Measuring the burden of herpes zoster and post herpetic neuralgia within primary care in rural Crete, Greece

<p>Abstract</p> <p>Background</p> <p>Research has indicated that general practitioners (GPs) have good clinical judgment in regards to diagnosing and managing herpes zoster (HZ) within clinical practice in a country with limited resources for primary care and general practice. The objective of the current study was to assess the burden of HZ and post herpetic neuralgia (PHN) within rural general practices in Crete, Greece.</p> <p>Methods</p> <p>The current study took place within a rural setting in Crete, Greece during the period of November 2007 to November 2009 within the catchment area in which the Cretan Rural Practice-based Research Network is operating. In total 19 GP's from 14 health care units in rural Crete were invited to participate, covering a total turnover patient population of approximately 25, 000 subjects. For the purpose of this study an electronic record database was constructed and used as the main tool for monitoring HZ and PHN incidence. Stress related data was also collected with the use of the Short Anxiety Screening Test (SAST).</p> <p>Results</p> <p>The crude incidence rate of HZ was 1.4/1000 patients/year throughout the entire network of health centers and satellite practices, while among satellite practices alone it was calculated at 1.3/1000 patients/year. Additionally, the standardised incidence density within satellite practices was calculated at 1.6/1000 patients/year. In regards to the stress associated with HZ and PHN, the latter were found to have lower levels of anxiety, as assessed through the SAST score (17.4 ± 3.9 vs. 21.1 ± 5.7; <it>p </it>= 0.029).</p> <p>Conclusions</p> <p>The implementation of an electronic surveillance system was feasible so as to measure the burden of HZ and PHN within the rural general practice setting in Crete.</p

Endurance performance is influenced by perceptions of pain and temperature: Theory, applications and safety considerations.

Models of endurance performance now recognise input from the brain, including an athlete’s ability to cope with various non-pleasurable perceptions during exercise, such as pain and temperature. Exercise training can reduce perceptions of both pain and temperature over time, partly explaining why athletes generally have a higher pain tolerance, despite a similar pain threshold, compared with active controls. Several strategies with varying efficacy may ameliorate the perceptions of pain (e.g. acetaminophen, transcranial direct current stimulation and transcutaneous electrical stimulation) and temperature (e.g. menthol beverages, topical menthol products and other cooling strategies, especially those targeting the head) during exercise to improve athletic performance. This review describes both the theory and practical applications of these interventions in the endurance sport setting, as well as the potentially harmful health consequences of their use

Determination of the exercise intensity corresponding with maximal lactate steady state in high-level basketball players

The purpose of the present study was to define the maximal lactate steady state (MLSSmeas) in high-level male basketball players and to compare it with the lactate turnpoint (LTP) and the respective point derived form a prediction method (MLSScal). Twelve high-level basketball players underwent one maximal and several submaximal tests on a treadmill on different days where MLSS and LTP were measured. MLSSmeas was observed at 75% of the maximal treadmill speed, at 77% of VO2max, at 88% of HRmax and at [La-] of 3.7 mmol.l−1. No differences were observed between MLSSmeas and LTP in any of the measured variables. A good agreement was observed between MLSSmeas and LTP, as well as between MLSSmeas and MLSScal. Therefore, LTP and MLSScal are offered as acceptable approaches to predict MLSS, but not all the indices used to define MLSS presents high agreement between the methods used. © 2018, © 2018 Informa UK Limited, trading as Taylor &amp; Francis Group

THE ROLE OF ACTIVE MUSCLE MASS ON EXERCISE-INDUCED CARDIOVASCULAR DRIFT

The purpose of this study was to examine the role of active muscle mass on cardiovascular drift (CVdrift) during prolonged exercise. Twelve subjects with peak oxygen uptake (VO2peak) of 3.52 ± 0.52 L·min-1 (mean ± SD) cycled for 55 min with 80 revolutions per minute with either two legs (2-legged) or one leg (1-legged). Oxygen uptake was at 60% of VO2peak throughout the 2-legged trial and at half of this value in 1- legged condition. Cardiac output (CO-CO2 rebreathing), heart rate (HR) and quadriceps integrated electromyographic activity (iEMG) were higher (p < 0.01) during 2-legged than 1- legged exercise. Changes in stroke volume from 20 to 50 min of exercise were greater in 2-legged than in 1-legged (∆SV: -20.8 ± 0.8 vs. -13.3 ± 1.3 ml·beat-1, p < 0.05). Similarly, changes in heart rate (∆HR) were +18.5 ± 0.8 and +10.7 ± 1.0 beats·min-1, in 2-legged and 1-legged, respectively (p < 0.01). Calculated blood volume changes declined significantly in 2-legged exercise (∆BV: -4.25 ± 0.43%, p < 0.05). Sympathetic activation as indicated by the ratio of low and high frequency in spectral analysis of HR (LF HF-1 ratio) was higher in 2-legged than in 1- legged trial (p < 0.05). At the end of exercise, CO had a tendency to decrease from 20th min in 2-legged (changes in CO = -0.92 ± 0.3 L·min-1, p = 0.07), whereas it was maintained in 1- legged cycling (∆CO = -0.15 ± 0.2 L·min-1, p = 0.86). Multiple regression analysis showed that HR rise and blood volume decline were predictors of SV drop whereas heart rate increase was explained by rectal temperature and magnitude of muscle mass activation, as indicated by iEMG (p < 0.05) in 2-legged cycling. In conclusion, apart from the well-known factors of thermal status and blood volume decline, it seems that muscle mass involved plays also a role on the development of CVdrif

