Geometry of the proximal femur in relation to age and sex: a cross-sectional study in healthy adult Danes

PURPOSE: To describe the natural variation in hip geometry in relation to Danish population characteristics, and to establish normal reference values. MATERIAL AND METHODS: We included 249 healthy individuals (94 M and 155 F, aged 19-79 years) and measured hip-axis-length (HAL), neck-width (NW), neck-shaft-angle (NSA), and femoral head-radius (HR) on dual-energy X-ray absorptiometry (DXA) screen images. RESULTS: HAL, NW, HR, and NSA were higher in men than in women (10.9 +/- 0.7 vs. 9.5 +/- 0.6 cm (P<0.001), 3.8 +/- 0.3 vs. 3.3 +/- 0.3 cm (P<0.01), 2.5 +/- 0.3 vs. 2.3 +/- 0.2 cm (P< 0.001), and 131 +/- 5 vs. 129 +/- 5 degrees (P< 0.01). NSA was higher in post-menopausal than in pre-menopausal women (130 +/- 4 vs. 128 +/- 5 degrees (P<0.001)). In multiple regression analysis, HAL, NW, and HR were positively related to body height in both sexes (R = 0.20 to 0.63, P<0.05 to P<0.001). In females, NSA was positively related to body height (R = 0.20, P<0.05) and negatively to body weight (R = -0.30, P<0.01). NW increased with age in men (R = 0.34, P<0.01) but not in women. CONCLUSION: Hip dimensions differ between genders in the Danish population. HAL, NW, and HR depend on body height. Finally, NW increases with age in men but not in women.     

Maintenance of plasma volume and serum sodium concentration despite body weight loss in ironman triathletes.

OBJECTIVE: To examine the relationship between body weight, plasma volume, and serum sodium concentration ([Na]) during prolonged endurance exercise. DESIGN: Observational field study. SETTINGS: 2000 South African Ironman Triathlon. PARTICIPANTS: 181 male triathletes competing in an Ironman triathlon. MAIN OUTCOME MEASURES: Body weight, plasma volume, and serum ([Na]) change from pre- to postrace. RESULTS: Significant body weight loss occurred (-4.9 +/- 1.7%; P < 0.0001), while both plasma volume (1.0 +/- 11.2%; P = 0.4: NS) and serum [Na] (0.6 +/- 2.4%; P < 0.001) increased from pre- to postrace. Blood volume (-0.6 +/- 6.6%) and red cell volume (-2.6 +/- 5.5%; P < 0.001) decreased in conjunction with the body weight loss. There was a strong correlation between blood and plasma volume change, both as a percentage, and absolute change in fluid volume (r = 0.9; P < 0.001). Body weight change was positively correlated with plasma volume change (r = -0.4; P < 0.001), but inversely correlated with serum [Na] change (r = -0.4; P < 0.001). Plasma volume change was not significantly correlated with serum [Na] change (r = 0.0; NS). Serum [Na] change was inversely correlated with both percentage of red cell volume change (r = -0.2; P < 0.05) and percentage body weight change (r = -0.4; P < 0.001). CONCLUSION: Plasma volume and serum [Na] were maintained in male Ironman triathletes, despite significant (5%) body weight loss during the course of the race. Body weight was not an accurate "absolute" surrogate of fluid balance homeostasis during prolonged endurance exercise. Clinicians should be warned against viewing these three regulatory parameters as interchangeable during an Ironman triathlon.     

Rowing performance of female and male rowers

This study evaluated the rowing performance of female and male rowers with regard to their body size. Body height, body mass, fat-free mass, maximal oxygen uptake (VO2max), and "2000-m" rowing ergometer performance were measured in 71 females (age range 18-24 years, height 153-173 cm, body mass 43-69 kg, fat-free mass 34-55 kg; VO2max 2.1-3.9 L min(-1); 2000-m time 437-556 s) and 120 males (age 18-24 years, height 164-193 cm, body mass 58-95 kg, fat-free mass 50-81 kg; VO2max 3.4-5.6 L min(-1); 2000-m time 378-484 s). Rowing performance was correlated to body height (r=-0.81, P<0.001), body mass (r=-0.85, P<0.001), fat-free mass (r=-0.91, P<0.001), and VO2max (r=-0.90, P<0.001). However, rowing time was slower in the females than in the males with a similar body height (by approximately 10%) and body mass (by approximately 9%), but the sex difference was smaller when the fat-free mass (by approximately 4%) and VO2max (by approximately 4%) were matched. This study suggests that individuals with large body size and aerobic capacity possess an advantage for a 2000-m row on an ergometer. However, among females and males the variation in body size and aerobic capacity cannot explain the entire sex difference in ergometer rowing performance.     

