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Nathan Goodyear

ScienceDirect.com - Journal of Chromatography B - Simultaneous determination of salivar... - 0 views

www.sciencedirect.com/...S1570023208008131

LC-MS liquid chromatography mass mass spectroscopy saliva salivary hormone hormones testosterone DHEA

shared by Nathan Goodyear on 14 Aug 12 - No Cached
  • Nathan Goodyear on 14 Aug 12
     
    LC-MS for salivary testosterone and DHEA validated.  Also, T and DHEA were shown to have specific diurnal rhythms.  Changes in levels were also followed after DHEA therapy.
Nathan Goodyear

Sex steroids and cardiovascular disease Yeap BB - Asian J Androl - 0 views

www.ajandrology.com/article.asp

cardiovascular disease CVD sex estradiol carotid intima-media thickness hormones hormone men Testosterone estrogen

shared by Nathan Goodyear on 15 Jan 14 - No Cached
  • Levels of SHBG are higher in older men, therefore levels of free T decline more steeply than total T as men's age increases.
  • calculations based on mass action equations may not reflect precisely free T measured using a reference method
  • free T declines more steeply with age than total T in both cross-sectional [35] and longitudinal studies, [36] as does free E2 in comparison to total E2
  • ...22 more annotations...
  • T may slow development of or progression of atherosclerosis by modulating effects on insulin resistance, inflammation, endothelial function, preclinical atherosclerosis or the vasculature.
  • these cross-sectional and longitudinal studies support a relationship between low circulating T with CIMT and higher E2 with its progression
  • lower levels of T are biomarkers for aortic vascular disease
  • circulating free T was negatively associated with the presence of AAA
  • luteinizing hormone (LH) was positively associated.
  • low levels of total or bioavailable T were associated with aortic atherosclerosis manifested as calcified deposits detected by radiography
  • Men with total or free T in the lowest quartile had increased adjusted ORs for PAD defined as ABI <0.90, as did men with free E2 in the highest quartile of values
  • The apparent association of SHBG with intermittent claudication reflects the correlation of total T with SHBG, while the contribution of E2 to risk of PAD remains unclear
  • men with total T in the lowest quartile of values (<11.7 nmol l−1 ) experienced an increased incidence of stroke or transient ischemic attack
  • lower total T with increased incidence of CVD events
  • cohort studies in mostly older men have supported the association of lower androgen levels with higher mortality
  • lower total or free T levels were associated with mortality in older men, but with discordant results for cause-specific mortality and for associations of E2
  • several large studies identifying lower endogenous levels of total or free T as independent predictors of all-cause or CVD-related deaths in middle-aged and older men
  • T exhibits anti-inflammatory effects, enhances flow-mediated brachial artery reactivity, and reduces arterial stiffness
  • Short-term T therapy had a beneficial effect on exercise-induced myocardial ischemia in middle-aged men with coronary artery disease or chronic stable angina, [95],[96],[97] and reduced angina frequency in older men with diabetes and coronary artery disease
  • T therapy resulted in an increase in treadmill test duration and time to ST segment depression
  • there are interventional studies supporting a protective effect of exogenous T against myocardial ischemia in men with coronary artery disease
  • employ conservative doses
    • Nathan Goodyear
      Nathan Goodyear on 16 Jan 14
       
      This dosing is 100 fold higher then peak production of a  young man at 20-22.
  • Observational studies indicate that lower levels of endogenous T in older men are associated with the presence of carotid atherosclerosis, aortic and peripheral vascular disease, and incidence of CVD events and mortality
  • Interventional studies have shown beneficial effects of exogenous T on vascular function and on exercise-induced myocardial ischemia in men with coronary artery disease
    • Nathan Goodyear
      Nathan Goodyear on 16 Jan 14
       
      the therapies employed in these studies were massively overdosed.
  • Nathan Goodyear on 15 Jan 14
     
    Nice review of all the sex hormones and their relationship to CVD in men.  
Nathan Goodyear

Molecular shuttle chelation: the use of a... [Cell Mol Neurobiol. 2004] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...15206824

Aluminum accumulation brain mitochondria cell

shared by Nathan Goodyear on 26 Nov 13 - No Cached
  • Nathan Goodyear on 26 Nov 13
     
