Effect of oral gamolenic acid from evening primrose oil on menopausal flushing.

OBJECTIVE--To evaluate the efficacy of gamolenic acid provided by evening primrose oil in treating hot flushes and sweating associated with the menopause. DESIGN--Randomised, double blind, placebo controlled study. SETTING--District general hospital and teaching hospital. SUBJECTS--56 menopausal women suffering hot flushes at least three times a day. INTERVENTION--Four capsules twice a day of 500 mg evening primrose oil with 10 mg natural vitamin E or 500 mg liquid paraffin for six months. MAIN OUTCOME MEASURES--Change in the number of hot flushes or sweating episodes a month. RESULTS--56 diaries were analysed, 28 from women taking gamolenic acid and 28 from those taking placebo. Only 18 women given gamolenic acid and 17 given placebo completed the trial. The mean (SE) improvement in the number of flushes in the last available treatment cycle compared with the control cycle was 1.9 (0.4) (P < 0.001) for daytime flushes and 0.7 (0.3) (P < 0.05) for night time flushes in women taking placebo; the corresponding values for women taking gamolenic acid were 0.5 (0.4) and 0.5 (0.3). In women taking gamolenic acid the only significant improvement was a reduction in the maximum number of night time flushes (1.4 (0.6); P < 0.05). CONCLUSION--Gamolenic acid offers no benefit over placebo in treating menopausal flushing.     

Interactions of Benzodiazepines with Warfarin

Administration of nitrazepam (10 mg nightly), diazepam (15 mg/day), and chlordiazepoxide (15 and 30 mg/day) had no effect on steady-state plasma warfarin concentrations, the plasma half-life of warfarin, or anticoagulant control in patients and it appears safe to prescribe these agents to patients on long-term oral anticoagulants. Urinary excretion of 6 β-hydroxycortisol, however, increased in two out of five patients given chlordiazepoxide. In rats pretreatment with chlordiazepoxide (40 mg/kg for four days) caused stimulation of liver microsomal enzyme activity but neither diazepam nor nitrazepam had this effect.     

Behavioral effects of benzodiazepine antagonists in chlordiazepoxide tolerant and non-tolerant rats

Rats were trained to respond under 3-min fixed-interval schedules of food presentation, and effects of the benzodiazepine-receptor ligands, flumazenil, 2-(4-methoxy-phenyl)-pyrazolo[4,3-c]quinolin-3(5H)-one (CGS 9895), 3-carbo-t-butoxy-beta-carboline (beta-CCtB), and beta-carboline-3-carboxylic acid ethyl ester (beta-CCE) were assessed before and after the induction of tolerance to chlordiazepoxide. Before daily administration of chlordiazepoxide, none of the antagonists produced appreciable effects on rates of responding up to doses of 32.0 mg/kg i.p. beta-CCE was the only antagonist studied at a higher dose (100.0 mg/kg i.p.), which decreased response rates. After 23 days of daily chlordiazepoxide administration (oral doses started at 10 and increased to 100 mg/kg/day by the 17th day), dose-effect curves for chlordiazepoxide were shifted to the right by about one-half log unit. Subjects were also more sensitive to the flumazenil, CGS 9895, and beta-CCtB, however, since these drugs produced only small effects in non-tolerant subjects, precise estimates of the degree of the shift in dose-effect curves could not be estimated. However, there were differences in the changes in the dose-effect curves induced by chlordiazepoxide tolerance. These results suggest differences in mechanism of action of antagonists in tolerant and non-tolerant subjects, and further that the sensitivity that is induced to antagonists in tolerant subjects is not conferred equally to all drugs having benzodiazepine antagonist activity.     