Reliable callosal measurement: population normative data confirm sex-related differences

BACKGROUND AND PURPOSE: Corpus callosal cross-sectional area (CCA) may be a clinical indicator of disease progression, but factors influencing callosal morphology in healthy subjects must be determined before comparisons can be made in patients. We sought to define a reliable and easily repeatable method for CCA measurement and to examine the effects of sex, age, handedness, and cerebral volume. METHODS: Neurologically healthy volunteers (age range, 14-68 years; mean age, 32.6 years +/- 12.3 [SD]; 44 men, 56 women; 87 right handed) underwent conventional MR imaging. Data were reoriented in the image space to account for intersubject variations in head position before the midsagittal plane was defined by using midpoints of the anterior commissure (AC), posterior commissure (PC), and interhemispheric fissure (IF). Midsagittal CCA and total cerebral volume were measured and correlated with sex, age, and handedness. RESULTS: The mean CCA was 6.27 cm(2) +/- 0.90. Women had a larger CCA proportional to cerebral volume (6.16 x 10(-3) cm(-1) vs 5.78 x 10(-3) cm(-1) in men; P =.02). The percentage difference for the CCA-cerebral volume from the group mean was +2.6% in women and -3.6% in men. Only a small linear relationship of CCA with cerebral volume was noted (r(2) = 0.15), and CCA was not significantly correlated with age or handedness. CONCLUSION: To our knowledge, this is the largest study of callosal area in a community-based sample of control subjects; such subjects provide controls for future studies. Our findings provide anatomic evidence of sex differences in interhemispheric connectivity. Much CCA variability is independent of cerebral volume.     

Determination of circulating hemoglobin mass and related quantities by using capillary blood

PURPOSE: A standardized carbon monoxide (CO) rebreathing procedure with measurements of CO-hemoglobin, hemoglobin concentration ([Hb]), and hematocrit (Hct) enables to determine total Hb mass (Hb(tot)), blood, erythrocyte, and plasma volume (BV, EV, and PV). These calculations are normally based on venous blood samples. However, micromethods also allow determinations from capillary blood. METHODS: The accuracy of using capillary blood for Hb(tot), BV, EV, and PV determination was evaluated in 42 men (age: 25.1 +/- 4.0 yr, body mass: 80.3 +/- 9.6 kg) by comparison of capillary and venous data. RESULTS: Capillary Hb(tot) (962 +/- 110 g) did not differ from venous values (959 +/- 106 g). Hb(tot) values were highly correlated (r = 0.987, P < 0.001, SEE 18 g). Also, capillary and venous BV, PV, and EV were highly correlated (0.94 < r < 0.98), but slightly different (-2.7 to 0.9%) because of higher capillary than venous [Hb] and Hct. Coefficients of variation of repeated Hb(tot), EV, PV, and BV measurements (3.0-5.2%) were similar in capillary and venous blood. CONCLUSION: Calculation of Hb(tot) using capillary blood is as accurate and reliable as using venous blood.     

