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Parks JC, Joplin MCP, Marshall EM, Kearney SG, Humm SM, Kern MA, Pinzone AG, Erb EK, Smith TM, Kingsley JD. Effects of resistance exercise alone or with caffeine on hemodynamics, autonomic modulation and arterial stiffness in resistance-trained women. Eur J Appl Physiol 2023; 123:2711-2721. [PMID: 37341819 DOI: 10.1007/s00421-023-05260-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/13/2023] [Indexed: 06/22/2023]
Abstract
AIM Both an acute bout of resistance exercise (RE) and caffeine consumption can significantly alter hemodynamics, autonomic modulation, and arterial stiffness, which may correlate with adverse cardiovascular events. However, effects of an acute bout of RE and caffeine are unclear in resistance-trained women. PURPOSE The purpose of this study was to compare the effects of an acute bout of RE with repetitions to failure on squat and bench press, with or without caffeine, on performance, resting and recovery measures of hemodynamics, autonomic modulation, as well as arterial stiffness in resistance-trained women. METHODS Eleven women participated in a double-blind, placebo controlled cross-over design in which they consumed caffeine (4 mg/kg) or placebo at least 72 h apart. Sixty minutes following ingestion, participants performed two sets of 10 repetitions followed by a third set to failure on squat and bench press. Hemodynamics, autonomic modulation, and arterial stiffness were measured at rest, 60 min post-ingestion, and three minutes and 10 min following RE. RESULTS Data demonstrated caffeine has no additive effects on performance, hemodynamics, autonomic modulation, or arterial stiffness (p > 0.05) before or following an acute bout of RE in resistance-trained women compared to a placebo. CONCLUSIONS Resistance-trained women may not observe any alteration to RE performance on the squat and bench press in terms of repetitions to failure following caffeine ingestion. In addition, the data from the present study suggests that there may also not be any further negative effects on the cardiovasculature if caffeine is consumed prior to the RE bout.
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Affiliation(s)
- Jason C Parks
- Kinesiology, State University of New York at Cortland, Cortland, NY, 13045, USA.
| | | | - Erica M Marshall
- Exercise Science, Florida Southern College, Lakeland, FL, 33801, USA
| | - Sarah G Kearney
- Exercise Science, Seton Hill University, Greensburg, PA, 15601, USA
| | - Stacie M Humm
- Exercise Science and Exercise Physiology, School of Health Sciences, Kent State University, Kent, OH, 44240, USA
| | - Michelle A Kern
- Exercise Science and Exercise Physiology, School of Health Sciences, Kent State University, Kent, OH, 44240, USA
| | - Anthony G Pinzone
- Exercise Science and Exercise Physiology, School of Health Sciences, Kent State University, Kent, OH, 44240, USA
| | - Emily K Erb
- Exercise Science and Exercise Physiology, School of Health Sciences, Kent State University, Kent, OH, 44240, USA
| | - Therese M Smith
- Exercise Science and Exercise Physiology, School of Health Sciences, Kent State University, Kent, OH, 44240, USA
| | - J Derek Kingsley
- Exercise Science and Exercise Physiology, School of Health Sciences, Kent State University, Kent, OH, 44240, USA
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Marshall EM, Gere J. Congruence and goal sharing of health-related goals among newly dating individuals explaining goal importance and commitment. Psychol Health 2023; 38:1623-1634. [PMID: 35137665 DOI: 10.1080/08870446.2022.2037849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 10/29/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The study aimed to determine whether perceived goal sharing (i.e., perceiving a partner as having the same health-related goal) and/or perceived goal congruence (i.e., being able to spend time together in health-related goal activities) with a romantic partner are associated with health-related goal commitment and importance. DESIGN AND MAIN OUTCOME MEASURES 80 participants with a health-related goal in a larger study on newly dating relationships completed two self-report questionnaires 3 months apart using validated assessments of goal commitment and importance. RESULTS Perceived goal congruence was associated with concurrent goal commitment and importance and higher goal commitment over time. However, perceived goal sharing was not associated with the health-related goal dimensions (even when interacting with goal congruence) with the exception of increased goal importance over time for those scoring lower than the average on relationship satisfaction. CONCLUSION One way to enhance health-related goal importance and commitment is to ensure goal congruence exists within romantic relationships, and partners can spend time together engaging in goal-related activities with their partner. Moreover, the results suggest that romantic partners exert an influence even among the newly dating, who are often presumed to be less impactful on health outcomes and processes.
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Affiliation(s)
| | - J Gere
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
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Marshall EM, Parks JC, Erb EK, Humm SM, Kingsley JD. Cardiac Autonomic Function Following Bilateral and Unilateral Upper Body Acute Resistance Exercise. Int J Environ Res Public Health 2022; 19:ijerph19106077. [PMID: 35627614 PMCID: PMC9141936 DOI: 10.3390/ijerph19106077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/13/2022] [Accepted: 05/15/2022] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to compare cardiac autonomic responses following bilateral and unilateral upper-body (UB) acute resistance exercise (ARE). In total, 14 individuals were assessed for markers of cardiac autonomic responses via heart rate variability (HRV) and baroreflex sensitivity (BRS) at rest and at 10- and 30-min following ARE. Logarithmically transformed (ln) HRV measures included: total power (ln TP), high-frequency power (ln HF power), low-frequency power (ln LF power), sympathovagal balance (ln LF: HF), and the square root of the mean squared differences of successive R-R intervals (ln RMSSD). BRS was assessed using the sequence method. Two-way repeated measures ANOVAs were used to analyze effects of UB ARE (bilateral, unilateral) across time (Rest, 10, and 30 min). There were no significant (p > 0.05) interactions. However, there were significant (p ≤ 0.05) main effects of time such that ln TP, ln HF power, ln RMSSD, and BRS decreased and did not recover within 30 min compared to Rest for both conditions. Collectively, this study suggests that bilateral and unilateral UB ARE yielded similar reductions, for at least 30 min, in respect to vagal measures of HRV and BRS.
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Affiliation(s)
- Erica M. Marshall
- Exercise Science, Florida Southern College, Lakeland, FL 33801, USA
- Correspondence:
| | - Jason C. Parks
- Kinesiology, State University of New York at Cortland, Cortland, NY 13045, USA;
| | - Emily K. Erb
- Exercise Science and Exercise Physiology, Kent State University, Kent, OH 44242, USA; (E.K.E.); (S.M.H.); (J.D.K.)
| | - Stacie M. Humm
- Exercise Science and Exercise Physiology, Kent State University, Kent, OH 44242, USA; (E.K.E.); (S.M.H.); (J.D.K.)
| | - J. Derek Kingsley
- Exercise Science and Exercise Physiology, Kent State University, Kent, OH 44242, USA; (E.K.E.); (S.M.H.); (J.D.K.)
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Tai YL, Marshall EM, Parks JC, Kingsley JD. Hemodynamic response and pulse wave analysis after upper- and lower-body resistance exercise with and without blood flow restriction. Eur J Sport Sci 2021; 22:1695-1704. [PMID: 34529554 DOI: 10.1080/17461391.2021.1982018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Resistance exercise (RE) has been shown to elevate hemodynamics and pulse wave reflection. However, the effects of acute RE with blood flow restriction (BFR) on hemodynamics and pulse wave reflection are unclear. The purpose of this study was to evaluate the differences between upper- and lower-body RE with and without BFR on hemodynamics and pulse wave reflection. Twenty-three young resistance-trained individuals volunteered for the study. Hemodynamics and pulse wave reflection were assessed at rest, 10, 25, 40, and 55 min after either upper- or lower-body with or without BFR. The upper-body RE (URE) consisted of the latissimus dorsi pulldown and chest press; the lower-body RE (LRE) consisted of knee extension and knee flexion. The BFR condition consisted of four sets of 30, 15, 15, and 15 repetitions at 30% 1-repetition maximum (1RM) while the without BFR condition consisted of four sets of 8 repetitions at 70% 1RM. Heart rate, rate pressure product, and subendocardial viability ratio significantly (p < 0.05) increased after all exercises. Brachial and aortic systolic blood pressure (BP) significantly (p < 0.05) elevated after LRE while brachial and aortic diastolic BP significantly (p < 0.05) reduced after URE. Augmentation pressure, augmentation index (AIx), AIx normalized at 75 bpm, and wasted left ventricular pressure energy significantly (p < 0.05) increased after URE while transit time of reflected wave significantly (p < 0.05) decreased after LRE. URE places greater stress on pulse wave reflection while LRE results in greater responses in BP. Regardless of URE or LRE, the cardiovascular responses between BFR and without BFR are similar.HIGHLIGHTS High-load resistance exercise and low-load resistance exercise with blood flow restriction may produce similar cardiovascular responses.Upper-body resistance exercise generates greater changes on pulse wave reflections while lower-body resistance exercise induces greater elevations in systolic blood pressure.
