bluuebunny/crossref_metadata_2025 huggingface dataset:
Hyperandrogenemia in women with polycystic ovary syndrome: prevalence, characteristics and association with body mass index
Authors: Alexiou Eleni , Hatziagelaki Erifili , Pergialiotis Vasilios , Chrelias Charalampos , Kassanos Dimitrios , Siristatidis Charalampos , Kyrkou Giannoula , Kreatsa Maria , Trakakis Eftihios
Published: January 2017

Background:

Hyperandrogenemia is one of the major diagnostic features for the diagnosis of polycystic ovary syndrome (PCOS). The aim of this study was to estimate the prevalence and the characteristics of hyperandrogenemia in women with PCOS and to investigate the association of clinical and biochemical characteristics with body mass index (BMI) according to the presence of hyperandrogenemia.

Materials and methods:

We studied 266 women diagnosed with PCOS. Hyperandrogenemia was defined by testosterone (T) and/or free testosterone (FT) and/or ∆4 androstenedione (Δ4-A) higher than 75% of the upper limits of each hormone. Patients were stratified in two groups according to a BMI threshold of 25 kg/m2.

Results:

Hyperandrogenemia was present in 78.2% of the patients. Elevated levels of T were found in 58.4%, while elevated levels of FT and Δ4-A were found in 42.5% and 34.1% of patients. In normal weight women (BMI≤25 kg/m2) with hyperandrogenemia lower values of hip circumference and HOMA-IR and increased levels of T, FT, Δ4-A, 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulfate (DHEAS), white blood cells (WBC) and neutrophils were observed compared to women without hyperandrogenemia. Also, in overweight women higher levels of T, FT, Δ4-A, 17-OHP, DHEAS and cortisol were measured, while lower thyroid-stimulating hormone (TSH) levels were comparable to women without hyperandrogenemia.

Conclusion:

This study showed high prevalence of hyperandrogenemia in PCOS women. Women with BMI≤25 kg/m2 have significant differences in androgens, WBC, neutrophils and HOMA-IR and women with BMI≥25 kg/m2 in androgens, TSH and cortisol according to the presence or not of hyperandrogenemia.
Bat fauna associated with artificial ponds in La Malinche National Park, a mountain ecosystem of Mexico
Authors: Ayala-Berdon Jorge , Vázquez-Fuerte Rommy , Rodríguez-Peña Nelly , Martínez Gómez Margarita
Published: January 2017

An increase in water demand in mountains has reduced its availability for the fauna. As conservation tools, artificial ponds can be used to offer water to animals. Many studies have assessed the use of ponds by bats. However, most of them have been concentrated in the United States and Europe, while in regions with higher bat diversity the information is scarce. We captured the bat species associated with artificial ponds in a Mexican mountain where water was intubated 25 years ago. We identified and analyzed the bats’ species proportion and sex ratio and evaluated if species richness and abundance were affected by season, mean monthly precipitation, maximum monthly temperature and maximum monthly humidity. We captured 90 bats of seven species (Vespertilionidae), where
1 g Model Tests on the Displacement Accumulation of Large-Diameter Piles Under Cyclic Lateral Loading
Authors: Albiker J. , Achmus M. , Frick D. , Flindt F.
Published: January 2017

Large-diameter monopiles are an established foundation type for offshore wind energy converters. A crucial aspect in the design of such piles is the bearing behavior under cyclically acting wind and wave loads, namely the accumulation of deflections and rotations under these loads. Regarding the prediction of the behavior under cyclic one-way load, some empirical approaches and also numerical simulation methods exist. In contrast, the behavior under cyclic two-way loading is widely unclear and must be investigated by pile tests. This paper presents the results of 1 g model tests with large-diameter piles in sand under arbitrary cyclic loading types. It was found that for almost rigid large-diameter piles, the effect of the loading type on the rate of displacement accumulation could be accounted for by a function which is almost independent on the system parameters, e.g., pile stiffness or relative density of the sand, but dependent on load eccentricity. The maximum accumulation rate occurs for asymmetric two-way loading. Using the functions found in the tests, a prediction of displacement accumulation for load spectra consisting of packages of arbitrary loads becomes possible. For flexible piles, a different effect of the loading type on the rate of displacement accumulation was observed. Here, asymmetric two-way loading was obviously not more unfavorable than one-way load.
Simple Method to Measure the Long-Term Load Change of Ground Anchors
Authors: Liao H. -J. , Cheng S. -H. , Chen H. -R. , Chen C. -C.
Published: January 2017

This paper introduces a simple and reliable method for measuring the long-term load changes of ground anchors. The method operates in a similar fashion to that of the tell-tale load cell in principle. However, in contrast to the tell-tale load cell, the proposed method is highly durable and inexpensive. It only requires the components used in a typical anchor assembly and consists of only one extra strand as the reference strand, which is not engaged by the anchorage. For this method, when the anchor-load changes, the anchorage moves and a relative deformation between the reference strand and anchorage is generated. Based on the measured relative deformation and the effective free-strand length, the change in anchor load can be approximately calculated. The suitability of this method was confirmed by stressing tests performed on field anchors. Although its accuracy may not be as high as that of electrical load cells, it is still satisfactory for evaluating the long-term stability of anchored slopes.
How Does Incarcerating Young People Affect Their Adult Health Outcomes?
Authors: Barnert Elizabeth S. , Dudovitz Rebecca , Nelson Bergen B. , Coker Tumaini R. , Biely Christopher , Li Ning , Chung Paul J.
Published: January 2017

BACKGROUND AND OBJECTIVES:

Despite the widespread epidemic of mass incarceration in the US, relatively little literature exists examining the longitudinal relationship between youth incarceration and adult health outcomes. We sought to quantify the association of youth incarceration with subsequent adult health outcomes.

