1
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Stewart KL, Szczesniak R, Liou TG. Predicting weight gain in patients with cystic fibrosis on triple combination modulator. Pediatr Pulmonol 2024. [PMID: 38607242 DOI: 10.1002/ppul.26982] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/12/2024] [Accepted: 03/13/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Cystic fibrosis (CF) is caused by CF transmembrane conductance regulator (CFTR) gene mutations producing dysfunctional CFTR proteins leading to progressive clinical disease. Elexacaftor-tezacaftor-ivacaftor (ETI) remarkably improves lung disease but is associated with substantial weight gain. STUDY DESIGN AND METHODS We performed a single-center longitudinal study predicting 6-month weight gain after ETI initiation. We used linear mixed effects modeling (LME) to determine association of ETI treatment with changing body mass index (BMI). Using linear regression, we examined BMI prediction models with distinct combinations of main effects to identify a model useful for patient counseling. We used up to eight commonly observed clinical characteristics as input variables (age, sex, percent predicted FEV1 [FEV1%], F508del homozygous state, pancreatic sufficiency, HgbA1c, prior modulator use and prior year number of pulmonary exacerbations). RESULTS We evaluated 154 patients (19-73 years old, 54% female, FEV1% = 19-121, 0-6 prior year pulmonary exacerbations). LME demonstrated an association between ETI use and weight increases. Exhaustive testing suggested a parsimonious linear regression model well-fitted to data that is potentially useful for counseling. The two variable model shows that on average, BMI decreases by 0.045 (95% Confidence Interval [CI] = -0.069 to -0.021, p < 0.001) for every year of age and increases by 0.322 (CI = 0.142 to 0.502, p = 0.001) for each additional prior year exacerbation at the time of ETI initiation. INTERPRETATION Young patients with many prior year pulmonary exacerbations likely have the largest 6 month weight gain after starting ETI.
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Affiliation(s)
- Kelly L Stewart
- The Adult Cystic Fibrosis Center, Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Rhonda Szczesniak
- Division of Biostatistics & Epidemiology, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Theodore G Liou
- The Adult Cystic Fibrosis Center, Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA
- The Center for Quantitative Biology, University of Utah, Salt Lake City, Utah, USA
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2
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Doxey RS, Wolferz RH, Stewart KL, Goossen R, Imber L. Building Flavor and Confidence in the Kitchen: A Pilot Virtual Cooking Class on Healthy Snacking. Am J Lifestyle Med 2023; 17:64-70. [PMID: 36636388 PMCID: PMC9830242 DOI: 10.1177/15598276221125686] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Cooking meals at home is associated with more healthful eating and even other healthy behaviors, such as increased physical activity, but for many there are numerous barriers to making this a reality. Healthy teaching kitchen interventions aim to help patients overcome these barriers. Our pilot program worked to address this issue by demonstrating the feasibility and acceptability of a virtual culinary medicine session designed for outpatient clinic patients. Participants were recruited from a single community primary care clinic for a virtual culinary medicine session. Of the 29 subjects who attended the class, 13 (45%) filled out the pre-course survey, and 8 (26%) filled out the post-course survey. Average participant confidence in preparing snacks at home from fresh ingredients increased from 3.62 to 4.38 out of 5 after attending this session, though the results were not statistically (OR .47; P = .172; 95% CI .16 to 1.3). Post-participation comments were overwhelmingly positive. This study showed that a virtual cooking class is feasible in a community clinic setting and is positively received. In addition, a culinary class teaching healthy cooking techniques paired with nutrition training may improve patient's confidence in the kitchen.