Sonographic evaluation of spleen size in tall healthy athletes

OBJECTIVE: The purpose of this study was to establish the range of spleen sizes in tall healthy athletes. SUBJECTS AND METHODS: Sonographic measurements of spleen size and left renal length were performed on 129 college athletes (82 men, 47 women). Length, width, and thickness of the spleen and left renal length were obtained. In addition, the height, weight, and age of each athlete were recorded. Pearson's product moment correlation coefficients were calculated, and linear regression analysis was used to create a model for calculating normative values. RESULTS: The mean body height for men was 74.3 (189 cm) +/-(SD) 3.7 inches (9 cm) and for women was 69.3 (176 cm) +/- 3.7 inches (9 cm). Spleen length was greater than 12 cm in 31.7% of the men (mean spleen length, 11.4 +/- 1.7 cm) and in 12.8% of the women (mean spleen length, 10.3 +/- 1.3 cm). In women, height correlated with spleen length (r = 0.3, p = 0.05), width (r = 0.4, p = 0.01), and volume (r = 0.3, p = 0.02) but not with thickness (r = 0.08, p = 0.6). Spleen length did correlate with left renal length (r = 0.5, p = 0.0005). In men, height correlated with spleen length (r = 0.4, p = 0.0003), width (r = 0.5, p = 0.0001), and volume (r = 0.4, p = 0.0002) and less with thickness (r = 0.3, p = 0.01). Spleen length and left renal length were poorly correlated (r = 0.2, p = 0.04). Regression analysis showed that in women taller than 5 ft 6 inches (168 cm), the mean splenic length of 10 cm increased by 0.1 cm for each 1-inch incremental increase in height. In men taller than 6 ft (180 cm), the mean splenic length of 11 cm increased by 0.2 cm for each 1-inch incremental increase in height. CONCLUSION: Spleen size correlates with height in tall healthy athletes. Nomograms from this data can be used to gauge the risk of returning to play after episodes of acute splenomegaly, as with infectious mononucleosis.     

Quantitation of liver and spleen uptake of (99m)Tc-phytate colloid using SPECT: detection of liver cirrhosis.

The purpose of this study was to assess the diagnostic performance of quantitative SPECT of (99m)Tc-phytate colloid in detecting liver cirrhosis and to assess the correlation between the SPECT results and the severity of disease. METHODS: Quantitative SPECT was performed on 60 patients (38 men, 22 women; mean age, 62.4 y) with liver cirrhosis and 36 control patients (21 men, 15 women; mean age, 58.7 y) without liver cirrhosis, and the results for the 2 groups were compared. Correlation with Child--Pugh classification and receiver operating characteristic methodology was used to analyze the results. RESULTS: Cirrhotic livers had a lower total uptake than did control livers (35.6% plus minus 13.5% vs. 61.6% +/- 10.2%, P < 0.0001). This reduced uptake was associated with a significantly reduced percentage injected dose per cubic centimeter (%ID/cm(3)) (0.024 +/- 0.01 vs. 0.044 +/- 0.01, P < 0.0001). The volume, 1,467 +/- 348 cm(3), was similar to that of control livers (1,487 +/- 397 cm(3), P = 0.80). Total uptake in the spleen was significantly greater in patients with cirrhosis than in control patients (24.9% +/- 12% vs. 7.6% +/- 3.2%, P < 0.0001) because of an increased volume (833 +/- 460 cm(3) vs. 239 +/- 90 cm(3), P < 0.0001). The %ID/cm(3) of spleen tissue was 0.033 +/- 0.01, which was similar to the value in control patients (0.032 +/- 0.01, P = 0.88). Spleen volume showed the best performance in detecting liver cirrhosis, with a mean area under the curve of 0.97 (95% CI = 0.91--0.99). The severity of liver disease correlated better with total liver uptake (r = -0.68, 95% CI = -0.80 to -0.52, P < 0.0001). CONCLUSION: Individual SPECT quantitation of (99m)Tc-phytate colloid uptake in the liver and spleen could be used as a noninvasive method to separate normal from cirrhotic livers and to evaluate the severity of disease.     

Quantitative Computed Tomography of the Lungs and Airways in Healthy Nonsmoking Adults