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Affiliation(s)
- Yu Lun Tai
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Brownsville, TX, USA.,Exercise Science and Exercise Physiology, Kent State University, Kent, OH, USA
| | - Erica M Marshall
- Exercise Science, Florida Southern College, Lakeland, FL, USA.,Exercise Science and Exercise Physiology, Kent State University, Kent, OH, USA
| | - Jason C Parks
- State University of New York Cortland, Cortland, NY, USA.,Exercise Science and Exercise Physiology, Kent State University, Kent, OH, USA
| | - J Derek Kingsley
- Exercise Science and Exercise Physiology, Kent State University, Kent, OH, USA
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Marshall EM, Parks JC, Erb EK, Humm SM, Kearney SG, Paskert MC, Kingsley JD. Bilateral And Unilateral Upper-body Resistance Exercise On Hemodynamics And Baroreflex Sensitivity. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000760088.48346.00] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Parks JC, Marshall EM, Humm SM, Erb EK, Paskert MC, Kearney SG, Kingsley JD. Cool-down Versus Passive Recovery After Supramaximal Interval Exercise On Vagal Modulation. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000759884.89520.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Marshall EM, Parks JC, Singer TJ, Tai YL, DeBord AR, Humm SM, Kingsley JD. Vascular Responses to High-Intensity Battling Rope Exercise between the Sexes. J Sports Sci Med 2021; 20:349-356. [PMID: 34211328 DOI: 10.52082/jssm.2021.349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/19/2021] [Indexed: 01/09/2023]
Abstract
The purpose of the study was to assess high-intensity battling rope exercise (HI-BRE) on hemodynamics, pulse wave reflection and arterial stiffness during recovery and between sexes. Twenty-three young, healthy resistance-trained individuals (men: n = 13; women: n = 10) were assessed for all measures at Rest, as well as 10-, 30-, and 60-minutes following HI-BRE. A one-way repeated measures ANOVA was used to analyze the effects of HI-BRE across time (Rest, 10, 30, and 60-minutes) on all dependent variables. Significant main effects were analyzed using paired t-tests with a Sidak correction factor. Significance was accepted a priori at p 0.05. There were significant reductions in hemodynamic measures of diastolic blood pressure (BP) in women, but not men following HI-BRE at 30 minutes. Further, measures of pulse wave reflection, specifically those of the augmentation index (AIx) and wasted left ventricular energy (ΔEw), were significantly increased in both men and women for 60 minutes, but changes were significantly attenuated in women suggesting less ventricular work. There were also significant increases in arterial stiffness in regard to the aorta and common carotid artery that were fully recovered by 30 and 60 minutes, respectively with no differences between men and women. Thus, the primary findings of this study suggest that measures of hemodynamics and pulse wave reflection are collectively altered for at least 60 minutes following HI-BRE, with women having attenuated responses compared to men.
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Affiliation(s)
- Erica M Marshall
- Cardiovascular Dynamics Laboratory, Kent State University, Kent, Ohio, USA.,Florida Southern College, Lakeland, FL, USA
| | - Jason C Parks
- Cardiovascular Dynamics Laboratory, Kent State University, Kent, Ohio, USA.,State University of New York at Cortland, Cortland, NY, USA
| | - Tyler J Singer
- Cardiovascular Dynamics Laboratory, Kent State University, Kent, Ohio, USA.,Fairmont State University, Fairmont, WV, USA
| | - Yu Lun Tai
- Cardiovascular Dynamics Laboratory, Kent State University, Kent, Ohio, USA.,University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Alexa R DeBord
- Cardiovascular Dynamics Laboratory, Kent State University, Kent, Ohio, USA.,Colorado State University, Fort Collins, CO, USA
| | - Stacie M Humm
- Cardiovascular Dynamics Laboratory, Kent State University, Kent, Ohio, USA
| | - J Derek Kingsley
- Cardiovascular Dynamics Laboratory, Kent State University, Kent, Ohio, USA
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Hare KR, Smith T, Marshall EM, Parks JC, Humm SM, Paskert MC, Kearney SG, Kingsley JD. Resistance Exercise And Caffeine On Performance, Hemodynamics, And Pulse Wave Reflection Measure In Resistance-trained Women. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000682936.53970.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Paskert MC, Kearney SG, Parks JC, Marshall EM, Humm SM, Kingsley JD. Heavy Battle Rope Exercise On Autonomic Modulation: Differences Between The Sexes. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000682876.31509.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kearney SG, Parks JC, Marshall EM, Humm SM, Paskert MC, Kingsley JD. EXPLORING SEX DIFFERENCES ON ARTERIAL STIFFNESS IN RESPONSE TO HEAVY ROPE EXERCISE. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000676084.66608.8b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Tai YL, Marshall EM, Parks JC, Kingsley JD. Pulse Wave Reflection After Upper-body Resistance Exercise With And Without Blood Flow Restriction Between Sexes. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000682880.34237.f8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Marshall EM, Parks JC, Humm SM, Erb EK, Paskert MC, Kearney SG, Kingsley JD. Bilateral And Unilateral Resistance Exercise On Pulse Wave Reflection And Arterial Stiffness. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000682896.26016.