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Affiliation(s)
- Richmond S. Doxey
- Internal Medicine, University of Utah Health, Salt Lake City, UT, USA (RSD); Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA (RHW, RG); Nutrition Care Services
Department, University of Utah Health Hospitals and
Clinics, Salt Lake City, UT, USA (KLS, LI)
| | - Richard H. Wolferz
- Internal Medicine, University of Utah Health, Salt Lake City, UT, USA (RSD); Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA (RHW, RG); Nutrition Care Services
Department, University of Utah Health Hospitals and
Clinics, Salt Lake City, UT, USA (KLS, LI)
| | - Kelly L. Stewart
- Internal Medicine, University of Utah Health, Salt Lake City, UT, USA (RSD); Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA (RHW, RG); Nutrition Care Services
Department, University of Utah Health Hospitals and
Clinics, Salt Lake City, UT, USA (KLS, LI)
| | - Rachel Goossen
- Internal Medicine, University of Utah Health, Salt Lake City, UT, USA (RSD); Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA (RHW, RG); Nutrition Care Services
Department, University of Utah Health Hospitals and
Clinics, Salt Lake City, UT, USA (KLS, LI)
| | - Lindsey Imber
- Internal Medicine, University of Utah Health, Salt Lake City, UT, USA (RSD); Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA (RHW, RG); Nutrition Care Services
Department, University of Utah Health Hospitals and
Clinics, Salt Lake City, UT, USA (KLS, LI)
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3
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Anderson CAJ, Stewart IB, Stewart KL, Linnane DM, Patterson MJ, Hunt AP. Sex-based differences in body core temperature response across repeat work bouts in the heat. Appl Ergon 2022; 98:103586. [PMID: 34560338 DOI: 10.1016/j.apergo.2021.103586] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/03/2021] [Accepted: 09/08/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the effects of repeated work bouts in the heat on peak body core temperature and to explore sex-based differences in body core temperature responses. METHODS Fourteen males and fifteen females performed four work bouts (two heavy and two moderate, alternating) in 32.5 °C Wet Bulb Globe Temperature (WBGT), each separated by 30-min seated rest in 28.0 °C WBGT. Participants wore a military combat uniform with body armour and helmet (10 kg load) during the work bouts, removing the vest and helmet during recovery periods. RESULTS Body core temperature elevation over time was faster in the first compared with subsequent work bouts of each intensity. Body core temperature elevation was similar between males and females during the first heavy work bout, then remained significantly lower in females for the reminder of the trial. CONCLUSIONS Contrary to the assumed progressive elevation in strain, but in agreement with recent literature, a gradual reduction in heat storage in subsequent exercise bouts prevented a cumulative increase in heat strain in the conditions tested.
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Affiliation(s)
- Christopher A J Anderson
- School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ian B Stewart
- School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kelly L Stewart
- School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Denise M Linnane
- Defence Science and Technology Group, Department of Defence, Melbourne, Victoria, Australia
| | - Mark J Patterson
- Defence Science and Technology Group, Department of Defence, Melbourne, Victoria, Australia
| | - Andrew P Hunt
- School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, Queensland, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Defence Science and Technology Group, Department of Defence, Melbourne, Victoria, Australia.
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Stewart KL, Gigic B, Himbert C, Warby CA, Ose J, Lin T, Schrotz-King P, Boehm J, Jordan KC, Metos J, Schneider M, Figueiredo JC, Li CI, Shibata D, Siegel E, Toriola AT, Hardikar S, Ulrich CM. Association of Sugar Intake with Inflammation- and Angiogenesis-Related Biomarkers in Newly Diagnosed Colorectal Cancer Patients. Nutr Cancer 2021; 74:1636-1643. [PMID: 34369225 DOI: 10.1080/01635581.2021.1957133] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Evidence suggests a positive association between sugar intake and colorectal cancer (CRC) outcomes. We sought to investigate inflammation and angiogenesis as underlying mechanisms behind increased sugar intake and worse CRC outcomes. Pre-surgery serum samples were obtained from 191 patients diagnosed with primary invasive stage I-IV CRC. Biomarkers of inflammation (CRP, SAA, IL-6, IL-8, MCP-1, TNFα) and angiogenesis (VEGFA, VEGFD, sICAM-1 and sVCAM-1) were analyzed (Meso-Scale-Discovery). Fructose, glucose, sucrose, and total sugar intake (calories/day, % total calories) were assessed by FFQ. Pearson's correlation and multiple linear regression analyses were performed. Patients were on average 64 years old, 64% were male, the majority was diagnosed with stage II-III (58%) cancers, and 67% were either overweight or obese. Among normal-weight individuals (BMI <25 kg/m2), we observed a significant inverse association between VEGFD and any type of sugar intake in cal/day (sucrose: p = 0.01, glucose and fructose: p < 0.001) and MCP-1 and fructose intake (p = 0.05). The magnitude of reduction in VEGF ranged between -1.24 for sucrose to 4.49 for glucose intake, and -2.64 for fructose intake for MCP-1 levels. Sugar intake was associated with some inflammation or angiogenesis biomarkers, among CRC patients; differences were observed by adiposity that warrant further investigation.Supplemental data for this article is available online at at 10.1080/01635581.2021.1957133.
