Évaluation de la sidération myocardique post-effort immédiat par tomoscintigraphie myocardique au 99mTc-sestamibi couplée à l’ECG

AimRepeated episodes of myocardial stunning may lead to chronic ventricular dysfunction. We attempted to assess the parameters related to post-exercise stunning in patients undergoing gated SPECT.MethodsSix hundred patients undergoing a one-day stress/rest ^99mTc-sestamibi gated SPECT were studied. Stress imaging was acquired within 15 minutes after injection. Summed perfusion scores (SSS, SRS and SDS) were calculated using QPS, and LV function assessed using QGS. Stunning was defined as the association of ischemia (SSS ≥ 4 and SDS > 0) and a minimum of 5% decrease in post-stress EF.ResultsIschemia was found in 225 (37.5%) patients. Among these, 67 (30%) showed myocardial stunning. Patients with stunning had a lower rest ESV (47 ± 24 mL vs 65 ± 52 mL, p < 0.0003) and EDV (108 ± 35 mL vs 122 ± 66 mL, p = 0.03), an increased rest LVEF (58 ± 10% vs 52 ± 13%, p < 0.0001) and a decreased post-stress LVEF (49 ± 10% vs 53 ± 13%, p < 0.02) compared to patients with no stunning. The number of myocardial segments showing reversible perfusion defects was increased in patients with stunning (2.7 ± 2.6 vs 1.7 ± 2.1, p < 0.02). On logistic regression, an extent of ischemia greater than two segments and a rest EF greater than 45% were independent predictors of the occurrence of myocardial stunning in patients with ischemia.ConclusionsIn patients with ischemia, exercise-induced stunning was associated with an increased extent of ischemia but also preserved rest ventricular function.     

The AV synchrogram: A novel approach to quantify atrioventricular coupling during atrial arrhythmias

The generation of ventricular response during atrial arrhythmias and its dependence on atrial activity is poorly understood. This paper introduces the atrioventricular (AV) synchrogram, a novel method for the beat-to-beat assessment of AV coupling during atrial arrhythmias, based on the stroboscopic observation of the ventricular phase at times triggered by atrial activation. The method was applied on a database of 120 atrial electrograms and ECG signals recorded in patients during typical atrial flutter (AFL), rapid atrial flutter (rAFL), and atrial fibrillation (AF). Synchronized epochs of different n:m order were automatically detected in the AV synchrogram and characterized in terms of percentage of significantly coupled beats (p_lb), maximal length of coupling segments (l_max), average conduction ratio (CR). Synchrogram analysis demonstrated that AV coupling and degree of conduction were significantly affected by the rate and regularity of atrial activity. The occurrence and stability of AV coupled epochs was maximal during regular atrial activation in AFL (median (interquartile range) of p_lb = 100 (100–100)%, l_max = 29.0 (28.5–29.4) s), and significantly (p < 0.001) decreased at faster atrial rates in rAFL (p_lb = 74.3 (57.6–100)%, l_max = 7.4 (3.9–28.7) s). A further decrease of coupling indexes occurred at higher irregularity of atrial activity in AF (p_lb = 25.7 (19.9–30.2)%, l_max = 2.1 (1.8–2.6) s). The increase of atrial rate led to a significant (p < 0.001) reduction of CRs from 0.50 (0.29–0.50) in AFL to 0.25 (0.22–0.25) in rAFL and 0.30 (0.24–0.35) in AF. Application of the analysis to the time course of AF showed the presence of a Farey sequence structure in n:m coupling patterns at increasing atrial rate, which was consistent with the scaling effect of nodal recovery on atrial beats. In conclusion, AV synchrogram analysis enables beat-to-beat assessment of AV coupling and dynamical tracking of AV response during atrial arrhythmias, which may favor mechanistic insight about the genesis of ventricular rhythms and potentially the development of efficacious rate control strategies.     