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Erb EK, Smith T, Marshall EM, Parks JC, Humm SM, Paskert MC, Kearney SG, Kingsley JD. Caffeine In Conjunction With Resistance Exercise On Vagal Modulation In Resistance-trained Women. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000680380.73681.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Parks JC, Marshall EM, Humm SM, Erb EK, Paskert MC, Kearney SG, Kingsley JD. Cool-down Versus Passive Recovery After Supramaximal Interval Exercise On Hemodynamics And Aortic Stiffness. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000682888.31095.1e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Varner AJ, Marshall EM, Parks JC, Humm SM, Kearney SG, Paskert MC, Kingsley JD. Sex Differences On Measures Of Pulse Wave Reflection Response To Heavy Battle Rope Exercise. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000680320.53489.8b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Schmidt R, Marshall EM, Parks JC, Kingsley DJ. Sex Difference On Arterial Stiffness And Measures Of Pulse Wave Reflection Response To Weight Machines. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000675536.21787.84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Marshall EM, Parks JC, Tai YL, Kingsley JD. The Effects of Machine-Weight and Free-Weight Resistance Exercise on Hemodynamics and Vascular Function. Int J Exerc Sci 2020; 13:526-538. [PMID: 32509112 PMCID: PMC7241642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The purpose of this study was to examine hemodynamic and vascular responses between machine-weight and free-weight exercise. Resistance-trained individuals were assigned to a machine-weight (n = 13) or free-weight (n = 15) group. Groups completed two visits consisting of their assigned exercise condition and a control (CON). A 2 × 2 × 3 repeated measures ANOVA was used to test the effects of group across condition and time on the hemodynamic parameters [cardiac output (CO), heart rate (HR), total peripheral resistance (TPR), mean arterial pressure (MAP), and stroke volume (SV)]. A 2 × 2 × 2 repeated measures ANOVA was used to test the effects of group across condition and time on the hemodynamic variable, forearm vascular conductance (FVC), as well as on vascular measures [forearm blood flow (FBF), blood flow peak, and total reactive hyperemia (RH)]. Main effects were analyzed using pairwise comparisons. The results of the present study demonstrate that both machine-weight and free-weight exercise produce similar (p > 0.05) alterations in hemodynamics and vascular function. Specifically, during recovery both groups demonstrated significant (p ≤ 0.05) increases in measures of hemodynamics such as CO, HR and FVC, as well as significant (p ≤ 0.05) decreases in TPR, MAP, and SV. Measures of vascular function such as FBF, blood flow peak, and total RH were also significantly (p ≤ 0.05) increased during recovery. Therefore, this study suggests that either machine weight or free-weight exercise may induce acute hemodynamic and vascular benefits, which may reduce the risk of cardiovascular disease (CVD) and CVD events.
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Affiliation(s)
- Erica M Marshall
- Cardiovascular Dynamics Laboratory, School of Health Sciences, Kent State University, Kent, OH, USA
| | - Jason C Parks
- Cardiovascular Dynamics Laboratory, School of Health Sciences, Kent State University, Kent, OH, USA
| | - Yu Lun Tai
- Cardiovascular Dynamics Laboratory, School of Health Sciences, Kent State University, Kent, OH, USA
- Department of Health & Human Performance, University of Texas-Rio Grande Valley, Brownsville, TX, USA
| | - J Derek Kingsley
- Cardiovascular Dynamics Laboratory, School of Health Sciences, Kent State University, Kent, OH, USA
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Parks JC, Marshall EM, Tai YL, Kingsley JD. Free-weight versus weight machine resistance exercise on pulse wave reflection and aortic stiffness in resistance-trained individuals. Eur J Sport Sci 2019; 20:944-952. [PMID: 31662038 DOI: 10.1080/17461391.2019.1685007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to compare the vascular responses to acute free-weight (FW) resistance exercise (RE) versus weight machines (WM). Thirty-two resistance-trained individuals participated in this study. Both modalities involved performing acute RE and a control. Blood pressure and measures of pulse wave reflection were assessed using pulse wave analysis. Aortic stiffness was assessed using carotid-femoral pulse wave velocity (cf-PWV). A repeated measures analysis of variance was used to determine the effects of modality (FW and WM) and condition (acute RE and control) across time (rest and 10-20 min after exercise) on measures of pulse wave reflection and aortic stiffness. Significance was set a priori at p ≤ 0.05. There were no modality by condition by time interactions for any variable, such that the FW and WM modalities responded similarly across time after acute RE (p > 0.05). There were significant (p ≤ 0.05) increases in heart rate, aortic systolic blood pressure, aortic pulse pressure, augmentation index normalized at 75bpm, and decreases in subendocardial viability ratio (SEVR) after acute RE, compared to rest. There was also a significant (p ≤ 0.05) increase in cf-PWV after acute RE, compared to rest. In conclusion, this study demonstrates that acute free-weight and weight-machine RE are associated with transient increases in measures of pulse wave reflection and aortic stiffness, with reductions in myocardial perfusion. These data demonstrate that both modalities result in significant stress on the myocardium during recovery, while simultaneously increasing pressure on the aorta for at least 10-20 min.
