK and Mb were observed at 24 and 48 hours post-match (p<0.05). No significant changes in the 1RM strength and T test were detected during recovery (24 and 48 hours after the match). These results suggest that a basketball match induced limited muscle damage with minimal effect on performance during recovery. The small increase in muscle damage markers following a basketball match did not affect strength and agility performance.     

Effect of Acute Exposure to Moderate Altitude on Muscle Power: Hypobaric Hypoxia vs. Normobaric Hypoxia

When ascending to a higher altitude, changes in air density and oxygen levels affect the way in which explosive actions are executed. This study was designed to compare the effects of acute exposure to real or simulated moderate hypoxia on the dynamics of the force-velocity relationship observed in bench press exercise. Twenty-eight combat sports athletes were assigned to two groups and assessed on two separate occasions: G1 (n = 17) in conditions of normoxia (N1) and hypobaric hypoxia (HH) and G2 (n = 11) in conditions of normoxia (N2) and normobaric hypoxia (NH). Individual and complete force-velocity relationships in bench press were determined on each assessment day. For each exercise repetition, we obtained the mean and peak velocity and power shown by the athletes. Maximum power (P_max) was recorded as the highest P_mean obtained across the complete force-velocity curve. Our findings indicate a significantly higher absolute load linked to P_max (∼3%) and maximal strength (1RM) (∼6%) in G1 attributable to the climb to altitude (P<0.05). We also observed a stimulating effect of natural hypoxia on P_mean and P_peak in the middle-high part of the curve (≥60 kg; P<0.01) and a 7.8% mean increase in barbell displacement velocity (P<0.001). No changes in any of the variables examined were observed in G2. According to these data, we can state that acute exposure to natural moderate altitude as opposed to simulated normobaric hypoxia leads to gains in 1RM, movement velocity and power during the execution of a force-velocity curve in bench press.     

Training,psychometric status,biological markers and neuromuscular fatigue in soccer

The study examined the relationship between psychometric status, neuromuscular, and biochemical markers of fatigue in response to an intensified training (IT) period in soccer. Fifteen professional soccer players volunteered to participate in the study (mean ± SD: age: 25 ± 1 years; body height: 179 ± 7 cm, body mass: 73.7 ± 16.2 kg, experience: 13.2 ± 3 years). Training load, monotony, strain, Hooper index and total quality recovery (TQR) were determined for each training session during a 2-week of IT. Counter-movement jump (CMJ) and biochemical responses [testosterone, cortisol, testosterone-to-cortisol ratio (T/C ratio), creatine kinase, and C-reactive protein] were collected before and after IT. Results showed that IT induced significant increases in cortisol, creatine kinase and C-reactive protein and significant decreases in T/C ratio and CMJ performance from before to after IT (p < 0.01, p < 0.001, p < 0.001, p < 0.01, p < 0.05, respectively). However, testosterone did not differ from before to after IT (p > 0.05). Training loads were positively correlated with Hooper index (p < 0.05) and negatively correlated with total quality recovery (p < 0.05). Hooper index was positively correlated with cortisol (p < 0.05), T/C ratio (p < 0.01), and creatine kinase (p < 0.01), and negatively correlated with CMJ (p < 0.05). Furthermore, TQR was negatively correlated with T/C ratio (p < 0.01), creatine kinase (p < 0.001), and C-reactive protein (p < 0.05), and positively correlated with CMJ (p < 0.01). Neuromuscular fatigue, muscle damage, and change in the anabolic/catabolic state induced by the IT were related to well-being and perceived recovery state among professional soccer players.     

Adequately Adapted Insulin Secretion and Decreased Hepatic Insulin Extraction Cause Elevated Insulin Concentrations in Insulin Resistant Non-Diabetic Adrenal Incidentaloma Patients

Background

Insulin-resistance is commonly found in adrenal incidentaloma (AI) patients. However, little is known about beta-cell secretion in AI, because comparisons are difficult, since beta–cell-function varies with altered insulin-sensitivity.

Objectives

To retrospectively analyze beta–cell function in non-diabetic AI, compared to healthy controls (CON).