METHODS:

We analyzed data from 14 344 adult participants in the National Longitudinal Study of Adolescent to Adult Health. We used weighted multivariate logistic regressions to investigate the relationship between cumulative incarceration duration (none, <1 month, 1–12 months, and >1 year) before Wave IV (ages 24–34 years) and subsequent adult health outcomes (general health, functional limitations, depressive symptoms, and suicidal thoughts). Models controlled for Wave I (grades 7–12) baseline health, sociodemographics, and covariates associated with incarceration and health.

RESULTS:

A total of 14.0% of adults reported being incarcerated between Waves I and IV. Of these, 50.3% reported a cumulative incarceration duration of <1 month, 34.8% reported 1 to 12 months, and 15.0% reported >1 year. Compared with no incarceration, incarceration duration of < 1 month predicted subsequent adult depressive symptoms (odds ratio [OR] = 1.41; 95% confidence interval [CI], 1.11–1.80; P = .005). A duration of 1 to 12 months predicted worse subsequent adult general health (OR = 1.48; 95% CI, 1.12–1.96; P = .007). A duration of >1 year predicted subsequent adult functional limitations (OR = 2.92; 95% CI, 1.51–5.64; P = .002), adult depressive symptoms (OR = 4.18; 95% CI, 2.48–7.06; P < .001), and adult suicidal thoughts (OR = 2.34; 95% CI, 1.09–5.01; P = .029).

CONCLUSIONS:

Cumulative incarceration duration during adolescence and early adulthood is independently associated with worse physical and mental health later in adulthood. Potential mechanisms merit exploration.
O Catecismo de Montpellier e a educação da criança no Brasil Imperial
Authors: Anjos Juarez José Tuchinski dos ,   Universidade de Brasília,  Brazil
Published: January 2017

Resumo Partindo da hipótese que os catecismos católicos, na interpretação dada ao quarto mandamento, colocavam em circulação representações sobre a educação da criança pela família, o objetivo deste artigo é identificar como tal educação era concebida no Catecismo de Montpellier, a fim de compreender de que modo ela servia aos interesses do Estado Regalista no Brasil Imperial.
Perfil dos consumidores de material de leitura no Brasil
Authors: Beltrão Kaizô Iwakami ,   Fundação Getúlio Vargas, Brazil, Duchiade Milena Piraccini ,   Associação Científica, Brasil
Published: January 2017

Resumo Foi ajustado um modelo linear generalizado à probabilidade de aquisição de material de leitura com dados da Pesquisa de Orçamento Familiar 2008-2009 do Instituto Brasileiro de Geografia e Estatística - IBGE. As variáveis explicativas foram idade, sexo, anos de estudo, ser estudante, renda familiar, escolaridade da pessoa de referência e área geográfica. A variável dependente foi o evento da aquisição de diversos tipos de material de leitura. O principal achado foi a existência de descontinuidade nas probabilidades de aquisição de material de leitura como função dos anos de estudo: indivíduos com pelo menos um ano de curso superior se diferenciam dos demais. Outro fator importante é o acesso via existência de canais de comercialização. O efeito da existência de estudante na família parece ser restrito a livros didáticos. O estudo confirma resultados observados por outros autores: diferenciais entre os sexos, mesmo controlando por nível socioeconômico, educação e idade.
Suicide and suicide attempts by the elderly in film: related factors as shown in feature films
Authors: Scalco Laércio Maciel ,   Universidade Católica de Brasília,  Brazil, Santos Juvenal Fernandes dos , Scalco Monique Gomes da Silva , Bezerra Armando José China , Faleiros Vicente de Paula , Gomes Lucy ,   Universidade de Brasília,  Brazil,   Universidade Católica de Brasília,  Brazil
Published: January 2017

Abstract Objective: to analyze cases of suicide and suicide attempts by elderly persons in feature films. Method: a survey of specialized internet cinema portals was carried out. A total of 19 feature films produced between 1950 and 2014 were identified. After the authors watched the films, synopses were written describing the circumstances of the suicide and dialogue that described the profile of the elderly character was transcribed. Results: films that described suicide among the elderly were classified as follows: male gender in 13 films (68%), depression with hopelessness in 12 (63%), existence and efficiency of health services, physical illness and absence of familiar support in ten (for each category) (53%), cognitive rigidity in eight (42%), suicidal thinking in seven (37%), dysfunctional assumptions and a self-perception of negativity in six (32%), problem-solving deficits in five (26%) and a lack of social support in five (26%). Conclusion: the portrayal of suicide among the elderly in films helps to raise awareness of this subject and prevent it.
Dietary patterns of the elderly: characteristics and association with socioeconomic aspects
Authors: Souza Jacqueline Danesio ,   Universidade Federal de Goiás, Brazil, Martins Marcos Vidal , Franco Fernanda Silva , Martinho Karina Oliveira , Tinôco Adelson Luiz ,   Universidade Federal do Oeste da Bahia, Brasil,   Faculdade Atenas, Brazil,   Faculdade de Ciências e Tecnologia de Viçosa, Brasil,   Universidade Federal de Viçosa, Brazil
Published: January 2017

