Aspects biologiques des interactions de l’exercice et de la récupération

Subject

The use of Fourier transform infrared spectrometry technique (FT-IR) as a pitch technique of the biological control of short and intense exercises close to those of Rugby matches.

Material and method

In reference to 28 rugbymen of international level, the biological results of three short and intense exercises and two periods of recovery were analyzed by TF-IR. The exercises are: (1) sprints; (2) 12 × 20 m of swerve running; (3) 6 × 30 s of shuttle run.

Results

Lactate, glucose, urea, and to a lesser degree, triglycerides showed a significant evolution. If the evolution of the two first was in conformity with the literature, the increase of urea probably results from the activation of the purins–nucleotides cycle, whereas the evolution of triglycerides is explained by their probable muscular use during periods of active recovery. Among proteins related to the healthy sportsman, only haptoglobin presents a significant variation difficult to explain whereas CRP, orosomucoid and immunoglobulins A, G and M remain close to their rest values.

Conclusion

With the use of FT-IR technique, it is possible to intervene directly on the pitches of the sporting practice to control the biological incidences and to adjust the loads individually. It is also possible to detect inflammatory and immunological problems related to the biomechanical and physiological stresses.     

Técnicas de recanalización vertebrobasilar antes de la introducción de las endoprótesis recuperadoras: la reapertura no es sinónimo de buena evolución

Objectives

To evaluate the recanalization rate and clinical outcome three months after endovascular treatment for vertebrobasilar occlusion before the placement of stentrievers.

Material and methods

We reviewed all cases of basilar thrombosis treated with endovascular techniques at our center. We reviewed the clinical outcomes with the main objective of determining the recanalization rate and the secondary objective of evaluating the outcome using the modified Rankin scale (mRS) three months after treatment. We assessed clinical and angiographic variables and correlated them with outcome and complications.

Results

We reviewed a total of 27 consecutive patients (mean age, 58.1 ± 15.5 y; median National Institutes of Health Stroke Scale (NIHSS), 21, interquartile range, 18-29; median Glasgow coma score (GCS) 7, interquartile range, 4-9.5). The mean time between the onset of symptoms and endovascular treatment was 26.3 ± 41.7 hours. Complete or partial recanalization was achieved in 23 (85.1%) patients. Three months after treatment, 16 (59.2%) had died and 6 (22.2%) had good outcome (mRS ≤ 2).

Conclusion

Endovascular treatment achieved a high rate of recanalization of occlusions of the basilar artery. Nevertheless, a high percentage of the patients did not have a good outcome. New materials might improve the prognosis in these patients.     

Effets d'une restriction hydrique et alimentaire prolongée (ramadan) sur la performance et les réponses cardiovasculaires au cours d'un exercice incrémental en milieu tropical chaud

Backgroung

Previous studies showed that maximal oxygen uptake and maximal heart rate were not different during prolonged fasting (ramadan) compared to normal feeding period. However, the effect of ramadan on the blood pressure response during incremental exercise has not been investigated.

Objective

This study aimed to evaluate the evolution of blood pressure during incremental trial in ramadan period.

Methods

Twelve young trained male aged 24 ± 4 yrs participated as voluntary subjects. Their anthropometric parameters, maximal aerobic power and maximal heart were measured in fasting and in normal feeding periods during incremental trial on cycle ergometer.

Results

No significant difference was observed in any anthropometric parameter. Maximal aerobic power of fasting period was significantly less (P < 0,05) compared to normal feeding. Heart rate at rest, at maximal exercise and during a 15 min period of recovery was not significantly affected. Systolic blood pressure of fasting period at maximal power was significantly lower than during the control period (P < 0,05).

Conclusion

Ramadan negatively influences the capacity of maximal power and cardiovascular response at maximal power.     

Deux mythes concernant l’exercice chez le diabétique de type 1 : le seuil hyperglycémique de 2,5 g/l de contre-indication à l’effort et le glucose pulse

Aims

We addressed the relevance of two usual beliefs about blood glucose response to exercise in insulin-treated diabetic patients. First, that a pre-exercise blood glucose value exceeding 250 mg/dL means that exercise should be avoided because it will result in worsening of hyperglycemia; second, the prediction of carbohydrate oxidation according to the level of exercise “glucose pulse” may have some value to predict how blood glucose levels will respond to exercise.