    Aluminum accumulation found to occur in the cell nucleus and the mitochondria of the brain.
Nathan Goodyear

Testosterone and the Cardiovascular System: A Comprehensive Review of the Clinical Lite... - 0 views

jaha.ahajournals.org/...e000272.full

Testosterone men male cardiovascular disease low T

shared by Nathan Goodyear on 20 Nov 13 - No Cached
  • Low endogenous bioavailable testosterone levels have been shown to be associated with higher rates of all‐cause and cardiovascular‐related mortality.39,41,46–47 Patients suffering from CAD,13–18 CHF,137 T2DM,25–26 and obesity27–28
  • have all been shown to have lower levels of endogenous testosterone compared with those in healthy controls. In addition, the severity of CAD15,17,29–30 and CHF137 correlates with the degree of testosterone deficiency
  • In patients with CHF, testosterone replacement therapy has been shown to significantly improve exercise tolerance while having no effect on LVEF
  • ...66 more annotations...
  • testosterone therapy causes a shift in the skeletal muscle of CHF patients toward a higher concentration of type I muscle fibers
  • Testosterone replacement therapy has also been shown to improve the homeostatic model of insulin resistance and hemoglobin A1c in diabetics26,68–69 and to lower the BMI in obese patients.
  • Lower levels of endogenous testosterone have been associated with longer duration of the QTc interval
  • testosterone replacement has been shown to shorten the QTc interval
  • negative correlation has been demonstrated between endogenous testosterone levels and IMT of the carotid arteries, abdominal aorta, and thoracic aorta
  • These findings suggest that men with lower levels of endogenous testosterone may be at a higher risk of developing atherosclerosis.
  • Current guidelines from the Endocrine Society make no recommendations on whether patients with heart disease should be screened for hypogonadism and do not recommend supplementing patients with heart disease to improve survival.
  • The Massachusetts Male Aging Study also projects ≈481 000 new cases of hypogonadism annually in US men within the same age group
  • since 1993 prescriptions for testosterone, regardless of the formulation, have increased nearly 500%
  • Testosterone levels are lower in patients with chronic illnesses such as end‐stage renal disease, human immunodeficiency virus, chronic obstructive pulmonary disease, type 2 diabetes mellitus (T2DM), obesity, and several genetic conditions such as Klinefelter syndrome
  • A growing body of evidence suggests that men with lower levels of endogenous testosterone are more prone to develop CAD during their lifetimes
  • There are 2 major potential confounding factors that the older studies generally failed to account for. These factors are the subfraction of testosterone used to perform the analysis and the method used to account for subclinical CAD.
  • The biologically inactive form of testosterone is tightly bound to SHBG and is therefore unable to bind to androgen receptors
  • The biologically inactive fraction of testosterone comprises nearly 68% of the total testosterone in human serum
  • The biologically active subfraction of testosterone, also referred to as bioavailable testosterone, is either loosely bound to albumin or circulates freely in the blood, the latter referred to as free testosterone
  • It is estimated that ≈30% of total serum testosterone is bound to albumin, whereas the remaining 1% to 3% circulates as free testosterone
  • it can be argued that using the biologically active form of testosterone to evaluate the association with CAD will produce the most reliable results
  • English et al14 found statistically significant lower levels of bioavailable testosterone, free testosterone, and free androgen index in patients with catheterization‐proven CAD compared with controls with normal coronary arteries
  • patients with catheterization‐proven CAD had statistically significant lower levels of bioavailable testosterone
  • In conclusion, existing evidence suggests that men with CAD have lower levels of endogenous testosterone,13–18 and more specifically lower levels of bioavailable testosterone
  • low testosterone levels are associated with risk factors for CAD such as T2DM25–26 and obesity
  • In a meta‐analysis of these 7 population‐based studies, Araujo et al41 showed a trend toward increased cardiovascular mortality associated with lower levels of total testosterone, but statistical significance was not achieved (RR, 1.25
  • the authors showed that a decrease of 2.1 standard deviations in levels of total testosterone was associated with a 25% increase in the risk of cardiovascular mortality
  • the relative risk of all‐cause mortality in men with lower levels of total testosterone was calculated to be 1.35
  • higher risk of cardiovascular mortality is associated with lower levels of bioavailable testosterone
  • Existing evidence seems to suggest that lower levels of endogenous testosterone are associated with higher rates of all‐cause mortality and cardiovascular mortality
  • studies have shown that lower levels of endogenous bioavailable testosterone are associated with higher rates of all‐cause and cardiovascular mortality
  • It may be possible that using bioavailable testosterone to perform mortality analysis will yield more accurate results because it prevents the biologically inactive subfraction of testosterone from playing a potential confounding role in the analysis
  • The earliest published material on this matter dates to the late 1930s
  • the concept that testosterone replacement therapy improves angina has yet to be proven wrong
  • In more recent studies, 3 randomized, placebo‐controlled trials demonstrated that administration of testosterone improves myocardial ischemia in men with CAD
  • The improvement in myocardial ischemia was shown to occur in response to both acute and chronic testosterone therapy and seemed to be independent of whether an intravenous or transdermal formulation of testosterone was used.
  • testosterone had no effect on endothelial nitric oxide activity