The effect of strength training at the same time of the day on the diurnal fluctuations of muscular anaerobic performances

The aim of this study was to examine the effects of training at the same time of the day on the diurnal variations of anaerobic performances to provide some recommendations to adjust training hours with the time of the day of competitive events. Thirty participants underwent 8 weeks of lower-extremity progressive resistance training performed 3 times per week designed to promote muscular strength and power. These subjects were randomly assigned to a morning training group (MTG, 07:00-08:00 hours, n = 10), an evening training group (ETG, 17:00-18:00 hours, n = 10), and a control group (CG, completed all tests but did not train, n = 10). Performance in the squat jump, the countermovement jump, the Wingate and 1 repetition maximum (1RM) during leg extension, leg curl, and squat tests was recorded just before and 2 weeks after an 8-week course of regular training. For all the subjects, the morning and evening tests were scheduled at the same time of the day as for the morning and evening training sessions. Before training, the results indicated a significant increase in performance from morning to evening tests (ca. 2.84-17.55% for all tests) for all groups. After training, the diurnal variations in anaerobic performances were blunted in the MTG. In fact, there was no significant difference in muscular power or strength between morning and evening tests. However, these intradaily variations in anaerobic performances persisted in the ETG and CG. From a practical point of view, adaptation to strength training is greater at the time of the day at which training was scheduled than at other times.     

Basal hyperchlorhydria and its relation to the plasma concentrations of secretin,vasoactive intestinal polypeptide (VIP) and gastrin during prolonged strain

Twenty young men divided into two groups participated in a five day training course with prolonged and heavy physical exercise, calorie supply deficiency and severe sleep deprivation. Basal acid output (BAO) was measured immediately after the course in seven of ten subjects who were given placebo tablets (placebo group) and in four of ten subjects who had a daily intake of 1 g cimetidine (cimetidine-group) during the course. Median BAO increased 3-fold in the placebo subjects (from 2.7 mmol/h to 8.2 mmol/h) but showed no increase in the cimetidine treated subjects. The median fasting plasma concentrations of secretin increased 2–8-fold during the course. Gastric suction for 1 h or ingestion of cimetidine reduced the plasma concentration of secretin by approx. 50%. Vasoactive intestinal polypeptide (VIP) increased 2-fold and was not influenced by reduction of gastric acid. The placebo group showed a small increase (P < 0.05) in plasma concentration of gastrin on day two during the course.The study shows a marked hyperchlorhydria which partly explains the fasting hypersecretinemia found during prolonged strain. This strain-induced hyperchlorhydria could be abolished by treatment with the selective H₂-receptor antagonist cimetidine.     

Comparison of the Efficacy of Morning versus Evening Administration of Olmesartan in Uncomplicated Essential Hypertension

A total of 18 diurnally active subjects with uncomplicated, mild to moderate, essential hypertension were studied to compare the efficacy of the morning versus evening administration of an oral olmesartan medication. After a two‐week, wash‐out/placebo run‐in period, subjects with clinic diastolic blood pressure (DBP) ≥90 mm Hg and <110 mm Hg began 12 weeks of 20 mg olmesartan medoxomil tablet therapy at 08:00 h daily. Four of the 18 subjects required dose escalation to 40 mg at eight weeks because of clinic DBP≥90 mm Hg. After the 12‐week period of once‐a‐day 08:00 h treatment, subjects were immediately switched to an evening (20:00 h) drug‐ingestion schedule for another 12‐week period without change in dose. Subjects underwent 24 h ambulatory blood pressure monitoring (ABPM) before the initiation of morning treatment and at the end of both the 12‐week morning and evening treatment arms. Dosing time did not exert statistically significant differences on the efficacy of olmesartan: the reduction from baseline in the 24 h mean systolic (SBP) and DBP was, respectively, 18.8 and 14.6 mm Hg with morning dosing and 16.1 and 13.2 mm Hg with evening dosing (p>0.152 between groups). The amplitude of the BP 24 h pattern did not vary with dosing time, indicating full 24 h BP reduction no matter the clock hour of treatment. Although, the BP‐lowering effect was somewhat better with morning dosing, the results of this study suggest that the studied olmesartan medoxomil preparation efficiently reduces BP when ingested in the morning (08:00 h) or evening (20:00 h) in equivalent manner, based on statistical testing, throughout the 24 h.     