Performance limitation and the role of core temperature when wearing light-weight workwear under moderate thermal conditions

The objective of this investigation was to achieve an understanding about the relationship between heat stress and performance limitation when wearing a two-layerfire-resistant light-weight workwear (full-clothed ensemble) compared to an one-layer short sports gear (semi-clothed ensemble) in an exhaustive, stressful situation under moderate thermal condition (25 °C). Ten well trained male subjects performed a strenuous walking protocol with both clothing ensembles until exhaustion occurred in a climatic chamber. Wearing workwear reduced the endurance performance by 10% (p=0.007) and the evaporation by 21% (p=0.003), caused a more pronounced rise in core temperature during submaximal walking (0.7±0.3 vs. 1.2±0.4 °C; p≤0.001) and from start till exhaustion (1.4±0.3 vs. 1.8±0.5 °C; p=0.008), accelerated sweat loss (13±2 vs. 15±3 g min⁻¹; p=0.007), and led to a significant higher heart rate at the end of cool down (103±6 vs. 111±7 bpm; p=0.004). Correlation analysis revealed that core temperature development during submaximal walking and evaporation may play important roles for endurance performance. However, a critical core temperature of 40 °C, which is stated to be a crucial factor for central fatigue and performance limitation, was not reached either with the semi-clothed or the full-clothed ensemble (38.3±0.4 vs. 38.4±0.5 °C). Additionally, perceived exertion did not increase to a higher extent parallel with the rising core temperature with workwear which would substantiate the critical core temperature theory. In conclusion, increased heat stress led to cardiovascular exercise limitation rather than central fatigue.     

Metabolic control and chronic complications during a 3-year follow-up period in a cohort of type 2 diabetic patients attended in primary care in the Community of Madrid (Spain)

BackgroundOur aim was to analyze both metabolic control and chronic complications of type 2 diabetes mellitus (T2D) patients regularly attended in primary care during a 3 years of follow-up in the Community of Madrid (Spain).MethodsFrom 2007 to 2010 we prospectively included 3268 patients with T2D attended by 153 primary care physicians from 51 family health centers. An prospective cohort study with annual evaluation over 3 years to the same population was performed. We measured the goals of control in diabetic patients and the incidence of chronic complications of diabetes during the study period.ResultsA significant decrease in serum glucose levels (143 ± 42 mg/dl vs 137 ± 43 mg/dl, p < 0.00), HbA1c (7.09 ± 1.2% vs 7.02 ± 1.2%, p < 0.00), total cholesterol (191.4 ± 38 mg/dl vs 181.5 ± 36 mg/dl, p < 0.00), LDL cholesterol (114.7 ± 31 mg/dl vs 105.5 ± 30 mg/dl, p < 0.00) and triglyceride levels (144.5 ± 93 mg/dl vs 138 ± 84 mg/dl, p < 0.00) during study period was documented. On the contrary, a significant elevation in HDL cholesterol levels was observed (49.2 ± 14 mg/dl vs 49.9 ± 16 mg/dl, p < 0.00). The incidence of diabetic complications throughout the study period was low, with a incidence of coronary heart disease of 6.2%, peripheral arterial disease 3%, ischemic stroke 2.8%, diabetic foot 11.2%, nephropathy 5.9%, retinopathy 4.5%, and neuropathy 3%.ConclusionMetabolic control in T2D patients attended in primary care in the Community of Madrid throughout 3 years is adequate and is accompanied by low percent of chronic diabetic complications during this period of follow-up.     

Serum sialic acid changes in non-insulin-dependant diabetes mellitus (NIDDM) patients following bitter melon (Momordica charantia) and rosiglitazone (Avandia) treatment

Diabetes mellitus is associated with an increase in sialic acid concentration along with other complications. Sialic acid changes in NIDDM patients were investigated following bitter melon (55 ml/24 h) and rosiglitazone (4 mg/24 h) treatment. A total of 25 patients of both sexes were used in each experimental group. Patients following bitter melon treatment showed no significant difference of serum sialic acid (57.95±4.90 vs. 57.6±5.56 mg/dl, p=0.17) and serum glucose concentration (93.7±9.63 vs. 88.35±6.31 mg/dl, p=0.78) as compared to control subjects. However, the concentration of total cholesterol was significantly high in these patients as compared to control subjects (192±14.23 vs. 170.6±15.1 mg/dl, p<0.03) but within normal range (160–200 mg/dl), suggesting the significant hypoglycemic and lipid-lowering properties of bitter melon. The patients following rosiglitazone treatment showed a significant increase of serum sialic acid concentration (60.2±5.80 vs. 57.6±5.56 mg/dl, p=0.01) along with glucose (112±6.2 vs. 88.35±6.31 mg/dl, p<0.04) and total cholesterol concentration (216.45±20.2 vs. 170.6±15.1 mg/dl, p<0.01) as compared to control subjects. In addition six of the patients had retinopathy, two of whom were suffering also from myocardial infarction and they still had a higher serum sialic acid (61.05±1.20 mg/dl), glucose (187±2.11 mg/dl), total cholesterol (239.10±5.04 mg/dl) and triglyceride (183±4.14 mg/dl) concentration, indicating a poor response of these patients to rosiglitazone. Comparison of serum sialic acid concentration of patients, following bitter melon and rosiglitazone treatment revealed no significant difference but the study showed that bitter melon could be more effective in the management of diabetes and its related complications as compared to rosiglitazone.     

