Effects of EPO on blood parameters and running performance in Kenyan athletes

Introduction: Recombinant human erythropoietin (rHuEpo) administration enhances oxygen carrying capacity and performance at sea level. It remains unknown whether similar effects would be observed in chronic altitude-adapted endurance runners. The aim of this study was to assess the effects of rHuEpo on hematological and performance parameters in chronic altitude-adapted endurance runners as compared to sea level athletes. Methods: Twenty well-trained Kenyan endurance runners (KEN) living and training at approximately 2150 m received rHuEpo injections of 50 IU·kg−1 body mass every 2 d for 4 wk and responses compared with another cohort (SCO) that underwent an identical protocol at sea level. Blood samples were obtained at baseline, during rHuEpo administration and 4 wk after the final injection. A maximal oxygen uptake (V˙O2max) test and 3000-m time trial was performed before, immediately after and 4 wk after the final rHuEpo injection. Results: Hematocrit (HCT) and hemoglobin concentration (HGB) were higher in KEN compared to SCO before rHuEpo but similar at the end of administration. Before rHuEpo administration, KEN had higher V˙O2max and faster time trial performance compared to SCO. After rHuEpo administration, there was a similar increase in V˙O2max and time trial performance in both cohorts; most effects of rHuEpo were maintained 4 wk after the final rHuEpo injection in both cohorts. Conclusions: Four weeks of rHuEpo increased the HGB and HCT of Kenyan endurance runners to a lesser extent than in SCO (~17% vs ~10%, respectively) and these alterations were associated with similar improvements in running performance immediately after the rHuEpo administration (~5%) and 4 wk after rHuEpo (~3%)

The role of emergency department HIV care in resource-poor settings: lessons learned in western Kenya

The human immunodeficiency virus (HIV) pandemic in sub-Saharan Africa and other high prevalence regions continues to overwhelm health care systems. While there has been a global response to improve the delivery of antiretroviral therapy in these high prevalence regions, there are few models that have developed an adequate plan to deal with HIV specifically in resource-poor emergency department settings. In this manuscript, we report on the experience scaling up HIV care at one emergency department in a large referral hospital located in western Kenya. Specifically, we describe how rapid bedside HIV testing helps to narrow the differential diagnosis of disease processes in acute care patients and how HIV screening of patients discharged from the emergency department can detect HIV-infected individuals

Bayes sampling designs for selection procedures

From k independent populations P_1,..., P_k, which belong to a one parameter exponential family #left brace#F_#theta##right brace#, #theta# element of #OMEGA# subset or equal R, random samples of sizes m_1,..., m_k, respectively, are to be drawn. After the observations have been drawn, a selection procedure will be used to determine which of these k populations has the largest value of #theta#. Given a loss for selections at each parameter configuration, given n past observations, and given a prior for the k parameters, a Bayes selection procedure can be found and its Bayes risk can be determined, where both depend on m_1,..., m_k. Let the sample sizes be restricted by m_1 +... + m_k=m, where m is fixed. The problem of how to find the optimum (minimum Bayes risk) sample design subject to this constraint is considered, as well as m-truncated sequential sampling allocations. Results for normal and binomial families, under the ''0-1'' loss and the linear loss, are presented and discussed. An introduction to Bayes selection procedures is included. (orig.)Available from TIB Hannover: RN 6363(1997,2) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman