Post-workout muscle building and repair blunted in obese adults

Obesity is associated with a host of health problems, including heart disease, type 2 diabetes and high blood pressure. According to a new study reported in the Journal of Physiology, obesity also diminishes a person’s ability to build muscle after engaging in resistance exercise.

“Several previous studies, including some from our lab, have shown reductions in muscle protein synthesis after food ingestion in obese adults compared with normal-weight adults,” said University of Illinois kinesiology and community health professor Nicholas Burd, who led the new research with division of nutritional sciences graduate student Joseph Beals. “Our new study goes further, showing there is an obesity-related impairment in building new muscle proteins in the fed state after a weightlifting session.”

Beals and his colleagues recruited nine obese and nine normal-weight 20- to 23-year-old adults for the new study. The participants, who did not engage in a regular exercise program, took a couple of standardized health surveys and were deemed healthy but “insufficiently active” prior to enrollment in the study.

After assessing participants’ body composition, glucose tolerance and ability to engage in a weighted leg extension exercise, the researchers began infusions of stable-isotope-labeled phenylalanine in all study subjects. This allowed the team to monitor amino acid levels in participants’ blood and muscles throughout the experiment.

The team took muscle biopsies from one leg of each of the study subjects, who then performed four sets of 10-12 repetitions of the resistance exercise with the opposite leg.

This weightlifting protocol is more demanding than most current exercise recommendations, Burd said.

Immediately after the exercise, subjects consumed 170 grams of lean ground pork, which amounted to 36 grams of protein and 4 grams of fat. Researchers then collected additional muscle biopsies from the exercised and inactive legs at 120 and 300 minutes after pork ingestion.

“By using participants’ own nonexercised legs as controls in the experiment, we were able to directly compare how weightlifting affects muscles’ ability to build new proteins versus a nonexercised state,” Burd said.

As expected, there were notable differences between the obese and normal-weight participants before the experiments began, Burd said.

“The obese adults had plasma insulin concentrations that were approximately 3.2 times higher at baseline, which highlights some level of whole-body insulin resistance,” he said. “Given that obesity is associated with increased muscle mass, but of poorer metabolic quality, the amount of work they could perform per unit of lean muscle mass also was lower than that of their normal-weight peers.”

Further differences between the normal-weight and obese adults appeared after the exercise and ingestion of protein-dense food. The most important of these involved rates of protein synthesis in myofibrillar proteins, the muscle proteins that generate force and allow muscles to grow bigger in response to exercise.

Rates of myofibrillar protein synthesis increased in both legs in all participants after pork ingestion, the researchers found. But the expected boost in protein synthesis in the exercised legs was more robust in the normal-weight adults than in their obese peers.

“We show that post-workout muscle building and repair is blunted in young adults with obesity,” Burd said. “This is significant because muscle building and repair after exercise has long-term implications for metabolic health and overall physical performance.”

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Story Source:

Materials provided by University of Illinois at Urbana-Champaign. Note: Content may be edited for style and length.

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Journal Reference:

1. Joseph W. Beals, Sarah K. Skinner, Colleen F. McKenna, Elizabeth G. Poozhikunnel, Samee A. Farooqi, Stephan van Vliet, Isabel G. Martinez, Alexander V. Ulanov, Zhong Li, Scott A. Paluska, Nicholas A. Burd. Altered anabolic signaling and reduced stimulation of myofibrillar protein synthesis after feeding and resistance exercise in people with obesity. The Journal of Physiology, 2018; DOI: 10.1113/JP276210

https://bit.ly/2NwZreQ

Alternative treatment for peripheral artery disease

Cristina Sabliov, LSU Biological and Agricultural Engineering professor, and Tammy Dugas, professor in the LSU School of Veterinary Medicine’s Department of Comparative Biomedical Sciences, have joined forces to fight peripheral artery disease, or PAD, an ailment affecting 8 million Americans.

Thanks to a $200,495 Louisiana Board of Regents grant and $50,000 LIFT2 grant, the pair is developing an alternative treatment for PAD using a nanoparticle delivery system and nontoxic polyphenols that will give patients better options for PAD treatment with possibly fewer side effects. Current procedures for treating PAD, a circulatory problem in which narrowed arteries reduce blood flow to limbs, can have harsh side effects and don’t always have a real impact on improving its symptoms.