  • There is growing evidence from in vivo animal models and in vitro models that testosterone induces coronary vasodilation by modulating the activity of ion channels, such as potassium and calcium channels, on the surface of vascular smooth muscle cells
  • Experimental studies suggest that the most likely mechanism of action for testosterone on vascular smooth muscle cells is via modulation of action of non‐ATP‐sensitive potassium ion channels, calcium‐activated potassium ion channels, voltage‐sensitive potassium ion channels, and finally L‐type calcium ion channels
  • Corona et al confirmed those results by demonstrating that not only total testosterone levels are lower among diabetics, but also the levels of free testosterone and SHBG are lower in diabetic patients
  • Laaksonen et al65 followed 702 Finnish men for 11 years and demonstrated that men in the lowest quartile of total testosterone, free testosterone, and SHBG were more likely to develop T2DM and metabolic syndrome.
  • Vikan et al followed 1454 Swedish men for 11 years and discovered that men in the highest quartile of total testosterone were significantly less likely to develop T2DM
  • authors demonstrated a statistically significant increase in the incidence of T2DM in subjects receiving gonadotropin‐releasing hormone antagonist therapy. In addition, a significant increase in the rate of myocardial infarction, stroke, sudden cardiac death, and development of cardiovascular disease was noted in patients receiving antiandrogen therapy.67
  • Several authors have demonstrated that the administration of testosterone in diabetic men improves the homeostatic model of insulin resistance, hemoglobin A1c, and fasting plasma glucose
  • Existing evidence strongly suggests that the levels of total and free testosterone are lower among diabetic patients compared with those in nondiabetics
  • insulin seems to be acting as a stimulant for the hypothalamus to secret gonadotropin‐releasing hormone, which consequently results in increased testosterone production. It can be argued that decreased stimulation of the hypothalamus in diabetics secondary to insulin deficiency could result in hypogonadotropic hypogonadism
  • BMI has been shown to be inversely associated with testosterone levels
  • This interaction may be a result of the promotion of lipolysis in abdominal adipose tissue by testosterone, which may in turn cause reduced abdominal adiposity. On the other hand, given that adipose tissue has a higher concentration of the enzyme aromatase, it could be that increased adipose tissue results in more testosterone being converted to estrogen, thereby causing hypogonadism. Third, increased abdominal obesity may cause reduced testosterone secretion by negatively affecting the hypothalamus‐pituitary‐testicular axis. Finally, testosterone may be the key factor in activating the enzyme 11‐hydroxysteroid dehydrogenase in adipose tissue, which transforms glucocorticoids into their inactive form.
  • increasing age may alter the association between testosterone and CRP. Another possible explanation for the association between testosterone level and CRP is central obesity and waist circumference
  • Bai et al have provided convincing evidence that testosterone might be able to shorten the QTc interval by augmenting the activity of slowly activating delayed rectifier potassium channels while simultaneously slowing the activity of L‐type calcium channels
  • consistent evidence that supplemental testosterone shortens the QTc interval.
  • Intima‐media thickness (IMT) of the carotid artery is considered a marker for preclinical atherosclerosis
  • Studies have shown that levels of endogenous testosterone are inversely associated with IMT of the carotid artery,126–128,32,129–130 as well as both the thoracic134 and the abdominal aorta
  • 1 study has demonstrated that lower levels of free testosterone are associated with accelerated progression of carotid artery IMT
  • another study has reported that decreased levels of total and bioavailable testosterone are associated with progression of atherosclerosis in the abdominal aorta
  • These findings suggest that normal physiologic testosterone levels may help to protect men from the development of atherosclerosis
  • Czesla et al successfully demonstrated that the muscle specimens that were exposed to metenolone had a significant shift in their composition toward type I muscle fibers
  • Type I muscle fibers, also known as slow‐twitch or oxidative fibers, are associated with enhanced strength and physical capability
  • It has been shown that those with advanced CHF have a higher percentage of type II muscle fibers, based on muscle biopsy
  • Studies have shown that men with CHF suffer from reduced levels of total and free testosterone.137 It has also been shown that reduced testosterone levels in men with CHF portends a poor prognosis and is associated with increased CHF mortality.138 Reduced testosterone has also been shown to correlate negatively with exercise capacity in CHF patients.
  • Testosterone replacement therapy has been shown to significantly improve exercise capacity, without affecting LVEF
  • the results of the 3 meta‐analyses seem to indicate that testosterone replacement therapy does not cause an increase in the rate of adverse cardiovascular events
  • Data from 3 meta‐analyses seem to contradict the commonly held belief that testosterone administration may increase the risk of developing prostate cancer
  • One meta‐analysis reported an increase in all prostate‐related adverse events with testosterone administration.146 However, when each prostate‐related event, including prostate cancer and a rise in PSA, was analyzed separately, no differences were observed between the testosterone group and the placebo group
  • the existing data from the 3 meta‐analyses seem to indicate that testosterone replacement therapy does not increase the risk of adverse cardiovascular events
  • the authors correctly point out the weaknesses of their study which include retrospective study design and lack of randomization, small sample size at extremes of follow‐up, lack of outcome validation by chart review and poor generalizability of the results given that only male veterans with CAD were included in this study
    • Nathan Goodyear
      Nathan Goodyear on 04 Dec 13
       
      The authors here present Total Testosterone as a "confounding" value
    • Nathan Goodyear
      Nathan Goodyear on 09 Dec 13
       
      This would be HSD-II
  • the studies that failed to find an association between testosterone and CRP used an older population group
  • low testosterone may influence the severity of CAD by adversely affecting the mediators of the inflammatory response such as high‐sensitivity C‐reactive protein, interleukin‐6, and tumor necrosis factor–α
  • Nathan Goodyear on 20 Nov 13
     
    Good review of Testosterone and CHD.  Low T is associated with increased all cause mortality and cardiovascular mortality, CAD, CHF, type II diabetes, obesity, increased IMT,  increased severity of CAD and CHF.  Testosterone replacement in men with low T has been shown to improve exercise tolerance in CHF, improve insulin resistance, improve HgbA1c and lower BMI in the obese.
Nathan Goodyear

Serum Albumin and Globulin - Clinical Methods - NCBI Bookshelf - 0 views

www.ncbi.nlm.nih.gov/...NBK204

albumin globulin liver

shared by Nathan Goodyear on 06 May 14 - No Cached
  • Nathan Goodyear on 06 May 14
     
    good, albeit brief, review of albumin and globulin serum values and their indication.
wheelchairindia9

Golden Motor Electric Wheelchair - 0 views

www.wheelchairindia.com/...GM-LITE-POWER-WHEELCHAIR

Power Wheelchairs Controlled Wheelchair Users accessories and equipment Best Power Wheelchair reduces downward sliding motorized Standing Wheelchair Golden Motor Electric Wheelchair

shared by wheelchairindia9 on 19 Apr 15 - No Cached
  • wheelchairindia9 on 19 Apr 15
     
    Powerchairs are generally four-wheeled or six-wheeled and non-folding, however some folding designs exist and other designs may have some ability to partially dismantle for transit. Four general styles of powerchair drive systems exist: front, centre or rear wheel drive and all-wheel drive. Powered wheels are typically somewhat larger than the trailing/castoring wheels, while castoring wheels are typically larger than the castors on a manual chair. Centre wheel drive powerchairs have castors at both front and rear for a six-wheel layout. Angel Wheelchair Electric standing wheelchair Standing up, driving function by power. Head and signal light (controlled by joystick). Adjustable headrest. Adjustable footplate. Detachable backrest Rigid steel framework W/liquid coating Flip-backward armrest Max speed: 9.15KM/H Front castor: 2.80/2.50-4 pneumatic castor (9") Rear wheels: 3.00-8 pneumatic tire (14") Available seat width: A (46 cm), D (42 cm) Max loading: A size: 135 kg Net weight w/o battery: 62.7 kg A powerchairs is a wheelchair that is propelled by means of an electric motor rather than manual power. Power wheelchairs are useful for those unable to propel a manual wheelchair or who may need to use a wheelchair for distances or over terrain which would be fatiguing in a manual wheelchair. They may also be used not just by people with 'traditional' mobility impairments, but also by people with cardiovascular and fatigue based condition. An powerwheelchair powers more than just chair. It gives the power to safely travel long distances on own. It empowers to navigate through home, backyard, school, workplace or local park. It gives power to do the things,want to do. It gives power. When accidents occur that leave permanent leg injuries, or as age sets in and joint pain becomes unbearable, the power chair acts as a gateway to continue living life to the fullest. The powerwheelchairs in our lineup are all battery powered, yet each device fills
Nathan Goodyear

ω-3 Fatty Acid Supplementation as a Potential Therapeutic Aid for the Recover... - 0 views

advances.nutrition.org/...268.full

omega 3 DHA EPA fish oil TBI traumatic brain injury concussions concussion brain injury

shared by Nathan Goodyear on 30 Aug 15 - No Cached
  • There is a growing body of preclinical literature suggesting that ω-3 FAs, and DHA in particular, may play a therapeutic role in mTBI
  • the potential for ameliorating or possibly even preventing the complications associated with concussions
  • DHA is the predominant ω-3 FA present in the brain, and, consistent with this finding, DHA, and not EPA, has been demonstrated to be critical for brain development and cognitive function throughout life
  • ...7 more annotations...
  • the concentration of EPA in the brain is negligible (77–80), suggesting that EPA plays a limited role in mediating the beneficial effects of LCPUFA supplementation on mTBI pathology
  • the current state of the science regarding LCPUFA supplementation for the treatment of concussion is based primarily on animal models
  • there is evidence that the amount of DHA in brain tissue is decreased after mTBI (65, 66), suggesting an elevated need for DHA in mTBI recovery.
  • the well-established role of DHA in supporting the structure and function of the brain throughout the lifespan (26, 27, 46, 47, 53) provides encouragement that LCPUFAs may also prove beneficial in the context of concussion recovery.
  • no therapies are currently available to aid the recovery from this injury
  • Previously discussed reports outlining the use of ω-3 FAs in the recovery from severe TBIs (reviewed in Ref. 92) described the use of very-high doses of LCPUFAs (16.2 g/d EPA plus DHA) in the recovery of these patients
  • Within the context of mTBIs/concussions, translating a DHA intake used in several rat studies of mTBI recovery (40 mg ⋅ kg−1 ⋅ d−1 DHA) (57, 63, 64) using body surface area conversion methods (93) amounts to an estimated human intake of 387 mg/d DHA
  • Nathan Goodyear on 30 Aug 15
     
    nice review of the evidence of n-3, particularily DHA, in concussions and concussion recovery.
Nathan Goodyear

