Search

Contains fulltext : 283453.pdf (Publisher’s version ) (Closed access) Cardiovascular (CV) disease (CVD) remains the leading cause of major morbidity and CVD- and all-cause mortality in most of the world. It is now clear that regular physical activity (PA) and exercise training (ET) induces a wide range of direct and indirect physiologic adaptations and pleiotropic benefits for human general and CV health. Generally, higher levels of PA, ET, and cardiorespiratory fitness (CRF) are correlated with reduced risk of CVD, including myocardial infarction, CVD-related death, and all-cause mortality. Although exact details regarding the ideal doses of ET, including resistance and, especially, aerobic ET, as well as the potential adverse effects of extreme levels of ET, continue to be investigated, there is no question that most of the world's population have insufficient levels of PA/ET, and many also have lower than ideal levels of CRF. Therefore, assessment and promotion of PA, ET, and efforts to improve levels of CRF should be integrated into all health professionals' practices worldwide. In this state-of-the-art review, we discuss the exercise effects on many areas related to CVD, from basic aspects to clinical practice.

If a threat cannot be avoided, the organism has two defense options: it can try to eliminate the threatening agent or boost physiological mechanisms to tolerate the challenge and its consequences. Both strategies can be (and usually are) used at the same time. Fighting an infection, for instance, requires mounting immune responses to control pathogen burden as well as physiologic adaptations to tolerate stress and damage. Thus, the two strategies are connected and interdependent. We are starting to understand how the regulation of host metabolic physiology during disease impacts both the ability to resist pathogens' burden and tolerate parenchymal tissue functional damage. Here, we review a number of recent publications that have begun to shed light on the physiological and immunological mechanisms that coordinate host defense and metabolic processes. In particular, we will cover the areas of energetic control, substrates utilization, and the regulatory signals that promote infectious disease tolerance.

The field of lizard sedation, anesthesia, and locoregional anesthesia is advancing with new drug protocols being evaluated, and new locoregional techniques being developed and evaluated. Inducing and maintaining effective and safe chemical restraint in lizards can be challenging, particularly in systemically diseased individuals. Understanding the anatomic and physiologic adaptations of lizards, using reversible or partially reversible injectable protocols, and using locoregional anesthesia may increase the quality of chemical restraint, facilitate faster recoveries, and limit anesthesia-related morbidity and mortality.

Naked mole-rats are highly valuable research models and popular exhibition animals at zoos worldwide. Here, we provide comprehensive descriptions of common postmortem findings of naked mole-rats from both research colonies and populations managed in zoological institutions. Included are brief reviews of their natural history and related physiologic adaptations, unique anatomical features, gross and histologic lesions of common as well as rarely reported disease processes, and discussions of possible pathogeneses with recommendations for future investigations to fill knowledge gaps. Based on postmortem data of several hundreds of naked mole-rats in managed care, it is clear that cancer is extremely rare and infectious disease is infrequently reported. However, despite relatively benign aging phenotypes in this species, several degenerative processes have been nevertheless observed in older populations of naked mole-rats. As such, some potential diet and husbandry-related issues are discussed in addition to the one of the most prominent causes of morbidity and mortality, conspecific aggression and traumas. From this review of lesions and disease, it is clear that pathology, including histopathology, is integral to better understanding mechanisms of healthy aging and cancer resistance of these extraordinary rodents.

The challenge of identifying cause of death in discarded bycaught marine mammals stems from a combination of the non-specific nature of the lesions of drowning, the complex physiologic adaptations unique to breath-holding marine mammals, lack of case histories, and the diverse nature of fishing gear. While no pathognomonic lesions are recognized, signs of acute external entanglement, bulging or reddened eyes, recently ingested gastric contents, pulmonary changes, and decompression-associated gas bubbles have been identified in the condition of peracute underwater entrapment (PUE) syndrome in previous studies of marine mammals. We reviewed the gross necropsy and histopathology reports of 36 cetaceans and pinnipeds including 20 directly observed bycaught and 16 live stranded animals that were euthanized between 2005 and 2011 for lesions consistent with PUE. We identified 5 criteria which present at significantly higher rates in bycaught marine mammals: external signs of acute entanglement, red or bulging eyes, recently ingested gastric contents, multi-organ congestion, and disseminated gas bubbles detected grossly during the necropsy and histologically. In contrast, froth in the trachea or primary bronchi, and lung changes (i.e. wet, heavy, froth, edema, congestion, and hemorrhage) were poor indicators of PUE. This is the first study that provides insight into the different published parameters for PUE in bycatch. For regions frequently confronted by stranded marine mammals with non-specific lesions, this could potentially aid in the investigation and quantification of marine fisheries interactions.

Diuretics are the most commonly prescribed class of drugs in patients with heart failure, and in the short term they remain the most effective treatment for relief from fluid congestion. This article reviews the mode of action of the various diuretic classes and the physiologic adaptations that follow and sets up the basis for their use in the treatment of volume-retaining states, particularly as applies to the elderly. In addition, the article reviews the common side effects related to diuretics.

Pregnant women are vulnerable to a low zinc status due to the additional zinc demands associated with pregnancy and foetal development. The present systematic review explores the relationship between habitual vegetarian diets and dietary zinc intake/status during pregnancy. The association between vegetarian diets and functional pregnancy outcome also is considered. A literature search was conducted of MEDLINE, PubMed, Embase, the Cochrane Library, Web of Science, and Scopus electronic databases up to September 2014. Six English-language observational studies qualified for inclusion in the systematic review. A meta-analysis was conducted that compared the dietary zinc intake of pregnant vegetarian and non-vegetarian (NV) groups, the zinc intake of vegetarians was found to be lower than that of NV (−1.38 ± 0.35 mg/day, p &lt, 0.001), and the exclusion of low meat eaters from the analysis revealed a greater difference (−1.53 ± 0.44 mg/day, p = 0.001). Neither vegetarian nor NV groups met the recommended dietary allowance (RDA) for zinc. In a qualitative synthesis, no differences were found between groups in serum/plasma zinc or in functional outcomes associated with pregnancy. In conclusion, pregnant vegetarian women have lower zinc intakes than NV control populations and both groups consume lower than recommended amounts. Further information is needed to determine whether physiologic adaptations in zinc metabolism are sufficient to meet maternal and foetal requirements during pregnancy on a low zinc diet.

The quests for performance gains in sport have become increasingly prominent over the past 30 years with steady increases in marathon participation, cycling, and triathlons. Children today are exercising for performance gains at an earlier age than ever before. It is imperative to recognize the medical considerations for such endeavors, including physiologic adaptations to training. With the following, we intend to illustrate the medical concerns associated with marathon and long-distance running, cycling, swimming, and triathlon participation. Additionally, we will review the literature in regard to exercise-induced adaptations to exercise in children.

Evidence from several studies consistently shows decline in cardiorespiratory (CR) fitness and physical function after disabling stroke. The broader implications of such a decline to general health may be partially understood through negative poststroke physiologic adaptations such as unilateral muscle fiber type shifts, impaired hemodynamic function, and decrements in systemic metabolic status. These physiologic changes also interrelate with reductions in activities of daily living (ADLs), community ambulation, and exercise tolerance, causing a perpetual cycle of worsening disability and deteriorating health. Fortunately, initial evidence suggests that stroke participants retain the capacity to adapt physiologically to an exercise training stimulus. However, despite this evidence, exercise as a therapeutic intervention continues to be clinically underutilized in the general stroke population. Far more research is needed to fully comprehend the consequences of and remedies for CR fitness impairments after stroke. The purpose of this brief review is to describe some of what is currently known about the physiological consequences of CR fitness decline after stroke. Additionally, there is an overview of the evidence supporting exercise interventions for improving CR fitness, and associated aspects of general health in this population.

The open operative management of pelvic and acetabular fractures in the obese is technically demanding, with a significantly higher rate of complications compared with patients who are nonobese. The decision to perform surgery should involve a thorough understanding of risks, and patients should be counseled. Careful attention should be paid to patient factors; coexisting systemic conditions and patient positioning to reduce complications. Wound complications are most commonly seen, and techniques to reduce risk should be incorporated. When complications occur, aggressive management can result in successful salvage. Future areas of study should include methods to reduce risk of surgical site infections and improving our understanding of the physiologic alterations that occur with obesity. This article summarizes the current literature on open treatment of pelvic and acetabular fractures in the obese patient, reviews the physiologic adaptations of obesity as they relate to pelvic surgery, highlights risk factors for complications, and provides recommendations to reduce the incidence of complications.

Purpose: The purpose of this study was to determine whether seven intermittent altitude exposures (IAE), in combination with either rest or exercise training, improves time-trial exercise performance and induces physiologic adaptations consistent with chronic altitude adaptation at 4300 m. Methods: Ten adult lowlanders (26 ± 2 yr; 78 ± 4 kg; means ± SE) completed cycle endurance testing during an acute exposure to a 4300-m-altitude equivalent (446 mm Hg) once before (pre-IAE) and once after (post-IAE) 7 d of IAE (4h·d-1, 5 d·wk-1, 4300 m). Cycle endurance testing consisted of two consecutive 15-min constant-work rate exercise bouts followed immediately by a time-trial exercise performance test. During each IAE, five subjects performed exercise training, and the other group of five subjects rested. Results: Both groups demonstrated similar improvements in time-trial cycle exercise performance and physiologic adaptations during constant-work rate exercise from pre-IAE to post-IAE. Thus, data from all subjects were combined. Seven days of IAE resulted in a 16% improvement (P < 0.05) in time-trial cycle exercise performance (min) from pre-IAE (35 ± 3) to post-IAE (29 ± 2). During the two constant-work rate exercise bouts, there was an increase (P < 0.05) in exercise arterial O2 saturation (%) from pre-IAE (77 ± 2; 75 ± 1) to post-IAE (80 ± 2; 79 ± 1), a decrease (P < 0.05) in exercise heart rate (bpm) from pre-IAE (136 ± 6; 162 ± 5) to post-IAE (116 ± 6; 153 ± 5), and a decrease (P < 0.05) in exercise ratings of perceived exertion from pre-IAE (10 ± 1; 14± 1) to post-IAE (8 ± 1; 11 ± 1). Conclusions: Our findings indicate that 7 d of IAE, in combination with either rest or exercise training, improves time-trial cycle exercise performance and induces physiologic adaptations during constant-work rate exercise consistent with chronic altitude adaptation at 4300 m.

Left atrial (LA) structural and functional remodeling reflects a spectrum of pathophysiological changes that have occurred in response to specific stressors. These changes include alterations at the levels of ionic channels, cellular energy balance, neurohormonal expression, inflammatory response, and physiologic adaptations. There is convincing evidence demonstrating an important pathophysiological association between LA remodeling and atrial fibrillation (AF). Measures that will prevent, attenuate, or halt these processes of LA remodeling may have a major public health impact with respect to the epidemic of AF. In this review, we describe the mechanisms involved in LA remodeling and highlight the existing and potential therapeutic options for its reversal, and implications for AF development.

The weightless environment of space imposes specific physiologic adaptations on healthy astronauts. On return to Earth, these adaptations manifest as physical impairments that necessitate a period of rehabilitation. Physiologic changes result from unloading in microgravity and highly correlate with those seen in relatively immobile terrestrial patient populations such as spinal cord, geriatric, or deconditioned bed-rest patients. Major postflight impairments requiring rehabilitation intervention include orthostatic intolerance, bone demineralization, muscular atrophy, and neurovestibular symptoms. Space agencies are preparing for extended-duration missions, including colonization of the moon and interplanetary exploration of Mars. These longer-duration flights will result in more severe and more prolonged disability, potentially beyond the point of safe return to Earth. This paper will review and discuss existing space rehabilitation plans for major postflight impairments. Evidence-based rehabilitation interventions are imperative not only to facilitate return to Earth but also to extend the safe duration of exposure to a physiologically hostile microgravity environment.

Diuretics are tools of considerable therapeutic importance. First, they effectively reduce blood pressure, while at the same time decreasing the morbidity and mortality associated with hypertension. Diuretics are currently recommended as first-line therapy for the treatment of hypertension. In addition, they remain an important component of heart failure therapy, in that they improve the symptoms of congestion, which typify the more advanced stages of heart failure. This article reviews the mode of action of the various diuretic classes and the physiologic adaptations that follow; sets up the basis for their use in the treatment of volume-retaining states, particularly as applies to the elderly; and reviews diuretic-related side effects that are normally encountered.

It is well accepted that in women with calcium intakes close to current recommendations, the physiologic adaptations for providing calcium to the fetus and infant are largely independent of calcium intake, and that there is no apparent bone benefit for the mother or infant of using calcium supplements. However, in women consuming low calcium diets, and in adolescent mothers, maternal bone adaptations during reproduction have been found to respond to increased calcium intake or calcium supplementation although not always as expected. Moreover, fetal and infant skeletal development has been found to be positively associated to increased maternal calcium intake or supplementation during pregnancy in some but not all studies. These apparently inconsistent results are possibly due to the complex interactions between genetics, diet composition, calcium intake, environment, and lifestyle on maternal and infant bone responses during pregnancy and lactation. In this chapter, studies evaluating the effect of maternal calcium intake during pregnancy and lactation, from the diet and from supplements, on maternal bone outcomes and on fetal and infant bone growth are reviewed. The effect of other factors on bone outcomes and the possible implications for the maternal and infant bone health are considered.

The childbearing woman with cardiac disease presents a unique challenge to healthcare providers. The physiologic adaptations that accompany pregnancy and labor predispose the woman with cardiac disease to cardiac decompensation. Ideally, these women are identified to perinatal nursing staff prior to admission to the hospital in labor or for obstetrical procedures in order to provide adequate time for review of the specific cardiac lesion and development of an interdisciplinary plan of care. This article provides a comprehensive review of typical intrapartum routines that require modification and discusses strategies for adapting labor management for the woman with cardiac disease.

Drug delivery in reptiles and amphibians can be challenging. The varied anatomical and physiologic adaptations of this diverse animal group must be considered when choosing routes of drug administration. This article will discuss specific techniques for delivering drugs via various routes of administration.

Magnetic resonance imaging is playing an increasingly prominent role in depicting brain maturation, especially gyral formation that follows a temporospatial pattern, and in detecting developmental abnormalities of the cortex and other brain sectors. Knowledge of the technical advantages and limitations of in-utero magnetic resonance imaging techniques, relative to those of the postnatal period, is essential to optimize magnetic resonance sequences for early diagnosis. This includes an understanding of the changes in both brain anatomy and magnetic resonance signals that occur with an increase in gestational age.Magnetic resonance imaging has evolved has an important adjunct in the diagnosis of brain malformations, particularly in the late-second or third trimester. Noxious conditions elicit more of a chronic rather than acute response in the fetal brain, which differs from that observed postnatally. Clinical applications of proton magnetic resonance spectroscopy may help elucidate fetal brain maturation and its abnormalities from a metabolic point of view.Indications for fetal brain magnetic resonance imaging have increased because of improvements in magnetic resonance techniques and the ability to detect subtle changes within the cerebral parenchyma, especially in fetuses at increased risk of brain damage.

Amphibians by nature have an intimate connection with the aquatic environment at some stage of development and fight an osmotic battle due to the influx of water. Many amphibians have acquired a more terrestrial existence at later stages of development and consequently have physiologic adaptations to conserve moisture. Renal adaptations have allowed amphibians successfully to bridge the gap between aqueous and terrestrial habitats. The kidneys, skin, and, in many amphibian species, the urinary bladder play key roles in fluid homeostasis. Renal impairment may be responsible for the clinical manifestation of disease, morbidity, and mortality (Box 1).

Influenza is a significant cause of morbidity and mortality from febrile respiratory illness worldwide. Influenza in pregnant women has historically been associated with a higher rate of morbidity and mortality. Pneumonia is the sixth leading cause of death in the United States, and it is the number one cause of death from an infectious disease. Although pregnant women do not get pneumonia more often than nonpregnant women, it can result in greater morbidity and mortality because of the physiologic adaptations of pregnancy. Pregnant patients who have either of these conditions require a higher level of surveillance and intervention.

Weight lifting, or resistance training, is a potent stimulus to the neuromuscular system. Depending on the specific program design, resistance training can enhance strength, power, or local muscular endurance. These improvements in performance are directly related to the physiologic adaptations elicited through prolonged resistance training. Optimal resistance training programs are individualized to meet specific training goals. When trained properly (i.e., similar intensity and volume), these functional and physiologic adaptations are similarly impressive among women and the aged as they are among young men. Yet, in contrast to relative measurements, sex and age differences exist in the absolute magnitude of adaptation. Of equal importance, perhaps most notably among the elderly, are the important health benefits that may also be derived from resistance training. For example, bone density, insulin sensitivity, and co-morbidities associated with obesity can be effectively managed with resistance exercise when it is conducted on a regular basis. The extent of the functional and health benefits to be accrued from resistance training depend on factors such as initial performance and health status, along with the specification of program design variables such as frequency, duration, intensity, volume, and rest intervals.

Pregnancy predisposes women to disproportionate morbidity and mortality from influenza infections. This is true for both seasonal epidemics as well as occasional pandemics. Inactivated yearly influenza vaccines are the best available method of disease prevention and are recommended for all pregnant women in any trimester of pregnancy and postpartum. Oseltamivir (Tamiflu(®)) is currently the first-line recommended and most commonly used pharmaceutical agent for influenza prophylaxis and treatment. Oseltamivir has been demonstrated to prevent disease among exposed individuals, as well as to shorten the duration of illness and lessen the likelihood of complications among those infected. The physiologic adaptations of pregnancy may alter the pharmacokinetics and pharmacodynamics of this important drug. Updated evidence regarding these potential alterations, current knowledge gaps, and future investigative directions is discussed.

Hypoglycemia in the pediatric population is a common finding important to recognize and manage to prevent brain injury. Recent advances in molecular genetics have provided new insight into its biochemical and physiologic basis and have led to more appropriate and specific treatment. Although a major cause of brain injury in pediatrics, the ability to predict the long-term outcome in these patients remains difficult. Identification of these at-risk individuals is important. The physiologic adaptations associated with transition from fetal to neonatal life are now better understood thus allowing for improved surveillance and management. Despite these advances, analytical limitations of point-of-care testing instruments at low glucose concentration continue to persist. This review aims to address these questions and provide an overview of pediatric hypoglycemia and the molecular pathways involved.

In the November 2008 issue of CJASN , Ibrahim et al. (1) reported racial differences in metabolic characteristics of the National Health and Nutrition Examination Survey (NHANES) 2003 through 2006 population with respect the presence or absence of chronic kidney disease (CKD) defined by an estimated GFR (eGFR) > and

Anorexia nervosa is often characterized by progressive deterioration in many different organ systems. Most medical complications are the result of starvation and can be reversed with a well-planned refeeding program. While some of the complications of anorexia nervosa are predictable physiologic adaptations to the self-imposed starvation, many others are potentially life threatening. It is therefore incumbent upon all primary care physicians to become familiar with this disorder, because it is increasing in incidence and is commonly burdened by substantial chronicity and recidivism.

During maternal cardiopulmonary arrest the physiologic adaptations of pregnancy and tendency toward hypoxia in the presence of apnea make it the presence of apnea make it more difficult to resuscitate the mother. Successful resuscitation of the mother and infant depend on proper initial management of cardiopulmonary arrest and pregnancy-required modifications to emergency cardiac care. This article provides an overview of the physiology and techniques of cardiopulmonary resuscitation (CPR), the effect of pregnancy on CPR, and the role of perimortem cesarean in maternal and neonatal survival.

The presence of nucleated erythrocytes and thrombocytes in reptile blood limits the use of electronic cell-counting devices for leukocytes so that manual counting techniques and evaluation of blood smears are necessary, resulting in time-consuming procedures requiring good training and experience. The evaluation of most hematologic values is complicated by the many physiologic adaptations occurring in reptiles, making references values very difficult to interpret. This article brings together most of the bibliography about hemochrome evaluation in reptiles, with schematic instruction about sample collection, handling, and evaluation. Information about evaluation of both qualitative and quantitative aspects of reptile hematology are also given.

The role of seed chemical traits (nutrient composition, energy contents and presence of secondary compounds) for the selection of foods by granivorous birds and for the evolution of bird granivory is analyzed and compared with the roles of other seed traits such as seed distribution and seed morphology. A literature review was made, focusing on: 1) seasonal dietary shifts from seeds to other food items; 2) dietary effects of between-seeds differences in energy and nutrient contents; and 3) dietary effects of seed secondary chemistry. Results suggest that the effects of seed chemistry on seed-eating bird diets are much less important than the effects of morphologic traits related to seed processing speed. Birds generally tend to select the food items they can process faster, their chemical composition being of secondary importance. Several experiments aimed to test this hypothesis are proposed. This pattern of food selection suggests that the evolution of bird granivory has been mainly focused on the development of morphologic adaptations for the mechanical digestion of seeds, whereas physiologic adaptations for their chemical digestion appear to be secondary. Additional data on the physiology of seed-eating birds in the wild would be necessary to corroborate this idea.

Pregnancy leads to diverse physiologic changes to accommodate the demands of the developing fetoplacental unit, which affect many major organ systems. Understanding these physiologic adaptations to pregnancy is important for all clinicians because they have important implications for the diagnosis and management of various disorders. This article provides a brief overview of the most notable of these adaptations, including cardiovascular, hematologic, respiratory, renal, immunologic, and gastrointestinal. Clinical correlate of pharmacokinetics and a patient case study are included.

Spinal cord injury is a life-transforming condition of sudden onset that can have devastating consequences. A multidisciplinary, functional goal-oriented programme is required to enable the tetraplegic patient live as fully and independently life as possible. Physiotherapy is a very important part of the multidisciplinary team required to prevent many of the immobilization complications that may result in serious functional limitations, reduce overall morbidity and achieve well patterned recovery. This study therefore highlights the neuromuscular adaptations of tetraplegic patients to physiotherapy over a period of six weeks. Fifteen patients participated in this study and the results showed that even though changes in the musculoskeletal parameters are inevitable in tetraplegics, the extent/degree of reduction of these parameters was grossly minimized in the studied subjects through the administration of physiotherapeutic measures. However, further research using a large sample size will be required to evaluate the physiologic adaptations of the neuromuscular system to the physiotherapy interventions among patients with spinal cord injury.

The combination of calorie deprivation and forced evasion is a unique and severe stress. The physiologic adaptations which occur under these conditions are complex. Performance decrements and psychological changes are evident within 24 hours of cessation of nutritional intake. Although marked losses of both lean tissue and total body mass are unavoidable, ultimate survival duration depends on many things. This article reviews some of the physiologic and pathologic changes which occur during total calorie deprivation and some of the factors which impact on the ability to survive.

A study of the morphologic and physiologic adaptations of orthotopic microneurovascular gracilis musculocutaneous transplantations was done on dogs, using postoperative electrostimulation or prior denervation, compared to controls. Postoperative electrostimulation helped preserve enzyme activity at muscle synapses. Prior denervation demonstrated the enhancement of nerve-fiber penetration into the transplanted muscle, producing better restoration of transplant contraction than in controls. These techniques maximize the functional results of dynamic gracilis musculocutaneous microneurovascular transplantation in the dog model.

Concern has been raised that negative physiological and psychological effects of dieting may outweigh aesthetic and health benefits. This review of the literature concludes the following: (a) The measurement of dieting is an important unresolved issue; (b) current dieting, chronic dieting, desire to lose weight, specific weight control behaviors, and weight changes may have different effects on health and need to be distinguished; (c) dieting is usually not associated with nutritional deficiencies, adverse physiologic adaptations, severe psychological reactions, or the development of eating disorders; and (d) recommendations against weight loss efforts involving moderate changes in eating and exercise habits are not warranted.

Background Overcoming spaceflight-induced (patho)physiologic adaptations is a major challenge preventing long-term deep space exploration. RNA interference (RNAi) has emerged as a promising therapeutic for combating diseases on Earth; however the efficacy of RNAi in space is currently unknown. Methods Caenorhabditis elegans were prepared in liquid media on Earth using standard techniques and treated acutely with RNAi or a vector control upon arrival in Low Earth Orbit. After culturing during 4 and 8 d spaceflight, experiments were stopped by freezing at −80°C until analysis by mRNA and microRNA array chips, microscopy and Western blot on return to Earth. Ground controls (GC) on Earth were simultaneously grown under identical conditions. Results After 8 d spaceflight, mRNA expression levels of components of the RNAi machinery were not different from that in GC (e.g., Dicer, Argonaute, Piwi; P>0.05). The expression of 228 microRNAs, of the 232 analysed, were also unaffected during 4 and 8 d spaceflight (P>0.05). In spaceflight, RNAi against green fluorescent protein (gfp) reduced chromosomal gfp expression in gonad tissue, which was not different from GC. RNAi against rbx-1 also induced abnormal chromosome segregation in the gonad during spaceflight as on Earth. Finally, culture in RNAi against lysosomal cathepsins prevented degradation of the muscle-specific α-actin protein in both spaceflight and GC conditions. Conclusions Treatment with RNAi works as effectively in the space environment as on Earth within multiple tissues, suggesting RNAi may provide an effective tool for combating spaceflight-induced pathologies aboard future long-duration space missions. Furthermore, this is the first demonstration that RNAi can be utilised to block muscle protein degradation, both on Earth and in space.

Barbosa, TM, Sousa, VF, Silva, AJ, Reis, VM, Marinho, DA, and Bragada, JA. Effects of musical cadence in the acute physiologic adaptations to head-out aquatic exercises. J Strength Cond Res 24(1): 244-250, 2010—The purpose of this study was to analyze the relationships between musical cadence and the physiologic adaptations to basic head-out aquatic exercises. Fifteen young and clinically healthy women performed, im- mersed to the breast, a cardiovascular aquatic exercise called the ''rocking horse.'' The study design included an intermittent and progressive protocol starting at a 90 bmin 21 rhythm and increasing every 6 minutes, by 15 bmin 21 , up to 195 bmin 21 or exhaustion. The rating of perceived effort (RPE) at the maximal heart rate achieved during each bout (HRmax), the percentage of the maximal theoretical heart rate estimated (%HRmax), and the blood lactate concentration ((La-)) were evaluated. The musical cadence was also calculated at 4 mmolL 21 of blood lactate (R4), the RPE at R4 (RPE@R4), the HR at R4 (HR@R4), and the %HRmax at R4 (%HRmax@R4). Strong relationships were verified between the musical cadence and the RPE (R 2 = 0.85; p , 0.01), the HRmax (R 2 = 0.66; p , 0.01), the %HRmax (R 2 = 0.61; p , 0.01), and the (La-) (R 2 = 0.54; p , 0.01). The R4 was 148.13 6 17.53 bmin 21 , the RPE@R4 was 14.53 6 2.53, the HR@R4 was 169.33 6 12.06 bmin 21 , and the %HRmax@R4 was 85.53 6 5.72%. The main con- clusion is that increasing musical cadence created an increase in the physiologic response. Therefore, instructors must choose musical cadences according to the goals of the session they are conducting to achieve the desired intensity.