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Affiliation(s)
- Kelly L Stewart
- Department of Nutrition and Integrated Physiology, University of Utah, Salt Lake City, United States
| | - Biljana Gigic
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Caroline Himbert
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Christy A Warby
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Jennifer Ose
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Tengda Lin
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Petra Schrotz-King
- Division of Preventive Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jürgen Boehm
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Kristine C Jordan
- Department of Nutrition and Integrated Physiology, University of Utah, Salt Lake City, United States
| | - Julie Metos
- Department of Nutrition and Integrated Physiology, University of Utah, Salt Lake City, United States
| | - Martin Schneider
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Christopher I Li
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - David Shibata
- The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Erin Siegel
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | | | - Sheetal Hardikar
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah.,Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Cornelia M Ulrich
- Huntsman Cancer Institute, Population Sciences, Salt Lake City, Utah.,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
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5
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Disher AE, Stewart KL, Bach AJE, Stewart IB. Contribution of Dietary Composition on Water Turnover Rates in Active and Sedentary Men. Nutrients 2021; 13:nu13062124. [PMID: 34205676 PMCID: PMC8234797 DOI: 10.3390/nu13062124] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/05/2021] [Accepted: 06/16/2021] [Indexed: 11/16/2022] Open
Abstract
Body water turnover is a marker of hydration status for measuring total fluid gains and losses over a 24-h period. It can be particularly useful in predicting (and hence, managing) fluid loss in individuals to prevent potential physical, physiological and cognitive declines associated with hypohydration. There is currently limited research investigating the interrelationship of fluid balance, dietary intake and activity level when considering body water turnover. Therefore, this study investigates whether dietary composition and energy expenditure influences body water turnover. In our methodology, thirty-eight males (19 sedentary and 19 physically active) had their total body water and water turnover measured via the isotopic tracer deuterium oxide. Simultaneous tracking of dietary intake (food and fluid) is carried out via dietary recall, and energy expenditure is estimated via accelerometery. Our results show that active participants display a higher energy expenditure, water intake, carbohydrate intake and fibre intake; however, there is no difference in sodium or alcohol intake between the two groups. Relative water turnover in the active group is significantly greater than the sedentary group (Mean Difference (MD) [95% CI] = 17.55 g·kg-1·day-1 [10.90, 24.19]; p = < 0.001; g[95% CI] = 1.70 [0.98, 2.48]). A penalised linear regression provides evidence that the fibre intake (p = 0.033), water intake (p = 0.008), and activity level (p = 0.063) predict participants' relative body water turnover (R2= 0.585). In conclusion, water turnover is faster in individuals undertaking regular exercise than in their sedentary counterparts, and is, in part, explained by the intake of water from fluid and high-moisture content foods. The nutrient analysis of the participant diets indicates that increased dietary fibre intake is also positively associated with water turnover rates. The water loss between groups also contributes to the differences observed in water turnover; this is partly related to differences in sweat output during increased energy expenditure from physical activity.
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Affiliation(s)
- Alice E. Disher
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane 4059, Australia; (A.E.D.); (K.L.S.); (A.J.E.B.)
| | - Kelly L. Stewart
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane 4059, Australia; (A.E.D.); (K.L.S.); (A.J.E.B.)
| | - Aaron J. E. Bach
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane 4059, Australia; (A.E.D.); (K.L.S.); (A.J.E.B.)
- National Climate Change Adaptation Research Facility (NCCARF), Griffith University, Gold Coast 4222, Australia
| | - Ian B. Stewart
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane 4059, Australia; (A.E.D.); (K.L.S.); (A.J.E.B.)
- Correspondence:
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6
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Maley MJ, Minett GM, Bach AJE, Stewart KL, Stewart IB. Extending work tolerance time in the heat in protective ensembles with pre- and per-cooling methods. Appl Ergon 2020; 85:103064. [PMID: 32174352 DOI: 10.1016/j.apergo.2020.103064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/16/2020] [Accepted: 01/27/2020] [Indexed: 05/28/2023]
Abstract
OBJECTIVES Investigate whether a range of cooling methods can extend tolerance time and/or reduce physiological strain in those working in the heat dressed in a Class 2 chemical, biological, radiological, nuclear (CBRN) protective ensemble. METHODS Eight males wore a Class 2 CBRN ensemble and walked for a maximum of 120 min at 35 °C, 50% relative humidity. In a randomised order, participants completed the trial with no cooling and four cooling protocols: 1) ice-based cooling vest (IV), 2) a non-ice-based cooling vest (PCM), 3) ice slushy consumed before work, combined with IV (SLIV) and 4) a portable battery-operated water-perfused suit (WPS). Mean with 95% confidence intervals are presented. RESULTS Tolerance time was extended in PCM (46 [36, 56] min, P = 0.018), SLIV (56 [46, 67] min, P < 0.001) and WPS (62 [53, 70] min, P < 0.001), compared with control (39 [30, 48] min). Tolerance time was longer in SLIV and WPS compared with both IV (48 [39, 58 min]) and PCM (P ≤ 0.011). After 20 min of work, HR was lower in SLIV (121 [105, 136] beats·min-1), WPS (117 [101, 133] beats·min-1) and IV (130 [116, 143] beats·min-1) compared with control (137 [120, 155] beats·min-1) (all P < 0.001). PCM (133 [116, 151] beats·min-1) did not differ from control. CONCLUSION All cooling methods, except PCM, utilised in the present study reduced cardiovascular strain, while SLIV and WPS are most likely to extend tolerance time for those working in the heat dressed in a Class 2 CBRN ensemble.
