Damage and the repeated bout effect of arm,leg, and trunk muscles induced by eccentric resistance exercises

This study compared nine resistance eccentric exercises targeting arm, leg, and trunk muscles in one session for changes in maximal voluntary isometric contraction strength (MVC), delayed onset muscle soreness (DOMS), plasma creatine kinase (CK) activity, and myoglobin (Mb) concentration after the first and second bouts. Fifteen sedentary men (20‐25 years) performed 5 sets of 10 eccentric contractions with 80% of MVC load for the elbow flexors (EF), elbow extensors (EE), pectoralis, knee extensors (KE), knee flexors (KF), plantar flexors (PF), latissimus, abdominis, and erector spinae (ES) in a randomized order and repeated the same exercises 2 weeks later. MVC decreased at 1 (16%‐57%) to 4 (13%‐49%) days, DOMS developed (peak: 43‐70 mm), and CK activity (peak: 23 238‐207 304 IU/L) and Mb concentration showed large increases after the first bout. The magnitude of decrease in MVC was greater (P < 0.05) for EF, EE, and PEC than others and for KF than KE, PF, and ES. DOMS was greater (P < 0.05) for EF, EE, and ES than others. Changes in all measures were smaller (P < 0.05) after the second than the first bout, and the magnitude of the repeated bout effect was similar among the muscles. Plasma CK activity and Mb concentration did not increase significantly after the second exercise bout. It was concluded that muscle damage was greater for arm than leg muscles, and muscle proteins in the blood increased to a critical level after unaccustomed whole‐body resistance exercises, but the magnitude of damage was largely attenuated for all muscles similarly after the second bout.     

Identification of the Actinobacillus pleuropneumoniae leucine-responsive regulatory protein and its involvement in the regulation of in vivo-induced genes

Actinobacillus pleuropneumoniae is a gram-negative bacterial pathogen that causes a severe hemorrhagic pneumonia in swine. We have previously shown that the limitation of branched-chain amino acids (BCAAs) is a cue that induces the expression of a subset of A. pleuropneumoniae genes identified as specifically induced during infection of the natural host animal by using an in vivo expression technology screen. Leucine-responsive regulatory protein (Lrp) is a global regulator and has been shown in Escherichia coli to regulate many genes, including genes involved in BCAA biosynthesis. We hypothesized that A. pleuropneumoniae contains a regulator similar to Lrp and that this protein is involved in the regulation of a subset of genes important during infection and recently shown to have increased expression in the absence of BCAAs. We report the identification of an A. pleuropneumoniae serotype 1 gene encoding a protein with similarity to amino acid sequence and functional domains of other reported Lrp proteins. We further show that purified A. pleuropneumoniae His₆-Lrp binds in vitro to the A. pleuropneumoniae promoter regions for ilvI, antisense cps1AB, lrp, and nqr. A genetically defined A. pleuropneumoniae lrp mutant was constructed using an allelic replacement and sucrose counterselection method. Analysis of expression from the ilvI and antisense cps1AB promoters in wild-type, lrp mutant, and complemented lrp mutant strains indicated that Lrp is required for induction of expression of ilvI under BCAA limitation.     

Inequity in cardiovascular care in the English National Health Service (NHS): a scoping review of the literature

There is a general understanding that socioeconomically disadvantaged people are also disadvantaged with respect to their access to NHS care. Insofar as considerable NHS funding has been targeted at deprived areas, it is important to better understand whether and why socioeconomic variations in access and utilisation exist. Exploring this question with reference to cardiovascular care, our aims were to synthesise and evaluate evidence relating to access to and/or use of English NHS services around (i) different points on the care pathway (i.e. presentation, primary management and specialist management) and (ii) different dimensions of inequality (socioeconomic, age‐ and gender‐related, ethnic or geographical). Restricting our search period from 2004 to 2016, we were concerned to examine whether, compared to earlier research, there has been a change in the focus of research examining inequalities in cardiac care and whether the pro‐rich bias reported in the late 1990s and early 2000s still applies today. We conducted a scoping study drawing on Arksey & O'Malley's framework. A total of 174 studies were included in the review and appraised for methodological quality. Although, in the past decade, there has been a shift in research focus away from gender and age inequalities in access/use and towards socioeconomic status and ethnicity, evidence that deprived people are less likely to access and use cardiovascular care is very contradictory. Patterns of use appear to vary by ethnicity; South Asian populations enjoying higher access, black populations lower. By contrast, female gender and older age are consistently associated with inequity in cardiovascular care. The degree of geographical variation in access/use is also striking. Finally, evidence of inequality increases with stage on the care pathway, which may indicate that barriers to access arise from the way in which health professionals are adjudicating health needs rather than a failure to seek help in the first place.     

Referrals

It is beholden to the general dental practitioner to refer patients for whom (s)he feels that treatment could be carried out to a higher standard, or more efficiently and effectively, by another dentist. In addition, patients are entitled to a referral for a second opinion at any time. This paper discusses the responsibilities of the referring dentist and those of the dentist to whom the patient has been referred. CLINICAL RELEVANCE: The experience of clinicians varies, so referral to another dentist may be appropriate if the patient's dental practitioner considers that treatment might be more effectively carried out by another dentist.     

A comparison of prosthetic ear models created from data captured by computerized tomography, magnetic resonance imaging, and laser scanning

PURPOSE: To compare the dimensional measurements and surface topography of stereolithographic models generated from computerized tomography (CT), magnetic resonance imaging (MRI), and laser scanning (LS) data with the same subjects' natural ears and ear casts. MATERIALS AND METHODS: Stereolithographic models were manufactured from images of the subjects' ears and ear casts recorded by CT, MRI, and LS, and dimensional measurements were compared. In the second part of the study, all stereolithographic models were CT scanned and reconstructed in an STL file format. A comparison of the surface topography of the CT, MRI, and LS model ears was made. RESULTS: Intraclass correlation coefficients indicated that dimensions could be reliably measured on the CT, MRI, and LS stereolithographic models. A 2-way analysis of variance revealed no statistical differences between the various sources of data (P = .991). The smallest differences of surface topography were observed on the MRI/CT superimpositions. CONCLUSION: The dimensional measurements on the stereolithographic models were similar to those from the original source. Only small differences were apparent between the surface topography of the CT, MRI, and LS models. MRI may be particularly appropriate to fabricate a prosthesis because it involves no radiation for the patient and internal form can be reproduced. The use of this technique in clinical practice requires further study.