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Affiliation(s)
- Jason C Parks
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
| | - Erica M Marshall
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
| | - Yu Lun Tai
- Department of Health & Human Performance, The University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - J Derek Kingsley
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
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Tai YL, Marshall EM, Glasgow A, Parks JC, Sensibello L, Kingsley JD. Autonomic modulation following an acute bout of bench press with and without blood flow restriction. Eur J Appl Physiol 2019; 119:2177-2183. [PMID: 31385030 DOI: 10.1007/s00421-019-04201-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/29/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE Traditional resistance exercise decreases vagal tone up to 30 min after an acute bout of resistance exercise, which may increase the risk of cardiovascular events. However, the effects of resistance exercise with blood flow restriction (BFR) on autonomic modulation are unclear. To evaluate autonomic modulation after resistance exercise with and without BFR in resistance-trained men. METHODS Eleven young men volunteered for the study. Autonomic modulation was assessed at rest, 15 (Rec 1), and 25 (Rec 2) minutes after low-load bench press with BFR (LL-BFR), traditional high-load bench press (HL), and a control (CON). Autonomic modulation assessments were expressed as natural logarithm (Ln), and included total power (LnTP), low-frequency power (LnLF), high-frequency power (LnHF), sympathovagal balance (LnLF/LnHF ratio), root mean square of the successive differences (LnRMSSD), and the proportion of intervals differing by > 50 ms from the preceding intervals (LnPNN50). A repeated measures ANOVA was used to evaluate conditions (LL-BFR, HL and CON) across time (Rest, Rec1, and Rec2) on autonomic modulation. RESULTS There were significant condition by time interactions for LnTP, LnHF, and LnRMSSD such that they were reduced during recovery after LL-BFR and HL compared to Rest and CON. There were no interactions in the LnLF, LnLF/LnHF ratio, and LnPNN50. CONCLUSIONS These data suggest that LL-BFR and HL significantly alter autonomic modulation up to 30 min after exercise with significant reduction after HL compared to LL-BFR when exercise volume is equated.
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Affiliation(s)
- Yu Lun Tai
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Brownsville, TX, USA. .,Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA.
| | - Erica M Marshall
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
| | - Alaina Glasgow
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
| | - Jason C Parks
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
| | - Leslie Sensibello
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
| | - J Derek Kingsley
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
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Marshall EM, Parks JC, Singer TJ, Humm SM, Kingsley JD. Autonomic Modulation After High-Intensity Heavy Rope Exercise in Resistance-trained Individuals. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000560496.21608.a6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Tai YL, Marshall EM, Parks JC, Kingsley JD. Upper- and Lower-body Resistance Exercise With and Without Blood Flow Restriction on Autonomic Modulation. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000560493.98736.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Humm SM, Marshall EM, Parks JC, Derek Kingsley J. Alterations in Vagal Tone After Acute Resistance Exercise in Resistance-Trained and Untrained Individuals. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000562905.73517.e7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Parks JC, Marshall EM, Singer TJ, Humm SM, Kingsley JD. Heavy Rope Exercise on Cardiovascular Hemodynamics and Arterial Stiffness in Resistance-Trained Individuals. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000561252.61483.