Methods

Twenty-four type-1 diabetics (12 men and 12 women, age 19–71 years) treated with basal-bolus or continuous insulin delivery by portable pump performed a steady-state exercise on ergocycle at 50% of their predicted P_max (40–200 W) with measurement of blood glucose levels, blood lactate, and exercise calorimetry. This protocol lowers blood glucose (p < 0.05), with a variable magnitude (−4 to −178 mg/dL [mean: −51 ± 9 mg/dL]), i.e., blood glucose decreased in 21 subjects (87.5%). Carbohydrate oxidation rates do not, however, predict the evolution of blood glucose. Baseline blood glucose G₀ (ranging between 89 and 270 mg/dL, i.e., on average 179 ± 14 mg/dL) was in fact negatively correlated (and not positively) to the variation of blood glucose during exercise (r = −0.462; p < 0.05), so that the higher is G₀ the more blood glucose decreases. When G₀ is greater than 250 mg/dL blood glucose decreased on average by −97 ± 26 mg/dL (p < 0.05). During these steady state bouts of exercise, which clearly decrease blood glucose, oxidation of carbohydrates does not predict the decline in blood glucose (minimizing the interest of the concept of “glucose pulse”), and a value of G₀ greater than 250 mg/dL does not predict exercise hyperglycemia so that it is no longer logic to set this value as a threshold for counter indicating exercise.     

Uchi-komi avec charge,une approche physiologique d'un nouveau test spécifique au judo

Objective

The aim of this study was to elaborate and validate a specific test to evaluate the physical condition of judo players.

Subjects and methods

Twenty-three volunteers, males, aged 22 ± 3.62 years old took part in our experiment. They did the progressive test of Leger et al. (1984), vertical Jump test (Sargent test), Australian shuttle run test and a specific judo test.

Results

The observed results showed significant correlations between muscular power and the number of Uchi-komi on the judo test reference scale (R = 0.52, P < 0.01). Furthermore, there were other correlations between the number of Uchi-komi at the two first sets of specific judo test and the anaerobic power represented by the distance covered in 30s at the Australian shuttle test (R = 0.86, P < 0.01), also between the anaerobic capacity represented by the whole distance covered and the total number of Uchi-komi achieved at the judo test (R = 0.88, P < 0.01).

Conclusion

The test reproduces the physiological characteristics of judo fight. It is a good indicator of the judoka's physical fitness and their cardiovascular adaptation in a physical effort.     

Effets d’un exercice de type anaérobie sur le statut antioxydant enzymatique au cours de la récupération chez les judokas

Aim

To evaluate the effect of the anaerobic exercise on the enzymatic antioxidant statute in judokas’ regional level, because the effects of anaerobic exercise on the free radicals and antioxidants are relatively rare and have some divergences.

Materials and methods

We made this study on ten male judokas (age = 18.1 ± 1.6 years; weight = 77.2 ± 11.6 kg; height = 176.4 ± 4.6 cm), which carried out 30 seconds anaerobic capacity test (Wingate test). Blood samples were taken, by an intravenous catheter, at rest (R), immediately after the Wingate test (P0) then five minutes later (P5), 10 minutes later (P10) then 20 minutes later (P20). The measured parameters are: the superoxide dismutase (SOD), the glutathion peroxidase (GPx) and the total antioxidant statute (SAT).

Results

The concentration of the SOD increases significantly (p < 0.05) at (P0); and regains the baseline values at (P20). The concentration of GPx increases significantly (p < 0.05) in (P0); in (P10) GPx reaches the baseline values. No significant effect of the anaerobic exercise was observed on the concentration of the SAT. Positive correlation was observed between the SOD and GPx to p < 0.05.

Conclusion

The anaerobic exercise modifies the activity of the antioxidant enzymes with different kinetics.     

