Pilot study : can inspiratory muscle training relieve symptoms ff dyspnoea and improve quality of life for advanced cancer patients ?: 1872 Board #24 June 2, 3: 30 PM - 5: 00 PM.

Dyspnoea is a common symptom of advanced cancer patients, and impacts upon physical, social and psychological wellbeing. Currently opioids are recommended for those suffering with chronic dyspnoea, despite an association with longer term health issues. Inspiratory muscle training (IMT) promotes chronic adaptations within the inspiratory musculature and has consistently been shown to reduce dyspnoea and improve lung mechanics, functional exercise capacity and quality of life in a variety of clinical populations, however this has yet to be tested in patients with cancer.N/

The Effects of PCSO-524®, a Patented Marine Oil Lipid derived from the New Zealand Green Lipped Mussel (Perna canaliculus), on Pulmonary and Respiratory Muscle Function in Non-asthmatic Elite Runners

International Journal of Exercise Science 11(3): 669-680, 2018. Habitual endurance training may be associated with mild airway inflammation and subsequent deterioration in lung function. PCSO-524™ (Lyprinol®/Omega-XL®), a supplement extracted from the New Zealand green-lipped mussel (Perna canaliculus), has been shown to moderate airway inflammation in asthmatic subjects. The purpose of this study was to determine whether supplementation with PCSO-524™ improves pulmonary and respiratory muscle function in non-asthmatic elite runners. Sixteen male, non-asthmatic elite runners were randomly assigned to either a treatment (PCSO-524™; 1 capsule contains 50 mg n-3 polyunsaturated fatty acids and 100 mg olive oil, n=8) or placebo (1 capsule contains 150 mg olive oil; n=8) group. During the supplementation period, subjects ingested 8 capsules of either treatment or placebo per day for 12 weeks. Resting pulmonary and respiratory muscle function testing were assessed at baseline and every two weeks throughout the 12 week supplementation period. No significant between- or within-subjects main effects were observed in forced vital capacity, forced expiratory volume in 1-second, forced expiratory flow from 25-75% of lung volume (FEF25-75), peak expiratory flow, maximal voluntary ventilation, maximal inspiratory mouth pressure, and closing volume (p\u3e0.05). A significant within-subjects main effect was observed in maximal expiratory mouth pressure (PEmax) (p=0.024) and lung diffusion capacity (DLCO) (pPEmax and DLCO (p\u3e0.05). A significant treatment by time interaction was observed in FEF25-75 (p=0.026) and DLCO (p=0.024), but no other significant interactions were observed (all p\u3e0.05). Supplementation with PCSO-524™ (Lyprinol®/Omega-XL®) does not improve pulmonary or respiratory muscle function in non-asthmatic elite runners

Omega-3 Fatty Acids and Airway Hyperresponsiveness in Asthma

ABSTRACT Despite the progress that has been made in the treatment of asthma, the prevalence and burden of this disease has continued to increase. Exercise is a powerful trigger of asthma symptoms and reversible airflow obstruction and may result in the avoidance of physical activity by patients with asthma, resulting in detrimental consequences to their health. Approximately 90% of patients with asthma are hyperresponsive to exercise and experience exercise-induced bronchoconstriction (EIB). While pharmacologic treatment of asthma is usually highly effective, medications often have significant side-effects or exhibit tachyphylaxis. Alternative therapies for treatment (complementary medicine) that reduce the dose requirements of pharmacologic interventions would be beneficial, and could potentially reduce the public health burden of this disease. There is accumulating evidence that dietary modification has potential to influence the severity of asthma and reduce the prevalence and incidence of this condition. A possible contributing factor to the increased incidence of asthma in Western societies may be the consumption of a proinflammatory diet. In the typical Western diet, 20-to 25-fold more -6 polyunsaturated fatty acids (PUFA) than -3 PUFA are consumed, which causes the release of proinflammatory arachidonic acid metabolites (leukotrienes and prostanoids). This review analyzes the existing literature on -3 PUFA supplementation as a potential modifier of airway hyperresponsiveness in asthma and includes studies concerning the efficacy of -3 PUFA supplementation in EIB. While clinical data evaluating the effect of -3 PUFA supplementation in asthma has been equivocal, it has recently been shown that pharmaceuticalgrade fish oil (-3 PUFA) supplementation reduces airway hyperresponsiveness after exercise, medication use, and proinflammatory mediator generation in nonatopic elite athletes with EIB. These findings are provocative and suggest that dietary -3 PUFA supplementation may be a viable treatment modality and/or adjunct therapy in airway hyperresponsiveness. Further studies are needed to confirm these results and understand their mechanism of action. 106

Eicosapentaenoic acid is more effective than docosahexaenoic acid in inhibiting proinflammatory mediator production and transcription from LPS-induced human asthmatic alveolar macrophage cells

This paper was published in the journal, Clinical Nutrition [© Elsevier Ltd and European Society for Clinical Nutrition and Metabolism] and the definitive version is available at: http://dx.doi.org/10.1016/j.clnu.2008.10.012Background & aims: The purpose of the study was to determine which of the active constituents of fish oil, eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA), is most effective in suppressing proinflammatory mediator generation and cytokine expression from LPS-stimulated human asthmatic alveolar macrophages (AMΦ). Methods: The AMΦ were obtained from twenty-one asthmatic adults using fiberoptic bronchoscopy. Cells were pretreated with DMEM, pure EPA, an EPA-rich media (45% EPA/10% DHA), pure DHA, a DHArich media (10% EPA/50% DHA) or Lipovenos® (n-6 PUFA), and then exposed to Dulbecco’s Modified Eagle’s Medium (DMEM) (-) or LPS (+). Supernatants were analyzed for leukotriene (LT)B4, prostaglandin (PG)D2, tumor necrosis factor (TNF)-α and interleukin (IL)-1β production. Detection of TNF-α and IL-1β mRNA expression levels was quantified by reverse transcriptase polymerase chain reaction. Results: 120 μM pure EPA and EPA-rich media significantly (p < 0.05) suppressed TNF-a and IL-1b mRNA expression and the production of LTB4, PGD2 and TNF-a and IL-1b in LPS-stimulated primary AMφ cells obtained from asthmatic patients to a much greater extent than 120 mM pure DHA and DHA-rich media respectively. Conclusions: This study has shown for the first time that EPA is a more potent inhibitor than DHA of inflammatory responses in human asthmatic AMΦ cells

