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https://www.readbyqxmd.com/read/27903669/exertional-dyspnoea-in-obesity
#1
Vipa Bernhardt, Tony G Babb
The purpose of cardiopulmonary exercise testing (CPET) in the obese person, as in any cardiopulmonary exercise test, is to determine the patient's exercise tolerance, and to help identify and/or distinguish between the various physiological factors that could contribute to exercise intolerance. Unexplained dyspnoea on exertion is a common reason for CPET, but it is an extremely complex symptom to explain. Sometimes obesity is the simple answer by elimination of other possibilities. Thus, distinguishing among multiple clinical causes for exertional dyspnoea depends on the ability to eliminate possibilities while recognising response patterns that are unique to the obese patient...
December 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27900193/exertional-rhabdomyolysis-physiological-response-or-manifestation-of-an-underlying-myopathy
#2
Renata S Scalco, Marc Snoeck, Ros Quinlivan, Susan Treves, Pascal Laforét, Heinz Jungbluth, Nicol C Voermans
Exertional rhabdomyolysis is characterised by muscle breakdown associated with strenuous exercise or normal exercise under extreme circumstances. Key features are severe muscle pain and sudden transient elevation of serum creatine kinase (CK) levels with or without associated myoglobinuria. Mild cases may remain unnoticed or undiagnosed. Exertional rhabdomyolysis is well described among athletes and military personnel, but may occur in anybody exposed to unaccustomed exercise. In contrast, exertional rhabdomyolysis may be the first manifestation of a genetic muscle disease that lowers the exercise threshold for developing muscle breakdown...
2016: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/27882640/physiological-markers-of-exercise-capacity-and-lung-disease-severity-in-cystic-fibrosis
#3
Laurie Smith, Charles C Reilly, Victoria MacBean, Caroline J Jolley, Caroline Elston, John Moxham, Gerrard F Rafferty
BACKGROUND AND OBJECTIVE: Peak aerobic capacity (VO2 peak) is an important outcome measure in cystic fibrosis (CF), but measurement is not widely available and can be influenced by patient motivation, pain and fatigue. Alternative markers of disease severity would be helpful. Neural respiratory drive, measured using parasternal intercostal muscle electromyography (EMGpara), reflects the load to capacity balance of the respiratory system and provides a composite measure of pulmonary function impairment in CF...
November 24, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27881506/development-and-evolution-of-a-hierarchical-clinical-composite-end-point-for-the-evaluation-of-drugs-and-devices-for-acute-and-chronic-heart-failure-a-20-year-perspective
#4
Milton Packer
Traditional approaches to the assessment of new treatments for heart failure have generally evaluated individual components of the syndrome at fixed points in time or have relied on surrogate physiological measures that are poorly correlated with the clinical status of patients. Conventional time-to-event trials that focus on morbidity and mortality represent an important methodological advance, but they generally assign undue weight to clinical events of less importance and are insensitive to difference in functional capacity among individuals who do not experience a clinical event during follow-up...
November 22, 2016: Circulation
https://www.readbyqxmd.com/read/27875498/a-murine-model-of-robotic-training-to-evaluate-skeletal-muscle-recovery-after-injury
#5
Stefano Lai, Alessandro Panarese, Ross Lawrence, Michael L Boninger, Silvestro Micera, Fabrisia Ambrosio
PURPOSE: In vivo studies have suggested that motor exercise can improve muscle regeneration after injury. Nevertheless, pre-clinical investigations still lack reliable tools to monitor motor performance over time and to deliver optimal training protocols to maximize force recovery. Here, we evaluated the utility of a murine robotic platform to (i) detect early impairment and longitudinal recovery after acute skeletal muscle injury and (ii) administer varying intensity training protocols to enhance forelimb motor performance...
November 21, 2016: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/27869890/-anmco-sic-sici-gise-sicch-consensus-document-risk-stratification-in-elderly-patients-undergoing-cardiac-surgery-and-transcatheter-aortic-valve-implantation
#6
Giovanni Pulignano, Michele Massimo Gulizia, Samuele Baldasseroni, Francesco Bedogni, Giovanni Cioffi, Ciro Indolfi, Francesco Romeo, Adriano Murrone, Francesco Musumeci, Alessandro Parolari, Leonardo Patanè, Paolo Giuseppe Pino, Annalisa Mongiardo, Carmen Spaccarotella, Roberto Di Bartolomeo, Giuseppe Musumeci
Aortic stenosis is one the most frequent valvular diseases in developed countries, and its impact on public healthcare resources and assistance is increasing. A substantial proportion of elderly patients with severe aortic stenosis is frequently not eligible for surgery because of advanced age, frailty and multiple comorbidities. Transcatheter aortic valve implantation (TAVI) enables the treatment of very elderly patients at high or prohibitive surgical risk considered ineligible for surgery and with an acceptable life expectancy...