Abstract Objective: To investigate the association between dietary patterns and the socioeconomic aspects of elderly patients registered with the Family Health Strategy in Viçosa, Minas Gerais. Method: A cross-sectional study with a probabilistic sample was employed. To identify dietary patterns, dietary intake was assessed through a Food Frequency Questionnaire (FFQ) adapted for an elderly population. From the FFQ dietary patterns were identified by factor analysis. After the identification of the dietary patterns, logistic regression was performed considering each different dietary pattern and the related socioeconomic variables. Results: The consumption of a Fat and sugar pattern was greater among women and lower in elderly persons who considered themselves as mixed race. The consumption of the Balanced pattern was also lower among mixed race, married individuals, with one to four years of schooling and from the CDE economic classes. The Fruit and fish pattern was less consumed by elderly persons with 1-4 years of schooling, while the opposite was observed among those with five years or more of study. But the consumption of a Leafy vegetables pattern was lower among those with five or more years of schooling. Conclusion: The evaluation of the consumption of dietary patterns and the establishment of a relationship with the socioeconomic aspects of the elderly helps to achieve a better understanding of risk and protective factors for health.
Teleconsultorias de fonoaudiologia em um serviço público de telessaúde de larga escala
Authors: Lucena Aline Moreira ,   Universidade Federal de Minas Gerais,  Brazil, Couto Erica de Araújo Brandão , Garcia Vinícius Soares , Alkmim Maria Beatriz Moreira , Marcolino Milena Soriano ,   Universidade Federal de Minas Gerais,  Brazil
Published: January 2017

RESUMO Objetivo: analisar o perfil das teleconsultorias de fonoaudiologia realizadas em serviço público de telessaúde de larga escala em Minas Gerais. Método: foram analisadas todas as teleconsultorias consecutivas de fonoaudiologia realizadas de fevereiro de 2011 a maio de 2014. As teleconsultorias foram agrupadas de acordo com tipo de dúvida, profissional solicitante e área de atuação fonoaudiológica. Resultados: as 259 teleconsultorias realizadas no período do estudo foram originadas de 81 municípios. A maior demanda de teleconsultorias foi dos próprios fonoaudiólogos (64,5%), seguidos de enfermeiros (27,0%) e médicos (5,0%). A maior parte das dúvidas eram assistenciais (81%), sendo que, destas, 35% eram para auxílio na definição diagnóstica e 65% para discussão de procedimentos e sugestão de condutas terapêuticas. Esta proporção foi semelhante, independente da formação do profissional solicitante: fonoaudiólogo e não fonoaudiólogo (65,7% vs. 64,9%, p=1,00). A maioria das dúvidas estava relacionada à área da linguagem (47%) e à motricidade oral (29%), seguidas de voz (20%), audiologia (18%), disfagia (10%) e saúde pública (3%). Conclusão: neste estudo, foi observado que a maioria das dúvidas para o serviço de teleconsultorias em fonoaudiologia estavam relacionadas à área da linguagem, mas há demanda em todas as áreas de abrangência da profissão. Embora o uso da teleconsultoria em fonoaudiologia seja ainda incipiente, observa-se grande potencial de utilização deste instrumento na prática clínica.
Banco de palavras para leitura de escolares do ensino médio: E-LEITURA III
Authors: Oliveira Adriana Marques de ,   Universidade Estadual Paulista "Júlio de Mesquita Filho", Brazil, Capellini Simone Aparecida ,   Universidade Estadual Paulista "Júlio de Mesquita Filho", Brazil
Published: January 2017

RESUMO Objetivo: elaborar um banco de palavras de alta, média e baixa frequência para leitura no Ensino Médio. Métodos: as palavras foram retiradas do material didático de língua Portuguesa, da rede de ensino do Estado de São Paulo. Selecionaram-se apenas os substantivos. Foi registrada a frequência de ocorrência das palavras. Para a classificação das frequências utilizou-se os tercis da distribuição, frequência média e ponto de corte dos tercis. Para verificar a classificação obtida foram avaliados 134 alunos: G1 (1ªsérie, n=44); G2 (2ª série, n= 44) e G3 (3ªsérie, n= 46). As palavras foram apresentadas, para leitura, em voz alta, em duas sessões: 1ª) alta e média frequência e 2ª) baixa frequência. Análise descritiva. Resultados: as palavras correspondem à classificação apresentada, porém, cada palavra apresenta seu nível de dificuldade e o profissional poderá eleger aquelas que melhor respondem aos seus objetivos, para que assim, possa elaborar instrumentos de avaliação e intervenção em leitura. Conclusão: o E-LEITURA III é um recurso útil para os profissionais, pois é disponibilizado um banco com ampla gama de palavras que poderá ser utilizado com escolares do Ensino Médio. Dessa forma, espera-se que o E-LEITURA III possa ser utilizado para elaborar procedimentos de avaliação e intervenção com leitura nesses escolares.
Fonoterapia com fonação em tubos em paciente com paralisia de prega vocal medializada cirurgicamente: estudo de caso
Authors: Lima Joziane Padilha de Moraes ,   Universidade Federal de Santa Maria,  Brazil, Cielo Carla Aparecida , Christmann Mara Keli ,   Associação Educacional Luterana Bom Jesus,  Brasil
Published: January 2017

