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Paris MT, Bell KE, Avrutin E, Rosati K, Mourtzakis M. Influence of Subcutaneous Adipose Tissue and Skeletal Muscle Thickness on Rectus Femoris Echo Intensity in Younger and Older Males and Females. J Ultrasound Med 2022; 41:2355-2364. [PMID: 34921442 DOI: 10.1002/jum.15922] [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: 06/04/2021] [Revised: 11/30/2021] [Accepted: 12/05/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Ultrasound measurements of muscle echo intensity are commonly used surrogates of muscle composition (eg, intramuscular adipose tissue). However, given that soundwaves are increasingly attenuated with tissue depth, the interpretation of echo intensity may be confounded by adipose and skeletal muscle thickness. Our objectives are to compare the associations between adipose or muscle tissue thickness and rectus femoris echo intensity in younger and older males and females. METHODS Participants included in this analysis were derived from 3 previously published cohorts of younger (<45 years) and older (≥60 years) males and females. Ultrasound images of the rectus femoris were evaluated for muscle thickness, echo intensity, and subcutaneous adipose tissue thickness. RESULTS Older adults (n: 49 males, 19 females) had a higher body mass index (P = .001) compared with younger adults (n: 37 males, 49 females). Muscle thickness was negatively associated with echo intensity in older males (r = -0.59) and females (r = -0.53), whereas no associations were observed in younger males (r = 0.00) or females (r = -0.11). Subcutaneous adipose tissue thickness displayed no associations with echo intensity in any group. CONCLUSIONS Despite the known influence of subcutaneous adipose tissue thickness on beam attenuation, we observed no association with muscle echo intensity, indicating that adipose tissue correction may be required to better understand muscle echo intensity across differences in adiposity. The negative associations between muscle thickness and echo intensity in older, but not younger adults, suggests these associations may be related to the co-occurrence of skeletal muscle atrophy and intramuscular adipose tissue infiltration with advancing age.
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Affiliation(s)
- Michael T Paris
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Kirsten E Bell
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Egor Avrutin
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Katherine Rosati
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Marina Mourtzakis
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
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Paris MT, Bell KE, Avrutin E, Mourtzakis M. Association of strength, power, and function with muscle thickness, echo intensity, and lean tissue in older males. Appl Physiol Nutr Metab 2022; 47:521-528. [PMID: 35104155 DOI: 10.1139/apnm-2021-0690] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dual-energy X-ray absorptiometry (DXA) appendicular lean tissue is used to screen older adults for sarcopenia. However, emerging data indicates that ageing-related muscle atrophy largely occurs within specific muscles, which may be masked using appendicular lean tissue. Comparisons between appendicular lean tissue and site-specific measures of muscle in relation to strength and physical function are needed to advance our understanding of these features in the context of poor muscle function in aged adults. Our primary objective was to compare correlations between lean tissue and site-specific muscle characteristics in relation to strength and physical function in older males. Older males (≥65 years) were evaluated for muscle strength, physical function (6-minute walk and 30-second sit-to-stand), and muscle size (appendicular and site-specific) and composition (echo intensity) using DXA and ultrasound. Of the 32 older males (75.4 ± 7.9 years), 12 had low appendicular lean tissue. All DXA and ultrasound muscle characteristics were associated (r = 0.39 to 0.83, p < 0.05) with torque or power producing capabilities. Except for the knee flexors, no differences in correlation coefficients were observed between muscle thickness or regional lean tissue in relation to muscle strength. Neither DXA nor ultrasound muscle characteristics were associated with physical function. In older males, ultrasound-based muscle thickness and DXA lean tissue provided similar associations with strength. Novelty: Lean tissue and muscle thickness provide similar associations with strength. Muscle thickness can distinguish low and normal appendicular lean tissue in older adults.
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Affiliation(s)
- Michael T Paris
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Kirsten E Bell
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Egor Avrutin
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Marina Mourtzakis
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
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Bell KE, Paris MT, Avrutin E, Mourtzakis M. Altered features of body composition in older adults with type 2 diabetes and prediabetes compared with matched controls. J Cachexia Sarcopenia Muscle 2022; 13:1087-1099. [PMID: 35174664 PMCID: PMC8978006 DOI: 10.1002/jcsm.12957] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/08/2021] [Accepted: 02/01/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Ageing is accompanied by muscle loss and fat gain, which may elevate the risk of type 2 diabetes (T2D). However, there is a paucity of data on the distribution of regional lean and fat tissue in older adults with T2D or prediabetes compared with healthy controls. The objective of this study was to compare regional body composition [by dual-energy x-ray absorptiometry (DXA)], muscle and subcutaneous adipose tissue (SAT) thicknesses (by ultrasound), and ultrasound-based muscle texture features in older adults with T2D or prediabetes compared with normoglycaemic controls. METHODS Eighteen adults > 60 years with T2D or prediabetes (T2D group) were individually matched to normoglycaemic participants [healthy matched (HM) group] for age (±5 years), sex, and body fat (±2.5%). In a single study visit, all participants received a whole-body DXA scan and ultrasound assessment of the abdomen and anterior thigh. At these two landmarks, we used ultrasound to measure muscle and SAT thickness, as well as texture features of the rectus femoris and rectus abdominis. We also conducted an exploratory subanalysis on a subset of participants (n = 14/18 in the T2D group and n = 10/18 in the HM group) who underwent additional assessments including strength testing of the knee extensors (using a Biodex dynamometer), and a fasting blood sample for the measurement of circulating markers of glucose metabolism [glucose, insulin, c-peptide, and the homoeostatic model assessment of insulin resistance (HOMA-IR)]. RESULTS The T2D group was 72 ± 8 years old (mean ± SD), predominantly male (n = 15/18; 83%), and overweight (BMI: 27.8 ± 4.2 kg/m2 , 33.2 ± 5.3% body fat). DXA-derived upper arm lean mass was 0.4 kg greater (P = 0.034), and leg fat mass was 1.4 kg lower (P = 0.048), in the T2D vs. HM group. Ultrasound-based texture features were distinct between the groups [rectus abdominis blob size: 0.07 ± 0.06 vs. 0.30 ± 0.43 cm2 , P = 0.045; rectus femoris local binary pattern (LBP) entropy: 4.65 ± 0.05 vs. 4.59 ± 0.08 A.U., P = 0.007]. When all participants who underwent additional assessments were pooled (n = 24), we observed that certain ultrasound-based muscle texture features correlated significantly with muscle strength (rectus abdominis histogram skew vs. power during an isokinetic contraction at 60°/s: r = 0.601, P = 0.003) and insulin resistance (rectus femoris LBP entropy vs. HOMA-IR: r = 0.419, P = 0.042). CONCLUSIONS Our findings suggest a novel body composition phenotype specific to older adults with T2D or prediabetes. We are also the first to report that ultrasound-based texture features correspond with functional outcomes. Future larger scale studies are needed to uncover the mechanisms underpinning these regional body composition differences.