September 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27836300/methods-of-assessment-of-the-post-exercise-cardiac-autonomic-recovery-a-methodological-review
#7
REVIEW
Tiago Peçanha, Rhenan Bartels, Leandro C Brito, Marcelle Paula-Ribeiro, Ricardo S Oliveira, Jeffrey J Goldberger
The analysis of post-exercise cardiac autonomic recovery is a practical clinical tool for the assessment of cardiovascular health. A reduced heart rate recovery - an indicator of autonomic dysfunction - has been found in a broad range of cardiovascular diseases and has been associated with increased risks of both cardiac and all-cause mortality. For this reason, over the last several years, non-invasive methods for the assessment of cardiac autonomic recovery after exercise - either based on heart rate recovery or heart rate variability indices - have been proposed...
October 23, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27834447/physical-capacity-in-lvad-patients-hemodynamic-principles-diagnostic-tools-and-training-control
#8
Nils Reiss, Thomas Schmidt, Anke Workowski, Detlev Willemsen, Jan D Schmitto, Axel Haverich, Birna Bjarnason-Wehrens
Over time left ventricular assist devices (LVAD) have become an alternative to heart transplantation because of enormous technical development and miniaturization. Most patients present a significant improvement in clinical conditions and exercise capacity. Nevertheless, exercise tolerance remains markedly limited even after LVAD implantation compared to a control group. The complex physiological and hemodynamic changes in LVAD patients, both at rest and during exercise, are not yet understood, or at least not completely...
November 11, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/27818024/exertional-dyspnoea-in-chronic-respiratory-diseases-from-physiology-to-clinical-application
#9
Bruno-Pierre Dubé, François Vermeulen, Pierantonio Laveneziana
Dyspnoea is a complex, highly personalized and multidimensional sensory experience, and its underlying cause and mechanisms are still being investigated. Exertional dyspnoea is one of the most frequently encountered symptoms of patients with cardiopulmonary diseases, and is a common reason for seeking medical help. As the symptom usually progresses with the underlying disease, it can lead to an avoidance of physical activity, peripheral muscle deconditioning and decreased quality of life. Dyspnoea is closely associated with quality of life, exercise (in)tolerance and prognosis in various conditions, including chronic obstructive pulmonary disease, heart failure, interstitial lung disease and pulmonary hypertension, and is therefore an important therapeutic target...
November 3, 2016: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/27816631/imi-oral-biopharmaceutics-tools-project-evaluation-of-bottom-up-pbpk-prediction-success-part-2-an-introduction-to-the-simulation-exercise-and-overview-of-results
#10
Alison Margolskee, Adam S Darwich, Xavier Pepin, Leon Aarons, Aleksandra Galetin, Amin Rostami-Hodjegan, Sara Carlert, Maria Hammarberg, Constanze Hilgendorf, Pernilla Johansson, Eva Karlsson, Dónal Murphy, Christer Tannergren, Helena Thörn, Mohammed Yasin, Florent Mazuir, Olivier Nicolas, Sergej Ramusovic, Christine Xu, Shriram M Pathak, Timo Korjamo, Johanna Laru, Jussi Malkki, Sari Pappinen, Johanna Tuunainen, Jennifer Dressman, Simone Hansmann, Edmund Kostewicz, Handan He, Tycho Heimbach, Fan Wu, Carolin Hoft, Loic Laplanche, Yan Pang, Michael B Bolger, Eva Huehn, Viera Lukacova, James M Mullin, Ke X Szeto, Chester Costales, Jian Lin, Mark McAllister, Sweta Modi, Charles Rotter, Manthena Varma, Mei Wong, Amitava Mitra, Jan Bevernage, Jeike Biewenga, Achiel Van Peer, Richard Lloyd, Carole Shardlow, Peter Langguth, Irina Mishenzon, Mai Anh Nguyen, Jonathan Brown, Hans Lennernäs, Bertil Abrahamsson
Orally administered drugs are subject to a number of barriers impacting bioavailability (Foral), causing challenges during drug and formulation development. Physiologically-based pharmacokinetic (PBPK) modelling can help during drug and formulation development by providing quantitative predictions through a systems approach. The performance of three available PBPK software packages (GI-Sim, Simcyp®, and GastroPlus™) were evaluated by comparing simulated and observed pharmacokinetic (PK) parameters. Since the availability of input parameters was heterogeneous and highly variable, caution is required when interpreting the results of this exercise...
