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Biomedical subjects

R C Toffle

Publications and source records attributed to R C Toffle.

10 recordsLinked to original sources

The effects of exercise intensity on body composition, weight loss, and dietary composition in women.

OBJECTIVE: There is controversy over whether exercise and/or exercise intensity has an effect on total caloric intake or diet composition. The purpose of this study was to test the effect of exercise intensity without dietary manipulation on body composition and/or weight loss and to determine whether exercise intensity affected total caloric intake or diet composition in normal weight young women. METHODS: Fifteen women aged 18 to 34 years with a maximal oxygen consumption average or below on the Palo Alto norms served as subjects. Subjects were randomly assigned to: 1) low heart rate intensity exercise group (LI, N = 7) which exercised 40 to 45 minutes approximately four times weekly at a mean heart rate of 132 beats per minute (bpm); 2) high heart rate intensity group (HI, N = 8) which exercised 40 to 45 minutes approximately four times weekly at a mean HR of 163 bpm. All subjects were given a maximal exercise test prior to and during weeks eight, 12 and 16. The first 4 weeks served as a control period, followed by approximately 11 weeks of exercise. Each subject recorded her dietary intake for 1 complete week, including a weekend, during weeks 2, 6, 10 and 14 of the study. RESULTS: VO2 max increased (p < .05) in HI (29 +/- 6 ml/kg/minute to 38 +/- 7) but did not change in LI (36 +/- 5 to 38 +/- 7). Percent fat decreased in HI (p < .05) (27 +/- 7 to 22 +/- 4) but was unchanged in LI (22 +/- 6 to 21 +/- 6). The weekly intake of total kcal, carbohydrate, protein and fat did change significantly for either group. The weekly intake of saturated fat declined significantly (p < .05) in HI (21.2 +/- 5.8 g to 14.9 +/- 5.5 g); their weekly intake of cholesterol also decreased (p < .05) between months 2 to 3 (249 +/- 109 mg to 159 +/- 58 mg). No other differences in dietary intake between groups were found. CONCLUSION: High heart rate intensity exercise training without dietary manipulation resulted in a decrease in body fat, but not weight change, as well as a decrease in the intake of saturated fat and cholesterol in normal weight young women. These changes were not observed after low heart rate intensity training.

Adolescent

Multiple gestation in a unicornuate uterus. A case report.

BACKGROUND: Uterine anomalies in the obstetric population have been reported to occur in 0.1-3.2% of patients, and the unicornuate uterus constitutes only 1-2% of these anomalies. CASE: A 35 year-old woman with known unicornuate uterus became pregnant with twins after controlled ovarian hyperstimulation and intrauterine insemination. The pregnancy was complicated by cervical incompetence, premature labor, dysfunctional labor, the need for cesarean delivery and postpartum uterine atony. CONCLUSION: This is the third reported successful outcome of multiple gestation following the use of assisted reproductive technologies in a patient with a unicornuate uterus. The presence of this müllerian anomaly should not be considered an absolute contraindication to the use of superovulation when treating infertility.

Adult

Effect of low dose oral contraceptives on exercise performance.

OBJECTIVE: to examine the effect of cycle phase or a low dose oral contraceptive on exercise performance in young women. METHODS: As controls, 15 men were tested twice by a maximal treadmill test (Vo2 max) and by an endurance run 14 d apart to determine performance variability from causes other than hormonal fluctuations. Ten women ages 18-30 were then tested for Vo2 max and endurance in the same way in both the follicular and the luteal phase (random order, ovulation assessed by sonography). They were then randomly assigned to placebo (n = 3) or oral contraceptive (1 mg norethindrone and 35 micrograms ethinyl oestradiol) (n = 7) for 21 days. Tests were repeated during the first and third weeks of treatment. Vo2 max and endurance tests were compared in the men and control cycle of the women by using independent t tests on percent change. The data for both cycles in the women were analysed by repeated measures ANOVA. RESULTS: There was no difference in per cent change in total test time, Vo2 max, or breathing frequency between the men and women in either test. Data obtained during the Vo2 max test revealed no difference between the follicular and luteal phases of the menstrual cycle for total test time [11.8 (SD 2.3) v 12.6 (2.3) min], Vo2 [41.6 (12.1) v 39.7 (11.4) ml.kg-1.min-1], or breathing frequency [26.8 (3.5) v 27.3 (9.9) breaths.min-1] respectively, or during the first and third weeks of treatment [total test time 12.0 (2.5) v 12.8 (2.4) min; Vo2 37.3 (7.4) v 41.0 (12.4) ml.kg-1.min-1; breathing frequency 27.8 (4.2) v 27.7 (3.4) breaths.min-1, respectively]. Data obtained during the endurance test revealed no difference between the follicular and luteal phase of the menstrual cycle for total test time [20.5 (15.7) v 16.2 (8.5) min], Vo2 [37.5 (9.4) v 32.9 (8.1) ml.kg-1.min-1], or breathing frequency [32.0 (6.0) v 33.2 (5.1) breaths.min-1, respectively], or during the first and third weeks of treatment [total test time 32.3 (34.9) v 30.6 (30.1) min; Vo2 33.9 (10.1) v 35.2 (8.6) ml.kg-1.min-1; breathing frequency 34.0 (5.9) v 34.8 (5.3) breaths.min-1, respectively]. CONCLUSIONS: Neither cycle phase nor a low dose oral contraceptive containing 1 mg norethindrone adversely affects performance during a maximal treadmill test or endurance run.

