Unanesthetized female animals were cooled without artifical ventilation in cylindrical screen cages under ice until the desired rectal temperature was attained. When fasted rats are cooled 15 minutes after the intraperitoneal administration of either glucose or sodium pyruvate, there is an impaired utilization of the glucose but not of the pyruvate. Rate of decrease of liver glycogen formed from administered glucose was not affected. The elevated level of blood lactic acid typical of hypothermic rats was further elevated by administration of pyruvate but not of glucose, suggesting increased production of lactic acid via pyruvic acid. Glucose utilization patterns of hamsters (hibernators) and rats (non-hibernators) were similar during hypothermia. In non-fasted rats rendered hypothermic there is a progressive increase in blood level of glucose accompanied by an initial decrease in liver glycogen level. Subsequent to this decrease in liver glycogen level, there is a marked increase in the plasma level of ketone bodies. It is concluded that although in hypothermia there is an impairment in glucose utilization, this probably represents decreased oxidative metabolism of carbohydrate, there being no apparent decrease in the formation of lactic acid via pyruvic acid. From the results of experiments with insulin- and alloxan-treated rats, it is concluded that metabolic alterations of hypothermia in rats may be modified in degree but are not eliminated by a prior state of diabetes or by prior administration of insulin.
Hypothermia was induced in non-fasted, female rats by placing animals in individual, cylindrical screen cages under crushed ice until a rectal temperature of 15 °C was attained. No anaesthetic or artificial ventilation was provided. Hypothermic animals were sacrificed after 0, 30, and 60 minutes' maintenance at this rectal temperature and metabolites were measured in blood and liver. It was observed that, as previously reported, hypothermia caused increases in blood packed cell volume, glucose and lactic acid levels, and plasma levels of inorganic phosphorus and total ketones. Maintenance of hypothermia for 30 or 60 minutes either caused no further change or accentuated the changes observed initially in these metabolites. Liver glycogen level decreased significantly after 30 minutes but returned to an almost normal level at 60 minutes. From these observations it is concluded that attainment of a "steady state" condition of hypothermia in non-fasted rats does not alter the pattern of metabolic changes observed in acute hypothermia of short duration.
Exercise is Medicine™ (EIM) is an approach to clinic-based physical activity (PA) promotion. Study aims were to 1) assess the acceptability of current EIM protocols among healthcare providers (providers) and health and fitness professionals (fitness professionals); and 2) pilot test the resultant modified EIM protocols comparing patients referred to community PA programming with patients exposed to the EIM protocols alone.During 2012-2013 in Chattanooga, Tennessee, USA, 30/80 invited providers and 15/25 invited fitness professionals received training and provided feedback in the use of the EIM protocols. Following EIM use, feedback from providers and fitness professionals about acceptability of EIM protocols resulted in the adaptation of EIM protocols into the electronic health record. Subsequently, 50 providers and 8 fitness professionals participated in the intervention phase of the pilot study. Healthy and/or disease managed adults 18 years and older were enrolled with a sample of patients exposed to both the EIM protocols and community PA programming (EIM +) while another sample was exposed to the EIM protocols only (EIM). All patients were assessed for physical activity and Health-related Quality of Life. Measures were repeated ~ 3 months later for each patient.Eighteen EIM + and 18 EIM participants were studied. The EIM + participants had a greater net increase in total PA (∆[Formula: see text] = + 250 min/week) vs. EIM participants (∆[Formula: see text] = - 38.6 min/week) (p = 0.0002).EIM + participation significantly increased PA levels among participants, suggesting this approach significantly impacts the PA of inactive adults more than just EIM only.
Neck masses are often seen in clinical practice, and the family physician should be able to determine the etiology of a mass using organized, efficient diagnostic methods. The first goal is to determine if the mass is malignant or benign; malignancies are more common in adult smokers older than 40 years. Etiologies can be grouped according to whether the onset/duration is acute (e.g., infectious), subacute (e.g., squamous cell carcinoma), or chronic (e.g., thyroid), and further narrowed by patient demographics. If the history and physical examination do not find an obvious cause, imaging and surgical tools are helpful. Contrast-enhanced computed tomography is the initial diagnostic test of choice in adults. Computed tomography angiography is recommended over magnetic resonance angiography for the evaluation of pulsatile neck masses. If imaging rules out involvement of underlying vital structures, a fine-needle aspiration biopsy can be performed, providing diagnostic information via cytology, Gram stain, and bacterial and acid-fast bacilli cultures. The sensitivity and specificity of fine-needle aspiration biopsy in detecting a malignancy range from 77% to 97% and 93% to 100%, respectively.
Evidence-Based Answer Soy formula feeding has no effect on growth (SOR: A, systematic review of RCTs and cohort studies with consistent results). Soy formula has been associated with extremely premature thelarche (prior to age 2) and increased duration and discomfort of menses in adulthood (SOR: C, case-control and cohort studies with multiple comparisons). But the American Academy of Pediatrics states that there is no convincing evidence that soy formulas affect human development, reproduction, or endocrine function (SOR: C, expert opinion).
Evidence-Based Answer While short-term use of valerian extract at doses of 50–150 mg daily appears safe, there is no evidence that it is any more effective than placebo for reducing anxiety, and it is less effective than diazepam (SOR: B, single RCT).
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