RESUMO O objetivo deste estudo foi verificar as modificações vocais perceptivo-auditivas e acústicas ocorridas após um método de fonoterapia breve usando três modalidades de fonação em tubos em um sujeito do gênero masculino com paralisia unilateral de prega vocal medializada cirurgicamente. Paciente do gênero masculino, 29 anos e um mês de idade, com diagnóstico otorrinolaringológico de paralisia de prega vocal esquerda em abdução e encaminhado para cirurgia de medialização da prega vocal esquerda (Tiroplastia tipo I) e fonoterapia. Foram realizadas cinco coletas da emissão da vogal /a:/ em momentos distintos, sendo eles: antes da cirurgia; após dez dias da cirurgia (antes da fonoterapia); após seis dias de execução da técnica de fonação em tubo de látex imerso em água; após seis dias de execução de fonação em tubo de vidro imerso em água; após seis dias de execução da fonação em tubo de menor diâmetro. Foi realizada avaliação acústica de fonte glótica, espectrográfica e perceptivo-auditiva. A fonoterapia com os três diferentes exercícios de fonação em tubo, durante 18 dias de tratamento condensado, proporcionou na análise acústica, melhora da maioria das medidas de perturbação de frequência e de componentes surdos ou não sonorizados; da intensidade da cor do traçado da espectrografia de banda larga, da regularidade dos traçados espectrográficos e da definição dos formantes; na análise perceptivo-auditiva, houve redução de tensão, aspereza e soprosidade.
Um modelo orientativo para a gestão municipal dos RCCs
Authors: Fernandes Maria da Paz Medeiros ,   Instituto Federal de Educação, Ciência e Tecnologia da Paraíba,  Brazil, Silva Filho Luiz Carlos Pinto da ,   Universidade Federal do Rio Grande do Sul,  Brazil
Published: January 2017

Resumo Os resíduos da construção civil (RCCs) decorrem de perdas e desperdícios na construção, demolição, reforma e reparos de obras. Sua geração é elevada nos sistemas de produção correntes, organizados em linha com geração e descarte dos resíduos. Tentando minorar essa problemática, municipalidades brasileiras vêm experimentando a gestão diferenciada dos RCCs, notadamente após a Resolução n. 307/2002 (modificada pelas Resoluções ns. 348/2004, 431/2011 e 448/2012) do Conselho Nacional do Meio Ambiente (Conama) e a Lei n. 12.305/2010, que instituiu a Política Nacional dos Resíduos Sólidos (PNRS). Com o objetivo de auxiliá-las, o presente artigo, fruto de pesquisa de doutorado, apresenta um modelo orientativo para gestão municipal dos RCCs. Para a elaboração do modelo foi utilizada a metodologia dos sistemas flexíveis ou metodologia SSM (Soft Systems Methodology), adequada para situações reais e complexas como esta, que necessita reunir e sistematizar práticas, legislação, percepções, conceitos e interesses diversos dos atores envolvidos. O levantamento de dados foi realizado de 2009 a 2013 usando pesquisa bibliográfica, documentação indireta em oito municípios com boas práticas e documentação direta em Belo Horizonte e João Pessoa. Como resultado obteve-se um modelo cíclico que, através de suas diretrizes, estratégias e metas, fornece ajuda aos municípios brasileiros na incorporação de melhorias graduais e consistentes para esse desafio.
Atributos ambientais desejáveis a uma unidade de alojamento conjunto Método Canguru a partir de uma experiência de projeto participativo
Authors: Ely Vera Helena Moro Bins ,   Universidade Federal de Santa Catarina,  Brazil, Cavalcanti Patrícia Biasi , Silveira Juliana Tasca Tissot da , Klein Marina Freitas , Soares Junior Amarildo ,   Universidade Federal de Santa Catarina,  Brazil,   Universidade Federal de Santa Catarina,  Brazil,   Universidade Federal de Santa Catarina,  Brazil,   Universidade Federal de Santa Catarina,  Brazil
Published: January 2017

Resumo Neste artigo aponta-se atributos ambientais desejáveis a unidades de alojamento conjunto centrados no ponto de vista de seus usuários. Os resultados são oriundos de uma experiência de projeto participativo realizada em uma unidade de alojamento conjunto do Método Canguru em Santa Catarina. Os métodos utilizados na pesquisa foram revisão de literatura, visitas exploratórias a duas unidades em funcionamento, brainstorming, poema dos desejos e seleção visual. Através deste estudo objetiva-se fornecer subsídios para orientar projetos de futuras unidades para que considerem os anseios de seus usuários.
Componentes BIM de sistemas prediais hidráulicos e sanitários baseados em critérios de desempenho
Authors: Costa Carolina Helena de Almeida ,   Universidade Estadual de Campinas,  Brazil, Ilha Marina Sangoi de Oliveira ,   Universidade Estadual de Campinas,  Brazil
Published: January 2017

Resumo Os sistemas prediais hidráulicos e sanitários (SPHS) são constituídos por inúmeros componentes e são várias as informações a serem consideradas para sua adequada seleção. Este trabalho tem como objetivo principal identificar características técnicas relativas ao desempenho desses sistemas com base nos critérios contemplados na normalização vigente e propor componentes BIM genéricos com essas informações. Para tanto, foi desenvolvida uma pesquisa construtiva que contemplou, para uma amostra de componentes: consulta aos documentos técnicos disponibilizados pelos fabricantes; levantamento das informações técnicas necessárias para a avaliação do desempenho a partir da normalização; validação das informações técnicas selecionadas por um grupo focal composto de projetistas desses sistemas; proposta de um modelo contemplando essas informações, e proposta e validação de componentes BIM genéricos. Destacam-se como contribuições teóricas desse trabalho a metodologia utilizada para a seleção das informações técnicas para a avaliação do desempenho, o modelo genérico para caracterização dos componentes e a proposta de incorporação de informações de desempenho na norma brasileira de BIM. O desenvolvimento de modelos aplicando essa metodologia a outros componentes dos SPHS possibilitará que o desempenho seja uma variável decisiva para a seleção das soluções e dos componentes a serem empregados, de forma a contribuir para a melhoria da qualidade do projeto desses sistemas.
Experimental and analytical study of X-section cast-in-place concrete pile installation effect
Authors: Zhou Hang , Liu Hanlong , Randolph Mark F. , Kong Gangqiang , Cao Zhaohu
Published: January 2017