Effets d'une complémentation nutritionnelle en vitamines et minéraux sur la chute de force et les marqueurs biologiques consécutifs à un exercice excentrique chez des personnes âgées

Purpose

The effects of vitamins and minerals complex supplementation on maximal voluntary contraction decrease (FMV) and biological markers following an eccentric exercise at old people.

Method

Sixteen elderly subjects took either placebo (Pl group) or vitamins and minerals (Isoxan Senior, NHS, Rungis, France) (group S) for 21 d before an eccentric exercise and for 3 d after the exercise. The FMV and surface EMG activity (RMS) of the vastus lateralis (VL), vastus médialis (VM) and rectus fémoris (RF) were recorded before (Pre), immediately after (Post), 24 h (Post 24) and 48 h (Post 48) after the exercise. CCVThe creatine kinase (CK), lactate déshydrogénase, malondialdéhyde, and tumor necrosis Factor (TNFα) levels were analyzed.

Results

The reduced MVC (S: 11,2 ± 4,8%; Pl: 17,8 ± 10,4%, P < 0,01) after exercise was associated with a significant reduction in RMS VL, RMS VM and RMS RF values for both groups. A faster FMV recovery appeared at 48 h for the S group (P < 0.05). CK and TNFα values increased in post-exercise.

Conclusion

A dietary supplementation of a vitamin and mineral complex does not attenuate the loss of contractile function immediately after the running exercise, and it may accelerate the recovery of maximal force capacity after 48 h by limiting the post-exercise pro-inflammatory processes.     

Contrairement à une idée reçue,les femmes n’oxydent pas plus de lipides à l’effort que les hommes,mais leur Lipoxmax survient à une puissance plus élevée

Aims

Several studies have shown that women, when they exercise at a given percentage of their aerobic capacity, oxidize more fat than men, thus saving their protein and glycogen stores. We wanted to characterize these differences in terms of levels of transition of balance of substrate oxidation and maximum lipid oxidation flow rate (MLOFR) during exercise.

Methods

Three groups (61 athletes, 196 sedentary and 47 type 2 diabetes mellitus [T2DM], in whom, men and women were matched for age, BMI and physical activity, performed a sub-maximal exercise test with four 6 min steady state steps for measurement of lipid and carbohydrate oxidation by indirect calorimetry. In all three groups MLOFRs are the same in both sexes (2 to 3 mg min⁻¹ kg⁻¹), but among athletes and sedentary women have a curve of oxidation of lipids shifted to the right, a crossover point of use of substrates (PCX, the power for which energy comes mainly from carbohydrates) occurring at a 10–15% higher percentage of VO_2max (p < 0.01). In DT2 this shift is no longer significant. The point of maximal lipid oxidation (Lipox_max) also occurs at a higher percentage of VO_2max (athletes: 44.27 ± 15.97% theoretical VO_2max versus 31.25 ± 15.66% in men, p < 0.001; sedentary: 50.29 ± 18.66% among women versus 36.75 ± 15.22% in men, p < 0.01; for T2DM these levels (42.8 ± 2.4 to 39.8 ± 3.7%) are not significantly different.

Conclusion

Gender-related differences are found on carefully matched subgroups, but are far to be major. They reflect a right shift by 10 to 15% of the curve of lipid oxidation as a function of VO_2max, while rates of oxidation at the Lipox_max do not differ between genders. In other words, women do not oxidize more lipids at exercise, but their ability to oxidize them reaches a maximum at a higher percentage of VO_2max. This discrepancy seems to disappear in T2DM.     

Body mass index-adapted prospective coronary computed tomography angiography. Determining the lowest limit for diagnostic purposes

Purpose

To investigate the value of 4 different protocols for prospectively triggered 256-slice coronary computed tomography angiography (coronary CTA).