Angiotensin II-induced activation of c-Ret signaling is critical in ureteric bud branching morphogenesis

The renin-angiotensin system (RAS) plays a critical role in ureteric bud (UB) and kidney morphogenesis. Mutations in the genes encoding components of the RAS cause a spectrum of congenital abnormalities of the kidney and urinary tract (CAKUT). However, the mechanisms by which aberrations in the RAS result in CAKUT are poorly understood. Given that c-Ret receptor tyrosine kinase (RTK) is a major inducer of UB branching, the present study tested the hypothesis that angiotensin (Ang) II-induced activation of c-Ret plays a critical role in UB branching morphogenesis. E12.5 mice metanephroi were grown for 24 h in the presence or absence of Ang II, Ang II AT₁ receptor (AT₁R) antagonist candesartan, phosphatidylinositol 3-kinase (PI3 K) inhibitor LY294002 or ERK1/2 inhibitor PD98059. Ang II increased the number of UB tips (61 ± 2.4 vs. 45 ± 4.3, p < 0.05) compared with control. Quantitative RT-PCR analysis demonstrated that Ang II increased c-Ret mRNA levels in the kidney (1.35 ± 0.05 vs. 1.0 ± 0, p < 0.01) and in the UB cells (1.28 ± 0.04 vs. 1.0 ± 0, p < 0.01) compared to control. This was accompanied by increased Tyr¹⁰⁶²Ret phosphorylation by Ang II (5.5 ± 0.9 vs. 1.8 ± 0.4 relative units, p < 0.05). In addition, treatment of UB cells with Ang II (10^?5 M) increased phosphorylation of Akt compared to control (213 ± 16 vs. 100 ± 20%, p < 0.05). In contrast, treatment of metanephroi or UB cells with candesartan decreased c-Ret mRNA levels (0.72 ± 0.06 vs. 1.0 ± 0, p < 0.01; 0.68 ± 0.07 vs. 1.0 ± 0, p < 0.05, respectively) compared with control. Ang II-induced UB branching was abrogated by LY294002 (24 ± 2.6 vs. 37 ± 3.0, p < 0.05) or PD98059 (33 ± 2.0 vs. 48 ± 2.2, p < 0.01). These data demonstrate that Ang II-induced UB branching depends on activation of Akt and ERK1/2. We conclude that cross-talk between the RAS and c-Ret signaling plays an important role in the development of the renal collecting system.     

Increased plasma levels of osteopontin are associated with activation of the renin–aldosterone system and with myocardial and coronary microvascular damage in dilated cardiomyopathy

In patients with dilated cardiomyopathy (DCM) abnormal myocardial blood flow (MBF) has been associated with coronary microvascular dysfunction. The aim of this study was to test the hypothesis that osteopontin (OPN) plasma levels could be associated with the activation of the renin–aldosterone system (RAS) in these patients and be involved in mediating myocardial and coronary damage. In 66 patients with idiopathic left ventricular dysfunction of variable severity the plasma levels of OPN were correlated with biomarkers of systemic metabolism, RAS activation, myocardial dysfunction and with clinical indexes of left ventricle (LV) function and perfusion obtained by 2D-echocardiography and PET. As compared to controls, patients showed a significant increase of inflammatory markers (OPN: 508 ± 30.8 ng/ml vs. 426.9 ± 16.4, p < 0.05 and interleukin (IL)-6: 1.71 ± 0.29 pg/ml vs. 0.38 ± 0.03 pg/ml, p < 0.001) and of indexes of cardiac damage. OPN levels were significantly correlated with the extent of microvascular dysfunction (MBF at rest: p = 0.01; during dipyridamole: p = 0.0003) and with plasma renin activity (PRA) (r = 0.26, p = 0.04). Both in patients with milder or more severe LV dysfunction lower MBF values were associated with higher OPN levels and PRA. These results suggest a interdependent role of RAS and vascular inflammation in cardiomyopathy.     

