Joseph P. Garry

No difference in the skeletal muscle angiogenic response to aerobic exercise training between young and aged men

Ischaemia‐induced skeletal muscle angiogenesis is impaired in aged compared with young mice. In humans, vascular endothelial growth factor (VEGF) mRNA and protein following an acute exercise bout are lower in aged compared with young untrained men. We hypothesized that exercise‐induced skeletal muscle angiogenesis would be attenuated in aged compared with young men. In eight aged (mean age: 64 years) and six young (mean age: 25 years) sedentary men, muscle biopsies were obtained from the vastus lateralis prior to (Pre), after 1 week and after 8 weeks of an aerobic exercise training program for the measurement of capillarization and VEGF mRNA. Dialysate VEGF protein collected from the muscle interstitial space was measured at rest and during submaximal exercise at Pre, 1 week and 8 weeks. Exercise training increased capillary contacts (CC) and capillary‐to‐fibre perimeter exchange index (CFPE) of type I and IIA fibres similarly in young and aged. The CC of type IIA and IIB fibres was lower in aged compared with young independent of training status. Exercise‐induced interstitial VEGF protein was lower in aged compared with young independent of training status. In untrained, greater exercise‐induced interstitial VEGF protein during exercise was associated with greater type I, IIA and IIB CC. Exercise training increased VEGF mRNA similarly in young and aged. These results demonstrate that the angiogenic response to aerobic exercise training is not altered during the ageing process in humans. In addition, muscular activity‐associated increases in interstitial VEGF protein may play an important role in the maintenance of skeletal muscle capillarization across the life span.

No difference in the skeletal muscle angiogenic response

Ischaemia‐induced skeletal muscle angiogenesis is impaired in aged compared with young mice. In humans, vascular endothelial growth factor (VEGF) mRNA and protein following an acute exercise bout are lower in aged compared with young untrained men. We hypothesized that exercise‐induced skeletal muscle angiogenesis would be attenuated in aged compared with young men. In eight aged (mean age: 64 years) and six young (mean age: 25 years) sedentary men, muscle biopsies were obtained from the vastus lateralis prior to (Pre), after 1 week and after 8 weeks of an aerobic exercise training program for the measurement of capillarization and VEGF mRNA. Dialysate VEGF protein collected from the muscle interstitial space was measured at rest and during submaximal exercise at Pre, 1 week and 8 weeks. Exercise training increased capillary contacts (CC) and capillary‐to‐fibre perimeter exchange index (CFPE) of type I and IIA fibres similarly in young and aged. The CC of type IIA and IIB fibres was lower in aged compared with young independent of training status. Exercise‐induced interstitial VEGF protein was lower in aged compared with young independent of training status. In untrained, greater exercise‐induced interstitial VEGF protein during exercise was associated with greater type I, IIA and IIB CC. Exercise training increased VEGF mRNA similarly in young and aged. These results demonstrate that the angiogenic response to aerobic exercise training is not altered during the ageing process in humans. In addition, muscular activity‐associated increases in interstitial VEGF protein may play an important role in the maintenance of skeletal muscle capillarization across the life span.

Team sports participation and risk-taking behaviors among a biracial middle school population

ObjectiveThere have been no large studies of middle school students to assess the association between team sports participation and risk-taking behaviors, despite evidence in high school and collegiate athletes. Our study evaluated whether team sports participation is associated with specific risk-taking behaviors among a biracial middle school population. DesignA cross-sectional survey using the Youth Risk Behavior Survey: Middle School Questionnaire. SettingTwenty-two public middle schools in three rural counties in eastern North Carolina. Participants4,346 middle school students in grades 6–8 completed the survey. All students participated if present in school the day the survey was administered. 648 students fulfilled specific exclusion criteria. Main Outcome MeasureMultiple logistic regression examined team sports participation as a predictor of 17 risk-taking behaviors while controlling for gender, race, and grade. ResultsOf the 3,698 students, 49% were male, 49.5% Caucasian, and 52.5% were involved in team sports. Sports participants, as compared with non–sports participants, reported significantly higher frequencies for carrying a gun (p < 0.001), carrying a weapon (p < 0.001), being in a physical fight (p < 0.001), current use of alcohol (p = 0.001), and experimentation with cigarettes and chewing tobacco (p < 0.001). In the multiple logistic regression analysis team sports participation was associated with the following behaviors: carrying a weapon (odds ratio 1.25, 95% confidence intervals 1.0731–1.4540), physical fight (1.15, 1.0017–1.3253), current alcohol use (1.24, 1.0560–1.4611), and experimentation with cigarettes (1.26, 1.0991–1.4502), cocaine (1.37, 1.0300–1.8139) and inhalants (1.20, 1.0141–1.4130). ConclusionsAmong a biracial middle school population, sports participants were more likely to demonstrate certain risk-taking behaviors when compared with non–sports participants. Further research is necessary to understand the relationships between risk-taking behaviors and team sports participation.

