The blood pressure response to dynamic exercise testing: a systematic review

Although blood pressure (BP) is measured routinely during exercise testing, its clinical significance is not fully understood or appreciated. As the number of studies has increased, conflicting data have emerged, partly due to differences in methodologies, populations studied, testing procedures, and definitions used for an abnormal BP response. This article attempts to review the literature studying the physiology and pathophysiology of the BP response to exercise testing and summarize the evidence for its diagnostic and prognostic applications.     

Strategies for Coordination of a Serosurvey in Parallel with an Immunization Coverage Survey

A community-based immunization coverage survey is the standard way to estimate effective vaccination delivery to a target population in a region. Accompanying serosurveys can provide objective measures of protective immunity against vaccine-preventable diseases but pose considerable challenges with respect to specimen collection and preservation and community compliance. We performed serosurveys coupled to immunization coverage surveys in three administrative districts (woredas) in rural Ethiopia. Critical to the success of this effort were serosurvey equipment and supplies, team composition, and tight coordination with the coverage survey. Application of these techniques to future studies may foster more widespread use of serosurveys to derive more objective assessments of vaccine-derived seroprotection and monitor and compare the performance of immunization services in different districts of a country.     

The effects of vigorous exercise training on physical function in children with arthritis: A randomized,controlled, SINGLE‐BLINDED trial

Objective

To examine the effectiveness of high‐intensity aerobic training compared with low‐intensity training in terms of energy cost of locomotion, peak oxygen uptake, peak power, and self‐reported physical function in children with juvenile idiopathic arthritis (JIA).

Methods

Eighty children with JIA, ages 8–16 years, were enrolled in a randomized, single‐blind controlled trial. Both groups participated in a 12‐week, 3‐times–weekly training program consisting of high‐intensity aerobics in the experimental group and qigong in the control group. Subjects underwent exercise testing measuring submaximal oxygen uptake at 3 km/hour (VO _2submax) as the primary outcome, maximal oxygen uptake, and peak power at the beginning and end of the program. Physical function was measured using the Child Health Assessment Questionnaire (C‐HAQ).

Results

The exercise program was well tolerated in both groups. There was no difference in VO _2submax or any other exercise testing measures between the groups through the study period and no indication of improvement. Both groups showed significant improvements in C‐HAQ with no difference between the groups. Adherence was higher in the control group than the experimental group.

Conclusion

Our findings suggest that activity programs with or without an aerobic training component are safe and may result in an important improvement in physical function. The intensity of aerobic training did not seem to provide any additional benefits, but higher adherence in the qigong program may suggest that less intensive regimens are easier for children with JIA to comply with, and provide a degree of benefit equivalent to more intensive programs.     

The ratio of means method as an alternative to mean differences for analyzing continuous outcome variables in meta-analysis: A simulation study

Background  

Meta-analysis of continuous outcomes traditionally uses mean difference (MD) or standardized mean difference (SMD; mean difference in pooled standard deviation (SD) units). We recently used an alternative ratio of mean values (RoM) method, calculating RoM for each study and estimating its variance by the delta method. SMD and RoM allow pooling of outcomes expressed in different units and comparisons of effect sizes across interventions, but RoM interpretation does not require knowledge of the pooled SD, a quantity generally unknown to clinicians.     

A meta-analysis of the effect of antibody therapy for the prevention of severe respiratory syncytial virus infection

Background  

The primary objective of this meta-analytic study was to determine the impact of RSV-IGIV and palivizumab on risk of respiratory syncytial virus (RSV)-related hospitalization. Secondary objectives were to determine if antibody therapy decreases the risk of RSV infection, intensive care admission, mechanical ventilation, and mortality in high risk infant populations.