OBJECTIVES: The purposes of this study were to evaluate the reference range of quantitative computed tomography (QCT) measures of lung attenuation and airway parameter measurements in healthy nonsmoking adults and to identify sources of variation in those measures and possible means to adjust for them. MATERIALS AND METHODS: Within the COPDGene study, 92 healthy non-Hispanic white nonsmokers (29 men, 63 women; mean [SD] age, 62.7 [9.0] years; mean [SD] body mass index [BMI], 28.1 [5.1] kg/m) underwent volumetric computed tomography (CT) at full inspiration and at the end of a normal expiration. On QCT analysis (Pulmonary Workstation 2, VIDA Diagnostics), inspiratory low-attenuation areas were defined as lung tissue with attenuation values -950 Hounsfield units or less on inspiratory CT (LAAI-950). Expiratory low-attenuation areas were defined as lung tissue -856 Hounsfield units or less on expiratory CT (LAAE-856). We used simple linear regression to determine the impact of age and sex on QCT parameters and multiple regression to assess the additional impact of total lung capacity and functional residual capacity measured by CT (TLCCT and FRCCT), scanner type, and mean tracheal air attenuation. Airways were evaluated using measures of airway wall thickness, inner luminal area, wall area percentage (WA%), and standardized thickness of an airway with inner perimeter of 10 mm (Pi10). RESULTS: Mean (SD) %LAAI-950 was 2.0% (2.7%), and mean (SD) %LAAE-856 was 9.2% (6.8%). Mean (SD) %LAAI-950 was 3.6% (3.2%) in men, compared with 1.3% (2.0%) in women (P < 0.001). The %LAAI-950 did not change significantly with age (P = 0.08) or BMI (P = 0.52). %LAAE-856 did not show any independent relationship with age (P = 0.33), sex (P = 0.70), or BMI (P = 0.32). On multivariate analysis, %LAAI-950 showed a direct relationship to TLCCT (P = 0.002) and an inverse relationship to mean tracheal air attenuation (P = 0.003), and %LAAE-856 was related to age (P = 0.001), FRCCT (P = 0.007), and scanner type (P < 0.001). Multivariate analysis of segmental airways showed that inner luminal area and WA% were significantly related to TLCCT (P < 0.001) and age (0.006). Moreover, WA% was associated with sex (P = 0.05), axial pixel size (P = 0.03), and slice interval (P = 0.04). Lastly, airway wall thickness was strongly influenced by axial pixel size (P < 0.001). CONCLUSIONS: Although the attenuation characteristics of normal lung differ by age and sex, these differences do not persist on multivariate analysis. Potential sources of variation in measurement of attenuation-based QCT parameters include depth of inspiration/expiration and scanner type. Tracheal air attenuation may partially correct variation because of scanner type. Sources of variation in QCT airway measurements may include age, sex, BMI, depth of inspiration, and spatial resolution.     

Sex differences in claudication pain in subjects with peripheral arterial disease

PURPOSES: To compare the claudication distances between men and women patients with peripheral arterial disease (PAD), and to determine whether sex differences in claudication pain persisted after controlling for potential confounders such as demographic, functional, and physiological measures. METHODS: A total of 488 men and 72 women functionally limited by intermittent claudication were evaluated. Patients were characterized on PAD-specific measures consisting of ankle/brachial index (ABI) and treadmill claudication distances, physical function measures consisting of ambulatory function, monitored physical activity, balance, and strength, and demographic measures obtained during a medical history. RESULTS: Initial claudication distance (ICD) was 33% shorter ( = 0.024) in women than in men (126 +/- 22 vs 189 +/- 13 m; mean +/- SEM), and absolute claudication distance (ACD) was 23% shorter ( = 0.022) in women (313 +/- 43 vs 407 +/- 18 m). These differences were present despite similar ( = 0.440) ABI values between women (0.63 +/- 0.02) and men (0.62 +/- 0.01). Peak oxygen uptake ( = 0.043) and self-perceived stair climbing ability ( = 0.020) were different between men and women, and were independently related to ICD (multiple R = 0.57, < 0.001) and to ACD (multiple R = 0.71, < 0.001). The sex differences in ICD ( = 0.524) and ACD ( = 0.722) were no longer present after controlling for peak oxygen uptake and self-perceived stair climbing ability. CONCLUSION: Shorter treadmill claudication distances in women with PAD were explained by their lower cardiopulmonary fitness and poorer self-perceived ability to climb stairs than compared with men. Therefore, women with intermittent claudication represent a subgroup of PAD patients who should receive high priority for exercise rehabilitation to improve physical function.     

