Skeletal muscle elastic modulus in marathon distance runners.

Skeletal muscle shear elastic modulus is a non-invasive surrogate for early detection of muscle damage and soreness consequent to unaccustomed eccentric muscle work. We investigated the influence of marathon distance running on skeletal muscle shear elastic modulus. Shear modulus of the rectus femoris was measured via ultrasound shear wave elastography in 80 participants (30 female, 50 male) before and after running a World Marathon Major.

ShopTalk - Barbers as partners in health promotion: Reviewing social determinants of health, revisiting cardiology pioneers, and moving forward.

Social Determinants of Health (SDOH) like education, economic stability, social context, neighborhood environment, and healthcare access are increasingly recognized as major drivers of persistent health disparities, particularly among minority populations. Over the past year, studies have demonstrated and quantified the impact that certain SDOH have on uncontrolled blood pressure in Black and Hispanic adults compared to white adults. This underscores the need to view chronic diseases through a SDOH lens and implement multilevel interventions targeting these underlying social factors to achieve health equity.

Cardiac effort and 6-min walk distance correlate with stroke volume measured by cardiac magnetic resonance imaging.

Right ventricular (RV) dysfunction in pulmonary arterial hypertension (PAH) is associated with poor outcomes. Cardiac magnetic resonance imaging (cMRI) is the gold standard for volumetric assessment, and few reports have correlated 6-min walk distance (6MWD) and cMRI parameters in PAH. Cardiac Effort, (the number of heart beats used during 6-min walk test)/(6MWD), incorporates physiologic changes into walk distance and has been associated with stroke volume (SV) measured by nuclear imaging and indirect Fick.

Effect of Antithrombotic Therapy on Clinical Outcomes in Outpatients With Clinically Stable Symptomatic COVID-19: The ACTIV-4B Randomized Clinical Trial.

Importance: Acutely ill inpatients with COVID-19 typically receive antithrombotic therapy, although the risks and benefits of this intervention among outpatients with COVID-19 have not been established.

Objective: To assess whether anticoagulant or antiplatelet therapy can safely reduce major adverse cardiopulmonary outcomes among symptomatic but clinically stable outpatients with COVID-19.

Design, Setting, And Participants: The ACTIV-4B Outpatient Thrombosis Prevention Trial was designed as a minimal-contact, adaptive, randomized, double-blind, placebo-controlled trial to compare anticoagulant and antiplatelet therapy among 7000 symptomatic but clinically stable outpatients with COVID-19.

Combination therapy improves vascular volume in female rats with pulmonary hypertension.

Pulmonary arterial hypertension (PAH) is a female predominant disease in which progressive vascular remodeling and vasoconstriction result in right ventricular (RV) failure and death. Most PAH patients utilize multiple therapies. In contrast, the majority of preclinical therapeutic studies are performed in male rats with a single novel drug often markedly reversing disease in the model.

Low dose monocrotaline causes a selective pulmonary vascular lesion in male and female pneumonectomized rats.

Unlabelled: Purpose/Aim: Low doses (30-80 mg/kg) of monocrotaline are commonly used to create experimental models of pulmonary hypertension in rats. At these doses, monocrotaline causes pulmonary endothelial apoptosis and acute lung injury which ultimately results in pulmonary vascular disease. Higher doses of monocrotaline (300 mg/kg) are known to create severe liver injury, but previous investigations with lower doses have not reported histology in other organs to determine whether the vascular injury with monocrotaline is pulmonary-selective or generalized.

A comparison of the incidence of undiagnosed congenital heart disease in hospital born and home born children.

Objective: To evaluate the incidence of otherwise undiagnosed congenital heart disease (CHD) in a population of children born in a hospital with routine pulse oximetry (RPO) screening compared to children born at home.

Methods: We reviewed 15 years of births at 2 hospitals for incidence of undiagnosed CHD with RPO. The Health Department reviewed the same data for out of hospital births.

Chronic Hyperinsulinemia Causes Selective Insulin Resistance and Down-regulates Uncoupling Protein 3 (UCP3) through the Activation of Sterol Regulatory Element-binding Protein (SREBP)-1 Transcription Factor in the Mouse Heart.

The risk for heart failure and death after myocardial infarction is abnormally high in diabetic subjects. We and others have shown previously that mitochondrial uncoupling protein 3 (UCP3) improves functional recovery of the rodent heart during reperfusion. Here, we demonstrate that pharmacological induction of hyperinsulinemia in mice down-regulates myocardial UCP3.

Evaluation for Testosterone Deficiency.

There has been a recent increase in the number of Operators presenting to clinics for evaluation of possible low testosterone. In response, USASOC recently released an Androgen Deficiency Clinical Practice Guideline (CPG) to help guide providers through the initial evaluation and treatment of patients. The diagnosis of hypogonadism is based on consistent signs and symptoms of androgen deficiency and unequivocally low serum testosterone (below 300 ng/dL).

Hepatic Shunting of Eggs and Pulmonary Vascular Remodeling in Bmpr2(+/-) Mice with Schistosomiasis.