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Tai YL, Marshall EM, Glasgow A, Parks JC, Sensibello L, Kingsley JD. Pulse wave reflection responses to bench press with and without practical blood flow restriction. Appl Physiol Nutr Metab 2018; 44:341-347. [PMID: 30205017 DOI: 10.1139/apnm-2018-0265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Resistance exercise is recommended to increase muscular strength but may also increase pulse wave reflection. The effect of resistance exercise combined with practical blood flow restriction (pBFR) on pulse wave reflection is unknown. The purpose of this study was to evaluate the differences in pulse wave reflection characteristics between bench press with pBFR and traditional high-load bench press in resistance-trained men. Sixteen resistance-trained men participated in the study. Pulse wave reflection characteristics were assessed before and after low-load bench press with pBFR (LL-pBFR), traditional high-load bench press (HL), and a control (CON). A repeated-measures ANOVA was used to evaluate differences in pulse wave reflection characteristics among the conditions across time. There were significant (p ≤ 0.05) interactions for heart rate, augmentation index, augmentation index normalized at 75 bpm, augmentation pressure, time-tension index, and wasted left ventricular energy such that they were increased after LL-pBFR and HL compared with rest and CON, with no differences between LL-pBFR and HL. Aortic pulse pressure (p < 0.001) was elevated only after LL-pBFR compared with rest. In addition, there was a significant (p ≤ 0.05) interaction for aortic diastolic blood pressure (BP) such that it was decreased after LL-pBFR compared with rest and CON but not HL. The subendocardial viability ratio and diastolic pressure-time index were significantly different between LL-pBFR and HL compared with rest and CON. There were no significant interactions for brachial systolic or diastolic BP, aortic systolic BP, or time of the reflected wave. In conclusion, acute bench press resistance exercise significantly altered pulse wave reflection characteristics without differences between LL-pBFR and HL.
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Affiliation(s)
- Yu Lun Tai
- Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA.,Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA
| | - Erica M Marshall
- Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA.,Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA
| | - Alaina Glasgow
- Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA.,Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA
| | - Jason C Parks
- Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA.,Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA
| | - Leslie Sensibello
- Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA.,Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA
| | - J Derek Kingsley
- Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA.,Cardiovascular Dynamics Laboratory, Exercise Physiology, 161F MACC Annex, Kent State University, Kent, OH 44242, USA
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Kingsley JD, Tai YL, Marshall EM, Glasgow A, Oliveira R, Parks JC, Mayo X. Autonomic modulation and baroreflex sensitivity after acute resistance exercise: responses between sexes. J Sports Med Phys Fitness 2018; 59:1036-1044. [PMID: 30035471 DOI: 10.23736/s0022-4707.18.08864-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to evaluate autonomic modulation, blood pressure variability and baroreflex sensitivity (BRS) responses to an acute bout of free-weight resistance exercise in resistance-trained men (N.=14) and women (N.=13). METHODS Participants underwent both an acute bout of resistance exercise (RE) consisting of 3 sets of 10 repetitions at 75% 1-repetition maximum on the squat, bench press, and deadlift, and a quiet control. Autonomic modulation, blood pressure variability (LFSAP), and cardiovagal BRS were assessed at rest, 15-20 minutes (Rec1) and 25-30 minutes (Rec2) postexercise. Log transformed measures of autonomic modulation included root square of the mean ssquared differences of successive RR intervals (LnRMSSD), high-frequency power (LnHFRR) and low-frequency power (LnLFRR) and sympathovagal balance (LnLFRR/HFRR). LFSAP was used as a measurement of vasomotor tone. Cardiovagal BRS was assessed using the sequence method. RESULTS There were no significant sex differences at rest and no significant sex by time by condition interactions for any variable. Compared with rest there were augmentations in LnLFRR/HFRR (P=0.002) and LFSAP (P=0.001) at Rec1 and Rec2. RMSSD and cardiovagal BRS were significantly (P=0.0001) decreased at Rec1 and Rec2 compared to rest after the acute RE. CONCLUSIONS Both sexes demonstrated that acute resistance exercise using free weights has a profound impact on autonomic modulation, blood pressure variability and cardiovagal BRS.