A new type of displacement pile, the X-section cast-in-place concrete (XCC) pile, has been developed recently in China. Extensive field and laboratory experiments are being undertaken in order to evaluate the soil displacements during pile installation. The paper describes laboratory arrangements and results of transparent soil model tests aimed at capturing the non-axisymmetric soil displacement field. Results from model tests using the XCC pile are presented to reveal the complete soil displacement patterns (a) in the horizontal plane, and (b) in vertical planes of symmetry. Based on results from the transparent soil tests, a modified cavity expansion model (MCEM) is proposed to predict the radial displacements in any vertical plane induced by XCC pile installation. The radial displacements predicted by the MCEM are compared with data from the transparent soil test and the field experiment. The results show reasonable agreement for all cases, with the proposed MCEM proving more suitable than the conventional (axisymmetric) CEM for predicting the radial displacements induced by XCC pile installation. It may therefore provide a basis in the future for developing predictions of stress changes and, ultimately, shaft capacity of the XCC pile in comparison to displacement piles of circular cross-section.
Use of probiotics and probiotic-based immunomodulators as adjuvant therapy for Helicobacter pylori eradication
Authors: Konorev M R , Andronova T M , Matveenko M E
Published: January 2017

At present, Helicobacter pylori (Нр) infection is the most common chronic bacterial infection in humans, the pathogen of which colonizes approximately 50% of the world’s population. Hp eradication is required to control complications of Hp-related diseases (gastric and duodenal ulcers). Nevertheless, a number of investigations have demonstrated widespread antibacterial therapy inefficiency due to Hp antibiotic resistance and patient non-compliance with treatment regimens. Due to the growing need to elaborate alternative eradication regimens, some researchers have drawn their attention to probiotics and immunomodulators derived from Lactobacillus in particular for eradication therapy in Нp-positive patients to enhance the effect of antibacterial drugs. The review analyzes the results of 10 meta-analyses of randomized clinical trials with a similar design, which were published in 2007 to 2015, and other clinical trials assessing the role of probiotics and probiotic-based immunomodulators as an adjuvant therapy for Hp eradication. The results of the analysis have established that Lactobacillus strain-containing probiotics, both monocomponent probiotics and those as part of multicomponent ones, when used as an adjunct to anti-Hp therapy, significantly increase the level of Нp eradication by 8.1—20.0% (p
Triple antianginal combinations in the treatment of elderly and senile patients with stable angina
Authors: Kanorskii S G , Smolenskaya N V
Published: January 2017

Aim. To compare the efficiency and safety of antianginal therapy (AAT) using a combination of bisoprolol, ivabradine, and trimetazidine or ranolazine in elderly and senile patients with stable angina. Subjects and methods. The study enrolled 107 patients aged 60 to 79 years with coronary heart disease and Functional Class II and III angina. When the patients taking bisoprolol 1.25—2.5 mg once daily and ivabradine 2.5—7.5 mg twice daily continued to have angina and/or silent myocardial ischemia, after randomization 54 patients received an additional 35 mg of trimetazidine twice a day and 53 patients had ranolazine 500 mg twice daily. A comprehensive clinical and instrumental study was conducted prior to randomization and after 6 months of triple AAT. Results. The patients tolerated well both treatments that substantially improved the results of a treadmill exercise test. Trimetazidine reduced to a greater extent the duration of silent ST-segment depression, as evidenced by Holter monitoring. Trimetazidine and ranolazine comparably improved left ventricular systolic and diastolic function, large arterial structure and function, and quality of life in the patients. Conclusion. The combinations of the low-dose β-blocker with ivabradine and trimetazidine or ranolazine may be used to treat refractory stable angina in elderly and senile patients. Trimetazidine is preferred due to its higher efficacy in treating silent myocardial ischemia and to its lower cost.
Impact of smoking on kidney transplantation outcomes
Authors: Stolyar A G , Tomilina N A
Published: January 2017

Aim. To investigate the impact of smoking on kidney transplantation outcomes. Subjects and methods. The materials of 350 patients (including 229 (65.4%) men aged 37.1±0.6 years) who had undergone kidney allotransplantation (KAT) for end-stage renal disease were analyzed. The main outcomes of KAT (patient status (alive or dead); renal allograft (RAG) function or dysfunction; development of chronic transplant nephropathy (CTN)), were studied. Results. There were 52 (14.8%) smoking patients (50 (96.2%) men and 2 (3.8%) women). The survival rate of smokers after KAT was significantly lower (p=0.043), as was the duration of graft function in the smoking patients (p=0.038). There were statistically significant associations of smoking with age, sex, time to normalize post-KAT serum creatinine concentrations, the development of CTN and graft rejection crises, postoperative hypertension, post-KAT serum creatinine, hemoglobin, and albumin levels, pretransplantation alanine aminotransferase concentrations, pre-KAT left ventricular hypertrophy, patient compliance with the prescribed treatment regimen, the presence or absence of a job in the patient after KAT (p
The informative value of non-invasive liver fibrosis markers in patients with nonalcoholic fatty liver disease
Authors: Livzan M A , Akhmedov V A , Krolevets T S , Gaus O V , Cherkaschenko N A
Published: January 2017