Methods

Two hundred and ten patients underwent prospectively triggered coronary CTA for suspected or known coronary artery disease (CAD). Patients with heart rate >75 bps before the scan despite ß-blocker administration and with arrhythmia were excluded. From January to September 2010, 60 patients underwent coronary CTA using a non-tailored protocol (120 kV; 200 mAs) and served as our ‘control’ group. From September 2010 to April 2012, based on the body mass index (BMI) of the examined patients (BMI subgroups of < 25; 25–28; 28–30, and ≥ 30 kg/m²) current tube voltage and tube current were: (1) slightly, (2) moderately or (3) strongly reduced, resulting into the 3 following BMI-adapted acquisition groups: (1) a ‘standard’ (100/120 kV; 100–200 mAs; n = 50), 2) a ‘low dose’ (100/120 kV; 75–150 mAs; n = 50), and 3) an ‘ultra-low dose’ (100/120 kV; 50–100 mAs; n = 50) protocol.

Results

Patients examined using the non-tailored protocol exhibited the highest radiation exposure (3.2 ± 0.4 mSv), followed by the standard (1.6 ± 0.7 mSv), low-dose (1.2 ± 0.6 mSv) and ultra-low dose protocol (0.7 ± 0.3 mSv) (radiation savings of 50%, 63% and 78% respectively). Overall image quality was similar with standard dose (1.9 ± 0.6) and low-dose (2.0 ± 0.5) compared to the non-tailored group (1.9 ± 0.5) (p = NS for all). In the ultra-low dose group however, image quality was significant reduced (2.7 ± 0.6), p < 0.05 versus all other groups).

Conclusion

Using BMI-adapted low dose acquisitions image quality can be maintained with simultaneous radiation savings of ∼65% (dose of ∼1 mSv). This appears to be the lower limit for diagnostic coronary CTA, whereas ultra-low dose acquisitions result in significant image degradation.     

La technique de Didier Patte dans les luxations récidivantes de l’épaule : notre expérience à propos de 35 cas avec un suivi d’une dizaine d’années

Aims

Authors report their personal experience on the surgical treatment of repeated anterior shoulder dislocations, using an anterior bone block in accordance with the procedure suggested by Didier Patte.

Results

From the year 1988 and during 10 years, 35 patients suffering from repeated anterior shoulder dislocations were surgically treated by this procedure. It was appropriate to retrospectively review the clinical and functional outcomes after Patte repair for recurrent anterior glenohumeral instability. The mean follow-up was approximately 10 years, with a mean percentage of 75% for the observance. There was no recurrence after surgery. Moreover, 88% of patients had good outcomes, according to the scale suggested by Butel et al., with total resumption of work and physical activities. The occurrence of chronic complication such as osteoathrosis was scarce (only one case for the series), while 20% of subjects showed apprehension during some specific shoulder movements.

Conclusion

In order to expect best functional outcomes, the choice of the surgical procedure should take into account the extent of initial injury. Considering these ground requirements, the Patte procedure seems to provide very satisfactory long-term functional outcomes.     

Iterative model reconstruction: Improved image quality of low-tube-voltage prospective ECG-gated coronary CT angiography images at 256-slice CT

Objectives

To investigate the effects of a new model-based type of iterative reconstruction (M-IR) technique, the iterative model reconstruction, on image quality of prospectively gated coronary CT angiography (CTA) acquired at low-tube-voltage.

Methods

Thirty patients (16 men, 14 women; mean age 52.2 ± 13.2 years) underwent coronary CTA at 100-kVp on a 256-slice CT. Paired image sets were created using 3 types of reconstruction, i.e. filtered back projection (FBP), a hybrid type of iterative reconstruction (H-IR), and M-IR. Quantitative parameters including CT-attenuation, image noise, and contrast-to-noise ratio (CNR) were measured. The visual image quality, i.e. graininess, beam-hardening, vessel sharpness, and overall image quality, was scored on a 5-point scale. Lastly, coronary artery segments were evaluated using a 4-point scale to investigate the assessability of each segment.

Results

There was no significant difference in coronary arterial CT attenuation among the 3 reconstruction methods. The mean image noise of FBP, H-IR, and M-IR images was 29.3 ± 9.6, 19.3 ± 6.9, and 12.9 ± 3.3 HU, respectively, there were significant differences for all comparison combinations among the 3 methods (p < 0.01). The CNR of M-IR was significantly better than of FBP and H-IR images (13.5 ± 5.0 [FBP], 20.9 ± 8.9 [H-IR] and 39.3 ± 13.9 [M-IR]; p < 0.01). The visual scores were significantly higher for M-IR than the other images (p < 0.01), and 95.3% of the coronary segments imaged with M-IR were of assessable quality compared with 76.7% of FBP- and 86.9% of H-IR images.