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Affiliation(s)
- Matthew J Maley
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia; Department of Sport, Institute of Human Sciences, University of Wolverhampton, Walsall, UK.
| | - Geoffrey M Minett
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Aaron J E Bach
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Kelly L Stewart
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Ian B Stewart
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
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White JS, Stewart KL, Maskell DL, Diallo A, Traub-Modinger JE, Willoughby NA. Characterization of Pot Ale from a Scottish Malt Whisky Distillery and Potential Applications. ACS Omega 2020; 5:6429-6440. [PMID: 32258878 PMCID: PMC7114139 DOI: 10.1021/acsomega.9b04023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/27/2020] [Indexed: 06/11/2023]
Abstract
Over 2.7 billion liters of pot ale is produced annually as a co-product of Scottish malt whisky, and apart from evaporation to pot ale syrup as a feed, it is primarily treated by anaerobic digestion or land/sea disposal. The aim of this study was to assess pot ale components and their potential applications. The insoluble solid fraction, mainly consisting of yeast, contained 55% protein, and as a protein feed ingredient, this could yield 32,400 tons of feed per annum, although the Cu content of this fraction would need to be monitored. The liquid fraction could yield 33,900 tons of protein per annum, and an SDS-PAGE profile of this fraction demonstrated that the proteins may be similar to those found in beer, which could extend their application as a food ingredient. This fraction also contained phosphorus, potassium, and polyphenols among other components, which could have added value. Overall, fractionation of pot ale could offer an alternative to evaporation to pot ale syrup while retaining the protein fraction in the food chain.
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Affiliation(s)
- Jane S. White
- International Centre
for Brewing and Distilling, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, U.K.
- Horizon
Proteins Ltd., 7-9 North
Saint David Street, Edinburgh EH2 1AW, U.K.
| | - Kelly L. Stewart
- Institute of Biological Chemistry, Biophysics and Bioengineering,
School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, U.K.
| | - Dawn L. Maskell
- International Centre
for Brewing and Distilling, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, U.K.
| | - Aboubakry Diallo
- Horizon
Proteins Ltd., 7-9 North
Saint David Street, Edinburgh EH2 1AW, U.K.
| | | | - Nik A. Willoughby
- Institute of Biological Chemistry, Biophysics and Bioengineering,
School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, U.K.
- Horizon
Proteins Ltd., 7-9 North
Saint David Street, Edinburgh EH2 1AW, U.K.
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Bach AJE, Maley MJ, Minett GM, Zietek SA, Stewart KL, Stewart IB. An Evaluation of Personal Cooling Systems for Reducing Thermal Strain Whilst Working in Chemical/Biological Protective Clothing. Front Physiol 2019; 10:424. [PMID: 31031643 PMCID: PMC6474400 DOI: 10.3389/fphys.2019.00424] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/27/2019] [Indexed: 11/13/2022] Open
Abstract
Objective The use of personal cooling systems to mitigate heat strain on first-responders achieves two potential performance benefits relative to the absence of such cooling: (1) the completion of a workload with less effort; and/or (2) the completion of a greater workload for the same effort. Currently, claims made by manufacturers regarding the capability of their products for use in conjunction with chemical/biological protective clothing remain largely unsubstantiated. The purpose of this investigation was to evaluate the means by which heat strain can be alleviated during uncompensable heat stress in chemical/biological clothing, using the ASTM F2300-10 methodology. Methods Eight healthy males completed five trials of continuous walking (4.5 km h-1; 35°C; 49% RH) for up to 120 min while wearing one of four cooling systems and/or a National Fire and Protection Association 1994 Class-3 chemical/biological ensemble. The four cooling methods (ice vest [IV], phase-change vest [PCM], water-perfused suit [WS], and combination ice slurry/ice vest [SLIV]) and no cooling (CON). Results We observed significant improvements in trial times for IV (18 ± 10 min), PCM (20 ± 10 min) and SLIV (22 ± 10 min), but no differences for WS (4 ± 7 min). Heart rate, rectal, mean skin, and body temperatures were significantly lower in all cooling conditions relative to control at various matched time points in the first 60 min of exercise. Thermal sensation, comfort and perceived exertion all had significant main effects for condition, and time, there were no differences in their respective interactions. Conclusion The IV, PCM, and SLIV produced lower heart rate, mean skin, rectal and mean body temperatures in addition to improved work times compared to control. The WS did not improve work times possibly as a result of the cooling capacity of the suit abating, and magnifying thermal insulation. Considering the added time and resources required to implement combination cooling in the form of ice slurry and ice vest (SLIV), there was no significant additive effect for perception, cardiovascular strain, rectal temperature and total trial time relative to the phase change vest or ice vest alone. This may be a product of a "ceiling" effect for work limit set to 120 min as part of ASTM F2300-10.