Rotator cuff tendinopathy alters the muscle activity onset and kinematics of scapula

Athletes with rotator cuff (RC) tendinopathy demonstrate an aberrant pattern of scapular motion which might relate to deficits in the scapular muscles. This study aimed to determine whether alteration in scapular kinematics is associated with deficits in the activity onset of scapular muscles. Forty-three male volleyball players (17 asymptomatic and 26 with RC tendinopathy) joined the study. Three-dimensional scapular kinematics was quantified using an acromial marker cluster method. The activity onset of the upper (UT), middle (MT), and lower trapezius (LT), and serratus anterior (SA) during arm abduction was assessed with electromyography. Athletes with RC tendinopathy demonstrated less scapular upward rotation (6.6 ± 2.3 vs. 8.2 ± 1.1°, p = 0.021) in the early phase of shoulder abduction from 0° to 30° when compared to asymptomatic athletes. The tendinopathy group had delayed activity onset of LT (14.1 ± 31.4 ms vs. 74.4 ± 45.1 ms, p < 0.001) and SA (−44.9 ± 26.0 ms vs. 23.0 ± 25.2 ms, p < 0.001) relative to UT when compared to the asymptomatic group. In asymptomatic athletes, earlier activity onset of MT and LT relative to UT was associated with more scapular upward rotation during 0–30° of abduction (r = 0.665, p = 0.021) and 30–60° of abduction (r = 0.680, p = 0.015), respectively. Our findings showed the control of the scapular upward rotation is related to the activity onset of the scapular muscles in athletes.     

Betacarotene supplementation increases ovulation rate without an increment in LH secretion in cyclic goats

This study aimed to evaluate the effects of betacarotene (BC) supplementation on ovulation rate (OR) and luteinizing hormone (LH) secretion in adult goats during the breeding season. Additionally, total ovarian activity (TOA) comprising the total number of ultrasonographically detectable antral follicles (AF) and corpora lutea (OR) was also assessed. In early October, adult goats [n = 22, 3.5 years of age, 7/8 Sannen-Alpine; 26°N, 103°W at 1117 m.a.s.l.] were randomly assigned to: (i) BC group (BCG), orally supplemented with 50 mg of BC/goat/day [n = 10; live weight (LW) = 45.9 ± 2.0 kg, body condition score (BCS; range: 0-emaciated to 5-obese) = 3.0 ± 0.1], and (ii) control group (CONT) [n = 12; LW = 46.2 ± 2.0 kg, BCS = 3.0 ± 0.1]. All animals received a basal diet of alfalfa hay, corn silage and corn grain, with free access to water and mineral salts. The whole experimental period spanned 34 days before and 17 days after ovulation. On day 23 of the experiment, estrus was synchronized with progestin-releasing intravaginal sponges; 36 h prior to estrus, an intensive blood sampling (every 15 min for 6 h) was performed to determine mean LH concentrations, pulsatility (LH-PULSE) and area under the curve (LH-AUC) for serial LH concentrations. Afterwards, by the end of the luteal phase (i.e., 17 days after the onset of estrus), an ultrasonographic scanning was performed to evaluate OR and TOA [AF + OR]. The average LW and BCS did not differ (p > 0.05) during the experimental period. BC-supplemented goats showed an increase in OR (3.4 ± 0.2 versus 2.8 ± 0.2; p < 0.05) and exhibited lower (p < 0.05) serum LH concentrations, LH-AUC and LH-PULSE compared to CONT. A positive correlation was recorded between OR and LW (r² = 0.42, p < 0.05) and BCS (r² = 0.47, p < 0.05). In addition, AF (5.0 ± 0.6 versus 3.4 ± 0.6) and TOA (8.4 ± 0.6 versus 6.2 ± 0.6) were greater (p < 0.05) in the BC-supplemented group than CONT. Supplementation with BC enhanced ovarian follicular development and ovulation rate in adult female goats under decreased photoperiods through LHRH-independant pathways or direct effects of BC on ovarian function.     

Ultrasonographic quantification of architectural response in tibialis anterior to neuromuscular electrical stimulation

While muscle contraction in voluntary efforts has been widely investigated, little is known about contraction during neuromuscular electrical stimulation (NMES). The aim of this study was to quantify in vivo muscle architecture of agonist and antagonist muscles at the ankle joint during NMES. Muscle fascicle lengths and pennation angles of the tibialis anterior (TA) and lateral gastrocnemius muscles were assessed via ultrasonography in 8 healthy young males. Measures were obtained during maximal NMES and torque-matched voluntary dorsiflexion contractions. In the TA, NMES induced a shorter fascicle length (67.2 ± 8.1 mm vs 74.6 ± 11.4 mm; p = 0.04) and a greater pennation angle (11.0 ± 2.4° vs 9.3 ± 2.5°; p = 0.03) compared with voluntary torque-matched dorsiflexion contractions. Architectural responses in the antagonist lateral gastrocnemius muscle did not significantly differ from rest or between voluntary and electrically induced contractions (p > 0.05). Contraction of the antagonist muscle was not a contributing factor to a greater fascicle shortening and increased pennation angle in the TA during NMES. TA architectural response during NMES likely arose from the contribution of muscle synergists during voluntary contractions coupled with a potentially localized contractile activity under the stimulation electrodes during NMES induced contractions.     

