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High- Intensity Intermittent Exercise and Fat Loss. Abstract. The effect of regular aerobic exercise on body fat is negligible; however, other forms of exercise may have a greater impact on body composition. For example, emerging research examining high- intensity intermittent exercise (HIIE) indicates that it may be more effective at reducing subcutaneous and abdominal body fat than other types of exercise. The mechanisms underlying the fat reduction induced by HIIE, however, are undetermined. Regular HIIE has been shown to significantly increase both aerobic and anaerobic fitness. HIIE also significantly lowers insulin resistance and results in a number of skeletal muscle adaptations that result in enhanced skeletal muscle fat oxidation and improved glucose tolerance. This review summarizes the results of HIIE studies on fat loss, fitness, insulin resistance, and skeletal muscle. Possible mechanisms underlying HIIE- induced fat loss and implications for the use of HIIE in the treatment and prevention of obesity are also discussed. Introduction. Most exercise protocols designed to induce fat loss have focused on regular steady state exercise such as walking and jogging at a moderate intensity. Disappointingly, these kinds of protocols have led to negligible weight loss . Thus, exercise protocols that can be carried out by overweight, inactive individuals that more effectively reduce body fat are required. Cardio And Fat Burning Workouts Exhale Yoga Teacher Training Review Beginner Yoga Classes In Torrance California Yoga And Meditation Classes In Long Beach Ca An. Diabetes has become a widespread epidemic, primarily because of the increasing prevalence and incidence of type 2 diabetes. According to the Centers for. Get your suspension training equipment directly from the source - TRX suspension trainers. 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Physical exercise has established efficacy as an antidepressant in individuals with depression and current medical evidence supports the use of exercise as both a. Accumulating evidence suggests that high- intensity intermittent exercise (HIIE) has the potential to be an economical and effective exercise protocol for reducing fat of overweight individuals. HIIE protocols have varied considerably but typically involve repeated brief sprinting at an all- out intensity immediately followed by low intensity exercise or rest. The length of both the sprint and recovery periods has varied from 6 s to 4 min. Most commonly the sprints are performed on a stationary cycle ergometer at an intensity in excess of 9. V. Subjects studied have included adolescents, young men and women, older individuals, and a number of patient groups . The most utilized protocol in past research has been the Wingate test which consists of 3. Subjects typically perform the Wingate test 4 to 6 times separated by 4 min of recovery. This protocol amounts to 3 to 4 min of exercise per session with each session being typically performed 3 times a week for 2 to 6 weeks. Insight into the skeletal muscle adaptation to HIIE has mainly been achieved using this type of exercise . Thus, the Wingate protocol is likely to be unsuitable for most overweight, sedentary individuals interested in losing fat. Other less demanding HIIE protocols have also been utilised. For example, we have used an 8- second cycle sprint followed by 1. Thus, instead of 4 to 6 sprints per session, as used in Wingate protocol studies, subjects using the 8 s/1. Total sprint time is 8 min with 1. For the HIIE Wingate protocols, total exercise time is typically between 3 to 4 min of total exercise per session. Thus, one of the characteristics of HIIE is that it involves markedly lower training volume making it a time- efficient strategy to accrue adaptations and possible health benefits compared to traditional aerobic exercise programs. This review summarises results of research examining the effect of different forms of HIIE on fitness, insulin resistance, skeletal muscle, subcutaneous, and abdominal fat loss. Acute Response and Chronic Adaptations to High- Intensity Intermittent Exercise. Acute responses to HIIE that have been identified include heart rate, hormones, venous blood glucose, and lactate levels, autonomic, and metabolic reactivity. Heart rate response is dependent on the nature of the HIIE protocol but typically is significantly elevated during exercise and declines during the period between sprint and recovery. For example, Weinstein et al. Heart rate response to the 8 s/1. HIIE which increases to 1. HIIE . In this protocol, there is typically a small heart rate decrease of between 5–8 bpm during each 1. A similar pattern of heart rate response was found for an HIIE protocol consisting of ten 6- second sprints interspersed with 3. Heart rate increased to 1. Hormones that have been shown to increase during HIIE include catecholamines, cortisol, and growth hormones. Catecholamine response has been shown to be significantly elevated after Wingate sprints for both men and women . Catecholamine response to HIIE protocols that are less intensive than