Conclusions

M-IR can provide significantly improved qualitative and quantitative image quality in prospectively gated coronary CTA using a low-tube-voltage.     

Effet d'un entraînement en endurance sur les concentrations de l'IGF-1 plasmatique chez le rat

Introduction

The aim of this study was to determine the effects of endurance training on IGF-1, corticosterone and insulin levels in male sedentary and trained rats.

Facts

IGF-1 concentrations decrease after training (p < 0.05), those of corticosterone increase (p < 0.01) whereas insulin levels remain stable.

Conclusion

A short period of endurance training leads to catabolic state with a decrease in IGF-1 concentrations and increase in corticosterone levels.     

30-15 Intermittent Fitness Test et répétition de sprints

Introduction

The maximal running velocity (V_IFT) reached at the end of the 30-15 Intermittent Fitness Tests (30-15_IFT) is very well related to most physiologic determinants of team-sport performance: explosive power of lower limbs, speed, maximal aerobic power and the ability to recover between exercise bouts. Nevertheless, its relationship with repeated sprint ability (RSA) was unknown.

Synthesis of the facts

Present results in 84 team-sport athletes show that V_IFT is very well related to mean sprint time during a RSA test (p > 0.001).

Conclusion

We conclude that V_IFT is highly representative of most physiologic determinants of performance in team-sports, and could thus been used to monitor athletic performance of team-sport players.     

L’utilisation d’un nouveau système d’enregistrement de fréquence cardiaque battement à battement pour l’analyse traditionnelle de variabilité de fréquence cardiaque

Introduction

The measurement of Heart Rate Variability (HRV) is widely used in the field of sport's sciences. However, the analysis which rises from these measurements requires equipment that conform to those conditions outlined by the Task force of 1996.

Purpose

The purpose of the present study was: 1) to determine the accuracy of a new heart rate “beat to beat” recorder; Polar RS 800 (Polar Electro Oy, Kempele, Finlande); 2) and whether the quality of the tachogram is sufficient for traditional analysis of HRV.

Device and methods

Heart rate was recorded on 15 persons (eight men, seven women) in three different situations, simultaneous with this device and a gold standard (ADInstruments, Castle Hill, Australia, else Novacor, Rueil-Malmaison, France). Signals are synchronized and compared with Bland and Altman method to asses the accuracy. HRV analysis is made and the same comparison method was applied.

Conclusion

This device enables measurements of R-R intervals with a precision of ± 1 to 5 ms, and is sufficient to analyse HRV without bias.     

Delayed-enhancement magnetic resonance imaging at 3.0 T using 0.15 mmol/kg of contrast agent for the assessment of chronic myocardial infarction

Objective

A recent international, multicenter, double-blinded, randomized trial shows delayed-enhanced magnetic resonance imaging (DE-MRI) using contrast doses of ≥0.2 mmol/kg is effective in the detection and assessment of myocardial infarction (MI), and 0.1 mmol/kg is not enough; intermediate doses between 0.1 and 0.2 mmol/kg have not been tested. The aim of this study was to prospectively test the performance of DE-MRI using 0.15 mmol/kg of contrast agent for the detection of MI.

Materials and methods

A total of 31 consecutive patients with chronic MI underwent DE-MRI at 3.0 T using both 0.15 mmol/kg and 0.2 mmol/kg of contrast agent in random order and on separate days. Infarction segment and infarction size were compared on DE-MRI images using a 17-segment model. Bland–Altman analysis was used to analyze correlation and agreement between global infarct sizes.

Results

DE-MRI showed enhanced myocardium in all the 31 patients with chronic MI. There was no significant difference between the 0.15 mmol/kg and 0.2 mmol/kg images in all 31 patients based on the infarction segment (7.87 ± 2.72 vs. 7.81 ± 2.64, respectively; p = 0.33). There was no significant difference between the infarction size obtained from 0.15 mmol/kg acquisition and that from 0.2 mmol/kg acquisition (16.3 ± 7.8% vs. 16.4 ± 7.9%, respectively; p = 0.87). A strong correlation between the infarction size obtained from 0.15 mmol/kg acquisition and that from 0.2 mmol/kg acquisition was indicated through Bland–Altman analysis.