Assessment of the reproductive parameters,laparoscopic oocyte recovery and the first embryos produced in vitro from endangered Canindé goats (Capra hircus)

The Canindé breed of goats (Capra hircus) is currently endangered. The aims of this study were to characterize the estrus behavior, ovulatory responses and progesterone profiles, and to evaluate the in vitro embryo production (IVP) in this breed. In Experiment 1, ten nulliparous and seven pluriparous females received medroxyprogesterone acetate (MAP)-containing sponges (60 mg) plus 75 μg d-cloprostenol for estrus synchronization and their reproductive parameters were evaluated. In Experiment 2, oocytes obtained by laparascopy from hormonally stimulated females (n = 15) were used for IVP. There was no difference (p > 0.05) between nulliparous and pluriparous goats in terms of estrus response (40.0% vs. 85.7%), time from progestagen sponge removal to the onset of estrus (62.0 ± 15.5 vs. 50.7 ± 19.2 h; mean ± SEM), duration of estrus (25.0 ± 16.1 vs. 30.0 ± 15.1 h), percentage of ovulating animals (60.0% vs. 85.7%), number of ovulations (1.2 ± 0.4 vs. 1.3 ± 0.8), and diameter of the preovulatory follicle (5.8 ± 0.5 vs. 6.1 ± 0.3 mm). Progesterone concentrations were also similar (p > 0.05) in both groups. During laparoscopic recovery, there were average 12.2 aspirated follicles and 9.1 oocytes per goat, resulting in a high recovery rate (74.3%, 182/245). A total of 78 embryos were produced (51.0%). The mean number of cells in the blastocysts at day 7 of in vitro culture was 170.3 ± 12.5. In conclusion, nulliparous and pluriparous Canindé goats exhibited similar reproductive profiles. It was possible to produce embryos in vitro, allowing the instigation of an embryo bank for preservation of this breed.     

Hair cortisol determination in sows in two consecutive reproductive cycles

Hair analysis has been proposed as a minimally invasive technique capable of furnishing information regarding the stress response during medium- and long-term periods. Bristle samples were collected from the rump region of sows at three key physiological phases (before delivery – BD; weaning time – WT; pregnancy diagnosis – PD) during consecutive reproductive cycles in order to test swine hair as a reliable matrix of cortisol evaluation. Cortisol was extracted from the bristles and assayed using radioimmunoassay. The highest mean hair cortisol concentrations were demonstrated (p < 0.001) at the PD time points (20.1 ± .95 and 16.29 ± 2.15 pg/mg). Moreover, cortisol was significantly higher (p < 0.001) at BD2 (10.48 ± 0.96 pg/mg) as compared to BD1 (5.17 ± 0.51 pg/mg) and WT1 (6.01 ± 0.47 pg/mg). The various physiological phases had a significant effect on cortisol concentration (p < 0.00001) with a higher cortisol concentration found during late pregnancy and lactation than in early-mid pregnancy. This could be due not only to the physiological hormonal status, but also to the different housing conditions (single crates vs. group housing). The season of the year was also observed to have an effect (p < 0.005), with the lowest cortisol concentration recorded during the hot season.     

Uptake of advanced glycation end products by proximal tubule epithelial cells via macropinocytosis