the Wingate protocol have also been shown to be elevated. For example, Christmass et al. From baseline, plasma epinephrine increased 6. Figure 1). The significant catecholamine response to HIIE is in contrast to moderate, steady state aerobic exercise that results in small increases in epinephrine and norepinephrine . The HIIE catecholamine response is an important feature of this type of exercise as catecholamines, especially epinephrine, have been shown to drive lipolysis and are largely responsible for fat release from both subcutaneous and intramuscular fat stores . Aerobic endurance training increases . Interestingly, in endurance trained women, . However, no data are available concerning HIIE training effects on . GH concentration was still ten times higher than baseline levels after 1 hour of recovery. Venous blood cortisol levels have also been shown to significantly increase after repeated 1. Lactate levels after the Wingate test are typically higher in trained anaerobic athletes and have been shown to be similar . Lactate rose to between 4 and 5 mmol. During a 1. 2 s/2. HIIE condition lactate levels of the untrained were similar but were significantly higher for the trained female cyclists (between 7 and 8 mmol. Despite increasing lactate levels during HIIE exercise, it appears that free fatty acid transport is also increased. For example, a 2. HIIE produced increased levels of glycerol indicating increased release of fatty acids . HIIE appears to result in significant increases in blood glucose that are still elevated 5 min . HIIE appears to have a more dramatic effect on blood glucose levels of exercising type 1 diabetic individuals. Twenty minutes of moderate- intensity aerobic exercise resulted in a significant fall in glycemia. However, one 1. 0- second sprint at the end of the 2. The stabilization of glycemia in the sprint trials was associated with elevated levels of catecholamines, growth hormone, and cortisol. In contrast, these hormones remained at near baseline levels after the 2. Thus, one 1. 0- second all out sprint significantly increased glucose, catecholamines, growth hormone, and cortisol of type 1 diabetic individuals for 5 min after HIIE. Authors suggest that the addition of one 1. Autonomic function has been analyzed after HIIE by assessing heart rate variability. These authors have further suggested that at the end of the HIIE bout, ATP resynthesis may be mainly derived from PCr degradation and intramuscular triacylglycerol stores. However, this pattern of fuel utilization during HIIE has not been demonstrated in humans. After hard, all- out HIIE exercise, complete phosphagen recovery may take 3- 4 min but complete restoration of p. H and lactate to pre- exercise levels may take hours . The recovery of the exercising muscle after HIIE to its pre- exercise state is undetermined. After a hard bout of aerobic exercise, recovery has typically been found to be biphasic with an initial rapid phase of recovery lasting 1. During recovery, oxygen consumption is elevated to help restore metabolic processes to baseline conditions. The postexercise oxygen uptake in excess of that required at rest has been termed excess postexercise oxygen consumption (EPOC). EPOC during the slow recovery period has been associated with the removal of lactate and H+, increased pulmonary and cardiac function, elevated body temperature, catecholamine effects, and glycogen resynthesis . Although EPOC does not appear to have been assessed after HIIE, it is enhanced after split aerobic exercise sessions. However, aerobic exercise protocols resulting in prolonged EPOC have shown that the EPOC comprises only 6–1. Whether HIIE- induced EPOC is one of the mechanisms whereby this unique form of exercise results in fat loss needs to be determined by future research. In summary, acute responses to a bout of HIIE include significant increases in heart rate, catecholamines, cortisol, growth hormone, plasma lactate and glucose levels, glycerol, and a significant decrease in parasympathetic reactivation after HIIE, and depletion of ATP, PCr, and glycogen stores. Chronic responses to HIIE training include increased aerobic and anaerobic fitness, skeletal muscle adaptations, and decreased fasting insulin and insulin resistance (Table 1). Surprisingly, aerobic fitness has been shown to significantly increase following minimal bouts of HIIE training. For example, Whyte et al. Previously, untrained males increased their V. Longer Wingate- type HIIE programs lasting 1. V. The less intense protocols (8 s/1. Collectively, these results indicate that participation in differing forms of HIIE by healthy young adults and older patients, lasting from 2 to 1. V. Mechanisms underlying the aerobic fitness response to HIIE are unclear although a major contributor is phosphocreatine degradation during repeated HIIE. Using thigh cuff occlusion to prevent PCr resynthesis during recovery, Trump et al. There is also evidence indicating that muscle aerobic capacity is increased following HIIE due to increases in PGC- 1a mediated transcription . A number of studies have demonstrated that HIIE lasting from 2 to 1. For example, Tabata et al. A number of studies have taken muscle biopsies after Wingate test performance in order to examine skeletal muscle adaptations. In a series of studies, Gibala et al. For example, Talanian et al. Exercise whole body fat oxidation also increased by 3. HIIE significantly increased muscle . Maryland Temporary Disability Assistance Program. Visit Maryland Temporary Disability Assistance. Maryland Assistance Programs Resources. Disability Entitlement Advocacy Program. 