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Affiliation(s)
- Aaron J E Bach
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Matthew J Maley
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.,Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Geoffrey M Minett
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Stephanie A Zietek
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Kelly L Stewart
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ian B Stewart
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
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9
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Maley MJ, Minett GM, Bach AJE, Zietek SA, Stewart KL, Stewart IB. Internal and external cooling methods and their effect on body temperature, thermal perception and dexterity. PLoS One 2018; 13:e0191416. [PMID: 29357373 PMCID: PMC5777660 DOI: 10.1371/journal.pone.0191416] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 01/04/2018] [Indexed: 12/19/2022] Open
Abstract
Objective The present study aimed to compare a range of cooling methods possibly utilised by occupational workers, focusing on their effect on body temperature, perception and manual dexterity. Methods Ten male participants completed eight trials involving 30 min of seated rest followed by 30 min of cooling or control of no cooling (CON) (34°C, 58% relative humidity). The cooling methods utilised were: ice cooling vest (CV0), phase change cooling vest melting at 14°C (CV14), evaporative cooling vest (CVEV), arm immersion in 10°C water (AI), portable water-perfused suit (WPS), heliox inhalation (HE) and ice slushy ingestion (SL). Immediately before and after cooling, participants were assessed for fine (Purdue pegboard task) and gross (grip and pinch strength) manual dexterity. Rectal and skin temperature, as well as thermal sensation and comfort, were monitored throughout. Results Compared with CON, SL was the only method to reduce rectal temperature (P = 0.012). All externally applied cooling methods reduced skin temperature (P<0.05), though CV0 resulted in the lowest skin temperature versus other cooling methods. Participants felt cooler with CV0, CV14, WPS, AI and SL (P<0.05). AI significantly impaired Purdue pegboard performance (P = 0.001), but did not affect grip or pinch strength (P>0.05). Conclusion The present study observed that ice ingestion or ice applied to the skin produced the greatest effect on rectal and skin temperature, respectively. AI should not be utilised if workers require subsequent fine manual dexterity. These results will help inform future studies investigating appropriate pre-cooling methods for the occupational worker.
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Affiliation(s)
- Matthew J. Maley
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
- * E-mail:
| | - Geoffrey M. Minett
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Aaron J. E. Bach
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Stephanie A. Zietek
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Kelly L. Stewart
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Ian B. Stewart
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
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10
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Costello JT, Stewart KL, Stewart IB. Inside the 'Hurt Locker': the combined effects of explosive ordnance disposal and chemical protective clothing on physiological tolerance time in extreme environments. Extrem Physiol Med 2015. [PMCID: PMC4580838 DOI: 10.1186/2046-7648-4-s1-a79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Stewart IB, Stewart KL, Worringham CJ, Costello JT. Physiological tolerance times while wearing explosive ordnance disposal protective clothing in simulated environmental extremes. PLoS One 2014; 9:e83740. [PMID: 24586228 PMCID: PMC3931617 DOI: 10.1371/journal.pone.0083740] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Accepted: 11/07/2013] [Indexed: 11/18/2022] Open
Abstract
Explosive ordnance disposal (EOD) technicians are required to wear protective clothing to protect themselves from the threat of overpressure, fragmentation, impact and heat. The engineering requirements to minimise these threats results in an extremely heavy and cumbersome clothing ensemble that increases the internal heat generation of the wearer, while the clothing’s thermal properties reduce heat dissipation. This study aimed to evaluate the heat strain encountered wearing EOD protective clothing in simulated environmental extremes across a range of differing work intensities. Eight healthy males [age 25±6 years (mean ± sd), height 180±7 cm, body mass 79±9 kg, V˙O2max 57±6 ml.kg−1.min−1] undertook nine trials while wearing an EOD9 suit (weighing 33.4 kg). The trials involved walking on a treadmill at 2.5, 4 and 5.5 km⋅h−1 at each of the following environmental conditions, 21, 30 and 37°C wet bulb globe temperature (WBGT) in a randomised controlled crossover design. The trials were ceased if the participants’ core temperature reached 39°C, if heart rate exceeded 90% of maximum, if walking time reached 60 minutes or due to fatigue/nausea. Tolerance times ranged from 10–60 minutes and were significantly reduced in the higher walking speeds and environmental conditions. In a total of 15 trials (21%) participants completed 60 minutes of walking; however, this was predominantly at the slower walking speeds in the 21°C WBGT environment. Of the remaining 57 trials, 50 were ceased, due to attainment of 90% maximal heart rate. These near maximal heart rates resulted in moderate-high levels of physiological strain in all trials, despite core temperature only reaching 39°C in one of the 72 trials.
