Evaluation of leg-to-leg BIA in assessing body composition of high-school wrestlers

PURPOSE: To evaluate the accuracy of leg-to-leg bioelectrical impedance analysis (BIA) in assessing fat-free mass (FFM) using the TBF-300WA in comparison with hydrostatic weighing (HW) and skinfolds (SK) in high-school (HS) wrestlers in a hydrated state. METHODS: Body composition was determined by BIA, HW, and three-site SK in 129 HS wrestlers (mean +/- SD, age: 15.5 +/- 1.3, height 1.70 +/- 0.08 m, body mass 65.6 +/- 13.1 kg). For all methods, body density (Db) was converted to percent body fat (%BF) using the Brozek equation. Hydration state was quantified by evaluating urine specific gravity. RESULTS: There were no significant differences for estimated FFM between BIA (56.9 +/- 8.4 kg) and HW (56.2 +/- 9.9 kg) or between SK (56.1 +/- 8.9 kg) and HW. The standard errors of estimate for FFM with HW as the reference method were 3.64 kg for BIA and 1.97 kg for SK. Significant correlations were found for FFM between HW and BIA (r = 0.93, P < 0.001), and between HW and SK (r = 0.98, P < 0.001). The FFM difference between BIA and HW was significantly correlated with the FFM average of the two methods (r = -0.39, P < 0.001). The FFM difference between SK and HW was also significantly correlated with the FFM average (r = -0.44, P < 0.001). CONCLUSIONS: This study demonstrates that SK should be considered as the preferred field method of estimating the FFM of HS wrestlers because of its greater individual precision than the leg-to-leg BIA method. Although the BIA is an attractive assessment tool and easy to use, it should be recommended as an alternative to the SK method only when trained skinfold technicians are not available.     

An unusual case of electromyographic recorded myokymic potentials: a case report

Abnormal spontaneous potentials, specifically myokymia, can occur from various causes. We present the case of a 64-year-old woman with a 12-month history of left leg weakness and difficulty descending stairs. The patients' medical history was significant for breast carcinoma (no node involvement), hypercholesterolemia, and vitamin B(12) deficiency. She previously had a modified radical mastectomy and received chemotherapy (5-flurouracil, methotrexate, Cytoxan [cyclophosphamide]), but received no radiation. She took simvastatin for hypercholesterolemia and received vitamin B(12) injections for her B(12) deficiency. She initially noticed her symptoms when she began taking simvastatin, and they were exacerbated when her dose was increased from 10 to 20mg/d. Electrodiagnostic studies were performed twice at a 6-month interval. Nerve conduction studies were normal, but the initial needle electromyography showed significant myokymic discharges in bilateral iliopsoas, adductor magnus, and left deltoid muscles. The second electromyograph had similar findings, except for the absence of myokymic discharges in the left deltoid muscle. The possible origins of these myokymic discharges are discussed.     

Glutathione-S-transferase-mediated methylthio displacement and turnover in the metabolism of pentachlorothioanisole by rats

1. The metabolism of pentachlorothioanisole to bis-(methylthio)tetrachlorobenzene was shown to involve turnover of about 50% of the original methylthio group. 2. Metabolites of the displaced methylthio group were methanesulphinic acid and sulphate in the urine, carbon dioxide in the expired air, and unidentified sulphur-containing compounds in the bile.     

Pharmacokinetics and pharmacodynamics of febuxostat, a new non-purine selective inhibitor of xanthine oxidase in subjects with renal impairment

To assess the safety, pharmacokinetics, and pharmacodynamics of febuxostat in subjects with normal renal function or renal impairment, febuxostat (80 mg/d) was orally administered for 7 days to subjects with normal renal function (n = 11, CLcr >80 mL/min/1.73 m) or to subjects with mild (n = 6, CLcr 50-80 mL/min/1.73 m), moderate (n = 7, CLcr 30-49 mL/min/1.73 m), or severe renal impairment (n = 7, CLcr 10-29 mL/min/1.73 m). The pharmacokinetics of febuxostat and its active quantifiable metabolites 67M-1, 67M-2, and 67M-4 as well as the pharmacodynamics of uric acid, xanthine, and hypoxanthine were determined in plasma (or serum) and urine. Febuxostat was safe and well tolerated. Regression analyses indicated that febuxostat tmax and Cmax,u values were not affected by CLcr. However, for AUC24,u, CLu/F, and t1/2z, regression analyses indicated a statistically significant relationship with CLcr. With the exception of 67M-1 Cmax, regression analyses for 67M-2 and 67M-4 Cmax, and for AUC24 for all 3 metabolites indicated a statistically significant linear relationship with CLcr. Irrespective of renal function group, the mean serum uric acid concentrations decreased by 55% to 64% by day 7. Although plasma exposure to febuxostat and its metabolites was generally higher in subjects with increasing degrees of renal impairment, the percentages of decrease in serum uric acid were comparable regardless of the renal function group. A once-daily 80-mg dose of febuxostat appears to be safe and well tolerated in different renal function groups and does not appear to require any dose adjustment based on differences in renal function.     