In conclusion, it is important to appreciate the anatomic and physiologic adaptations in pregnancy in order to accurately diagnose and treat cardiopulmonary disease states in the gravid woman. Without knowing what constitutes normalcy in pregnancy, inappropriate diagnosis and interventions may occur. Furthermore, this knowledge is fundamental for understanding how disease states affect pregnancy and how pregnancy affects disease.

AHS is a benign condition consisting of physiologic adaptations to the increased cardiac work load of exercise. Its primary features are biventricular hypertrophy and bradycardia associated with normal systolic and diastolic function. In addition, the alterations in cardiac structure are related to the type of training with dynamic training causing proportionally greater dilation and static training primarily increased wall thickness. AHS is associated with abnormalities in ECG, radiograph, and echocardiographic findings. It is important to be aware of these changes so that they are not misinterpreted to represent pathologic states. In particular, the distinction between AHS and HCM can be difficult, although certain historic and echocardiographic features can help differentiate the two.

Resistance and endurance training are often performed concurrently in most exercise programs and in rehabilitative settings in an attempt to acquire gains in more than 1 physiologic system. However, it has been proposed that by simultaneously performing these 2 modes of exercise training, the strength gains achieved by resistance training alone may be impaired. Thus, the aim of this study was to compare the effects of 16 weeks of resistance training and concurrent resistance and endurance training on muscular strength development in 38 sedentary, apparently healthy males (25 yr +/- 8 mo). Subjects were age-matched and randomly assigned to either a control (Con) group (n = 12), resistance training (Res) group (n = 13), or concurrent resistance and endurance training (Com) group (n = 13). After 16 weeks, no changes were found in the strength of the subjects in the Con group. Resistance training and concurrent resistance and endurance training significantly (p < or = 0.05) improved strength in all of the 8 prescribed exercises. The data also indicated that 16 weeks of concurrent resistance training and endurance training was as effective in eliciting improvements in strength as resistance training alone in previously sedentary males. As such, concurrent resistance and endurance training does not impede muscular strength gains and can be prescribed simultaneously for the development of strength in sedentary, apparently healthy males and thus may invoke all the physiologic adaptations of resistance and endurance training at once.

These articles review the physiologic adaptations occurring during the transition from fetal to neonatal life and examine common red flags which may alert care providers to an infant experiencing delayed transition or an underlying disease process, congenital abnormality, or birth injury.

The prospects for extending the length of time that humans can safely remain in space depend partly on resolution of a number of medical issues. Physiologic effects of weightlessness that may affect health during flight include loss of body fluid, functional alterations in the cardiovascular system, loss of red blood cells and bone mineral, compromised immune system function, and neurosensory disturbances. Some of the physiologic adaptations to weightlessness contribute to difficulties with readaptation to Earth's gravity. These include cardiovascular deconditioning and loss of body fluids and electrolytes; red blood cell mass; muscle mass, strength, and endurance; and bone mineral. Potentially harmful factors in space flight that are not related to weightlessness include radiation, altered circadian rhythms and rest/work cycles, and the closed, isolated environment of the spacecraft. There is no evidence that space flight has long-term effects on humans, except that bone mass lost during flight may not be replaced, and radiation damage is cumulative. However, the number of people who have spent several months or longer in space is still small. Only carefully-planned experiments in space preceded by thorough ground-based studies can provide the information needed to increase the amount of time humans can safely spend in space.

Nursing care for the childbearing woman in microgravity will be the challenge of the future. The purpose of this theoretical article is to stimulate creative thought. Information garnered through years of research in obstetrics and, more recently, in space medicine is reviewed. Physiologic adaptations occur as a result of both pregnancy and space flight. The potential interplay of these changes is discussed, and questions are raised for further consideration.