Neuro-ophthalmologic and blood biomarker responses in ADHD following subconcussive head impacts: a case–control trial

IntroductionThis clinical trial aimed to determine the influence of attention-deficit/hyperactivity disorder (ADHD) on neuro-ophthalmologic function and brain-derived blood biomarkers following acute subconcussive head impacts.MethodsThe present trial consisted of age- and sex-matched samples with a ratio of 1:1 between two groups with a total sample size of 60 adults (age ± SD; 20.0 ± 1.8 years). Soccer players diagnosed with and medicated daily for ADHD were assigned into an ADHD group (n = 30). Soccer players without ADHD were assigned into a non-ADHD group (n = 30). Participants performed 10 soccer headers with a soccer ball projected at a velocity of 25mph. King-Devick test (KDT), near point of convergence (NPC), and serum levels of NF-L, tau, GFAP, and UCH-L1 were assessed at baseline (pre-heading) and at 2 h and 24 h post-heading.ResultsThere were no statistically significant group-by-time interactions in outcome measures. However, at baseline, the ADHD group exhibited lower neuro-ophthalmologic functions compared to the non-ADHD group (NPC: p = 0.019; KDT: p = 0.018), and persisted at 2 h-post (NPC: p = 0.007; KDT: p = 0.014) and 24 h-post heading (NPC: p = 0.001). NPC significantly worsened over time in both groups compared to baseline [ADHD: 2 h-post, 1.23 cm, 95%CI:(0.77, 1.69), p &lt; 0.001; 24 h-post, 1.68 cm, 95%CI:(1.22, 2.13), p = 0.001; Non-ADHD: 2 h-post, 0.96 cm, 95%CI:(0.50, 1.42), p &lt; 0.001; 24 h-post, 1.09 cm, 95%CI:(0.63, 1.55), p &lt; 0.001]. Conversely, improvements in KDT time compared to baseline occurred at 2 h-post in the non-ADHD group [−1.32 s, 95%CI:(−2.55, −0.09), p = 0.04] and at 24 h-post in both groups [ADHD: −4.66 s, 95%CI:(−5.89, −3.43), p &lt; 0.001; Non-ADHD: −3.46 s, 95%CI:(−4.69, −2.23), p &lt; 0.001)]. There were no group-by-time interactions for GFAP as both groups exhibited increased levels at 2 h-post [ADHD: 7.75 pg./mL, 95%CI:(1.41, 14.10), p = 0.019; Non-ADHD: 7.91 pg./mL, 95%CI:(1.71, 14.14), p = 0.015)] that returned to baseline at 24 h-post. NF-L levels increased at 2 h-post heading in the ADHD group [0.45 pg./mL, 95%CI:(0.05, 0.86), p = 0.032], but no significant NF-L changes were observed in the non-ADHD group over time.DiscussionTen soccer headers elevated GFAP levels and NPC impairment in both groups. However, persisting group difference in NPC, blunted KDT performance, and increased NF-L levels in the ADHD group suggest that ADHD may reduce neuro-ophthalmologic function and heighten axonal response to soccer headers.Clinical trial registrationClinicalTrials.gov, identifier ID: (NCT04880304)

Carbohydrate Mouth Rinse Improves Cycling Time-Trial Performance without Altering Plasma Insulin Concentration

Rinsing the mouth with a carbohydrate solution has been shown to improve exercise performance in a manner similar to carbohydrate ingestion. However, the underlying mechanisms behind these ergogenic benefits remain unclear. This study evaluated whether rinsing the mouth with a carbohydrate solution alters plasma insulin and glucose concentration during the initial stages of a 40 km cycling time-trial. Eight trained, competitive cyclists [age (mean ± SEM) = 24 ± 2 y; V̇O2max = 64.5 ± 2.2 ml·kg-1·min-1] completed three simulated 40 km time-trials comprised of a familiarization trial, a carbohydrate condition (CHO) and a placebo mouth rinse condition (PLA). In the two mouth rinse conditions, rinsing was administered prior to onset of exercise and every 5 km throughout exercise. Plasma insulin was collected at 5 km intervals throughout the first 25 km, and glucose samples were collected at 5 km intervals throughout the exercise bout. No change in plasma insulin was detected between conditions (p = 0.638, ES < 0.03) for the first 25 km of the time-trial. Likewise, plasma glucose concentration did not differ between CHO and PLA (p = 0.801, ES < 0.01) and remained relatively stable throughout exercise. Time to complete the 40 km time-trial was significantly faster for CHO (67.1 ± 1.1 min) compared to PLA [67.9 ± 1.0 min; (P = 0.028, ES 0.27)]. Performance time was faster by an average of 1.1% (95% confidence interval range 0.2-2.0%) in the CHO condition. Exercise intensity (% V̇O2max) throughout the trial was similar between conditions (p = 0.846). Respiratory exchange ratio was not significantly different between conditions (0.88 ± 0.01 for PLA, and 0.91 ± 0.01 for GLC; p = 0.081). Performance gains elicited by a carbohydrate mouth rinse occurred independently of changes in plasma insulin concentration