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Affiliation(s)
- J Derek Kingsley
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
| | - Yu-Lun Tai
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA -
| | - Erica M Marshall
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
| | - Alaina Glasgow
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
| | | | - Jason C Parks
- Cardiovascular Dynamics Laboratory, Exercise Physiology, Kent State University, Kent, OH, USA
| | - Xian Mayo
- Observatory of Healthy & Active Living of Spain Active Foundation, Center for Sport Studies, King Juan Carlos University, Madrid, Spain
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DeBord A, Glasgow A, Geither K, Sensibello L, Parks JC, Marshall EM, Tai YL, Derek Kingsley J. Autonomic Modulation After Acute Resistance Exercise in Resistance-Trained Individuals. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000535992.12173.e3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Glasgow A, Geither K, Parks JC, Marshall EM, Sensibello L, Tai YL, Kingsley JD. Acute Resistance Exercise Effects on Blood Flow in Resistance-Trained Versus Untrained Individuals. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000535683.84965.ef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Marshall EM, Parks JC, Tai YL, Glasgow A, Sensibello L, Geither K, Derek Kingsley J. Different Restrictive Devices to Achieve Blood Flow Restriction on Pulse Wave Reflection. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000536863.87999.ba] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Geither K, Sensibello L, Parks JC, Marshall EM, Tai YL, Kingsley JD. Free-Weight Resistance Exercise Versus Weight Machines on Pulse Wave Reflection. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000535699.32493.2b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Tai YL, Marshall EM, Glasgow A, Parks JC, Geither K, Sensibello L, Oliveira R, Derek Kingsley J. Upper and Lower-body Resistance Exercise With and Without Blood Flow Restriction on Pulse Wave Reflection. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000535994.57914.d2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kingsley JD, Geither K, Glasgow A, Marshall EM, Parks JC, Sensibello L, Tai YL. Autonomic Modulation in Response to Three Different Autonomic Reflex Tests in Women with Fibromyalgia. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000535705.70611.c0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Parks JC, Marshall EM, Tai YL, Glasgow A, Sensibello L, Geither K, Kingsley JD. Resistance Exercise on Pulse Wave Reflection and Arterial Stiffness Between Trained and Untrained Individuals. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000536892.78590.0c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sensibello L, Tai YL, Marshall EM, Glasgow A, Geither K, Parks JC, Oliveira R, Kingsley JD. The Effects of Upper- and Lower-body Blood Flow Restriction Exercise on Vascular Function. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000535691.17246.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Marshall EM, Glasgow A, Thai YL, Kingsley JD. Sex-specific Differences In Pulse Wave Reflection And Arterial Stiffness After Resistance Exercise. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000517807.62558.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kinney AY, Marshall EM, Dudley WN, Martin CF, Sandler RS. #12 Limited social support or religious involvement as risk factors for colon cancer. Ann Epidemiol 2002. [DOI: 10.1016/s1047-2797(02)00300-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Boyd M, Livingstone A, Wilson LE, Marshall EM, McCluskey AG, Mairs RJ, Wheldon TE. Dose-response relationship for radiation-induced mutations at micro- and minisatellite loci in human somatic cells in culture. Int J Radiat Biol 2000; 76:169-76. [PMID: 10716638 DOI: 10.1080/095530000138826] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSE The study was designed to determine the dose-response relationship for radiation induction of mutations at mini- and microsatellite loci in human somatic cells. Mutations induced by graded doses of gamma-irradiation were quantified by screening clones derived from single irradiated cells for micro- and minisatellite alterations following irradiation with 1, 2 or 3 Gy. MATERIALS AND METHODS After irradiation, the moderately radioresistant glioma cell line UVW was seeded at low density into Petri dishes to allow formation of discrete colonies, 100 of which were examined at each dose. All the cells within a colony were presumed to have arisen from a single irradiated cell. Radiation-induced microsatellite alterations were determined at 16 different loci, by PCR amplification and visualization on polyacrylamide gels. Minisatellite alterations were identified at four different minisatellite loci by restriction enzyme digestion and Southern blotting. RESULTS A dose-response curve for mutation frequency was obtained by analysis of 100 clones, yielding a minisatellite mutation rate of 5.5x10(-3) mutations/locus/Gy/cell and a microsatellite mutation rate of 8.75x10(-4) mutations/locus/ Gy/cell. At microsatellite loci, alterations were predominantly simple loss or gain of repeat units and loss of heterozygosity (LOH). The mutations in minisatellite loci resulted predominantly in LOH and variation in repeat number. The background instability at each locus was determined by analysis of non-irradiated clones. Only 2% and 1% of the micro-and minisatellite loci respectively showed altered bands. CONCLUSIONS This is the first report of a dose-response relationship for radiation-induced micro- and minisatellite mutations in human somatic cells. Described is a sensitive method for analysis of low-dose radiation mutagenesis in somatic cells that may prove to be a useful tool for radiation protection and dosimetry.
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Affiliation(s)
- M Boyd
- Department of Radiation Oncology, Glasgow University, UK.