Salivary cortisol in psychoneuroendocrine research... [Psychoneuroendocrinology. 1994] ... - 0 views

www.ncbi.nlm.nih.gov/...8047637

salivary cortisol testing hormone saliva

shared by Nathan Goodyear on 22 Nov 10 - No Cached
  • The assessment of cortisol in saliva has proven a valid and reliable reflection of the respective unbound hormone in blood. To date, assessment of cortisol in saliva is a widely accepted and frequently employed method in psychoneuroendocrinology
  • Nathan Goodyear on 22 Nov 10
     
    saliva cortisol testing "widely" accepted in 1984
Nathan Goodyear

[Bone and Men's Health. Measurement of salivary te... [Clin Calcium. 2010] - PubMed result - 0 views

www.ncbi.nlm.nih.gov/...20118513

saliva salivary testosterone biodentical testng

shared by Nathan Goodyear on 22 Nov 10 - No Cached
  • Testosterone is secreted into saliva. In saliva, testosterone is not bound to proteins. Thus concentration of testosterone in saliva is quite close to the serum free testosterone level. Currently serum free testosterone is measured by a convenient method in Japan, that reflects only 10% of the correct values. However, the correct measurement of serum free testosterone is quite costly. Collection of saliva is not invasive to subjects, and it can be done without paramedicals. Besides it is relatively cheaper. Acquisition of samples in multiple occasions is possible. These advantages of utilizing saliva will introduce the measurements of salivary testosterone in cohort studies or screening of low testosterone levels in the community.
  • Nathan Goodyear on 22 Nov 10
     
    Saliva Testing of Testosterone is standard
Nathan Goodyear

Salivary Testosterone in Hirsutism: Correlations with Serum Testosterone and the Degree... - 0 views

jcem.endojournals.org/...1015

salivary testosterone hirsutism

shared by Nathan Goodyear on 19 Jan 11 - No Cached
  • SaT seems to relate to the bioavailable fraction of the hormone and, thus, appears to be an optimal method for studying hirsute women
  • Nathan Goodyear on 19 Jan 11
     
    salivary testing proves to be realiable testing to evaluate correlation between degree of hair growth and testosterone levels
Nathan Goodyear

Salivary estradiol and progesterone levels in conception and nonconception cycles in wo... - 0 views

www.fertstert.org/...abstract

salivary estradiol progesterone

shared by Nathan Goodyear on 19 Jan 11 - No Cached
  • Salivary measurements of E2 and progesterone can be used as noninvasive methods for assessment of ovarian function. Salivary specimens can be collected at home and brought to the laboratory for analysis, obviating the need for frequent phlebotomy. The sensitivity and precision of the salivary E2 assay make it comparable with assays of serum E2 for assessing changes in hormone levels.
  • Nathan Goodyear on 19 Jan 11
     
    salivary estradiol and progesterone used to assess women with infertility
Nathan Goodyear

Assessing cortisol and dehydroepiandrosterone (DHEA) in saliva: effects of collection m... - 0 views

jop.sagepub.com/...643.abstract

saliva cortisol DHEA

shared by Nathan Goodyear on 18 Jan 11 - No Cached
  • Assessing cortisol and dehydroepiandrosterone (DHEA) in saliva:
  • Nathan Goodyear on 18 Jan 11
     
    assessing cortisol and DHEA in saliva
Nathan Goodyear

Parenteral nutrition in obstetric patients. [Nutr Clin Pract. 1990] - PubMed result - 0 views

www.ncbi.nlm.nih.gov/...2117234

IV nutrition therapy pregnancy

shared by Nathan Goodyear on 23 Feb 11 - No Cached
  • Sufficient favorable clinical experience over the last 10 years suggests that PN is a relatively safe and effective method for reversing maternal malnutrition and promoting normal fetal growth and development.
  • Nathan Goodyear on 23 Feb 11
     
    IV nutritional therapy shown to be safe 
Nathan Goodyear

Occupational Safety and Health Guideline for Xylene - 0 views

www.osha.gov/...recognition.html

xylene

shared by Nathan Goodyear on 23 Feb 11 - No Cached
  • * Signs and symptoms of exposure
  • EXPOSURE SOURCES AND CONTROL METHODS
  • Nathan Goodyear on 23 Feb 11
     
    everything you wanted to know about the toxin xylene
Nathan Goodyear

Uptake, Distribution, and Speciation of Selenoamino Acids by Human Cancer Cells: X-ray ... - 0 views

pubs.acs.org/...bi101678a

selenium cancer

shared by Nathan Goodyear on 12 May 11 - No Cached
  • Nathan Goodyear on 12 May 11
     
    cancer benefits from selenium depend on type of selenium supplemented
Nathan Goodyear

