Objective: The objective of this study is to evaluate the safety and tolerability of inosine in patients with relapsing-remitting multiple sclerosis (RRMS). The secondary objectives are to assess the effects of inosine administration on serum urate (UA) levels, the progression of neurologic disability, the cumulative number of new, active lesions on magnetic resonance imaging (MRI), and changes in serum levels for markers of inflammation. Design: Oral administration of inosine was used to raise serum levels of the natural peroxynitrite scavenger UA in 16 patients with RRMS during a 1-year randomized, double-blind trial. Outcome measures: The endpoints studied were relapse rate, disability assessed by the Kurtzke Expanded Disability Status Scale (EDSS), MRI, and analysis of serum levels of nitrotyrosine, and oxidative and proinflammatory makers. Results: Increased serum UA levels correlated with a significant decrease in the number of gadoliniumenhanced lesions and improved EDSS. A number of MRI intensity-based parameters were altered by inosine treatment, in certain cases correlating with changes in serum UA levels. In a patient with low serum UA and high lesion activity, raising UA levels by inosine treatment decreased serum nitrotyrosine while increasing the ratio of Th2 to Th1 cytokines in circulating cells. The only side-effect correlated with inosine treatment was kidney stone formation in 4=16 subjects. Conclusions: These data suggest that the use of inosine to raise serum UA levels may have benefits for at least some MS patients. The effect of this treatment is likely to be a consequence of inactivation of peroxynitritedependent free radicals. Close monitoring of serum UA levels as well as other measures are required to avoid the potential development of kidney stones.

The purpose of this study “was to examine dispositional, cognitive, and situational predictors of coaching burnout within Smith's cognitive-affective model of spoil burnout. High school and college coaches (N=848) completed the Maslach Burnout Inventory, the Trait Anxiety Inventory, and a demographic/cognitive appraisal questionnaire via a mail survey. Descriptive results indicated that a substantial percentage of coaches fell into the moderate and high burnout ranges and that female coaches were higher in emotional exhaustion than male coaches were. Trait anxiety emerged as the strongest predictor of burnout, and several cognitive perceptions of the coaching role were also predictive of burnout. Actual time spent in coaching and leisure activities, type of sport, competition level, and personal status were not related to burnout. These findings provide some support for Smith's model and indicate that burnout may be predicted by dispositional and cognitive factors more so than actual situational or behavioral factors.

SUMMARYThe changes in ionic gradients were related to the development and resolution of ischemic brain swelling, and to the electrophysiological events during and after ischemia.

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