Wanting to develop a harmless and more effective treatment, Dugas discovered two drugs to treat PAD — resveratrol and quercetin. Both of these are found in red wine, have beneficial effects on cells within arteries, and promote healing of the vessel wall, presumably without the unwanted side effects associated with other drugs used in PAD therapies. Dugas and Sabliov’s goal in treating PAD is to use drugs that don’t destroy cells but rather keep them from growing and narrowing an artery without the use of a stent.

“Dr. Dugas discovered that these two drugs in combination worked well for that purpose,” Sabliov said. “She found the right potion, but she wanted the drugs released over time, and for that, she needed a smart delivery system.”

Knowing of Sabliov’s experience working on nano-delivery, Dugas asked her to create a nanoparticle containing both drugs to serve as that delivery system.

“To be able to do that, Assistant Research Professor Carlos Astete and myself loaded these drugs into a nanoparticle,” Sabliov said. “Nanoparticles are really, really small — only 100-200 nanometers (nm). In comparison, a hair is 70,000 nm thick.”

The way in which the drug would be administered is similar to angioplasty, where currently, doctors insert a drug-coated balloon, or DCB, attached to a catheter into the narrowed vessel and inflate the balloon to expand the blood vessel and improve blood flow. The balloon releases a drug called paclitaxel to slow the growth of cells on the vessel walls where applied. The problem with this is that paclitaxel, which is also used as a breast cancer chemotherapy agent due to its ability to slow the growth of cancer cells, can actually reduce the proper healing of the vessel. Stents that are typically applied within arteries of the heart are relatively ineffective in PAD and are sometimes associated with a risk of breakage, particularly when placed where the leg bends.

“There are places where the stent is not suitable,” Sabliov said. “You can’t have a stent in the part of the leg that bends. You want that artery to stay open, but without the stent, so what do you do? With these new drugs, they stop the artery cells from growing back and causing the artery to re-narrow.”

Sabliov and Dugas will develop a DCB therapy in which the red wine compounds are evenly sprayed on the outside of the balloon in a nanoparticle form that will hopefully adhere to the vessel walls, release the drug, and prevent the cells from growing to narrow the vessel and restrict the blood flow. Therefore, a stent should not be needed once the balloon is removed.

“The whole procedure takes only a few minutes, so we need to make sure the particles are released from the balloon very quickly,” Sabliov said.

Though the idea sounds foolproof, the devil is in the details.

“We have some challenges because, number one, you want the drugs released over time,” Sabliov said. “And number two, the two different chemicals have to be in the optimum ratio that she [Dugas] finds works best.”

Some objectives of the project were for the particle to be less than 300 nm, spherical, have a positive charge, and release the drug loaded at 1:2 molar ratio (quercetin:resveratrol) over a period of 14 days.

“If they have a positive charge, then they attach quickly to the cells,” Sabliov said. “The ratio must be 1:2 because that’s the magic potion that will make the drugs effective. We didn’t want the drugs to kill the cells. We just wanted them to prevent the cells from growing back.”

Getting the particles to be of identical size is also part of the plan. If the particles are of varying size, it will affect the release time. Once this is worked out, the next step is putting the particles on the balloon. The coating method is done with an electrospray that uses a syringe filled with the drug-coated particles. As the inflated balloon rotates on a rod, the syringe sprays and covers all sides of the balloon within a matter of minutes.

“If you take the balloon and just dip it in the nanoparticle solution, it doesn’t work,” Sabliov said. “We want uniform particle covering of the balloon. We just need to optimize it — how long you spray, from how far, how quickly the balloon rotates, etc.”

The project is set to be completed by 2019, with hopes that it will be used to treat both animals and humans in the future.

It was also recently published in the Journal of Biomedical Materials Research, with Sabliov giving credit to her research team of Astete; undergraduate students Gabrielle Brewer, Madison Longwell, Taylor Fradella, and Jacob Braun; and research associate Merilyn Jennings.

“I just emailed them to let them know we were published,” she said. “When you work on something for so many years, and it finally publishes, it’s a big deal for all of us. I’m so proud of them.”

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Story Source:

Materials provided by Louisiana State University. Note: Content may be edited for style and length.