Reliability of air displacement plethysmography in a large, heterogeneous sample

INTRODUCTION: Several studies have assessed the validity of air displacement plethysmography (ADP), but few have assessed the reliability of ADP using a large, heterogeneous sample. PURPOSE: This study was conducted to determine the reliability of ADP using the Bod Pod in a large, heterogeneous sample. METHODS: A total of 980 healthy men and women (30 +/- 15 yr, mean +/- SD) completed two body composition assessments separated by 15-30 min. All testing was done in accordance with the manufacturer's instructions. RESULTS: A significant correlation (r = 0.992, P = 0.001) was found between body density (BD) 1 (1.046 +/- 0.001 kg.L(-1); mean +/- SEM) and BD 2 (1.046 +/- 0.001 kg.L(-1). A paired t-test revealed no significant difference between BD 1 and 2 (P = 0.935). The coefficient of variation (CV) for BD was 0.15%. A significant intraclass correlation coefficient (ICC) was found for BD (ICC = 0.996, P = 0.001), and the standard error of measurement (SEM) was 0.001 kg.L(-1). Body mass (BM) 1 and 2 were correlated significantly (r = 0.999, P = 0.001); however, a significant (P = 0.001) decrease was seen from BM 1 (75.510 +/- 0.461 kg) to BM 2 (75.497 +/- 0.461 kg). Body volume (BV) tended to decrease (P = 0.08) from BV 1 (69.900 +/- 0.449 L) to BV 2 (69.884 +/- 0.449 L). CONCLUSION: ADP using the Bod Pod appears to assess BD reliably; however, the observed CV suggests that multiple trials are necessary to detect small treatment effects.     

Impact of acute weight loss and/or thermal stress on rowing ergometer performance

PURPOSE: The impact of acute weight loss on rowing performance was assessed when generous nutrient intake was provided in 2 h of recovery after making weight. METHODS: Competitive rowers (N = 17) completed four ergometer trials, each separated by 48 h. Two trials were performed after a 4% body mass loss in the previous 24 h (WT) and two were performed after no weight restrictions, that is, unrestricted (UNR). In addition, two trials (1 x WT, 1 x UNR) were in a thermoneutral environment (NEUTRAL, mean 21.1 +/- SD 0.7 degrees C, 29.0 +/- 4.5% RH) and two were in the heat (HOT 32.4, +/- 0.4 degrees C, 60.4 +/- 2.7% RH). Trials were performed in a counterbalanced fashion according to a Latin square design. Aggressive nutritional recovery strategies (WT 2.3 g x kg(-1) carbohydrate, 34 mg x kg(-1) Na, 28.4 mL x kg(-1) fluid; UNR ad libitum) were employed in the 2 h after weigh-in. RESULTS: Both WT (mean 2.1, 95% CI 0.7-3.4 s; P = 0.003) and HOT (4.1, 2.7 - 5.4 s; P < 0.001) compromised 2000-m time-trial performance. Whereas WT resulted in hypohydration, the associated reduction in plasma volume explained only part of the performance compromise observed (0.2 s for every 1% decrement) Moreover, WT did not influence core temperature or indices of cardiovascular function. CONCLUSIONS: Acute weight loss compromised performance, despite generous nutrient intake in recovery, although the effect was small. Performance decrements were further exacerbated when exercise was performed in the heat.     

Lower-limb activity during the power serve in tennis: effects of performance level

PURPOSE: The aim of the present study was to investigate the differences in lower-limb activity during the tennis power serve between players of different performance levels. METHODS: Thirty-two participants distributed in three groups (beginner, B; intermediate, I; elite, E) performed countermovement jumps to measure leg power (P(max)) and 15 power serves from a force platform. Lateral, horizontal, and vertical forces (Fx, Fy, and Fz) were sampled simultaneously with EMG signals from six leg muscles. Racquet-ball impact height (I(height)) and maximum velocity of the ball (V(max) were measured with video analysis and radar, respectively. The total duration of the serve was fractioned into four phases: preparation (Pre), eccentric (Ecc), concentric (Con), and suspension (Sus). RESULTS: Pmax was similar in the three groups. The duration of Pre was longer (P < 0.05) in E than in B, whereas Con was shorter (P < 0.05). Vmax (169.4 +/- 11.3 vs 107.2 +/- 6.1 kmxh, P < 0.001), I(height) (149.2 +/- 2.7 vs 142.6 +/- 4.7% of standing height, P < 0.05), and Fz(max) (2.12 +/- 0.36 vs 1.68 +/- 0.33 of body weight, P < 0.01) were higher in E than in B. I(height) was correlated (r = 0.85, P < 0.001) with Fz(max) in E. Peaks EMG occurred earlier (P < 0.05) in E (79 +/- 17% of Con) than in other groups (B: 94 +/- 11% and I: 94 +/- 15%). CONCLUSION: The vertical forces and coordination in lower extremities during the tennis serve were different between players of different skill levels but with the same P(max). This may partly explain the differences in serve efficiency.     