Chronic hyperglycaemia during diabetes leads to non-enzymatic glycation of proteins to form advanced glycation end products (AGEs) that contribute to nephropathy. We describe AGE uptake in LLC-PK1 and HK2 proximal tubule cell lines by macropinocytosis, a non-specific, endocytic mechanism. AGE–BSA induced dorsal circular actin ruffles and amiloride-sensitive dextran–TRITC uptake, significantly increased AGE–BSA–FITC uptake (167 ± 20% vs BSA control, p < 0.01) and was ezrin-dependent. AGE–BSA–FITC uptake was significantly inhibited by amiloride and inhibitors of Arf6, Rac1, racGEF Tiam1, PAK1 and actin polymerisation. AGE–BSA–FITC, Arf6 and PIP2 co-localised within dorsal circular actin ruffles. AGE–BSA increased PAK1 kinase activity (212 ± 41% vs control, p < 0.05) and protein levels of Tiam1, a Rac1 activator. AGE–BSA significantly increased TGF-β₁ protein levels (160 ± 6%, p < 0.001 vs BSA), which were significantly inhibited by inhibitors of Arf6 (82 ± 19%, p < 0.001 vs AGE) and actin polymerisation (107 ± 11%, p < 0.001 vs AGE), suggesting AGEs partially exert their profibrotic effects via macropinocytosis. PAK1 and PIP5Kγ siRNA significantly decreased AGE–BSA–FITC uptake (81 ± 6% and 64 ± 7%, respectively, p < 0.05 vs control for both), and AGE-stimulated TGF-β₁ protein release (99 ± 15% and 49 ± 8% of control, p < 0.05 and p < 0.001, respectively). Inhibition of AGE uptake by macropinocytosis inhibitors and a neutralising TGF-β antibody, reversed the AGE-induced decrease in surface Na⁺K⁺ATPase, suggesting AGE uptake by macropinocytosis may contribute to diabetic kidney fibrosis and/or EMT by modulating this pump. Understanding methods of cellular uptake and signalling by AGEs may lead to novel therapies for diabetic nephropathy.     

Short-term glutamate administration positively affects the number of antral follicles and the ovulation rate in cyclic adult goats

The acute effects of short-term glutamate administration on the number of antral follicles and ovulation rate were examined in adult goats. Neither live weight (44.5 ± 1.3 kg) nor body condition (3.3 ± 0.8 units) differed between the control (untreated) and glutamate-treated (0.175 mg/kg) animals (p > 0.05). However, the number of antral follicles (3.4 vs. 2.1, p = 0.05) and ovulation rate (2.5 vs. 1.5, p = 0.05) was higher in the glutamate-administered group than in the controls.     

EMG normalization to study muscle activation in cycling

The value of electromyography (EMG) is sensitive to many physiological and non-physiological factors. The purpose of the present study was to determine if the torque–velocity test (T–V) can be used to normalize EMG signals into a framework of biological significance. Peak EMG amplitude of gluteus maximus (GMAX), vastus lateralis (VL), rectus femoris (RF), biceps femoris long head (BF), gastrocnemius medialis (GAS) and soleus (SOL) was calculated for nine subjects during isometric maximal voluntary contractions (IMVC) and torque–velocity bicycling tests (T–V). Then, the reference EMG signals obtained from IMVC and T–V bicycling tests were used to normalize the amplitude of the EMG signals collected for 15 different submaximal pedaling conditions. The results of this study showed that the repeatability of the measurements between IMVC (from 10% to 23%) and T–V (from 8% to 20%) was comparable. The amplitude of the peak EMG of VL was 99 ± 43% higher (p < 0.001) when measured during T–V. Moreover, the inter-individual variability of the EMG patterns calculated for submaximal cycling exercises differed significantly when using T–V bicycling normalization method (GMAX: 0.33 ± 0.16 vs. 1.09 ± 0.04, VL: 0.07 ± 0.02 vs. 0.64 ± 0.14, SOL: 0.07 ± 0.03 vs. 1.00 ± 0.07, RF: 1.21 ± 0.20 vs. 0.92 ± 0.13, BF: 1.47 ± 0.47 vs. 0.84 ± 0.11). It was concluded that T–V bicycling test offers the advantage to be less time and energy-consuming and to be as repeatable as IMVC tests to measure peak EMG amplitude. Furthermore, this normalization method avoids the impact of non-physiological factors on the amplitude of the EMG signals so that it allows quantifying better the activation level of lower limb muscles and the variability of the EMG patterns during submaximal bicycling exercises.     

Effects of medially posted insoles on foot and lower limb mechanics across walking and running in overpronating men

Anti-pronation orthoses, like medially posted insoles (MPI), have traditionally been used to treat various of lower limb problems. Yet, we know surprisingly little about their effects on overall foot motion and lower limb mechanics across walking and running, which represent highly different loading conditions. To address this issue, multi-segment foot and lower limb mechanics was examined among 11 overpronating men with normal (NORM) and MPI insoles during walking (self-selected speed 1.70 ± 0.19 m/s vs 1.72 ± 0.20 m/s, respectively) and running (4.04 ± 0.17 m/s vs 4.10 ± 0.13 m/s, respectively). The kinematic results showed that MPI reduced the peak forefoot eversion movement in respect to both hindfoot and tibia across walking and running when compared to NORM (p < 0.05–0.01). No differences were found in hindfoot eversion between conditions. The kinetic results showed no insole effects in walking, but during running MPI shifted center of pressure medially under the foot (p < 0.01) leading to an increase in frontal plane moments at the hip (p < 0.05) and knee (p < 0.05) joints and a reduction at the ankle joint (p < 0.05). These findings indicate that MPI primarily controlled the forefoot motion across walking and running. While kinetic response to MPI was more pronounced in running than walking, kinematic effects were essentially similar across both modes. This suggests that despite higher loads placed upon lower limb during running, there is no need to have a stiffer insoles to achieve similar reduction in the forefoot motion than in walking.     