Traumatic injuries of the distal radioulnar joint

Traumatic injuries of the distal radioulnar joint (DRUJ) may give rise to complex wrist pathologies. Substantial ongoing disability can arise should these injuries go unrecognized resulting in sub-optimal treatment and lack of appropriate rehabilitation. Injuries of the DRUJ may occur in isolation but more commonly are found with a fracture of the radius. These challenging DRUJ injuries may be simple or complex (irreducible or severe instability), acute or chronic. An adequate knowledge of the stabilizers of the DRUJ is essential in understanding treatment options. Traumatic instability of the DRUJ is reviewed and the anatomy and stabilizing factors are discussed. An algorithm to guide selection of treatment options in complex cases is presented.     

Swimming Upstream: Breastfeeding Care in a Nonbreastfeedtng Culture

Women once gave birth and began breastfeeding within the cultural context of a traditional system of care; now they begin breastfeeding in a hospital. Historically, hospital care was arranged to fit artificial feeding. Little was known about the science of breastfeeding until recently. Basing our breastfeeding care on the cultural norm of bottle feeding has led to the development of many unfavorable attitudes and practices. Given an opportunity to learn how breastfeeding works and to improve our breastfeeding care skills, hospital nurses can play an important part in current efforts to make breastfeeding the community norm.     

Pharmacokinetics of sertindole and dehydrosertindole in volunteers with normal or impaired renal function

Objective: To study the effect of renal impairment on the pharmacokinetics of sertindole. Methods: A single 4 mg oral dose of sertindole was given to normal subjects ( n = 6) and subjects with various degrees of impaired renal function ( n = 18) classified into mild, moderate, and severe/hemodialysis based on their creatinine clearance). The relationships between the pharmacokinetic parameters and the degree of renal impairment were investigated using regression analysis with creatinine clearance as an explanatory variable along with body weight. Subjects were also genotyped for CYP2D6-A or 2D6-B mutations. Results: The mean CL/f and t_1/2 values of sertindole ranged from 14 to 31 l · h⁻¹ and from 73 to 93 h, respectively, and were not significantly related to creatinine clearances. There was no indication of any influence of creatinine clearance on the fraction of sertindole (0.994–0.995) binding to plasma proteins. The total fraction of the sertindole dose removed by dialysis was less than 0.1%. Subjects with B/B genotype ( n = 2) for CYP2D6 were associated with a distinctly lower clearance of sertindole (6.3 vs 25.3 l · h⁻¹) than subjects with wt/wt genotype for CYP2D6. Conclusions: Since the pharmacokinetics of sertindole are unchanged by renal impairment, dosage adjustment does not appear to be necessary for subjects with various degrees of renal insufficiency or subjects with renal failure requiring hemodialysis. Received: 19 August 1996 / Accepted in revised form: 9 January 1997     

A double perfusion system with two-channel recording for the simultaneous study of the contractile responses of the circular and longitudinal smooth muscle layers of the rat vas deferens

A device for double perfusion of the vas deferens externally and through the lumen is described in detail. The perfusion system allows the simultaneous recording of drug-induced or spontaneous contractions of the circular and longitudinal smooth muscle layers of the organ. Isometric contractions of the longitudinal (external) layer are recorded through a tension transducer. The contractions of the circular (internal) smooth muscle layer are recorded as changes of the pressure of internal perfusion. Therefore, four different effects can be recorded for a given concentration of agonist by combining the variables related to the route of perfusion (external or internal) and type of muscle (longitudinal or circular). In addition, antagonism or synergism can be studied by simultaneously perfusing a second drug. Results can be expressed as single records or as mean concentration-response curves from which drug-receptor parameters can be directly or indirectly obtained. The importance of employing this method for the analysis of some less usual problems related to the mechanism of drug action is discussed.