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Smiley JA, Angelot JM, Cannon RC, Marshall EM, Asch DK. Radioactivity-based and spectrophotometric assays for isoorotate decarboxylase: identification of the thymidine salvage pathway in lower eukaryotes. Anal Biochem 1999; 266:85-92. [PMID: 9887216 DOI: 10.1006/abio.1998.2935] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A few organisms, notably some fungi, have the ability to metabolize thymidine to uracil, thus conserving the pyrimidine ring for subsequent metabolic use. Neurospora crassa possesses this pathway, termed the thymidine salvage pathway, and can utilize thymidine as a total pyrimidine source. The enzyme isoorotate decarboxylase (IDCase) completes this pathway via the enzymatic removal of the carboxylate from isoorotate to yield uracil. We describe in this communication two assays for IDCase and their application to determine activity levels, kinetic constants, and inhibitory properties. One uses [carboxy-14C]isoorotate from which the enzymatically generated 14CO2 is collected and quantitated. The second assay utilizes the spectral difference between 2-thioisoorotate and its decarboxylated product, 2-thiouracil. The spectral difference is greatest at 334 nm, out of the range of absorbance of total protein and thus usable for a spectrophotometric assay. The assays are sufficiently sensitive and accurate to be used in the measurement of Km values for both substrates. IDCase activity is found to be significantly higher in N. crassa strains lacking uc-1, a putative regulatory gene, suggesting a degree of metabolic control over this pathway. 5-Nitrouracil is found to inhibit IDCase with an estimated Ki value that is too low for accurate determination.
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Affiliation(s)
- J A Smiley
- Department of Chemistry, Youngstown State University, Youngstown, Ohio, 44555,
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Marshall EM. Valvular heart disease associated with fenfluramine-phentermine. N Engl J Med 1997; 337:1775; author reply 1775-6. [PMID: 9411252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Greco FA, Figlin R, York M, Einhorn L, Schilsky R, Marshall EM, Buys SS, Froimtchuk MJ, Schuller J, Schuchter L, Buyse M, Ritter L, Man A, Yap AK. Phase III randomized study to compare interferon alfa-2a in combination with fluorouracil versus fluorouracil alone in patients with advanced colorectal cancer. J Clin Oncol 1996; 14:2674-81. [PMID: 8874326 DOI: 10.1200/jco.1996.14.10.2674] [Citation(s) in RCA: 106] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE To compare the efficacy and toxicity profiles of a combination of fluorouracil (5-FU) and recombinant human interferon alfa-2a ([IFN alpha 2a] Roferon-A; Hoffmann-LaRoche, Basel, Switzerland) versus 5-FU alone in the treatment of advanced colorectal cancer (ACC). PATIENTS AND METHODS A total of 245 previously untreated ACC patients were randomized to receive either IFN alpha 2a (9 million IU) subcutaneously (SC) three times weekly with 5-FU (750 mg/m2/d) by continuous intravenous (CIV) infusion on days 1 to 5 and then, after a 1-week hiatus, as a weekly IV bolus at the same dose (IFN/ 5-FU), or 5-FU alone at the same dose schedule (5-FU). RESULTS There were no significant differences between IFN/5-FU and 5-FU alone in the overall response rate (24% v 17%, P = .2), duration of response (median, 6.4 v 8.1 months), time to response (plateau at 3 months), time to progressive disease ([PD] median, 4.8 v 4.9 months), or survival duration (median, 13.9 v 13.2 months). Toxicity profiles were not statistically different except for constitutional symptoms, which were more frequent and more severe with IFN/5-FU. More patients interrupted treatment for adverse events (AEs) with IFN/ 5-FU (34%) than with 5-FU alone (21%) (P = .03). The number of deaths (mostly unrelated to drug treatment) during the study (8%) was similar with both regimens. CONCLUSION The combination IFN/5-FU produced a response rate, response duration, and survival duration similar to that of 5-FU alone. The addition of IFN to 5-FU in the doses and schedules used in this study did not provide any further benefit over 5-FU alone and cannot be recommended for patients with metastatic ACC. This study confirms the value of large prospective randomized clinical trials to determine the clinical value of regimens that emerge from smaller single-center phase II studies.
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Affiliation(s)
- F A Greco
- Roche International Clinical Research Center, Lingolsheim, France
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Abstract
This historical review reveals that our profession has a solid understanding of occupation and its meaning to the injured or ill worker. Pioneer occupational therapists developed elemental concepts of work, basic skills of evaluation, and therapeutic uses of work skills. Our last generation of therapists has added theories and vital concepts of occupational behavior and human adaptation. The integration of our knowledge through further discourse, research, theory building, writing, and practice will enable us to use our understanding of human development through occupation to evaluate the work role of any individual regardless of age or disability. An unnamed patient (26) translates our philosophy into simple and direct language: "The joy of doing work and doing it well broadens the mind and extends to the outside world."
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