Influence of the Observer on the Frequency of the ‘Morning-Dance’ in the Arabian Babbler

The Arabian babbler, Turdoides squamiceps, displays an unusual behaviour, the ‘morning-dance’. This article examines the influence of the presence and behaviour of an observer on the dance frequency. The results are the summary of more than 3 yr of study by 12 observers, who performed 1335 observations and witnessed 286 dances that took place among 15 groups of babblers. Different experiments were carried out on 148 additional mornings. Different observers witnessed different dance frequencies. Dance frequency witnessed by an observer decreased with observer's experience. Observers watching groups of babblers on single days witnessed more dances than those who watched the same groups for several consecutive days. Dance frequency was higher on the first day of a series of observations than on the following days in the same series. If a group of babblers remained unobserved for one day, the frequency of dancing increased. An evening observation considerably decreased the frequency of dancing the following morning. Feeding experiments did not elevate dance frequency. Experimental disturbance at the roost before dawn increased dance frequency while permanent disturbance and frightening experiments did not. Change in the observer's presence and behaviour caused the babblers to react by dancing. The hypothesis that the observer's presence and behaviour influences different group members differently, and therefore alters the relationships among them, is offered to explain the results that observers can affect the dance frequency.     

Day and Night Aspirin-Induced Gastric Mucosal Damage and Protection by Ranitidine in Man

The severity of gastric mucosal injury produced by aspirin (ASA) was endoscopically assessed during morning and evening studies in 10 healthy, male volunteers. In a randomized, double-blind design, subjects received either ASA (1300 mg) alone or ASA (1300 nig) plus Ranitidine (150mg) or placebo tablets during morning and evening studies. Each subject had 3 morning and 3 evening studies. The severity of damage produced by ASA was assessed by counting the number of punctate mucosal hemorrhages observed in the gastric antrum and low-body. This study demonstrated (1) wide intersubject variability in the severity of damage produced by ASA (range of 47-1030 lesions/subject in morning studies), (2) significant protection against ASA-indueed damage by Ranitidine and (3) significantly greater damage produced by ASA in the morning compared to the evening studies. Because evening acid secretory rates are higher and because ASA-induced damage is believed to be acid-dependent, this last observation was unexpected. It suggests mucosal resistance is higher in the evening and raises the possibility that there may be circadian variation in gastric mucosal resistance.     

Day and Night Aspirin-Induced Gastric Mucosal Damage and Protection by Ranitidine in Man

The severity of gastric mucosal injury produced by aspirin (ASA) was endoscopically assessed during morning and evening studies in 10 healthy, male volunteers. In a randomized, double-blind design, subjects received either ASA (1300 mg) alone or ASA (1300 nig) plus Ranitidine (150mg) or placebo tablets during morning and evening studies. Each subject had 3 morning and 3 evening studies. The severity of damage produced by ASA was assessed by counting the number of punctate mucosal hemorrhages observed in the gastric antrum and low-body. This study demonstrated (1) wide intersubject variability in the severity of damage produced by ASA (range of 47-1030 lesions/subject in morning studies), (2) significant protection against ASA-indueed damage by Ranitidine and (3) significantly greater damage produced by ASA in the morning compared to the evening studies. Because evening acid secretory rates are higher and because ASA-induced damage is believed to be acid-dependent, this last observation was unexpected. It suggests mucosal resistance is higher in the evening and raises the possibility that there may be circadian variation in gastric mucosal resistance.     

The effect of training at the same time of day and tapering period on the diurnal variation of short exercise performances

The purpose of this investigation was to assess the effects of training and tapering at the same time of the day on the diurnal variations of short exercise performances. Thirty-one physically active men underwent 12 weeks of lower-extremity resistance training and 2 weeks of tapering. These subjects were matched and randomly assigned to a morning training group (MTG, training times 0700-0800 hours, n = 10), an evening training group (ETG, training times 1700-1800 hours, n = 11), and a control group (CG, completed all tests but did not train, n = 10). Muscular strength and power testing was conducted before (T0) and after 12 weeks of training (T1) and after 2 weeks of tapering (T2) in the morning (0700-0800 hours) and in the evening (1700-1800 hours). All morning and evening tests were performed in separate sessions (minimum interval = 36 hours) in a randomized design. In T0, the oral temperature and performances during the Wingate, vertical jump (squat jump and countermovement jump), and maximal voluntary contraction tests were higher in the evening than in the morning for all the groups. In T1, these diurnal variations were blunted in the MTG and persisted in the ETG and CG. In T2, the 2 weeks of tapering resulted in further time of day-specific adaptations and increases in short-term maximal performances. However, there was no significant difference in the relative increase between the MTG and the ETG after both training and tapering. From a practical point of view, if the time of competition is known, training and tapering sessions before a major competition must be conducted at the same time of the day at which one's critical performance is programmed. Moreover, if the time of the competition is not known, a tapering phase after resistance training program could be performed at any time of the day with the same benefit.     

Evening Alcohol Suppresses Salivary Melatonin in Young Adults

The study objective was to determine the acute effects of a moderate evening dose of alcohol on salivary melatonin levels in humans with stable prior sleep‐wake histories and in a controlled environment. Twenty‐nine adults (nine males) ages 21 to 25 (M=22.6, SD=1.2) yrs adhered to a 10‐day at‐home stabilized sleep schedule followed by three in‐lab adaptation, placebo, and alcohol (order counterbalanced) study nights. Alcohol (vodka: 0.54 g/kg for men and 0.49 g/kg for women) or placebo beverage was consumed over 30 min, ending 1 h before stabilized bedtime. At 140 and 190 min after alcohol administration, melatonin level was reduced by 15% and 19%, respectively, in comparison to placebo. The findings indicate that a moderate dose of alcohol in the evening suppressed melatonin in young adults.     

Effect of cimetidine suspension on appetite and weight in overweight subjects.

OBJECTIVE--To investigate the weight reducing effect of cimetidine, comparing it with placebo. DESIGN--Block randomised parallel group double blind study using suspensions with identical appearance and taste. SETTING--Primary care practice. SUBJECTS--55 women and 5 men aged 18-59, body mass index 25-37 kg/m2, completed the study according to the protocol. INTERVENTIONS--Cimetidine suspension 200 mg or placebo 30 minutes was given before the three main meals for eight weeks. Subjects followed a diet restricted to 5 MJ/day supplemented with 9 g fibre per day. MAIN OUTCOME MEASURES--Weight reduction; abdominal and hip circumferences and systolic and diastolic blood pressures were also recorded. RESULTS--Subjects given cimetidine lost a mean of 7.3 (95% confidence interval 6.5 to 8.3) kg more than subjects given placebo (p < 0.001); body mass index decreased 3.33 (SD 0.76) and 0.77 (0.43), respectively (p < 0.001). Abdominal and hip circumference was decreased more in the cimetidine group (8.6 (3.9) cm and 7.8 (3.1) cm) than in the placebo group (2.2 (1.5) cm and 2.1 (1.5) cm). Mean reductions in systolic and diastolic blood pressure were greater in the cimetidine group than the placebo group (mean 5.8 v 0.4 and 6.5 v 0.4, p < 0.001). CONCLUSION--Intake of cimetidine suspension 30 minutes before meals in overweight subjects may lead to reduced hunger, less food intake, and subsequent weight loss. This effect may be due to the suppression of gastric acid secretion. Cimetidine suspension may be a valuable adjunct in treating obesity.     

Soy protein hydrolyzate with bound phospholipids reduces serum cholesterol levels in hypercholesterolemic adult male volunteers

This study was done to evaluate the effects of soy protein hydrolyzate with bound phospholipids (c-SPHP), on the serum cholesterol levels in hypercholesterolemic subjects over a three-month period. Subjects were Taiwanese adult male volunteers whose serum total cholesterol levels were above 220 mg/dl. Twenty-one subjects were divided into three groups randomly, and each group was given c-SPHP zero, 3, or 6 g per day. Test diets were orally administered in a powdered drink form that contained c-SPHP or casein hydrolyzate (placebo). The subjects were given the test diet four times daily. The study consisted of a two-week pre-feeding period, a three-month feeding period, followed by a two-week post-feeding period. After 3 months of c-SPHP administration, 3 g per day, serum total cholesterol decreased significantly from the initial level (15.0%, p<0.01) and compared with the placebo group (p<0.05). Furthermore, LDL-cholesterol decreased significantly (27.7%, p<0.01) and the LDL/HDL ratio also decreased significantly (47.4%, p<0.01) from the initial levels. These effects of c-SPHP were dose-dependent. This study suggests that c-SPHP has remarkable improving effects on the serum cholesterol levels in hypercholesterolemic subjects.     