Methods

AI (n=217, 34%males, 57±1years, body-mass-index:27.7±0.3kg/m²) and CON [n=25, 32%males, 56±1years, 26.7±0.8kg/m²] with comparable anthropometry (p≥0.31) underwent oral-glucose-tolerance-tests (OGTTs) with glucose, insulin, and C–peptide measurements. 1mg-dexamethasone-suppression-tests were performed in AI. AI were divided according to post–dexamethasone-suppression–test cortisol-thresholds of 1.8 and 5µg/dL into 3subgroups: pDexa<1.8µg/dL, pDexa1.8-5µg/dL and pDexa>5µg/dL. Using mathematical modeling, whole-body insulin-sensitivity [Clamp-like-Index (CLIX)], insulinogenic Index, Disposition Index, Adaptation Index, and hepatic insulin extraction were calculated.

Results

CLIX was lower in AI combined (4.9±0.2mg·kg^-1·min^-1), pDexa<1.8µg/dL (4.9±0.3) and pDexa1.8-5µg/dL (4.7±0.3, p<0.04 vs.CON:6.7±0.4). Insulinogenic and Disposition Indexes were 35%–97% higher in AI and each subgroup (p<0.008 vs.CON), whereas C–peptide–derived Adaptation Index, compensating for insulin-resistance, was comparable between AI, subgroups, and CON. Mathematical estimation of insulin–derived (insulinogenic and Disposition) Indexes from associations to insulin-sensitivity in CON revealed that AI-subgroups had ~19%-32% higher insulin-secretion than expectable. These insulin-secretion-index differences negatively (r=-0.45, p<0.001) correlated with hepatic insulin extraction, which was 13-16% lower in AI and subgroups (p<0.003 vs.CON).

Conclusions

AI-patients show insulin-resistance, but adequately adapted insulin secretion with higher insulin concentrations during an OGTT, because of decreased hepatic insulin extraction; this finding affects all AI-patients, regardless of dexamethasone-suppression-test outcome.     

The influence of compressive gear on maximal load lifted in competitive powerlifting

The competition in powerlifting has been divided into two divisions, with gear equipment (EQ) and without gear equipment (RAW). When competing in the EQ division, additional supportive gear can be worn by the athletes, while in the RAW division such gear is not allowed. The aim of the study was to compare the results of the RAW and EQ powerlifting divisions based on the results of world championships and current world records. One-hundred and twenty powerlifters (63 men, 57 women) were included to the analysis. Post hoc analysis for the results of men’s world championships indicated significantly higher results of the barbell squat (SQ; p < 0.001; ES = 1.31), bench press (BP; p < 0.001; ES = 1.27) and deadlift (DL; p < 0.001; ES = 0.37) for EQ compared to the RAW division. Post hoc analysis for the results of women’s world championships indicated significantly higher results of the SQ (p < 0.001; ES = 1.31), BP (p < 0.001; ES = 1.13) and DL (p < 0.001; ES = 0.71) for the EQ compared to the RAW division. Post hoc analysis for men’s world record indicated significantly higher results in the SQ (p < 0.001; ES = 1.32) and BP (p < 0.001; ES = 1.24) for the EQ compared to the RAW division. Furthermore, there were no significant differences in the results of world records in the DL (p = 0.901; ES = 0.26) between the EQ and RAW divisions. Post hoc analysis for women’s world records indicated significantly higher results in the SQ (p < 0.001; ES = 1.22) and BP (p < 0.001; ES = 1.99) for the EQ compared to RAW division. The main finding of the study was that supportive gear increases maximal load lifted during powerlifting competition.     

Impact of Renal Sympathetic Denervation on Left Ventricular Structure and Function at 1-Year Follow-Up

Background

Catheter-based sympathetic renal denervation (RDN) is a recent therapeutic option for patients with resistant hypertension. However, the impact of RDN in left ventricular (LV) mass and function is not completely established. Our aim was to evaluate the effects of RDN on LV structure and function (systolic and diastolic) in patients with resistant hypertension (HTN).

Methods and Results

From a single centre prospective registry including 65 consecutive patients with resistant HTN submitted to RDN between July-2011 and April-2015, 31 patients with baseline and 1-year follow-up echocardiogram were included in this analysis. Mean age was 65±7 years, 48% were males, 71% had type 2 diabetes. Most had hypertension lasting for more than 10 years (90%), and were being treated with a median number of 6 anti-hypertensive drugs, including 74% on spironolactone. At 1-year, there was a significant decrease both on office SBP (176±24 to 149±13mmHg, p<0.001) and DBP (90±14 to 79±11mmHg, p<0.001), and also in 24h ABPM SBP (150±20 to 132±14mmhg, p<0.001) and DBP (83±10 to 74±9mmHg, p<0.001). There was also a significant decrease in LV mass from 152±32 to 136±34g/m² (p<0.001), an increase in LV end diastolic volume (93±18 to 111±27 mL, p = 0.004), an increase in LV ejection fraction (65±9 to 68±9%, p = 0.001) and mitral valve E deceleration time (225±49 to 247±51ms, p = 0.015) at 1-year follow up. There were no significant changes in left atrium volume index or in the distribution of patients among the different left ventricle geometric patterns and diastolic function subgroups.