A reduced core to skin temperature gradient,not a critical core temperature,affects aerobic capacity in the heat

The purpose of this study was to determine the impact of the core to skin temperature gradient during incremental running to volitional fatigue across varying environmental conditions. A secondary aim was to determine if a “critical” core temperature would dictate volitional fatigue during running in the heat. 60 participants (n=49 male, n=11 female; 24±5 yrs, 177±11 cm, 75±13 kg) completed the study. Participants were uniformly stratified into a specific exercise temperature group (18 °C, 26 °C, 34 °C, or 42 °C) based on a 3-mile run performance. Participants were equipped with core and chest skin temperature sensors and a heart rate monitor, entered an environmental chamber (18 °C, 26 °C, 34 °C, or 42 °C), and rested in the seated position for 10 min before performing a walk/run to volitional exhaustion. Initial treadmill speed was 3.2 km h⁻¹ with a 0% grade. Every 3 min, starting with speed, speed and grade increased in an alternating pattern (speed increased by 0.805 km h⁻¹, grade increased by 0.5%). Time to volitional fatigue was longer for the 18 °C and 26 °C group compared to the 42 °C group, (58.1±9.3 and 62.6±6.5 min vs. 51.3±8.3 min, respectively, p<0.05). At the half-way point and finish, the core to skin gradient for the 18 °C and 26 °C groups was larger compared to 42 °C group (halfway: 2.6±0.7 and 2.0±0.6 vs. 1.3±0.5 for the 18 °C, 26 °C and 42 °C groups, respectively; finish: 3.3±0.7 and 3.5±1.1 vs. 2.1±0.9 for the 26 °C, 34 °C, and 42 °C groups, respectively, p<0.05). Sweat rate was lower in the 18 °C group compared to the 26 °C, 34 °C, and 42 °C groups, 3.6±1.3 vs. 7.2±3.0, 7.1±2.0, and 7.6±1.7 g m⁻² min⁻¹, respectively, p<0.05. There were no group differences in core temperature and heart rate response during the exercise trials. The current data demonstrate a 13% and 22% longer run time to exhaustion for the 18 °C and 26 °C group, respectively, compared to the 42 °C group despite no differences in beginning and ending core temperatures or baseline 3-mile run time. This capacity difference appears to result from a magnified core to skin gradient via an environmental temperature advantageous to convective heat loss, and in part from an increased sweat rate.     

Menstrual Disorders and Androgen-Related Traits in Young Women with Type 1 Diabetes Mellitus: a Clinical Study

Objective: To investigate possible causes of menstrual disorders and androgen-related traits in young women with type 1 diabetes mellitus (T1DM).Methods: Fifty-three women with T1DM (duration 8.0 ± 5.6 years), 41 women with (polycystic ovary syndrome) PCOS, and 51 controls matched for age (19.4 ± 4.3 years vs. 21.2 ± 2.7 years vs. 20.8 ± 3.1 years; P>.05) and body mass index (BMI) (22.2 ± 2.7 kg/m² vs. 21.9 ± 2.0 kg/m² vs. 21.4 ± 1.9 kg/m²; P>.05) were prospectively recruited.Results: Two women (3.8%) in the T1DM group had not experienced menarche (at 15.5 and 16.6 years); of the rest, 23.5% had oligomenorrhea, 32.1% hirsutism, and 45.3% had acne. The age at menarche was delayed in the T1DM group compared to controls (12.7 ± 1.3 vs. 12.0 ± 1.0 years; P = .004), while no difference was observed with the polycystic ovary syndrome (PCOS) group (12.4 ± 1.2 years). There were no differences in total testosterone (0.43 ± 0.14 ng/mL vs. 0.39 ± 0.14 ng/mL; P>.05), dehydroepiandrosterone sulfate (DHEA-S) (269 ± 112 μg/dL vs. 238 ± 106 μg/dL; P>.05) or Δ4-androstenedione (2.4 ± 1.3 ng/mL vs. 1.9 ± 0.5 ng/mL; P>.05) concentrations between T1DM and controls. However, patients with T1DM had lower sex hormone binding globulin (SHBG) concentrations than controls (61 ± 17 nmol/L vs. 83 ± 18.1 nmol/L; P = .001), which were even lower in the PCOS group (39.5 ± 12.9 nmol/L; P = .001 compared with T1DM). The free androgen index (FAI) was higher in the PCOS group compared with both other groups (T1DM vs. PCOS vs. controls: 2.53 ± 0.54 vs. 7.88 ± 1.21 vs. 1.6 ± 0.68; P<.001). FAI was higher in patients with T1DM compared to controls as well (P = .038). There was no difference in DHEA-S concentrations between T1DM and PCOS patients (269 ± 112 μg/dL vs. 297 ± 100 μg/dL; P>.05).Conclusion: Menstrual disorders and androgen-related traits in young women with T1DM may be attributed to an increase in androgen bioavailability due to decreased SHBG concentrations.     