Aim. To estimate the diagnostic and informative value of clinical and laboratory parameters in the development and progression of liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) to enhance efficiency of their treatment. Subjects and methods. An open-label case-control study included 77 patients with NAFLD. Clinical and laboratory examinations were done. To search for additional noninvasive fibrosis markers, the investigators studied the serum concentrations of insulin, leptin, adiponectin, matrix metalloproteinase-9 (MMP-9) and its inhibitors, such as tissue inhibitor of matrix metalloproteinases 1 (TIMP-1) and TIMP-2. All the patients underwent elastometry to assess the degree of liver fibrosis with the Metavir scale with the use of a Fibroscan machine. Results. The serum levels of low-density lipoproteins, glucose, MMP-9, and leptin proved to be most informative in assessing the progression of the initial stages (1-2) of fibrosis, as were the increased liver size detected by physical examination, systolic blood pressure, carbohydrate metabolic disorders, alanine/aspartate aminotransferase levels, waist-to-hip ratio, TIMP-1, and TIMP-2 in evaluating the progression of Stage II fibrosis 2 to Stage 3. Conclusion. The clinical and laboratory parameters can serve as reliable noninvasive markers that reflect the progression of fibrotic changes in liver tissue.
Oligosecretory monoclonal gammopathy with renal involvement
Authors: Kozlovskaya L V , Rameev V V , Androsova T V , Kogarko I N , Kogarko B S , Mrykhin N N , Rekhtina I G
Published: January 2017

The article deals with the so-called monoclonal gammopathy of undetermined significance (MGUS), which is being actively explored in the world and has been recently investigated in Russia. It indicates the principles of identifying the phenotypes of MGUS and criteria for assessing the risk of its progression to cancer. There is an update on the possible involvement of monoclonal proteins in the pathogenesis of certain non-neoplastic kidney diseases, renal injuries in particular. The paper gives their classification and enumerates differential diagnostic techniques, including the Freelite method, a highly sensitive one to determine free light chains (FLC), prognostic criteria, and approaches to treating each separate form in relation to the phenotype of a monoclonal protein. The authors present their own data on detection rates for MGUS at a multidisciplinary hospital and a clinical case of MGUS-associated membranoproliferative glomerulonephritis, by justifying a treatment regimen containing bortezomib (velcade).
Pedometer step counting in South Africa: tools or trinkets?
Authors: Cook I
Published: January 2017

Objectives. This study addressed (i) the accuracy of measuring ambulatory signals and (ii) the susceptibility to nonambulatory signals, of the Discovery Vitality Pedometer
(VT) and the Kellogg's Special K Step Counter (KL) compared with three research-grade pedometers (DW: Yamax DigiWalker SW-401, MTI: MTI Actigraph AM-7164-2.2 ,
NL: New Lifestyles NL 2000).
Design. One hundred instruments (20 instruments/brand) were tested at five level walking speeds on a motorised treadmill (3.24, 4.02, 4.80, 5.64, 6.42 km.hr-1) and during
motor vehicle travel on tarred roads (62.9 km).
Results. The KL was highly variable across all speeds, while the VT tended to be variable at the lowest speed. The DW, NL and VT significantly underestimated steps below 4.80km.hr-1 (41 - 94%, p < 0.02) but accuracy improved at speeds ≥ 4.80 km.hr-1 (98 - 102%). The KL displayed the highest variability (60% inter-instrument variance) followed by the VT (10% inter-instrument variance). The research-grade pedometers were the least variable
(0 - 1% inter-instrument variance). At 4.80 km.hr-1, all research- grade pedometers measured within a 10% margin of error compared with the 90% of VT units and 42% of
KL units. The VT was significantly more resistant to nonambulatory signals than the DW (p < 0.01). The KL was the most variable in its response to non-ambulatory signals
while the NL was the most consistent. The MTI detected the most non-ambulatory signals (p < 0.05).
Conclusions. The KL should not be used as a promotional pedometer. The VT achieved the minimum standards required of a promotional pedometer. Further testing is required for longevity, and performance under free-living conditions. South African Journal of Sports Medicine Vol. 18 (3) 2006: pp. 67-78
Skinny fashion – a role for sports medicine?
Authors: Lambert M
Published: January 2017

Skinny fashion – a role for sports medicine?
The effects of exercise training in patients with peripheral vascular disease - a review
Authors: Parr BM , Derman EW
Published: January 2017

Patients with peripheral vascular disease (PVD) suffer from the symptom of intermittent claudication and are therefore intolerant to walking. Exercise training has been
shown to be a beneficial treatment for patients with PVD. Therefore studies have aimed to assess the efficacy of exercise training programmes. This review summarises
the data on the efficacy of exercise training programmes in patients with PVD. Recommendations are made for the mode, duration, frequency and intensity of exercise training programmes. A systematic review of Medline, Pubmed and Science Direct
was done of studies on exercise training and patients with PVD, particularly those using randomised controlled trials. Exercise training improves walking tolerance in patients
with PVD. The common mode of training in patients with PVD in the past decade has been walking on a treadmill; however recently an upper-limb cycle ergometry programme
proved to be as effective as lower-limb cycle ergometry in improving walking tolerance in patients with PVD. As weight-bearing walking programmes are uncomfortable for patients with PVD, this is an important development in exercise prescription for these patients. Most
successful exercise programmes have been 3-6 months in duration for a period of 30 minutes to 1 hour, 2-3 times per week. However, 1 study showed that a shorter period (6
weeks) was of sufficient duration to improve functional capacity in patients with PVD. This is helpful for practitioners as exercise programmes of 3 or 6 months can be daunting for a patient to embark on. Finally, patients should exercise to maximal claudication pain in order to elicit the best training response. South African Journal of Sports Medicine Vol. 18 (4) 2006: pp. 116-121
High-intensity exercise and recovery during short-term supplementation with creatine plus a protein-carbohydrate formula
Authors: Clark JR
Published: January 2017