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Affiliation(s)
- Kirsten E Bell
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Michael T Paris
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Egor Avrutin
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Marina Mourtzakis
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Paris MT, Bell KE, Avrutin E, Mourtzakis M. Body size normalization of ultrasound measured anterior upper leg muscle thickness in younger and older males and females. Eur J Clin Nutr 2022; 76:958-963. [DOI: 10.1038/s41430-022-01070-0] [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] [Received: 06/24/2021] [Revised: 12/14/2021] [Accepted: 01/06/2022] [Indexed: 11/09/2022]
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Bell KE, Pfeiffer AG, Schmidt S, Bos L, Russell C, Barnes T, Di Sebastiano KM, Avrutin E, Gibson M, Dubin JA, Mourtzakis M. Low-frequency exercise training improves cardiovascular fitness and strength during treatment for breast cancer: a single-arm intervention study. Sci Rep 2021; 11:22758. [PMID: 34815445 PMCID: PMC8610997 DOI: 10.1038/s41598-021-01962-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/26/2021] [Indexed: 11/09/2022] Open
Abstract
Aerobic and resistance exercise during and after cancer treatment are important for health-related outcomes, however treatment-specific barriers may inhibit adherence. We explored the effect of lower-frequency exercise training on fitness, body composition, and metabolic markers (i.e. glucose and lipids) in a group of recently diagnosed breast cancer patients. Fifty-two females ≥ 18 years with stage I-IIIB breast cancer were instructed to attend 2 cardiovascular and strength training sessions/week over 12 weeks, but program length was expanded as needed to accommodate missed sessions. Pre- and post-intervention, we measured: (1) cardiovascular fitness, (2) isometric strength, (3) body composition (dual-energy X-ray absorptiometry), and (4) fasting glucose, insulin, c-peptide, and lipids. Pre-intervention, participants were 53 ± 10 years old (mean ± SD) and overweight (BMI: 27.5 ± 5.4 kg m-2, 40.1 ± 6.5% body fat). Forty participants completed the program over a median 20 weeks (range: 13-32 weeks, median frequency: 1.2 sessions/week), over which predicted VO2peak improved by 7% (2.2[0.1-4.4] mL/kg/min) (delta[95% CI]), and strength increased by 7-9% (right arm: 2.3[0.1-4.5] N m; right leg: 7.9[2.1-13.7] N m; left leg: 7.8[1.9-13.7] N m). Body composition and metabolic markers were unchanged. An exercise frequency of 1.2 sessions/week stimulated significant improvements in fitness, and may represent a practical target for patients during active treatment.
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Affiliation(s)
- Kirsten E Bell
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Amanda G Pfeiffer
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Schuyler Schmidt
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Lisa Bos
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Caryl Russell
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Tyler Barnes
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Katie M Di Sebastiano
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Egor Avrutin
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Marielle Gibson
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Joel A Dubin
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Marina Mourtzakis
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.
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Paris MT, Bell KE, Avrutin E, Mourtzakis M. Associations between skeletal muscle echo intensity and thickness in relation to glucose homeostasis in healthy and glucose impaired older males. Exp Gerontol 2021; 154:111547. [PMID: 34506901 DOI: 10.1016/j.exger.2021.111547] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/18/2021] [Accepted: 08/30/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Aging-related changes in muscle composition and mass may predispose older adults to developing insulin resistance. Ultrasound echo intensity and thickness are surrogates of muscle composition and mass, however, their associations with glucose homeostasis are not well established. We examined how muscle echo intensity and thickness correlate with markers of glucose homeostasis in older (≥65 years) males with normal (n = 22) or impaired (n = 10) glucose control. METHODS Echo intensity was measured for the biceps brachii, rectus abdominis, and rectus femoris. Muscle thickness was evaluated for the biceps brachii + brachioradialis, rectus abdominis, and rectus femoris + vastus intermedius. Glucose homeostasis was evaluated using a 2-h oral glucose tolerance test. RESULTS In older males with normal glucose homeostasis, higher echo intensity of the rectus abdominis and rectus femoris was moderately (r = 0.36 to 0.59) associated with 2-h glucose. On the contrary, higher muscle echo intensity of the rectus abdominis, biceps brachii, and rectus femoris was moderately-to-strongly (r = -0.36 to -0.79) associated with indices of better glucose homeostasis in the impaired group. Rectus abdominis muscle thickness was moderately associated (r = 0.36) with better glucose tolerance in the normal glucose homeostasis; however, in the glucose impaired group, muscle thickness was associated with (r = 0.37 to 0.73) with poorer glucose homeostasis. CONCLUSIONS Muscle echo intensity displays divergent associations with glucose homeostasis in older males with normal compared to impaired glucose control. Larger muscle thickness was associated with poorer glucose homeostasis in the glucose impaired group, but rectus abdominis muscle thickness was correlated with better homeostasis in healthy older males.
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Affiliation(s)
- Michael T Paris
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Kirsten E Bell
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Egor Avrutin
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Marina Mourtzakis
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.
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Paris MT, Bell KE, Avrutin E, Mourtzakis M. Older males exhibit reduced anterior upper leg and anterior abdominal muscle thickness compared to younger males when matched for relative appendicular lean tissue. Arch Gerontol Geriatr 2021; 96:104483. [PMID: 34274873 DOI: 10.1016/j.archger.2021.104483] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 12/14/2022]
Abstract
Background Ageing-related muscle atrophy does not occur uniformly across the body; rather, atrophy occurs to a greater extent in specific muscle groups compared to others. However, site-specific comparisons of muscle mass between older and younger adults typically do not account for relative muscle mass (i.e., matched for age- and sex-specific percentiles), which may confound site-specific differences. Furthermore, the uniformity of ageing-related differences in muscle composition (e.g., intramuscular adipose tissue) across the body are not well characterized. Purpose To examine site-specific muscle mass and composition differences between younger and older males matched for relative muscle mass. Methods Younger (18-44 years old, n = 19) and older (≥65 years old, n = 19) males were matched for relative appendicular lean tissue index (NHANES age- and sex-specific Z-scores) measured using dual-energy x-ray absorptiometry. Site-specific differences in skeletal muscle size (thickness) and composition (echo-intensity) were evaluated using ultrasound for 8 distinct landmarks across the body. Results Relative appendicular lean tissue mass was well matched between younger and older males (Z-score difference: -0.02, p = 0.927). Compared with younger males, older males had smaller muscle thickness for the anterior upper leg (difference: -1.08 cm, p < 0.001) and anterior abdomen (difference: -0.53 cm, p < 0.001). However, older adults displayed higher echo intensity across all muscles (p < 0.05), except for the posterior upper arm (p = 0.377), in comparison to the younger males. Conclusions When matched for relative appendicular lean tissue, muscle thickness differences between younger and older males are not-uniform across the body, whereas echo intensity was more uniformly higher in the older males.
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Affiliation(s)
- Michael T Paris
- Department of Kinesiology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada
| | - Kirsten E Bell
- Department of Kinesiology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada
| | - Egor Avrutin
- Department of Kinesiology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada
| | - Marina Mourtzakis
- Department of Kinesiology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada.
