Influence of Aerobic Exercise on Appetite-Regulating Hormones, Ghrelin-o-Acyltransferase and Perceived Hunger in Normal Weight and Obese Adults

Background: Obesity is a major public health issue in the United States (U.S.), affecting an estimated 78 million US adults. Aerobic exercise (AE) is recommended by the American College of Sports Medicine to prevent and treat obesity, yet the effects of AE on circulating hunger hormones including acylated ghrelin and its biological catalyst, ghrelin o-acyltransferase (GOAT) are less known. Objectives: We investigated the effects of AE on circulating concentrations of appetite regulating hormones and GOAT in a pilot sample of adults classified with normal weight (NW) and obese (OB) body weight status. Methods: Using a quasi-experimental design, nine adults with NW (n=4, body mass index [BMI] = 21.3±1.2 kg/m2 ) and OB (n=5, BMI = 38.9±6.2 kg/m2 ) body weight status completed a preliminary health/fitness assessment. Participants returned to the laboratory on three separate occasions, separated by ≥ 48 hours to perform cycle exercise at 30% and 60% oxygen uptake reserve (VO2 R) or a seated control session with no exercise for 40 min. Fifteen mL of blood was taken pre-and-post exercise and control and were assayed in duplicate. Nonparametric procedures determined whether mean rank differences existed between NW and OB for acylated ghrelin, leptin, insulin, and GOAT in response to exercise and control. Alpha levels were set a priori to p \u3c0.05. Results: Significant mean rank reductions were found in GOAT after compared to before AE and control for NW and OB (p\u3c.05). Significant mean rank differences were found in acylated ghrelin after compared to before performing AE at 60% VO2 R in NW and OB (p\u3c.05); however, differences were not observed between NW and OB (p\u3e.05). Conclusions: Our findings reveal the first available data regarding the effects of AE on GOAT, with NW and OB experiencing equivocal changes pre-to-post AE at 60% VO2 R, and in response to a seated control session

The effects of betalain-rich concentrate supplementation in attenuating muscle damage following eccentric exercise

Betalains are bioactive pigments that have been shown to reduce muscle damage and enhance recovery from exercise. However, to date, studies have examined the effects of betalains on aerobic exercise alone, and thus, their possible benefits for muscle damage recovery following eccentric exercise is unknown. We, therefore, aimed to examine the effects of a betalain-rich concentrate (BRC) on indices of muscle damage following eccentric exercise. Eleven healthy, recreationally active males were randomly assigned into a treatment group (50 mg of BRC, containing 12.5 mg of betalains, 3 times per day for 3 days) or a control group and performed 30 maximal eccentric contractions of the elbow flexors. Maximal voluntary contraction (MVC), arm circumference (AC), muscle soreness (MS), and range of motion (ROM) were measured before, immediately after, and 24, 48, and 72 hr following eccentric exercise. Creatine kinase (CK) was measured before, 24, 48, and 72 hr following the eccentric exercise. No significant differences or interactions were observed for any of the variables (p = > .05); however, a non-significant trend with a large effect size (p = .07, ηp2 = 0.28) was found for the main effect for MVC. Although we failed to identify any statistically significant differences in any of the variables measured, the large effect size observed for MVC may have practical benefits in the enhancement of skeletal muscle recovery following eccentric exercise

Multistate US Outbreak of Rapidly Growing Mycobacterial Infections Associated with Medical Tourism to the Dominican Republic, 2013–2014

During 2013, the Maryland Department of Health and Mental Hygiene in Baltimore, MD, USA, received report of 2 Maryland residents whose surgical sites were infected with rapidly growing mycobacteria after cosmetic procedures at a clinic (clinic A) in the Dominican Republic. A multistate investigation was initiated; a probable case was defined as a surgical site infection unresponsive to therapy in a patient who had undergone cosmetic surgery in the Dominican Republic. We identified 21 case-patients in 6 states who had surgery in 1 of 5 Dominican Republic clinics; 13 (62%) had surgery at clinic A. Isolates from 12 (92%) of those patients were culture-positive for Mycobacterium abscessus complex. Of 9 clinic A case-patients with available data, all required therapeutic surgical intervention, 8 (92%) were hospitalized, and 7 (78%) required ≥3 months of antibacterial drug therapy. Healthcare providers should consider infection with rapidly growing mycobacteria in patients who have surgical site infections unresponsive to standard treatment