Effect of strength training on resting metabolic rate and physical activity: age and gender comparisons

PURPOSE: The purpose of this study was to compare age and gender effects of strength training (ST) on resting metabolic rate (RMR), energy expenditure of physical activity (EEPA), and body composition. METHODS: RMR and EEPA were measured before and after 24 wk of ST in 10 young men (20-30 yr), 9 young women (20-30 yr), 11 older men (65-75 yr), and 10 older women (65-75 yr). RESULTS: When all subjects were pooled together, absolute RMR significantly increased by 7% (5928 +/- 1225 vs 6328 +/- 1336 kJ.d-1, P < 0.001). Furthermore, ST increased absolute RMR by 7% in both young (6302 +/- 1458 vs 6719 +/- 1617 kJ x d(-1), P < 0.01) and older (5614 +/- 916 vs 5999 +/- 973 kJ x d(-1), P < 0.05) subjects, with no significant interaction between the two age groups. In contrast, there was a significant gender x time interaction (P < 0.05) for absolute RMR with men increasing RMR by 9% (6645 +/- 1073 vs 7237 +/- 1150 kJ x d(-1), P < 0.001), whereas women showed no significant increase (5170 +/- 884 vs 5366 +/- 692 kJ x d(-1), P = 0.108). When RMR was adjusted for fat-free mass (FFM) using ANCOVA, with all subjects pooled together, there was still a significant increase in RMR with ST. Additionally, there was still a gender effect (P < 0.05) and no significant age effect (P = NS), with only the men still showing a significant elevation in RMR. Moreover, EEPA and TEE estimated with a Tritrac accelerometer and TEE estimated by the Stanford Seven-Day Physical Activity Recall Questionnaire did not change in response to ST for any group. CONCLUSIONS: In conclusion, changes in absolute and relative RMR in response to ST are influenced by gender but not age. In contrast to what has been suggested previously, changes in body composition in response to ST are not due to changes in physical activity outside of training.     

Validation of air displacement plethysmography for assessing body composition

PURPOSE: The purpose of this study was to verify the validity of an air displacement plethysmography device (Bod Pod) for estimating body density (Db). METHODS: The Db from the Bod Pod (DbBP) was compared with the Db from hydrostatic weighing (DbHW) at residual lung volume in a heterogeneous sample of 30 black men who varied in age (32.0 +/- 7.7 yr), height (180.3 +/- 7.5 cm), body mass (84.2 +/- 15.0 kg), body fatness (16.1 +/- 7.5%), and self-reported physical activity level and socioeconomic status. The Db for each method was converted to relative body fat (%BF) using race-specific conversion formulas and subsequently compared with %BF obtained from dual-energy x-ray absorptiometry (%BFDXA). RESULTS: Linear regression, using DbHW as the dependent variable and DbBP as the predictor, produced an R2 = 0.84 and SEE = 0.00721 g x cc(-1). However, the mean difference between the two methods (0.00450 +/- 0.00718 g x cc(-1) was significant (P < 0.01). The Bod Pod underestimated the Db of 73% of the sample. The %BF estimates from the Bod Pod, HW, and DXA differed significantly (P < 0.01). The average %BFBP (17.7 +/- 7.4%) was significantly greater than %BFHW (15.8 +/- 7.5%) and %BFDXA (16.1 +/- 7.5%); however, there was no significant difference between %BFHW and %BFDXA. CONCLUSION: The Bod Pod significantly and systematically underestimated Db, resulting in an overestimation of %BF. More cross-validation research is needed before recommending the Bod Pod as a reference method.     