Mechanical properties of the patellar tendon in adults and children

It is not currently known how the mechanical properties of human tendons change with maturation in the two sexes. To address this, the stiffness and Young's modulus of the patellar tendon were measured in men, women, boys and girls (each group, n=10). Patellar tendon force (F_pt) was calculated from the measured joint moment during a ramped voluntary isometric knee extension contraction, the antagonist knee extensor muscle co-activation quantified from its electromyographical activity, and the patellar tendon moment arm measured from magnetic resonance images. Tendon elongation was imaged using the sagittal-plane ultrasound scans throughout the contraction. Tendon cross-sectional area was measured at rest from ultrasound scans in the transverse plane. Maximal F_pt and tendon elongation were (mean±SE) 5453±307 N and 5±0.5 mm for men, 3877±307 N and 4.9±0.6 mm for women, 2017±170 N and 6.2±0.5 mm for boys and 2169±182 N and 5.9±0.7 mm for girls. In all groups, tendon stiffness and Young's modulus were examined at the level that corresponded to the maximal 30% of the weakest participant's F_pt and stress, respectively; these were 925–1321 N and 11.5–16.5 MPa, respectively. Stiffness was 94% greater in men than boys and 84% greater in women than girls (p<0.01), with no differences between men and women, or boys and girls (men 1076±87 N/mm; women 1030±139 N/mm; boys 555±71 N/mm and girls 561.5±57.4 N/mm). Young's modulus was 99% greater in men than boys (p<0.01), and 66% greater in women than girls (p<0.05). There were no differences in modulus between men and women, or boys and girls (men 597±49 MPa; women 549±70 MPa; boys 255±42 MPa and girls 302±33 MPa). These findings indicate that the mechanical stiffness of tendon increases with maturation due to an increased Young's modulus and, in females due to a greater increase in tendon cross-sectional area than tendon length.     

Acute effect of heel-drop exercise with varying ranges of motion on the gastrocnemius aponeurosis-tendon’s mechanical properties

The objectives of this study was to investigate the acute effects of various magnitudes of tendon strain on the mechanical properties of the human medial gastrocnemius (MG) in vivo during controlled heel-drop exercises. Seven male and seven female volunteers performed two different exercises executed one month apart: one was a heel-drop exercise on a block (HDB), and the other was a heel-drop exercise on level floor (HDL). In each regimen, the subjects completed a session of 150 heel-drop exercises (15 repetitions × 10 sets; with a 30 s rest following each set). Before and immediately after the heel-drop exercise, the ankle plantar flexor torque and elongation of the MG were measured using a combined measurement system of dynamometry and ultrasonography and then the MG tendon strain and stiffness were evaluated in each subject. The tendon stiffness measured prior to the exercises was not significantly different between the two groups 23.7 ± 10.6 N/mm and 24.1 ± 10.0 N/mm for the HDB and HDL, respectively (p > .05). During the heel-drop exercise, it was found that the tendon strain during the heel-drop exercise on a block (8.4 ± 3.7%) was significantly higher than the strain measured on the level floor (5.4 ± 3.8%) (p < .05). In addition, the tendon stiffness following the heel-drop exercise on a block (32.3 ± 12.2 N/mm) was significantly greater than the tendon stiffness measured following the heel-drop exercise on the level floor (25.4 ± 11.4 N/mm) (p < .05). The results of this study suggest that tendon stiffness immediately following a heel-drop exercise depends on the magnitude of tendon strain.