Objective. To determine the effect of short-term creatine supplementation plus a protein-carbohydrate formula on high-intensity exercise performance and recovery.
Design. A repeated-measures, experimental study, employing a randomised, double-blind, placebo-controlled, group comparison design was used.
Interventions. Thirty active but not sprint-trained male subjects were randomly assigned to 1 of 3 groups: creatine plus protein-carbohydrate formula (CRF); creatine only (CRE); and control (CON). All groups were exposed to the same high-intensity sprint exercise programme, 3 times per week for 30 days.
Main outcome measures. Dependant variables included total repeat sprint distance, fatigue index, perceived muscle pain, and blood lactate, urea, creatine kinase, and cortisol concentrations.
Results. All groups significantly (p ≤ 0.05) increased total sprint distance and decreased blood urea concentrations. There were no significant changes in blood lactate or cortisol
concentrations in any group. CRF showed significant decreases (p ≤ 0.05) in fatigue index, muscle pain, and creatine kinase concentration. However, no significant differences
were found between groups.
Conclusion. Short-term creatine supplementation with or without protein-carbohydrate supplementation does not appear to enhance performance or recovery significantly over high-intensity exercise training alone in non-sprint-trained individuals. A longer trial period may be required to evaluate effect on recovery more conclusively. In addition, the prime importance of physical conditioning, and in particular task-specific exercise training, in stimulating performance and recovery adaptations is highlighted. South African Journal of Sports Medicine Vol. 18 (4) 2006: pp. 136-140
Higher log position is not associated with better physical fitness in professional soccer teams in South Africa
Authors: Clark JR
Published: January 2017

Objective. To assess the difference in physical fitness of players in successful versus less-successful professional soccer teams in South Africa.
Design. Professional soccer players (N = 140) underwent a battery of tests assessing important physiological components during the early part of their competitive season.
Players were then separated into two groups on the basis of their teams' final log position in the Premier Soccer League (PSL) in South Africa. Players in successful (N =
70) and less-successful (N = 70) teams were in the top four or bottom six positions on the log respectively. Descriptive statistics (mean ± standard deviation (SD)) were
calculated for each group, and independent t-tests were used to compare the means of the groups for each of the physical tests.
Main outcome measures. Body composition, flexibility, muscle strength-endurance, power, speed, agility, aerobic endurance, and repeat sprint distance.
Results. There were no significant differences between groups for all measures of body composition, flexibility, repeat sprint distance, and agility. Significant differences
(p < 0.05) were found for sit-ups, aerobic endurance, and speed, but these were generally small, not meaningful differences in performance. Players in successful squads
were significantly (p < 0.01) older than those in less-successful teams.
Conclusions. The results demonstrate that in South Africa level of physical fitness is not higher in more-successful compared with less-successful teams in the PSL. Factors
other than physical fitness may be more important in determining successful league performance and discrimi-nate better between players in teams with different levels
of success. Improving professional soccer performance may require coaches and trainers to focus more attention on technical and tactical skill development in sport-specific
training once an acceptable standard of fitness has been attained.. South African Journal of Sports Medicine Vol. 19 (2) 2007: pp. 40-45
Changes in neutrophil count, creatine kinases and muscle soreness after repeated bouts of downhill running
Authors: Smith LL , Semple SJ , McKune AJ , Neveling N , Caldeira M , Swanepoel J-M , Tsomele L , Naidoo M , Sibanda E
Published: January 2017

Objective. A primary objective was to examine circulating neutrophil count after repeated bouts of downhill running. An additional aim was to determine creatine kinase (CK)
levels during the initial 12 hours, after repeated DHRs.
Design. Eleven healthy, untrained Caucasian males performed 2 x 60 min bouts of DHR (-13.5%), spaced 14 days
apart, at a speed equal to 75% VO2max on a level grade. Blood was collected before, after, and every hour for 12 hours, and every 24 hours for 6 days. Absolute neutrophil
count, CK, and delayed-onset muscle soreness (DOMS) were assessed. Results were analysed using repeated measures ANOVA (p
Maintenance of hyperglycaemia does not improve perfomence in a 100 km cycling time trial
Authors: Bosch AN , Kirkman MC
Published: January 2017

Objectives. The aim of this study was to determine whether the elevated plasma glucose oxidation rate (~ 1.8 g.min-1) in the latter stages of prolonged exercise in subjects in which hyperglycaemia (± 10 mmol.l-1) is maintained via a glucose clamp, improves 100 km cycling time-trial (TT) performance.
Design. Seven endurance-trained male cyclists (22±4 yrs) participated in this randomised crossover trial. On two occasions, separated by 7 - 10 days, subjects performed
a self-paced TT in the laboratory. During one TT blood glucose was maintained at a euglycaemic concentration of ± 5 mmol.l-1 (ETT) and during the other, at ±10 mmol.l-1
(HTT). Each TT was interspersed with 5 X 1 km high-intensity periods (HIP) and 4 X 4 km HIP, in an attempt to mimic the variable intensity of competitive road races. Subjects
were instructed to complete the TT in the ‘fastest time possible', taking the 9 HIP (21 km) into consideration.
Results. There were no significant differences between ETT and HTT in overall time (143:09±7:14 v. 142:23±7:16 min:s), mean power (275±39 v. 279±39 W) and heart rate
(160±9 v. 158±11 beats.min-1).
Conclusion. Time trial performance over 100 km is not improved by maintaining a hyperglycaemic (10 mmol.l-1) blood glucose concentration. South African Journal of Sports Medicine Vol. 19 (3) 2007: pp. 94-98
Nature and proportion of total injuries at the Stellenbosch Rugby Football Club: a comparason of the years 1973 1975 with 2003 -2005
Authors: Puren MS , Barnard JG , Viviers PL
Published: January 2017