Salivary IgA antigliadin antibody as a marker for coeliac disease. - 0 views

www.ncbi.nlm.nih.gov/...PMC1793814

salivary IgA antigliadin antibodies celiac disease screening

shared by Nathan Goodyear on 06 Sep 11 - No Cached
  • Measurement of salivary IgA AGA provided excellent discrimination between those children with coeliac disease and the control groups, and our study suggests that it may provide a rapid, non-invasive method of screening for this disease before intestinal biopsy
  • Nathan Goodyear on 06 Sep 11
     
    salivary IgA antigliadin antibodies shown to be highly effective as screening tool for celiac disease
Nathan Goodyear

American Journal of Hypertension - Treatment of Hypertension: A Failing Report Card - 0 views

www.nature.com/...ajh2008324a.html

hypertension treatment Laragh method renin

shared by Nathan Goodyear on 08 Sep 11 - No Cached
  • Nathan Goodyear on 08 Sep 11
     
    hypertension has different causes and needs to be treated based on the underlying pathophysiology, not a pin the tail on the donkey approach
Nathan Goodyear

NMJ Original Research: Reproducibility and Reliability of Two Food Allergy Testing Meth... - 0 views

www.naturalmedicinejournal.com/article_content.asp

ALCAT

shared by Nathan Goodyear on 02 May 11 - No Cached
  • Nathan Goodyear on 02 May 11
     
    ALCAT shown to be reproducible and reliable
Nathan Goodyear

Diagnosing Growth Hormone Deficiency in Adults - 0 views

www.hindawi.com/...972617

HGH GH human growth hormone growth hormone IGF-1

shared by Nathan Goodyear on 04 Nov 14 - No Cached
  • it is clear that serum IGF-1 and or IGFBP-3 can be normal in patients with undisputed GHD
  • Various investigators have reported normal IGF-1 values in 37–70% of GH deficient adults
  • The co-administration of arginine and GHRH (the combined test) is a powerful stimulus for GH production and has gained increasing acceptance as a useful method of diagnosing GHD [34]. This test has been advocated as a suitable alternative to ITT
  • ...12 more annotations...
  • The glucagon stimulation test (GST) is a reliable, safe alternative to the ITT in the diagnosis of GHD
  • An intravenous infusion of arginine (0.5 g/kg body weight) together with an intravenous bolus of GHRH (1 mcg/kg body weight) is administered [30]. Serum samples for GH are then obtained every 15–30 minutes for two hours.
  • Obesity, particularly marked obesity, is associated with blunted GH secretion in response to provocative stimuli
  • It has also been suggested that that even mildly increased BMI (25–30 kg/m2) can result in diminished stimulated GH production in 13% of healthy subjects
  • Corneli et al. have defined BMI-specific cut-off points for diagnosing adult-onset GHD using GHRH + arginine—11.5 ng/mL for those with BMI < 25 kg/m2, 8.0 ng/mL for BMI 25–30 kg/m2, 4.2 ng/mL for those with BMI > 30 kg/m2
  • GH levels are higher during the luteal phase in comparison with the follicular phase of the cycle
  • Oral, in contrast to transdermal oestrogen, lowers IGF-1 levels and is associated with increased GH levels
  • Adequate pituitary replacement with thyroxine and hydrocortisone are needed for optimal GH production
  • one cannot rely on a low IGF-1 to diagnose GHD in women taking oral oestrogen preparations.
  • Numerous GH secretagogues are available with the insulin tolerance test being the gold standard and the glucagon stimulation test or the GHRH + arginine as acceptable alternatives
  • ain et al. found the GST to be at least as good as the ITT in provoking GH secretion
  • the GST is safe, with almost no contraindications, it causes nausea and sometimes vomiting in 15–20% of subjects
  • Nathan Goodyear on 04 Nov 14
     
