Stroke Volume Does not Plateau in Female Endurance Athletes.

Int J Sports Med. 2012 May 11;

Authors: Wang E, Solli GS, Nyberg SK, Hoff J, Helgerud J

Abstract
It has been a long-lasting debate whether the heart's stroke volume (SV) increases at high aerobic intensities or plateau. Further, sex and level of aerobic power are shown to influence the response. The purpose of this study was to investigate the SV at increasing intensities in elite female athletes and moderately trained females. 13 elite athletes and 11 moderately trained controls with maximal oxygen consumption (VO2max) of 67.1±6.1 and 49.5±2.3 mL ? min - 1 ? kg - 1, respectively, were recruited. SV was measured at rest, and running on a treadmill at 40%, 60%, 80% and 100% of VO2max using the single breath acetylene uptake (SB) technique. Both groups showed a significant (p<0.05) increase in SV from 40% of VO2max to VO2max, with increases from 105.3±19.0 to 129.1±16.3 mL? beat-1 for the elite females and from 68.7±21.7 to 82.7±14.0 mL ? beat - 1 for the moderately trained. No differences were observed between groups in these increases, but the elite athletes displayed a larger (p<0.05) SV at all intensities. It is concluded that the SV increases at high aerobic intensities both in elite athlete females and moderately trained females.

PMID: 22581683 [PubMed - as supplied by publisher]

Is modified constraint-induced movement therapy more effective than bimanual training in improving upper arm motor function in the subacute phase post stroke? A randomized controlled trial.

Clin Rehabil. 2012 May 4;

Authors: Brunner IC, Skouen JS, Strand LI

Abstract
Objective: To compare the effect of modified constraint-induced movement therapy (mCIMT) to bimanual task-related training for patients in the subacute phase post stroke.Design: A single-blinded randomized controlled trial.Settings: Inpatient and outpatient rehabilitation clinics and the patient's home.Subjects: Thirty patients in the subacute phase post stroke (2-16 weeks) were randomized to modified constraint-induced movement therapy with an emphasis on unimanual tasks, or bimanual task-related training, emphasizing bimanual tasks. All trained with a therapist 4 hours a week for four weeks, followed by a 2-3 hours daily self-training program. Patients in the modified constraint-induced movement therapy group were supposed to wear a restraining mitt on the unaffected hand for 4 hours a day for four weeks.Main measures: Blinded assessments at pre and post treatment and after three months with Action Research Arm Test as a primary outcome measure, Nine-Hole Peg Test and Motor Activity Log.Results: Power calculations suggested an inclusion of 60 patients, but due to recruitment difficulties the trial was stopped after an interim analysis at 30 patients. There was no difference in change (P > 0.05) between the groups on any of the measures, neither at post treatment nor at follow-up assessments. From pre- intervention to follow-up assessment the modified constraint-induced movement therapy group obtained a mean change score of 17.77 (14.66) on Action Research Arm Test, the bimanual group 15.47 (13.59).Conclusion: Bimanual training was as effective as modified constraint-induced movement therapy in improving arm motor function. Wearing a mitt seems unnecessary for most patients in the subacute phase post stroke when focused affected arm training is provided.

PMID: 22561098 [PubMed - as supplied by publisher]

Carotid artery plaque progression and cognitive decline: the Tromsø Study 1994-2008.

Eur J Neurol. 2012 Apr 27;

Authors: Arntzen KA, Schirmer H, Johnsen SH, Wilsgaard T, Mathiesen EB

Abstract
BACKGROUND: Carotid atherosclerosis is a risk factor for stroke and cognitive decline, but knowledge on how progression of carotid atherosclerosis affects cognitive function in stroke-free individuals is scarce. METHODS: In the population-based Tromsø study, we calculated the change in ultrasound-assessed carotid plaque number and total plaque area from baseline (survey 4) to follow-up 7 years later (survey 5) in 4274 middle-aged stroke-free subjects. Cognitive function was assessed at follow-up by the verbal memory test, the digit-symbol coding test, and the tapping test and repeated after an additional 6 years in a subgroup of 2042 subjects (survey 6). Associations between the average of survey 4 and survey 5 plaque scores and the progression of plaque scores and cognitive test scores were assessed in regression analyses adjusted for baseline age, sex, education, depression, and cardiovascular risk factors. RESULTS: Progression of total plaque area was associated with lower scores in the digit-symbol coding test (multivariable adjusted standardized ?, -0.03; 95% CI, -0.05 to -0.00; P = 0.04) and the tapping test (?, -0.03; 95% CI, -0.06 to -0.00; P = 0.03). Similar results were seen for progression of plaque number. The average plaque scores were associated with lower scores in all cognitive tests (P-values ? 0.01). No association was found between plaque scores and cognitive decline. CONCLUSIONS: The average plaque scores were associated with lower scores in all cognitive tests. Progression of plaque scores was associated with lower scores in the digit-symbol coding test and the tapping test, but not with the verbal memory test or with cognitive decline.

PMID: 22537454 [PubMed - as supplied by publisher]

The role of structural information in the discovery of direct thrombin and factor Xa inhibitors.

Trends Pharmacol Sci. 2012 Apr 11;

Authors: Nar H

Abstract
The quest for novel medications to treat thromboembolic disorders such as venous thrombosis, pulmonary embolism and stroke received a boost when the 3D structures of two major players in the blood coagulation cascade were determined in 1989 and 1993. Structure-guided design of inhibitors of thrombin (factor IIa, fIIa) and factor Xa (fXa) eventually led to the discovery of potent, selective, efficacious, orally active and safe compounds that proved successful in clinical studies. In 2008, the direct thrombin inhibitor dabigatran etexilate developed by Boehringer Ingelheim became the first novel antithrombotic molecular entity to enter the market in 50 years. Additional compounds targeting factor Xa were subsequently granted marketing authorization or are in late-stage clinical studies. In this review, I use selected case studies to describe the discovery of novel fIIa and fXa inhibitors, with a particular emphasis on the pre-eminent role that structural information played in this process.

PMID: 22503439 [PubMed - as supplied by publisher]