Rationale: Schistosomiasis is a major cause of pulmonary arterial hypertension (PAH). Mutations in the bone morphogenetic protein type-II receptor (BMPR-II) are the commonest genetic cause of PAH.

Objectives: To determine whether Bmpr2(+/-) mice are more susceptible to schistosomiasis-induced pulmonary vascular remodeling.

Biomechanics of uphill walking using custom ankle-foot orthoses of three different stiffnesses.

Unlabelled: Ankle-foot orthoses (AFOs) can provide support and improve walking ability in individuals with plantarflexor weakness. Passive-dynamic AFO stiffness can be optimized for over-ground walking, however little research exists for uphill walking, when plantarflexor contributions are key.

Purpose: Compare uphill walking biomechanics (1) between dynamic AFO users and able-bodied control subjects.

A comparison of slow, uphill and fast, level walking on lower extremity biomechanics and tibiofemoral joint loading in obese and nonobese adults.

We determined if slow, uphill walking (0.75 m/s, 6°) reduced tibiofemoral (TF) loading compared to faster, level walking (1.50 m/s) in obese and nonobese adults.

The effects of walking speed on tibiofemoral loading estimated via musculoskeletal modeling.

Net muscle moments (NMMs) have been used as proxy measures of joint loading, but musculoskeletal models can estimate contact forces within joints. The purpose of this study was to use a musculoskeletal model to estimate tibiofemoral forces and to examine the relationship between NMMs and tibiofemoral forces across walking speeds. We collected kinematic, kinetic, and electromyographic data as ten adult participants walked on a dual-belt force-measuring treadmill at 0.

Vaccination in the county jail as a strategy to reach high risk adults during a community-based hepatitis A outbreak among methamphetamine drug users.

Illicit drug use (IDU) is an important risk factor for hepatitis A, but implementing vaccination programs among drug users is difficult. During January 2001-July 2002, 403 hepatitis A cases were reported in Polk County, Florida; 48% were drug users and of these, 80% were recently in jail. To assess the county jail as a potential vaccination venue, we interviewed 280 inmates and conducted a serologic survey during July--August 2002.

State-mandated staffing ratios within ESRD: benefits and costs.

Currently at least five states regulate the ratio of licensed to unlicensed staff in dialysis clinics; ten states have required patient-to-staff ratios. In addition, nurse practice acts in at least 18 states strictly limit the practice of the patient care technician (PCT). State-mandated staffing ratios, coupled with restrictive nurse practice acts, may be impacting the delivery of care to renal patients.

Dislocation of rotating hinge total knee prostheses. A biomechanical analysis.

Background: Symptomatic instability and implant dislocation are occasionally encountered in patients with a rotating hinge total knee prosthesis. A biomechanical study of rotating hinge total knee implants was performed to determine the association between the design (length and taper) of the central rotational stem and the stability of the implant.

Methods: The stem lengths and tapers of knee implants made by seven manufacturers were measured.

Skin ulceration from tibial cement extrusion: case report and literature review.

Polymethyl methacrylate extrusion through a small tibial defect occurred during revision of a long-stemmed total knee arthroplasty. It caused necrosis and ulceration of the overlying skin. Resection of the protruding cement, debridement of the ulcer, and primary closure effected a cure.

Topographic assessment of irregular astigmatism after photorefractive keratectomy.

Objective: To correlate new quantitative topographic indexes of corneal irregular astigmatism to best spectacle-corrected visual acuity (BSCVA) following excimer laser photorefractive keratectomy (PRK).

Setting: Department of Ophthalmology, LSU Eye Center, and Refractive Surgery Center of the South, Ear, Nose & Throat Hospital, New Orleans, Louisiana; Manhattan Eye, Ear and Throat Hospital, New York, New York, USA.

Methods: Videokeratography data (TMS-1) were obtained preoperatively and 1, 3, 6, 12, 18, and 24 months postoperatively from 100 eyes having PRK for low to mild myopia.

Rapidly progressive herpetic retinal necrosis: a blinding disease characteristic of advanced AIDS.

Eleven patients with rapidly progressive herpetic retinal necrosis (RPHRN) complicating AIDS were investigated retrospectively to study the disease spectrum, systemic involvement, and therapy. The mean CD4 cell count was 24/microL. There was a characteristic disease pattern with rapid progression, 82% bilaterality, relative resistance to intravenous antiviral therapy, and 70% retinal detachment.

Reproducibility of videokeratographic digital subtraction maps after excimer laser photorefractive keratectomy.

Background: Digital subtraction photokeratography can best identify topographic changes after excimer laser photorefractive keratectomy (PRK). To evaluate the reproducibility of these topographic maps, the authors used a topographic modeling system to generate multiple subtraction maps from different combinations of technically acceptable preoperative and postoperative maps for eyes that underwent PRK. The assigned patterns for each patient then were evaluated for consistency.

Ocular deviation following excimer laser photorefractive keratectomy.

We present a case of ocular deviation and diplopia that developed 9 months after monocular excimer laser photorefractive keratectomy. In this case, decompensation occurred because of a breakdown of fusion at distance. We suggest a cover test to assess the presence of significant phorias in all candidates for refractive surgery procedures.