The effects of cycle racing on pulmonary diffusion capacity and left ventricular systolic function

The purpose of this study was to examine the effects of a 20 km cycle race (TT) on left ventricular (LV) systolic and pulmonary function in 12 endurance cyclists. Spirometry, single-breath diffusion capacity (DLCO) with partitioning of membrane (DM) and capillary blood volume (Vc) components and 2-D echocardiograms were performed before and after the TT. During the TT mean oxygen consumption was 3.79 +/- 0.5 L x min(-1) (83 +/- 5.5% of VO2max) and mean blood lactate was 8.4 +/- 2.4 mM. Following the TT, spirometry values were unchanged, however, DLCO and DM were significantly (P<0.05) reduced. LV systolic function was increased (P<0.05) immediately after exercise, while end-diastolic area was decreased (P<0.05) at all points during recovery. The reduction in DM was correlated with LV systolic function following the TT. This relationship suggests a cardiovascular contribution to pulmonary diffusion impairment following exercise.     

Remission of persistent childhood asthma: Early predictors of adult outcomes

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Decreased lung capillary blood volume post-exercise is compensated by increased membrane diffusing capacity

The diffusing capacity of the lung for carbon monoxide (DLCO) decreases to below the pre-exercise value in the hours following a bout of intense exercise. Two mechanisms have been proposed: (1) development of pulmonary oedema and (2) redistribution of central blood volume to peripheral muscles causing a reduction in pulmonary capillary blood volume (V_c). In the present study DLCO, V_c and the membrane diffusing capacity (D_m) were measured in nine healthy females using a rebreathing method, in contrast to the single breath technique employed in previous studies. DLCO, V_c and D_m were measured before and at 1, 2, 3, 16 and 24 h following maximal treadmill exercise. Compared with pre-exercise values, DLCO was depressed by up to 8.9 (3.0)% (P<0.05) for the first 3 h following exercise, but had returned to pre-exercise values by 16 h post-exercise. V_c fell by 21.2 (4.1)% (P<0.05) at 3 h post-exercise, but at the same time D_m increased by 14.7 (9.1)%. It was concluded that: (1) the increase in D_m made it unlikely that the fall in DLCO was due to interstitial oedema and injury to the blood gas barrier; (2) on the other hand, the reduction in DLCO following exercise was consistent with a redistribution of blood away from the lungs; and (3) the trend for D_m and V_c to reciprocate one another indicates a situation in which a fall in V_c nevertheless promotes gas transfer at the respiratory membrane. It is suggested that this effect is brought about by the reorientation of red blood cells within the pulmonary capillaries following exercise.     

Effect of aerobic capacity on sweat rate and fluid intake during outdoor exercise in the heat

We measured the aerobic capacity, sweat rate and fluid intake of trained athletes during outdoor exercise and examined the relationship between aerobic capacity and thermoregulatory responses at high ambient temperatures. The maximal aerobic capacity ( ) of the subjects, nine male baseball players of college age, was determined by maximal exercise tests on a cycle ergometer. The subjects practised baseball regularly without drinking fluids from 1330 to 1530 hours. After 30 min rest, they played a baseball game with free access to a sports drink at 15°C from 1600 to 1830 hours. At a mean ambient temperature of 36.7 (SEM 0.2)°C, the mean percentage of body mass loss (m _b) and increase of oral temperature (T _o) from 1330 to 1530 hours was 3.47 (SEM 0.12)% and 0.81 (SEM 0.14)°C, respectively. The sweat loss from 1330 to 1830 hours was 56.53 (SEM 1.56)ml · kg^–1 of body mass (M _b) while the mean fluid consumption was 44.78 (SEM 2.39)ml · kg^–1 ofm _b, with recovery of 76.08 (SEM 2.81)% of sweat loss. The was significantly inversely correlated withm _b, fluid intake and rehydration amount, but showed no correlation withT _o. These results would suggest that at a given exercise intensity in subjects with a higher aerobic capacity body temperature is maintained with a lower sweating rate than that in subjects with a lower aerobic capacity.     

Cystometric changes in the early phase of streptozotocin-induced diabetes in rats: evidence for sensory changes not correlated to diabetic neuropathy