Adult

Cardiopulmonary arrest in pregnancy: the role of caesarean section in the resuscitative protocol.

A 36-year-old black multipara at 32 weeks gestation was referred with apparent peripartal cardiomyopathy. Upon arrival, she was found to be in pulmonary edema; and shortly thereafter developed cardiopulmonary arrest. She failed to respond to initial attempts at cardiopulmonary resuscitation but subsequently responded after Caesarean section and pericardiocentesis. This case exemplifies the unique aspects of performing cardiopulmonary resuscitation on a gravid female in the latter part of pregnancy and that Caesarean section should be considered an integral part of the resuscitative protocol when standard protocols fail.

Adult

Catamenial pneumothorax. A case report.

Catamenial pneumothorax (CPT) is a rare complication of systemic endometriosis, as shown by this classic case. A nonsteroidal antiinflammatory prostaglandin synthetase inhibitor was used to treat the patient.

Adult

Pregnancy-induced changes in prolactinomas as assessed with computed tomography.

Seven women with prolactin-secreting pituitary microadenomas and three with persistent hyperprolactinemia after surgical adenomectomies were evaluated with computed tomography to assess the effect of pregnancy on the volume of pituitary prolactinomas and hyperfunctioning pituitary tissue. In one patient a microadenoma enlarged to become a macroadenoma. Tumor enlargement occurred in the remaining six patients with microadenomas. None of the patients with previously resected adenomas exhibited hypertrophy of residual pituitary tissue or tumor recurrence after pregnancy.

Female

Intrauterine insemination: the University of Minnesota experience.

Forty-five patients initiated intrauterine insemination between October 1981 and August 1983. Indications for insemination included poor semen (count less than 20 X 10(6)/ml and/or motility less than 40%), poor cervical mucus, presence of sperm antibodies, unexplained poor postcoital tests, or various combinations of the above. During this time period, 374 inseminations were performed in 163 cycles and resulted in eight pregnancies in the 45 patients receiving artificial insemination by homologous donor, for an overall pregnancy rate of 17.4%. The fact that five of the pregnancies occurred in the first insemination cycle and two in the second cycle was felt to indicate a cause-and-effect relationship. A trial of intrauterine insemination in selected patients would appear to be warranted.

Adult

The management of elective, repeat cesarean section.

The perinatal outcome of 252 consecutive, elective, repeat cesarean section was studied retrospectively. One hundred fifty patients (60%) were scheduled for delivery within approximately seven days of their expected delivery, cesarean (EDC), designated on the basis of rigorous clinical criteria and corroborative sonographic biparietal diameters. One hundred two patients (40%) did not meet these criteria and required analysis of amniotic fluid for L/S ratio and creatinine prior to their operations. Forty-three patients (17%) labored prior to their scheduled procedure or amniocentesis and underwent cesarean section shortly after admission. No cases of the respiratory distress syndrome were noted in the electively delivered patients. The authors conclude that careful clinical assessment of gestational age will prevent the occurrence of iatrogenic hyaline membrane disease in infants born to mothers by elective, repeat cesarean section. When the EDC is in question, however, amniotic fluid phospholipid analysis is clearly advisable.

Amniocentesis