Influence of L-carnitine administration on maximal physical exercise

The effects of L-carnitine administration on maximal exercise capacity were studied in a double-blind, cross-over trial on ten moderately trained young men. A quantity of 2 g of L-carnitine or a placebo were administered orally in random order to these subjects 1 h before they began exercise on a cycle ergometer. Exercise intensity was increased by 50-W increments every 3 min until they became exhausted. After 72-h recovery, the same exercise regime was repeated but this time the subjects, who had previously received L-carnitine, were now given the placebo and vice versa. The results showed that at the maximal exercise intensity, treatment with L-carnitine significantly increased both maximal oxygen uptake, and power output. Moreover, at similar exercise intensities in the L-carnitine trial oxygen uptake, carbon dioxide production, pulmonary ventilation and plasma lactate were reduced. It is concluded that under these experimental conditions pretreatment with L-carnitine favoured aerobic processes resulting in a more efficient performance. Possible mechanisms producing this effect are discussed.     

Oral arginine attenuates the growth hormone response to resistance exercise.

This study investigated the combined effect of resistance exercise and arginine ingestion on spontaneous growth hormone (GH) release. Eight healthy male subjects were studied randomly on four separate occasions [placebo, arginine (Arg), placebo + exercise (Ex), arginine + exercise (Arg+Ex)]. Subjects had blood sampled every 10 min for 3.5 h. After baseline sampling (30 min), subjects ingested a 7-g dose of arginine or placebo (blinded, randomly assigned). On the exercise days, the subject performed 3 sets of 9 exercises, 10 repetitions at 80% one repetition maximum. Resting GH concentrations were similar on each study day. Integrated GH area under the curve was significantly higher on the Ex day (508.7 +/- 169.6 min.ng/ml; P < 0.05) than on any of the other study days. Arg+Ex (260.5 +/- 76.8 min.ng/ml) resulted in a greater response than the placebo day but not significantly greater than the Arg day. The GH half-life and half duration were not influenced by the stimulus administered. The GH secretory burst mass was larger, but not significantly, on the Arg, Ex, and Arg+Ex day than the placebo day. Endogenous GH production rate (Ex > Arg+Ex > Arg > placebo) was greater on the Ex and Arg+Ex day than on the placebo day (P < 0.05) but there were no differences between the Ex and Arg+Ex day. Oral arginine alone (7 g) stimulated GH release, but a greater GH response was seen with exercise alone. The combined effect of arginine before exercise attenuates the GH response. Autonegative feedback possibly causes a refractory period such that when the two stimuli are presented there will be suppression of the somatotrope.     

Attempts at dietary alteration of prostaglandin pathways in the management of pre-eclampsia

It has been suggested that dietary supplementation with prostaglandin precursors may enhance the synthesis of PGE which lowers vascular sensitivity to increased levels of angiotensin II in pregnancy. Therefore the effect of dietary supplementation with evening primrose oil (linoleic acid and gamma-linoleic acid) in African primigravidae with established pre-eclampsia was studied. Patients were randomly allocated to one of two groups. Group A (23 patients) received 8 capsules/day of evening primrose oil and group B (24 patients) received 8 capsules of placebo. No significant differences were found between the groups in respect to perinatal outcome, blood pressure lowering effect and haematological indices.     