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Bell KE, Snijders T, Zulyniak M, Kumbhare D, Parise G, Chabowski A, Phillips SM. Correction: A whey protein-based multi-ingredient nutritional supplement stimulates gains in lean body mass and strength in healthy older men: A randomized controlled trial. PLoS One 2020; 15:e0243876. [PMID: 33320850 PMCID: PMC7737894 DOI: 10.1371/journal.pone.0243876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Bell KE, Snijders T, Zulyniak MA, Kumbhare D, Parise G, Chabowski A, Phillips SM. Correction: A multi-ingredient nutritional supplement enhances exercise training-related reductions in markers of systemic inflammation in healthy older men. Appl Physiol Nutr Metab 2020; 45:1310. [DOI: 10.1139/apnm-2020-0763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Kirsten E. Bell
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Tim Snijders
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada
| | | | - Dinesh Kumbhare
- Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Gianni Parise
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Adrian Chabowski
- Department of Physiology, Medical University of Bialystok, 15-222 Bialystok, Poland
| | - Stuart M. Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada
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Bell KE, Fang H, Snijders T, Allison DJ, Zulyniak MA, Chabowski A, Parise G, Phillips SM, Heisz JJ. Corrigendum: A Multi-Ingredient Nutritional Supplement in Combination With Resistance Exercise and High-Intensity Interval Training Improves Cognitive Function and Increases N-3 Index in Healthy Older Men: A Randomized Controlled Trial. Front Aging Neurosci 2020; 12:611387. [PMID: 33192494 PMCID: PMC7653091 DOI: 10.3389/fnagi.2020.611387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kirsten E. Bell
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
- *Correspondence: Kirsten E. Bell
| | - Hanna Fang
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Tim Snijders
- NUTRIM, Department of Human Biology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - David J. Allison
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Michael A. Zulyniak
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Adrian Chabowski
- Department of Physiology, Medical University of Bialystok, Bialystok, Poland
| | - Gianni Parise
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | | | - Jennifer J. Heisz
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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Paris MT, Bell KE, Mourtzakis M. Myokines and adipokines in sarcopenia: understanding cross-talk between skeletal muscle and adipose tissue and the role of exercise. Curr Opin Pharmacol 2020; 52:61-66. [PMID: 32668398 DOI: 10.1016/j.coph.2020.06.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 12/12/2022]
Abstract
Detrimental age-associated changes in skeletal muscle and adipose tissue increase the risk of sarcopenia. Age-related changes in myokines, such as myostatin and irisin, as well as adipokines, such as leptin and adiponectin, contribute to cross-talk between muscle and adipose tissue. These age-related changes in myokines and adipokines have important implications for sarcopenia, however, recent literature highlights discrepancies in these relationships. Exercise may alter serum profiles and muscle receptor expression of these factors, but future work is needed to determine whether these changes in myokines and adipokines relate to improvements in muscle mass and function. Here, we describe myokine-mediated and adipokine-mediated interactions between muscle and adipose tissue, and discuss the fundamental importance of these cytokines to understanding the development of sarcopenia.
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Affiliation(s)
- Michael T Paris
- Department of Kinesiology, University of Waterloo, Waterloo, ON N2L 1A3, Canada
| | - Kirsten E Bell
- Department of Kinesiology, University of Waterloo, Waterloo, ON N2L 1A3, Canada
| | - Marina Mourtzakis
- Department of Kinesiology, University of Waterloo, Waterloo, ON N2L 1A3, Canada.
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Nederveen JP, Joanisse S, Thomas ACQ, Snijders T, Manta K, Bell KE, Phillips SM, Kumbhare D, Parise G. Age‐related changes to the satellite cell niche are associated with reduced activation following exercise. FASEB J 2020; 34:8975-8989. [DOI: 10.1096/fj.201900787r] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 03/18/2020] [Accepted: 03/31/2020] [Indexed: 01/18/2023]
Affiliation(s)
| | - Sophie Joanisse
- Department of Kinesiology McMaster University Hamilton ON Canada
| | | | - Tim Snijders
- Department of Kinesiology McMaster University Hamilton ON Canada
- Human Biology NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Center+ Maastricht the Netherlands
| | - Katherine Manta
- Department of Kinesiology McMaster University Hamilton ON Canada
| | - Kirsten E. Bell
- Department of Kinesiology McMaster University Hamilton ON Canada
| | | | | | - Gianni Parise
- Department of Kinesiology McMaster University Hamilton ON Canada
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Paris MT, Bell KE, Avrutin E, Mourtzakis M. Ultrasound image resolution influences analysis of skeletal muscle composition. Clin Physiol Funct Imaging 2020; 40:277-283. [DOI: 10.1111/cpf.12636] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/30/2020] [Accepted: 04/20/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Michael T. Paris
- Department of Kinesiology University of Waterloo Waterloo ON Canada
| | - Kirsten E. Bell
- Department of Kinesiology University of Waterloo Waterloo ON Canada
| | - Egor Avrutin
- Department of Kinesiology University of Waterloo Waterloo ON Canada
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Bell KE, Brook MS, Snijders T, Kumbhare D, Parise G, Smith K, Atherton PJ, Phillips SM. Corrigendum: Integrated Myofibrillar Protein Synthesis in Recovery From Unaccustomed and Accustomed Resistance Exercise With and Without Multi-ingredient Supplementation in Overweight Older Men. Front Nutr 2020; 7:611389. [PMID: 33195379 PMCID: PMC7662067 DOI: 10.3389/fnut.2020.611389] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 11/30/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fnut.2019.00040.].
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Affiliation(s)
- Kirsten E. Bell
- 1Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Matthew S. Brook
- 2School of Life Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Tim Snijders
- 3Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Dinesh Kumbhare
- 4Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Gianni Parise
- 5Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Ken Smith
- 6School of Graduate Entry Medicine and Health, University of Nottingham, Derby, United Kingdom
| | - Philip J. Atherton
- 6School of Graduate Entry Medicine and Health, University of Nottingham, Derby, United Kingdom
| | - Stuart M. Phillips
- 5Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
- *Correspondence: Stuart M. Phillips
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Bell KE, Fang H, Snijders T, Allison DJ, Zulyniak MA, Chabowski A, Parise G, Phillips SM, Heisz JJ. A Multi-Ingredient Nutritional Supplement in Combination With Resistance Exercise and High-Intensity Interval Training Improves Cognitive Function and Increases N-3 Index in Healthy Older Men: A Randomized Controlled Trial. Front Aging Neurosci 2019; 11:107. [PMID: 31143111 PMCID: PMC6521794 DOI: 10.3389/fnagi.2019.00107] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 02/19/2019] [Accepted: 04/23/2019] [Indexed: 12/18/2022] Open
Abstract
We aimed to evaluate the effect of multi-ingredient nutritional supplementation, with and without exercise training, on cognitive function in healthy older men. Forty-nine sedentary men [age: 73 ± 6 years (mean ± SD); body mass index: 28.5 ± 3.6 kg/m2] were randomized to consume a supplement (SUPP n = 25; 1500 mg n-3 polyunsaturated fatty acids, 30 g whey protein, 2.5 g creatine, 500 IU vitamin D, and 400 mg calcium) or control beverage (CON n = 24; 22 g maltodextrin) twice daily for 20 weeks consisting of Phase 1: SUPP/CON followed by Phase 2: 12-week resistance exercise training plus high-intensity interval training, while continuing to consume the study beverages (SUPP/CON + EX). At baseline, 6 weeks, and 19 weeks we assessed cognitive function [Montréal Cognitive Assessment (MOCA)], memory [word recall during the Rey Auditory Verbal Learning Test (RAVLT)], executive functions (working memory inhibition control), and nutrient bioavailability. We did not observe changes to any aspect of cognitive function after Phase 1; however, significant improvements in the following cognitive function outcomes were detected following Phase 2: MOCA scores increased (6 weeks: 23.5 ± 3.3 vs. 19 weeks: 24.4 ± 2.5, p = 0.013); number of words recalled during the RAVLT increased (6 weeks: 6.6 ± 3.6 vs. 19 weeks: 7.6 ± 3.8, p = 0.047); and reaction time improved (6 weeks: 567 ± 49 ms vs. 19 weeks: 551 ± 51 ms, p = 0.002). Although between-group differences in these outcomes were not significant, we observed within-group improvements in composite cognitive function scores over the course of the entire study only in the SUPP group (Δ = 0.58 ± 0.62, p = 0.004) but not in the CON group (Δ = 0.31 ± 0.61, p = 0.06). We observed a progressive increase in n-3 index, and a concomitant decrease in the ratio of arachidonic acid (ARA) to eicosapentaenoic acid (EPA) within erythrocyte plasma membranes, in the SUPP group only. At week 19, n-3 index (r = 0.49, p = 0.02) and the ARA:EPA ratio (r = -0.44, p = 0.03) were significantly correlated with composite cognitive function scores. Our results show that 12 weeks of RET + HIIT resulted in improved MOCA scores, word recall, and reaction time during an executive functions task; and suggest that a multi-ingredient supplement combined with this exercise training program may improve composite cognitive function scores in older men possibly via supplementation-mediated alterations to n-3 PUFA bioavailability. Clinical Trial Registration: http://www.ClinicalTrials.gov, identifier NCT02281331.
