Effects of 12 Weeks of Essential Amino Acids (EAA)-Based Multi-Ingredient Nutritional Supplementation on Muscle Mass, Muscle Strength, Muscle Power and Fatigue in Healthy Elderly Subjects: A Randomized Controlled Double-Blind Study

Objective: To counteract muscle mass, muscle strength and power loss during aging, and to study age-related change of neuromuscular manifestation of fatigue in relation to nutritional supplementation. Design: randomized controlled double-blind study. Setting: Twice-daily consumption for 12 weeks of an Essential Amino Acids (EAA)-based multi-ingredient nutritional supplement containing EAA, creatine, vitamin D and Muscle Restore Complex®. Participants: 38 healthy elderly subjects (8 male, 30 female; age: 68.91±4.60 years; body weight: 69.40±15.58 kg; height: 1.60±0.09 m) were randomized and allocated in supplement (SUPP) or placebo (PLA) group. Mean Measurements: Vitamin D blood level; Appendicular Lean Mass (ALM); Visceral Adipose Tissue (VAT); Maximal Voluntary Contraction (MVC) and Peak Power (PP); myoelectric descriptors of fatigue: Fractal Dimension and Conduction Velocity initial values (FD iv, CV iv), their rates of change (FD slopes, CV slopes) and the Time to perform the Task (TtT). Mean Results: Significant changes were found in SUPP compared to baseline: Vitamin D (+8.73 ng/ml; p<0.001); ALM (+0.34 kg; p<0.001); VAT (-76.25 g; p<0.001); MVC (+0.52 kg; p<0.001); PP (+4.82 W; p<0.001). Between group analysis (SUPP Vs. PLA) showed improvements: vitamin D blood levels (+11,72 ng/ml; p<0.001); Legs FFM (+443.7 g; p<0.05); ALM (+0.53 kg; p<0.05); MVC (+1.38 kg; p<0.05); PP (+9.87 W; p<0.05). No statistical changes were found for FD iv, CV iv, FD and CV slopes and TtT, either compared to baseline or between groups. Significant correlations between mean differences in SUPP group were also found. Conclusion: The study demonstrates that in healthy elderly subjects an EAA-based multi-ingredient nutritional supplementation of 12 weeks is not effective to change myoelectric manifestation of fatigue and TtT failure but can positively affect muscle mass, muscle strength, muscle power and VAT, counterbalancing more than one year of age-related loss of muscle mass and strength

Muscle Fiber Conduction Velocity Correlates With the Age at Onset in Mild FSHD Cases

A majority of patients with facioscapulohumeral muscular dystrophy (FSHD) report severe fatigue. The aim of this study was to explore whether fatigability during a performance task is related to the main clinical features of the disease in mildly affected patients. A total of 19 individuals with a molecular genetic-based diagnosis of FSHD (median D4Z4 deletion length of 27 kb) performed two isometric flexions of the dominant biceps brachii at 20% of their maximal voluntary contraction (MVC) for 2 min, and then at 60% MVC until exhaustion. Fatigability indices (average rectified value, mean frequency, conduction velocity, and fractal dimension) were extracted from the surface electromyogram (sEMG) signal, and their correlations with age, age at onset, disease duration, D4Z4 contraction length, perceived fatigability, and clinical disability score were analyzed. The conduction velocity during the low level contraction showed a significant negative correlation with the age at onset (p &lt; 0.05). This finding suggest the assessment of conduction velocity at low isometric contraction intensities, as a potential useful tool to highlight differences in muscle involvement in FSHD patients

Treatment continuation and satisfaction in women using combined oral contraception with nomegestrol acetate and oestradiol: a multicentre, prospective cohort study (BOLERO)