November 2, 2016: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27798349/impact-of-commonly-prescribed-exercise-interventions-on-platelet-activation-in-physically-inactive-and-overweight-men
#11
Andrew Haynes, Matthew D Linden, Elisa Robey, Gerald F Watts, Hugh Barrett, Louise H Naylor, Daniel J Green
The exercise paradox infers that, despite the well-established cardioprotective effects of repeated episodic exercise (training), the risk of acute atherothrombotic events may be transiently increased during and soon after an exercise bout. However, the acute impact of different exercise modalities on platelet function has not previously been addressed. We hypothesized that distinct modalities of exercise would have differing effects on in vivo platelet activation and reactivity to agonists which induce monocyte-platelet aggregate (MPA) formation...
October 2016: Physiological Reports
https://www.readbyqxmd.com/read/27796854/the-effect-of-vigorous-versus-moderate-intensity-aerobic-exercise-on-insulin-action
#12
REVIEW
Robert W McGarrah, Cris A Slentz, William E Kraus
Due to the beneficial effects on a wide range of modern medical conditions, most professional societies recommend regular aerobic exercise as part of a healthy lifestyle. Many of the exercise-related health benefits exhibit a dose-response relationship: Up to a point, more exercise is more beneficial. However, recent studies have suggested that different exercise intensities may provide distinct health benefits, independent of energy expenditure (i.e., exercise dose). One of these benefits, primarily mediated by the skeletal muscle, is exercise-related changes in insulin action and glucose homeostasis...
December 2016: Current Cardiology Reports
https://www.readbyqxmd.com/read/27776670/quantitative-computed-tomography-measurements-to-evaluate-airway-disease-in-chronic-obstructive-pulmonary-disease-relationship-to-physiological-measurements-clinical-index-and-visual-assessment-of-airway-disease
#13
Atsushi Nambu, Jordan Zach, Joyce Schroeder, Gongyoung Jin, Song Soo Kim, Yu-Il Kim, Christina Schnell, Russell Bowler, David A Lynch
PURPOSE: To correlate currently available quantitative CT measurements for airway disease with physiological indices and the body-mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index in patients with chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: This study was approved by our institutional review board (IRB number 2778). Written informed consent was obtained from all subjects. The subjects included 188 current and former cigarette smokers from the COPDGene cohort who underwent inspiratory and expiratory CT and also had physiological measurements for the evaluation of airflow limitation, including FEF25-75%, airway resistance (Raw), and specific airway conductance (sGaw)...
November 2016: European Journal of Radiology
https://www.readbyqxmd.com/read/27767984/the-optimum-hematocrit
#14
Walter H Reinhart
The hematocrit (Hct) determines the oxygen carrying capacity of blood, but also increases blood viscosity and thus flow resistance. From this dual role the concept of an optimum Hct for tissue oxygenation has been derived. Viscometric studies using the ratio Hct/blood viscosity at high shear rate showed an optimum Hct of 50-60% for red blood cell (RBC) suspensions in plasma. For the perfusion of an artificial microvascular network with 5-70μm channels the optimum Hct was 60-70% for high driving pressures. With lower shear rates or driving pressures the optimum Hct shifted towards lower values...
October 21, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27765846/non-invasive-assessment-of-cardiac-output-by-brachial-cuff-technique-comparison-to-the-open-circuit-acetylene-washin-method
#15
Pavol Sajgalik, Vaclav Kremen, Alex R Carlson, Vratislav Fabian, Chul-Ho Kim, Courtney M Wheatley, Vaclav Gerla, John A Schirger, Thomas P Olson, Bruce D Johnson
Cardiac output (CO) assessment as a basic hemodynamic parameter has been of interest in exercise physiology, cardiology and anesthesiology. Non-invasive techniques available are technically challenging, and thus difficult to use outside of the clinical or laboratory setting. We propose a novel method of non-invasive CO assessment using a single upper arm cuff. The method uses the arterial pressure pulse wave signal acquired from the brachial artery during 20 second intervals of suprasystolic occlusion. This method was evaluated on a cohort of 12 healthy individuals (age of 27...
