Supplementation Strategies for Strength and Power Athletes: Carbohydrate, Protein, and Amino Acid Ingestion.

It is a common belief amongst strength and power athletes that nutritional supplementation strategies aid recovery by shifting the anabolic/catabolic profile toward anabolism. Factors such as nutrient quantity, nutrient quality, and nutrient timing significantly impact upon the effectiveness of nutritional strategies in optimizing the acute responses to resistance exercise and the adaptive response to resistance training (i.e.

Modeling Gastrointestinal Tract Wet Pool Size in Small Ruminants.

The gastrointestinal tract (GIT) wet pool size (GITwps) refers to the total amount of wet contents in GIT, which in small ruminants can reach up to 19% of their body weight (BW). This study aimed to develop models to comprehensively predict GITwps in small ruminants using a meta-regression approach. A dataset was created based on 21 studies, comprising 750 individual records of sheep and goats.

Net mineral requirements for growth of Saanen goat kids in early life are similar among genders.

The current mineral requirements for growing goat kids are based on sheep and cattle studies without differentiating between the stages of development or gender. The aims of this study were to determine the net requirements for growth of Ca, P, Mg, Na and K of Saanen goat kids during the initial stages of growth and to analyse the effect of gender on the net requirements for growth of these macrominerals. Eighteen female, 19 intact male and 10 castrated male Saanen goat kids were studied.

Impact of a clinical microbiology-intensive care consulting program in a cardiothoracic intensive care unit.

A preintervention-postintervention study was carried out over a 4-year period to assess the impact of an antimicrobial stewardship intervention, based on clinical microbiologist ward rounds (clinical microbiology-intensive care partnership [CMICP]), at a cardiothoracic intensive care unit. Comparison of clinical data for 37 patients with diagnosis of bacteremia (18 from preintervention period, 19 from postintervention period) revealed that CMICP implementation resulted in (1) significant increase of appropriate empirical treatments (+34%, P = .029), compliance with guidelines (+28%, P = .

Pre-operative left atrial strain predicts post-operative atrial fibrillation in patients undergoing aortic valve replacement for aortic stenosis.

Post-operative atrial fibrillation (AF) is a common and serious complication in patients undergoing aortic valve replacement (AVR). Speckle tracking echocardiography (STE) has recently enabled the quantification of longitudinal myocardial left atrial (LA) deformation dynamics. Our aim was to investigate LA preoperative mechanical function in patients undergoing AVR for aortic stenosis using STE and determine predictors of post-operative AF.

Influence of positive end-expiratory pressure on myocardial strain assessed by speckle tracking echocardiography in mechanically ventilated patients.

Purpose: The effects of mechanical ventilation (MV) on speckle tracking echocardiography- (STE-)derived variables are not elucidated. The aim of the study was to evaluate the effects of positive end-expiratory pressure (PEEP) ventilation on 4-chamber longitudinal strain (LS) analysis by STE.

Methods: We studied 20 patients admitted to a mixed intensive care unit who required intubation for MV and PEEP titration due to hypoxia.

Speckle tracking echocardiography as a new technique to evaluate right ventricular function in patients with left ventricular assist device therapy.

Background: Right ventricular (RV) systolic function has a critical role in determining the clinical outcome and the success of using left ventricular assist devices (LVADs) in patients with refractory heart failure. RV deformation analysis by speckle tracking echocardiography (STE) has recently allowed a deeper analysis of RV longitudinal function. The aim of the study was to observe RV function by STE in patients with advanced heart failure before and after LVAD implantation.

An uncalibrated pulse contour method to measure cardiac output during aortic counterpulsation.

Background: Less-invasive monitoring systems, such as pulse contour methods, are increasingly being used to estimate cardiac output (CO). However, alterations in the arterial waveform caused by intraaortic balloon pump counterpulsation may affect the ability of pulse contour algorithms to determine CO. We investigated the reliability of an uncalibrated pulse contour method, the MostCare system, in patients with cardiac failure receiving intraaortic balloon pump counterpulsation by comparing its measurements of CO with those determined by an intermittent thermodilution method.

A simple clinical model for planning transfusion quantities in heart surgery.

Background: Patients undergoing heart surgery continue to be the largest demand on blood transfusions. The need for transfusion is based on the risk of complications due to poor cell oxygenation, however large transfusions are associated with increased morbidity and risk of mortality in heart surgery patients. The aim of this study was to identify preoperative and intraoperative risk factors for transfusion and create a reliable model for planning transfusion quantities in heart surgery procedures.

Prediction of stroke volume by global left ventricular longitudinal strain in patients undergoing assessment for cardiac transplantation.

Purpose: Speckle-tracking echocardiography (STE) is a novel technique that can be used for assessment of left ventricular (LV) longitudinal deformation dynamics. Using cardiac catheterization as the reference standard, the aim of this study was to evaluate the relation between LV global longitudinal strain (GLS) assessed by STE and LV stroke volume in patients undergoing assessment for cardiac transplantation.

Methods: Conventional echocardiography and STE were performed during right-sided cardiac catheterization in 51 patients referred for cardiac transplant assessment.

Relationship between N-terminal pro-B-type natriuretic peptide (Nt-proBNP) and cardiac cycle efficiency in cardiac surgery.