The association between flow-mediated dilation and physical function in older men

The probability that an individual is able to live independently decreases sharply below the threshold score of 57 units on the physical functional performance (PFP-10) test. PURPOSE: To examine the relation between brachial artery flow-mediated dilation (BAFMD) on individual and total scores on the PFP-10. We hypothesized that lower scores on the PFP-10 test would be associated with lower BAFMD. METHODS: Sixty-four men (age, 84 +/- 11 yr) from the Louisiana Healthy Aging Study were studied. Participants were classified by their performance on the PFP-10 test (Class I, score <26; Class II, score between 26 and 57; and Class III, score > 57). BAFMD was assessed after 5 min of forearm occlusion, using high-resolution ultrasonography. RESULTS: The average total score on the PFP-10 test and BAFMD were 42.9 +/- 22 U and 2.76 +/- 2.13%, respectively. The BAFMD was associated with total PFP-10 score (r = 0.45, P = 0.0001) and age (r = -0.36, P = 0.003). BAFMD was significantly different (P = 0.001) between the PFP-10 classes (Class I, 1.44% [95% CI, 0.49-2.39]; Class II, 2.67% [95% CI, 1.95-3.38]; and Class III, 4.01% [95% CI, 3.16-4.85]). CONCLUSIONS: This study reports significant relationships between BAFMD and individual and combined measures of physical function in elderly men. More specifically, when individuals were categorized based on their PFP-10 total score, those in the highest functional class, exhibited the highest BAFMD, compared to those in the middle class, who had greater vasoreactivity than those in the lowest functional class.     

Feasibility of preclinical cardiac output and systemic vascular resistance in HEMS in thoracic pain--the ultrasonic cardiac output monitor

BACKGROUND: Cardiac output (CO) and systemic vascular resistance (SVR) are important hemodynamic parameters in emergency patients and for clinical early goal-directed therapy. This study evaluated the feasibility of CO and SVR determination using preclinical continuous wave Doppler ultrasound in a helicopter emergency medical service (HEMS) on emergency patients presenting with or without thoracic pain as a pilot observational study. METHODS: Forty-four consecutive medical emergency patients (62.8 +/- 22 years of age, 23 males) were classified at the scene as with (15 patients, 69 +/- 14 years of age, 40% male) or without (29 patients, 60 +/- 25 years of age, 59% male) thoracic pain by an emergency physician. Hemodynamic parameters were determined based on continuous wave Doppler noninvasively (USCOM, Sydney, Australia): stroke volume (SV), CO, cardiac index (CI), minute distance (MD), and SVR. RESULTS: Noninvasive SV, MD, CO, CI, and SVR determination is feasible using preclinical ultrasound in HEMS. Thoracic pain patients had higher SVR (2,709 +/- 891 vs 1,499 +/- 661 dyne*sec*cm-5) and lower CO/CI (3.37 +/- 1.1 vs 5.06 +/- 2.9 L/min, CI: 1.67 +/- 0.58 vs 3.18 +/- 1.34 L/min/m2) as well as a reduced aortic minute distance (11.2 +/- 3.3 m/min vs 19.1 +/- 8 m/min, P = .001) than patients without thoracic pain. Highest cardiac outputs were measured during and within 30 minutes after seizures (n = 5, 7.5 +/- 3.05 L/min). The range of CO measured in six cardiopulmonary resuscitation patients was 2.7 to 12 L/min; the level of CO was not associated with the establishing of sustained circulation. CONCLUSIONS: Determining SV, CO/CI, and SVR in different emergency situations in HEMS using rapid CW Doppler ultrasound is feasible. Thoracic pain patients have increased SVR and lower CO/CI and reduced aortic minute distance than do non-thoracic pain patients in the preclinical setting.     