Conclusions

In this single centre registry of patients with resistant hypertension, renal denervation was associated with significant reduction in both office and ABPM blood pressure and a significant decrease in left ventricle mass evaluated by transthoracic echocardiogram at 1 year follow-up.     

Acute and long-term effects of two different static stretching training protocols on range of motion and vertical jump in preadolescent athletes

This study examined the acute and long-term effects of two static stretching protocols of equal duration, performed either as a single stretch or multiple shorter duration repetitions on hip hyperextension range of motion (ROM) and single leg countermovement jump height (CMJ). Thirty female gymnasts were randomly assigned to stretching (SG) or control groups (CG). The SG performed two different protocols of static stretching, three times per week for 9 weeks. One leg performed repeated stretching (3 × 30 s with 30 s rest) while the other leg performed a single stretch (90 s). The CG continued regular training. ROM and CMJ were measured pre- and 2 min post-stretching on weeks 0, 3, 6, 9, and 3 weeks into detraining. CMJ height increased over time irrespective of group (main effect time, p = 0.001), with no statistical difference between groups (main effect group, p = 0.272). Three-way ANOVA showed that, CMJ height after stretching was not affected by either stretching protocol at any time point (p = 0.503 to 0.996). Both stretching protocols equally increased ROM on weeks 6 (10.9 ± 13.4%, p < 0.001, d = 0.42), and 9 (21.5 ± 13.4%, p < 0.001, d = 0.78), and this increase was maintained during detraining (17.0 ± 15.0%, p < 0.001, d = 0.68). No increase in ROM was observed in the CG (p > 0.874). Static stretching of long duration applied either as single or multiple bouts of equal duration, results in similar acute and long-term improvements in ROM. Furthermore, both stretching protocols do not acutely affect subsequent CMJ performance, and this effect is not influenced by the large increase in ROM and CMJ overtime.     

Schlemm’s Canal and Trabecular Meshwork in Eyes with Primary Open Angle Glaucoma: A Comparative Study Using High-Frequency Ultrasound Biomicroscopy

We investigated in vivo changes in Schlemm’s canal and the trabecular meshwork in eyes with primary open angle glaucoma (POAG). Relationships between Schlemm’s canal diameter, trabecular meshwork thickness, and intraocular pressure (IOP) were examined. Forty POAG patients and 40 normal individuals underwent 80-MHz Ultrasound Biomicroscopy examinations. The Schlemm’s canal and trabecular meshwork were imaged in superior, inferior, nasal and temporal regions. Normal individuals had an observable Schlemm’s canal in 80.3% of sections, a meridional canal diameter of 233.0±34.5 μm, a coronal diameter of 44.5±12.6 μm and a trabecular meshwork thickness of 103.9±11.1 μm, in POAG patients, Schlemm’s canal was observable in 53.1% of sections, a meridional canal diameter of 195.6±31.3 μm, a coronal diameter of 35.7±8.0 μm, and a trabecular meshwork thickness of 88.3±13.2 μm, which significantly differed from normal (both p <0.001). Coronal canal diameter (r = -0.623, p < 0.001) and trabecular meshwork thickness (r = -0.663, p < 0.001) were negatively correlated with IOP, but meridional canal diameter was not (r = -0.160, p = 0.156). Schlemm’s canal was observable in 50.5% and 56.6% of POAG patients with normal (<21 mmHg) and elevated (>21 mmHg) IOP, respectively (χ = 1.159, p = 0.282). Coronal canal diameter was significantly lower in the elevated IOP group (32.6±4.9 μm) than in the normal IOP group (35.7±8.0 μm, p < 0.001). This was also true of trabecular meshwork thickness (81.9±10.0 μm vs. 97.1±12.0 μm, p < 0.001). In conclusion, eyes with POAG had fewer sections with an observable Schlemm’s canal. Canal diameter and trabecular meshwork thickness were also lower than normal in POAG patients. Schlemm’s canal coronal diameter and trabecular meshwork thickness were negatively correlated with IOP.     