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Affiliation(s)
- Ian B. Stewart
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
- * E-mail:
| | - Kelly L. Stewart
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Charles J. Worringham
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Joseph T. Costello
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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Josse EM, Gan Y, Bou-Torrent J, Stewart KL, Gilday AD, Jeffree CE, Vaistij FE, Martínez-García JF, Nagy F, Graham IA, Halliday KJ. A DELLA in disguise: SPATULA restrains the growth of the developing Arabidopsis seedling. Plant Cell 2011; 23:1337-51. [PMID: 21478445 PMCID: PMC3101537 DOI: 10.1105/tpc.110.082594] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 03/03/2011] [Accepted: 03/16/2011] [Indexed: 05/19/2023]
Abstract
The period following seedling emergence is a particularly vulnerable stage in the plant life cycle. In Arabidopsis thaliana, the phytochrome-interacting factor (PIF) subgroup of basic-helix-loop-helix transcription factors has a pivotal role in regulating growth during this early phase, integrating environmental and hormonal signals. We previously showed that SPATULA (SPT), a PIF homolog, regulates seed dormancy. In this article, we establish that unlike PIFs, which mainly promote hypocotyl elongation, SPT is a potent regulator of cotyledon expansion. Here, SPT acts in an analogous manner to the gibberellin-dependent DELLAs, REPRESSOR OF GA1-3 and GIBBERELLIC ACID INSENSITIVE, which restrain cotyledon expansion alongside SPT. However, although DELLAs are not required for SPT action, we demonstrate that SPT is subject to negative regulation by DELLAs. Cross-regulation of SPT by DELLAs ensures that SPT protein levels are limited when DELLAs are abundant but rise following DELLA depletion. This regulation provides a means to prevent excessive growth suppression that would result from the dual activity of SPT and DELLAs, yet maintain growth restraint under DELLA-depleted conditions. We present evidence that SPT and DELLAs regulate common gene targets and illustrate that the balance of SPT and DELLA action depends on light quality signals in the natural environment.
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Affiliation(s)
- Eve-Marie Josse
- School of Biological Sciences, Institute of Molecular Plant Sciences, University of Edinburgh, Edinburgh EH9 3JH, United Kingdom
| | - Yinbo Gan
- Department of Biology, Centre for Novel Agricultural Products, University of York, York YO10 5YW, United Kingdom
| | - Jordi Bou-Torrent
- Centre for Research in Agricultural Genomics, Consejo Superior de Investigaciones Cientificas-Institut de Recerca i Tecnologia Agroalimentàries-Universitat Autònoma de Barcelona, 08034 Barcelona, Spain
| | - Kelly L. Stewart
- School of Biological Sciences, Institute of Molecular Plant Sciences, University of Edinburgh, Edinburgh EH9 3JH, United Kingdom
| | - Alison D. Gilday
- Department of Biology, Centre for Novel Agricultural Products, University of York, York YO10 5YW, United Kingdom
| | - Christopher E. Jeffree
- School of Biological Sciences, Institute of Molecular Plant Sciences, University of Edinburgh, Edinburgh EH9 3JH, United Kingdom
| | - Fabián E. Vaistij
- Department of Biology, Centre for Novel Agricultural Products, University of York, York YO10 5YW, United Kingdom
| | - Jaime F. Martínez-García
- Centre for Research in Agricultural Genomics, Consejo Superior de Investigaciones Cientificas-Institut de Recerca i Tecnologia Agroalimentàries-Universitat Autònoma de Barcelona, 08034 Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats, 08010 Barcelona, Spain
| | - Ferenc Nagy
- School of Biological Sciences, Institute of Molecular Plant Sciences, University of Edinburgh, Edinburgh EH9 3JH, United Kingdom
- Plant Biology Institute, Biological Research Center, H-6726 Szeged, Hungary
| | - Ian A. Graham
- Department of Biology, Centre for Novel Agricultural Products, University of York, York YO10 5YW, United Kingdom
| | - Karen J. Halliday
- School of Biological Sciences, Institute of Molecular Plant Sciences, University of Edinburgh, Edinburgh EH9 3JH, United Kingdom
- Address correspondence to
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Abstract