Summary 1. The effect of streptozotocin (STZ) induced diabetes on rat urinary bladder function was investigated by means of in vivo cystometry and in vitro recording of bladder strips contractility. A group of sucrose-fed animals was included to determine to what extent the STZ-induced changes were ascribable to the increased diuresis. 2. After 7–9 weeks from STZ injection there was a marked increase in weight of bladder and ureters. Cystometry revealed a marked increase in bladder capacity (volume threshold) although pressure threshold and amplitude of micturition contraction were unaffected. Sucrose-fed animals, having normal blood glucose levels but a similar increase in urine production exhibited cystometric changes identical to those of STZ animals. 3. In vitro experiments indicated that the response to field stimulation (0.1–20 Hz) is reduced in STZ-pretreated but increased in sucrose-fed animals, as compared to controls. 4. The content of urinary bladder and ureters in sensory neuropeptides (substance-P, neurokinin-A and calcitonin-gene related peptide-like immunoreactivity) was increased by STZ diabetes when values were corrected for the increased weight of these organs. 5. The capsaicin-induced contraction of the rat isolated bladder strips, presumably caused by neuropeptides released from intramural sensory nerves, is unaffected by STZ diabetes. 6. These findings indicate that STZ diabetes produces, at an early stage, changes similar to those reported to occur in the human disease, e. g. a greater bladder capacity with unimpaired voiding function. The increased bladder capacity of STZ-rats seems largely, if not solely, ascribable to changes in physical properties of the detrusor muscle, thereby allowing accomodation of greater than normal volumes with similar increase of intraluminal pressure. No sign of diabetic neuropathy of the capsaicin-sensitive sensory nerves can be observed at this stage (7–9 weeks) of STZ diabetes. Send offprint requests to P. Santicioli at the above address     

Policemen's physical fitness in relation to the frequency of leisure-time physical excercise

Summary Ninety to ninety-five men (aged 27 to 46 years) from the police academy were the study subjects. Their prior habits of physical excercise, estimated aerobic capacity ( ), muscular performance, and thickness of subcutaneous fat were determined. The policemen were taller (181 cm vs 175 cm) and heavier (84 kg vs 74 kg) than the average 20- to 40-year-old Finnish man, and their (1 · min^–1) was higher (3.41 1 · min^–1 vs 2.96 1 min^–1 The frequency of prior physical exercise significantly correlated with most of the variables studied. Those policemen who did not exercise at all (n = 12) were inferior to the average 20- to 40-year-old Finnish man on all the physical fitness tests, whereas the results of the most active policemen (n = 23) were clearly higher. The results indicate that the selection of heavier and taller men for police training guarantees a certain absolute level of physical performance capacity. However, the physical activity involved in police work is insufficient to maintain a high level of physical fitness, which must be achieved through participation in regular and effective physical training.     

Impact of Game-Based Interventions on Health-Related Outcomes in Hospitalized Older Patients: A Systematic Review

ObjectivesTo examine the effectiveness of game-based interventions compared with usual care on health-related outcomes for acutely hospitalized older patients.DesignSystematic review of randomized controlled trials (RCT) and nonrandomized trials.Setting and ParticipantsAdults aged 65 years or older admitted to an Acute Care for Elderly unit were selected.MeasuresHealth-related outcomes (eg, functional capacity, quality of life, adherence to treatment).ResultsFour RCTs were included in the review. The interventions were based on the implementation of serious-game programs using Nintendo Wii in acute medical patients. Across the included studies, no significant differences were observed between groups on functional capacity and health-related quality of life. Significant differences were found between groups on the adherence to treatment (in favor of the control group), but no differences were obtained in other outcomes such as enjoyment and motivation.Conclusions and ImplicationsIn general, there is very limited evidence for the efficacy to reach conclusions about the effects of game-based interventions on health-related outcomes in acutely hospitalized older patients. Future studies are needed to improve our knowledge in the field; however, we consider that these strategies should be considered in the future complementary to usual care.     

高原不同海拔地区儿童肺活量肺通气量与形态指标的相关性

目的了解高原不同海拔地区儿童肺活量肺通气量与形态指标的相关性,以便为制定高原性疾病防控策略提供参考依据。方法于2019年1月至2020年6月采用随机抽样调查法,选择青海西宁地区(海拔2260 m,低海拔组)、青海海西地区(海拔2900 m,中海拔组)、青海玉树地区(海拔4493 m,高海拔组)7~15岁中小学生作为研究对象,检测受试儿童肺活量、肺通气量和形态指标。结果低海拔组、中海拔组、高海拔组肺活量、肺通气量和形态指标比较,差异均有统计学意义(P均<0.05)。肺活量、肺通气量与肺容积呈正比关系,与肺密度、肺径线呈反比关系(P<0.05)。研究数据的logistic回归分析显示,影响儿童肺活量和肺通气量的因素有以下3个:肺密度平均值、全肺横径、全肺容积,且以上因素差异间有统计学意义(P<0.05)。结论监测儿童形态指标,关注肺密度平均值、全肺横径、全肺容积可有效判断儿童肺功能,对防治相关高原性疾病的发生具有一定价值。     

结节病患者肺功能变化研究

目的：肺结节病患者肺功能测试的研究。方法：40例肺结节病患者不同时期肺功能测试结果和应用激素的回顾分析。结果：显示此类患者有限性通气功能障碍并伴有弥散功能下降和小气道功能受限,PaO2明显下降,pH升高,PaCO2也有下降的趋势。激素治疗结果显示,患者的MMF有明显的提高。其它肺功能指标如VC,RV,RV/TLC,MVV,FEV1,DLCO等都有升高的趋势。结论：VC,RV,MMF,DLCO,DLCO/VA等对诊断结节病的病情发展有直接参考价值,而MMF在糖皮质激素治疗后有显著的变化,提高MMF对结节病的治疗和预后具有动态参考价值。