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Journal Reference:

1. Tammy R. Dugas, Gabrielle Brewer, Madison Longwell, Taylor Fradella, Jacob Braun, Carlos E. Astete, Merilyn H. Jennings, Cristina M. Sabliov. Nanoentrapped polyphenol coating for sustained drug release from a balloon catheter. Journal of Biomedical Materials Research Part B: Applied Biomaterials, 2018; DOI: 10.1002/jbm.b.34157

https://bit.ly/2BWt4ol

More survive sudden cardiac arrest with new EMS technique using breathing tube

A new study showed that a change in the type of breathing tube paramedics use to resuscitate patients with sudden cardiac arrest can significantly improve the odds of survival and save thousands of lives. More than 90 percent of Americans who experience sudden cardiac arrest die before, or soon after, reaching a hospital.

“During resuscitation, opening the airway and having proper access to it is a key factor for the survival of someone who goes into cardiac arrest outside of a hospital,” said George Sopko, M.D., M.P.H., program director in the NHLBI’s Division of Cardiovascular Sciences and coauthor of the study. “But one of the burning questions in prehospital emergency care has been, ‘Which is the best airway device?'”

Funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, this study is the largest of its kind to test oxygen delivery methods used by firefighters, emergency medical service (EMS) providers and paramedics. It is the first to show that a particular airway intervention can positively affect patient survival rates. The findings were published online in the Journal of the American Medical Association.

“This study demonstrated that just by managing the airway well in the early stage of resuscitation, we could save more than 10,000 lives every year,” said Sopko.

EMS providers treat the majority of the 400,000 out-of-hospital cardiac arrests each year. For more than three decades, their standard-of-care technique for resuscitation has been endotracheal intubation — the insertion of a plastic tube into the trachea to maintain an open airway. They use this technique in hopes that mirroring the care given by in-hospital physicians will produce better patient outcomes.

“While identical to techniques used by doctors in the hospital, intubation in these severe and stressful prehospital settings is very difficult and fraught with errors,” said Henry E. Wang, M.D., professor and vice chair for research in the Department of Emergency Medicine at McGovern Medical School at The University of Texas Health Science Center at Houston. Wang was the study’s lead author.

Today, however, new devices such as laryngeal tubes, offer simpler alternatives to opening and accessing an airway. These tubes are easier to use, and the trial showed that cardiac arrest patients treated with this alternative had a higher survival rate.

Usually caused by a heart attack, sudden cardiac arrest occurs when the heart suddenly or unexpectedly stops beating, cutting off blood flow to the brain and other vital organs. The vast majority of out-of-hospital cardiac arrests occur at home, and only about 10 percent of people survive, according to the American Heart Association.

The Pragmatic Airway Resuscitation Trial was a multicenter research study conducted by the Resuscitation Outcomes Consortium. It compared survival rates among 3,000 adults with cardiac arrest who were treated by paramedic crews from 27 EMS agencies, in Birmingham, Alabama; Dallas-Fort Worth; Milwaukee; Pittsburgh; and Portland, Oregon. Approximately half of the patients received the newer laryngeal tube treatment, while the other half received traditional endotracheal intubation.

Overall, patients in the laryngeal tube group had significantly better outcomes. For instance, 18.3 percent of patients survived three days in the hospital and 10.8 percent survived to reach hospital discharge. For the group with traditional endotracheal intubation, the survival numbers were 15.4 and 8.1 percent, respectively. Also, the proportion of patients surviving with good brain function was higher in the laryngeal tube group.

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Story Source:

Materials provided by NIH/National Heart, Lung and Blood Institute. Note: Content may be edited for style and length.

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Journal Reference:

1. H.E. Wang et al. Effect of a Strategy of Initial Laryngeal Tube Insertion vs. Endotracheal Intubation on 72-Hour Survival in Adults with Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. Journal of the American Medical Association, 2018; DOI: 10.1001/jama.2018.7044

https://bit.ly/2wi4AAL

Free Health Visits via Teladoc for Residents Impacted by Hurricane Lane

Teladoc Health (NYSE: TDOC), the global leader in virtual care, is providing free, 24/7 general medical visits to those impacted by Hurricane Lane and the resulting wildfires currently devastating many parts of the Hawaiian Islands. Residents and others displaced by the disaster can call 855-549-2234 to access care from the Teladoc Health network of board-certified, state licensed physicians for many non-emergency illnesses. Teladoc Health has also activated a separated dedicated hotline for use by people the Red Cross serves.