Irisin and the Metabolic Phenotype of Adults with Prader-Willi Syndrome

Context

Hyperphagia, low resting energy expenditure, and abnormal body composition contribute to severe obesity in Prader Willi syndrome (PWS). Irisin, a circulating myokine, stimulates “browning” of white adipose tissue resulting in increased energy expenditure and improved insulin sensitivity. Irisin has not been previously studied in PWS.

Objectives

Compare plasma and salivary irisin in PWS adults and normal controls. Examine the relationship of irisin to insulin sensitivity and plasma lipids.

Design and Study Participants

A fasting blood sample for glucose, lipids, insulin, leptin, adinopectin, and irisin was obtained from 22 PWS adults and 54 healthy BMI-matched volunteers. Saliva was collected for irisin assay in PWS and controls.

Results

Fasting glucose (77±9 vs 83±7mg/dl, p = 0.004), insulin (4.1±2.0 vs 7.9±4.7μU/ml, p<0.001), and triglycerides (74±34 vs 109±71mg/dl, p = 0.007) were lower in PWS than in controls. Insulin resistance (HOMA-IR) was lower (0.79±0.041 vs 1.63±1.02, p<0.001) and insulin sensitivity (QUICKI) was higher (0.41±0.04 vs 0.36±0.03, p<0.001) in PWS. Plasma irisin was similar in both groups, but salivary irisin (64.5±52.0 vs 33.0±12.1ng/ml), plasma leptin (33.5±24.2 vs 19.7±19.3ng/ml) and plasma adinopectin (13.0±10.8 vs 7.6±4.5μg/ml) were significantly greater in PWS (p<0.001). In PWS, plasma irisin showed positive Pearson correlations with total cholesterol (r = 0.58, p = 0.005), LDL-cholesterol (r = 0.59, p = 0.004), and leptin (r = 0.43, p = 0.045). Salivary irisin correlated negatively with HDL-cholesterol (r = -0.50, p = 0.043) and positively with LDL-cholesterol (r = 0.51, p = 0.037) and triglycerides (r = 0.50, p = 0.041).

Conclusions

Salivary irisin was markedly elevated in PWS although plasma irisin was similar to levels in controls. Significant associations with plasma lipids suggest that irisin may contribute to the metabolic phenotype of PWS.     

Prolonged Delayed Graft Function Is Associated with Inferior Patient and Kidney Allograft Survivals

It is unclear if there is an association between the duration of delayed graft function (DGF) and kidney transplant (KT) outcomes. This study investigated the impact of prolonged DGF on patient and graft survivals, and renal function one year after KT. This single center retrospective analysis included all deceased donor KT performed between Jan/1998 and Dec/2008 (n = 1412). Patients were grouped in quartiles according to duration of DGF (1–5, 6–10, 11–15, and >15 days, designated as prolonged DGF). The overall incidence of DGF was 54.2%. Prolonged DGF was associated with retransplantation (OR 2.110, CI95% 1.064–4.184,p = 0.033) and more than 3 HLA mismatches (OR 1.819, CI95% 1.117–2.962,p = 0.016). The incidence of acute rejection was higher in patients with DGF compared with those without DGF (36.2% vs. 12.2%, p<0.001). Compared to patients without DGF, DGF(1–5), DGF(6–10), and DGF(11–15), patients with prolonged DGF showed inferior one year patient survival (95.2% vs. 95.4% vs. 95.5% vs. 93.4% vs. 88.86%, p = 0.003), graft survival (91% vs. 91.4% vs. 92% vs. 88.7% vs. 70.5%, p<0.001), death-censored graft survival (95.7% vs. 95.4% vs. 96.4% vs. 94% vs. 79.3%, p<0.001), and creatinine clearance (58.0±24.6 vs. 55.8±22.2 vs. 53.8±24.1 vs. 53.0±27.2 vs. 36.8±27.0 mL/min, p<0.001), respectively. Multivariable analysis showed that prolonged DGF was an independent risk factor for graft loss (OR 3.876, CI95% 2.270–6.618, p<0.001), death censored graft loss (OR 4.103, CI95% 2.055–8.193, p<0.001), and death (OR 3.065, CI95% 1.536–6.117, p = 0.001). Prolonged DGF, determined by retransplantation and higher HLA mismatches, was associated with inferior renal function, and patient and graft survivals at one year.