Participation in introductory APIB training at the Colorado NIDCAP Center-Report on the training and its applicability to future studies-

本研修の目的は,新生児・早産児行動評価(Assessment of Term and Preterm Infant Behavior:APIB 1))を研究に活用するため,その具体的な方法を学ぶことであった.今回,国際NIDCAP®連盟(Newborn Individualized Developmental Care and Assessment Program FederationInternational:NFI)が認定する公式のトレーニング施設,Colorado NIDCAPセンターにおいて,2013年9月7日～8日の2日間,APIBの導入研修に参加する機会を得た.NFIは米国マサチューセッツ州ボストンに本部を置き,北米,南米,ヨーロッパに20のトレーニング施設を認定し,包括的で質の高いトレーニングとコンサルテーションの機会を提供している.APIBは,正期産児を対象とする新生児行動評価(Neonatal Behavioral Assessment Scale:NBAS 2))を,早産児と発達上のリスクを持つ新生児に適合するように開発された評価法であり,新生児と観察者の相互作用を通して,中枢神経系の組織化の状態と受け入れられる刺激を評価し,発達の評価や発達支援の方策を考案するために用いられている.APIBを研究に活用する際は,評価者としての認定が必要であり,トレーニングは「準備の段階」「導入トレーニング」「自主トレーニングおよび指導者との調整(中間評価)」「信頼性の評価」の4段階からなる.今回参加した導入研修では,APIBの基盤となる理論と実際の評価法を学び,評価の進め方とスコア化の基準を理解するとともに,早産児の現在の状態と受け入れられる刺激を評価することの重要性を知ることができた.本稿では,研修内容および今後の研究への活用性について報告する

The Effect of High Dose Cholecalciferol on Arterial Stiffness and Peripheral and Central Blood Pressure in Healthy Humans: A Randomized Controlled Trial

<div><p>Background</p><p>Low levels of serum 25-hydroxy vitamin D are associated with increased arterial stiffness and hypertension. Supplementation with vitamin D precursors has been proposed as a treatment option for these conditions. We examined the effect of oral cholecalciferol on arterial stiffness and blood pressure in healthy normotensive adults.</p><p>Methods</p><p>40 healthy adults were randomised in this double-blinded study to either oral cholecalciferol 3000 IU/day or matching placebo and were followed for 16 weeks to examine any effects on pulse wave velocity (PWV), augmentation index (AIx), peripheral and central blood pressure and 24-hour ambulatory blood pressure.</p><p>Results</p><p>22 subjects in the cholecalciferol arm and 18 subjects in the placebo arm completed the 16 weeks of follow-up. There was no difference in changes in PWV, AIx corrected for heart rate or central or peripheral blood pressure between the two groups. There was no correlation between serum 25-hydroxy vitamin D and any of these parameters.</p><p>Conclusions</p><p>Oral cholecalciferol 3000 IU/day does not affect arterial stiffness or blood pressure after 16 weeks of treatment in healthy normotensive adults.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="http://clinicaltrials.gov/ct2/results?term=NCT00952562&Search=Search" target="_blank">NCT00952562</a></p></div

Former Abusers of Anabolic Androgenic Steroids Exhibit Decreased Testosterone Levels and Hypogonadal Symptoms Years after Cessation: A Case-Control Study

<div><p>Aims</p><p>Abuse of anabolic androgenic steroids (AAS) is highly prevalent among male recreational athletes. The objective of this study was to investigate the impact of AAS abuse on reproductive hormone levels and symptoms suggestive of hypogonadism in current and former AAS abusers.</p><p>Methods</p><p>This study had a cross-sectional case-control design and involved 37 current AAS abusers, 33 former AAS abusers (mean (95%CI) elapsed duration since AAS cessation: 2.5 (1.7; 3.7) years) and 30 healthy control participants. All participants were aged 18–50 years and were involved in recreational strength training. Reproductive hormones (FSH, LH, testosterone, inhibin B and anti-Müllerian hormone (AMH)) were measured using morning blood samples. Symptoms of hypogonadism (depressive symptoms, fatigue, decreased libido and erectile dysfunction) were recorded systematically.</p><p>Results</p><p>Former AAS abusers exhibited significantly lower median (25^th –75^th percentiles) total and free testosterone levels than control participants (total testosterone: 14.4 (11.9–17.7) nmol/l vs. 18.8 (16.6–22.0) nmol/l) (P < 0.01). Overall, 27.2% (13.3; 45.5) of former AAS abusers exhibited plasma total testosterone levels below the lower reference limit (12.1 nmol/l) whereas no control participants exhibited testosterone below this limit (P < 0.01). Gonadotropins were significantly suppressed, and inhibin B and AMH were significantly decreased in current AAS abusers compared with former AAS abusers and control participants (P < 0.01). The group of former AAS abusers had higher proportions of participants with depressive symptoms ((24.2%) (11.1; 42.2)), erectile dysfunction ((27.3%) (13.3; 45.6)) and decreased libido ((40.1%) (23.2; 57.0)) than the other two groups (trend analyses: P < 0.05).</p><p>Conclusions</p><p>Former AAS abusers exhibited significantly lower plasma testosterone levels and higher frequencies of symptoms suggestive of hypogonadism than healthy control participants years after AAS cessation. Current AAS abusers exhibited severely decreased AMH and inhibin B indicative of impaired spermatogenesis.</p></div

Results of Cholecalciferol Treatment versus Placebo.

<p>Results of Cholecalciferol Treatment versus Placebo.</p

Demographic Characteristics.

<p>Demographic Characteristics.</p

Treatment Effect on 25-OH Vitamin D Levels.

<p>Treatment Effect on 25-OH Vitamin D Levels.</p

Correlations between 25-OH Vitamin D and Vascular Stiffness and 24-hour Ambulatory Blood Pressure.

<p>Correlations between 25-OH Vitamin D and Vascular Stiffness and 24-hour Ambulatory Blood Pressure.</p

Treatment Effect on 1,25-(OH)₂ Vitamin D Levels.

<p>Treatment Effect on 1,25-(OH)₂ Vitamin D Levels.</p

Treatment Effect on Pulse Wave Velocity.

<p>Treatment Effect on Pulse Wave Velocity.</p

Symptoms of depression, erectile dysfunction and decreased libido in the three groups.

<p><b>Footnote:</b> T bars show standard errors. Depressive symptoms, erectile dysfunction and decreased libido were compared across the groups with trend analyses and all were statistically significant (P < 0.05). <b>AAS,</b> anabolic androgenic steroids.</p