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Governmental: Government agency. Jurisdictional structure. Operations jurisdiction*County of Miami- Dade in the state of Florida, United States. Size. 2,4. 31 sq mi (6,3. Population. 2,4. 78,7. General nature. Operational structure. Headquarters. Doral, Florida. Officers. 2,6. 33. Facilities. Stations. Websitehttp: //www. Footnotes* Divisional agency: Division of the country, over which the agency has usual operational jurisdiction. The Miami- Dade Police Department (MDPD), formerly known as the Metro- Dade Police Department (1. The MDPD has approximately 4,7. The Department is still often referred by its former name, the Metro- Dade Police or simply Metro. Miami- Dade Police officers are easily identified by their taupe/brown colored uniforms. Miami- Dade Police vehicles are identified by their green and white livery. MDPD officers carry silver badges, while officers with the ranks of sergeant and above carry gold badges. The MDPD operates out of eight district stations throughout Miami- Dade County and several specialized bureaus. The MDPD is internationally accredited by the Commission on Accreditation for Law Enforcement Agencies, as well as at the state level by the Florida Commission for Law Enforcement Accreditation. The current director of the department is Juan J. The department's headquarters are located in Doral, Florida. In the early years, the entire area was policed by as few as three deputies on horseback, and Dade. In 1. 89. 9, the office of the sheriff became an elected position. By 1. 91. 5, the jurisdiction area had been reduced to its present size of approximately 2,1. The Public Safety Department. In 1. 96. 0, the Public Safety Department also assumed responsibility for police operations at the Port of Miami and Miami International Airport. That year a long- standing controversy over the selection/election procedure for choosing a county sheriff was resolved by voter mandate. Subsequently, non- elected sheriffs were appointed by the county manager as . By that year, the Public Safety Department had also been divested of all other non- police responsibilities in order to concentrate entirely on law enforcement services. In July 1. 98. 1, the Public Safety Department was renamed the Metro- Dade Police Department. In September 1. 99. In December of the same year, the Metro- Dade Police Department was renamed the Miami- Dade Police Department. Another officer suffered a serious leg injury. The suspect, Shawn Sherwin Labeet, fled the scene but was found in an apartment complex later that day. He was cornered in a poolhouse bathroom by members of Miami- Dade Police Special Response Team (equivalent to SWAT), and was shot and killed when he refused to drop a pistol he was holding. On the morning of Thursday, January 2. Miami- Dade Police officers were shot and killed by a homicide suspect, Johnny Sims. According to Miami- Dade Police Director James Loftus, the MDPD fugitive warrant team were assisting the U. S. Marshals Service in the city of Miami in apprehending the suspect, for whom a murder warrant had been issued. Police arrived at the suspect's mother's house and made contact with a member of the family, when the suspect surprised police by opening fire. Detective Roger Castillo, a 2. Detective Amanda Haworth, a 2. Jackson Memorial Hospital's Ryder Trauma Center in grave condition. She underwent emergency surgery there, but died shortly thereafter. The suspect, Sims, was shot and killed by another detective at the scene. Through its European. Topical preparations for pain relief: efficacy and patient adherence. Abstract. There has been an increasing focus on development of new routes of drug administration to provide tailored treatments for patients, without decreasing efficacy of analgesia, in proportion to the progression of the knowledge of pain mechanisms. While acute pain acts as an alarm, chronic pain is a syndrome requiring meticulous selection of analgesic drugs of high bioavailability for long- term use. Such criteria are challenges that topical medications aim to overcome, allowing progressive delivery of active component, maintaining stable plasma levels, with a good safety profile. This review presents recent findings regarding topical formulations of the most widely used drugs for pain treatment, such as nonsteroidal anti- inflammatory agents, anesthetics, and capsaicin, and the role of physical agents as delivery enhancers (phonophoresis and iontophoresis). Although the number of topical agents is limited for use in peripheral conditions, increasing evidence supports the efficacy of these preparations in blocking nociceptive and neuropathic