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Increase in myofibrillar protein accretion can occur in the very early post-exercise period and can be potentiated by ingestion of essential amino acid (EAA). Furthermore, strength exercise induces important disturbances in protein turnover, especially in novice athletes. The purpose of this investigation was to evaluate the effects of an EAA supplementation on muscle mass, architecture and strength in the early stages of a heavy-load training programme. 29 young males trained during 12 weeks. They were divided into a placebo (PLA) (n = 14) group and an EAA group (n = 15). At baseline, daily food intake and nitrogenous balance were assessed with a food questionnaire over 7 days and two 24-h urine collections. The effect of training on muscle mass was assessed by anthropometric techniques. Muscle thickness and pennation angle were recorded by ultrasonography of the gastrocnemius medialis (GM). Maximal strength during squat and bench press exercises were tested on an isokinetic ergometer. Training resulted in significant increase in muscle mass and strength in both PLA and EAA groups. Positive linear regressions were found between nitrogen balance and increase in muscle mass in the PLA group (P < 0.01, r2 = 0.63) and between the initial strength and the increase in muscle strength in the EAA group (P <0.05, r2 = 0.29). EAA ingestion resulted in greater changes in GM muscle architecture. These data indicate that EAA supplementation has a positive effect on muscle hypertrophy and architecture and that such a nutritional intervention seems to be more effective in subject having lower nitrogen balance and/or lower initial strength. [ABSTRACT FROM AUTHOR]

This study examines the incidence, predictors, and evolution of postoperative atrioventricular block (AVB) after mitral valve repair (MVR) in 115 consecutive patients using Carpentier’s technique (between November 1996 and April 1997). Postoperative AVB occurred in 27 patients (23%). Third-degree AVB was found in 7 patients (6%) in the immediate postoperative period, but in 4 it was transient, resolving partially or completely before the seventh postoperative day. Second-degree AVB (Mobitz type I) occurred in 4 patients (3%) immediately after operation and resolved in all before hospital discharge. Isolated first-degree AVB occurred in 16 patients (14%) and was permanent in 12. Neither the preoperative variables nor the mitral procedures including anterior versus posterior leaflet repair were related to postoperative AVB. A lesser systemic hypothermia during surgery was the only, modestly independent predictor of postoperative AVB (odds ratio 1.53; 95% confidence interval 1.04 to 2.25; p = 0.031). Three patients (2.6%) had permanent pacemaker implantation, on average 18 days after operation, and all had persistent third-degree AVB. With a mean follow-up of 3 years, no recurrence or worsening of conduction disturbances, no further pacemaker implantation, and no late deaths were observed. [Copyright &y& Elsevier]

The article reports on ways to prevent rheumatic heart disease and acute rheumatic fever which include the coordination to produce vaccine, improvement of the use of valve repair function, and the research on echocardiographic screening. Topics mentioned include the safety measures for rheumatic heart disease patients, the need to cooperate by organizations World Health Organization (WHO) and World Heart Federation, and the safety measures for surgical valve repair techniques.