Heat production and heat loss responses to cold water immersion after 35 days horizontal bed rest

Introduction: Bed rest is a terrestrial experimental analogue of unloading experienced during exposure to microgravity. Such unloading causes atrophy predominantly of the postural muscles, especially those of the lower limbs. Methods: We tested the hypothesis that 35 d horizontal bed rest alters thermoregulatory responses of subjects (N = 10) immersed in 15oC water, particularly the heat produced by the shivering tremor of the skeletal muscles. Before and after bed rest we measured the thickness of the gastrocnemius medialis (GM), vastus lateralis (VL), tibialis anterior (TA), and biceps brachii (BB) muscles by ultrasonography. During the immersions, we monitored rectal and skin temperatures, heat fl ux, heart rate, and oxygen uptake. Results: After bed rest, muscle thickness decreased signifi cantly by 12.2 \ub1 8.8% and 8.0 \ub1 9.1% in the GM and VL, respectively. No changes were observed in the TA and BB muscles. The 35-d bed rest caused a signifi cant reduction in aerobic power, as refl ected in maximal oxygen uptake. There were no signifi cant differences in any of the observed thermoregulatory responses between the pre- and post-bed rest immersions. Conclusions: Cardiovascular and muscular deconditioning had no effect on the heat production and heat loss responses. Due to the signifi cant reduction in the mass of the muscles in the lower limbs, concomitant with no change in heat production, we conclude that leg muscles do not play a signifi cant role in shivering thermogenesis

The Effect of Wet Conditions and Surface Combat Swimming on Shooting.

INTRODUCTION: Shooting ability is an important aspect of performance in some sports and is vital during a military operation. Load carriage, clothing, and equipment normally associated with fatigue and reduced field of vision or lack of stability at a specific point are important factors that affect the ability to aim when shooting. Additionally, gun support and equipment appear to differentially affect shooting ability with varying shooting positions. All of the studies examining these factors have taken place on dry land and not in water. However, up to date, no study has examined the effect of wet conditions, especially after surface combat swimming (sCS), on shooting ability in different shooting positions. The purpose of this study was to determine the effect of fatigue, produced by prolonged sCS, on a fighter&apos;s shooting ability. In addition, we investigated whether the effect of fatigue and wet conditions differed between the shooting positions. MATERIALS AND METHODS: Forty-five participants performed 10 shots in a shooting simulator while standing (ST) and 10 shots while kneeling (KN). This was performed twice and in three conditions: dry, wet, and after 1,000 m of sCS. RESULTS: Wet conditions did not significantly affect shooting abilities. Surface combat swimming negatively affected shooting ability when both ST and KN. The reduction in the center of gravity (COG) of the shots after sCS was 3.7 ± 2.5\% for ST and 3.5 ± 0.8\% for KN (P {\textless} .01). This was accompanied by the increase in horizontal and vertical movement of the gun after the sCS (P {\textless} .01). Kneeling was more stable, as shown by a higher percentage of COG of the shots by 3.3 ± 0.1\% (P {\textless} .01) and by fewer gun movements in both axes (P {\textless} .01). CONCLUSIONS: In conclusion, combat swimming affects shooting ability, both in ST and in KN positions. The KN position provides better stability and improved shooting ability

The effect of normobaric hypoxic confinement on metabolism, gut hormones and body composition

To assess the effect of normobaric hypoxia on metabolism, gut hormones and body composition, eleven normal weight, aerobically trained ( O2peak: 60.6±9.5 ml·kg-1·min-1) men (73.0±7.7 kg; 23.7±4.0 yrs, BMI 22.2±2.4 kg·m-2) were confined to a normobaric (altitude⋍940m) normoxic (NORMOXIA; PIO2⋍133.2 mmHg) or normobaric hypoxic (HYPOXIA; PIO was reduced from 105.6 to 97.7 mmHg over 10 days) environment for 10 days in a randomized cross-over design. The wash-out period between confinements was 3 weeks. During each 10-day period, subjects avoided strenuous physical activity and were under continuous nutritional control. Before, and at the end of each exposure, subjects completed a meal tolerance test, during which blood glucose, insulin, GLP-1, ghrelin, peptide-YY, adrenaline, noradrenaline, leptin, and gastro-intestinal blood flow and appetite sensations were measured. There was no significant change in body weight in either of the confinements (NORMOXIA: -0.7±0.2 kg; HYPOXIA: -0.9±0.2 kg), but a significant increase in fat mass in NORMOXIA (0.23±0.45 kg), but not in HYPOXIA (0.08±0.08 kg). HYPOXIA confinement increased fasting noradrenaline and decreased energy intake, the latter most likely associated with increased fasting leptin. The majority of all other measured variables/responses were similar in NORMOXIA and HYPOXIA. To conclude, normobaric hypoxic confinement without exercise training results in negative energy balance due to primarily reduced energy intake