pain. Patient adherence to medical treatment is also a challenge, especially in chronic painful conditions. It is known that reduction of treatment complexity and pill burden are good strategies to increase patient compliance, as discussed here. MendMeShop - the fastest road to Permanent Tendon Injury Recovery!However, the role of topical presentations, when compared to traditional routes, has not yet been fully explored and thus remains unclear. Keywords: medication adherence, administration, topical, patient compliance, pain, therapeutics. Introduction. The International Association for the Study of Pain defines pain as a multidimensional entity that involves nociception, afferents to the central nervous system, modulation, affective responses, endogenous analgesia, behavioral adjustments, and changes of social roles. The International Association for the Study of Pain defines pain as a multidimensional entity that involves nociception, afferents to the. Night Waking With Internal Intense Body Heat? I have been waking in the night with intense body heat at about 12 or 1 AM every night. This is not night sweats, as I. For many years, Carter and Holmes Orchids has been the premier source for orchids of every variety. We invite you to search our on line catalog for your orchid and. I too had a bad experience with an epidural. The doctor had accidently done a spinal tap on me which caused me horrendous headache pain for over two week’s that. Back pain and sciatica Description. An in-depth report on the causes, diagnosis, treatment, and prevention of back pain, including sciatica. TurboBit.net provides unlimited and fast file cloud storage that enables you to securely share and access files online. Find a unique combination of doctors' and patients' views at onhealth.com - Owned and Operated by WebMD. As a family-owned business with over 52 years of experience, here at Colt’s, we offer true quality salesmanship and are here to meet your needs, whether we are. While pain trigger factors are endured, pain degenerates to an independent response, manifesting even when it is possible to eradicate the primary stimulus. Despite technological advances and thorough established treatments, chronic pain continues to defy health professionals, because it is a poorly controlled condition; 1 partly because there are three aspects involved in the pathogenesis of pain: nociception (pain sensation and topography), emotional (fear and depression), and behavioral factors (catastrophism, vigilance, and somatic awareness). Pain management faces difficulties that restrict therapeutic success, such as the limited efficiency of analgesics, systemic effects, and cognitive impairment of drugs due to central effects. As the understanding of pain pathophysiology and treatment increases, new routes of drug delivery are being discovered with the objective of attempting to block pain at peripheral sites, with maximum active drug and minimal systemic effects. Topical preparations are the result of such exploration. For patients, the rationale is the application of analgesics directly on the site of soreness, even if the sensation is a referred pain from another source. They perceive that oral treatments can potentially lead to more adverse effects as compared to topical treatment. In addition, the intention of applying localized treatment within the lay population may be a means of enhancing the efficacy of the placebo element of topical analgesia. Such mechanisms are of limited value if the area of soreness is large, such as an entire limb in sympathetically maintained pain syndromes, and overall, placebo interventions do not seem to be involved in important clinical effects. Nevertheless, it is well known that placebo interventions may influence reported outcomes, especially pain, nausea, and other subjective complaints that are subject to context. On the other hand, physicians are aware that chronic pain is a complex syndrome involving peripheral and central factors, justifying the prescription of multimodal therapies and drugs of central action. Evidence based on empirical practice has suggested that topically applied medications can be almost as effective as those taken orally, with a good safety profile in terms of adverse effects. The ultimate goal that motivates the development of topical preparations is the improvement of patient compliance to medical treatment, by providing efficient pain relief with less central nervous system effects and minimal drug regimen burden. Topical preparations can potentially benefit the pediatric population, whose chronic pain management is just as challenging as in adults. Topical analgesics or anesthetics are defined as liquids, gels, powders, creams, semisolids, emulsions, patches, foams, or aerosols containing an analgesic or anesthetic agent applied on or around the painful site. Most topical preparations are available as patches, ointments, or creams, and this review will focus on cutaneous applications for adult patients, although some studies in children are also mentioned. Topical preparations and topical delivery systems. Among the most widely known drugs with peripheral