October 20, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27763579/effects-of-physical-training-for-people-with-hiv-associated-lipodystrophy-syndrome-a-systematic-review
#16
Rafael E Pedro, Débora A Guariglia, Sidney B Peres, Solange M Moraes
BACKGROUND: Human immunodeficiency virus-associated lipodystrophy syndrome (HALS) is a major problem among people living with HIV/aids. The exercise training has been used for its treatment; however, the knowledge about benefits and safety still is emerging. The aim was systematically review the literature for physiological, metabolic, immunologic, and morphologic adaptations to aerobic, resistance, and concurrent training in people living with HALS. METHODS: A search of the Medline, Embase, Cinahl, Lilacs, Scielo, Web of Science, the Cochrane Controlled Trials Register Library and PEDro was performed...
October 20, 2016: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/27747393/exercise-effects-in-huntington-disease
#17
Sebastian Frese, Jens A Petersen, Maria Ligon-Auer, Sandro Manuel Mueller, Violeta Mihaylova, Saskia M Gehrig, Veronika Kana, Elisabeth J Rushing, Evelyn Unterburger, Georg Kägi, Jean-Marc Burgunder, Marco Toigo, Hans H Jung
Huntington disease (HD) is a relentlessly progressive neurodegenerative disorder with symptoms across a wide range of neurological domains, including cognitive and motor dysfunction. There is still no causative treatment for HD but environmental factors such as passive lifestyle may modulate disease onset and progression. In humans, multidisciplinary rehabilitation has a positive impact on cognitive functions. However, a specific role for exercise as a component of an environmental enrichment effect has been difficult to demonstrate...
October 17, 2016: Journal of Neurology
https://www.readbyqxmd.com/read/27747182/improved-cardiac-function-and-exercise-capacity-following-correction-of-pectus-excavatum-a-review-of-current-literature
#18
Marie Maagaard, Johan Heiberg
Patients with pectus excavatum (PE) often describe improvements in exercise stamina following corrective surgery. Studies have investigated the surgical effect on physiological parameters; still, no consensus has yet been reached. Therefore, the aim of this literature review was to describe the cardiac outcome after surgical correction, both at rest and during exercise. In February 2016, a detailed search of the databases PubMed, Medline, and EMBASE was performed. We assessed clinical studies that described cardiac outcomes both before and after surgical correction of PE...
September 2016: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27746287/nonobstructive-hypertrophic-cardiomyopathy-out-of-the-shadows-known-from-the-beginning-but-largely-ignored%C3%A2-until-now
#19
Barry J Maron, Ethan J Rowin, Martin S Maron, Eugene Braunwald
Hypertrophic cardiomyopathy was first recognized as a disease of obstruction to left ventricular outflow, hence its early names and acronyms such as idiopathic hypertrophic subaortic obstruction. The nonobstructive subset of patients, incapable of developing mechanical impedance to left ventricular outflow at rest or with physiologic exercise, was initially recognized by the Braunwald group at the National Institutes of Health >50 years ago in the pre-imaging era and is now recognized as comprising about one-third of hypertrophic cardiomyopathy patients...
October 13, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27730171/blunted-perception-of-neural-respiratory-drive-and-breathlessness-in-patients-with-cystic-fibrosis
#20
Charles C Reilly, Caroline J Jolley, Caroline Elston, John Moxham, Gerrard F Rafferty
The electromyogram recorded from the diaphragm (EMGdi) and parasternal intercostal muscle using surface electrodes (sEMGpara) provides a measure of neural respiratory drive (NRD), the magnitude of which reflects lung disease severity in stable cystic fibrosis. The aim of this study was to explore perception of NRD and breathlessness in both healthy individuals and patients with cystic fibrosis. Given chronic respiratory loading and increased NRD in cystic fibrosis, often in the absence of breathlessness at rest, we hypothesised that patients with cystic fibrosis would be able to tolerate higher levels of NRD for a given level of breathlessness compared to healthy individuals during exercise...
January 2016: ERJ Open Research
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