This study determined whether four self-paced household tasks, conducted in the subjects' homes and a standardised laboratory environment, were performed at a moderate intensity [3-6 metabolic equivalents (METs)] in a representative sample of thirty-six 35- to 45-year-old females. Energy expenditure was also predicted via indirect methods. Self-paced energy expenditure during sweeping, window cleaning, vacuuming and mowing was measured using the Douglas bag technique. Heart rate, respiratory frequency, Computer Science Applications (CSA) movement counts (hip and wrist), Borg rating of perceived exertion and Quetelet's index were also recorded as potential predictors of energy expenditure. While the four activities were performed at mean intensities >or=3.0 METs in both the home and laboratory, all comparisons between these two environments were statistically significant ( P<0.001). The 95% confidence intervals (CIs) for the home and laboratory prediction equations were +/-1.1 METs and +/-1.0 MET, respectively. These data suggest that the aforementioned household chores can contribute to the 30 min x day(-1) of moderate-intensity activity required to confer health benefits. However, the substantial between-subject variability in energy expenditure resulted in some persons performing these tasks at a light intensity (<3.0 METs). The significant MET differences between the home and laboratory emphasise the effects of 'environment and terrain' and the 'mental approach to a task' on self-paced energy expenditure. Considering the means for the five activities ranged from 3.1 METs to 6.0 METs, the 95% CIs for the regression equations lack predictive precision.

Low hematocrit (Hct < 20) during cardiopulmonary bypass (CPB) is associated with higher mortality and other adverse outcomes. More frequently, low Hct is encountered in patients with small body size and women patients. This prompted us to take an aggressive approach in our care of these patients, involving a strategy for predicting patients at risk of low Hct, with the aid of an electronic worksheet that accurately predicts CPB Hct, and two prevention strategies: use of a low-prime CPB circuit (LP) for all adult patients with a body surface area (BSA) < 1.7 m(2) and use of autologous circuit priming (AP), in addition to the low-circuit volume in some patients. The two cohorts of patients in whom these techniques were employed were compared to a group matched for body size where our standard adult circuit (STD) was used. There were 233 patients in the standard group, 139 in the LP group, and 68 in the LP/AP group. The CPB circuit prime volume was 1,710 ml for the STD group and 1,110 ml for the LP group. Use of autologous priming techniques further reduced the prime volume by 545 +/- 139 ml. The incidence of low Hct (<20%) during CPB was thus reduced from 70% to 15% (p = 0.001) when using both techniques together without increasing red blood cell (RBC) transfusions. These changes in perfusion management resulted in a reduction in the incidence of renal complications (STD = 9.4%, LP = 6.5% (ns) and LP/AP = 0%,

This study measured the energy expenditure of four self-paced household and garden tasks to determine whether 55- to 65-year-old men performed them at a moderate intensity [3-6 metabolic equivalents (METs)] and to predict the activity intensity via indirect methods. Resting metabolic rate and oxygen consumption were measured using Douglas bags in 50 men (X +/- SD: 60.6 +/-3.2 years, 175.8 +/- 5.6 cm, 82.6 +/- 10.1 kg ) who performed self-perceived moderate paced walking and self-paced sweeping, window cleaning, vacuuming and lawn mowing. Heart rate, CSA accelerometer counts (hip and arm), Quetelet's index, Borg rating of perceived exertion and respiratory frequency were measured as possible predictors of energy expenditure. Each of the four household and garden activities was performed at a mean intensity of > or = 3.0 METs in both the standardised laboratory environment (sweeping = 3.4, window cleaning = 3.8, vacuuming = 3.0 and lawn mowing = 5.3 METs) and the subjects' homes (sweeping = 4.1, window cleaning = 3.5, vacuuming = 3.6 and lawn mowing = 5.0 METs). Comparisons between the two settings were significantly different (p < or =0.008). Except for window cleaning, the MET values were not different from those of our previous younger sample (35-45 years). Regression analysis yielded prediction equations with 95% confidence intervals of +/-0.8 METs for both the laboratory and home environments. Although the energy expenditure means for these activities indicate that they can contribute to the 30 min day(-1) of moderate intensity physical activity required to confer health benefits, there was substantial inter-individual variability. While the regression equations lack predictive precision at the individual level, they were able to determine whether energy expenditure was above the 3.0 MET threshold with correct classification rates of 91% and 94% in the laboratory and home, respectively.

Objective. To investigate the trafficking of circulating blood neutrophils and synovial fluid neutrophils in rheumatoid arthritis (RA) patients and the influence of a 1,000-mg intravenous pulse of methylprednisolone succinate (MP).Methods. Neutrophils were isolated from the circulation and from the knee synovial compartments of subjects with RA. Circulating neutrophils were labeled with technetium-rn hexametazime (*Tc-HMPAO) and reinjected intravenously. Synovial fluid neutrophils were labeled with indium-111 oxine and reinjected into the knee from which they were isolated. Gamma camera images were obtained at intervals up to 24 hours post MP. Each patient had a baseline study (no MP) and a study in which MP was administered either 4 hours before (2 patients), 10 minutes before (1 patient), or 30 minutes to 1.5 hours after (6 patients) injection of the radiolabeled neutrophils. Subsequent analysis allowed quantitation of the neutrophil uptake into and clearance from the knee as a function of time.Results. Nine patients who had not received glucocorticoids in the previous 3 months were studied. MP significantly decreased neutrophil ingress in 13 of the 16 knees studied (almost total inhibition in 5 knees), and this occurred within 1.5 hours of MP administration in all except 1 knee. At 24 hours after MP administra-

This study determined whether some of the more vigorous household and garden tasks (sweeping, window cleaning, vacuuming and lawn mowing) were performed at a moderate intensity (3-6 METs or metabolic equivalents) by a representative sample of 50, 55 to 65-year-old women (X +/- SD; 59.3 +/- 3.1 years, 161.5 +/- 5.2 cm, 69.4 +/- 12.4 kg, 38.4 +/- 7.3% BF). Data collection was conducted in a standardised laboratory environment and in the subjects' homes. Energy expenditure during self-perceived moderate paced walking around a quadrangle was also used as a marker of exercise intensity. Energy expenditure measured via indirect calorimetry was also predicted from: HR, CSA accelerometer counts, Quetelet's index and the Borg rating of perceived exertion. Ninety-six percent of the subjects walked at an intensity of>or= 3.0 METs. Except for vacuuming in the laboratory (X = 2.9 METs; P = 0.19), the intensity of each of the other activities was significantly (P or= 3.0 METs when the four household/garden activities were performed in the subjects' homes. These activities therefore have the potential to contribute to the 30 min day(-1) of moderate intensity physical activity required to confer health benefits but there was much inter-individual variability in the intensity at which these tasks were performed. Random intercept regression analyses yielded prediction equations with 95% confidence intervals of +/- 0.80 and +/- 0.84 METs for the laboratory and home based equations, respectively. Considering the means for the five activities ranged from 2.9 to 5.5 METs, these 95% confidence intervals lack predictive precision at the individual level. Nevertheless, the laboratory and home-based equations predicted with correct classification rates of 89 and 90%, respectively, whether energy expenditure was < 3.0 or >or= 3.0 METs.