Objective. The purpose of this study was to compare the nature and proportion of total injuries occurring at Stellenbosch Rugby Football Club in Stellenbosch, South Africa,
between the years 1973 - 1975 and 2003 - 2005.
Design. Retrospective, descriptive study.
Main outcome measures. Injured rugby players from the Stellenbosch Rugby Football Club from the different time periods were included in the study. Results from the 1973
- 1975 time period were obtained from two previously published articles (Roy, 1974; Van Heerden, 1976), while data from the 2003 - 2005 time period were available through
the Stellenbosch University Rugby Injury Database.
Results. An increase in the proportion of head and facial injuries from 1973 - 1975 (21%) to 2003 - 2005 (42%) was found as well as a doubling in the proportion of concussions
between the two time periods (12% - 23%). There was an overall decrease in total injuries between the two time periods.
Conclusion. The findings highlight the high and increased proportion of head and facial injuries in the game of rugby at the Stellenbosch Rugby Football Club. This is a matter
that should be further investigated. South African Journal of Sports Medicine Vol. 19 (5) 2007: pp. 125-128
Do we have a niche market?
Authors: Lambert M
Published: January 2017

Do we have a niche market?
Medication use by Team South Africa during the XXVIIIth Olympiad: A model for quantity estimation for multi-coded team events
Authors: Derman WE
Published: January 2017

Objective. This descriptive study was undertaken to report the medications used by the athletes and officials of Team South Africa at the 2004 Olympic Games and to provide a model for the estimation of quantities to be used for planning support to future events.
Setting. South African medical facility, 2004 Olympic Games, Athens, Greece.
Methods. The names of the medications, including the dosage and quantity of medications dispensed, were recorded in the pharmacy stock control book at the South African medical facility, 2004 Olympic Games, Athens, Greece. Retrospective review of patient files and medical encounter forms was also undertaken to check against the pharmacy stock control book to ensure complete data capture of dispensed medications.
Main outcome measures. Quantities of medications consumed during the observation period. The units of medication consumed per travelling team member were calculated by dividing the number of units (tablets, capsules, tubes, inhalers, bottles and ampoules)
used during the trip by the total number of travelling team members.
Results. Complete records of medications included in the travelling pharmacy are described. Quantities of medications included ranged from single units to 2 250 units and percentage use of various medications varied from 0% to 100% of stocks. Units per team member ranged from 0 to 9.43. Medications were consumed from all categories of agents. The most utilised agents included the analgesics, musculoskeletal and non-steroidal anti-inflammatory
agents as well as certain vitamin and mineral supplements.
Conclusions. This study describes the consumption of pharmacological agents by the athletes and officials of Team South Africa during the Athens 2004 Olympic Games. It also provides a model to assist with the estimation of quantities of medications to be
included in the travelling pharmacy for future international multicoded sports events. South African Journal of Sports Medicine Vol. 20 (3) 2008: pp. 78-84
Chlorine in swimming pools
Authors: Schoeler L
Published: January 2017

To the Editor: As a former competitive swimmer who is now involved in the health and fitness industry, I am often approached by swimmers and coaches to get my opinion on the water quality in swimming pools used for training by competitive swimmers. Many swimming clubs train in heated indoor pools, mostly in a gym environment, and most of the swimmers complain of a number of symptoms such as sinus problems, itchy skin and itchy ear channels as a result of spending several hours per week exposed to chlorinated water. The scientific literature around the topic of swimming and water quality focuses on asthma and allergies caused by chlorine in swimming pools. However, none of the studies mention any normative values for chemical levels in swimming pools.
The cost of physical inactivity to a nation: the role of sports medicine and its allied health professionals in preventing a crisis
Authors: Brown J , Smith JM
Published: January 2017

No Abstract
Common lower extremity injuries in female high school soccer players in Johannesburg east district
Authors: Mtshali P , Mbambo-kekana N , Stewart AV , Musenge E
Published: January 2017

Objectives. Soccer is one of the sports in South Africa which hasseen an increase in the participation of youth and adult female players. The aim of this study was to determine point and 1-year prevalence, profile of injuries that affect female soccer players, associations between injuries and player position, age, use of equipment, frequency of play, and training duration. Methods. A retrospective questionnaire-based descriptive survey of 103 first team high school female soccer players in the Johannesburg east district was conducted.Results. The 1-year prevalence for the participants who reportedinjuries was 46% (N=47) and the point prevalence was 33% (N=34). From these, a total of 78 and 42 injuries for the 1-year and point prevalence respectively were reported. An extended duration of skills (p=0.0001) and fitness (p=0.02) training in this population reduced the likelihood of incurring an injury. The older the participants, the more chance there was of sustaining injuries (p=0.01). The participants who wore shin guards were less prone to shin/leg injuries (p=0.01), the relative odds being 0.35. Themidfielders had more foot and toe injuries than the other players(p=0.05). Starting age (p=0.78), frequency of play (p=0.83), wearing of shoes (p=0.54) and stretching had no influence on injury. The knee and ankle were the main locations of injury, with defenders and midfielders mostly being injured. Conclusion. A decrease in the duration of training for both skills and fitness and not wearing shin guards are risk factors for injury in female soccer players in high school. The profile of injuries andthe risk factors determined from this study do not differ from the studies done in male adolescent and adult soccer players.