The effect of cardiorespiratory fitness and obesity on cancer mortality in women and men

PURPOSE: The purpose of this study was to determine the independent and combined effects of cardiorespiratory fitness and obesity on all-cause cancer mortality for women and men. METHODS: Using the Lipids Research Clinics Prevalence Study, we examined the relationship of fitness and obesity on cancer mortality among 2585 women and 2890 men followed from 1972-1976 to 1998. Cardiorespiratory fitness was measured using a treadmill test and obesity was assessed using body mass index (BMI) calculated from measured height and weight. Gender-specific hazard ratios (HR) were calculated from proportional hazard models, which included covariates for age, education, smoking, alcohol intake, Keys score, and menopause (women only). RESULTS: Adjusted cancer mortality was significantly lower in the most fit quintile relative to the other four quintiles for men (HR = 0.47; 95% CI, 0.27-0.81) but not for women (HR = 0.84; 95% CI, 0.52-1.36). Adjusted cancer mortality was significantly higher in the highest BMI quintile relative to the other four BMI quintiles for women (HR = 1.49; 95% CI, 1.06-2.09) but not for men (HR = 1.05; 95% CI, 0.77-1.43). Further adjustment for BMI on fitness and adjustment for fitness on BMI did not meaningfully change the HR. There were no significant interactions between fitness and obesity in predicting cancer mortality for either women or men. CONCLUSION: In this study, high fitness was a stronger predictor of cancer mortality in men, whereas high BMI was a stronger predictor of cancer mortality in women.     

Effect of growth hormone on exercise tolerance in children with cystic fibrosis

PURPOSE: The effect of growth hormone (GH) treatment on exercise tolerance in children with cystic fibrosis was investigated. METHODS: 10 prepubertal children (mean +/- SD; age: 12.1 +/- 1.7 yr; height: 137.4 +/- 9.2 cm; body mass: 27.8 +/- 4.2 kg; forced expiratory volume in 1 s (FEV1): 68 +/- 22% predicted) were randomly assigned to either control period (CON, standard therapy) or recombinant human growth hormone (GH) period (additional GH treatment, 0.11-0.14 IU.kg-1, daily, s.c.) for the first 6 months, and then assigned to the other period for the next 6 months. At study entry and after each period, anthropometric data, pulmonary function, and exercise capacity (peak exercise capacity, .VO(2peak), and isokinetic muscle strength) were measured. RESULTS: Changes in height (+4.3 +/- 1.0 cm), total body mass (+2.2 +/- 0.8 kg), and lean body mass (LBM, +2.9 +/- 0.7 kg) were significantly higher (P < 0.01) after GH treatment compared with CON. Pulmonary function did not significantly change in either of the periods. In contrast to CON, GH treatment improved absolute .VO(2peak) (+19%, P < 0.01), peak ventilation (+14%, P < 0.01), and peak oxygen pulse (+18%, P < 0.01). Analysis of variance revealed that most of the changes (71%) in .VO(2peak) could be explained by those in LBM and FEV1 (P = 0.001). CONCLUSION: GH treatment clearly improved exercise tolerance, presumably resulting from the combined effects of GH on the muscular, cardiovascular, and pulmonary capacity.     

Muscle mass and strength, body composition and dietary intake in master strength athletes vs untrained men of different ages

AIM: The aim of this study was to compare muscle strength and thickness, body composition and dietary intake between master strength athletes and controls. METHODS: Cross-sectional comparison between: 1) young control men (25.7+/-3.4 y; n=10); 2) middle-aged master athletes (52.1+/-4.7 y; n=9); 3) middle-aged control men (51.9+/-3.1 y; n=11); 4) older master athletes (71.8+/-3.8 y; n=8); and 5) older control men (70.6+/-3.3 y; n=10). Athletes had been strength trained for 22.8+/-14.9 y. Maximal isometric strength of the leg extensors was measured with a leg dynamometer, body composition by skin folds, muscle thickness of the vastus lateralis with an ultrasound scanner and dietary intake by food diaries for 4 days. RESULTS: Athletes had more lean body mass than age-matched controls (P<0.001-0.05) and young controls more than older controls (P<0.01). No group differences were observed in the thickness of vastus lateralis. Athletes showed higher absolute strength and strength per vastus lateralis thickness ratio than all control groups (P<0.01-0.001). Body mass adjusted dietary intake did not differ between the strength trained and control men. Dietary intake did not correlate with strength, muscle thickness and lean body mass. CONCLUSION: The present older men with a long-term history of strength training showed greater muscle strength and strength per muscle thickness ratio than the untrained controls. The data support the usefulness of continuous strength training to preserve muscle strength in older men.