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Affiliation(s)
- Kirsten E Bell
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Hanna Fang
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Tim Snijders
- NUTRIM, Department of Human Biology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - David J Allison
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Michael A Zulyniak
- Department of Medicine, McMaster University, Hamilton, ON, Canada.,School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Adrian Chabowski
- Department of Physiology, Medical University of Bialystok, Bialystok, Poland
| | - Gianni Parise
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Jennifer J Heisz
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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Allison DJ, Nederveen JP, Snijders T, Bell KE, Kumbhare D, Phillips SM, Parise G, Heisz JJ. Exercise training impacts skeletal muscle gene expression related to the kynurenine pathway. Am J Physiol Cell Physiol 2019; 316:C444-C448. [PMID: 30649918 DOI: 10.1152/ajpcell.00448.2018] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Exercise positively impacts mood and symptoms of depression; however, the mechanisms underlying these effects are not fully understood. Recent evidence highlights a potential role for skeletal muscle-derived transcription factors to influence tryptophan metabolism, along the kynurenine pathway, which has important implications in depression. This has important consequences for older adults, whose age-related muscle deterioration may influence this pathway and may increase their risk for depression. Although exercise training has been shown to improve skeletal muscle mass in older adults, whether this also translates into improvements in transcription factors and metabolites related to the kynurenine pathway has yet to be examined. The aim of the present study was to examine the influence of a 12-wk exercise program on skeletal muscle gene expression of transcription factors, kynurenine aminotransferase (KAT) gene expression, and plasma concentrations of tryptophan metabolites (kynurenines) in healthy older men over 65 yr of age. Exercise training significantly increased skeletal muscle gene expression of transcription factors (peroxisome proliferator-activated receptor-γ coactivator 1α, peroxisome proliferator-activated receptor-α, and peroxisome proliferator-activated receptor-δ: 1.77, 1.99, 2.18-fold increases, respectively, P < 0.01] and KAT isoforms 1-4 (6.5, 2.1, 2.2, and 2.6-fold increases, respectively, P ≤ 0.01). Concentrations of plasma kynurenines were not altered. These results demonstrate that 12 wk of exercise training significantly altered skeletal muscle gene expression of transcription factors and gene expression related to the kynurenine pathway, but not circulating kynurenine metabolites in older men. These findings warrant future research to determine whether distinct exercise modalities or varying intensities could induce a shift in the kynurenine pathway in depressed older adults.
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Affiliation(s)
- David J Allison
- Department of Kinesiology, McMaster University , Hamilton, Ontario , Canada.,Department of Heath Research Methods Evidence and Impact, McMaster University , Hamilton, Ontario , Canada
| | - Joshua P Nederveen
- Department of Kinesiology, McMaster University , Hamilton, Ontario , Canada
| | - Tim Snijders
- Department of Kinesiology, McMaster University , Hamilton, Ontario , Canada.,Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Kirsten E Bell
- Department of Kinesiology, University of Waterloo , Waterloo, Ontario , Canada
| | - Dinesh Kumbhare
- Department of Medicine, McMaster University , Hamilton, Ontario , Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University , Hamilton, Ontario , Canada
| | - Gianni Parise
- Department of Kinesiology, McMaster University , Hamilton, Ontario , Canada
| | - Jennifer J Heisz
- Department of Kinesiology, McMaster University , Hamilton, Ontario , Canada
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Bell KE, Brook MS, Snijders T, Kumbhare D, Parise G, Smith K, Atherton PJ, Phillips SM. Integrated Myofibrillar Protein Synthesis in Recovery From Unaccustomed and Accustomed Resistance Exercise With and Without Multi-ingredient Supplementation in Overweight Older Men. Front Nutr 2019; 6:40. [PMID: 31032258 PMCID: PMC6470195 DOI: 10.3389/fnut.2019.00040] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/20/2019] [Indexed: 12/30/2022] Open
Abstract
Background: We previously showed that daily consumption of a multi-ingredient nutritional supplement increased lean mass in older men, but did not enhance lean tissue gains during a high-intensity interval training (HIIT) plus resistance exercise training (RET) program. Here, we aimed to determine whether these divergent observations aligned with the myofibrillar protein synthesis (MyoPS) response to acute unaccustomed and accustomed resistance exercise. Methods: A sub-sample of our participants were randomly allocated (n = 15; age: 72 ± 7 years; BMI: 26.9 ± 3.1 kg/m2 [mean ± SD]) to ingest an experimental supplement (SUPP, n = 8: containing whey protein, creatine, vitamin D, and n-3 PUFA) or control beverage (CON, n = 7: 22 g maltodextrin) twice per day for 21 weeks. After 7 weeks of consuming the beverage alone (Phase 1: SUPP/CON only), subjects completed 12 weeks of RET (twice per week) + HIIT (once per week) (Phase 2: SUPP/CON + EX). Orally administered deuterated water was used to measure integrated rates of MyoPS over 48 h following a single session of resistance exercise pre- (unaccustomed) and post-training (accustomed). Results: Following an acute bout of accustomed resistance exercise, 0-24 h MyoPS was 30% higher than rest in the SUPP group (effect size: 0.86); however, in the CON group, 0-24 h MyoPS was 0% higher than rest (effect size: 0.04). Nonetheless, no within or between group changes in MyoPS were statistically significant. When collapsed across group, rates of MyoPS in recovery from acute unaccustomed resistance exercise were positively correlated with training-induced gains in whole body lean mass (r = 0.63, p = 0.01). Conclusion: There were no significant between-group differences in MyoPS pre- or post-training. Integrated rates of MyoPS post-acute exercise in the untrained state were positively correlated with training-induced gains in whole body lean mass. Our finding that supplementation did not alter 0-48 h MyoPS following 12 weeks of training suggests a possible adaptive response to longer-term increased protein intake and warrants further investigation. This study was registered at ClinicalTrials.gov. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT02281331.