Conclusion

DE-MRI at 3.0 T using 0.15 mmol/kg of contrast agent is effective for the assessment of MI.     

Overtraining syndrome : la piste de la suractivité ?

Introduction

Overtraining is clearly a multifactorial disturbance. We aimed at evaluating the relative importance of overactivity and nutritional imbalances.

Methods

A comparison of 17 footballers with seven subjects with a diagnosis of overtraining evidenced that the two groups differ by energy expenditure resulting from physical activity (1573 ± 378.6 kcal/d from 804.7 ± 184.7 kcal/d) while food intake does not exhibit significant differences.

Conclusion

In this sample of subjects, inadequate food intake is found in both groups, so that overtraining appears rather characterized by a higher level of physical activity. Therefore, a relative energy deficit resulting from overactivity rather than dietary mistakes appears to explain the syndrome in these athletes, who are thus truly “overtrained”.     

Acute epididymitis in ultrasound: Results of a prospective study with baseline and follow-up investigations in 134 patients

Objectives

To perform a comprehensive follow-up analysis of ultrasonographic scrotal features and associated signs in patients with acute epididymitis.

Methods

Between 2007 and 2012, 134 adults (median age 54 years) with acute epididymitis underwent scrotal ultrasonography and palpation at first presentation and after 2 weeks and 3 months.

Results

At first presentation, 61 patients (45.5%) had hydrocele, 63 (47.0%) concomitant orchitis, and 8 (5.9%) epididymal abscess. Epididymitis was predominantly located in 24 cases (17.9%) in the head, 52 cases (38.8%) in the tail, and 58 cases (43.3%) in both. On the affected side, testicular volume was 16.9 ± 6.8 ml and peak systolic velocity of the testicular artery was 23.7 ± 7.5 cm/s, compared to the healthy side with 12.3 ± 4.4 ml and 9.5 ± 3.6 cm/s respectively (P < 0.001). Concomitant orchitis was associated with hydrocele, testicular enlargement and pain (P < 0.01). Orchiectomy due to secondary testicular infarction was necessary in four cases, while in all other patients ultrasound parameters normalized. Only 16/90 patients (17.8%) showed a persistent epididymal swelling after 3 months.

Conclusions

Common ultrasound features include hydrocele, epididymal enlargement, hyperperfusion, and testicular involvement. Under conservative treatment, ultrasound parameters normalize without evidence of testicular atrophy even in patients with epididymal abscess or concomitant orchitis.     

Optimal sequence timing of CT angiography and perfusion CT in patients with stroke

Objective

Standard stroke CT protocols start with non-enhanced CT followed by perfusion-CT (PCT) and end with CTA. We aimed to evaluate the influence of the sequence of PCT and CTA on quantitative perfusion parameters, venous contrast enhancement and examination time to save critical time in the therapeutic window in stroke patients.

Methods and materials

Stroke CT data sets of 85 patients, 47 patients with CTA before PCT (group A) and 38 with CTA after PCT (group B) were retrospectively analyzed by two experienced neuroradiologists. Parameter maps of cerebral blood flow, cerebral blood volume, time to peak and mean transit time and contrast enhancements (arterial and venous) were compared.

Results

Both readers rated contrast of brain-supplying arteries to be equal in both groups (p = 0.55 (intracranial) and p = 0.73 (extracranial)) although the extent of venous superimposition of the ICA was rated higher in group B (p = 0.04). Quantitative perfusion parameters did not significantly differ between the groups (all p > 0.18), while the extent of venous superimposition of the ICA was rated higher in group B (p = 0.04). The time to complete the diagnostic CT examination was significantly shorter for group A (p < 0.01).

Conclusion

Performing CTA directly after NECT has no significant effect on PCT parameters and avoids venous preloading in CTA, while examination times were significantly shorter.