Global TravEpiNet: a national consortium of clinics providing care to international travelers--analysis of demographic characteristics, travel destinations, and pretravel healthcare of high-risk US international travelers, 2009-2011

BACKGROUND: International travel poses a risk of destination-specific illness and may contribute to the global spread of infectious diseases. Despite this, little is known about the health characteristics and pretravel healthcare of US international travelers, particularly those at higher risk of travel-associated illness. METHODS: We formed a national consortium (Global TravEpiNet) of 18 US clinics registered to administer yellow fever vaccination. We collected data regarding demographic and health characteristics, destinations, purpose of travel, and pretravel healthcare from 13235 international travelers who sought pretravel consultation at these sites from January 2009 through January 2011. RESULTS: The destinations and itineraries of Global TravEpiNet travelers differed from those of the overall population of US international travelers. The majority of Global TravEpiNet travelers were visiting low- or lower-middle-income countries, and Africa was the most frequently visited region. Seventy-five percent of travelers were visiting malaria-endemic countries, and 38% were visiting countries endemic for yellow fever. Fifty-nine percent of travelers reported \u3e/=1 medical condition. Atovaquone/proguanil was the most commonly prescribed antimalarial drug, and most travelers received an antibiotic for self-treatment of travelers\u27 diarrhea. Hepatitis A and typhoid were the most frequently administered vaccines. CONCLUSIONS: Data from Global TravEpiNet provide insight into the characteristics and pretravel healthcare of US international travelers who are at increased risk of travel-associated illness due to itinerary, purpose of travel, or existing medical conditions. Improved understanding of this epidemiologically significant population may help target risk-reduction strategies and interventions to limit the spread of infections related to global travel

Pre-exposure rabies vaccination among US international travelers: findings from the global TravEpiNet consortium.

BACKGROUND: People who travel to areas with high rabies endemicity and have animal contact are at increased risk for rabies exposure. We examined characteristics of international travelers queried regarding rabies vaccination during pretravel consultations at Global TravEpiNet (GTEN) practices during 2009-2010. MATERIAL AND METHODS: We performed bivariate and multivariable analyses of data collected from 18 GTEN clinics. Travel destinations were classified by strength level of rabies vaccination recommendation. RESULTS: Of 13,235 travelers, 226 (2%) reported previous rabies vaccination, and 406 (3%) received rabies vaccine at the consultation. Common travel purposes for these 406 travelers were leisure (26%), research/education (17%), and nonmedical service work (14%). Excluding the 226 who were previously vaccinated, 8070 (62%) of 13,009 travelers intended to visit one or more countries with a strong recommendation for rabies vaccination; 1675 (21%) of these 8070 intended to travel for 1 month or more. Among these 1675 travelers, 145 (9%) were vaccinated, 498 (30%) declined vaccination, 832 (50%) had itineraries that clinicians determined did not indicate vaccination, and 200 (12%) remained unvaccinated for other reasons. In both bivariate and multivariate analyses, travelers with trip durations \u3e6 months versus 1-3 months (adjusted odds ratio [OR]=4.9 [95% confidence interval [CI] 2.1, 11.4]) and those traveling for research/education or to provide medical care (adjusted OR=5.1 [95% CI 1.9, 13.7] and 9.5 [95% CI 2.2, 40.8], respectively), compared with leisure travelers, were more likely to receive rabies vaccination. CONCLUSIONS: Few travelers at GTEN clinics received rabies vaccine, although many planned trips 1 month long or more to a strong-recommendation country. Clinicians often determined that vaccine was not indicated, and travelers often declined vaccine when it was offered. The decision to vaccinate should take into account the strength of the vaccine recommendation at the destination country, duration of stay, availability of postexposure prophylaxis, potential for exposure to animals, and likelihood of recurrent travel to high-risk destinations