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Affiliation(s)
- Kirsten E. Bell
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Matthew S. Brook
- School of Life Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Tim Snijders
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Dinesh Kumbhare
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Gianni Parise
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Ken Smith
- School of Graduate Entry Medicine and Health, University of Nottingham, Derby, United Kingdom
| | - Philip J. Atherton
- School of Graduate Entry Medicine and Health, University of Nottingham, Derby, United Kingdom
| | - Stuart M. Phillips
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
- *Correspondence: Stuart M. Phillips
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Snijders T, Nederveen JP, Bell KE, Lau SW, Mazara N, Kumbhare DA, Phillips SM, Parise G. Prolonged exercise training improves the acute type II muscle fibre satellite cell response in healthy older men. J Physiol 2018; 597:105-119. [PMID: 30370532 DOI: 10.1113/jp276260] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [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: 09/19/2018] [Accepted: 10/22/2018] [Indexed: 01/08/2023] Open
Abstract
KEY POINTS Skeletal muscle stem cells, termed satellite cells, play a crucial role in repair and remodelling of muscle in response to exercise An age-related decline in satellite cell number and/or function has been hypothesized to be a key factor in the development of sarcopenia and/or the blunted muscle fibre adaptive response to prolonged exercise training in older persons We report that performing prolonged exercise training improves the acute type II muscle fibre satellite cell response following a single bout of resistance exercise in older men. The observed improvement in muscle satellite function is associated with an increase in muscle fibre capillarization following exercise training suggesting a possible functional link between capillarization and satellite cell function. ABSTRACT Age-related type II muscle fibre atrophy is accompanied by a fibre type-specific decline in satellite cell number and function. Exercise training restores satellite cell quantity in older adults; however, whether it can restore the impaired satellite cell response to exercise in older adults remains unknown. Therefore we assessed the acute satellite cell response to a single exercise session before and after prolonged exercise training in older men. Fourteen older men (74 ± 8 years) participated in a 12-week exercise training programme (resistance exercise performed twice per week, high intensity interval training once per week). Before and after training, percutaneous biopsies from the vastus lateralis muscle were taken prior to and following 24 and 48 h of post-exercise recovery. Muscle fibre characteristics were evaluated by immunohistochemistry and mRNA expression by RT-PCR. Whereas no changes were observed in type II muscle fibres, type I muscle fibre satellite cell content increased significantly at 24 and 48 h after a single bout of resistance exercise before the exercise training programme (P < 0.01). Following the exercise training programme, both type I and type II muscle fibre satellite cell content increased significantly at 24 and 48 h after a single bout of resistance exercise (P < 0.05). The greater acute increase in type II muscle fibre satellite cell content at 24 h post-exercise recovery after training was correlated with an increase in type II muscle fibre capillarization (r = 0.671, P = 0.012). We show that the acute muscle satellite cell response following exercise can be improved by prolonged exercise training in older men.
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Affiliation(s)
- Tim Snijders
- Department of Kinesiology and Medical Physics & Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada, L8S 4K1.,Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Joshua P Nederveen
- Department of Kinesiology and Medical Physics & Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada, L8S 4K1
| | - Kirsten E Bell
- Department of Kinesiology and Medical Physics & Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada, L8S 4K1
| | - Sean W Lau
- Department of Kinesiology and Medical Physics & Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada, L8S 4K1
| | - Nicole Mazara
- Department of Kinesiology and Medical Physics & Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada, L8S 4K1
| | - Dinesh A Kumbhare
- Toronto Rehabilitation Institute, University of Toronto, Toronto, Ontario, Canada, M5G 2A2
| | - Stuart M Phillips
- Department of Kinesiology and Medical Physics & Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada, L8S 4K1
| | - Gianni Parise
- Department of Kinesiology and Medical Physics & Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada, L8S 4K1
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Snijders T, Bell KE, Nederveen JP, Saddler NI, Mazara N, Kumbhare DA, Phillips SM, Parise G. Ingestion of a Multi-Ingredient Supplement Does Not Alter Exercise-Induced Satellite Cell Responses in Older Men. J Nutr 2018; 148:891-899. [PMID: 29878269 DOI: 10.1093/jn/nxy063] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/08/2017] [Indexed: 11/13/2022] Open
Abstract
Background Nutritional supplementation can have beneficial effects on body composition, strength, and function in older adults. However, whether the response of satellite cells can be altered by nutritional supplementation in older adults remains unknown. Objective We assessed whether a multi-ingredient protein-based supplement taken over a prolonged period of time could alter the muscle satellite cell response after exercise in older men. Methods Twenty-seven older men [mean ± SD age: 73 ± 1 y; mean ± SD body mass index (kg/m2): 28 ± 1] participated in a randomized double-blind experiment. Participants were randomly divided into an experimental (EXP) group (n = 13) who consumed a multi-ingredient protein-based supplement [30 g whey protein, 2.5 g creatine, 500 IU vitamin D, 400 mg Ca, and 1500 mg n-3 (ω-3) polyunsaturated fatty acids] 2 times/d for 7 wk or a control (CON; 22 g maltodextrin) group (n = 14). After 7 wk of supplementation, all participants performed a single resistance exercise session, and muscle biopsy samples were taken from the vastus lateralis before and 24 and 48 h after exercise. Immunohistochemistry was used to assess the change in type I and II muscle fiber satellite cell content and activation status of the cells. In addition, mRNA expression of the myogenic regulatory factors was determined by using reverse transcriptase-polymerase chain reaction. Results In response to the single bout of exercise, type I muscle fiber satellite cell content was significantly increased at 24 h (0.132 ± 0.015 and 0.131 ± 0.011 satellite cells/fiber in CON and EXP groups, respectively) and 48 h (0.126 ± 0.010 and 0.120 ± 0.012 satellite cells/fiber in CON and EXP groups, respectively) compared with pre-exercise (0.092 ± 0.007 and 0.118 ± 0.017 satellite cells/fiber in CON and EXP groups, respectively) muscle biopsy samples (P < 0.01), with no difference between the 2 groups. In both groups, we observed no significant changes in type II muscle fiber satellite cell content after exercise. Conclusion Ingesting a multi-ingredient protein-based supplement for 7 wk did not alter the type I or II muscle fiber satellite cell response during postexercise recovery in older men. This trial was registered at www.clinicaltrials.gov as NCT02281331.
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Affiliation(s)
- Tim Snijders
- Department of Kinesiology and Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada.,Department of Human Biology and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands
| | - Kirsten E Bell
- Department of Kinesiology and Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Joshua P Nederveen
- Department of Kinesiology and Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Nelson I Saddler
- Department of Kinesiology and Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Nicole Mazara
- Department of Kinesiology and Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Dinesh A Kumbhare
- Toronto Rehabilitation Institute, University of Toronto, Toronto, Ontario, Canada
| | - Stuart M Phillips
- Department of Kinesiology and Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Gianni Parise
- Department of Kinesiology and Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario, Canada
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Bell KE, Snijders T, Zulyniak MA, Kumbhare D, Parise G, Chabowski A, Phillips SM. A multi-ingredient nutritional supplement enhances exercise training-related reductions in markers of systemic inflammation in healthy older men. Appl Physiol Nutr Metab 2017; 43:299-302. [PMID: 29106814 DOI: 10.1139/apnm-2017-0533] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We evaluated whether twice-daily consumption of a multi-ingredient nutritional supplement (SUPP) would reduce systemic inflammatory markers following 6 weeks of supplementation alone (phase 1), and the subsequent addition of 12 weeks of exercise training (phase 2) in healthy older men, in comparison with a carbohydrate-based control (CON). Tumour necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) concentrations were progressively reduced (P-time < 0.05) in the SUPP group. No change in TNF-α or IL-6 concentrations was observed in the CON group.