Aging and the Skeletal Muscle Angiogenic Response to Exercise in Women

Whether aging lowers skeletal muscle basal capillarization and angiogenesis remains controversial. To investigate the effects of aging on skeletal muscle capillarization, eight young (YW) and eight aged (AW) women completed 8 weeks of exercise training. The response and relationships of muscle capillarization, interstitial vascular endothelial growth factor (VEGF), and microvascular blood flow to aerobic exercise training were investigated. Vastus lateralis biopsies were obtained before and after exercise training for the measurement of capillarization. Muscle interstitial VEGF protein and microvascular blood flow were measured at rest and during submaximal exercise at PRE, 1-WK, and 8-WKS by microdialysis. Exercise training increased (20%-25%) capillary contacts of type I, IIA, and IIB fibers in YW and AW. Interstitial VEGF protein was higher in AW than YW at rest and was higher in YW than AW during exercise independent of training status. Differences in muscle capillarization were not explained by secreted VEGF nor were differences in VEGF explained by microvascular blood flow. These results confirm that aging (57-76 years age range) does not impair the muscle angiogenic response to exercise training, although sex differences may exist in similarly trained women and men.

In Vivo Nitric Oxide Suppression of Lipolysis in Subcutaneous Abdominal Adipose Tissue Is Greater in Obese Than Lean Women

Mounting evidence suggests there is a reduced mobilization of stored fat in obese compared to lean women. It has been suggested that this decreased lipid mobilization may lead to, or perpetuate, the obese state; however, there may be a beneficial effect of reduced lipolysis, either by allowing for a sink of excess fatty acids, or by limiting a potentially harmful rise in interstitial and circulating fatty acid concentration. Nitric oxide (NO) may be responsible for a portion of the reduced in vivo rates of lipolysis in obese women because NO reduces adipose tissue lipolysis and adipose tissue nitric oxide synthase (NOS) mRNA is higher in obese than lean individuals. The purpose of this study was to determine if the inhibition of NOS by l‐Ng‐monomethyl‐l‐arginine (l‐NMMA) in the absence and presence of lipolytic stimulation would result in a larger increase in lipolytic rate in obese (OB) than lean (LN) women. Microdialysis probes were inserted into the subcutaneous abdominal adipose tissue of seven obese and six lean women to monitor lipolysis. Dialysate glycerol concentration increased in response to l‐NMMA in OB (basal 125 ± 26 µmol/l; l‐NMMA 225 ± 35 µmol/l) to a greater extent than in LN (basal 70 ± 18 µmol/l; l‐NMMA 84 ± 20 µmol/l) women (P < 0.05). Dialysate glycerol increased to a similar extent in OB and LN in response to adrenergic stimulation by isoprenaline or norepinephrine in the presence of l‐NMMA. The differential glycerol responses to l‐NMMA between obese and lean could not be explained by differential blood flow responses. It can be concluded that NO suppresses basal lipolysis in obese women to a greater extent than in lean women.

Diabetic groups as defined by ADA and NDDG criteria have a similar aerobic capacity, blood pressure and body composition