This study examined the capabilities of an ultraendurance athlete to self-regulate their diet during an attempt on the record for the longest period of stationary cycling. The attempt required the athlete to complete at least 20 km/hr, with a 15 minute break allowed every eight hours. Laboratory tests determined a heart rate-oxygen consumption regression equation enabling calculation of energy expenditure from heart rate during the attempt. Energy intake was determined by a non-weighed dietary record collected at the time of consumption. The athlete completed 46.7 hours, covering 1126 km, at a speed of 24 +/- 1.6 km/hr. He expended 14486 kcal and consumed 11098 kcal resulting in an energy deficit (-3290 kcal) and a weight loss (-0.55 kg). The carbohydrate (42 +/- 32 g/hr), water (422 +/- 441 ml/hr), and sodium (306 +/- 465 mg/hr) intake were all below current recommendations. The athlete was unable to self-regulate his diet or exercise intensity to prevent a negative energy balance.
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Affiliation(s)
- Ian B Stewart
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia.
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Abstract
Category clustering is a robust finding in the free recall of familiar category members, but has rarely been studied with artificial categories. In the present study, college students learned artificial categories via stimulus-equivalence methodology. Arbitrary match-to-sample training with nonsense syllables established three interrelated conditional discriminations, and, for most subjects, unreinforced test trials revealed the emergent stimulus-control relations considered to be evidence of equivalence classes. Free-recall tests revealed evidence of significant within-class clustering both before and after equivalence testing, but was more pronounced after the equivalence tests. These findings confirm that classic phenomena like clustering in free recall can be studied with stimulus-equivalence methodology, thus allowing for experimental control over relevant variables.
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Affiliation(s)
- M Galizio
- Department of Psychology, University of North Carolina, Wilmington 28403, USA.
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Abstract
Group housing guinea pigs can save space and money, while improving housing standards. The authors describe enclosure design, enrichments, and husbandry techniques that facilitate group housing female guinea pigs.
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Affiliation(s)
- S S Raje
- University of Notre Dame, 400 Freimann Life Science Center, Notre Dame, IN 46556
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Febbraio MA, Stewart KL. CHO feeding before prolonged exercise: effect of glycemic index on muscle glycogenolysis and exercise performance. J Appl Physiol (1985) 1996; 81:1115-20. [PMID: 8889742 DOI: 10.1152/jappl.1996.81.3.1115] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.3] [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
This study examined the effect of preexercise carbohydrate (CHO) ingestion on muscle CHO metabolism and performance during prolonged exercise. Six endurance-trained men performed three exercise trials on a cycle ergometer after ingesting either a high glycemic index (HGI), low glycemic index (LGI), or placebo (Con) meal 45 min before exercise. During each trial, subjects cycled at a workload corresponding to 70% peak oxygen uptake for 120 min, followed by a 15-min performance cycle where total work (kJ) was measured. Ingestion of HGI resulted in an elevated (P < 0.01) blood glucose concentration 15 min after ingestion, compared with LGI and Con, but there were no differences in the glycemic responses to the meals thereafter, despite plasma insulin concentration being higher (P < 0.01) throughout the rest period after ingestion of HGI compared with LGI and Con. Plasma free fatty acid concentrations were lower (P < 0.05) throughout exercise in HGI compared with LGI and Con. In addition, concentrations of this metabolite were lower (P < 0.05) during the first hour of exercise in LGI compared with Con. Despite these results, no differences were observed in either the rate of muscle glycogen utilization during submaximal exercise or work output during the performance cycle when the three trials were compared. These results demonstrate that preexercise CHO ingestion has no effect on muscle glycogen utilization or exercise performance, irrespective of the glycemic or insulinemic responses to the ingested meals.
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Affiliation(s)
- M A Febbraio
- Department of Human Movement Science, Royal Melbourne Institute of Technology, Bundoora, Australia.