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Affiliation(s)
- Kirsten E Bell
- a Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Tim Snijders
- a Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Michael A Zulyniak
- b Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Dinesh Kumbhare
- b Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Gianni Parise
- a Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Adrian Chabowski
- c Department of Physiology, Medical University of Bialystok, 15-222 Bialystok, Poland
| | - Stuart M Phillips
- a Department of Kinesiology, McMaster University, Hamilton, ON L8S 4L8, Canada
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Bell KE, Snijders T, Zulyniak M, Kumbhare D, Parise G, Chabowski A, Phillips SM. A whey protein-based multi-ingredient nutritional supplement stimulates gains in lean body mass and strength in healthy older men: A randomized controlled trial. PLoS One 2017; 12:e0181387. [PMID: 28719669 PMCID: PMC5515445 DOI: 10.1371/journal.pone.0181387] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [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: 05/24/2017] [Accepted: 06/27/2017] [Indexed: 12/19/2022] Open
Abstract
Protein and other compounds can exert anabolic effects on skeletal muscle, particularly in conjunction with exercise. The objective of this study was to evaluate the efficacy of twice daily consumption of a protein-based, multi-ingredient nutritional supplement to increase strength and lean mass independent of, and in combination with, exercise in healthy older men. Forty-nine healthy older men (age: 73 ± 1 years [mean ± SEM]; BMI: 28.5 ± 1.5 kg/m2) were randomly allocated to 20 weeks of twice daily consumption of either a nutritional supplement (SUPP; n = 25; 30 g whey protein, 2.5 g creatine, 500 IU vitamin D, 400 mg calcium, and 1500 mg n-3 PUFA with 700 mg as eicosapentanoic acid and 445 mg as docosahexanoic acid); or a control (n = 24; CON; 22 g of maltodextrin). The study had two phases. Phase 1 was 6 weeks of SUPP or CON alone. Phase 2 was a 12 week continuation of the SUPP/CON but in combination with exercise: SUPP + EX or CON + EX. Isotonic strength (one repetition maximum [1RM]) and lean body mass (LBM) were the primary outcomes. In Phase 1 only the SUPP group gained strength (Σ1RM, SUPP: +14 ± 4 kg, CON: +3 ± 2 kg, P < 0.001) and lean mass (LBM, +1.2 ± 0.3 kg, CON: -0.1 ± 0.2 kg, P < 0.001). Although both groups gained strength during Phase 2, upon completion of the study upper body strength was greater in the SUPP group compared to the CON group (Σ upper body 1RM: 119 ± 4 vs. 109 ± 5 kg, P = 0.039). We conclude that twice daily consumption of a multi-ingredient nutritional supplement increased muscle strength and lean mass in older men. Increases in strength were enhanced further with exercise training. Trial Registration: ClinicalTrials.gov NCT02281331
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Affiliation(s)
- Kirsten E. Bell
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Tim Snijders
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
- NUTRIM, Department of Human Biology and Movement Sciences, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Michael Zulyniak
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Dinesh Kumbhare
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Gianni Parise
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Adrian Chabowski
- Department of Physiology, Medical University of Bialystok, Bialystok, Poland
| | - Stuart M. Phillips
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
- * E-mail:
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Di Sebastiano KM, Bell KE, Mitchell AS, Quadrilatero J, Dubin JA, Mourtzakis M. Glucose metabolism during the acute prostate cancer treatment trajectory: The influence of age and obesity. Clin Nutr 2016; 37:195-203. [PMID: 27998647 DOI: 10.1016/j.clnu.2016.11.024] [Citation(s) in RCA: 5] [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] [Received: 07/05/2016] [Revised: 11/14/2016] [Accepted: 11/28/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND & AIMS Obesity and age, key risk factors for aggressive prostate cancer, are associated with insulin resistance. Glucose-related parameters in patients with aggressive prostate cancer were compared with 2 reference groups: men of similar age and body mass index (BMI) without cancer, and healthy young men. Acute changes in these parameters following radiation treatment were also evaluated. METHODS Nine patients with aggressive prostate cancer underwent metabolic assessments prior to treatment (baseline), 7 and 33 weeks post-baseline (post-treatment initiation). Baseline measures were compared with the 2 reference groups. Evaluations included: 1) fasting and oral glucose tolerance test (OGTT) blood samples for glucose, C-peptide, and insulin, 2) fasting blood samples for triglycerides, cholesterols, leptin, adiponectin, IL-6, and TNF-α, 3) body composition, 4) nutrition, and 5) physical activity. RESULTS At baseline, patients had normal fasting glucose concentrations (<5.6 mM; 4.9 ± 1.2 mM) but impaired 2-h OGTT glucose concentrations (>7.8 mM; 8.7 ± 2.9 mM). Both reference groups had normal fasting (matched males: 4.2 ± 0.5 mM; young males: 3.7 ± 0.4 mM) and 2-h OGTT glucose concentrations (matched males: 5.6 ± 1.8 mM; young males: 3.1 ± 0.1 mM) that were significantly lower than patient values. During the OGTT, patients had higher insulin (120 min) and C-peptide (45, 60, 90, 120 min) concentrations compared to the matched males. At 7 weeks, 2-h OGTT glucose concentrations in patients improved to healthy ranges without changes in insulin, C-peptide, IGF-1, IGFBP-3 or other metabolic parameters. CONCLUSIONS At baseline patients with aggressive prostate cancer demonstrated impaired glucose tolerance compared with men of similar age and body size. Following treatment, glucose tolerance improved in the absence of changes in expected modifiers of glucose metabolism. These improvements may be related to treatment.
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Affiliation(s)
| | - Kirsten E Bell
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Andrew S Mitchell
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Joe Quadrilatero
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Joel A Dubin
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - Marina Mourtzakis
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.
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Bell KE, von Allmen MT, Devries MC, Phillips SM. Muscle Disuse as a Pivotal Problem in Sarcopenia-related Muscle Loss and Dysfunction. J Frailty Aging 2016; 5:33-41. [PMID: 26980367 DOI: 10.14283/jfa.2016.78] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An age-associated loss of muscle mass and strength--sarcopenia--begins at around the fifth decade of life, with mass being lost at ~0.5-1.2% per year and strength at ~3% per year. Sarcopenia can contribute to a variety of negative health outcomes, including an increased risk for falls and fractures, the development of metabolic diseases like type 2 diabetes mellitus, and increase the chance of requiring assisted living. Linear sarcopenic declines in muscle mass and strength are, however, punctuated by transient periods of muscle disuse that can accelerate losses of muscle and strength, which could result in increased risk for the aforementioned conditions. Muscle disuse is recognizable with bed rest or immobilization (for example, due to surgery or acute illness requiring hospitalization); however, recent work has shown that even a relative reduction in ambulation (reduced daily steps) results in significant reductions in muscle mass, strength and possibly an increase in disease risk. Although reduced ambulation is a seemingly "benign" form of disuse, compared to bed rest and immobilization, reports have documented that 2-3 weeks of reduced daily steps may induce: negative changes in body composition, reductions in muscle strength and quality, anabolic resistance, and decrements in glycemic control in older adults. Importantly, periods of reduced ambulation likely occur fairly frequently and appear more difficult to fully recover from, in older adults. Here we explore the consequences of muscle disuse due to reduced ambulatory activity in older adults, with frequent comparisons to established models of disuse: bed rest and immobilization.