“Our call center reps and board-certified and state-licensed physicians are standing by to help those families who have been displaced from their doctors and regular care seeking options, through our hotline,” said Lewis Levy, MD, chief medical officer, Teladoc Health.

What service is being offered?: Free general medical care visits. Among those adult and pediatric conditions that can be effectively diagnosed and treated are common conditions including sinus problems, respiratory infections, allergies, cold and flu symptoms and many other non-emergency illnesses.

Who is qualified to receive care: All victims of Hurricane Lane and the resulting fires—both Teladoc members and non-members alike. For emergencies, always call 911.

When: Effective immediately.

For more information visit Teladoc.com/lane.

https://bit.ly/2PGtHW1

Rural communities to receive proceeds from Mission Health-HCA sale

Mission Health’s Board of Directors announced Monday, Aug. 20, if and when the Mission Health and HCA Healthcare transaction is closed, each Entity Legacy Foundation will receive a distribution of $15 million to improve the health and well-being of their respective community.

None of the existing Foundations within the Mission Health system are part of the contemplated transaction with HCA. They are independent and will remain so. As part of the contemplated transaction, however, each will be redefining its goals and purpose since their purpose will no longer be to give funds to their local hospital or care facility. The Member Legacy Foundations that will be created or converted are:

• Angel Medical Center Foundation

• Blue Ridge Regional Hospital Foundation

• CarePartners Foundation

• Highlands-Cashiers Hospital Foundation

• Mission Hospital Mc-Dowell Foundation

• Transylvania Regional Hospital Foundation

Angel Medical Center currently does not have a foundation and will create one.

The proceeds from Mission Health will be distributed over a three-year period beginning with $5 million upon closing of the contemplated transaction with HCA. Those funds are intended to build infrastructure capacity for the future and to improve the health and well-being of their local community. The terms of the disbursement of funds in years two and three will be contingent upon each foundation’s previous year’s progress and its commitment to continue to develop community capacity to improve the health and well-being of its citizens and a successful start to improving the health and well-being of their communities, including a focus on the local social determinants of health.

Local impact capacity will prepare the Legacy Foundations to work in partnership with the Dogwood Health Trust to dramatically improve the health and well-being of all people and communities of Western North Carolina.

“Throughout the due diligence process, Mission Health’s board has discussed various ways to provide additional support for the communities served by our member entities,” said John R. Ball, Mission Health board chair. “In addition to significant protections against program or facility closures for our rural communities, we are pleased to provide each member entity with proceeds from the sale of Mission Health to benefit their communities directly and locally.”

The public may visit http://www.dogwoodhealthtrust.org for more information.

https://bit.ly/2oijMcz

Cryotherapy may relieve sneezing and runny nose

A new treatment that delivers a freezing or near-freezing temperature to the back of the nose can offer relief to people suffering from chronic stuffy or runny nose, postnasal drip and cough. These symptoms result from persistently inflamed nose and sinuses, a condition known as chronic rhinitis.

Called ClariFix, the treatment is a form of cryotherapy – the use of cold temperatures as a medical treatment—that targets out-of-balance nerves that result in chronic rhinitis. These faulty nerves tell the nose to drip, run and swell more than necessary.

The ClariFix device includes a small, chilled pad on a thin stem that is inserted through a nostril and applied to a targeted spot inside the nasal cavity. The freezing temperature interrupts the errant nerve signals, preventing them from triggering runny, stuffy noses. Specifically, ClariFix interrupts the neural pathway, a connection between parts of the nervous system that triggers rhinitis symptoms.

Rush University Medical Center ear, nose and throat specialists offer treatment to patients using ClariFix cryotherapy, which provides long-lasting relief and is the first and only FDA-cleared device for treating chronic rhinitis.

“Longstanding runny nose and congestion can slowly deprive patients of their quality of life. In the past, medications were the only option that could be offered to our patients. The introduction of ClariFix now offers the possibility of a more definitive solution that has the potential to offer long-lasting relief from rhinitis symptoms,” said Dr. Pete Batra, professor and chairperson of the Department of Otorhinolaryngology-Head and Neck Surgery at Rush.