effects are nonsteroidal anti- inflammatory drugs (NSAIDs), anesthetics, capsaicin, alpha- adrenoreceptor antagonists, and cannabinoids. However, not all medications applied topically on the skin have peripheral action. Topically applied opioids predominantly have a central effect. Therefore, one can didactically distinguish transdermal medication such as buprenorphine and fentanyl and topical drugs acting locally, which have a primary role on the peripheral nervous system and decrease of nociceptive afferents (Figures 1 and . In addition, systemic absorption can be reduced without compromising the desired effect. However, several items must be considered regarding topical preparations. Marked interindividual variability of skin properties may influence percutaneous absorption and distribution of the drug when applied topically, since the stratum corneum is a barrier that limits penetration of substances. The therapeutic effects also depend on the rate, amount, and depth of penetration into the skin and the potential toxicological hazards of drugs. High doses of sensitizing molecules cannot be administered or diffused into skin, and topical preparations should be water soluble and have an affinity for lipids. Besides, the amount of variability of individual metabolic properties directly influences bioavailability and needed doses or precautions. This is of special interest when a well- established preparation used in an adult population is used for children in an off- label or unlicensed fashion. Physical agents such as electricity (a system called iontophoresis) and ultrasound (phonophoresis) are progressively used as enhancers to increase permeability and delivery of substances into and through the stratum corneum. Despite their popularity, questions remain regarding definitive treatment. Iontophoresis is the application of high- voltage pulses to the skin. The method enhances transdermal delivery of specific drugs, migrating charged particles across membranes. The target can be either local/focal or have systemic effects, and chemical enhancers can be associated. Electrical application is well tolerated in vivo, but can induce muscle contractions. Skin irritation is a common adverse effect. Phonophoresis is the use of ultrasound waves to enhance drug penetration via heating properties. The effectiveness of ultrasound is reduced when used for muscle spasms or when circulation to the area is disrupted, since its mechanism of action depends on vasodilation and increase of local metabolism. Phonophoresis at an intensity of 1–3 W/cm. MHz for 3. 0 min is able to better enhance ketorolac permeation when compared to 1–2 W/cm. Shorter application periods (5 min as described in several protocols) provide nonsignificant effects when compared to ultrasound only. A continuous ultrasound mode is more effective in promoting drug transport than a pulsed mode. However, there are reports of tissue destruction or patient intolerance using 3. In order to maximize the clinical effectiveness of phonophoresis, skin must be adequately hydrated, preheated, and shaved for ideal ultrasound transmission. Previously applied ultrasound enhances the percutaneous penetration of agents. A technique associating regional hypothermia and iontophoresis improved bioavailability of sodium diclofenac and prednisolone in synovial fluid. Other results in animal models suggest the therapeutic antinociceptive effect of diclofenac depends on the current density but not on the application time, and that direct iontophoresis application to the inflamed knee of rats enhanced the therapeutic effect, probably because of direct delivery of the drug. Both iontophoresis and phonophoresis of naproxen are equally effective electrotherapy methods in the treatment of chronic musculoskeletal conditions, such as lateral epicondylitis. Other popular devices are biodegradable implantable controlled drug delivery systems, which claim to offer good control of pain, as they continuously apply substances to tissue. Fewer fluctuations of serum levels of drugs are considered to induce less adverse effects with greater patient compliance. Opioids. The analgesic effects of opioids are well known, and the two most described are buprenorphine and fentanyl. Despite their transdermal application, the effects are primarily central. Recent research demonstrated the presence of mu and delta opioid receptors at the endings of sensory afferent neurons. Clamping the sciatic nerve in animals caused an inflammatory response, resulting in an accumulation of beta- endorphinergic receptors at both sides of the ligature. In human models, topical morphine promoted relief of mucositis- related pain among patients undergoing head and neck chemotherapy. However, other studies have failed to demonstrate benefits from the topical use of opioids administered for skin ulcer and dental procedures and painful hypertonic bladder. Welcome to On. Healthonhealth. Owned and Operated by Web. MD and part of the Web. MD Network. Please visit us at Medicine. Net. com for healthy living information. Online Photography Degree Programs . 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