Objective: The aim of the study was to examine treatment continuation and satisfaction over 1 year among women receiving nomegestrol acetate (NOMAC)/oestradiol (E2) combined oral contraception (COC) in real-world clinical practice. Methods: The 17 beta-Estradiol and Nomegestrol Acetate (BOLERO) Study is an observational, non-interventional, prospective, multicentre cohort study of premenopausal women (aged 18-50 years) who received prescription NOMAC/E2 (2.5 mg/1.5 mg) for contraception during routine clinical practice. Assessments were carried out at enrolment and at 3, 6 and 12 months. Probability of treatment continuation through 12 months (primary outcome) was examined using Kaplan-Meier survival analysis. Secondary outcomes included treatment satisfaction, menstrual cycle-related symptoms, libido and adverse events (AEs). Results: Of 298 enrolled women, 292 were evaluable. The probability of NOMAC/E2 continuation through 12 months was 73.7% (95% confidence interval [CI] 68.0%, 78.5%). Satisfaction with NOMAC/E2 increased from 56.9% (37/65) of women at initial evaluation to 89.2% (58/65) of women at 12 months. Physician ratings at 12 months showed satisfactory to very satisfactory in 84.0% (168/200) of women. Libido was not affected. Menstrual cycle-related symptoms significantly declined from enrolment (6.04 +/- 4.32) to 3 months (3.25 +/- 3.05) and 12 months (2.62 +/- 2.74; p &lt; .0001). Treatment-related AEs were reported by 38.7% (113/292) of women. Conclusion: The real-world experience of women receiving NOMAC/E2 indicated very good treatment continuation, high satisfaction and significantly improved menstrual cycle-related symptoms

Changes in sexual function after medical or surgical termination of pregnancy

OBJECTIVE: To evaluate how first trimester termination of pregnancy (TOP) by either surgical (group 1) or medical procedure (group 2) affect sex- ual function. DESIGN: This observational study included 211 patients (132 in group 1 and 79 in group 2) who requested first trimester TOP, in agreement with our national law, between September 2010 and May 2012. At 6-month follow-up, 122 women in group 1 and 71 women in group 2 completed the study. MATERIALS AND METHODS: Medical TOP (mifepristone and miso- prostol) was offered to patients up to 49 days of gestation. Surgical TOP was performed up to 12 weeks. The Female Sexual Function Index (FSFI) was used to evaluate sexual function before TOP, after 1, 3 and 6 months from TOP. RESULTS: Medical TOP (mifepristone and misoprostol) was offered to patients up to 49 days of gestation. Surgical TOP was performed up to 12 weeks. The Female Sexual Function Index (FSFI) was used to evaluate sex- ual function before TOP, after 1, 3 and 6 months from TOP. CONCLUSION: Voluntary TOP is an important public health concerns. Sexual dysfunction after surgical TOP has been reported in the literature; however, no previous study compared sexual function after medical or surgical TOP by using validated instruments. This study shows that the number of sexually active women and the overall FSFI is reduced in women undergoing surgical TOP compared with those undergoing medical TOP. Counselling regarding sexual function changes should be included in the discussion of morbidity related to medical or surgical TOP

Opinion paper: scientific, philosophical and legal consideration of doping in sports

The term doping is generally used to indicate practices based on the use of performance-enhancing drugs (PEDs) or the abuse of medical therapies. Mostly analysed by doctors and officials, doping nevertheless also requires a philosophical consideration to avoid being simplistically portrayed as an isolated practice. To do this, we need to pay attention to the contradictions and paradoxes in the modern approach to doping in sport. In this context, doping is not only relevant to the health of an individual involved in the violation of World Anti-Doping Agency (WADA) criteria, but it actually represents a double-edged phenomenon containing ethical and legal points of view. Several philosophical items affect the ethics of doping. While, indeed, through a deontological vision it is easy to morally condemn an athlete who takes the decision to turn to doping, the same condemnation becomes difficult when the practice of doping is compared with the strong social demand of winners in every field of life. This point must be considered to prevent doping from becoming accepted as a daily practice to excel at all costs and regarded not only as normal but as a necessity for those participating in sport at both an amateur and professional level. Furthermore, a complete discussion on doping has to consider not only the philosophy of performance-enhancing drug abuse, but also the widespread practice of an inappropriate and excessive intake of certain dietary supplements with the unique and obsessive purpose (similar to doping) of increasing physical or mental performance. Based on the above, the aim of this paper is to provide a critical opinion of the doping problem and its related practices and analyze possible solutions considering issues that go beyond the impact of doping on health and reflect on whether it is right or not that an athlete does all he can to improve his performance. Graphical Abstract: [Figure not available: see fulltext.]