More than 24 million Americans suffer from the frustrating symptoms caused by chronic rhinitis.

Traditional medical treatments such as nasal sprays, drops and pills can help manage chronic rhinitis symptoms for some people, but often does not address the underlying problem and may have side effects.

ClariFix cryotherapy is a proven treatment option that can be performed in the office. After a numbing medication has been inserted into the patient’s nose and left in place for 10 to 15 minutes, the patient receives the 30 second treatment on each side and can return to work after the procedure. The most common side effects associated with ClariFix cryotherapy are temporary increased congestion and transient pain or discomfort, which normally resolved or is mild after 1 to 2 days. Many patients rate pain as minor.

Clinical study results published in October showed that the treatment was well-tolerated with no device or procedure-related adverse events. After treatment, there was an improvement in runny nose and congestion symptoms and four out of five patients reported long-lasting symptom improvement. Results were similar in both allergic and non-allergic rhinitis patients.

 Explore further: AAO-HNSF clinical practice guideline: Allergic rhinitis

https://bit.ly/2BWnAKh

Children taking multiple medications at risk for severe reactions

Nearly one in five American children use at least one prescription medication, and roughly one in 13 kids takes more than one prescription drug, according to a new study.

And among the children taking more than one medication, one in 12 is at risk of a harmful drug interaction, researchers report in Pediatrics.

Adolescent girls are most at risk of adverse reactions, including a potentially deadly heart condition, the researchers found. In fact, one in five of those taking multiple medications were found to be at risk of a major drug-drug interaction.

“Currently, adverse drug events are the leading cause of injuries and death among children and adolescents,” said the study’s lead author, Dima Qato, of the College of Pharmacy at the University of Illinois at Chicago.

“Parents need to ask their pharmacist or pediatrician about potential side effects and interactions associated with the medications their children are taking,” Qato said. “Prescribers also need to be aware and to be proactive and to ask their patients and their patients’ parents about the medications being taken.”

Qato and her colleagues analyzed the medication use of 23,179 children and adolescents who were participants in the larger ongoing National Health and Nutrition Examination Survey (NHANES). For children under the age of 16, parents provided information on medication use. Those who were 16 or older answered for themselves.

Overall, 19.8 percent of children and adolescents had taken at least one prescription medication in the previous 30 days, with 13.9 percent using medications long-term and 7.1 percent using them for a short period of time.

Medication use increased with age, from 14.7 percent in children up to age 5 years to 22.8 percent among adolescents aged 13 to 19 years old. Short term use was most common among the younger children, who were less likely to be taking medications long term.

The most common medications were respiratory agents, usually for asthma, and psychotherapeutic agents, including stimulants and antidepressants.

The vast majority of potential drug-drug interactions involved antidepressants. The most common potential interaction was QT prolongation, an abnormal heart rhythm that can cause sudden death in otherwise healthy kids.

“QT could occur within days,” Qato said. “It can last more than a month after taking the drug. So even though a child may have used the drug for a week or a few weeks, the adverse effect can be a serious one.”

The study didn’t look at whether any of the children actually developed any of the potential side effects from their medications. It only looked at how many kids were at risk.

Still, the findings were a surprise to Dr. Nathan Samras, an assistant professor in the division of pediatrics and internal medicine at the University of California, Los Angeles.

“It was eye opening,” said Samras, who was unaffiliated with the new study. “I was surprised by the prevalence of prescriptions for all kids as well as the potential for drug-drug interactions.”

Samras said he hopes the new research will prompt parents to report all medications taken by their children – including those sold over-the-counter – to the children’s doctors.

While praising the study for raising awareness of possible dangerous drug interactions, Samras said he hoped it would not lead to parents and physicians “overreacting.”

“You don’t want people to be too scared to use medications when they have more potential benefits than risks,” he explained.

“The absence of data on actual outcomes makes the decision process more difficult,” Samras said. “But being aware of possible drug-drug interactions is important in making prescribing choices.”

SOURCE: bit.ly/2wlqqn1 Pediatrics, online August 27, 2018.

https://reut.rs/2BVnwdH