N-terminal pro-B-type natriuretic peptide (Nt-proBNP) is a peptide released from myocardium in response to ventricular wall stress and dysfunction. Nt-proBNP plasma levels are elevated in a variety of cardiovascular disorders and are largely used for diagnosis and treatment of cardiac diseases. The cardiac cycle efficiency (CCE) is a haemodynamic variable that represents the left ventricle wall stress and the heart's effort to maintain an adequate blood flow to tissues.

Fenoldopam to prevent renal replacement therapy after cardiac surgery. Design of the FENO-HSR study.

Introduction: Acute kidney injury requiring renal replacement therapy is a serious complication following cardiac surgery associated with poor clinical outcomes. Until now no drug showed nephroprotective effects. Fenoldopam is a dopamine-1 receptor agonist which seems to be effective in improving postoperative renal function.

Energetic myocardial metabolism and oxidative stress: let's make them our friends in the fight against heart failure.

Heart failure (HF) is a syndrome causing a huge burden in morbidity and mortality worldwide. Current medical therapies for HF are aimed at suppressing the neurohormonal activation. However, novel therapies are needed for HF, independent of the neurohormonal axis, that can improve cardiac performance and prevent the progression of heart dysfunction.

An adjusted EuroSCORE model for high-risk cardiac patients.

Objective: To verify the accuracy and precision of the logistic European system for cardiac operative risk evaluation (EuroSCORE) in high-risk cardiac surgery patients and to develop and externally validate a new system of recalibration.

Methods: The development series included 4279 high-risk patients who had undergone cardiac operations at the IRCCS Policlinico S. Donato.

Predicting transfusions in cardiac surgery: the easier, the better: the Transfusion Risk and Clinical Knowledge score.

Background And Objectives: Allogeneic blood products transfusions are associated with an increased morbidity and mortality risk in cardiac surgery. At present, a few transfusion risk scores have been proposed for cardiac surgery patients. The present study is aimed to develop and validate a risk score based on adequate statistical analyses joint with a clinical selection of a limited (five) number of preoperative predictors.

Predictive role of pretransplant serum CXCL10 for cardiac acute rejection.

Background: The detection of acute rejection in heart transplantation remains an important feature of transplant management, especially in the early phase. Frequent surveillance with endomyocardial biopsy is necessary, even though it is an invasive procedure and carries a certain risk. Hence, noninvasive biomarkers able to predict acute rejection could be a further helpful tool in patient management.

A comparative analysis of predictive models of morbidity in intensive care unit after cardiac surgery - part II: an illustrative example.

Background: Popular predictive models for estimating morbidity probability after heart surgery are compared critically in a unitary framework. The study is divided into two parts. In the first part modelling techniques and intrinsic strengths and weaknesses of different approaches were discussed from a theoretical point of view.

A comparative analysis of predictive models of morbidity in intensive care unit after cardiac surgery - part I: model planning.

Background: Different methods have recently been proposed for predicting morbidity in intensive care units (ICU). The aim of the present study was to critically review a number of approaches for developing models capable of estimating the probability of morbidity in ICU after heart surgery. The study is divided into two parts.

NT-proBNP changes, oxidative stress, and energy status of hypertrophic myocardium following ischemia/reperfusion injury.

N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a sensitive functional marker in heart disease, including left ventricular hypertrophy (LVH) secondary to valvular aortic stenosis (AS). We evaluated the association between NT-proBNP changes, oxidative stress, energy status and severity of LVH in patients with AS. Ten patients undergoing aortic valve replacement for AS were studied.

Lowest hematocrit on cardiopulmonary bypass impairs the outcome in coronary surgery: An Italian Multicenter Study from the National Cardioanesthesia Database.

Severe hemodilutional anemia on cardiopulmonary bypass increases morbidity and mortality after coronary surgery. The present study focuses on the lowest hematocrit values during extracorporeal circulation and on allogenic blood transfusions as mortality and morbidity risk factors. The records of 1,766 consecutive adult patients undergoing isolated coronary artery bypass graft surgery at 3 institutions have been analyzed retrospectively for in-hospital mortality and adverse outcomes.

A multivariate Bayesian model for assessing morbidity after coronary artery surgery.

Introduction: Although most risk-stratification scores are derived from preoperative patient variables, there are several intraoperative and postoperative variables that can influence prognosis. Higgins and colleagues previously evaluated the contribution of preoperative, intraoperative and postoperative predictors to the outcome. We developed a Bayes linear model to discriminate morbidity risk after coronary artery bypass grafting and compared it with three different score models: the Higgins' original scoring system, derived from the patient's status on admission to the intensive care unit (ICU), and two models designed and customized to our patient population.

Anaerobic metabolism during cardiopulmonary bypass: predictive value of carbon dioxide derived parameters.

Background: Hyperlactatemia during cardiopulmonary bypass (CPB) is a common event and is associated to a high morbidity and mortality after cardiac operations. The present study is aimed to identify the possible predictors of hyperlactatemia during CPB among a series of oxygen and carbon dioxide derived parameters measured during CPB.

Methods: This is a prospective observational study on 54 patients undergoing cardiac surgery with CPB.

Systemic arterial waveform analysis and assessment of blood flow during extracorporeal circulation.

Background: The pressure recording analytical method (PRAM) is a method for real-time beat-to-beat quantification of peripheral blood flow based on the analysis of arterial waveform morphology. Since PRAM can be implemented in any conditions of flow, whether physiological or artificial, we assessed its accuracy in patients undergoing cardiac surgery during extracorporeal circulation (ECC), using the roller-pump device as the reference gold standard.

Methods: We prospectively studied 32 patients undergoing elective coronary surgery.