Essential amino acids (EAA) mixture supplementation: Effects of an acute administration protocol on myoelectric manifestations of fatigue in the biceps brachii after resistance exercise

Background: The purpose of this study was to investigate the acute effects of a single oral administration of an essential amino acids enriched mixture (EAA) on myoelectric descriptors of fatigue and maximal force production after a resistance exercise protocol (REP). Methods: Twenty adult males (age: 27 ± 6 years; body mass: 72.7 ± 7.50 kg; height: 1.76 ± 0.06 m) were enrolled in a double-blind crossover placebo-controlled study. Subjects were randomized to receive EAA mix (0.15 g/kg BM) or a placebo (PLA) in two successive trials 7 days apart. In both trials subjects completed a REP 2 h after the ingestion of the EAA mix or PLA. Before ingestion and after REP subjects performed isometric contractions of the dominant upper limb with the elbow joint at 120 degrees: (1) two maximal voluntary contractions (MVCs) for 2-3 s; (2) at 20% MVC for 90 s; (3) at 60% MVC until exhaustion. Mean values of MVC, conduction velocity initial values (CV), fractal dimension initial values (FD), their rates of change (CV slopes, FD slopes) and the Time to perform the Task (TtT) were obtained from a multichannel surface electromyography (sEMG) recording technique. Basal blood lactate (BL) and BL after REP were measured. Results: Following REP a significant decrease of MVC was observed in PLA (P < 0.05), while no statistical differences were found in EAA between pre-REP and post-REP. After REP, although a significant increase in BL was found in both groups (P < 0.0001) a higher BL ?% was observed in PLA compared to EAA (P < 0.05). After REP, at 60% MVC a significant increase of CV rate of change (P < 0.05) was observed in PLA but not in EAA. At the same force level TtT was longer in EAA compared to PLA, with a significant TtT ?% between groups (P < 0.001). Conclusion: Acute EAA enriched mix administration may prevent the loss of force-generating capacity during MVC following a REP. During isometric contraction at 60% MVC after REP the EAA mix may maintain CV rate of change values with a delay in the TtT failure

Correlation between patellar tendon mechanical properties and oxygenation detection by near infrared spectroscopy in males

Background. The purpose of this study was to determine the correlation between the patellar tendon mechanical properties and oxygenation in healthy men. Methods. In two subsequent sessions, eight (mean age ± SD: 27 ± 4) recreationally active, healthy males performed 4-sec isometric knee extensions of the dominant leg at 20-80% of maximal voluntary contraction (MVC), maintaining a knee joint angle of 90° of flexion. In the first session, B-mode ultrasonography was used to record tendon length, cross-sectional area (CSA), and elongation, parameters needed to calculate stiffness. In the second session, tendon/peritendon hemodynamic parameters, namely total hemoglobin ΔtHb, ΔHHb and tissue oxygenation index (TOI% = O2 Hb/tHb x 100), as indicators of blood flow and oxygen extraction respectively were measured by near infrared spectroscopy (NIRS). Correlations between blood volume (tHB), tissue oxygenation and tendon mechanical properties were tested using Pearson’s correlation coefficient (R). Results. At all % of MVCs, a reduction of tHb and TOI%, and an increase of HHb were observed. At 80% MVC, ΔTOI% was negatively correlated with strain (R =-0.64) and elongation (R =-0.48), whereas a significant positive correlation was found with Young modulus (R = 0.69) and stress (R = 0.62); as regards blood volume, a significant negative correlation was found between elongation and ΔtHb (R =-0.44) and a positive correlation was found between stress and ΔtHb (R = 0.4). Conclusions. Patellar tendon mechanical properties and tendon/peritendon oxygen extraction and blood volume appears to be moderately correlated when studied by ultrasound and NIRS