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Affiliation(s)
- K E Bell
- Stuart M. Phillips, Ph.D. Department of Kinesiology, McMaster University, 1280 Main St. West, Hamilton, ON, L8S 4K1, Canada, Phone: +1-905-525-9140 x24465, Fax: +1-905-523-6011,
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Oikawa SY, Bell KE, Hector AJ. Resistance exercise training and circulatory responses to feeding and skeletal muscle protein anabolism in older men. J Physiol 2015; 593:3771-2. [PMID: 26331832 DOI: 10.1113/jp270969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 06/29/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Sara Y Oikawa
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, 1280 Main Street West, Hamilton, ON, Canada, L8S 4K1
| | - Kirsten E Bell
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, 1280 Main Street West, Hamilton, ON, Canada, L8S 4K1
| | - Amy J Hector
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, 1280 Main Street West, Hamilton, ON, Canada, L8S 4K1
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Bell KE, Séguin C, Parise G, Baker SK, Phillips SM. Day-to-Day Changes in Muscle Protein Synthesis in Recovery From Resistance, Aerobic, and High-Intensity Interval Exercise in Older Men. J Gerontol A Biol Sci Med Sci 2015; 70:1024-9. [DOI: 10.1093/gerona/glu313] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 12/17/2014] [Indexed: 12/14/2022] Open
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Bell KE, Di Sebastiano KM, Vance V, Hanning R, Mitchell A, Quadrilatero J, Russell C, Dubin JA, Bahl M, Califaretti N, Campbell C, Mourtzakis M. A comprehensive metabolic evaluation reveals impaired glucose metabolism and dyslipidemia in breast cancer patients early in the disease trajectory. Clin Nutr 2013; 33:550-7. [PMID: 24011971 DOI: 10.1016/j.clnu.2013.08.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Revised: 07/08/2013] [Accepted: 08/05/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND & AIMS Weight gain in breast cancer patients during treatment is prevalent; the metabolic implications of this weight gain are poorly understood. We aimed to characterize glucose metabolism in breast cancer patients near the initiation of chemotherapy. METHODS Stage I-II breast cancer patients (n = 8) were evaluated near the initiation of chemotherapy and compared with a group of age- and body mass index-matched, as well as a group of young healthy, non-malignant females. Fasting blood samples (analyzed for lipids and cytokines) were taken and an oral glucose tolerance test was performed. Body composition, waist circumference, diet, cardiovascular fitness and muscle strength were evaluated. RESULTS Breast cancer patients were abdominally obese (mean ± SD: 94.6 ± 14.0 cm), overweight (28.8 ± 6.0 kg/m(2)) and dyslipidemic (triacylglycerides: 1.84 ± 1.17 mM; high-density lipoprotein cholesterol: 1.08 ± 0.23 mM). Compared to non-malignant matched females, fasting glucose and insulin concentrations were similar but fasting c-peptide was greater in patients (2.6 ± 1.2 ng/mL vs. 1.9 ± 0.8 ng/mL, p = 0.005). Glucose was elevated to a greater extent in patients during the oral glucose tolerance test compared with all non-malignant females. During the glucose tolerance test, c-peptide, but not insulin, remained elevated in patients compared with all non-malignant females. No differences in body composition, serum cytokines, nutrition or exercise capacity between patients and matched, non-malignant females emerged. CONCLUSIONS Breast cancer patients present with unhealthy metabolic features early in the disease trajectory. Future investigations need to examine the underlying mechanisms and the potential longitudinal changes following chemotherapy.
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Affiliation(s)
- Kirsten E Bell
- Department of Kinesiology, University of Waterloo, Burt Matthew Hall Rm. 1117, 200 University Avenue W., Waterloo, ON N2J 3G1, Canada
| | - Katie M Di Sebastiano
- Department of Kinesiology, University of Waterloo, Burt Matthew Hall Rm. 1117, 200 University Avenue W., Waterloo, ON N2J 3G1, Canada
| | - Vivienne Vance
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Rhona Hanning
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Andrew Mitchell
- Department of Kinesiology, University of Waterloo, Burt Matthew Hall Rm. 1117, 200 University Avenue W., Waterloo, ON N2J 3G1, Canada
| | - Joe Quadrilatero
- Department of Kinesiology, University of Waterloo, Burt Matthew Hall Rm. 1117, 200 University Avenue W., Waterloo, ON N2J 3G1, Canada
| | - Caryl Russell
- Department of Kinesiology, University of Waterloo, Burt Matthew Hall Rm. 1117, 200 University Avenue W., Waterloo, ON N2J 3G1, Canada
| | - Joel A Dubin
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - Mala Bahl
- Grand River Regional Cancer Center, Grand River Hospital, Kitchener, ON, Canada
| | - Nadia Califaretti
- Grand River Regional Cancer Center, Grand River Hospital, Kitchener, ON, Canada
| | - Carolyn Campbell
- Grand River Regional Cancer Center, Grand River Hospital, Kitchener, ON, Canada
| | - Marina Mourtzakis
- Department of Kinesiology, University of Waterloo, Burt Matthew Hall Rm. 1117, 200 University Avenue W., Waterloo, ON N2J 3G1, Canada.
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Affiliation(s)
- L J Cooke
- Department of Clinical Neurosciences, University of Calgary and the Calgary Health Region, Calgary, Alberta, Canada
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Abstract
We have analysed the sequence variability of the banana bunchy top nanovirus (BBTV) DNA-1 sequence from 17 isolates collected throughout Vietnam, and showed that the level of DNA-1 sequence variation within Vietnam was approximately double that previously reported for Asian BBTV isolates. Furthermore, the sequences separated into two geographical subgroups that generally correlated to the northern or southern regions of Vietnam. We have also characterised an additional putative Rep-encoding component associated with some BBTV isolates from Vietnam. This component, which we have named BBTV-S3, shared 47%, 69%, 56% and 65% nucleotide sequence identity with the previously reported Rep-encoding components BBTV DNA-1, S1, S2 and Y1 respectively.
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Affiliation(s)
- K E Bell
- Centre for Molecular Biotechnology, School of Life Sciences, Queensland University of Technology, Brisbane, Australia
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Affiliation(s)
- G V McDonnell
- Northern Ireland Regional Neurology Service, Royal Victoria Hospital, Belfast, Northern Ireland
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Paterson A, Winder J, Bell KE, McKinstry CS. An evaluation of how MRI is used as a pre-operative screening investigation in patients with temporal lobe epilepsy. Clin Radiol 1998; 53:353-6. [PMID: 9630274 DOI: 10.1016/s0009-9260(98)80008-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/30/2022]
Abstract
AIMS A retrospective analysis was carried out of how magnetic resonance imaging (MRI) is used as a pre-operative screening investigation in patients with a clinical diagnosis of medically intractable temporal lobe epilepsy (TLE). Up to 65% of such patients are said to have hippocampal sclerosis (HS). MATERIALS AND METHODS Forty-six patients in a 26-month period underwent MR examination on a 1.5 T scanner according to a routine protocol. Each patient had coronal T1-weighted and oblique coronal T2-weighted scans performed. Hippocampal volume was calculated from the T1-weighted images, the T2-weighted images being assessed for relative hippocampal signal intensity. Each individual patient's medical records were audited. RESULTS Thirty per cent of patients in our study had a diagnosis of HS made on their MR scan. No patient had a diagnosis of HS made without prior clinical evidence of seizure lateralization. Sixty-eight per cent of patients with clinical evidence of a unilateral seizure focus had HS diagnosed by MR scanning. Forty-three per cent of patients did not have clinical evidence of an unilateral seizure focus. It was found that over 25% of patients referred to the unit did not fit the criteria of having medically intractable TLE. Nine per cent of patients had previously stated that they did not want epilepsy surgery. CONCLUSION The lower than expected diagnostic rate of HS in this patient population reflects the broad criteria used in referring patients for imaging studies. This is likely to mirror the initial investigation of these patients outside specialist units where more extensive investigation prior to MRI is available. However, when MRI is used as an initial screening investigation, this study indicates that implementation of simple clinical criteria should significantly reduce the number of unnecessary scans.