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Seals RR, Kuebker WA, Stewart KL. Immediate complete dentures. Dent Clin North Am 1996; 40:151-67. [PMID: 8635619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
When dentists treat patients for immediate complete dentures, they assume responsibility not only for the clinical and laboratory techniques unique to immediate complete denture fabrication, but also the responsibility for informing their patients about their treatment options, instructing their patients in the care of their oral tissues and dentures, and for continuing maintenance of the immediate dentures. Immediate dentures can be a traumatic introduction to complete dentures if patients are not informed fully about the complexity of the clinical and laboratory procedures, the need for immediate denture maintenance, and the costs associated with immediate denture treatment. The importance of 8 to 12 months of continuing care for immediate denture patients must be explained to patients and the dangers of neglecting continuing care must be emphasized.
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Affiliation(s)
- R R Seals
- Department of Prosthodontics, University of Texas Health Science Center at San Antonio, USA
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Stewart KL, Schroeder VA. A milking device for rats. Contemp Top Lab Anim Sci 1995; 34:80-1. [PMID: 16457576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- K L Stewart
- University of Notre Dame, Department of Biological Sciences, Freimann Life Science Center, IN 46556, USA
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Austin JR, Stewart KL, Fawzi N. Squamous cell carcinoma of the external auditory canal. Therapeutic prognosis based on a proposed staging system. Arch Otolaryngol Head Neck Surg 1994; 120:1228-32. [PMID: 7917206 DOI: 10.1001/archotol.1994.01880350036007] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To determine the adequacy of the proposed TNM staging system and evaluate the therapeutic modalities used at our institution in an attempt to synthesize guidelines for therapy of primary squamous cell carcinoma (SCC) of the temporal bone. DESIGN Case series of 22 patients with previously untreated or residual SCC of the temporal bone treated between 1970 and 1990. Mean follow-up of the surviving patients was 124.5 months (range, 46 to 210 months). SETTING University of Texas M. D. Anderson Cancer Center, Houston, an ambulatory and hospitalized care referral center. PATIENTS The hospital charts of 41 patients with carcinoma of the temporal bone seen between 1970 and 1990 were retrospectively reviewed. Twenty-two of these patients had previously untreated or residual SCC of the external auditory canal and were chosen for this study. Information was collected regarding symptoms, tumor location, treatment methods, pathologic diagnosis, and patient outcomes. MAIN OUTCOME MEASURE Accuracy of proposed staging system in predicting 5-year survival. Effect of surgery alone, radiotherapy alone, and surgery combined with radiotherapy on survival. RESULTS Using the Pittsburgh staging system, the conditions of eight patients (36%) were staged at T1, four (18%) were staged at T2, six (27%) were staged at T3, and four (18%) were staged at T4. (The 19 patients with either recurrent disease or non-SCC were also treated, but their conditions were not staged). Statistical validation is impossible owing to the small sample sizes. Combination therapy with surgery and radiotherapy provided a higher 5-year survival rate than surgery or radiotherapy alone. Extrapolation of our data confirms that a staging system is useful in planning therapy. Surgical resection followed by radiotherapy is the preferred treatment for SCCs of the external auditory canal.
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Affiliation(s)
- J R Austin
- Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston
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Abstract
Recent advances in diagnosis and surgical therapy of glomus tumors of the temporal bone have been made. These advances make it possible for surgeons to benefit patients affected by this locally aggressive and morbid tumor. More sensitive diagnostic modalities and a physician alertness make early surgical cure a possibility. Careful planning and observation of basic surgical principles help to minimize morbidity and improve functional results.
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Affiliation(s)
- K L Stewart
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Medical School at Houston 77030
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Abstract
The 2 components of detrusor compliance were analyzed in 32 children with myelomeningocele and compared to compliance in 15 age-matched controls with nonneuropathic enuresis. In myelomeningocele initial compliance was variable, whereas terminal compliance was relatively constant. Low terminal compliance corresponded with vesicoureteral reflux, deterioration of upper tract morphology and diminished renal function.
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Affiliation(s)
- G M Ghoniem
- Section of Urology, University of Michigan Medical Center, Ann Arbor
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Chertow BS, Williams GA, Kiani R, Stewart KL, Hargis GK, Flayter RL. The interactions between vitamin A, vinblastine, and cytochalasin B in parathyroid hormone secretion. Proc Soc Exp Biol Med 1974; 147:16-9. [PMID: 4438319 DOI: 10.3181/00379727-147-38272] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Stewart KL, Quesinberry BW, Rudd KD. An investigation of model investments. Tex Dent J 1967; 85:10-6. [PMID: 5230848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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