Multilevel modeling of chronotype and weekdays versus weekends to predict nonrestorative sleep

Nonrestorative sleep, a form of subjective sleep disturbance that has been largely neglected in the literature, is newly accessible to researchers via the validated restorative sleep questionnaire (RSQ). The daily version of the RSQ allows for analysis of within-subjects variation in restorative sleep across repeated samplings, and such day-to-day regularity in sleep variables has been highlighted as an important new direction for research. The present study used a sophisticated statistical approach, multilevel modeling, to examine the contributions of circadian chronotype, calendar day of questionnaire completion (weekends versus weekdays), and their interaction in explaining both interindividual and intraindividual variance in restorative sleep. Analyses were conducted using an archival dataset of college undergraduates who continuously completed daily RSQs over a 14-day sampling period. In the final multilevel model, possessing an evening type predicted lower restorative sleep between subjects, while sampling on weekdays predicted lower restorative sleep within subjects. Furthermore, a cross-level interaction was observed, such that the difference in restorative sleep on weekends versus weekdays was more pronounced among those with greater evening circadian preference. All of the effects were maintained after accounting for the significant influence of gender (women had less restorative sleep than men). These results are theoretically consistent with findings that evening types display stronger disparities in sleep schedules across free and workdays (i.e., social jet lag), and attest to the usefulness of multilevel models for statistically investigating how stable traits interact with factors that vary day to day (e.g., work or school schedules) in influencing sleep outcomes.     

Effect of long-term treatment with salmeterol on asthma control: a double blind,randomised crossover study.

OBJECTIVES: To determine the effect of adding salmeterol 50 micrograms twice daily for six months to current treatment in subjects with asthma who control their inhaled corticosteroid dose according to a management plan. DESIGN: A double blind, randomised crossover study. SETTING: Nottingham. SUBJECTS: 101 subjects with mild or moderate asthma taking at least 200 micrograms twice daily of beclomethasone dipropionate or budesonide. INTERVENTIONS: Salmeterol 50 micrograms twice daily and placebo for six months each, with a one month washout. Subjects adjusted inhaled steroid dose according to guidelines. MAIN OUTCOME MEASURE: Reduction in inhaled steroid use, exacerbations of asthma, and use of oral steroids. RESULTS: Data were available for 87 subjects. When compared with placebo salmeterol treatment was associated with a 17% reduction in inhaled steroid use (95% confidence interval 12% to 22%) with no significant difference in the number of subjects who had an exacerbation (placebo 25%, salmeterol 16%) or use of oral steroids. For secondary end points salmeterol treatment was associated with higher morning and evening peak expiratory flow and forced expiratory volume in one second; a reduction in symptoms, bronchodilator use and airway responsiveness to methacholine; and no effect on serum potassium concentration, 24 hour heart rate, or the final forced expiratory volume in one second achieved during a salbutamol dose-response study. CONCLUSIONS: In subjects who adjusted their inhaled steroid treatment according to guidelines the addition of salmeterol 50 micrograms twice daily was associated with a reduction in inhaled steroid use and improved lung function and symptom control.     

Effect of a Single Bout of Exercise and β-Carotene Supplementation on the Urinary Excretion of 8-Hydroxy-deoxyguanosine in Humans

We investigated the effects of acute exhaustive exercise and β-carotene supplementation on urinary 8-hydroxy-deoxyguanosine (8-OHdG) excretion in healthy nonsmoking men. Fourteen untrained male (19-22 years old) volunteers participated in a double blind design. The subjects were randomly assigned to either the β-carotene or placebo supplement group. Eight subjects were given 30 mg of β-carotene per day for 1 month, while six subjects were given a placebo for the same period. All subjects performed incremental exercise to exhaustion on a bicycle ergometer both before and after the 1-month β-carotene supplementation period. The blood lactate and pyruvate concentrations significantly increased immediately after exercise in both groups. The baseline plasma p-carotene concentration was significantly 17-fold higher after β-carotene supplementation. The plasma β-carotene decreased immediately after both trials of exercise, suggesting that β-carotene may contribute to the protection of the increasing oxidative stress during exercise. Both plasma hypoxanthine and xanthine increased immediately after exercise before and after supplementation. This thus suggests that both trials of exercise might enhance the oxidative stress. The 24-h urinary excretion of 8-OHdG was unchanged for 3 days after exercise before and after supplementation in both groups. However, the baseline urinary excretion of 8-OHdG before exercise tended to be lower after β-carotene supplementation. These results thus suggest that a single bout of incremental exercise does not induce the oxidative DNA damage, while β-carotene supplementation may attenuate it.