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Affiliation(s)
- A Paterson
- Department of Neuroradiology, Royal Victoria Hospital, Belfast, UK
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Affiliation(s)
- M H Love
- Department of Neuroradiology, Royal Victoria Hospital, Belfast, UK
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Affiliation(s)
- M H Love
- Department of Neuroradiology, Royal Victoria Hospital, Belfast, Northern Ireland
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Ellis PK, Bell KE. The radiological investigation of neurosarcoidosis. Ulster Med J 1995; 64:101-4. [PMID: 7502392 PMCID: PMC2449082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Ellis PK, Reilly M, Bell KE. Bilateral subdural collections invisible on a CT brain scan. Ulster Med J 1995; 64:98-100. [PMID: 7502410 PMCID: PMC2449080] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- P K Ellis
- Department of Radiology, Altnagelvin Hospital, Londonderry
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Bell KE, Loughrey C, Morrison CM. Initial experience with a electronic CT image transfer system. Ulster Med J 1994; 63:23-6. [PMID: 8658991 PMCID: PMC2449088] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
An electronic image transfer system for computed tomographic images links the CT scanner in Altnagelvin Hospital, Londonderry with the regional neuroradiology department in the Royal Victoria Hospital, Belfast. In the first 13 months of operation, scans of 100 patients were transferred; 49 scans were taken in acute neurosurgical emergencies, and 51 were non-acute sent for a specialist neuroradiological opinion. Potentially hazardous inter-hospital transfer was avoided in 21 cases of acute neurosurgical emergency, and more efficient and appropriate referral was achieved in the cases whose scans had been sent for sent for radiological second opinion. We believe that the system has substantially improved the diagnosis and management of patients with neurosurgical problems in both hospitals.
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Affiliation(s)
- K E Bell
- Department of Neuroradiology, Royal Victoria Hospital, Belfast
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Abstract
In 216 consecutive patients investigated for subarachnoid haemorrhage, 44 (20.3%) of cerebral angiograms were either normal or equivocal for the presence of aneurysm. Arteriography was repeated in 30 patients and an aneurysm was demonstrated in 10 cases. Repeat arteriography is recommended in proven subarachnoid haemorrhage even when the initial study is normal, and in this study achieved a reduction in overall negative rate to 15.6%.
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Affiliation(s)
- N Pathirana
- Department of Neuroradiology, Royal Victoria Hospital, Belfast, Northern Ireland
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Begley A, Bell KE, Byrnes DP, McKinstry CS. Traumatic carotico-cavernous fistula presenting as delayed epilepsy. Ulster Med J 1993; 62:101-4. [PMID: 8516965 PMCID: PMC2449025] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- A Begley
- Royal Victoria Hospital, Belfast
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Abstract
The authors investigated the combined effects of direct instruction and precision teaching by peer tutors in a high school driver education curriculum. Learners (N = 4) included students with intellectual and learning disabilities and students without disabilities. Peer tutoring was associated with immediate increases in correct responding and a simultaneous and rapid deceleration of errors. Three learners passed the written tests in the driver education classroom, obtained driver's licenses, and produced similar or better driving records than students who did not require assistance. This program is being continued and expanded by school personnel without assistance from the authors.
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Affiliation(s)
- K E Bell
- Department of Psychology, Utah State University, Logan 84322-2810
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McKinstry CS, Bell KE. The failed back syndrome: the diagnostic contribution of computed tomography. Ulster Med J 1990; 59:122-30. [PMID: 2278107 PMCID: PMC2448294] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- C S McKinstry
- Department of Neuroradiology, Royal Victoria Hospital, Belfast
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Khan MT, McKinstry CS, Bell KE, Fannin TF, Byrnes DP, Vasishta R. Serpentine aneurysm of the posterior circulation: report of two cases. Br J Neurosurg 1990; 4:217-23. [PMID: 2397048 DOI: 10.3109/02688699008992727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Giant serpentine aneurysms form a subgroup of giant intracranial aneurysms with specific radiological and surgical features. Previous reports have stressed the predilection of these lesions for the carotid circulation, particularly the middle cerebral artery. Two cases of serpentine aneurysm affecting the posterior circulation are reported and the problems of diagnosis and treatment of this lesion are discussed.
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Affiliation(s)
- M T Khan
- Department of Neurosurgery, Royal Victoria Hospital, Belfast, Northern Ireland
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Bell KE, Mills JI. Certified nurse-midwife effectiveness in the health maintenance organization obstetric team. Obstet Gynecol 1989; 74:112-6. [PMID: 2733926] [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: 01/02/2023]
Abstract
This study of the effectiveness of certified nurse-midwives in a health maintenance organization (HMO) led to five conclusions: 1) Maternity patients accepted certified nurse-midwife care; 2) the general female HMO population had little awareness of certified nurse-midwives but was receptive to receiving certified nurse-midwife care once the role was explained; 3) certified nurse-midwives reduced inpatient cost; 4) the use of certified nurse-midwives did not affect perinatal outcomes; and 5) physicians and certified nurse-midwives worked well together as team members. Certified nurse-midwives proved to be an unqualified success as team members in this setting.
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Affiliation(s)
- K E Bell
- Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Anaheim, California
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Gibbs J, Bell KE. Rehabilitation in head injury: a case study. Rehabil Nurs 1987; 12:137-8. [PMID: 3647557 DOI: 10.1002/j.2048-7940.1987.tb00578.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Abstract
Forty patients, mainly post-operative, were examined for suspected leakage from the oesophagus and/or stomach using iopamidol. Oesophageal leaks were demonstrated in seven patients, tracheo-oesophageal fistulae in two and an unsuspected gastro-jejunostomy intusussception in one. Only two cases were regarded as technically unsatisfactory due to poor coating. Normal examinations were found in 28 (70%) patients. This was confirmed by the subsequent clinical course. Aspiration into the bronchial tree occurred in five (12.5%) patients without ill-effects. Furthermore no adverse side effects as a result of the administration of iopamidol were recorded. It is concluded that a non-ionic medium such as iopamidol is the agent of choice in the detection of oesophageal and gastric perforation, particularly in post-operative patients where there is an increased risk of aspiration.
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Abstract
Kaposi's sarcoma is known to occur in a variety of immunosuppressed patients. The course of the disease varies depending on the underlying risk factors. A male homosexual patient in whom Kaposi's sarcoma developed while he was being treated with prednisone for Henoch-Schönlein purpura is described. The resolution of his lesions once the steroid was discontinued places him in the group of patients whose main risk factor is the steroid itself, rather than the acquired immune deficiency syndrome (AIDS) risk group. A review of the literature on steroid-treated patients in whom Kaposi's sarcoma developed is presented.
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Larsen LS, Kloos TH, Bell KE. Tetanus as a complication of small bowel obstruction. N J Med 1986; 83:42-4. [PMID: 3456498] [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: 01/05/2023]
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Abstract
The use of dehydration in patients undergoing intravenous urography remains widespread, despite evidence that it may be dangerous and despite lack of evidence of any effect on the urinary concentration of contrast media. In total, 100 patients were studied, having been allocated randomly into two groups, one of which had undergone dehydration, the other group being normally hydrated. No significant difference in the quality of the urograms was detected. It is suggested that the practice of dehydration in preparation is unnecessary and should no longer be undertaken.
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Sacks DA, Bell KE, Schwimmer WB, Schifrin BS. Sinusoidal fetal heart rate pattern with intrapartum fetal death. J Reprod Med 1980; 24:171-3. [PMID: 7373601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
A case of sinusoidal fetal heart rate pattern with intrapartum fetal death is presented. This pattern has been observed infrequently during both the antepartum and intrapartum periods. Not all sinusoidal patterns may be ominous. A reasonable plan of management includes maternal position change, oxygen administration, scalp sampling and preparation for immediate delivery.
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Schwimmer WB, Bell KE. A new blunt pneumoperitoneum needle. Obstet Gynecol 1974; 44:900-2. [PMID: 4437830] [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] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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