Aims/hypothesis. In 1997 the American Diabetes Association (ADA) published new categories for diabetes based on fasting plasma glucose that classified diabetes as a plasma glucose of 7.0 mmol/l, or more, rather than one of 7.8 mmol/l or more, as published previously by the National Diabetes Data Group (NDDG) in 1979. We compared the cardiovascular disease risk factors of subjects classified as having Type II (non-insulin-dependent) diabetes mellitus under the NDDG and ADA criteria.¶Methods. We examined a database of approximately 3700 men (40.4 ± 11.5 years old) and distributed them into four categories: normal fasting plasma glucose (NFG) of less than 6.1 mmol/l, impaired (IFG) 6.1 to 7.0 mmol/l, ADA diabetic 7.0 to 7.8 mmol/l and NDDG diabetic of 7.8 mmol/l or more.¶Results. Fasting glucose was 5.2 ± 0.5, 6.4 ± 0.2, 7.3 ± 0.2 and 11.2 ± 2.9 mmol/l for the subjects of the NFG, IFG, ADA and NDDG groups, respectively. Estimated treadmill VO2max was 41.4 ± 8.0, 36.0 ± 7.8, 32.2 ± 7.6, 30.6 ± 7.0 ml · kg–1· min–1 in the NFG, IFG, ADA, and NDDG groups, respectively (NFG and IFG > ADA and NDDG: p < 0.05). The ADA and NDDG groups were also similar for resting and exercise blood pressure and body composition. Triglycerides and total: HDL cholesterol ratios were higher and LDL cholesterol concentration was lower, in the NDDG group than in all other groups (p < 0.05). Total and LDL cholesterol in the ADA and NDDG groups were similar.¶Conclusion/interpretation. The similarities in the aerobic capacities, blood pressure and body composition of the ADA and NDDG groups indicate that the decision to lower the cut-off from 7.8 mmol/l to 7.0 mmol/l blood glucose for the clinical classification of diabetes was appropriate. The ADA and NDDG groups, however, might not have identical risks for cardiovascular disease because of differences between total:HDL cholesterol ratios, circulating HDL cholesterol and triglyceride concentrations. [Diabetologia (2001) 44: 26–32]

Geriatric Anorexia Nervosa

Eating disorders are not commonly diagnosed in individuals aged >50 years, yet they are associated with significant psychiatric comorbidities and overall morbidity. Anorexia nervosa is the most common eating disorder among this age group, and women are affected most often. We present the fatal case of a 66-year old woman with severe malnutrition and newly diagnosed anorexia nervosa. Inpatient refeeding was unsuccessful, and she succumbed to multisystem organ failure. The timely recognition of eating disorders among older people is important for family physicians who care for patients across the life spectrum.

Is osteoarthritis a deadly disease

Submit Manuscript | http://medcraveonline.com earlier mortality risk [2]. Osteoarthritis, while not classified as an inflammatory arthritis, does have intermittent joint inflammation as a characteristic of the disease process [3]. In line with the evidence of early mortality risk and rheumatoid arthritis, OA of the hip or knee has also been convincingly associated with early mortality risk in diverse populations studied.

A rare case of thoracic spinal stenosis in a white male

Introduction Thoracic myelopathy due to thoracic spinal stenosis is a rare condition, which is most commonly because of the ossification of the ligamentum flavum (OLF) as first described in 1960 (1). Thoracic spinal stenosis due to OLF has been noted to occur predominantly in older East Asian populations and is rare among whites (2,3). The mean age at presentation is 50 to 60 years, and the duration of symptoms before diagnosis has been shown to range from 1 to 3 years (4,5). Symptoms at presentation are often vague, but generally include chest, abdominal, or lower-extremity motor or sensory changes. Symptoms can include leg numbness, gait disorder, foot weakness, bowel or bladder involvement, zonesthesia of the abdomen or chest, heaviness in the lower extremity, or back pain (6Y8). Although far less common than either cervical or lumbar spinal stenosis, thoracic spinal stenosis deserves consideration in the differential diagnosis of patients presenting with vague lower-extremity motor or sensory symptoms. The inconsistent presentation and spectrum of symptoms can contribute to a delay in diagnosis where initiation of treatment is time sensitive. The case presented illustrates the rare presentation of thoracic spinal stenosis due to OLF in a younger white male.

EXERCISE AND PREGNANCY OUTCOME AMONG URBAN, LOW INCOME, BLACK WOMEN

Few studies have focused on the association between maternal exercise and outcomes of pregnancy among low-income, Black women. The analysis reported here examines the associations between exercise before and during pregnancy and pregnancy outcomes of preterm birth and low birth weight among a sample of urban, low-income, Black women. Women (N=922) were enrolled in this prospective cohort study during their first prenatal visit at five hospital-based prenatal clinics located in Baltimore City, Maryland, from 1993 to 1995. A questionnaire was used to ask women about their participation in strenuous and non-strenuous exercise before and during pregnancy. Nearly two thirds of the women reported participating in exercise during pregnancy; most women participated in non-strenuous exercise (56%). The risks of both low birth weight (12.2%) and preterm birth (13.7%) were not significantly different whether women reported exercising or not, either before or during pregnancy. For women who were considered high risk because of chronic diseases or previous poor pregnancy outcome, stratified analysis indicated no significant difference in preterm birth or low birth weight between those who exercised and those who did not. Our analysis failed to identify any association between exercise and pregnancy outcomes among low-income, urban, Black women.