Enhancement of bone mineral acquisition during growth may be a useful preventive strategy against osteoporosis. The aim of this study was to explore the lean mass, strength, and bone mineral response to a 10-month, high-impact, strength-building exercise program in 71 premenarcheal girls, aged 9 -10 years. Lean body mass, total body (TB), lumbar spine (LS), proximal femur (PF), and femoral neck (FN) bone mineral were measured using the Hologic QDR 2000؉ bone densitometer. Strength was assessed using a grip dynamometer and the Cybex isokinetic dynamometer (Cybex II). At baseline, no significant difference in body composition, pubertal development, calcium intake, physical activity, strength, or bone mineral existed between groups. At completion, there were again no differences in height, total body mass, pubertal development, calcium intake, or external physical activity. In contrast, the exercise group gained significantly more lean mass, less body fat content, greater shoulder, knee and grip strength, and greater TB, LS, PF, and FN BMD (exercise: TB 3.5%, LS 4.8%, PF 4.5%, and FN 12.0%) compared with the controls (controls: TB 1.2%, LS 1.2%, PF 1.3%, and FN 1.7%). TB bone mineral content (BMC), LS BMC, PF BMC, FN BMC, LS bone mineral apparent density (BMAD), and FN bone area also increased at a significantly greater rate in the exercise group compared with the controls. In multiple regression analysis, change in lean mass was the primary determinant of TB, FN, PF, and LS BMD accrual. Although a large proportion of bone mineral accrual in the premenarcheal skeleton was related to growth, an osteogenic effect was associated with exercise. These results suggest that high-impact, strength building exercise is beneficial for premenarcheal strength, lean mass gains, and bone mineral

The sensitivities and specificities of several different diagnostic assays for Streptococcus pneumoniae were assessed using 99 clinical isolates of S. pneumoniae and 101 viridans streptococci and were as follows: Pneumoslide, 99 and 87%, respectively; Directigen, 100 and 85%, respectively; Phadebact, 100 and 98%, respectively; deoxycholate drop test, 99 and 98%, respectively; deoxycholate tube test, 100 and 99%, respectively; optochin, 99 and 98%, respectively; and Gram Positive Identification Card, 90 and 96%, respectively. Identification of clinical isolates of S. pneumoniae should be confirmed using one or more diagnostic assays with well-documented high (e.g., >95%) sensitivities and specificities.Despite the clinical importance and frequent isolation of Streptococcus pneumoniae, there is no one "gold standard" or reference method for its identification. Laboratory identification of this pathogen has been accomplished using one or more assays, including Gram stain morphology, colony morphology, and hemolysis on sheep blood agar, pyrrolidonyl arylamidase reactivity, optochin susceptibility, solubility in deoxycholate (bile), carbohydrate utilization, reaction with specific antisera, miniaturized manual systems such as the API 20 Strep system (bioMerieux Vitek, Inc., Hazelwood, Mo.), the automated Gram Positive Identification (GPI) Card (bioMerieux Vitek, Inc.) and DNA probes (Gen-Probe, San Diego, Calif.) (1, 2, 5-9, 15, 17, 19, 20).Deoxycholate solubility has been associated with a sensitivity of Ն98% and a specificity of 100% (6,7,17,19). However, 10 strains of nonencapsulated, deoxycholate-insoluble (but optochin-susceptible) S. pneumoniae isolated from eye swabs were reported (13). Optochin susceptibility has been reported to be 90 to 100% sensitive and 99 to 100% specific (2,6,8,19) although numerous studies have confirmed optochin-resistant isolates of the organism (2, 4, 10-12, 14, 18). At least one report exists of an optochin-susceptible viridans streptococcal isolate with an 18-mm zone of inhibition (4). The few published studies of the Pneumoslide (Becton-Dickinson Microbiology Systems, Cockeysville, Md.) (5, 7, 17), Directigen (Becton-Dickinson Microbiology Systems) (20), and Phadebact (Boule Diagnostics AB, Huddinge, Sweden) (6, 12, 19) serological methods for S. pneumoniae antigen identification have reported them to be close to 100% sensitive but often, if not always, to have a substantially lower specificity. Only two studies could be found concerning the relative accuracy of the GPI Card for the identification of S. pneumoniae. They reported (in 1984) sensitivities of only 71% (9) and 81% (1). The study reported herein was undertaken to reassess the current sensitivity, specificity, and predictive values associated with each of the more common and traditionally used identification methods for S. pneumoniae. Identification of isolates.Fresh clinical isolates of both S. pneumoniae and viridans streptococci from various sites were each identified using three serological tests (Pneumoslide, Dire...

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