    Nice, more recent analysis, of HGH testing.
Nathan Goodyear

Intravenous Fluid Use in Athletes - 0 views

www.ncbi.nlm.nih.gov/...PMC3435915

IV intravenous fluid nutrition athletes athlete sports medicine sports exercise

shared by Nathan Goodyear on 13 Jan 15 - No Cached
  • Treatment of exercise-associated hyponatremia with hypertonic IV infusion to correct plasma sodium levels is also a standard and accepted use of IV fluid infusions
  • athletes who present for medical care with hypernatremia who cannot tolerate oral fluids can benefit from IV fluids
  • Vaporization of sweat accounts for 80% of heat loss in hot, dry atmospheric conditions. This mechanism of water loss is the major contributor for exercise-associated dehydration
  • ...30 more annotations...
  • The rate of water loss can be quantified through measurement of sweat rate
  • Pre- and postexercise body weight measurements are the most common means to estimate overall water loss but are condition specific
  • It appears that 1% to 2% body weight loss is well tolerated by the exercising athlete
  • Dehydration, defined as greater than 2% loss of body weight, can negatively affect performance
  • In highly trained endurance athletes, plasma volume and sodium serum concentration were preserved despite a 5% body weight loss
  • In Ironman triathletes, dehydration to 5% body weight loss did not correlate with occurrence of medical complications
  • hydration should begin hours prior to exercise, especially if known deficits are present, and fluids should be consumed at a slow, steady rate, with 5 to 7 mL/kg taken 4 hours prior to exercise
  • Sodium concentration did not produce significant changes in the rate of absorption but was primarily dependent on carbohydrate concentration
  • Replacing 150% of body weight loss over 60 minutes has been tolerated without complications
  • IV treatment of severe dehydration (>7% body weight loss), exertional heat illness, nausea, emesis, or diarrhea, and in those who cannot ingest oral fluids for other reasons, is clinically indicated
  • A recent survey of the National Football League teams revealed that 75% (24 of 32) of the teams utilized IV infusion of fluids for prehydration in at least some otherwise healthy individuals
  • In the National Football League, an average of 1.5 L of normal saline was administered approximately 2.5 hours prior to competition
  • after 2 hours of exercise, the rectal temperature was 0.6° higher in the group not receiving IV infusion. Also, stroke volume and cardiac output were 11% to 16% lower in the control group versus the IV infusion group.
  • Recent evidence suggests the etiology of EAMC is related to muscle fatigue and neuronal excitability
  • no correlation between hydration status or electrolyte concentrations with EAMC
  • there may be a subset of muscle cramping that is associated with a loss of both body fluid and sodium
  • Glycerol is the primary agent for oral hyperhydration
  • elevation of plasma volume by 200 to 300 mL via dextran infusion resulted in 15% increase in stroke volume, 4% increase in VO2 max, and an increase in the exercise time to fatigue
  • Neither the tonicity nor mode of hydration resulted in improved speed of rehydration, greater fluid retention, or improved performance
  • There are beneficial anecdotal reports of EAMC treatment in elite and professional-level athletes with IV hydration during the course of an event
  • Plasma volume was better restored during rehydration with IV fluids at preexercise and 5 minutes of exercise. At 15 minutes, there was no difference between IV and oral rehydration
  • More rapid restoration of plasma volume was accomplished in the IV treatment group with no advantages over oral rehydration in physiological strain, heat tolerance, ratings of perceived effort, or thermal sensations
  • No difference was found in exercise time to exhaustion. IV and oral rehydration methods were equally effective. Heart rates were statistically higher in the oral rehydration group through 75 minutes of exercise, and there were higher increases in norepinephrine plasma concentrations
  • No significant differences between the groups were found for time to recovery, number of days with pain, number of days with stiffness, sleep disturbance, fatigue, rectal temperature, and loss of appetite
  • The current data suggest that IV rehydration is faster than oral
  • There may be physiological benefits of decreased heart rate and norepinephrine in athletes rehydrated via IV route
  • Postexercise blood 1 hour and 24 hours showed no differences in circulating myoglobin or creatine kinase
  • The use of IV fluid may be beneficial for a subset of fluid sensitive athletes
  • this should be reserved for high-level athletes with strong histories of symptoms in well-monitored settings.
  • Volume expanders may also be beneficial for some athletes
  • Nathan Goodyear on 13 Jan 15
     
    to be read
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